Sick cat, diabetes and ketones

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Steve Freeby

Member Since 2019
Hi all,

I posted my situation on the welcome page so I will start a new one here:

My cat is a 15 year old male who has been on thyroid meds for 6 months.
About 7 to 10 days ago began losing weight , was lethargic and about 3 days ago began vomiting.
Today he could barely walk and we take him to our longtime vet. Our cat was very dehydrated.
Vet keeps him for about 6 hours and gives IV fluids and testing
His glucose is over 400 and was given I believe is Humirin 70/30.
Testing shows bad kidney numbers. Keep in mind he was tested for kidney function as part of his thyroid issue in December and he was fine. Vet thinks fluids may help.
We take him home and he is marginally better but will not eat or drink.
I have Humerin 70/30 and the doctor recommends a 1 u dose but not to use till he starts eating.

I think that is it. I really need some help from someone going through this. I need him to eat, how? Is his recovery slow, My wife and I will be great caregivers.

One last thing, he walked to his cat box twice with a lot better look than he did this morning.
 
Hi again Steve. You are doing really well and you have come to the right place for help!
Here is your post from the into page
http://www.felinediabetes.com/FDMB/threads/diabetes-advice.209941/
I have asked @Marje and Gracie if she could help you too.

At this point getting him to eat anything is ok..is there anything he likes..
Did the vet give you anything for nausea? He could well be feeling sick and not want to eat..

Are the shops still opened where you live..?
if you could buy some Ketostix from a pharmacy test the urine for ketones, that would be very helpful..it is really important to get rid of the ketones.. it is an easy urine test..
 
Steve Freeby said:
Hi all,

I posted my situation on the welcome page so I will start a new one here:

My cat is a 15 year old male who has been on thyroid meds for 6 months.
About 7 to 10 days ago began losing weight , was lethargic and about 3 days ago began vomiting.
Today he could barely walk and we take him to our longtime vet. Our cat was very dehydrated.
Vet keeps him for about 6 hours and gives IV fluids and testing
His glucose is over 400 and was given I believe is Humirin 70/30.
Testing shows bad kidney numbers. Keep in mind he was tested for kidney function as part of his thyroid issue in December and he was fine. Vet thinks fluids may help.
We take him home and he is marginally better but will not eat or drink.
I have Humerin 70/30 and the doctor recommends a 1 u dose but not to use till he starts eating.

I think that is it. I really need some help from someone going through this. I need him to eat, how? Is his recovery slow, My wife and I will be great caregivers.

One last thing, he walked to his cat box twice with a lot better look than he did this morning.
Click to expand...
Can you check the insulin bottle and see if it says Humulin N?

The concern that Bron is mentioning is that diabetic cats can develop ketones which can quickly progress to diabetic ketoacidosis ( DKA). DKA can be fatal and is caused by not enough insulin + infection + lack of food/ water. Do you have any of the lab test results and did they test blood or urine ketones?

I’ve got more info for you but I’ll let you read this first. I’ll post more while you are reading and checking insulin. Do you have a glucometer and test strips there and are you able to test his BG?
 
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I asked about the Humulin because we typically see Humulin N prescribed and not Humulin 70/30 which combines the short action of Humulin R with the intermediate action of Humulin N.

It’s really important to get food in him but, as Bron said, if he’s nauseous and been vomiting, he won’t want to eat.

Quite frankly, if he were my cat, I’d take him to the ER and have him admitted where they can give him Humulin R, get him on anti nausea meds and IV fluids, and be sure his electrolytes are not out of whack. He needs to eat a bit so you can get insulin in him safely but he’s not likely to eat if he is nauseous. And if he eats a bit and you shoot the insulin, then he vomits, it’s not a good scenario. I’ve been around here a very long time and have seen and helped with ketones and DKA. It’s best dealt with in a vet hospital.

Do you have an ER?
 
My guy has been through DKA twice and I agree with @Marje and Gracie's advice about taking your kitty to a veterinary ER if you have access to one and can afford it. It can take some time to get the kitty stabilized and doing better. It's best to take him home afterward with a pharmacy of meds - antinausea, appetite stimulant, supplies to give subQ fluids, etc. His appetite might not be what it should be afterward at home but he MUST eat, hence the need for meds. Being well hydrated is very important so learning to give subQ fluids at home is very useful. Recovery back to his "normal" can take weeks afterward. This is a very serious health crisis.
 
It is early Saturday morning and I will take your meds advice. I will report back later this morning. Cost is an issue.
 
Steve

@Kris & Teasel hit a lot of good points and she’s spot on. We don’t usually recommend that you try to treat high ketones and potentially DKA at home. If it’s just high ketones, you can try but you’ll need the following from the vet:
  • Bag of lactated Ringers solution, needles, IV administration set and you’ll need to know how much fluid to give him daily. If you click on the blue print HERE, it will take you to my video on how to give subcutaneous fluids at home.
  • Cerenia for nausea and if the vet will give you a prescription for ondansetron that you can get at the pharmacy, that’s a great addition. You don’t need to get a bottle of 30 as he will only get 1/4 of a 4 mg tab 2-3 times a day and it’s expensive so get maybe 10 with a refill or two.
  • An appetite stimulant that you will give after the cerenia and ondansetron have had time to work (usually 30 mins). Vets like to give mirtazapine but if you can get your vet to give you cyproheptadine, it’s a better choice. Start with half the dose the vet tells you to give as they usually start too high. You can always increase it later up to the dose recommended.
  • A/D canned cat food from the vet and 10 mm/cc syringes. You must get food in him and you can purée this food with a little water and syringe feed it to him if he won’t eat on his own.
If you have a Walmart nearby, you’ll need:
  • A human glucometer if you don’t have one. The ReliOn Prime is inexpensive and you’ll need at least 100 test strips for it to start.
  • A bottle of urine ketone test strips.
  • U100 0.3cc 31g (29g or 30g are also fine but the higher the number, the smaller the needle and the less “ouch”) insulin syringes with half unit markings, they might tell you they don’t carry them with half unit markings but they do.
Your goal is that you MUST get some food in him because he MUST have insulin. Without insulin, you will lose this battle.

Bottom line, though, is if you can get care credit or a payment plan from the vet, the best place for your kitty is the hospital. You’ll still need to be prepared with the items above for when he comes home but it will give you a few days and if they can get him eating and get the ketones under control, it will be better for all.

Please keep us posted and sending him lots of healing energy.
 
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We are all pulling for you. Your cat has a tough battle ahead but if treated properly and quickly has a good chance to pull through.
 
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