? Insulin and low potassium

Had to take Frank to the vet today. Wondering if anyone has experience with low potassium as a result of insulin, and what that experience was like. Elevated bilirubin (1.8 when it should be around .9) and low potassium so we've started a potassium supplement. Frank is lethargic, not eating, hasn't pooped (but she said there was poop in him), dehydrated (got fluids with a possibility for more tomorrow), regular body temp, high glucose...of course...(262 on the AT2 and 320 when they drew his blood), normal liver enzymes. Just looking to see if all of this sounds like a result of not enough potassium due to insulin. (My spreadsheet sucks so please don't look at it for help, lol.)

 

Hi Sarah, I can't tell you if all the other signs are the result of low potassium, but I can tell you that it's not uncommon in diabetic kitties, and that it can make them feel pretty crappy. My sugar baby has been on a supplement for it for over a year. It's not a problem, just a tiny scoop of powder added to breakfast and dinner.

 

They gave me a supplement that's in a tube, like tooth paste. He hates it. He literally gagged when I gave it to him earlier!

 

There are a lot of different brands of supplements out there. The first one they gave me for Squallie was a gel in a tube; he liked it fine, but it was expensive. Now he is on Vetoquinol Renal K powder. If your cat doesn't like the one the vet suggested, ask him if it's okay for you to try a different one. I mean, it's not really going to do kitty much good if he won't eat it, right?

 

Vetoquinol renal k paste is what she gave me. Might need to switch to a powder. But I can't get him to even eat tuna tonight, so maybe once I get him eating it'll be a different story.

 

I can sympathize with the not eating business- Squallie and one of my civvies are on appy stimulants, and sometimes they still won't eat. Very worrisome, and frustrating!

 

I use this and just mix with food
https://www.destinationvitamins.com...Ou9l7v1yx5zvB1nxpguvMYG3GZYWcJZxoCDnsQAvD_BwE

 

He's just so incredibly sick. I syringe fed him .5tsp potassium, 1.5tsp water with a tiny bit of food, and about .25tsp pumpkin today. Back to the vet at 215.

 

Let us know how it goes at the vet's, we worry about all the FDMB kitties like they were our own!

 

No change yet. He's lethargic, not eating, not pooping, hiding in the basement. Sub Q fluids today, a 14 day antibiotic to cover our bases, I syringe fed about 3 tsp of watered down food and close to .5 tsp potassium supplement. At home sub Q for the next few days. He's a bit wobbly on his back legs still, which can be a sign of the low potassium. They're still thinking sludgy gall bladder. I'm wondering when to take him to another vet. Will probably call around tomorrow.

 

I've syringe fed a few times today. Not more than 3tsp in any one sitting but I'm hoping it's all been enough to give him a bit more pep. Seems like it's most likely all stemming from gallbladder issues, and everything I can find online indicates we're on the right track for treatment. We're being a bit less strict on diet right now. The important thing is to get him to eat, and poop...and the subq fluids are supposed to help with that. It's hard trying to manage the diabetes and this current issue at the same time...the vet has recommended a 1u 2x a day since he isn't eating. BGs are in the 220-260 range.

 

Just keep us updated, Sarah and let us know if you get an appointment somewhere today . Sending healing vines to Frank!

 

When they're reluctant to eat, all food restrictions go right out the window. Eating is far more important. Keep us posted.

 

We have a standing apt at a fancy vet clinic today whenever I can sneak out of work to take him.

Frank puked this morning while being syringe fed his K+ supplement...a gross, watery, green puke. :-(

 

We'll be awaiting an update

 

Sounds like bile from his gall bladder. Good luck at the vet appt.

 

Sarah, I'm so sorry to hear that Frank is so unwell!
Potassium supplement can make them puke and the paste is particularly unpleasant.
Frank is low in potassium probably due to diabetes not due to injecting insulin. When they are diabetic they drink a lot of water and they pee a lot getting rid of vital salts (potassium) with the water flow. if he is so low in potassium and he is very ill and not eating properly adding potassium to food would make things worse so your vet should give him potassium with the fluids.
You will find all information about that on Tanya's site www.felinecrf.org.

 

At the clinic now, waiting for an available vet. They let me schedule a walk in/as available bc it costs much less than an emergency walk in. The downside is we wait until someone is available. Thank god for smart phones and Internet to keep me occupied.

 

He feels awful.

 

Poor baby ...

 

That's exactly what I just said when I looked at his picture . Any update yet, Sarah?

 

I'm sorry to hear he's sick. I hope you get some results from the fancy clinic.

 

Alrighty guys...the diagnosis is.....DKA and a UTI. Ugh.
ICU overnight, hoping he comes home tomorrow. I feel terrible. I'm so upset his vet didn't catch that (I asked more than once because I know that DKA can reoccur!). He got an antiotic yesterday but only after I questioned things several times. "Well, we can give him an antibiotic just in case, if it'll make you feel better." I feel awful that it took 3 days and 3 vet visits to get this diagnosis. He did have an ultrasound done today to just make sure things were OK, and everything in his abdomen looks good. Lots of different crystals in his urine, red blood cells, bilirubin, and 2 different bacterias. No woder he was feeling so bad!
I need to get a test solution for my relion. Wonder if it's reading wrong? He HAS NOT been crazy high at all (over 350) in weeks.
So...lesson learned to spreadsheet EVERYTHING, get back to lots more tests during his cycles, and start in home ketone testing. What an expensive lesson.
Can't wait to have him back home and up to his jerk behaviors again.

 

And sorry if my lack of update caused any concern. It took a long time at the vet, then I had to drive home and back with his insulin or they were going to charge $180 for a new bottle. Plus dinner, care for the rest of my zoo, mop floors that have been peed and puked on in the last 36 hours. And had to pretend I have a life this week by catching up on Facebook. Haha.
I'm so nervous for what this 3rd visit is going to cost me. I'm PRAYING it's under $1000....which is just ridiculous.

 

DKA can happen even in a cat with normal numbers.....it's not only a matter of high ones, but with a known diabetic, anytime there's not enough food + inflammation or infection + not enough insulin, that's the "recipe" for it.

Any time a cat acts sick, it's a good idea to check for ketones....You can check them at home with urine ketone strips....anything over "Trace" is an emergency

Sending prayers for your dear Frank and hugs to you

 

We just worry about all the kitties but we know you'll update when you can . Very frustrating that it took 3 Vet's over 3 days to actually diagnose him . Could've started his treatment 3 days ago . Not angry with you at all, Sarah! Upset with the Vet's. Totally not your fault!
Update us as you are able and sending healing vines to Frank

 

Frank is doing....ok....this morning. His BG is over 400, and they were going to consult the vet on how much insulin to give bc he's still not eating. He did pee for them, but no poop yet. But he's only been there less than 12 hours, so I know I need to give it time.

 

Thanks...I'm mad at me. I clearly got to lax in my care for him, and he's paying the price. It won't happen again. But I'm happy I pushed for more answers than a sludgy gall bladder. Grrrr.

 

Don't be too hard on yourself, Sarah
Is he still showing ketones?

 

Not sure. I don't even know if they would have tested it again already, with the urinalysis being done so late last night. I'll call back closer to lunch. I don't want them thinking I'm too helicopter mom-ish....

 

There are usually specific things done to treat a DKA. They can include giving fluid electrolytes, fast-acting insulin (R insulin) to pull BG down faster, dextrose, etc. It's easy to test urine for ketones and I think that should be one of the first things they do when an FD kitty is brought in feeling sick.

You're not being too helicopter-ish if you ask for specific information.

 

Voicemail from the vet...Franks BG was 464 this morning so they gave 4U. Still not eating so they may start force feeding. He's on an IV still and resting in his cage.

 

Oh Sarah, I'm so sorry about your poor baby and I can imagine the stress you are under!
At least now Frank is in good hands and is treated so fingers crossed that you get him home soon feeling better.
Sending hugs
Marlena

 

Frank is doing a nice big bounce at the vet. Who would ever have guessed that would happen. Last report he still wasn't eating, bg was 496 at 230 (close to what should have been nadir), but was resting and had peed a few times.

 

As soon as he starts eating the vet will send him home. I did remind the tech I do at home testing...so she's going to pass that along to the Dr and he may get to come home sooner.

 

BG tonight pre shot was 404. Gave 4U at vet.

 

Vet wants to wait until frank is eating on his own so I can safely give insulin. I let the tech know I do in home testing...she's going to let the Dr know, and he may release him tomorrow to come home since I'm a knowledgeable, proactive sugar kitty mom. All thanks to this page and the awesome group of people here.

 

Sorry you and Frank are having to go through all of this.

If you want to check your meter's accuracy and do not have control solution, you can always test yourself or a non-diabetic cat.

 

@Tanya and Ducia I saw in another thread that you mentioned your cat having high cholesterol. Frank's cholesterol was quite high this week....400, I think is what the results say but can look late if need be. Did your vet give a reason for this? I'll ask mine next time I call in, but do you know if it's diabetes related?

 

BG was 99 this AM, so no shot at the vet. Dr thinks he may have been overzealous with the insulin, which looking at Frank's numbers in recent weeks and what I've been giving him for insulin would support that thought. He still isn't eating on his own, they are going to do another urinalysis, nadir and PMPS tests and decide if he can come home or needs to stay another day.

 

I hope he starts eating on his own. Are they giving an appetite stimulant?

 

Sarah, please ask the vet for appetite stimulant!

 

They may be giving one, but I'll be sure to ask when I call again!

 

I know you're going through a lot, Sarah but if you could try to use the SS again, it will help us help you more when Frank comes home

 

Oh, I will be so on that spreadsheet!

 

Hi Sarah, sorry I do not get tag notifications unless I am online and I wasn't.

No we never discussed Ducia's cholesterol although it was 409 at the time of Dx. Ducia was at the death door at the time of Dx and the cholesterol seemed to be the lesser evil to pay attention to at the time.

Her cholesterol was just a little above norm on the latest bloodwork test. Nothing was ever done about it - no meds, no special diets, nothing. We were fighting the ketones, dehydration and sever underweight issue (6.5 lb v. 9 lb ideal weight). Sorry I could not be of any help here .

On the good note: Ducia ate fatty Friskies Pates, a lot of it - up to 250 Kcal/day, gained weight and cholesterol issue almost resolved on it's own. Somehow.. The Apr 1st test shows cholesterol at 232 with Ref Range 90 - 225. I cannot explain why it improved in one month...

Our goal in nursing her at home as opposed to professional settings was a bit old fashioned - just to restore the natural strength/defense mechanisms of her body with food and hydration, and of course the insulin shots.

Wishing Frank speedy recovery an the best of luck to you!


PS. If possible - request a copy of all Frank's records at that clinic. I am sure happy to have done so for Ducia.

 

Sarah, I think you don't need to worry about high cholesterol in cats, it is not causing heart problems or cardiovascular disease like in people although newest research does not confirm dangers of high cholesterol for people either!
There is still a lot we don't know about human or animal health.