Sick cat.. she is in ER with DKA -COMING HOME TODAY!

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nancy and payne

nancy and payne

Member Since 2010
My cat Payne was Dx 10/10 and was on pzi until 3/9 when we changed to Lantus, and she's been doing well. She is prone to ketones and has had DKA x3. Last night one of my boy's gave her some sardines in water and we saw some in 2 piles of throw up this morning. She is acting sick, not ketone sick, like she's just sick and I'm hoping it's just sardines. Her AMPS was 228 but didn't give her her shot because she won't eat but I did give her 1/4 pepcid. What to do about her shot?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Hi Nancy welcome to LL! How long ago was she supposed to get her shot?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Her shot was suppose to be 90 min. ago, we just got her caught up with the time change .... not like pzi :)
I have not been able to test for ketones because she won't pee.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Hi Nancy, welcome to LL!

I see a note on Payne's SS for yesterday..."small ketones"...what exactly was the ketone test result? I have no direct experience with ketones, I have asked for some experienced eyes on your condo. Is she drinking?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Do you have any baby food in the house? If not, is it easy for you to get some? You'd want a variety that is only meat + broth. (Gerber Stage 2 has cornstarch and is OK. Beechnut doesn't have cornstarch. Just no onions or veggies.) Baby food is easier to digest, easier on the stomach, and most cats regard it as a treat. If you can sprinkle something that Payne likes on his food, that may help.

How long ago did you give the Pepsid? It usually takes anywhere from 30 - 60 min. to start to work.

I'm curious, as well, as to what you mean by "small" ketones. Are you using a meter that measures ketones?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

I just got 1/2 jar baby food and some water in her, she is still not eating on her own .... we are now two hours past her shot time. This doesn't look like ketones .... but I have not been able to get her to pee yet.
(she also runs some ketones at different times)
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

She was given the pepcid about 90 min. ago. and she is keeping the baby food down. We don't use a monitor for ketones just strips. She has always had some ketones at different times, vet not sure why and every test has been run. The DKA's were in the beginning and I know what to look for now. We just tested her and she is at 278 .... 2 1/2 hours past her shot time, shoot 1u?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Hi Nancy,
I have a whole lot of experience with ketones. After looking at your spreadsheet I would advise that you syringe 1/2 jar of stage 1 baby food(not all at 1 time of course), into Payne's mouth and give him 1/2 of his usual dose of insulin after you get that food down. I'd suggest doing the same with water if you can. If you have a ketone prone kitty and he doesn't get insulin, and food, you will be ..more than likely...looking at a ketone situation. I'm sure you already know that for ketones to be kept at bay, your cat needs insulin, food and water...food first. if he goes low you can always rub some corn syrup on his nose but at least he'll have gotten his insulin.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Nancy and Payne said:
She was given the pepcid about 90 min. ago. and she is keeping the baby food down. We don't use a monitor for ketones just strips. She has always had some ketones at different times, vet not sure why and every test has been run. The DKA's were in the beginning and I know what to look for now. We just tested her and she is at 278 .... 2 1/2 hours past her shot time, shoot 1u?
Click to expand...

shoot 1.5
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Nancy,

There is a difference between ketosis and DKA. Ketosis is when there are a small amount of ketones and the cat is not terribly sick yet. DKA is when the cat is very sick and needs hospitalization. Either Payne just has a really bad tummy from the sardines or is in the beginning stages of ketosis...not necessarily DKA. You can get him out of that. I have to admit that it would be helpful if you had subQ fluids but even if you don't, insulin, food and plenty of water will help. And that is why I suggest not skimping on the insulin.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Sienne and Gabby said:
Do you have any baby food in the house? If not, is it easy for you to get some? You'd want a variety that is only meat + broth. (Gerber Stage 2 has cornstarch and is OK. Beechnut doesn't have cornstarch. Just no onions or veggies.) Baby food is easier to digest, easier on the stomach, and most cats regard it as a treat. If you can sprinkle something that Payne likes on his food, that may help.

How long ago did you give the Pepsid? It usually takes anywhere from 30 - 60 min. to start to work.

I'm curious, as well, as to what you mean by "small" ketones. Are you using a meter that measures ketones?
Click to expand...

small ketones are light pink on the ketones stix. a step above trace but nothing serious unless you don't know how to read the stix.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

with Lantus you have a couple of hours to get food into him before the insulin kicks in. It's +14.5 and the shed is draining. I don't see any reason to not shoot full dose as long as you think you can get him to keep some food down in the next couple of hours. It sounds like he has already kept some baby food down, right?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

I was talking to ER, they are full and will get back to me .... although I did shoot 1.5 a few min. ago. I am very familiar with ketones, ketosis and DKA and wish I wasn't! I do have SubQ and I could do that now. I am hoping it was the food, just found out from another kid she also had some egg salad ohmygod_smile obviously I need to monitor what she eats better .... or get new kids! But she looks sick but not that ketone look, I'm hoping. SQ now?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

So her baby food has stayed down, I shot 1.5 20 min. ago, she should get the other 1.5 now?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

I'm betting it's either a result of the eggs or the sardine and egg combo. (I think I'd be nauseous from that.) I think if you can get more baby food into Payne that would be great, even if it means assist feeding.

You could also give another 1/4 tab of Pepsid, The max dose is 1/2 tab twice a day but I'd only do that if Payne is looking nauseated when you put food in front of him.

I don't think the sub-q fluids would hurt but I've not used them and would prefer someone with more experience chimes in.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

if you have already shot, I wouldn't go back and shoot more. Just monitor and see where he goes. If you have given him fluids before, those shouldn't hurt now (some cats shouldn't have fluids if they have heart issues or some other issues, but since you have them I assume your vet has ok'd them for Payne).
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Nancy and Payne said:
So her baby food has stayed down, I shot 1.5 20 min. ago, she should get the other 1.5 now?
Click to expand...

my opinion is that I would give him fluids (50 ml now unless she seems dehydrated and then maybe go with 75). To see if he is dehydrated pinch up the skin between his shoulders. if it snaps back, he is not, if it slides back slowly, he is.

You now have 2 different people giving you opinions on the dosage. If it were my cat and I didn't know which way the eating was going to go, I'd stick to the smaller dose. If he seems hungry to you and it appears that he might start to eat more then go ahead and give him more. I suggested the fluids for 2 reasons. you have not gotten a ketone test so you have no idea what's going on. if there are any, the fluids will start to flush them out. Also, Payne vomited a lot....the fluids will help replace electrolytes that may have been lost.

I would rather err on the side of caution. If Payne starts feeling better you can always give his next shot a little early. JMHO.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Yes, we have used SQ before .... they go hand in hand with R insulin for fighting ketones, which we just got and they are small which she had yesterday. I took in for a second opinion to a vet that I got as a referral from this list. I loved him and the clinic! Ten vets, 24/7 ER and two internists. The internist we saw spent quite a bit of time with her, went over all her tests from Davis and at one point scooped her up as he was leaving the room, looked back and said he needed to look at this under an ultra sound, no charge .... he put her on Lantus, took her off pred/tylosin and R insulin. His feelings on the ketones were the BG#'s were more important AND how she looked but that she shouldn't be getting R daily. She hasn't had R since she started Lantus (3/9)

I thought Lantus shots had to be timed 12 hrs. apart. I will stay with the 1.5 because that feels right to me but she is now hiding in a cupboard ..... I will give her SQ.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Nancy and Payne said:
Yes, we have used SQ before .... they go hand in hand with R insulin for fighting ketones, which we just got and they are small which she had yesterday. I took in for a second opinion to a vet that I got as a referral from this list. I loved him and the clinic! Ten vets, 24/7 ER and two internists. The internist we saw spent quite a bit of time with her, went over all her tests from Davis and at one point scooped her up as he was leaving the room, looked back and said he needed to look at this under an ultra sound, no charge .... he put her on Lantus, took her off pred/tylosin and R insulin. His feelings on the ketones were the BG#'s were more important AND how she looked but that she shouldn't be getting R daily. She hasn't had R since she started Lantus (3/9)

I thought Lantus shots had to be timed 12 hrs. apart. I will stay with the 1.5 because that feels right to me but she is now hiding in a cupboard ..... I will give her SQ.
Click to expand...

you can give or take 30 minutes...and you didn't give a full dose. hiding, huh? have you taken her temp? Sounds like something is brewing....not necessarily ketones but something (I know I wouldn't feel very good if I had sardines and egg salad). Tell the kids to stop feeding the kitty ohmygod_smile
Feel her ears and paws (unless of course you can take her temp). Are they hot? The fluids may help this too if they are.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

We had to find her ..... she found a new hiding place, this is when kids come in handy, find the kitty! Her temp. is 101.2 and she doesn't feel warm, so we fed her the rest of the jar of all meat baby food mixed with water. (by syringe) She looks like she doesn't feel well and this time fought the food a little, didn't last time. I also gave her another 1/4 pepcid and since there was water in the food I'm going to hold off on the SQ because she doesn't feel dehydrated but could do later.

I don't understand Lantus the way I did pzi but if we gave her half her dose 1.5u 2 1/2 hrs. past her shot time then what time should we give her PM shot, same time? I didn't know you could shoot the L's t.i.d.? She did well t.i.d. but I thought Lantus was 12/12?
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

i don't know anything but just wanted to say "sardines and egg salad?" OY!? Bless those children! :lol:

hope your baby feels better soon!
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

sending healing vines to your girl, and bumping your post for better eyes than mine...

celi & binks
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

any updates?
when you have a chance, please update spreadsheet too.
 
Re: Sick cat, new to Lantus, won't eat ..... insulin?

Nancy and Payne said:
We had to find her ..... she found a new hiding place, this is when kids come in handy, find the kitty! Her temp. is 101.2 and she doesn't feel warm, so we fed her the rest of the jar of all meat baby food mixed with water. (by syringe) She looks like she doesn't feel well and this time fought the food a little, didn't last time. I also gave her another 1/4 pepcid and since there was water in the food I'm going to hold off on the SQ because she doesn't feel dehydrated but could do later.

I don't understand Lantus the way I did pzi but if we gave her half her dose 1.5u 2 1/2 hrs. past her shot time then what time should we give her PM shot, same time? I didn't know you could shoot the L's t.i.d.? She did well t.i.d. but I thought Lantus was 12/12?
Click to expand...

I don't use Lantus....I use Levemir. I don't know anyone who shoots tid on Lantus either.
and as it says on my signature...my dosing schedule is specifically for Alex. It works for him and helps keep his ketones under control...after many unsuccessful attempts and many other methods of shooting. NO ONE ELSE SHOULD DO WHAT I DO!
That's why I have a disclaimer :!:

Lantus is 12/12....I don't think there is a person on the boards who hasn't shot 30 minutes early or late at one point or another....and Payne didn't get a full dose. Why don't you let her numbers and whether or not she's eating help you determine what would be best? :razz:

Maybe she'll even pee for you by then!!!!
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

Trust me I won't do anything stupid, we have been through too much but I do miss pzi but think that Lantus is better for her. At + 3 1/2 from shot (1/2 dose 1.5) she is going up some, 284 from shot 278. She looks like? miss being able to cuss ..... ohmygod_smile and I really don't understand Lantus at this point but I am learning.
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

There are cats here, besides Caryl's Alex, who shoot TID. It is not a recommended approach unless you have given BID dosing a thorough try (read that as many months, not weeks). It is havoc on your schedule and it can be dangerous due to the degree of overlap between shots. The vast majority of cats do well on BID dosing given the duration of Lantus.

You want to shoot 12 hours from when you gave your shot this morning. You can recover your time from today in one of three ways. You can move shot times 15 min. at each shot until you are back on schedule. Alternatively, you can move the time by 30 min. in a 24-hour period until you're back on schedule. If Payne is running in high numbers (i.e., above 300), you could conceivably shoot an hour early. I would not suggest doing this unless you have extra strips, high carb food, and are able to stay awake to monitor in case numbers run low. Giving an early shot acts like a dose increase.

Has all of today's litter box activity been normal?
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

Not too much, I hope. I just spoke with the vet and her ketones are up to moderate but he wasn't concerned as much because she is not running a fever and is not up-chucking today. (we are just assuming throw up last night was her's, I have civvies who apparently got fed yesterday, also. ohmygod_smile

Vet said to shoot full dose tonight, eleven hours from the shot, sound right? then make up a 1/2 hr. a day until back to schedule .... I have never dealt with a hypo, we have never been in the green :) keeping fingers and paws crossed.

After reading last post I may want to shoot 12 hr. from last shot, as I said above we have NEVER gone low and I could not deal with today. She is hiding and only goes to the LB when we take her for ketone test.
Nancy and my poor Payne :)
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

Sienne and Gabby said:
There are cats here, besides Caryl's Alex, who shoot TID. It is not a recommended approach unless you have given BID dosing a thorough try (read that as many months, not weeks). It is havoc on your schedule and it can be dangerous due to the degree of overlap between shots. The vast majority of cats do well on BID dosing given the duration of Lantus.

You want to shoot 12 hours from when you gave your shot this morning. You can recover your time from today in one of three ways. You can move shot times 15 min. at each shot until you are back on schedule. Alternatively, you can move the time by 30 min. in a 24-hour period until you're back on schedule. If Payne is running in high numbers (i.e., above 300), you could conceivably shoot an hour early. I would not suggest doing this unless you have extra strips, high carb food, and are able to stay awake to monitor in case numbers run low. Giving an early shot acts like a dose increase.

Has all of today's litter box activity been normal?
Click to expand...

I totally agree with this statement in oh so many ways. I tried for a very long time, tried many other ways and had many mini breakdowns before trying this last option. I wish that I could shoot bid..and maybe someday I will be able to, if Alex's pancreas starts to heal.This takes a lot of data, a lot of testing and a lot of adjusting to keep Alex out of danger. It is very difficult, to say the least...but so far for us, the results have outweighed the risks.

I also have to mention that Alex does have other health factors that keep the insulin from metabolizing correctly. That is why I do this.
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

Nancy --

It's entirely your call (and your vet's) as to when you shoot. Shooting at +11.5 or +11.75 is safe. I overslept the daylight savings time shift (and I'm the one who wrote the instructions - go figure!) and moved Gabby's shots by 30 min. for the next 2 days. No one here will twist your arm to do something you're not comfortable with. Having a kitty who is causing you to worry is sufficiently stressful. Do what you think is right for Payne.
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

I have been reading this list since Payne's Dx and I would never feel pressure from you guys, I just appreciate you helping and giving me all your opinions. I remember when Payne was first Dx and went straight to DKA and all the wonderful advice I got then, especially from the people who have lived with ketones. I have said this before, I truly believe had I not found this list, Payne would have not made it. She has survived 3xDKA and a vet??? who didn't help. Now with the new, very user friendly vet and this list, there is much hope. I know so much that I never thought I would learn .... plus all the advice has helped my civvies. I believe feeding the wet with extra water is the best advice EVER! (I lost two civvies to kidney failure last year) we had to add extra litter boxes but it just thrills me regardless .... all that liquid in, all that liquid out!
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

if ketones are increasing and are now moderate, I wouldn't hesitate to shoot as early as +11 if the numbers permit. How about testing at +10 and +11, and if he is rising and still pink then shooting at +11? I think he will be high enough since you shot a reduced dose after a delay this morning. That will help with your schedule and will also get some more insulin into Payne earlier.

I'm not entirely comfortable with treating moderate ketones at home, but if you have done it before and your vet is comfortable then I guess I don't have much say in the matter. :lol: Food, fluids, and insulin, and get another ketone test when you can.

Question, I see that you have used R with Payne in the past (on ProZinc). Did you ever do an "R curve" (test at PS, +1, +2, +3, +4 after giving R) to get an idea of how much of a drop he got on various doses of R? A few cats here do use R, especially when ketones are an issue. We use it very differently than you did with ProZinc, though.
 
Re: Sick cat, new to Lantus, ketones, need dosing advice

I realize that I only have part of Payne's SS on my sig. this https://docs.google.com/?hl=en#all
should take you into google docs where Payne's old SS sits. It shows where we dosed t.i.d. and she was given 1.5uR t.i.d.

We are off to the vet .... she has not absorbed the fluid and she looks like .... will let you know. ketones are down to small.
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

We just got back, she is in ER with DKA ..... I have no idea how this one happened? she was perfect yesterday and maybe I said that too loud and the God's are getting me. Thank you Hope for the great vet recommendation I like them a lot! The ER vet said there are 3 types of ketones, I know of 2, not sure what the third kind are, I have been too upset to ask in depth questions .... once you hear DKA the mind goes, thank you all for your good thoughts.
Nancy
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

We're here with you. Lots of good thoughts for Payne's speedy recovery will be heading your way.
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

sorry to hear this nancy...

sending healing vines and prayers for Payne...

celi & binks
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

I am sorry Nancy - also glad you got her to the ER. Positive thoughts from Mannie and me for a speedy recovery. We are sending as many healing vines as we can find. Update when you can.
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

Nancy, I'm so sorry that you have such a sick baby again - sounds like she went into DKA pretty fast.

I have no advice for you - I use Levemir for Dude and in 7 years (anti-jinx and knock on wood) we've never had to fight ketones for which I'm very grateful.

I'm just clicking in here to say I'm sending lots of healing lights and prayers your way for Payne to feel better immediately and that Lantus will do the trick for her (and you) once and for all.

Will watch for your updates.

Emmy & Dude (& Mittsi too)
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

Many healing vines for your baby, Payne. I hope she comes home soon and is much healthier.
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

healing vines and a blizzard of snowflakes for your kitty hope things get better soon
275bfbe84d9a09be7b99c6f0fcea18f1.gif
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

oh my goodness, ((((Nancy)))) I'm hoping Payne will pull thru this, sending lots of positive thoughts your way.
Please update when you can.
 
Re: Sick cat, new to Lantus .... she is in ER with DKA.

(((((Nancy))))) I hope that Payne will be feeling much better today. Sending positive thoughts, healing vines, and snowflakes for your girl. I'm very glad you took her to the ER last night. Please update when you can.

Ella & Rusty
 
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