DKA- 10 grand vet estimate- ADVICE NEEDED

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Rose L

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Hi,
I am looking for help- at my wit's end here.
Summary: Prozinc not working, diabetes unregulated, Ketoacidosis, 10 grand estimate for treatment.

My rescue cat (probably about 14 or 15 yrs old) was diagnosed with diabetes AND chronic pancreatitis 2 years ago.

At the time his blood sugar was all over the place, which the vet said was a result of pancreatitis coming and going...and I was told best we could do is to do a reasonable dose of insulin (1 unit ) daily and sort of hope for the best ....he was on the libre monitor a few times...

Fast forward to now, I don't think he has EVER been properly regulated. I have been giving him prozinc twice a day but after another round of Libre monitoring, his glucose is ALL over the place. I upped his dose, but he was having crashes to below 3 blood glucose, then up to 28 all morning and evening.

On top of this, he just had a UTI treated with injectable antibiotics. He also isn't eating properly. He has been slowly losing weight for the past 2 years, which has accelerated now to muscle wasting.

Took him back to the emergency vet today, as his UTI symptoms hadn't resolved, and he also just seems sick/ still losing weight. She said the UTI would have been cured by the antibiotic injection he had, so other symptoms are just related to his uncontrolled diabetes.

Anyway...she thinks he is in or near ketoacidosis.
She recommended a 10,000 dollar emergency vet stay!!! He would board for 3 nights and get the following treatment:
- IV fluids
- nasogastric tube feeding
- insulin infusion and BG monitoring
- transfer to specialist for continued case workup and management - abdominal ultrasound - chest x-rays - monitoring bloodwork - medications

OR euthanasia!

I love my cat too much to just euthanize him, but spending 10 grand when she couldn't even say if there was a good chance this would really turn things around seems crazy.

We are in Ontario, Canada.

Can anyone offer advice...am I able to turn things around at home ? Or should I spend the 10 grand for all this treatment (it would be hard for us right now, but I am willing to do it if I had confidence it would really help him)...

My biggest fear is that I board him at the vet for 3 nights and then he comes home and dies anyway, having spent his last days at the vet.

If you had an elderly cat with DKA and treated him/ her, did he/ she survive? Live longer?
 
Oh my god so sorry about this!
What was the antibiotic he got, was it Convenia? If so, this specific antibiotic is never a good choice for UTIs, and how on earth can the vet possibly know that that infection has resolved without any urine culture?
 
Thank you...and yes, I just looked and it WAS Convenia! Why is Convenia not good and what should have been given? Feeling stressed about next steps still...and time is running out!
 
Rose L said:
Hi,
I am looking for help- at my wit's end here.
Summary: Prozinc not working, diabetes unregulated, Ketoacidosis, 10 grand estimate for treatment.

My rescue cat (probably about 14 or 15 yrs old) was diagnosed with diabetes AND chronic pancreatitis 2 years ago.

At the time his blood sugar was all over the place, which the vet said was a result of pancreatitis coming and going...and I was told best we could do is to do a reasonable dose of insulin (1 unit ) daily and sort of hope for the best ....he was on the libre monitor a few times...

Fast forward to now, I don't think he has EVER been properly regulated. I have been giving him prozinc twice a day but after another round of Libre monitoring, his glucose is ALL over the place. I upped his dose, but he was having crashes to below 3 blood glucose, then up to 28 all morning and evening.

On top of this, he just had a UTI treated with injectable antibiotics. He also isn't eating properly. He has been slowly losing weight for the past 2 years, which has accelerated now to muscle wasting.

Took him back to the emergency vet today, as his UTI symptoms hadn't resolved, and he also just seems sick/ still losing weight. She said the UTI would have been cured by the antibiotic injection he had, so other symptoms are just related to his uncontrolled diabetes.

Anyway...she thinks he is in or near ketoacidosis.
She recommended a 10,000 dollar emergency vet stay!!! He would board for 3 nights and get the following treatment:
- IV fluids
- nasogastric tube feeding
- insulin infusion and BG monitoring
- transfer to specialist for continued case workup and management - abdominal ultrasound - chest x-rays - monitoring bloodwork - medications

OR euthanasia!

I love my cat too much to just euthanize him, but spending 10 grand when she couldn't even say if there was a good chance this would really turn things around seems crazy.

We are in Ontario, Canada.

Can anyone offer advice...am I able to turn things around at home ? Or should I spend the 10 grand for all this treatment (it would be hard for us right now, but I am willing to do it if I had confidence it would really help him)...

My biggest fear is that I board him at the vet for 3 nights and then he comes home and dies anyway, having spent his last days at the vet.

If you had an elderly cat with DKA and treated him/ her, did he/ she survive? Live longer?
Click to expand...
@Bron and Sheba (GA)
 
Rose L said:
Thank you...and yes, I just looked and it WAS Convenia! Why is Convenia not good and what should have been given? Feeling stressed about next steps still...and time is running out!
Click to expand...
Convenia is a 3d generation antibiotic, which means that it's meant to be used if the first and second rounds of AB didn't work.
It is specifically targetting skin infections in cats, (skin infections AND UTIs in dogs only).

I've seen here and in other forums so many cats being treated for UTIs with that AB it makes me crazy because it does NOT penetrate the kidneys and it is NOT effective in treating urinary tract infections. It is simply convenient, as its name suggests: one shot=14 days of no need to pill the cat, how marvelous!
Some (rare) cats have very serious side effects, and there is nothing that can be done but to wait for the system to clear the AB.

I really believe that you should push your vet to give you at least 14 days of amoxicillin and/or clavulanate (they are often combined). That's my opinion.

Then, I would ask for a second opinion for all the rest.
 
Daphne and Aida said:
Convenia is a 3d generation antibiotic, which means that it's meant to be used if the first and second rounds of AB didn't work.
It is specifically targetting skin infections in cats, (skin infections AND UTIs in dogs only).

I've seen here and in other forums so many cats being treated for UTIs with that AB it makes me crazy because it does NOT penetrate the kidneys and it is NOT effective in treating urinary tract infections. It is simply convenient, as its name suggests: one shot=14 days of no need to pill the cat, how marvelous!
Some (rare) cats have very serious side effects, and there is nothing that can be done but to wait for the system to clear the AB.

I really believe that you should push your vet to give you at least 14 days of amoxicillin and/or clavulanate (they are often combined). That's my opinion.

Then, I would ask for a second opinion for all the rest.
Click to expand...
@Bron and Sheba (GA)
 
Sorry I had to rush off earlier.
Your kitty needs IV antibiotics and blood tests to check if the electrolytes are ok. If he only has ketones and not DKA he may only need a day in hospital.
And I would also get them to recheck the UTI. It may not have been dealt with the convenia.
Once he comes home we can help you a lot with his recovery. Please keep us updated.
 
Not at all an expert, but it sounds like your vet is incompetent in diabetes management and in general.
Wrong antibiotic for urinary infection, and you decide an infection is gone by TESTING, not declaring it to be so.
Sounds like they've also offered no proper diabetes management and treatment.
Can you find another vet?
Can some members here recommend a diabetes-competent vet in their area?
 
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