TIFIL DKA advice please

Re: TIFIL DKA

Isil, are you looking at the Glucose test colors on the bottle (which 500 would be an olive color)? or the Ketone test colors?

 

Re: TIFIL DKA

My package of ketostics says that after they have been opened, they expire in 6 months and you need fresh ones.

 

Re: TIFIL DKA

She just received these ketone test strips today, in the mail.

 

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I am searching for a emergency vet but I don't think I can find one.. there are two, one that we went before for dka, but they couldn't medicate her right, they didn't give insuline during the medication...
Second one is a clinic that killed my cat (after shaving her fur she died because of intestinal knot).

So I can't take tıfıl there

 

Re: TIFIL DKA

Yes the olive color...

 

Re: TIFIL DKA

Isil,
My Bayer Keto-Diastix bottle test both Glucose (test results from 0 to 2000) and Ketones (test results from 0 to 160).
I don't know if your's are the same as mine, but the only 500 on mine is for Glucose.

 

Re: TIFIL DKA

I've tested myself, I am ketone free...

 

Re: TIFIL DKA

I don't have any advice, but I'm sending all kinds of good thoughts, hugs and chin scratches for you and Tifil. (Well, the chin scratches are just for Tifil!)

 

Re: TIFIL DKA

I am really stupid, sorry for this...
let me write again;
The color is redish brownish, it is +++ and it stands to 80

sorry for my stupidness...

 

Re: TIFIL DKA

Isil:

Do you have Ketodiastix or Ketostix? Ketodiastix test both for urinary glucose AND ketones. Olive would be the color for glucose.

This is what the color coding for the Ketodiastix looks like:



If you are getting a "large" ketone reading, this is not a situation that you can manage at home. You need to get Tifil to an emergency vet.

 

Re: TIFIL DKA

I found a emergency vet, but he is looking if he has fluids with electrolytes...
Does tıfıl have to have fluids with electrolytes, as emergency can she have another iv flid, and which one?

 

Re: TIFIL DKA

I agree with Sienne.

 

Re: TIFIL DKA

He called, they have a iv fluid with electrolytes...please tell me? should we give this one or another serum that you suggest?

 

Re: TIFIL DKA

I honestly don't know. You need to let the vet assess Tifil. They need to check labs to see if her electrolyte values are abnormal.

 

Re: TIFIL DKA

I would leave it up to the vet, as I do not know. I think she needs 24 hour monitoring in a hospital, tonight.
I said the biggest prayer. I have a candle lit. I am sending vines and snowflakes for a good vet for her, tonight.

 

Re: TIFIL DKA

I'm glad you are getting her to a vet and getting fluids. Sending more prayers.

 

Re: TIFIL DKA

We're all praying for you and Tifil tonight...what a lucky girl little Tifil is to have you as her bean!

 

Re: TIFIL DKA

:YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG:

Ella & Rusty

 

Re: TIFIL DKA

I have bad news
The vet couldn't handle tıfıl, she was scratching and bitting very bad
He couldn't mannage to give the iv fluids, we are back home

 

Re: TIFIL DKA

Did the vet give you fluids for you to give at home or at least tell you what to do?

 

Re: TIFIL DKA

No, I wanted it but he told me to come back at 9 am, it is 4 am now

 

Re: TIFIL DKA

Sending a storm of prayers and positive thoughts your way, dear.

celi & binks

 

Re: TIFIL DKA

((((((isil & tifil)))))

oh what a terrible time you've had. i wish we had some way to help more - you were on my mind the entire day at work.

one more question - is Tifil the kind of cat to eat things laying around - rubber bands, strings, anything like that?

i hope you've been able to get a tiny bit of sleep. :YMHUG:

 

Re: TIFIL DKA

Işil, soon you will be taking Tıfıl to the vet. I know you are exhausted and worried, but please let us know what happens at the clinic and how Tıfıl is doing.

:YMHUG:

 

Re: TIFIL DKA

Sending you and Tifil lots of prayers and positive thoughts... :YMHUG:

 

Re: TIFIL DKA

Thinking of you and Tifil. Sending good vet vines and wishes for a successful visit and a proper dx and good treatment plan & solution for her so that she gets better fast!

Please keep up posted.

 

Re: TIFIL DKA

((((Isil)))) it does seem the problem is DKA, Vyktor had +++ 80 on the ketodiastix when he was hospitalised very very ill. I have looked up our bill to see what kind of fluids were given for Vyktor on the bill all it says is 'Intensive care - IV fluid therapy' so I don't think this helps you but in his records it says a little more, it says saline spiked with KCI. I don't know what this KCI means but maybe someone else on the board does. To me it is not clear about how much was given but again myabe someone else knows what this means, it says "started saline (spiked with KCI) and gave 3su sc. cont BG throughout the day". In fact I am not sure but the 3sc sc. may be referring to the insulin they gave him (which was 3 units of caninsulin) rather than the fluids they gave him.

Instead of an x-ray for Tifil perhaps an ultrasound is better to be able to see more.

I hope you find the vet that is not stupid and can help you today Vyktor and I have all our fingers and paws crossed for you.

 

Re: TIFIL DKA

Hi Isil

You are a wonderful friend to your cat -- I know you're very worried right now, but remember that you have been doing your best for her all along. Can you take her back to the vet school in the morning? I don't know the time difference. If your insulin dose is close to the time you will be at the hospital, I would NOT give the insulin for two reasons:
1) If your cat has a low potassium, insulin will make it lower.
2) The doctor at the vet school will see her glucose is very high, and with those ketones he will want to start a shorter-acting insulin. If she has her Lantus before she goes, it is stuck in her system and it may be dangerous to give other insulin. (She would go back on her Lantus before she leaves.) DKA is treated with fluids, but also with insulin.

Re: low potassium: Is your cat strong enough to hold up her own head? Is she not walking around because she feels bad, or is she too weak to stand up when she wants to? Is she making urine in the box or just right on herself as she lays there?

Also just to make clear, IV fluids are fluids that are attached to the vein. Fluids can also be put under the skin, then it is called SQ fluids. You can do SQ fluids at home but not IV fluids. To make it confusing, sometimes the same type of fluids can be given SQ or IV. All fluids given IV or SQ have electrolytes in them, otherwise they would just be sterile water (which can be harmful) and no one gives plain water.

When you go for your appointment tomorrow, bring your meter and ask to test it at the same time so you know if your meter is not right. Also, although you are getting a lot of information from us, you need to work with the professor for your cat, so I would let him do his examination and get the blood, and then talk about his plan for your kitty. If he says he wants to do [blah blah], ask what will [blah blah] show, how will you treat her for this or that, etc. I would not start off by saying "Here is what is wrong and here is what I want you to do." None of us can put our hands on your cat and do an exam, and none of us are qualified to prescribe medicine. So you need a partner to treat Tifil with you. From my experience, especially with male doctors, it is much better to ask, "Do you think there could be something wrong with her belly?" than to say " I want you to do [or why aren't you doing] x-rays of her belly to see what's wrong?"

These doctors may all be jerks, but they may also feel "questioned" rather than "asked" [mookiesmom can you translate that for us?] and that means that you will both get stuck in your position, and he will not listen. Does that make sense?

I have no idea where you are in your day, I hope this helps and I hope Tifil is getting the care she needs from those doctors. please keep us posted.

 

Re: TIFIL DKA

Hello,
Tıfıl is at the vet that I went last night (The 24 hours open one). There is a vet (not the one last night) taking care of her, she is having iv fluids with electrosytes...

She can hold her head up, it looks like she is weak to stand up because she changes rooms all the time (I think something is disturbing her inside) and she is going to her litter box to make her toilet. when she was first dka, she couldn't do these things...she was making her toilet where she was laying like you said..

But this time, she is better. I must say that she threw up all the food I force feeded her nast night.
She was very very angry at the vet, she scratched every single vet overthere and including me!
She is not eating but they will force feed her during the day...
For the hypokalaemia, tıfıl is weak, I can't say that she is so energic but not as bad as she was last time she was dka...
They wanted me to leave because the actual vet will be coming at 2pm and the time was 10 am when I left.
I will go back at 2pm....

By the way, I gave lantus before I read your post
she was 255 at +11...couldn't test amps because I was at the vet......I just shot without testing....


I understand what you mean about man vets...I must say that not only vet as a man, all the man in Turkey are just like you said...you have to know how to talk to them, the imperatives are not working on them, that's for sure....

I hope they are doing the right thing with tıfıl.....I am worried

 

Re: TIFIL DKA

Do they know that you gave her her Lantus this morning? They may not be familiar with the long acting insulin. I would remind them that her nadir will be around 12:00pm (or whatever time her nadir is) today. Your best guess.
I am wishing you the Best Of Luck and will be thinking about Tifil and you, all day. (((((Hugs))))))

 

Re: TIFIL DKA

Here's hoping Tifil is getting the care she needs at this vet and that you can develop a good working relationship with this vet.

Even here in the U.S. sometimes I have trouble with vets, sometimes you just have to let them think they are boss! Sometimes they are, but sometimes we know our cats better than they do.

Good luck with this new vet for both Tifil and you. Will be thinking of you and sending healing wishes all day. Please post when you can and keep us updated.

Desi

 

Re: TIFIL DKA

We're continuing to hold you in our thoughts today...

 

Re: TIFIL DKA

Sending prayers for good vets and regained health for Tifil. (((Isil)))....we're thinking of you and sending you many caring thoughts.

 

Re: TIFIL DKA

Praying for you guys!

 

Re: TIFIL DKA

Sending lots of healing vines and energy your way for you and Tifil. ((((Isil))))

 

Re: TIFIL DKA

Hello,
I am back home and I will go to the vet to shoot tıfıl after 2 hours...
The new vet is very good thanks good...he immediately did tests and he said that tıfıl is DKA...
the keton result was +++ just like I saw on ketostix....
He said that there is infection so he started antibiotics...

From all the results, all I can remember is her potassium leve
result was 2 and the reference values are between 3.5 and 5....

The vet is giving two different kinds of iv fluids, one is lactate ringer (I don't know the english name)
The other is an iv fluid with electrolytes (ı guess lactate ringer also has electrolytes)

The vet said that he won2t give extra potassium because he is afraid that too much potassium will efect her heart...what do you think, are the iv fluids enough for potassium?

 

Re: TIFIL DKA

I don't know the answer to your question, but I am glad the vet is very good.
More hugs to you, and prayers and healing vines are flowing to Tifil.

 

Re: TIFIL DKA

I don't have answers either, but I am so relieved that you were able to finally find a good vet for sweet Tifil. You are a strong fighter - you go, girl!!

 

Re: TIFIL DKA

Isil,
I can't answer your question because I don't know what the fluids contain. It sounds like your new vet understands what is happening with Tifil and is treating it. Too much potassium (and too little potassium) can cause muscle weakness, breathing and heart problems. That's why that value is very important.

I'm so thankful that you found this new vet!!! I worried about you both all night.

BIG HUGS!!!!

 

Re: TIFIL DKA

Sounds like this vet is on the right path thankgoodness! Get better Tifil cat_pet_icon

 

Re: TIFIL DKA

:YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: I am so relieved that this vet is working with you. Sending prayers and healing thoughts for Tifil. You two have been through so much. Is this a vet you can see regularly or ER only?

I don't know a lot about DKA, thankfully I have never had to deal w/ it. I do know that Lactated Ringers solution is often given to cats. Here is some of the info on what is in it from Wikipedia:

 

Re: TIFIL DKA

Thank you everyone for your beautiful support

Ann, this vet is only there in the mornings but there is a vet staying at nights...
This new vet told me that he is planning to give the iv fluids dring the day and he wants me to take tıfıl home during the nights except tonight...he said that tıfıl is a fearful cat and to stay at the vet for so long will make her feel worse...but he said he will decide IF tıfıl feels better tomorrow...
By the way he is giving w/d and recovery...I didn't care so much because it's important that she gets something in her stomach

Her lab glucose level was 298 at +5.5

 

Re: TIFIL DKA

I am ecstatic that you finally found what sounds like a decent, competent, caring vet! And so glad you said she is getting Recovery, is she eating it on her own? When Tawny would not eat a thing and b4 she had her e-tube Recovery was the ONLY thing she would eat and she practically inhaled that.

Tawny's potassium levels were lower than you say Tifil's are. She got the IVs too and eventually she got potassium supplement, but I let the vets decide when that was needed and later, when it wasn't any longer. Her potassium levels did normalize with the proper care at the hospital.

Tifil is very, very lucky to have you as her bean, Isil, and it is only because you have fought so hard for her that she is finally getting the care she needs. You go girl! You keep fighting for her and we'll be right here for you when you need us. You Rock!

Desi

P.S. I think REcovery is pretty high in carbs, if I remember correctly about 29%, as opposed to what we usually like to feed which is under I think 7-10%, (Tinkerbell & Tawny don't get anything over 8% and usually only 4-5%), but right now the most important thing is that Tifil eats. So let her eat. If I remember correctly, I think Recovery is high in calories, that should also help fight the ketones.

 

Re: TIFIL DKA

Işil,
Ben çok mutluyum! Şimdi Tıfıl tekrar İnşallah iyi bir sağlık olacaktır!

:YMHUG:

 

Re: TIFIL DKA

Cheers to finally finding a vet who can help you and Tifil! I'm hoping for a speedy recovery for her now!

 

Re: TIFIL DKA

I am back from the vet, I gave tıfıl insulin and she was 257 at PMPS...
But sorry to say that we have some problems...
first problem: Tıfıl is not getting iv fluids trough the night because they think that she had enough today. But there is another problem, my old vet couldn't go in the vein and all the liquid gathered under her armpit
so it means she got her iv fluids under her skin not in her vein, is this a big problem? they said they will open a vein tomorrow morning...

second problem: Tıfıl is biting and scratching every humun being except me, so the intern student staying tonight said that he can't force feed her and he can't check blood sugar tonight

 

Re: TIFIL DKA

I'm sorry this is so difficult for you! I can't offer advice on what to do, but someone will come along. Maybe if you put ADVICE PLEASE after DKA in your subject line people will know you have a new question.
hugs

 

Re: TIFIL DKA

Ok...thank you dear Randa...by the way I love your Turkish
öpüyorum kocaman

 

Re: TIFIL DKA

Not 100% sure about the fluids Isil but think it's probably not so bad because fluids are given under the skin sometimes anyway.

Is the vet near to you, can you go in to test her blood and feed her in the night, will they let you? Hopefully she is home for tonight anyway.

 

the vet is not close to my house but not so far away with car.
But it is 12 am here and I will be there at 8.30 am. I fed her at 11 pm...I hope she can survive untill the morning till I come....

 

I believe that Jess addressed this in one of her posts. Fluids can be given either IV (intravenous -- into the vein) or subcutaneously (sub-q; under the skin). When sub-q fluids are given, there is a big fluid bulge, usually under or around the armpit. As the fluids are needed, they are absorbed. It's fine. When people here administer fluids, they do so subcutaneously. The vast majority of people here do not know how to stick a needle into a vein.

If there is a student there, he or she should know how to make friends with a very stressed cat. You would think just sitting quietly with Tifil and talking to her, offering a treat, etc. might be a way to help her calm down with a new person.

 

((((((((((Isil and Tifil)))))))))) The Ringers lactate is often given under the skin by pet owners at home, so there is no problem. I think that it is just much faster to rehydrate a cat if given IV. Sub Q will still help her, but right now IV would be faster results.

My first cat Cleo (GA) had a bad rep at her vet. He called her the Beast! She would go crazy there, but was the friendliest cat outside the clinic. After we moved and Cleo was at the vet in ICU w/ no problems there. Then we had to be away for a weekend and boarded her at the vet, she went nuts again. it turns out it was being close to other cats there, when the separated her back to the ICU area even w/ dogs nearby she was fine! With Tifil it could be a combination of pain and upset at the different surroundings.

 

Isil,

I know w/Tawny, she was good and tolerated all kinds of handling but when they put her NG feeding tube in twice they had to be careful not to sedate her too much (or at all?) b/c her potassium levels were too low for sedation.

Depending on where Tifil is with all her other issues, can they give her s/thg to calm her down, or can they not b/c her potassium level or s/thg else? When they put Tawny's e-tube in they did not put her under completely but they only lightly sedated her, she was awake the whole time the vet said. In fact they had to wait a couple of days for her potassium levels to normalize b4 they could even do it.

Have they tried wrapping her in a towel kitty-burrito style? I have a cat that has a bad wound on his face that I am treating and I must wrap him up really tight in a towel and hold him down in order to tend to the wound and help him heal. Any other time he is a big Mommie's baby and just as sweet and mellow as he can be.

Maybe some of the experts here will come on and post about giving Tifil s/thg to calm her without putting her in danger.

I don't know if this is possible, it's just a query.

It's good you got her to eat. Do you think you can get her to eat a little bit every 2-3 hours until you go back to the vet's in the morning? Keeping calories in her will help fight the ketones. With Tawny's e-tube when she was DKA she had to be tube fed 20-30mls every 2-3 hours overnight.

 

Isil,

Sienne is right, here is what Jess (I think she works as a vet tech) posted about this earlier:

I don't know anything about this but from what the others have posted it looks like it's fine.

 

Isil, I admire you for being so persistent in getting care for Tifil. I hope this vet turns out to be one you'll be comfortable working with. You deserve to find a good vet partner who can help you help Tifil.

I actually think it seems like a good sign that Tifil is fighting the vets. If she were too weak or sick, she might not have the energy to scratch them. I remember when Lucy was DKA, the day she finally felt well enough to try to bite the vet and run away, the whole staff cheered. :lol: We never thought she would survive, let alone put up a fight. Keep up your strength - you are doing a great job.

 

Still praying for you and sweet Tifil...

celi & binks

 

thrilled beyond belief that you've found a good vet! that's such great news - and i hope more good news about Tifil is coming soon. many hugs, isil!

 

Merhaba Isil,

So glad to hear you feel good about the new vet. I hope he will be the one.
I agree with Libby - it may be a good sign that Tifil is fighting the vets!

Sending healing thoughts to Tifil and hoping for a speedy recovery. :YMHUG:

 

So happy to hear you have found this vet, Isil. Sending prayers that he will be able to make Tifil well again. Sending you hugs and prayers.

 

I agree with Libby too, Vyktor's file from his DKA admission says "increasingly cranky through the day indicating he is feeling better".

It is very hard to watch your baby when they are scared and angry like that but it is a good sign.

 

Hello
Today she got 150 ml of lactated ringer from the vein (at last). It's 2pm now and I came from the vet to my moms house (very close to the vet) to write the new news...
In the morning her amps was 247, +1.5 258, (fluids) +3 320
After I shot her I feeded her but she vomitted all of it so the vet gave her an injection for her stomach (He also gave it yesterday).

They tested her ketones in the morning and it is still +++
Is something going wrong,why didn't it reduce alittle

After tıfıl got the fluids I force feeded her, she didn't throw up but I don't know what happened after I came home...

I will go back and force feed her again...
I am planning to take her home tonight and take her to the vet in the morning.
The vet said maybe it is better for her to stay there but I told him that the intern vet who stays through the night isn't capable for testing bg's and force feeding...


So I know I have asked this before but I want to ask it again to be sure, while having a dka medication, how much fluid did your cats get for I day?
Somebody said 150ml, is this enough?
I mean, if tıfıl doesn't take the fluids during the night will it be bad for her because the vet is not giving her fluids through the night, even if she stays there, he doesn't think it is necessary...but I am confused and I want to be sure,,,how much iv fluids does she need per day?

 

Just bumping for your question...and still holding you in our thoughts!

 

Thinking of you and Tifil and sending you strength and healing energy to your sweet kitty. Good for her for fighting!
Liz

 

Hi Isil,
I can't answer your question about how much fluids should be given (but many of the people here have experience with fluids and they will certainly be able to answer). I want to tell you what a great advocate you are for Tifil and how happy I am that you have finally found a vet who will work with you. Sending many healing vines and many hugs to you and Tifil today,

Ella & Rusty

 

There isn't a specific daily amount. It depends on what your cat's needs are. This is why Jess stressed you need to have a vet who is seeing your cat and can make these kinds of assessments.

Also, if your are testing urinary ketones, it can take a while for the ketone levels to change. Unlike a blood ketone test, when testing via urine, the wastes need to collect and your cat's bladder has to fill. A blood ketone test will give you information about where the ketone level is at the moment whereas with urinary ketones it's a level over several hours.

Isil -- could you start a new thread. This one is getting very long.

 

Isil,

Two quick things: I agree w/Sienne about starting a new thread b/c this one has gotten so long. Just be sure to post a link to this thread at the top of your new thread so people can quickly find it and go back and look at it if need be. Do you know how to do this? PM me if you don't, or ask the board b/c I will be offline part of the day. I'm sure anyone here will be glad to help you w/that.

Also, on the "force feeding", you know by know that I have just gone thru s/thg similar w/Tawny. One thing I learned from Karrie (& Maverick) and from joining a Yahoo forum she recommended, the FAF group, is that if we think of this as "Assist Feeding" rather than "force feeding" it is easier on you and your cat. Make it a bonding time. Pet her, talk to her, make it a good experience, not a forced experience. In fact I believe "FAF" stands for "Feline Assisted Feeding". Try thinking of it that way, it may help, and if the vets and techs see that you have started calling it "assist" rather than "force" they might learn s/thg about "making friends" with cats.

Also I use a Precision Xtra meter to test blood ketones (BBK) on both my diabetic cats, Tinkerbell and Tawny. It is true that that will give you a better picture of what is "going on right now" as opposed to the urine ketones, which as Sienne said, have to collect in the bladder and may have been sitting there awhile. So the ketones may be clearing but w/out a BBK (beta blood ketone) test it is difficult to tell, b/c you don't know how long the urine has been sitting there, it could be registering what was going on w/Tifil 3 or 4 hours ago.

You are doing so great and Tifil is so lucky to have such a strong bean as you fighting for her. You keep on going girl!