HELP!!! Time is running out - cat has DKA! :(

Discussion in 'Feline Health - (The Main Forum)' started by Chloe'sMom, May 14, 2015.

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  1. manxcat419

    manxcat419 Well-Known Member

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    She will be tired - you must be too! We'll see where she is in 30 and figure out if you need to push her a bit on the food.
     
  2. Chloe'sMom

    Chloe'sMom Member

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    Ok this is slow going. We are at 85. I didn't give her anything this time. Trying food. I won't give insulin until I can call my vet at 8 or so. Dr comes in around 9 they said. She's not eating. Seems to be sleeping. We are both tired. 2 nights of little sleep and I am exhausted. Hubby is sleeping so at lead tone of us has energy.
     
  3. manxcat419

    manxcat419 Well-Known Member

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    Hopefully she can keep rising slowly even without food. How close are you to 12 hours since your last shot time now? It might be that most of the dose is out of her system at this point.
     
  4. Chloe'sMom

    Chloe'sMom Member

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    9 hours since insulin.
     
  5. Larry and Kitties

    Larry and Kitties Well-Known Member

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    You are doing a good job. Can you tabulate in one place the various recent BGs with times and when you gave insulin and how much. This makes it easer for other to see what is going on. It is hard to go through all the posts to get that information and easy to miss one.
    What I have doe with low BGs was to mix Karo with canned food. The proportion depends upon the situation. Food elevates BG longer.
     
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  6. manxcat419

    manxcat419 Well-Known Member

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    OK, I don't think she's going to make it to 200 by shot time unless she bounces, so definitely call your vet before you give her next dose to see what they think as they've seen her recently and done the blood work for her DKA.
     
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  7. Chloe'sMom

    Chloe'sMom Member

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    Thank you for your help. You have no idea! I will keep pushing food and may syringe feed more. We are up to 92. Will give subq fluids soon but for now we both might rest. She's sleeping and we will check in another hour or so. Thank you!
     
  8. manxcat419

    manxcat419 Well-Known Member

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    You're very welcome - that's what this board is about. :bighug: How long is it at this point since she had any karo?
     
  9. Chloe'sMom

    Chloe'sMom Member

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  10. manxcat419

    manxcat419 Well-Known Member

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    OK, you should be good to wait an hour to test again. I have to get some sleep - it's 3:30 am here and I don't want to fall asleep on my keyboard and miss anything you have questions on. @Vyktors Mum has said she will keep an eye on you for the next hour or so - she got me through the first few times Rosa went low so I'm definitely leaving you in very safe hands - she has a lot more experience than I do. I hope the rest of the night is uneventful for you and I'll look in on you tomorrow to make sure you're doing OK. :) :bighug:
     
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  11. Chloe'sMom

    Chloe'sMom Member

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    Thank you! Hugs!
     
  12. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Nigh night April

    Hello Chloe's mum :) I've just been reading through your condo - yikes haven't you been having a time of it!

    Get some rest, see you in an hour
     
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  13. Chloe'sMom

    Chloe'sMom Member

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    Ok she woke up at 6:25 with more diarrhea and I wanted to make sure she didn't get in it again.checked her glucose and it was 101. Going to give subq fluids and try wet foods. Still no interest in food. 4 am was a miracle when she ate a few pieces of kibble. Glucose heading back down. She's at 89. Vet opens in about an hour. Ideas? Worried!! Seems so much more herself, but now really low glucose.
     
  14. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Do we have another Chloe test result?
     
  15. Chloe'sMom

    Chloe'sMom Member

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    Just posted above. :)
     
  16. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Fluids can lower BG so I'm not sure that I would give those now.

    more comments to make but want you to see this asap
     
  17. Chloe'sMom

    Chloe'sMom Member

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    Ok, I haven't administered the subq yet.
     
  18. Chloe'sMom

    Chloe'sMom Member

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    seems very lethargic and tired!
     
  19. Vyktors Mum

    Vyktors Mum Well-Known Member

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    One thing to bear in mind is that you seem to have been conditioned by a vet as to what numbers are low/safe etc. 89 isn't low as such it's normal and I noticed earlier in the thread you stopped giving insulin when she was hanging around at about 180 which is well outside the normal range. Normal cat BG numbers range between about 50 and 120. When you're home testing and able to monitor well these are great numbers for the cat to be in. We start propping the numbers up with carbs/syrup at 50 when a kitty's on insulin to keep the insulin from pushing them any lower.

    I'm glad I caught you before the fluids! Since it's only an hour til the vet opens I think it best to wait and see what they think.

    If you can syringe feed her it would be good to try and get more food into her, or even more kibble if she'll take it.

    You're about 2 hours from when her next shot's due aren't you?

    ETA - she's not really dropped since the last test, 91 and 89 are pretty close to the same thing, we call it surfing :D
     
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  20. Chloe'sMom

    Chloe'sMom Member

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    Yes, about 2 hours. They were telling me the norm for diabetics I guess was 150-250. She's a bit of a rag doll at the moment so I'm not sure if it's exhaustion or that she keeps crashing. I will go with food for now. Most likely will be syringe fed. I'm quite worried!
     
  21. Vyktors Mum

    Vyktors Mum Well-Known Member

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    If you're not home testing and monitoring you have to let the cat's BG run higher so there is a big margin for safety and that's where most vets heads seem to get stuck - around here we know better ;) but we can worry about all that later. The important thing for you to know for now is that her current numbers are normal and not dangerous at all :)
    I'm concerned that your vet may tell you not to shoot these lower numbers because of where their head is stuck. If you are still able to monitor and have enough strips etc I would definitely be looking to shoot something, even if it's just a token dose. Not enough insulin is part of the equation that got Chloe to where she's at now.

    You are doing a great job. DKA is very hard to treat at home so you're managing very well. Vyktor was at the vet for about 5 days when he went DKA.
     
  22. Meya14

    Meya14 Well-Known Member

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    You've had a long night! For cats in DKA, it's best to try to steer the blood sugars to higher than where we'd want them in a normal cat, about 150-250s. This allows you some wiggle room, and allows the insulin enough sugar to change her metabolism back. Do whatever it takes to bring her blood sugar to this level, high carb food is often necessary. You don't want to have to skip insulin doses, as it will set back her progress. You might want to get some high carb wet food to syringe in addition to the high cal food.

    When max first started eating again I made a cat "soup" that he seemed to tolerate. Mix dry kibble with warm water and smash it all up once the kibble is soft. I suspect that nausea is holding her back from eating. If you are going back to the vet, I'd push the issue about the anti-nausea. Mirtazapine and other appetite stimulants do nothing to help nausea, and sometimes can make it worse. This was the magic bullet to get max to start eating.

    Pedialyte can cause diarrhea, I don't know how much she is getting.
     
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  23. BJM

    BJM Well-Known Member

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    How are things now?
     
  24. Chloe'sMom

    Chloe'sMom Member

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    Just an update - I took Meya's suggestion and made a mix with her kibble. I think it's higher in carbs than the Purina DM so that is what we are giving her. Still no word from vet. Was warned I may not hear back until 1pm EST when they were done for the day. Still haven't given the subq fluids. No change in her not eating or drinking. Did not give insulin. I wouldn't worry so much except her highest glucose 120 taken at noon (24 mins ago). Hoping to hear from them soon.

    Oh and I meant to mention that she is acting almost 70-80% normal minus the low glucose readings!!
     
  25. BJM

    BJM Well-Known Member

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    Dehydration check again, please.
    Hydration reduces the concentration of ketones in the blood and helps flush them out in the urine.
     
  26. manxcat419

    manxcat419 Well-Known Member

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    Awesome job last night with Chloe! And thank you so much Serryn @Vyktors Mum for taking over for me. :)

    That's quite the surf Chloe got going once she decided to stay clear of the low 50s (and lower). Those 80s and 90s are the sort of numbers we love to see our kitties in! :D I'm glad she leveled out for you in the end. :)
     
  27. Chloe'sMom

    Chloe'sMom Member

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    Yes, thank you Vyktors Mom and Manxcat!

    I'm unfamiliar with the terminology, but what do you mean by surf?

    Hubby stopped by the vet today and he gave us Cipro, Cerenia tabs, probiotic powder (a little concerned about loose stool and diarrhea) and stated that he stated that if she drops below 80 with her glucose, he wants her to have 1ml of karo.

    Here are some of her latest glucose readings. All times are in EST:
    9am: 73
    10: 102
    11: 117
    12pm: 120
    1pm: 130
    3: 88
    4: 87
    5: 64
    6: 86
    6:40: 90
    8:35: 62

    I don't like how all of the sudden since early AM hours today (late last night) she has been well under the 150s+. I cannot figure out - and most likely because I've never been through this why she was so high (150-180-200s) and now I can barely keep her around the 80s. I have not checked her ketones lately. Dr ordered for 3/4 unit of the Lantus and I administered the subq fluids per his request. He doesn't want her under 80. I've not had rest today and now I afraid I'm in for a long night - third night. I'm afraid of running down and getting sick! Hubby is going to switch off every other hour so I can at least get 2 hours of sleep straight each time.

    Should I be worried with these numbers? MAJOR VICTORY: Chloe is now eating somewhat regularly and on her own. No forced feedings (other than the syrup) since noon today. We have to sometimes urge her to eat, but we have also observed her going to the food on her own 2-3 times. She only eats about 10-15 kibble at one time, but it's better than nothing.

    Suggestions and thoughts? Thank you all in advance. Dr was quite impressed with her recovery and said it is all due to us acting like an ER and being detailed and vigilant. I was sure to share about this site and all of the help I've received and tell him what a godsend it has been. :)
     
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  28. Chloe'sMom

    Chloe'sMom Member

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    Glucose test just now has her at 134 from 62 30 mins ago after she ate a little and 1ml karo. And the roller coaster continues....
     
  29. manxcat419

    manxcat419 Well-Known Member

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    Surf is when they are in normal numbers for a few hours during a cycle - some cats after a while can surf pretty much all day...almost level numbers and all in the healing zone. Like Chloe's doing today - you see how her numbers are all in the normal zone and aren't going up or down very much from 3 right through until 8:35? That's a surf! :D

    You should be delighted with those numbers! They're all in the healthy zone which means Chloe's getting healing time in - both for the DKA and for her pancreas! And she's eating on her own too - that really is a major victory!! :D Little and often with the food is most likely what she needs right now - that's how a lot of us feed our diabetic kitties anyway as it's easier on their pancreas than just a couple of big meals during the day. :)

    With insulin on board and no real way of knowing where the dose is going to take her, I have to agree it could be another fairly long night. Or she might level out in the 100-120 range. We just don't have enough data on Chloe to tell yet as she's so newly diagnosed. I'm so pleased your hubby is going to switch with you through the night so you can both get at least some sleep. If you can leave him logged in to the site so he can ask any questions he might have later on too - that way he can maybe ask us here instead of having to wake you! If she wasn't recovering from DKA, you might have the option to skip a PM shot so you can sleep, but I don't think letting her go without insulin is going to do her any good at this point so it's great that you've got him there to help you take care of her.

    I'm not surprised your vet is impressed - you really have pulled her through this and got her on the road to recovery. She is still safe at under 80 - as long as you can keep her above 50 she's all good. Though the way she was up and down last night, I can understand him wanting a bit more of a safety margin for now too. :)

    The 134 is likely a combination of the karo and maybe the start of a food spike - I'd imagine she's going to be starting to come back down from that in about another hour though the timescale does depend on how long the food lasts in her system.
     
  30. Chloe'sMom

    Chloe'sMom Member

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    Thank you manxcat for the info. I was hoping as tired as I am that it made some sense. Lol. Vet wanted us to check her glucose every 2hours but with her dropping so low, we check more often. I hate pricking her but she has grown more a costumed to it. Poor thing just sleeps a lot lately.

    Hmmm I know others have suggested too that vets are more conservative on glucose numbers but when she's anywhere below 100 we notice a big change in her. She is still going for the dry kibble that she had for a while and prefers that and vet said that to give her anything just to get her eating. I will say we feel like she's in the 60-70% recovery range. We literally thought we had a dead animal only days ago, so we are thrilled with the results.

    Im used to glucose readings 150s+, so annoying thing this low scares me. Vet said 150+ is typical for diabetic cats and with DKA.

    We are checking again in 90 minutes and then I'm getting up in 3 hours for insulin. The hat gives me a 3 hour nap -yay!!!!
     
  31. Chloe'sMom

    Chloe'sMom Member

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    Oops I hit the button accidentally. This kitty mom needs rest! Lol. I hope she eventually normalizes some. She has a lot of her spunk back when she's not so low on #s so we can tell she's improving.

    I guess this is normal for DKA? We are happy that the end of the day is so much better than tha day before and so on. Forward momentum is welcomed!!

    Chat soon. Zzzzzzzzz
     
  32. manxcat419

    manxcat419 Well-Known Member

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    Yes, you made sense - I know it's difficult when it goes on day after day with no proper sleep. And I agree with checking more often - if you hadn't checked her last night, those dropping numbers could have turned into a real problem for her instead of being something you were able to get under control.

    Vets do tend to be conservative with numbers - they go for the cat feeling well rather than trying to give the cat a chance at remission which is what a lot of us here do. It really does sound as though she's recovering well now - eating and acting more normally! :D

    Yeah, I'm familiar with that sort of thinking. My vet told me to aim for 180 as a target number for the lowest point in the cycle...and my brain said "no way". That's one of the biggest issues some of us have with vets - they're not used to people home testing the way people here do so they have to be conservative with their targets to keep the cat safe. 150 is, IMO, too conservative - it's still above normal range for a cat so isn't going to be as good for her long term as if you can keep her in the 50-120 range.

    Sounds good - I'll check in with you at your next test time to make sure everything's going OK.

    Her numbers are normalizing and she's feeling better - I'd say that's some really good forward momentum! :D

    I hope you get a really good nap. If there's one thing feline diabetes teaches all us caregivers it's to value the sleep time we can get!
     
  33. Meya14

    Meya14 Well-Known Member

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    At this point, you actually -DO- want her higher than the "normal range". In order to get ketones to resolve, you need to be able to give enough insulin to convert her metabolism. Because she is not eating well, the insulin necessary to send her blood sugar <100 might not be enough to convert the metabolism.

    This extra blood sugar is called "substrate" and gives her body something to burn instead of burning fat. It's much much much better at this point to be giving her lots of carbs and a higher dose, then be conservative with the carbs (and karo) and have to reduce a dose.

    After she is eating well on her own, and ketones have been gone for a week, you can pull back on the carbs/insulin if necessary and allow her to be in the lower numbers.
     
  34. manxcat419

    manxcat419 Well-Known Member

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    Thank you @Meya14 - I wasn't aware of that. In that case @Chloe'sMom let's adjust the target numbers we're aiming for for now and keep her a bit higher. :)
     
  35. BJM

    BJM Well-Known Member

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    Generally, giving Karo will bring up the glucose quickly in about 20-30 minutes. It also can wear off pretty quickly, so following the Karo with some regular food can help sustain the level you're targeting.

    Fancy Feast Gravy lovers are high carb foods which may be used to bring up the glucose levels, too. We often use a gravy type food for dealing with low numbers and feed a couple of teaspoons at a time when the numbers get uncomfortably low.

    You may find it helpful to read over my signature links Glucometer Notes and Secondary Monitoring Tools for some more info on assessing how she is doing.
     
  36. Chloe'sMom

    Chloe'sMom Member

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    Wow, ok a lot to consider again. I'm learning! She's been diabetic for 2 years but until this DKA episode I knew little to nothing and still feel I only know a little more, lol.

    Ok, I had a nap and now it's hubby's turn. I will go nap again too now since she just had her insulin and her danger zone is 3-6 hours after (according to them).

    Updated stats:
    11:10pm- glucose 141. Urinated and ate a few bites of dry kibble with gravy
    12:30am- glucose is 205. 3/4unit insulin (Lantus), ate s few bites of dry kibble and quickly back to sleep. (She's catching up on sleep which is good!!!!! For days she'd only sit and half close eyes and adjust positions in room or house every few mins).

    Planning to check glucose in 2 hours (per vet) and then closer between 3:30-6:30. Doesn't eat unless put in front of food and a little the same with going to the bathroom (minus when she had diarrhea). She isn't drinking but she has the subq fluids under her skin. So thankful we haven't had to force feed anything except for karo!!! she isn't eating s ton, but she is eating every hour or two even if it is little bites.

    As always, thanks for the tips, help and care! Will check in at 2:30.
     
  37. manxcat419

    manxcat419 Well-Known Member

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    Those are definitely more comfortable numbers than last night. Hopefully she'll stay up a little higher for you tonight so you can get a few hours sleep between tests (anti-jinx). Even if she's having to be encouraged to eat, it's good that she's eating when you put her by the food. And getting her caught up on sleep should help her to feel better too. :)
     
  38. BJM

    BJM Well-Known Member

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    Glad she's hanging in for you. And envious that you have someone to help!

    We like to reference our tests in terms of how long it has been since insulin was given, as folks can be in different time zones and the interpretation of numbers varies with how long it has been since the shot.
    Like this:
    AMPS = morning (AM)pre-shot test (PS)
    PMPS = evening (PM) pre-shot test (PS)

    +# = any test # hours since a shot
    ex +3 would be 3 hours after a shot
     
  39. Meya14

    Meya14 Well-Known Member

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    You sure are getting a crash course in all of this! Hang in there, she's moving in the right direction. That she's eating something by herself this quickly is great. Max had to be syringe fed for about a week.
     
  40. Chloe'sMom

    Chloe'sMom Member

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    May 14, 2015
    Great news. She went and ate on her own twice since the last glucose test 2 hours ago.

    As for pre test and hours oh I need a bit more sleep to calculate, lol. I'm truly getting sleep here and there and it's helping, but I need to catch up.

    Now this time the glucose test was quite high. She is at 286 and 2 hours post shot. We seem to go from extreme lows back to really high now. One more hour before we are 3 hours post shot and in the "danger zone". This time up she ate on her own (2nd time) and finally went to her water bowl!! She also urinated which is good.

    Just not sure why we went from the 60's-80's to Hugh 200's except that she's eating? I don't want to disrupt too much, but the kibble isn't diabetic friendly and vet said to give her anything that would get her eating again. Should I pull out the Purina DM diabetic wet? I will be back at 4am (1 hour and 10 mins) with hubby to test.

    Forgive my lethargy and any misspellings and scattered direction of my posts!
     
  41. manxcat419

    manxcat419 Well-Known Member

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    She's eating and she's had a fair bit of karo over the last 24 hours too so she has quite a lot of carbs on board as she's eating dry food if I remember right. There might be a bit of a delayed bounce in there too from last night of course. She'll come back down - you know she can do it now. And at least she's letting you get some sleep tonight! :)

    Unless she's dropping quickly at her next test, you should be good to get a few hours decent sleep after that. It really does sound as though she's starting to take a lot more of an interest in eating which is great news!

    I agree with your vet on this one - she has to eat, so whatever she'll take for now is fine. If she'll eat a bit of the DM that's fine too, but if she doesn't want it I'd stick with what she's enjoying right now - no point in upsetting her by taking away the food she does want until she's over the DKA and is clear of ketones...it'll make things much easier for you if you don't have to syringe feed her. :)

    And no worries - we all understand the exhaustion from late nights and early mornings here! You're actually making very good sense, especially given the limited amount of sleep you've been able to get over the last couple of days. :bighug:
     
  42. Chloe'sMom

    Chloe'sMom Member

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    May 14, 2015
    Ok her 4am reading is 355!!! We have a serious extreme and now I'm worried it's too high? Do I give more insulin? She's not due for more for another 8 hours. I'm just so worried at these extremes. She just got up to eat more.
     
  43. manxcat419

    manxcat419 Well-Known Member

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    I don't think you should give more insulin in between regular shots - we try not to do that with Lantus to avoid there being too much overlap with the amount in her system. Let her eat - and you are at least safe to leave her to get some sleep for a few hours. If you can post here for advice before her next shot to see what you should do...I think she's bouncing and there's really not much you can do about that except wait for it to stop, but there are others here with direct experience of DKA in cats, which I don't have (only in humans). If you can get a ketone test when she next urinates just to see where she's at with those, but I think you should try and get some sleep too - you need it and she's not going to head into the hypo zone any time in the next few hours. :bighug:
     
  44. Larry and Kitties

    Larry and Kitties Well-Known Member

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    I agree, I would not give more Lantus between scheduled shot times. If yo do them Chloe could go too low later. That is why I prefer R insulin it only last 4-6 hours.
    How much food is Chloe getting per day? Id not a "normal" amount I would supplement with syringe feeding. The previous low BGs could be due to not eating much
     
  45. BJM

    BJM Well-Known Member

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    Evo Cat and Kitten Dry is roughly 8% calories from carbohydrate. You might pick up a small bag of the Turkey (Pet Supplies Plus on Lane Ave west of OSU and Pet People on N High St in Clintonville have it; maybe other pet supply stores). Slowly offer a few pieces at feeding times. If she likes it and will eat it, getting switched over slowly will help her maintain her calorie intake without shooting her glucose high. And dry takes longer to digest and absorb, so it may keep her numbers more stable for you.
     
  46. Meya14

    Meya14 Well-Known Member

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    Because she is eating on her own her BS may rise and you might have to increase again on the insulin. I'd wait for today and if tomorrow she is still pretty high, and still eating on her own, ask your vet if you can go back up to 1U. Of course, monitor closely. Insulin needs may change a lot because of everything going on.

    Also, is she drinking on her own? If not, you should continue the subQ fluids or syringe fluids.
     
  47. Chloe'sMom

    Chloe'sMom Member

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    BG is 417 at 9:30am. Gonna try the Purina DM and check every 2 hours. She's doing better eating and drinking on her own. Definitely more vocal with normal sounding cries. We'll check ketones later. Both of us are trying to get a little sleep.
     
  48. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    You are doing a great job.
    Try not to get worried about her numbers going back up.... that is a bounce. It is a normal response from her body after dropping into those lower numbers.
    And the good part of that for her is that it will give you a better comfort zone to continue giving her insulin when it's shot time.
    She needs that insulin to help her recover.
    Keep syringing the water as much as you can. You might try getting a can of human tuna and you can use the fluid , add water to make her
    some tuna water. ( if she likes tuna) There is also cat-sip.... ( kitty milk) at pet food stores and sometimes even a grocery store might carry it.
    You can add water to it because she might be willing to drink it on her own.
    I also just learned that goatmilk ( primal brand has one) but that may have to wait until you can find it.
     
  49. Louellen

    Louellen Member

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    I've just seen this thread and read through it quickly. Oh my goodness what a wonderful job done by Chloe'sMom and Manxcat and everyone else who has been part of this journey! I know I have nothing to offer in terms of help but, I just wanted to add something...my admiration for all of you!
     
  50. Chloe'sMom

    Chloe'sMom Member

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    Ok, great, thank you!! She is still drinking and urinating, but I might give her the subq fluids to help.
     
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  51. Chloe'sMom

    Chloe'sMom Member

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    Thank you! I have learned a lot but these people here have been a Godsend to our success!
     
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  52. Chloe'sMom

    Chloe'sMom Member

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    May 14, 2015
    Just checked glucose again and we are two hours past insulin and she is at 402. Eating and drinking and urinating ok.
     
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  53. manxcat419

    manxcat419 Well-Known Member

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    OK, she's pretty level at least. Great that she's eating and drinking OK now! :) It's really going to be a case of waiting out the bounce now until she starts to come back down (that can take up to 6 cycles) but as long as her other signs are good then I think all it will be is a bounce. While she's a bit higher, if you can check ketones whenever you get a chance to make sure she's good on that score too that would help. And get as much sleep as you can while she's higher and safe - now is your chance to catch up a bit! :)
     
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  54. Chloe'sMom

    Chloe'sMom Member

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    May 14, 2015
    Thank you Manxcat. Great idea on the sleep. I'm pretty out of it after this last week! So happy to still have our kitty in our life! ❤️
     
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  55. Jeanne

    Jeanne Member

    Joined:
    Jan 18, 2015
     
  56. Jeanne

    Jeanne Member

    Joined:
    Jan 18, 2015
    I am so thankful you kitty is improving. I have to say wow you are all doing an amazing job. You are all like guardian Angels. What wonderful people we have on this site. I will continue to pray for your kitty.
     
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  57. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    Ketones update: she just urinated and I tested with two brands of strips. CVS ones show the color between negative and trace and the ReliOn ones show negative. I'm not sure if she has ketones or not, but if she does, she is slowly ridding herself of them. Anyway - MAJOR success and had to share!!!! Thank you all. We still have to get her regulated, but wow, I'm so a excited to share with our vet tomorrow.
     
  58. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Great news! Thank you for the update - that really is so good to hear! :D
     
  59. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    good news....
    just keep pushing the fluids, no skipping on insulin... and you said cipro... so I assume there is an antibiotic....

    infection + not enough insulin + dehydration can lead to dka.
     
  60. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Good job! I know it has been hard work.

    Since she is starting to stabilize, you might read over Cat Info and consider what foods you may want to feed, if any, from the food chart. Feeding low carb foods will help bring the glucose numbers closer to normal, rather than increasing the insulin.

     
  61. Peg and Toby

    Peg and Toby Well-Known Member

    Joined:
    Aug 5, 2014
    I been following your posts. So glad Chloe is doing so much better. You have done a wonderful job with her. Prayers and Hugs to you all.:bighug:
     
  62. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    Hello all- me again...

    Last night wasn't too bad. I only was up once to check - I had to risk the fact her numbers were good and that my body desperately needed sleep. She stayed in the mid 100's and ate and drank fantastically.

    Today, I followed up with her Dr and he said that we were doing great but that he was concerned with how high she spiked (400's). I have been giving the 3/4-1 unit every 12 hours as instructed and she has been about 80% normal kitty all day, which has been a blessing.

    Now, though I noticed her pupils really dilated and her head do a slight jerk to the side (I had witnessed this when she was low before) and nervously did a glucose test to find she is at 72. I know many here say that's ok but Dr really worries with her being below 80 with the issues as of late. Since she had been eating mostly the diabetic food all day (no kibble which is higher in carbs), I figure it's made her drop down. I think that if she was low and acting normal I wouldn't worry so much. But, the fact her pupils are big and she jerks her head every so often worries me. I just reintroduced the dry kibble as her next round of insulin is due in less than an hour and I'm afraid that will make her bottom out completely. I still have so much to learn but I'm having a hard time being comfortable with her being under 100. And, not to mention that she doesn't seem to be staying in one place at all. Thank goodness she isn't getting higher doses of insulin - I'm afraid it would kill her. Could the food be the cause of these highs and lows? I have read many places that cat food is the reason why kitties have diabetes to begin with.

    Thank you all again for your wisdom. I'm hoping to have a good night but worry I will be up every hour checking her again.
     
  63. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    What meter are you using?

    Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

    Understanding the spreadsheet/grid:

    The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

    Each day is 1 row. Each column stores different data for the day.

    From left to right, you enter
    the Date in the first column
    the AMPS (morning pre-shot test) in the 2nd column
    the Units given (turquoise column)

    Then, there are 11 columns labeled +1 through +11
    If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
    If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
    and so on.

    Halfway across the page is the column for PMPS (evening pre-shot)
    To the right is another turquoise column for Units given at the evening shot.

    There is second set of columns labeled +1 through +11
    If you snag a before bed test at +3, you enter the test number in the +3 column.

    We separate day and night numbers like that because many cats go lower at night.

    It is merely a grid for storing the info; no math required.
     
    Last edited: May 18, 2015
  64. Meya14

    Meya14 Well-Known Member

    Joined:
    Jan 2, 2015
    I'd think targeting above 100 right now is a good idea. You have a lot of buffer room for those lows. Once she's well, you and your vet can decide if your target can move lower. The spreadsheet mentioned above is a great tool.

    My concern is this jerking you described. When a cat has DKA or it is resolving there is the potential for very severe changes to electrolytes. When certain electrolytes are too low or too high there is the potential for muscle spasm, weakness, seizures, heart arrhythmia. SubQ fluids can make electrolytes off balance as well. I'd ask your vet to test them.
     
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  65. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    I think it was @Meya14 who said that you should try to keep Chloe running a little higher than we would usually aim for at the moment so, yes, I think you should try to keep her at least above 80 or even 100 (which I think was what Meya suggested) for now - for most of us (and once Chloe's over the DKA fully it will be the same for you) we have the option of reducing or even skipping a shot when the cat is running lower than we're comfortable with. As Chloe shouldn't really skip shots at the moment, it's going to be a case of letting her have some extra carbs for now to keep her numbers high enough that she can have her insulin every time. There's time enough to start getting her running a little lower later on once you don't have to worry about the DKA.

    Because of that, I'm not sure I would withdraw the kibble completely for now unless she's having a bounce day like she did yesterday. You've no doubt read elsewhere on here that generally we don't like dry food for cats, but there are instances where it serves a purpose and I think keeping Chloe high enough to get her shots for now is one of those purposes. The other option which a lot of us use is to feed a high carb (in-gravy type) wet food, but that will depend on whether or not Chloe will eat that at the moment...no matter what, for now, she has to eat plenty so she can have her insulin.

    ETA - Cross posted with @Meya14 ;) Thank you Meya :) - I was trying to remember exactly what you'd said without taking too long looking back through the whole thread as Chloe's close to her next shot time!
     
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  66. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    I second the electrolyte tests; too little or too much of some of these can be fatal.
     
  67. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    Ok Meya and Manxcat - I'm so new to this, the forum, etc so forgive me if I'm being redundant. Again the diabetes seemed manageable, but this whole DKA thing and the various things I've read have thrown me for a complete loop! I'm reading things on the Facebook group that differ, I'm reading so much on different sites that I'm literally becoming discombobulated.

    I've reintroduced the dry kibble and she took to it instantly. It must be like me and bread. If I eat a slice, I become addicted and I gain weight. ;) (Another story for another time...). She seems pretty alert but I tested her again and she's down to 61 and closer to shot time. Forgive me, she is NOW an hour out from her shot. I misspoke earlier getting my times confused. So, I'm to assume that she is still coming out of the DKA? I was hoping we were getting passed that, but I realize that my hope might be higher than the reality of it all.

    So to be sure I have this straight... I introduce the kibble - done. I give her insulin shot still in an hour? (Lantus and 3/4-1unit) Eventually a lower BG is ideal, but not this soon with DKA? We still follow vet's orders and want her 80+. Per his orders I am to give 1ml of karo, and right now I just gave her 1/2ml. When I gave her more (2ml over a 6 hour period) she spiked up to the 400's and I'm assuming we don't want to go that high if we can help it? She's drinking ok and skin snaps back immediately today so I did not give the subq fluids - should I administer those at this point, or just keep her drinking her water? And for my own heart's sake - bounces are normal?????? Because I'm already tearing up in fear that the last week is going to repeat itself... Forgive me, this has been one emotional roller coaster!!! :'(

    BJM - I will give the charting a try. For now, my instinct is to research the death out of something and keep my copious convoluted notes. ;) Thank you for the charting suggestion. I will definitely look into it once I can settle my anxiety that I'm experiencing at the moment!!

    Are any of you on the Facebook group? PM me if so.

    And again- you are all saints. I am beginning to think we call could have DVM (Diabetic Veterinary Medicine) after our names with all of this!!! Thank you again. <3
     
  68. Meya14

    Meya14 Well-Known Member

    Joined:
    Jan 2, 2015
    Yes, to everything you said. You are going to see swings until she is regulated. -That is normal- . To get rid of ketones, insulin is the magic bullet. Definitely if your choice to control high blood sugars is less food vs more insulin, at this point, choose more insulin.

    Feed her whatever she will eat that will keep her sugars stable. I'd pick one type of food and stick with it for now, as food changes can lead to those very highs and lows your were seeing.

    Really, you are not out of the clear from DKA until a few weeks -AFTER- she no longer has ketones, this is because nausea, dehydration, poor eating, and electrolyte imbalances all take a while to go away. Ketones can resurface if these factors don't resolve.

    Don't get too hung up on the numbers, just keep an eye out for hypos. Your numbers won't be stable probably for a while, but that's ok.
     
  69. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    She will definitely be getting over the DKA I think and her BG is well under control (possibly slightly too well for the moment). However, it's important that you don't have to skip her shots to stop her slipping back into DKA again which is why you need more of a safety net with her numbers than you would do otherwise.

    That's exactly it! :) Eventually you'll want to aim for her being in normal numbers for a cat, but keeping her in normal numbers now would mean you would have no choice but to skip some shots because there just isn't enough data on her numbers yet for it to be safe for you to shoot at a low level. While a lot of us do shoot low numbers, it just isn't safe to do so until you have a lot of data on how an individual cat reacts to shots at lower levels and with Chloe there just isn't enough data yet to be sure you can do that safely.

    At a minimum, yes - you ideally want to aim for 100+ as @Meya14 said to give you an extra safety margin.

    Not quite that high if it can be helped, no. But if she bounces she might go that high anyway. There really isn't anything you can do about bouncing at this stage - if she drops low, she is most likely going to bounce for now. It's completely normal so please try not to worry about it if it happens (I know, it's impossible not to worry, but knowing that it's normal might help just a bit).

    At this point I think that might actually not be a bad thing. Dry food takes longer to get into a cat's system than high carb wet and longer to get back out too, so isn't as good as either syrup or gravy food for quickly raising a number under 50 without keeping numbers high for a while afterwards. But for the moment while you're trying to keep her numbers a bit higher, a food that takes longer into her system and longer out might help you to keep her settled at a higher level.
     
  70. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    The charting is a good way to see the numbers from pre-shot to pre-shot and show you how the insulin is working. It may help reduce some of the anxiety, particularly as you start seeing stable cycles from shot to shot.
     
  71. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    Ok, thank you guys for clarifying. And I will do my best to relax and not panic too much. ;)

    I must also say - that upon ketone testing at 3:30PM EST yesterday, with two different strip brands, one showed NEGATIVE which I was nearly jumping for joy over (ReliOn) whereas the CVS brand showed a color that was slightly darker than negative, but lighter than the trace. Dr made notes of that as well. (Our conversation with the Dr today was via phone, so he didn't actually see Chloe) Speaking of Dr... he said that if she continues to eat and improve he'd like to see her towards the end of the week to do some liver function testing. He didn't indicate why, but any ideas? He is perplexed (as he is with all of this - Chloe has had her Dr and ER Dr and office staff scratching their heads... she only had some of the DKA symptoms, so they didn't rule it as that until her urine showed the ketones - not sure what else the thought was going on) as to why she has lost 2# since Sept. '14 to last Tuesday when I took her in. She had lost nearly a 1/2# (according to his scales - though they were different scales in different rooms) from Tuesday of last week to Friday. That is significant. Maybe he thinks there is a secondary problem? (Oh Lord, I hope not!) When we go in, I will be sure to suggest the electrolyte test as well. Though, I will say that throughout this, (until Sunday) she was getting pedialyte off/on through the days/nights.

    Ok, so we are 10 mins from the insulin and I will administer it. Suggestions for how often I should check her glucose throughout the night? He stated before that 3-6 hours after administering it, that was the "danger zone".
     
  72. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Elevated liver values would suggest that the weight loss had sent too much fat to the liver at once, causing it difficulty in functioning, ir, possible hepatic lipidosis.
     
  73. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    How often you need to check tonight will depend really on what her pre shot number is. We would always recommend at least a +2 test as that can be an indicator of how the cycle is likely to go. But if she's starting out still low then you might need to get a +1 and a +2 and then we'll work out from there what you need to do next.

    The negative, or below trace, ketones is great news. It sounds as though the vet wants to make sure that everything's progressing as it should and that there's no damage to her liver function. The weight loss could be down to high glucose levels - many diabetic cats lose weight before diagnosis as they aren't able to use the food that they're eating.
     
  74. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    Yes, at first, they thought she had hepatic lipidosis. The first day I took her to the Dr she was so dehydrated that he wasn't able to get a urine sample. That next 24 hours she slipped into a low - death like state that had us running to the MedVet ER. Had we not, I'm confident she wouldn't be here... :'(
     
  75. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015

    Thank you for explaining. And I'm assuming that the +1 and +2 means the number of hours after the insulin for testing? I'm learning. ;) I was going to wait until that 3-6 hour mark, but that may not be smart with as low as she was an hour ago. In fact, I might test again. I'm nervous of her slipping lower and lower from that 61 that she was at...
     
  76. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Yes, +# is the number of hours post-shot.
    If you could jot down the numbers in a column that way, and repeat it with new numbers added in later posts, that really helps us see any patterns.


    PMPS waas
    +? was
    ... etc.

    Lantus hits its peak effect usually between +5 to +7 hours post-shot, which is why your vet said +6 hours post-shot.
     
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  77. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Nervous is fine - none of us ever want to be completely relaxed about low numbers. But remember, she came back up the other night when she was low and if it happens again, she'll come back up again. Testing a little more often when she's started out low so that you can see quickly if you need to intervene with karo or high carb food is never a bad thing. :)
     
  78. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    BJM, I need DKA 101. ;) PMPS?

    Oh gosh guys... I was just admiring Chloe sleeping and she started twitching really strong. It wasn't a seizure like twitching I don't believe, but it was enough for me to worry. I'm not sure if it was because she was dreaming (she doesn't usually twitch like that), but her little legs just started twitching enough that I had to wake her up to pull her out of it. Going to test BG right now...
     
  79. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    Ok, maybe it was dreaming... Mama's in a panic, I tell ya! :nailbiting:

    BG is 180. Will update with chart. And I'm sorry, someone asked me my glucometer is a Bayer Contour Next (human).
     
  80. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    That's OK - better to test and find her in good numbers than to wait until later and find she's all the way down in the 40s and needing syrup. :)

    My Regan dreams like that just occasionally too - usually she's quiet when she sleeps, but just now and then she'll twitch a lot and even meow in her sleep! Even with no other health problems, she scared me the first few times she did it so I can imagine how you must have felt watching Chloe do that! :bighug:
     
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  81. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    PM = evening PS = pre-shot test
    AM = morning
     
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  82. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    Yes! I'm on such high alert, it's ridiculous. Ha. I have a day of work training on Wednesday that will take me out of the house (I have a home office) for 12 hours while hubby is at work and I'm considering not attending just to keep an eye on her! Thank you for understanding so much what I'm feeling. I swear, I feel like you all are neighbors/friends that I've known for years. I can't stop saying it, but I'm truly grateful. I've never met a community of people so kind and willing to be there for others! I only hope that I can return the favor to someone else in the future! :bighug:
     
  83. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Oh I know how you feel - I ended a work contract early so I could stay home with Rosa for her last couple of weeks on insulin because I was having to skip so many shots. And I don't think I could have worked the first few weeks she was diagnosed - I was barely sleeping at all and was so nervous all the time that I wouldn't have been able to concentrate!

    It really is like having another family here. That's exactly how I feel about all the people I've "met" on this board. :) And you really will be able to help other people in the future - when I started out here I'd never have thought I could talk anyone through getting low numbers back up or give any sort of advice, but it's amazing how much you learn really quickly and then you start noticing questions that you know the answers to! :) :bighug:
     
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  84. Meya14

    Meya14 Well-Known Member

    Joined:
    Jan 2, 2015
    Just checking in. How's everything going?
     
  85. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
    :bighug::bighug:Hello everyone. We'be had a busy few days as we've resumed normal life again. Chloe is doing great. The only concern I have with her is her slight shuddering that she is doing. I notice this occasionally when she Is sitting but mainly it is as she is falling asleep. I need to take her in for more tests as the vet isn't convinced that her weight loss was only due to the DKA. He is concerned she may have something going on with her liver. She is slightly playful, but I think she is still regaining her strength. Minus the shuddering or occasional jerking motion, she is at 90-95%! I'm so thankful that she is here and I tell her that daily!! We need to get our bank account to recoup a bit and I will take her for another blood test. Those tests are so expensive when you add in the vet fee, etc. $150-200 later! Just wish I could figure out the shuddering/jerking motion myself. She is eating normally and drinking as well.

    Thank you for checking in! I will keep posting updates along the way. I wanted to give everyone a break as I know I was so fearful and need of help for several days. I cannot thank you all enough. :bighug:
     
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  86. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    I'm glad she is doing better. Thanks for the update. Continued prayers and good thoughts to her full recovery.
    Is she eating better now?
     
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  87. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    I'm so happy to hear Chloe is doing better now. :) And hoping for nothing worrying to come out of her next blood work when you get it run (and our vet is also at least $150 per visit so I know what you mean about it adding up fast)!! Hopefully Chloe will continue to go from strength to strength and be fully recovered in the next few days. :bighug: :bighug: :bighug:
     
  88. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    If you've a moment, perhaps you might add a few things to your signature which will help us give you better feedback:

    Editing your Signature:

    In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

    Click on your ID.

    On the left, under Settings, Click on Signature.
    This is where you will put information that helps us give you feedback.
    This is where you paste the link for your spreadsheet, once it is set up.
    Add any other text, such as
    your name,
    cat's name,
    date of Dx (diagnosis)
    insulin
    meter
    any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
    Click the Save Changes button at the bottom.

    There are more options under there that you may wish to edit when you have time.
     
  89. Chloe'sMom

    Chloe'sMom Member

    Joined:
    May 14, 2015
  90. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Thank you for the update - I was wondering how Chloe was getting on and hoping that no updates meant she was doing well. :) I've replied on your new thread.
     
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