Risk of DKA with my Chunk

Mel&Chunk

Member Since 2024
Updates: Preshot 320, +2: 328, +4: 291, +6: 315. +9: 290. Preshot 286, +3: 237, +6: 195. +9: 197. No vomiting since last dose of insulin!

Hi there!

I joined this group when Chunk was diagnosed, and haven't been an active poster on here but I've gotten a lot of great tips from it so thank you in advance. I'm going to give you a quick summary, and where we're at now, and appreciate all of the help I can get over the next 24 hours.

Summary about Chunk: Diagnosed almost 2 years ago, has been on Prozinc since diagnoses. Never been DKA. Most recent dosage was 2.5 units/twice a day. Domestic Long hair, 13 pounds currently. Diet is Fancy Feast pate, 1.5 cans twice a day. Flavors: Chicken pate, beef pate, or chicken and liver depending on what he'll eat (he's picky and switches constantly). Mealtime is rolling around the floor with him for half an hour while convincing him to be interested in finishing his food, but hey it works! As for testers, we've done curves at home and reported directly to our vet for dosage adjustments every 2 months, but other than that none until recently. Last vet visit before his latest stunt suggested us to go up to 3, but i opted not too as his levels were very controlled and he seemed to be doing good! Also, he hates tests and he gets extremely traumatized going to the vet.

About my Husband and I: Very demanding careers but we've managed to be available at all dose times over the last two years. We're starting to get very tired and feel bad that we haven't been able to do more like testing or financially with specialists but we've pretty much given up our personal lives happily to give Chunk the best shot he can get. Having a diabetic cat is starting to affect our jobs and our bosses view of us so it's becoming a struggle when emergencies happen. We're trying our best to keep ourselves afloat and Chunk and will continue to do so for as long as we can. I sometimes feel like a failed pet owner because I haven't had as much time like some of you to dedicate to this and I respect you all so much.

Sunday-Friday: Sunday evening we decided to do a test to check if he maybe should be moved to 3, and his BG was 143 an hour before shot time so I'm pretty happy we did not blindly jump the units. We gave him his normal dose 2.5 and he had his first hypo episode ever 7 hours into his curve. He mainly laid down, his legs were tremoring, difficulty seeing. Luckily since I've read a decent amount of these boards, we found honey very quickly. tested him an hour after administering honey and his sugar got up to 100. we called the emergency vet hotline (vet is closed) and asked if it was okay to come in the next day and skip his evening dose for now, they suggested giving him 1.5 that evening and the next morning so we did. Brought him to the vet and his BG was 60. Vet advised that he could be in remission and to stop insulin until next vet visit on Saturday. We asked vet if we should continue to test at home through it to stay vigilant and she advised it may stress the cat out so to hold off and just keep an eye on any out of the ordinary symptoms. Chunk was fine until Friday, where he seemed disinterested in eating so we opted to keep his food out to let him graze as he wanted. He threw up at 9pm that night. Called emergency vet again and they advised to bring him in the next day, but to bring him to the ER that night if he threw up again, which he did not.

Today: BG is 444, bloodwork and urinalysis was done but I unfortunately do not have a copy. Everything seemed mild or normal, some ketones were present so they advised hospitalization. We are on a very limited budget, and he is traumatized for the vet. I want to stress a few things: this clinic means we see a new vet every visit, first hypo episode but his third time having ketones in the urine since diagnosis. For occurence 1&2 we managed at home with every other day vet visits with anti nausea, appetite stimulant, antibiotics (if needed) and fluid injections. He does not at all seem as sick as the other 2 occurrences, and again he gets traumatized by the vet. He was only slightly dehydrated but is otherwise pretty normal. Money aside, my husband and I feel confident that if he is hospitalized he has worst chances at getting better due to his stress levels. We want to leave that for absolute necessary conditions, and vet explained it was more of a to be on the safest side suggestion to avoid him getting like he had before. We were sent home with the same mix of medicine, nausea, appetite stimulant, and fluid injections. Advised to do 1 unit dosing for Prozinc and bring him back Monday.

Now: Vet suggested 24 hour monitoring for the next day for best results. We're cracked up on caffeine and ready to go. It's 1:38pm currently. Our current plan is appetite stimulant at 4, start food at 5 and shot at 5:30 if everything goes well. We'll test him before his shot and then every two hours from that point on.

We can take all of the tips and advice you have to offer, so please advise if you have experience!
 
Last edited:
Did the vet say he is in DKA? That would mean his electrolytes would be off too, such as potassium, sodium. If just ketones and levels aren't high, those can be managed at home. Did the vet give any numbers or scale associated with the ketones? Are you home testing for ketones now?

What is the name of the anti nausea drug you are giving now? You should give it before the appetite stimulant as you don't want to give a stimulant to a nauseous cat or it could cause food aversion. Which appetite stimulant are you giving?

At this point, if you can give multiple small meals a day and 1.5 times his normal calories, that will help.

Tagging @Suzanne & Darcy who has experience with DKA.
 
Did the vet say he is in DKA? That would mean his electrolytes would be off too, such as potassium, sodium. If just ketones and levels aren't high, those can be managed at home. Did the vet give any numbers or scale associated with the ketones? Are you home testing for ketones now?

What is the name of the anti nausea drug you are giving now? You should give it before the appetite stimulant as you don't want to give a stimulant to a nauseous cat or it could cause food aversion. Which appetite stimulant are you giving?

At this point, if you can give multiple small meals a day and 1.5 times his normal calories, that will help.

Tagging @Suzanne & Darcy who has experience with DKA.
Hi thank you for your response. I misspoke, anti nausea was the shot form to last 24 hours. We were not given the labs, but were told trace of ketones. All other levels were relatively normal, they were concerned for possibility of future issues in addition to the high blood sugar, low appetite, and the one vomitting incident. It was more of a precaution. Once we told the vet our decision to manage at home they expressed that the Chunk was in fine condition to try it. This vet we saw today was different than the previous vet. Appetite stimulant given is to dose 0.6 units Elura liquid 20mg/ml by mouth. How do I test for ketones?
 
Hi thank you for your response. I misspoke, anti nausea was the shot form to last 24 hours. We were not given the labs, but were told trace of ketones. All other levels were relatively normal, they were concerned for possibility of future issues in addition to the high blood sugar, low appetite, and the one vomitting incident. It was more of a precaution. Once we told the vet our decision to manage at home they expressed that the Chunk was in fine condition to try it. This vet we saw today was different than the previous vet. Appetite stimulant given is to dose 0.6 units Elura liquid 20mg/ml by mouth. How do I test for ketones?
For ketone testing,you can go to a pharmacy or Walmart type store and buy KetoStix and put them in the urine stream while he’s using the litter box. You can also purchase a blood ketone meter which is used the same way you test blood glucose by pricking the ear and testing a drop of blood with a special test strip inserted into the meter. This is what I did after my boy spent a week in emergency care for DKA.
 
The shot form would be Cerenia. You should also have pills to give at home once the 24 hours is up.

See if the Elura works for your kitty. It doesn't for all and is contraindicated for cats with a certain type of diabetes cause by acromegaly. If Elura doesn't work, see if you can get the product called Mirataz, which is an ointment you put on the inside of the ear.
 
With regard to nausea and appetite stimulants, the nausea must be controlled before giving any form of appetite stimulant. If the nausea is not controlled first, then the poor kitty will be hungry and yet nauseated at the same time. This is not only uncomfortable but can cause food aversions in cats.

Most likely your cat received a Cerenia (Maropitant) injection, which lasts for 24 hours. If he’s not eating well or is showing signs of nausea then it’s important to continue with medication to control nausea. Zofran is very effective and less expensive than Cerenia tablets. Cerenia does help some cats though. Zofran (Ondansetron) would require your vet to write you an Rx to take to a pharmacy for filling. I’m currently paying about $16.00 per box of 30 orally dissolving tablets. It’s a small tablet and can be given every 8-12 hours.
 
If you are unable to test him at home for some of the reasons you have mentioned, I would advise using a Freestyle Libre sensor. We have members who apply these themselves and do not have to pay the vet to do it. Your Chunk has already had a few episodes where he has dropped too low with symptoms of hypoglycemia, and you don’t want that again. The only way to keep him safe and to get him regulated is not with random spot checks here and there — and also not with curves run occasionally at the vet, which is just a one-day picture and not indicative of what his blood glucose is really doing at home on other days. Also, as high stress as he is at the vet, his BG is probably significantly elevated by stress hormones. You need to know how low the dose of ProZinc is taking him (nadir) in order to make good decisions about his dose.

@Staci & Ivy is very experienced with the Libre cgm and can answer any questions you may have about them. You would even be able to monitor the glucose from work.
 
With regard to nausea and appetite stimulants, the nausea must be controlled before giving any form of appetite stimulant. If the nausea is not controlled first, then the poor kitty will be hungry and yet nauseated at the same time. This is not only uncomfortable but can cause food aversions in cats.

Most likely your cat received a Cerenia (Maropitant) injection, which lasts for 24 hours. If he’s not eating well or is showing signs of nausea then it’s important to continue with medication to control nausea. Zofran is very effective and less expensive than Cerenia tablets. Cerenia does help some cats though. Zofran (Ondansetron) would require your vet to write you an Rx to take to a pharmacy for filling. I’m currently paying about $16.00 per box of 30 orally dissolving tablets. It’s a small tablet and can be given every 8-12 hours.
Thank you for the Libre & Zofran suggestions, I’ll look into it!
 
If you are unable to test him at home for some of the reasons you have mentioned, I would advise using a Freestyle Libre sensor. We have members who apply these themselves and do not have to pay the vet to do it. Your Chunk has already had a few episodes where he has dropped too low with symptoms of hypoglycemia, and you don’t want that again. The only way to keep him safe and to get him regulated is not with random spot checks here and there — and also not with curves run occasionally at the vet, which is just a one-day picture and not indicative of what his blood glucose is really doing at home on other days. Also, as high stress as he is at the vet, his BG is probably significantly elevated by stress hormones. You need to know how low the dose of ProZinc is taking him (nadir) in order to make good decisions about his dose.

@Staci & Ivy is very experienced with the Libre cgm and can answer any questions you may have about them. You would even be able to monitor the glucose from work.
I also want to add that he has not thrown up since and is seeming lively and hungry. We’re going to try the appetite stimulant still before injection just in case.
 
Good news about no vomiting and being lively!
Wanted to give an update on chunk, since his last shot his readings are: Preshot 320, +2: 328, +4: 291, +6: 315. +9: 290. No vomiting still! Still walking around and "talking" to us normally! Using litter box fine. At +6 he was hard to get a reading from as he was mad about getting woken up and fighting us compared to other readings so that's my line for the rise in the middle but we'll see during the next curve. I think he's frustrated because he hasn't really been able to nap/sleep all day with the constant pokes. We opted to get a reading at +9 because of reaction at +6. I wish regular vet hours were available today so that I get get dosage increase advice but perhaps it's best to do another round of 1 anyways, I don't know.
 
If you are unable to test him at home for some of the reasons you have mentioned, I would advise using a Freestyle Libre sensor. We have members who apply these themselves and do not have to pay the vet to do it. Your Chunk has already had a few episodes where he has dropped too low with symptoms of hypoglycemia, and you don’t want that again. The only way to keep him safe and to get him regulated is not with random spot checks here and there — and also not with curves run occasionally at the vet, which is just a one-day picture and not indicative of what his blood glucose is really doing at home on other days. Also, as high stress as he is at the vet, his BG is probably significantly elevated by stress hormones. You need to know how low the dose of ProZinc is taking him (nadir) in order to make good decisions about his dose.

@Staci & Ivy is very experienced with the Libre cgm and can answer any questions you may have about them. You would even be able to monitor the glucose from work.
Hi Mel and Chunk,
If you’d like to consider using a Libre sensor to monitor his glucose, that’s a very good option. And it’s excellent that you are able to ear poke him to double check any BG that looks questionable.
With a Libre, when they drop low, it’s very important to ear poke and see what the BG is on a handheld meter for verification. (Such as under 50 on a Libre, as it can read lower than actual BG).

We have prepared a document to inform Libre users with great information and understanding how to use one.
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

I also advise people to join the Facebook group Freestyle Libre for dogs and cats.
There’s a vast array of information and people on there who can answer any questions.
I’ve been using a Libre 3 with my cat for three years as she will not tolerate your pokes all the time.
I am able to ear poke her if she goes low to verify her actual glucose with a handheld glucometer.

As Suzanne mentioned, if that’s something that you would like to do it’s good to be able to learn how to apply the Libre yourself so it’s not to have to take the cat to the vet all the time and incur that cost.
It’s very easy to do once you get used to it another thing to keep in mind as vets tend to use surgical glue to attach them to the cat and that can destroy the sensor as well as hurt the cats’s fragile skin. You do not want to use any surgical glue at all.
I have never used any and follow all of the advised methods to attach the sensor and don’t have any problems.
If you have any questions about using a Libre, please feel free to ask, I’m happy to help. There are several people on this website who are also well-versed in using a Libre that can also help you.
Wishing you all the best with Chunk, you’re doing a great job 🥰💓
 
Wanted to give an update on chunk, since his last shot his readings are: Preshot 320, +2: 328, +4: 291, +6: 315. +9: 290. No vomiting still! Still walking around and "talking" to us normally! Using litter box fine. At +6 he was hard to get a reading from as he was mad about getting woken up and fighting us compared to other readings so that's my line for the rise in the middle but we'll see during the next curve. I think he's frustrated because he hasn't really been able to nap/sleep all day with the constant pokes. We opted to get a reading at +9 because of reaction at +6. I wish regular vet hours were available today so that I get get dosage increase advice but perhaps it's best to do another round of 1 anyways, I don't know.
I don’t think that vet has given you very good dosing advice so far. If you can enter your tests into the spreadsheet and get a few days of data in there, I would be able to help with a dose recommendation.
 
I don’t think that vet has given you very good dosing advice so far. If you can enter your tests into the spreadsheet and get a few days of data in there, I would be able to help with a dose recommendation.
That would be very much appreciated, thank you! I'll continue testing as much as I can then!
 
Hi Mel and Chunk,
If you’d like to consider using a Libre sensor to monitor his glucose, that’s a very good option. And it’s excellent that you are able to ear poke him to double check any BG that looks questionable.
With a Libre, when they drop low, it’s very important to ear poke and see what the BG is on a handheld meter for verification. (Such as under 50 on a Libre, as it can read lower than actual BG).

We have prepared a document to inform Libre users with great information and understanding how to use one.
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

I also advise people to join the Facebook group Freestyle Libre for dogs and cats.
There’s a vast array of information and people on there who can answer any questions.
I’ve been using a Libre 3 with my cat for three years as she will not tolerate your pokes all the time.
I am able to ear poke her if she goes low to verify her actual glucose with a handheld glucometer.

As Suzanne mentioned, if that’s something that you would like to do it’s good to be able to learn how to apply the Libre yourself so it’s not to have to take the cat to the vet all the time and incur that cost.
It’s very easy to do once you get used to it another thing to keep in mind as vets tend to use surgical glue to attach them to the cat and that can destroy the sensor as well as hurt the cats’s fragile skin. You do not want to use any surgical glue at all.
I have never used any and follow all of the advised methods to attach the sensor and don’t have any problems.
If you have any questions about using a Libre, please feel free to ask, I’m happy to help. There are several people on this website who are also well-versed in using a Libre that can also help you.
Wishing you all the best with Chunk, you’re doing a great job 🥰💓
I'm going to talk to my vet about perhaps getting one applied, and then a prescription for future use! I read the article and my biggest worry is him ripping it off but it's worth a few tries!
 
I'm going to talk to my vet about perhaps getting one applied, and then a prescription for future use! I read the article and my biggest worry is him ripping it off but it's worth a few tries!
Some cats leave the Libres alone, but if you think he would possibly mess with it, it can’t hurt to try a little T-shirt or some kind of covering.
I’m sure most people do try to cover it in some way.
I know I can’t trust my girl, she’s proven herself, untrustworthy a few times 😢
 
Some cats leave the Libres alone, but if you think he would possibly mess with it, it can’t hurt to try a little T-shirt or some kind of covering.
I’m sure most people do try to cover it in some way.
I know I can’t trust my girl, she’s proven herself, untrustworthy a few times 😢
Oh Chunk is super finicky and flexible there's no doubt in my mind that he needs the bandage AND shirt😂
 
I don’t think that vet has given you very good dosing advice so far. If you can enter your tests into the spreadsheet and get a few days of data in there, I would be able to help with a dose recommendation.
Hi! His +6 and +9 reading was around 195, if his preshot is still in that range, do you think it's still safe to shoot?
 
Have you been able to test for ketones today?
Picking up strips tomorrow, and I know that test is the main reason for the vet visit tomorrow. And to answer your question regarding dosing, not knowingly. Previously to latest stint we only tested at home for a curve if recommended by vet, or of our own volition if concerned about dose increases. Tested sugar at vet every 6-8 weeks. Not doing that again obviously. I'm hoping he goes back up a little we have some time (1 hour, 45 minutes). He's really coming back personality wise and has been using the bathroom normally, still no vomiting or excessive thirst. Hunger is somewhat back but going to administer Emura still as a precaution for shot time. Seems like each preshot test so far is lower than the last.
 
let’s see where he is at shot time. How many minutes now?
Emura was given at 4:15PM PS at 5 was 323. Happy it’s above 200 but what a jump. Does emura have sugar? Should I ask for an alternative tomorrow? He was also super mad and fighting us on eating it so maybe stress too
 
Emura was given at 4:15PM PS at 5 was 323. Happy it’s above 200 but what a jump. Does emura have sugar? Should I ask for an alternative tomorrow? He was also super mad and fighting us on eating it so maybe stress too
Even though Emura was given, not wanting to eat as much as I'd like at this point. Ate almost a can of Fancy Feast, will try for a "snack" in a few hours
 
Emura was given at 4:15PM PS at 5 was 323. Happy it’s above 200 but what a jump. Does emura have sugar? Should I ask for an alternative tomorrow? He was also super mad and fighting us on eating it so maybe stress too
Elura can cause increased blood glucose for a while after administering and may not be advisable in cats with diabetes
1767576450186.jpeg
 
Even though Emura was given, not wanting to eat as much as I'd like at this point. Ate almost a can of Fancy Feast, will try for a "snack" in a few hours
I would not use the Elura but would ask for Mirataz which is an ointment that is put on the inner ear flap. Use a very small amount at first to see the effect on your cat. Sometimes a pea sized amount is all that is necessary once a day. Or 1/3 to 1/2 of the strip length shown on the box every other day or so. Every cat is different and you don’t want to end up with an extremely restless meowing cat.
 
Update: Did give 1 unit of insulin Sunday pm. Took chunk to the vet today and there are still a small amount of ketones but he maintained his weight and is no longer dehydrated. Prescription for ointment appetite stimulant is in, will be shipped to us. He ate relatively no problem tonight! Last reading at +4 in the 200’s, lower than previously pm cycles. Thinking it was in fact the elura. Vet wants to continue with this dose for until next check up next week unless there are changes. My cat is meowing and very affectionate again, no longer trying to hide! Still no committing either
 
I have to jump in to say that transdermal Mirtaz seems to work well for a lot of cats here, mine included.
Every cat is different, but my cat who was prescribed Elura became very agitated and disoriented, and I've see similar comments about it. I hope Chunk is feeling much better now, and if it's no longer an emergency, you can remove the 911 prefix.
 
Back
Top