GA dka cat

Tom is an 8-year-old cat. He got scratched. We took him to the hospital for the small scratches.

Then we were SHOCK to find out that Tommy is in DKA status. The medical bill was already 3000 dollars. Tommy is currently in the ER.

We are very worried about Tommy's status and long term treatment costs.
1) What should we pay attention to when picking Tommy up home?
2) Is there any low-cost long term treatment method?

Thank you so much!

 

I'm so sorry you and Tom are going through this crisis!

I don't have personal experience with DKA, but we have several members here who successfully nursed their kitty back to health after a DKA episode, so they will be able to help with specific advice when Tom gets home. But he has to get stable first, and out of actual DKA.

Did you know he was diabetic before this happened? Is he on insulin? The 'recipe' for ketones/DKA is: not enough food, not enough insulin, and some kind of stress/inflammation, so in simplest terms, recovery/prevention involves reversing all three: enough food, enough insulin, and making sure that whatever the precipating stress was has been taken care of.

The most obvious candidate for the stress sounds like the scratches, but make sure the vets are checking for other possibilities that might be hiding (UTI, dental issues).

As for food and insulin, he'll need food both to directly counteract ketone development and also to be something for the insulin to act on safely. So food is really key. They should be taking steps to make sure that he's getting enough calories at the vet, with assist feeding or a feeding tube if necessary. Anti-nausea meds and appetite stimulants can really help here as well, and are invaluable tools in the toolkit for home recovery.

Once out of the ER and home, he would need some intensive nursing for a time, but if he makes it through this, a complete recovery is possible.

Fingers and paws crossed for your little guy!

 

Hi and welcome to FDMB. I am sorry you are going through this with your kitty Tom.

Has Tom been a diabetic long? Or has he just been diagnosed? What insulin is he on?

Cats can recover fully from DKA and go on to lead normal lives but you will always need to be aware that he is prone to ketones and test for them. Once he has recovered fully there will only be the normal costs for having a diabetic cat. No ongoing long term costs. Just the costs of the Ketostix strips to test the urine for ketones which cost about $10 for a bottle of 100.

In the short term, once you get Tom home there are things you will need to be doing to make sure he fully recovers. Quite often vets don’t mention these things, but we will be very happy to help you.
When you bring Tom home:

• You will need to make sure he is eating 1 1/2 times as many calories as he would normally do. Food is like a medicine for DKA kitties. Small frequent meals throughout the day and evening.
• Test the blood glucose with a human meter..We can help you set up a spreadsheet to add the BG data. And if you are not already home testing, we can help you get started.
• Don’t skip any insulin doses. If you are unsure what to do, post and ask for help.
• Make sure you test at least daily for ketones in the urine. Buy a bottle of Ketostix from Walmart or a pharmacy.
• Make sure he is drinking plenty of fluids. You may need to add some water to his food to make it soupy if he will let you.
• Before he comes home, go out and buy a variety of low carb canned foods for him to eat. And also some higher carb food in case his BG drops lower
• Ask the vet for some antinausea medication for when Tom is home. A lot of DKA cats are nauseated when they come home. Ask for cerenia and or ondansetron..
• Also ask if he will need some subQ fluids for you to give at home.

I will add a couple of links for you to look at in the next post.
All the best for Tom

 

Link to useful information about a hypo kit, settling up a spreadsheet, setting up you signature
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Food chart for low carb food and some higher carb food.
Look for 10% and under for low carb
11% to 16% for medium carb
17% and above for high carb
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Home testing link
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

I hope your boy Tommy will make a full recovery. Praying for him ♥

 

Thank you so much for your detailed replies and support. Tommy was never a diabetic cat. He is always happy and healthy. Therefore, his illness was a completely shock to our family. We know NOTHING about how to care for a diabetic cat (e.g. food, injections etc). We were in a PANIC condition and had to put his medical cost on the Carecredit. Some follow-up questions:

1) What is the average monthly cost for a diabetic cat? What does cost involve?
2) Are there any assistance program/fundraising that helps with big cost?
3) Any food brand recommendation?


Thanks again.

 

I’ll ask @Chris & China (GA) to address the financial side of things for you

A lot of people feed fancy feast pates as they are low carb food. You need canned food 10% or less carbs. Look for 10% or less carbs
Here is a list for you to look at
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

We can help you with getting set up to look after a diabetic cat. Don’t worry ......it is a lot to learn in the beginning and it’s hard when they are sick with something else as well something like DKA but we will help you every step of the way.

ask as many questions as you like, we are happy to answer them.

 

Getting started is the biggest expense because you have to buy insulin. Depending on what type of insulin your vet prescribes will dictate how much that will cost you. The best insulins for cats are Glargine (also known as Lantus, Basaglar and Semglee) and ProZinc. Most of us buy our Glargine from a pharmacy in Canada since it's 1/3 to 1/2 the price. $190 will buy 5 pens of Lantus which is 1500 units and enough to last most cats at least 1 year and some up to 2 years. The problem though is that it will take 7-10 days to get it from them and with the recent DKA, you can't wait.

The new Semglee is cheaper than the other brand names of Glargine and you may be able to save some by using GoodRx at a local pharmacy so you'd have some to get started.

The other options are ProZinc and Vetsulin (these are veterinary only insulins). A lot of vets are still using Vetsulin because it's what they're used to but it's really a better insulin for dogs. In cats, it tends to hit hard and fast and then wear off before the next shot is due. Vets see more diabetic dogs than cats and tend to try to treat their feline patients like small dogs and it just doesn't usually work very well. ProZinc is specifically made for cats. It's $106 from Chewy.com but if your vet prescribes it, they should have some there to sell you.

Most of us use a human meter from your local pharmacy because it's accurate and affordable to use. A favorite here in the US is the Relion Prime from WalMart. The meter is only $9 and the strips are $17.88 for 100.
There are "pet" meters, but the strips for them are about $1.00 EACH which is too much for most of us when we test at least 4 times a day (more if they're running low or dropping fast)

You can get syringes for the human insulin's at WalMart for $12.58/100. If your vet prescribes ProZinc, you'll need to get U40 insulin syringes. This is where I suggest you order U40 syringes from (your vet will need to sell you some to get started)

I'd say if you average the costs out, you're talking at about $30-40 per month

 

Thank you so much for this information. Is there any assistance program out there (I can apply for) that may help with emergency room costs (I suspect it's ridiculously high)? I will update Tommy's status once he is out of the hospital.

 

Would you mind taking down the 911 sign please, now that we have given you some information. Otherwise everyone will flock to the 911 sign as we only use that for emergencies. Thanks!
Looking forward to seeing an update on how Tom is progressing,

 

Another food option is Friskies pates. You want to avoid any canned goods with gravy such as shreds and bits types. They are high in carbs. You also don't need prescription foods either. Most of them are not low in carbs and not as healthy as the vet would like you to think they are. Also if your cat eats dry food, you need to wean him off it also as soon as possible. Almost all dry food is high in carbs.

By learning to test at home you will save a lot of money by not having to take him to the vet just to be tested. Plus since stress can easily raise glucose levels, the vets tests are usually higher than your results will be.

You want to start at the lowest dose, no more than 1 unit twice a day. Too much insulin can cause hypoglycemia. It will look like a very tiny amount, but the majority of cats don't need more than 1 to 2 units per dose. It is always better to start at the lowest dose and if an increase is needed and determined by your testing, it is only increased by 1/4 to 1/2 unit. We can help you determine if an increase is needed.

 

GA??

 

I took down the GA - that's meant for cat's that have Gone Ahead or become Guardian Angels. And GA does cause our hearts to skip a beat.

 

Sorry, I thought GA meant general answer I am picking up tommy home today.

 

Great to hear that Tommy's coming home today!

Really cute pic of your little one.


Mogs
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Cosign all of this!!!!!

 

Glad he is coming home. Hopefully he will feel better quickly.

 

Tommy is home safe. I will take him back to the vet in three days as instructed. He got his prescribed insulin (Novolin).

 

Welcome home, Tommy!

Wishing you a solid and speedy full recovery.

(((Tommy)))


Mogs
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Some helpful resources for you:

FDMB Guide for Novolin N (I am assuming that you have been given Novolin N insulin. I would be grateful if you confirm this.)

Important safety note: Novolin N typically hits quite hard and fast early in the cycle so it's important to have some food on board ready for the insulin to work on. Assuming that the preshot BG is high enough to give insulin, the above guidelines recommend that you make sure your kitty eats a substantial feed, then you wait 60 minutes before giving the insulin. If you're not yet ready to start monitoring BG levels at home, it would be no harm to give Tommy additional small 'snack' feeds once an hour for 3-4 hours after giving the insulin dose.

Here are some very important safety links:

Recommendations for hypo toolkit supplies

How to treat hypos (print a copy of this out, familiarise yourself with it, and keep a copy with the toolkit)

As Bron mentioned above, it's vital to recovery that a post-DKA kitty gets enough to eat but they may be a little queasy while recovering. While Tommy is convalescing, keep a close eye on how much he's eating. If he's reluctant to eat, keep an eye on his behaviours and watch for any signs of nausea. Here's helpful info:

Nausea symptoms and treatments

If Tommy shows any sign of being nauseated and going off his food, I strongly recommend you get back to your vet immediately and ask for supportive meds to help Tommy eat OK.


Mogs
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Thank you so much for the resource.

Yes, the vet prescribed us Novolin N insulin and Hills glucosupport food. We fed Tommy first and then gave him the shot. He actually has a REALLY good appetite. The poor baby fell asleep now.

 

I am so glad your kitty is home.
We need to get you set up with a spreadsheet
I will ask @Bandit's Mom if she will help you.
Make sure you are feeding multiple small snacks during the day and night as well as the main meal before the insulin. It is really important that Tommy eats 1 1/2 times as much as he would normally do. This is to help prevent the ketones reforming.
Are you waiting an hour after the main meal before you give the Novolin N?

Can you tell us how much Novolin N you are giving please each time?

Are you home testing the blood glucose to see if it is safe to give the dose of insulin?
It is important that you don’t skip any doses of the insulin but you need to also make sure before you give the dose that the blood glucose (BG) is high enough so that it is safe to give the insulin.

also do you have any Ketostix to test the urine fir ketones. It is important that you check and test daily at the moment to see that the ketones are not coming back. You can buy the Ketostix from Walmart or a pharmacy.

 

Thank you so much for the support!!
Yes, I wait for an hour before giving the Novolin N. The doctor asked me to give him 1 mml.

I am not currently home testing blood glucose as the doctor told me NOTHING about it. He asked me to bring Tommy back in three days. However, based on this forum, I've ordered the meter online.

I will also get Ketostix tomorrow.

 

Well done!

 

More helpful links:

Home testing links and tips

Testing and injection tips


Mogs
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Do you mean 1 unit (1U)?

 

yes. i used the human meter it reads 412. is it dangerously high?

 

not in the short term. How long has it been since the last shot?

 

an hour

 

And is this your first test? Congratulations!!!!

To expand on the brief answer above: numbers like what you are seeing (416, ouch!) can do damage over months, but cats tolerate them better than humans do. We do want to get him into lower numbers, as it will help him recover, but it's not an immediate health crisis the way that low numbers (under 50 on a human meter) are.

OK, good to know. Even a fast-acting insulin like Novalin probably hasn't gotten revved up yet (but soon), so it's not too surprising that he's so high.

Do you think it might be possible to get another test in a couple hours, to see how the insulin is doing?

 

Yes, i will get another test in a couple of hours. thanks for the info.

I was a bit freak out to see such a high number.

 

Tommy has been puking for the past week. Is it because of insulin injection? He looks lost and tired. Is there anything I can do to help? I am very worried.

 

Have you been testing Tommy for ketones with the ketostix? Are you still testing his blood sugars? Do you have any recent data for either that you can share.

 

How is Tommy now?

 

GA??