Cat coming home tomorrow

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Atticus Finch's mom

Hello, cat moms and dads -
I am a new mom of a recently diagnosed diabetic cat. My baby was taken to the emergency hospital and diagnosed with ketoacidosis. He has been there since Sunday but is coming home tomorrow. I am scared I am going to accidentally kill my cat by doing something wrong. The doctor treating him has been wonderful. I have been in contact with a very nice lady who works for a foundation for diabetic cats only. She has told me about Lantus and everything I have read so far seems very promising. My doctor started Atticus on ProZinc and said it was fine to switch once he was stable. I am already conflicted on what to do. Please help.
 
Hi Atticus Finch's Mom,

Just popping in quickly to welcome you both. It has been a while since you posted and it's tough waiting for a reply when your kitty's not very well. :bighug: (Been there.)

You've found a great place to learn about diabetes and to get help and support - both practical and moral - when you need it.

I'm really glad to hear that the doctor looking after Atticus Finch (great name! :) ) is so good; it makes such a difference.

To answer your first question your doctor is right in that you can switch to Lantus once Atticus is stable and recovered. In the meantime, ProZinc is also a very good insulin for cats. We have members here who have a lot of experience with both of those insulins so please post any time you have a question or aren't sure about anything and we'll do our best to help you. There are members from around the globe so there's usually someone around 24-7. (BTW, my own little one started on Caninsulin - compulsory in the UK - but then we switched to Lantus.)

Most of us find things really scary at the beginning. The diabetes diagnosis alone can be very overwhelming but you and little Atticus really have had a rough start with the DKA. But you will very quickly learn how to look after your little sugar cat, and as you learn your confidence will grow. Hang in there; it will get better. :bighug:


Mogs
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Thank you so much for the encouragement. I have already learned so much from reading this forum the past few days. I'm looking forward to learning from everyone's experiences and getting to know the other sugar babies.
 
I'm glad to do some small thing to try to help you. The early days are fairly heavy going when it's 'just' the diabetes. I can only imagine how much tougher it must be when dealing with DKA as well. :(

I'd have been lost without FDMB - for both education and emotional support. (The natives are very friendly here! :) )The vet we were registered with at the time completely missed Saoirse's diabetes when I knew something was really wrong with her. Thankfully I found the forum and from what I learned here I was able to go back a couple of weeks later and insist Saoirse be tested for diabetes. What I have learned here - not just about diabetes - has helped me to look after Saoirse much better since her diagnosis.

A couple of things for tomorrow. It's very important that Atticus is able to eat when he gets home. Sometimes kitties who've been in DKA have a bit of a time of it getting back to eating well. Be sure to ask the vet about giving you something to take home with you for treating nausea and possibly an appetite stimulant as well. Hopefully Atticus won't need anything but having an appropriate treatment immediately to hand will allow you to address any problems that might arise quickly and that will help recovery go much more smoothly.

You can pick up Keto-diastix or similar urine test strips at a pharmacy or anywhere that sells diabetic supplies. It's important to keep monitoring for ketones, especially while Atticus is recovering. (For reference, anything more than trace ketones on a test result and you need to get back to the vet straight away. Not trying to alarm you here, just putting information somewhere you can find it quickly should you need it. :) )

I'd also strongly recommend that you ask the vet to show you how to use a glucometer to test Atticus' blood sugar levels at home. Most people here use human glucometers with a cat-specific reference range (they read a little lower than pet glucometers but can still be used to monitor a cat safely). The test strips for human meters are much cheaper than the ones for pet meters. (If you're in the US, Relion Micro or Confirm meters from Walmart are quite popular with members here. The strips are reasonably priced and easily obtainable.) We can help you with home testing, too. (Lots of teaching materials in the forum stickies.)

While the vets are caring for Atticus try to get a bit of rest for yourself. You've both been through a lot. :bighug:


Mogs
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Welcome to the boards.
I'm still new to all of this too. However there is a lot of help on here. I know it's scary and easy to get worrying. However like the other person above said.. Relax ! Understand that you are doing the best you can do, feel good that you care for your kitty! I am glad to hear the cutie is going home to you. It's hard to be without the little fluff ball! People are here to help you.
bighug.gif
 
Thank you Critter Mom and Georgie! I just spoke to the vet and Atticus ate a little without protest tonight, which is a first since his hospitalization. I'm just worried because he has never, ever cared for wet food. But I understand it's Necessary.
I am going to WalMart tomorrow morning to get the Relion glucometer and strips and also urine test sticks so the vet can show us how to use them.
I have read some posts saying to give appetite stimulant and some saying don't. A couple of posts I read earlier stated it was like forcing someone to eat when they were nauseated from the flu. So I do have a worry about that because I know he must eat.
I'm trying to remind myself, If I seem too stressed, he will react to that. Thanks for the info and encouragement.
I may be on here several hours a day in the next few weeks.
 
Morning! I hope by the time you read this you'll have managed to get some bit of rest for yourself.

Right now, don't worry too much about what Atticus should be eating. Anything he will eat is the right food while he's recovering: if he can only eat dry food then his insulin can be worked around that. Meya often recommends Iams Maximum-Calorie food (definitely comes as canned - not sure about dry) or an equivalent. As the name suggests, it's very calorie-dense and calories are what Atticus needs now. You can work on optimising carbs once he's fully recovered.

With regard to the use of supportive meds, if Atticus continues to eat well then in theory he shouldn't need them. If he does, then anti-nausea med should be given first. If that's not sufficient on its own to get Atticus eating again, then that is the point where you'd introduce the appy stimulant. Dealing with the nausea first is key, because if the appy stimulant works well a cat will feel compelled to eat. I hope that's a little clearer.

Great news on the glucometer front! Being able to home monitor makes all the world of difference. Here's a forum sticky for you with a really helpful diagram of the part of the ear from which it is typically the easiest to get a blood sample:

Testing tips (with ear 'sweet spot' diagram).

It's a bit of an ask trying not to appear stressed when one is worried out of one's tiny mind over one's poorly baby! (I had to adopt a 'fake it till ya make it' act with Saoirse.) However, as Atticus starts to improve as a result of your ministrations you'll gain a little confidence. As you feel more confident, Atticus will pick up on that, too, and you'll be able to reinforce and amplify the positives for each other thereafter. :)

I'll try to check back later to see how things are going with you both.


Mogs
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Thank you for getting back to me. I couldn't wait until tomorrow so went tonight when my partner got home and bought the things I need. Although, I accidentally bought Friskies instead of Fancy Feast. Ahhhh! Gotta exchange that in the morning. The Relion Micro was recommended to me but the only one available was the Relion Ultima. It reads results in 5 seconds and I can download the results to help keep track. I hope this one is acceptable. I have very shaky hands, always have. So after I bought the lancets, I also found an Accu-Chek fast click lancing device. It is more like a pen and I think I will be more stable with that. Not sure if that's better or worse. I bought a Sharps container and Relion ketone test strips. That's all that were available. Others have mentioned different ketone strips but these are all I could find even with assistance at the store. I am taking this with me tomorrow so hopefully will see what works best.
 
You've done brilliantly! The Relion ketone strips are just fine. :cat:

Know what you mean about the shaky hands. I have PTSD and I shake, too. I 'freehand' the poke to get a sample from Saoirse's ear now, but I have to have the lancet in the pricking device to keep it steady.

BTW, some of the Friskies varieties (patés) are also low carb.

Must dash. It's time for Saoirse's test and insulin. Will check back later. :)


Mogs
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Talked to the doctor about an hour ago. Atticus didn't do well last night. He's developed hypertrophic cardiomyopathy. He's on oxygen now. They said he was having to breathe through his mouth. I mentioned this to the doctor yesterday that his breathing looked labored. They are doing an ultrasound and consulting with some cardiologists and we are just waiting...
 
Hope Saoirse is having a good day. I love that name.
 
Thank you for asking after my girl. She wasn't so good overnight but she was a bit better this morning and she has picked up a good bit this afternoon. She has chronic pancreatitis so things can be very up-and-down at times. Any changes to her maintenance regimen can trigger destabilisation. Recently her liver support supplement formulation was changed and it has really disagreed with her. I have her on a different brand today and it hasn't upset her system. Thankfully the company that brought out the changed formulation sold the licence for Saoirse's old formula to another manufacturer and I have some on order for her. It's due before the end of the week. I hope to high Heaven it will stabilize her again. She's lying beside me snoring contentedly at the moment. (((Saoirse)))

I'm very sorry to hear that Atticus had a bad night. :( I don't know anything about hypertrophic cardiomyopathy but I have seen discussions here where it has been mentioned. I've taken the liberty of posting a note on the main Feline Health board alerting other members to this thread. (The Feline Health board gets more visitors than this one, so the help request should get better visibility there.) I have asked for members who may have relevant, helpful experiences to share to post on this thread so that you'll only have to look in one place for any replies.

I've just looked at this FDMB article about DKA. It does list breathing issues as a symptom. I know it's very hard to see our little ones so poorly but Atticus is where he needs to be to get help. Your veterinary team sound like they're very good. I've got everything crossed for you both over here that Atticus' treatment will help him feel better very, very soon.

((((Atticus Finch and Mom))))


Mogs
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Atticus Finch's mom said:
He's developed hypertrophic cardiomyopathy.
Click to expand...

He's evidently had HCM just undiagnosed until now. More than likely what "developed" is fluid. That is really the way it occurs, undiagnosed heart disease, then fluid build-up.

Just for future reference, you can check the Resting Respiratory Rate yourself and keep it in a journal just like you do BG readings.
When your cat is resting (not purring) with a stop watch, count the number of breaths taken in 10 seconds. Multiply by 6 and that is the RRR. Open mouth breathing, panting, sides heaving, or RRR of 35+ sustained is reason to head to the ER.

If Atticus has fluid retention, now is the time to consider low sodium foods, 50-80 mg per k/cal. This list will give you not just carbs but sodium and phos too. http://www.felinecrf.org/canned_food_usa.htm#canned_usa

Also, please consider joining the feline heart group: https://groups.yahoo.com/neo/groups/feline-heart/info
 
We got a call from the doctor about 30 minutes ago. Atticus went into cardiac arrest and is mostly brain dead.
Thank you-all for the info and support. I'm only sorry we can't share more stories in the future.
I hope y'all have many more wonderful years with your sugar babies.
 
Oh, no ... I am desperately, desperately sorry. My heart goes out to you ... :bighug:


I know that this board's primary focus is feline diabetes, but the Feline Health board is very active and there are all manner of discussions about a wide range of cat health topics. There are so many kind and knowledgeable people here. I've learned - and been helped - so much since joining the year before last. If ever you need any help, or an understanding ear, we'll be here for you. Maybe some day you might share some stories with us.

I feel so sad for you both.

:bighug::bighug::bighug:


Mogs
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I am so terribly sorry to hear about Atticus Finch. My heart is breaking for you. I know about HCM and what a terrible disease it is. I am just so sorry.

Please know you can post here any time, we are all here for you. Sending love and strength,

Lucy :bighug::bighug::bighug::bighug::bighug:
 
Thank you for all the comforting messages. Now that Atticus has been cremated, I am thinking back on certain events and I am angry. When we took him to the vet at Animal Care Clinic, he had lost 2 pounds since his visit with his regular vet on Monday. He lost 2 full pounds in 5 days. When we went to the vet on Saturday, the vet gave him a Convenia injection and told me he "probably" had an infection. He was limping on his right front foot and his hind legs were weak. They did a full senior blood panel and his glucose was 493. The vet said he was "probably diabetic". He said, "If he doesn't get better by tomorrow, bring him in and we can hospitalize him."

How can a "doctor" not realize that these signs were critical to a cat with DKA? He said, "Well, hindsight is 20/20, but moving forward, now you know what to look for. I told him my cat had been drinking a dog-sized water bowl full of water, plus drinking from the toilet (which he has NEVER done) and jumping in the shower to lick up the water there (which he has NEVER done).
I think with a competent doctor, my cat would be alive right now. I now know that those were definite signs of neuropathy of a cat with DKA.
Is there somewhere that I can complain or report this "doctor"?
 
Oh, I am just sickened to read what happened to Atticus. It is just horrible! We should be able to put faith in our vets that they are knowledgeable with FD but clearly they are not! My heart aches for you.

As far as complaint about an incompetent vet, I do not know the answer to that but, sure hope someone knows and will weigh in. Even in human medicine, it is hard to sue an incompetent medical doctor as there are no to very few other doctors that will testify against the incompetent doctor. It is so very sad. Peace.
 
Again, I'm so sorry for your loss! It's terrible when we rely solely on our vets' knowledge, only to feel like they dropped the ball when they might have been able to save a life! I faced that situation three years ago and still have not come to terms with it.

I don't know whether or not this will help but it might be a starting point, anyway.

https://www.aavsb.org/Complaint/

There are state boards that govern veterinarians just like the ones for doctors for people. I doubt you'll get very far with them, but at least you can make a complaint. Just specify that you want it to go "on the record". If they say they'll open an investigation, ask for a case number.

I didn't realize they had given Atticus a Convenia shot. Are you at all familiar with this drug? It seems to have a high incidence of potentially serious and/or life-threatening reactions in cats.

http://www.catinfo.org/?link=convenia

http://www.drugs.com/vet/convenia.html

Good luck, and please keep us posted.

Fly free, beloved Atticus cat_wings>o
 
@Atticus Finch's mom -

Oh, my ... :(

You are right to feel so hurt and angry. I have had vets fail my little ones in the past. It makes the loss even more devastating ...

I am so, so sorry ... there are no words to fully express how sad I feel for you and for your beloved little Atticus Finch. If I could turn back time for you I would ... :(

((((Mom and Spirit Atticus Finch))))


iu



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Thank you. The more I read, the angrier I get. The vet at the Animal Care Clinic gave him a Convenia injection without even asking me about it because his WBC were a little bit high.
But now I am reading about how it affects the red blood cells. His rbc were licing (spelling?) and I wonder if that had something to do with it.
If a vet doesn't recognize the signs of DKA, should he be practicing?
Atticus could barely walk and his front paw was hurting and he was limping.
The "vet" told me to bring him back the next day if he didn't get better. How can a vet think he would "get better" on his own?
I have learned with DKA, time is of the essence. I think our baby could have been saved with a knowledgable doctor.
 
Atticus Finch's mom said:
If a vet doesn't recognize the signs of DKA, should he be practicing?
Click to expand...

The sad truth is that some vets don't even recognise straight diabetes. I was refused any diagnostic testing when I first brought Saoirse to the vets we were registered with at the time Saoirse's symptoms became obvious. The practice vet who saw her packed us off with a 'hit 'n' hope' steroid jab, a Dx of "old lady", and a vague suggestion to bring Saoirse back in a few weeks if I was still concerned. Concerned? Excuse me?? She just wrote Saoirse off. I went online to find out what I could and mercifully I found FDMB and learned that Saoirse was a poster kitty for diabetes. I went back to the practice and demanded they run diagnostics. I'd have raised merry hell if they had refused a second time.

Sadly I lost my Danú to hepatic lipidosis a few years earlier because the so-called cat specialist at the same practice didn't treat her as an emergency case. She was only seven, and had no underlying illness. It was a complete failure on the part of the vets responsible for her care. Because of severe financial problems at the time I didn't have the option to move to another practice; unusually for a UK vet practice they used to give me time to pay my bills in instalments. I was afraid to complain because I feared losing that goodwill for Saoirse's sake. I've never forgiven them for it and, like Lucy, I've never come to terms with the loss. I also feel guilty for not taking it up with the practice owner because I worry about the fates of other cats who go there in case they'd make the same error again (although I have lost count of how many times I've had that showdown in my own head). Do not ask me how much I worry about their approach to diabetes treatment ...

My beloved Danú was supposed to be coming home the next day, too. I keep looking at the title of this thread and my heart aches even more for you. I am desperately sorry that the vets failed Atticus and failed you ... :(

:bighug::bighug::bighug:

((((Mom and Spirit Atticus))))



Mogs
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I am so sorry about your baby, Danu, and for Saoirse. I know there's a reason they call it "practicing medicine". Our bodies and other animals' bodies are such an intricate thing. I always get a senior panel on my cat every year. When he got his vax on Monday, two weeks ago, they said maybe he had hyperthyroidism, but saw nothing emergent. I decided to wait to do bloodwork in January and a dental in February due to money issues.
They were fine with that. I can't help but think if I had just done the bloodwork that day. But they told me there was no need to be alarmed.
I had to visit the same vet last year due to illness of my cat, asked for a senior panel, and they refused, also. They said there was no need for it.
We have such good instincts, but when a doctor whom is supposed to know what they are doing tells you there is no reason for major concern, of course, you are going to believe them.
I'm looking back now and kicking myself. But, you're right: we rely on the doctors to know what they are doing.
As I mentioned before about the water intake, everyone I have spoken to since then (internal specialists and a very nice lady at the feline diabetic foundation) immediately said that was a dangerous sign and should have been treated as such.
I just don't know what to think. And thank you for your kind words. Yes, I keep looking at the title of my post and thinking ,"what a dummy I was".
 
Oh please don't blame yourself. You are just like all of us who had likely never even heard the acronym DKA, much less knew the symptoms. My first diabetic cat was diagnosed in 2009, but I had never heard of DKA until I came to this board in 2014 with my second diabetic cat.

FWIW, I keep looking at the title of your post and thinking what a loving and hopeful Mama you were (and are), and that you had the collective support of hundreds of people around the world wishing for the best for you and your baby. Now you forever have an angel watching over you.

May you soon find peace through your grief. I am so sorry, my heart breaks for you. I wish we could just snap our fingers and make it better...

Sandi.
 
You're not a dummy. Anything but. You did your level best for Atticus. As you say, we are supposed to be able to depend on trained professionals to help us look after our little ones. As humans, we all make mistakes from time to time. Vets are human, their work is very demanding and stressful, they can't be experts in all conditions, and it's impossible for them to keep up with all the latest research. But ... we do place our trust in their ability to at least identify something at general practice level which should be investigated, even if diagnostics merely serve to rule out a problem.

I think most people's reasonable expectation when they consult with a vet about their little ones' health is that they will be consulting an expert in general animal health who will be able to identify, advise on and offer effective treatments for all common pet ailments. We expect them at minimum to be able to spot warning signs, to run appropriate diagnostics (our little ones cannot describe what's wrong), and to refer cases out to external experts with different specialisms should the need arise. We also expect them to listen to us and take us seriously when we have identified something unusual about our companions' clinical signs and/or behaviours. As you say, our instincts are good, and we know our little ones, but sometimes it's very hard to be assertive enough when the vets are the gatekeepers to the treatments our little ones need. With the vets, we expect our little ones to be in good hands; to be as safe as possible.

A word popped into my head earlier when I was thinking about my reaction to vets not giving me the right advice (twice with fatal consequences and one a near miss). It's a word that sums up in three syllables the essence of how I feel: Betrayed.

I also feel angry with myself for having let vets intimidate me in the past, but that anger is a very pale shadow of the rage I have felt toward vets who have withheld treatment that could have benefitted - maybe saved - my beloved companions.

Keeping you very much in my thoughts ...

:bighug::bighug::bighug:



Mogs
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