DKA on introductory forum needs help vet won't help

http://www.felinediabetes.com/FDMB/threads/please-help-phoebe.160595/

cat has DKA emergency vet no help - sent home
bean needs advice from experienced beans who have DKA experience

 

bump - please help Eric in thread above

 

Thank you Carol & Murphy. I just purchased glucose meter. Phoebe is showing 222. What do l do?

 

When did she have her last insulin shot?

 

At 730am.

 

The vet told me over the phone this morning that they were afraid to let me give her her normal dosage which is 4 units without then testing her levels today butt they couldn't get her in at all today

 

Is she eating? She needs to eat before she gets the Vetsulin. @Meya14 do you know about dosing Vetsulin?

 

I would think 4 units at one time would be too much. Get her to eat or syringe feed her. Use treats, dry, whatever it takes.

 

She's been getting 4 units of vetsulin every morning since September. As for feeding her l just syringe fed her 1.5 oz of gerber chicken baby food about an hour and a half ago.

 

Erich what are your cats current symptoms?

 

Slow moving. Not liking the syringe feeding.

 

from carols other post is this near you? emergency vet clinic in Grayslake - don't know how far it is but may be worth a call in to them
http://www.premiervets.net

 

That's were l went. They're horrible!

 

222 isn't a horrible number. How's she feeling, will she eat on her own? Since it's been over an hour since she ate, maybe feed her some more then shoot. I don't know Vetsulin dosing, but she needs insulin because of the DKA
@MrWorfMen's Mom may know

 

@BJM Any dosing suggestions?

 

Is Grayslake far from you? can you call the emergency vet there?

Oh, I'm sorry - they have an emergency clinic in Chicago and are highly regarded

 

I highly recommend only doing 1 unit of vetsulin and monitoring but only if you can get her to eat and keep it down. It is a hard fast acting insulin. The low number is a couple hours after injection.

 

Let me look.
I can't post more often than every 7 minutes, so I will up date this post.

222 isn't horribly high. Since you are now testing, I would go with a 0.5 -1.0 units.
You may need to test at least hourly to monitor the condition and it could be a long night of nursing. If you drink coffee, you might put on a pot to help you stay awake.

Are there any 24 hour pharmacies near you?
- If yes, you might pick up some regular insulin, so we don't have to worry about overlapping nadirs. If not, we'll go with what you have. Urine ketone test strips may also be helpful.
H
ow does the breath smell - like vinegar or flowers? Either of those is a sign of possible ketones and those building up can make the body acidic, which we do not want.

Check for dehydration
- if you pull up the scruff and release, does it stay pulled up and only slowly go back down? If yes, that is moderate to severe dehydration
- if you press on the gums in her mouth and release, do they stay white or pink right back up? Are the gums tacky/sticky? That may indicate mild to moderate dehydration.
-- syringing in water will help flush the ketones, but don't slam it in or she may vomit.

Is she drinking? Peeing? How does the urine smell? (sweet is another sign of glucose dumping; sour could be ketones).

 

I just tried to feed her again. She's not liking it.

 

She's been keeping what l gave her down.

 

was she vomiting at all today?

 

Will she eat treats, tuna, kibble?

 

Not once.

 

Usually . But not today. That's why l've been syringe feeding her. And now every idiot around is firing off fireworks and it's stressing her out.

 

Ok. my cat was on vetsulin when first diagnosed for almost 3 weeks and it was a rollercoaster ride. he sometimes wouldnt eat. I am wondering if your cat has an infection going on possibly.

 

No infection l was told yesterday when l took her in. I just spoke to the Vet and told her Phoebe's blood glucose levels were at 222 and she said don't give her any vetsulin tonight.

 

See BJ's post above#18. She's edited it to add info.

 

Ok are they going to see her tomorrow?

 

How long since you fed her?
Have you given any insulin yet?

Would you please get another test?

 

With having DKA your kitty needs to have some insulin as well as food and fluids. Whatever you need to feed her to get her to eat, just go ahead and get some food into her.

Can someone give a suggestion of what dose should be given for this ituation?

 

Yes

 

I just attempted to feed her 20 minutes ago. Didn't go well. She's getting tired of the syringe feedings. She only had 2 units of vetsulin this morning.

 

I've been syringe feeding her baby food. She's getting annoyed and not having it anymore.

 

Google search for 24 hour vet near mchenry il
https://www.google.com/?gws_rd=ssl#q=24 hour vet near mchenry il

OK. Needs some insulin, question is how much.
You have fed her some food within the last hour. That is likely to bump her glucose up. To counter that somewhat, a dose of 0.25 to 1.0 units could be given. Without test data, we don't know her normal insulin response, so I would err with the lower amount first, which you'd need to eyeball.

Vetsulin lasts 8-12 hours, depending on the cat. It hits its maximum effect about 3-4 hours post shot.

 

Grayslake is the closest one and l was there yesterday and been in contact with them today. They just told me no vetsulin tonight.

 

So about an hour ago, she tested 222, you tried to syringe feed, did she eat any?

 

Just a little. She started growling and fighting it. The previous times today it went better.

 

Maybe she's tired of that food. Do you have some treats. I don't know if I can agree with the vet about no insulin. I've never dealt with DKA, but from everything I've read they need insulin and 222, while not horrible, is a shootable number. But she needs food in her system. BJM suggested .25 units with monitoring.

 

How much are you syringe feeding at a time?

I haven't dealt with this, but I had to syringe feed for about 4 days for a different reason.

If you can manage it, I found it much easier to give small amounts but more frequently. Mine would only accept 2.5 ml (about 0.5 tsp) at a time of a food/water mixture, but he would accept that amount every 10-15 minutes. So I was able to get food into him without too much fighting that way. I just made up a small bowl of the food/water mixture and kept it in the fridge, then every little bit went and got some, fed it, and left him alone again.
A few times I tried to up it to 5 ml (1 tsp), and he would have none of it.

It's exhausting, but if you have the time it might be worth a try.

 

I'm going to attempt too sleep.

I've tried multiple types of food today including our normal cat food as well as kibbles. Plus treats and tuna fish and baby food.

 

How many hours since the shot this morning?

7:30 am 2.0 units Vetsulin

+15 hours post-shot 222 mg/dL (10:30 pm)

 

It was at 730am it's 1047pm now.

 

I just wanted to thank everyone for your help. Phoebe and l appreciate all your kindness. Today has been a long day. I've been up since 5am trying to help Phoebe. I'm gonna sign off so Phoebe and l can get some rest. Thank you everyone!

 

Sleep well and let us know how she's doing in the AM

 

Sorry I just saw the tag. I have never dealt with DKA myself. Fluids, food and insulin are the key components necessary to deal with it. I agree with several comments here that insulin is needed and I wouldn't skip doses entirely but without much data to see how insulin is working for Phoebe it's difficult to determine what the dose should be.

 

Eric, how's Phoebe?

 

Well l just got back from the emergency vet. They administered fluids, famotidine injection, and famotidine injection. They also administered a feeding just so I can get her home and give her 2 units of insulin which I just did. They also sent me home with mirtzapine which will stimulate her appetite which I don't understand why they didn't send it home initially on Saturday? But everyone please pray and send positive energy Phoebe's way in hopes we make it to our normal vet tomorrow.

 

Hope she feels a little better now that she has some meds to help.

 

Thank you.

 

any luck checking for ketones? Did the vets do that? Did they do any bloodwork?
Eric, sending you and Phoebe all the positive energy possible

 

Glad you got her to the vet. Prayers all goes well

 

Eric - this thread is quite long
how about for your next post you start a new thread in the health forum (this one)

 

Ok. I will. Sorry very new too this and new to having an extremely ill cat.

 

Eric - don't apologize - just want to make it as easy as possible for you to get the help you need
We all want Phoebe to get better!!

 

I know you all do. I'm extremely overwhelmed with emotions seeing Phoebe like this. I started a new thread.

 

I just wanted to post an update on Phoebe. I was told I'll be able to pick her up tomorrow morning at 9 a.m.!!! I am extremely happy humbled and grateful for everything and what everyone did for us! You guys are all proof that there are good people in this world!

 

My Mom just said Phoebe won't be released because she hasn't eaten and they can't administer her insulin. I'm waiting too hear from the Doctor. This is a nightmare.

 

Oh Eric - I hope it is not a setback - come on Phoebe - eat!!!

 

Praying for you both.... Hopefully they'll get her to eat or figure out why shes not wanting to eat.

 

Any updates?

 

I visited Phoebe twice today and so did my Mom separately. I just got home. She ate a little for my Mom. I tried to give her her favorite treats and she didn't want them. She was up a little and walked around in the visiting room. They want to try the long term insulin again tonight at 8pm or 9pm too get rid of the trace amounts of keytones that they have found. I was thinking l was mentally and physically exhausted but that's how my poor beautiful little Phoebe appears to me. I'd give anything to switch places with her and make it better. Hopefully another miracle happens and l can bring her home. Homes not the same without her.

 

I hope she gets her appetite back and comes home soon! Prayers and healing thoughts sent, for Phoebe

 

I know what its like to come home with a furbaby at the ER it feels very lonely when I had to leave Houdini at Er he had only been home for 2 months and in that short time I missed his presence here. I pray for healing and that your furbaby comes home soon.

 

I hope Phoebe is better today - are they giving her anti-nausea meds, appetite stimulants and cerenia?

 

Eric, how's Phoebe today?

 

Phoebe made it home today at 1pm. She has eaten a little but is drinking water and using the litter box. She's really enjoying her pettings and hugs. She's been by my side since I've gotten home. Lot's of purring and talking to me. I think she just needs to get back into her routines and she'll be eating normally again.

 

Sooooo happy Eric What insulin is she on? Please be sure to start posting on that insulin forum so we can help keep her happy and healthy Congratulations on her homecoming

 

Happy day shes home time for healing!!!!!

 

So glad she's home!!! Please make sure she eats and gets her insulin, and be sure to give her some chin scritches from me!

 

She's on Vetsulin and eating Purina Veterinary Diets DM.

 

I will Sharon! That's her favorite!

 

I agree! I can't wait till she's 100% again!

 

Good morning! I wanted to give everyone an update on Phoebe. Yesterday l was having difficulty getting her to eat any of her food. She really didn't want any of the 5 things l had too offer her. The Dr. told me give her anything she wants. So finally after eating just some sunflower seeds for lunch I decided to have a hamburger for dinner. I actually had time to take care of myself. Well guess who wanted some hamburger? Phoebe. She's never eaten hamburger in all her life! It was the strangest thing! I tore a piece of the party off and gave it to her. Then an hour after that she started eating her regular food! Unbelievably strange! And I was able to give her her insulin at 8 p.m. without any worries! She's laying on my lap as I post this message.

 

Super news! So glad she's eating!!!!!

 

Wonderful news. You never know what will get them to eat. Do you keep a jar of meat baby food on hand, it's a good option.

 

Well she kind of liked baby food until the syringe feeding started over the holiday weekend. Now not so much.

 

Well Phoebe went to the vet too get checked out and everything was good. Her appetite isn't where it was before the crash but l hope that'll change soon. I still thinks she's recovering from the week of hell. But we did switch her insulin today. She's off of Vetsulin and is now on Prozinc.

 

Good, Eric
- Prozinc is a much better insulin
Why don't you start posting on the Prozinc forum - we can help with dosing and the like

 

Great news! ProZinc is a good insulin. Are you testing her blood sugar?

 

Very nice.

 

Sharon l have everything to test Phoebe with but l'm not sure what levels to look for? Can you help me and what's the best way?

 

Hi Eric! How's Phoebe?

Here's some info on how to test
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
With ProZinc you first aim for regulation, which is Preshot in the 200's and a nadir(low point) 5-7 hours later in the 100's or double digits but above 50. If she gets to 50, that's considered hypo territory and you'll need to feed some high carb food or a little karo or honey. @Sue and Oliver (GA) is our ProZinc dosing guru.

 

She's doing great Sharon! She's not 100 % but she's getting there. She's been playing with Bobo again! Getting her old self back. Still waiting for her 5am wake ups that were daily. Small steps.

 

So glad to hear it! @Carol & Murphy and I were just wondering about her and hoping she was fine. Please keep us posted and do start testing her. It will help avoid another DKA episode if you can keep track of her glucose numbers. You can get a spreadsheet set up to help track her progress.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
If you need help setting it up(like I did) just ask and someone will do it for you!

 

Thank you Sharon for all your help!

 

Eric
If you start posting on the Prozinc forum you can get advise on dosing - it's scary to start on a new insulin
also, here's the prozinc sticky