Tigger and ketoacidosis

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CarolandTigger

CarolandTigger

Member Since 2015
Tigger went into DKA this weekend and currently is in the hospital. Hoping he can come home today, as the vet seemed to feel we may have caught it early on. Have a question about his recovery. He's on Vetsulin, but they now have him on Humulin, which is protocol I guess. I had been wanting to switch him to Lantus or one of the longer acting insulins anyway. Will they keep him on Humulin, I wonder? Of course I'll find all this out when we go back. This is a different vet, and I'm glad because we'd been wanting to switch him anyway.
 
CarolandTigger said:
Hoping he can come home today
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Don't leave the hospital without an Rx for appy stimulants and anti-nausea meds. Fingers and paws crossed Tigger won't need them but having them immediately to hand to address any potential eating difficulties is invaluable.

Sending prayers for Tigger to have a speedy recovery and :bighug: for you, Carol.


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HUGS Carol - well THIS stinks huh! Is he in full 'ketoacidosis' or just 'ketonic'? If ketonic, that can be managed at home with LOTS of fluids, a/b for likely infection and enough insulin. If he's already 'acidic', they may need to keep him for a bit longer until his ph balance is better. Ask vet about giving fluids at home. Be sure you have both LC and HC food at home. He'll likely be nauseated so do at least get some med for that. If by chance you can find some 'Royal Canin Recovery' canned food, grab 3-4 cans of that. You'll need a syringe that's good for syringe feeding too - vet should give you a couple of those. You may not need it but it's better to have it and not need it huh.

Humulin N (I'm assuming it's 'N' and not 'R'). Humulin N and Vetsulin are about the same. Humulin 'R' should NOT be used at home - it's straight insulin and given by tiny drops, not by 'units'.

Lots of thoughts and prayer for sweet Tigger and for you too Carol.

More HUGS,
 
Thanks everyone We did get an update from the vet this morning and they're going to keep him tonight also. His heart rate is still low and they're trying to figure that out and his potassium levels are low also. On a positive note he ate a little bit last night! They're hoping it's just dehydration. They have them on a drip of Humulin and she'd like to put him on Lantus when he recovers. Just wish his heart rate would come up!
 
Low potassium can cause slow heartbeat but they would already know that. Sounds like they're doing all the right things! They can't raise the potassium too quickly or it will cause other problems...eating a bit sounds WONDERFUL!

More HUGS
 
Regular insulin is the choice for acute management in a vet setting. Lantus is a better choice for maintenance insulin in ketone prone cats. It is longer lasting than the vetsulin or N insulins so there won't be periods of time where his body is without insulin. The shorter acting can wear off hours before the next dose, and ketones can develop during these times. It's good they are looking at electrolytes, ask if you should supplement at home when he comes home.
 
You are all wonderful..thank you for the great advice! I called the hospital for update on Tigger this afternoon and the tech I talked to was a little hard to understand but she did say that all of his vitals were good including his heartbeat so that was encouraging! She also said he ate two thirds of what she gave him and he was purring and sitting up. She said they're now just trying to regulate his BG. Fingers crossed he gets to come home tomorrow! The vet said she call tomorrow morning so I'm praying for good news.
 
Carol, I am very glad that you have got such an encouraging update. Sending prayers for Tigger's continued improvement. And don't forget the Rx for those meds. Fingers and paws crossed you won't need to give them, but get them any way.

:bighug:


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Visited Tigger today and he's improving even more! Yay! They're keeping him one more night (3 nights total). Vet said today he was "super" and "spunkier". Heart rate and all vitals are normal, and he's eating! Said bloodwork was "vastly improved". His potassium and phosphates (?) still a little below normal. Now going to transition him from the Humulin R drip he's on to 2.5 u. Lantus. (He'd been on Vetsulin). One more problem...his BG is still high..400's this a.m....hoping when the potassium, etc; gets better that number will improve, but she thought it odd he was still high even while on an IV drip of insulin! He was happy to see us..has to wear a cone because he keeps trying to bite the IV lines! They said he really ate today, and he was drinking water while we were there..he had been quite dehydrated.
Going to be a big change when he comes home..I know all vets are different..but I really trust this place. Its a very popular, busy veterinary hospital and everyone I know who goes there, loves it. Vet is advising that I don't need to home test as much as I was. She said to watch his actions instead...if he's eating plenty, no need to test...maybe once or twice a week. She said if he eats less, lessen the insulin, and if he stops eating to bring him in. She also wants to put him on the diabetic food...he's eating it...but if its the same food the other vet started him on last year when diagnosed, he didn't like it. This might be different? And feed less often than the 3 1/2 times a day we were feeding. We'll see. Just hoping the Lantus helps! One day at a time......
 
Hi Carol - WOOHOO on the improvement!

One thing I must disagree with strongly - please test even more right now. A human wouldn't go thru this change without careful monitoring their bg, our cats are no different. Many cats show no symptoms of a hypo until suddenly it's there and it's too late. KT was diagnosed in June, if I hadn't been testing, I would have shot a full dose into a 42 - he looked and acted fine.

HUGS! Yes, one day at a time...
 
I am glad that Tigger is doing so well and that he's in a good hospital. It makes such a difference.

I agree with Lyresa about the testing.

I hope you are doing OK, too. :bighug:


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Thanks..and don't worry, I'll still be testing! He's never ever been really low....but things can change. Now he'll be on a new insulin and new food, so we will see.
 
I agree, you NEED to test, at the very least for AMPS and PMPS. Also, I would be cautious about "diabetic food"; so much of it really isn't good, and is sometimes just bad, for our sugar cats. A lot of it is very high in carbs so please research it thoroughly before changing to it!

Just out of curiosity, did she say why she wants you to feed less frequently than your 3 1/2 meals a day?
 
I'll still test. Yes, she said to feed less frequently. But here's the thing: we were testing twice a day, we were feeding him about 3-3 1/2 cans of low carb Fancy Feast Classics. No dry food. 3 units of Vetsulin twice daily. Doing everything by the book. Even his BS numbers over the weekend when he went into DKA gave us no clue. In fact he was in the 200's. There were a few times in the mornings when we wouldn't shoot because he was under 200. That was probably a mistake. Basically, we did everything by the book, and he STILL got DKA. I'm willing to switch things up per the vet, and we'll see what happens. I'm still doing a lot of reading about this. I had wanted to switch to Lantus months ago, but we were lazy and just hung on to the Vetsulin. Obviously what we were doing wasn't managing him well. When he stopped eating the other day, that was the clue there was a problem. Anyway, I'll still test, but I'm willing to try something a little different to see what happens. Thank you all for your support and suggestions!!
 
Just had another discussion with the vet..and there are 24 vets in this practice, and she conferred with several of them. She said Tigger was "doing well", but they want to monitor him all day before they release him to us tonight. (they are open 24/7, which I love!) They're still having trouble regulating his BS..but he did just start Lantus last night. He'll come home tonight, then we monitor him for the next few weeks. If he regulates, then no problem. If not, they adjust the dose. If that doesn't work, then she said they look at other things that could be causing it...i.e. pancreatitis, dental disease, abdominal tumor, etc. So we'll see. I'm still worried. She also told me that Fancy Feast Classics Ocean Fish would be the best food for him...she keeps her cat on this exclusively. She said even the chicken and turkey would raise his BS, and to feed the fish exclusively. I thought because of mercury in fish, this wasn't good? As far as testing....test more at first, as he regulates, maybe not so much. But she said to do a curve once in awhile, and we'll go from that. I'm fine with all that.
So how long for a new insulin to regulate him???
 
You are correct she is not. Fish especially the fish in cat food has high mercury levels because a lot of that fish comes from largeer adult fish. Chicken and turkey is fine. If your cat's bg goes up you just adjust the insulin.

You have a vet who sounds obsessive about her control. You may have to adjust insulin levels frequently and she's going to charge you a bundle for almost daily advice which really you can do yourself with home monitoring.
 
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