diagnosed with ketoacidosis
- Thread starter jesmar
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Thread on Health: viewtopic.php?f=3&t=7656&p=76369#p76369
jojo and bunny
Active Member
i just was leaving to go to bed but i will tell you i 100% agree with everyone on health forum that suggested that your cat be at a 24 hours veterinary facility. there is a HUGE difference between a diabetic cat throwing ketones and being in DKA. you have a diagnosis of DKA, that means hospitalization is needed.
"He's been diabetic for two years and he was on Lantus for a long time. He hasn't had any insulin for about two weeks because I wanted to see how he'd do without it and it turned out he was doing better off it than on."
i am sorry but i have to say what no one else has, no he did not do better off insulin, he went into DKA without the insulin his body needs. sorry but someone had to say that so you understand that a diabetic cannot just have their insulin discontinued like that. you have a very sick cat on your hands and he seriously needs to be in a 24 hospital. cats can recover from DKA but only with intensive vet care.
I monitor his glucose
I have ketone strips
I just gave 1/2 unit of Lantus insulin (I know how to do it)
I tube-fed him (I don't know that the vet will take the time I'm taking to feed him -it took 45 minutes)
I'm giving the IV's (this is the real difference because they have an intravenous pump and I don't)
why did it take you 45 minutes to tube feed him? it does not take that long, do you have the right terminology? do you mean syringe fed him by mouth? tube feeding is something different. do not worry about vet staff not getting required number of calories in, that is their job, they will. also you are not giving IV fluids, that can only be done at vet hospital, IV= intravenous. you are giving SQ fluids, under skin, (SQ=subcutaneous) NOT as good when a cat is in DKA, that is the difference, not the pump, the method of administration of the fluids. the treatment for DKA is complicated and requires much more than what you have listed there. i'm sorry but this is way over anyone's ability to do take care of at home, i am a vet tech and i would not treat a cat at home for DKA, i do not have the lab equipment in my house to monitor the blood values that need monitoring nor all the meds that need to be given (and i have way more in my house than the average person). you are in way over your head if you think you can try to handle this at home. please go to 24 hour vet now. DKA is an extremely dangerous condition.
It's kind of hard to here the comments about how everyone else's cat reacted to something. I can't really do anything with that information and it makes it a little confusing. My cat is different than everyone else's cat.
actually your cat is just like how many of ours have been, a diabetic cat in serious trouble with DKA. everyone's cat is different however veterinary medicine's rules do not change because of that. this is a board of laypeople, and there is some confusion because someone posted that they took care of their DKA cat at home, no, they took care of a cat with ketones at home, is an entirely different thing. people have handled ketones at home, but no one has handled a DKA cat at home and had the cat live to tell about it. please take him in now.
"He's been diabetic for two years and he was on Lantus for a long time. He hasn't had any insulin for about two weeks because I wanted to see how he'd do without it and it turned out he was doing better off it than on."
i am sorry but i have to say what no one else has, no he did not do better off insulin, he went into DKA without the insulin his body needs. sorry but someone had to say that so you understand that a diabetic cannot just have their insulin discontinued like that. you have a very sick cat on your hands and he seriously needs to be in a 24 hospital. cats can recover from DKA but only with intensive vet care.
I monitor his glucose
I have ketone strips
I just gave 1/2 unit of Lantus insulin (I know how to do it)
I tube-fed him (I don't know that the vet will take the time I'm taking to feed him -it took 45 minutes)
I'm giving the IV's (this is the real difference because they have an intravenous pump and I don't)
why did it take you 45 minutes to tube feed him? it does not take that long, do you have the right terminology? do you mean syringe fed him by mouth? tube feeding is something different. do not worry about vet staff not getting required number of calories in, that is their job, they will. also you are not giving IV fluids, that can only be done at vet hospital, IV= intravenous. you are giving SQ fluids, under skin, (SQ=subcutaneous) NOT as good when a cat is in DKA, that is the difference, not the pump, the method of administration of the fluids. the treatment for DKA is complicated and requires much more than what you have listed there. i'm sorry but this is way over anyone's ability to do take care of at home, i am a vet tech and i would not treat a cat at home for DKA, i do not have the lab equipment in my house to monitor the blood values that need monitoring nor all the meds that need to be given (and i have way more in my house than the average person). you are in way over your head if you think you can try to handle this at home. please go to 24 hour vet now. DKA is an extremely dangerous condition.
It's kind of hard to here the comments about how everyone else's cat reacted to something. I can't really do anything with that information and it makes it a little confusing. My cat is different than everyone else's cat.
actually your cat is just like how many of ours have been, a diabetic cat in serious trouble with DKA. everyone's cat is different however veterinary medicine's rules do not change because of that. this is a board of laypeople, and there is some confusion because someone posted that they took care of their DKA cat at home, no, they took care of a cat with ketones at home, is an entirely different thing. people have handled ketones at home, but no one has handled a DKA cat at home and had the cat live to tell about it. please take him in now.
He was fed with a syringe. He is now at 196. He got up to go to the cat litter to pee and I checked his ketones and they are between small to moderate. At the vet, they were dark brown (high). I got at least 100 units of fluids in him and he seems to have absorbed them because I'm not seeing any soft pouches where I inserted the needle.
I just called the emg. clinic and spoke to the vet there. She knows us. She asked me how his glucose and ketones were doing and when I told her they both went down, she said he is responding. She asked about the fluids and she said that, since he was on a pump yesterday and today for over 24 hours, plus he got at least 100 units from me tonight, that SHE wouldn't be giving him any fluids tonight, and that I could monitor him throughout the night and if he changes for the worse in any way, to bring him in. She also said the 500-600 fluids a day seemed too much but to do what the vet said. I am not going to give that much in case there was a misunderstanding. 200 a day seems agreeable to a couple other vets. She also said it is normal for him to be somewhat slow and sluggish because of the ketones but that it will take a couple days to get rid of them and since they're going down, to make sure he gets food and give insulin.
That's the emg. clinic vet. I think the main point here that she was saying is that he was on the pump for over 24 hours and got more fluids from me already and that's why she felt safe leaving him with me tonight, so long as I came in if there were any changes and so long as I checked him in the morning. She thought his ketones might keep coming down. This is confusing and I'm trying to do my best. I am going to contact the vet tomorrow after testing, feeding, checking ketones again. Thanks for the advice -it made me call her and it made me not give as much fluids.
I just called the emg. clinic and spoke to the vet there. She knows us. She asked me how his glucose and ketones were doing and when I told her they both went down, she said he is responding. She asked about the fluids and she said that, since he was on a pump yesterday and today for over 24 hours, plus he got at least 100 units from me tonight, that SHE wouldn't be giving him any fluids tonight, and that I could monitor him throughout the night and if he changes for the worse in any way, to bring him in. She also said the 500-600 fluids a day seemed too much but to do what the vet said. I am not going to give that much in case there was a misunderstanding. 200 a day seems agreeable to a couple other vets. She also said it is normal for him to be somewhat slow and sluggish because of the ketones but that it will take a couple days to get rid of them and since they're going down, to make sure he gets food and give insulin.
That's the emg. clinic vet. I think the main point here that she was saying is that he was on the pump for over 24 hours and got more fluids from me already and that's why she felt safe leaving him with me tonight, so long as I came in if there were any changes and so long as I checked him in the morning. She thought his ketones might keep coming down. This is confusing and I'm trying to do my best. I am going to contact the vet tomorrow after testing, feeding, checking ketones again. Thanks for the advice -it made me call her and it made me not give as much fluids.
Glucose keeps falling. Now he's at 173.
Forgot to say this: I have no intention of treating this by myself. The plan was for me to take care of the cat over the weekend on my own, if and only if the kitty does better. I am supposed to go to the vet first thing Monday morning. Also think there was a miscommunication and the vet must have meant 150-200 units a day. He wasn't the one that told it to me so I think something was muffled. Also, I know I shouldn't have taken him off the insulin -didn't know that then, know that now. He is snuggling right next to me right now and I keep waking up to check on him.
Forgot to say this: I have no intention of treating this by myself. The plan was for me to take care of the cat over the weekend on my own, if and only if the kitty does better. I am supposed to go to the vet first thing Monday morning. Also think there was a miscommunication and the vet must have meant 150-200 units a day. He wasn't the one that told it to me so I think something was muffled. Also, I know I shouldn't have taken him off the insulin -didn't know that then, know that now. He is snuggling right next to me right now and I keep waking up to check on him.
Ann & Maggie11 (GA)
Very Active Member
Hi Jesmar,
Just thinking some positive thoughts about kitty and you. I hope she is doing better.
Just thinking some positive thoughts about kitty and you. I hope she is doing better.
That's so nice. People being sweet is really, really helpful. I am home waiting for my vet to call me on his off day.
Glucose down to 150 half an hour before I was supposed to give insulin this morning. I force-fed 14ML this morning and it was easier this time, though I still got a fight. Half an hour after I fed him, he was 140. One hour later, he is now 141. I got 135 units of fluids in him and he doesn't have any soft pockets/pouches so I'm thinking he's absorbed them. The vet's going to let me know if he meant 150-200 fluid units ONCE a day or THREE times a day. His ketones were in the medium range last night at "moderate" and that's good, too, because they were in the high range at the vet and dark brown. I've talked to the emg vet, the on-call vet, and the vet on duty this morning, and all of them are telling me that my vet would not have sent me home with subcutaneous fluids if he thought my cat should be hospitalized. This vet told me the other day that I *HAD* to leave my cat overnight the first night and that there was no other option and then the next day, he said it was better to leave him there so he could have a pump but that the cat was doing well and could do well on subcutaneous fluids, and that if anything at all went wrong, to change the plan and come in. My cat is drinking water on his own but not a lot. He has peed on the carpet twice, including once this morning, probably because he knows the cat litter is in another room so I'll have to move it. Yesterday, he walked to the cat litter. He does get up to move around now and then.
When I pull up on his fur, it falls right back down all over his back. His scruff and neck are the only places where it doesn't fall back down. His gums are not dry and not sticky -they were when I first brought him into the vet. These are the things I was told to check for. I love this cat so much. I'm trying so hard. I'm not employed right now so I'm stressing out, trying to do the best I can.
Sorry for the rant. confused_cat
Glucose down to 150 half an hour before I was supposed to give insulin this morning. I force-fed 14ML this morning and it was easier this time, though I still got a fight. Half an hour after I fed him, he was 140. One hour later, he is now 141. I got 135 units of fluids in him and he doesn't have any soft pockets/pouches so I'm thinking he's absorbed them. The vet's going to let me know if he meant 150-200 fluid units ONCE a day or THREE times a day. His ketones were in the medium range last night at "moderate" and that's good, too, because they were in the high range at the vet and dark brown. I've talked to the emg vet, the on-call vet, and the vet on duty this morning, and all of them are telling me that my vet would not have sent me home with subcutaneous fluids if he thought my cat should be hospitalized. This vet told me the other day that I *HAD* to leave my cat overnight the first night and that there was no other option and then the next day, he said it was better to leave him there so he could have a pump but that the cat was doing well and could do well on subcutaneous fluids, and that if anything at all went wrong, to change the plan and come in. My cat is drinking water on his own but not a lot. He has peed on the carpet twice, including once this morning, probably because he knows the cat litter is in another room so I'll have to move it. Yesterday, he walked to the cat litter. He does get up to move around now and then.
When I pull up on his fur, it falls right back down all over his back. His scruff and neck are the only places where it doesn't fall back down. His gums are not dry and not sticky -they were when I first brought him into the vet. These are the things I was told to check for. I love this cat so much. I'm trying so hard. I'm not employed right now so I'm stressing out, trying to do the best I can.
Sorry for the rant. confused_cat
No worries and if that's a rant...well.. hang around. We're all just worrying with you about your kitty. Many of us have been through having a cat with DKA and know first hand, how serious it is and how quickly things can head south. Please, if anything changes -- you smell an acetone/alcohol smell on your cat's breath, the ketones go up, he's having trouble walking -- anything, get your cat to the ER vet. DKA can kill. Most of us don't over react and push someone to take their cat to the vet if we think it is a situation that can be managed at home, so please keep that in mind.
I took my cat to the emg clinic and he's getting IV's and whatever he needs. I'm worried about something, though. The vet on earlier told me he was going to feed him before giving insulin and the vet now says she's not going to feed him until 6 hours after giving insulin! She's not listening to me. They're only giving half a unit but a long time ago, not lately, he went to 30 at half a unit.
300 -before insulin, 140 -lowest. 230- now
They were going to give him insulin NOW and it's 10hrs 30 minutes since his last shot. I said, please wait until 12 or 11 hours later at least. She said okay but that she was going to feed 6 hours later because I told her I had a hard time feeding him last night. I said, yes but he was easier to feed this morning and she just acted like she was in a hurry and hung up. This is exactly why I hate bringing my animals to hospitals. So they've got him on IV fluids which is good but they don't know a thing about Lantus. Do I need to worry about this? Should I be calling her to tell her to feed earlier again?
Also, the electrolytes are what they are most focused on, trying to bring them up. She said they won't check the electrolytes until 12 hours later. Is that right? HOW ARE THEY SUPPOSED TO KNOW HOW HE'S DOING IF THEY DON'T CHECK MORE OFTEN? Can he get worse and they won't know about it?
300 -before insulin, 140 -lowest. 230- now
They were going to give him insulin NOW and it's 10hrs 30 minutes since his last shot. I said, please wait until 12 or 11 hours later at least. She said okay but that she was going to feed 6 hours later because I told her I had a hard time feeding him last night. I said, yes but he was easier to feed this morning and she just acted like she was in a hurry and hung up. This is exactly why I hate bringing my animals to hospitals. So they've got him on IV fluids which is good but they don't know a thing about Lantus. Do I need to worry about this? Should I be calling her to tell her to feed earlier again?
Also, the electrolytes are what they are most focused on, trying to bring them up. She said they won't check the electrolytes until 12 hours later. Is that right? HOW ARE THEY SUPPOSED TO KNOW HOW HE'S DOING IF THEY DON'T CHECK MORE OFTEN? Can he get worse and they won't know about it?
Changes in electrolytes should not happen instantaneously. The changes should be gradual. If they pumped in a ton of potassium, this would be just as dangerous as letting the levels run too low. They will probably do a slow infusion of electrolytes like potassium and phosphorus and then check 8 to 12 hours later.
Also be aware that in emergency situations, they may not want to use a long acting insulin like Lantus exclusively. They may use a bolus insulin -- a short acting insulin, like Humulin R, that will work like a burst to quickly lower BG levels and it can be used in conjunction with Lantus if BG levels are running too high. Again, this is a typical way that acute conditions are dealt with in an emergency situation.
If you are concerned about food, call and speak with one of the vet techs. Make a friend. Let the tech know how worried you are. Then call back an hour or two later to check on your kitty.
If you want more information about acute care, I'd also post over in Health. There are a few vet techs who are members of FDMB who are often on the Health board and who are very able to answer some of these questions.
Also be aware that in emergency situations, they may not want to use a long acting insulin like Lantus exclusively. They may use a bolus insulin -- a short acting insulin, like Humulin R, that will work like a burst to quickly lower BG levels and it can be used in conjunction with Lantus if BG levels are running too high. Again, this is a typical way that acute conditions are dealt with in an emergency situation.
If you are concerned about food, call and speak with one of the vet techs. Make a friend. Let the tech know how worried you are. Then call back an hour or two later to check on your kitty.
If you want more information about acute care, I'd also post over in Health. There are a few vet techs who are members of FDMB who are often on the Health board and who are very able to answer some of these questions.
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