New Member - 11/09/20 My sweet ginger cat is newly diagnosed- home after hospitalization from DKA

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Kshe105

Kshe105

Member Since 2020
Hi all!

My 10 yo cat Mr.Alfred is finally home after making it through a scary bought of DKA.

A bit about his diagnosis and where we are at now - about a month ago I noticed an increase in urine in the litter box. We went in to the vet for blood work and everything came back normal. A few weeks later, we noticed a decrease in appetite, so we went back to the vet but everything was still normal with the blood work. The vet suspected that Alfred may have some bowel inflammation so we switched up his diet to limited ingredient wet food and we started him on weekly B12 injections. He was eating well at first, but had some decreased appetite and vomiting. Just over a week ago, he became very lethargic so we took him in to the emergency vet.

It turned out that he was in DKA with a kidney infection, some hepatic lipidosis and pancreatitis. Things were not looking great for the first few days, but he slowly recovered and he was just discharged home a little over a week later- this morning.

He went home with a freestyle libre (which is awesome!) and on 1/2 unit of Lantus twice daily. He also had an E tube placed and I just did my first feeding with it this evening. So far, his BG has been around 300 ish, but he did have a hypo episode before leaving the hospital so we are being a bit conservative with the insulin to start and are going back for a recheck on Friday.

we are so so thankful to have gotten through the initial DKA episode, but I know we still have a long road ahead of us- the vet said early on that “best case we would have a diabetic cat who needed insulin twice daily for the rest of his life” but if it means I may have a bit more time with him it is worth it!

Alfred is truly the sweetest best kitty - even when he was sick he charmed everyone at the hospital. Being at the vet is always a certain degree of stressful for cats but thankfully he doesn’t mind so much- he is always happy to meet new friends!

I’m glad this forum is a thing so I can learn from anyone else’s experiences - I’m particularly interested if anyone has any experience or advice on how to manage the E tube - it’s a bit overwhelming but I’m sure we will get used to it.
 
As did @Aleluia Grugru & Minnie and @JL and Chip
Hopefully they will see the tag.
They were talking about etubes in this thread today.
https://www.felinediabetes.com/FDMB...f-water-high-ketone-test.238278/#post-2676493

My, you and Mr. Alfred have been through the wringer.

A warning: the libre rarely stays on for the entire 14 days. You might want to get a back-up meter. Below is a shopping list for what you will need.
A number of people use the Relion from Walmart.
ReliOn Prime glucometer - $9
ReliOn Prime test strips - $18 for 100
ReliOn Lancets 26 G (or 28 if unavailable) - $1-2 for 100
ReliOn Lancing Device (optional) - $5
Travel-size Vaseline - $1
Neosporin Ointment + Pain Relief (ointment only, NOT cream) - $6
Cotton Pads (optional) - $2


Hypo Kit Supplies:

Karo Syrup - $3
Ketone Test Strips (Ketostix) - $6
A few cans of Fancy Feast Gravy Lovers Marinated Morsels/Sliced in Gravy/Grilled in Gravy varieties - $0.60 each (these are your medium-carb cans)
A few cans of Fancy Feast Gravy Lovers/Medleys Tuscany/Medleys Gravy in Sauce varieties - $0.60 each (these are your high-carb cans)

Medium Carb is 11-15%
High Carb is 16%+​

My apologies for my terseness. I'm on a wonky laptop.
 
Minnie had an etube as well. How did the feeding go? Did they show you how to clean the area around the tube once a day? Minnie managed to unwrap it from the collar a few times and would drag it around but it resisted all her mischief. It sure made it easy to give meds! It was a god sent and it got us through those rough first 2 weeks when she got back from the hospital after a severe IBD flare. Sending Mr. Alfred many healing vibes! :bighug::bighug::bighug:
 
Hi! Welcome to you and sweet Alfred :cat:

Jax did great on his e-tube - helped him overcome a severe infection. Just always flush it with water. I never had to clean the stoma site so I can't help there (my IM would just check on it at follow-ups....Jax was also in the hospital for a few days after he had it put in so I never had to deal with the fresh stoma site). We used it for feeding and meds for about a week or so and I think he only had it in for a total of 3 weeks. We also always left food out so if he wanted to eat it, he could.

What are you feeding? We used hills a/d. It was super easy to syringe when mixed with water.

I hope Alfred will heal and start eating on his own - the feeding tube will help give him the energy to have the opportunity :bighug::bighug::bighug: And every feeding will get easier :bighug:
 
Welcome to you and Mr Alfred. My goodness you have both been through a lot. But I’m so glad to see Mr Alfred home again. And he does sound a sweetheart, and I’m very partial to ginger boys!

Is he on any Pain medication for the pancreatitis?
Or antinausea medications?
It would be very helpful if you were able to set up a spreadsheet and enter the BG readings. Here is a link. I am going to tag @Bandit's Mom as she may be able to help you set it up as I am sure you are very busy with Mr Alfred.
https://www.felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/

Are you testing for ketones in the urine.? It is very important that they are monitored every day after an episode of DKA. You can get a bottle of Ketostix from Walmart or any pharmacy. You just need to collect a urine sample and dip the test strip into the urine and read exactly 15 seconds later against the colours on the side of the bottle.

Food is also extremely important for the DKA and the hepatic lipodosis. We recommend feeding 1 1/2 times the normal amount of calories per day. Multiple small meals throughout the 2 cycles but withholding the food for the 2 hours before the insulin is due.

I agree with @Red & Rover (GA) that it would be a good idea to get yourself set up with a glucose meter which you can use as an emergency and also for after the freestyle Libre comes off.

Here is another link to useful information
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Hopefully Mr Alfred will recover fully from the DKA, pancreatitis, hepatic libidosis and the kidney infection and be able to lead a normal life again for many more years.

Ask lots of questions as there is sure to be someone who can help you with whatever question you ask.:)
 
WELCOME TO FDMB! First off Mr Alfred is ADORABLE.

You already have excellent advice and helpers . Aren't they just the best?

I'm going to direct you here:
New? How You Can Help Us Help You!
This way, you can acquaint yourself with how things run around here , PLEASE pay particular attention to the "Profile/ Signature" section. All this info you enter will, appear at the bottom of all your posts in light gray letters. Its all the info we need to give quick and accurate response to any question you have or God forbid any emergency. Also you wont have to keep answering the same questions over and over. Questions like,"what insulin is Mr Alfred on?"

WELCOME TO OUR FAMILY:bighug:

We all look forward to getting to know you and Mr Alfred.
You have landed in a safe place because it the BEST place, to learn everything you need to know about feline diabetes;)
jeanne
 
Charlie had a feeding tube three times. They can seem daunting, but they really aren’t as bad as they first seem and are truly life savers. If you have any specific questions or concerns, please ask.

I remember very well the extensive notes I took and my initial concerns about making a mistake. Be careful, obviously, but don’t let it get in your head. Each time got easier and soon we had the routine down. I’m guessing the same will be true for you. The key points were to warm the food slightly (I sat the bowl of “gruel” in a container of warm water and then checked it on my wrist, as one would do with baby formula), inject the food into the tube slowly (too fast can cause the food to back up and/or the cat to vomit), flush the tube with a bit of water when done feeding (dried food will block the tube), and clean the stoma site (where the tube goes into the body) daily. Charlie was a super chill cat, so I made a cushy bed for him, covered it with a towel, then put him on the bed in my lap as I fed him and cleaned the site. I was supposed to stretch the feeding over 20-30 minutes so we hung out watching TV. I had all of the paraphernalia handy on a table next to me. Medications were crushed and mixed in with the food, which was easy (you might want to buy a pill crusher if you don’t have one).

I agree with others that you should pick up a glucometer to have on hand, along with the items for a hypo toolkit. I also strongly suggest that you practice with the meter and learn to test on the ear while the Libre is still on board — that way you’ll be comfortable doing it when/if the Libre comes off and you’ll also have a general feel for how the meter readings compare to the Libre readings (expect some variance).

Kidney infections can be stubborn and sometimes require multiple rounds of medications. I found with the feedings and medications and so forth, it was helpful to keep a journal of what was given when, how Charlie was acting, the BG values, ketone test results, and so forth. My vet appreciated the detail.

Good luck, and let us know how you’re getting along.
 
I’m completely overwhelmed with all of your good wishes and replies!It’s nice to have found a corner of the internet who is as passionate about helping diabetic kitties as you all are.

The tube feedings have been going pretty well- I felt more and more on top of it each time today. We are doing Purina AD in the tube and are offering the purina DM dry food before feedings - he has been eating some each time I offer it to him. Even at the best of times Alfred is very picky but ideally I would like to get him on a wet food, but for now we are doing whatever he will eat.

I bought a glucometer to have on hand in case the libre falls off before our recheck- I haven’t used it on Alfred yet, but I did check my BG to see how much the finger prick hurt, and good news, I’m likely not also diabetic :)

I was able to get a ketone sample and we are still looking good there.

He’s on buprenorphine, zofran, omeprazole, an antibiotic, a probiotic and mirtazepine right now.

At this point I think am most concerned about the pancreatitis. I have noticed that Alfred will do “meatloaf cat” after his feedings because I think he is in more pain once he starts digesting. I’m glad he is on pain meds- they seem to help - but it’s a bit hard to tell what other symptoms he has once he’s had a dose because he gets so sleepy after I give it to him. He does seem to be acting pretty “cat like” before his feedings. I just really worry about how much pain he is in.
 
Dont be worried about hurting Mr Alfreds ears with necessary pokes to his ears. The reason it hurts us so much is because humans have MANY nerves at our fingertips. Cats ears not so much.:bighug:
Look at the ears of feral cats.;)
j
 
I don’t think any of the above mentioned meds are an anti nausea. He should probably be on one as well since the apetite stimulant won’t work if he’s nauseated. Can you ask your vet about either Cerenia or ondansetron to add to the mix?

and yay, for not being diabetic. I wondered the same until I tests myself too ha!
 
Kshe105 said:
At this point I think am most concerned about the pancreatitis. I have noticed that Alfred will do “meatloaf cat” after his feedings because I think he is in more pain once he starts digesting.
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Maybe try giving Mr. Alfred a toy filled with good quality catnip (e.g. Yeoww brand). Saoirse liked to lick a catnip toy after eating and it seemed to help a little with postprandial discomfort. Gentle fingertip massage around the scruff and shoulder area seemed to help her a little too (encourages endorphin release).


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