Thelonious the Super Cat

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Aurore

Aurore

Member Since 2017
I posted on the newb board and Kris & Teasel suggested I repost here, hope that's alright!

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"Hello! So, today is day three. On Thursday we went to the vet cause T-lone had suddenly lost a lot of weight and was uncharacteristically sluggish. He's usually very mellow and we recently fostered a kitten for a few months (validating unusual behavior) and I'm a two-job single catlady so all said, I didn't see the signs until the last minute. Really, like the very last minute. I'd have come home in the next few days to find he had passed away quietly under a bed if I hadn't brought him in when I did. Ketoacidosis is pretty terrifying.

So, the worst is finally behind us! Many tears have been shed, particularly today when the vet said he could go home tomorrow and oh, guess what?! The bill's not nearly as much as we thought and we'll even let you pay off a small part of it over the next six months! Yep, even more tears.

T-lone is only 8 years old. The first vet said, 'look, this is really bad (cause I did not at all comprehend anything at that point). You can take him to the ER for about $4000 or we can discuss more humane options...' Um, yeah no. Not my boy. Not my T-lone. No way, no how, let's go figure out how to make this work...

So, three days of absolute terror and stress and tears and anxiety and boy did my whole body ache last night! But today, hallelujah, the news was good! He's coming home tomorrow!

Now what??! I'm shopping for a monitor and any advice is appreciated! And all the other advice as well. I'm so ready to have him home and get him healthy again!"

Kris says I should answer some questions;
  1. What insulin has been prescribed and what dose (was he on insulin before the DKA?)
Don't know yet! Will update tmrw.
  1. What glucose meter you'll be using
Same, looking for advice! Preferably something I can get on Amazon real quick.
  1. Any other meds/health issues he has
Nada! Had an ear mite infection a few years ago, hence his 'boxer's ear'. Otherwise always in perfect health.
  1. Your approximate location/time zone because advice givers are all over North America/Europe.
Northeast US.

Guess I should work on my signature line info huh?

Oh, and I should mention that I've always given my two cats dry Purina One Indoor food. Now what?
 
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Insulin:
  • Vetsulin/Caninsulin is economical but isn't optimal for most cats. It's fast in onset, can drop blood glucose low quickly and doesn't always last 12 hours. Cats are dosed every 12 hours because they metabolize insulin quickly.
  • ProZinc is a cat insulin that works well for many in a similar way to Vetsulin but is slower, gentler and longer lasting. It's expensive though.
  • Lantus and Levemir are human insulins that work well in cats. They're gentle and long-lasting and have a type of "slow release" feature called the insulin"depot". They're also very expensive. Many American users buy it from a Canadian pharmacy for less than half the price.
  • A good starting dose regardless of which insulin you use is 1 unit twice a day. There's a tendency for vets to prescribe too high a dose to start, although a kitty recovering from DKA is a special case - more below.
Glucose Meter:
  • Vets often recommend the AlphaTrak2 pet meter because it gives readings quite close to what they measure in the clinic. However, the test strips are $$$$. The cost of using a glucose meter is in the test strips. Many people use a human meter and the Walmart ReliOn brand is popular. Get a model that works with a tiny blood drop - the ReliOn Micro is one. The test strips are economical and readily available. A human meter will give glucose values that are lower than a pet meter's but the difference is greater at high numbers and less at low numbers. You'll be understood here if you test blood glucose with a human meter.
  • We have lots of tips and tricks to help you with blood glucose testing at home.
Post-DKA:
  • Your kitty will take a while to get his strength back. He's been through a serious health crisis.
  • Three key needs post-DKA: enough calories, enough hydration, enough insulin. You have to keep ketones at bay and that means enough insulin to keep blood glucose down, enough water to flush ketones out and enough calories to counteract insulin as well as prevent ketone-producing biochemical pathways from being activated. We can address this more later once you know the vet's discharge plan. There are members here who are very knowledgeable in this area.
  • Buy a bottle of urine ketone test strips - cheap at any human pharmacy. One brand is Bayer Keto-Diastix. We have tips for urine ketone testing which is essential in a post-DKA kitty. Ketones can build quickly and your kitty is vulnerable right now.
  • Ask how his appetite has been at the clinic and whether he's had nausea. He MUST eat once he's home. If necessary get antinausea and appetite stimulant meds to take home.
I think this will get you started. :)
 
Thanks, you're awesome! Also good to see I'm not the only one with a young male cat with diabetes... All my research made it seem like only older cats or obese cats have diabetes. My son was diagnosed with Hashimoto's when he was fifteen (typically found in middle-aged women) and with T-lone I was like, seriously, again?!! What's going on?! Lol.

I will buy the ketone strips and the relion meter asap!
 
Cat Food:
We recommend a diet of low carb wet food only. With few exceptions, including prescription kibble for diabetics, dry food is too high in carbs. There's no need to break the bank. Grocery store brands like Friskies and Fancy Feast pates are used by many of us - no sauce or gravy types because they're too high in carbs. One low carb kibble that's available online in the US is Young Again Mature Zero. It's used by some with kibble addicts. They have a website and will send a free sample.
 
Quick update:

He's home now. Wish I could say he's doing fine but he's still spending his time either at the water bowl or under a bed. I was hoping my other cat would be happy he was home but I think she's actually mad at me for bringing him back. Sigh.

Got a Relion and tested at 335. I guess I can assume that may be more like 435? That's so scary. Ugh.

He's meant to take 3 units of Prozinc at 6pm along with Clavamox and Famatodine. I have to be at work at 515 so that will be at 5pm. Should I be so worried that I should have someone check on him before I get home at 1130?
 
Oh, and he's not eating. Took a few peices of the DM kibble and won't touch the DM wet food. Got some FF and will put that down too.
 
Aurore said:
Quick update:

He's home now. Wish I could say he's doing fine but he's still spending his time either at the water bowl or under a bed. I was hoping my other cat would be happy he was home but I think she's actually mad at me for bringing him back. Sigh.

Got a Relion and tested at 335. I guess I can assume that may be more like 435? That's so scary. Ugh.

He's meant to take 3 units of Prozinc at 6pm along with Clavamox and Famatodine. I have to be at work at 515 so that will be at 5pm. Should I be so worried that I should have someone check on him before I get home at 1130?
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Congratulations on doing the blood glucose test! Don't try to convert one meter reading to another - there's no true conversion factor. tThey'll read further part at high numbers but closer at low.

Was he positive for an infection (Clavamox)? Was it a urinary tract infection? The famotidine is a stomach acid reducer but it won't do much for nausea or as an appetite stimulant. Clavamox itself is known to cause GI upset.

Did your vet say anything about testing for ketones in urine after the DKA episode? You can choose to do it yourself, of course. Was there any mention of the importance of eating, being hydrated, etc. after a DKA episode?
 
Ack, I'm just reading this now, and I guess you've already gone to work, but I just wanted to say: it's really important that he is eating right now. Don't worry too much about the DM or about getting onto a low-carb food right now-- if he'll eat the Purina Once he's used to, then by all means give him that, for now.

If he won't eat even that, then as Kris says you may need to get something like anti-nausea meds (if that's the problem), but with the DKA, and a 3U starting dose of insulin, he's got to eat.
 
Kris & Teasel said:
Congratulations on doing the blood glucose test! Don't try to convert one meter reading to another - there's no true conversion factor. tThey'll read further part at high numbers but closer at low.

Was he positive for an infection (Clavamox)? Was it a urinary tract infection? The famotidine is a stomach acid reducer but it won't do much for nausea or as an appetite stimulant. Clavamox itself is known to cause GI upset.

Did your vet say anything about testing for ketones in urine after the DKA episode? You can choose to do it yourself, of course. Was there any mention of the importance of eating, being hydrated, etc. after a DKA episode?
Click to expand...

Well, there were so many different doctors at the hospital, I don't think I ever talked to the same one twice . The guy who checked us out said that DKA usually causes urinary tract infections, though he didn't specific whether this had been confirmed with T-lone. It felt like a 'just to be safe' thing. The other was supposed to be for nausea. Hm.

No mention of urine testing but I ordered some strips. He was an anti-home-monitoring doctor so I checked my words. Didn't want to get into an argument.

I already knew the importance of eating and hydration so if he said it it may have gone in one ear and out the other. I don't specifically remember him saying it.

As it happens, though there were already two foods on the floor, I decided to put out the FF and HE ATE IT!! Sooooo grateful for finding this forum as I wouldn't have thought of it otherwise! He likes the FF! Hallelujah.

I should be home by 11 and will test again then.
 
One more thing... I dropped the bottle of insulin, about three feet onto carpet. Should I be terrified that I ruined it???
 
Sorry for the late reply, I work too much! He seems better. BG around midnight was in the 360s, BG this morning was 319. He's on top of the bed more often as opposed to under it, and he's eating the FF really well! When can I expect to see his BG come down?
 
Aurore said:
Sorry for the late reply, I work too much! He seems better. BG around midnight was in the 360s, BG this morning was 319. He's on top of the bed more often as opposed to under it, and he's eating the FF really well! When can I expect to see his BG come down?
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I suggest you set up a spreadsheet like the one we use here and enter all the BG data you have. Testing AM and PM is great. If you could fit in a few other tests through the time between doses it would help to assess the 3 u dose he's on. For example, test just before your bedtime or mid cycle on days off. You need to know how low his BG is going.

The spreadsheet instructions are found in the "Suggestions, Testing and Tech Support" forum near the top of the page listing all forums.
 
So I got home at 7, gave him his insulin and meds, and tested him at 8. The relion said 472. This is so stressful!
 
Aurore said:
So I got home at 7, gave him his insulin and meds, and tested him at 8. The relion said 472. This is so stressful!
Click to expand...
It's hard to know why he's running high like this. It could be from the UTI if he actually has one, a dose that's too low or a dose that's too high (can cause rebound hyperglycemia). If you set up your spreadsheet tomorrow and enter all the BG test data you have, that's a good start.

I'm not sure what your testing routine is right now but this is what we recommend:
  • AM and PM before feeding and injecting (no food at least 2 hours before these tests) to make sure the dose isn't too high
  • at least one other test during the time between shots or just before bed to see how low the BG is going
  • extra tests on weekends or days off.
 
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