911 MY cat is in ER - eDKA

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acaro7

acaro7

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Hi everyone,

I’m devastated with my cat in the ER for more than 24 hours with fluids.

A stupid careless negligent vet prescribed him w bexacat, despite him having low ketones and more.

He’s stable but weak and they cannot start insulin therapy with him because the electrolytes & potassium are not stable yet.

Any experts suggest a treatment?

I’m going to have him hospitalized for more time hoping he will be a bit more stable and hoping for insulin therapy, but at this point I’ve lost my faith in doctors and hoping for someone who knows how to cut corners and save him.

I can provide lab results and whatever is necessary to get a better opinion.

Thank you so much and please I need help now, time is of the essence.
 
I don’t have experience with this and I’m so sorry you and your cat are going through it. It’s insane the amount of bad vets out there. I’m tagging more experienced members here for you
 
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I would talk to the vets about the use of a short acting insulin. Typically, they use Humulin R (also called "regular" insulin) and have your cat on a dextrose drip (intravenously administered dextrose which is basically a sugar solution to prevent numbers from dropping too low) and too get your cat hydrated. At the same time, they would be titrating the electrolytes in order to get your cat our of a metabolic acidotic state.

This is a summary treating DKA from a veterinary conference. The information is about 10 years old but is will give you a baseline for what needs to be done. It's a bit technical since it's written for vets. They may be correct about holding on insulin but I am surprised. Just make sure you understood if they were talking about the insulin you would use at home vs what they would be using in the hospital. You will not be using Humulin R at home.

If it were me, after my cat was safe and I calmed down, I would be having a long discussion with your previous vet about how his negligence (i.e., not recognizing that your cat had ketones the labs suggested DKA and he prescribed a drug he was not familiar with and that can cause DKA) is going to cost you a small fortune for your cat's treatment. I would be suggesting he pay for the hospitalization. Alternatively, you can file a complaint with the state veterinary licensing board.
 
Sienne and Gabby (GA) said:
I would talk to the vets about the use of a short acting insulin. Typically, they use Humulin R (also called "regular" insulin) and have your cat on a dextrose drip (intravenously administered dextrose which is basically a sugar solution to prevent numbers from dropping too low) and too get your cat hydrated. At the same time, they would be titrating the electrolytes in order to get your cat our of a metabolic acidotic state.

This is a summary treating DKA from a veterinary conference. The information is about 10 years old but is will give you a baseline for what needs to be done. It's a bit technical since it's written for vets. They may be correct about holding on insulin but I am surprised. Just make sure you understood if they were talking about the insulin you would use at home vs what they would be using in the hospital. You will not be using Humulin R at home.

If it were me, after my cat was safe and I calmed down, I would be having a long discussion with your previous vet about how his negligence (i.e., not recognizing that your cat had ketones the labs suggested DKA and he prescribed a drug he was not familiar with and that can cause DKA) is going to cost you a small fortune for your cat's treatment. I would be suggesting he pay for the hospitalization. Alternatively, you can file a complaint with the state veterinary licensing board.
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Sorry you're going thru this hard time, me personally, I do not trust Vets with diabetes illness, they will burn a hole in your pocket. I trust this Forum blindly. Since my Corky was Diagnosed on July 2nd this year and hospitalized for 8 days, all the information I got from the Vet once I picked my Corky, it was totally wrong, Follow the suggestions from this Forum, I have yet to take Corky to the Vet since... My Corky has gained all his weight back, he's doing amazing thanks to all the guiding from the members in this Forum. My suggestion, stick to this Forum like glue.. You, your kitty and your pocket will appreciate it. Best to you.:bighug:
 
Just to offset the comment above, my vet and the emergency hospital vet saved Gabby's life. At diagnosis, she was diabetic and in DKA, had pancreatitis, and hepatic lipidosis -- her liver was shutting down. Both vets said that she was in rough shape. The emergency hospital was excellent and she had 24/7 care. They gave me lab values and were supportive when I called and they called me with updates routinely. If I had one complaint, the emergency vet was still using Novolin for treating feline diabetes. Once Gabby was home and back seeing my regular vet, and I had been doing my research here and elsewhere, we eventually switched her over to Lantus. That said, I needed to push my vet and provide her with the research literature since Lantus was not yet widely used. The result was she switched the entire practice at a cat only vet group to using Lantus.

The majority of vets are not in it for the money. They have grown up with a love for animals. Think about the costs involved in a vet practice. Most MDs do not have Xray equipment, a surgical suite, the means for sterilizing equipment, boarding facilities, ultrasound, and a host of other equipment. MDs send you for tests and procedures that a vet does in the office. Vet school is easily as expensive as med school. In addition, vets are expected to know everything about every species. They also have an incredibly high suicide rate. Before trashing a vet, and some vets like like some MDs deserve to be trashed, look at the big picture.
 
Sienne and Gabby (GA) said:
Just to offset the comment above, my vet and the emergency hospital vet saved Gabby's life. At diagnosis, she was diabetic and in DKA, had pancreatitis, and hepatic lipidosis -- her liver was shutting down. Both vets said that she was in rough shape. The emergency hospital was excellent and she had 24/7 care. They gave me lab values and were supportive when I called and they called me with updates routinely. If I had one complaint, the emergency vet was still using Novolin for treating feline diabetes. Once Gabby was home and back seeing my regular vet, and I had been doing my research here and elsewhere, we eventually switched her over to Lantus. That said, I needed to push my vet and provide her with the research literature since Lantus was not yet widely used. The result was she switched the entire practice at a cat only vet group to using Lantus.

The majority of vets are not in it for the money. They have grown up with a love for animals. Think about the costs involved in a vet practice. Most MDs do not have Xray equipment, a surgical suite, the means for sterilizing equipment, boarding facilities, ultrasound, and a host of other equipment. MDs send you for tests and procedures that a vet does in the office. Vet school is easily as expensive as med school. In addition, vets are expected to know everything about every species. They also have an incredibly high suicide rate. Before trashing a vet, and some vets like like some MDs deserve to be trashed, look at the big picture.
Click to expand...

I suppose you are right, I did not mean to trash every Vet, I just happened to experience an overwhelming feeling of mistrust, bad judgement and monetary interest in the 2 Vets, it freaks me out. Yes the first Vet that saw her at the hospital did indeed saved my Corky's life with the correct diagnosis while her 8 days hospitalization but every day I went to see Corky, I was asked for more and more money, even after the fact that a Foundation, covered $1,500 I depleted my savings with the little bit I had and refused to release Corky unless I would pay them another $600.This left me with a sour taste in my mouth, then Our original Vet That has been Corky's and Coco's
V
et for over 10 years, 2 days after Corky came home with a sensor, it fell off, and the Vet decided he was no longer, taking care of my pets to find another Vet. He was also an amazing Vet. So I apologize for sounding bitter towards Vets, as far as I am concerned, This Forum has been the one to save my Corky's life.
 
Thank you all.

I appreciate everyone’s replies.

I’m still at the ER and the bill is getting insane.

it’s at about 10K now.

I’m attaching his latest lab summary for reference.

https://drive.google.com/file/d/1k3jZDKAqiQrNA6RX-sg5AthMi2ktRc8W/view?usp=drivesdk

He is getting fluids, insulin, dextrose, food through his nose, etc…

I don’t think I can keep up paying these amounts as I don’t have it.

My plan is to leave him as long as possible here, 24 hours more or so and then taking him home.

I rather try and see if he fights this and gets better, but will not out him down here just because the doctors say so.

Any advice anyone?

I have glargine insulin at home and maybe I can try my best at home with him?

Help please.

This has been really rough and I don’t want to lose him.
 
Carlos -

This seems like a lot of money for roughly 24 hours of hospitalization. I would ask to talk to the practice manager and see if there's a way they can adjust the costs. The other option may be Care Credit.

Fundamentally, DKA is not manageable at home. Your cat needs to have labs drawn and run in order to determine which electrolytes are needed. They are typically given intravenously. Again, unless you're a vet tech, none of us is equipped to adjust IV medications. It's not a matter of just giving insulin. Lantus takes about a week to build up in a cat's system. As I mentioned earlier, they are likely using a short acting insulin that's offset by having your cat on a dextrose drip. Again, this approach to insulin management may not be feasible at home. As a reference point, when my cat was diagnosed with diabetes, she was also in DKA. She was hospitalized for 3 days.
 
Yeah he’s been in ER since Friday and I’ve spent around 8k-9k.

I can’t keep him hospitalized and also don’t want him to suffer.

it kills me to see him there laying down with all these things going into him.

I don’t think I can put him down there, I don’t have it in me.

But also, if I take him home, I don’t want him to suffer…

I don’t know what to do!

I can’t put in words how I feel.
 
I just wanted to say that I am so sorry you are in this position. Just know that your cat loves you, and that what's happening now isn't your fault. You clearly love your cat and are doing everything you can to help him. Your vet made a terrible mistake. Not you. Whatever happens, just don't forget that.
 
It's beyond shameful that this has happened and sadly not a big surprise. I'll give you a few legal pointers, some are obvious to the point of being condescending, just want to make sure I haven't forgotten anything.
>Who's "fault" it was can be hard to pin down. Was it the vet, the lead tech or a student who advised and authorized the final decisions and dosages.
>Any tests and lab results are legally your property including imaging of any kind.
>It won't be hard to find out who or what you can record on a phone. Don't get mad, keep conversations going with direct and yes/no questions. Never be the one who hangs up first. Do not make threats you can't back up and if you really want to push a doctor's buttons mention things like ethics and code of conduct. The state or provincial veterinary college should have a printable version of their code of conduct.
>Don't be afraid to make a stink with the veterinary college. It will be to your benefit to register a complaint but never look like you're out for vengeance, you only want what's fair.
>That bill sounds excessive, don't settle for some slight reduction. Money is hard for all of us and while I have my own issues with GoFundMe that's what it's there for. If you need to rationalize using it for something like this remember it's not pity that makes people give, it's compassion.
Best of luck to both of you, this could be any of us.

as for looking at his labs @Larry and Kitties
 
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