Hospitalized Siamese, Can anyone help!?

Coco is my Snowshoe Siamese who was diagnosed FD about 2.5 yrs ago, its been a long & difficult road... mngment has been hard off of Prozinc, In Dec he got an ear infection which gave him a 3rd eyelid... & after that I noticed he started to lose weight AGAIN (this is how i figured out he was diabetic). So I took him to Banfield & we started running tests & everything would show that his BG was in the 400's & would slightly come down & then go back up... we did a Fructose test & that came back at 804, Ive taken him back once a week to do a curve through out the day, nothing has changed. They tested his urine last week for Ketones & said it was negative. This past Friday we actually didnt test the urine, not sure why, but the curve showed high 300's. Eventually they told me there isnt much more they can do, to take him to a specialist, I came home & noticed he was very lethargic. He was super thirsty, I laid down for a nap & when I got up I couldnt find him anywhere... then found him hiding behind some boxes under a table in a room we barely use. I picked him up & he had no life in him, I tried giving him wet food, milk, chicken & nothing he wouldnt eat. I finally decided to take him to the ER vet, which was also the specialist I was referred to. I was told he was in a semi coma state already & that he may NOT make it. He stayed all day & he is still there... they have ran blood work & it looks normal, ultrasound & thats normal, tested the pancreas & that was normal... He BG was in the 400's when they tested in the morning & then slowly started to come down, then at night it went back up... they have him on an IV type of insulin. He has refused to eat, but he is lifting his head & getting up to use the litterbox.

To me I wonder if this is rare, but they tell me no. How is it that there are no answers to whats going on? Could this really be the beginning of the end? Is his body shutting down? I am so worried! The bill is costing me an arm & a leg... I dont have the $$ to continue paying all this, I just dont know. Please Please Please help!!!

Please help & pray as well...

 

Hi Christyaran. Hugs to you.
Did the doctors say anything about DKA or ketones? My cat J.D., had DKA about 5 or 6 years ago and had to be hospitalized for awhile, and he survived. He also didn't eat and was extremely lethargic, and was in critical condition when admitted to the hospital. But he got a little tiny bit better every day. I went to visit him every day, and he had tubes all over him, and very slowly he got healthy again, to where I could take him home with a feeding tube, because he wouldn't eat while at the vet. There are a lot of people on this board who have had their cats survive from DKA.

Cats can only go so many hours without eating. If Coco still isn't eating on his own, please make sure that your vet is feeding him in some way, by syringe or feeding tube. You don't want Fatty Liver Disease to develope on top of what he currently has.

I am praying for your Coco to come through this.

 

Dyana,
What is DKA? I was told that the ketones wont come down unless the glucose comes down, so they arent testing for it anymore b/c they already know that is an issue. What i dont get is he's healthy other than this, hes been at the 400's before but never felt this way... How can a cat be healthy but the glucose be so high & him lethargic... Im trying to find someone with an answer or an idea so i can take it to the vet to test. They told me they will try & force feed him today, so who knows. But hes def not eating & that just make me more worried.

 

http://www.felinediabetes.com/ketones.htm

DKA diabetic ketoacidosis

 

i did hear the Vet mention that word yesterday....

 

DKA is caused by a combination of not enough insulin, not enough food and infection. They have to give him insulin, they have to force him to eat (tube if necessary) and they have to treat the infection. The ketones can be fatal. He can get ovee the ketone crisis and still have high numbers. My Bob survived DKA and was still up in the 400 range afterwards. The high numbers don't kill quickly but the ketones can.
Carl

 

Here's a quick explanation of what ketones are and why they must be treated immediately. I am quoting from this website.

Prayers for all of you,

 

OK so the latest from the Dr is that it IS the DKA... they said his # was 2+ yesterday & its at 1+ today, his insulin came back down to 380, they said they dont want to force feed him until they get the BG normalized. So its just a waiting game... they expect him to hopefully get better tomorrow. but stay at the hospital til Tuesday/ Wednesday.

Thank u! I will keep everyone updated as I get more info.

 

at least he is where he needs to be since this is not treatable at home. they need fluids and insulin around the clock to flush out the ketones.
when home, it is important to test so you know where he is in his BG. food and insulin go hand in hand with a cat prone to ketones. did you read the link I have in my post?? get a heads up on how you should care for at home so you are not overwhelmed when kitty comes home. site should explain and of course those here will lend a hand

 

Latest update: As of 4PM, his BG came down to 138, they told me he is now at about 156, he is still not eating. They are going to force feed at some point. I tried to feed him some but that was 6PM, & very little.

I just got my latest update & they told me that his temperature is at 97... How does an animals temp go down? What could this mean??

Keep praying! Thank you!

 

Christy-

We are sending prayers and healing thoughts for sweet Coco.

Celi, Binks, Smudge, and Annie

 

Thank you everyone for the continued prayers & support... latest update: His BG has remained in the normal range for 24 hrs now, hes drinking water but not eating, though hes not turning away from it... they also said that the Ketones are still coming down. So we're on our way to recovery... hoping he gets even better by the end of today!! I will be back!! U guys have been amazing!

 

BTW... what insulin do you all recommend??? Please do not tell me Prozinc as it looks like we may take him off of it!

 

Well the three best would be Lantus, Levemir or yes...Prozinc. I have no experience with the Prozinc since Maxwell as a Lantus boy before he went into remission, and Musette is a Levemir girl after taking her off Lantus, but I do know that lots of cats do well on Prozinc. However, just like many cats do great on Lantus, it didn't work well for Musette so I moved her to Levermir and she is doing fabulous. It really comes down to what is the best insulin for your cat.

The only one that doesn't do well for cats is Humulin N, it hits too hard and wears off too quickly.

Mel, Maxwell, Musette & The Fur Gang

 

Happy to hear that he's doing better. You might want to take an unwashed tshirt or pillow case to him to lay with, when you go to visit him. It will remind him of home, and make him feel a little more comfortable in the hospital.

 

One thing you can do for your cat when you do go back on insulin is to learn to test his blood glucose levels at home daily. You can use a human glucometer (many of us use the Relion from Walmart because it has the cheapest test strips). It may take a few days to get the hang of it, but it's actually pretty easy to do. By knowing your cat's numbers, you are better able to figure out the correct dose of insulin for your cat. I'm not a prozinc user (Mikey is on Lantus) and I know their dosing protocol is different, but it's possible the vet didn't have your cat on enough insulin....or that he had him on too much! Too much insulin can look a lot like too little over the long term, and if you're not testing, you won't know how to tell the difference. I'm sure some of the prozinc folks can help you with dosing for your boy. But once you learn to hometest, it makes the whole process SO much less stressful!

Also, I didn't see if you said what his regular food is, but a low-carb all wet diet can go a long way toward lowering blood glucose. Most of us aim for under 7% of total calories from carbs, and there are many foods you can choose from.

There are some great charts here by Janet & Binky that give % of calories from carbs (you can't get it from the info on the can): http://binkyspage.tripod.com/canfood.html

Mikey gets mostly Fancy Feast Classics with some Great Choice from PetSmart. Changing him to a better diet lowered his blood glucose by 100 virtually overnight, and he's managed with insulin from there.

I know this is a lot of new info to digest while your boy is in the hospital, but it can definitely help him ion his road to recovery! Several of our members have had cats with DKA who have recovered and are doing great! We're pulling for your boy to travel the same road!

 

So sad to hear about Coco! I like the suggestion of taking an article of some sort from his home. My civvie spent alot of days at the vet in her last few months and I would make sure there was a shirt, pillow case, small blanket that they let her have while there... seemed to me to make alot of difference to her. Please keep us updated! Furry hugs and lots of prayers coming your way!

 

Thanks, for this! I had this done already! But thank you.

 

Hi guys... thank you sooo much for all the suggestions... I did at one point test him at home but was told to do it via the ear, & it was hard. The vet said to do the paw pads... so I will def be on top of it. As of this morning he was negative for Ketones, & started Lantus as of 2 AM, 1.5 units ( I assume every 2 hours or so). He still hasnt started eating on his own so they are feeding him through an IV, that is just the weirdest thing that he doesnt eat!

For those that asked about his food, I had him on either blue buffalo wilderness or wellness... Banfield recently put him on m/d dry & I will verify with the vet if that the food ill keep him on. He is expected to come home at about 4ish tomorrow. So we'll see what happens. I will be back tomorrow with an update!

 

i realize you are digging your way through a snowstorm of information...
but this caught my eye...and I feel the need to clarify it....

Lantus is a long-acting insulin, and almost always administered twice daily in equal doses at 12 hour intervals.
There ARE exceptions to this, as you will learn as you get to know the board better...but I'm sure your vet is not giving 1.5 units every 2 hours.
That would risk overdosing most kitties.
1.5 unit every 12 hours is more likely the dose. :smile:
Unlike some of the other insulins, Lantus and Levemir are gentler and longer-lasting, so are on a set dosing schedule.

Not trying to concern you or contradict you...
just pointing out the difference between long-acting and short-acting insulins.

AND ABSOLUTELY HOORAY FOR COCO GETTING BETTER!!
Nice work, Christy (I'm assuming your name is Christy...please correct me if I'm wrong)

Celi & Binks

:thumbup :thumbup

 

hI, yES MY NAME IS cHRISTY! I may be misinformed with all the crazy info they are sending my way... but they are monitoring him. hES STILL LETHARGIC & have advised me to be prepared to test for ketones daily. Other than that he remains the same... no eating but they say that is normal.

Thanks everyone.

 

Sending (((hugs))) to you and Coco. Hoping for a speedy recovery and that he will be home soon. cat_pet_icon

 

Thank you!!!!! Will be back later with an update. Crossing fingers he comes home today!!!

 

Crossed Fingers.

 

Christy.

Is it OK to take the 911 off this thread. You can go in to edit your first post and remove the 911.