New Member 11th April 25 - Recovery from DKA

Hi all, firstly sorry if this is written poorly and lacks detail, it's 2am and I'm tired. My boy was diagnosed on the 12th of December 2025, he's been mostly high since then averaging around 15 nmol, I home test. I just got him back from the vets earlier after spending 3 nights there in DKA. He never threw up, he just hadn't been eating well for a week so I got ketone strips and he tested high. He's usually on 2 units of Lantus, although I missed his evening then morning dose a couple weeks ago when I attended a wedding and forgot to set my morning alarm. He was lower at 11 with no dose than I'd seen him in a while (I'd been getting between 13 and 16) so I halved his dose to 1 unit (not yet using syringes but about to transition to them). He stayed around 11-13 then I put him back up to 2 units around 3 days later as his levels were rising again. I'm not sure if his eating issues started before or after all this.

Anyway the vet had him on fast-acting insulin and managed to get him back down to 11 as he'd been much higher there over the last few days. After taking him off and not giving him anything for a few hours his glucose raised to 33. She gave him 4 units of Lantus at 3pm (terrible time but I guess necessary) and instructed me to give another 4 at 3am and to continue with the 4 units. My concern is 4 units will be too much, as it's double his usual dose. I've spoken with others in the Facebook group for this forum and they agree, and suggested no more than 2 units. I tested him at 5:34pm and he was 27.6, then again at 10:55pm around 8 hours after the dose and got 21.8. Just tested him again at 1:29am and he's 22.0. Is it then dangerous to only give 2 units if these numbers remain this high at pre-shot? 4 units makes me nervous as when they first dosed him in December they did 2 units with a U40 syringe as they didn't have a U100, which is closer to 5 units. He dropped to around 3.2 so I had to skip his next dose. His current numbers also make me nervous, and his appetite hasn't properly returned. He ate a bit earlier, but is still ignoring most of his food. I'll have to buy some more chicken tomorrow as it seems to be all he really wants to eat.

I'm also unsure if it's best to move the dose forwards or backwards in 15 minute increments. The vet said to do an hour at a time, as in 4am tomorrow, 5am the next day until reaching his usual 9am and 9pm shot time, but I've been informed that's too big a length and to do no more than 30 minute changes a day. It's difficult for me as I work full-time. Dosing 15 minutes earlier each time is easier on my sleep schedule as I'm usually awake until 2am anyway, although may be more difficult with work as I start at 10am and will be rushing home on early breaks. Is dosing 15 minutes early worse for him than dosing 15 minutes late? Thanks!
 
Maybe I should just do the 2 as that's what admins and mods on the Facebook group suggested, I don't think they're on right now so thought I'd ask here, but I need to get the insulin in him as he's quite high. Also need to sleep as I get up in 5 hours to get ready for work. I should have posted sooner!
 
I am going to share @Bron and Sheba (GA)'s list of things you need to do to help Elkie. This is the same list that was shared with me to help my Kobe recover from DKA.
"
  • 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 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, don't 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. To test for ketones you will need to buy a bottle of ketostix from a pharmacy. Please get these asap as it is very important we know if ketones are present
  • Give antinausea medication if needed such as ondansetron or cerenia. Nausea is very common in post DKA kitties and it needs to be addresses immediately
  • 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
  • Post daily with updates and ask for help as often as needed."
 
It looks like we are having the same issue here. I am not seeing the moderators on at the moment. I can't tell you what to do, but you are the one holding the syringe. This is your cat that you are keeping safe. You do not have to administer a dose that scares you. I will check on you if you'd like. :bighug::bighug::bighug:
 
I am going to share @Bron and Sheba (GA)'s list of things you need to do to help Elkie. This is the same list that was shared with me to help my Kobe recover from DKA.
"
  • 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 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, don't 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. To test for ketones you will need to buy a bottle of ketostix from a pharmacy. Please get these asap as it is very important we know if ketones are present
  • Give antinausea medication if needed such as ondansetron or cerenia. Nausea is very common in post DKA kitties and it needs to be addresses immediately
  • 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
  • Post daily with updates and ask for help as often as needed."

Thanks, I can give an anti-nausea now. Just tested and he's at 20.5 which I guess is a decent drop from the 33 he was on at the vets. They were using a pet monitor though so his current reading would likely be 22 if I wasn't using a human one.
 
It looks like we are having the same issue here. I am not seeing the moderators on at the moment. I can't tell you what to do, but you are the one holding the syringe. This is your cat that you are keeping safe. You do not have to administer a dose that scares you. I will check on you if you'd like. :bighug::bighug::bighug:
Thanks, I went with 2 units for now as his appetite still isn't great!
 
That's good! you want that boy eating!!! What kind have you got?

That's good! you want that boy eating!!! What kind have you got?

I've got Periset which is Ondansetron, do you know if it's safe to give within 24 hours of being on fluid drip? I haven't asked my vet if it would interact with anything they've given him. He ate a little of his raw meat after some prompting, but refused his pate. I was hoping he'd eat it for hydration as I'd added water as I usually do!
 
Ondansetron can be given every 6-8 hours. It should start to help about 20-30 minutes after you give it. Can you syringe food if he won’t eat?

Get a test at +2 and post as that’s usually when Lantus starts to work.
 
Ondansetron can be given every 6-8 hours. It should start to help about 20-30 minutes after you give it. Can you syringe food if he won’t eat?

Get a test at +2 and post as that’s usually when Lantus starts to work.

Welcome to FDF, you are in the right place, we will do everything we can to help you, it is frustrating when we find out our baby has diabetes, we all have been there, we would like you to create your signature and create a spreadsheet to monitor his BG, you are home testing, that is great news, but we need to have some data to be able to assist you below are two links for you to help us help you, the sooner you create these, the quicker we can help you with dosing all you should know, read the sticky notes in the Main Forum there is a lot of valuable information there, I have tagged, a few monitors and well knowledgeable members to help you with Lantus dosing, the more we know your cat the better we can help, keep posting no concern is a small concern, I am sure someone will click in shortly:bighug::cat::cat:

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
https://www.felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/
@Sienne and Gabby (GA)
@Diane Tyler's Mom GA
@Suzanne & Darcy
@Bron and Sheba (GA)
 
Alyse --

It would be extremely helpful if you could set up a spreadsheet so we can track Elke's blood glucose numbers along with you. The second link in Maria/Corky's post above has a link to spreadsheet information. We are very numbers oriented and are typically reticent to offer dosing suggestions without benefit of seeing a spreadsheet.
 
Ondansetron can be given every 6-8 hours. It should start to help about 20-30 minutes after you give it. Can you syringe food if he won’t eat?

Get a test at +2 and post as that’s usually when Lantus starts to work.

Thanks, I gave him half a tablet before going to sleep, unfortunately didn't get the +2 reading though.
 
Alyse --

It would be extremely helpful if you could set up a spreadsheet so we can track Elke's blood glucose numbers along with you. The second link in Maria/Corky's post above has a link to spreadsheet information. We are very numbers oriented and are typically reticent to offer dosing suggestions without benefit of seeing a spreadsheet.

Thanks, I have one ready to use I just need to add in the numbers. He's 21.8 this morning, up since I dosed him.
 
Welcome to FDF, you are in the right place, we will do everything we can to help you, it is frustrating when we find out our baby has diabetes, we all have been there, we would like you to create your signature and create a spreadsheet to monitor his BG, you are home testing, that is great news, but we need to have some data to be able to assist you below are two links for you to help us help you, the sooner you create these, the quicker we can help you with dosing all you should know, read the sticky notes in the Main Forum there is a lot of valuable information there, I have tagged, a few monitors and well knowledgeable members to help you with Lantus dosing, the more we know your cat the better we can help, keep posting no concern is a small concern, I am sure someone will click in shortly:bighug::cat::cat:

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
https://www.felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/
@Sienne and Gabby (GA)
@Diane Tyler's Mom GA
@Suzanne & Darcy
@Bron and Sheba (GA)

Thanks, I've had a spreadsheet set up for me, I just need to add in the numbers. He's 21.8 this morning so a little higher than when I dosed him.
 
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