Recent ketoacidosis uninsured Mitzy

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Kr29

Kr29

Member Since 2019
Hi there, very new here. Mitzy is 9 and diagnosed diabetic in August. Initially put on Caninsulin and 1 unit twice a day. She is a very difficult cat to get hold of let alone inject etc. Due to my 12 hour shifts, days and nights the vet advised 1 injection per day at 1.5 units. In hindsight this was clearly not the thing to do. Over the last 2 months she has lost over a kilo in weight. She had stopped eating as much and was still drinking and peeing lots. Due to my lack of knowledge of diabetes she was only checked at the vets on Friday - 5 days ago where they did blood tests and urine sample. Urine showed ketones. She came home and was monitored overnight. We ended up at the Vet Hospital the next day. Her breath smelt of acetone (pointed out by the vet) they kept her all weekend And we returned to our vets on Monday. Now the vet at the hospital stated she should have been put on "normal" insulin as soon as ketones noticed. We had still given Caninsulin as we weren't told any different. Ketones not detected at our vets on Monday. Our vet advised changing to Prozinc and definitely twice a day at 1 unit. I have brought home a glucometer but haven't tried this out yet. This morning Mitz seems fine but turned her nose up at her meat. So here I am panicking again that I can't give her insulin as she may not eat.

Sorry for the long message. I'm so stressed and back at work on shift tomorrow where I would feed her and have to inject at 5am. What if she doesn't eat again????
 
Kr29 said:
Hi there, very new here. Mitzy is 9 and diagnosed diabetic in August. Initially put on Caninsulin and 1 unit twice a day. She is a very difficult cat to get hold of let alone inject etc. Due to my 12 hour shifts, days and nights the vet advised 1 injection per day at 1.5 units. In hindsight this was clearly not the thing to do. Over the last 2 months she has lost over a kilo in weight. She had stopped eating as much and was still drinking and peeing lots. Due to my lack of knowledge of diabetes she was only checked at the vets on Friday - 5 days ago where they did blood tests and urine sample. Urine showed ketones. She came home and was monitored overnight. We ended up at the Vet Hospital the next day. Her breath smelt of acetone (pointed out by the vet) they kept her all weekend And we returned to our vets on Monday. Now the vet at the hospital stated she should have been put on "normal" insulin as soon as ketones noticed. We had still given Caninsulin as we weren't told any different. Ketones not detected at our vets on Monday. Our vet advised changing to Prozinc and definitely twice a day at 1 unit. I have brought home a glucometer but haven't tried this out yet. This morning Mitz seems fine but turned her nose up at her meat. So here I am panicking again that I can't give her insulin as she may not eat.

Sorry for the long message. I'm so stressed and back at work on shift tomorrow where I would feed her and have to inject at 5am. What if she doesn't eat again????
Click to expand...


UPDATE - Mitzy ate and had her insulin. I took her to the vets anyway and they checked her teeth in case she's having issues eating. All looks good. Had a small injection of a pain killer and now snoozing away.
 
That's so stressful, sorry you guys had to go through that.! I'm on the 12 hour shifts too so I feel your pain !
I hope she continues to feel better throughout the day !!!
 
So glad to hear she is eating! That’s very important for a kitty recovering from DKA. It definitely does not sound like your diabetic journey got off to a very good start - Caninsulin usually does not last long enough for cats when dosed 2x a day, so only dosing 1x a day was definitely not enough. But Prozinc is a much better insulin! It’s also good you have a meter - I really encourage you to start testing Mitzy’s blood glucose so you can make sure she’s getting enough insulin, and testing for ketones too. Here is a link to some info about DKA that may be helpful to you

www.felinediabetes.com/FDMB/threads/ketones-diabetic-ketoacidosis-dka-and-blood-ketone-meters.135952/
 
Here is the Beginners Guide to Prozinc

It is fantastic that you have a glucometer to test.
Please check out an excellent video made by one of our experienced members:
Video I made showing how to test your cat's blood sugar
and
Hometesting Links and Tips - includes numerous links, instructions, pictures, & videos

It would be wise to get a couple of tests in today.
And do offer food throughout the cycle. It is very important that Mitzy eats. DKA = not enough insulin + not enough food + infection/inflammation. Add water to her food as well. Water helps flush ketones out of the system.
Just no food for the 2 hours before the next shot so that the preshot test numbers is not food influenced.

Did the vet send her home with any meds or instructions?
 
Thanks for replying everyone. Mitzy hasn't eaten since this morning and is refusing to. I've tested her sugars and they are 15.2 mol.i don't have a kit to test for ketones. She is very angry when anyone goes near her. I've spoken to the vet who suggested giving her cheese - she won't even have that. Vets have suggested going in an hour to check for ketones. Someone please help as I'm completely out of my depth here
 
Does she seem nauseous? They may be able to give her an appetite stimulant at the vet but she may also need an anti nausea med as well. Will she eat any dry food?
 
Hi there, no she won’t eat a thing. Has a sniff then walks away. Currently sat in the bets and they are going to test her blood for ketones. We do have a stimulant-Mertazapine. But checking for ketones first. I never dreamt this would be so stressful and difficult
 
You can test for ketones at home yourself using Ketostix. You collect a specimen of urine and dip in the test strip and read it exactly 15 seconds later against the colours on the side of the bottle
Anything above a trace needs vet attention.

Mitzi may be nauseated. Hopefully the vet will give her an injection of antinausea medication such as cerenia. Ask for some tablets (cerenia) to take home as well.

You have been unlucky with getting ketones as well as the diabetes. . Things will settle down and we can help you.
But as said above it is really important she eats and gets her insulin and any infection or inflammation is treated.
 
Kr29 said:
Hi there, no she won’t eat a thing. Has a sniff then walks away. Currently sat in the bets and they are going to test her blood for ketones. We do have a stimulant-Mertazapine. But checking for ketones first. I never dreamt this would be so stressful and difficult
Click to expand...


UPDATE - There was a trace of ketones We have bought her home and she's had an appetite stimulant, some tuna and her insulin She's back at the vets tomorrow or morning to check for ketones again. A day on a drip if there is any. I have just noticed that she started grinding her teeth whilst eating tuna???? She'll be the death of me this one
 
Bron and Sheba (GA) said:
You can test for ketones at home yourself using Ketostix. You collect a specimen of urine and dip in the test strip and read it exactly 15 seconds later against the colours on the side of the bottle
Anything above a trace needs vet attention.

Mitzi may be nauseated. Hopefully the vet will give her an injection of antinausea medication such as cerenia. Ask for some tablets (cerenia) to take home as well.

You have been unlucky with getting ketones as well as the diabetes. . Things will settle down and we can help you.
But as said above it is really important she eats and gets her insulin and any infection or inflammation is treated.
Click to expand...
Thank you, only just seen this! Are the ketones there as there may be something else going on I wonder?? I forgot about asking for something regarding nausea Vet is calling me shortly to see how we have got on. How would I get a urine sample from her?? She uses her cat litter tray. Thank you all so much for your help .
 
Kr29 said:
Thank you, only just seen this! Are the ketones there as there may be something else going on I wonder?? I forgot about asking for something regarding nausea Vet is calling me shortly to see how we have got on. How would I get a urine sample from her?? She uses her cat litter tray. Thank you all so much for your help .
Click to expand...
Try and catch her peeing and put a small container under her or large spoon.
Or you could crumple some plastic in her favourite spot in the LB and hope she pees there. You just need a small amount.

If she has recently had ketones or DKA, ketones can be prone to reappear. That is why you need to test daily for them for a while and make sure she is eating well, is getting her insulin and any infection or inflammation is being treated or has been treated.
Ask any questions if you are unsure.

Do ask about antinausea meds though. Cats won’t eat if they are nauseated.
 
Bron and Sheba (GA) said:
Try and catch her peeing and put a small container under her or large spoon.
Or you could crumple some plastic in her favourite spot in the LB and hope she pees there. You just need a small amount.

If she has recently had ketones or DKA, ketones can be prone to reappear. That is why you need to test daily for them for a while and make sure she is eating well, is getting her insulin and any infection or inflammation is being treated or has been treated.
Ask any questions if you are unsure.

Do ask about antinausea meds though. Cats won’t eat if they are nauseated.
Click to expand...
Ok, thank you. She tried to steal my pizza!! Will mention the medication for nausea when the vet rings later. Shall I order Ketone tester from Amazon/similar or are they a similar price from the vets? The kids (both adults) are taking her in the morning #prayforMitzyandKerry
 
I just read your previous post and saw she had trace ketones.
I would go out to Walmart and buy a bottle of Ketostix today and test yourself later today. It is really important to monitor ketones. They can go from trace to higher quickly. That is your first line of defence and is something you can do

Also she needs fluids so encourage her to drink. You can mix some in with her food if she will eat it or you can get a syringe and give her some that way. Just be careful doing it that it doesn’t go down the wrong way.
You can also give her some chicken stock by boiling up some chicken bones for a few hours and giving her the cooled juice. Don’t put any salt or anything else I’m it. Just chicken/bones and water.

At the moment it is really important she eats so give her whatever she will eat. If she will only eat dry food then that is ok to get her eating again. The important thing is she eats and eats plenty if you can get her to eat.
 
I would go out and buy the Ketostix from Walmart or a pharmacy today so you can test today. If you want to get the blood ketone meter you could order that but I would still get the urine test strips today.
It is far easier to deal with ketones when they are in small numbers than if they increase.
 
Re the anti nausea medication./ appetite stimulant
If a cat is nauseated, which it sounds as if Mitzy is if she is sniffing and walking away, it is not a good idea to give an appetite stimulatant if she is nauseated.
It is far better to give her an antinausea medication and then if she still won’t eat an hour later, give the appetite stimulant.
 
Bron and Sheba (GA) said:
Re the anti nausea medication./ appetite stimulant
If a cat is nauseated, which it sounds as if Mitzy is if she is sniffing and walking away, it is not a good idea to give an appetite stimulatant if she is nauseated.
It is far better to give her an antinausea medication and then if she still won’t eat an hour later, give the appetite stimulant.
Click to expand...
Bron and Sheba (GA) said:
Here is a link in how to stimulate kitty’s appetite
http://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/
Click to expand...
Thanks so much for your support. Mitzy went back to the vets today. She had nibbled over night and ate this morning so had her insulin of 1 unit. There was more than a trace of ketones at 9 am this morning and sugars were 20!! So she spent the day on a drip again with the vet. Back home now and they have put her Prozinc up to 2 units. We don't know if there is also something else going on maybe Cancer, tumour etc. She has also had an anti sickness injection and has eaten lots of tuna
 
Did you get a bottle of Ketostix to test the urine?
It is really important that you test for ketones EVERY DAY until things settle down again.
It is also really important that she eats plenty of food and that she gets her insulin.
These are the things that will help stop ketones coming back.

Are you home testing the blood sugars?
If not I would STRONGLY advise you to look at doing it.
It is the only way you are going to be able to tell if it is safe to shoot each time and to keep her safe.
And it is very important that she gets the insulin.
Just getting the BG checked at the vet every week will not do that.
Here is a link to home testing. We can help you with it. It is not hard and Mitzi wil not hate you

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Please keep us updated as we worry about our kitties when they are not well, easpecially ones that have ketones :)
 
Bron and Sheba (GA) said:
Did you get a bottle of Ketostix to test the urine?
It is really important that you test for ketones EVERY DAY until things settle down again.
It is also really important that she eats plenty of food and that she gets her insulin.
These are the things that will help stop ketones coming back.

Are you home testing the blood sugars?
If not I would STRONGLY advise you to look at doing it.
It is the only way you are going to be able to tell if it is safe to shoot each time and to keep her safe.
And it is very important that she gets the insulin.
Just getting the BG checked at the vet every week will not do that.
Here is a link to home testing. We can help you with it. It is not hard and Mitzi wil not hate you

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Please keep us updated as we worry about our kitties when they are not well, easpecially ones that have ketones :)
Click to expand...
Hi there, sorry for lack of messaging. Mitz was on the drip Thursday, Friday and Saturday morning at the vets. Her sugars are stable but ketones are plus 1 this morning. She's been eating and drinking fine over the weekend and having her insulin and seems so much brighter. I have a glucometer but it's a human one - reads slightly higher/lower but still very close. I have ketone strips but haven't managed to catch her peeing yet. She's pretty quick!! I've read that ketones can stay in the system for some time. What would you do if there was ketones? Apart from taking her to the vets? She had a hydration drink that she seems to like that I either syringe into her mouth or she drinks from a dish.
 
So glad to see an update.
Because Mitzy has had ketones itis really important you do a few things consistenty
  • She needs plenty to eat. This is REALLY important.
  • Feed her frequently during the day and night. The food is needed to help keep away the ketones so make sure she eats about 1 1/2 times as much as she normally would.
  • If she is not eating you need to get some antinausea medication from the vet such as cerenia or ondansetron
  • Test the blood glucose before every shot to see it is safe to give the insulin
  • Test during the cycles to see how low the insulin is taking Mitzy
  • Mix some water in with her food, if she will tolerate it, so she gets extra fluids. Or syringe as you are doing...that's good!
  • Try and get a daily urine ketone test. Have you tried putting plastic into the litter box to catch some urine? Or marine stones.
  • If you can't do a urine ketones test, then think about buying a blood glucose meter. Monitoring the ketones is really important.
Using a human meter is absolutely fine....most of us use human meters here and our dosing methods are based on the human meter.

Do you think you could set up your signature please as it will have information in it that helps us help you.
Her is the link
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

Also if you could set up your spreadsheet, we will be able to help you with dosing and how to keep Mitzy safe. If you have any trouble setting it up ask for help and we will assist you. Here is the link
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If Mitzy has more than a trace of ketones, you need to contact the vet, upp the water intake and food intake.And if you have a SS set up and running we can help you with the doses of insulin which are also really important following ketones.

Can you please tell us is she on caninsulin still or has she changed over to Prozinc.
And what dose is she on?
Is she getting it twice a day?

I am going to tag @MrWorfMen's Mom as she is familiar with both caninsulin and Prozinc.

Keep posting and asking questions....we are very happy to help. Getting the signature and SS up and running will be a great help to us helping you.:)
 
Hello and welcome to FDMB. I'm glad you found us but so sorry you needed to. I'm so sorry you are dealing with ketones along with the diabetes but as Bron said, we can help you get Mitzi feeling better and get her BG under better control.

Right now there is not much I can tell you. Bron has brilliantly covered everything so far. We are going to need to start getting some BG tests to look at before making any comment about dosing. I'll keep an eye out for any updates.

In the meantime, if you can get your signature set up that would be a great help. If you need help setting up the spreadsheet, I can do it for you. Just holler and let me know.:)
 
Last edited:
Bron and Sheba (GA) said:
So glad to see an update.
Because Mitzy has had ketones itis really important you do a few things consistenty
  • She needs plenty to eat. This is REALLY important.
  • Feed her frequently during the day and night. The food is needed to help keep away the ketones so make sure she eats about 1 1/2 times as much as she normally would.
  • If she is not eating you need to get some antinausea medication from the vet such as cerenia or ondansetron
  • Test the blood glucose before every shot to see it is safe to give the insulin
  • Test during the cycles to see how low the insulin is taking Mitzy
  • Mix some water in with her food, if she will tolerate it, so she gets extra fluids. Or syringe as you are doing...that's good!
  • Try and get a daily urine ketone test. Have you tried putting plastic into the litter box to catch some urine? Or marine stones.
  • If you can't do a urine ketones test, then think about buying a blood glucose meter. Monitoring the ketones is really important.
Using a human meter is absolutely fine....most of us use human meters here and our dosing methods are based on the human meter.

Do you think you could set up your signature please as it will have information in it that helps us help you.
Her is the link
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

Also if you could set up your spreadsheet, we will be able to help you with dosing and how to keep Mitzy safe. If you have any trouble setting it up ask for help and we will assist you. Here is the link
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If Mitzy has more than a trace of ketones, you need to contact the vet, upp the water intake and food intake.And if you have a SS set up and running we can help you with the doses of insulin which are also really important following ketones.

Can you please tell us is she on caninsulin still or has she changed over to Prozinc.
And what dose is she on?
Is she getting it twice a day?

I am going to tag @MrWorfMen's Mom as she is familiar with both caninsulin and Prozinc.

Keep posting and asking questions....we are very happy to help. Getting the signature and SS up and running will be a great help to us helping you.:)
Click to expand...
Hi there, I tested ketones in urine last night and it was between negative and trace. She's eaten and drank and also had 2 units of Prozinc this morning. She gets stressed sometimes when giving the insulin and she definitely did this morning. Insulin given at 8 and blood sugars tested at vets at 9. Sugars were 20!!!!! How much of that is stress related??? But also this was only an hour after giving insulin. Vets monitoring and checking ketones in blood and putting her on drip again today. They are looking at maybe increasing her insulin today too. The human glucometer requires quite a lot of blood which I can't always get so have to try it a few times which in turn stresse her out even more. The vets glucometer only needs a small speck of blood so looking at getting one of those to help and cause less stress.
 
Good to hear ketones are staying low and Mitzy is eating and drinking. More hydration will definitely help flush the ketones out of her system.

I have to seriously question the vet's suggestion of increasing insulin dose based on a BG test done one hour post shot. ProZinc's action doesn't onset until about 2 hours post shot. If Mitzy just ate around 7:30 to 8am the BG test at 9am would still be elevated due to food influence. Add to that the stress of travelling to and being at the vet clinic and I frankly don't think a BG of 20 is unusual or cause for alarm. Vet stress alone can raise BG as much as 5.0 mmol or more and a food bump of 2.0 mmol wouldn't be unusual so actual BG could potentially be as low as 13 which while high is not cause for alarm or a dose increase at this time at least without knowing how low the dose is dropping BG when insulin action is at it's peak.

On the glucometer front, The Freestyle Freedom Lite meter is identical to the AT2 meter in a different colour if it is available in the UK. It's the meter on which the AT2 pet meter was based. It takes the same small blood sample as the AT2 and is a highly rated human meter. Human meters will read lower than the pet meter however the pattern of readings will be very similar. Pet meters are fine but extremely expensive to use due to the cost of strips.

Thanks for the update and please do keep us posted.
 
Quick update - There was a trace of Ketone sin urine at home last night and this morning at the vets there was just a trace in her bloods. Yaaaaaaayyyyyy, they've come down. Fingers crossed this stays that way. There was a dog being very noisy at the vets and her sugars were 27!!!! She's obviously a very stress cat. I've had the alphatrak 2 delivered this morning. Managed to syringe water and oralade into her mouth last night and she also drank some from a bowl. Lots of chicken and tuna eaten too.
 
Thanks for the update.
Great the ketones are down to trace
And yay! On the alphatrak meter delivery.
Looking forward to seeing some BG levels and the spreadsheet. Don’t forget if you have any trouble setting up the SS, ask for help.
Great lots of food eaten

Keep up all the good work.
What dose of Prozinc are you giving?
 
Sorry for no updates, I have been sick.
The struggle to get Mitzy to tolerate her sugars being taken continues to be a problem. She doesn't like being held much and won't sit still if she knows you're about to do something to her. She growls and gets very stressed which either results in a very high reading or not enough blood for the meter to read. She has been eating plenty, little and often and drinking plenty too. Up until yesterday we didn't have any ketones but there was a trace this morning. Currently on 2.5 units twice a day.
 
Bron and Sheba (GA) said:
So glad to see an update.
Because Mitzy has had ketones itis really important you do a few things consistenty
  • She needs plenty to eat. This is REALLY important.
  • Feed her frequently during the day and night. The food is needed to help keep away the ketones so make sure she eats about 1 1/2 times as much as she normally would.
  • If she is not eating you need to get some antinausea medication from the vet such as cerenia or ondansetron
  • Test the blood glucose before every shot to see it is safe to give the insulin
  • Test during the cycles to see how low the insulin is taking Mitzy
  • Mix some water in with her food, if she will tolerate it, so she gets extra fluids. Or syringe as you are doing...that's good!
  • Try and get a daily urine ketone test. Have you tried putting plastic into the litter box to catch some urine? Or marine stones.
  • If you can't do a urine ketones test, then think about buying a blood glucose meter. Monitoring the ketones is really important.
Using a human meter is absolutely fine....most of us use human meters here and our dosing methods are based on the human meter.

Do you think you could set up your signature please as it will have information in it that helps us help you.
Her is the link
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

Also if you could set up your spreadsheet, we will be able to help you with dosing and how to keep Mitzy safe. If you have any trouble setting it up ask for help and we will assist you. Here is the link
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If Mitzy has more than a trace of ketones, you need to contact the vet, upp the water intake and food intake.And if you have a SS set up and running we can help you with the doses of insulin which are also really important following ketones.

Can you please tell us is she on caninsulin still or has she changed over to Prozinc.
And what dose is she on?
Is she getting it twice a day?

I am going to tag @MrWorfMen's Mom as she is familiar with both caninsulin and Prozinc.

Keep posting and asking questions....we are very happy to help. Getting the signature and SS up and running will be a great help to us helping you.:)
Click to expand...
Unfortunately Mitzy fell asleep on Dec 7th, breaking our hearts ♥️ xx
 
MrWorfMen's Mom said:
Good to hear ketones are staying low and Mitzy is eating and drinking. More hydration will definitely help flush the ketones out of her system.

I have to seriously question the vet's suggestion of increasing insulin dose based on a BG test done one hour post shot. ProZinc's action doesn't onset until about 2 hours post shot. If Mitzy just ate around 7:30 to 8am the BG test at 9am would still be elevated due to food influence. Add to that the stress of travelling to and being at the vet clinic and I frankly don't think a BG of 20 is unusual or cause for alarm. Vet stress alone can raise BG as much as 5.0 mmol or more and a food bump of 2.0 mmol wouldn't be unusual so actual BG could potentially be as low as 13 which while high is not cause for alarm or a dose increase at this time at least without knowing how low the dose is dropping BG when insulin action is at it's peak.

On the glucometer front, The Freestyle Freedom Lite meter is identical to the AT2 meter in a different colour if it is available in the UK. It's the meter on which the AT2 pet meter was based. It takes the same small blood sample as the AT2 and is a highly rated human meter. Human meters will read lower than the pet meter however the pattern of readings will be very similar. Pet meters are fine but extremely expensive to use due to the cost of strips.

Thanks for the update and please do keep us posted.
Click to expand...
Unfortunately Mitzy fell asleep on Dec 7th, breaking our hearts ♥️ xx
 
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