New Member - Into 2nd Hospital Stay for DKA since diagnosis

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Lauren & Keller, May 18, 2020.

  1. Lauren & Keller

    Lauren & Keller New Member

    Joined:
    May 16, 2020
    Hi All,

    First off, this is my first time posting but have been pouring over posts and comments since the diagnosis and thank you for all the guidance I've taken away thus far. This month has been a doozy.

    To get into it - Keller, my 8yr Old Tabby is recovery in the hospital from his 2nd bout of DKA since being diagnosed last month. In mid April, I brought my kitties into their primary vet to get tested for a URI since they were both exhibiting some mild sneezing and Keller was diagnosed as a diabetic the following day (Glucose reading of 520 at vet). My vet prescribed starting with a diet change and holding off on insulin until his next glucose reading in 3 weeks time, unfortunately, Keller went into DKA three days later and spent five days in the hospital with the underlying diagnosis of pancreatitis.

    At home treatment: 1U of Lantus twice Daily, Alpha Trk 2 meter, DM Wet Food twice Daily, Ketodiasitx Strips ( I don't have a chart made for him yet)
    Out of the hospital Keller regained his appetite and energy but his glucose readings stayed consistently in the 400's and his excessive thirst and urinating remained, fortunately without any Ketones. Last week we went back to vet to get his glucose curve and he was bumped up to 3U of Lantus per day (1 in the morning and 2 in the evening), still no ketones in his urine but did have a UTI and was prescribed Clavamox.

    Four days later he started exhibiting disinterest in food, lethargy and signs I now know are consistent with him when he's going into DKA. Now he's entering his third day in the hospital, diagnosed once again with pancreatitis and expected to leave this afternoon. According to the hospital, this is unusual for cats to go into DKA in such a short period of time so they are checking him for other intestinal issues and/or possible food allergies as an underlying reason for the pancreatitis. I've also been asked to try to get the
    https://www.freestylelibre.us/system-overview/freestyle-14-day.html
    glucose reader that sticks to his skin like a patch but it seems to be only prescription based and not sure if it can be prescribed to animals.

    Here a just a few questions that I can gather right now

    Any advice on what could cause two DKA visits so close to each other besides a regular diabetes diagnosis?
    Could he be resistant Lantus?
    Are there specific food allergies/intestinal problems coupled with diabetes that are known to contribute to DKA?
    Has anyone successfully used one of these meters before? If so, how did you purchase? https://www.freestylelibre.us/system-overview/freestyle-14-day.html

    I'm really trying to wrap my mind around his diagnosis, the two hospital stays and how fast my seemingly healthy cat can take such a turn. Thank you for reading and I would be really grateful for any advice or guidance!

    - Lauren & Keller

    *******************************************************
    More info on Keller that may or may not be relevant:
    Keller is an 8 yr. old 14lb (usually 16lb) orange Bengal/Tabby. He's naturally lean, very tall and not overweight. He's labeled as "fractious" at the vet but its definitely more anxiety than aggression. He was diagnosed a few years ago with hyperesthesia, a disorder that isn't super well known but is definite underlying cause of his anxiety.
     
  2. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hello and welcome!

    Wow, you guys are really going through the wringer with this :(. Two DKA episodes in a short period of time!

    I don't know if anyone knows what makes a cat ketone-prone, but for those that are, here's the "recipe":

    not enough insulin + not enough food + an infection or other stressor

    Unfortunately, it looks like Keller is prone to ketones. The explanation for why he went into DKA twice in such a short period of time may be no more than the bad luck to get two infections at just the wrong time. We find that the immediate period after a DKA can be pretty delicate, too, with extra care needed to make sure that food and insulin are sufficient to keep ketones at bay.

    Answering your other questions as best I can:

    It's possible he may have developed some insulin resistance-- when cats have been unregulated and in high numbers for a while, their body can get used to those numbers and take a while to respond to insulin. Secondarily, while lantus is a great insulin for cats, it's not always the best suited for DKA treatment or recovery, as it's better at keeping numbers low and level than bringing them down in the first place. I wouldn't recommend switching insulins at this point, just noting it as a possible factor.

    Not really as far as I know-- there are some things that are seen more commonly (UTIs, dental infections, pancreatitis), but just about anything that throws a cat "off" can trigger ketones/DKA under the right circumstances.

    I haven't used one myself, but I think the general verdict is: great when they work, absolutely revolutionary when working with difficult cats, but expensive over time and can be really fussy to get working on a cat (you have to shave a patch of fur, which grows back quickly, and the sensor is hard to keep on).

    I hope Keller is feeling better and out of the hospital soon! Keep asking questions, we have a lot of people here with experience in DKA recovery as well as home BG testing and insulin dosing. Let us know how we can help you and your extra-sweet kitty!
     
  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi and welcome Lauren and Keller. I am so sorry you are going through this.

    First of all, your kitty should have been put on insulin straight away with a BG of 520. If the vet wanted to try a change over of diet first, it is really really important to test for ketones while you are doing the change over to prevent DKA happening. If you are testing and ketones appear, then the insulin must be started straight away.
    Once a cat has had ketones he can be more prone to getting them again. Once you get him home it is really important that the ketones are monitored every day at least once a day. I’m glad you have Ketostix.
    Ketones form when there is not enough food, not enough insulin and then when there is an infection of inflammation then it can escalate into DKA very easily.

    It is not really that uncommon to hear that a cat has had a second bout of DKA especially if it has not been managed properly once the cat comes home the first time.......this is no reflection on the caregiver....rather the vet who has not given proper instructions as to what needs doing.

    So this is what you need to do once he gets home.
    • Keller needs 1 1/2 times as many calories as he normally gets. It is really important he eats well. Food is like a medicine to cats recovering from DKA.
    • Feed him before the shots and give him several smaller snacks during the day and night to make up that 1 1/2 times the normal amount.
    • If he is nauseated he will need an antinausea medication so ask your vet for some cerenia and ondansetron. Dont leave the hospital without them.
    • Test every day for ketones
    • It is really important that Keller gets his insulin. Not enough insulin is one of the things that can make ketones reappear.
    • If you are not home testing I would encourage you to start....I think you are doing it so thats good.
    • Set up a spreadsheet so we can see the data and keep it up to date.
    • Lantus likes consistency so the same dose morning and night is much better. If you are giving 1 unit in the morning and 2 at night you would be better giving 1.5 units for both doses. That is the same amount of insulin per day.
    • Encourage fluids.
    Once you get him home we can help you a lot. I doubt he is resistant to Lantus, but he is probably getting used to being in higher numbers now and needs to get used to lower ones again. He just needs to be managed better....again no reflection on you at all.
    The freestyle Libre has been used by a few people with varying success.
    Keller should recover fully from the DKA with the proper care. While he is still in hospital I would get organised for his return.
    Set up the SS, get food in for him.......low carb and some higher carb food in case you need it. Plenty of test strips.
    DKA happens because there is not enough food, not enough insulin and an infection or inflammation. It has nothing to do with allergies etc.
    Big hugs :bighug:
    You will be able to manage him once he gets home. He’s a lucky boy to have you.
    Keep asking questions and please keep us posted.
    We will be here for you.
    Bron
     
  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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  5. Dusty & Roe

    Dusty & Roe Member

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    Apr 28, 2020
    Hi Lauren and Keller my cat Dusty is wearing a Libre now the sensor is suppose to last 14 days hers needs to be replaced today so it lasted 9 days . The Vet puts it on yes they shave a spot and the sensor is like a white disc , it’s glued on with surgical glue .If Keller will wear a tee shirt at first that would be ok so not to try to remove it . Dusty removed her shirt and scratched herself up but then to my surprise was fine wearing it . Once it’s on when you want to know her levels you just pass the reader above it . If you upload it your Vet can access the chart . I’m still trying to get Dusty’s sugar level regulated so for me this is one less stressful step for her till I start home testing . Fell free to talk anytime Roe
     
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  6. Liang & Nathan

    Liang & Nathan Member

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    May 15, 2020
    May I know the cost (including vet's charge) of putting the sensor and the reader?
    Thank you.
     
  7. Dusty & Roe

    Dusty & Roe Member

    Joined:
    Apr 28, 2020
    Sure the reader was $64.99 the 14 day sensor was $38.70 the Vet charged $50 to set it up and put it on but the sensor lasted only 9 days some people get more days though . So now I have to buy a new sensor . I’m pretty sure GoodRx has coupons
     
  8. Liang & Nathan

    Liang & Nathan Member

    Joined:
    May 15, 2020
    Thank you for your reply. So will you put the new sensor on you own, or would you still need to go to vet's office to change the sensor?
     
  9. Dusty & Roe

    Dusty & Roe Member

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    Apr 28, 2020
    Ohhh I have a difficult Kitty that will fight me so yes the Vet will remove this one and put the new one on .
     
  10. Dusty & Roe

    Dusty & Roe Member

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    Apr 28, 2020
    Hey feel free to talk with me anytime I new to all of this and just learning but can at least let you know what I’m going through
     
  11. Liang & Nathan

    Liang & Nathan Member

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    May 15, 2020
    Thank you very much for the info.
     
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  12. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
  13. Lauren & Keller

    Lauren & Keller New Member

    Joined:
    May 16, 2020

    Hi Nan! Thank you so much for your reply.

    I picked up Keller today from the hospital at 5pm. He has his the freelibre sensor attached and was given Mirataz to stimulate his appetite and I will be delivered Cerenia tomorrow for nausea.

    While I'm happy he's home I am still a little worried about his condition. He seemed curious when getting home initially, feeling well enough to hang around us but increasingly became more lethargic and soon went to the place he likes to hide when he's not feeling well. When it came time to eat, he seemed interested enough to come check it out but took only a few bites before becoming disinterested. I called the hospital to see if I could give him the Mirataz that is next due tomorrow night to stimulate his appetite but was told to hold off and give him the 2U without a full meal since his sensor read HI throughout the night- anything above 500. I also checked his urine for ketones and they came back with a moderate amount. The hospital confirmed that he was sent home with trace amounts of ketones with the hopes that his eating would improve and they would clear themselves out. I don't think this was the case after his last hospital stay.

    I'm really hoping that the way he's acting at the moment is part exhaustion from the hospital and his anxiety and not a complete reversal of his condition. I'm thinking that he is prone to ketones and I really wish I had known just how delicate the time after DKA is and that he'd require extra food. I've been trying to be strict about keeping him on the 330 kkcals a day that was listed on his discharge paperwork.

    Looks like this will be another sleepless night but at least he's home!
     
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  14. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    I’m glad he is home.
    Continue to encourage food. It is so important. It is fine for him to eat whatever he wants. Dry is fine too. The important thing is he eats, especially with moderate ketones in the picture still.
    You may have to syringe feed him to get food into him. If he’s coming out and looking at the food and walking away that’s nausea.
    Why didn’t they give you cerenia to bring home?
    Did they happen to give him a cerenia shot before he left the vets?
    Also encourage fluids. Did they send you home with subQ fluids?

    Don’t skip the insulin dose with ketones in the picture. Do you have honey or karo if needed.?
    I’ll post a link to how to stimulate appetite although if he’s nauseated only antinausea meds will fix that.
     
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  15. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
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  16. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Do you have his spreadsheet done yet?
    If not I will ask @Chris & China (GA) to help you. I’m sure you have your hands really full looking after Keller but we really do need to see the SS to help you.
     
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  17. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    Hi Bron!

    Thanks for taking the time with your reply. I'm kicking myself for not coming on here as soon as he was out of the hospital the first time. I'm really thinking that I was not giving him the amount of food he needed after DKA but rather sticking to the twice a day feeding. Additionally, I don't think the 2U a day was enough for him and possibly the new addition of the 2U in the morning and 1U at night threw him off.

    I'm worried now that he's home and still a little disinterested in food but hoping that it can be helped with the anti-nausea medication coming tomorrow. I didn't have time to come on and see that you said to not leave with out it :(
     
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  18. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    Thanks for this - Just replied to you from before not seeing that you responded tonight. Still getting the hang of this. I'll read through now.
     
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  19. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    I don't yet - i'll look into starting one now.
     
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  20. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Concentrate on getting a Keller to eat tonight. Don’t worry about the SS until tomorrow. He’s more important.
     
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  21. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    Ok thank you - He went out a little bit ago and ate a couple bites but you're spot on with the nausea
    I will def get him his favorite foods tomorrow first thing. They told me the Cerenia is coming from a prescription service but he was given some before he left today. I'm not sure why it wasn't given considering they've always given me everything I needed when I walked out. They did not give me SubQ fluids. Is that something I can purchase on my own? How do you outfit the cats so it stays on them and can you do yourself? And I do have honey and Karo!
     
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  22. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    It only takes about 5 minutes to give the subQ fluids. I’ll post a link. You need to mark the bag with a texta with how much you give. It’s usually about 100 mls. It goes through quickly in about 5 minutes but need to ask the vet first if it’s ok for him to have them. They will help flush out the ketones. They will have the bag of fluids, the tubing and the needles there so get them from the vet.
    I hung the bag on a coat hanger over a door.
    While there ask the vet for some ondansetron for the nausea. It works on a different pathway to cerenia and can be given at the same time as cerenia.
    Keep offering lots of food.,. Anything he will eat.
    http://www.felinediabetes.com/FDMB/threads/how-to-give-subcutaneous-fluids-video.144366/
     
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  23. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    My iPhone keeps autocorrecting. If it doesn’t make sense refresh it.

    keep the insulin site away from the scruff which is where you give the fluids.
     
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  24. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    just watched the video. I'm going to call in the morning ask to pick the fluids and supplies up. He ate a little more dry food about 20 mins ago. I'll keep trying! Thanks so much again Bron - its feels so great know I'm not completely alone in this at moment!
     
  25. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    I’m very happy to help. I know how precious our kitties are to us.
    Did he get his insulin?
    You might like to post some of the BG numbers to give us an idea too.
    Chris probably won’t be on until tomorrow now to help with the SS as she lives in the US but that’s OK.
    Every little bit of food helps. How does he seem?
    Post any ketone test results too please.
     
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  26. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Lauren, how is Keller today?
     
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  27. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    Hi Bron,

    He's not great - honestly worse than when I took him in for his 1st DKA bout. Has hardly eaten anything today besides bites of Friskies kitten food that is his absolute favorite but bites at best. I finally got hold of my doctor around 2pm and she agreed that we should try SubQ fluids which I received around 4pm. I gave him 75ml around 5PM and he ended up throwing up what he had eaten and a lot of water around 5:30pm. The Cerenia just arrived about 20mins ago (8pm) and I gave .5ml to him immediately, which he ended up throwing up all of 3mins later. I then gave him .3ml little by little so he would hold it down. He hates any medication give orally and is prone to gag it up even when he's not sick. As of right now, he's keeping the medication down and I'm waiting for it to kick in to see if he's interested in food at all. He was also given his normal 2U dose this morning when his meter read in the 400's.

    He did experience a dip in BU after the threw up going down to 107 which I have never seen before but now the meter is reading 465. I did also put the fluids quite near the sensor could that have produced the low readings?

    He's extremely lethargic and now has a slight bit of drool happening after giving the Cerenia which he's never had before. Ketones moderate yesterday and have gone up to the second highest level on Stix. They confirmed he went home with a 2.7 ketone level The doctors are hoping we can get him back on the right track at home but it's looking like he's for another hospital stay.

    Here are his numbers from the last 24 (I promise to get a chart soon, just haven't had time to make)

    5/18/20

    8:50PM- HI above 500
    10:20PM- HI above 500

    5/19/20

    2AM - HI above 500 (2U Lantus - I work a 5pm - 2am news job)
    3AM - HI above 500
    3:40AM - 475
    4AM - 474
    4:30AM - HI above 500
    6:20 AM - 497
    12:40PM - 477
    1:50PM- 460 (2U of Lantus, ate some bites of Friskies)
    2:20PM - 467
    3PM - 437
    5:30PM- 425 (After SubQ Fluids and before throwing up)
    5:50PM- 129
    6:10PM - 121
    6:20PM - 104
    6:30PM - 107
    6:41PM - 148
    6:50PM - 188
    7PM - 221
    7:10PM- 236
    7:20PM - 274
    7:30PM- 302
    8PM - 373
    8:50PM - 435

    I have only given him 75ml of Fluids and it looks like it was mostly absorbed - should I be giving more?

    Thanks again for checking in
     
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  28. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    He doesn’t sound great does he?
    I am very concerned about you keeping hm home if he is not eating and the ketones have gone back up. That is getting dangerous.
    I think you should take him back to the hospital. It would be far safer for him.

    Then when you bring him home next time, if he is not eating, ask about a feeding tube. That is sometimes necessary with DKA kitties who can’t eat. They only need it for a week or two until they can start eating again. It can make all the difference to their recovery.
    And you will need cerenia and zofran (ondansetron) for the nausea. And you have the subQ fluids.
     
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  29. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Mar 19, 2016
    I agree... This:

    Is really really worrying-- not sure about the reading yesterday (there are different scales for ketone readings, on some 2.7 is fine, on others it might not be), but the Stix level definitely sounds like more than you want to have to deal with at home.

    If the meds kick in and he starts eating, great, but if not, I think Bron's suggestion of a feeding tube is excellent.

    Feel better soon, little guy!
     
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  30. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    I agree. I've spoken to the doctors a few times today as well as seeing them at the hospital and they want me to see if the Cerenia helps tonight and if he's not eating then I can bring him after I get off of work around 2:30am.

    Would you suggest any more fluids to get him through till then? I only gave him .3ml of Cerenia after he threw it up. Should I try to give him a little more?
     
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  31. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Mar 19, 2016
    I'd be nervous about giving more meds, even though he threw up the first batch (you never know how much stayed down), but see what others say, it may be OK with Cerenia.

    On the fluids, same. Usually we wouldn't give much more than the 75ml and it's not good to overload them, but if he was really dehydrated this may be special circumstances. Let's see if others who give fluids regularly have an opinion on this.

    Sorry I can't help much on these questions :(. I hope he starts eating soon.
     
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  32. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    how long since the SubQ fluids?
    What is the strength of the cerenia.
    I think you should ask the vets both those questions really just to be on the safe side.

    Are you working at home?
     
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  33. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    I am, working on some news shows throughout the night with my last being at 1am. I have off completely off now so want to be able to give him what I can.

    I don't have the stuff to make a liver shake but would you suggest making a shake out of some of the pate and water and seeing what I can get into him?
     
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  34. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    Gave SubQ at 5pmish and the Maopitant/Cerenia is 22MG/ML
     
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  35. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Yes you can try syringe feeding him with pate and water
    I live in Australia so telling me you gave fluids at 5 pm means nothing to me. ;)
    Did you ring the vet about giving more cerenia or subQ fluids?
     
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  36. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    Ah of course - sorry. 7am your time. Actually a couple of my shows are based out of Sydney hence the late hours for me!

    I rang but was told i'd get a call back.
     
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  37. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    Also, have started syringe feeding. I'm glad he can still be a little fractious when he's feeling ill at least not all of his energy is gone.
     
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  38. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    I’m glad you are getting some food into him. Keep doing that, little bits often.
    7 am was only 6 hours ago. I think that’s too soon to give moe fluids but let’s see what the vet says. Don’t give the Fluids near the Libre, it could effect the BG readings.
    Have you been able to test for ketones again?

    What are the shows you do in Sydney?
     
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  39. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    The Vet ok'd the 2nd 75ml of fluids since he seems so dehydrated and a 3ml more Cerenia.
     
  40. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    I gave the fluids further back this time - are there any side effects too watch out for if its too much fluid?

    I work for Bloomberg news and do the Market open in Sydney and then the rest of Asia! Working from home is something really new for me.
     
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  41. Patricia & Noodle

    Patricia & Noodle Well-Known Member

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    Jan 21, 2015
    I’ve always used Cerenia in pill form. Others may have more insight but maybe the liquid is hard for him to keep down?

    The vet could do a Cerenia shot as well to give him a boost if you being him back.

    Sending good thoughts to you and Keller!
     
  42. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    If the vet ok’d it, it should be ok. The main thing is that the cats heart is ok to take the fluids and the vet would have checked that.
    How is the syringe feeding going?

    Is the market open on Foxtel?
     
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  43. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    Syringe feeding is going. He really hates it and its hard stressing him out more. I think I've gotten maybe 30ml in him :/ He's keeping it down which is an improvement considering he threw everything up earlier but I was given the direction to give him 3U if he was well fed and 1.5 if he didn't eat. I've been able to get a little food in him so do you think 2U would be ok? His BU is 406 right now
     
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  44. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    What meter are you using?
    What dose have you been giving?
    Are you able to stay up and monitor him all night?
    Do you have any high carb food to feed him?
     
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  45. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    He's on the Free Libre meter and he's been getting 2U for the last week but the vet has said that it didnt seem to be enough for him. She's never prescribed 3U to him until today. I will definitely be up all night to monitor him and do have high carb food available, put getting it into him is the hard part.
     
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  46. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Can you blend some of the higher carb food with water and syringe it?
    If you think you can, then you could give a higher dose than 2 units. With ketones and DKA we sometimes give higher carb food do we can increase the insulin.

    what higher carb food do you have?
     
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  47. Lauren & Keller

    Lauren & Keller New Member

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    May 16, 2020
    We’re at the hospital now. Waiting to hear what his state is. Cannot believe we’re into our 3rd DKA hospital visit in a month
     
  48. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I’m very glad to hear you are at the hospital. That is the best place for him at the moment. Oh dear what a terrible time you have had. You must be very stressed and exhausted. :bighug:
    When he come home next time we will make sure it all works out and be organised for all eventualities.
    I hope they keep him in for at least a day. Ask about an injection of cerenia before he comes home so he has that aboard and make sure you have plenty of cerenia and zofran ( ondansetron) to bring home.. Also ask about a feeding tube if he won’t eat.
    Also ask them if they are testing the blood and checking the electrolytes and ketones. That is important with DKA
    Please keep us updated. We worry about our sick kitties. :bighug:
     
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  49. Lauren & Keller

    Lauren & Keller New Member

    Joined:
    May 16, 2020
    Just got a call from the doctor - Keller's definitely back in DKA and blood acid level is 4.7. His red blood cell count is also low and told me there is a chance that he may need a blood transfusion later today. Is this a semi common thing with diabetic cats? I'm so sad for my guy.
     
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  50. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Yes that blood is very acidic. I’m so glad you have him back in hospital. I don’t think he was ready to come home yesterday with those high ketones still.
    The low red blood cells may be from all the illness he has just had.
    I’ll ask @Marje and Gracie about that. She’s excellent with path results. Marje Keller back in hospital for third time with DKA and has low res blood cells. Only came home yesterday but back today as couldn’t eat and very lethargic.
     
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  51. Lauren & Keller

    Lauren & Keller New Member

    Joined:
    May 16, 2020
    Thanks Patricia! We'll take all the good thoughts we can get. When he leaves the hospital again i'll make sure he gets the shot. I really think not having the Cerenia last night was a major part of him going back into DKA :(
     
  52. Lauren & Keller

    Lauren & Keller New Member

    Joined:
    May 16, 2020
    I really do think he came home too soon. Last time there were no Ketones when he left but then they let him come home with "trace" but 2.7 does still seem pretty high. She also told me the blood count was just as low when he left and thats probably why he's feeling so lethargic. I'm just upset that he came home and now it seems we're back to where we were days ago and its probably a few more days without him and the cost of it all is something I'm still wrapping my mind around - sorry pure exhaustion is finally taking effect ahh :(
     
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  53. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I’m sure you feel exhausted mentally and physically at the moment.
    He’s in the best place for care at the moment. please keep us posted with every update you get.
    :bighug:
     
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  54. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Since they were the ones that released him too soon if they will adjust your bill accordingly?
    Sorry this just pisses me off.
     
  55. Lauren & Keller

    Lauren & Keller New Member

    Joined:
    May 16, 2020
    Keller is not doing well today. He's not taking the fluids well and is having trouble breathing. Also has the lowest PH level they've ever seen and all the staff that know say he's never looked so sick. They are now asking me to really think about humane euthanasia because of how chronic this seems to be and the state he is in now. I'm in disbelief that he could turn this quickly in 24 hours since him coming home from the hospital.
     
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  56. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Praying very hard for Keller. I am :(so sorry.
     
  57. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
  58. Patricia & Noodle

    Patricia & Noodle Well-Known Member

    Joined:
    Jan 21, 2015
    I'm so sorry, Laura. I wish I had more advice to offer, but sending you lots of love.
     
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  59. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I am so sorry Lauren. I do hope he can turn the corner soon. Vets often talk about euthanasia too soon so don’t give up hope yet. He is going to need time to let his body turn this around. Please keep us updated.
    :bighug::bighug::bighug:
     
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  60. Lauren & Keller

    Lauren & Keller New Member

    Joined:
    May 16, 2020
    Hi Everyone, I cant believe I'm typing these words through my sobs but we said goodbye to Keller this afternoon. They said he was most likely in Kidney failure, his breathing was growing deeper, and would also need a blood transfusion without knowing if he would ever come out of the state. I'll never know if it was the right thing to do.

    It's hard knowing that he just wasn't ready to come home from the hospital in the first place but I'm trying to focus on how he's just not in pain anymore. He was diagnosed just little over a month ago and I'm still in shock that my huge 16lb cat wasted away so fast. Thank you for all the love and support through everything and I just wish that we were both able to get to know and thrive better with this community.

    Wow this hurts.
     
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  61. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    :bighug::bighug::bighug:
    Oh Lauren, I am so sorry to hear this news. It is such a hard decision to make to release our kitties. It is the hardest thing to do but if he was deteriorating further and suffering you did the kindest and most loving thing you could for him.
    I know how much this hurts and I’m so sorry.
    Sometimes all the love and medical care in the world just can’t save them.

    He knew how much you loved him and fought for him.
    Fly free beautiful Keller and land softly at the rainbow bridge :rb_icon:cat_wings>o

    Take care of yourself Lauren as you mourn your beautiful boy:bighug:
    Bron
     
  62. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Oh Lauren, I am so sorry. This is so hard under any circumstances, but so much worse when there is any doubt. Just know that you did everything you could given the recommendations you were getting. DKA is really unpredictable and dangerous-- they can turn a corner and recover, or they can turn the other way and decline rapidly. It can happen so fast, and sometimes it just doesn't matter how much you do. So please, don't worry about whether it was the right decision. In the state he was in, it was, and the kindest thing you could do for him.
    He is pain-free now, but still with all your love. :rb_icon:

    :bighug: :bighug: :bighug: :bighug:
     
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  63. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Oh my gosh Lauren I am so sorry to read this. Your beautiful Keller sigh...
    Fly free big boy! Land ever so softly in moms heart forever:rb_icon:
    *Sniff* youre right, this is hard.:(
     
  64. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Lauren if you put GA in the subject line, that will let people know that Keller is now a guardian angel You can do this by Going into the subject line snd selecting the GA option in the left side of the subject line :bighug:
     
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  65. Patty & Teal'c

    Patty & Teal'c Member

    Joined:
    Nov 8, 2019
    So sorry for your loss.
     
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  66. Patricia & Noodle

    Patricia & Noodle Well-Known Member

    Joined:
    Jan 21, 2015
    So very sorry, Lauren. :bighug:
     
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  67. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Oh Lauren just seeing this my heart is breaking for you. I have no words, I'm so so sorry. Keller is not in pain anymore, such a cute boy. Fly high sweet Keller and watch over momma, please take care of yourself Lauren♥♥cat_wings>o
     
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  68. Lauren & Keller

    Lauren & Keller New Member

    Joined:
    May 16, 2020
    Hi Everyone, thank you so much for your kind words about my Kell. I'm having a really, really hard time. He was young and vibrant only a week ago and I'm definitely in the ”what if” stage of grief.

    He’s my first pet and cat love. So particular, handsome and curious. He took up so much space in my tiny apartment that it now feels so empty without him. I just always imagined he'd be with me for so much more.

    I started as his foster, his fourth in fact, and when he was adopted out after five months with me I was sad to see him go but happy for him. Unfortunately, the rescue didn't explain his particularness to the adopter and she returned him after he bit when she got too close too fast.
    They called me and said that after her and his hardships in previous houses that he had to be marked as unadoptable and would basically live at the shelter or have to be put down if I wasn't able to take him. I hated them for putting me in that place at that time but I’m so grateful that he made his way back to me now.

    Gaining his trust and love is one of, if not the, most rewarding experiences of my life. The first time he sat next to me on the couch was magic, the first time he slept next to me was pure joy. I miss his heavyness and his warmth, the way he made the floor boards creek when he walked, I miss his motorboat purrs and constant leg rubs as I walked.

    I know it's only day two but the grief and shock is so profound.

    I realize I should probably be writing this in the grief section but I wanted thank you all again and give you a little taste of the brave guy you tried to help.

    Thanks again. <3

    [​IMG]
    [​IMG]
     
  69. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    :bighug: Its ok we know. sniff:(
     

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