Bobby has DKA and fatty liver

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Jessica2085

Jessica2085

Member Since 2016
Can anyone help me understand this. I took him to vet today and he is so sick. Hevisit on IV. I'm scared he won't make it. I have Googled it but I mostly see the long term prognosis is not good with this. any help is appreciated
 
I'm so sorry your kitty is ill. I assume that Bobby is diabetic because you came to this forum. Is Bobby at the vet clinic right now? These are conditions that require round the clock intensive care by a vet who has experience treating them. Treatment involves intravenous fluids, electrolytes and fast acting insulin to get blood glucose down. DKA can arise when they aren't eating well and blood glucose is high. Not eating enough puts them at risk of developing hepatic lipidosis (fatty liver) as well.

Please give us more info on Bobby so that we can help you better: his age, other health problems, when diabetes was diagnosed, what insulin he's on at what dose, what food you give him, whether you test his blood glucose at home.
 
I've gone back and found your other threads. I didn't realize you have been a frequent visitor. Did you ever post a spreadsheet of Bobby's numbers?
 
Jessica2085 said:
No I never have posted his numbers.
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I've been reading your threads to get Bobby's background. I see that you adopted him as a diabetic from a shelter with very little info on his diabetes and what to do about it. Do you record his numbers regularly at home? Do you test his BG before each shot?

My cat had a DKA episode at the end of March 2016. He was in hospital for 3 days hooked up to an IV and was receiving fluids, electrolytes and fast-acting insulin as I described above. Is this what's happening to Bobby right now?
 
All I know is he is on IV right now. the vet said he wants to do more tests and I try to test him. as much as I can he has been higher for a while now he has had a rough life medically
 
Jessica2085 said:
All I know is he is on IV right now. the vet said he wants to do more tests and I try to test him. as much as I can he has been higher for a while now he has had a rough life medically
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I think the early posts said he was on a high dose (5 u?) of lantus and you had an episode where he went very low. What is his current dose? Are there other health issues that made his BGs higher?

You mentioned DKA and fatty liver in your thread title tonight. Has the vet said that's what Bobby has? What other tests is the vet doing? I'm fairly sure that DKA can be diagnosed quickly and the faster proper treatment starts, the better.
 
The vet told me he has ketoacidosis and very high liver enzymes. I should change that info he is on 1 unit 2x a day. he is on lantus. and nothing I can think of he has always had issues around the diabetes. he was really hard to regulate. then went off insulin for a fèw mths and then went back on it.
 
Jessica2085 said:
The vet told me he has ketoacidosis and very high liver enzymes. I should change that info he is on 1 unit 2x a day. he is on lantus. and nothing I can think of he has always had issues around the diabetes. he was really hard to regulate. then went off insulin for a fèw mths and then went back on it.
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Is your vet experienced in treating DKA? Is it a 24 hour clinic? A lot of monitoring is needed.

I truly understand a cat being hard to regulate. My guy was diagnosed last January and still isn't regulated. If BG numbers stay too high for too long that can put a susceptible kitty at risk of DKA, especially if they stop eating, get dehydrated, etc. You mentioned that Bobby's BGs have been high lately. Was that on 1 u of Lantus? Were you thinking of raising his dose? Sorry for all the questions ...
 
My vet is the best. it is 24 hrs. as for his insulin we weren't sure about using more. they are doing all of these test and everything for free for me. the vet closed at 530 and our vet (the owner) was still there with Bobby at 830.
 
Jessica2085 said:
My vet is the best. it is 24 hrs. as for his insulin we weren't sure about using more. they are doing all of these test and everything for free for me. the vet closed at 530 and our vet (the owner) was still there with Bobby at 830.
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I'm glad you have a good vet. Is the clinic equipped to treat on an emergency basis for 24 hours at a time - ie., is an experienced vet there all through the night and not just a vet tech?

You said you weren't sure about using more insulin. Did you ask your vet for input on this? There are many here on the forum who would gladly help with advice as well.

Please keep us posted on how things are going.
 
I'm sure after tonight I will know about insulin. the thing is with Bobby there is no happy medium. with him being so sick so much is in the air. I will definitely let ya know what happens. I should know more in the morning
 
Bobby is still at the vets. he is on fluid as well as dextrose. they won't send him home until he is regulated again. his keynotes were +3. he did eat last night thank god they figure he will be there for another 2-3 days
 
Hi Jessica,

I'm sorry to hear that Bobby has DKA and fatty liver problems. I'm very relieved to hear that he has started eating again. Be sure to ask the vets about the following before you bring him home:

1. A suitable diet. (Calorie-dense foods are best for treatment of DKA but I'm not sure of the specific dietary recommendations for treatment of hepatic lipidosis.

2. Supportive meds - anti-nausea treatment (e.g. ondansetron generic) and appetite stimulant (e.g. cyproheptadine).

3. Advice on maintaining proper hydration.

4. DKA-specific advice on insulin dosing.

I also recommend that you do a forum search for posts about diabetic ketoacidosis (DKA) by member @Meya14; she is very knowledgeable about DKA and there is a lot of highly valuable information in her posts.

I'd also suggest that you might consider getting a blood beta ketone meter to keep a check on Bobby's ketone levels during his convalescence; the strips are pricey but it is so much easier on a poorly kitty to do a quick ear prick to make sure ketone levels are safe (and it's much more predictable than waiting for Bobby to produce a urine sample).

Sending prayers for Bobby to feel much better very soon. While he's at the vets try to get as much rest as you can so that you'll be fighting fit to nurse him when he gets home.

:bighug::bighug::bighug:


Mogs
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Hi again, Jessica.

I just had a quick look online for info on hepatic lipidosis treatment. According to the link below a calorie-dense food is also suitable for cats with HL.

http://www.peteducation.com/article.cfm?c=1+2135&aid=217

The article mentions metoclopramide as an anti-nausea med but there are better anti-nausea meds with more acceptable side effect profiles (ondansetron, Cerenia).

Also it is worth looking at this article on catinfo.org about feeding tubes.

Sending more prayers.

:bighug:


Mogs
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@Meya14 recommends some US calorie-dense foods in this post:

http://www.felinediabetes.com/FDMB/threads/critical-condition.159294/#post-1705934

This thread has more posts from Meya about food and insulin needs in DKA cats. (Please disregard any info specific to the kitty who is the subject of the thread; just look at the general food and insulin info):

http://www.felinediabetes.com/FDMB/threads/never-give-up.157045/#post-1667130

http://www.felinediabetes.com/FDMB/threads/never-give-up.157045/#post-1667164

Before you even think of introducing a different food please discuss this with your vet, Jessica. As long as Bobby is getting enough calories and insulin [ETA: to address the DKA/HL] on a food that agrees with him it may be the wisest course to work on an if-it-ain't-broke-don't-fix-it basis. When a nauseated cat starts eating any food it is most often the wisest thing to stick with what the cat is eating successfully and keeping down; attempting a food change may increase GI distress and the kitty may stop eating again - and that's certainly not what you want right now! (My experience of trying to help a cat overcome eating difficulties is to find something that the cat will eat as readily and reliably as possible while enabling safe administration of sufficient insulin (if diabetic) and stick to it like glue.)

:bighug:


Mogs
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My vet wanted to put him on prescription food I told him he did best on fancy feast. it's just the store I went to didn't have it so had to get another brand.
 
Well here is an update. it's not a great update but could be worse. Bobby is not doing good. he is still at the vets. he is so weak. still not eating. the vet is really concerned for him. they were gonna try to out a tube down his throat to feed him tonight. now if something happens and he doesn't do good with that I may have to say bye to my little buddy Bobby is extremely sick right now. and he has not improved at all he has gotten worse. I was told he ate the night of brought him in. but I guess it wasn't even a teaspoon. so in 12 hours I find out where we go from here. if he does good with the feed tonight they will book him in for surgery and get him a feeding tube. I'm very scared. have done a lot of crying. I'm not ready to say good bye to him. but when he looked at me today he had this look of I'm done mom. and I bawled my eyes out. he was so life less. can't stand won't move just lays there doing nothing. I spent most the day with him today.
 

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Still keeping Bobby in our prayers, Jessica!!!

Don't give up hope.....a lot of times they look the worst right before they turn a corner.....getting some food into him is really important for his liver so if they can get the tube in, that could help things a lot.

I know from the Facebook group that they're only using Lantus....I'd talk to them about using a rapid insulin like R while he's there and on a glucose drip.....Lantus is a great insulin, but it doesn't work well bringing down high numbers

The R insulin works faster and could get him down quicker to help with the DKA
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Oh Jessica, I went thru this with Elmo back in July. The first 24-48 hours was the roughest but on the 3rd day he began to improve...still weak and not fully well but was improved. Elmo is 17 years old so if he can make it I'm believing Bobby can too. I know the heartache of seeing them like that and my heart goes out to you. Will be keeping u and Bobby in my thoughts and prayers. You are a great kitty Momma and your vet sounds wonderful. It just takes time for them to come back from DKA. If you haven't already try hand feeding him tomorrow, maybe try Gerber meat baby food. :bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug:
 
Sending many many prayers and healing energy that Bobby can turn the corner and get on the road to improvement.

(((JESSICA)))
 
Yes, same good wishes and positive vibes from me. Don't give up on him yet. My guy was really sick when he had his episode. Good info above about using faster acting insulin while in hospital.
 
I will make an update as soon as I can. I have ever to be at the vet in am hour. that was the worst sleep ever. I'm hoping the vet will tell me that we can go ahead with feeding tube.
 
Jessica...know that many hearts and prayers are with you as you go and for Bobby as well .
 
Purrs and prayers for your Bobby. Our Evie was DKA 3 years ago and almost didn't make it, but she did pull through. Sending you hope, strength, courage and hugs.
 
The feeding tube will make it much easier for him to recover, food is the key in DKA and hepatic lipidosis. Sometimes in DKA both liver and kidney enzyme levels can rise due to dehydration and short term damage to the organs, this tends to resolve somewhat after recovery from DKA.

My kitty had a bad bout of DKA prior to him being diagnosed with diabetes. He went from being ok to being on death's door very quickly. When we took him in to the vet, he was like a limp rag, not moving, weak, etc. With care he recovered almost completely in about 2 weeks. DKA is scary, but cats regularly recover with good care, with no lasting effects. Prayers for your baby.
 
Hi Jessica - I too am praying for Bobby. My Murphy had fatty liver a few years ago (pre diabetes) He was upset another cat was staying with us, and stopped eating - I didn't notice until too late - he had a feeding tube at the vets and was there about 5-6 days until he started eating on his own. He was fine for about 1.5 years when he developed diabetes.
He will probably be sent home on some meds for liver support (vitamin E and denamarin maybe) but don't worry about that now. Hopefully, he is getting better and stronger by now. :bighug::bighug:
 
Update for everyone then I need to take a break from here and Facebook. my poor Bobby isn't coming home. I was really praying he would. I had to make a heart wrenching decision today. he has now crossed the rainbow bridge. my boy is no longer sick or in pain. I am not doing very well since I had to do this. thank u for the love and support.
 
Oh, no ...

My heart aches for you. I'm so, so sorry ...

:bighug:(((Jessica))):bighug:

Bobby could not be more loved.


Mogs
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I'm so sorry Jessica.

There is no greater testament to how much we love our furkids, than releasing them from pain.

Hugs and purrs for your hurting heart.
 
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