New Member, 3/18/2024, 15M Kitty Underweight

Hi everyone,

My sweet boy Walter was just diagnosed on Friday 3/15/2024. He was DKA so he was hospitalized and is still there. During his treatment, he developed hypernatremia (high sodium levels), which the vet told me was atypical but not unheard of. Thankfully they've been able to get his sodium levels down. They want to monitor him for another night or two to ensure the sodium levels don't spike again now that he is coming off treatment for it.

Walter is also underweight and ideally needs to gain ~2 lbs. Has anyone else had a diabetic cat that needs to gain weight? I'm so grateful I found this forum.

 

Hi Elizabeth and Walter. Welcome to FDMB. We can help you learn how to care for Walter's diabetes when he comes home.

Many diabetic cats are underweight when first diagnosed. This is because their bodies cannot process the food properly.

Often when their glucose levels get regulated, they start to gain weight. Getting diabetes under control requires three things. First a low carb, high protein diet. Dry food is usually very high in carbs. The best foods are under 10% carbs and are canned or raw food diet. Pate flavor canned food are generally lower in carbs. You want to avoid dry food and any canned foods such as bits, shreds and filets. Also despite what the vet may tell you, there is nothing special about prescription food. Most of it including diabetic food is too high in carbs anyway.

Next is a long acting insulin. The ones we recommend are glargine (Lantus, Basaglar and Semglee are some of the brands), Levemir and ProZinc. Avoid short acting insulins such as Vetsulin or Caninsulin. Start at a low dose such as 1/2 to 1 unit twice a day.

The third thing is home testing. This means checking Walter's glucose levels before every shot. This is important to know how well the insulin is working and to prevent giving the dose if his levels are too low. You can use either a pet meter or human glucose meter. The human meters are less expensive to use and strips are readily available.

We can help you learn everything you need to know. Right now you are probably feeling scared and overwhelmed. This is normal when you first find out your cat is diabetic. I promise you it does get easier. You have a lot of very experienced members on this board and we are here to help you. Feline diabetes is very manageable.

 

Is Walter eating on his own now? When he gets home, you'll want to make sure you have a bunch of supportive meds for him. That includes Cerenia and ondansetron to help with vomiting and/or nausea and possibly Mirataz as an appetite stimulant. Hopefully they'll be short term medications until he's feeling better an eating on his own.

Post DKA, he'll need to get 1 and a half times the normal calories he's used to eating. Note, that is calories, not carbs. Look for foods that might have slightly higher fat content or at least not low fat. And what is most important that he eats. If in the beginning in means higher carb food, so be it - he needs to eat.

Here's a post on DKA that might help you: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

You'll have to watch him closely for ketones when he gets home. Detail in how on the post above. You can test either with urine test strips like Ketostix or a blood ketone meter. Liquids can help flush out ketones, you may get sent home with a bag of fluids and instructions on how to administer them. You can add lots of water to his wet food too.

A large number of kitties are underweight when first diagnosed with feline diabetes. Insulin and good food will help.

 

Let us know when he is coming home and we can help you each day.
I would recommend you think about hometesting and getting set up to do that for when he comes home. I’d look for a human glucose meter.
And also setting up a spreadsheet to put the blood glucose data into. If you have any trouble setting it up, let us know and we can ask @Bandit's Mom to help you with that.
I would also get the bottle of Ketostix that Wendy mentioned to test the urine for ketones as this is really important.
And I’d get some canned low carb food in for when he comes home. He might be still nauseated when he comes home so make sure you ask for the ondansetron and cerenia that Wendy mentioned. Look for foods that are 10% or under carbs
Link to spreadsheet and the signature here HELP US HELP YOU
FOOD CHART

 

Thank you all so much! It was such a scary weekend, and I'm very overwhelmed, and these messages have really helped reassure me.

He is eating at the ER Vet. They have been giving him wet food that is the bits in gravy type, and he has been mainly licking up the gravy and only eating a few bits. They gave him some dry food but he only ate a couple of kibbles. I told them he was on a wet food pate diet before this, so they were going to give him pate last night to see if he would do better with it. I'll ask how that went when I get an update today.

Thankfully the ER Vet actually recommended I do non-prescription wet food food and is giving me a list of high protein, low carb ones to try. I know they already moved him to a long acting insulin and that is what they're recommending I do at home. I don't remember which one. Glargine sounds familiar, but I'll respond when I have the correct information. He should be released either this afternoon/evening or tomorrow. Their main focus at the moment is monitoring his sodium levels to ensure they don't spike again as I guess that could mean he likely has another undiagnosed issue. Although they're pretty sure the spike was just because he was drinking so much but not peeing out the sodium so it became concentrated as he got dehydrated.

I'll work on getting Ketostix and some high protein, low carb pate wet foods today. I talked to the Vet about trying one of the patch glucose monitors when he discharges. He was not vomiting prior to being admitted or during his stay. I honestly think they triaged him as less urgent because of that. I will ask if they think an appetite stimulant would be helpful though, but hopefully he also did better with the pate food last night. Thank you all so much! I'll respond once he's discharged and I have more information.

 

As a former Chicago person, some of the vets there are wonderful. My cat was hospitalized with DKA, pancreatitis, and hepatic lipidosis when she was diagnosed with diabetes. She survived the ordeal and thrived. When she came home, we had anti-nausea meds, an appetite stimulant and and antibiotic since they presumed there was an underlying infection that set the entire process in motion.

The only thing I would add to what others have said is to consider adding some water or broth to the canned food. The additional liquid will help to keep the ketones flushing out of your cat's system.

Please let us know if you have questions. We're here to help.

 

The ER Vet just called. His sodium spiked again overnight. They aren't sure why he is having difficulty regulating it on his own. He is making other improvements though. Increased appetite, more alert and mobile. We're going to try to get it down again to see if he can regulate it on his own, and they also made some tweaks to his insulin dosage. I just don't know if I should keep putting him through more treatment, but I also don't want to give up on him. I'm not sure what I'm looking for but wanted to provide an update.