Newly diagnosed... Lux is in DKA.. need advice!

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luxthekitty

Member Since 2013
Hi everyone-- newly(ish) diagnosed here and I am a bit frazzled so I'm sorry for the wall of text!

Lux was diagnosed as diabetic in November. He is only 3 years old and could have stood to lose a pound or two but was not obese or very overweight by any means. This diagnoses came as a huge shock to us. The vet suspected that he was teetering on the edge and had received a cortisone shot for his kitty allergies/asthma a few weeks before the diagnosis that could have sent him over the edge. When I brought him in after coming home from vacation Lux was extremely thin-- he has lost a lot of weight and wasn't eating or drinking much of anything. He was very lethargic and non responsive when I tried to get him to play or run around with me. When I brought him into the vet he was admitted for 3 nights and was hooked up to IV's for for dehydration and electrolytes, etc. The vet told me he was not in DKA (but 5 months later I realize that he likely was). After 4 months of trying to get his glucose regulated with the PZI insulin we were still not getting anywhere. The vet I had been taking to him is wonderful, but not so skilled in feline diabetes. So I recently took him to a new vet with much more skill in feline diabetes.

It's been about 2 weeks since he has seen the new vet and everything seemed to be going well. I got a home glucose tester (AlphaTrak2) and continued him on the PZI but with a lower amount (currently have been giving him 3 units in a U-40 syringe) because we discovered my technique might have been off and he could have been getting the insulin in the skin rather than underneath the layer of skin.

Lux can be a picky eater but we have him on the Purina DM now and he seemed to enjoy it until about 3 days ago. On Wednesday night I noticed he wasn't eating as much but thought he just wasn't that hungry. Gave him his 3 units of insulin. Thursday morning he won't eat his wet food. He ate some dry food and I figured it was enough so I gave him his insulin that morning. Throughout the day on Thursday my boyfriend could NOT get him to eat anything. When I came home from work he wouldn't eat-- not even any treats. Around the time for his insulin shot he would not touch anything, so I skipped his shot when I checked his glucose and it was at 295 out of fear it would drop too low. The next morning again, he would not eat. He was very lethargic again and his water intake and urination has been high. I didn't give him his insulin and called the vet who wanted me to bring him in immediately.

At the vet they determined he was in DKA and hooked him up to more IVs/etc. My vet closes at 6pm so I transferred him at their recommendation to an ER vet on Friday night and he has been there since. He seemed to be improving but when I went to visit last night he had a slight fever and his glucose was continuing to elevate.

After speaking with an ER vet she told me that she thinks there is an underlying issue that has not been caught. She discussed this with another vet and they both agree. Lux is a mix breed with a lot of Siamese in him and she told me about how they are prone to more uncommon diseases. She thinks it is totally abnormal (which I agree) for a cat so young and otherwise healthy to develop diabetes and for it to take so long to get it under control. She recommends that I take him to a Vet Specialist to get very specific blood-work done and some x-rays and MRI's to make sure that there isn't something going on that we are missing.

I have already spent $5000+ since the diagnosis and am about to spend another $1500 when he checks out of the ER. She told me the specialist and the testing will run me another $3000-$5000. Of course this is insane and I do not have that kind of money but Lux means everything to me-- he's my little boy! I will drain my savings account or borrow money from my boyfriend if need be... anything to take care of him.

Do any of you have any ideas or similar experiences? Do you think this is something that needs to be done? I'm so drained and have run out of tears to cry. I hope he can come home today but I won't find out until later. I just want to make sure I am doing the right thing.

For reference:
Lux is 3 1/2 years old-- weighing 12lbs currently.
3 units of PZI insulin 2x a day with U-40 syringes.
Purina DM dry/wet food when he'll eat it. Otherwise Wellness Core or Friskies Pate/Minced.
 
He stopped eating (have you tried FF or Friskies in place of the DM), he didn't get his insulin, maybe an upset tummy....all factors can lead to ketones/DKA. My Hope was dx diabetic at 3 also and there have even been younger ones. He needs to be monitored constantly at a 24 hr. ER where he is right now. Electrolytes may be off....some may be high, some may be low.......ER can treat that. As for an MRI....he would probably have to be put under for that to keep him still and there is no way you do that to a cat in DKA. Has anyone done an ultrasound on him yet? Just the not eating and no insulin can cause this and he needs to start eating before fatty liver kicks in also. Some cats, no matter what, never get into ketone problems. Some do at the drop of a hat and my Mishka is one of them.

He needs to be on fluids and if his numbers are climbing and his potassium is good then I would imagine ER will add some insulin, probably R, to help treat the higher numbers. At home, if we get a trace on the urine strip and the cat is still getting insulin, we can help them with sub-Q fluids, anti.-nausea meds, etc. But once that trace moves up on the strip they need vet care.

Please don't give up yet. At one point within the first 3 months of battling DKA when I first adopted Mishka her blood pH was 6.9. That is close to death but she did pull through. Have they checked to see if he has pancreatitis? An ultrasound will show also if that is inflamed. Main thing is to get him through this episode.
 
I am so sorry you are going through all of this.

Do you know how they are managing Lux's BG levels? Typically, a longer acting insulin in combination with a short acting insulin (It's called a basal and bolus combination with the short acting insulin being the bolus) is used to get BG under control with a cat experiencing DKA. Have they gotten Lux's numbers into an acceptable range? Are his electrolytes back to good levels? Is he eating? Have they ruled out pancreatitis (it's very common in diabetics) and made sure he didn't develop hepatic lipidosis ("fatty liver) from not eating?

DKA can develop as a result of an infection/inflammation (e.g., pancreatitis, urinary tract infection) + not eating + not enough insulin. Making sure there's no infection is important and that includes any dental problems.

You also might want to broach the subject of switching insulin with your vet. Not all cats do equally well on all types of insulin. If Lux isn't getting a good response from PZI, then perhaps trying Lantus or Levemir might be an option.
 
Hi everyone--

Sorry for the late update! I am new the the message board and have been so preoccupied with my kitty. Lux spent the weekend at the ER vet and he came home late Sunday afternoon. He is still re-cooping but is doing much better. He has a follow up at the end of the week at his regular vet to make sure he is looking good.

Based on the way he responded to treatment at the ER they think he might be insulin resistant or that there may be an underlying issue that is complicating his diabetes (hence the recommendation to see the specialist). I just want my baby to be ok and get the help he needs! He is eating for now. He won't touch the DM of course, but is more than willing to gobble up the Friskies.
 
Glad he's doing ok now - it must have been really scarey.
Friskies pates are fine - mine prefer them to any other food.

Is he on insulin now?
 
Yes-- he's back on insulin. I just got word from my boyfriend that he is refusing to eat again. I'm at work so I'm having him drive him over to the vet right now to make sure it doesn't spiral out of control again. I'm so damn worried.
 
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