New Here... My Cat is DKA.... Please Help

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MrPouncersMom

Member Since 2013
Hi Everyone,

This is my first time posting to a Message Board anywhere so I apologize in advance for any mistakes or annoyances.

On New Years Day we had to rush my 8 year male cat, Mr Pouncers to the Emergency vet. He had been losing weight and was acting lethargic for a couple of months. We kept putting off going to the regular vet because my father had a heart attack and has been going to doctors and for procedures and is scheduling surgery so everything has been crazy and up in the air. We tried switching Mr Pouncers to a grain free dry food. He is the pickiest cat when it comes to eating. He only eats dry food and prefers what we call the "naughty salmon" (its the only thing my 14 yr old persian will eat so we cant not offer it) since it is not grain free but will eat the grain free chicken dry food. Hes been eating his food and seeming to act more like himself so we thought he might be getting better.

Late on New Years Eve Mr Pouncers threw up once and then stopped eating. We couldnt get him to drink water either. He is normally addicted to water. As an 8 month old he had a urinary tract blockage that required surgery and ever since hes been addicted to water. Given the chance he will jump into the shower with you and get soaking wet and never be happier. The drip of a faucet would have him running in excitment so his not wanting water was the major sign something was really wrong.

On New Years Day he just laid on the bed not wanting to move much but did attempt to jump off to hide under the bed but knowing he was really sick we didnt let him. We rushed him to the emergency vet and they examined him and ran his blood work. His blood glucose level was 657 and he had ketones in his urine. His white blood cell count was also high showing some kind of infection. So the vet told us he had DKA, was severly dehydrated and needed to stay with them.

At 11 pm that night the vet called to tell us that his blood pressure had dropped really low but they were able to bring it back up but he was still severly dehydrated and she felt he had a 50/50 chance of survival. She did say that they retested his BG level and it had dropped to 550 just with fluids. Of course we rushed to the hospital to see him and when he saw us he actually stood up and walked to the edge of the cage and kept trying to jump out. While there i got him to drink a little of the water from the dish. He seemed a little better.

Yesterday the vet called to tell us that he had an ultrasound done and it did not show any tumors or any sign of cancer. His chest xray was good and his heart appeared strong and healthy. She said that his blood pressure was good and staying normal. She said he was still dehydrated but they couldnt push the fluids any faster. She said at 2 am they gave him some insulin and his BG level was down to the 150 range but he didnt pee for them yet so they couldnt check the ketones. She said they did see that he has a kidney infection so they were starting him on antibiotics. She also said he tried to eat a bite of the food they were offereing him but not much of anything. They were starting him on some anti nauseous to see if that helped.

We went to visit him and he was very lethargic again. He picked his head up for us, was purring and swung the front of his body to the front of the cage but didnt try to stand up or anything. He seemed worse then the night before. When we asked the vet on call she said it was because he was still dehydrated and they couldnt push fluids faster because of brain swelling. This came as a shock since no one mentioned anything about brain swelling before! We couldnt ask more because an emergency came in and we were pretty much shown the door. We left some of his regular food so they could try to get him to eat more.

This morning the regular vet called and said that he ate half the amount of food they gave him and he was more active and walking around his cage. They tested his urine and found ketones again but the biggest problem was that his blood pressure dropped again. They were able to bring it back up again but said he was still critical and still 50/50. She was going to have the Internal Medicine doc examine him today and call us later with an update but we are so lost and worried.

Does anyone have any experience with DKA like this? Are these problems like the low blood pressure normal? Are there any lasting side effects from DKA? Do cats normally survive DKA like this?

We are so worried that we are going to lose him and hearing 50/50 chances doesnt help. Any advice, thoughts or past experience would help a lot.

Thanks for taking the time to read this long post.

MrPouncers Mom- Bethany
 
I'm new here and I don't know much of anything about DKA. I just wanted to let you know that I read your post and will be sending prayers and warm thoughts for both you and your sick kitty.
 
If I remember correctly from physiology class:

With dehydration, you get a concentration issue - not enough water, with too much solute (what gets dissolved in water); cells shrink, circulatory pressure may drop.
When you start adding fluid into the circulatory system, it starts increasing the volume (blood pressure) and it is drawn into cells where the concentration of solute is higher. This causes the cell to swell.
Once it gets to the correct ratio of solute to water, the cells may start releasing some of the solute and excess water.
Until then, the cell may be swollen. This may explain the brain swelling.

If they are doing the fluids IV, you might ask about doing some subcutaneous too. The subcutaneous fluid will be absorbed more gradually.

Also, the reason the fluids dropped the glucose level is due to dilution.

He may need his potassium level adjusted; ask them to check.
 
My cat Kitty survived DKA at age 16. She was receiving an inadequate dose of insulin and developed a Urinary Infection at the time of going DKA. It is not uncommon for infections to accompany a DKA diagnosis.

It is a good sign that your cat is eating some and that he is responding to insulin. At the time Kitty went DKA, it took about a week for her to respond to any insulin. Initially she was given "R" regular insulin and then was transitioned back to a longer lasting insulin. If Mr Pouncer is eating, receiving fluids and responding to insulin-- they are good signs. DKA is VERY hard on the cats and it takes time for them to show signs of improvement or to fully recover, but a full recovery is possible. After going DKA, I started home testing for Ketones at home- something you should consider when Mr Pouncer comes home. I tested with Ketostix- urine strips, but there also blood meters that monitor Ketones. Once a cat has had ketones, they always need close ketone monitoring-- it is very easy. Some cats are prone to ketones, while others are not. Ketones occur when the body is not digesting the food properly- a side effect of diabetes. Once Mr Pouncer gets on insulin therapy, he will digest/break down food properly and most likely regain weight. Diabetic cats lose weight, because the insulin is used to help break down the food and when this is not done properly, due to insufficient insulin, the cat begins to break down their body fat and muscle to live on-- thus the weight loss.

Kitty never had any blood pressure problems with her DKA episode. I checked Kitty very often for ketones, but she never tested positive again for ketones after going DKA and she lived another year.

Like I stated, DKA is hard on the cat, but many cats survive and go on to live long happy lives. There are many cats here, on FDMB, that have survived DKA.

Good Luck and Prayers to you and Mr Pouncer.
 
Mr Pouncer has a fellow diabetic ketosis across the pond, here in the UK in my cat, Milo.

He's a fellow bathroom obsessive & was recently diagnosed with diabetes after a spectacular crash in the same manner you describe. This was the last week of November 2012, coincidentally the same time one of our best two-legged friends was rushed into an emergency triple cardiac bypass, so we spent the next week shuttling between the Heart Hospital & the Vet Hospital, not knowing if we'd see either friend again. We have & we are blessed with both of them in our lives still, but there's still a long way to go.

The Vet gave us the same odds as they gave you, although they didn't tell us at the time. Milo is being hospitalised again tomorrow morning as although he recovered from his ketosis, his insulin/glucose is all over the place & has been since. He lost 30% of his bodyweight during his DKA crash, and is still a walking wobbly furry skeleton, but he survived. He has not yet put on any weight & continues to get lighter, but he's now eating, drinking, weeing & crapping again, in between purrs & destroying his favourite toy snake.

Mr Pouncer is in the right place having the right attention. He is responding to your presence & is taking on food & fluids. All good signs. One day at a time & one hour of every day at a time.

Hometesting for glucose & ketones is overwhelming at first, when you are overloaded with information, but it is very straightforward when you get down to it. A lovely lady on here (Elizabeth & Bertie - who also directed me to your thread!) gave me a glucometer yesterday afternoon. I did my first glucose curve on Milo today whilst working at home.

It's a horrible time at the moment & I feel for you. There is light at the end of the tunnel & it might not be an oncoming train!

I shall keep all my bits crossed for you & your moggie.

Juliet
 
Welcome, Juliet.

My kitty is a DKA survivor, as well. The hospital is the best place for Mr. Pouncer, under the circumstances.

There are several questions that come to mind. With DKA, your cat's electrolyte balance is out of kilter. You should ask about potassium and phosphorus levels. In particular, if the ER vet said they thought there was a kidney infection because there was blood in Mr. Pouncer's urine, the blood may have been due to low phos levels. When treating DKA, they slowly adjust the levels of electrolytes in order to get them back to normal. I'd also want to find out if the sodium levels are in normal range. There is a complication of diabetes where dehydration is prominent and blood pressure drops (it's called hyperglycemic hyperosmolar syndrome or HHS). I'd ask the vet about this.

Ketones can develop when there's an infection, not enough insulin, and a cat stops eating. Fluids will help to "dilute" the ketones and, if HHS is a factor, fluids are the treatment for that, as well. Getting insulin into Mr. Pouncer is obviously essential and it sounds like he's responding with his blood glucose levels coming down.

Did the vet get a sterile urine sample? This procedure is called a cystocentesis and they then run a culture and sensitivity in order to make sure the appropriate antibiotic is being given. You want to make sure that your cat is on an antibiotic that is appropriate for the UTI.

I'd also want to make sure that pancreatitis isn't an issue. The test that is used is either a Snap fPLI or a Spec fPLI. Pancreatitis is often the cause for diabetes.
 
I don't have any experience with DKA, but I just wanted to send some well-wishes, strength and healing vines to Mr Pouncer. I hope he weathers the storm.
 
My kitty is a DKA survivor, and he was pretty sick for awhile. He got better and better very slowly in the 8 and 1/2 days he was hospitalized. He came home with a feeding tube because he would not eat for the vets all that time, which he quickly dispensed with once he got home.
I wish you The Best Of Luck with your kitty.
 
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