A year into diagnosis, from stable to DKA+Pancreatitis overnight.

Hi all,
We've got a 5 year old cat who was diagnosed a year ago. After the massive stress involved in learning how to test glucose (that was a fun week...), getting her to eat again (greatest feeling in the world), working through glucose curves, and finally finding the perfect dosage of insulin, we got her to an incredibly stable glucose range of 150 highs and 50 lows. She was perfectly fine for the rest of the year and was back to her old amazing self the entire time. We felt great, confident, and closer than ever to her.

Then we went on vacation for a week and a half, boarding her at the vet. She came home missing a claw and was slightly less cuddly, but we didn't think much of it since we knew she needed to get comfortable again after that week and a half.

A week later, we went on another trip and boarded her at a local cat specialist with incredibly great reviews. A couple days into our trip, we got the call... She was vomiting and dropped significantly in temperature. They moved her to a 24-hour care vet, and she went into shock. After stabilizing her, they determined it was a DKA along with Pancreatitis. Her glucose levels were in the 500s. They couldn't figure out what the cause was since their tests showed we were perfectly regulating her insulin and glucose levels at home.

Since then she has stopped eating completely, she barely moves at all the entire day. We'll place her somewhere comfortable to feed or medicate her, and she'll simply curl up at that spot and not move for at least 3 hours. We're now syringe feeding her which she hates, and we're dreading the possibility she'll need a feeding tube installed. We also have IV fluids with B Vitamins and Potassium, Anti-Nausea medication, a long acting Antibiotic, and Mirtazapine to spur appetite. None of it seems to be making any difference except the Anti-Nausea medication which has at least stopped the vomiting after syringe feeding.

I work from home, so I've been able to take care of her while my better half is out during the day. The problem is that I'm spending nearly my entire day worrying about, caring for, and cleaning her (syringe feeding an unhappy cat is ridiculously messier than expected). I don't mind it at all, but I'm having an increasingly harder time focusing on work when I'm constantly shifting focus back to her every hour or so.

We're unbelievably exhausted, terrified that we won't be able to get her back to her old self, and are constantly reassured by the Vet that she'll get better despite her not showing literally any signs of improvement in an entire week. We were recommended this site given how supportive the community is, and we're really struggling here. If we could just get her to eat... Literally anything nutritional... it would make all the difference in the world. She won't even touch her treats, her favorite food, or even deli meat (which she would normally go insane over despite us never giving her more than a fingertip sized minibite once a month). We're scared that the more we syringe feed her, the less likely she'll be to ever actually eat again herself.

I posted this in the introduction forum, but it was recommended I repost here. We appreciate any advice and support you can provide, since we know there are many of you who understand exactly where we're at.

 

You have had a horrid experience with your sweet kitty. Many here have done tube feeding and it has been a life saver but I am sure it seems very scary. Here are threads with advice about tube feeding

http://www.felinediabetes.com/FDMB/search/1457472/?q=Tube feeding&o=date&c[title_only]=1

Have you seen this page? There are threads on syringe feeding, getting cats to eat etc

http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/

I wish I had some direct experience. Have you tried baby food - without spices - although not a complete diet, sometimes it stimulates the appetite

 

There is a pancreatitis primer here but basically you need to control pain with buprenex, nausea with cerenia a vet med or ondansetron a human Ned that I use, a c fluids if not getting enough water in the food. My Max was diagnosed with chronic pancreatitis almost 7 years ago and became diabetic almost 2 3/4 years ago. When gets inappetent he will sometimes eat Gerbers 2nd ham, beef, or chicken baby food. Sometimes finger feeding gets them started. You need to make sure at least 3/4 of the normal amount of food is eaten to avoid fatty liver. Feed small amounts often. I'm sorry tgey didn't take better care of your kitty.

 

If you can get ketone strips at your local pharmacy, you can test her urine at home. Ketones can linger in the system if there isn't enough food and insulin and with high ketones, most kitties won't eat. Once the ketones come down, the appetite usually improves. This can take 2-4 weeks with aggressive monitoring of the blood sugars, increasing the insulin as much as possible, and syringe feeding. With DKA it's vital that the cat gets at least 200 calories a day. This is a little over one 5.5oz can for most foods. Syringe feeding every 1-2 hours around the clock is sometimes necessary. Tube feeding is honestly probably less stressful to the cat if the eating issue takes longer to resolve (due to pancreatitis).

Can you monitor blood sugars at home?
Could you test ketones at home?
What was her last potassium lab level?
What kind of insulin and how much are you giving?

If you don't want to go the tube route yet, and you are testing ketones and BS, you can mix honey or karo into the cat food to give extra calories, and to allow you to give a higher dose of insulin.

 

Thank you all for the support and advice. We test her glucose at home regularly, but we didn't know we could test her ketones. Not sure what her potassium lab level was. In terms of Insulin, we were giving her 1.5cc of U100 with PZI Vetsulin insulin. We were able to regulate her glucose to an amazing range as mentioned (50 low, 150 high). Since the DKA though, her glucose has been much higher, even at lows (around 200 low 320 high), so we've upped it to 2.0cc of U100 at the recommendation of our Vet.

An incredible update - Last night when the better half came home, we were relaxing on the couch watching the Olympics opening ceremonies when Tonks suddenly jumped up onto the couch and cuddled with us for the first time since she came home. She unexpectedly had way more energy than she'd ever had this week. Shortly after that, we saw her eating some of the chicken we left in her feeding area! Then this morning, she was almost completely back to her old self energy-wise. She wasn't eating again, but then we got Panera and she freaked out like she used to at the smell. I gave her a tiny pinch of plain turkey, and she devoured it.

I don't have to tell you we both teared up instantly. I've never felt more unbelievably relieved in my life. We're heading to the pet store to buy each of the most recommended low carb cat food so we can find something she'll enjoy eating - She's pretty much been turned off to her usual Fancy Feast Classic Salmon due to the trauma of syringe feeding it. We're obviously still taking all precautions and monitoring her regularly. We know Tonks isn't out of the woods yet, and there's a chance we may not find food she'll eat. We also know she might not be completely ready to eat full meals yet, and that we'll likely need to keep syringe feeding her to keep her calories up. It's just such an incredible feeling to know she's finally starting to get better.

 

Great news!

 

Whatever you use to syringe feed her with, you can plan on her never wanting to eat it again.

 

I have syringe fed many cats and none subsequently developer food aversion.

 

You are lucky. I have read posts from some people who couldn't get their cats to eat a food after syringe feeding. But then, we all know that every cat is different.