Newly diagnosed, recovering from DKA

Hi all!

My name is Sherry and my 10yr old Layla ( Leeloo is her nickname) has recently been diagnosed with FD. I am new to the community and I was hoping to seek some advice or comfort in knowing if my kitty is recovering properly. So on 7/9/21, Layla was admitted to an emergency care clinic to be treated for DKA. While there she began eating healthily, her ketones and electrolytes returned to normal, her blood glucose steadied around 150’s-250’s with short acting insulin and then continued to stay around there when switched over to Lantus. When she got there originally it was towards 700. On Monday, I was able to pick her up since the vet felt comfortable with her levels and how she was eating. Since being home, Layla has been eating readily. She receives 1 can of fancy feast in the morning and 1 at night, both with insulin injections that are 0.5units. And her first glucose curve is scheduled for 7/22/21. So my concerns are, am I giving her enough food? She’s about 8-8.5lbs since going through her DKA. She does drink water but I feel as though she isn’t drinking enough since I’ve had to entice her to drink once. She is pretty responsive and alert and likes to get up and walk around for a bit when it’s food time. But she also spends a great amount sleeping as well, and laying around in general. She doesn’t really have any interest in playing at the moment. I haven’t started home testing since the meter is ordered and in the mail. But should I be concerned with the given observations or is this typical after a DKA hospitalization?

Also, I’m sorry if I missed any information or gave too much information. This is all new to me and is alittle overwhelming

 

Hi Sherry and Layla and welcome to the forum.
I am so glad Layla is recovering from DKA.
The main things that will stop ketones and DKA reappearing are food, insulin, fluids and treating any infection. Therefore you need to be doing the following:

• Layla needs to be eating 1 1/2 times as many calories as normal at the moment. So apart from the 2 main meals at shot time, she should be having regular snacks throughout the day and evening. I would offer a small snack every two hours, except foe the 2 hours preshot once you start testing the BGlevels.
• Don’t skip any doses of insulin. Once you start testing, we can help you in deciding if the BG is high enough to shoot. You can always post and ask for help.
• Give extra fluids. If she will let you add some warm water to her food, do that. Even a teaspoon each snack is help.
• Test daily for ketones….this is very important. If you don’t have any Ketostix to test the urine, please go out today and buy some from a pharmacy or Walmart.
• Continue with any antibiotics given for any infection

Can you tell me how much Lantus she is on please?
You are lucky she is wanting to eat as many cats removing from DKA have nausea.

Do you think she is lethargic at all? I am just wondering about her BG levels. When will the glucose meter arrive?
I am going to give you a couple of links. If you could set up your signature and your spreadsheet ready for when you are testing that would be great!

HELP US HELP YOU LINK

What are you feeding? Wet foods 10% or under are best for a diabetic cat.
FOOD LINK

Do you have a hypo kit set up in case it is needed? You will find info about that in the link above called Help us help you.
Keep asking questions
Bron

 

Hi Bron,
Currently she is on 0.5 units of Lantus twice a day. She has been scheduled for a follow up on 7/22 for a glucose curve. And I was surprised too, she very willing to eat, she is always wanting more food after finishing a whole can on fancy feast (which I’ve only gotten the classics so far since I’ve read gravy is bad and dry food is a no-no). I’m not sure if she’s lethargic, she just seems to want to sleep more than what I think is usual, such as before going though the DKA. She loves to follow me around the house so it seems like she has the energy. Unfortunately the confirmation email I have just says that it is still being processed. I ordered it from Chewy yesterday, it’s the Alphatrak meter. But I will definitely follow up on those links! I do have karo syrup in hand that my mom gave me since she has had a diabetic dog as well.

 

You can always pick up a ReliOn glucose meter and strips very cheaply from Walmart. And also the Ketostix at the same time.
The sooner you are hometesting the BG the better so we can see if she is getting enough insulin.
Once you are hometesting you won’t need to go to the vet for curves as you will have plenty of data in your SS. Cats mostly run higher at the vet from stress so hometesting gives a more accurate reading.
If she’s always hunger I would feed her as she is needing to put weight back on isnt she? and the food is needed to combat the ketones.

 

I understand, I will definitely do that as soon as possible. I didn’t know there were ketostixs available as well. There wasn’t much in depth explaining when she was discharged and I unfortunately am not very aware of how in-depth diabetes goes. The only information I received was what to look out for hyper/hypoglycemia. And to feed her either fancy feast or the hills m/d or Purina dm. There wasn’t too much more information besides how to handle her insulin and the dosage. But I am learning a lot here. I did want to find out about putting weight on her but not too fast to where she spikes and goes back into dka. So I’ve been hesitant to feed anymore than what the vet said. Also thank you for all the information you’ve provided thus far.

 

You won’t put her back into DKA by feeding her more. Food is like a medicine with ketones, as the body needs the food to prevent the ketones from forming. Ketones form when the body is not getting enough food and instead of being able to get the carbs from food, the body starts to use the fats and protein in the body and the byproduct of that is ketones. The other thing the body needs to utilise the carbs, is insulin. That is why making sure they get the insulin and feeding enough food is so important in the prevention of ketones which is the prelude to DKA. Does that make sense?

We have helped many kitties recovering from DKA and most do not get detailed information from their vets about what to do at home.

 

Welcome Sherry, like Bron said you can go to Walmart and pic up the
Relion Prime human meter, most of us use the because the test strips for the Alpha Trak are about 54.00 for 50 strips and you will be going thru a lot of them in the beginning
The Relion Prime Meter is 9 dollars
17.88 for 100 test strips
Buy 26 or 28 gauge lancets to poke the ear
Cotton rounds to put behind her ear when testing, after that fold it over her ear to stop the bleeding, press gently for about 15 seconds
Our numbers here are based on human meters, but if you don't mind paying for those Alpha Trak strips that's fine.
Since you can't buy them in a store always make sure you always have an extra bottle.
At least you can run to Walmart and pick them up, there shipping is very fast if you had to order them online

You can always use the Pet meter to do curves for your vet

 

You should have on hand med and high carb food on hand in case she drops too low and you need to bring his BG up to safe numbers
Also some honry

Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs



Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs

Or any other ones from the food chart, here is the link

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

 

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capillaries it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Are you using 26 or 28 gauge lancets?

 

VIDEO: How to test your cat's blood sugar
One of our members made this video

 

Yes Bron! I completely agree! I feel as though the vet left out so much information for what to expect. I knew there was more questions and answers to be had but I just didn’t know the correct questions to ask. But everything makes sense and I’ve stepped up on feeding her more and seem she’s more than happy to eat the portions I give her.

Thank you Diane for all this very helpful information. Hopefully when I start home testing it’s not too hard on her, I could tell the clinic had issues getting blood since she has little bruises on her ears currently from the blood draws. But she was also dehydrated at the time so maybe it was more difficult to get blood then? Along with the information Bron gave me, I have made Layla a little hypo kit and have started feeding her 3 cans of fancy feast mixed with water to give her more calories and hopefully let her put on some weight as time goes on. She does seem to get more energetic as the days goes on. It’s been 3 days since being out of intensive care. I have heard of a human meter that has strips compatible with the alphatrak but I can’t remember the name specifically. I think it’s relion brand, there’s also pet sure! Test strips on Amazon that are compatible too. Could I possibly do that as well? Or is it too risky to use different strips for the same device? My alphatrak is coming in tomorrow but I am stopping by Walmart today to hopefully get the meter and ketostixs, my Walmart does not replenish well so I couldn’t find them yesterday. Also I am so sorry for the late replies, I’m still trying to find a balance of work and going home to give Layla her insulin. It’s definitely been a bumpy first few days at this.

 

Thank you for letting me know that, I was just wondering in case the alphatrak strips became out of stock for some unforeseen reason. But I did get a relion one as well. And will use the alpha one for vet visits and if it seems she acting different and I want a more accurate result. I did get the ketostixs but they are proving alittle bit of a challenge with having two other kitties in the house so I just kind of wait until I know she’s the one in the litter box.
But thank you, it means so much to hear that and have this kind of support to understand better of how to handle all of this. Layla is actually getting more and more energy each day. She’s actually chasing bugs and her toys again and seems to have gained some weight since I can’t feel her spine as much now. So definitely improvements!
I haven’t set it up on here yet but I’ve looked at it and am currently doing a physical copy in a notebook for easier access but will transfer it when I get more data complied. But I may have some questions as to what each column means.

 

We do not recommend using a different brand of strips in the AT meter. There is a discussion on this topic in the Think Tank forum.

In the Helping Us to Help You link that Bron provided, in addition to the instructions for setting up the spreadsheet (SS), there's also a link to How to Use the Spreadsheet.