Cat in DKA

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C.C.

Member Since 2023
My 8-10 yr old cat was diagnosed with diabetes a month ago. It's been a struggle all month to get him to eat enough and he lost 6 pounds. Feeding only low carb wet food for a month didn't change his glucose numbers so vet started him on Bexacat 3 days ago. Glucose went down to 170 after 24 hours. Then he went into DKA last night with ketones at 6 and glucose of 86. Took him to emergency vet last night where they started him on Dextrose to bring glucose up a little. After less than 24 hours ketones should have started down, but they are going up. Now they are starting him on a little insulin but are concerned it will drive the glucose too low. I pick him up tomorrow morning to transfer to his regular vet who is actually out of the country for a week, so don't know what vet I will get. I also worry that they won't be watching him overnight like the emergency vet does, but omg, they are CRAZY expensive! This is so nerve wracking! Has this happened to anyone else?
 
Many of us began our experience with feline diabetes by having a cat that developed DKA.

First and foremost, the Bexacat MUST be stopped. Bexacat can't be used with a cat that has ketones. You cat will need insulin in order to recover from DKA and once your cat has been started on insulin, Bexact is not a possibility.

The basics for DKA are that there is an infection or inflammation present + not enough calories + not enough insulin. Typically, a cat is on IV fluids to correct for dehydration and is usually supplemented with dextrose which provides some nutrition . The IV should also be supplemented with electrolytes. The vet should be getting blood tests at least twice a day to check on potassium, sodium, and phosphorus levels as well as other levels. Insulin should be started. Often the vets will use a short acting insulin (e.g., "regular" insulin -- Novolin R or Humulin R) as a bolus and ultimately along with a longer acting insulin such as Lantus. It's also important to get your cat to eat. Cats usually feel pretty lousy with DKA so appetite stimulants and anti-nausea medication may be used. In all likelihood, your cat may also need an antibiotic.

This is an older paper that provides some good information on treating DKA so you have a good idea about what should be done. Treating DKA is expensive. It's a life threatening condition and it requires constant monitoring and frequent lab tests.
 
I’m sorry you and your kitty are going through this.
I see @Sienne and Gabby (GA) has posted giving you some information. I absolutely ageee with everything she has said.
Here is some information for you for when get your kitty home
  • 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, 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. Before he leaves hospital ask the vet for some cerenia and ondansetron for nausea. Most DKA kitties will still be nauseated when they get home.
  • Give appetite stimulant if needed after the antinausea medication. Ask the vet about this before he leaves hospital.
  • Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
  • Ask the vet about subQ fluids
  • Ask the vet if they tested for an infection or inflammation and if he is having an antibiotic.
  • Set up a spreadsheet and test the BG frequently. We can help you set up a spreadsheet @Bandit's Mom
  • Post daily with updates and ask for help as often as needed.
Here is a like to our FOOD CHART
Look for foods that are 10% carbs or lower. Also look for some higher carb foods around 14% (medium carb )and 20% (higher per carb) for your hypo box. If you are finding he won’t eat food, try him with anything, even if it is not suitable for a diabetic cat because eating is more important than what he eats at this point.
Ask as many questions as you like as we are happy to help you land having a kitty with DKA can be overwhelming.
 
I am so sorry, my cat had to stay at the emergency vet 4 nights, the first two she was in critical care. It was very expensive but i had no choice, she had 24 hour care.
 
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