? Cat DKA'd, please help!!

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Hannah & Max

Member Since 2019
This might not be the most articulate post-- I'm sorry if I jump around and type too much-- I'm panicking a little right now. My cat, Max, has not been well regulated since being diagnosed back in May. His numbers go all over the place, but usually stay in the 300's - 400's mg/dL range (I will see about attaching a spreadsheet.) When he was first diagnosed, he weighed 13.8 pounds. He now weighs 10.5 lbs. He has lost most of his muscle mass... He used to be a buff cat, lots of muscle, and a little overweight (probably due to his old diet of free-feeding dry, years ago, before I knew how awful it was), but now he is just skin and bones and fat, no muscle. He is having a hard time walking, very weak, and doesn't have an appetite.

To rewind a bit, back around the first of August, his insulin dosage had been 2 u. His numbers, which were normally high, had dropped so low at night that I couldn't shoot. One night it was 50 mg/dL.
I brought him in to the vet to figure out why they had done a 180° from really high numbers, some days 400 - 600 mg/dL, to low ones below 100 mg/dL. Once we ran some tests, we found that he had a UTI, so he was on clavamox for 10 days to treat it. The vet had also noticed a small amount of ketones, 15 mg/dL, and said that if he acts out of the ordinary at all, bring him in immediately.
Last week, while he and I were out of town, I noticed that his appetite was getting bigger. He even tried eating dog food when I wasn't looking. Which, maybe that wasn't terribly surprising, but it was still out of the ordinary.
Then the next night, while we were still away, I noticed how bony his hind end looked. He had definitely lost weight. At this point I was getting really concerned. The next evening, when we were finally home, I gave him dinner and he wouldn't touch it. :(
First thing in the morning, last Saturday, I called the vet. They wanted him in ASAP. His primary vet was out of town, so a different vet had to see him. He had lost 1/2 lb since his last visit on the 5th. She did a T4 to test for hyperthyroidism-- something his primary vet was worried about-- and that came back normal... Then she showed us his urinalysis results. He still had a small amount of bacteria in his urine, so that UTI hadn't been resolved, and his ketones were 150 mg/dL!!! Once I saw that, I nearly fell over.
She said it was the early stages of DKA, but she still wanted him sent to the emergency vet ASAP.

So, we were transferred to the emergency vet. They gave him humulin CRI and IV fluids over the weekend. They were nice enough I suppose, but they really didn't keep me informed or in the decision making at all. When we first brought him in and I asked about the insulin treatment and what brand they would give him, the doctor asked me if I was a nurse in what seemed like a passive-aggressive way. When I was there on Sunday evening and asked about how he was doing, they told me he was doing great, eating well, urinating well, resting and his glucose was normal (~200 mg/dL.) When I asked when his discharge would be, they gave me a bit of a run-around. I didn't even talk to the doctor on Sunday, just the receptionist and tech. They finally said he had to be kept to monitor his glucose level, even though they knew I home tested. It seemed like an excuse, but I kept him there nonetheless.
First thing yesterday morning, I picked him up. I asked about his temp and if he had been given antibiotics for the UTI and they said no. I asked for a hard copy of his records and the doctor sent them to his primary vet and told me I could just get them there. Then she said wanted him transferred there for a reassessment, since the emergency vet was closing. They left his catheter in.

Yesterday, I was just a mess. I had spent over $1,000 and hardly seen my baby all weekend. I really didn't want to transfer again, not because I didn't care about him, but because I was so worried about not being able to afford his care. I'm an 18 year old student and I work part-time. I had just used up almost all of my savings... It had cost $218 at the emergency vet just to test his glucose!
I transferred anyway, after I brought him home to give him breakfast and start a curve. He had eaten almost all of his breakfast and seemed to be doing well. He was drinking and urinating well. When I brought him in, the vet office didn't really see why he needed to be transferred, especially if he was eating well. His primary vet still wasn't in. He had lost 1/2 lb over the weekend, though :( They prescribed a 7-day course of clavamox, tested his electrolytes, and sent us on our way. (The vet did want to do a urinalysis for ketones, but since I have ketostix I just skipped it because I desperately need to cut any corner I can...)

Then when we were home, I noticed how he was acting. His hind end is very weak and he has stumbled a few times. He can jump, but he has trouble walking on my bed. He is very weak and just wants to lay around. I gave him dinner last night and he wouldn't touch it. I did manage to get him to eat some cooked chicken and a handful of treats, so I figured he had eaten enough for insulin. His glucose was high enough to shoot. I gave him a lower dose, 1 u, just in case.


I'm really worried about him. Should I bring him back to the vet? What will they do? I really can't afford tests. I'm trying to do everything that I can. My family hasn't been the most supportive through this, and the vets I've seen this weekend have been less than helpful. I'm so scared, I feel like I'm desperate for any advice right now. I don't want to lose him. He is terribly weak and thin. I had asked the vet yesterday about doing lactated ringers but they didn't think he needed it where he was eating. Should I syringe feed him? Please, any advice would be helpful right now....
 
Also, the emergency vet said his ketones had lower when I picked him up but she didn't say how low.
When I asked for records to be emailed to me from my normal vet, they emailed all except the emergency vet ones...
 
This might not be the most articulate post-- I'm sorry if I jump around and type too much-- I'm panicking a little right now. My cat, Max, has not been well regulated since being diagnosed back in May. His numbers go all over the place, but usually stay in the 300's - 400's mg/dL range (I will see about attaching a spreadsheet.) When he was first diagnosed, he weighed 13.8 pounds. He now weighs 10.5 lbs. He has lost most of his muscle mass... He used to be a buff cat, lots of muscle, and a little overweight (probably due to his old diet of free-feeding dry, years ago, before I knew how awful it was), but now he is just skin and bones and fat, no muscle. He is having a hard time walking, very weak, and doesn't have an appetite.

To rewind a bit, back around the first of August, his insulin dosage had been 2 u. His numbers, which were normally high, had dropped so low at night that I couldn't shoot. One night it was 50 mg/dL.
I brought him in to the vet to figure out why they had done a 180° from really high numbers, some days 400 - 600 mg/dL, to low ones below 100 mg/dL. Once we ran some tests, we found that he had a UTI, so he was on clavamox for 10 days to treat it. The vet had also noticed a small amount of ketones, 15 mg/dL, and said that if he acts out of the ordinary at all, bring him in immediately.
Last week, while he and I were out of town, I noticed that his appetite was getting bigger. He even tried eating dog food when I wasn't looking. Which, maybe that wasn't terribly surprising, but it was still out of the ordinary.
Then the next night, while we were still away, I noticed how bony his hind end looked. He had definitely lost weight. At this point I was getting really concerned. The next evening, when we were finally home, I gave him dinner and he wouldn't touch it. :(
First thing in the morning, last Saturday, I called the vet. They wanted him in ASAP. His primary vet was out of town, so a different vet had to see him. He had lost 1/2 lb since his last visit on the 5th. She did a T4 to test for hyperthyroidism-- something his primary vet was worried about-- and that came back normal... Then she showed us his urinalysis results. He still had a small amount of bacteria in his urine, so that UTI hadn't been resolved, and his ketones were 150 mg/dL!!! Once I saw that, I nearly fell over.
She said it was the early stages of DKA, but she still wanted him sent to the emergency vet ASAP.

So, we were transferred to the emergency vet. They gave him humulin CRI and IV fluids over the weekend. They were nice enough I suppose, but they really didn't keep me informed or in the decision making at all. When we first brought him in and I asked about the insulin treatment and what brand they would give him, the doctor asked me if I was a nurse in what seemed like a passive-aggressive way. When I was there on Sunday evening and asked about how he was doing, they told me he was doing great, eating well, urinating well, resting and his glucose was normal (~200 mg/dL.) When I asked when his discharge would be, they gave me a bit of a run-around. I didn't even talk to the doctor on Sunday, just the receptionist and tech. They finally said he had to be kept to monitor his glucose level, even though they knew I home tested. It seemed like an excuse, but I kept him there nonetheless.
First thing yesterday morning, I picked him up. I asked about his temp and if he had been given antibiotics for the UTI and they said no. I asked for a hard copy of his records and the doctor sent them to his primary vet and told me I could just get them there. Then she said wanted him transferred there for a reassessment, since the emergency vet was closing. They left his catheter in.

Yesterday, I was just a mess. I had spent over $1,000 and hardly seen my baby all weekend. I really didn't want to transfer again, not because I didn't care about him, but because I was so worried about not being able to afford his care. I'm an 18 year old student and I work part-time. I had just used up almost all of my savings... It had cost $218 at the emergency vet just to test his glucose!
I transferred anyway, after I brought him home to give him breakfast and start a curve. He had eaten almost all of his breakfast and seemed to be doing well. He was drinking and urinating well. When I brought him in, the vet office didn't really see why he needed to be transferred, especially if he was eating well. His primary vet still wasn't in. He had lost 1/2 lb over the weekend, though :( They prescribed a 7-day course of clavamox, tested his electrolytes, and sent us on our way. (The vet did want to do a urinalysis for ketones, but since I have ketostix I just skipped it because I desperately need to cut any corner I can...)

Then when we were home, I noticed how he was acting. His hind end is very weak and he has stumbled a few times. He can jump, but he has trouble walking on my bed. He is very weak and just wants to lay around. I gave him dinner last night and he wouldn't touch it. I did manage to get him to eat some cooked chicken and a handful of treats, so I figured he had eaten enough for insulin. His glucose was high enough to shoot. I gave him a lower dose, 1 u, just in case.


I'm really worried about him. Should I bring him back to the vet? What will they do? I really can't afford tests. I'm trying to do everything that I can. My family hasn't been the most supportive through this, and the vets I've seen this weekend have been less than helpful. I'm so scared, I feel like I'm desperate for any advice right now. I don't want to lose him. He is terribly weak and thin. I had asked the vet yesterday about doing lactated ringers but they didn't think he needed it where he was eating. Should I syringe feed him? Please, any advice would be helpful right now....
The trouble walking may be diabetic neuropathy. The way to treat that is by getting his bg into a more regulated range and adding b12 methylcobalamin supplements. Many of us use a brand called zobaline. (Available on amazon). If that's out of your budget try vitacost b12 methylcobalamin capsules that you can open and sprinkle on the food.

What food are you feeding?

Keep testing those ketones since he's prone to them. I use a blood ketone meter so I don't have to wait for her to pee.

Of you fill out a spreadsheet that will help us advise you for doses. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

The medical records belong to you. I always have the vet email me a copy of them.
 
Have you gotten a recent ketone test? Yes syringe feed and sub Q fluids. If the ketones are still present, the vet may be the best place. You can contact Diabetic Cats In Need (DCIN) for monetary assistance. @Chris & China (GA)
 
The trouble walking may be diabetic neuropathy. The way to treat that is by getting his bg into a more regulated range and adding b12 methylcobalamin supplements. Many of us use a brand called zobaline. (Available on amazon). If that's out of your budget try vitacost b12 methylcobalamin capsules that you can open and sprinkle on the food.

I'll see if I can order some today. Thank you
 
Hi Hannah and Max and welcome to the forum.
I think you were treated very shabbily by the ER vets. You are entitled to be kept in the loop with Max’s care.

So the really important things that a kitty recovering from DKA are
  • Get him to eat as much as possible... food is like a medicine for cats recovering from DKA. Any food at all is fine at the moment as long as it is cat safe. Even dry food.
  • He needs to get enough insulin so that the ketones don’t reform
  • You need to test the urine at least once a day for ketones anything above a trace needs vet attention
  • Make sure he is drinking enough
  • Make sure you finish the course of antibiotics
I’m going to tag @Rachel @Djamila @MrWorfMen's Mom as they all use prozinc and will be able to help you.
 
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Have you gotten a recent ketone test? Yes syringe feed and sub Q fluids. If the ketones are still present, the vet may be the best place. You can contact Diabetic Cats In Need (DCIN) for monetary assistance. @Chris & China (GA)

Unfortunately, no. He urinated this morning but I didn't know he was at his box until I heard scratching-- at which point I was too late.
 
Hi Hannah and Max and welcome to the forum.
I think you were treated very shabbily by the ER vets. You are entitled to be kept in the loop with Max’s care.

So the really important things that a kitty recovering from DKA are
  • Get him to eat as much as possible... food is like a medicine for cats recovering from DKA. Any food at all is fine at the moment as long as it is cat safe. Even dry food.
  • He needs to get enough insulin so that the ketones don’t reform
  • You need to test the urine at least once a day for ketones anything above a trace needs vet attention
  • Make sure he is drinking enough
  • Make sure you finish the course of antibiotics
I’m going to tag @Rachel @Djamila @MrWorfMen's Mom as they all use prozinc and will be able to help you.

Thank you, Bron. I've started to feel like I'm going crazy. The other people I've talked to about the ER vet either didn't see why I was upset, or didn't see why I went there in the first place! Why am I the "crazy one" for bringing my sick family member to the ER? I know those people would do the same thing if it were their child.

I'm trying to push him to eat. I think I'm going to have to syringe feed because he isn't taking it on his own at this point.
He is definitely drinking a lot. He seems to be having trouble bending his neck to drink, though. :(
I will make sure the antibiotics are finished.

Thank you for tagging the others.
 
Unfortunately, no. He urinated this morning but I didn't know he was at his box until I heard scratching-- at which point I was too late.
Consider a blood ketone meter. Works just like a bg meter. This is the one I use. There's a less expensive brand on amazon as well

KETO-MOJO Blood Ketone and Glucose Testing Kit, Monitor Your Ketogenic Diet, 1 Meter, 10 Ketone & 10 Glucose Test Strips,1 Lancing Device, 10 Lancets https://www.amazon.com/dp/B0789G8KTG/?tag=felinediabetesfdmb-20
 
Thank you, Bron. I've started to feel like I'm going crazy. The other people I've talked to about the ER vet either didn't see why I was upset, or didn't see why I went there in the first place! Why am I the "crazy one" for bringing my sick family member to the ER? I know those people would do the same thing if it were their child.

I'm trying to push him to eat. I think I'm going to have to syringe feed because he isn't taking it on his own at this point.
He is definitely drinking a lot. He seems to be having trouble bending his neck to drink, though. :(
I will make sure the antibiotics are finished.

Thank you for tagging the others.
Prop the bowls on a book so he's stretching less. Maybe he would eat a can of tuna in water? I'm glad to hear he's drinking at least.
 
I will reply to everyone when I get back. I'm going to take Max to the vet. I'm starting to get really worried because he is getting weaker and weaker just this morning. Please keep me in your thoughts. I'll give an update once I'm back home.
 
I will reply to everyone when I get back. I'm going to take Max to the vet. I'm starting to get really worried because he is getting weaker and weaker just this morning. Please keep me in your thoughts. I'll give an update once I'm back home.
I'm so sorry he's still struggling. Praying for knowledge for the doctors and a full recovery
 
So sorry to hear Max is not improving. Sending heaps of healing vines for Max. If Max has ketones and isn't eating a vet visit is definitely in order. Do keep us posted. :bighug::bighug::bighug::bighug:
 
Hi everyone,

I'm sorry for not posting sooner. This has been a very difficult day for me.

With a very heavy heart, I'm saddened to say that I lost him... I called his vet after my last message on here, but they were very busy and said they would call me back about Max. Four hours later, I still hadn't gotten a call back. He was declining even further at that point so I called them again and expressed my increased concern, and they had me bring him in ASAP.
He had lost 1/2 lb overnight again. When they took a blood sample from his back leg he fell over. He had 15 mg/dL of ketones still and his liver wasn't looking good. His electrolytes had significantly lowered. They told me we could take him back to the ER vet to be hospitalized overnight but there was no guarantee. It was either the hospital or euthanasia.
I took him home after that. I told his vet I would call this morning about the final decision after I got an estimate from the ER vet... But once we got home he looked even worse. He was declining so quickly, I don't think there was anything they could have done. He became incontinent and couldn't walk. He had always been an indoor-only kitty, but he loved to chitter and chatter at birds, so my boyfriend and I carried him outside and let him enjoy it for the last time. We were going to spend the whole night with him to say our goodbyes and euthanize in the morning, but he looked terrible. He looked like he was just waiting to go... I couldn't stand to see him suffer like that. We took him to the ER vet late last night and had him put to sleep.. It really wasn't the ideal setting-- I wanted his primary vet to be able to say their goodbyes too-- but that wouldn't have been fair to him. He was in too much pain. I stayed with him to the very end and he was even purring... That was the first time I had heard him do that since being hospitalized.

We brought him to a private pet crematory today. I'm going to have a pendant with his ashes so he will always be near my heart.

Thank you all for your help. I know you all care very much on here. Like when I first joined after his diagnosis, I felt so overwhelmed. You all patiently taught me "the ropes" and helped me feel more confident in helping Max. It's nice to know that you aren't alone and that no question is a dumb question.

Thank you all for your thoughts and prayers towards Max. I think he knew he was very loved. ❤
 
I think you made the right decision for Max. Everyone here has been in similar situations and it's always so difficult. Feline diabetes is not easy to deal with and you gave Max the best. My condolences for the loss of your best friend.
 
Tears for a kitty well loved and your broken heart. You did your best for Max and he was lucky to have such a caring loving person. They are never with us long enough and they leave a paw print on our hearts. You were his guardian angel and now he is yours. Making that final decision is so difficult but it is the last gift of love we can give them. May your happy memories carry you through this difficult time. :bighug::bighug::bighug::bighug::bighug:for you. RIP sweet Max. cat_wings>o
 
we are all with you, we are all shedding tears, you did the right thing, the caring thing, and you made his days the best they could be

he'll live in your heart, and next time you see those birds, you'll hear him chittering in the background

fly free, Max cat_wings>o
 
Hi Hannah,
My condolences fo the loss of sweet Max. I am so, so sorry.
No words can alleviate the pain that you must be feeling at this moment.
You did everything you could do for him. Sometimes we are just not in control.
Please take care of yourself. :bighug:
 
Oh Hannah, I am tearing up right now reading about you holding Max and he was purring. He was telling you it was OK, that you were the best mama he could ever have and he knows you did everything possible. Max will always be close to your heart like you said. Again my heart goes out to you.
 
Thank you all for your kind words.
There will always be a piece of my heart that is now no longer with me-- until we meet again, at least-- but I've been lucky enough to have some very caring people reach out to me and support me through this hard time. I'm trying to take care of myself, little by little, I know one day it will get easier.
When I saw all the replies, I was overwhelmed by your thoughtfulness so I felt I needed to reach out and thank you all. Again, thank you for your loving words. You don't know how much each individual response means to me. :bighug:

and next time you see those birds, you'll hear him chittering in the background

I have seen so many little birds by my window, I actually had to take a picture of them the other day. I truly believe it was a sign. Thank you :bighug:

Oh Hannah, I am tearing up right now reading about you holding Max and he was purring. He was telling you it was OK, that you were the best mama he could ever have and he knows you did everything possible.

Thank you for saying that, Diane. I have come back to re-read your comment multiple times because it does bring me a sense of comfort. I truly hope he knew the amount of love I had (and have!) for him. cat_wings>o

Making that final decision is so difficult but it is the last gift of love we can give them.

I'm trying so hard to believe that. Thank you :bighug:
 
I'm so very sorry for your loss, Hannah, and the hard times you are experiencing right now. Your plan to have Max's ashes made into a pendant for you to keep forever is truly lovely. Cats have ways of staying with us and I hope that will remind you of his continued presence every day.
 
I'm so very sorry for your loss, Hannah, and the hard times you are experiencing right now. Your plan to have Max's ashes made into a pendant for you to keep forever is truly lovely. Cats have ways of staying with us and I hope that will remind you of his continued presence every day.

Thank you, Liz. I hope it will as well.
 
Oh Hannah, I am so sorry to read this. Thank you for giving Max the ultimate gift of love and allowing him to go ahead in a humane way. Peace and comfort in the coming days, weeks and months as you adjust to a new chapter in your life. :bighug::bighug:cat_wings>o
 
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