HELP!!! Time is running out - cat has DKA! :(

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She will be tired - you must be too! We'll see where she is in 30 and figure out if you need to push her a bit on the food.
 
Ok this is slow going. We are at 85. I didn't give her anything this time. Trying food. I won't give insulin until I can call my vet at 8 or so. Dr comes in around 9 they said. She's not eating. Seems to be sleeping. We are both tired. 2 nights of little sleep and I am exhausted. Hubby is sleeping so at lead tone of us has energy.
 
Hopefully she can keep rising slowly even without food. How close are you to 12 hours since your last shot time now? It might be that most of the dose is out of her system at this point.
 
You are doing a good job. Can you tabulate in one place the various recent BGs with times and when you gave insulin and how much. This makes it easer for other to see what is going on. It is hard to go through all the posts to get that information and easy to miss one.
What I have doe with low BGs was to mix Karo with canned food. The proportion depends upon the situation. Food elevates BG longer.
 
OK, I don't think she's going to make it to 200 by shot time unless she bounces, so definitely call your vet before you give her next dose to see what they think as they've seen her recently and done the blood work for her DKA.
 
Thank you for your help. You have no idea! I will keep pushing food and may syringe feed more. We are up to 92. Will give subq fluids soon but for now we both might rest. She's sleeping and we will check in another hour or so. Thank you!
 
OK, you should be good to wait an hour to test again. I have to get some sleep - it's 3:30 am here and I don't want to fall asleep on my keyboard and miss anything you have questions on. @Vyktors Mum has said she will keep an eye on you for the next hour or so - she got me through the first few times Rosa went low so I'm definitely leaving you in very safe hands - she has a lot more experience than I do. I hope the rest of the night is uneventful for you and I'll look in on you tomorrow to make sure you're doing OK. :) :bighug:
 
Nigh night April

Hello Chloe's mum :) I've just been reading through your condo - yikes haven't you been having a time of it!

Get some rest, see you in an hour
 
Ok she woke up at 6:25 with more diarrhea and I wanted to make sure she didn't get in it again.checked her glucose and it was 101. Going to give subq fluids and try wet foods. Still no interest in food. 4 am was a miracle when she ate a few pieces of kibble. Glucose heading back down. She's at 89. Vet opens in about an hour. Ideas? Worried!! Seems so much more herself, but now really low glucose.
 
Fluids can lower BG so I'm not sure that I would give those now.

more comments to make but want you to see this asap
 
One thing to bear in mind is that you seem to have been conditioned by a vet as to what numbers are low/safe etc. 89 isn't low as such it's normal and I noticed earlier in the thread you stopped giving insulin when she was hanging around at about 180 which is well outside the normal range. Normal cat BG numbers range between about 50 and 120. When you're home testing and able to monitor well these are great numbers for the cat to be in. We start propping the numbers up with carbs/syrup at 50 when a kitty's on insulin to keep the insulin from pushing them any lower.

I'm glad I caught you before the fluids! Since it's only an hour til the vet opens I think it best to wait and see what they think.

If you can syringe feed her it would be good to try and get more food into her, or even more kibble if she'll take it.

You're about 2 hours from when her next shot's due aren't you?

ETA - she's not really dropped since the last test, 91 and 89 are pretty close to the same thing, we call it surfing :D
 
Yes, about 2 hours. They were telling me the norm for diabetics I guess was 150-250. She's a bit of a rag doll at the moment so I'm not sure if it's exhaustion or that she keeps crashing. I will go with food for now. Most likely will be syringe fed. I'm quite worried!
 
If you're not home testing and monitoring you have to let the cat's BG run higher so there is a big margin for safety and that's where most vets heads seem to get stuck - around here we know better ;) but we can worry about all that later. The important thing for you to know for now is that her current numbers are normal and not dangerous at all :)
I'm concerned that your vet may tell you not to shoot these lower numbers because of where their head is stuck. If you are still able to monitor and have enough strips etc I would definitely be looking to shoot something, even if it's just a token dose. Not enough insulin is part of the equation that got Chloe to where she's at now.

You are doing a great job. DKA is very hard to treat at home so you're managing very well. Vyktor was at the vet for about 5 days when he went DKA.
 
You've had a long night! For cats in DKA, it's best to try to steer the blood sugars to higher than where we'd want them in a normal cat, about 150-250s. This allows you some wiggle room, and allows the insulin enough sugar to change her metabolism back. Do whatever it takes to bring her blood sugar to this level, high carb food is often necessary. You don't want to have to skip insulin doses, as it will set back her progress. You might want to get some high carb wet food to syringe in addition to the high cal food.

When max first started eating again I made a cat "soup" that he seemed to tolerate. Mix dry kibble with warm water and smash it all up once the kibble is soft. I suspect that nausea is holding her back from eating. If you are going back to the vet, I'd push the issue about the anti-nausea. Mirtazapine and other appetite stimulants do nothing to help nausea, and sometimes can make it worse. This was the magic bullet to get max to start eating.

Pedialyte can cause diarrhea, I don't know how much she is getting.
 
Just an update - I took Meya's suggestion and made a mix with her kibble. I think it's higher in carbs than the Purina DM so that is what we are giving her. Still no word from vet. Was warned I may not hear back until 1pm EST when they were done for the day. Still haven't given the subq fluids. No change in her not eating or drinking. Did not give insulin. I wouldn't worry so much except her highest glucose 120 taken at noon (24 mins ago). Hoping to hear from them soon.

Oh and I meant to mention that she is acting almost 70-80% normal minus the low glucose readings!!
 
Dehydration check again, please.
Hydration reduces the concentration of ketones in the blood and helps flush them out in the urine.
 
Awesome job last night with Chloe! And thank you so much Serryn @Vyktors Mum for taking over for me. :)

That's quite the surf Chloe got going once she decided to stay clear of the low 50s (and lower). Those 80s and 90s are the sort of numbers we love to see our kitties in! :D I'm glad she leveled out for you in the end. :)
 
Yes, thank you Vyktors Mom and Manxcat!

I'm unfamiliar with the terminology, but what do you mean by surf?

Hubby stopped by the vet today and he gave us Cipro, Cerenia tabs, probiotic powder (a little concerned about loose stool and diarrhea) and stated that he stated that if she drops below 80 with her glucose, he wants her to have 1ml of karo.

Here are some of her latest glucose readings. All times are in EST:
9am: 73
10: 102
11: 117
12pm: 120
1pm: 130
3: 88
4: 87
5: 64
6: 86
6:40: 90
8:35: 62

I don't like how all of the sudden since early AM hours today (late last night) she has been well under the 150s+. I cannot figure out - and most likely because I've never been through this why she was so high (150-180-200s) and now I can barely keep her around the 80s. I have not checked her ketones lately. Dr ordered for 3/4 unit of the Lantus and I administered the subq fluids per his request. He doesn't want her under 80. I've not had rest today and now I afraid I'm in for a long night - third night. I'm afraid of running down and getting sick! Hubby is going to switch off every other hour so I can at least get 2 hours of sleep straight each time.

Should I be worried with these numbers? MAJOR VICTORY: Chloe is now eating somewhat regularly and on her own. No forced feedings (other than the syrup) since noon today. We have to sometimes urge her to eat, but we have also observed her going to the food on her own 2-3 times. She only eats about 10-15 kibble at one time, but it's better than nothing.

Suggestions and thoughts? Thank you all in advance. Dr was quite impressed with her recovery and said it is all due to us acting like an ER and being detailed and vigilant. I was sure to share about this site and all of the help I've received and tell him what a godsend it has been. :)
 
Glucose test just now has her at 134 from 62 30 mins ago after she ate a little and 1ml karo. And the roller coaster continues....
 
Surf is when they are in normal numbers for a few hours during a cycle - some cats after a while can surf pretty much all day...almost level numbers and all in the healing zone. Like Chloe's doing today - you see how her numbers are all in the normal zone and aren't going up or down very much from 3 right through until 8:35? That's a surf! :D

You should be delighted with those numbers! They're all in the healthy zone which means Chloe's getting healing time in - both for the DKA and for her pancreas! And she's eating on her own too - that really is a major victory!! :D Little and often with the food is most likely what she needs right now - that's how a lot of us feed our diabetic kitties anyway as it's easier on their pancreas than just a couple of big meals during the day. :)

With insulin on board and no real way of knowing where the dose is going to take her, I have to agree it could be another fairly long night. Or she might level out in the 100-120 range. We just don't have enough data on Chloe to tell yet as she's so newly diagnosed. I'm so pleased your hubby is going to switch with you through the night so you can both get at least some sleep. If you can leave him logged in to the site so he can ask any questions he might have later on too - that way he can maybe ask us here instead of having to wake you! If she wasn't recovering from DKA, you might have the option to skip a PM shot so you can sleep, but I don't think letting her go without insulin is going to do her any good at this point so it's great that you've got him there to help you take care of her.

I'm not surprised your vet is impressed - you really have pulled her through this and got her on the road to recovery. She is still safe at under 80 - as long as you can keep her above 50 she's all good. Though the way she was up and down last night, I can understand him wanting a bit more of a safety margin for now too. :)

The 134 is likely a combination of the karo and maybe the start of a food spike - I'd imagine she's going to be starting to come back down from that in about another hour though the timescale does depend on how long the food lasts in her system.
 
Thank you manxcat for the info. I was hoping as tired as I am that it made some sense. Lol. Vet wanted us to check her glucose every 2hours but with her dropping so low, we check more often. I hate pricking her but she has grown more a costumed to it. Poor thing just sleeps a lot lately.

Hmmm I know others have suggested too that vets are more conservative on glucose numbers but when she's anywhere below 100 we notice a big change in her. She is still going for the dry kibble that she had for a while and prefers that and vet said that to give her anything just to get her eating. I will say we feel like she's in the 60-70% recovery range. We literally thought we had a dead animal only days ago, so we are thrilled with the results.

Im used to glucose readings 150s+, so annoying thing this low scares me. Vet said 150+ is typical for diabetic cats and with DKA.

We are checking again in 90 minutes and then I'm getting up in 3 hours for insulin. The hat gives me a 3 hour nap -yay!!!!
 
Oops I hit the button accidentally. This kitty mom needs rest! Lol. I hope she eventually normalizes some. She has a lot of her spunk back when she's not so low on #s so we can tell she's improving.

I guess this is normal for DKA? We are happy that the end of the day is so much better than tha day before and so on. Forward momentum is welcomed!!

Chat soon. Zzzzzzzzz
 
Yes, you made sense - I know it's difficult when it goes on day after day with no proper sleep. And I agree with checking more often - if you hadn't checked her last night, those dropping numbers could have turned into a real problem for her instead of being something you were able to get under control.

Vets do tend to be conservative with numbers - they go for the cat feeling well rather than trying to give the cat a chance at remission which is what a lot of us here do. It really does sound as though she's recovering well now - eating and acting more normally! :D

Yeah, I'm familiar with that sort of thinking. My vet told me to aim for 180 as a target number for the lowest point in the cycle...and my brain said "no way". That's one of the biggest issues some of us have with vets - they're not used to people home testing the way people here do so they have to be conservative with their targets to keep the cat safe. 150 is, IMO, too conservative - it's still above normal range for a cat so isn't going to be as good for her long term as if you can keep her in the 50-120 range.

Sounds good - I'll check in with you at your next test time to make sure everything's going OK.

Her numbers are normalizing and she's feeling better - I'd say that's some really good forward momentum! :D

I hope you get a really good nap. If there's one thing feline diabetes teaches all us caregivers it's to value the sleep time we can get!
 
At this point, you actually -DO- want her higher than the "normal range". In order to get ketones to resolve, you need to be able to give enough insulin to convert her metabolism. Because she is not eating well, the insulin necessary to send her blood sugar <100 might not be enough to convert the metabolism.

This extra blood sugar is called "substrate" and gives her body something to burn instead of burning fat. It's much much much better at this point to be giving her lots of carbs and a higher dose, then be conservative with the carbs (and karo) and have to reduce a dose.

After she is eating well on her own, and ketones have been gone for a week, you can pull back on the carbs/insulin if necessary and allow her to be in the lower numbers.
 
Generally, giving Karo will bring up the glucose quickly in about 20-30 minutes. It also can wear off pretty quickly, so following the Karo with some regular food can help sustain the level you're targeting.

Fancy Feast Gravy lovers are high carb foods which may be used to bring up the glucose levels, too. We often use a gravy type food for dealing with low numbers and feed a couple of teaspoons at a time when the numbers get uncomfortably low.

You may find it helpful to read over my signature links Glucometer Notes and Secondary Monitoring Tools for some more info on assessing how she is doing.
 
Wow, ok a lot to consider again. I'm learning! She's been diabetic for 2 years but until this DKA episode I knew little to nothing and still feel I only know a little more, lol.

Ok, I had a nap and now it's hubby's turn. I will go nap again too now since she just had her insulin and her danger zone is 3-6 hours after (according to them).

Updated stats:
11:10pm- glucose 141. Urinated and ate a few bites of dry kibble with gravy
12:30am- glucose is 205. 3/4unit insulin (Lantus), ate s few bites of dry kibble and quickly back to sleep. (She's catching up on sleep which is good!!!!! For days she'd only sit and half close eyes and adjust positions in room or house every few mins).

Planning to check glucose in 2 hours (per vet) and then closer between 3:30-6:30. Doesn't eat unless put in front of food and a little the same with going to the bathroom (minus when she had diarrhea). She isn't drinking but she has the subq fluids under her skin. So thankful we haven't had to force feed anything except for karo!!! she isn't eating s ton, but she is eating every hour or two even if it is little bites.

As always, thanks for the tips, help and care! Will check in at 2:30.
 
Those are definitely more comfortable numbers than last night. Hopefully she'll stay up a little higher for you tonight so you can get a few hours sleep between tests (anti-jinx). Even if she's having to be encouraged to eat, it's good that she's eating when you put her by the food. And getting her caught up on sleep should help her to feel better too. :)
 
Glad she's hanging in for you. And envious that you have someone to help!

We like to reference our tests in terms of how long it has been since insulin was given, as folks can be in different time zones and the interpretation of numbers varies with how long it has been since the shot.
Like this:
AMPS = morning (AM)pre-shot test (PS)
PMPS = evening (PM) pre-shot test (PS)

+# = any test # hours since a shot
ex +3 would be 3 hours after a shot
 
You sure are getting a crash course in all of this! Hang in there, she's moving in the right direction. That she's eating something by herself this quickly is great. Max had to be syringe fed for about a week.
 
Great news. She went and ate on her own twice since the last glucose test 2 hours ago.

As for pre test and hours oh I need a bit more sleep to calculate, lol. I'm truly getting sleep here and there and it's helping, but I need to catch up.

Now this time the glucose test was quite high. She is at 286 and 2 hours post shot. We seem to go from extreme lows back to really high now. One more hour before we are 3 hours post shot and in the "danger zone". This time up she ate on her own (2nd time) and finally went to her water bowl!! She also urinated which is good.

Just not sure why we went from the 60's-80's to Hugh 200's except that she's eating? I don't want to disrupt too much, but the kibble isn't diabetic friendly and vet said to give her anything that would get her eating again. Should I pull out the Purina DM diabetic wet? I will be back at 4am (1 hour and 10 mins) with hubby to test.

Forgive my lethargy and any misspellings and scattered direction of my posts!
 
She's eating and she's had a fair bit of karo over the last 24 hours too so she has quite a lot of carbs on board as she's eating dry food if I remember right. There might be a bit of a delayed bounce in there too from last night of course. She'll come back down - you know she can do it now. And at least she's letting you get some sleep tonight! :)

Unless she's dropping quickly at her next test, you should be good to get a few hours decent sleep after that. It really does sound as though she's starting to take a lot more of an interest in eating which is great news!

I agree with your vet on this one - she has to eat, so whatever she'll take for now is fine. If she'll eat a bit of the DM that's fine too, but if she doesn't want it I'd stick with what she's enjoying right now - no point in upsetting her by taking away the food she does want until she's over the DKA and is clear of ketones...it'll make things much easier for you if you don't have to syringe feed her. :)

And no worries - we all understand the exhaustion from late nights and early mornings here! You're actually making very good sense, especially given the limited amount of sleep you've been able to get over the last couple of days. :bighug:
 
Ok her 4am reading is 355!!! We have a serious extreme and now I'm worried it's too high? Do I give more insulin? She's not due for more for another 8 hours. I'm just so worried at these extremes. She just got up to eat more.
 
I don't think you should give more insulin in between regular shots - we try not to do that with Lantus to avoid there being too much overlap with the amount in her system. Let her eat - and you are at least safe to leave her to get some sleep for a few hours. If you can post here for advice before her next shot to see what you should do...I think she's bouncing and there's really not much you can do about that except wait for it to stop, but there are others here with direct experience of DKA in cats, which I don't have (only in humans). If you can get a ketone test when she next urinates just to see where she's at with those, but I think you should try and get some sleep too - you need it and she's not going to head into the hypo zone any time in the next few hours. :bighug:
 
I agree, I would not give more Lantus between scheduled shot times. If yo do them Chloe could go too low later. That is why I prefer R insulin it only last 4-6 hours.
How much food is Chloe getting per day? Id not a "normal" amount I would supplement with syringe feeding. The previous low BGs could be due to not eating much
 
Evo Cat and Kitten Dry is roughly 8% calories from carbohydrate. You might pick up a small bag of the Turkey (Pet Supplies Plus on Lane Ave west of OSU and Pet People on N High St in Clintonville have it; maybe other pet supply stores). Slowly offer a few pieces at feeding times. If she likes it and will eat it, getting switched over slowly will help her maintain her calorie intake without shooting her glucose high. And dry takes longer to digest and absorb, so it may keep her numbers more stable for you.
 
Because she is eating on her own her BS may rise and you might have to increase again on the insulin. I'd wait for today and if tomorrow she is still pretty high, and still eating on her own, ask your vet if you can go back up to 1U. Of course, monitor closely. Insulin needs may change a lot because of everything going on.

Also, is she drinking on her own? If not, you should continue the subQ fluids or syringe fluids.
 
BG is 417 at 9:30am. Gonna try the Purina DM and check every 2 hours. She's doing better eating and drinking on her own. Definitely more vocal with normal sounding cries. We'll check ketones later. Both of us are trying to get a little sleep.
 
You are doing a great job.
Try not to get worried about her numbers going back up.... that is a bounce. It is a normal response from her body after dropping into those lower numbers.
And the good part of that for her is that it will give you a better comfort zone to continue giving her insulin when it's shot time.
She needs that insulin to help her recover.
Keep syringing the water as much as you can. You might try getting a can of human tuna and you can use the fluid , add water to make her
some tuna water. ( if she likes tuna) There is also cat-sip.... ( kitty milk) at pet food stores and sometimes even a grocery store might carry it.
You can add water to it because she might be willing to drink it on her own.
I also just learned that goatmilk ( primal brand has one) but that may have to wait until you can find it.
 
I've just seen this thread and read through it quickly. Oh my goodness what a wonderful job done by Chloe'sMom and Manxcat and everyone else who has been part of this journey! I know I have nothing to offer in terms of help but, I just wanted to add something...my admiration for all of you!
 
rhiannon and shadow said:
You are doing a great job.
Try not to get worried about her numbers going back up.... that is a bounce. It is a normal response from her body after dropping into those lower numbers.
And the good part of that for her is that it will give you a better comfort zone to continue giving her insulin when it's shot time.
She needs that insulin to help her recover.
Keep syringing the water as much as you can. You might try getting a can of human tuna and you can use the fluid , add water to make her
some tuna water. ( if she likes tuna) There is also cat-sip.... ( kitty milk) at pet food stores and sometimes even a grocery store might carry it.
You can add water to it because she might be willing to drink it on her own.
I also just learned that goatmilk ( primal brand has one) but that may have to wait until you can find it.
Click to expand...


Ok, great, thank you!! She is still drinking and urinating, but I might give her the subq fluids to help.
 
Louellen said:
I've just seen this thread and read through it quickly. Oh my goodness what a wonderful job done by Chloe'sMom and Manxcat and everyone else who has been part of this journey! I know I have nothing to offer in terms of help but, I just wanted to add something...my admiration for all of you!
Click to expand...

Thank you! I have learned a lot but these people here have been a Godsend to our success!
 
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