Wrong diagnosis?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by OrangeBeast, Sep 29, 2017.

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  1. OrangeBeast

    OrangeBeast New Member

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    Sep 29, 2017
    Long time reader, but new poster. Please forgive my forum using inexperience!
    On Monday we brought our approx. 12 yr. old cat Kagemusha to the vet thinking he may have a blockage for incongruously not eating (he normally eats everything in sight!), overgrooming his stomach that a hairball seemed highly possible (he's never done that before either) and throwing up what he did eat outside the litter box. It was over the weekend and after he still had not eaten or drunk water and was lethargic I syringe gave him 2 tbs. water, some Nutri Cal and coaxed him to eat about 3/4 can Fancy Feast. We thought blockage for having a cat before who exhibited the same symptoms ending up in emergency because of it.

    The vet asked us the standard questions and brought him back to run xray, blood and urinalysis. They found no blockage or anything out of the ordinary on xray. He had no ketones in his urine, but she said his bg was 250. He was highly stressed at the time. In general he's had higher stress from us having a baby after a lifetime of child free home and in between this time two of our other cats passed away (one from suspected pancreatitis, the other (seperated from him) of complications from FeLv). Still, 250 is high and from our former blocked kitty having been diagnosed diabetic years prior we accepted the vets assesment Kagemusha is diabetic. We'd tested him a few years ago along with our other guy and his bg was always in perfect range, but understandably things could've changed. I didn't have test strips on hand to check him myself this time, so to err on the side of caution decided to start him on lower dose of .25 Lantus every 12 hours instead of their recommended 1 unit until I could check where he's at. We started him on Tuesday night and I stayed up with him to make sure he didn't go hypo. He didn't, but I did notice around the time it would be peaking he seemed more tired and at the 12 hour mark he seemed perkier which I found a bit alarming. 3 more doses in between then and this morning and it was the same. Today he perked up more and asked for his food at the usual times like he normally does. He's still not eating as much as he was before (usually 3 cans a day), but it seems understandable from feeling ill. His energy level is very low.

    Tonight we got the new Relion glucometer and test strips, so after eating his dinner and before giving him his shot I tested and it came back with 68!?! Feeling doubtful I did a couple more and it was still 68. I did not give him the insulin. I'm going to test him again at different hours to see how it fluctuates, but wanted to ask what anyone here thinks … could he have been incorrectly diagnosed?! Is it possible his numbers at the vet were wrong from illness or stress? Could the high amount of glucose in the Nutri Cal cause his numbers to be that high? Am I mistaken in thinking there's no possible way Lantus can act that quickly? I'm a bit distressed he could've been spending the past couple days being hypo from the insulin.
     
  2. OrangeBeast

    OrangeBeast New Member

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    Update: He's had tooth issues for awhile now. We thought it would be something the vet would look at when examining him and when nothing was mentioned figured it was from nothing being wrong. While waiting to do his next test I just got him to let me look in his mouth and can see one of his teeth is inflamed. Though fairly recently he had a cleaning at our former vet, in general his teeth are a mess with build up again and he was extremely sensitive to me going anywhere near them. Pretty obvious explanation for being off eating and even possibly the stomach upset. It's not on the side I'd used the syringe for giving him water, ruling that out.
     
  3. JanetNJ

    JanetNJ Well-Known Member

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    250 is low for a recently diagnosed diabetic, and given that he was clearly in discomfort and very stressed and baby stressed it's highly likely that he is not diabetic. Does sound like a tooth problem could be the coulpret. He should not have been diagnosed on one bg test. They should have run a fructosamine test to determine his average over the last 2-3 weeks. Lantus isn't cheap.... Your vet wasted a lot of your money. Thank goodness you tested at home!
     
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  4. OrangeBeast

    OrangeBeast New Member

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    Sep 29, 2017
    Thank you!! I just tested him again over 4 hours later and it's 70. I started reading up on stomatitis and considering his last vet said it was unusual for the buildup to come back before 6 months and now his gums are blood red with the tooth in the back being the worst, I'm thinking that's a far higher likeliness. I'm beyond tired of bad vets here and all the ailments my babies could've gotten help for if it'd been diagnosed correctly and not discovered later through home research. I swear when they don't say "idiopathic" for everything here, they shrug and say it must be diabetes before trying to sell us new food (even when we had them only eating Wellness wet!). With his numbers he could've died from the insulin. Our other guy who passed away numbers started at 600 and never dropped below 323. The lethargy during what should've been peak times seemed very off to me with Kagemusha.

    On a positive note they originally prescribed us Novolin and from reading on the high incidents of hypo from it I called and requested they change the prescription to Lantus Solostar. I was so elated they happened to have a donated one in their fridge and gave it to us for free. Unfortunately we spent so much on his initial appointment I didn't have the test strips sooner and now we have to scramble to find a way to have his teeth taken care of (most likely extraction). Not feeling really confident with any vet here to diagnose or do it properly if that is what's wrong!

    Thank goodness for this forum!!! You all are the reason I knew how to test, to start the dose so low, what to look for and to switch insulins in the first place! Thank you!!! Now I know what test to demand next time I hear them say that and prevent it from happening again!
     
    Elinor & Sibon likes this.
  5. Waheeda

    Waheeda Well-Known Member

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    Apr 11, 2017
    Hi,
    I brought my cat for stomatitis and his BG was 180 at the vet after fasting for 10 hrs. Luckily the vet said they don't put cats on insulin at that number. His gums were red especially at the molars. Took out 4 molars. Are you thinking of removing the teeth? We were hoping that he would feel better after the extraction but nope.
     
  6. OrangeBeast

    OrangeBeast New Member

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    Sep 29, 2017
    That's the same as what mine has along with horrible plaque buildup and some bleeding in the back. I was thinking of extraction, but was reading just now it has to be all teeth and thorough xrays afterwards to make sure all roots and bits of plaque are removed or it will still continue. On a better note the articles said if that's done their health improves greatly and it never comes back. Being able to afford it and finding someone who can diagnose correctly and do that though … I'll find and attach the links to the articles I found in case it can be helpful to you!
     
  7. OrangeBeast

    OrangeBeast New Member

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  8. OrangeBeast

    OrangeBeast New Member

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    Correction … articles did note it still continues in some cats regardless of such drastic measures, but is the only known cure to have worked for many.
     
  9. FurBabiesMama

    FurBabiesMama Well-Known Member

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    I'm curious, did the urinalysis show glucose in the urine? It is my understanding that, while in-clinic BG tests can be elevated due to stress, if there is glucose in the urine, it is more of an indication of diabetes. The documentation for the AlphaTRAK says that 250 is the beginning of what should be considered hyperglycemic. So, if he was in a clinic setting, and had been feeling bad, and it was just 250, that alone would not have screamed diabetes.
     
    Noah & me (GA) likes this.
  10. Waheeda

    Waheeda Well-Known Member

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    Apr 11, 2017
    Yup I've read up a lot about it. I know it's a 50-50 chance but it's still a chance of taking him off steroid. He has been on monthly prednisolone jab for about 3 years. I found an experienced vet to do it and he also couldn't guarantee total cure. His gum is no longer red but he still paws at the mouth. Next appt is on Monday. Will see what the vet says. Hope you find a good vet.
     
  11. OrangeBeast

    OrangeBeast New Member

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    Thank you! I hope your appointment gives better news! Did yours start the same way with dental cleaning and coming back after only a couple months? Or is that (along with other symptoms) a sign of it already having progressed to the more severe? (Our guys look like they could be siblings!)
     
  12. OrangeBeast

    OrangeBeast New Member

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    I think she did say that, but they didn't give us a copy of what exactly they ran, so we need to call and get it! I just tested again after he was eating and it reads only 75. Is there any explanation for his numbers being so much lower if he is hyperglycemic? I'm going to continue testing throughout the day as well, but so far there hasn't been a huge shift, he's eating normally again and less lethargic.
     
  13. Waheeda

    Waheeda Well-Known Member

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    Apr 11, 2017
    Oh yes our cats are long lost siblings! Lol! He's not the one with stomatitis.
    It's my other cat who was a stray who used to come to the door daily for food. He disappeared for a year and reappeared out of the blue looking unkempt, skinny, saliva drooling and couldn't eat. Brought to the vet and diagnosed with stomatitis so I adopted him.
     
  14. Waheeda

    Waheeda Well-Known Member

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    Definitely he's not diabetic!
     
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  15. OrangeBeast

    OrangeBeast New Member

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    You might find it funny, not really funny, but more ridiculous … you said his long lost sibling isn't the one who has stomatitis and it reminded me the other vet we brought him to for his teeth said "it seemed to be an orange cat thing". When we brought him for the follow up a couple months later they shrugged saying maybe it was early onset arthritis … because they'd seen it a bunch of times with orange cats. For our other cat we brought around the same time (known FeLv) they chalked her issues up to being a black cat. ??!!?? That's when we stopped going to that one.

    Your baby is so fortunate to have you! How you met yours is how we've met and adopted all of ours too. I really hope I can find a doctor as good as yours to figure out if that's what ails him without him getting to the point of not being able to eat! It really does look like he's reabsorbed some teeth in the back next to the one that's the worst. I could never get him to let me brush and I'm kicking myself for not having checked sooner!
     
  16. OrangeBeast

    OrangeBeast New Member

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    Tested this morning before meal and around 12 hour mark … 69. He's definitely perkier and again came running for his food. Only really noticeable difference was he's usually amicable and after poking him so many times through the night he was looking at me funny while taking breaks to go sharpen his claws on the scratching post.
     
  17. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    Another long lost sibling here. All of Noah's teeth should have been pulled a long time ago but an enlarged heart and cardiomyopathy mean surgery is not possible. It certainly sounds like you've done your research so I'm not here to hold your hand. I do feel your frustration/anger at a vet missing the obvious and not listening to you, the one person who lives with The Beast 24/7. What makes Noah's life worth living (I hope) is that he is on transdermal Buprenorphine for any dental pain just so that he can eat like ne needs and deserves to. Travelling is highly stressful for Noah and a baby would be an unwelcome addition for him. All I can add is keep up the excellent work (a symptom of love) and don't accept a condescending vet.
     
  18. Waheeda

    Waheeda Well-Known Member

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    Most of my cats won't let me brush their teeth!
    Now that my cats are in senior years with all kinds of problems, I regretted not reading up and starting everythg earlier when they were younger. Stuff like brushing thing, eating raw food etc.
     
    Noah & me (GA) likes this.
  19. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Ain't that the truth! I go so far back as to when there were no Pet Smarts/Value/World. It was pig-slop from Safeway or whatever the vet had. And no inter-web-net-ahoy, only the Readers Digest. Can't go back now!
     
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  20. OrangeBeast

    OrangeBeast New Member

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    Thank you so much! The support and understanding is such a huge help! All of you coming on here to share your experience and wisdom is invaluable! I was wondering about what a difference it might make if he had some pain relief to get back to being able to eat to regain his strength after this. I worry about his age and the risk anesthesia might pose to him unless he does and even if he is in better shape I'm very grateful you brought up Noah's heart issues for us not knowing or having considered that! The most frustrating thing about him and the baby is the big galoot won't stay away from him!! He seems to thinks he's a new playmate, so we constantly have to keep an eye on the two of them for their lack of awareness of size and being different species. Both are like bulls in a china shop and we just feel way too old for this! Part of it is he lost his best friend right before the babe was born and seems to have transferred it over to him. It's so hard for neither one of them being able to be reasoned with. Hopefully half of the equation will improve with time! Right?! Sigh.
    I feel much better knowing he has such a mighty family out there with such amazing people!
     
  21. OrangeBeast

    OrangeBeast New Member

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    Yes! I spent so much time getting them all comfortable being generally handled when they were young, but never knew about teeth. I cringe at the food they ate for years and only finding out after things began to go wrong. I got them switched to wet food, but none of them would ever touch raw food. I try telling him cats don't hunt cows or cook their food in nature, but he hasn't budged.
     
  22. OrangeBeast

    OrangeBeast New Member

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    Me too! Vets and feed stores, Readers Digest and having to go to the library if you wanted to look anything up (if they had it!). It gave us skills that serve us well now in having to figure these things out. I wish veterinarian schools were instilling that in their new students!
     
  23. Waheeda

    Waheeda Well-Known Member

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    Lol! Mine don't know how to eat raw either!
     
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