GA Two DKA Episodes in one day, vet says too hard to regulate. HELP

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Rusty & Smokey

Rusty & Smokey

Member Since 2015
I'm gonna need you guys' help again. Smokey's having another hypoglycemic episode. We gave him about a teaspoon and a half of honey. Do we follow with his high carb Fancy Feast?
 
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How is he acting? Be careful not to feed him too much in case you need him to eat in a little bit because his number drops again.

Did you already give him insulin? What time and what was his last number before this? I know you guys just got back from the vet with the DKA episode, but don’t know if this was your first reading since then. What amount and when was the last the vet gave him?
 
Up to 48 now. Doesn't really wanna eat the HC food.

Stacy & Asia said:
How is he acting? Be careful not to feed him too much in case you need him to eat in a little bit because his number drops again.

Did you already give him insulin? What time and what was his last number before this? I know you guys just got back from the vet with the DKA episode, but don’t know if this was your first reading since then. What amount and when was the last the vet gave him?
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He did not get insulin. I don't know when he last ate. He had his isulin last at 8 AM.
 
Okay, do you have any food he likes? It doesn’t need to be HC as long as you can get honey in him if you need to. Just get him to eat some food if you can and give some more honey and test again in 20-30 until you get him over 50
 
Stacy & Asia said:
Okay, do you have any food he likes? It doesn’t need to be HC as long as you can get honey in him if you need to. Just get him to eat some food if you can and give some more honey and test again in 20-30 until you get him over 50
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His BG is now at 59, though he still doesn't want to eat. We're offering him Glycobalance kibble, two flavors of FF Gravy Lovers, and we've just offered him one of his FF Classic flavors.
 
It's a double edge sword here; the good news is that he hasn't had insulin since 8 am. The bad news is that with a recent DKA he needs some insulin but I am not too sure how much. Can your schedule be off if he comes up some and you shoot?
 
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Does he normally not like HC? I would like to see him eat something. As Stacy said you don't want him to eat a lot and get too full, in case the honey wears off suddenly you may need to get him to eat later. He may just be exhausted from all the days at the vet.
 
I also wouldn’t want to skip insulin but not knowing what his readings were at the vet, I think obviously .5 for right now is too much.

Are you able to syringe feed him if needed?
 
Dyana said:
Does he normally not like HC? I would like to see him eat something. As Stacy said you don't want him to eat a lot and get too full, in case the honey wears off suddenly you may need to get him to eat later. He may just be exhausted from all the days at the vet.
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We have never given him the HC food before. He doesn't even want his treats or his FF. BG is now at 86.
 
I'm glad he's going up.
Can you call the vet and see it they have any BG test data from today? Does he seem interested at all in the food, and then lick his lips or turn away?
 
Dyana said:
I'm glad he's going up.
Can you call the vet and see it they have any BG test data from today? Does he seem interested at all in the food, and then lick his lips or turn away?
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Will do. And yes, he seems interested, but then turns his head away. He had Cerenia at noon today.
 
Sometimes cats need Ondansetron and/or Cerenia for nausea. You wouldn't happen to have any Ondansetron would you? How is his hydration, has he been drinking?
 
Dyana said:
Sometimes cats need Ondansetron and/or Cerenia for nausea. You wouldn't happen to have any Ondansetron would you? How is his hydration, has he been drinking?
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He had Cerenia at noon, and we have some tablets that the vet gave us. He was in his pumpkin since we got home.
 
How far off schedule can you be? Can you let him be for a bit, let him settle a little, keep testing, and give his shot when he is a bit higher and staying up? I'm thinking if he comes up over 100, maybe you can give him 1/4 unit to get some insulin in him. You may need to keep testing for a while.
Let's see what opinions you get from others.
 
Just make sure you keep testing him for a bit. Usually after 2 hours post honey/HC you can relax a bit, but if it wears off and he hasn’t been eating much, it can go back down again. Also, without data from what happened today and his recent hospitalization, I would monitor him throughout the night if can set alarms every couple hours or something. Also, if you are skipping, be sure to test for ketones and try to keep him eating and drinking.
 
I agree with Dyana that if he comes up a bit to shoot, it is much better to have insulin on board with the DKA history and very recent episode. That being said, you have little more than preshot data on your SS. I would not give any insulin if you can not monitor him and test frequently.
 
Rusty & Smokey said:
They are Maropitant/Cerenia.
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Okay, that’s something you only want to give every 24 hours. Perhaps your vet can prescribe some onda, it’s a different anti nausea medication. I have to run out for a couple of hours but will be back to check up after that. The 911 should get attention if anything comes up.
 
I'm glad he ate well this morning. I am hoping he just needs some time to adjust to being back home.
Are you able to stay up or set alarms to keep testing on and off tonight?
I am going to have to sign off, but there are others around to help you. Just keep posting the updates and any questions you have.
When you called the vet, did you mention he isn't eating? Maybe they will give you some appetite stimulant like Cyproheptadine or Mirtzapine?
I will check in on you in the morning. My kitty was a DKA survivor, so I know how good it is to get them home. J.D. came home with a feeding tube. That lasted all of 1 day, before he pulled it out and started eating on his own. I wish you the same luck with Smokey, that he is soon eating and feeling much better.
 
Dyana said:
How far off schedule can you be? Can you let him be for a bit, let him settle a little, keep testing, and give his shot when he is a bit higher and staying up? I'm thinking if he comes up over 100, maybe you can give him 1/4 unit to get some insulin in him. You may need to keep testing for a while.
Let's see what opinions you get from others.
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He got his insulin at 8:40 this morning at the vet's. I'm not sure how to measure a quarter unit, despite reading everything on here about dosing.
 
Dyana said:
I'm glad he ate well this morning. I am hoping he just needs some time to adjust to being back home.
Are you able to stay up or set alarms to keep testing on and off tonight?
I am going to have to sign off, but there are others around to help you. Just keep posting the updates and any questions you have.
When you called the vet, did you mention he isn't eating? Maybe they will give you some appetite stimulant like Cyproheptadine or Mirtzapine?
I will check in on you in the morning. My kitty was a DKA survivor, so I know how good it is to get them home. J.D. came home with a feeding tube. That lasted all of 1 day, before he pulled it out and started eating on his own. I wish you the same luck with Smokey, that he is soon eating and feeling much better.
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We did, and they of course said to bring him into the ER.
 
That's good. I would test some more, and if he keeps going up, give him some insulin. Are you going to be able to give him his insulin 12 hours after you give him his insulin tonight?
This is what 1/4 unit looks like. The picture can be found in the yellow Stickeys at the top of the page.
025unit-1.jpg
 
Dyana said:
That's good. I would test some more, and if he keeps going up, give him some insulin. Are you going to be able to give him his insulin 12 hours after you give him his insulin tonight?
This is what 1/4 unit looks like. The picture can be found in the yellow Stickeys at the top of the page.
025unit-1.jpg
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Our syringes don't let us do that. The zero is like... at a weird position.
 
We're gonna bring him in. His belly feels hard and he keeps loafing. I'm hoping it's just gas like it was the other day, and from his pancreatitis.
 
Take your test kit and some honey either you. You don't want his numbers going down again when the honey wears off.

Good luck and keep us posted.:bighug:
 
We took him. It appears to be nothing too serious. Just that his pancreas is still very angry! The doctor gave us the choice of bringing him home and monitoring him, or hospitalizing him just overnight. We decided to have him stay, just to make extra sure everything checks out. The doctor was really nice, and he didn't seem too concerned about Smokey. He's just gotta get through this nasty flare up!
 
I’m sorry you had to take him back in, but it’s better than him suffering and you worrying all night and not being able to do much about it. I hope he’s feeling better soon and eating for you. :bighug:
 
Sending vines for Smokey to be feeling much better and eating better for you, today. :bighug:
 
Is he getting anything for pain?

I will give you a couple of things I do..

Free feed (leave a bowl with food he has access to all the time), in fact, I leave about 3 scattered around his "areas." I also spoon a bit of water on top to keep it moist (and it is getting more fluids into him as he eats).
Keep regular schedule with the Cerenia, Ondan and pain meds. Even after Gizmo seems better, I continue for about 5-7 days (especially the Cerenia).
Canna - I am not sure what this does for the pain but it definitely helps. It also stimulates the appy. It seems to relax him and make him more comfortable.
Slippery Elm Bark or Marshmallow root slurry - this can be difficult because no meds can be given 2 hours before or after meds. It coats the lining of the GI system and seems to easy the nausea and discomfort. I give Gizmo MMR slurry every AM/PM on a regular basis (every day).
Hills RX a/d food. It is about 6% carb but it is the only thing that Gizmo will even consider eating when he rejects all else. You have to get it from the vet or get an prescription for it.
Test for Ketones regularly - if you don't have a blood meter, seriously consider getting one. With the lack of fluid intake getting the pee tests can be a challenge (and Gizmo would never have let me get a sample anyway) - silly cat, likes his privacy.

Pancreatitis is a rough go. Gizmo has been hospitalized 3x for it but now we can manage (for the most part) at home. He will go to the vet if he needed a prescription refill or fluids (but now I am set up to give fluids at home).

Eating may be a slow-go but just keep it available, it will slowly pick back up (I know that isn't ideal with insulin on board).

:bighug::bighug::cat:

Get to feeling better Smokey :cat:
 
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Im glad that the vet got you an answer and I hope he is feeling better when you get him! My cats have never had pancreatitis, but I've seen what it does to plenty kitties here. Lizzie gave some excellent advice. The three prescription meds are key - and def insist on some kind of pain med. Pancreatitis is painful but some vets don't realize it. :mad:

Sending healing vines!
 
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