Please help Phoebe!

Discussion in 'Feline Health - (Welcome & Main Forum)' started by EricH., Jul 2, 2016.

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  1. EricH.

    EricH. Well-Known Member

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    Hello everyone and thank you for this group! I'm here because my beautiful orange tabby Phoebe pictured here in my avatar needs help! I recently took the bad advice too stop giving Phoebe her her vetsulin. I was told she would be ok with plenty of water and quality wet foods. That was Tuesday. Today l awoke to Phoebe not eating and being lethargic. The vets are all closed on this holiday weekend! I gave her a shot of vetsulin earlier and I've given her honey in attempts too get her up. I'm scared. Please help!
     
  2. Sharon14

    Sharon14 Well-Known Member

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    If Phoebe has not had insulin since Tuesday, then she is not hypo. Can you home test her glucose? And do you have any ketone test strips? Hopefully her glucose is just high and getting her on a good regimen of insulin and testing is all she needs.
     
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  3. EricH.

    EricH. Well-Known Member

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    Sharon l have none of that. I gave her a shot of vetsulin this morning. I've given her honey as well because l was told it'll get her levels up. She was diagnosed as having diabetes last September and this was the first time l ever strayed from our regiment.
     
  4. Sharon14

    Sharon14 Well-Known Member

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    can you get to a pharmacy and pick up a meter?
     
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  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Can you go out and buy a glucometer to test the blood today.? Also buy a bottle of ketostix to test for ketones in her urine.
    If she has had no insulin for several days and is not eating and is lethargic, she could have ketones....which you can test for if you get the ketostix to test her urine. This can be a serious condition so I would not ignore it.
     
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  6. EricH.

    EricH. Well-Known Member

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    What do l do once l get a meter? I was only ever told too give her 4 units per day. I don't know what to do wuth the results?
     
  7. Sharon14

    Sharon14 Well-Known Member

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    Get the meter and the ketone test strips then post. We will help you learn to test and with what to do with results.
     
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  8. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    it is important she eats if she has been given insulin. Try and get her to eat something.
    If you get the meter AND the ketostix we will help you
     
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  9. Sharon14

    Sharon14 Well-Known Member

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    Don't forget lancets and strips. Lots of strips!
     
    Last edited: Jul 2, 2016
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  10. EricH.

    EricH. Well-Known Member

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    Thank you all! I found an emergency vet that's open. We're actually here now and Phoebe is being seen. Please send prayers, positive energy and thoughts her way!
     
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  11. Sharon14

    Sharon14 Well-Known Member

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    Sending prayers. Please let us know how she is!
     
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  12. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I am very glad you managed to get into a vet to have Phoebe seen. Please keep us posted.
    Sending many vines her way
     
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  13. Sharon14

    Sharon14 Well-Known Member

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    How's Phoebe?
     
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  14. EricH.

    EricH. Well-Known Member

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    Well the tenative diagnosis was ketotic diabetic. They wanted to hospitalize her but l was told that would cost $1,600 starting and go up from there. I sadly don't have that kind of money and they don't except payments. They gave her fluids and sent her home with me. The Doctor said there's a chance that l caught it early enough when l gave her her dose of insulin. I was told if she's not eating try a syringe feeding. I did. She's been up and about. I'm monitoring her very closely. Please continue to pray for her and send healing thoughts. This is tearing my heart out.
     
  15. Sharon14

    Sharon14 Well-Known Member

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    She absolutely needs food and insulin, add as much water to her food as she will tolerate as water will help flush the ketones. Please pick up a glucose meter and ketone test strips. It will really help you to help her. Sending prayers
     
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  16. EricH.

    EricH. Well-Known Member

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    Thank you Sharon. I gave her 2.5 oz. of Gerber chicken and gravy. Very moist and liquidity. When l opened the jar Phoebe started licking the food out of the jar. A good sign. I let her consume as much on her own before l gave it to her with the oral syringe. Before that she actually consumed some of her favorite treats. All good signs considering she wouldn't eat anything yesterday. I then contacted the vet and they told me to give her 2 units of vetsulin and continue too monitor her.
     
  17. Sharon14

    Sharon14 Well-Known Member

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    So glad she's eating!!! Is she drinking? Water is very important in the treatment, so encourage it. And please keep us posted and if you need some help, or just some hand holding, post in the health forum.
     
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  18. EricH.

    EricH. Well-Known Member

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    Sharon she's not taking much water. Should l use the oral syringe full of water?
     
  19. Sharon14

    Sharon14 Well-Known Member

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    I would mix the water with some food -she needs that too- syringe it slowly into the side of her mouth not straight in, so she doesn't aspirate. To encourage her to drink on her own, try putting small bowls of water in her favorite places to sit. I have teacups in my window sills and my cats love that!
     
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  20. EricH.

    EricH. Well-Known Member

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    I did all that. Thanks again Sharon!
     
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  21. Sharon14

    Sharon14 Well-Known Member

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  22. BJM

    BJM Well-Known Member

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    @Meya14 has a experience with managing ketones.

    You can search for her posts in the upper right corner of the screen.
     
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  23. Meya14

    Meya14 Well-Known Member

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    Hi there! Sorry this happened, ketones can be scary!

    I have a couple questions that might help direct advice:
    Are you home testing blood sugar?
    How much vetsulin and how often are you giving it?
    Would you be willing to test ketones at home (urine dipstick)?
    Did the vet draw a potassium level?
    What are the fluids they gave you (it should say on the bag)?

    For a start, with ketones, it's important to have 24hour insulin coverage. This is called a "basal" or background insulin. Vetsulin has about the same duration as other zinc insulins, so maybe 8 hours or less in cats. In order to maintain a basal rate and eliminate ketones, 3 times a day dosing is better. Even better than that would be to switch to a long acting insulin such as lantus or levemir. Cats prone to ketones should always be on a long acting, in my opinion. Ask your vet if you can switch.

    Also, dehydration gets really serious with ketones. The subQ fluids are good. Oral fluids are better as it disrupts electrolytes less, but sometimes not possible. Plain pedialyte is good for oral replacement as it has electrolytes, you can mix it with the food your are syringing. A normal cat needs about 300ml oral fluid a day, more when ketones are in play. This includes the moisture in canned food which is probably 120-150ml/5.5oz can.

    Food is necessary. Feed her anything she will eat. Even treats, even dry food. Whatever. You can adjust the insulin to compensate. Eating+appropriate insulin is the only way to make her body stop burning fat and making ketones.

    Ask your vet about a anti-nausea (not an appetite stimulant). That can help your cat eat earlier and make her recovery faster.

    Low potassium is a major and common complication of ketones. It's VERY important that this is tested, and supplemented if low. Low potassium can lead to fatal heart arrythmias, and muscle weakness that can slow recovery.
     
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  24. EricH.

    EricH. Well-Known Member

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    Meya l was told too give her 4 units of vetsulin only in the morning before all of this happened. This morning l was only able to get her too eat 12 blue buffalo chicken treats followed by 2.5 oz. of Gerber chicken and gravy. She ate some of the gerber but l then had too syringe feed it too her. That was at 730am. Then l called the vet. They told me to only give her 2 units of vetsulin because they were afraid too give her a full dose. Later she drank at the water dish for a good 3 minutes this afternoon.
     
  25. EricH.

    EricH. Well-Known Member

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    Meya the sent me home with nothing too test her with nor did they ever mention testing. I really feel the vet doesn't care because l don't have the $1600 they wanted from me yesterday to leave Phoebe there. I'm looking at my invoice and it says Fluids - Subcutaneous. I-Stat (EC8+). Urine Myltistix. And thats it. This was the emergency vet service l went to because my normal vet is closed for the holiday.
     
  26. Sharon14

    Sharon14 Well-Known Member

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    Did they send any fluids home with you? I would definitely shoot insulin twice/day and learn to home test her glucose. That's the only way to know if it's safe to give insulin. You can get a human meter from any pharmacy the Relion from Walmart is a popular one. Also she needs to eat, syringe feed her if necessary, several times/day, as often as possible.
     
  27. EricH.

    EricH. Well-Known Member

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    They didn't send any fluids home they didn't send anything to test her with I'm pretty much in the dark on this I was actually headed up to the vet again to get her tested. It pretty much seems pointless because I think I'm just going to leave me in the dark and not really give me anything to help her with. Do you recommend I just go to the store and pick up something to test her with and start feeding her immediately as well as pick up Pedialyte?
     
  28. EricH.

    EricH. Well-Known Member

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    When I called the vet again today I talk to the nurse and she wasn't helpful at all I asked her should I start feeding her some more and she seemed really Clueless and told me that I shouldn't feed her until I bring her in to get tested again which I find absurd.
     
  29. scoobydoox

    scoobydoox Member

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    Call that emergency vet place back and ask them if they will sell you a bag of sub q fluids. You can give them at home.
     
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  30. scoobydoox

    scoobydoox Member

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    do you have walmart near you?
     
  31. Sharon14

    Sharon14 Well-Known Member

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    I've never dealt with DKA, but from what I understand food, insulin and fluids are vital. If you can get to the store get a meter, test strips and lancets along with ketone test strips and unflavored pedialyte. Make sure you have plenty baby food too and check to be sure there are no onions or garlic in the baby food.
     
  32. EricH.

    EricH. Well-Known Member

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    Yes
     
  33. EricH.

    EricH. Well-Known Member

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    This Emergency Veterinary service is horrible I've been trying to get her back in there today it's gone from A 2 hour wait till 4 hour wait now I'm going on 6 hours
     
  34. Sharon14

    Sharon14 Well-Known Member

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    At Walmart, Pick up a Relion Confirm or Micro, lots of test strips and 25-28 gauge lancets, ketone test strips, pedialyte and if you need more baby food. Is there another emergency clinic around?
     
  35. scoobydoox

    scoobydoox Member

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    There is no need to buy a ton of strips. just get the meter and a container of 50 until you can get to a vet. there is also a ketones test kit relion sells that you should get. see if the er vet will sell you the sub q fluids bag you can just pick it up and administer at home. do you have a syringe with no needle to do fluids by mouth?
     
  36. scoobydoox

    scoobydoox Member

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  37. EricH.

    EricH. Well-Known Member

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    Since I've been talking to both of you I drove to the emergency vet just to be told I have to wait for hours I asked if I could purchase a bag of Q fluids the receptionist said the doctor would call me back. That was 45 minutes ago he still hasn't called back! Instead of waiting there for my cat to die I figure I'll listen to you guys. I just dropped Phoebe off at home and now I'm heading to Walmart to purchase everything I need! I'm hoping I can get her to Tuesday so she could see my normal vet!
     
  38. EricH.

    EricH. Well-Known Member

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    No other emergency clinic around. They're way understaffed. I'm still waiting for the call back on q fluids! What can use in it's place?
     
  39. Sharon14

    Sharon14 Well-Known Member

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    You'll have to get her to drink the pedialyte or syringe it. Hopefully things will slow down at the clinic later.
     
  40. scoobydoox

    scoobydoox Member

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    If they will get your the sub q fluids make sure they supply the needles with it.
     
  41. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    Where do you live, Eric?
     
  42. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    and the connecting tubing
     
  43. scoobydoox

    scoobydoox Member

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    Please start tagging the more knowledgable people to try and walk her through this possible DKA the emegency vet she went to is making her wait.
    @Chris & China @jayla-n-Drevon
     
  44. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    I'm going to post a link to this thread on health with a 911
     
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  45. EricH.

    EricH. Well-Known Member

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    McHenry Illinois.
     
  46. EricH.

    EricH. Well-Known Member

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    I bought the meter. They didn't have the ketones test kit.
     
  47. Sharon14

    Sharon14 Well-Known Member

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  48. Sharon14

    Sharon14 Well-Known Member

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    When you get a chance, please start a thread in the main health forum. More people are there that maybe can help.
    Or you can just start posting on the thread that @Carol & Murphy started there for you.
     
    Last edited: Jul 3, 2016
  49. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    yes, start posting on the 911 thread that I posted for you in the health forum -what's your nearest big city? did you contact diabetic cats in need to see if they can help pay for the DKA treatment?
     
  50. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    there is an emergency vet clinic in Grayslake - don't know how far it is but may be worth a call in to them
    http://www.premiervets.net
     
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  51. Meya14

    Meya14 Well-Known Member

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    It's important that you get multiple blood sugar tests in a day for us to see a pattern and be able to help you with the insulin and feeding amounts. Otherwise you have no way to track her. Almost every pharmacy sells Ketone sticks that you dip into the urine. You really don't need a ketone meter, as they can be a little pricey.

    Also, vetsulin is not really supposed to be a once a day only insulin. Your vet is probably not very up to date on the treatment of diabetes. I would look to find a new Vet as soon as possible. If you are willing to drive to milwaukee, I can recommend my vet, which is a cat-only practice, and she's like the #1 diabetes vet for cats in my area.

    As for fluids, I wouldn't do subq at home unless you are taught how and have good vet support. The fluids need oversight from a vet due to changes they can cause to electrolytes. Pedialyte (the plain kind) is a good fluid replacement and can be mixed with food.

    Whatever the vet tells you to give for the insulin, I would give half the dose in the AM and half in the PM. Ideally, if you could do every 8 hours that would be better.
     
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  52. Sharon14

    Sharon14 Well-Known Member

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  53. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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  54. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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  55. manxcat419

    manxcat419 Well-Known Member

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    I haven't ever handled DKA myself, but I think the key here is to get you started on home-testing as soon as possible so you can keep a close eye on Phoebe's glucose levels. This link should help you to get started http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ Depending on how she is responding to insulin, as Meya says, you might need to dose every 8 hours with Caninsulin for now to make sure she always has active insulin in her system. I think every major pharmacy sells ketostix too - you don't need a meter, you just stick a strip under her when she pees and get the reading that way. I am surprised that they were only able to give you a tentative diagnosis - every ER vet should have the facility to test for ketones to make sure their diagnosis is correct. Did they give a reason for not sending sub-q fluids home with her? While there is always the potential for over-hydration, most cats in DKA are going to need fluids of some description. Giving fluids orally is possible, but actually takes longer than giving them sub-q...my feeling would be that if they thought she really needed to be on an IV, then the second choice should really have been sub-q rather than oral so I really hope they come through with those for you.
     
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  56. Sharon14

    Sharon14 Well-Known Member

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