Kitty diagnosed with DKA Need advice

Blackberry has been at the vet since 9:30am this morning (it is now 8p) being treated for DKA. Unfortunately, our vet does not have 24 hour care so we are transferring him to an overnight clinic now and will then bring him back to the vet in the morning. Just reaching out for any advice or suggestions or personal experience from anyone who has gone through this?

Blackberry was diagnosed with diabetes in May 2016, initially on Lantus, but switched to ProZinc in September. We have had great trouble trying to regulate him but his behavior and appetite have been normal. Two days ago is when we saw a significant change in his eating and suddenly became very lethargic, which is why we brought him to the vet immediately.

Thanks for any feedback, i really appreciate it!

 

Originally posted on http://www.felinediabetes.com/FDMB/threads/cat-not-eating-vet-emergency.167001/#post-1806966

Post #8 -#13

Blackberry is being taken to an overnite clinic for treatment and will go back to the regular clinic in the morning

 

I've never had to deal with DKA so I have no helpful advice but I'm sending prayers and healing vines for a full, speedy recovery!

 

Thank you!

 

Sending prayers, healing vines and

 

This link has a lot of information on DKA with links to other articles included.

http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/


Once Blackberry is home it would be prudent to do urine testing with ketodiastix to check for ketones.

 

Thank you!

 

Yes, i certainly agree. Thank you so much!

 

Prayers going up for Blackberry and you.

 

Vegetable had DKA once. She spent 3 or 4 days at the vets on IV fluids & fast acting insulin along with her lantus until she was stable.

After vegetable came home she was still a bit off but bounced back pretty quickly.

Hope your baby gets better soon

 

Teasel had DKA at the end of March this year. About 3 days in vet ER with fluids, fast acting insulin, etc., etc., etc. Very expensive time and he took a while to get back to normal. They definitely need careful monitoring while in hospital. When Blackberry is back home you'll want to start urine ketone testing on a regular basis. Teasel will tolerate me putting a long handled spoon under his backside to collect urine while he pees. You don't need very much. Ketone testing strips are available in any human pharmacy.

 

The prozinc only lasts 8-12 hours in cats, so if you have a cat where it wears off before 12 hours, you will have up to 4 hours between each shot where the cat has no insulin in his system. Insulin actually has many functions - one is to lower blood sugar. A more important function is to allow cells to use energy from foods. Without insulin, cells "starve" and the body sends out signals to change the metabolism into "starvation mode" which means using ketones for energy instead of sugars. Unfortunately, ketones can only be used for a short period before they become toxic to the body. Reducing calories or food when a cat already is in starvation mode because of too low insulin further speeds up this process. So on prozinc, you could potentially have 4 hours of "starving" every day, in addition to the doses you had to skip because blood sugar went low. My kitty is a survivor of DKA as well, and now, we -NEVER- skip doses. When he would go low, I'd much rather give the insulin, feed him a bowl of dry food and ruin the blood sugars for the day than risk another DKA episode. As long as you monitor well, you should be safe from hypos.

You may want to consider switching back to lantus or levemir (I prefer lev). These last 12+ hours in cats, and there won't be that gap without insulin. I know that you said that you had trouble regulating on lantus, but I suspect that your dose may have just been too low. And it takes time to really regulate. The change back to a healthy metabolism happens a long time before you really see the blood sugars become stable. Most diabetics who have had DKA need a basal-type insulin to prevent a recurrent episode. If you haven't tried levemir, it might work for you. Some vets are afraid to keep increasing doses, and rather play musical chairs with insulins, however, a cat needs the dose it needs.

 

It's Vetsulin that lasts 8-12 hours. ProZinc lasts 10-14 hours. I changed from Vetsulin for that reason. Getting the different insulin's mixed up is easy to do.

 

You are correct, the PZI and prozinc have a similar action to the glargine. My mistake was thinking of other zinc-based insulins used in humans which are intermediate and not long acting. So prozinc should provide basal coverage when shot at 12hour intervals. So more likely the skipping of shots may have been the trigger rather than poor insulin duration, amongst other things. Usually though there are multiple factors that start the ketone process.

Thanks for catching that.

 

@SilverSap

Is there any update on Blackberry?

 

Hi everyone! Blackberry is home! It has been a rough week but he got home on Thursday night, after spending a total of 7 days and 6 nights at the vet. He is stable now and slowly getting back to his normal, loving self. While at the vet his electrolytes were very low and his liver values were significantly off. Also, his red blood cell count was low. He was on a feeding tube for most of his time there. Now that he is home, the main priority is to make sure he keeps eating. Once we get him back to eating and feeling better, we will look further into his insulin doses. Right now, he is back on the ProZinc. We are seeing an internal specialist moving forward to help with his insulin. He had a check up yesterday, Sunday, after 3 days at home. His liver value is back to normal, as is potassium, and his red blood cell count increased, so all wonderfully positive signs. I want to thank everyone for the thoughts and prayers while we went through this very difficult period! Blackberry thanks you all very much <3

 

YAH!!! GREAT NEWS!!

Thank you so much for the update. So glad Blackberry is back home and doing well. The important thing now is to make sure he keeps eating well and keep his glucose levels as much in check as possible.

Hopefully the specialist will have a good plan for his diabetes treatment. Please let us know how things are going and what has been decided.

 

Great news!!!

 

Excellent news!