DKA and pancreatitis home treatment - advice please!

Discussion in 'Feline Health - (The Main Forum)' started by Smokie’s Mom, Sep 10, 2018.

  1. Smokie’s Mom

    Smokie’s Mom New Member

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    Sep 10, 2018
    Hi everyone. My 8yo male, Smokie, was diagnosed with diabetes last Thursday. We started on Prozinc (2 units 2x a day) Thursday night. He was fine until yesterday - he became lethargic, no appetite, vomited many times throughout the day.

    I took him to the vet today and they were concerned about ketoacidosis, but he tested negative. They then suspected pancreatitis, though they did not actually test for it (they did blood work and urine). Vet gave sub-Q fluids, anti-nausea, pain med, and appetite stimulant. Said to call tonight or tomorrow if no improvement.

    I don’t see a drastic improvement - he ate a little, is walking around a little, but not much. I am having anxiety at the thought of needing to take him back to the vet AGAIN - he’s cost me upwards of $1000 in a week! I am so worried because I feel like he should be acting like himself by now (at least, the vet said he should have perked up by now).

    I am equipped and ready to manage his diabetes but right now this is all throwing me for a loop.
     
  2. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Are you monitoring his blood glucose at home? You did not mention what his glucose levels were yesterday when he had those issues. 2 units is a bit of a high starting dose for ProZinc. 1 unit is the normal starting dose, so I am curious how his glucose levels are doing on that dose.
     
    Jenna Josie likes this.
  3. Smokie’s Mom

    Smokie’s Mom New Member

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    Sep 10, 2018
    His initial blood work on Thursday at the vet was 418. I bought supplies for home testing. Sunday morning his AMPS was 407, and +6 was 340. He hasn’t had insulin since Sunday morning because he hasn’t eaten enough/much of anything. Vet said she was more concerned about getting him to feel better/eat than regulating the diabetes/getting insulin in at this point.

    Food: I’ve been giving him fancy feast pate.
     
  4. Smokie’s Mom

    Smokie’s Mom New Member

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    Sep 10, 2018
    So Smokie wasn’t getting better and I called the vet yesterday. They had sent me home on Monday with cerenia plus pain meds and an appetite stimulant. He still wasn’t eating and seemed lethargic. Long story short he ended up being admitted to the emergency hospital. This morning they called and said he has DKA and pancreatitis. Theyrecommended several days of inpatient treatment as the best course of action. I had spent almost $1100 in the last week at the vet, and I paid the low end of the estimate ($2600 - high end was $3500) last night, and I just do not have the money to pay for several more days, at $1000+ a day. The doctor said I can try home treatment but warned me more than once that it’s usually not successful. I am feeling SO defeated and sad. I don’t want to euthanize him, I don’t want to blow through my life savings, and I don’t want him to suffer. I am picking him up this afternoon to try home treatment but I am not optimistic at all that his will work.
     
  5. jaykay

    jaykay Member

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    Sep 10, 2018
    Sending you many hugs, and fingers crossed that you are successful at home xx
     
  6. Smokie’s Mom

    Smokie’s Mom New Member

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    Sep 10, 2018
    I brought Smokie home from the hospital a little while ago. The plan is to give:
    SQ fluids 100ml 1x/day
    monitor BG every 4 hours and give Humulin (intramuscular) (dose between .5U and 2U depending on what his BG is)
    cerenia 24mg 1/2 tablet 1x day
    mirtazapine 7.5mg 1/2 tablet every 48 hours

    Plus to follow up with the regular vet tomorrow to recheck electrolytes and potassium, and to monitor ketones every day.

    I’m feeling incredibly overwhelmed, I’ve cried so much today, and I don’t feel all that hopeful that this will be successful. ANY anecdotes, success stories, advice, anything at all is greatly appreciated! Thank you!
     
  7. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    I can't offer to much. I do know with DKA you can't miss giving insulin. Is the humulin in addition to the prozinc? Normally the short acting is to bring down the higher numbers.

    You must also keep them eating. Anything anytime that works as long as they eat. Even baby food so have a lot of options to offef. Do not stop meds prematurely just because he seems better.

    Blood work will need to be monitored very closely for electrolytes.

    It is doable. It will be exhausting, frustrating, grueling work. You must do your due diligence to stay on top of it. A lot of people choose to have kitty at primary vet during their office hours and transfer them to 24 hr hospital for the night. That could be an option if you find it to difficult.
     
  8. Harley Baby & Michele

    Harley Baby & Michele Member

    Joined:
    Jun 3, 2018
    @Smokie’s Mom Hang in there. My Harley had DKA x 2. Second time I really thought he wouldn't make it. He was at my Vets office during the day for fluid but I took him home at night to give fluid. You must get some food and oral fluid into him to counteract low blood sugar. Below are some quick links to read. Ketone strips will be very helpful to monitor. You can pick them up cheap at Walmart. I just hold the stick under him when he pees, quick and easy. Right now I would try to check every pee until he is negative for a few days then do spot checks.

    Can you clarify exactly what insulin you are giving, dose and frequency. Is the Humulin N or R? N is intermediate acting and R is fast acting. I also believe all insulin is given subcutaneous not into the muscle. It will be important to check glucose often to make sure he is not dropping to low. Have some honey or Karo Syrup available to rub on his tongue if hypoglycemic.

    https://www.walmart.com/ip/ReliOn-Ketone-Test-Strips-50-Ct/33574014
    http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
    http://www.felinediabetes.com/FDMB/threads/syringe-assisted-feeding-video-and-tips.144367/
    http://www.felinediabetes.com/FDMB/threads/how-to-give-subcutaneous-fluids-video.144366/

    You may also want to add a ? or 911 infront of the title of the thread so more people will see this and help if able.
     
    PussCatPrince - GA likes this.
  9. Harley Baby & Michele

    Harley Baby & Michele Member

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    Jun 3, 2018
  10. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Well-Known Member

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    Sep 15, 2017
    I’m so sorry for you & Smokie. I haven’t dealt with DKA but I know several here that have had success. Prayers for you both :bighug::bighug::bighug:
     
  11. Smokie’s Mom

    Smokie’s Mom New Member

    Joined:
    Sep 10, 2018
    Humulin R.

    His BG at midnight was 249, at 4am 195, at 8am 283. He had 1U of Humulin R at midnight and 8am, and .5U at 4am, per the hospital’s dosing chart. He ate a little here and there, is walking around, and purring more. I know he’s not out of the woods but he definitely LOOKS better than he did on Tuesday, and has perked up a bit since we brought him home last night. This am we are going to test his urine for ketones and give SQ fluid.
     
  12. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Well-Known Member

    Joined:
    Sep 15, 2017
    You’re a wonderful cat momma! I’m so glad you’re seeing improvement. :bighug: You can do it, come on Smokie!
     
    Smokie’s Mom likes this.
  13. Harley Baby & Michele

    Harley Baby & Michele Member

    Joined:
    Jun 3, 2018
    Fabulous! I am so glad to hear he is looking better.

    Sounds like you did a great job with the Humulin R. I think I only ever heard of it being used 1-2x on this site.

    I do encourage you to purchase the Ketone Strips for home checks. You need to catch DKA early as it progresses rapidly.

    Best wishes. :joyful:
     
    Smokie’s Mom likes this.
  14. Smokie’s Mom

    Smokie’s Mom New Member

    Joined:
    Sep 10, 2018
    Just tested his urine with ketone strips. He had moderate ketones at the hospital yesterday, and just now (I checked twice to be sure) it read as trace amounts. I am feeling hopeful!
     
  15. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Smokie's Mom, I have been reading your threads in the Intro forum and here. I would like to suggest that you create a signature so that Smokie's pertinent info is available to all who read your posts. Here is how to do that: SIGNATURE
    I guess I'm confused because you started with Prozinc, now you are talking about Humulin R and poor little kitty getting so sick with DKA and pancreatitis. I am not experienced or knowledgeable about the insulins, or the conditions, and I am hoping that the more experienced members will chime in here with advice.
    I did find some info on both conditions here on the board tho, that might be helpful:
    DKA http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/ by @Jill & Alex (GA)
    and Pancreatitis: http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/ by @Marje and Gracie
    When you can, also set up the SPREADSHEET, so members can see the BG readings you are getting and when and how much insulin you are shooting. It's hard to try to determine what's going on when you have to scroll back through threads and gather information.
    I know you are dealing with a lot right now but getting the signature and spreadsheet set up is a one time thing and they are both so very helpful when you are asking for advice and help.
     
  16. JeanW

    JeanW Member

    Joined:
    Jul 24, 2017
    All the best to you and Smokie. Keep up the good work. :bighug:

    As others have mentioned, the spreadsheet will help you and help other members help you. Be sure to home test BG levels at least twice a day and preferably more.

    How many units are you presently giving? I am not an expert but agree with someone else who said 2 units to start out is a lot. Too much insulin is bad as is too little insulin.

    Keep us posted.
     
  17. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    If you need any help setting up the SS or would like me to do it, please send me a private message by clicking on “Marje and Gracie” to the left and then “start a conversation”.

    Many vines for your little guy.
     
    Cynthia and Merlin likes this.
  18. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Be sure to keep up anti-nausea treatment and only rein back when your cat is well and truly out of the woods. Generic ondansetron can be absolutely invaluable when treating a cat who is having difficulty eating (and it can be given in conjunction with Cerenia - ask your vet about dosing of both). As mentioned above it's absolutely critical that a cat recovering from DKA gets enough food and insulin during treatment and recovery in order to prevent relapses. Enabling the kitty to eat enough makes it much more straightforward to ensure that sufficient insulin can be administered regularly to help kitty to make a good, strong recovery.


    Mogs
    .
     
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