AW: Trudi's Dexter mit Lantus
Hallo Trudi,
ich kann nur alles unterstreichen was Ute geschrieben hat.
I'll continue in English. Here is a good protocol for dealing with DKA in cats and dogs. I hope that the vet can read English - if she can, please give it to her (or the German one of course, that was linked in yesterday):
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2005&PID=11020&Category=1549&O=Generic
I'll quote some relevant parts:
"Laboratory Findings
Ketonemia and ketonuria--are detected in essentially 100% of patients. Rarely, ketones are undetectable due to a laboratory error." For what I can gather, they haven't tested for ketones other than by smelling the breath of the cat. This is not acceptable, either for getting a proper diagnosis or for treatment purposes. The ketone levels in the blood should be monitored frequently until the ketosis has resolved.
"HYPERGLYCEMIA
Insulin Therapy (Always use Regular Insulin): All complicated diabetics require insulin to lower blood glucose. Only regular insulin is appropriate for emergency management of DKA." So please ask them to stop using Caninsulin and start using regular insulin - if they don't have it, they must be able to order it.
They also need to do a few other things, which are very important and outlined in the protocol e.g. glucose infusions, etc.
I generally try to avoid being overly critical of vets in public (and of course I am probably not aware of many important facts), but from what I can gather the veterinary clinic that Dexter is in don't know what they are doing. DKA requires a complex treatment plan, and if they already appear to be getting the basics wrong, it is
very worrying. Is it possible to have him transferred somewhere else close by that someone in the Dutch forum has had a good experience with? Or perhaps the vet in the clinic can consult by telephone by another vet that is more experienced in these matters?