My cat has diabetes, kidney failure, ketoacidosis. What's the best option?

I am sorry to hear Khouie is an severe and concerning clinical situation. This is a very difficult time I understand. I would suggest to avoid giving insulin as that should be given only after measuring blood glucose (giving insulin could cause otherwise hypoglycemia). Ketoacidosis is usually diagnosed when ketones are inside urine (so urine analysis would be ideally needed). Discomfort and lack of appetite would require an immediate check up to evaluate his quality of life and eventually discuss euthanasia with your local veterinarian. Please do not hesitate to contact us again on the forum or by requesting a consultation if you have any more questions or to discuss it any further.

Yes unfortunatley in cases where a diabetic cat is not able to be medicated and maintain hydration, euthanasia is the best option. The fact she has other complicating factors reducing her mobility and causing her discomfort means this may be very soon to prevent suffering. See the following article for information on helping to decide when http://vet.osu.edu/assets/pdf/hospital/companionAnimals/HonoringtheBond/HowDoIKnowWhen.pdf

Unfortunately this is a really tough disease to treat, even with veterinary care. Your cat would likely need to be on fluids and then start getting regulated on insulin to get his diabetes under control. Until his dehydration and blood sugar is under control he will probably still be lethargic and anorexic. I am sorry you're having to go through this with your cat. I wish there was more I could tell you. Best of luck.

I am sorry to hear about Cozy. Unfortunately diabetes is a disease that does require medical management. Your kitty is going to get progressively sicker and eventually will probably go into diabetic ketoacidosis, and make her very sick. It sounds like she is already declining, losing lots of weight and vomiting frequently. I would consider euthanasia as a humane option if you are unable to treat her, as she is likely to continue to go downhill. She may not be in pain, such as pain when you break a bone, but she likely does not feel well or herself.

Having him euthanized is a valid option if his quality of life is not good. If he cannot control his bowels and is not able to eat, that is not a happy life for him. Older cats can have liver, kidney disease and diabetes that can cause illness. You may want to have a vet examine him to see what the treatment options maybe before making that difficult decision. They can tell you want to expect long term to see what his quality of life will be like if he starts on a treatment. You know him better than anyone, so you will be able to know best how happy he currently is.

I am sorry to hear about Ernie's conditions. It certainly sounds like he has been through an awful lot and isn't feeling to well. Obviously without seeing Ernie in front of me, I can't give you my fully official opinion. However, if you feel that Ernie is no longer able to do the things he enjoys, can't eat a meal without being in pain, and is spending more time sleeping and hiding, it may be time to start seriously considering his quality of life. I know that this is a very personal and difficult decision, but sometimes it is the kindest and most humane decision you can make for your pet. All of the conditions you have named are incurable and are likely to progress. When in concert with one another, they may progress even faster. No one can make this decision for you, but I think you should do whatever you feel is right in your heart.

Diabetes is a serious disease in cats. Prednisone is not commonly prescribed in diabetic cats as it can cause issues with regulating their insulin needs. If Boo Boo is newly diagnosed with diabetes, then he may need further testing to see if he is also ketoacidotic (diagnosed with a urine or blood sample). If he is, he will require aggressive hospitalization to overcome this problem and to get him home so you can continue with insulin treatment for the diabetes. Fatty liver disease is a very serious issue in cats. Most cats diagnosed with this disease will require aggressive hospitalization and treatment, including IV fluids and feeding tubes. The only hope of getting over this particular disease is to start eating. Many time appetite stimulants can aid in getting the cat to eat. I recommend that Boo Boo be hospitalized, preferably at a care center that offers 24 hours service, as he will likely need 24-hour monitoring and adjustments to his medications. It sounds like he has a few serious hurdles to jump in the next few days, and hospitalization will give him the best odds of recovering and returning to health.