Ketoacidosis

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Lisasuze

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I haven't been on this forum in a few months. My cat Apollo has been doing great until this week. For some reason, he just wasn't acting himself and within a short couple of days, he went downhill fast. He stopped eating and drinking and he was weak. He has been at the vetst all day and through the night with an IV for fluids/electrolytes. He still is very sick. I went to see him tonight and brought him some things from home. What is the % or positive prognosis of a kitty recovering from ketoacidosis? It is possible that the insulin (Lantus) I've been using is not as effective. Does anyone know the expiration of this, if refridgerated and used? I love my Apollo and hope he will be o.k. Lisa
 
I've been here for nearly 5 years now and I've seen plenty of kitties come thru DKA. it takes good agressive care to do it but i have seen it happen. i'm not going to lie to you, i've seen it not work either. but it is definitely worth giving it a fair shot and if kitty is at a 24 hour facility getting round the clock care, that's exactly what needs to be happening. it can take a few days to beat it too. (((Lisa)))
 
Lisa,
My cat Payne was Dx on Oct.11 and immediately went into DKA and was in the hospital for
6 days. She went on to do it two more times and we thought she was gone on the last one.
Yet today, a short time later, she is doing extremely well. Take a deep breath and believe
everything will work out. But when he comes home you need to get some urine strips and
test his urine frequently, that way you can catch any problems before it goes into DKA.

I don't use Lantus so you'll have to wait for one of them to come along and advise you but
there are many reasons for DKA. Good luck!
Nancy
 
Just a quick reply from me. My cat J.D. was taken to the ER and dx with DKA, and then because they were only open nights and weekend, I had to transfer him to the University of PA Veterinary Hospital where he stayed for 8 days. Slowly, he got a little better each day. That was 5 or 6 years ago. I check his urine for ketones when he's high, and I test his blood to see if he's high or low before each shot, and a couple times at night, and then try to do curves on the weekend.
I used Lantus for years and in the beginning before I joined this board, used to use a vial or 6 months. After coming onto this board, I started buying the Lantus in individual cartridges or pens, because they (the makers of Lantus) say you should throw it out after 28 days. A lot of people get more than 28 days from Lantus, though. If you tested your cat's blood glucose at home, you would know if the Lantus was getting "old" by the numbers you received when you tested.
I now use Levemir, which is very similar to Lantus but lasts longer than Lantus.

I wish you the best of luck with your baby. Taking some things from home with your smell on them to the hospital is a nice comfort for your cat. Go visit her as often as you can. Say prayers and think possitive.
 
It's a long and expensivce road, but many cats recover from DKA if caught and treated quickly, so please don't give up hope for your sweet Apollo.

Lantus has a manufacturer's expiry of 28 days (refrigerated or not), but as has been said, many people get months out of it. The only way to tell if it's working is to hometest. And now that Apollo is ketone-prone, hometesting will be more important than ever.

Absolutely buy the urine strips - he will have to be regularly monitored. There is also a meter- the Precision Xtra- that actually tests blood ketones, and is considered more accurate than urine strips. Either way, you need to start checking for ketones on a routine basis once he is home with you again.

For now, just keep the positive vibes flowing and don't give up! He will be in the thoughts and prayers of many from this board.
 
I also have a cat who survived DKA twice. If you don't test your cat's BG yer that would certainly be something you should start doing immediately. However, you shouldn't rely on just monitering the BG alone. The second time my cat had DKA his blood glucose was only 240. I use a meter made by Abbott called the precision that test for both BG and serum ketones. Some other people use the urine dip sticks . We have had some lively debates about which method is better ( LOL). and I stand by my opinion that serum ketone testing is more accurate. The most important thing is that you test for ketones from now on regardless of which method you use. We have paws crossed for you!
 
A year ago, just before my now almost 19-year old cat (Jake) went into remission and still is in remission, he developed DKA due to veterinarian error. He was very, very sick with the same things you describe. With the proper treatment, however, (I went and got him at my old vet's hospital and took him to the experts at a local E.R.) he pulled through just fine even at his age. He was treated 24/7 with Regular insulin (his usual was Lantus), fluids, pain medication for suspected acute pancreatitus, and a feeding tube. Jake was in the E.R. for six days before the acidosis cleared. He came home with a feeding tube that stayed in another couple of weeks until he started eating completely on his own. The feeding tube was a Godsend and was very easy to use in addition to the great relief that he was getting nutrition even though he wasn't ready to eat yet. So if your cat is recommended to have a feeding tube, don't let it intimidate you. It's simple to implement, and it will save your kitty's life. So there is lots of hope!!

Judy & Jake
 
Oh and about the Lantus. It has been said that opened refrigerated Lantus can last up to six months. I never used it past the three month mark preferring not take any chances. Also, the internist at the E.R. said that DKA can develop even at a 200 reading.

Judy & Jake
 
drjsiems said:
. Also, the internist at the E.R. said that DKA can develop even at a 200 reading.
Judy & Jake
Click to expand...

Absolutely. It's important to remember that DKA is not just a product of high BGs. It can be also be due to not eating, and can occur when there is not enough insulin present- even with lower BGs. That's why they will often run an IV of glucose while giving insulin as part of the DKA treatment.
 
A little more information - I was told by the same internist and another doctor at the E.R. that the perfect storm for the development of ketones and subsequent acidosis is high blood sugar, inappetance, and an infection. Unfortunately having an infection is common with diabetes and along with an antibiotic can make kitty inappetant. We tend to give less insulin when kitty is not eating as much; thus BGs are usually higher setting the stage for the presence of ketones and ketoacidosis.
When this happens, kitty really does not want to eat compunding the issue. That's why assist feeding is so important and can be done either by syringe or feeding tube.

Judy
 
Diabetic ketoacidosis is a subtype of ketoacidosis. There are other factors that can cause ketoacidosis besides diabetes. Alcoholism and starvation can cause ketoacidosis in people even if they aren't diabetic. (Please note I said starvation not just fasting a day or two). Overdoses of certain medications can also cause ketoacidosis. I don't think there are any alcoholic cats out there, but it would be technically possible for a cat to get ketoacidosis even if they aren't diabetic. Someone else once debated with me that alcoholism and starvation couldn't cause ketoacidosis. Just goggle the terms or use another search engine if anyone wants to check this out yourself.

The acidosis starts when the ph drops below a certain level. A human internist I know says that the true diagnostic criteria for ketoacidosis is more dependent on the drop in ph rather than just the ketone level per se. If anyone really wants to get into. Ketoacidosis Harrison's principals of Internal Medicine has a whole chapter on it!
 
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