Bicarbonate Supplementation?

Hello Again, Everyone!

I'm posting as a new topic, simply because my Scouty girl is still in the hospital and not eating on her own.

Her glucose is now in the normal range and her white count is back down.

However, there are still small amounts of ketones in her urine, and her potassium levels are low. She is dull and listless and not making improvement the way my vet had hoped with her glucose under control. We have ruled out a tumor on her pancreas and are now looking mostly at her electrolytes.

My vet spoke with an experienced internist this morning who advised more frequent feedings and potassium supplementation. She also recommended I get Scout to the facility in my area that can check her bicarbonate level accurately.

I've read whatever I can find on bicarbonate supplementation, and was wondering how many of you have had to go this route? Was it successful?

I also would appreciate some feedback from experienced members on how long it usually takes a cat to rebound from a serious case of DKA?

I have a pack of nine lives at home, and I can honestly tell you that Scout has the most complex personality of the pack. She has never been a cuddler, but is so sensitive to my moods and state of health, that any time I have been sick in the past 13 years, Scout has come to bed with me to keep the others away until she sensed that I was better. She has never had to be hospitalized for any reason until now, and up until last week has never spent a night away from home. We had "the talk" about letting go when it was time last Tuesday, so despite her listlessness, I know she wants to hang in there and isn't doing it just for me!

I'm visiting her every chance I can, and gave her a homeopathic remedy for depression tis morning, but I feel like I'm running out of options here. I'm having a hard time grasping how her numbers could have improved so much, and Scout still be so ill.

Any thoughts, anyone?

Thanks again.

Linda & the "Cat Pack"

 

Linda,



My cat has had DKA many times, and no vet, including the univeristy vets, ever mentioned bicarbonate supplementation to me.

You can read about CRF here: http://www.felinecrf.com/comm0.htm

They are normally listless when they have DKA, so, that part is normal. Has your vet been supplementing the potassium while in the hospital?
How much are they force-feeding her per day? What foods are kept in her cage with her? Mine won't eat AD under the best of circumstances - so, go for something a little different - something with gravy, something with a little cheese on top...
The last time I went through this I had to get a feeding tube inserted in Layla - and fed Royal Canin Recovery. She liked it enough that she would try to get the syringe away from me to get to the food.

When she goes home you want to make sure that the ketones are cleared, that she is eating (and be sure to get an appetite stimulent), and make sure she is free from infection - bring home another course of antibiotics if needed.

They can and do recover, but try to remember they don't feel well. Take catnip toys, an old t-shirt with your scent on it when you go see her.

Will watch for you next update.

Best,
Pam & Layla

 

Thanks, Pam.

Upon the recommendation of my vet, I'm transporting Scout to a nearby facility tomorrow where they will run a blood test with an iSTAT for her actual bicarbonate and PH levels, so we will know for sure if she is out of range.

They increased the number of her syringe feedings today and upped the potassium in her IV bag. If there are positive results by tomorrow morning, I won't take her for the other test.

I will also try canned tuna and KFC oven roast with the skin removed tomorrow before I schedule the test in the hopes of getting her to eat.

Nothing I've ever encountered with my other cats has prepared me for DKA. I always knew when it was time, simply because I knew my kits weren't going to recover from their cancer or CRF. I keep hoping and telling myself that this is different, this takes time, and this is reversible. All I need now is reassurance that I'm right!

Thanks again.

Linda

 

Hang in there Linda. It sounds like you and Scout have what it takes to make it through this rough time. I cannot even count the times I had to whisper fight into Layla's ear. Make sure you take time to take care of yourself - this is a stressful time, but it does get better. When things calm down, read as much as you can about feline diabetes, because that will help you when Scout gets home.

 

Hi Linda

Welcome to the board, despite the circumstances!

I think the confusion here is that the bicarb and pH are measured to diagnose the "acidosis" part of the ketoacidosis. In rare cases, severe acidosis is carefully treated with bicarb but this is unusual.

Linda I'm glad he's transferring to a full-care facility, hopefully he'll be under the care of an internist at that point? Do keep us posted ok? I know how miserable they can look, but they can pull through this with good supportive care and treatment of their diabetes.

 

Thanks, Jess & Earl!

We have GOOD NEWS. The extra potassium in Scout's IV seems to be doing the trick and as of this morning, my vet didn't feel the blood test for pH and bicarbonate was necessary.

Scouty was much more bright-eyed and alert this morning when I visited. She's still being syringe fed, though. My vet is making several trips in this weekend just for her.

She also told me that when the acidosis is severe, as Scout's was, it takes quite some time to get things back to normal. I've decided to be thankful she responded to the insulin as fast as she did and cross my fingers that now we've found the right dosage of potassium that she will be eating by next Monday so I can bring her home. She's one tough little cookie, and instead of telling her "fight" and "heal" this morning, I told her to get some real rest and eat.

I get to visit again Monday morning and Monday after work and with continued good luck will learn how to give her insulin shots then.

Thanks again everyone.

P.S. That's Scout, my calico cutie, in the avatar!