Need advice! Possible ketoacidosis!

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TriPaC87

Member Since 2013
I have a 13 year old maine coon who is in really bad shape. Here is the situation from beginning to end. Any help is much appreciated!

Dan was diagnosed with diabetes after a chronic vomiting problem in December of 2012. We immediately changed his diet to a low-carb wet food diet twice (half a can of FF for breakfast, half a can at night) a day with a vet prescribed diabetic dry cat food for some hard food in the bowl for him to eat throughout the day. We gave him 4u of Lantus after each wet meal (morning and night). After about two weeks he would not let me give him his insulin, he would roll over on his back and try biting me. He would only let my boyfriend give him his shots. This did not work for us because my boyfriend works crazy hours and we travel often. We decided to stick with the low carb food diet and ween him off the insulin. I assume he went in to remission.

Then on July 16 we had our carpeting cleaned. I locked both of our cats in the bathroom for around two hours while. When I let them out they were freaked out from the smell, the wet carpet, the furniture being out of place, and the loud fans I had blowing down/up stairs to dry the carpeting. They slept on the bed the rest of the afternoon until dinner time. At dinner time they would not come downstairs to the kitchen for their wet food so I brought it up to them. Dan only ate a few bites. The next morning I put all of the furniture back and gave them their breakfast. Dan only ate a few bites. That night, he didn't eat any of his wet food. Come Thursday, he would not eat anything at all and had very rapid breathing. I took him to the vet Friday morning (July 19) and he was diagnosed with hypertrophic cardiomyopathy. His heart was very enlarged and she gave me Diltiazem tabs to give him every 12 hours. She gave me a few cans of Hill's A/D and some syringes and told me to assist feed him. She also told me to begin with the insulin injections again starting with 2u. His blood sugar was around 640.

Also, Dan would stay beside his water bowl about 18 hours a day. Very little activity. Our bed is very tall and we have an ottoman set up for them to have a step to help them get up on to the bed. Dan jumped on to the ottoman and then when he tried to jump on to the bed, he fell. He has never had issues like this before.

Over the course of the next week we syringe fed him the Hill A/D mixed with water twice a day. Continuing with the 2u. At one point I called the vet and told her his symptoms and she said to go up to 3u. By Friday the 26th he was still not eating anything on his own. One of my employees told me about a vet that got his very ill cat to start eating again so I called. The vet wasn't in but her tech told me to feed him pure chicken, carrots, green beans, and sweet potatoes. He said to mash it all up and see if he would eat it. If not, add a little broth. If he wouldn't eat that, then add water and syringe feed him. I went to Wal-Mart and got all of that stuff in baby food. I also bought some canned tuna. When I made up the mixture he did not eat want any of it. Not even straight tuna. So over the weekend, we syringe fed him and continued with the 3u.

Come Monday, he still was not eating so I took him to the vet my employee recommended. She called herself a "hollistic" vet and over the course of her interactions with me and Dan, and learning more about him, she came to the conclusion that he had some sort of infection, an immunity issue, and either an enlarged kidney or a tumor near his kidney. She told me to continue with the natural diet (chicken, carrots, gb, and sp) and gave me an antibiotic and a mulit-vitamin formulated for cats.

We continued syringe feeding until last Wednesday (July 31) as he would still not eat anything on his own. Also, he had resorted to going downstairs in the middle of the night and hiding under the pool table. We put a water bowl down there and this is where he lays all day. When I come in the room, he does nothing. Just lays there. When my boyfriend comes in the room, Dan tries to get up and walk to him but he only makes it a few steps before he kind of "collapses". So last Wednesday I took him back to his regular vet to get another glucose test. It was around 430. She said it was still high and I told her that's because I forgot his morning Insulin (I know, very bad.) She said the only other thing we could do to try to get him to eat on his own would be to give him a small dose of Valium that can stimulate their appetites. She prescribed me that and also gave him a Vitamin B Complex shot.

That night we gave him the Valium and about 15 minutes later offered him the natural food mixture and plain tuna. He ate a few bites of tuna and a few bites of the baby food mix! It was a milestone!! I went ahead and syringe fed him the rest so he would have a full meal. About 30 mins after giving him the Valium he could not walk at all. He was totally jacked up on the medicine. We have not given it to him since.

Since last Wednesday he has not improved. He is still laying under the pool table unless we pull him out to feed him or we take him upstairs to lay in bed with us for a little while. Also, he is not peeing in his litter box. He won't eat any food except for the occasion kitty snack that he used to LOVE. I offer him snacks and he usually only wants 2 or 3. There are some days when I get home and he is just laying on his side and won't move until I pull him out and some times he won't even sit up. When we feed him his ears are back and I can tell he is not enjoying it. Also, I upped his insulin to 4u on Saturday or Sunday (I can't remember).

This morning I fed him at 8:30am and took him to the vet for a glucose test at 10:30... his BG was still 430. I can't tell if this is because he is stressed when he goes there or if his blood sugar is still way off. She told me to move up to 7u since we are not seeing any improvement with the smaller doses.

This afternoon around 5pm I went in to feed him and he was laying where he has been having his "accidents". When I picked him up to move him on to the towel to feed him his stomach was completely soaked with urine and there was a spot the size of a dinner plate underneath him soaked with urine. I know it's a bad sign when a pet sits in their own urine/feces. I went ahead and fed him but he was not complying so I stopped about halfway through.

Also, I forgot to add that when he was diagnosed last Dec, he weighed 24.5 pounds. When we took him to the vet on July 19 he was down to 18 pounds. Last week he was about 16.4 pounds. Today he was 17 pounds.

One more thing... when he walks, he isn't up on his feet like a normal cat. He is walking on the lower part of his back legs.

So what should I do? Tomorrow I am going to get a glucose meter to start testing him at home in a stress-free environment. What else should I do? He is only 13 so I would like to think he has some more life left if we could get his BG under control.

Any advice will help. I'm sure I left some important details out so please ask. It's late and I'm very tired from worrying about this sweet baby!
 
OK, the problem with the way he is walking sounds like neuropathy. It's associated with diabetes in some cases. It's a nerve problem but it can be reversed by treating with methylB-12. Ask your vet about it. It's something you can pick up off the counter at the drug store.

Has he ever been tested for ketones? I would hope that the vet has tested him, but if not, he needs to be. You can do this by using "ketostix" found in the diabetes aisle in the pharmacy. You have to catch him peeing and wet the stick with fresh urine. There's a chart on the box that tells you the ketone level based on what color the stick turns.

If he does show ketones, he needs to see a vet asap if it's any higher than "trace levels". Diabetic Keto Acidosis can't be treated at home. It requires vet treatment, and if it gets really bad, emergency room treatment. It can be fatal quickly. My cat was "DKA" and survived but he spent three days in the ER.

You are absolutely correct. A cat who pees on himself or lays in it is not a good thing to see. And I'd say a vet visit is a really really good idea as soon as you can get him there.
 
The mix you describe may be nutritionally unbalanced and could be contributing to what you're observing. Before you change the food, however, you need to be testing for safety. Pop over to Cat Info to read up on feline nutrition from a vet who specializes in it.

If you don't abhor WalMart, pick up the ReliOn Confirm or Confirm Micro glucometer, test strips, and 27-28 gauge lancets for testing.

Otherwise, pick up a glucometer elsewhere without the word "True" in the name as we've them unreliable with cats.
 
What insulin are you using? Jumping from 4U to 7U sounds very unsafe to me. Please, get that human glucometer, matching test strips, lancets for alternate test site use, some high carb wet food like Fancy Feast gravy lovers style, ketone urine test strips and start home testing. That's my recommendation. Here are some home testing tips.

With the little bits of food you describe feeding, it's a possibility your cat has hepatic lipidosis. I think a vet visit is in order.

You need to be syringe feeding at least 6-8 ounces of cat food a day, in many mini-meals throughout the day. If you can not do that by mouth, it may be time to consider a feeding tube. Feeding tubes save lives.

Cats do not require any vegetables, fruits or grains in their diet. They do need vitamins and minerals which you will find in the cat food but not the human baby food.

3 ounces of cat food is not enough for a 17 pound diabetic cat. My 12 pound non-diabetic cat eats 6 ounces of food a day.
 
This morning when I woke up I found Dan shivering and barely alert. I wrapped him up in a warm towel and held him for about 30 minutes. He let out a little moan. A few minutes later I let my boyfriend (Dan's "person") hold him and he was very limp. Eyes completely dilated. I laid him on the floor in the towel to re-wrap him and he let out another loud moan. Then his mouth started to open and he stared off for a minute. I put a few drips of water in his mouth and it took about 15 seconds for him to respond and swallow it. We rushed him to our vet (who is two blocks away) and we nearly lost him on the way.

They took him straight back and got his vitals. His blood sugar was 200 which is the lowest we have been able to get it over the last 3 weeks. She said he was not responding to her touching his back legs and that she had to use hemostats on his back feet to get him to respond. Then I told her about the two moans he let out and she said it was a blood clot. She said they are very painful. She said it appeared that he had given up his fight and it was time for him to go. Apparently, after a cat passes a blood clot the future is bleak. He was laying on the table in his towel barely awake. We decided to let her put him to sleep so he would not have to feel any more pain or suffer. We stayed with him for a few minutes and pet him until he seemed to pretty calm.

Thank you for your advice. I wish I would have been able to use it as it was my mission to get him to a stable diabetic state. Unfortunately, I could not help his heart. Thanks again.
 
I am so sorry it was your baby's time to go. You did everything you could and can take comfort in knowing he is no longer in pain rb_icon .
 
I am so sorry for your loss. Friends of mine have lost 2 Maine Coons to the heart problems that they have.
 
Fly free little Dan. You have earned your wings. wings_cat

You were greatly loved and will be sorely missed.

A ring of candles in Dan's memory.
 

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