(Semi) Post-DKA help

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McLoviinnn

Member Since 2024
Sending out my first SOS for my sugar baby, Tony he is about 5 years old, adopted about a year ago with little knowledge of health history. He was diagnosed about 9 months ago, put on Prozinc 1U 2x per day which was eventually upped to 2U 2x per day. He was doing fairly well and for the most part, numbers were staying in the 200s with our Reliom meter. (I am currently working on a spreadsheet but have previous numbers in a note on my phone). We recently ran out of insulin and we have been very, very strapped due to my husband changing jobs, mine reducing to about 20% of my normal income, and our son & I both both dealing with recent seizures, (I mean, temp loan from my mom for groceries to feed our four kids, broke) and our poor boy suffered because of it. We were about 1 week between refills because we couldn’t afford the $165 for the prozinc, and our boy ended up DKA

We brought him to the emergency vet Monday night who kept him until yesterday morning around 10AM. $2,700 later, they were able to get his keytones down to moderate, potassium level regulated, and get him rehydrated. They wanted to keep him another 12-24 hours, but I literally had to borrow from my mom who borrowed from my Nana to help us even keep him there for 36 hours. We brought him home yesterday with 2 antibiotic (one broad spectrum, one targeting GI). We were told when we took him home that we was still on the IV drip of insulin and they usually like to do the transition back to injectable there so that they can monitor if he has developed a sensitivity or resistance due to the IV route being used. We were advised to only give 1U last night at dinner time and going forward until we can get him into our vet for a curve.

Both my mom’s vet and our vet said they do not have the staffing available to do a curve. I know I’ve seen it mentioned in here that vet curves are difficult anyway due to the stress increasing their levels. We are able to do one at home with our relion, but the ER doc made us feel like terrible parents and said a home curve isn’t helpful due to the relion numbers not being accurate. We had tested him 3x the day we bright him in and his numbers were 243, 239, 221 all about 2 hours apart, when we got to the vet he was reading 399 but I know he was also stressed out too so I’m not sure how inaccurate it actually is

So where I’m struggling today; we gave him the 1U last night and his sugar was high 300 this morning, I tested again 2 hours after feeding and it had gone down 10 (396 -> 386). He’s back to eating his full meals and took his antibiotics like a champ, I’m just concerned that the 1U is too low and I’m going to send him back into DKA.

Second more general concern, how in EARTH do I figure out how much food he should be getting he was around 15lb before diagnosis, around 12 when he got diagnosed, now he’s down to 8.5 and we just can’t figure out the balance of how much food to give so he puts some weight back on without sending his numbers through the roof. I’ve found the carb calculator online and idk if I’m doing it wrong because half the time I get a negative answer, and I don’t know what to do with that number once I get it in order to figure out how much to give him (i.e. one can of wet + 1/4 cup dry, etc). We had him totally off dry but he was so ravenous I added just a bit back in. I was also advised by the vet to not give any food between the 12 hours but my poor guy is so hungry and I’ve also seen comments on needing to feed between meals; I’m not sure if this should be taken from the total carbs per day or what my husband found this new food (reveal) that the kitties seem to love and numbers are lower on the can but of course that’s calories not carbs

Thank you all in advance and I appreciate any insight you may have. So sorry to be so long-winded! — feeling worried.
 
Don't worry about amount limiting food and how it will impact his numbers. For a cat that is recently out of DKA, you need to give him 1 and a half times his regular calories (not carbs). He's lost a lot of weight so he needs to put it back on, and that will help with the ketones. Ignore the vets advice about just feeding twice. It's OK to feed multiple small meals, with a good sized meal before his shot. Even human diabetics eat multiple smaller meals. Make sure his food is well watered down - post DKA he needs plenty of water too.

Are you testing ketones regularly at home now? You can get ketone test strips at any pharmacy, Ketostix is one such brand. From this post that you should read: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters is a link to how to test for ketones. Tips to catch and test a urine sample

Any data you could put in the spreadsheet for a few days before the DKA would also be helpful, as well as data up to today. When you get the signature set up, we'd like to know what type/brand of food you are feeding now. Wet is much better for him now if he will eat it, he needs the fluids.

If he goes off his food at all, you should have some anti nausea medication such as ondansetron to feed him - many post DKA cats are nauseous.
 
I am so sorry this has happened to you and your kitty. As Wendy said he needs lots of food and multiple times a day. You can add a teaspoon of warm water to each snack of food. That will help with hydration.
And test for ketones in the urine every day. That’s very important.
I’m going to ask @Bandit's Mom to help you set up the spreadsheet and signature, so we can see the data. She will contact you.
 
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Wendy&Neko said:
Don't worry about amount limiting food and how it will impact his numbers. For a cat that is recently out of DKA, you need to give him 1 and a half times his regular calories (not carbs). He's lost a lot of weight so he needs to put it back on, and that will help with the ketones. Ignore the vets advice about just feeding twice. It's OK to feed multiple small meals, with a good sized meal before his shot. Even human diabetics eat multiple smaller meals. Make sure his food is well watered down - post DKA he needs plenty of water too.

Are you testing ketones regularly at home now? You can get ketone test strips at any pharmacy, Ketostix is one such brand. From this post that you should read: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters is a link to how to test for ketones. Tips to catch and test a urine sample

Any data you could put in the spreadsheet for a few days before the DKA would also be helpful, as well as data up to today. When you get the signature set up, we'd like to know what type/brand of food you are feeding now. Wet is much better for him now if he will eat it, he needs the fluids.

If he goes off his food at all, you should have some anti nausea medication such as ondansetron to feed him - many post DKA cats are nauseous.
Click to expand...


Thank you!! I have ordered the young again dry food to be delivered Sunday, and he is back on his fancy feast pate. He was getting a VERY small amount (like legitimately 8-10 small kibbles) of dry food at the bottom, but we’ve stopped until we get the young again. I’m still not 100% sure how much I should be giving of each throughout the day, but do understand he needs more than just the food every 12 hours. Since he gets a whole can of FF at food time, should he get 1/2 can after 4 hours and 1/2 after another 4? (Ish, obviously some wiggle room if he’s acting hungry). I just want to be sure I’m not offsetting his blood sugar process by giving him too much but I’m still learning

also, my blood meter for ketones arrived today! First reading is .5 - is that good for a kitty recovering from a bout of DKA?

thank you so much!!
 
Bron and Sheba (GA) said:
I am so sorry this has happened to you and your kitty. As Wendy said he needs lots of food and multiple times a day. You can add a teaspoon of warm water to each snack of food. That will help with hydration.
And test for ketones in the urine every day. That’s very important.
I’m going to ask @Bandit's Mom to help you set up the spreadsheet and signature, so we can see the data. She will contact you.
Click to expand...


Thank you so much! Very excited to get a spreadsheet set up; my email is <Email address removed, use PM instead> if that is easier!

finally got our ketone testing meter today and had the first reading of .5, still trying to figure out what’s a good range and what’s high
 
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@McLoviinnn please remove your email address from the two posts. It is personal information and other people who are not part of this group could access to and cause you harm. @Bandit's Mom will contact you via a private message on this forum.
McLoviinnn said:
also, my blood meter for ketones arrived today! First reading is .5 - is that good for a kitty recovering from a bout of DKA?
Click to expand...
Yes the 0.5 reading on the ketones meter is nothing to worry about. Keep testing once a day and let us know what it is please.
McLoviinnn said:
again. I’m still not 100% sure how much I should be giving of each throughout the day, but do understand he needs more than just the food every 12 hours. Since he gets a whole can of FF at food time, should he get 1/2 can after 4 hours and 1/2 after another 4? (Ish, obviously some wiggle room if he’s acting hungry). I just want to be sure I’m not offsetting his blood sugar process by giving him too much but I’m still learning
Click to expand...
Don’t worry about trying to offset the food against the blood sugar. Cats have to eat and the insulin is dosed accordingly. With DKAin the picture it is very important that Tony eats a lot of food as it is food and insulin that keeps the ketones away. So give him a good meal with both the insulin doses and then offer him a snack of low carb food every couple of hours. A snack is a couple of teaspoons of low carb food. It’s great he is hungry. Often post DKA cats are nauseated and can’t eat…so that is good.
 
@McLoviinnn I can help set up your spreadsheet and signature. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

Did the folks on our FB group tell you about Diabetic Cats in Need? Diabetic Cats in Need has two Compassionate Assistance Programs...one is for one time help for people who can't come up with the start-up supplies (insulin, syringes, lancets and a blood glucose meter) and the other is a continuing assistance program for low income caregivers who can't afford the treatment costs.
 
Hi and welcome to the DKA club. My boy Hendrick was hospitalized for two days but pulled through, and then the advice I got here was priceless in helping him recover! Especially the part about feeding extra and making sure he has lots of water, and testing for ketones once or even twice a day!
 
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