Cat with DKA in ER, venting and sharing

I've been lurking here for awhile learning and understanding about this- 14 year old cat has been diabetic for two years, with 2 units of lantus 2x a day - we had a few glucose curves done to make sure this was right. He was doing great until last night, and he started vomiting clear liquid and stopped eating and drinking. He was barely moving this morning so we took him straight to the ER, where DKA was diagnosed.

Got an update from the vet that an ultrasound showed an enlarged liver and intestines, and indicated it could possibly be lymphoma but they can't do a biopsy until he's more stable. He has not eaten for over 24 hours and is still dehydrated and on fluids/insulin for the time being. The hospital will continue to monitor.

Been reading threads on DKA in here as much as I can, trying to understand this better. The cost makes it even more difficult to know what to do (5-7k for treatment), especially given that there might be another condition hiding. The enlarged organs is what has me worried now, but this is my first experience with DKA and I have no idea what 'normal' is. They're planning to introduce food to him overnight, but he's still not in stable condition after ~6 hours of fluids and insulin.

Really no questions except wanting to vent somewhere, and worrying both about my cat and the possibility of spending almost 10k and still having the same outcome (and putting the cat through more hardships along the way).

EDIT: if anyone has any recommendations on what to do next other than wait, I'd love to hear more DKA stories. Can't keep my mind at ease, and likely won't until this is over.

 

My poor kitty who was not known to be diabetic but one day was found to be in DKA with coma (she appeared dead and was barely breathing) was in the hospital for 4 nights on fluids 24/7 (she was given IV nutrition and insulin too) and made a full recovery after about a month. We were sent home with a bolus of IV fluids to give her twice a day and a syringe to force feed her. She also had mirtazapine to stimulate her appetite and potassium gel because she was hypokalemic. She had a liver supplement too for liver failure. They said not eating causes liver failure in kitties. Your cat might need a feeding tube or to be force fed to get them out of this. Try that before you biopsy because that's a lot for your baby to go through. My vet is reasonably priced so we dropped $1400 on her inpatient stay and another $400 on meds for her to take home. I hope and pray that your poor baby makes a full recovery. I'm not an expert here but speaking from my personal experience and what the vets told us (please consult your vet before taking any of my advice). Best of luck to you

Edit: your cat probably will not bounce back after 6 hours... my cat was opening her eyes at 24 hours, lifting her head up at 48, and sitting upright and walking a couple of steps by the end of the second or third day. Cats tend to look terrible during DKA recovery. Hydration is paramount as I am sure you know. Honestly I would probably count on your cat needing about a week in the hospital. Don't be afraid to tell them to keep trying, even if they say there is no hope. They told me to euthanize my cat 2 months ago and look at her now! She runs, jumps, and acts like a kitten.

 

Thank you for the encouraging story. Just knowing that there's a possible light at the end, however small, is so helpful. We leave on vacation all next week, which makes it even harder. The delivery of the latest news from the vet just felt so hopeless, but it's entirely possible I'm inflating it in my mind.

 

You are most welcome. It is not my business or my decision, but I hope that there is a family member or trusted friend who can stay close by in case your kitty is ready to go home while you are away. BTW vets tend to prepare you for the worst so that you won't be mad at them if something terrible does happen. No one expected my kitty to bounce back the way she did (including me). Again, my thoughts and prayers are with you guys.

 

We have family a few hours away that can be here. If they can't be here, and treatment starts to show improvement, I think we'll likely spend the extra money to keep him hospitalized. Need to research if there are other lower cost options for boarding, though, that can also be responsible with continuing post-release treatment.

 

I have no experience with dka but wanted to say I'll say a prayer for you and your cat.

 

One other question - for the IV fluids and force feeding, was this something you did for the entire month after being released?

 

Sending feel better soon wishes to your kitty and these are for you.

 

The whole ordeal is kind of a sleep-deprived blur for me, but as far as I can remember we were able to discontinue both about 2 weeks after she came home. As soon as muffin had the strength to walk to her food and water bowl. (She was too weak to even stand up to get to the litter box for a long time, so she would pee and have diarrhea all over herself. It was a very difficult time providing her with 24-hour care at home.) I hope that your kitty will be in better condition when you get her home than ours was and that she will not need all that.

 

Vet called and no improvement, said he's got too many other underlying issues that will need to be individually looked at, and is likely going to be a very sick cat even if he pulls through the DKA. Looks like the journey ended. Thanks for the support, everyone.

 

Wow I am extremely sorry! I had my fingers crossed for you. Do what you're comfortable with. If you aren't ready to have her put down don't be afraid to tell the vet to keep trying. Again, I really do feel for you and am truly sorry.

 

I am so sorry to read this...

In case no tough decision has been made yet here is what I initially wanted to tell you in support:

You know, this is exactly how I was made to feel in the ER when my cat was in DKA... it was almost 2 years ago. She is still here and doing fine. She asked me to tell you do not think the worse.

what exactly idid they say _ anything about the electrolytes? Or having high ketones? Not eating?
The levels of electrolytes maybe low but if numbers are not falling and remain stable than there is a hope, I think. Any other issue can be investigated later, after the DKA is under control. Imho, anyway.

My heart goes out to you, I've ben exactly where you are right now, it is hard.
@finn1010

 

He had damaged intestines, which they believe indicated something worse, along with what they thought indicated lymphoma. He was not improving - ketones were extremely high and not going down. We decided not to put him through this recovery only to have more treatment ahead. Extremely hard decision to make, and I'll probably second guess it for the rest of my life.

 

I'm so sorry you had to let your kitty go.

 

So sorry.

 

It sucks, but sometimes it's the kindest thing we can do, is not let them suffer.

 

I'm so sorry. For what it's worth, I've had to put down several beloved pets in my lifetime, and the only ones I second guess are the ones that I let go for too long. I kept thinking I could save them and exhausted every possible option/treatment and I really regret putting them through all of that when it made no difference in the end, and they suffered.