Don’t know where to turn for help

hello all - please excuse my ramblings but I seem to have nowhere else to turn and have stumbled upon this great group that I pray can maybe steer me in the right direction. I am struggling with a huge amount of guilt and hope someone can help me out.

My cat Rudy was diagnosed with diabetes in January after giving the typical signs - accidents outside litter box, large amounts of urination and drinking and very rapid weight loss. He is a very large boned cat and tall, and used to weigh 22 lbs in his prime. I am horrified to say he weighs a mere 12 lbs now and is still losing. He turns 18 on July 21.

Our vet had told me to begin treating him with insulin but also changed his food to Purina DM. I chose the wet food after a bit of research. He was to be given 3 units of insulin 2x a day for a week and we were going to do a panel or every two hour check a week after starting the treatment. He made it five days before his seizure. After a rush to the vet and fluids and life saving measures I decided to really educate myself on this and feel so stupid for blindly injecting insulin as per directed. I now understand the diet should have been changed and dosage should have been checked as we moved forward. He has not been on insulin since.

Since then we had a lot of trouble with getting him to eat so I took your suggestions and looked at a very extensive food chart from a great vet in the states and put him on specific brands from friskies that are 5 or lower in carbohydrates. He rebounded and was doing great w no insulin at all. However now he has been going downhill again and I am at a loss. My vet has basically left it with me as he is old And we can put him down but my gut tells me I am missing something here. He still goes outside and hunts, still seems to be happy and not in pain or not showing me any signs, slightly increased urination and has bouts of soft stool that can move into diarrhea, but his weight which was slowly going up is declining again and his coat is dull.

I understand he is older and I am happy for the years I have had with him but I feel I can do more for him. When I test his blood sugars at home I’m told the range I’m looking for is between 5-12. I calibrated my testing unit with my vets to ensure accuracy. I have tested him every 2 hours 3 days in a row and couldn’t get a reading above 12. (Keep in mind this is with no insulin only the change in diet.). I feel I can’t give him insulin as at times in the am before I feed him he can be at a 3.5. He just slowly eats a bit all day and I rotate the kinds of food and have done literally everything I can think of to try to get home to eat more (and have used all your suggestions as well).

I would appreciate your support and suggestions and please keep in mind all blood work and testing has been done however I feel at this point making more vet visits is a mute point as I don’t feel I’m being heard and feel that they do not wish to pursue Rudy’s case due to his age. And quite frankly it’s getting very expensive to hear put him on insulin when I feel I would give him another seizure.

I look forward to hearing from any and all who gave time to respond. Thanks in advance.

 

I think it's really important for you to get his thyroid checked.....hyperthyroid can cause a lot of the same symptoms as diabetes like increased urine, continued weight loss, etc......and it's very common in "old" cats.

Not all bloodwork includes the specific tests for thyroid that you need

The best test is the thyroid panel which is usually total T4, free T4 by equilibrium dialysis (ED), Total T3 and TSH. However, that can be really pricey so, at a minimum you would want to ask for the tT4 and fT4 by ED. Sometimes it will be evident just with tT4 but if it's borderline, you need the fT4 by ED and you don't want to have to go back.

 

I agree with Chris about checking his thyroid levels. At minimum, a "total T4" value and a "free T4 (by ED)" should help rule out thyroid issues.

I'm also curious about his kidney values. Kidney disease can cause decreased appetite, weight loss, an unkempt coat, etc. and is very common in elderly cats. On recent bloodwork, were there values for BUN and creatinine? Did they run a urinalysis? If so, what was the Urine specific gravity (USG)?

How are his teeth? Does he ever drool or bat at his mouth? Does he have bad breath? Sometimes a bad tooth can cause difficulty eating and thus weight loss.

Does he ever go to food, act anxious to eat, then take a few licks and walk away? Ever smack his lips? Those can be signs of nausea. Ondansetron or Pepcid AC can sometimes help.

Finally, you mentioned that Rudy goes outdoors and hunts. When was the last time he was dewormed? Parasites can also cause weight loss, stool issues, unkempt fur, and so forth. Even if a stool sample comes back negative (you CAN get a negative result even when they have worms), I automatically deworm the outside strays I care for a couple of times a year because who knows what they eat and are exposed to.

Age is a consideration, not a disease. It may come into play when making certain decisions but I disagree strongly with your vet that it's a reason not to do additional diagnostics. Some diseases and issues are relatively easy and inexpensive to treat. Picked up a tapeworm by eating an infected flea from that mouse? Easy fix ... its called a dewormer. Thyroid issue? Two inexpensive pills a day can manage that. Knowledge is power ... I'd think you could run a few more tests to rule things in or out without breaking the bank. If your vet refuses, I'd find a vet who will. A cat who still goes out to hunt and enjoys life is not a cat who seems like he's ready to die.

 

Thanks so much for your ideas and questions I can add to my list on Wednesday. My vet tech is going to draw blood Wednesday which helps as their is no fee for the vet visit. She’s going to run t3 t4 levels and check kidney as well. We are going to start there for right now and if it’s ok I can share numbers with you guys. As for worming I routinely worm him with wormer and it also includes tapeworms. Thanks for making me feel like I’m not crazy to give up on the old boy just yet it’s nice to have support. I’ll be in touch!

 

When he is high enough to give insulin, what are you giving? Starting out with 3 units was a very dangerous suggestion. Some cats never need that much. The recommended starting dose is 1 unit twice a day.

Since your cat is underweight feed him as much as he wants whenever he wants... Just no food 2 hours prior to the preshot test so the number is not food influenced.

FortiFlora is a tasty probiotic many cats can't resist. Sprinkling it on the food may encourage him to eat more.

 

Well the results are in - glucose levels within normal limits, thyroid levels are within normal limits, everything else came back within normal limits with the exception of slightly on the higher end kidney values which we can try to slow down but cannot reverse or fix ( about $50/month) He does have one molar that looks like it may be bugging him so has been put on metacam low dose but surgery for his tooth at this point is thought to be risky d/t his age and condition.

I really want to thank everyone for their help and suggestions - helped me feel more educated about what to ask about and also helped me feel like I had covered all the possible basis for a great companion. Just want to do the best I can for him and until he shows me he is in any pain we will continue to do what he loves and allow him to live out his days hunting and doing whatever he so desires! Thanks again it is truly so appreciated. Best of luck with all of your feline companions. And keep up the great work!

 

A really great group for help with the kidney issues is a Facebook group called Cats with Chronic Renal Failure. They can offer great advice and support. Glad overall your cat is doing OK.