Kelly and Vesper
Member
Oh whoops! I just edited the sheet to reflect that this is nighttime. We are in the US (Seattle). We will ask the vet about a liquid form!
New here: Need advice on DKA, possible euthanasia
- Thread starter Kelly and Vesper
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Oh whoops! I just edited the sheet to reflect that this is nighttime. We are in the US (Seattle). We will ask the vet about a liquid form!
Diane Tyler's Mom GA
Very Active Member
@Bron and Sheba (GA)
I asked Kelly the same question and googled this
I wasreading about potassium for cats
How do you give a cat potassium supplement?
Potassium is given by mouth in the form of a tablet, powder, gel, or liquid solution. It should be given with food to help prevent stomach upset.
I wonder if you can get it in liquid form from a compounding pharmacy if the pill is really big and you have trouble giving it to Vesper , ask your vet.
I would be so nervous giving it if it was really big, but that's just me
I asked Kelly the same question and googled this
I wasreading about potassium for cats
How do you give a cat potassium supplement?
Potassium is given by mouth in the form of a tablet, powder, gel, or liquid solution. It should be given with food to help prevent stomach upset.
I wonder if you can get it in liquid form from a compounding pharmacy if the pill is really big and you have trouble giving it to Vesper , ask your vet.
I would be so nervous giving it if it was really big, but that's just me
Ailish’s Brother
Active Member
Hey, I have to give my cat potassium. The pills were horrible. She hated them more than the diabetes testing and shots.
I ended up switching to the gel that mixes into her food. It’s more expensive but way less stressful for us both.
This is the one I use. https://www.google.com/aclk?sa=L&ai=DChcSEwi9wtbzxJqLAxVZNQgFHdHAGtsYABAfGgJtZA&co=1&gclid=Cj0KCQiAwOe8BhCCARIsAGKeD56cArbZ2jpijymlouamtsBLtZqEOp-8HTMpiwh7DeFU9q5pu0VakD0aAgiKEALw_wcB&sph=&cce=1&sig=AOD64_26du5zqeCRfo5mpYrdIToBoEvlSw&ctype=5&q=&ved=2ahUKEwjmlNDzxJqLAxWql4kEHcy1MUsQwg8oAHoECAQQDA&adurl=
Hang in there, you’re doing the best you can for your buddy!
squeem3
Very Active Member
Pilling tips: https://www.felinediabetes.com/FDMB/threads/pilling-your-cat.286477/
A pill dough / mask for pets works well if you can find one that doesn't contain sugar.
With any medicine, ask the vet if the medicine what form it is in and if it is available in a different form that is easier to give. Wedgewood Pharmacy is a popular place to get medicines compounded into different forms for pets such as flavored liquids, chewable treats, and tiny tabs. A local compounding pharmacy should also be able to compound medicine for a pet.
A pill dough / mask for pets works well if you can find one that doesn't contain sugar.
With any medicine, ask the vet if the medicine what form it is in and if it is available in a different form that is easier to give. Wedgewood Pharmacy is a popular place to get medicines compounded into different forms for pets such as flavored liquids, chewable treats, and tiny tabs. A local compounding pharmacy should also be able to compound medicine for a pet.
Kelly and Vesper
Member
Hi all. I'm feeling a bit discouraged today. Vesper is showing less interest in food and is lower energy than when we brought her home yesterday. She's eating a little, but not nearly enough. I gave her the morning dose because her libre said her level was so high she was out of range, but I'm not sure if I should give her the potassium if she's not eating a lot. I have a call into my vet and have also asked for odansetron and sub Q fluids. I'll add in an appetite stimulant in a bit too.
Diane Tyler's Mom GA
Very Active Member
Hendrick Cuddleclaw
Very Active Member
are you able to check ketones yet?
I was worried when I saw you post about her hovering over the water dish and seeming out of it. Hendrick did that when he was going into DKA.
Diane Tyler's Mom GA
Very Active Member
I'm glad you're calling your vet. When I had to give fluids to Tyler my vet had it in her office . It was Vetivex fluids. She also gave me 2 size needles , one was bigger so the fluid flowed faster and the other one was smaller which took longer for the fluids to go in. I hope you hear back from your vet soon
Remember Bron said above
You always need a clearance from a vet to give those fluids because the cats heart needs to be checked first as some heart issues rule out sub Q fluids. She may not need them.
@Kelly P
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I'd rather not pill my cats at all if I don't have to and as I recall, Tumil-K and the like are quite large and really difficult for a little cat throat. You also have to be careful to not hold the head up which makes swallowing almost impossible. Pilling and not following with a water chaser runs the risk of the pill getting stuck and irritating the esophagus, making the cat even less cooperative in the future.
https://catinfo.org/pilling-cats-an...natives-transdermal-medications-pill-pockets/
Pill pockets work for some cats but the goal is for the cat to eat it like a treat and avoid the whole pilling trauma. You can try cutting the pill into smaller pieces or crushing it and mixing in food. Potassium is also available in a gel form but may contain artificial sweeteners and maple flavoring, neither palatable to cats.
I use NOW Potassium Gluconate, 100% pure powder so you only need to give a tiny amount which is tasteless and mixes easily into food. There's a chart and you'll need to do a little math:
http://www.zzcat.com/CRF/supplies/potassium.htm
Hope you're able to get sub-q fluids. It's like the vet is refusing to provide necessary medicine. Vesper was well hydrated when she came home from the hospital but that needs to be maintained because she's still fragile and could backslide. Hovering over the water dish is a sign of dehydration.
https://catinfo.org/pilling-cats-an...natives-transdermal-medications-pill-pockets/
Pill pockets work for some cats but the goal is for the cat to eat it like a treat and avoid the whole pilling trauma. You can try cutting the pill into smaller pieces or crushing it and mixing in food. Potassium is also available in a gel form but may contain artificial sweeteners and maple flavoring, neither palatable to cats.
I use NOW Potassium Gluconate, 100% pure powder so you only need to give a tiny amount which is tasteless and mixes easily into food. There's a chart and you'll need to do a little math:
http://www.zzcat.com/CRF/supplies/potassium.htm
Hope you're able to get sub-q fluids. It's like the vet is refusing to provide necessary medicine. Vesper was well hydrated when she came home from the hospital but that needs to be maintained because she's still fragile and could backslide. Hovering over the water dish is a sign of dehydration.
Kelly and Vesper
Member
She just drank a lot of water but still isn't really eating. I've held off on the potassium until I hear back from the vet, but unsure if that's the right call.
Kelly and Vesper
Member
Ok she ate a decent(?) snack (about 1/4 cup of freeze dried chicken), so I gave her the potassium.
Larry and Kitties
Very Active Member
I ma concerned about the low hematocrit
HCT 23.0 % 26.0 47.0
I do the see in the tet results the reticulytes (immature red blood cells). I high reticulocyte count is good since it means that the body is making more red blood cells to try to counteract the low red blood cell numbers. The reticulyte helps determine if the cause is not making enough RBS or that too many RBS are be lost either to internal bleedings ore they are being destroyed prematurally.
HCT 23.0 % 26.0 47.0
I do the see in the tet results the reticulytes (immature red blood cells). I high reticulocyte count is good since it means that the body is making more red blood cells to try to counteract the low red blood cell numbers. The reticulyte helps determine if the cause is not making enough RBS or that too many RBS are be lost either to internal bleedings ore they are being destroyed prematurally.
Kelly and Vesper
Member
She has a history of nonregenerative anemia (happened during her first DKA episode and again this time too).
The vet put this in her discharge summary: "
Normocytic, normochromic non-regenerative anemia
Vesper's anemia is most consistent with an anemia of chronic/inflammatory disease, most likely due to her underlying
pancreatitis. Since her last hospitalization, it has progressed significantly, which is likely due to the sampling of blood that was
done during her previous hospitalization last week. Please continue to monitor her for clinical signs of anemia, such as pale
gums, weakness, lethargy, unsteadiness when walking, or even collapsing episodes. If you notice these signs, please have her
re-evaluated by a veterinarian immediately."
These were here #s about 6 hours before discharge from the hospital yesterday:
Test Results Unit Lowest Value Highest Value Qualifier
pO2 31.4 mmHg 27.0 50.0
O2SAT 60.1 % 50.0 80.0
pCO2 33.7 mmHg 31.0 51.0
HCO3-act 20.1 mmol/L 15.0 27.0
mTCO2 19.4 mmol/L 16.0 25.0
pH 7.383 7.250 7.430
BE(ecf) -5.0 mmol/L -5.0 2.0
Na+ 145 mmol/L 148 163
K+ 2.7 mmol/L 3.6 5.6
Cl- 110 mmol/L 111 128
Ca++ 1.14 mmol/L 1.21 1.51
AGapK 19 mmol/L 9 26
Lact 0.99 mmol/L 0.50 3.20
BUN 15 mg/dL 15 32
Crea 0.77 mg/dL 0.50 1.90
Glu 233 mg/dL 63 133
Hct 20 % 28 50
PCV: 19%
TP: 6.8
BC: <1%
Plasma: Clear
Kelly and Vesper
Member
Another update: The vet called and said her urine tests are showing that she likely has a UTI too. They are calling in clavamox. She said this could cause further gastrointestinal issues and agreed to also call in odansetron. Advice on how long to wait to administer the clavamox given her current low appetite/energy?
Laurie&Petey
Very Active Member
Hi Kelly, if you don't already give a probiotic you'll want to start. Also I used pro plan hydracare for Petey, when he stopped eating he would always drink his "juice". It helps to get water into the cells and keep them hydrated, Petey loved it so much!
Kelly and Vesper
Member
Do you have one you recommend?Hi Kelly, if you don't already give a probiotic you'll want to start. Also I used pro plan hydracare for Petey, when he stopped eating he would always drink his "juice". It helps to get water into the cells and keep them hydrated, Petey loved it so much!
Laurie&Petey
Very Active Member
I have used the pro plan fortiflora -it also helped to entice him to eat wet food when he was sick. Today we are using Proviable.
Kelly and Vesper
Member
Dyana
Very Active Member
I would make sure she gets those antibiotics as they are important, and some probiotics to help with any stomach upset.
I saw your post on Facebook and felt so much for you and your baby who looks a little like my J.D. He had DKA when he was first diagnosed at 11 and lived a happy life until 20. He had to have a couple transfusions while hospitalized with DKA and came home with a nasal feeding tube.
He also had low potassium later in life, and needed to be tested for that as too much potassium can be as bad as too little, so besides getting the sub Q fluids, ondansetron, and an appetite stimulant, be sure to ask your vet when to test the potassium levels next to make sure the potassium suplement dose is correct. You can give ondansetron 4 times a day.
It sounds sometimes like Vesper might be feeling nauseous when she doesn't want to eat much.
I saw your post on Facebook and felt so much for you and your baby who looks a little like my J.D. He had DKA when he was first diagnosed at 11 and lived a happy life until 20. He had to have a couple transfusions while hospitalized with DKA and came home with a nasal feeding tube.
He also had low potassium later in life, and needed to be tested for that as too much potassium can be as bad as too little, so besides getting the sub Q fluids, ondansetron, and an appetite stimulant, be sure to ask your vet when to test the potassium levels next to make sure the potassium suplement dose is correct. You can give ondansetron 4 times a day.
It sounds sometimes like Vesper might be feeling nauseous when she doesn't want to eat much.
Laurie&Petey
Very Active Member
squeem3
Very Active Member
FortiFlora isn't the best probiotic. It only has one strain of bacteria and a very low amount. The only good thing FortiFlora is for is to get inappentent cats to get because the taste is addictive. Here's some info about probiotics (ignore the IBD stuff. The general info is good for all cats):
https://www.rawfeedingforibdcats.org/probiotics-for-cats---why-and-which-ones.html
https://www.ibdkitties.net/supplements/probiotics/
Visibiome is supposed to be a really good probiotic. The Human product is the same as the veterinary product, or so I've heard. A cat dose is one capsule or packet but start with 1/4 capsule or packet to start. Slowly ramp up to the full capsule/packet over a few days. Too much probiotic to start can cause an upset tummy or poop issues. For other brands of probiotic, also start with a small amount and ramp up.
Give a probiotic two hours before or two hours after the antibiotic. Don't give it at the same time as the antibiotic because, well, the antibiotic will kill all the good bacteria in the probiotic.
https://www.rawfeedingforibdcats.org/probiotics-for-cats---why-and-which-ones.html
https://www.ibdkitties.net/supplements/probiotics/
Visibiome is supposed to be a really good probiotic. The Human product is the same as the veterinary product, or so I've heard. A cat dose is one capsule or packet but start with 1/4 capsule or packet to start. Slowly ramp up to the full capsule/packet over a few days. Too much probiotic to start can cause an upset tummy or poop issues. For other brands of probiotic, also start with a small amount and ramp up.
Give a probiotic two hours before or two hours after the antibiotic. Don't give it at the same time as the antibiotic because, well, the antibiotic will kill all the good bacteria in the probiotic.
Kelly and Vesper
Member
Could I start with the FortiFlora to help get her to eat more and then switch to another once her appetite has improved? Or should she be on the same one the whole time?
Kelly and Vesper
Member
I'm okay. I really don't know how this is going to end up, but I'm committed to listening to her and fighting as hard as I can if she's still down to fight. I'm suppressing the other emotions and just focusing on what needs to be done and when. I'm SO SO grateful for the support of this community, though, it actually moves me to tears.How are YOU holding up.
I decided to wait before administrating gabapentin again. The vet said it was helping her stay comfortable with all of these interventions and her pancreatitis, but she seemed happier when it wore off (she even laid on the bed in the sun and showed her belly).
squeem3
Very Active Member
I think the only bad thing that could happen is that your cat will expect an entire packet of FortiFlora with every meal and may refuse to eat unless you add FortiFlora. Most people just use a tiny little sprinkle of FortiFlora on food to make it more yummy but a little sprinkle won't have much of a probiotic effect. Use the FortiFlora for now since you've already order it and look for a another probiotic in the meantime.
Kelly and Vesper
Member
The easiest thing for me to get her to eat is the freeze dried chicken. Is it going to cause problems if she is eating mostly that right now?
Laurie&Petey
Very Active Member
I'm not qualified to answer that, but I would think she may need some other nutrients/fiber. To use what works, can you rehydrate it just a little bit and add a small amount of wet food.... till her appetite is better and adjust accordingly.... how's her water consumption?
squeem3
Very Active Member
Freeze dried chicken treats aren't a complete diet with all the necessary vitamins and minerals. Can you crush up some treats and sprinkle it over canned food? A shredded chicken in gravy food like Weruva's Paw Lickin Chicken generally works for many cats. Worry about carbs later. Your cat needs to eat and get enough calories and nutrients in.
There are more tips here: https://felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/
There's a way to turn meat baby food (the kind with no onion or garlic) into a complete diet but I'm not sure how. It was often mentioned on another cat board but I don't ever recall seeing directions.
There are more tips here: https://felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/
There's a way to turn meat baby food (the kind with no onion or garlic) into a complete diet but I'm not sure how. It was often mentioned on another cat board but I don't ever recall seeing directions.
Kelly and Vesper
Member
Good ideas, will try!
Bron and Sheba (GA)
Very Active Member
If that is what she will eat right now, then let her. As said it is not a complete meal but it won’t hurt for a few days to get her over a hump. Eating anything is better than nothing.
I’m glad you are starting the antibiotic. And are getting ondansetron.
Visbiome is a great probiotic in my opinion.
Kelly and Vesper
Member
I collected my first urine sample, and I'm fairly certain it was negative for ketones!
Bron and Sheba (GA)
Very Active Member
That is great news! Well done both of you!
Keep up the good work. Remember it is food and insulin that will help keep the ketones away.
Suzanne & Darcy
Very Active Member
For a few days it will be okay. Long-term it would be a problem because you would need to add critical nutrients like Taurine to her diet. But just that she’s eating is wonderful. If she wants to eat ham baby food (usually a silver bullet) or turkey or chicken baby food then okay.
Suzanne & Darcy
Very Active Member
Visbiome Vet is what I use in a couple of cats. I have had remarkable results from it in terms of reduced need for medications (they have IBD).
Suzanne & Darcy
Very Active Member
Chewy.com says this food is not low carb. Maybe it’s not correct? Here is what they say:
What is the carbohydrate content of this food?
Answer by • Sep 25, 2023
This recipe has a carbohydrate content of 14.0% as fed and 15.38% on a dry matter basis.
squeem3
Very Active Member
You can ask the vet about this product to get some essential nutrients into your cat if she's not eating regular cat food: https://oxbowanimalhealth.com/product/critical-care-carnivore/
Kelly and Vesper
Member
Vesper is doing great this morning!! She snuggled me in bed last night (which is the #1 sign she is feeling better) and eagerly came for breakfast. She even took 3 of her medications by pill pocket. I'm feeling hopeful!!
Suzanne & Darcy
Very Active Member
Oh I am so happy to hear this news!! 
Laurie&Petey
Very Active Member
LOVE, LOVE, LOVE! One of the first things I did this morning was look for an update on Vesper! So happy you got some snuggles and Vesper saw some yellows yesterday!
Ailish’s Brother
Active Member
That’s awesome to hear!
Kelly and Vesper
Member
I finally figured out how to add a picture so you could see my sweet beautiful girl. Thank you all for helping us.
Kelly and Vesper
Member
Today Vesper's glucose has been increasing post-insulin administration. At what point should I become concerned and/or do something? Is it because she is eating more?
Laurie&Petey
Very Active Member
I know it's scary to see but totally normal.. she is what they call bouncing from the new lows she saw yesterday... I'm sure someone else will respond with why a bounce happens... Petey is in a bounce today too, from the new lows he saw for a few days -if you look at where we started, there was a lot of those scary reds and blacks... just be consistent and stay the course. Loves. Water. Food. Insulin. More Loves.
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Hendrick Cuddleclaw
Very Active Member
Awww what a beautiful cat she is, and quite the sparkle in her eye! Glad to hear she was feeling herself this morning, hope it continues!
Bron and Sheba (GA)
Very Active Member
Vesper is a beautiful kitty and I am so happy to hear she is doing better. Keep doing everything you are doing.
Have you tested again for ketones? Another result will be helpful when deciding on the dose. And can you put all ketones results into the results column of the SS please? Thanks.
How long has she been on twice a day Lantus now?
Have you tested again for ketones? Another result will be helpful when deciding on the dose. And can you put all ketones results into the results column of the SS please? Thanks.
How long has she been on twice a day Lantus now?
Diane Tyler's Mom GA
Very Active Member
Kelly and Vesper
Member
I will test again for ketones tomorrow, I wasn't able to do it today. Which column do I put those results in?
She has only had 5 doses of Lantus (2.5 days), as she was on a CRI infusion of insulin at the hospital.
One new symptom today is that she has been yelping a bit in pain. I noticed it when she was grooming and also occasionally when she shifted position while napping. I think it was when she was grooming her genital area but can't be sure. She is still VERY snuggly though, so I'm hoping she's not in too much pain. Do you think this is pain from her UTI? Is there anything else I can give her? Should I put her back on the gabapentin? I'm reluctant to do that unless it will help with pain because it makes her pretty out of it.
She is down to 8lbs 15 oz, so I am also eager to see her gain some weight. Years ago she was a hefty kitty (around 12 lbs), and in the last year or so she was around 10.
Bron and Sheba (GA)
Very Active Member
Results into the results column which is in the right hand side of the SS. The ketone result is important as it helps tell us if we are giving enough food and enough insulin.
It could be from the UTI. Has she started the antibiotic yet?
Will she eat any more food than you are feeding now?
Diane Tyler's Mom GA
Very Active Member
Ketone results you can put in the remarks section all the way to the right like Bron said
SmallestSparrow
Very Active Member
Since the fortiflora probiotic flora is different in from visbiome (which I prefer for Methos’ gut) I use both at the same time—visbiome as a probiotic and a tiny sprinkle of Fortiflora as appetite stimulant)—when I first started, before visbiome I just used fortiflora and at the time I was most worried about him eating. Fortiflora is a Miracle in that regard.
im not sure if I missed a suggestion but mirataz ointment also works wonders to stimulate appetite.
SmallestSparrow
Very Active Member
It could be pain from the uti—humans have a lot of pain from them so I imagine so do cats—especially if she’s grooming there
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