DKA without classic symptoms?

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Terruscats

Terruscats

Member Since 2016
Hi, I am relatively new to this site. I mainly read all the useful info on the threads & in main forum. Today I took my diabetic cat to the vet, his name is Eddie, I am Terry, his Mom. He's had diabetes for almost a year now & has been on Vetsulin. I do not consider him well controlled due to the sometimes huge spikes at the end of the nadir. I have been seriously considering switching to PZI from BCP. This past week, maybe a little longer, I began to notice a change in his gait, instead of walking on tip toe, walking with hind feet more flat footed & the right leg with a bit of a drag but not consistently, other times he'd be walking fine, but kept a close watch & checked his ketones which come up negative every time. I check him once a week. Well the gait became more persistent & then he started having to make more rest stops when moving from room to room. I took him to his vet right away then & discussed neuropathy as well as potassium deficiency. The vet was convinced it was neuropathy & poorly controlled diabetes causing both the gait changes & weakness. No blood work done that day but I took him back a day later after deciding he needed blood work as well as UA because he then became disinterested in eating & this morning didn't want to eat at all. He's alert & social but something is definitely off. I have other cats & we seem to be cycling thru some sort of a virus with vomiting & anorexia. Eddie did vomit up the little bit of food I had finally got him to eat. He went to litter box & had a mostly normal BM, light tan, formed, but soft serve at the end. He then peed & it was a very small pee ball. Called the vet. They said bring him in for observation. His new blood work & UA were there but they wouldn't tell me much because a vet hadn't looked it over yet. His vet is off today,unfortunately, so he's be tended to by one of the other vets. They told me he would be worked into the schedule but didn't know when a vet would actually attend to him. I am wondering if a cat can have DKA without all the classic sympyoms. He's had a decrease in drinking & peeing, he has weakness & at times strikes me as depressed. He's never tested positive for ketones at home & I have the impression there were none in the UA but they said his glucose was 500. He was past his 12 hour cycle at vet at time of this test, so that accounts for a little of that stunning number. He normally runs in low to mid 300s or high 200s at the end of his curve. He receives 2.5 to 3.5 units of Vetsulin twice a day. I am trying to get spread sheet put together to post but so far it won't load on my tablet & my lap top is in need of look over by the geek squad. Eddie is on Fancy Feast classics only. I do give him a few treats in the evenings. Temptations. I worry that he's being observed for a blockage when the real issue is DKA. Is it possible to have DKA without ketones being present?
 
Hi Terry, sorry Eddie isn't feeling well. The change in gait does sound like neuropathy. Zobaline, a methyl B12 supplement for diabetic cats, can help with that. It's good to get the potassium levels checked too though, just in case. As far as DKA, ketones will show up in blood before they do in urine, so if your vet only checked Eddies urine, it's possible he has ketones. An infection can raise the chances of developing ketones, so it's definitely worth monitoring since there's an illness going through your crew. If you need someone to set up your spreadsheet, just ask.
 
Thanks for info, I will definitely look into getting Eddie on Zobaline. To test for ketones in his blood, is this a specific & separate test? The doc has never mentioned this as something to test for. They want me to pick him up at 5:30 today as they close at six. I am pretty sure we will be at ER before the night is over. There is something wrong that just hasn't shown itself yet. Thanks again for info.
 
Thanks. I had no idea! So it should be a test they, the vet can run in house. Going to check into costs of meter for home use. Be worth the cost for Eddie's health & my peace of mind!
 
The glucose was 500 in his urine. They say he's been in the 400s at the vet all day so far. He was 295 this morning and because he ate so little we only have him 1.5 units. Then he threw up & peed small amt so took him in. I don't know if they've given him any more insulin today at the clinic. They are going to give him antinausea med and send him home.I am pretty sure we will be at ER tonight or tomorrow.
 
I am trying to get SS going. When my husband gets home I will have him get it loaded on his tablet, mine is not able to accommodate it.
 
Sharon14 said:
You can get a blood ketone meter. You use it just like the glucometer. The strips are expensive though. @Bobbie And Bubba can tell you more
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Hi there. I use the Abbott Precision Xtra. It's around 35 bucks but, the strips are pricy. The cheapest place I found was Universal Online Pharmacy in Canada. It is so worth it to me to have an immediate result with the ketone meters because the ketones do not show up in the urine for up to a 1/2 day after they are present. If you get a ketone meter, please request information as to how to read the results for a cat as they are human meters and the instructions are human specific.
 
Terruscats said:
The glucose was 500 in his urine. They say he's been in the 400s at the vet all day so far.
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The urine dipstick measurements are Negitive, 100, 250, 500,100 and >2000. It appears the 400's is the blod glucose levels. The blood glucose and urine glucose measurements are not directly comparable.
 
Hey Terry, I just went back and read your original post as when I had responded, it was to Sharon's tag and I did not read everything. I want to address a couple of things. When at the vets the kitties Blood Glucose (BG) can be 100- 150 points higher due to vet stress.

And as far as your insulin, Vetsulin, you mentioned that :
Terruscats said:
I do not consider him well controlled due to the sometimes huge spikes at the end of the nadir
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Vetsulin can give fast hard drops and not have enough duration. As you can see by that forum, it is very inactive as very few cats are on it anymore. It is more affordable than some of the other insulin but not an ideal choice in my opinion.

If you can switch to ProZinc or Lantus or Levemir, I think you will get a better result.

About the tan colored poo....is that still happening? Sometimes it can be tan colored if food goes through their digestive tract to fast. You mentioned something was going through your kitties and maybe that can account for the tan color. Is there a horrid smell present as well? Hopefully is a virus that is running through your kitties.If it persist, some testing needs to be preformed by your vet.

If you need help with the SS just post again and our Geru SS person, @Marje and Gracie can help you with that.

Sharon gave you some good info for neuropathy with the Zobaline, a methyl B12 supplement. Many say that within two weeks to a month of being on it their kitties were new cats!

Keep us posted and let us know how we can help you.
 
If I can do a spreadsheet for you, please send me a private message by clicking on "Marje and Gracie" under Gracie's photo at your left and then click on "start a conversation". I'd be happy to help!
 
Eddie is home. Sorry I wasn't able to post until now but when I got him home he ate very well. Not as much as is his usual but enough to get his insulin going. His labs, except glucose of 501, were all surprisingly good, even kidney panel & UA. At time of blood draw he was past due for supper & p.m. insulin but still higher than his norm. This morning, he didn't want to eat again. I did get a handful of dry food in him so he could get his insulin. He was 226 this morning and last night at 11 p.m. he was 126. He is currently sleeping under my desk,which is a place he goes when he's either upset or scared. He's alert but still not being Eddie. Very subdued. The doc does not think ketoacidosis or pancreatitis is his issue. Her thinking is perhaps whatever bug is passing thru our household. I think there is something more going on internally that doesn't show up in blood work. I am thinking maybe an ultrasound is our next step. He's obviously not well. I have attached his labs. I hope this is acceptable here. If not, I apologize in advance & request the administrator to delete the post. Thanks to all for your input. I will be incorporating the Zobaline into his routine & going to obtain the glucose plus ketone monitor if I can get proper education on interpreting it for a cat. But, will need to see if he's well or not via ultrasound. Time to go to the Internist, I think.

When Eddie had the tan poo yesterday, it was not obnoxiously smelly & the other cats had been pooping regular type poo except one cat had diarrhea, one bout, during bout with bug. All the cats were vetted as they picked up the bug. I have 2 more who haven't become ill yet & praying they escape it.
 

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Right, but he still isn't well. He's not eating much and now hiding in cupboard but that could be because he's worried I might try to cage him and take him to the vet again. I am going to give him another day or two to settle in & hopefully trust me again, & start eating better, if that doesn't happen, I am thinking ultrasound of abdomen to make sure there's nothing brewing. I can't think of anything else to do.
 
I have noticed this morning that after Eddie pees he hides. He's peed twice & both times, afterwards, he's hid in cupboard in the kitchen. I watched him pee just now and he isn't straining, pee ball is decent size & does not appear to be in pain but with a cat appearances are deceptive. I've also noticed he doesn't use his normal box with the higher sides instead uses box that's supposed to be exclusively for our old CRF kitty. Unfortunately, on Wednesday's our vet closes at 11 o'clock. I don't know if he could have an infection in spite of blood work or if the neuropathy causes discomfort when he squats to pee? Any thoughts?
 
Hi Terry, I am going to post the ketone meter information now as I am leaving town tomorrow for 3 1/2 days and I don't know how much I will be on the boards while gone. Hope Eddie starts eating better for you. Have you tried baby food? Beechnut chicken with chicken broth or turkey with turkey broth. Often kitties when off their feed they will eat baby food. It isn't a complete nutrition source for cats but a few days to a week on it will not be a problem according to my vet.

Just saw your post come in about the peeing and hiding. It could be the neuropathy causing discomfort especially since you said he is using the lower sided box. When cats feel injured or are in pain, they hide. I would think an infection would have shown in the BW if one was present. @Marje and Gracie is great at interpreting BW.

For interpreting ketone blood meters for cats:

The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter.

So any number under 2.4 is nothing to worry about.


Here are two studies if you are interesting in reading.


Measurement of ketones - Weingart_J VET Diagn Invest-2012(1).pdf
Measuring ketones - JSAP_Zeugswetter - 2012.pdf

As far as treats go, you might want to look into getting Bonita Flakes ( can get online or an Asian food store) or freeze dried chicken treats, two companies that make them are Pure Bites and Stella and Chewy. The above are all protein and no carbs. The Temptation treats are high is carbs.
 
Thank you so much for info,I am online shopping for meter now. Just ordered the Zobaline & going to pet store this afternoon for the treats. I remember seeing the Stella & Chewy treats you mentioned. We give him four little squares of Temptations after his test & shots. It was the love of his life before diabetes. He begs all day for more but we try to distract him with play but I do weaken sometimes & give him more, but the last three or four days, he's not begging or playing. He won't take the baby food & has never cared for human food. He loves Weruva fish cat food, but have always tried to stay away from any fish for the cats, tho fish is in every flavor of Fancy Feast. I am wondering if I should get him Weruva fish until he's eating bettter. I guess I will replace the litter boxes with lower sides too. Thanks again for the advice & info. I'd be traveling blind without this site!
 
Terruscats said:
I am trying to get SS going. When my husband gets home I will have him get it loaded on his tablet, mine is not able to accommodate it.
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Some tablets can not hold the spreadsheet. If the initial set up is done on desktop usually you can use a tablet after that. It is also a Google sheet not excel.
 
I agree with Bobbie to ditch the Temptations, but if you can't get him to eat, try crushing one up and sprinkling it on top of his food. The smell of it may entice him to eat.
 
Have you tried Tiki cat food? It has quite a bit of juice in the food and might entice him. Are you home testing? Human meter is inexpensive, a lot of people use the Wal-Mart brand confirm or micro. Testing with urine sticks is not accurate.
 
I have been sprinkling Forti Flora on his food, which has animal digest in it which is what Temptations are coated with, but a crushed Tempation may be provide the texture he's used to. Going to give it a shot.

Right now, my "tablet" is a Kindle Fire. I have better security on my laptop but that is going to the Geek squad this weekend because it runs hot all the time now so once it's repaired I am going to get a SS posted.
 
Not sure if you saw the post above where Marje offered to set up the SS for you if you need her to.
 
Surprisingly, none of my cats will touch Tiki cat food! Thought I had found a treasure for them, but they all walked away! Even my human food addict!
 
His labs look good to me other than the glucose.

I wonder if you should get a GI panel? It will test him for his folate, cobalamin, TLI, and spec fPL. The first two relate to vitamin B12, the TLI is an indicator of exocrine pancreatic insufficiency, and the last is pancreatitis.

If a kitty has soft, tan, sometimes smelly poo, that might be a little large or fatty looking, I suspect EPI. If this has just come on him, I'd wait and see if it is chronic or acute.
 
Hubby does not want me using his tablet. He uses it for work which is why he's paying to get my laptop fixed. When it's fixed, I'd appreciate any help with getting it set up.
 
Terruscats said:
I have been sprinkling Forti Flora on his food, which has animal digest in it which is what Temptations are coated with, but a crushed Tempation may be provide the texture he's used to. Going to give it a shot.

Right now, my "tablet" is a Kindle Fire. I have better security on my laptop but that is going to the Geek squad this weekend because it runs hot all the time now so once it's repaired I am going to get a SS posted.
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It won't work on kindle fire as that is what I use. There is no app for it. You can only view the ss. Entering data will have to be done by phone or desktop.
 
Marje and Gracie said:
His labs look good to me other than the glucose.

I wonder if you should get a GI panel? It will test him for his folate, cobalamin, TLI, and spec fPL. The first two relate to vitamin B12, the TLI is an indicator of exocrine pancreatic insufficiency, and the last is pancreatitis.

If a kitty has soft, tan, sometimes smelly poo, that might be a little large or fatty looking, I suspect EPI. If this has just come on him, I'd wait and see if it is chronic or acute.
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I just seen post on GI panel. This is something I am going to get done for sure. His regular vet is retiring as of this Saturday. He didn't give me much notice, so now have to search for a vet who is going to be willing to work with us. I am beginning to think his issue is pain from neuropathy but will not overlook a GI panel.
 
Woodsywife said:
@Terruscats. How is Eddie doing?
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Thanks for asking. I took him to vet yesterday and had GI panel done, as suggested here, they send it out so it will be a couple of days before results are known. I am expecting PZI this morning from BCP and Xobaline will be here beginning of next week. The vet continues to believe everything is connected to neuropathy & diabetes being poorly regulated. I believe there's something more going on and if GI panel is negative I will take him for an ultrasound. He is just not acting like himself, not real interested in food, which is his number one love (I am second), not into everything, not vocal, which has always been how he rolls. He's alert though and social with other cats. I just miss his antics and vocalizations.

The vet wants us to try the PZI in hopes we will gain a straighter curve. I am trepidatious because anything new is always a little unsettling but we will start it this weekend, maybe. For now, as long as he eats enough to get his shot, I am happy. Thanks for asking about Ed.

And, has anyone heard of allergic reactions to bovine PZI in cats? I lean toward paranoia when it comes to my guys and new things!
 
Terruscats said:
Thanks for asking. I took him to vet yesterday and had GI panel done, as suggested here, they send it out so it will be a couple of days before results are known. I am expecting PZI this morning from BCP and Xobaline will be here beginning of next week. The vet continues to believe everything is connected to neuropathy & diabetes being poorly regulated. I believe there's something more going on and if GI panel is negative I will take him for an ultrasound. He is just not acting like himself, not real interested in food, which is his number one love (I am second), not into everything, not vocal, which has always been how he rolls. He's alert though and social with other cats. I just miss his antics and vocalizations.

The vet wants us to try the PZI in hopes we will gain a straighter curve. I am trepidatious because anything new is always a little unsettling but we will start it this weekend, maybe. For now, as long as he eats enough to get his shot, I am happy. Thanks for asking about Ed.

And, has anyone heard of allergic reactions to bovine PZI in cats? I lean toward paranoia when it comes to my guys and new things!
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Did you find you achieved a straighter curve with PZI? The Vetsulin seems to keep him in check for 5 to 6 hours then the big spike up for the next 4 to 6 hours before next shot. He's been in double digits today at 6 hour mark at 81. Something that rarely happens.
 
The Zobaline &PZI both arrived today; Zobaline was not expected until August 3rd, so pretty impressive as I ordered it less than 48 hours ago. My question is, if anyone knows, if there are possible allergic reactions to Zobaline? Going to Google it too. And the PZI, I am not sure how you would know if your cat is allergic to protamine zinc without shooting blind? I am wondering if I should wait for results of GI panel as it's recommended not to use protamine zinc if there are other known diseases. Also, wondering if I should take him to vet for first shot & have him observed for a couple of hours. I'd like to start the Zobaline as soon as possible but my over thinking always leaves me stalled. Anyone ever have a cat adversely to Zobaline?
 
I don know if anyone answered you. I have not heard of any adverse reactions to Zobaline. A lot of people here use it. I crush it and mix in one of his meals. I does take time to see any improvement. What isn't absorbed will be excreted out in the urine.

I can't answer about the insulin, I'm unfamiliar with that. Did vet recommend a starting dose? Are you home testing? You want to know it's safe before you give insulin.

You can edit your title to this thread by clicking on prefix and the the ? Mark and put insulin arrived how much do I give. People will answer very quickly.
 
Sorry I went silent for so long but we have had one cat emergency after another. I have been referring to it as the cat apocalypse. I have a crf cat that came down with cystitis & made run to ER for hydration & pain meds, had a cat eat something that caused vomiting, inappetannce & yukkiness, another trip to ER for US to discover he'd eaten some plastic & it was slowly working its way thru the intestines & through it all working with Ed. I had the GI panel done which was negative for pancreatitis but had possible dysbiosis which I understand to be a disruption in the flora of the intestines & pro/prebiotics were suggested or low dose antibiotics. The vet went with pre/probiotic which I started & after two doses he was miserable. Pooping every 10 minutes. He finally laid in the litter box & pooped lying down. No more pre/probiotics until I go to holistic vet who can better guide me in a gentler approach. I started him on Zobaline. Some days his neuropathy does not seem as pronounced as on other days. He's still on Vetsulin because suddenly it seemed to be keeping him in check. I am talking numbers in the 70s, 90s & 100s with his highs being in the 200s instead of the 300/400s we were getting at the end of his cycle but lately we are getting the bounce again so we will have to make the switch to PZI. I am going to talk to the doc about hospitalizing him on the first day so they can do a curve & make sure he has no adverse reaction to it. Due to the recent cat emergencies the purchase of the glucose/ketone meter & laptop repair are on hold until our finances recoup but I still check his ketones once a week in the urine. He actually pees into a cup for me! Again, sorry for taking so long but have been nursing my little crf girl, giving fluids & shots & watching cat poop for the plastic surprise to make its way into litter box which it finally did!
 
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