Relapse after 2 years off Insulin

Status
Not open for further replies.
Rosanna and Harvey

Rosanna and Harvey

Member Since 2018
Hello Again,

We have had a very traumatic Easter weekend. On Thursday evening Harvey went out for a wander (very unusual for him) and was hit by a car, a neighbour found him and I then rushed him to the animal emergency department. Thankfully he only had some minor lung bruising and facial trauma but was otherwise okay. Then overnight I noticed he was drinking quite a bit and had a large wee, his BGL was 19 so I rushed him back to emergency. After 2 years of being in complete remission, the vets have said his diabetes is back and he will be in ICU for at least 24 hours.
I knew this day would come eventually but daunted by the reality of working shift work as a nurse with a FIFO partner and managing 12 hourly insulin shots.
 
Hi Rosanna, I am so sorry to hear that Harvey was hit by a car, but so glad his injuries were not too serious.
Did the vets do a fructosamine test to see what the BGs have been like over the past few weeks.
It is possible his BG is up from the trauma of the car accident.
It is possible he has fallen out of emission but I would ask that they check that first before starting insulin again.
 
Hello,

Thanks so much for replying. They have sent some blood work to the lab to confirm ketone numbers etc so hopefully, the fructosamine was included but I will ask when they call with an update. I am really hopeful that it is just the shock from the accident, but his last BGL at the vet was 24 at least 8 hours post food. He was 8% dehydrated and in early acidosis, so I was happy for insulin to be given to stabilise him. Of course, as Murphy's law would have it we moved house recently and I decluttered basically all our diabetes supplies including 4x unopened pens of Lantus :( and administration needles. VERY expensive weekend over here.
 
The vets have also said it looks like he's developing a urine tract infection, so could be related. I'm really hoping I'll be able to get him back into remission soon.
 
If there are ketones involved and early acidosis, you definitely need to get that sorted out before he comes home.
Very unlikely that he would have ketones if he didn’t have the FD back again so it looks like he does have it back.

There are several things you can do while you are waiting for him to come home.
I would get a bottle of ketostix from a pharmacy or Walmart so you can test the urine for ketones when he gets home.
It will be very important that you monitor them for a time to ensure they don’t come back.
I would also ask the vet, when he is discharged, for some antinausea medications such as cerenia and ondansetron, as kitties with ketones can be nauseated and will not want to eat.
It is really important that your kitty eats well after he gets home so make sure you have plenty of food for him.
We can help you with it all once he gets home.
We have found that vets often don’t give clear advice on how to care for post ketone/DKA kitties.


Rosanna Short said:
The vets have also said it looks like he's developing a urine tract infection, so could be related. I'm really hoping I'll be able to get him back into remission soon.
Click to expand...

Having the UTI could explain why he is so unwell as the path to ketones and DKA is not enough insulin, not enough food and an infection or inflammation. So it is really important that the UTI is treated.

Also make sure you have plenty of test strips to test the BGs as we will need to make sure he is getting enough insulin to help combat the ketones.

It sounds as if it was all caught before he actually went into DKA which is good.
Please keep us posted as to how he is going, and ask lots of questions if you need to. We are happy to help
 
I have just noticed you live in WA!
I live in Sydney.
The Ketostix I mentioned should be able to be got from pharmacies that sell diabetic products.
What type of meter are you using?
Another thing you might like to do while you are waiting for Harvey to come home is to set up a SS. You can add all the BG data in thee and that will help tremendously with dosing help and how things are going with him after the ketones.
If you have any trouble setting it up @Chris & China (GA) would help you do it I know.

you might find this helpful
http://www.felinediabetes.com/FDMB/threads/information-for-aussie-feline-diabetic-caregivers.217781/
 
Thank you,

I’ve still got ketone sticks from his initial diagnosis thankfully. I’ve still got the freestyle glucometer but I’m down to about 11 strips (and they’re technically expired). I’ve asked the vet to give me a script for the insulin as soon as they decide he’ll need it at home so I can start sourcing it and I’ll need to stock up on testing lancets and needles to administer. Also want to switch out his litter for a softer kind as his paws are quite scuffed from the accident. I’m a little bit nervous about sourcing items given the current COVID situation with everyone panic buying supplies
 
Initiaally you will probably have to get the test strips from the chemist so you can have them on hand. Later you can buy from eBay. I used to get mine from eBay all the time with no issues.
I wouldnt use the out of date test strips if they are much out of date as they might not be accurate.
After ketones it is really important that you don’t skip any insulin shots so make sure you have the insulin at home ready to go when he comes home.
Size 26 or 28 gauge lancets are easiest to use when first starting out again if you have a choice.

I’m sure it is difficult with the current lockdowns trying to manage your situation with Harvey. Thank goodness the vets are still open and can treat out animals.
 
Harvey is home
Discharged with advice to do 1unit BD of lantus. Obviously I will continue to monitor. His blood work from this admission also showed some signs of pre chronic kidney disease, so I’m investigating the phosphorus levels of his current Ziwipeak food that I’ve been really happy with carb and quality of ingredients wise. He had a bit of dry food creeping back into his diet as we got a bit too comfortable and he will be back to 100% wet only now with a bit of the ziwipeak air dried as a treat.
I’m vet shopping now as when I called our usual practice they said our normal vet who initially diagnosed Harvey has moved on and we’ve also moved house so are no longer close to the practice.
Overall Harvey looks so much better than when he came home after the MVA. Brighter, better gone and is grooming himself again.
Thank you for all your support as we continue on our diabetic journey
 

Attachments

  • 183A6FFC-9486-49EA-B06E-6304FFCB9250.jpeg
    183A6FFC-9486-49EA-B06E-6304FFCB9250.jpeg
    52.6 KB · Views: 128
@Bron and Sheba (GA) do you know about dry matter analysis vs typical analysis and which to go with?
I have been feeding Harvey the ZiwiPeak canned food, according to Dr Lisa's chart, they were between 6-3% carb on typical analysis however when I emailed the company they provided me with the DRY MATTER calcs which were 15g/100 for his flavour and 1342mg/100g of phosphorus.
Which numbers do I take?? Is 15% carb on DRY MATTER analysis to high for a diabetic kitty???
I've just purchased $150 worth of this food thinking it was the best thing :(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:arghh::arghh::arghh:
 
Thank you,
The charts above were what I used initially to select this food. Just not sure about the dry matter analysis and whether it's more reliable, as according to the dry analysis it's much too high in carbs :(.
Thank you for tagging hopefully @Elizabeth and Bertie will be able to help!
 
Rosanna and Harvey said:
Thank you for tagging hopefully @Elizabeth and Bertie will be able to help!
Click to expand...
Hi Rosanna, carbs are best calculated on a 'percentage of calories' basis (as in Dr Lisa's list). And we're looking for foods that have less than 10% of calories from carbs.

But phosphorous is always compared on a dry matter basis.
There are different ways of showing phos information. One way (as on Dr Lisa's list) is mg's per 100 calories of food. Another way (such as is used on the Tanya CKD site) is dry matter by weight.

Eliz
 
Okay thank you for that. By the looks of the %calories calculations I've done from another thread I found it's 12% calories from carbs :( though doctors Lisa's list listed it as 3% :(. I will see if I can return what I've bought and go back to the drawing board.
Thanks for your help. :)
 
Status
Not open for further replies.
Back
Top