Low Readings After No Insulin

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Jane Anne

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Snowcone had a reading of 250 on the morning of 3 Aug. We gave her the normal dose of 1.5 units that Evening , and on 3 and 4 August twice a day of 1.5 units. On 5 August her morning reading was 204, so we didn't give her any insulin that morning. We haven't given her any insulin since and this morning (6 Aug), the reading was 189. We are fairly new to this forum, so I am wondering if these readings mean anything to you out there! Is it possible she is in remission?
 
It sounds like she is doing really well. We generally consider a cat in remission if they range from 40-120 off insulin for 14 days. So she is a little high. Does she go down during the day or after food? (If she drops after eating, it means her pancreas is working ) I think, if she were mine, and she was close to 200 at shot time (like your 189) I'd stall and see if she rises up closer to 200. So don't feed her and retest her in 20 minutes. If she has risen and is in the 200s, maybe give her 0.5 units. Then test in the 5-7 range to see where that dose took her. If she drops but stays in safe ranges (above 50) that might be a good dose for awhile. If she in higher and flatter, maybe one unit is a better dose.

It seems like she may need a little insulin to keep her in lower ranges, but she may be headed to remission. Sometimes, with some lucky kitties, all they need is a diet change and a few weeks of insulin.
 
She hasn't eaten anything? She needs to eat. What have you tried?

Her lower levels could be because she is not eating. But she can get really sick if she doesn't eat.
 
.Thanks for the information. Snow Cone was at the vet a week ago for not feeling well, and the vet said she had a slight fever and put her on Amoxicillin for seven days and she was doing fine until two days ago. She quit eating and looked terrible. We force fed her this morning and she looked better and took her back to the vet and they x-rayed and said she said she is very constipated and they are doing an enema right now. Said to stay off the insulin until she starts eating on her own. This is not the diabetes vet but a different general one. The diabetes vet doesn't have the time to answer question, so we are going to change vets soon.
 
I hope they get her eating again. It is important that she also receive insulin, if her numbers warrant it.

Once things get back to normal, you can see what her numbers look like and start again.
 
Just got back from the vet, they tested her urine, said that it had ketones, and diagnosed her with Diabetic Ketoacidosis. They also wanted us to take her straight to the Emergency Clinic. We declined on that, will keep her at home until tomorrow when we have an appointment with our diabetes vet. They said try and get her to eat so that we can give her some insulin. If she won't eat, and her reading is above 250, the vet said to go ahead and give her insulin anyway. Also she has lost one pound in the last week.
 
Hi Jane,
I don't have any direct experience with DKA but it is a very serious condition. It's critical that your kitty eats so you may need to force feed with a syringe. It's also really important that she's getting insulin. You might want to edit your heading and add DKA to get more experienced eyes on this thread. I'm sorry I can't really be of more help. Please keep us posted!
@BJM, @Meya14, @Jill & Alex (GA), can anyone offer advice on dealing with DKA at home? I know there was a thread not too long ago about this but I don't remember who's kitty it was.

Joan
 
The important thing is to get food in so you can give insulin, and to get water in to help flush the ketones. If there is an emergency vet around that you trust, you might need to go there, depending on how severe the condition is.
Ketones in the urine mean there was fat breakdown for calories. It doesn't necessarily mean the body was acidotic unless your vet did some other blood work? Nevertheless, it is a red flag for monitoring diligently, and following your insulin protocol as exactly as possible.
 
Ketones are best treated at the vet because they can put her on IV fluids which help flush them out. She may have to spend a day or two at your regular vet. For now, if you are home testing, and are able to syringe feed, you do want to give her insulin, but what dose depends on what she's been taking. You may have to mix karo or honey into the food you are feeding to keep her numbers up. You should test the blood sugar frequently.

For the vet tomorrow, ask about the following things:

1. Anti nausea med like cerinia or ondansetron
2. Blood test for potassium and a supplement if she's low (low potassium is common with ketones and can cause constipation and heart issues)
3. SubQ or IV fluids. If she doesn't stay at the vet ask if they can show you how to do the subQ fluids at home.
4. High cal food - Iams max cal, royal canin recovery, or whatever high cal critical care food they have
5. Supplies for syringe feeding if you don't have them


From the grocery store or pharmacy pick up some ketone urine test strips for home testing. You should home test a couple times a day.

Cats develop ketones because of lack of insulin, lack of food, or both. Infection raise insulin needs, and is often the trigger.
 
I agree with your vet, Sue and Meya14. Ketones are best treated at the vet and it sounds like treatment should be started ASAP. This can be very serious... even fatal. After having gone through a full blown case of DKA with Alex, I wouldn't take any chances.

There's some good info about Ketones and DKA in the link Joan posted above.
 
I'd like to chime in and urge you to go straight to the emergency vet also. DKA can be fatal very quickly. Please, please scoop her up and head to the ER. She needs to be treated as quickly as possible.
 
We took Snowcone to the vet on Friday and our diabetes vet didn't think it was DKA because her glucose reading wasn't high enough. She thought it was most likely pancreatitis. She said that she was critical and that we should leave her with them, which we immediately agreed. The next morning they called and said there was no improvement and she was still critical. At that point, we just decided that we couldn't go on with it and decided to have her euthanized. The vet called us later and said it was the right decision. We miss her, and our other three babies also know that she is gone. One thing we have noted is that there is significantly less clumping in the litter box. She was evidently creating a great deal of urine. We had noticed that, but couldn't pin it down to any one of them. It was obviously Snowcone.

Thanks for all the advice, information, and help. We have really appreciated it.
 
Oh Jane Ann, I am so sorry to hear you have lost your sweet Snowcone. Pancreatitis is fairly common with diabetic kitties and can be very difficult to treat.
 
Jane Anne, I am so so sorry. I know how much it hurts. Remember, it is the last, greatest gift we can give...to ease their suffering and let them go. You were such a good mama bean to Snowcone, and she was taken such great care of.

Fly free sweet Snowcone! Land softly.
 
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