DKA recovery, still high numbers

Status
Not open for further replies.
Mer and Max

Mer and Max

Member Since 2018
Hello! This is my first time posting in here, but this forum has been such a wealth of knowledge I though I would put our case out here just to see if anyone has any similar experiences to give us any nugget of help.

A little background; Max is a 9-yr-old Maine Coon and was diagnosed back in March. We figured out home testing and have been ok about tracking it, and we've had some good numbers here or there, but he's bounced around a lot, and admittedly been skewing higher this winter. He's been on 2 units of Prozinc since the summer and it's seemed to be ok... On Christmas day we realized that he had urinated blood outside the litterbox and then he just started peeing all over the house, which of course signaled to us something was wrong. We tested him and his BG was in the high 400s, and brought him into our vet the next day. He was diagnosed with an UTI and he was going into DKA so my vet treated him for 2 days and then we transferred him to the ER for 24 hours. The ER vet was worried about his kidneys, but they showed signs of improvement during his ER stay, so they sent us home with fluids for home-treatment.

The immediate days after coming home he was super sad, I'm guessing from the stress of it all, but he actually has shown improvement. He has started getting his personality back and wants to cuddle and purr (I know that's not scientific but when he's super sick he wouldn't do any of that), and puts up a fight when I give him fluids, lol. He's still not eating a ton, but every day he seems to be eating a little bit more.

The problem is, his BG has been super high ever since coming home. Either we just get "hi" readings (meaning over 600) or in the 500s, and we took him to the vet yesterday for a follow up and he came up as 668 (ugh!). His kidney levels were also worse, and our vet was at a loss, bc she said he should be totally wiped out with the way his levels were at, not seemingly getting better. She did give us more fluids, pain killer, and appetite simulate to see if that helps in the next few days, and we're upping his insulin from 3 to 4 units now and checking 3 times/day. Two checks in and still getting "hi" :-/ ...

I know DKA recover is slow, but we're so confused, and I just am worried about the outcome of it all!
 
Welcome to FDMB Mer and Max. I am so sorry that you and Max have been going through all of this. Just to get you started here so that the experienced members can offer suggestions or advice, please set up the signature and spreadsheet. The signature is Max's pertinent info that will display with each of your posts, it saves members from having to ask the same questions or having to try to scroll back through previous posts to gather that info each time. Here is a link on how to do that: SIGNATURE Please let us know at least a general geographic location, sometimes it is important to know what time zone you are in.
Second, the spreadsheet. This is the way we record and view the insulin time/dose and BG testing data you are getting. Please set it up: INSTRUCTIONS and fill in as much data as you can. Since it's now 2019 and just about all of your testing data occurred in 2018, so I am going to tag a couple of people that will assist you in setting up the spreadsheet with a second sheet for the previous year, so at least some of the past year's BG and insulin data can be reviewed. @Marje and Gracie @Chris & China
Adding a link so that you can read about how to understand the spreadsheet: GRID
You might visit the Prozinc insulin support forum to better understand the protocols we use here, and what the insulin advice is based on: PROZINC
Mer, you are in the right place for support and information while you work to help Max recover and feel better. Hugs to you :bighug:, soft head scritches to Max :cat:. Wishing him a smooth recovery and better health going forward.
 
It's great that you're testing his BG at home. :) DKA is awful! My cat has had it twice. It takes a kitty many weeks to feel normal afterward. A few thoughts:
  • if he isn't eating much the insulin dose he's getting *might" be too high causing him to drop too low then rebound to high numbers and stay there
  • enough insulin is key post DKA, though, and you might have to feed wet food that's a little higher in carbs to support the insulin dose
  • he needs more calories than normal right now so you might have to do some syringe feeding to supplement
  • nausea can continue to be a problem post DKA so anti nausea meds (eg. Cerenia or ondansetron) should be available and given before trying an appetite stimulant
  • subQ fluids are a good idea because proper hydration is very important to wash out any ketones
  • I recommend testing his urine for ketones at home (using human ketone test strips from a pharmacy) at least once a day for now because they can rebuild quickly.
Here's some ways to get urine for a ketone test:
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
 
Thanks @Idjit's mom, I'll try to figure out the spreadsheet. Added the signature.

@Kris & Teasel we have been trying to get him to eat as much as possible, he's a former kibble addict, so we have Dr Elsey's dry food that we've been giving him alongside the wet food we usually give him, so maybe that will help support the insulin? He seems to get the most excited about that, more so than the wet food. We were syringe feeding him when he first came home because he still wasn't eating a ton, but maybe I will still do that a little bit more just in case...

I think our vet gave us Cerenia, but I'll have to check when I get home from work. I'll look into getting the ketone strips, that's a good idea.
 
Mer and Max said:
Thanks @Idjit's mom, I'll try to figure out the spreadsheet. Added the signature.

@Kris & Teasel we have been trying to get him to eat as much as possible, he's a former kibble addict, so we have Dr Elsey's dry food that we've been giving him alongside the wet food we usually give him, so maybe that will help support the insulin? He seems to get the most excited about that, more so than the wet food. We were syringe feeding him when he first came home because he still wasn't eating a ton, but maybe I will still do that a little bit more just in case...

I think our vet gave us Cerenia, but I'll have to check when I get home from work. I'll look into getting the ketone strips, that's a good idea.
Click to expand...
I think Dr. Elsey's dry is 4 - 5% carbs as fed. He might need something closer to 10 - 15% carbs for now. Total calories is very important.
 
My kitty was a DKA survivor. He got DKA when he was 12 and lived to be 20. He was hospitalized for a long time (8 days). I second what Kris said about getting those ketone test strips (on your way home from work?) and checking at least a couple of times a day, for awhile. It is important that he get enough food into him. The recipe for DKA is not enough insulin + not enough calories + an infection or other stress. My kitty came home with a feeding tube, which helped to get in the calories needed. It is suggested to try to get in 1.5 times the calories he normally eats.
 
If you need help with the SS or would like me to do it for you, please send me a private message so I can get some info.

To send me a PM, pls click on “Marje and Gracie” at the left and then “start a conversation”.

Welcome to FDMB!
 
Status
Not open for further replies.
Back
Top