Thoughts Needed - Critical DKA

Hi everyone, I'm "new again" here. Our 14 year old cat Sammy has been diabetic for 10 years with no complications. We meticulously managed him and he was doing fine until a setback at the hospital. On September 7th I admitted him to the vet with a lower resp infection that turned out to be pneumonia. He hadn't eaten for 3 days prior to that. On the 9th, his vet placed a feeding tube. He was receiving a constant drip of food to re-introduce his body to food, along with meds for the pneumonia. A day or two after that, his vet started him on the high calorie food. Unbeknownst to me, they were not properly managing his diabetes, even after I asked about it, and he went into DKA this past Friday evening. They started the protocol for that. On Saturday morning the 13th, he crashed. They got him back but he's not doing well, he pretty much just lays there, he does respond when we talk to him and he does purr for us, kicks our fingers away when we tickle his toes, moves his ears around and looks at us, he will get up on occasion to move around in his cage. He was on a constant drip of Humulin R but his b/g is still running pretty high. They changed him to an intra-muscular insulin as of yesterday. He is still getting 25 ml of the high calorie food several times a day. He was pretty dehydrated so his vet upped him to 12% rehydration.

Any thoughts on any of this? Input? We're devastated. Thanks.

 

Re: Thoughts Needed - Critical

How awful for all of you. I am so sorry that this happened, and after you had worked hard to get his diabetes under control. I have no experience with DKa. The only suggestion I have is to go back to your original post and change the title of your thread to add DKA. We do have cats who have survived DKA and their beans may be able to give you some guidance.

I so hope your sweet little guy will survive this setback and that you'll have him home safe again soon.

 

My heart truly goes out to you. I don't have any knowledge or experience to share, but you have my prayers for Sammy to get through this. I wish I could do or say something to help.

 

J.D. had DKA and was critical when first admitted. He was hospitalized for 8 and 1/2 days, and was just laying around like you describe for the first few days. Slowly, he got stronger. I went to visit him everyday. That was the highlight of my day, that 20 minutes of visitation.
Just hang in there, say prayers, and keep positive. He is in the best possible place for him right now. And bring him something with your smell on it like an unwashed pillow case or shirt that he can lay with, to comfort him.

 

thinking of you and hope he gets through this. xxx

 

Tink was also in critical DKA when diagnosed. Spent 11 days in the hospital ($OUCH$). Wouldn't eat - when I finally insisted he come home (he was not improving at the vet and they did NOT know feline diabetes well), he had a feeding tube. I cried so hard when I gave them the okay to insert the tube - but I'm SO glad I did. Of course the downside of the tube is that you almost have to continue with the hc food. I think getting him to eat again was the hardest part of his recovery. Which is ironic since now I can't STOP him from trying to eat everything in sight.

Did your vet say why they switched up the food? Is there any way to get him back to a lc option? Of course when they aren't eating - just getting ANY food in them is a battle. Tink wound up with hepatic lipidosis too by the time he came home.

Tink took a LONG time to get back to "healthy" - but once he was home, he was OTJ fairly quickly. Unfortunately that only lasted about 6mo and we're struggling to regulate him again. But Tink is one of those cats that HAS to be at home. He was too stressed out at the vet and it was quite apparent that he would never improve as long as he was there. I took him used pillowcases for comfort, but he was still terrified and confused.

I don't really have advice for you. What a horrible situation. All I can do is say that I have a DKA survivor - one which I really did not think would survive. I had made the decision in my mind to let him go - but that day he seemed a little perkier and I'm VERY glad I changed my mind. On the other hand, only you know your cat enough to know when he doesn't have any fight left. I will say that if you're not confident in your vet, dont be afraid to shop around. Make some calls, ask some questions. I was VERY unhappy with my first vet, but I LOVE the one I have now.

Good luck to you and Sammy. Paws crossed for a speedy recovery.

 

Thanks everyone for your good words of encouragement. Sadly, our Sammy Cat succumbed to crashingly low b/g yesterday and they were unable to revive him with Dextrose and other things they tried. Once he was no longer swinging high with his b/g, he started swinging way low. They had him on 1 unit of Humulin R. When he went low, they'd give him some Dextrose to bring it up. After 2 days of this, he crashed. We meticulously regulated this cat for 10 years on Lantus and never had a problem. He developed the DKA at the vet because they were not monitoring his b/g after the tube feeding started which he needed in response to the non-eating because of his pneumonia - the original reason for his admittance to the hospital. This was quite a surprise/disappointment to me because his doctors/techs are normally very much on their A-game. He was never able to recover. Our little man will be loved and missed forever.

 

I'm SO sorry to hear this. What a tragic ordeal. The worst part is that from what you've said, it really sounds like the vet was negligent in all this and essentially caused the DKA and ultimate death. Are they at least working with you on the bill? I mean, I know things happen that aren't expected... but if they knew he was a tightly regulated FD kitty, it seems like there are a lot of things they did wrong here. It would be one thing if they'd worked closely with you on treatment options, feeding, etc and this STILL happened. Then I'd say of course, you're responsible for the resulting bill. But that they made changes unbeknownst to you and were not monitoring his known condition (especially a condition that is KNOWN to complicate other matters)... I dont know. I'd be pretty miffed.

In any case, I am sorry for your loss. At least you have the comfort that YOU made his life possible these last ten years. Most of his LIFE wouldn't have happened without your love and devotion. Fly free little Sammy.

 

Requiem aeternum, Sammy Cat.

{{hugs}}

 

Sending purrs and prayers at this difficult time.

 

Oh I'm SO SO sorry it was Sammy's time to cross...BIG HUGE LOOOOOOOONG HUG. Remember, he's not gone - you just have to hug him differently.

Thoughts and prayers for comfort and another HUG,

 

Fly free and land softly, sweet Sammy. Join the chorus and sing to your family at the next full moon. wings_cat

 

So sorry for your loss.

 

So sorry for your loss. RIP Sammy.

 

Reading with tears! How awful to lose but due to them?
Sending much needed paw w/ claw hugs your way!

Please stop and say HI to my Gumpy & Slappy girls...let them show you the beautiful places to chase butterflies!
wings_cat

 

So sorry for your loss. :cry:

 

There are no words....

Fly free Sammy. :sad:

 

oh, I am so very sorry for your loss.....my heart is breaking for you.

 

I am in tears, too, about Sammy Cat. To lose him at all is heartbreaking, but like this ... :cry:

My heart and my thoughts go out to you.

((((Catmom66 & Spirit Sammy Cat))))

 

I am so sorry for your loss. Fly free little one and land softly.

 

Sammy's MamaBean, there are people on the facebook feline diabetes group that don't post here but wanted to send their condolences and hugs too....I'm copying them here for you as they're posted:

Velma Amundson - so sorry for your loss.

Kellie Marie Bell - I am very sorry. Fly free.

Ruth - Heartbreaking. I do not post on the FDMB, so please let them know that our thoughts and prayers over here on the FB page are being sent their way, too!

Sending more extra hugs,

 

So sorry for your loss. There are just no words.

 

So very very sorry for your loss. Keeping you and your family in my prayers!

 

I'm so sorry for your loss. Furry hugs from my family to yours.

 

So sorry for your loss. I'm in tears :cry:
My heart goes out to you.
The rb_icon bridge is a beautiful place for Sammy to be. RIP Sammy wings_cat
Paula & kitty Michael

 

So heartbroken for you and your Sammy.