9.22.2025 "New Member" Luna newly diagnosed diabetes with DKA

E

edfknox

New Member
Hello,
Thanks for letting me join, backstory, last Wednesday we took Luna to the vet she was just not acting right, somewhat lethargic, some eye drainage, nothing specific it was just a hunch. We have 3 cats and a dog, so it can be challenging to keep up with all the details. They looked in her mouth and said "she has diabetes", tested glucose at 339 and then urine was quite dark, did a complete blood panel and urine test, bilirubin high, Pancreatic enzymes high, kidneys ok. Gave her insulin and an antibiotic injection. Sent us home to return the following day for fluids. They don't have emergency care.

Next day, Thursday glucose 99, fluids all day, she actually looked bright eyed when we picked her up, sent us home mission to get her to eat came home maybe ate 2 tablespoons of her regular food, urinated, layed on me enjoyed pets, I was encouraged although she seemed restless a bit not sleeping hard.

Friday, 9/20 she was not interested in food in the am, did drink and urinated. Glucose was lower 86 and 99, received IV fluid electrolytes all day. Picked up not pert, not interested in food pm, layed on me but no eating, drank some and urinated. Asked to return for more fluids following day.

Saturday am, not interested in food, took in fluids at Vet until 1 pm, came home drank, urinated and ate 10 or so Applauz treats, I was encouraged. About 5 pm she ate 15 or so more, no interest in her normal food, tested BG 250, our vet said only do insulin when over 250 for now. Feeling like we needed emergency care decided that in the am if no eating going to ER vet.

Sunday am, not interested in eating, still alert but not herself. Up until this point we had been told diabetic cat, elevated bilirubin and pancreatic enzymes but no mention of keytones. ER vet checked her in repeated some test small amount of keytones found. Protocol followed IV fluids and electrolytes, feeding tube nutrition, pain management and round the clock care.

Monday noon, I saw her today 24 hours later and she was dazed a bit likely from the pain meds, weak, but knew me. Licked tips but did not eat any food, was sleepy and just seemed worn out, I was a bit discouraged but her BG numbers trending down below 200 with continuous readings and small bits of insulin.

Thanks for sticking with me, I believe she will be coming home tomorrow. I don't know the exact plan, but they had us bring her Lantus and mentioned something about "bolus", not sure what this is. She also have the BG reader in that will stay for 2 weeks? Anybody who has been thru this need all the things...
1. how to get kitty to eat
2. what does home care look like after ER care and DKA?
3. what should we look for that could be sign of not improving?
4.just need some real life input tell me where to find it

Its crazy a cat can go from no health issues to this and it just breaks my heart that I didn't recognize any issue sooner. Thanks for listening and for any feedback.
 

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Glad to see you make it over here Emily! @Bron and Sheba (GA) can give you a lot of the information about what you need to have when Luna comes home from the hospital. If they're already talking about sending her home tomorrow, she must be doing well! Just need to keep giving her the extra care she'll need until she's back to her heathly self! @Bron and Sheba (GA) is in Australia so is usually on soon. We also tagged her in the group so hopefully she'll be able to help you soon.
 
Hello and welcome. We've seen (unfortunately) lots of kitties here with DKA. Here is a post on it for background: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters. You will want to test both her blood sugars and ketones levels. Hometesting Links and Tips The two week reader is a Freestyle Libre, a good start, but you'll eventually want to get a blood glucose reader and you can test at ketones at home either with a blood reader or a urine test strips. We have several people here who use the Libre a lot, especially for fractious cats. It's a good tool in the beginning when you are overwhelmed learning everything else.

Key is getting enough insulin, enough food and liquid, and making sure she is treated for any infection or system inflammation. More on pancreatitis and treatment here: A Primer on Pancreatitis

Lantus is a good insulin. A bolus insulin is an addition insulin on top of that. For human diabetics, they will use something called R or Regular insulin that is fast acting and only lasts a short while, mainly around meal times. Typically vets don't send people without feline diabetes experience home with using R too, but it can be a good tool, just an advanced technique. Hopefully they'll give you lots of guidance about it's use.

What brand/make of food was she eating before this all went down? And now what is she getting? An appropriate food for a diabetic cat is a wet food (or raw) low carb food, under 10% in carbs. However, at this point, it is more important that she get calories in her, about 150% of her normal calories. We'll worry about carb levels later. Also make sure any food has plenty of water added. Or maybe they'll send you home with subq fluids. We have a video on that if you've not done it before. Fluids help flush out ketones.

Antinausea drugs are very important at this phase. Many DKA kitties are nauseous. Licking lips and not eating is a sign. You want to get her home with a prescription for ondansetron (filled at any human pharmacy) and possibly Cerenia/maropitant as well. A couple other posts with feeding tips that might help:
Sorry to pile on the info, but as you can see from the links, what you are doing is not uncommon.
 
Hi Emily and Luna and welcome to the forum. So sorry Luna has DKA.
Wendy has most of the necessary information. I’ll just add my bit.
  • you need to give one and a half times as many calories as Luna 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 Luna won’t eat the low carb food, feed her whatever he will eat as eating any food is better than not eating. We can worry about carbs later.
  • 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. A lot of post DKA kitties are nauseated so ask the vet for some ondansetron or cerenia.
  • 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.
 
Morning thanks for the info, we are at a crossroads, Luna's bilirubin is 5.6 up from 4.0 last Wed and hasn't gone down with the ER treatment of fluids etc. Otherwise she is tolerating care well, bg 205-218 and no temp, but clearly tired and week. We have 3 options ready her to go home which will require esophageal feeding tube to be put in :(, stay an additional day at emergency vet (costly and she is a very nervous cat), send home w/o feeding tube and hope will start eating.

This is heart wrenching and I know none of you can give me an answer, I just don't know when you are putting a cat thru too much. Thanks again for your thoughts prayers and info.
 
Hello and welcome! I'm sorry you and Luna are here, and I hope Luna feels better soon!

Can you talk with your vet about a transdermal appetite stimulant? These are ointments that you rub on the inside of your cat's ear, and about an hour later, they're hungry. There are also pill formulations, but I hate using them because you have to fight to get the not-hungry very to eat them; this is easier and more subtle.

There are two formulations: mirtazapine and ciproheptadine. There's a company that makes premade little tubes of transdermal mirtz; afaik, transdermal ciproheptadine be to be made at a compounding pharmacy. While mirtz is easier to get, I tend to prefer ciproheptadine: mirtz can make some cats agitated and 'meowy' to various degrees, and I like to be sure that whatever behavior I'm seeing is a result of the underlying condition and not a side effect of medication.

It's possible that your cat may need the resources of the hospital right now, but I'd suggest talking with the vet about transdermal appetite stimulants if you think that's something you may benefit from at home.
 
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