Cassie's home! (DKA)

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bookw0rm

bookw0rm

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Hello. My youngest, Cassie (11) was diagnosed diabetic about 10 days ago. I didn't panic, although I worried about money and making sure I'd be around for meds. Cass was put on 1 unit of ProZinc daily. He ate his prescription canned food reasonably well (of course his.brother Benny likes it better) and didn't seem to mind his shot. He had lost about 5 pounds in a month-6 weeks.

Last night he wouldn't eat. This morning he wouldn't eat and was vomitting. He seemed lerhargic and disoriented. I assumed low blood sugar, gave him honey and called the vet. They said to bring him in in the morning. He still wouldn't eat or drink and was not responsive.

I finally paniced and called the vet again. BS 450+, temperature, dehydrated. Lost another pound in 10 days. Turns out he has ketoacidosis (sp?). He's at the vet for IVs, etc. I worry because they didn't check before even though he'd lost so much weight and I didn't know to ask. I asked about home monitoring but they say I have to use a special meter and tell me it's not necessary.

I guess I'm just feeling overwhelmed. It helps to tell someone even if it's some message board I haven't frequented before. I hope the vet has a clue-this is a new vet for us and I saw a different doctor since this was a last minute appointment.
 
Re: New diagnosis & ketoacidosis

Hi there and welcome

I'm sorry that you are going through this; the diabetes diagnosis is tough enough, let alone ketoacidosis. I won't lie, DKA is tough and some cats don't make it, but with proper care they can, and go on to live good lives. I don't have my bookmarks on this computer but others should. Its important to ensure fluids, that electrolyte balances are corrected, that short acting insulin is given if electrolytes aren't too wacky, food fed or assisted fed, etc. Take a shirt in that smells like you so that there is something familiar, and let us know how things go

Jen
 
Re: New diagnosis & ketoacidosis

Hi, I'm still new to this board myself, and have been more than impressed with all the knowledge that can be found here. You might want to look at the thread DKA/FHL/Etube It's looking up! There is so much information on that thread that can help you understand what is going on with your sweet sugarcat.

I hope that lots of others come and help you out. As I said, I'm still new here. (Though the amount of vets that don't give the right advice is really alarming me.) You will get the right info here.

You are in our thoughts and prayers,
Theresa and Christian
 
Re: New diagnosis & ketoacidosis

Welcome to the one place you never wanted to be but the best place to help you. Cats need insulin 2x a day, once a day isn't enough, when he comes home you will need to talk to your vet about that.

My cat has survived DKA 4x and it can be done, our prayers are with you.

Nancy and Payne
 
Re: New diagnosis & ketoacidosis

Dear Cassie's Mom,
First please tell us your name?
We are a family of diabetic cat parents and I must tell you....99% of our kitties live in excellent health and we have found ways to make this process all sooooo doable and inexpensive.
I read your post so quickly...do you hometest your Cassie yet?
If not, may I send you a kit to get you started.
check out the link below on my signature...Newbie Kits.
Lori
and Tomtom
 
Re: New diagnosis & ketoacidosis

Cassie's Mom,
I felt like I was reading my own story when I read your first post. My guy Bob was also 11, diagnosed with diabetes, and spent three days at the vet early on with DKA. He also was prescribed PZI although his initial dose was 1 unit twice a day.
I can only offer you this hope - that was the first week of May 2011. With home-testing, a diet change to low-carb all canned food, lots of attention and regular insulin doses, and sub-q fluids treatments done at home (after that 3 days stay at the vets), Bob received his last insulin shot on July 19th and is now in remission.
While the details of your situation may be different, and of course Every Cat Is Different, there is reason to hope and believe that you could be saying the same thing in a couple months.

Now that you have found this amazing site, you are going to learn so much, and become so skilled at dealing with the problems that poor Cassie is having. There is a ton of information here, and lots and lots of terrific people who are always willing to help in any way they can.

Please keep us updated on Cassie, and what you find out from the vet. If possible, ask for a copy of her lab results to take home. The data in that report, while it might be confusing, will be a great tool that you can use to understand what exactly is going on with your sugarkitty. If you have questions, concerns, or just need to vent, there are plenty of "ears" here to listen and offer advice, reassurance and understanding no matter what the issue is.

Carl in SC
 
Re: New diagnosis & ketoacidosis

Hi bookworm and Cassie

Simba had DKA once and survived it. It is the electrolytes and when the blood pH-level gets disrupted at high blood sugar levels. With the right and tender care at the vets (see violet and Garlands DKA thread) it can be reversed.


Conserning the home testing, that is something you really should do, both with urine dip strips, and with human blood glucose meter.


But lets get Cassie out of the DKA and well and home again before we burden you with that.
 
Re: New diagnosis & ketoacidosis

Lisa & Cassie:
Welcome to the boards! This site and the message boards are a wealth of info on cat health! Like Carl, I was able to get my cat into diabetes remission in about a month (except we were on Lantus). Within aobut 3 days of starting the insulin I was home testing (it was Easter weekend, and the Wal-Mart pharmacy was closed on Easter, the day I went to get the Relion micro meter I bought, the strips are sold at the pharmacy counter but the meter is not - so I had a meter with no strips until Tuesday!), as it is very imoprtant to see what Cedric's blood glucose levels were. I still test him (log book is at home near his supplies) although my spreadsheet below needs to be updated. He currently stays in the 60s range.

You'll get through it! thoughts and prayers are with you.
 
Re: New diagnosis & ketoacidosis

Just talked to the vet. Cassie's BS is down to 117 but he's still not eating and still acts like he's feeling bad. Still a wait & see situation. More info this afternoon.

Thanks for the support so far. I'll keep you posted.
 

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Re: New diagnosis & ketoacidosis

My cat, Kitty, is a DKA survivor. She went into DKA 3 weeks after her dx for diabetes. She spent 4 days and nights in the ER on IV fluids --but, she survived!

Five months later she is waking me up to head butts and playing every day.

Don't give up ....DKA is a tough opponent--but, your kitty can survive.


Kim and Kitty
 
Re: New diagnosis & ketoacidosis

Dearest Lisa,
You will want to be kit ready when Cassie comes home.
It is free. Thank you to the members of FDMB. I can send you a meter, strips, a rice sock (to warm the ear) keto stix (to check for ketones) and at least 2 fabulous toys to greet your baby back home.
Please be ready....
The Newbie Kits Link is below....I just want you to have it ok.
Lori
 
Re: New diagnosis & ketoacidosis

Update on Cassie: Not so good. His BS is down, but it looks like the Ketones in his urine are up. He's still not eating, although they have done some force feeding. He's still not responding. This vet does not have 24-hour monitoring capabilities and I don't think there are any nearby (closest is over an hour, I think). The vet is worried that he needs more intensive care than they can offer and is afraid there's something else wrong. They tried to get me to make a decision tonight but I couldn't. I'm going to go in in the morning and discuss options but it's not looking good. I don't know what I"m going to do.

Lori & Tom: I'm diabetic myself, so I have everything but the ketosticks, thanks.
 
Re: New diagnosis & ketoacidosis

I've decided to try to talk the vet into waiting until Mon. before making any big decisions. From.what I've read it's not been long enough to decide he's not improving. My concern at this point is how much they can (or are willing to do) over the weekend.

Prayers and best wishes gladly accepted. Benny is being extra cuddly-we both miss Cassie right now.
 
Re: New diagnosis & ketoacidosis

Cassie is one handsome kitty. Is there any way you can get him to a 24 hr. ER? All his electrolytes need to be monitored and supplemented when needed to pull through DKA. He may also need a feeding tube, an E tube, but to pull him through a regular hours vet cannot do it. Even if it is an hour's drive, that could make all the difference in the world as far as his care and pulling him through this. Mishka also has survived, several bouts of DKA, but she was always monitored 24/7. Sending many prayers for your gorgeous baby.
 
Re: New diagnosis & ketoacidosis

bookw0rm said:
Update on Cassie: Not so good. His BS is down, but it looks like the Ketones in his urine are up. He's still not eating, although they have done some force feeding. He's still not responding. This vet does not have 24-hour monitoring capabilities and I don't think there are any nearby (closest is over an hour, I think). The vet is worried that he needs more intensive care than they can offer and is afraid there's something else wrong. They tried to get me to make a decision tonight but I couldn't. I'm going to go in in the morning and discuss options but it's not looking good. I don't know what I"m going to do.

Lori & Tom: I'm diabetic myself, so I have everything but the ketosticks, thanks.
Click to expand...


Did they describe what they are doing for her? I'm assuming they are giving her fluids? Hope is right, they probably don't have the capibility to treat her there, and if there's anyway you can possibly do it, you should look at transfering her to a 24 hour place that can give her the treatments she'll need. Bob spent 3 days getting treated for DKA in May and pulled through, but also needed home fluids a couple times a week since then to get his electrolytes back to normal ranges. She can probably pull through too, but it'll need to be at a place where they can perform the treatments.

Healing thoughts are on the way from SC

Carl
 
Re: New diagnosis & ketoacidosis

carlinsc said:
She can probably pull through too, but it'll need to be at a place where they can perform the treatments.
Carl
Click to expand...

That's one of the things I'm going to ask about tomorrow. I don't want to give up too soon and I need to find out what the options are. Thanks.
 
Re: New diagnosis & ketoacidosis

Update: Cassie is doing better. He's more alert & is starting to fight when force-fed. Had a good visit this morning. Will see how he does over theweekend but I'm feeling better.
 
Re: New diagnosis & ketoacidosis

That is excellent to hear! Paws crossed in prayer, human hands as well!
Do they have an attendent there for the weekend?
 
Re: New diagnosis & ketoacidosis

Awesome news! And I apologize for referring to "him" as a "she"!
carl
 
Re: New diagnosis & ketoacidosis

HI! Your thread caught my eye... I know exactly how your feel. My cat Garland had/has DKA. She has spent the last 7 days in ICU and I was finally able to bring her home today. My story is the "DKA/FHL/ETUBE" thread. Its heartbreaking when they are sick like this

The people here are amazing and will hold your hand every step of the way. They have become my 2nd family this week.

Having just gone through this, i know my big thing is wishing I had the feeding tube put in earlier. She got the FHL because she wasnt eating for a few days.So make sure to be active on asking about eating.

I am praying for you and your kitty. Keep us updated!
 
Re: New diagnosis & ketoacidosis

Thanks everyone.

Carl: no prob. We thought he was a girl at first so Cassandra became Cassidy, Cassie for.short. We've gotten used to people thinking he's a girl (he was cute in a hot pink collar).

Theresa: there will be people in & out. No 24 monitoring but they can maintain the same level of care he's been getting. They've been successful force feeding so I don't think a tube is needed (checking for FHL).

Violwt: saw your thread; that's part of why I wantwd to give him more time last night when things weren't looking good. I'm glad Garland is better.

I don't expect updates until Mon. unless there's a problem, but I'll update when I hear something.
 
Re: New diagnosis & ketoacidosis

Mixed news of Cass cat. He's actually eating a little on his own, but has also been vomiting over the weekend. His BS is low (160s) and the ketone level is going down. No temp, and no sign of liver problems. Still largely unresponsive. No info on the urine culture they sent off Thurs. So it's still a wait and see game.

Vet said she wants to see him eating reliablybefore he comes home. She's worried about the vomiting and is afraid something else is wrong. So we're still in limbo.

We miss our Cassie.
 

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Re: New diagnosis & ketoacidosis

bookw0rm said:
Thanks everyone.

Carl: no prob. We thought he was a girl at first so Cassandra became Cassidy, Cassie for.short. We've gotten used to people thinking he's a girl (he was cute in a hot pink collar).
Click to expand...

As funny as that sounds, that has happened to our family too. My sister adopted a long haired white & marmalade cat that she named "Rosie." a short time later, to the vet she went where it was discovered she was a he and was promptly renamed "simba." He was the first boy cat that my dad adopted after having 2 females. Simba was long hairs, so it was hard to tell unless you looked...

:lol:
 
Re: New diagnosis & ketoacidosis

Cass cat was referred to the "local" (1.5 hours away) reaching after an overnight BS crash that left him comatose this morning. Despite all this he ate a little this morning. They're goin to keep him a couple days & run some tests. We did learn he has a heart murmur. I'm still hopeful we can figure out what's going on. Local vet did fine but doesn't have the resources needed. Wish they'd offered to send him sooner!
 
Re: New diagnosis & ketoacidosis

Prayers coming for Cassie that pulls through this. He should not have been found comatose this a.m...don't they check before shooting insulin and closing up for the night? FWIW, not all vet clinics will "send" a pet somewhere else.........they think more in terms of money they might lose if they send the animal to a 24/7 facility or a specialist. You really have to take the bull by the horns and decide for them and take your pet out of one place and go to another.
 
New Vet for Cassie (Ketoacidosis)

Update on Cassie: (changed topic)

As of this morning, Cassie was doing better. After another BS crash at the new vet, I was told he perked up after some glucose and was looking more alert. His BS was in the 200-300 range overnight (check every 2 hours) without any insulin. He did eat last night, but not this morning. An abdominal ultrasound found no problems. They're going to do some bloodwork today to check electrolytes, etc., and they're also planning a chest X-ray to see what kind of heart problems he has (they found a heart murmur that no one else had ever noticed). They said he was a little more alert this morning. He's still dehydrated, so he's getting fluids.

I'm a little more optimistic at this point. We've ruled out a bunch a potential problems with the ultrasound, and he's being monitored every 2-3 hours so he shouldn't crash again. He apparently crashed at the old vet over the weekend, too, but no one told me until he did it again Tuesday morning.

Still hoping for good news, and waiting. confused_cat

(BTW, how do I change the thread title? I though changing my subject would do it, but apparently not.)
 
Re: New diagnosis & ketoacidosis

Glad to hear things are looking up for Cassie.

To change your header title, you need to go back to your first post, click edit and then change it there. Then it will show up on the board with the new title.

Mel, Maxwell, Musette & The Fur Gang
 
Re: New diagnosis & ketoacidosis

bookw0rm said:
Mixed news of Cass cat. He's actually eating a little on his own, but has also been vomiting over the weekend. His BS is low (160s) and the ketone level is going down. No temp, and no sign of liver problems. Still largely unresponsive. No info on the urine culture they sent off Thurs. So it's still a wait and see game.

Vet said she wants to see him eating reliablybefore he comes home. She's worried about the vomiting and is afraid something else is wrong. So we're still in limbo.
Click to expand...

Did the old vet ever get this urine culture back?
 
Re: New diagnosis & ketoacidosis

No evening report today; I hope that means nothing but good news in the morning. Last I heard about the urine culture was that they found something but hadn't ID'd it yet-that was yesterday morning.
 
Re: New diagnosis & ketoacidosis

bookw0rm said:
No evening report today; I hope that means nothing but good news in the morning. Last I heard about the urine culture was that they found something but hadn't ID'd it yet-that was yesterday morning.
Click to expand...

I would think they would have gotten that back by now. Can you call them and make sure they are passing that info onto the ER vet?

Sending hugs and prayers for both you and your Cassie. :(
 
Re: New vet for Cassie (ketoacidosis)

Update: Cassie is starting to eat better (they finally gave him an option of some dry food), and they're considering an appetite stimulant. They've stated him back on 1 unit of PZI (don't know if this is once or twice a day). He's running another fever. Chest X-ray didn't show any problems. They're still trying to determine if there's anything else wrong besides the diabetes. Nothing in the urine sample; still waiting for results from the urine culture. I've asked the old vet (again) to forward info ASAP. They said he's much more alert and is soliciting extra attention when petted ( :smile: ). They're trying to get his BS and dosage stabilized at this point, but it's looking good.
 
Re: New vet for Cassie (ketoacidosis)

Great news!
Stay on that old vet's backside about forwarding the info...

Keep us posted,
Carl in SC
 
Re: New vet for Cassie (ketoacidosis)

I haven't read your entire thread, but have kept up with your situation some.

I just want to comment where you said...you weren't sure if your cat was getting 1 unit of Prozinc once a day or twice a day.

My cat, Kitty, was started on Prozinc 2 units once a day (sid) in Feb. I posted daily in the PZI ISG and was continually advised to give the Prozinc twice a day..even if I split the dose and gave 1 unit and 1 unit. But, my vet continued to tell me once a day was enough. Unfortunately, I listened to the vet instead of the members of the board. Kitty went into DKA 3 weeks after being dx with FD.

Please find out if your cat is getting insulin twice a day. Prozinc does not last longer than 12 hours in the cat's body. And, it can be argued that Prozinc's duration is less than 12 hours. Your Kitty needs insulin twice a day.

I learned from my mistake, at Kitty's expense. But, I promised myself that I would pay it forward and speak out anytime I saw a cat getting once a day (sid) dosing of Prozinc.

Prozinc needs to be given twice a day.

The DKA landed Kitty in the vet for 4 days and nights---and I wasn't sure she would survive.

Please don't make the mistake that I did.

Kim
 
Re: New vet for Cassie (ketoacidosis)

Potentially good news: Cassie ate really well last night, probably due to an appetite stimulant. He's being very affectionate today. They're going to monitor him overnight, and he may (all appendages crossed) get to come home tomorrow afternoon. :-D

The urine culture proved positive for some type of Staph infection, but it's atypical. They're putting him on a broad-spectrum antibiotic, possibly long-term, and are following up to see why the culture is weird. He's showing signs of an intermittent fever, so there's something going on.

Kim: When I said I wasn't sure how often he was getting insulin, it was because it didn't register. I'm assuming twice a day, but I'll confirm with the vet--and if necessary, I'll figure out how to adjust his dose on my own. I'm also planning to have them show me how to home monitor his BS. It sounds like he's going to be tricky to regulate, so I suspect he may be on a sliding insulin scale of some sort. Lots of questions for the the vet when he comes home. She made sure to point out that he's not "cured" (which I knew) but that he was probably stable enough to come home.
 
Re: New vet for Cassie (ketoacidosis)

bookw0rm said:
Potentially good news: Cassie ate really well last night, probably due to an appetite stimulant. He's being very affectionate today. They're going to monitor him overnight, and he may (all appendages crossed) get to come home tomorrow afternoon. :-D

The urine culture proved positive for some type of Staph infection, but it's atypical. They're putting him on a broad-spectrum antibiotic, possibly long-term, and are following up to see why the culture is weird. He's showing signs of an intermittent fever, so there's something going on.

Kim: When I said I wasn't sure how often he was getting insulin, it was because it didn't register. I'm assuming twice a day, but I'll confirm with the vet--and if necessary, I'll figure out how to adjust his dose on my own. I'm also planning to have them show me how to home monitor his BS. It sounds like he's going to be tricky to regulate, so I suspect he may be on a sliding insulin scale of some sort. Lots of questions for the the vet when he comes home. She made sure to point out that he's not "cured" (which I knew) but that he was probably stable enough to come home.
Click to expand...

Oh good, so glad to hear he is doing better Lisa. :)

A couple of things you can do while you are waiting to bring him home, is to set up a Profile and a Spreadsheet. This is not mandatory, it just helps people to help you better if you are going to be posting for further help in the future with dosing, health concerns, etc. The instructions are in the Tech Forum:

Tech Form

Here are also some helpful links on how to hometest:

Hometesting Links and Tips

I hope they are able to nail down that infection soon. Did they say what antibiotic he was put on? Be sure to get copies of all his medical records from the Er vet when you pick him up. I am sure he is going to be so happy to come home! :)

Keep us posted, okay?
 
Cassie's home
cat_pet_icon
He's on 1.5 u bid of PZI, clavamox, & mirtazapine. He looks happy to be home, is eating (some), drinking, purring, and preening. He's very affectionate right now.

If he eats okay, he doesn't have to go back to the vet for a week. I tried to check his BS, but couldn't get any blood. He was very good at letting me manhandle him. We'll try again tomorrow morning with the new rice sock I made.

I'll work on his spreadsheet & profile soon; I'm also trying to move back into my office at work and get ready for classes next week. My only internet @ home is my phone, which works fine for FDMB & email but not so great for anything complicated.
 
Witha little coaxing, Cass ate well this.morning. Amps 470; rice sock helped tremendously. Then, of course, I was so excited he was eating I managed a fur shot :oops:

I've been trying to upload a pic but my phone's not cooperating.
 
Yeah for eating. Furshots happen. But it can be a problem for Cassie, coming off DKA. What was his BG level this morning?

It's looks like your life next week might be too complicated with office/classes to get back on schedule if you were to recheck and shoot as needed at +6 from the furshot. However, PZI can be forgiving that way. Depending on the BG level, PZI doses can be adjusted to shoot three or four times a day.

If you might be interested in doing that, let us know. There are lots of current and former PZI beans around.
 
I'm so glad your Cassie is home (((hugs))), and eating :-D .
I wish you the best of luck getting those BGs down. Come on Cassie, you're home now, you can relax, and get better.
 
I answered your post in PZI. I use PZI and shoot tid (three times a day) along with some others in the PZI ISG. Can you get some spot checks in---maybe at +2,+4 and +6? Normally it is advisable not to shoot PZI sooner than +8--but, that is not taking the furshot into consideration. I realize the insulin need, especially following DKA.

Try to get the checks and hopefully that will allow us to help you adjust your dose.

Hopefully some of the other tid users in PZI will also respond.

I will check back.
 
Update: I got some advice in the PZI forum. We've been playing a juggling game. He dropped way to fast on 1 u, so I've been giving .5 for a coupke days. He's been rnning high the last few cycles so I'm worried about ketones. No sign yesterday but no chance to test today. He was 331 at +6, down from 428. I suspect he has a late nadir, but this was my onky chance ro test mid-cycle. Trying to decide whether to go up in dose or wait.
 
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