Need advice help

[Toby22]

Hello,
I have a male 15 year old cat named Toby. He has been a diabetic for 2 years. Well controlled with 1 unit twice a day. Never had any problems. Took him for yearly check up. Had frutosimine test. His results were 210. Vet called said he is in remission stop insulin bring him back in 4 weeks for another frutosime. I have never tested bg at home never told to. One week later he was not eating lethargic. I took him to the hospital and they said he had mild dka and mild pancreatitis. His bg was 476. he also has cystitis. He stayed in the hospital overnight. Since coming home he still is not eating like he should and still not acting normal. After reading this board I think the vet made a mistake saying he was in remission and stopping insulin. Am I correct? When I questioned her she said it was standard protocol and he could have went too low and went into a coma and died. I am afraid he will never get well now. He did so good for 2 years

 

[Don Degludec]

I think I can jump in briefly and speak for the well-known members/moderators here:
Buy a glucometer [most of us use human meters], set up a spreadsheet and put Toby back on insulin, as soon as.
[If I were you, I'd also change vets.]

Edit to add: healthy cat/remission BG values are between 50-100 on a human meter. Renal threshold is around 200-250, but you really want to keep the cat consistently way below 200.

 

[Chris & China (GA)]

Vet wasn't necessarily 100% wrong, but we usually don't recommend going from 2U to zero. One of the reasons we stress home testing is so we know what's going on in our cat's body every day. If they start to spend time in normal numbers (50-120 on a human meter, 68-150 on a pet meter), we would reduce the dose by 0.25 units....if the cat continues to stay in normal numbers for another week, we reduce another 0.25 units with the goal to eventually get to where they are still getting normal numbers on zero insulin.

With the fructosamine being that low, it could mean that your cat was in normal numbers for enough time that it made your vet think he was in remission, but without daily testing and good record keeping, your vet didn't have all the information necessary to tell you he was in remission (and also probably knew nothing about how WE treat our sugarcats).

Best thing you can do is start home testing his blood glucose levels, and since he was just dealing with ketones, you also need to test for ketones at LEAST once a day. There are Urine ketone strips you can use or there are blood ketone meters but those usually have to be bought online and the strips are about $1 each....but if money is no problem, blood ketone meters will catch problems sooner than the urine strips will.

Here are some ways you can Help us help you

I will also tag @Bron and Sheba (GA) who can give you lots of great information on post-DKA treatment. She's in Australia but should be online soon (if not already)

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
Was your kitty given any antibiotics for the cystitis?
I am concerned he is not eating enough and is not acting like himself.
What type of insulin is he getting and what is the dose?
I am going to give you a list of things you need to be doing for Toby now that he is home from the hospital.

• you need to give one and a half times as many calories as he normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If Tony won’t eat the low carb food, feed him whatever he will eat as eating any food is better than not eating,
• Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, dont feed and test again in 20 minutes and post and ask for help.
• Test daily for ketones. This is very important. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all. To test for ketones you need to buy a bottle of Ketostix from Walmart or a pharmacy, collect a urine sample from Toby and follow the directions on the bottle. Get this done now as a priority as it is important tp know if he has any ketones.
• Give antinausea medication if needed. If he’s not eating, he could be nauseated which is common in post DKA cats. Ask the vet for some cerenia or/ and ondansetron.
• Give appetite stimulant if needed after the antinausea medication
• Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
• Ask the vet about subQ fluids
• Set up a spreadsheet and test the BG frequently
• Post daily with updates and ask for help as often as needed.

The most important things you need to do for Toby are to get those Ketostix and test for ketones, get the antinausea medications and make sure he is eating. Also get the Spreadsheet set up and start testing the blood glucose
Bron