New Member, New Diabetic cat in DKA

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oreocookiemonster

oreocookiemonster

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Hi everyone,

My cat was just diagnosed with diabetes this past Friday (7/7). The vet called in his prescription for insulin and a freestyle libre and we were supposed to start him on all of this this past Monday (7/10). Over the weekend, he got worse and ended up in DKA. He’s currently in the hospital getting everything under control. It turns out he had a UTI so I’m thinking that may have kickstarted his DKA. The hospital has put his libre on him already and just started his Lantus today. They had only been giving him short acting insulin to get his ketones and blood sugar under control. Obviously his potassium and other electrolytes are out of whack, so there’s been some fighting to get those back to normal as well.

For my personal background, I have been a type 1 diabetic since 2009. I’m on an insulin pump and a Dexcom CGM and I test my ketones using a keto-mojo blood meter.

For my cat, Cook (Oreo->Cookie->Cook) I am terrified of not being able to check his ketones myself. Has anyone ever tried using a blood ketone meter to check a cat’s ketones? If not, is there a practical way to use urine testing? I know that’s not always the best as it’s delayed information versus blood which would be more current. Also, in the event that he does go low, what would be the best treatment? Cake gel on the gums?

I won’t lie, I’ve been crying every day. I know what it’s like to live with diabetes and I can’t believe my poor Cookie has to go through it too. I know he’s not the only cat in the world with this, but I’m a bit terrified I will miss something since he can’t voice to me what he feels.

Cook’s background: He showed up to my door almost 3 years ago as a stray. The vet guesstimated he was about 6 at the time. We got him fixed and everything then. He is FIV+ and has stomatitis on top of all of this.
 
Welcome and thank you for taking him in!

most of us here use a human meter, which the libre is btw, to test our sugar kitties and make sure they’re safe. The libre is fine but you may want to have a back meter like Walmarts ReliOn. That’s the one most of use use since the test strips are the most economical.

I could be wrong but I thought ketones developed as a result of not enough food and not enough insulin. How is his eating lately? Tagging a member who is more experienced with DKA @Bron and Sheba (GA)

With a diabetic cat you need:
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs. Although I believe with DKA the most important thing is that he eats as he recovers no matter what.
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after Cook
We consider a take action number anything below 50 on a human meter and you’d want to run some Karo or honey on his gums if that happens. You can and should also give high carb food to bring his bg up when that happens.

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.
 
He was acting a bit lethargic, was drinking a lot, lost about 5lbs in total now… I figured diabetes as those were my symptoms when I was diagnosed so I’m glad I got him in when I did. He wasn’t eating a lot of anything, eventually he just stopped. I just know being sick can put you in DKA if not treated, but I’m not sure that is what put him there. No organ damage or anything, just the UTI and DKA. He’s currently still in hospital and is doing a lot better, thankfully. Eating, responding to insulin, so far so good.

I am going through the checklist of the Hypo Tool Box and I see to get food with 18% carbs or higher, but I can’t seem to find anything on the amount of carbs in a can of wet food when I check the nutrition labels. I see crude fat, protein, moisture, etc but not carbs. On Chewy and Amazon I see “Purina Fancy Feast Grilled Wet Cat Food Seafood Collection in Wet Cat Food Variety Pack” - is this the recommended option? I did read elsewhere that chicken and Turkey would be better options over seafood but I could be wrong, or is it up to what the pet might like more in terms of flavor?

I will be looking at the spreadsheet soon and see if I can get that setup, along with my signature. To be honest I am a bit confused by the spreadsheet, but I need to sit down and really look at it here in a bit. We have visiting hours with Cook soon first ❤️
 
That’s great news that he’s reacting well to the treatment. Most people are not aware that if cats go longer than 24 hours without eating they’re at risk for ketones. I’d suggest you ask for antinausea meds as well as apetite stimulant so you can have those at hand once he comes home. Maybe also some recovery food that you can syringe feed him if needed.

I find the Fancy Feast Medleys Tuscany line to be the easy go to high carb food for hypos. Since it has rice in it, I think it’s one of their highest carb ones.

FOOD CHART have a look on this chart and choose foods that are under 10% for her diet and higher than that for your hypo kit.

when you look a good up on Chewy, if you browse through the questions, most of the time someone has already asked about carb content and Chewy has answered it. Some brands like Weruva will list they on their website but most don’t since they’re not required too so we have to do a bit of detective work there.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions.
 
oreocookiemonster said:
Hi everyone,

My cat was just diagnosed with diabetes this past Friday (7/7). The vet called in his prescription for insulin and a freestyle libre and we were supposed to start him on all of this this past Monday (7/10). Over the weekend, he got worse and ended up in DKA. He’s currently in the hospital getting everything under control. It turns out he had a UTI so I’m thinking that may have kickstarted his DKA. The hospital has put his libre on him already and just started his Lantus today. They had only been giving him short acting insulin to get his ketones and blood sugar under control. Obviously his potassium and other electrolytes are out of whack, so there’s been some fighting to get those back to normal as well.

For my personal background, I have been a type 1 diabetic since 2009. I’m on an insulin pump and a Dexcom CGM and I test my ketones using a keto-mojo blood meter.

For my cat, Cook (Oreo->Cookie->Cook) I am terrified of not being able to check his ketones myself. Has anyone ever tried using a blood ketone meter to check a cat’s ketones? If not, is there a practical way to use urine testing? I know that’s not always the best as it’s delayed information versus blood which would be more current. Also, in the event that he does go low, what would be the best treatment? Cake gel on the gums?

I won’t lie, I’ve been crying every day. I know what it’s like to live with diabetes and I can’t believe my poor Cookie has to go through it too. I know he’s not the only cat in the world with this, but I’m a bit terrified I will miss something since he can’t voice to me what he feels.

Cook’s background: He showed up to my door almost 3 years ago as a stray. The vet guesstimated he was about 6 at the time. We got him fixed and everything then. He is FIV+ and has stomatitis on top of all of this.
Click to expand...
I used the keto-moto to monitor my cats ketones! You can also use your blood glucose reader to check her levels. I have a video in my signature showing how I tested my cat CC at home.
 
JanetNJ said:
I used the keto-moto to monitor my cats ketones! You can also use your blood glucose reader to check her levels. I have a video in my signature showing how I tested my cat CC at home.
Click to expand...

That was actually the first thing I watched when I got on here! I saw your tagline and read the YouTube comments. Thank you for making that video! I will feel a lot better checking Cook's sugar when he finally comes home. Also, good to know about the keto mojo meter. I did see you were using the AlphaTrak2 in the video - is this still a recommended meter or would the keto mojo or contour next meter be better? I think I read the human meters read a bit lower, but not sure how much lower.


Ale & Bobo & Minnie (GA) said:
That’s great news that he’s reacting well to the treatment. Most people are not aware that if cats go longer than 24 hours without eating they’re at risk for ketones. I’d suggest you ask for antinausea meds as well as apetite stimulant so you can have those at hand once he comes home. Maybe also some recovery food that you can syringe feed him if needed.

I find the Fancy Feast Medleys Tuscany line to be the easy go to high carb food for hypos. Since it has rice in it, I think it’s one of their highest carb ones.

FOOD CHART have a look on this chart and choose foods that are under 10% for her diet and higher than that for your hypo kit.

when you look a good up on Chewy, if you browse through the questions, most of the time someone has already asked about carb content and Chewy has answered it. Some brands like Weruva will list they on their website but most don’t since they’re not required too so we have to do a bit of detective work there.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions.
Click to expand...

Thank you! I will look at the food chart and start reading comments as well as look up that FF :) I have been loving reading everything that is here, there is so much information - I love it!
 
Hi and welcome to you and Cookie to the forum. I am so sorry he has ended up in hospital with DKA. I wonder if the vet tested him for ketones at diagnosis.
DKA happens when there is not enough food, not enough insulin and an infection or inflammation. And the fact Cookie was not eating much, and had a UTI and was not on insulin yet…gave him the perfect recipe for DKA. Ketones form first and if they are not addressed it progresses to DKA.
It is excellent you got him to the Er quickly and he is now on treatment.
You will be busy looking after him for the first week after he comes home, especially is he has not got his appetite back.
I am going to give you a list of things you can do now. Enforce he comes home so you are ready when he does
  • buy Ketostix for testing ketones. Can be bought from Walmart in the US or a pharmacy. Or you can get a blood ketones meter. Both are OK.
  • Ask the vet for antinausea medication such as cerenia or ondansetron. Most post DKA kitties are nauseated for a time after discharge.
  • You may also need an appetite stimulant. Always give the antinausea medication first before the appetite stimulant.
  • Ask the vet about giving sub Q fluids at home. They can show you how to give them. If not we can show you.
  • Get a range of canned food for when Cookie gets home including some higher carb foods.
  • set up a spreadsheet and the signature before the cat comes home. If you have any trouble @Bandit's Mom is a whizz at setting them up in a minute.
  • If you don’t already have a glucose meter I would buy a human glucose meter over an alphatrak meter. I know you have the libre attached but you will need a meter moving forward.
  • get a copy of all the path exults from the ER
Once Cookie gets home this is what you will need to be doing.
  • you need to give one and a half times as many calories as he/she 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 him whatever he will eat as eating any food is better than not eating,
  • 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
  • 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..
  • Give subQ fluids if the vet has agreed you can give them
  • Add all the BG data to the spreadsheet as you go so we can see it at a glance and test the BG frequently.
  • Post daily with updates and ask for help as often as needed. Ask any questions.
  • We can help you with the dosing of the insulin.
  • Report any lethargy, lack of appetite, diarrhoea or vomiting, or increased thirst to us immediately please.
We will watch for updates how he is going in the ER, and we are looking forward to seeing him back home and helping his recovery here.
Bron
 
oreocookiemonster said:
That was actually the first thing I watched when I got on here! I saw your tagline and read the YouTube comments. Thank you for making that video! I will feel a lot better checking Cook's sugar when he finally comes home. Also, good to know about the keto mojo meter. I did see you were using the AlphaTrak2 in the video - is this still a recommended meter or would the keto mojo or contour next meter be better? I think I read the human meters read a bit lower, but not sure how much lower.




Thank you! I will look at the food chart and start reading comments as well as look up that FF :) I have been loving reading everything that is here, there is so much information - I love it!
Click to expand...
I am a bit out of the loop on recommending meters. My diabetic passed away a few years ago. My personal preference was a pet meter (I believe there is an Alphatrak 3 out now)... But MOST on here use a human meter. The reason I liked the ALPHATRAK was for the very tiny sample size and I liked having the same numbers as my vet. Human meters do run lower, so the important thing to know is that normal on a pet meter is 68-150 and normal on a human meter is 50-120. The two types of meters are similar at these lower numbers but tend to be farther apart at higher numbers. So while there isn't much difference between a 50 and a 68.... A 250 on a human meter might be 300+ on a pet meter. Either one will tell you if your cat is too high or too low. I say use what you have.
 
When we were visiting him last night, he started feeling really warm. We got him taken back to get hooked back up to his IV (I am unsure why they would not let him stay hooked up - he was the other day!) and called back to check on him. His fever had spiked to 105.5, he was on ice packs and a fan. His glucose also spiked to 538. I called a few hours later and his temp was down to 103 and his bg was down to 300.

I just got off the phone with the vet who is treating him and she said she suspects either a bacteria resistant strain from his UTI or possibly pancreatitis. His temp is still at 103, though she said overnight it did go to 102, but he is on ice packs and a fan still. They are going to be starting him on what she called a “very reserved antibiotic used only for really sick pets” (Baytril?) and switching his catheter to his other paw as she also worries maybe the line was getting bad.

I’m worried sick about him. I really want him to come home but I’m terrified he may not. I’ve been crying nonstop. Waiting is so hard. I have been told to wait on buying supplies for him “just in case”. I don’t know. :’(
 
I am sorry to hear of this setback.. hopefully the new antibiotic will help. He is in the best place and they seem to be on top of it all.
I am sure you are worried sick about him. It is awful having a kitty in hospital so unwell.:bighug::bighug::bighug:

Did they say how his electrolytes were?
And are they testing for ketones each day?
Is he able to eat at all yet?
Please give us any updates as we worry too about our kitties here on the forum.
 
We just got back from another visitation. I don’t know what happened - but he just bounced back! No ketones, potassium is just on the edge of low, no fever. They have taken him off of the potassium and as far as I’m aware (haven’t been told otherwise) he is still on Baytril. The vet said as long as he is stable over night, he might be able to come home tomorrow afternoon! He was walking around meowing and purring when we saw him. He’s been eating like a champ they said :) When I talk to the vet tomorrow I will update here!
 
oreocookiemonster said:
When we were visiting him last night, he started feeling really warm. We got him taken back to get hooked back up to his IV (I am unsure why they would not let him stay hooked up - he was the other day!) and called back to check on him. His fever had spiked to 105.5, he was on ice packs and a fan. His glucose also spiked to 538. I called a few hours later and his temp was down to 103 and his bg was down to 300.

I just got off the phone with the vet who is treating him and she said she suspects either a bacteria resistant strain from his UTI or possibly pancreatitis. His temp is still at 103, though she said overnight it did go to 102, but he is on ice packs and a fan still. They are going to be starting him on what she called a “very reserved antibiotic used only for really sick pets” (Baytril?) and switching his catheter to his other paw as she also worries maybe the line was getting bad.

I’m worried sick about him. I really want him to come home but I’m terrified he may not. I’ve been crying nonstop. Waiting is so hard. I have been told to wait on buying supplies for him “just in case”. I don’t know. :’(
Click to expand...
In sorry to hear he’s so sick still.
 
oreocookiemonster said:
We just got back from another visitation. I don’t know what happened - but he just bounced back! No ketones, potassium is just on the edge of low, no fever. They have taken him off of the potassium and as far as I’m aware (haven’t been told otherwise) he is still on Baytril. The vet said as long as he is stable over night, he might be able to come home tomorrow afternoon! He was walking around meowing and purring when we saw him. He’s been eating like a champ they said :) When I talk to the vet tomorrow I will update here!
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Omg great update. Well done to the vets for trying the new antibiotic! Seems to have done the trick!!!!
 
Oh that is wonderful news! You must be so relieved.
I hope they give him the full course of Baytril. That is important.
Make sure when he is discharged (ask in advance) that you are given an antinausea medication (ondansetron is best), even if he is eating.
You don't want to get him home and find he stops eating. You need to have something at home just in case because it is really important that he eats plenty of food.
I think you can start getting that list I sent you to be ready for his return home. When he gets home, post and let us know how things are going. I would post every day for at least a couple of weeks.
Can you find out what insulin they are sending him home on and remember to ask for all the lab results so we can see them please.
 
Cookie is back home! Right now he is on gabapentin so he’s pretty loopy. We’re laying on the floor taking a nap currently :) He still has his libre on and the pharmacy actually gave me a Test Buddy meter, they’ve been reading very similarly so far thankfully. I did go ahead and order an AlphaTrak 3 and it’s getting here tomorrow. Right now he’s at 447, I’ve given him his nightly insulin, and I’m about to start his spreadsheet now. We are going back to the vet on Saturday to re-run some blood work as he’s anemic right now. I do have Cerenia for nausea and an appetite stimulant I can start him on tomorrow if I need. The gabapentin is still pretty strong in his system so he only had a few bites of food tonight. I’m going to be getting up a few times during the night to check him. He went down to 92 at the vet before we picked him up and they fed him some carbs to bring him up. I’m just worried I won’t catch if he goes low… that’s why I love my Dexcom, it just alerts me if I’m low. Maybe the libre does too? I’m not too familiar with the system.

Overall, he’s home!! I just don’t want to mess anything up. I already don’t like that he’s so high right now, poor thing. High blood sugars are not fun to feel.

edit: I have oral Baytril to keep him on for 6 days as well as medication for his anemia.
 
That is great news he is home!
How much gabapentin is he on?
I see he is on 2 units of Lantus insulin and you have chosen SLGS. With him recovering from DKA, I would prefer see you following tight regulation (TR) as we can make adjustments to the dose more easily and quickly if needed. Would you be happy to do that ?

Have you read through all the information again about what he needs once he gets home ?
Try and get him to eat as much as you can (except for the 2 hours preshot as we don’t want the preshot BG food influenced).
I would definitely get up several times during the night to offer him a bit of food each time you get up to check the BGs.

Do you have the Ketostix to test his urine each day?

Please post every day, or more often, with updates about Oreo as we are always concerned about DKA kitties when they first come home.
 
He is on 50mg/mL of gabapentin. He was due for another dose at 10 (~20 minutes from now) but he is so out of it, the vet said we could hold off and use it as needed.
That is fine with me about the TR - I am just wondering how to go about doing that. I am terrified of him going low, and we don't have any regular insulin, just Lantus.

Everything that I need for him at home is getting here early in the morning from Amazon. I do not have Ketostix (I used to use those myself) and prefer blood ketones instead as I find those to be more accurate since urine is a delayed reading. I remember using those strips, seeing that I had high ketones, but used them again 10 minutes later and I had no ketones at all. I have a keto-mojo meter and blood ketone strips. I've ordered his own set as well so he doesn't have to eat into mine. However, I am new to all of this, so if there are better suggestions I am open to them.

Regarding food, what kind of food do you recommend offering him during the night/middle of the day? We have the Purina DM, but his freeze dried treats and whatnot aren't getting here until early morning. We do have temptations and pill pockets, as well as regular canned food he was eating pre-diagnosis, but I don't want to spike his blood sugar. I know eating is important no matter what, but I guess my questions is overall what should I focus on first before going to the other stuff for our other non-diabetic kitties?
 
Want to add I just tried getting his ketones on the keto-mojo meter and it gave me an error. E4 - Incorrect sample. Discard the test strip and repeat the test with a new test strip. Make sure that you are using a blood sample or the Keto-Mojo® Glucose/Ketone control solution
 
oreocookiemonster said:
He is on 50mg/mL of gabapentin. He was due for another dose at 10 (~20 minutes from now) but he is so out of it, the vet said we could hold off and use it as need
Click to expand...
How often is the gabapentin 50 mg? If he is still out of it, I would withhold it also.

oreocookiemonster said:
That is fine with me about the TR - I am just wondering how to go about doing that. I am terrified of him going low, and we don't have any regular insulin, just Lantus.[/Can read about TR HERE
I would keep using the Test Buddy if it is a human test meter while you are using the libre.
You should get frequent BG reading with the line. Under 100 the libre can be unreliable so double check any BG under Libre tends to read BGs lower than a human meter under 100.
You don’t need any regular insulin when using Lantus.
If he is dropping low you can give some higher carb food to being the BGs up a bit. Or rub some honey on the gums if the BG is under 50 on the human meter, or under 68 on the pet meter.

Blood ketone meter is fine. Normally readings under 2.4 are ok for cats. That is when that normally start showing up in the urine, although we like to know if there are any ketones above 1.5-2 so we can keep an eye on them.

Here is a food chart . Have a look and choose food that is 10% or under carbs. Most of us use around 4-7% carbs.
Also get some canned food that is medium carbs 11-15% and high carb 16% and over for your hypo kit that also should have some honey or Karo and some extra test tips I reserve.

I would offer normal low carb food for the snacks and if he will let you add a teaspoon of warm water to each snack, that would be good. If he won’t eat the low carb food, offer whatever he will eat. The most important thing is he eats food. We can worry about low carb later once he’s a bit further down the track from DKA.
There is no need to feed prescription foods. There is nothing special about them except the price.

So you main focus at the moment is plenty of food, enough insulin, plenty of fluids, testing for ketones every day, and monitoring the BGs.
Click to expand...
 
My answer got caught up with your reply above.:banghead:
HERE if the information about TR. If you change over the atR can you put that into your stand change it in the SS please.
I would keep using the Test Buddy if it is a human test meter while you are using the libre.
You should get frequent BG reading with the line. Under 100 the libre can be unreliable so double check any BG under Libre tends to read BGs lower than a human meter under 100.
You don’t need any regular insulin when using Lantus.
If he is dropping low you can give some higher carb food to being the BGs up a bit. Or rub some honey on the gums if the BG is under 50 on the human meter, or under 68 on the pet meter.

Blood ketone meter is fine. Normally readings under 2.4 are ok for cats. That is when that normally start showing up in the urine, although we like to know if there are any ketones above 1.5-2 so we can keep an eye on them.

Here is a food chart . Have a look and choose food that is 10% or under carbs. Most of us use around 4-7% carbs.
Also get some canned food that is medium carbs 11-15% and high carb 16% and over for your hypo kit that also should have some honey or Karo and some extra test tips I reserve.

I would offer normal low carb food for the snacks and if he will let you add a teaspoon of warm water to each snack, that would be good. If he won’t eat the low carb food, offer whatever he will eat. The most important thing is he eats food. We can worry about low carb later once he’s a bit further down the track from DKA.
There is no need to feed prescription foods. There is nothing special about them except the price.

So you main focus at the moment is plenty of food, enough insulin, plenty of fluids, testing for ketones every day, and monitoring the BGs.
 
The gabapentin is 1mL every 12 hours for 30 days.

The Test Buddy is actually from our pharmacy and it's made for cats and dogs. It's still reading the same as the libre which is nice. I really like that it barely needs any blood, too. I have found that I have to use the side of his toe beans to get any blood, his ears are almost impossible to get and he doesn't seem to mind the toe bean pricks.

I have FF Classic Seafood Pate we were feeding him before, and it's between 0-1% carbs. I currently have 47 cans from the vet of Purina DM that I'm going to go through. I also have FF Medleys Tuscany that are between 20-23% carbs that are on the way but about a week backordered. I will be picking something up tomorrow from the store.

Currently in my hypo kit (most will be here in the morning):
FF Medleys Tuscany
Karo
Honey sticks
Bulb syringe
5mL needle-less syringe
20mL needle-less syringe
Keto-mojo meter and strips (though it's not reading his ketones at all with the error 4)
AlphaTrak 3 Meter, strips + extra strips, and extra lancets
Extra alcohol swabs
Extra cottons pads
Temptations treats

Any other recommendations?
 
Last edited:
I would get some medium carb ca
oreocookiemonster said:
The gabapentin is 1mL every 12 hours for 30 days.

The Test Buddy is actually from our pharmacy and it's made for cats and dogs. It's still reading the same as the libre which is nice. I really like that it barely needs any blood, too. I have found that I have to use the side of his toe beans to get any blood, his ears are almost impossible to get and he doesn't seem to mind the toe bean pricks.

I have FF Classic Seafood Pate we were feeding him before, and it's between 0-1% carbs. I currently have 47 cans from the vet of Purina DM that I'm going to go through. I also have FF Medleys Tuscany that are between 20-23% carbs that are on the way but about a week backordered. I will be picking something up tomorrow from the store.

Currently in my hypo kit (most will be here in the morning):
FF Medleys Tuscany
Karo
Honey sticks
Bulb syringe
5mL needle-less syringe
20mL needle-less syringe
Keto-mojo meter and strips (though it's not reading his ketones at all with the error 4)
AlphaTrak 3 Meter, strips + extra strips, and extra lancets
Extra alcohol swabs
Extra cottons pads
Temptations treats

Any other recommendations?
Click to expand...
I would get some medium carb cans as well for the high carb for the hypo box.
I can’t imagine he will need 50 mg gabapentin for 30 days.
Most cats don’t come home on pain meds after DKA unless they have pancreatitis and then not for long normally.
Do they think the UTI is painful…it should resolve quickly with the antibiotics.
 
I believe the vet suspected pancreatitis (though lab tests, she said, did not show an increase, she was suspicious of it due to his temp spike and symptoms in hospital). I am going to be asking about that and the UTI once we go back on Saturday for a checkup. The Baytril really seems to be helping him though, no matter what it was.

In the meantime, I'm trying to find a solution to this blood ketone issue if anyone has any suggestions for that. That is still my preferred method if I can just find a meter that works. I found a thread on this site where the owner used keto-mojo blood ketone strips and it worked fine, so I'm not sure why it isn't working for Cookie. I would feel a lot better if I could check his just like I check mine.
 
Bron and Sheba (GA) said:
@Hendrick Cuddleclaw
@JanetNJ may be able to help you with the blood ketone meter problem

You need to make sure the UTI has gone completely.
I would trial Cookie without the gabapentin for today and see how he goes and if he is not as sedated and will eat more. If he is in pain he will need it of course
Click to expand...

Yep! I am going to keep him on his antibiotic and we will see where he is with his infection on Saturday. I will be watching to see how he does later today before giving him anymore gabapentin.


JanetNJ said:
My guess is too small of a sample for the ketone meter. Maybe test it out on yourself to see how big of a drop is needed.
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I tried, same error. It works perfectly fine for me, but no matter the amount of blood I am putting on the strip for him it still gives me E4.
 
I talked to the vet this morning and she is not concerned right now with his high blood sugars. They stayed steady in the 400s all night and this morning. He still acts a bit out of it...

He didn't eat this morning and was advised to only give half his dose of insulin. I did get all but his nausea med in him as that one kind of fell out of his mouth. The vet said not to give anymore since that may have dissolved some. If he's not able to eat regularly, they're putting in a feeding tube :(

About 1030am he was able to eat a little bit, some treats and some of his previous canned food, so I was able to give his other half of his insulin then, as well as his anemia meds (no food=no anemia meds per instructions due to causing nausea)

I did voice my concerns about ketones, and the vet is wanting me to watch more for how he acts than anything, as he did not have any ketones for the past few days he was in the hospital. I did go ahead and order a CentriVet blood ketone meter made for pets, but I'm unsure when exactly that is getting here as it's shipping from California (it's gotta get to Florida!). We are going to the vet tomorrow for bloodwork, so she will be seeing him then.

I didn't sleep but maybe 2 hours last night. I'm just worried about him being in the 400s all of this time, but apparently that's fairly normal for cats and I'm really working myself up. To be fair, I've barely eaten anything I've been so upset, and I know I'm dehydrated and exhausted. I don't know if I'm ever going to feel okay enough to sleep through the night again.
 
What are the antinausea medication you are giving? And what time are you giving the antinausea meds? I would try and give them an hour before the main meal if possible. If you don’t have ondansetron, ask the vet for that because it is better for nausea than cerenia.
I don’t agree with the vet about giving a half dose of that insulin. He is high enough to have been given the full dose and if he dropped lower you could rub honey on the gums. It is very common for post DKA kitties to be nauseated and be hard to get to eat. Let him eat whatever he wants to eat at this point. It doesn’t matter if it is not low carb. Don’t be frightened of a feeding tube. Some post DKA kitties need them and they are not hard to manage.
I would be more concerned about the Ketones and not eating than the BG being higher.
We do not advice to give insulin during the cycle as you did at +2. You will now potentially have 2 nadirs.
You need to look after yourself or you won’t be able to look after Cookie. Things will settle down, it can be exhausting for the first few days after a kitty comes home post DKA if they are not eating well.
Let us know how the vet visit goes. :)
 
He is on cerenia, but I'll inquire about zofran. I have it for myself, but they're dissolvable and super tiny.

Since he just got home last night, the vet is wanting to be a bit cautious, as he did go down to the 90s while in hospital on his 2 units, but since he didn't eat anything this morning it was advised to only give half. We were also advised to wait to give him anything else until his dinner so we can watch his sugars. I have non-carb snacks he likes to lick on. He's also anemic and feels like hell from it. No energy, laying around. We are rechecking everything tomorrow. I'll update then.

Also grabbed some Ketostix from Walgreens and will try to catch a sample when I see him go.
 
I used the zofran wafers and they were easy to administer. Just need to make sure your hands are dry. Mine were 4 mg and I gave 1/2 wafer. My kitty was 5 kg.
Please don’t wait until dinner to give more food. It is food and insulin which will keep the ketones away. If your kitty does not get food he will start to use the fat and protein in his body again and the byproduct of that is ketones.
You can still watch his sugars while he eats. If eating causes the BGs to rise, then you increase the dose of insulin. You don’t withhold the food to lower the BGs.
We recommend that all kitties (not just DKA) kitties get snacks during the cycles as well as the 2 main meals and we have a lot of success getting kitties into remission.
Just feeding 2 meals a day is old thinking.
I do question how much your vet knows about the recovery of DKA kitties. I know they did a great job getting him through it but he still needs lots of food and enough insulin to stop ketones from reappearing. We get a lot of post DKA kitties here that arrive who have been given very little information about the post DKA care that cats need.
Great you have got some Ketostix. Let us know how you go with the testing:)
 
Besides him still being anemic, his blood work is excellent. Electrolytes are back to normal, no ketones this morning. His blood sugar at the vet was 223! Nervous because this is the lowest he’s been with us, so I’m going to be watching him like a hawk and of course checking his bs every 2-3 hours. We go back in 2 weeks to run blood work again.
 
Stay with the 2 units unless he drops under 90 and keep feeding plenty of food and testing the ketones daily. Also add a teaspoon of warm water to each snack if he will allow you to do that.
 
Update - he went back to the ER last night due to high fever. He was 105.8 at home, 104.7 at the ER. He’s in a cooling tank and on an IV. He’s eating totally normal and acting totally normal otherwise. I feel so lost. He’s sneezy and maybe has an upper respiratory infection? He’s still on Baytril and they still suspect maybe pancreatitis? We have him on immune support powder - Viralys - that we add to his meals twice a day. If it’s not one thing then it’s another… we haven’t been able to keep him cool enough at home (cooling blankets, fans, ice packs, water, low house temp) so I know the vet is the best place for him to get his fluids and to cool down, but I cannot get any sort of answer as to why this fever is so relentless. I know they can’t really tell me for certain, but I feel so bad for him. We saw him in the cooling tank before we left him there last night and he was trying to get out to go home with us! He obviously thinks he’s fine and wants to come home, I can’t even imagine what he’s kicked on his own as a 6 year stray, but this is nuts.
 
No, they did a chem panel and nothing popped. They said they check for pancreatitis via ultrasound. The tech said to mention that to the doctor in the morning, so I will be doing so. Right now his temp is down, they're trying to wean him off the cooling tank. BS is 118. Eating wonderfully. Just need to kick this stupid infection.
 
He’s back home, fever gone! Finishing up his antibiotics and whatnot, but he’s back to being my normal happy boy again. We got a new libre put on him, and it’s actually been accurate so far. So far so good!
 
Nope. One still suspects pancreatitis, the other doctors say upper respiratory infection. He’s still has 3 more days of antibiotics and he’s going back for another checkup next week. Blood work was great, though. They’re not concerned. ‍♀️ he’s a happy boy
 
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