old thread. do not reply. DKA / Low-Glucose / Lantus

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tiffmaxee said:
I’m sorry we have offended you we have lots of cats here and mist follow our methods of dosing. Many cats need 3 or more units at some point. I would hope the vet you saw would have taken a blood ketone test. There is a good chance she was overdosed in addition.
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Thanks. I am not offended. I just don't have time to defend what I've shared here on every post. It is exhausting. I am not saying I'm right--just sharing what I've done.
Her bg went up to 135 so I think we're headed in the right direction. Our emergency vet records say that they detect the presence of ketones but was done via urinalysis. Same with our regular vet when she was inpatient there since Mon a.m. Level not stated. I am doing urine strips at home obviously.

My family member vet thinks that a GI upset threw things off and unregulated her. And/or our insulin was too old (could be--we had a 100ml vial of lantus but kept it refrigerated and recently got a new vial when we ran out). She thinks we need a urine culture vs a urinalysis to see if there is bacteria that was too diluted for a urinalysis.
 
:bighug:Those are good things to check. People don’t always read the whole thread when they see a 911 or frankly in a hurry. Just respond to what you find pertinent if you decide to stay on FDMB. I highly encourage you to do so as these emergencies often happen when only the ER is open and nobody wants to go there if possible. It’s true not all understand depot drugs like lantus. Anyhow I’m glad you aren’t offended. We are very data oriented. :bighug:
 
SSSMom said:
Thanks. I am not offended. I just don't have time to defend what I've shared here on every post. It is exhausting. I am not saying I'm right--just sharing what I've done.
Her bg went up to 135 so I think we're headed in the right direction. Our emergency vet records say that they detect the presence of ketones but was done via urinalysis. Same with our regular vet when she was inpatient there since Mon a.m. Level not stated. I am doing urine strips at home obviously.

My family member vet thinks that a GI upset threw things off and unregulated her. And/or our insulin was too old (could be--we had a 100ml vial of lantus but kept it refrigerated and recently got a new vial when we ran out). She thinks we need a urine culture vs a urinalysis to see if there is bacteria that was too diluted for a urinalysis.
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Sorry to just get here. I don’t have anything g to add right now. Without labs, there is no way to tell if she had DKA or just ketones. While ketones are a precursor to DKA, it is possible to catch the ketones before they get too high and DKA develops. Too bad the ER didn’t do serum levels...did they do any serum chemistries?

Insofar as a vet advising 3u of insulin, while that might have been too much in this case, it is not u common for us to see cats actually needing 3u of insulin every 12 hours.

Do you mean a 10 ml vial of Lantus? I’ve not seen a 100 ml vial of Lantus. We have found that with proper care, Lantus can be used to the last drop.

You would normally see ketones developing if there was infection brewing so doing a culture and sensitivity on a sterile urine sample is a good idea.

I am happy to do a spreadsheet for you although you will have to fill it in. If you can send me a private message, I can tell you what info I need from you to do the SS. Click on “Marje and Gracie” to the left and “start a conversation” to send me a PM.

I’ll remove the 911 for you. If the BG drops again, you can put it back up if you need to.

Also....I didn’t see this question answered for you but we don’t ever give HC food or honey to bring the BG up to a number we can shoot. If you need to use HC food or honey near shot time, you need to wait two hours to shoot to br sure it has worn off and you aren’t shooting a food-induced BG spike.
 
Marje and Gracie said:
Sorry to just get here. I don’t have anything g to add right now. Without labs, there is no way to tell if she had DKA or just ketones. While ketones are a precursor to DKA, it is possible to catch the ketones before they get too high and DKA develops. Too bad the ER didn’t do serum levels...did they do any serum chemistries?

Insofar as a vet advising 3u of insulin, while that might have been too much in this case, it is not u common for us to see cats actually needing 3u of insulin every 12 hours.

Do you mean a 10 ml vial of Lantus? I’ve not seen a 100 ml vial of Lantus. We have found that with proper care, Lantus can be used to the last drop.

You would normally see ketones developing if there was infection brewing so doing a culture and sensitivity on a sterile urine sample is a good idea.

I am happy to do a spreadsheet for you although you will have to fill it in. If you can send me a private message, I can tell you what info I need from you to do the SS. Click on “Marje and Gracie” to the left and “start a conversation” to send me a PM.

I’ll remove the 911 for you. If the BG drops again, you can put it back up if you need to.

Also....I didn’t see this question answered for you but we don’t ever give HC food or honey to bring the BG up to a number we can shoot. If you need to use HC food or honey near shot time, you need to wait two hours to shoot to br sure it has worn off and you aren’t shooting a food-induced BG spike.
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Thanks for clarifying the honey thing. I was definitely confused because it seemed like it didn't make sense to combine with lantus, but would be good to use in an emergency.

Yes, I added an extra zero--it is 10ml vial. It seems like a huge coincidence that we started a new vial three days before the emergency vet, but I have not experienced it going bad in the past (she's been on Lantus since early 2014 I believe). Though honestly I've dropped probably one a year because I have horrible fine motor skillls and usually have someone hanging on my leg when I'm drawing them up.

I uploaded the labs I have here: https://drive.google.com/drive/folders/1IHtKWG40wI4TOVGy7PPeVLT-Oe64VRyP
I don't expect that anyone has the patience, time or eye sight to read any of them but would most certainly appreciate any insight if anything jumps out. Unfortunately the print quality isn't great and I don't have a scanner so they're iPhone pics.

I appreciate the offer to start a spreadsheet and will PM you later when I get off of work (if I ever do. lol. I am so behind since I've stopped 100 times to check on the cat)
 
SSSMom said:
Thanks for clarifying the honey thing. I was definitely confused because it seemed like it didn't make sense to combine with lantus, but would be good to use in an emergency.

Yes, I added an extra zero--it is 10ml vial. It seems like a huge coincidence that we started a new vial three days before the emergency vet, but I have not experienced it going bad in the past (she's been on Lantus since early 2014 I believe). Though honestly I've dropped probably one a year because I have horrible fine motor skillls and usually have someone hanging on my leg when I'm drawing them up.

I uploaded the labs I have here: https://drive.google.com/drive/folders/1IHtKWG40wI4TOVGy7PPeVLT-Oe64VRyP
I don't expect that anyone has the patience, time or eye sight to read any of them but would most certainly appreciate any insight if anything jumps out. Unfortunately the print quality isn't great and I don't have a scanner so they're iPhone pics.

I appreciate the offer to start a spreadsheet and will PM you later when I get off of work (if I ever do. lol. I am so behind since I've stopped 100 times to check on the cat)
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I can read the labs but I’ll have to do it a little later. How about I PM you what I need for the SS and then later today, at your convenience, you can send the info over to me? That will cut down on one step for you. Just look at your Inbox in the upper right corner and if you see a number by it, then you have a message or messages.
 
SSSMom said:
9.5lbs as of Saturday night.
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Ok. Be cafeful giving that much fluids. The rule of thumb is 10 ml per pound of weight. 200 ml for a few days is probably ok but I would reduce that to 50-75 twice a day after that. Otherwise you run the risk of it collecting around the heart. And always make sure the previous fluids have been absorbed before giving more.
 
@SSSMom .

Hope things are a bit better today.

I'm no expert on labs, but we all look at them. Marje is the one to interpret for you. Some of us put results our ss tab labeled labs. It is pain in neck to do using a phone though.

I will say the WBC are elevated so pretty sure there is infection somewhere. The SNAP test that was done is not the best it's just a yes or no result. It's abnormal so more than likely, pancreatitis is an issue. A lot of other results could be dehydration.

Dka is a real possibility. So you want to keep him eating, treat infection and get insulin in him. If you have to give any food he will eat and dose insulin safely, accordingly. Keep hydrated.

My Ollie is chronic p'titis so always dealing with it. I have all meds at home and can start treating immediately when it flares, it help keep it from becoming serious and requiring hospitalization.

You mentioned early on about sugar free Pedialyte. Not necessarily a bad thing. I have no experience with it but I do know people who take in neonate orphaned kittens use original unflavored Pedialyte.

Hang in, keep us posted.
 
I think your cat definitely has an infection and with the high kidney values, BUN and creatinine most likely a kidney infection Timon and not just a UTI. How’s it going today? I dint see the pancreatitis test but will look again. The SNAP test is accurate if it’s positive but if negative you dint know if it’s in the gray zone. It could be elevated just from the infection though. She needs a culture and sensitivity test and antibiotics.

I found the test for pancreatitis and it’s very likely except that it could be so like I said from all the other values. The ALT is also quite high. Max had chronic pancreatitis and he often registered high when he had an episode.
 
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