Day 3 of DKA diagnosis - are we doing OK

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MeowMeowsMom

MeowMeowsMom

Member Since 2023
Hello all, thank you for having me. I have been reading every relevant post I can find on here (thanks ChloesMom from 2015 and so many others) and now it's time to post.

My BELOVED cat Meow Meow wasn't acting right AT ALL (not eating or drinking, refused tuna and roast chicken which he never has in his life, spacey, not affectionate, not sleeping with me, not playing, eyes off, etc) on Weds so we took him to the emerg vet and had labs done and the next morning we found out he has DKA. He was dehydrated Weds they vet told us.

Labs from Weds night got Thurs morning:
His original labs were AST 196 high, ALT 427 high, Alakline phosphate 104 (high), billirubin 14.2 high, glucose 17.2 high, sodium 138 low, cholesterol 6.5 high, trigliseerates 2.69 high. He has the COMPLEX form and his liver was (is?) failing. The cat hospital and vet would have been around 13g in our area and we can't afford that so we are paying 3g for vet care and meds and have become our own cat hospital.

Thursday and beyond care:
He immediately went on fluids and insulin (1.5 units twice a day) Mirataz behind the ear (not working), Clavama (twice a day via liquid syringe), Denamarin (1 pill a day), Marbofloxin 25mg once a day.
and immediate syringe feeding and had this all day Thursday and all day today (Sat).

Thursday he got 14 - 3 CC syringes of high calorie low carb vet food from the vet and 9am and 6pm vet trips for fluids injected.
Friday (today) he got 24 - 3 CC syringes of food which is the daily goal! I am getting better at it and him too. He is normally a dry food guy but won't eat or drink.

Thursday and today the vet said he was hydrated and that the fluids worked. We got his glucose under control with the insulin - to 15 to 13 to 12.?, the vet is happy.

His mood is a lot better but he still looks weak when he walks. He pees a few times a day but won't bury it. He started meowing weirdly this evening and I don't know if it's good or bad and he's obsessed with going to the basement (we don't let him but he wants to) and he normally never goes there. It's dark and nothing is there. I keep being scared his is going there to ... I won't say it....but he looks so much better than Weds night. The vet is worried he won't eat or drink but it's only day 2 of treatment and he is getting all his calories so would he even want to eat?! I need to keep thee food going to combat the liver issues as I understand and he gets fluids injected so maybe not thirsty? I tired cat nip tea but he didn't even want that! (or milk, I was just testing him as he loves a dot of milk normally).

So anyhow - how are we doing?! Seriously?! Should he be walking weak or is that bad? Any knowledge on the wobble walking? Any knowledge on the not pooping or burying pee? He won't clean himself but LOVES the "momma cat baths".

Thurs night he slept in my bed (he snuck in my bed at night) and that was a good sign as the other 2 nights he avoided me.

Any thoughts or advice GREATLY welcomed. Our world revolves around this amazing cat. He has the BEST personality. I am a photographer and all my clients became obsessed with the photos he posed for (you can see them on my site www.kristynphotography.com/pets if you like - all the grey and white cat photos are him but too big to post).

Please help me save him!! I am trying SOOOO hard!

Kristyn and family, Meow Meow's mom.
 
Hi and welcome to the forum Kristen and Meow Meow. I’m sorry you are going through this but you behave come to the best place for help.
What is the name of the insulin you are giving him?
When did he come home?

I’m going to give you a list of the things we recommend you do with a kitty that has had DKA and just come home.
  • you need to give one and a half times as many calories as he normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If your kitty won’t eat the low carb food, feed her whatever he will eat as eating any food is better than not eating.
  • If you are syringe feeding, offer frequent smaller meals and make sure you have supplies of foods you can syringe feed easily such as Hills a/d which you can get from the vet.
  • Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, dont feed and test again in 20 minutes and post and ask for help.
  • Test daily for ketones. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all.
  • Give antinausea medication if needed. Ondansetron is a very good anti nausea for cats. And he may need the antinausea medication for some time after coming home again as many post DKA kitties have nausea.
  • Give appetite stimulant if needed after the antinausea medication
  • Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
  • Ask the vet about subQ fluids
  • Set up a spreadsheet and test the BG frequently
  • Ask the ER vets for a copy of any path results and post them so we can see please.
  • Post daily with updates and ask for help as often as needed
I’ll post this and then answer your questions
Bron
 
MeowMeowsMom said:
Should he be walking weak or is that bad
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If he is recovering from DKA he will be feeling weak.
when was he diagnosed with diabetes?


MeowMeowsMom said:
Any knowledge on the not pooping or burying pee? He won't clean himself but LOVES the "momma cat baths".
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I would say he is feeling too unwell to bother burying his business at the moment. If he is just a few days post DKA he will be feeling probably nauseated, weak and unwell. Dont worry about that at the moment

MeowMeowsMom said:
The vet is worried he won't eat or drink but it's only day 2 of treatment and he is getting all his calories so would he even want to eat?! I need to keep thee food going to combat the liver issues as I understand
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It is very very common for DKA kitties to not want to eat. That is why we recommend they be given anti nausea medication routinely for several days if they are not willingly eating. No one wants to eat if they are nauseated. Ondansetron and care is are both good antinausea meds and I would ask to have both at home. Don’t take no for an answer! It’s that important!
Giving an appetite stimulant will not work if he is nauseated. He needs the anti nausea meds first before the appetite stimulant.

At this point it doesn’t matter what he eats. If he will eat totally unsuitable food for a diabetic cat….then let him. Eating is the most important thing as well as the insulin doses. We can worry about the diabetic food later on when he is better.

I am sending you a link for new members which has useful information as well as the spreadsheet and the signature and hypo kit information
HELP US HELP YOU
 
Are you testing for ketones in the urine? You don't mention it at all. It is very important that ketones in the urine are checked daily in DKA kitties.
If you don't have any Ketostix or Keto Diastix I would recommend strongly you go and buy a bottle from a pharmacy that sells diabetic supples. Most pharmacies have them. It is a simple test and needs reading exactly 15 seconds after collecting.
If you have the balance right of food and insulin...then there should be no ketones in the urine. If there are, then the dose of insulin needs increasing and the food amount increasing. Testing for ketones is your early warning system.
 
Waving from the Kawarthas. Welcome.

@Bron and Sheba (GA) has put together an excellent list.

Food and insulin are incredibly important in fighting DKA. Extra water and subq fluids help the body get rid of ketones and excess glucose. Subq fluids can be done at home. Ask the vet to show you how. It's easier than it looks. And importantly, do ask for ondanestron (Zofran). It should help. For some cats, clavamox is hard on the stomach.
 
Good morning everyone and thank you Bron, Sheba & Red Rover. We are off for his morning check in 15 min and will ask for the anti nausea meds you recommended and will be insistant. He goes morning and night. He was only allowed to go home because I can't afford the hospital stay not because he's better but they do think we have the DKA under control and his glucose. Canin is the insulin brand. He's getting sub Q fluids twice a day. They aren't testing keytones to my knowledge but I will ask now and will get strips for us on the way home. He's eating more calories and I am on that all day with a big syringe. I switched to a giant one fro the 3CC one and it's a lot easier and he's also getting used to being force fed too. He had diabetes for about a month and we didn't know and he was diagnosed when his labs came in. He was drinking a lot of waster and peeing a lot and I should have known but this is my first cat.

I understand how important food is and am trying so hard.

With the keytones test do I stick it in the litter box clump of pee?
 
We just got back from the vet. Meow Meow had is Sub Q fluids injected, his insulin was increased to 2 units (from 1.5) as his glucose is still at 12.3 (same as yesterday). They did follow up blood and urine testing and we get the results tomorrow morning (Sunday morning). They also gave us an anti nausea, the first dose was by injection and the rest will be via pill (1/4 tablet of cerenia 16mg once a day for 8 days).

He took his first poop since he was sick right before we left. It was a harder nugget but a good enough size.

The vet says he has a "poor prognosis" and I could barely hold in the tears. I thought we are going OK and that he's making baby steps. He said we'll know more when the labs came back but that was what the specialist there told him was her opinion.

I am so scared.
 
If it matters:

Food Tues = a few bites of kibble

Food Weds = a few syringes at emergency vet

Food Thurs = 14 syringes out of 24



Food Friday = 24 syringes out of 24


5 x 3 = 15 ML 10am
6 x 3 = 18 ML 1:30
1 x 3 = 3 ML 2pm
1.5 x 3 = 4.5 ML 3pm
1. 3 = 3 ML 3:35pm
1 x 3 = 3ML 5:10pm

2.5 x 3 - 8mL at 6:15pm
1.5 x 3 = 4.5 ML at 8
2 x 3 = 6 ML

 at 10

Pee at lunch and 7:20



Extra water 10-12 ML at 11pm



Food Sat so far 33 out of 24 syringes (lots over and it's 3:30pm!! feedings are going GREAT with big size syringe)

15 ML at 8am
 (was at vet 8:30 - 10:30am)

15 ML at 11:15am
12 ML at 12 noon
10 ML at 1pm
15 ML at 2:15pm
18 ML at 3:30 m
8 ML at 4:30pm
5 ML at 6pm
8 ML at 9:35pm
 
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Cats can come back from DKA. You will need to be vigilant and follow Bron's instructions. She lives in Australia so she's sleeping now.
What food are you feeding? Calories are important. Insulin is important and can be adjusted depending on the carb count of the food. Fluids are important.
You might want to set an alarm and add a few middle of the night feedings on top of the 24.

Also, you can test blood sugar at home.
The FreeStyle Lite is a good meter. It takes the smallest drop of blood.
A bit of a warning: strips are far more expensive in Canada (roughly $80/100) than in the US (but our insulins are cheaper). There is a meter with cheaper strips but it and the strips are only available by mail. PC points can be used at Shopper's or any PC store.

Hoping the cerenia helps. I know the subq fluids will make Meow Meow feel better for awhile. Any reason why the vet would not give you ondanestron (yes, it's costly but there is a human generic available) and fluids?
 
Red & Rover (GA) said:
Cats can come back from DKA. You will need to be vigilant and follow Bron's instructions. She lives in Australia so she's sleeping now.
What food are you feeding? Calories are important. Insulin is important and can be adjusted depending on the carb count of the food. Fluids are important.
You might want to set an alarm and add a few middle of the night feedings on top of the 24.

Also, you can test blood sugar at home.
The FreeStyle Lite is a good meter. It takes the smallest drop of blood.
A bit of a warning: strips are far more expensive in Canada (roughly $80/100) than in the US (but our insulins are cheaper). There is a meter with cheaper strips but it and the strips are only available by mail. PC points can be used at Shopper's or any PC store.

Hoping the cerenia helps. I know the subq fluids will make Meow Meow feel better for awhile. Any reason why the vet would not give you ondanestron (yes, it's costly but there is a human generic available) and fluids?
Click to expand...

We asked him a few times and he said that for our cat this was the best and all we can do is trust!

Thank you for the advice regarding the strips. I am definitely going to get up and feed him through the night if it helps. He is eating so much more today (syringe fed)!!

He is on purina vet DK wet food cans.
 
MeowMeowsMom said:
He is on purina vet DK wet food cans.
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Do you mean DM cat food?
The DM pate is 6% carbs (low carb) and 191 calories per can.
The DM savory in sauce is 10% carbs and 171 calories per can.

How many cans does Meow Meow take during a 24 hour period?
My concern is that he is not getting enough calories.
Here is a guide to how many calories is needed for a healthy cat: https://www.animalmedicalcenterofchicago.com/cat-diet-calorie-requirements-for-cats/
With DKA in the mix, you need to feed 1 1/2 times the recommendation.

Possible pet store higher calorie options:
Wellness Core Chicken, Turkey, Chicken Liver 218 cal.
Natural Instincts pates and limited ingredient pates (around 200cal).

It might be a good idea to grab a couple of cans. Quite a few cats go off the taste of Purina DM quite quickly.
 
Hi Kristyn, just catching up on what’s been happening with Meow Meow. I’m very glad he got subQ fluids and a cerenia injection and some to bring home. Very disappointed you didn’t get ondansetron (zofran). But you can push for that tomorrow. It’s excellent for nausea in cats.
I echo what @Red & Rover (GA) has said. I would urge you to go out today and get a glucose test kit and start testing today. If you are testing the blood glucose you can see how well the insulin is working. And it will keep MM safe.
Definitely get up during the night to feed him. He needs 1 and a 1/2 times as many calories as he normally eats. It is food and insulin that stops the ketones from forming.
That is why we want you to get a meter to test the blood glucose to see how well the insulin is bringing down the BG AND why we want you to start testing for ketones in the urine. If you haven’t bought the Ketostix yet, please go out today and get them. If there are still ketones in the urine we need to increase the insulin and food intake. Both these things are two of the biggest things in your tool box to fight DKA.
It doesn’t sound as if your vet has looked after many DKA cats if he is having to consult a specialist. I’m glad he is though, if he hasn’t.
When you go back later today for the sub Q fluids…are you still doing that … please ask for some Hills a/d. He is your cat and you are entitled to feed what you want. If he refuses, is there another vet you can go to to pick some up? You are MM advocate, he can’t speak for himself.
I can’t see how sick MM is, but you are doing all you can for him … please get the test meter and the ketone strips.. as both those will tell us where we are up to and what we need to adjust. We get a lot of post DKA cats come here and almost all survive. … the difference for you is MM isn’t post DKA yet, so lots of work to be done for him. So try not to get too down hearted with what the specialist said. She can’t see MM.
please keep posting here at least a couple of times a day so we can help you:bighug:
 
Red & Rover (GA) said:
Do you mean DM cat food?
The DM pate is 6% carbs (low carb) and 191 calories per can.
The DM savory in sauce is 10% carbs and 171 calories per can.

How many cans does Meow Meow take during a 24 hour period?
My concern is that he is not getting enough calories.
Here is a guide to how many calories is needed for a healthy cat: https://www.animalmedicalcenterofchicago.com/cat-diet-calorie-requirements-for-cats/
With DKA in the mix, you need to feed 1 1/2 times the recommendation.

Possible pet store higher calorie options:
Wellness Core Chicken, Turkey, Chicken Liver 218 cal.
Natural Instincts pates and limited ingredient pates (around 200cal).

It might be a good idea to grab a couple of cans. Quite a few cats go off the taste of Purina DM quite quickly.
Click to expand...


It is this exact food here : https://www.proplanveterinarydiets.ca/consumer/products/dm-dietetic-management-canned-feline-formula
 
Red & Rover (GA) said:
Click to expand...
I REALLY appreciate the link and tips, thanks for that!
Bron and Sheba (GA) said:
Hi Kristyn, just catching up on what’s been happening with Meow Meow. I’m very glad he got subQ fluids and a cerenia injection and some to bring home. Very disappointed you didn’t get ondansetron (zofran). But you can push for that tomorrow. It’s excellent for nausea in cats.
I echo what @Red & Rover (GA) has said. I would urge you to go out today and get a glucose test kit and start testing today. If you are testing the blood glucose you can see how well the insulin is working. And it will keep MM safe.
Definitely get up during the night to feed him. He needs 1 and a 1/2 times as many calories as he normally eats. It is food and insulin that stops the ketones from forming.
That is why we want you to get a meter to test the blood glucose to see how well the insulin is bringing down the BG AND why we want you to start testing for ketones in the urine. If you haven’t bought the Ketostix yet, please go out today and get them. If there are still ketones in the urine we need to increase the insulin and food intake. Both these things are two of the biggest things in your tool box to fight DKA.
It doesn’t sound as if your vet has looked after many DKA cats if he is having to consult a specialist. I’m glad he is though, if he hasn’t.
When you go back later today for the sub Q fluids…are you still doing that … please ask for some Hills a/d. He is your cat and you are entitled to feed what you want. If he refuses, is there another vet you can go to to pick some up? You are MM advocate, he can’t speak for himself.
I can’t see how sick MM is, but you are doing all you can for him … please get the test meter and the ketone strips.. as both those will tell us where we are up to and what we need to adjust. We get a lot of post DKA cats come here and almost all survive. … the difference for you is MM isn’t post DKA yet, so lots of work to be done for him. So try not to get too down hearted with what the specialist said. She can’t see MM.
please keep posting here at least a couple of times a day so we can help you:bighug:
Click to expand...


He has but I don't think he's ever had anyone care about the outcome this much and he's really, really motivated to see Meow Meow pull through. Each day he's phoned another specialist he knows (3 total) to confer/confirm. He's really trying his best and wants to make sure no errors are made and no stone unturned, as best he can/he knows how. But I too am doing all I can on my end - so 2 vets, 3 specialists, my hubby and I and you guys!!!

I am only listening because I thought it IS the best food for him and if not we will GLADLY switch. They have every food there and chose this as the best option and what do I know but to listen!! Plus the cat is eating it well and has had more than our goal by a long shot today so I am happy about that! I hope I didn't ruin things by him not eating yet more in the past days. I am beating myself up over everything I could have done even better.

I really appreciate the support and willingness to help.

Tomorrow am at 9 will be KEY - we get the updated urine and blood and I will buy my own strips. Today he peed in his bed and I found it an hour later so I couldn't even test.

I will be up to feed him in the night and check here!
 
MeowMeowsMom said:
He has but I don't think he's ever had anyone care about the outcome this much and he's really, really motivated to see Meow Meow pull through. Each day he's phoned another specialist he knows (3 total) to confer/confirm. He's really trying his best and wants to make sure no errors are made and no stone unturned, as best he can/he knows how. But I too am doing all I can on my end - so 2 vets, 3 specialists, my hubby and I and you guys!!!
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I am sure he is trying his best and I’m glad to hear he will ring someone else if he doesn’t know what else to do.

Checking regularly for ketones will tell you if you need to feed more or increase the dose….as well as looking at the SS to see how high the BGs are, and how kitty is….is he lethargic, depressed, drinking a lot, not wanting to walk around, breathing fast, not wanting to eat, vomiting…..all these things add up to how he is and if more needs to be done.

Keep on doing what you are doing ….you are doing a really good job with him.
 
Thank you Bron!!

It's 3am and I did

11pm - 3 CC
1 am - 8 CC food
2:30 am - 8 CC and he woke up and took a BIG poop and tried to bury it
4:15 am - 12 CC (peed between then and 8am)
8:40 am - 12 CC
9:30 am - sub Q fluids at vet
10:40am - 10 CC (he peed between then and next feed)
12:30pm - 15 CC
2pm - 23 CC and 15 CC water, he peed
2:35pm - 7 CC food and 12 CC water
3:40pm - 10 CC food and 18 CC water, he peed
4:45pm - sub Q fluids at vet
5:20pm - 6 CC food and 12 CC water

He also jumped up twice this night to sleep with me!!!

Totals so far - 111 CC food (since midnight - 5:30pm) and 69 CC water (plus 2 rounds sub Q)
 
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We just got back from the vet and we got the detailed labs from yesterday. I do not have permission to attach files on this site so I uploaded it on my own website and here is the link for anyone that can take a look please?

www.kristynphotography.com/meowmeow

His glucose reading is 10.9 this am
Keytones (blood drawn) from YESTERDAY that got today were 2. I can't catch any pee of my own quickly enough. He did one on his towel yesterday and another in the litter box the 2 hours I was sleeping.

He was 10.2 pounds on Weds and lost a pound and is 9.2 lbs this morning.

Any thoughts?
 
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There’s a tab on the ss to add the labs when you get a chance. They are too hard to read from your web. Still having ketones is concerning. Fluids are needed and add water to the food. How is the appetite?
I put Saran Wrap over the pee to test but that only works if you test it right after.
 
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The urinary ketones are +2 and it looks like the liver values (bilirubin, ALT) are elevated. The liver values look better than what you noted previously. I'm worried about the ketones. I'm surprised the vet did not get a blood ketone level. Also, the potassium is low. Did the vet give you anything to supplement potassium?

I would suggest calling the vet and going over the labs and asking what the plan is.

FWIW, the ketones that are on the labs are urinary ketones. They are not blood ketones. Urinary ketones are measured differently but we look to have them at trace or less.
 
MeowMeowsMom said:
We just got back from the vet and we got the detailed labs from yesterday. I do not have permission to attach files on this site so I uploaded it on my own website and here is the link for anyone that can take a look please?

www.kristynphotography.com/meowmeow

His glucose reading is 10.9 this am
Keytones (blood drawn) from YESTERDAY that got today were 2. I can't catch any pee of my own quickly enough. He did one on his towel yesterday and another in the litter box the 2 hours I was sleeping.

He was 10.2 pounds on Weds and lost a pound and is 9.2 lbs this morning.

Any thoughts?
Click to expand...


The vet does them twice a day at open and close and will teach us if MM gets out of the danger zone.

His glucose tonight is 12.2 (200) and in normal range and they were happy with that.

He's peed 5 times already when every other day it was 1 or 2 times ma he peed. That's a good sign to me. He's acting so much better - moving his tail, eye contacting, meowing when we get to the vet, jumping up.

I have been feeding him SO much wet food and water - as much as I can. And keeping on it 24/7

Sundays food/water schedule:

11pm - 3 CC food
1 am - 8 CC food
2:30 am - 8 CC and he woke up and took a BIG poop and tried to bury it
4:15 am - 12 CC (peed between then and 8am)
8:40 am - 12 CC
9:30 am - sub Q fluids at vet
10:40am - 10 CC (he peed between then and next feed)
12:30pm - 15 CC
2pm - 23 CC and 15 CC water, he peed
2:35pm - 7 CC food and 12 CC water
3:40pm - 10 CC food and 18 CC water, he peed
4:45pm - sub Q fluids at vet
5:20pm - 6 CC food and 12 CC water
6pm - pee
7:35pm - 7 CC food and 8 CC water and pee
8:45pm - 7 CC food and 6 CC water
9:30pm - pee and poo
11pm - 11 CC food and 5 CC water

He also jumped up twice this night to sleep with me!!!

Sunday totals - 136 CC food (since midnight - 5:30pm) and 88 CC water (plus 2 rounds sub Q, 6 pees and 2 poops)



Monday -
1:15am - 5 CC food and 5 CC water
(peed 2 big pees sometime in here)
4:15am - 15 CC food and 5 CC water
8:15am - 5 CC food, 3 CC water
9am - 3 CC food and 3 CC water (round of Sub Q fluids at vet)
10 am - 15 CC food and 10 CC water and pee
12 pm - 10 CC water
1 pm - 10 CC food and 12 CC water, peed and tested with keytone strip but didn't seem to work

Monday totals so far = 63 CC food and 48 CC water by 1:40pm plus sub Q fluids, 4 pees and 0 poops today.
 
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Sienne and Gabby (GA) said:
The urinary ketones are +2 and it looks like the liver values (bilirubin, ALT) are elevated. The liver values look better than what you noted previously. I'm worried about the ketones. I'm surprised the vet did not get a blood ketone level. Also, the potassium is low. Did the vet give you anything to supplement potassium?

I would suggest calling the vet and going over the labs and asking what the plan is.

FWIW, the ketones that are on the labs are urinary ketones. They are not blood ketones. Urinary ketones are measured differently but we look to have them at trace or less.
Click to expand...

They gave him a shot of potassium and pills we give him daily from now on for potassium and they were concerned about keytones and are monitoring and told us to feed him and give him water as much as I can and that's what I have been doing! I am annoying the heck out of him with endless feeding and water.
 
tiffmaxee said:
There’s a tab on the ss to add the labs when you get a chance. They are too hard to read from your web. Still having ketones is concerning. Fluids are needed and add water to the food. How is the appetite?
I put Saran Wrap over the pee to test but that only works if you test it right after.
Click to expand...

I have come back to this 5 times today and tried to figure out what "tab on SS to add labs means". I have no idea how to do this and see nothing in the signature area if that's what that means? I just am too new or don't have permission to attach files. I don't know why we can't just attach photos and files here easily. But anyhow, out of lack of any other options I had to post MM's labs on my website as screen shots and they can be found on www.kristynphotography.com/meowmeows (it was a fax so that's why it is dark). Thank you!
 
It doesn't look like you have your spreadsheet attached to your signature. The information on setting up your signature and spreadsheet are in this post on helping us to help you. It may be why you're confused. All of us use the same spreadsheet template and there are several pages/tabs for the spreadsheet. They are labeled Sheet 1 (which is typically for the current year), Template (so you can add an additional year if needed), and Labs. These are along the bottom of the spreadsheet. We create a signature (the information at the bottom of your posts) that includes a link to your cat's spreadsheet and other basic information.

If you take a look at Newman's spreadsheet (I'm linking a new member's cat's spreadsheet), along the bottom of the spreadsheet is a tab that's called "Labs". That's where you can add the information on your cat's lab results. You can also look at my cat's spreadsheet. You'll have to scroll to the left side of the bottom menu bar to find the Lab results tab.

As for attaching files, there's a glitch on the website. Below the sticking notes at the top of this forum is a post about uploading files. The webmaster hasn't fixed the glitch despite it being a year since the problem occurred. It has nothing to do with permissions.
 
Kristyn, Are you hometesting the blood glucose yet? If not I would strongly recommend you do.
Without a signature it is hard to keep track of everything (I have been helping 5DKA kitties over the past week and I rely on the signature and SS a lot for information.) It saves having to go back through the thread all the time looking for information as that is very time consuming.
With +2 ketones (you mention he did a blood test for that) but the urine report says +2. Can you confirm were both done or just the urine ketones please? And what were the results of both.
It would be really helpful if you could catch a urine sample and test for ketones asap.
A BG of 200 is not within normal range but is above it. Normal range is 50-120 ( 2.8- 6.6).
With ketones still present I think the insulin dose needs increasing, but without a spreadsheet and data it is really hard to advise you about the dose. We really need to see what the BG is doing during the cycles so we can help you with dosing. Just getting a test a couple of times a day is not enough when a kitty has DKA and ketones and needs insulin doses changed when there are ketones still present.
If you don’t think you can do the hometesting, what about a freestyle libre attached while you learn? . I can’t stress enough how important it is to be able to see the BGs all the time.
I will tag @Bandit's Mom to help you with the SS and signature setup.
 
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Bron and Sheba (GA) said:
Any updates on Meow Meow Kristyn?
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I am scared nobody here can help me if I can't get thee SS done right and just don't have the same info to input bc we are reliant on the vet for daily updates. I am trying to keep the cat alive on my own with not enough money or access all the good stuff you guys can like glucose testing. I posted in my free group if anyone has a glucose tester. I am up every 90 min to do food and water 24 hours a day, we drive 35 min each way twice a day for fluids. I have 3 kids and 3 dogs and a rabbit too that are barely being taken care of. I am about to lose my job. I can't afford the damn glucose stuff or pretty much anything else at this staged my card is now maxed.

I finally got keytone tests and he FINALLY peed in front of me and I stuck it in mid stream and counted to 15 seconds and it showed as fine when he isn't fine/just traces (times 2 tests over 2 hours and that makes NO sense bc it was at 3 and dangerous last blood lab 2 days ago). I can't afford more labs for real we can't. I have no idea what to put in the darn SS beyond what I did so I added a new tab to update how much food, water. Sub Q fluids as that has to be my focus without access to all the rest. I just want to cry and scream. I don't think I have enough info for you all to help me? In the mean time I track what he eats and poops and pees and the glucose levels they tell me once a day. I don't know what to do. I wish I had more resources. Already spent $4,000 I don't have and we don't even have groceries. I already tried a fundraiser and it didn't go well.
 
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Bron and Sheba (GA) said:
Kristyn, Are you hometesting the blood glucose yet? If not I would strongly recommend you do.
Without a signature it is hard to keep track of everything (I have been helping 5DKA kitties over the past week and I rely on the signature and SS a lot for information.) It saves having to go back through the thread all the time looking for information as that is very time consuming.
With +2 ketones (you mention he did a blood test for that) but the urine report says +2. Can you confirm were both done or just the urine ketones please? And what were the results of both.
It would be really helpful if you could catch a urine sample and test for ketones asap.
A BG of 200 is not within normal range but is above it. Normal range is 50-120 ( 2.8- 6.6).
With ketones still present I think the insulin dose needs increasing, but without a spreadsheet and data it is really hard to advise you about the dose. We really need to see what the BG is doing during the cycles so we can help you with dosing. Just getting a test a couple of times a day is not enough when a kitty has DKA and ketones and needs insulin doses changed when there are ketones still present.
If you don’t think you can do the hometesting, what about a freestyle libre attached while you learn? . I can’t stress enough how important it is to be able to see the BGs all the time.
I will tag @Bandit's Mom to help you with the SS and signature setup.
Click to expand...

we asked the vet about increasing glucose and he said we are at the appropriate amount for him. So what does my ignorant self know?!?
 
GUYS - A MIRACLE HAPPENED - MEOW MEOW ran over to where his food bowl always is (diff room from his "cat hospital") so I filled it asap and it GOBBLE his kibble down. He hasn't eaten in a week on his own and I had JUST force fed him 20 CC. I can't even believe it but that HAS to be good!! Last night he curled up and me and purred and he's been so off and ill and not himself, it was a gift he purred for an hour and then today this!!

For anyone reading this that has a kitty that needs help I HIGHLY recommend you force feed water and as much as you can. That's when things started turning for us. He also gets sub q fluids at the vet twice a day.

I AM SO HAPPY.
 
That’s very encouraging he is eating some food on his own! I am very happy to read that. Also that you managed to get a urine ketone done. Not sure if you are saying it read negative or trace… but certainly better than +2
Re the meter… maybe start a different thread and ask if anyone in Canada has a spare or old meter you can have, at least for a while … you would still have to buy the strips.
 
DCIN (Diabetic Cats in Need) may supply you with a meter, enough strips to get you started, and may even throw in some insulin as well.
One of the Canadian case managers lives in Richmond Hill.
https://dcin.dreamhosters.com/one-time-assistance-program/
@Chris & China (GA) can tell you more and perhaps help to fast track your application.

Fluids at the vet (hopefully you won't need them soon and glad that MeowMeow is eating on his own):

If you give fluids at home, you won't have to drive to the vet and pay the likely exorbitant fees.

A few years ago, I had to give emergency fluids to one of my cats (it's quite easy to do at home) and went to the vet to pick up "a kit" – almost $30!!! for 1 1000ml bag + 1 admin kit + 10 needles.

At petsdrugmart.ca
1 bag 0.9% sodium chloride $7.42 (1 bag of lactated ringers, if that is what is being used, is $9.45)
1 admin kit (can be used for 10 days) $4.49
100 needles $9.10
plus shipping (not sure how much or at what dollar free shipping kicks in)

From the same place:
Caninsulin 10 ml vial $39.95 or 10 x 2.5ml vials $106.00
U40 syringes (Carepoint) $28.00
(More on Caninsulin in my next post)

Cheapest meter and strips:
https://omnipod.diabetesexpress.ca/products/bravo-meter-only
I believe the meter is $10 and the strips are $40/100.
There are two drawbacks.
1. It takes a bigger drop of blood than some meters
2. (and this one is important) You can only get the strips through the mail. If there was a low numbers crisis, you would not be able to run to the drug store to buy more. What this means is that you need to have at least 100 strips on hand at any given time and also 100 strips in your hypo kit. During a low numbers event, you would go through more strips than you could imagine.

Next post may take awhile. I have to take a phone call.
 
Insulin.

There are better insulins for cats than Caninsulin ("canine" gives it away - it was designed for dogs who have a slower metabolism). It tends to drop cats fast during the first part of the cycle and not last the whole cycle. As MeowMeow becomes more stable, you might want to think about switching to a cat-friendly insulin.

One such is Lantus. The reason no one brought it up in detail before is that Lantus is a depot insulin and it can take up to 5 days to build up the depot. With DKA in the picture, MeowMeow did not have 5 days to get up to speed.
Lantus can be bought over the counter in Canada. A pack of 5 3ml vials ($110-$130) will last you a long time (think months and months) if kept in the refrigerator. In a 3ml vial, there is 100 units of Lantus. Lantus uses a U100 syringe which is different from the U40s you are using now.
You can read about Lantus here (I know, the last thing you need right now is more information but the folks here can help you every step of the way and I don't know but strongly suspect that it is cheaper over the long haul):
Lantus / Levemir / Biosimilars

Another good insulin for cats is Prozinc ($100/10ml vial). It too can last a long time if properly stored. Prozinc, like caninsulin is an in-and-out insulin and uses U40 syringes.
Prozinc / PZI
 
I second Lantus insulin but while DKA is still an issue caninsulin is a better insulin as it is an ‘in and out’ insulin which acts straight away whereas Lantus is a depot insulin and takes a few days for the full effect of the dose to take place. Would definitely swap to Lantus but MM needs to be a bit further along the road … free of ketones for a week or two and eating well on her own first.
 
Red & Rover (GA) said:
DCIN (Diabetic Cats in Need) may supply you with a meter, enough strips to get you started, and may even throw in some insulin as well.
One of the Canadian case managers lives in Richmond Hill.
https://dcin.dreamhosters.com/one-time-assistance-program/
@Chris & China (GA) can tell you more and perhaps help to fast track your application.

Fluids at the vet (hopefully you won't need them soon and glad that MeowMeow is eating on his own):

If you give fluids at home, you won't have to drive to the vet and pay the likely exorbitant fees.

A few years ago, I had to give emergency fluids to one of my cats (it's quite easy to do at home) and went to the vet to pick up "a kit" – almost $30!!! for 1 1000ml bag + 1 admin kit + 10 needles.

At petsdrugmart.ca
1 bag 0.9% sodium chloride $7.42 (1 bag of lactated ringers, if that is what is being used, is $9.45)
1 admin kit (can be used for 10 days) $4.49
100 needles $9.10
plus shipping (not sure how much or at what dollar free shipping kicks in)

From the same place:
Caninsulin 10 ml vial $39.95 or 10 x 2.5ml vials $106.00
U40 syringes (Carepoint) $28.00
(More on Caninsulin in my next post)

Cheapest meter and strips:
https://omnipod.diabetesexpress.ca/products/bravo-meter-only
I believe the meter is $10 and the strips are $40/100.
There are two drawbacks.
1. It takes a bigger drop of blood than some meters
2. (and this one is important) You can only get the strips through the mail. If there was a low numbers crisis, you would not be able to run to the drug store to buy more. What this means is that you need to have at least 100 strips on hand at any given time and also 100 strips in your hypo kit. During a low numbers event, you would go through more strips than you could imagine.

Next post may take awhile. I have to take a phone call.
Click to expand...
THANK YOU - that is a LOT of valuable information that I GREATLY appreciate!!
 
Red & Rover (GA) said:
Insulin.

There are better insulins for cats than Caninsulin ("canine" gives it away - it was designed for dogs who have a slower metabolism). It tends to drop cats fast during the first part of the cycle and not last the whole cycle. As MeowMeow becomes more stable, you might want to think about switching to a cat-friendly insulin.

One such is Lantus. The reason no one brought it up in detail before is that Lantus is a depot insulin and it can take up to 5 days to build up the depot. With DKA in the picture, MeowMeow did not have 5 days to get up to speed.
Lantus can be bought over the counter in Canada. A pack of 5 3ml vials ($110-$130) will last you a long time (think months and months) if kept in the refrigerator. In a 3ml vial, there is 100 units of Lantus. Lantus uses a U100 syringe which is different from the U40s you are using now.
You can read about Lantus here (I know, the last thing you need right now is more information but the folks here can help you every step of the way and I don't know but strongly suspect that it is cheaper over the long haul):
Lantus / Levemir / Biosimilars

Another good insulin for cats is Prozinc ($100/10ml vial). It too can last a long time if properly stored. Prozinc, like caninsulin is an in-and-out insulin and uses U40 syringes.
Prozinc / PZI
Click to expand...

I wonder if it is actually the best insulin afterall as our cat was in SUCH dire condition and did so well. He has shocked everyone. Nobody at the vets can believe their eyes!!! He is doing SO well. He started grooming himself today! He burries his poops. He's eating all alone, no more FF - 1 1/3 cups since yesterday!!!
 
Bron and Sheba (GA) said:
I second Lantus insulin but while DKA is still an issue caninsulin is a better insulin as it is an ‘in and out’ insulin which acts straight away whereas Lantus is a depot insulin and takes a few days for the full effect of the dose to take place. Would definitely swap to Lantus but MM needs to be a bit further along the road … free of ketones for a week or two and eating well on her own first.
Click to expand...

Thank you for explaning that. Caninsulin worked MIRACLES for us. MIRACLES. But makes sense to switch when stable.
 
Bandit's Mom said:
Hi @MeowMeowsMom! I see a spreadsheet in your Signature. Looks like you were able to set one up? If you need any help with your spreadsheet or signature, please let me know?
Click to expand...

Thank you! Yes I was I just don't get the first page with all the colours and how to do that one AT ALL but we also don't have detailed keytons and glucose info like most of you. I don't think ONE keytone strip has actually worked and I do it as he pees and measure 15 sec. They showed neg the day after he had a BLOOD DONE score of 3. They always show negative!!
 
I updated my SS incase it helps anyone now or in the future. We didn't have as many resources as we could have and were still able to save the cat. We were told 3 times at the vet that there were slim odds and not to expect a good outcome and we were SO lucky. DON'T GIVE UP!!!!

What do we think made the difference?
1 - force feeding water and as much as you can PLUS twice a day Sub Q fluids - LIFE SAVER For a normally 10 lb cat it was at least 80 CC (ML) of water plus 2 150ML sub Q rounds
2 - potassium supplements
3 - force feeding as much as you can and MUST be around the clock (the more the better, at least 100 CC for a 10 lb cat but try even more). MUST be around the clock, can't go more than 2 hours MAX without another round of food or water. Sleep later, you HAVE to get up and do this.
4- appropriate insulin dosage ASAP
5 - the anti nausean pill (1/4 pill) IMMEDIATELY helped and we didn't even get the one suggested. So at least get something. See my chart for what we used.
6 - do NOT let your cat have the chance to crawl off and hide when they are at their worst. They also need to not give up. We blocked off access to the basement/closets etc and set up a cat hospital in our room.
7 - but #1 PRAY and ask God to heal your cat.

They keytone strips don't work for us, they always show negative when not true. We only had access to glucose numbers a max of once a day so we assumed they were bad and fed and watered LIKE MAD. Worst case your cat needs to gain weight anyhow probably so think Nemo and "just keep feeding, just keep watering".

Our cat Meow Meow was in DIRE condition Weds with a fully failing liver and a week later he is acting like himself and eating and drinking, pooping and peeing many times a day - it's a true miracle. We were told MANY times there was no hope and to euthanize him but we'd never listen. We still have a road ahead to keep him well but there is no reason he won't live a full and happy life now. Good luck everyone and THANK YOU. If you need an update or have questions just post or message me!

Meow Meow thanks you too.
 
that is such a great story, I am so happy to hear he is acting like himself again! I was following this thread closely. It does seem like sometimes vets are ready to give up too early imo, and I'm not sure why that is.
 
Red & Rover (GA) said:
How is everything going, Krysten? @MeowMeowsMom
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Thank you so much for checking in! Meow Meows is totally back to his old self and I cannot believe the miraculous recovery he has made. He is eating his kibble willingly, scratching his post, sleeping with the dog again, playing his fav game snowball, grooming himself, drinking water, having normal sized pees and he's his happy and normal self. He is finishing his last round of Clomax and is on 2 unit of Caninsul twice a day and then he takes a pill for his liver once a day (so far, he'll be tested in a couple weeks and then we'll go from there). None of the vets can believe it.
 
Lovely to hear such a good update about Meow Meow.:)
Please continue to feed lots of food.
I'm surprised to hear the ketone strips did not work. Were they in date?. If they were showing negative, how did you know that was not true?
MeowMeowsMom said:
force feeding water and as much as you can PLUS twice a day Sub Q fluids - LIFE SAVER For a normally 10 lb cat it was at least 80 CC (ML) of water plus 2 150ML sub Q rounds
Click to expand...
Two lots of 150 ml sub Q fluids a day is a lot for a cat to manage. Did the vet suggest that?

I can only see one BG number in your Spreadsheet. Are you hometesting yet?
I would really recommend you think about doing the tests yourself. Insulin needs change and only getting them done every so often at the vet may not catch very low numbers.
Do you have a hypo kit set up
 
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