New member (post DKA)!

Elohelay

Member Since 2025
Hi all!
I wanted to introduce myself and my newly diagnosed cat.
I also wanted to thank you for the help you've already provided by kindly sharing links to blood glucose monitors and test strips!

I'm Sarah, and Lola is my heart cat.

Lola is a spunky 10-ish year old Sphynx cat. She was diagnosed with diabetes on 12/23/25 and spent the last few days being hospitalized due to DKA in my area's only 24 hour clinic. Her liver values have me worried, but she's anxiously awaiting her 6:30 PM meal time, so I hope we can get them back into normal ranges soon.

To say that she had been difficult around eating for the past month or so is definitely an understatement. She would fall in love with a canned food flavor or texture for about 4 days, I'd stock up at the pet store, only to have her go on hunger strikes until I found her a new flavor/texture. Then she would only eat 1 spoonful at a time in her dish. Then she would only eat off the spoon. Then she would only eat out of the can. Then she would only eat out of the can on the floor. It got to the point that last weekend she would only eat the wet food when I would hide freeze dried minnows in the food. She'd eat enough to get the minnow out, but wasn't happy about it. I was concerned, but we had an upcoming appointment on Wed (12/24), so I was just trying my best to keep her going. When she refused plain baked salmon on Tuesday morning, I knew something was horribly wrong and got her in with the vet ASAP.


Honestly, I'm spiraling. I'm hoping that we can get everything under control and where it needs to be. We've lost two senior doxies over the past year and a half, and I want to make sure she sticks around for a long time. Please point me in the direction of any threads you think are required reading!
 
Many of the threads here are good for reading: Health Links / FAQs about Feline Diabetes

A 2025 guide to managing diabetes in cats, mostly for vets but a good read for cat owners: https://journals.sagepub.com/doi/full/10.1177/1098612X251399103 The one in the Heatlh Links section is an old guide.

The main FDMB page has basic info in the drop down lists at the top: Felinediabetes.com

If you can edit your post and add "post-DKA" to it members here who have experience with DKA will see it and be able to help.
 
Many of the threads here are good for reading: Health Links / FAQs about Feline Diabetes

A 2025 guide to managing diabetes in cats, mostly for vets but a good read for cat owners: https://journals.sagepub.com/doi/full/10.1177/1098612X251399103 The one in the Heatlh Links section is an old guide.

The main FDMB page has basic info in the drop down lists at the top: Felinediabetes.com

If you can edit your post and add "post-DKA" to it members here who have experience with DKA will see it and be able to help.
Done! Thanks for that tip!
 
Many of the threads here are good for reading: Health Links / FAQs about Feline Diabetes

A 2025 guide to managing diabetes in cats, mostly for vets but a good read for cat owners: https://journals.sagepub.com/doi/full/10.1177/1098612X251399103 The one in the Heatlh Links section is an old guide.

The main FDMB page has basic info in the drop down lists at the top: Felinediabetes.com

If you can edit your post and add "post-DKA" to it members here who have experience with DKA will see it and be able to help.
Hi, I'm hoping you can help. The emergency vet handed us the meds, but didn't explain. How much is .5 units?
the directions state "Give .5 units (1/2 unit) every 12 hours, after feeding.

The syringe they gave us goes from 5 - 20 units.
Am I correct that this is .5 units?
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We did a blood test 30 mins after eating, right before giving her vetsulin.
She was at 314.
I'm not sure how much insulin she actually got because after my husband pulled the needle out, some of the insulin trickled out onto her back/shoulders.

Do we wait 30 mins, test again and then re-dose? 😭
 
Hi Sarah and welcome.

Never re-dose if you are unsure how much insulin was given. Since you don’t know how much was actually absorbed, if you were to give more, Lola could experience a hypoglycaemic reaction and those can be fatal.

Continue to test as you normally would and continue with her regular dose at the beginning of her next cycle.
 
Hi Sarah and welcome.

Never re-dose if you are unsure how much insulin was given. Since you don’t know how much was actually absorbed, if you were to give more, Lola could experience a hypoglycaemic reaction and those can be fatal.

Continue to test as you normally would and continue with her regular dose at the beginning of her next cycle.

I don't know what normal testing looks like! How frequently should I be testing?
 
I am not overly familiar with Vetsulin since my girl was on Lantus.

Here is the link to the Vetsulin sticky that has more information.

Sticky - BEGINNER'S GUIDE TO CANINSULIN/VETSULIN

With Lola being newly diagnosed and new to insulin, it does mention that she should be closely monitored in the first few days of starting insulin, testing 3, 6 and 9 hours after her dose.

Are you feeding her small meals throughout her cycle on top of her main meal at shot time?

Here is another link that has more information about Vetsulin.

Sticky - INTRODUCTION TO CANNISULIN/VETSULIN & N/NPH
 
Are you feeding her small meals throughout her cycle on top of her main meal at shot time?
No. We were told to feed only twice 12 hours apart and no snacks.

I did see that freeze dried minnows would be an appropriate snack for after an ear prick. I think I'll give her one after testing from now on.
 
I would like to feed her small meals throughout the day as I feel that may help her put on weight and help her liver values improve. How can I do that safely?
 
Hi, I'm hoping you can help. The emergency vet handed us the meds, but didn't explain. How much is .5 units?
the directions state "Give .5 units (1/2 unit) every 12 hours, after feeding.

The syringe they gave us goes from 5 - 20 units.
Am I correct that this is .5 unit


Yes, halfway between the zero line and the 1 unit line is 0.5 units. The purple line is correct. To make it easier, you can get U40 syringes with half unit markings. Here's one brand available:

71NFApTYSoL._AC_UF1000,1000_QL80_.jpg



You can buy syringes from Amazon with no prescription. Here's the listing for the above syringes: https://www.amazon.com/UltiCare-Ins...kings/dp/B08HX9BPH7?tag=felinediabetesfdmb-20

I don't know what normal testing looks like! How frequently should I be testing?


Always test before giving insulin. That way you know if it safe to give insulin or now. Newbies are generally advised to not give insulin if the cat is under 150 mg/dl.

Spot checks in between the insulin shots are ideal so you have an idea of how the insulin and dose are working for your cat. This doesn't need to be done every day but you can if you want. Keep track of the blood glucose levels. Many people here use a shareable Google spreadsheet. Instructions: https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/ The instructions are now slightly inaccurate since Google has changed a few things in Sheets :rolleyes: If you get stuck, we can help.

No. We were told to feed only twice 12 hours apart and no snacks.

I did see that freeze dried minnows would be an appropriate snack for after an ear prick. I think I'll give her one after testing from now on.

You can ignore the vet about food and timing :) Many people here use a programmable timed feeder to give snacks throughout the day. Canned food is fine to leave out all day. There are various ways to keep food fresh like using a feeder that has a cooling feature or freezing canned food in portion sizes and putting the frozen chunk into the feeder to slowly defrost.

Any freeze dried treat works :)
 
@Wendy&Neko @Sienne and Gabby (GA) OP needs post-DKA advice.

Just a thought - Vetsulin isn't an ideal insulin to use. It's good for dogs, not so much for cats. Ask the vet about Lantus or ProZinc insulin once your cat has recovered from DKA. If you go with ProZinc, you can use the same U40 syringes. If you go with Lantus, you need to use U100 syringes which you can buy at any pharmacy (may need a prescription from the vet) or just buy online (may need to provide a vet's phone number to buy, depending on your state law. Or just buy from Amazon).
 
A few things that you need to manage post-DKA. You need to monitor for ketones at home, daily. That can be done either with a meter that tests the blood, or with urine test strips. You can pick up the Ketostix to test the urine at any pharmacy.

Part of managing at home as well is to make sure your cat gets 1.5 times more calories than you would usually feed and if she will tolerate it, add some water to her food as well to help with her hydration. Actually feeding smaller snacks throughout the day is more helpful with kitties who have had DKA, so please continue to feed her often.
 
In addition to needing lots of food as above, most post DKA cats are nauseous. You might want to see if you can get an anti nausea medication to give at home, such as ondansetron or maropitant/Cerenia. I find ondansetron works better for nausea, but it doesn't last as long as maropitant which can be given just once per day. If that still doesn't increase how much she eats, you may need an appetite stimulant in addition, such as Mirataz. Also a post that may help:
 
The other feedback I'm mention is that while we typically suggest to skip a shot (or delay) if numbers are below 150 and if you're new at managing your cat's diabetes, if your cat is recently recovering from DKA we are more aggressive. Unfortunately, some cats are very susceptible to developing ketones. We try to avoid having you skip a shot. If Lola's numbers are lower than you're comfortable shooting, please post and ask for help.

I also agree that Vetsulin is a less than desirable insulin for cats. The American Animal Hospital Assn no longer recommends its use for managing feline diabetes. They recommend either Lantus or Prozinc. Vetsulin does not last for 12 hours. Especially with DKA, you want a longer acting insulin.
 
Hello, all! Thank you for your support! We had a post-hospital follow up this morning, and it looks like Lola is improving slowly, but she did lose a little more weight. 😭

Our normal vet didn't feel comfortable with her being on Vetsulin and switched us over to Prozinc.

We're continuing Elura until she's eating consistently and puts on more weight.

I've searched the forum and just want to make sure that I'm not using outdated information: Is Tiki Cat Seafood Selects Variety Pack Grain-Free Wet Cat Food low carb enough/appropriate if I can get her to eat it? We have 1/2 a box left from when she decided to stop eating it this summer and it would be nice if we could finish it. If not, I can get something else. I need to return a lot of food to Petsmart anyway.

I plan on getting her some Vital Essentials freeze dried nibs tomorrow when the local pet store is open so that she has something out to graze from all day.

I'm off to read the Prozinc threads. Thank you very much for any feedback and/or comments. I feel a lot more level headed today and Lola's been a little mischievous today, so I think she's getting better, too!

 

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Yes, those Tiki Cat are fine. Generally you don't want to fed too much seafood because some cats get addicted to eating it. See if you can include chicken or other protein canned food into the diet.

Canned food is fine to leave out all day :) It's a cooked product so it won't go bad. Most people here use a programmable timed feeder. There are ways to keep food fresher longer in a feeder such as using a feeder with a fancy cooling feature (https://felinediabetes.com/FDMB/thr...tlibro-polar-wet-food-feeder-read-this.302714) or freezing canned food into portion sizes and putting the frozen chunks into the feeder compartments to defrost.

Air dried raw would be a better option to leave out than freeze dried. Freeze dried is ideally rehydrated before feeding otherwise it acts like a sponge inside the tummy and soaks up all the water which can cause dehydration. Air dried raw is fed straight out of the bag. Ziwi Peak is one brand.
 
Good morning! I’m so glad that you have us in the habit of checking before each insulin injection. This morning Lola‘s right ear gave us a 141 and Lola‘s left ear gave us a 137 so I will not be administering insulin.

I believe that is correct. Please let me know if I’m wrong. I’m still within my window and I can dose her, but I don’t want to risk a hypo.
 
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137 and 141 are essentially the same. Are you still on 0.5 units of ProZinc? The general "no insulin" cut off number for newbies is 150.

There may be info here on what to do with normal cat bgs (roughly 60 to 150): Sticky - PROZINC DOSING METHODS

@Suzanne & Darcy

If you don't hear back from a ProZinc user, then it may be safer to skip insulin than to risk a hypo if you're not able to do spot checks today.
 
137 and 141 are essentially the same. Are you still on 0.5 units of ProZinc? The general "no insulin" cut off number for newbies is 150.

There may be info here on what to do with normal cat bgs (roughly 60 to 150): Sticky - PROZINC DOSING METHODS

@Suzanne & Darcy

If you don't hear back from a ProZinc user, then it may be safer to skip insulin than to risk a hypo if you're not able to do spot checks today.
Yes. She’s still on .5 units of prozinc.
 
If you haven’t fed yet, another option is to stall (not feed) and test again in 20 minutes to see if numbers are coming up to where you are comfortable giving insulin. Have you been testing at home for ketones? With kitties who have had a history of DKA especially so recently, skipping insulin is not ideal.
 
If you haven’t fed yet, another option is to stall (not feed) and test again in 20 minutes to see if numbers are coming up to where you are comfortable giving insulin. Have you been testing at home for ketones? With kitties who have had a history of DKA especially so recently, skipping insulin is not ideal.
She would not stop yammering for food, and I was so happy that she had an appetite that I fed her 😫. I guess I should have waited.

Knowing that I’ve fed her, is there anything I can do at this point? In an hour or two?
 
If you haven’t fed yet, another option is to stall (not feed) and test again in 20 minutes to see if numbers are coming up to where you are comfortable giving insulin. Have you been testing at home for ketones? With kitties who have had a history of DKA especially so recently, skipping insulin is not ideal.
I was just able to get a urine sample. The ketone strip test was negative.
 
Hi all!
I wanted to introduce myself and my newly diagnosed cat.
I also wanted to thank you for the help you've already provided by kindly sharing links to blood glucose monitors and test strips!

I'm Sarah, and Lola is my heart cat.

Lola is a spunky 10-ish year old Sphynx cat. She was diagnosed with diabetes on 12/23/25 and spent the last few days being hospitalized due to DKA in my area's only 24 hour clinic. Her liver values have me worried, but she's anxiously awaiting her 6:30 PM meal time, so I hope we can get them back into normal ranges soon.

To say that she had been difficult around eating for the past month or so is definitely an understatement. She would fall in love with a canned food flavor or texture for about 4 days, I'd stock up at the pet store, only to have her go on hunger strikes until I found her a new flavor/texture. Then she would only eat 1 spoonful at a time in her dish. Then she would only eat off the spoon. Then she would only eat out of the can. Then she would only eat out of the can on the floor. It got to the point that last weekend she would only eat the wet food when I would hide freeze dried minnows in the food. She'd eat enough to get the minnow out, but wasn't happy about it. I was concerned, but we had an upcoming appointment on Wed (12/24), so I was just trying my best to keep her going. When she refused plain baked salmon on Tuesday morning, I knew something was horribly wrong and got her in with the vet ASAP.


Honestly, I'm spiraling. I'm hoping that we can get everything under control and where it needs to be. We've lost two senior doxies over the past year and a half, and I want to make sure she sticks around for a long time. Please point me in the direction of any threads you think are required reading!
Hello and welcome. I have been where you are now My boy spent a week in emergency care for a very serious DKA. I will be happy to help with your ProZinc. Are you testing for ketones at home? I purchased a blood ketone meter to test my boy Darcy every single day after we brought him home from the hospital. Keto stix urine strips are also an option. You need to keep her hydrated and get a lot of food into her. What medications is she currently on. How is her appetite?
 
Please help me to understand where you are now. You are four hours past her usual shot time and her BG is 302 and she has not yet received any insulin?
 
If you give insulin now, then you will be very off schedule and it will take us a few days to get her back on schedule. It’s kind of up to you as to how you want to proceed. As you can see, it wasn’t a good idea to skip the shot, but it’s a learning process. I am sorry I wasn’t here earlier to help. Great job getting up to speed on testing and a spreadsheet! Please tell me what your time zone is and what your regular shot times are.
 
If you give insulin now, then you will be very off schedule and it will take us a few days to get her back on schedule. It’s kind of up to you as to how you want to proceed. As you can see, it wasn’t a good idea to skip the shot, but it’s a learning process. I am sorry I wasn’t here earlier to help. Great job getting up to speed on testing and a spreadsheet! Please tell me what your time zone is and what your regular shot times are.

I appreciate you being here now! We are in the central time zone. I do the initial BG test at about 7 am before my husband goes to work because sometimes she wakes up spicy and won’t sit still for me to test, and the shot anywhere from 20-30 mins later depending on how long it takes her to eat.

I was very afraid of her ending up hypo and that’s why I didn’t feel comfortable giving her the shot.

Her appetite is back, which I love. I’m giving her Fancy Feast Classic pates (she taps out at about 1.5 cans; I am weighing and keeping track of intake) and my shipment of Dr. Esley’s dry kibble just came in. I’m trying to get calories into her, and I think it’s working because I can see less of her vertebrae each day.

I believe her spreadsheet is up to date, but let me switch the tab order.
Hope I didn’t miss any info.
 
Hello and welcome. I have been where you are now My boy spent a week in emergency care for a very serious DKA. I will be happy to help with your ProZinc. Are you testing for ketones at home? I purchased a blood ketone meter to test my boy Darcy every single day after we brought him home from the hospital. Keto stix urine strips are also an option. You need to keep her hydrated and get a lot of food into her. What medications is she currently on. How is her appetite?

I have the urine strips, but need to work on getting a blood ketone meter. Which are you using? My concern is the cost of test strips.

She’s currently on:
Ursodiol 50mg once daily
Denamarin once daily
prednisone 5mg (tapering off)
Prozinc .5 unit
 
I have the urine strips, but need to work on getting a blood ketone meter. Which are you using? My concern is the cost of test strips.

She’s currently on:
Ursodiol 50mg once daily
Denamarin once daily
prednisone 5mg (tapering off)
Prozinc .5 unit
I have a Nova Max Plus, but the strips are terribly expensive. These days they have other blood ketone meters available. There are more options than when I was purchasing mine. Keto Mojo is one I see people using but I have no idea how much they cost. I always told myself it was less expensive than another DKA.
 
Ursodiol. Does she have sludge in her gallbladder?

I am glad you are using Denamarin. It will help her liver a lot. I have used it in many of my kitties.
 
I have a Nova Max Plus, but the strips are terribly expensive. These days they have other blood ketone meters available. There are more options than when I was purchasing mine. Keto Mojo is one I see people using but I have no idea how much they cost. I always told myself it was less expensive than another DKA.
That is a very good point! I’ll have to order one today.
 
I do the initial BG test at about 7 am before my husband goes to work because sometimes she wakes up spicy and won’t sit still for me to test, and the shot anywhere from 20-30 mins later depending on how long it takes her to eat.
Okay. Good to know. With ProZinc you don’t need to wait until she finishes eating to give the shot —as long as her appetite is reliable, of course. She doesn’t have to eat a huge amount right at shot time, but right now we want her to gain back the lost weight, right? I would recommend giving her some more food at +2 when ProZinc typical onsets and will begin to lower her BG. Then give her another small meal at +4 and possibly again in another two hours if she’s hungry. We can adjust this, if necessary, as she starts getting into better blood glucose numbers more consistently and as her weight rebounds.
 
Oh yikes. I see it’s almost three o’clock here -and I have a vet appointment at 4:15. I will check back with you later. I will be around in the evening as well after we return home. It looks like you will not have a difficult time making the decision to shoot tonight. But I would try my best to get an evening test on her tonight. It would have been a good thing to have gotten one last night since she had the yellow PMPS. Many cats will drop a little lower at night (not all cats but many do.) and you are weaning Pred so that will work to lower her BG as well.

Do you know what caused the DKA? An infection? Some inflammation? Sorry if I missed your explanation of that. Was the Pred prescribed for IBD? Skin problems?
 
Ursodiol. Does she have sludge in her gallbladder?

I am glad you are using Denamarin. It will help her liver a lot. I have used it in many of my kitties.
I’m really not sure, it was just sent home with her from her hospitalization. I think they’re just trying to keep her liver and gallbladder happy. The emergency vet didn't really go into a lot of detail, but our normal vet said to stick with it until we do another chem panel in a week.

Where are you in the tapering process for the prednisolone?

So the vet re-evaluated her treatment plan on Monday and today was supposed to be the last day of her taper (1 every other day) before we switched to Atopica, but the medication hasn't come in yet, and more importantly, she still has 4 pills left, so I'm waiting on a call back from the vet because I don't want to stop without tapering enough because I'm worried about the issues THAT may cause.

I also don't really like the idea of starting Atopica right now because it can cause nausea/upset stomach and weight loss. She went from 10.5 lbs to 6.4 lbs and I don't think she can afford to lose anymore at the moment.
 
Oh yikes. I see it’s almost three o’clock here -and I have a vet appointment at 4:15. I will check back with you later. I will be around in the evening as well after we return home. It looks like you will not have a difficult time making the decision to shoot tonight. But I would try my best to get an evening test on her tonight. It would have been a good thing to have gotten one last night since she had the yellow PMPS. Many cats will drop a little lower at night (not all cats but many do.) and you are weaning Pred so that will work to lower her BG as well.

Do you know what caused the DKA? An infection? Some inflammation? Sorry if I missed your explanation of that. Was the Pred prescribed for IBD? Skin problems?

*Edit: Not sure on the DKA. She's been having monthly CBCs since Sept because of her low platelet numbers, but we hadn't run a chem panel in a while until 12/23/25 and that's when we caught it.

She is on the steroid because she's had a low platelet count on multiple CBCs. This is her second round of steroids to help bring them up.
 
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I’m really not sure, it was just sent home with her from her hospitalization. I think they’re just trying to keep her liver and gallbladder happy. The emergency vet didn't really go into a lot of detail, but our normal vet said to stick with it until we do another chem panel in a week.



So the vet re-evaluated her treatment plan on Monday and today was supposed to be the last day of her taper (1 every other day) before we switched to Atopica, but the medication hasn't come in yet, and more importantly, she still has 4 pills left, so I'm waiting on a call back from the vet because I don't want to stop without tapering enough because I'm worried about the issues THAT may cause.

I also don't really like the idea of starting Atopica right now because it can cause nausea/upset stomach and weight loss. She went from 10.5 lbs to 6.4 lbs and I don't think she can afford to lose anymore at the moment.
I have a cat on Atopica and he is now taking it every other day. We haven’t had any trouble with nausea or vomiting. For the first month or two we were giving it daily. Now we do every other day. Read the studies that were done with cats. They’re very informative about side effects and how common/uncommon they were. A tip for not having nausea is to store the capsules in the freezer and give them frozen. Also, feed a small amount of food with it and do not give it on an empty stomach. I give it with about a tablespoon of wet food. It has been very effective for my Siamese’ skin — he was nearly bald and had breakouts and scabs all over. OBTW, it’s much cheaper when purchased from Chewy or Allivet or other online pharmacies.
 
*Edit: Not sure on the DKA. She's been having monthly CBCs since Sept because of her low platelet numbers, but we hadn't run a chem panel in a while until 12/23/25 and that's when we caught it.

She is on the steroid because she's had a low platelet count on multiple CBCs. This is her second round of steroids to help bring them up.
How low of a platelet count?
 
I also don't really like the idea of starting Atopica right now because it can cause nausea/upset stomach and weight loss. She went from 10.5 lbs to 6.4 lbs and I don't think she can afford to lose anymore at the moment.
I can relate to this. The cat I just took to the vet today is now down to 6 lbs 3 oz. He should be at least 10 lbs and has been a lot more than that. 🙁
 
Please be sure to get a test tonight. How many hours until you plan to go to bed? Also, please remember to give her a small meal/snack at +2. I don’t know if you will be awake at +4, but another small meal at then or before bed would be great.
 
How low of a platelet count?
The first time the caught it, they did a manual count under the microscope and came up with 5.

A round of steroids and antibiotics later, she was in the 400s. This was in 2024.

When we checked again:
early Sept 2025: 34
Late Sept: 294
Oct: 291
Nov: 152
Dec 10th: 91
Dec 23: 374 (current round of steroids)
Dec 24: 493
Dec 25: 446
Dec 26: 335
 
Please be sure to get a test tonight. How many hours until you plan to go to bed? Also, please remember to give her a small meal/snack at +2. I don’t know if you will be awake at +4, but another small meal at then or before bed would be great.
I just tested at +2 and she’s down to 166 from 311 at meal time.
 
The first time the caught it, they did a manual count under the microscope and came up with 5.
Wow. I don’t even know what to say to that. Is that something particular to Sphinx cats? Do you know? I know they are particularly prone to heart problems, sadly, so I hope your gorgeous girl is free of that anyway.
 
The first time the caught it, they did a manual count under the microscope and came up with 5.

A round of steroids and antibiotics later, she was in the 400s. This was in 2024.

When we checked again:
early Sept 2025: 34
Late Sept: 294
Oct: 291
Nov: 152
Dec 10th: 91
Dec 23: 374 (current round of steroids)
Dec 24: 493
Dec 25: 446
Dec 26: 335
And your vet believes the Atopica will help with the low platelet count? Is it an autoimmune condition?
 
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