? DKA/Pancreatitis Recovery

[Marc & Jen]

Hi All,

It's been quite some time since I last posted, new job, lots of travel etc. however we have still been very much committed to managing Fat Albert's diabetes. Unfortunately FA went DKA (likely due to moderate pancreatitis) while we were on vacation in Norway about 3 weeks ago and ended up spending 3 days in the hospital - I am so lucky to have such awesome in-laws and a pet-sitter who basically stopped their life to take care of him. When he came home from the hospital, he was initially on clavamox for the pancreatitis/infection and they did give us some appetite stimulant but we only used that for a day or two. He seems mostly back to normal now with a few changes and I would be curious if anybody has experienced this before:

• BG seems more stable/lower than before he was hospitalized and treated for pancreatitis which we are of course very happy about. Perhaps he had an underlying infection for some time that was affecting his BG?
• His appetite isn't quite as big as it was before the hospitalization - he is still very excited for each meal but he no longer eats it all in one sitting - he'll eat some and then come back and finish the rest later or he goes and eats Molly’s leftovers and she eats his etc
• His relationship with Molly (our other cat) is a little more volatile than it used to be. When he was sick, my in-laws told us that Molly attacked him and he didn’t fight back (usually it is the other way around). When he came home from the hospital, he was then terrified of her for the first day so we kept them separated. They then went back to normal however when we were away this past weekend, the pet sitter said Molly attacked him again and he hid in the closet and wouldn’t eat so she had to skip his insulin dose. Just wondering if anybody has any knowledge of why Molly would do that and why FA would suddenly be so scared of her? They usually get along just fine and if anybody is doing the ‘attacking’ it is usually FA pouncing on Molly when she least expects it. Molly gets pretty mad when we leave so maybe she is taking it out her anger on him? We don’t know.

Again, things with him seem pretty much back to normal, he is playful and seems happy but would be interested if anybody has experienced any of these types of behaviours before! I am nervous about leaving them again and our pet sitter also seems a bit more nervous with them due to these recent events.

 

[Idjit's mom]

Bumping this up so that it doesn't sink to the bottom and disappear.....

I am so sorry to read that FA was so sick...boo, and you were away. Yes, thank goodness for a caring competent support group!

 

[Wendy&Neko]

Sorry to hear about what happened to FA while you are gone. You had awesome pet Sitters! Have you read @Marje and Gracie excellent post on pancreatitis? http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

Lowering the dose by 1 unit may have been too big a drop in dose while you are gone. Too little insulin is also an factor in DKA. http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/

He does look better back on 3 units now. Are you testing daily for ketones at home now? With recent DKA, you need to test daily for a while. Is he maintaining his weight on his current food amount? Inappetance is another DKA warning sign. But he could also just be less hungry with being in better blood sugar numbers. Or it could be nausea from the pancreatitis. Did the vet give you any anti nausea meds such as Cerenia or ondansetron?

FA probably smelt funny after being at the vet, plus cats can detect when one is weaker, upsetting the balance of power in the house. Either once could be why Molly attacked him. Have you tried Feliway plug ins?

 

[Marc & Jen]

Thanks for the response @Wendy&Neko!

We haven't been testing for ketones, any tips on how to do this? We have never tested his urine. He has actually gained almost all the weight back that he lost when he was sick (almost 2 lbs) and he does eat the same amount that he did before, just slower. We didn't get any anti nausea meds but they did give him some while he was in the hospital. My mother-in-law is an NP and helped us navigate through understanding the results of the lab work and asked the right questions - he had some other elevated numbers when he was initially admitted (liver being one of them which my understanding was likely related to the inflammation in the pancreas) and they all came down to normal levels before he was discharged.

I've never heard of Feliway plug ins! It sounds like it could be a really good option for us - do they actually work?

 

[Penelope and Mačka]

Hi @Marc & Jen ,

It's very easy to test ketones in the urine. Buy a box of Ketostix urine strips (for humans) at any pharmacy.
When FA goes to his litter box, catch the stream with your strip and in 15 seconds you get the result. If he doesn't let you do this, you can try to catch the urine with a spoon. Last resort you can dip the strip in the puddle before he buries it. I do it everyday, sometimes more!

My other cat bullies Macka all the time so we have to keep them separated. I have plugged 2 feliway "multiple cats" plugs and they seem to help a little, but it's not miraculous, at least not for us. But it sure calms them down. What works very well on the other hand is cat music. I find it on Spotify under "cat music" (^^) and it sends them right to sleep!

Good luck!

 

[Wendy&Neko]

If you cannot get a urine ketone test done, there are blood ketone meters. I just followed Neko with a ketostix, but have had kitties who are stealth pee-ers. Some people put a bit of plastic wrap in with the litter and use that to catch some.

I have used Feliway to successfully reduce stress. I also worked at a shelter that used them and have seen them in some vet offices. Your mileage may vary, worth an experiment. Another option is Rescue Remedy for Pets.

 

[Las]

Hi @Marc & Jen ,

It's very easy to test ketones in the urine. Buy a box of Ketostix urine strips (for humans) at any pharmacy.
When FA goes to his litter box, catch the stream with your strip and in 15 seconds you get the result. If he doesn't let you do this, you can try to catch the urine with a spoon. Last resort you can dip the strip in the puddle before he buries it. I do it everyday, sometimes more!

My other cat bullies Macka all the time so we have to keep them separated. I have plugged 2 feliway "multiple cats" plugs and they seem to help a little, but it's not miraculous, at least not for us. But it sure calms them down. What works very well on the other hand is cat music. I find it on Spotify under "cat music" (^^) and it sends them right to sleep!

Good luck!

24 years ago we had a kitty that had pancreatitis & onset Diabetes which went totally away in one month. I kept a bathroom sized Dixie cup by the litter box & when I saw him heading to the potty I would follow. If he was going to pee he stood a certain way & I'd grab the Cup, slip it under his behind to catch the urine. And it finally got to the point I could put him in the potty box & tell him to "pee" in the cup for me & he would! My vet was 1st shocked & then impressed that we'd worked that out so nicely...

 

[Krystina & Nelli]

works very well on the other hand is cat music. I find it on Spotify under "cat music" (^^) and it sends them right to sleep!

I have been playing music for Nelli, quite some time- recently I stumbled across Relax My Cat. this music is amazing Nelli becomes completely relaxed, snores and falls into a deep sleep. It exceeds any other Music for cats! There are two different apps THE one I am referring to is spelled RelaxMyCat and under Lifestyles (see bottom left)... stay away from this one: Relax My Cat $9.99- under Entertainment (upper right)

 

[Marc & Jen]

If you cannot get a urine ketone test done, there are blood ketone meters. I just followed Neko with a ketostix, but have had kitties who are stealth pee-ers. Some people put a bit of plastic wrap in with the litter and use that to catch some.

Good to know! I just ordered a blood ketone meter off of amazon and thanks to same day delivery I'll be able to test him later today. I think this will be easier than having to chase him around, especially when we are busier and not home as much.

 

[Marc & Jen]

My other cat bullies Macka all the time so we have to keep them separated. I have plugged 2 feliway "multiple cats" plugs and they seem to help a little, but it's not miraculous, at least not for us. But it sure calms them down. What works very well on the other hand is cat music. I find it on Spotify under "cat music" (^^) and it sends them right to sleep!

I didn't think of music! I'm thinking about trying the Feliway plugs but may see how music works first instead. Molly and FA seem to be getting along just fine again, I haven't actually witnessed the bullying as it has only happened when we've been out of town! They used to be such easy cats and love their petsitter so I'm hoping this was just a little phase...

 

[Dyana]

That's great that you have such awesome in-laws and pet-sitter!
When my kitty came home from the hospital after DKA he was still weak. I'm sure FA knew he was still not 100% and when Molly attacked him, he feared for himself and hid from her. I would not advise skipping a shot as your pet sitter did when recovering from DKA. Lack of food and insulin are two of the ingredients that cause DKA in the first place.
I'm glad you're getting the blood ketone meter later today.

I kept a little clear plastic cup (like the kind you get ketchup in at a take out) close to the litter boxes, and would wait around the corner until J.D. started to pee and then approach him and put the little cup under his tail to test for ketones in the urine. I would use the blood ketone meter for when I did not want to wait around for him to pee. Also the blood ketone meter gives you results for now and the urine ketone strips will tell you what his ketones were a couple or few hours ago.

 

[Marc & Jen]

When my kitty came home from the hospital after DKA he was still weak. I'm sure FA knew he was still not 100% and when Molly attacked him, he feared for himself and hid from her. I would not advise skipping a shot as your pet sitter did when recovering from DKA. Lack of food and insulin are two of the ingredients that cause DKA in the first place.
I'm glad you're getting the blood ketone meter later today.

I had instructed the petsitter not to give the shot when he didn't eat (she called me immediately) as that's what the vet originally instructed us to do when he was diagnosed and before we began home testing. Would he not be at risk of going hypoglycemic if she were to have given him his shot and he hadn't eaten? Or if this were to happen again, should I instruct her to give a reduced dose?

 

[Las]

Hi All,

It's been quite some time since I last posted, new job, lots of travel etc. however we have still been very much committed to managing Fat Albert's diabetes. Unfortunately FA went DKA (likely due to moderate pancreatitis) while we were on vacation in Norway about 3 weeks ago and ended up spending 3 days in the hospital - I am so lucky to have such awesome in-laws and a pet-sitter who basically stopped their life to take care of him. When he came home from the hospital, he was initially on clavamox for the pancreatitis/infection and they did give us some appetite stimulant but we only used that for a day or two. He seems mostly back to normal now with a few changes and I would be curious if anybody has experienced this before:

• BG seems more stable/lower than before he was hospitalized and treated for pancreatitis which we are of course very happy about. Perhaps he had an underlying infection for some time that was affecting his BG?
• His appetite isn't quite as big as it was before the hospitalization - he is still very excited for each meal but he no longer eats it all in one sitting - he'll eat some and then come back and finish the rest later or he goes and eats Molly’s leftovers and she eats his etc
• His relationship with Molly (our other cat) is a little more volatile than it used to be. When he was sick, my in-laws told us that Molly attacked him and he didn’t fight back (usually it is the other way around). When he came home from the hospital, he was then terrified of her for the first day so we kept them separated. They then went back to normal however when we were away this past weekend, the pet sitter said Molly attacked him again and he hid in the closet and wouldn’t eat so she had to skip his insulin dose. Just wondering if anybody has any knowledge of why Molly would do that and why FA would suddenly be so scared of her? They usually get along just fine and if anybody is doing the ‘attacking’ it is usually FA pouncing on Molly when she least expects it. Molly gets pretty mad when we leave so maybe she is taking it out her anger on him? We don’t know.

Again, things with him seem pretty much back to normal, he is playful and seems happy but would be interested if anybody has experienced any of these types of behaviours before! I am nervous about leaving them again and our pet sitter also seems a bit more nervous with them due to these recent events.

Yes, when I've had kitties that have had to stay at the vet ( even over night ) when they come home they "smell" weird to the cats at home. Plus cat's know when other cats are ill & some will take advantage of that & try to get a "paw-up" on the ill kitty. When I brought Sierra home last Friday ( after being there for a week ) some of that cats where curious, some where scared & yesterday when I showed Bogart that Sierra was home he hisses like crazy at her ( & she helped me raise Bogart & his sister Penny when my hubby found them on the side of the road when they where just babies ). So until he's better it might be best to keep her away from him ( esp. when you are not there to intervene for him ).

 

[Marc & Jen]

We just received the blood ketone meter in the mail - his ketone reading is at 0.7 mmol/L and BG is 357 (huge jump from his +7 earlier today). I've referenced the table in this post and it looks like we just need to monitor frequently at this point? He has been eating well and has been getting his full dose of insulin for the last week - what else can we do to try to get the ketones down? Could they be high because BG is high? I expect his BG to decrease pretty quickly again as he seems to be responding well to the 3 units of insulin.