New Member - Michael the cat DKA & Diabetes

Hello, My almost 12 y/o cat was recently hospitalized Thursday(a week ago) with DKA. After 4 days in the ER he is now home and getting .5ml units of insulin 2x's daily. His vet would like to see him in the range of 100-250. Per her notes if his Pre shot numbers are not 230 or higher I should not give him insulin but instead to call her office. Since it is Saturday evening the office is closed, however I did email but am wondering at what point do I not bother with giving him the shot. He and I are very new to all this. What I have been reading that it is worse to have very low numbers vs very high. I am scared if I give him any medicine he will dip too low.

His pre feeding shot was 178
after eating, 15 mins he was at 187 and 10 minutes later back down to 178. He has a human glucose monitor on him currently and I scan him about 30x's a day because I have become neurotic. Good news he has been in his target range since 8 am. Insulin injections are usually around 6:30 am/pm.
He is eating DM wet food and I put a little tuna water on meals to get him to eat a little more since he is only 7lbs.

Any suggestions on what I should do would be greatly appreciated.

 

With a recent DKA cat, you don't want to skip insulin. What type of insulin are you giving? Do you have any higher carb food around? Are you testing at home for urinary ketones, and if so what are the results?

More information in this post: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

 

Welcome to FDMB Tiffany. Poor kitty kitty. We will try and get him and you feeling better. you may want to start here:
New? How You Can Help Us Help You!

Please come back and ask questions. there are no dumb questions here! We know neurotic it happens to the best of us.
Just know that theres a wealth of information with good advice to help you help your kitty.
WELCOME TO OUR FAMILY!
jeanne

I dont have any experience with DKA Here is what you need to know about it:
Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

 

thank you Wendy

 

@AliceMeowliss&Cassandra is an experienced DKA survivor, plus we have many others here.

 

He is taking Prozinc. I had to skip 2 doses (per his vet) this week because he had a scheduled ultrasound. His first dose back was last night then second this morning. My other cat Sophia is on the prescription ISO UTI wet and dry food. Should I try that? I just scanned him again and he is at 210. My vet did not mention testing for any ketones at home.

 

Check the post Jeanne and I link - it has a link to another post on how to test for urinary ketones. If ketones get above trace, you need to get him to the vet.

I don't mean to give the higher carb now, but you do if he starts going lower. For new people, we suggest withholding insulin if below 200 (not 230), but not if there is recent DKA. Since you've got a continuous monitor (yeah!) testing shouldn't be an issue. Your other option if you can't stay up to check him is to do a reduced dose. Can you measure a 0.25 units on your syringes? Eyeballing it of course. Some people get U-100 syringes to measure smaller doses of Prozinc.

 

Wendy youre a life saver in more ways than one!
I have to sign off for the evening. sorry

 

I will read that other post and also ask my vet about testing to ketones at home. Thank you for this info. I did not realize it is something we should be watching for as well. I have the U40, however i can try to estimate it. I just grabbed a different can of food (royal canine Glycobalance) and he seems to be enjoying it much more. I personally don't ever want to give up this monitor. He is like my child and I have been testing him in the middle of the night since he's been home.

When you say to do a redose- meaning give him .25 now and if he does spike later give him .25 again then? What about the injection tomorrow morning? Do i still do one at 6:30 am?

 

How late after your normal shot time are you now? Can you scan again quickly? The glycobalance could be a good compromise.

 

2 hours exactly after normal shot time. He just read 255. My husband and I just gave him .25ml of the insulin.

 

I'm not a Prozinc expert, but unless he's quite high in the morning, I don't think I'd give insulin as early as 6:30 AM if tonight was 2 hours late. Tagging @Panic and @Deb & Wink who might be able to help there.

In the future, for us to really help you with dosing, it'd really help us if you could set up a spreadsheet to record the numbers when you scan them. Here are some instructions on how to do that.

FDMB Spreadsheet Instructions:

• Please set up a Google Spreadsheet as soon as possible. Always keep spreadsheets up-to-date! Valuable time may be lost looking for information when a spreadsheet is not up to the minute.
• If you have not been able to transition your kitty off of DRY food yet, please note it on your spreadsheet and in your signature. A dry food diet will often require higher doses of insulin to bring numbers down. Having this information plainly visible will help us help you.

Understanding the Spreadsheet/Grid

 

DKA kitties need a little extra TLC than a kitty without a history of it. The 230 number your vet was referencing may have been more for pet meters ... but I think the "don't shoot" number for pet meters is more like 250. But since your fella is DKA you want to avoid skipping. Even a smaller dose is better than none.

With Prozinc it's really not safe to give insulin more than 1 hour early.

 

ok thanks! we took the food away for the rest of the evening to help keep him from going higher. He's 271 at the moment and will keep an eye on him tonight. We have been trying to adjust his timing by 15-20 mins each day. When we brought him home from hospital we were doing 5 am shots. So pushing it back tomorrow will actually help us get him to a 7am/pm shot time. I will look into the google spreadsheet. I tried to upload the picture of his Freestyle Libre report on my first post but for some reason it didn't work. Thank you again for all the info and i will take back a few questions with my vet on tuesday. Especially the home ketone testing.

Thanks again! Happy Labor Day!

 

Don't take the food away! With recent DKA, you need him to eat. He needs his calories.

 

oh man, I really am a rookie! ok, putting it back down for him. Thanks again

 

Hey, we were all rookies to start. Food is how kitties can keep themself safe if they go low when you aren't home or are asleep too.

 

Did you mean to say you gave your cat 0.25U (units) of insulin?
.25 ml would be 25 units

The 0.25U would be barely above the very first line on the syringe. Here is a picture of a U100 syringe, showing the plunger placement of what 0.25U would look like. The concept is the same for a U40 syringe, almost at the very first line on the syringe. The zero units mark almost, on your U40 syringe.



Please confirm what amount of insulin you gave your cat.