? recent DKA, dose advice | Loki and Alessia

aleLoki

aleLoki

Member Since 2026
Hi everyone,
My name is Alessia and I live in Italy. My cat, Loki, is a 5-year-old neutered male. He weighed 7.5 kg at the time of his diabetes diagnosis in February 2026, when he started treatment with Senvelgo.
Since February, despite eating well, he continued to lose weight. Between the end of February and the end of July, he lost an average of about 200 g per month. Before he was hospitalized, he weighed only 6 kg. He was eating two cans of wet food every day (Lily's Kitchen and Almo Nature Daily), plus a small amount of dry food, even though he has never really liked kibble.

Unfortunately, on July 31st he was hospitalized with diabetic ketoacidosis (DKA), which was caused by the medication. Surprisingly, when we brought him to the hospital, he was still active and had eaten one can of wet food that day. However, his blood ketones were 6.6 mmol/L, and he had a fever of 40.3°C (104.5°F). The veterinary team immediately started him on IV fluids, insulin, and antibiotics.

Thankfully, he has improved a lot. His ketones have now dropped to 1.2 mmol/L, his fever is gone, and all of his bloodwork has remained normal throughout his hospitalization. Since Monday, they have started him on ProZinc at a dose of 1.5 units. He will probably be discharged tomorrow, and the veterinary team will place a glucose sensor that lasts 15 days to monitor his blood glucose levels.

I'm really worried because I don't know anything about managing diabetes with insulin. I'm wondering whether the insulin dose is adjusted based on the glucose readings or if it's usually a fixed dose. If it needs to be adjusted, how is that typically done?

I know my veterinarian will explain everything to me tomorrow before Loki comes home, but I was hoping to hear from those of you with experience so I can better understand what to expect. Any tips about living with a diabetic cat on ProZinc, using a glucose sensor, or what to expect during the first few weeks would be greatly appreciated.

Thank you so much for any advice or reassurance you can share!
 

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Hi Alessia welcome! We have so many beautiful black kitties on this forum (including my Moonie) so I’m happy to see handsome Loki here :)

You should wait for a more experienced member to provide advice, but in the meantime, if you adjust your title, you’ll likely get a faster response. There is a dropdown by your title and I’d put “?” and I would include something like (recent DKA, dose advice) in the title itself. That way, experienced members know to prioritize your thread for a more immediate response.
 
Connie & Parker & Moonie said:
Hi Alessia welcome! We have so many beautiful black kitties on this forum (including my Moonie) so I’m happy to see handsome Loki here :)

You should wait for a more experienced member to provide advice, but in the meantime, if you adjust your title, you’ll likely get a faster response. There is a dropdown by your title and I’d put “?” and I would include something like (recent DKA, dose advice) in the title itself. That way, experienced members know to prioritize your thread for a more immediate response.
Click to expand...
Thank you for your advice! Moonie is so beautiful :)
 
Hello and welcome. Sorry to hear your kitty went into DKA. That is one of the risk factors of Senvelgo. Did the vet have you check for ketones at home? This is something you should be doing now. You can either get sticks to test the pee, or blood meters that test ketones. Tips to catch and test a urine sample
aleLoki said:
I'm wondering whether the insulin dose is adjusted based on the glucose readings or if it's usually a fixed dose. If it needs to be adjusted, how is that typically done?
Click to expand...
Yes, there are dosing methods for the different types of insulin. But the ones we use here determine how to change the dose based on how low the dose is taking their kitty. The way to do that is the glucose sensor or testing with a blood glucose meter. The glucose sensor (Libre?) need to be replaced regularly. Some kitties remove them before the 15 days is up. More on those sensors here: Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

It's a good skill to have to also be able to use a blood glucose meter. Tips on testing and videos in this post: Hometesting Links and Tips

To learn more about Prozinc and the dosing methods used with it, look at the Sticky Notes on the top of this subforum: Prozinc / PZI
 
Hi everyone, Thanks for the feedback! We monitored his urine for ketones once a week! And I've read all of your guides, and they've been super helpful!
Yesterday we had a vet consultation. The vet prescribed 1.5 Units of ProZinc twice daily. Here is where I am feeling confused and a bit overwhelmed by the instructions:
- The vet plans to fit a 15-day continuous glucose monitoring sensor on Loki this coming Monday. However, when I asked how I should monitor him at home until Monday, he simply told me to "just watch him visually for any abnormal behavior." Because I want to keep Loki safe, I bought a human blood glucose meter to test him at home anyway.
- The vet didn't provide any reference ranges or specific blood glucose thresholds (e.g., when it's safe to shoot, when it's too low, or what to do in case of low numbers). He strictly told me never to adjust the dose on my own and that only he will adjust it.
- He recommended feeding Loki dry kibble (specifically a GI diet high in rice/carbs). From everything I’ve researched, a wet-food-only, low-carb (<10% carbs) diet is essential for feline diabetes.

Honestly, I feel completely lost and confused. If I hadn't done my own researche beforehand, I would have left the clinic with a set of completely wrong info.

Since I now have a human glucometro/meter:
  • What blood glucose levels on a human meter should I consider safe to give 1.5U of ProZinc?
  • What is the "no-shoot" threshold for a beginner testing at home
 
Hello Alessia! Welcome to our FDMB! I really can help you once you start getting some data filled in on your spreadsheet. Right now, in the very beginning, we would not recommend giving insulin when your cat is below 200 on the human meter. Your vet must be giving you advice based on some outdated thinking regarding feline diabetes. It’s so good that you have done your own research. You will be able to help your cat much better this way.

Since Loki doesn’t like kibble, you can just completely get rid of it. That’s very fortunate! That high carb kibble will only keep his blood glucose levels higher and that will mean a higher dose of insulin and more difficult to manage blood glucose.

Let me know what other questions you have. Please start putting his numbers into the spreadsheet as soon as you can. You are doing a wonderful job already— getting everything set up.
 
As someone else already mentioned, the safe way that we adjust the insulin dose is to know the cat’s nadir (lowest BG reading of the cycle.) We will give consideration to preshot numbers as well, but it is essential to know how low the dose is taking Loki.
 
Since Loki is very recently diagnosed with DKA, we don't want you to have to skip insulin at all. If he's below 200 at shot time, post and we can help. Options could include waiting until his blood sugar is higher, or giving him a smaller dose of insulin.

While DKA is so recent, it's best to test for ketones every day if you can. Ketones can go from trace to high very quickly.
 
I'd like some advice about Loki's feeding schedule. This is his current routine:
  • 7:00 AM: Half a can of Almo Nature Daily Rabbit wet food (2.6% carbs from calories).
  • 12:00 PM: The other half of the same can.
  • 4:00 PM: Half of a second can of Almo Nature Daily Rabbit.
  • 7:00 PM: The other half of the second can, together with his insulin shot.
  • Overnight: I leave him about 20 g of Thrive Chicken dry food (8.9% carbs from calories) so he has something to eat during the night.
Does this feeding schedule seem appropriate? Is it okay for him to eat this way throughout the day, or would you recommend changing the timing or the portions?
I'd really appreciate any advice or suggestions. Thank you!:cat:
 
the schedule is great, feeding several meals or snacks during the day helps to keep the insulin in check, however, the dry food, normally is very high carb anywhere between 20-30, here is a food calculator link https://felinediabetes.com/FDMB/direct-messages/carb-calculator.121353/ place the nutrient on the calculator to make sure is low carbs the correct carb% will be the DRY MATTER CARB on the calculator, a diabetic cat needs to have a diet between 0-10%
I feed about the same schedule to Corky, click on his spreadsheet below, and scroll to the left, you'll fid when where and what I feed 🫶
 
I've just tested him and got a 60. However he's active
He's now eating both wet food and kibble.
His prozinc dose should be in half hour, what should I do?
 
aleLoki said:
I've just tested him and got a 60. However he's active
He's now eating both wet food and kibble.
His prozinc dose should be in half hour, what should I do?
Click to expand...
Maybe for a quicker response, you could also try making a new thread. I’d link this thread in the post and make sure the title makes it clear your shot time is very soon and you need dosing advice to know if you can shoot. And you can use the dropdown menu to include “?” with the title too. Good luck!
 
At what point in the cycle is that 60? Please include the data on your spreadsheet.

I think you could tweak your schedule. It's better if most of the carbs are fed in the first half of the cycle, before the insulin effect starts to fade. I would move his 12 noon feeding up a couple hours to around +3, then maybe do the meal that is currently at +9 at around +6. If he needs additional food later in the cycle, try to find something that is very low, if any carbs.
 
aleLoki said:
I'd like some advice about Loki's feeding schedule. This is his current routine:
  • 7:00 AM: Half a can of Almo Nature Daily Rabbit wet food (2.6% carbs from calories).
  • 12:00 PM: The other half of the same can.
  • 4:00 PM: Half of a second can of Almo Nature Daily Rabbit.
  • 7:00 PM: The other half of the second can, together with his insulin shot.
  • Overnight: I leave him about 20 g of Thrive Chicken dry food (8.9% carbs from calories) so he has something to eat during the night.
Does this feeding schedule seem appropriate? Is it okay for him to eat this way throughout the day, or would you recommend changing the timing or the portions?
I'd really appreciate any advice or suggestions. Thank you!:cat:
Click to expand...
That’s too much food too late in the cycle for a cat on ProZinc. After breakfast, the first meal would be better given two hours after the shot because that is about when ProZinc will start to lower his blood glucose. Then you can feed about two hours later. If Loki is extremely hungry you could feed your lowest carb wet food at +6, but I do not recommend feeding after nadir because it can shorten the duration of the ProZinc and cause his BG to rise prematurely.
 
You can always also post on the ProZinc forum where I shoud see it. If you post on this forum for now, please tag me because that is the ONLY way I will see it on this forum (unless someone else tags me on your thread.)
 
And since this thread has only a total of 20 posts, let’s keep to this thread for a little while because it has Loki’s history. If it goes onto a second page, go ahead and start a new thread but link a copy of this thread in your first post.
 
aleLoki said:
I've just tested him and got a 60. However he's active
He's now eating both wet food and kibble.
His prozinc dose should be in half hour, what should I do?
Click to expand...
If you just got a 60 at his evening preshot time then do not give insulin. Skip the dose for tonight. That is too low to shoot. For tomorrow and going forward, his new dose is 1.25 units.
 
Please let me know that you received the message about not giving insulin tonight. I know that with a recent DKA we try not to skip shots (and what are his ketones today by the way?) He has now eaten both dry food and wet so any test you would get now will be elevated by that food. Please let me know about the ketones! He is making progress and that is good.
 
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