How to prepare for a first return home after intensive ketoacidosis treatment.

Hi All,

I've been directed to here from Facebook. It looks like a fantastic site and a crucial resource.

My lovely 13 year old boy, Murphy, was diagnosed as diabetic last Thursday. I gave him his first injection of caninsulin 1U on Friday morning. By the evening, I thought he'd become hypo as was more sleepy than usual. I hadn't got (or understood the importance of getting) a home monitoring kit for BG, or to be equipped with ketone testing strips. I took Murphy to the vet on Saturday morning, where he was diagnosed with ketoacidosis and therefore admitted to the vet hospital for intensive treatment. He started on short acting insulin injections and they're currently giving him caninsulin and attempting to taper off the short acting. He was a little hypo at one point, so he had glucose. He also spiked today to 31, but its since come back to 17.8.

He had no ketones in his urine this morning, he's eating.
The vet has said he can come home in the morning if his urinary ketones are still clear.

I'm feeling very unprepared however. And very nervous.
My question is, what do you think would be useful to have ready at home, for his return?

So far I've thought, BG monitor, ketone sticks, caninsulin. Anything else? They won't prescribe short acting insulin for home use.
Would it be useful to have equipment in place for sub q rehydration (saline etc)?

I've had the steepest learning curve over the past few days - and there's still soooo very much to learn.
Thank you,
Amy.

 

Hi Amy and welcome to you and Murphy!

It actually sounds as though you're doing some really good work on getting prepared for Murphy to come home!

Everything you've got on your list would definitely be useful...including the bag of sub-q fluids (he might not need them but it's easier to have them ready to go just in case he does). For your home monitoring kit, it will be much easier when you're starting out testing if you can get some alternate site use lancets - they're a slightly bigger needle and make it much easier to get enough blood for testing at least to begin with.

I would add some syrup or honey (in case of a hypo), some high carb food (the in-gravy types work well, also in case you have to get his numbers back up quickly). And some low-carb treats (freeze dried meat or fish is good, but some plain cooked chicken with nothing added to it also works) for treats for test times.

You might also want to check with your vet about anti-nausea medication and possibly an appetite stimulant in case he's a little nauseous or not wanting to eat much when you get him home. Which reminds me of another thing you might want to add to your list - the syringes without needles that you can use in case you need to assist feed him at any point. Baby food (the kind that's just meat and broth) can be useful for situations where the cat doesn't want to eat regular cat food - a lot of cats seem to love it and it's easier to syringe feed than a lot of cat foods. You might not want to stock up on that at this point, because if he's eating at the vet it's likely he'll eat at home too, but knowing where you can get it if you do happen to need it wouldn't be a bad idea.

Hopefully other people will be along soon to see if there's anything else that needs to be added to your list.

 

Thank you so much manxcat, that's brilliantly helpful. I've got syringes and we eat lots of broth, so that's good. I need to buy more gravy food.
Ill get some freeze dried treats.
And I'll look for some alternate lancets.

 

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback without having to go look in all your past posts.

Editing your Signature

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Add any other text, such as
your name,
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Thank you BJM. I've added some info to my signature.. Ill add more as I go along.

 

Terrific.
How's he doing today?

 

He was ketone negative in his bloods this morning, so the vet let him come home. The alphatrak bg monitor hasnt arrived to the vet yet, so I've come home without one. Feeling very nervous as just gave him his evening caninsulin. I won't sleep tonight.
Murphy's vet felt that whilst he's still bouncing and body getting used to the insulin, then I shouldn't look at the numbers. Thankfully the window IS getting smaller but still. I'm feeling fairly terrified to be fair.

 

Pick up an inexpensive human glucometer as a fall back for now, to keep him safe. The values run about 30-40% lower than the AlphaTrak and you can use the reference ranges in my signature link Glucometer Notes.