DKA Recovery

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Kate & Toby

Kate & Toby

Member Since 2019
Hi everyone,

My boy Toby has been in the ER all weekend with DKA, his ketone levels are coming down nicely but he still wont eat. The vet is letting me bring him home overnight to see if I can get him to eat, they wont consider assisted feeding until another 2 days, I have looked at his hospital sheets and apart from fluids, electrolytes, insulin and a glucose drip he hasn't had anything else that would make him not want to eat. My BG monitor is out with the courier for delivery so I may not have it tonight, which worries me as I know he needs the insulin but if he won't eat then I am terrified to give it to him. I am going to try syringe feeding him, and have ordered some Liquivite.

My questions are:

How can I help him to feel better/hungry?
Do I still shoot if he hasn't eaten?
What else should I be doing or be aware of with a DKA recovery?

Thank you all so much in advance.

Kate x
 
Kate,
Can you borrow a blood glucose Meter from the vet overnight?

Ask the vet for some A/D canned food for Toby. It is good for sick cats. You can syringe feed it too.

Try offering him some food first before syringe feeding. Any food at this point is ok. Even dry food. Whatever he will eat as long as it’s cat friendly.

The really important things you can do for Toby are
  • Make sure he eats. Food is like a medicine in the recovery of DKA cats. Try sprinkling Parmesan cheese over the food.
  • DKA cats need insulin. Once you get him home and hopefully you have a meter from the vet, post and ask for advice re how much insulin to give.
  • If you can’t get a meter from the vet consider buying a human meter from Walmart. The ReliOn meter is good and not expensive
  • Give some fluids if he won’t drink on his own.
  • Make sure the vet has given him antinausea meds to cover til the morning.
  • Do you have any Ketostix to test for ketones in the urine?. I know you are looking at the blood glucose meter but you may need the test strips until it arrives.
I am heading to bed (I’m in Australia) but will tag @Rachel and @Djamila @MrWorfMen's Mom as they use Prozinc
 
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Thanks Bron, you are an angel. I will ask to borrow it overnight yes. I have got some keto sticks from the pharmacy until my meter arrives for the ketones.
I have got some Hills AD from the pet store and a big ish syringe at the ready, I am hopeful it wont come to syringe feeding but I will do whatever it takes to get some food in that little tummy.

Sleep well x
 
Hi guys,

I'm just waiting for my husband to get home to do the spreadsheet but this is where we are at the moment.
1iu of Prozinc given at midday
BG mmol/l tested on Alpha Trak 2
9am 25.1
11am 27.7
1pm 22.8
3pm 20.2
5pm 14.0
6pm 13.8
7pm 12.4

I've got him at home, hes had a lovely big drink, a wee but will not even look at fresh chicken or his sheeba pouch.

I'll retest at 7pm and then go with the hills AD by syringe. Update, tested at 7, we've dropped again.
 
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So it was the vet who gave the 1u at midday, I take it - did they say when to dose again? Prozinc is normally given at 12-hourly intervals so you may be looking at a late-ish night! Those timings may not usually work for you so it may be better to slowly adjust the dosing times until you get a routine that suits you, eg 7am and 7pm or whatever.

Then thirst and consequent weeing are not unusual all the while bg is high so don't worry about that for now, hopefully both will lessen as bg gets more under control.

It will certainly help to have a spreadsheet set up (shout if you need any help) but meanwhile do you know the way to log data in a way that everyone can instantly see whatever time zone they're in? It would be

Morning pre shot (AMPS) bg of ?? 1u given, and then
+ 2 - bg of ??
+3
+ 4
and at whatever intervals you choose to take readings up to
Evening pre shot (PMPS) bg of ?? x u given

Etc etc so everyone can see at a glance at what point the insulin starts to take effect, what the lowest point is and how long the insulin lasts. Not sure if you know all this already, if so apologies! From the data you've given above it looks as if Toby has dropped steadily throughout the cycle but this may not be a typical cycle for him, bearing in mind what he's gone through and the change from bis normal eating pattern.

As far as eating goes, you may have to tempt him with strong smelling foods such as tuna and Parmesan cheese to give his appetite a nudge.

If you're planning to dose again at midnight, make sure you test bg before you give the 1u to make sure he's on a shootable number (not less than 11). But don't be surprised at whatever you get, basically - today isn't typical so you will very likely be making adjustments as you go along.

Sorry again if any of this is superfluous or repetitive! I'm sure you'll get the hang of all this very quickly. Best of luck!
 
Kate & Toby said:
BG mmol/l tested on Alpha Trak 2
9am 25.1
11am 27.7
1pm 22.8
3pm 20.2
5pm 14.0
6pm 13.8
7pm 12.4
Click to expand...
Hi Kate, those numbers are fine, but if he continues to drop he may be too low for insulin at the scheduled time. And ideally, since he's recovering from DKA, it's good to have 'some' insulin in the system if at all possible. It might be necessary to give at least a token dose as long as the blood glucose is rising.
I do not have any personal experience of DKA. But I will try to tag some people who might be able to help in this situation, who either have DKA or Prozinc experience.
@Marje and Gracie, @MrWorfMen's Mom, @Squeaky and KT (GA)
 
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Diana&Tom said:
So it was the vet who gave the 1u at midday, I take it - did they say when to dose again? Prozinc is normally given at 12-hourly intervals so you may be looking at a late-ish night! Those timings may not usually work for you so it may be better to slowly adjust the dosing times until you get a routine that suits you, eg 7am and 7pm or whatever.

Then thirst and consequent weeing are not unusual all the while bg is high so don't worry about that for now, hopefully both will lessen as bg gets more under control.

It will certainly help to have a spreadsheet set up (shout if you need any help) but meanwhile do you know the way to log data in a way that everyone can instantly see whatever time zone they're in? It would be

Morning pre shot (AMPS) bg of ?? 1u given, and then
+ 2 - bg of ??
+3
+ 4
and at whatever intervals you choose to take readings up to
Evening pre shot (PMPS) bg of ?? x u given

Etc etc so everyone can see at a glance at what point the insulin starts to take effect, what the lowest point is and how long the insulin lasts. Not sure if you know all this already, if so apologies! From the data you've given above it looks as if Toby has dropped steadily throughout the cycle but this may not be a typical cycle for him, bearing in mind what he's gone through and the change from bis normal eating pattern.

As far as eating goes, you may have to tempt him with strong smelling foods such as tuna and Parmesan cheese to give his appetite a nudge.

If you're planning to dose again at midnight, make sure you test bg before you give the 1u to make sure he's on a shootable number (not less than 11). But don't be surprised at whatever you get, basically - today isn't typical so you will very likely be making adjustments as you go along.

Sorry again if any of this is superfluous or repetitive! I'm sure you'll get the hang of all this very quickly. Best of luck!
Click to expand...
Thank you so much for your reply, yes the vet gave him at midday, he is usually 7am/7pm.
Absolutely needed the education so thank you, I'll make some notes and start quoting properly. I know he needs some insulin on board to help rid his body of ketones which is why I'm desperately trying to get him to eat and then see a rise soni can shoot. He almost gagged when I put the food up to his nose. He had anti sickness at 9am and if was a 24hr dose. When my husband gets home I will get him to help me syringe feed, hopefully once he starts he will get the idea.
 
Hope the syringe feeding goes ok - it should be easier with two of you. I'm sure you'll be as gentle as possible! It sounds as if you have a very strong bond with Toby so hopefully he trusts you do be doing the right thing for him during this episode, however unfamiliar it is.

If he does continue to drop, and you're worried about shooting tonight, do post and ask here - you would probably get more replies if you start a new thread with a succinct heading suggesting an urgency! The US folk and maybe Bron in Oz will be around then even if there aren't any UKers.
 
Kate I am so sorry to hear of your handsome Toby's situation. You've got great advice so far and as Elizabeth said, Toby's BG is fine at this time. I think your biggest challenge is getting Toby to eat.

It sounds like Toby is nauseated despite what I assume was a shot of Cerenia this AM at the vet's. There is another anti nausea medication ondansetron that works a bit differently for nausea and it might be an idea to see if your vet will prescribe that for Toby as an alternative. It doesn't sound like the Cerenia has really helped.

There are also medications to stimulate appetite and that is something else you should ask your vet about. Mirtazapine is one and cyproheptadine is the other.

In the meantime, try to get as much food/water into Toby as you can. If he continues to refuse to eat or syringe feeding is difficult for him, the vet could install a feeding tube. That can make getting enough food into Toby much easier on both of you.

You have a little bit of leeway for your shot time tonight and if BG is high enough and Toby is taking a reasonable amount of food and keeping it down, then you could give his shot an hour early at 11pm tonight. I suggest you don't feed him between 8 and 10pm. Test BG at 10pm and post the reading.
Let us know how the syringe feeding goes.
 
BG was 19.8, one hour after food.

Just got two more big syringes of Hills AD recovery into him, he wont take it on his own.

Thoughts about shooting? Hes due his prozinc at midnight, usually 2iu, but Vet only have 1iu today. I really want to give him some insulin as I know this helps with ketone omissions. I'll test again at 10.15pm.
Thanks guys x
 
Kate I'm in Canada so when referring to times we don't use clock time.... we use hours post shot ie 1 hour after =+1, 2 hours = +2. So where are we now in terms of hours past the midday shot the vet gave? ;)
 
Wonderful!

Now the only problem is that your numbers are not being converted onto the US sheet. I'm betting that you started inputting your numbers on the US sheet and then deleted them. If that is the case, may I suggest you copy your numbers from the World sheet row and paste them in a row or two below where they are now on the World sheet. Let's see if that fixes this. If it does, you can delete the first row on you world sheet. I'm fine with your mmol but the US folks aren't so we convert our reading so the US folks can help without having to do the math. :)
 
MrWorfMen's Mom said:
Wonderful!

Now the only problem is that your numbers are not being converted onto the US sheet. I'm betting that you started inputting your numbers on the US sheet and then deleted them. If that is the case, may I suggest you copy your numbers from the World sheet row and paste them in a row or two below where they are now on the World sheet. Let's see if that fixes this. If it does, you can delete the first row on you world sheet. I'm fine with your mmol but the US folks aren't so we convert our reading so the US folks can help without having to do the math. :)
Click to expand...
Yes I did! On it!

Done!
 
Following sweet Kate & Toby. Toby is so lucky to have you.!! Come on Toby, eat for Mommy, you're doing great Kate and you got this :bighug::bighug:
 
Thank you Cindy,

PMPS just now is 26.1.... shoot or no shoot? Usual 2iu or less? Hes eaten well but not his usual amount.
 
OK, then follow your vets instructions. As long as you're testing now :) You should be able to keep Toby safe. Do you have anything in case of a low?
 
Hi Kate and Toby, morning here for me and just catching up on your post.
I'm sorry he couldn't eat on his own, but that is very common at this point with DKA cats recovering....
Sounds like you were very successful with the syringe feeding...great.
From what you say, it sounds as if he wanted to eat but couldn't......is that correct?
Have you checked his mouth to see all is OK there?
If it's nausea stopping him eating, I agree with @MrWorfMen's Mom, I would ask for some ondansetron as well and an appetite stimulant.
My internet is very unreliable at the moment but I will try and look in later, especially when the US go to bed.
 
Bron and Sheba (GA) said:
Hi Kate and Toby, morning here for me and just catching up on your post.
I'm sorry he couldn't eat on his own, but that is very common at this point with DKA cats recovering....
Sounds like you were very successful with the syringe feeding...great.
From what you say, it sounds as if he wanted to eat but couldn't......is that correct?
Have you checked his mouth to see all is OK there?
If it's nausea stopping him eating, I agree with @MrWorfMen's Mom, I would ask for some ondansetron as well and an appetite stimulant.
My internet is very unreliable at the moment but I will try and look in later, especially when the US go to bed.
Click to expand...
@Bron and Sheba (GA) I believe Kate is the UK. I think it's +5 hours ahead of our US eastern time, so right now it's 9PM here eastern US, so, 2AM her time. Maybe napping in between testing:)
 
Hi guys, testing going well, hes much brighter in himself, showing interest in food but then walks away, he did just chase and eat a moth though whilst I was getting ready to test, does that count as food ha!
I've wanted to get his teeth checked yes, but didn't want to put him through the trauma of a dental right now.
Its 430am, hes due at vet at 830, I'll mention the anti sickness you have quoted, thank you.
BG dropping nicely, 12.2 last test, can't update spreadsheet on phone, will do laptop when its proper morning.
Husband will be up at 6, we will syringe feed together again then (it's a 2 man job).

Thank you for being there.
 
dental may not be as bad as you fear -- Catcat soared through his, even with four teeth extracted he was eating as usual, acting just a little bit sleepier, the antibiotic kept everything healing well, and the pain pills didn't seem to taste when added to his food -- didn't affect his BG much as far as I could tell but it cleared up some inflammation in his mouth that I thought were just age spots
 
Thank you all.
I managed to get another 2 large syringes of the recovery food into him at 6am, he's had plenty to drink overnight and was wondering in the garden this morning at first light.
I have dropped him back at the vets now for further IV fluids and monitoring but they are hopeful he can come back home early afternoon, they were delighted with what I had managed to do with him overnight and the testing I had done.

The results of his Thyroid Tests came back normal, this was a worry as it was suspected something else was going on in the background as to why he was being difficult to regulate. I had a high BG reading at 6am before his food which was +6 so not sure what that is about.

I have asked them to check his teeth aswell, and also get a blood ketone test for me.

That's it for now!
 
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