11/8 Tawny DKA Update | Feline Diabetes Message Board - FDMB

11/8 Tawny DKA Update

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DD & Tinkerbell

DD & Tinkerbell

Member since 2009
Just talked to LVRC, they said Tawny's blood sugars "did well overnite" but did not give me #s, they said the vet would call me back with a more detailed update later.

Also said Tawny has not eaten on her own yet, they will start syringe feeding her today and see if that helps her to start eating on her own.

It's not much, but it's all I know at the moment.

LVRC is posting on DCIN's FB page, and vice versa, ( http://www.facebook.com/LAVRC?sk=wall ) that's great! Venita put her picture up, she is such a beautiful cat, and is also keeping Tawny's blog updated, http://fdmb-cin.blogspot.com/2010/05/ta ... le-la.html, thank you Venita.

Thank you also for the contributions to the chip-in fund to help Tawny. There has been a donation jar on the counter at my store for DCIN for a while now and I have moved it to a very visible spot (right in front of the cash register) and put up an additional sign about Tawny being a locally DCIN placed kitty and needing emergency help right now.

Tawny is so very special to so many of us.

Thank you all.

Desi
 
Hi guys .. thanks for the update on tawny .. I hope the vet calls soon and can fill you in on anything else that might be new .. you of course are in our thoughts and prayers still ...
 
Re: 11/8 Tawny has a Feeding Tube

From LVRC FB page http://www.facebook.com/LAVRC?sk=wall 30 minutes ago:

"We placed a nasogastric feeding tube in Tawny today so that we can provide her some nutrition while we continue to try to stabilize her electrolytes. The NG tube is a good short term feeding option that doesn't require anesthesia."

That's all I know right now...

Desi
 
Re: 11/8 Tawny DKA Update 3 p.m. CST

Just talked to the clinic, here's what they said:

She has feeding tube;

Her liver enzymes are elevated, they did not say anything else, just that her liver enzymes were elevated;

The tech and the vet both feel like she is brighter and more energetic today.

Her BGs are good, but still not throwing any #s at me (they never have the chart when I ask).

Desi
 
Hi Desi,
That sounds like a pretty good report on Tawny's condition. It is good that she's doing better than yesterday. I'm sure that the feeding tube will help. Karrie (Maverick) knows a lot about assisted feeding and feeding tubes and belongs to an assisted feeding group on Yahoo. Here is a link to her tribute to Maverick: https://docs.google.com/View?id=dddmxzzn_51gr5dpk5w

Continuing to think good thoughts for Tawny and sending healing vines to her and lots of strength to you,

Ella & Rusty
 
Re: 11/8 Tawny DKA Update P.M.

Tawny's Dr. says that everyone at the clinic believes she is doing better today. She has a temp feeding tube in b/c they don't want to put the more permanent one in until her potassium levels normalize, and he believed that should happen overnight, then they can anesthesize (sp?) her and put the long-term one in. She will come home with that feeding tube that she will have to keep in probably for 3 or 4 weeks. He said that usually the home feedings thru the tube need to occur 3 to 4 times over a 24-hour cycle. If it needs to be done more often than that, I will deal with it. I will bring her to the store w/me everyday and keep her safe in the office and feed her when needed. I have a couple people who can cover the cash register for me during the times I have to spend with her doing that. I will get up every 2 hours every nite all nite long if I have to for as long as I have to. The vet said he thought this would be for about 3 or 4 weeks, her feedings thru her tube. I have absolutely no experience with this kind of thing whatsoever and will once again need to rely on all of you here at FDMB for help, guidance and support. He says there is an 80-85% success rate.

Her BGS are good, her highest #s under 250 dipping into the 100s.

She is getting s/thg called Clinicare in her feeding tube which he described as a "constant drip".

They are doing everything they can and describe her as a really sweet cat.

We all already knew that, tho, didn't we?

The support of this board, not just in LL but in the other forums too, and DCIN, and now this LVRC clinic in Mandeville, LA just brings me to tears.

Thank you all.

The power here never ceases to amaze me, and I don't amaze easily.

Desi

& for those of you wondering, our beloved Tinkerbell is still OTJ after 11 months! How 'bout that!
 
I'm so glad she is getting a feeding tube!!!! It is a great thing for a kitty that needs assist feeding and lots of calories like Tawny - to recover from DKA and prevent a relapse and get her eating again. I've been participating on the Yahoo Feline Assisted Feeding forum for three years now. Maverick had a PEG tube for 10 weeks. My vet didn't place an Etube. I sure wish he did. Garland just recovered from DKA and had her tube for three weeks.

The Recovery RS food is only 6% carbs and is very high in Calories. Violet (Garlands mom) mixed clinicare with it to water it down as it has calories and water doesn't so it could go through the etube easier. But the clinicare has 25% carbs.

Please join the Assisted Feeding Group. You will be sent some autofiles. There are pictures on changing bandages and if you have a question that needs immediate assistance there are a lot of knowledgeable people there to help. It is an active group. One of the moderators is in Australia so all time zones are covered.

It sounds really scary but you will adjust quickly. The first week is kind of nerve wracking. But Tawny will adjust faster than you will. She won't even notice it. You will also get a routine and get in a groove.

Tawny will need a lot of calories 50% more than a non DKA kitty from what I recall from Garlands experience. Do you have a baby scale you can weigh her on - or someone you can borrow one from? Or a shipping scale?

Do NOT give an appetite stimulant - no cypro or mirtzapine. Focus on tube feeding for the first week at least. A cat with no appetite should not be given a stimulant.

Most cats can handle 30-40ccs/mls of food at one feeding and if there are no stomach motility issues every three hours. You can add night time feedings to get more food in. Lost sleep can be made up after a couple weeks when less food is needed.

Some vets have the belief that an etube should go directly into the stomach. It shouldn't - it should stop before the esophogus. So double check with them on placement. A good vet will do a post placement xray.

A few more things:
1. There is no need to do a preflush of the tube before feeding or giving medicine in the tube. Just a good post flush of 6-8mls of pure water after food and meds to clear the tube.
2. Nothing sticky in the tube like karo.
3. Have coca cola on hand in case you get a tube block. Its not an emergency, just plain coca cola, not pepsi or diet.
4.. If Tawny gets a sudden urge to bold, drop the syringe. Don't try and hold her back by holding onto the syringe ;) A mess is much easier to clean up than replacing the tube :lol:

Is Tawny only recovering from DKA? If her liver enzymes are high it may indicate feline hepatic lipidosis which is what Maverick had. Food is the medicine for this but also antinausea medication - ondansetron or dolasetron is ideal. Cerenia is more for acute vomiting and metoclopromide/reglan isn't effective in cats (but is for dogs) unless stomach motility is an issue. And a liver supplement - denosyl, marin or denamarin.
 
I'm glad Tawny seems to be doing better today. Keep on getting better everyday, Tawny girl cat_pet_icon
J.D. came home with a feeding tube, up his nose, I think. It was so long ago. He wouldn't eat for them in the hospital.
Good luck with everything. You are such a kind soul. I am going to PM Karrie and Maverick for you, as Karrie knows a lot about assist feeding and feeding tubes.
Sending lots of feel better vines to Tawny.
images


ETA: I see Karrie is already here :)
 
Desi --

Karrie was an incredible resource for Violet during Garland's recovery from DKA. Garland was being fed every couple of hours so bringing Tawny with you may be a good option. Small, frequent meals really seemed to help. I believe the calorie 1.5 x the usual amount that Tawny eats, was what Jill had recommended. It doesn't matter what the carb count is -- it's the calories that matter -- and insulin can be worked around the food.

Hang in there.
 
I came to give an update on Tawny, but I see that Desi already has. Just a couple more things.

The feeding tube she has is a nasal gastric tube. They didn't have to anesthetize her for that. Her potassium is still too low for anesthesia.

General information about Tawny's ICU care--IV fluids with supplements (potassium and phosphorus), R insulin through constant rate infusion, antinausea meds (pepcid), injected unisen (a Clavamox-type antibiotic), clinicare through her nasal tube through constant rate infusion, central line for introduction of medication and for blood draws. Tawny's BG levels were being tested every two hours, and are in a reasonable 100 to 200 level.

The vet sees Tawny headed to hepatic lipidosis (fatty liver). Her liver values, especially billirubin, are up. As soon as her potassium is stabilized, they will place an E-tube.

The results of Tawny's fPLI for pancreatitis should be in today. The vet also is thinking she may have triaditis--dysfunction of the pancreas, liver, and gastrointestinal tract. http://pethealthlibrary.purinacare.com/articles/cats-articles/feline-pancreatitis-and-triaditis/. One of the treatment medications involves steroids. However, I am sure Desi can work the insulin around the steroids, if they are needed.

Tawny may be in ICU two or three more days.

Thanks to all for your caring and your advice. Keep those prayers and well wishes coming!!
 
The instructions I gave above are for an etube not a ng tube. Most vets won't send a kitty home with a ng tube and its for liquids only.
 
Sending lots of prayers and healing vines this morning to beautiful Tawny. Come on, girl, you can lick this!

(((((Desi))))) Hang in there.

Hugs from
Ella & Rusty
 
Sending more healing vines, white light, snowflakes and prayers for Desi and Tawny. You can lick this Tawny. Thanks for the update.
 
11/9 Tawny is eating on her own!!

Tawny is eating on her own!! She is walking around, being friendly, meowing, and making biscuits!!

I spoke with Dr. Hebert. The placement of an eating tube is on hold for now. In fact, the vet pulled the nasal tube so that Tawny could better swallow the palatable dry (sorry!) food that the vet finds many recovering cats will eat well. If she continues to eat well, the clinic will transition her back to diabetic food.

If she continues to eat through the day, she may be switched from R insulin back to her Lantus. Otherwise, her treatment continues as it has been.

The vets did a liver aspiration yesterday to biopsy some cells. The results of that aspiration and the fPLI are due back later today. Tawny's urinalysis showed some rare bacteria, so it may have been a urinary tract infection that threw her into crisis. The central line in Tawny's jugular wasn't working properly, so the vets replaced that with a long catheter in her rear leg for blood draws. She must look like a poodle. Dr. Hebert is going to try to post some pictures of her today.

Posted on the DCIN blog here, which is where the Chip-in is.
 
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