Time running out

Sorry to be so dramatic. My Katya (17.5 yrs) was diagnosed with diabetes last Thursday the 19th. She is showing beginning kidney disease as well. I've had her since she was 11 hours old and she has always preferred dry food. About 8-12 months ago I noticed twitching in her front legs and weakness in her rear. I mentioned it to her vet and she thought is was neurological. At that time (teeth cleaning) her glucose was 200 and the vet thought it was elevated because of fear. In the meantime when she started drinking more water and throwing up I thought it was CKD, I had a cat with that and he did the same thing. About a week ago I just had a feeling something was off so I went to another vet and had a blood draw, urinalysis that lead to a fructosomine (sp) test and ultra sound (high calcium). Glucose was 400. Diagnosis, diabetes. They gave me the spiel, but never mentioned me testing her glucose. Found you guys and went and bought a Reli On Prime tester etc.....Doctor wanted me to feed her wet two times a day. Then start her on Lantus. So I would feed her at 11am and 11pm only she does not eat on command. I took her back on Saturday because she was not doing well. She lost almost 1/2 a pound. She has always had dry stools and mild constipation. They gave her an enema, a cerenia shot (vomiting foam the night before) and I asked them to give her fluids. I also requested a bag for sub q's at home. I've done that before with my CKD cat. When she got home she did eat a little. Today I left out a no grain kibble since I need her to eat anything. I have not started the insulin yet since she's not eating well nor twice a day. I bought sardines in oil cause I thought the protein with no carbs would be good and the oil might help her eliminate. I think the twitching and back leg weakness is neuropathy which means the diabetes has been there a while. I'm afraid she'll go into that ketoacidosis (she was negative for it on Saturday) from lack of food. I don't know what is the most important thing to establish first.

 

Hello Keni (is that your name?) and extra-sweet Katya,
and welcome to FDMB.

I would think the most important thing at the moment is that Katya eats. So it's important to find out why she isn't eating, and try to address that.
I see that your vet gave a Cerenia shot (for nausea?), did s/he also discuss appetite stimulants?
(I'm going to tag a couple of folks who know more about this area than I do: @phlika29 , @Critter Mom )

Has Katya actually been diagnosed with CKD? And if so, what stage?
If the diabetes can be brought under control that will help to take some strain off the kidneys also.

Is Katya still experiencing weakness and twitching in her back legs? The weakness might be caused by diabetic neuropathy, but can also have other causes such as low potassium. And twitching can have many causes including, I think, imbalances of potassium/phosphorous/calcium. Did the tests show any potassium or phosphorous imbalances? (I see you wrote that the calcium was high)

You can test for ketones at home using Ketodiastix. They should be available from most pharmacies. You just dip the test strip into cat's pee, and wait for the result (crumpling food wrap in the litter tray can help to catch a sample). Anything above a trace level is a reason for a vet visit.
Here's a link to a page of info from the Sugarpet site about how to use Ketodiastix:
http://www.sugarpet.net/urine.html

Have you tried to test Katya's blood glucose yet? And if so, how did you get on?

Reassuring hug to you,

Eliz

 

If Katya was free fed before then I would leave it that way (I did for Vyktor) the only thing is you want to pick up the food at +10 hours after you have dosed her up until after you have taken your preshot test. This ensures that the reading you get is not food influenced. It's better (less stress on the pancreas) for diabetics to have smaller, more frequent meals or to graze than it is to have just the two meals a day.

With numbers that high you don't want to mess around too long before starting the lantus, diabetic ketoacidosis can be deadly. If she really won't eat anything you will need to assist feed. Cats can't go very long without eating before they start developing liver problems.

If it is diabetic neuropathy (is she walking down low on her hocks?) the best thing to do is get her regulated and start giving her Zobaline.

Welcome aboard and a huge gold star for you for getting a meter and starting to test so promptly

 

Hi and welcome to the forum.

I agree feeding is key and you need to get her to eat ASAP or you need to being assist feeding her.

Do you have any ideas why she isn't eating? Will she eat her old food at all? Do you think she wants to eat but is nauseous? This can manifest itself as lip licking, teeth grinding, walking up to good then walking away, acting like she is hungry but then not eating, etc. I would suggest that you ask your vet for more cerenia (was she better after that for a whole) and /or ondansetron just in case it will make her feel better. You can also add in an appetite stimulant but it isn't recommended unless they are on an anti nausea med at the same time.

Do they suspect pancreatitis at all? I would go careful of any oily food such as that sardines as this can cause pancreatitis flairs. If you do give it make sure you wash off all the oil.

Do you think the change in food upset her tummy? Did you do it slowly ? What food is it?

Here is a good website for tips on getting cats to eat

http://www.assistfeed.com/index.html

And this link
http://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

 

Hi there,

I'm sorry to hear that Katya isn't eating. I disagree with your vet's advice to feed only twice daily. The foamy vomitus could be due to build-up of excess stomach acid due to fasting. I received similar instructions about feeding when my Saoirse was diagnosed with diabetes and pancreatitis last year. I only stuck to that for a couple of days before reverting to feeding Saoirse every few hours because the long fasts left her howling with pain and throwing up (symptoms not present prior to the vet's insistence I feed twice daily). I agree with Vyktor's Mum that with Lantus small, regular meals work well. It's a long-acting insulin. I fed Saoirse about every 2 hours when she was on Lantus (still do now that she's diet-controlled). It's fantastic that you'll be home testing. As well as getting a test before each insulin injection, you need to get some mid-cycle tests (morning and evening) to monitor how Katya's responding to the insulin and the feeding schedule you use. DKA is a real risk with inappetence and no insulin. Even without the complication of diabetes being present, because of the way their metabolisms work it is vital that cats don't go any length of time without food. As Sarah has already advised above, anti-nausea and appetite stimulant meds can really help, but assist feed if you need to.

If you haven't already come across it, Tanya's site is a very well-respected resource for feline kidney issues. Here's a link to the nausea and vomiting symptoms page on the site. It might be able to help you determine whether nausea may be the cause of Katya's inappetence. The page has information on a variety of medications that can help. Saoirse still gets a small dose of ondansetron every day. If nausea is present, then anti-nausea treatment is invaluable (as are meds like famotidine for excess stomach acid). There's also info on the site about how to tempt a cat with appetite issues to eat. Just a thought. Are you sure Katya can smell her food OK? Try warming it a little or putting something smelly like parmesan or tuna water onto it. Raising the bowl to a more comfortable height can be really helpful, too.

 

Welcome to the best place where you never wanted to be! Great job with the home testing- it's the best way to keep your kitty safe once you start insulin. If you have any additional questions regarding the CKD or any other health concerns, c'mon over to the Health Forum.

 

Thank you everyone for the advice. She is eating again and like Vyktors Mom and Critters Mom said, I went back to leaving food out. I bought no grain low carb evo and some canned. To my surprise she is eating the wet food just not much. She eats about 3 tbsp and then stops. I've ordered some Young Again No Carb. Today was the first time testing her glucose and the stick went rather well. My only concern is that the reading was 77. Could it be because she wasn't eating till yesterday? Now at the vets it was 400 so I'm not sure what is going on. I bought a ReliOn Prime at Walmart. I go over to the health forum and post the results. Critter Mon I am familiar with Tanya's site. I lived on that site for the two years my soulmate Thomas was on sub q for CKD. I could not have gotten through without it. That is what led me to search for a diabetic site. Thanks guys

 

Hi @Keni ,
Congrats on getting that test!

Can you just confirm that Katya is not yet on insulin?
That 77 is a lovely normal number for a cat not on insulin. But for a cat on insulin that may need watching in case it drops lower.
.

 

I wonder if just giving her the low carb food bought her numbers lower?. As Elizabeth asked is she on insulin yet? Was the 400 after this at the vets or before when you took her?

 

Hi guys, I answered Elizabeth but I'm not really sure where the answer ended up?? I think you might be right Phlika29. She didn't eat for a day and a half and is eating little bits. She is NOT on insulin yet, that was why I tested her. I didn't want to give her the insulin without knowing her numbers. I'm just worried that I did something wrong and the numbers aren't accurate. The 400 was at the vets. She always has a high glucose at the vet but usually around 200. Will be getting a better meter when payday arrives

 

I found your other thread and answered you there. I don't think you did anything wrong and yes you are very lucky you tested. If in doubt you can always repeat the test straight away.

 

Just in case you can't find your other thread

http://www.felinediabetes.com/FDMB/threads/first-time-testing.133721/#post-1378786