Help! Newly dx cat and poss ketones

[AshelyandMax]

So, my cat was diagnosed with diabetes about 3 weeks ago. My vet recommended Lantus 2 units twice a day and said that he possible has ketones too but acted like insulin would help with that too. He was eating FF classics, with dry food left out (I have another cat that I am not sure how would handle not having dry food through the day, and Max eats here and there too)
Max, my cat, who is only 8 y/o, has been throwing up here and there and has diarrhea, I think this started before tx, not sure but it has not improved. I called my vet about a two weeks ago and told him about this and he recommended that I feed him plain chicken that was boiled, or tune. So for the past two weeks he has been eating a some dry chicken, mixed with a little can tuna when he will not eat the chicken by itself. But he is eating and drinking. He is also urinating a lot still. I have not started monitoring his BG yet, as my vet acted like I didn't need to do that. I have been reading a lot on here though and you all seem to know a lot more than my vet, lol. Should I go back to FF, stay with chicken? What can I do to help with ketones? I might take him back to the vet this Sat. He does not seem to be any better since starting the insulin, although after reading so much here I feel bad for not having a monitor to track his levels.
Please help, I am really stressed and not sure what else I need to be doing for my fur baby.
Thank you in advance for any advice!

 

[StephG]

You need to include some FF as his food. Chicken and tuna doesn't have all the necessary nutrients they need. Edited to add: I would use chicken and tuna as treats and feed FF as primary meals. Switching from dry to wet quickly can cause GI upset. It could take some time to calm down.
Do you have ketone test strips? You can get them at almost any Pharmacy. They're urine dip strips. Catch a little urine in a long handled spoon, put some plastic wrap on his favorite spot in the litter box making an indentation to catch urine, or put the strip directly in his stream to get a test.
You can start home testing whenever you're ready. Human monitors work just fine.
If you can afford it, taking him to the vet for a ketone test and BG reading can't hurt.
Edited to add: plain pureed pumpkin might help with diarrhea, I started with 1/2 tsp twice a day. S. Boulardi really helped my cat with his very soft poos. Other probiotics might help too, fortiflora is a popular one and you can get it from your vet if you take him in.

 

[Critter Mom]

Welcome, Ashley and Max,

I'm in the UK and about to disappear right now but here is some info on ketones:

Testing your cat for ketones

Tips for collecting urine samples

A kitty needs both enough food and enough insulin to keep ketones at bay. Since Max is finding it tricky food-wise at the moment and the vet already raised the issue of ketones, I recommend you start testing for ketones at home ASAP. (Some kitties are more ketone-prone.)

I see that Max is having problems with vomiting and diarrhoea. High ketone levels can definitely cause nausea issues but also so can pancreatitis. You can ask your vet for a Spec fPL test if pancreatitis is suspected.

Here are helpful links:

Nausea symptoms and treatments

IDEXX Pancreatitis Guidelines

Ondansetron and Cerenia are very effective anti-nausea/anti-emetic treatments for cats. (NB: Some vets prescribe Reglan/metoclopramide as a first line treatment for feline nausea but it is not effective as a treatment unless the nausea/vomiting is due to problems with constipation or poor gut motility, and it's only suitable for very short term treatment at that.)

ETA:

As Steph mentions above, plain chicken and tuna aren't complete foods but as a stopgap for a cat with appetite problems it's better to feed these for a short while rather than the cat not be able to eat anything at all (and that's a major no-no for any cat, not just cats being treated with insulin).

Before starting any treatments for GI issues it is important to get the vet to perform a physical exam to make sure there are no blockages, etc. (Note that diarrhoea can often appear when a cat is constipated, as can vomiting.)

Sorry this is a bit piecemeal. Will try to check back tomorrow.


Mogs
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[StephG]

Sorry if my reply sounded harsh at all. I didn't mean for it to be. Compared to Mog's reply it certainly seems a bit harsh now. Forgive me if it does.