Hi all. Looking for advice. Maddie has been really sick the past few weeks and losing weight (that's been an ongoing issue). She was put on antibiotics the end of August. Things didn't get better. Her appetite continued to decline - she's always been a big eater - she continued to lose weight and by last week has basically stopped eating anything. Went to vets 9/13. Did blood work again. Still showed signs of infection of some sort. Vet prescribed 2 additional antibiotics, amoxicillan in liquid and another one that starts with M. He also prescribed mirtazapine to stimulate appetite. Her blood sugar that evening was in the 90s. With her not eating I skipped insulin that night and through Sunday when additional spot tests looked low. The appetite stimulants began working and she started eating a bit by Sunday. Monday morning I hauled her to vet for an ultrasound. He said her intestines were quite thickened and thought it was IBS Or IBD. Suggested a hydrolyzed diet. All they had was dry and I foolishly bought it even though I knew it had carbs and was likely completely inappropriate. I was desperate to get her eating and feeling better. She ate that pretty good Tuesday and was actually looking like she was improving. She got out of the dog crate where she had taken up camp for the weekend. I was hopeful. Wednesday morning 9/18 I tested her and the meter said HI. The book says this means over 600. I immediately gave her her normal 1 unit of insulin. In the evening she'd pretty much lost interest in food. Meter said HI again so I gave her her shot. This morning same reading. She's never had HI readings like this. Up until last Spring she was pretty stable with a nice curve. The duration has seemed shorter lately and she's had a few 300s and 400s with an occasional 90 thrown in but nothing like this. I have no idea why she's so high especially with so little food. Anyone have ideas or suggestions. Could it just be because her overall health is so bad right now. I am at my wits end. I don't know what to do. I told the vet to be truthful if he thought there wasn't hope and he said he isn't shy about that. I just don't want her suffering and I don't want to think there is something I should do but I'm not.
Can you get your spreadsheet set up so we can all see the doses and the numbers that you have collected? You will also want to read the stickies and choose a protocol - TR or SLGS - so we can help you with increases/decreases, etc. She's been on insulin since last June, 2018? You have over a year's worth of data - so let's see what our experts can gather from the data and get you some real help for your pretty girl.
Can you confirm whether she is still on antibiotics, and exactly what they are? Amoxicillin in liquid concerns me because the first thing that comes to mind is the reconstituted amoxicillin suspension cherry-flavored (yes, as if any of our cats love Cherry flavor), which is likely loaded with sugar. Let us know all that you know about it, assuming she is still on it. Thx.
Here are the spreadsheet instructions: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/ If you are unable to set it up, let us know, there are members who can set it up for you.
A belated p.s.: Hang in there, I know it's stressful, but hopefully this is just a bump in the road. Infections can really throw a wrench in things. Btw, when we first got Whispy we went through all kinds of things related to suspected IBD, including the Royal Canin Hydrolyzed Protein diet, dry. I've never seen diarrhea shoot through a cat like a bullet as when we started him on that food - way worse than the original IBD issues! Also, lately I am partial to cyproheptadine for an appetite stimulant rather than mirtazapine. If the mirtazapine doesn't seem to be working well then you should ask to try the cyproheptadine.
Hi Lisa! Welcome to the forum. I’m sorry that Maddie is feeling so poorly. I hope she feels better really soon! Are you testing for ketones? Or did the vet run a test for ketones? I don’t want to startle you but I think one potential risk Maddie might be facing with her combination of issues is the possibility of developing diabetic ketoacidosis (DKA). The recipe for DKA is infection + high blood sugar + not enough food. You can get ketostix at any pharmacy, if the vet didn’t test for ketones I would urge you to get some as soon as possible and post the results here for feedback. If Maddie starts seeming really lethargic it might be a good idea to take her right to the vet. I will admit I’m not experienced in this area @Sienne and Gabby (GA) @Bron and Sheba (GA) do you think Maddie could be at risk for developing DKA? Right now I think it probably doesn’t matter what you’re feeding Maddie as long as she will eat for you. But if you have food she will eat that isn’t dry and is low in carbs it would be better to feed that to her instead since dry food will definitely raise her BG levels. If she has an infection that is probably adding to her raised BG levels, along with the skipped shot. There are some other members here that have cats with IBD and diabetes, I’ll try to think of some to tag and hopefully they will be able to give you some ideas of what food can be great for kitties with both IDB and diabetes. I seem to remember novel proteins are helpful. In the meantime you can always return the dry food for a refund and just tell your vet that your cat refused to eat it Many members with IBD kitties or kitties that won’t eat also use forti-flora which is a probiotic to help stop diarrhea and I think they love the smell so it even helps urge them to eat. @carfurby posted on another members wall today with some tips to promote eating here post 2 Take a few deep breaths you’re doing a really great job taking care of Maddie!! There are a lot of members here with a lot of variable experience that can give you some ideas of what to do. Thinking of you and Maddie
A couple things regarding IBD. First, a website for you https://www.ibdkitties.net/ A novel protein diet and probiotics can help a lot. Second, cats don’t get IBS, just IBD. Another thing that can cause weight loss and thickened intestines is small cell lymphoma. Don’t let the name scare you, on the proper medication protocol, the majority of kitties go into remission. And lastly, don’t give an appetite stimulant without making sure you have dealt with any nausea first. Other wise you can build food aversion. Ondansetron and Cerenia (if vomiting), are good anti nausea meds for cats. On the dose, have you been getting any mid cycle tests? We determine how to dose based on lows, which typically happen in the middle of the cycle.
Piling onto Amanda’s post, don’t use Fortiflora. It’s a bad probiotic with only a single strain of flor? There are good suggestions for probiotics on the website I listed. Visbiome is also good as it is a probiotic specifically for IBD.
Thanks Wendy! I have no experience with IBD Lisa! Wendy is very knowledgeable and experienced in these matters so please follow her guidance
I agree with Wendy. You really need to consider novel proteins if this is IBD. The only way to know for sure if this is IBD vs lymphoma is through a biopsy. Another good website is Raw Feeding for IBD Cats. Even if you don't want to transition to a raw diet, they have a wealth of suggestions for managing IBD. They also have a Facebook page if you want more interaction and/or advice. There are some high quality, low carb novel protein canned foods ZiwiPeak has venison and a rabbit and lamb combo. They also have freeze dried food. Getting your kitty back on low carb food will help get the numbers down.
I would also encourage you to look at the option of a raw diet. You will know exactly what is going into the food. I feed my cats only a raw diet and it is cheaper that buying canned food and I use human grade meat. I know how hard it is trying to get kitties with IBD to eat sometimes. I would get rid of the dry if you can, but the most important thing is he eats. If you are having trouble with the SS someone can help you set it up so don't let that stop you doing it. It's a really important tool. Hang in there, there are many people here who have IBD kitties who can help you.
