JustDiagnosed DKA and Terrified

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Rosie'sMom

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Hello Everyone.
Over the weekend my 10 year old cat stopped eating and became very weak. I took her to the vet 1st thing Mon morning and she is still hospitalized and being treated for diabetic ketoacidosis. I am a mess at this point and sick w/ worry. Hearing she has diabetes is scary enough but I am worried about her coming out of this. She is still not eating (4 days now) but they may try to force feed her tomorrow w/ a syringe if she doesn't eat on her own. They are doing the usual, giving insulin, bringing her sugar down, giving fluids, etc and are treating the acidosis more aggressively today with medicine given the fact she is still not eating. The doc did say that she looks a little "brighter" today.
Yesterday I made the decision to move forward w/ treatment but now I'm questioning myself. At this point, the bill is already approaching $1000. Don't get me wrong,it is not an issue but at some point it could become an issue. The vet absolutely will not allow anyone to make payments. She is my baby and I don't mind but how do I know when enough is enough? Am I simply prolonging her a life of sickness? Will the DKA return or further complicate her diabetes?
Have any of your babies fully recovered from DKA and returned to normal? It is the unknown that terrifies me. I just want my Rosie back. Thanks for listening. Any advise?
 
They should put a feeding tube in her asap


Simba survived DKA with feeding tube and all the care there was available at the ER hospital. He was in hospital for two weeks.
 
Rosie'sMom said:
Hello Everyone.
.....
Have any of your babies fully recovered from DKA and returned to normal? It is the unknown that terrifies me. I just want my Rosie back. Thanks for listening. Any advise?
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Welcome, you're in the right place to help Rosie! BIG HUG! We understand the diabetes diagnosis, we've ALL been there.

To answer your question above, off the top of my head posting right now are:

* Violet and Garland
* Isil and Tifil
* Jessica and Boo Radley

There's many others my poor gray-haired brain can't remember right now.... :roll:

HUGS!
 
Don't' despair Rosies mom!

MANY of us have been in your shoes - by the end of the day I'm sure you will have a whole lot of feedback.

My Black Kitty is a survivor of 2 episodes of DKA. I was told, by vets "Prepare your mind" and "trying to treat diabetes in a cat that is FIV+ is an uphill battle". . .
I have an invoice from a vet visit that has written across the bottom "Prognosis Poor". I also know how hard DKA is on the checkbook.
Today BK is bright eyed and bushy tailed, as are many that have survived.

Do you feel the vet is competent and experienced with her condition? It is critical that your kitty get enough calories, so a feeding tube may be needed. There are folks around here with experience to guide you.

My advice is to use this time before she returns home to learn the basics of treating Feline Diabetes (FD); it sounds like you were unaware of it until the DKA . There is quite a bit to learn however there are plenty of folks here to help. Personally I recommend you ask your vet for a prescription for the insulin Lantus. Most cats with FD use it with excellent results - my BK happens to be one of them. :-D

I don't want to bombard you with too much, a good place to start would be this document.

Keep us posted and ask any questions that may come to mind,

Hang in there - you came to the right place
 
Rosie's Mom,
Please don't 2nd guess your decision to move forward with treatment! My sugarcat, Bob, was diagnosed DKA as well. That was in May. The vet at that time told me that another day or two without treatment, and I would have lost him. He spent 3 days in emergency care. He didn't need a feeding tube fortunately. When I got him home, he began insulin treatments and sub-q fluids. In July, he went into remission.

At this moment, he's in the kitchen insisting that it is time for dinner.

There are also various ways that you can get some help with the vet bills if they get to the point where they become too much.

Don't give up!
 
Thanks everyone. I can tell this site will be a lot of help as Rosie and I begin our journey. But first, we have to get thru this crisis.
Carl - your experience defintely gives me hope. I take it Bob was not eating either at first?
Tomorrow is Rosie's 3rd day in the hospital. Still waiting for today's final update.
 
Rosie's Mom,

There is a terrific organization called "Diabetic Cats In Need" which may be able to help you and Rosie.
Here is a link to their blog:
http://fdmb-cin.blogspot.com/p/our-mission.html

Financial Assistance for Diabetic Cats

DCIN helps with the insulin and other diabetic supply and treatment costs of certain cats, both to help facilitate their rehoming and to help them stay in their original homes. On occasion, DCIN helps with treatment costs when diabetic cats have other health problems that require veterinary care. See this page for the details of DCIN's Financial Assistance Program.
Click to expand...

On the page that links goes to, scroll down and towards the bottom on the left side of the page, you'll see the names and contact numbers of three case managers. You can contact one of them by email for more information.

Carl

Just saw your questions -
Bob was eating some, but not enough. They had to syringe feed him a few times at the clinic. After the 3 days when I brought him home, his appetite had improved enough so that I didn't have to force feed him.
 
My Cassie had.dka about a week after he was diagnosed diabetic. It was scary a expensive-he spent 8 days at the vet (the last half at the vet school 1.5 hours away since my vet didn't have 24 hour care). He's been home 5 months.now & is himself again. He's still.diabetic but close to regulated and has become a lap.cat.

Dka is not a death sentence. It's survivable. Some cats are ketone prone; Cass.hasn't had problems since. There is usally some.kind of infection involved in.dka; that will need to be addressed as well.

It is important that she eat; if force feeding isn't successful you may need a feeding tube (thankfully my boy didn't). Learn about diabetes, ask questions, and breathe! We'll help as muxh as we.can and you're not alone.
:YMHUG:
 
Damaging to the wallet but they can pull through. Mishka has battled quite a few DKA episodes, week at a time for her hospitilization every single time......especially when I first adopted her......and then several times she has thrown ketones but it did not go into DKA. At one point her Critical Care vet said her blood pH was so low it bordered imminent death. Now we are 8+ years of treating her diabetes and in the past 3 years she has been DKA free whereas before I could usually figure on one episode of DKA a year. She is doing great. IMHO a newly dx'd kitty that is DKA has to be monitored with blood glucose testing and also urine test strips. If, for any reason, Mishka flat out stops eating she immediately goes into ER and her IM specialists. She has no good veins left either so getting a catheter into her would be extremely hard. Sending many prayers your kitty pulls through.......they can, many have, so don't give up hope.
 
Hang in there Rosie's Mom! My Alex went into DKA the day after she was diagnosed with diabetes. That was back in July of 2006. Right now she's laying next to me with her head propped on the keyboard. Many, many of our kitties survive with proper treatment.
Sending positive thoughts your way...

(((((Hugs)))))
 
Rosie'sMom said:
She is still not eating (4 days now) but they may try to force feed her tomorrow w/ a syringe if she doesn't eat on her own.
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Four days is too long already. They need to get food into her today. There's no reason to wait until tomorrow. Please insist that they start feeding her ASAP. It will help her to recover.
 
Hi Rosie's mom. Believe me , I understand the terror. DKA IS terrifying. but your cat is in the right place getting the intensive treatment that is needed.
I haven't been around here for a long time, but I'm gladI happened to stop back in and saw your message, so I could share another survival story.
My cat Louis had DKA in 2008 when he was ca 12 yrs old. He had DKA, severe pancreatitis, a UTI and liver damage ( basically bordering on hepatic lipidosis). Just about ALL his blood chemistry was abnormal. it was very questionable whether he would survive the first 24 hours. Someone seeing the numbers etc. told me he was as sick as a cat could get and still be alive.
But he made it! he was in the hospital for about a week. Then came home and was tired at first -- and the blood sugar was totally nuts for about a week after he got home. but he gradually improved and within a couple months he was playing with mylar balls. I think his liver was helped by a liver support medicine he took for a few months called Denamarin.
Anyway, as sick as Louis was, if he could make it, hopefully there is a good chance for Rosie.

And as you've already heard there have been many DKA survivors on this board. ( & Sandy's Black Kitty is one I sure remember !) Here is a link to an old thread I remembered where several of us posted ( darn it i'm having trouble getting it to work , let's try again)
http://www.felinediabetes.com/phorum5/read.php?8,1208847,1211528

It sounds positive that the vet says she is looking brighter ! I think it took longer than that with Louis before the vet's voice sounded hopeful.

There is some good info on the pet diabetes wiki http://petdiabetes.wikia.com/wiki/Ketoacidosis
And I found it helpful reading vet papers about the condition and its treatment -- which is pretty complicated. for example here is Dr Thomas Schermerhorn's paper from the 2005 WSAVA conference http://www.vin.com/proceedings/Proceedi ... &O=Generic
This helped me understand what was going on so I could talk to the vet, and it reassured me that they were doing what I saw recommnded there... or if they hadn't been, I would have at least been able to recognize that and ask about it.
Since that time , here is another one that has been published , it starts on page numbered 24 ( which is page 25 of the pdf) http://www.avsg.net/documents/WWTSClean.pdf

They do need to be getting food into her.
Before Louis started eating again he was getting dextrose in the IV fluids for a while, once the bg went under a certain level -- ( It takes more insulin to metabolize the ketone bodies than it does to control theblood glucose. so they sometimes need to give dextrose to balance out the blood glucose. then fortunately he started eating on his own.)
If she won't eat it may help to have a temp feeding tube put in as others have mentioned. and you could continue to feed that way at home for a while. There is a Yahoo group about that called "Feline Assisted Feeding". Hopefully it won't be necessary but it's not as drastic as it may sound & it has saved many cats' lives.

Louis just had it again although not nearly so badly but understand that Louis has other chronic health problems that cause inflammation ( which causes insulin resistance) , plus he had got a URI, stopped eating and wham! Fortunately we caught it more quickly this time so he was only in for a couple days.

Sending prayers & good thoughts to Rosie & you

Cheri and Louis
 
Rosie's Mom,

I found the thread I was looking for...

In early August last year, a kitty named "Garland" was in the same place. Her "person", Violet, found this board just like you have, and over the next few days, we all got to watch a miracle take place. If I wasn't convinced before then, Garland's story made me positive that this site is the best place in the world for our kitties and for us to be.

That story is here:
http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=49370&

If you have an hour or two (seriously, it'll take that long!), read all about it.
 
Hi Rosie's Mom. My kitty had DKA soon after being diagnosed. He was at the University of Pennsylvania School Of Veterinary Medicine hospital for 8 1/2 days, the winter of 2006. I went to visit him everyday. At first he was so sick, and then day by day, slowly, he got a little better and a little better. He came home with a feeding tube because he totally refused to eat while at the hospital. A day after being home, he took the feeding tube out himself and began eating on his own. J.D. is a happy kitty, right now. I remember, it was sooooo scary, and all I thought about was visiting him. I think the visits helped him too, besides the excellent care he received at the hospital.
So, yes, DKA is survivable. Don't give up hope.
 
Gabby is another survivor. When she was diagnosed with diabetes, she was also diagnosed with DKA, pancreatitis, and hepatic lipidosis. That was more than 2.5 years ago. She is still diabetic but otherwise a happy and healthy kitty who is currently curled up at my feet. DKA is scary. Once your cat is stablized, the rest is manageable. The learning curve is big but it's something you can do.
 
hi!! I just saw your thread. ((hugs)) DKA is not a death sentence. Many kitties have gone through this. Stay strong .

The not eating is what scares me.I think your kitty needs a feeding tube. Its what saved Garlands life when this happened to her. Garland one day just was laying on the floor. I had no idea what was wrong.. she couldnt walk, barely could move. I was scared out of my mind. Thank goodness I found this board. With their help I got Garland to the ER. She was there over a week with DKA. The fluids and insulin battled the ketones, but since she hadnt eaten in a week she developed FHL while at the ER. A feeding tube is the only thing that can help a kitty with FHL. It develops because the cat isnt eating. Karrie (of Karrie and Maverick) walked me through all I needed to know when it came to FHL. Has your vet mentioned a tube? Garland survived DKA and FHL and is spunkier than ever now. :)

Also, look into CareCredit for a payment plan. Its a credit card for vets. Most places take it I think. Its like financing for kitties.

Sending healing vines and prayers for you and your little one
 
Sorry for the late post--we had a bad storm here all day and I am on satellite internet & the storm kicked me offline till just a little while ago.

Tawny, my adopted-from-DCIN diabetic kitty, between the first of November 2011 and the middle of December was in the ER 3 times in 6 weeks w/DKA, hepatic lipidosis and pancreatitis, a urinary tract infection and I don't even know what else. Long story short, she was really really really sick, and the folks here at FDMB helped get Tawny (& me) thru it. & an excellent clinic about 50 miles away, the Louisiana Veterinary Referral Center & ER Clinic (LVRC). The vets there worked with all their heart to pull Tawny thru 3 times. They worked with me and DCIN and the info from this board. Today Tawny is happy and well on the road to recovery and pretty healthy again except for needing to put on another couple pounds. And needing insulin of course. She had a pmps of 199 tonight, excellent for her!

Her story is long and complex but you can search this board and find many of her old condos w/great info about DKA & treatment, along w/the condos from others who have been thru similar experiences.

I agree w/everyone else, your kitty needs to eat now! 4 days is way too long for her to go w/out food. If they can assist feed her via syringe every couple of hrs starting right now that would be great. It does sound like she might need a feeding tube, Tawny got an e-tube (which we had to insist on several times, they wanted to do a stomach tube). That tube saved Tawny's life, b/c it got her to eat again. I was sooooooo terrified I sat in the parking lot of the clinic after her 3rd trip to the ER in 6 weeks and sobbed on the phone to Venita of DCIN for almost an hour b4 I could even drive home.

I learned so much about feeding tubes and DKA from the people here it was amazing, we will all help you thru it.

Sending healing wishes, vines, prayers and snowflakes to your beloved kitty.

Desi, Mommie to Tawny & Tinkerbell (diabetic kitties), 14 other felines, 2 horses, and 3 droolers
 
Vyktor is another DKA survivor, it was three days before the vet stopped starting phone calls with "well he survived".
 
Re: Update - JustDiagnosed DKA and Terrified

This site and you folks are an unbelievable blessing to me! To be honest, last night I had all but decided to let my Rosie go after hearing from the vet last night that she still wasn't eating and they needed to put a feeding tube in her. I just couldn't see putting her thru everything. This morning, I talked to the other vet (whom I'm more comfortable with) for over 20 min. She put my mind at ease re: the feeding tube and how great Rosie's chances are once she starts to get nutrition in her. She is hepatic right now but the doc is sure that will turn around rapidly w/ nutrition. She did say we are at a point where a decision must be made and they would need to insert the tube today. They would keep her thru the weekend and I'll probably bring her home Monday w/ the tube if she is doing well as they expect.
I'm going to visit my "yellow" Rosie in about 30 min and am going to tell the vet to put the tube in ASAP. I'm still scared and nervous but I feel good about my decision, especially after hearing from all of you.

Vicki
a/k/a Rosie's Mom
 
Vicki
That is terrific news! One suggestion. Bring something, a blanket, sweater, something that smells like you and home for her to snuggle with.
Carl
 
Is she getting an e-tube?

Couple of things: get a fine mesh strainer to strain the food thru (at least twice, I strained mine 3 times (OCD)). They gave me a "practice" tube, a tube just like the one in Tawny's neck to test the mixture thru over the kitchen sink to make sure it was fine enough to go thru the tube b4 actually feeding it to Tawny.

Keep Coca-Cola on hand for help w/dislodging any clogs (hopefully you won't have to use it). Not Pepsi, Dr. P, anything else. Use Coke only.

CliniCare if this is what they want you to put thru the tube is high carb. W/Tawny in the beginning it was let her eat anything she wants, including dry when she would eat on her own.

It was recommended that whatever you feed thru the tube is not the same thing as what your kitty normally eats, this helps avoid food aversion problems.

Also I see this on the board all the time and even Tawny was getting it in the beginning, until Karrie pointed out to me that you DO NOT GIVE MIRTAZAPINE (or any appetite stimulant) to a cat with a feeding tube. Something about it causing possible food aversion. I think every post I've ever read about kitty's w/tubes has listed an appetite stimulant on the kitty's med's list.

Here's what Karrie said in that post and here's a link to it also, there is lots of good info in it:

Karrie and Maverick wrote: Do not give a cat with a feeding tube an appetite stimulant. There is no need. It has a lot of side effects and is often called meowzapine. You have the tube. She will eat when she feels better. An appetite stimulant can actually cause long term food aversion and you will have the tube for a much longer time.
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Here's a link to that post: Tawny 12/18/11

Also it's important to remember that a kitty recovering from DKA needs 1.5 times it's normal daily caloric intake, so a 10# cat would need at least 300 calories a day. Karrie developed a feeding chart SS for Tawny that breaks several different kinds of food down into grams and then calculates the # of calories that equates to so that I could track Tawny's calorie intake according to what she was eating (Wellness, Recovery, Friskies) and how she was eating (assist feed, on her own, etc.) There is a link to that SS in the above post as well. A lot of the data for Tawny is incomplete, so don't pay close attention to the #s I put in, but you should be able to copy it and adapt it to Rosie's feedings. It helped me tremendously when Tawny was being tube fed and finger fed. When she started eating on her own I would start out the day putting in the data and then never finish cuz I just knew she had eaten plenty!

Good luck w/all this. We are here for you. Insulin & calories fight ketones. This is a very important thing to remember for a recovering DKA kitty.
 
Yay!! Getting an e-tube is a great decision! I also recommend to order a Kitty Kollar from KittyKollar.com. LOVE that thing. Its so much easier to take care of with the bandage changing. (much cuter too :smile: ) Here is a video I made showing everyone on the board her new kollar -->> http://www.youtube.com/watch?v=N6yEQ7WofEk

You will find what works for you, but here is how I did it with Garland. I would blend 3 cans of Recovery with a few tablespoons of clinicare (or water) and keep it in the fridge. Then I would pull out her 36cc for that feed and warm it to room temperature. I used small syringes, other people like the bigger ones. If she had meds, I would do the meds first, before the feed. She was given 30-36cc every 3-4 hours. We did not use the appetite suppressant. Garland was on a potassium gel and an anti-nausea (odanstron) Karrie recommended that med, and it did wonders for Garland! Her spreadsheet has all her feeding on there. I started writing them down after about two weeks with the tube.

At first you have to go really slow when feeding her, so she keeps it down. But after a few weeks it goes much faster. Then she will start healing, even wanting to eat some on her own. Its very important to not try and force a kitty to eat. She will start eating when shes ready, just offer it gently to her.

Good luck!!! Let us know how the tube insertion goes :-D
 
Violet just sent me a PM that you were getting an etube. That is great news and will make the recovery easier. DKA I hear is infection, not enough insulin and not enough calories. Do they know if she has an infection?

Please join the Yahoo Feline Assisted Feeding forum. You will be in great hands with anything you need for the feeding tube. They have moderators and members across the world that are always on hand if there is a question or a crisis about the feeding tube. They are not the diabetes experts though - that is what FDMB is for. Here is the URL. When you join you will be sent some autofiles. http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/

Please make sure your vet does a post placement xray. The last few months many FAF members have posted on their vets putting the tube right into the stomach. It should stop before the esophagus.

I would post an intro tonight so if you need anything everyone will already know the basics. The FAF group saved Maverick's life in 2008 when the vets did everything they could to try and kill him ohmygod_smile.

Don't go with AD food if the vet wants to sell you this. Wellness Chicken has 200 calories a can and is only 4% carbs. I have to call tomorrow to find out the carbs in Iams MaxCal - it is 330 calories a can. But with DKA - its the calories that count - not the carbs. Blend the food in a blender and water down enough that it can go through the tube. We recommend running it through a sieve/strainer to prevent blocks. Those people that strain the food rarely get tube blockages. Coca Cola (not diet or pepsi) on hand will help with this.

I don't want to overwhelm you with information. You will get through this. We can help you coordinate feedings and insulin, home testing, medication, managing nausea if any presents.

You will get comfortable and adjust, things will become routine. Make the feeding a very good experience. Sing to her, brush her, tell her how beautiful she is. Maverick and I developed a deep bond over tube feeding. He became my best friend in the world.

Do not race her into eating on her own. Eating on their own doesn't mean cured. You will have the feeding tube. Use it. Your cat will eat when they are feeling better. Don't race to have the tube removed either. More on that another time.

Also look into buying a kitty kollar. www.kittykollar.com.

Sending you big hugs. You can get through this. You have absolutely amazing support on FDMB and if you need it FAF. I have never met so many wonderful, caring, giving, knowledgeable people.
 
Karrie and Maverick said:
Don't go with AD food if the vet wants to sell you this. Wellness Chicken has 200 calories a can and is only 4% carbs. I have to call tomorrow to find out the carbs in Iams MaxCal - it is 330 calories a can. But with DKA - its the calories that count - not the carbs. Blend the food in a blender and water down enough that it can go through the tube. We recommend running it through a sieve/strainer to prevent blocks. Those people that strain the food rarely get tube blockages. Coca Cola (not diet or pepsi) on hand will help with this.
Click to expand...

Wellness Kitten is also very high calorie (161 calories per 3 oz can) and low carb. I used it to keep weight on Gabby as we dealt with her stomach cancer, and it worked really, really well. It only comes in 3oz cans, though. When I researched high calorie foods for Gabby, it was the highest I could find.

Someone can correct me if I'm wrong, but I think that the A/D does have added potassium, and since DKA kitties have depleted levels it could be beneficial to feed the A/D in the first few weeks of recovery even if it's a little high in carbs. I don't have experience with DKA though, so I hope someone else can comment on this.
 
Karrie and Maverick said:
I don't know if you can get enough calories with AD - its a lot of volume as its low calorie. The kitten food is a great idea.
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Thanks, Karrie. That makes perfect sense. I would also assume that there is also an oral potassium supplement that could be given along with the Wellness, if the vet is concerned about the potassium levels.
 
Julia & Bandit said:
Karrie and Maverick said:
I don't know if you can get enough calories with AD - its a lot of volume as its low calorie. The kitten food is a great idea.
Click to expand...

Thanks, Karrie. That makes perfect sense. I would also assume that there is also an oral potassium supplement that could be given along with the Wellness, if the vet is concerned about the potassium levels.
Click to expand...

There are several potassium supplements available, both in tablet form and paste form. IIRC, two of them are called TumilK and RenalK. (need prescription for those) The tablets can be crushed and mixed into the wet food.
Bob, who was also DKA, received sub-q fluid treatments many times with fluids that had added potassium, so that's another option. I am guessing that once Rosie is sent home, she'll go home with a bag of fluids like Bob did.
Carl
 
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