Possible DKA??

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I have first hand experience with low potassium and DKA. Bob had both at the same time too.

Once Bob was ketone free, hydrated, and started on PZI insulin, the improvement was obvious. It took weeks for me to slowly get his potassium up to the normal range. That was done by giving fluids daily, then every other day, then 3 times and 2 times per week. It took weeks, but the supplement was not large. It sounds like your vet is being more agressive with the potassium. Bob also had to go to the vet every couple of weeks to have his potassium level checked so that it didn't go too high, because too high is just as bad as too low.

The big symptom of low potassium with Bob was overall muscle weakness. So he was lethargic. Once I got him home, he didn't look "sickly" but he was definitely lethargic and lazy for the first few days. He came home with a normal appetite, which was good so I knew he was eating enough. And the fluids insured that he was hydrated enough. I just had to be patient with his muscle weakness but he improved gradually. Within two or three days I could see he looked overall better off. It was a comination of the insulin, the food and the fluids that got him there.

Bubba's BG numbers tonight sure do look a lot more encouraging! And if he can spend another day or two staying hydrated, managing to eat even if it's forced on him, and his potassium numbers come up, I think you'll notice he looks and feels better that quickly.

They may send you home with a bag of fluids, with or without added potassium. They might give you potassium supplements to mix into his food to help his levels stay "normal". If they do that, ask for the pill or powdered form rather than the tube of paste kind. Usually the paste style had some sort of added sweetener in order to make it "palletable", but sweets and diabeties don't mix. I used the powdered kind for a while too, and I just used to mix it in Bob's food and he didn't seem to notice it was there. Actually, he's what we call a "hoover". He sucks up his food so fast I doubt he tastes much of it. :smile:

Overall, in your shoes, I'd be encouraged even if you aren't seeing rapid or vast improvement with Bubba yet.
 
See, that is how I feel. I think it's good to see his number normalizing but I think he might need a couple days to start feeling better. I guess we will just have to wait and see. We are so exhausted. I've slept maybe 5 hours in the last 60 hours and we have hardly eaten. I am trying to distract myself with TV and movies, but I just feel guilty once I actually start to enjoy anything, because I know Bubba is so miserable.

Thank you again.
 
I know how you feel. J.D. was hospitalized on December 22nd and stayed there through Christmas, and I just couldn't think about anything but him. I slept little and must have looked ragged those long days. My joy everyday day was going to visit him and comfort him. It was a long time ago, and I didn't know that much about asking questions, but I know J.D.'s electrolytes were off but I don't remember which ones. The first couple of days, he could barely lift his head. Maybe by the 3rd day he was laying down but holding his head up. On the 4th day when I went to visit him he was moved out of ICU and into the Intensive Care Unit and he was sitting up but kind of leaning his weight on the back of the cage. I saw him try to groom himself a little that day, and felt he was getting better. Of course I never gave up hope. After a day or so in Intensive Care, he was moved again to Internal Medicine. He slowly got stronger, but it took a long time. Twice he had to have a blood transfusion. Like I said he was released after 8 days (right before New Years), and he was weak when he got home, but much better. He came home with a feeding tube, but was soon eating on his own. Right now 7 and 1/2 years later, he is behind me climbing up on his cat tree and anxiously waiting for me to get off the computer so I can take him outside. I still test him for ketones when he goes high, but he hasn't had any since.
I hope along with you, that your Bubba is healing and gets to come home and finish healing soon, like the rest of our cats that are DKA survivors on this board, and there are a lot of them. Blessings to you and Bubba cat_pet_icon
 
Have they given you any liver enzyme results, like ALT or AST?

Enlarged liver could be many things. A couple are
- hepatitis - liver inflamation, possibly from an infection
- hepatic lipidosis - fat breakdown overwhelms the liver, blocking bile drainage. May include jaundice, a yellowing of the skin. Totally disrupts digestion and thus deranges metabolism, sometimes severely.
- malignancy

More info here: Merck Manual Hepatic Disease in Small Animals
 
Thanks for your stories about J.D., Dyana. Crystina went and saw Bubba this morning and said he is looking a little bit better. The vet however seems to be convinced there is something wrong. She wants to do an ultrasound today, and she really seems to think they will find something. Crystina said the doctor just thinks he should be better by now, but when I read stories like yours Dyana, I think he is doing ok. His first day in, he couldn't even hold his head up hardly. Yesterday he seemed a bit more alert and was holding his head up, but still laying down. Crystina said today he was sitting up, and was reacting to sounds, which to me sounds like he is improving.

Here is a picture of him taken this morning.

http://i.imgur.com/xGP6rOj.jpg

We keep thinking the doctor expects to see more improvement, but then we ask her "Are you expecting to see more improvement by now?" and her answer is "No not really". It's possible that she is just trying to rule everything out maybe? I guess we will know in a few hours with the ultrasound results. His BG levels were high again, around 400, so maybe that is concerning her? He hasn't had insulin in 24 hours (at that point; they have given him a bit now), so that seemed kind of normal to me.

I don't know.. Part of me thinks I'm starting to be too optimistic, and part of me thinks the doctor is just being pessimistic in case something does go wrong. If the ultrasound shows nothing abnormal, we are going to get a full panel done to rule anything else out hopefully. Then we just plan on keeping him hospitalized as long as he needs.

Thanks everyone, you are all awesome.
 
A full blood panel should be done to check all his electrolytes, his blood pH, his kidney values, etc. A blood test called a fPLI should also be done to rule out pancreatitis which can be painful. The liver is amazing and can completely turn around but if he starts becoming jaundice, a feeding tube will be needed. Are they giving him anything for being nauseous? Catinfo.org has everything on feeding tubes. Sometimes we never find out why they stopped eating but the tube pulled them through till they decided on their own to eat again. The E tube, through the neck is a quick surgery and much less invasive than a stomach peg tube.

Sending prayers for Bubba, such a cute kitty that looks so sad right now, and for both of you that he is soon home and feeling well again. Is there any chance of a 24 hr. ER facility to take him to with Sunday coming up? He should not be left alone.

http://catinfo.org/?link=feedingtubes
 
I think Bubba going from laying down to sitting up sounds like he is improving.
I am keeping Bubba in my daily prayers along with you.
 
Thanks guys. Hope, does he look that bad? He definitely looks a lot better compared to yesterday. The place he is hospitalized at in open 7 days a week, but no one is there at night. Do you think we shouldn't do what we did last night and leave him there with an I/V?

We are still waiting on the ultrasound results, so I don't want to get my hopes up on anything yet. Thanks guys.
 
I just called the vets office and asked if Bubbas results were in. The tech put me on hold and came back a few minutes later and said "We did get them back but no doctor is available to go over them with you at the moment. Can we call you back?" and I said yea, that is fine. He then said "Ok, we will give you a call back, but it probably wont be until after 6:00". 6:00 is conveniently about the time the doctor we are seeing goes home for the day. Right now it looks like they may have found something and are having another doctor give us a call at the end of the day. We are preparing for the worst.
 
No, he doesn't look that bad...just sad and feeling yucky. He is sitting up and that is a good sign. If he needs the IV then you need to leave him. If he can do without the IV at night and the potassium level is up, ask if he can go home till a.m. and see if he'll eat at home. If he has pancreatitis, he may also be in pain. Does he even attempt to eat or does he gag at the smell of food? That picture just makes one want to reach out and hug him cat_pet_icon Glad to know they are open 7 days. Keeping Bubba in my prayers.
 
I thought he looked disgusted being in the room with all the dog pictures on the walls. Like he was saying "I want my own cat dedicated exam room. No droolers need ever cross my path. Come on now, make it snappy with the redecorating."
 
Hope + (((Baby)))GA said:
No, he doesn't look that bad...just sad and feeling yucky. He is sitting up and that is a good sign. If he needs the IV then you need to leave him. If he can do without the IV at night and the potassium level is up, ask if he can go home till a.m. and see if he'll eat at home. If he has pancreatitis, he may also be in pain. Does he even attempt to eat or does he gag at the smell of food? That picture just makes one want to reach out and hug him cat_pet_icon Glad to know they are open 7 days. Keeping Bubba in my prayers.
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Thanks Hope. He won't eat on his own, but they are feeding him 5ml of food every two hours and he has held it all down. They have said he still is drinking water on his own, but doesn't have any interest in food. Right now, I am just worried about his ultrasound results, because they are waiting until the end of the day to tell us and are having a different doctor tell us. Like I said, we are trying to be prepared for the worst.
 
Deb & Wink said:
I thought he looked disgusted being in the room with all the dog pictures on the walls. Like he was saying "I want my own cat dedicated exam room. No droolers need ever cross my path. Come on now, make it snappy with the redecorating."
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Haha, yes he does. I don't know if that would make a difference. He doesn't care for the vet much at all.
 
Ok, the doctor called and she said she didn't see any tumors or anything, but that his liver is enlarged, and his pancreas is swollen. She said we should do a full panel to help rule out anything that may be wrong with his pancreas. I get the impression from talking to her, that his liver and pancreas are the problem, and he is sick because of that, not the other way around. We have asked her if those things could happen due to DKA and she basically said "Well yea they might".

Like I said, she seems to think he is sick because his liver and pancreas are having problems, not that he is sick and it is affecting his liver and pancreas. Unfortunately they close at 6:00 so we wont be able to go down and see him again tonight. :sad:

From what we have read, an enlarged liver is a clinical sign of diabetes. We are thinking that because he has been receiving insulin, the doctor thinks he was well regulated. We are pretty sure he was never actually regulated, because we thought if he doesn't have ketones he is good to go. His BG has never been below 250, so I think he is basically in the same boat as a lot of cats that have never been treated for their diabetes. I don't know, at the same time he did get a lot better before this. He was gaining weight, eating a good amount, running around the house and playing. I understand why they are concerned it may be something else, because if these were just complications from the diabetes, he shouldn't have gotten better once we started treating his diabetes.

As always, thanks for the support guys. We are going to go see him tomorrow morning, and hopefully he is looking at least a little bit better.
 
The fPLI test will show if it is pancreatitis and if they even suspect it, he may be in pain from it and could use some pain meds. There are also good meds for the liver.......Denamarin is one...I use Marin and Denosyl individually whereas Denamarin combines the two together. Ursodiol is another good med if gall bladder might be affected. So glad they didn't find anything bad like the C word and he can pull through this. By now they should have done a full blood panel....not waited....and looked at everything. A B 12 shot wouldn't hurt either. I give a shot once a week to my three diabetics. Sure hope you can see him tomorrow......that is so important to the kitties.
 
Hope + (((Baby)))GA said:
The fPLI test will show if it is pancreatitis and if they even suspect it, he may be in pain from it and could use some pain meds. There are also good meds for the liver.......Denamarin is one...I use Marin and Denosyl individually whereas Denamarin combines the two together. Ursodiol is another good med if gall bladder might be affected. So glad they didn't find anything bad like the C word and he can pull through this. By now they should have done a full blood panel....not waited....and looked at everything. A B 12 shot wouldn't hurt either. I give a shot once a week to my three diabetics. Sure hope you can see him tomorrow......that is so important to the kitties.
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Thanks Hope. I am relieved, because I feel like he at least now has a chance. I am just hoping the blood tests don't reveal anything too serious. If that is the case, I am confident he can stay strong and make it through this. To be fair, we opted out of the blood test on Wednesday because we still weren't too sure how serious it was. Hopefully the results should be back by tomorrow evening. Crystina (my girlfriend) went and visited him this morning and let me sleep because I had only slept a few hours over the past few days. We planned on going again tonight towards the end of the day, but the doctor didn't call until 6:00, and when I mentioned coming by she said they were closing up for the night (they usually close at 7:30).

Thanks again. We are trying to stay optimistic while realistic at the moment. He has improved, but the doctors seem to be expecting more of an improvement.
 
Thanks again. We are trying to stay optimistic while realistic at the moment. He has improved, but the doctors seem to be expecting more of an improvement.
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It does sound like he has turned a corner for the better. Sending more purrs and prayers for Bubba. You are in our positive thoughts.

Sending {{{{{{Hugs}}}}}} to you {{{{{{Herdo}}}}}} and to your girlfriend {{{{{{Crystina}}}}}}.

Please, keep us posted. We want to know what is going on with one of our FDMB family members.

p.s. I don't think you have ever told us your name.
 
We just got a call from the doctor with terrible news. It seems as though Bubba has taken a turn for the worst. His temperature was dangerously low this morning when the doctor arrived,I think they said 94 degrees, and his BG was very low as well. They have him in an incubator right now trying to raise his temperature. The blood tests came back showing signs of pancreatitis.

Apparently, the pancreatitis is causing his BG to fluctuate wildly with even just a small dose of insulin, so he is going from 400 to dangerously low with even a small amount of insulin.

I have found a few stories of cats with both pancreatitis and diabetes online, and it seems like it's a constant uphill battle that requires hospitalization often. My fear right now is that we are going to get him better just to have to put him through this again. For the first time in my life, I understand what it feels like to want to end my babies suffering. I really hate to say that, but I can't imagine putting him through this again, and it seems as though within cats pancreatitis is most commonly chronic.

They said he is too sick to come see right now, and they would call when we can come in. We think right now they are just trying to get him to a point where we can come in and see him one last time.

Has anyone else dealt with this before? I'm thinking it might be time to say goodbye, as much as that hurts me to say. I know I feel this way because I am more afraid of what it means if he makes it through this. I know pancreatitis can be very painful, and I just don't want to drag this out.

So does anyone agree that maybe it would be better to say goodbye?
 
Prayers and lots of knees here...come on sweet baby, this can be overcome!

Yes there are several members who's cats have had pancreatitis and got over it...I'm sure they'll post,,,

BIG HUGE HUG,,,
 
There is chronic pancreatitis and unlike dogs, where you give them a low fat diet and dogs always seem to eat, cats are harder. Main thing is support and pain control. It is painful and that alone can affect them so pain meds are needed. That fPLI test should have been run sooner so pain meds could've been used. Then there is acute pancreatitis which is basically a one time deal......they either pull through or they pass away. Mishka suffered an acute attack, was extremely sick but she did survive and has never had an attack of pancreatitis again.

I have to say that low temp is not good news...almost like his body is shutting down. Not what you want to hear but I would immediately go see him. Forget what the vet says, go see your boy, give him lots of love and kisses, let him know you are there and ignore how he may look. He needs to know he hasn't been abandoned.

Many, many prayers coming for Bubba.
 
Bubba passed away today at about 2:15. We made the difficult decision to end his suffering after the rest of his blood results came back and his liver appeared normal. The doctor said she was fairly convinced his liver was cancerous, because if it was anything else, it should have shown up in the blood panel.

We are so crushed right now. I've lost my best friend.

Here is the post I made about his passing: viewtopic.php?f=28&t=98890

I just wanted to say thank you to everyone here for keeping us strong through this. We couldn't have done this without you.
 
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