New diagnosis help

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AlexH

AlexH

Member Since 2021
Hello all! Firstly this forum has been incredible for a new diagnosis and getting to grips with everything, so thank you already...

My name is Alex, recently our poor Bengal Ziggy has been diagnosed with diabetes, and I am finding it all quite overwhelming. I am based in the UK and finding vets less than helpful (Basically a "here's your insulin - good luck" approach)

Recently he had to be taken to an emergency vets with DKA just a few days after diagnosis and being on Caninsulin (2.0u) Thankfully he's back home now and doing a lot better on Prozinc, and was also fitted with a libre tracker (which has annoyingly already stopped working!)

My big worry is that his levels still seem very high after nearly a week now, I have been doing a curve today while I work from home and he is dropping to 14.7mmol and popping right back up to 25mmol a few hours later. The vet seems very unconcerned by this, should I be worried? Should I be increasing his dose? He's currently on 2.0u

Another side point is that his appetite is CRAZY. He howls (typically Bengal) for food endlessly, he seems stressed and restless, and sprints to the kitchen whenever I stand up. He has even taken to trying to eat the dogs food out of desperation - anyone any experience of this? Does it ever get better?

Thanks all!
 
Excellent, thank you

I have actually just spoken to the vet who suggested putting him up again to 2.5u based on his curve - this seams very high, but he is a very big cat (as in size, not weight)
 
Hi and welcome to the forum. I am sorry Ziggy has had DKA.
I am going to give you some information about how to look after kitties who have come home from hospital after having DKA
DKA happens when there is not enough insulin, not enough food and an infection or inflammation. So the treatment is to ensure that the cat is getting enough insulin, enough food and the infection or inflammation is being treated.

  • you need to give one and a half times as many calories as he/she 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 your kitty 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. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all. If you are not already testing for ketones you need to buy a bottle of Ketostix or Dia Ketostix from a pharmacy. Put the results of the tests into the remarks column of the Ssplease.
  • Give antinausea medication if needed. Ask the vet for Cerenia or ondansetron if your kitty is not eating well.
  • 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.
I would increase the dose to 2.25 units if @JanetNJ ]@Panic[/USER] don’t answer. I am not a Prozinc user but I can see the dose needs increasing. With DKA we need to be a bit more aggressive with dosing then normal.
Please keep monitoring the BG closely.
Bron
 
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AlexH said:
Another side point is that his appetite is CRAZY. He howls (typically Bengal) for food endlessly, he seems stressed and restless, and sprints to the kitchen whenever I stand up. He has even taken to trying to eat the dogs food out of desperation - anyone any experience of this? Does it ever get better?
Click to expand...
It’s very common for diabetic cats who are not regulated to be very hungry. That will improve once the BGs return to more normal levels.
You are lucky really he is hungry and wanting to eat a snack as many post DKA kitties are nauseated and don’t want to eat.
Are you feeding him lots of snacks during the day and night as well as the 2main meals? It is really important he eats lots of food.
He is gorgeous by the way.
 
Thank you! that is a really useful info - the vet suggested that a bout of pancreatitis alongside his diabetes was the catalyst. That day he wouldn’t eat, and because of this we were then advised by the vet to not inject insulin without him eating, the combination of pancreas inflammation and lack of insulin seemed to cause a massive spike in his BG and trigger the DKA.


Bron and Sheba (GA) said:
It’s very common for diabetic cats who are not regulated to be very hungry. That will improve once the BGs return to more normal levels.
You are lucky really he is hungry and wanting to eat a snack as many post DKA kitties are nauseated and don’t want to eat.
Are you feeding him lots of snacks during the day and night as well as the 2main meals? It is really important he eats lots of food.
He is gorgeous by the way.
Click to expand...

The vet was pretty pleased with his bounce back after DKA, he’s always been a big eater. At the moment he’s getting 2 big meals just before his insulin shots, then roughly 3smaller meals spread throughout the day, plus a few high protein low carb snacks. He’s probably getting above 1.5x his daily amount if I am honest, just because he seems so distressed about food!
 
AlexH said:
That day he wouldn’t eat, and because of this we were then advised by the vet to not inject insulin without him eating, the combination of pancreas inflammation and lack of insulin seemed to cause a massive spike in his BG and trigger the DKA.
Click to expand...
I would say you are probably right.
If your kitty won’t eat, you can still give a half dose of insulin.
Are you testing daily for ketones?
 
Good that you are feeding lots of small meals. You can feed as often as you want, just no food at least 2 hours prior to the preshot tests. How much does he weigh and how many calories is he currently eating?

Great job testing and getting that spreadsheet going. I'm glad you raised to 2.5. Give it several days at this dose then his dose can be reevaluate. Having had dka we don't want to hold an ineffective dose too long.
 
The reason your kitty is ravenous is that without enough insulin, glucose (aka what his food breaks down into) isn't getting into his cells. Insulin transports glucose into the cells. If there's not enough insulin, your cat is literally starving to death -- and apparently your cat is quite vocal in that regard. As you see Ziggy's numbers coming down into a better range, his appetite should come back to normal. It's fine to give more food unless you see that Ziggy is gaining too much weight. Did your vet recommend that Ziggy be fed a low carbohydrate, canned food diet?

Bron provided great information on DKA. Just so you are aware, we treat kitties that are post-DKA with great care. It's important to not skip shots. If you get a lower pre-shot number, please post and ask for help. Often a post-DKA kitty can easily slip back into developing ketones. You can use urine test strips to monitor ketone levels. There are also blood ketone meters. Which type you opt for is up to you but I'd strongly encourage you to test for ketones on a daily basis for the time being.

If you are looking for more information on Prozinc, this is the link to the Prozinc forum. There is a great deal of information about Prozinc and its use in the sticky notes at the top of the board.
 
Thanks all - we have started to increase his food to deal with his hunger now, I was initially worried about food causing spikes in his BG? But after the help provided so far I can see the priority is to keep his ketones down and keeping him well fed with low carb high protein food.

he weighs 6kg, but looks very slim due to his size, and is getting about 300 - 350 calories a day, does this seem about right?

We have some test strips now too and he has no trace of ketones so far which is great, we will keep on top of this each day going forward!
 
AlexH said:
weighs 6kg, but looks very slim due to his size, and is getting about 300 - 350 calories a day, does this seem about right?
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As he has had DKA he needs 1 and a half times as many calories as he normally gets. For his size 340-350 would be for him normally without DKA.
You need to increase that by a half again to ensure he gets those extra calories he needs at the moment.

AlexH said:
We have some test strips now too and he has no trace of ketones so far which is great, we will keep on top of this each day going forward!
Click to expand...
That’s good news!


AlexH said:
I was initially worried about food causing spikes in his BG
Click to expand...
In a normal kitty without diabetes, the pancreas supplies the insulin in response to food and any rise in BG is brought down by the insulin.
You are doing it for Ziggy at the moment while his pancreas isn’t producing insulin.
Don’t ever restrict the food.
 
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