DKA slow recovery--any advice?

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smokeymay

Member Since 2012
Hi,

My beloved precious cat had a bout of DKA. She was hospitalized a week ago. Right now the numbers look good on paper, apart from slight kidney failure. But she is still slow, not as responsive as she should be, not eating/drinking much. The vet is even worried, and if she's not better after the weekend they will run further tests to make sure they're not missing anything. He will call me tomorrow, so it's also my opportunity to ask him questions. I was wondering if anyone had experience with a cat that was slow to recover from DKA, with good numbers on paper. Is there a chance she'll recover? Is there anything else we should check for? I'm devastated for her. Before this I hadn't given her insulin for a few weeks because she was always a "mild" diabetic on a low dose, and at times would get low blood sugar... she still seemed low and then the DKA. I didn't realize about home testing.... I feel so terrible, like I am responsible. If she makes it, I will test her several times a day now, give her special kidney food, hydration injections for the kidneys..... I can't bear the thought of her not making it. She's like a daughter to me. If anyone has any advice or good wishes, please share.

Thanks so much,

A human who is owned by her cat.
 
I dont have this kind of experience but I know people here have. I'm sure you will hear from them. Good luck and God bless. Sending prayers for your kitty.
jeanne
 
She needs to eat to recover from DKA. My cat came home with a feeding tube because he wouldn't eat while hospitalized. I would ask about how to get enough calories in her, and make sure she's not dehydrated and maybe needs fluids.

I wish you the best of luck.
 
Thanks. They took the catheter out yesterday because she appeared to have been hydrated, etc. The vet was force feeding her baby food with a syringe. Today he put some on a plate and she ate it a bit. He is also injecting her with warm fluids for the kidney issues. Usually my cat has an appetite even when needing to stay at the vet's. She's a spunky girl. She's like a tiny lump right now. :( I should mention also that her weight is down to 5 or 6 lbs, down from her normal of 7 lbs.
 
No DKA issues, sorry- while mine threw out ketones they never went that far.

Now would be a time to try all her favorites- does she like chicken? Bring her a boiled chicken breast to tempt her- or tuna or hamburger meat. Anything really to get her to eat. You can even do baby food that is just plain chicken.
 
Thanks. Actually it is chicken flavored baby food. My cat loves what she is forbidden to eat... dry food. She won't touch it. It is good she ate the baby food without it being force fed to her though. She eats a tiny bit.... just not enough. I should also mention, her kidney levels are elevated. They haven't gotten worse, but have stayed slightly elevated throughout this ordeal. The vet says it's nothing to be alarmed about for now (we would do treatments for that after she gets past this crisis). But it does concern me, lack of appetite, that something major is going on. Her eyes tend to roll back in her head instead of her focusing (though a bit better today with that) and she also has diarrhea. I'm hoping that she's just exhausted and worn out.... but am sick with worry. Vet calls tomorrow and runs more tests Monday if she doesn't improve.
 
Mine was at the vet for almost a week with DKA and a UTI. He had an IV but I came one or twice a day and talked/held him and he would eat while I was there. Even now if he won't eat and I am at work my SO puts the phone next to him and I talk to him.

I also brought a t-shirt my SO slept in so It smelled like the bed at home where he normally slept.
My cat was only on dry food before the vet and he was feeding her 1/2 & 1/2. I switched to all wet with only a sprinkling of crushed dry (like 4 pieces) on top for the first few days. Then I found the frieze dried chicken- Kitty Crack! Spinkle that on anything and he will eat it.

My cat Terror had Kidney issues and I used to hand feed him with a spoon or a syringe. He like peanut butter powder (no sugar) mixed in food. Not sure how that would be for a diabetic cat though.

Fingers & Paws crossed for a speedy recovery!
 
Unfortunately I have quite a bit of experience with DKA .... my Payne has been in it 4x in two years BUT not
in the last year! She is a very complicated diabetic and it took awhile to figure it all out.

First you need to test before each shot, ALWAYS .... there will come a time when she will be low and you will give her insulin. We constantly spend time with people who are dealing with a hypo with their cat because they did not test before the shot. it can kill and it happens fast.

You will always need to test for ketones. Go to the search engine and type in testing for ketones and there is tons of info. If she continues to show ketones you may want to get a blood meter. The strips are expensive but not as much as a DKA. :mrgreen: Everyday for awhile you will want to get ketostix to test her urine and if you don't have a problem you can do it weekly. Ketones are your first signal that SOMETHING is wrong but when you add to ketones not enough insulin, infection, not eating, etc. and you are off to DKA.

But .... you have to have ketones to go into DKA .... so always knowing where she is with ketones helps you to not go there!! Also it makes you aware that something is off and you need to be a detective, find it and you can keep her healthy.

My Payne has had an infection lately, I know by her numbers BUT she has no ketones so I am being aggressive with her insulin using R to help keep her numbers down but I am not in a panic!!

There is so much more and most of it is written in posts, many deal with ketones .... take the time to read and always ask questions.
Nancy
 
Thanks. Right now she is not really eating or drinking even when I am there. I can't visit til Monday cause the vet is closed.... but will ask about bringing in a shirt that I wore. I will try to pick her up (she's mostly wanted to lie down and sleep so I was afraid to hold her, I just pet her and she did enjoy that). When I'm there sometimes she puts her head above the food or water bowl, but isn't consuming it. I will maybe try some turkey from the deli that she usually loves... will have to ask the vet first of course. I will ask him about your suggestions when the vet calls, thanks. Keeping my paws crossed for my precious baby who I'm determined will get better.
 
Thanks, just saw your reply, Nancy.

I do have a meter now and plan on testing her 4 x /day, before her shot and 4 hours after each one (she's on humulin). Knowing what I know now I would have been testing her (esp while not giving her insulin) and I feel so much pain for maybe being the cause... it could be the DKA that caused her kidney issue (I think?) and I feel horrible for that.

The ketones the hospital had said need not necessarily be daily.... I use a clumping litter so I'd have to try to catch it when she pees. She has not been producing any ketones for a few days now. I was thinking in the future to test for that once/week? But if more I would do it, whatever it takes, and certainly would test frequently when (praying) she comes home. I plan on asking the vet about that. I'm just hoping for her to pull through so then I can keep on top of things. I'm hoping that the lack of testing/insulin is what set it off and now I will just be super careful and monitor her closely and hopefully avoid future problems.

BTW what is R?

Oh my baby cat..... mommy sends you hugs and she will see you soon. Keep hanging in there!
 
We have a lot of work ..... if she is at a vet's someone s taking care of her and you should be able to visit. If no one is there, then move her! If she has not been showing ketones for 3 days, she is not in official DKA and something else is going on. Usually DKA does not harm kidneys but each cat is different.

Recovering from DKA is very, very hard! she will need time and lots of food and loving. You are using the wrong insulin, humulin is not good for cats. If this is all your vet will use, find a new vet. How much insulin are you giving? how often? Food, canned only! pates like Fancy Feast, Friskies, etc. there is a list. It is a good idea to mix water in with it, starting with a small amount, adding more as she gets used to. Payne is up to 1 can food with 2 cans water but she fights for food with two civvies and that helps.

How old is she? R is what you are using .... there are excellent insulins for cats, pzi the two L's because they last longer in the cat and are usually given twice a day, 12 hours apart. When a cat needs an extra ump we can add a little R which is a regular human insulin which does not last long in a cat. Right now because of the infection Payne gets 4u of pzi and 1u of R together, 3x a day. The R will take hold before the pzi so in theory she has an insulin working more. In fighting ketones or high numbers this can be helpful BUT don't attempt on your own.
Nancy
where are you, state?
 
I will have to ask my vet why humulin. I think he is willing to use others, but can't remember how or why we chose that one.

The vet lives where he practices, so he can monitor her as necessary. With my first cat, from childhood, he stayed up all night every hour with him when he was going downhill at age 18 and took excellent care of him. So I'm comfortable with him to dote on my precious baby girl. I will also consult the hospital where she stayed, which is really top notch, and see what insulin they recommend as well. I've been using humulin for awhile with her. Right now she is officially "regulated" b/c her blood sugar is 120 or so when at peak. The vet is even lowering the dose to ensure he doesn't give her hypo. She is on two units currently, and will drop to at least 1.5. This was the first day she was regulated. however her level does go up inbetween doses.... so PZI might be better, but will ask, I think vet wanted to give her what we usually gave her to rule out other factors.

He does have both wet and dry food in front of her right now just because he is trying to get her to eat at all. He is monitoring her very carefully, checking BG and kidney levels and etc constantly so if she spikes at all from food they would catch that quickly. Prior to this episode she ate exclusively wellness wet food, which is grain and gluten free. We'd tried avoderm in the past and it spiked her BS so we stuck with wellness which she seems to tolerate quite well. I'm not concerned as much with home care right now.... I'm concerned at why she is not recovering like she should. It has been about 3 days ketone free I think. So I would love to see her eat more, be more alert.... if we can get her there then I will monitor and dote on her every second of every day.

I'm near the NYC/NJ metro area.
 
Oh PS I should mention my cat has historically been *very* sensitive to insulin. She has been on as small as 1/2 unit and is rarely above 1 unit. Occasionally in the past her diabetes would seemingly go into a brief "remission" where she wouldn't need insulin. That would only be for half a day or a day. This time around the "remission" seemed to last longer... nervous that something may be up. Anyway maybe a shorter acting insulin is safer if she's so sensitive to it? Def something I will follow up on asking the vet and hospital.
 
I may have missed it but how old is she and her name is Smokey and you are May? makes it easier and what state are you in? Sometimes just the basics help. It sounds as if she wasn't getting enough insulin, especially being sensitive and throwing lower numbers. When you test her you will be able to see a pattern and adjust her insulin, this will help her to always have enough. The main cause of ketones is not enough insulin AND you can't have DKA without ketones .....

Don't lose hope. I had four vets tell me to let Payne go .... with each DKA because each time she almost died. But she has a will to live, so hang in! If you want to feel better look up Violet and Garfield in the search engine, it is a remarkable story.
 
Tx... Smokey is my cat. You may call me May if you wish. :)

Smokey is 13 years old. Is there any vet/hospital in my area you particularly recommend? I will look up that story, thanks. I am holding out hope for her. She is so strong. She lost two "mommies" before I adopted her. I'm her mommy for good, forever. Because of this we have a special bond and she worships the ground I walk on. She's always been there for me and now I will be there for her. Anyway my girl is spunky. If she's in a new environment, she adapts quickly, as long as I'm with her. I'm nervous b/c if something else is wrong I don't know what it is or how severe it is. I so want her to be okay and each new hour feels like an eternity. Monday at least I will have some idea. Thank you all for info and suggestions and keep them coming if you have any. I'm keeping hope for my angel baby and I'm trying hard to stay positive.
 
Oh yes and one thing forgot to add.... the vet said sometimes when he puts her on the exam table she jumps off (the table is high) and lands perfectly well and walks away.... which is what she does when she's well. He said if she were really sick she would crumble when she landed. So the fact she can jump from a height and walk away without a problem is a good sign. :)
 
Is May your name? and what state are you in?

She sounds spunky, that is a great thing! Learn everything you can, that is about all you can do and love her, she will do the rest. Payne is a 14 pound cat and during her DKAs she was down to 6 lbs. When they get better and start eating well, the weight will come back. Also there are pills to help them eat and not be nauseous.

You will do fine ......
 
Oreo has just recovered from DKA. She was hospitalized the week before Halloween. She came home and went back 2 days later for urinary tract infection (actually just cystitis since culture came back negative). While she was at home she was throwing large amounts of ketones and was losing weight. Initially when she came home she would only eat 1-2 tbs of food. We started letting her free feed on wet always having tempting food available for her and was giving her subq fluids as well. Finally this week she started acting more like herself and her ketone numbers finally dropped. So yes I did have a case where numbers were good on paper but her ketones were really high but didn't go back into DKA. Most important is food intake, hydration, keeping glucose as low as possible safely, and knowing where their ketone levels are by either urine or blood testing.
I know how stressful it can be.
Hugs
Cj
 
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