Casey's started peeing on the floor...

...and it isn't even near her litter box! About three weeks ago she began peeing on the carpet of my bedroom, right outside the doorway of the bathroom that has the litterbox in it. Now she's peeing in the hallway. She doesn't look like she's in pain or anything, she just starts walking down the hallway, stops, crouches down, and pees!

I don't get it. I called the vet and asked for some Orbax, thinking she had a UTI. She's been on Orbax since May 3, but she's still peeing in the hallway. I thought maybe she was having trouble getting into the litterbox, so I got a nice low one she can practically walk into, but nothing doing. She's still peeing in the hallway.

But she doesn't poop in the hallway - she still goes into the litterbox to do that. So it's not like she forgot where it is, or is having trouble getting into it. She's just suddenly decided she prefers the hall carpet!

She's eating and drinking just fine, doesn't seem ill in any way, and her poop looks normal. I'm cleaning up the messes as fast as she's making them, so I don't think she's peeing out of a sense that she's 'marked' her spot. I'm flummoxed! I guess I could take her to the vet, but she doesn't seem to have any symptoms! Just, she's decided she doesn't want to pee in the litterbox anymore.

Does anyone have any suggestions as to what could be going on? I'm flummoxed!! And running out of paper towels...

ETA I haven't updated Casey's spreadsheet in a while, but she's currently on 7u of Lantus 2x and her preshots have been right around 200. Still not low, but not abnormally high either, for her.

 

A vet check may be needed.

Interstitial cystitis doesn't respond to antibiotics; it may respond to glucosamine and pain meds. Sometimes, it can be triggered by food sensitivity or allergy.

Renal insufficiency results in frequent urination due to the use of extra water to attempt to filter solute out.

Bladder stones don't respond to antibiotics, although they may serve as a resevoir and make a UTI difficult to eradicate. An s-ray may be able to identify that.

If she can see/get outside and there are other cats she can see or smell, it could be territorial. Scrubbing down outside surfaces with enzyme products to remove scent/spray can help, as may deterring them from your yard.

 

For those who don't know Casey, she is a high-dose kitty, so don't be alarmed at the 7 units!

Has there been any blood? Have you actually caught her peeing to see if she is straining? Stones?

Other ideas: Has anything changed in the house? Is it the same brand litter? Have you tried putting a small box where she's peeing?

 

I know you've said you clean it up each time, but ... are you using something that really removes the urine odor? Wiping it up isn't usually enough, they can still smell it even if we can't. I use a product called 'Nature's Miracle', seems to work pretty well imo.

(Obviously you still need to get to the bottom of her lb avoidance, but ... that aside, ^ this may help once you've figured out the problem and rectified it)

 

Thanks for the replies, folks! Here is more info:

1. I did have to change her and Kennedy's dry food, because what I usually feed them - EVO Innova turkey and chicken formula - is currently under recall, so I can't get it. She's currently eating something called 'Simply Nourish Source' Chicken and Turkey recipe. It's actually brought her numbers down a little, I think.

I also had to briefly change the cat litter brand when I couldn't find World's Best Cat Litter (single cat variety) anywhere, but I switched right back when I got my hands on some, and that was weeks ago.

2. Believe me, I'm cleaning the heck out of everywhere she goes. I blot up the excess, saturate with Nature's Miracle, blot THAT up, and then follow up with a thorough carpet shampooing with my Bissell. I hate a stinky carpet!

3. There's no blood or straining or anything unusual that I can see. She just walks along, stops, crouches a bit, and pees. It's like she knows she has to go, but along the way to the litterbox thinks, "Eh, what the hey, I'll just pee here!" She doesn't seem to be in any pain, or discomfort, or anything.

I'll try to put a small litterbox where she's peeing, and see what happens. Thanks for all the help! If it doesn't clear up soon I guess it'll be off the vet.

 

Definitely sounds like a UTI of some sort. Being born feral, Mikey had never used a litter box until the first hour I got him. He had no problem knowing what it was for and used it immediately whenever he needed it...until right after he got fixed. Turns out he had a UTI (and hyperglycemia). Took a week on clavamox before he stopped peeing "half-way to the litter box" and another week before he was officially diagnosed as diabetic.

My vet said UTIs are a common problem with high sugar because it creates a perfect environment for bacteria. I've never heard of Orbax but a quick google shows it's a quinolone antibiotic, so it might not be working against a different type of infection (from sugar vs. contamination) and you might want to give the clavamox (penicillin) a try.

If it's crystals, or cystsis, no antibiotics will work, so see BJM's reply above.

 

Thanks, KPassa! The vet put her on Orbax for her last UTI, and it worked like a charm. This time, it's taking longer, but part of it might have been my fault because I didn't know you couldn't give dairy within 2 hours of administering Orbax and was giving her Whiskas pet milk as a treat when I took her BG. I stopped as soon as I found out, of course, but that was a few days ago.

ETA - OK, I just went out into the living room and she pooped on a piddle pad I had on the floor. So now she isn't using the litterbox at all. The poop looks normal, she seems fine, but totally ignored the small litterbox I set out in the hall where she'd been peeing. Sigh!! Time to call the vet and open the wallet...

 

Ask your vet about a Prozac prescription for the cat. We had the same issue, no UTI, nothing medical, and the vet said some research pointed to prozac helping with some of the stress (cat is 17yoa). Its not our sugar cat that's on it, but another one. And it did help. The cat now uses the litter box again.

 

Any chance that she really LIKED the other litter you had bought, and doesn't want to use this kind again? Just a thought.

 

Heh! Knowing cats, that's definitely a possibility!

However, things are looking up. Last night Casey used the low-ride litterbox I set out in the hallway, and overnight she used it twice, to pee and poop in. So, maybe it really was that she couldn't get into the higher one easily anymore. Since everything else looks normal, I'm going to hold off taking her to the vet and see how she does today while I'm at work. If she uses the low-ride litterbox and stops relieving herself on the floor, I'll continue the Orbax (just in case) and see about edging the low-ride litterbox over to where it's supposed to be. Hopefully she'll follow it, and my problem will be solved. Although if she's starting to get arthritic in her hips, maybe the vet can give me something to help her with that.

Thanks again for the help, everybody!

 

Glucosamine may help with either interstitial cystitis or arthritis, as both are types of inflammation.

 

I just went through this same episode with my 16 year-old feline...I had started using cheap, wet food "Chef's Choice" just because she was eating it for a change from Fancy Feast...It happened about the same time as food change that she started peeing, just stop and pee, or miss the litter box (on purpose)...I have her back on wet Fancy Feast the past week, and the peeing is diminishing to the point of 'almost gone'...Coincidence? Not sure, but no more cheap wet food in this house.

 

My cat Shadoe started to pee outside the LB and I took her to the vet for that very reason. She was diagnosed with diabetes and then later, with acromegaly. She was healthy but just peed outside the box. About the only thing that helped her sometimes was to put a step in front of the LB because I don't think she liked her belly rubbing on the edge of box... she had short legs. Changes in litter made no difference to her.

I am assuming that you have already tested Casey for acromegaly and IAA or are planning to have the tests done? The dose of 7u is in the range of resistance.

One thing you can try and it may make a difference is to switch to Levemir. Shadoe had more erratic numbers and was more tense and jumpy on Lantus, but within a couple days on Lev, she was better.
I never was able to get her to pee in the LB, so I just left pee pads in front and she was fine with that.

Gayle

 

Thanks for the suggestions, everybody!

The good news: I've been moving the litterbox closer to the 'litterbox room' by a few feet every day, and Casey's still using it. Today I got home from work and she'd pooped and peed in it, and hadn't gone anywhere else. She hasn't peed on the carpet since I got the low-rise litterbox, and seems healthy in every other way.

The bad news: there's a spot in the living room where I used to have a scratching pad (you know, those boxes with the corrugated cardboard insides that cats can sharpen their claws on.) Last month, I caught Casey peeing in it and threw it out.

About ten minutes ago, Casey walked into the living room where I have a paper towel with some catnip on it on the floor in approximately the same place as the scratch pad was, squatted on the towel, and peed on it!!

WHAT the heck is going on? She knows where the low-rise litterbox is, and in fact it was a longer walk to get to the paper towel than it would have been to go to the litterbox, so I know it isn't a mobility issue. So why did she pee on the paper towel? (she deliberately walked to the towel, I watched her do it). Was it because I was in the living room and she wanted the attention? Was she mad at me because I wasn't giving her any Whiskas milk? (you can't give dairy for two hours after giving Orbax). Has my cat lost her marbles?!!

Any thoughts?

 

well, some cats get 'excited' from catnip and pee..... I know of one who cannot have catnip now because of it.

Also, if it's by the spot where there may be some odor from the past, you may need to get some type of cleaner for that spot.

Combining an old pee spot with catnip and a cat who has been known recently to pee in wrong spots, maybe it's not resolved yet.

Shadoe did have good days and bad spells.

ETA: Just wondering if you have the numbers to update her spreadsheet as there are a few months missing. Her numbers may be more telling on her current problem. If you have the numbers, maybe you can put in the last week or so for now as it may help others to help you.

 

I just updated Casey's spreadsheet for the last two weeks. It really doesn't tell much, though, her preshots have been in the high 100s/low 200s for the most part. I'll sweep up all the catnip off the carpet, and shampoo the carpet again to get out any lingering scent. Further bulletins as events warrant!

 

What are you basing the dose increases on? I don't see any mid-cycle numbers , nadirs, to base an increase of dose on.

I'm only seeing pre-shot numbers on the spreadsheet. Probably missing some of the history here, but you do not have a profile set up for your cat.

 

I haven't had a chance to do a curve the last couple of weekends - been out of town. I work full-time so the only chance I would have to do a curve would be the weekend, and the last two weekends that hasn't been possible. I'm planning on doing a curve tomorrow.

 

Update!

I found a place in the living room to discreetly place a litter box so Casey could use it, and got up this morning to find nothing in it. Thought "Uh oh!", then went to check the other litter box and found she'd pooped and peed in that one! I think the cat's faking me out.

 

How did the curve go? The ss numbers stop at the 16th.
Any thoughts on testing for acro and IAA yet?
You want to keep in mind that many acro cats have heart issues, so it's good to know if positive, you will want to have the heart checked as there are not really any outward signs of heart issues.

Gayle

 

Hi Gayle! Sorry I haven't checked in, things have been a little nuts!

The curve pretty much didn't go. Saturday I was gone most of the afternoon, and on Sunday I must have done a furshot because the numbers went UP all day, not down. I'm planning on doing another curve this weekend, because I'll be home both days(I was out of town over Memorial Day.)

Casey's doing fine - she's using the litterbox I put in the living room MOST of the time, but still peeing on the carpet occasionally. My cat sitter who looked after her over the weekend thought she was walking funny and thinks she might have arthritis. I'm going to make an appointment with the vet and take Casey in, just to have her checked out and see if this could be true. She seems to be moving around OK, and her BG numbers have been normal (I'll get them updated ASAP, I haven't had time lately). All of her vitals seem good - she's pooping, peeing, purring and preening - but it could be that if she's got arthritis that's what's keeping her from using the litterbox every time. I'll ask the vet about testing for acro and IAA. Casey DOES have a heart murmur, for whatever that info is worth.

Further updates as events warrant! I may ask the vet about switching Casey to Levemir or ProZinc, since the Lantus doesn't seem to be getting her numbers down...

 

And there you go.... heart murmur says to me check for resistance.
Tell the vet you want to switched to Levemir... ProZinc does not last long enough with many cats and if Casey turns out to test positive for acro and/or IAA, you don't want to be dosing every 8hrs. Levemir lasts much longer and has smoother curves. Lantus is also good, but at higher doses, humans have stated that it stings, so since cats can't talk, we can watch for their wincing when getting shots of Lantus or just switch to Lev. My Oliver was OK on both, but Shadoe did not do near as well on Lantus... within days of switching to Lev, I saw her visibly relax.

Gayle

 

Thanks, Gayle, I'll ask. I made an appointment to take Casey in tomorrow after work. I'll let y'all know what happens!

 

Best of luck at the vet tomorrow.... you want to switch to Levemir, and have the acro and IAA tests done.

Gayle

 

I'm also going to ask about Casey's BG numbers - they've been in the mid-100s all week! She seems fine, she's eating drinking and pooping and peeing and all that, but for some reason her pre-shots have all been in the mid to low 100s. I've been giving her half-doses (3.5u) but still she's in the mid-100s! I got 115 this morning. I'm a little baffled, but maybe the vet can figure out why her numbers are suddenly so normal!

 

Your SS last input is May 16? so I cant tell so maybe you hit the ideal dose? Her Bg could start coming down real fast if that happens and she may need a decrease but you need to test outside of preshot to know that.

You should definitely get mid cycle tests as soon as possible if you arent already as you dont want her dropping too low during the cycle, and if they are under 50 she gets a decrease. If you are working during the day then at least get a before bed test a few hours after pm shot, and I would also want a mid night test around +5 or +6... so set the alarm.

Wendy

 

Hi Wendy,

Yes, I intend to do at least one curve this weekend - what I can't figure out is why she's still giving me low 100s even when I give her 3.5u. She's been at 7 for about 3 weeks, and I haven't moved that because I have no idea how whatever peeing problem she's having is affecting her BG - she only started giving me low numbers on Tuesday (sorry I haven't done updates). There are so many variables at play at the moment that I'm not sure how much to trust the numbers! Plus, she's been at 7us before and the numbers didn't budge (this was last year, before the pancreatitis). I'd be thrilled if it turned out that I found her perfect dose, but does that mean I shouldn't switch her to Levemir? She doesn't have any symptoms of acro, so should I still have her tested? It's all so confusing! %-(

 

How did the vet appointment go???

 

Oh, it hasn't happened yet! It's at 5:20, after I get off work. I'll let you know!

UPDATE: They're keeping Casey overnight. All of her vitals looks fine, no temperature, all of her other numbers look fine, but the vet said she has a lot of fluid in her abdomen - it's clear, but she says it's putting a lot of pressure on Casey's organs and that's probably why she's peeing inappropriately (from pressure on her bladder.) They're going to do an ultrasound in the morning to see what's up. The vet suspects it's something with Casey's heart.

I have an appointment tomorrow morning to have my car looked at (yep, the cat and the car decided to go south at the same time), and the vet is going to call me with the ultrasound results. I'll let you all know then.

 

Do you think you can have the vet draw some blood for testing of acro and IAA? It's becoming more frequent that acro cats have heart issues, but it can be treated for many. Has the vet ever mentioned anything about Casey having a murmur?
Best of luck with the drain of fluids and news on the u/s.

Gayle

 

Hi - you've covered a lot of things in this thread, so if it seems like I'm jumping around, please forgive me.

My boy Moochie Pooch (a cat) is FIV, and had inapproprate peeing issues on floor, wall, countertops... EXTREMELY frustrating and stressful keeping things cleaned up. We went with several rounds of antibiotics (ABs) to no avail - he typically takes 3 rounds for a response due to the FIV. We had a Culture & Sensitivity (C&S) test done. No issues in blood OR urine... so the vet determined it was not a physiological cause. We started Fluxotine - kitty Prozac. It was like flipping a switch. The C&S was expensive, but definitely worth it, so we knew what we were NOT dealing with, as I had an aversion to giving him Prozac.

Because serveral of my kitties were outdoor/wild/ferals before coming in, several tend to pee vertically, so I use Rubbermaid tubs. When Grayson was dx with FD, he was peeing next to the box, which I later realized was because he couldn't get in. The lower box helps tremendously - or a hole cut into the wall of the tub.

I've not had the fluids issue, so no comment on that issue.

Sounds like you're doing well cleaning up, so that shouldn't be an issue either. Buy stock in paper towels!

We started out on ProZinc, but Grayson was dx with Acromegaly a little over a year ago. We had the option of Lantus or Lev, and opted for the Lev. Grayson IS an extremely high-dose kitty, and Levemir is pH neutral, whereas Lantus is more acidic - which is why some kitties - especially high dosers - feel a sting when injected. But there are several high-dose kitties successfully being treated with Lantus.

I did have the IGF-1 and IAA tests done at MSU. If you plan to have them done, have your vet request the mailers from them - it's much more cost effective than getting the specific Fed Ex boxes to send the samples with. When the tests were done, I was in complete denial. After all, my 22# cat was down to an anorexic-looking 12#! The insulin resistance test (IAA) was no surprise. He had been up to 6u ProZinc TID (3x), and barely left the pinks. But the positive IGF-1 test results were hard to believe. I read EVERYTHING I could. And then I looked at his teeth. Acros often have the jaw growth that creates a gap between the canines. G also had a heart murmer, albeit minor, from a small leak in a valve (id'ed on an echocardiogram). We had an ultrasound at NC State, which showed enlarged - but not diseased - organs. Every one of these issues were good indicators of Acromegaly - but none of them considered a "slamdunk". But according to Dr. Lunn, one of the leading Acro specialists, the unregulated/unregulate-able diabetes - was one of the clearest indicators. It was not what I wanted to hear, but it was what I needed to hear, in order to keep Grayson is the best health I could provide. I'm all about knowing what you're dealing with. Test results answer a LOT of questions.

As to why Casey is doing as well on 3.5u as on 7u, I have no explanation. I know I did a "re-boot" on ProZinc and saw similar results from 6u to 3u to 2u... but then we had ketones and I climbed up the dosing ladder very quickly. It is a possibility that some of the resistance has broken. If that's the case, great! Think of it as a bonus - your insulin will last much longer!

Don't feel like you have to do a full curve on a weekend... just get some mid-cycle tests. More often than not, my tests are at +6.3 or +4.8 (every 6 min is a decimal point) as my schedule is very sporadic! It's just best to be able to make decisions with as much data as we possibly can.

Hopefully your vet results will show something definitive. Good luck! I'll be checking back to see how you're doing. If I can offer any more info, please let me know.

Lu-Ann

 

... forgot one more thing. Lots of kitties seem to do better with some pain meds. Bupe, or Gaba, or Tramadol (I think) are probably the most common that I've seen used for pain management - including neuropathy.

This is the gap I referred to in the previous post (some kittys' gaps are much wider):

 

Hi everybody! Back from the vet's!

First, the good news: the vet doing the ultrasound couldn't find any fluid, or anything really abnormal-looking in Casey at all. Her heart looks OK, the only organ that he said was bigger than it should be is the gall bladder. He thinks she might be having some digestive issues as a result, because it doesn't look like the gall bladder is draining totally, but there wasn't a lot of "gunk" in it and he didn't think it's causing her any pain. All of her blood work and levels are normal, and she ate and purred and was pretty happy at the vet's. The only option to fix her gall bladder is surgery, which I am not going to do to a 14-year-old diabetic cat!

He's going to share his findings with the other vet, so I'll probably be talking to her sometime this week.

He had no explanation for her suddenly low BG levels, but said if they go back up again that they could test for acro and IAA. Since right now she seems to be responding better to the Lantus, I'm OK with that, but if/when her numbers go up again, I'll get the tests done.

The bad news: I still don't know why she's peeing on the carpet! Except, it doesn't seem to be a physical thing. the vet suggested I could get her some glucosamine and see if it is a joint-pain issue, so it's off to Meijer for me!

Thanks for the advice and good thoughts, everybody. Any updates, I'll let you know!

 

Glad to hear the vet visit went well and did not find anything serious going on.

 

I'm so glad the vet's report seems so good. So there wasn't a bunch of fluid after all?

Just an idea...when Maggie got old she had trouble squatting and keeping her balance in the box because of her joints. She would actually wind up sitting on the litter and getting her bottom all dirty. We lowered the side of the box and used pee pads on top of a couple of layers of newspapers instead of litter and it helped a great deal.

 

I guess not! Or maybe there was, and Casey's body re-absorbed it? I'm not sure, but I saw the ultrasound and there was no fluid there.

Thanks for the suggestion! I'll try it!

 

What's Casey's current dose on Lantus? The spreadsheet stopped 2 weeks ago at 7u.
Be very careful to have the vet use a kitten sized tube if you need to have Casey get any work done that requires tubing in the throat because many acro issues are not seen .... you want to watch for soft tissue growth and sudden heart stoppage. You can delay the acro and IAA tests, but Casey will still be affected by the progress of the condition.

My acro, Shadoe, was the same with the peeing outside the box; the bladder may be too full and it rubs on the edge of the box, so adding a step up, or cutting the edge lower for Casey may help as it did for Shadoe. I also used newspaper and puppy pads along the front of the box and on the step in front of the box.

Gayle

 

Hi Gayle,

I updated Casey's spreadsheet. At the moment she isn't really showing any signs of having acro or IAA - in fact she seems to be responding well to an adjusted dose of 3.5u - and her heart looks normal (I saw it). Her heart is pumping normally, is the correct size, and is showing no signs of thickening or having any abnormalities at all aside from the murmur, which isn't that severe. The vet did not think she has acro, but if her numbers go up again I'll get the test done.

BTW, what's the treatment for acro? If Casey had it, what would I be doing for her that I'm not doing now?

 

Let me see if I got this right, you halved the dose and are getting blues??

 

I know! Weird, ain't it? I thought maybe it was because maybe Casey wasn't eating, but nope - she's packing away her food, pooping like a champ, and for some strange reason her preshots are suddenly in the low to mid-100s! I'm stumped, the vets are stumped, nobody knows why it's happening. She's healthy in every aspect (except her gall bladder). I'm going to do a curve today and see what I get. It's really odd!

 

Brainstorming possible explanations:

Maybe if the gall bladder bile isn't getting into the digestive tract, it could impair fat absorption which might reduce calories going in, leading to lower glucose levels.

Or maybe the pancreas is waking up a bit.

Or something else.

 

Treatment for acromegaly is radiation therapy to kill off the tumor. I understand that it can take a year after treatment to see the benefits of the treatment.

Maybe her dose was too high and you had bypassed a good dose.
Maybe she dose have acromegaly, but the pituitary tumor is dormant right now.

 

Thanks, Deb. I did have Casey at a dose of 3.5 for a while (see spreadsheet) but her numbers didn't change. So, who knows! In any case, as long as she's throwing blues I'll just wait and watch.

 

My Oliver tested positive for acromegaly and IAA. He reached a dose of 37u BID at one point, leveled off at 21u for quite awhile, then got sick and went off insulin within 10days. He's still acro, but has not received insulin since Jan7/2012.

The biggest worry for acros is surfacing to be the heart. Casey has a murmur; no surprise. Not all acro owners can afford to treat their cats with SRT, but they do watch closely for the internal issues that DO happen with time. Acros have headaches and joint issues and major heart issues in time... you can't see those kinds of problems in Casey.

I truly don't see the harm in testing Casey for acro and IAA, but it's your call. Not testing will not make the health problems go away if Casey were to test positive. You may want to look into getting an echo on Casey's heart if you are not going to test him for acro and IAA.

Gayle

 

I'm already watching Casey for signs of pain or discomfort; I've always done that with both my cats. My question is, if I knew Casey had acro, would I be doing anything differently with her than I'm doing now?

 

BJM, that's a possibility I suppose! She's at 9.5 lbs. right now, thinner than the 12 lbs. she was at before this whole diabetes adventure started but the vet didn't think she was too thin.

Without knowing for sure - and since all of her blood work and the ultrasound came out OK except for the gall bladder - I'm just going to keep her on 3.5us and see what happens. Unfortunately there isn't anything you can do for a bad gall bladder except surgery, which may not even be effective, and I'm not going to put her through that.

 

A thought, since I was reading about it for something else. Medium chain triglycerides appear not to need bile to be digested. When and if her weight becomes an issue, this might be something to discuss with the vet as a supplement.

'Nother thing which can happen is that the pancreas sometimes is unable to provide all the digestive enzymes at the necessary levels. You'll notice stinkier poo, it may increase in volume, and be a grayish mound, rather than formed feces. Its called exocrine pancreatic insufficiency (EPI). If you ever see anything like that, talk with the vet about adding in some digestive enzymes. Fortunately, those are over the counter and less likely to ruin the budget. :smile:

 

You don't say! In fact she HAS had some stinky poo over the last couple of weeks, and some diahrrea that was sort of grayish-looking. I took in a stool sample though, and they didn't find anything unusual, but maybe they weren't looking for that. Are digestive enzymes something I can just go to Meijer and get? If her gall bladder's gone wacky it might help...thanks for the info!

 

Here's one you might try:
Dr Mercola Healthy Pets Digestive Enzymes 5.26 oz
Has Betaine, pancreatin (protease, amylase, lipase), Ox Bile extract (45% cholic acid), Bromelain, and papain.

Amylase breaks down starch.
Lipase breaks down fat.
Protease and papain break down protein (papain comes from papaya and is found in meat tenderizer.

 

Thanks! What about this stuff? Petco carries it...

http://www.meijer.com/s/fresh-digest-co ... _/R-187138

Would that be OK to give to a diabetic cat?

 

Well, the cellulase may not be necessary if you're feeding a low carb diet; the other enzymes appear to be OK. I would encourage you to discuss it with your vet, just to make sure it won't interfere with anything.

I have some of the Mercola and no longer need it. I could probably meet you about halfway between Columbus and where you live.

 

You know, there IS something you may want to have done soon if Casey were to test positive for acromegaly...... check the heart!

Too many acros have heart issues, it's a silent killer, but with the help of meds, it can be better controlled.

You may want to check with Nancy and Pepper..... I think she said the same thing awhile ago "if I knew Pepper had acro, would I be doing anything differently with him than I'm doing now?"
Well, she has now found that Pepper does have some issues, and she is going for SRT later this month.

No matter if you go for SRT or not, it's better to know than not know. There are many other health issues connected to acromegaly, so depending on the state of Casey's organs, you may well need to add a few meds to his daily insulin shots. If Casey tests positive, he is not diabetic, but merely has diabetes as one of the signs of acromegaly...you would then need to move your focus to the condition of his internal organs.

Gayle

 

Hi everybody,

I just got off the phone with the vet, and based on everything we've done on Casey so far she thinks the strongest possibility is Cushing's. I'm taking Casey in on Monday so they can do the tests, and I'll get the results by Tuesday. If the Cushing's tests are negative, then I'll have her tested for acro (unless we can do both at the same time, which the vet is going to look into.)

I'll keep y'all posted, keep the happy kitty thoughts coming.

(PS Gayle I saw your post, and AFAIK Casey's heart is fine - the vet did an ultrasound on it and it looks perfect, no wall thickening or anything. All the other organs checked out too, except for the gall bladder.)

 

I am having my Tiggy tested for acromegaly right now too.. so sending healing thoughts. Let me know he gets on. But I do like his low dose - seems to be working fairly well although I would like to see more greens!

Keep me posted !

 

I will, Wendy. Paws crossed for Tiggy too!

 

Good luck tomorrow! let us know how it goes..

 

I am curious why the vet thinks it's Cushings... are you having issues with thin skin and ripping? No enlarged liver? Any balding?
Any chance you can find out info on exactly WHAT tests are being done? Some are a waste, and I don't think there is any firm yes/no result for cushings.
Most people wait until after testing for acro and IAA because there are just too many signs/symptoms that are the same for acro and cushings, but cushings differs with the skin & hair issues that do not affect acros.
Many vets think acromegaly is rare but it's not near as rare as cushings.
Unless Casey has the specific cushings signs, I think your money would be better spend on the other 2 tests.

Cushings Info
Many different signs of Cushing's syndrome can occur, including excessive drinking and urination (polyuria/polydipsia), increased appetite, enlargement of the abdomen, lethargy, muscle wasting, poor coat condition/hair loss, curling of the ear tips and the development of very thin and fragile skin. The skin can be so fragile that it very easily bruises and also can very easily tear.

Cushings
Symptoms and signs include the following...
concurrent diabetes in 81% of cases
polydipsia (excessive thirst) and polyuria (excessive urination)
pendulous abdomen
polyphagia (excessive hunger)
alopecia (hair loss) and poor coat
muscle wasting and weight gain in over 50% of cases
hepatomegaly (enlarged liver)
fragile skin syndrome in almost 50% of cases (skin may tear off easily)
infections
depression
weight loss in almost 20% of cases
easy bruising

In addition to thin skin and bruising, cushings disease can create skin conditions that include:
comedones (blackheads)
baldness on the trunk and abdomen
poor coat condition
abscesses
hyperpigmentation

Additional secondary infections produced by Cushings disease in cats may include facial abscesses, bacterial and fungal cystitis, pyothorax, bronchitis, rhinitis, pancreatitis, and demodicosis.

Cushings further info

Cushings Test Info from Dr.Lisa
You may want to ask your vet to peruse VIN if she/he is a member. I am not faulting your vet for the test that was run because it seems like this has never been very clear-cut but here are some excerpts from the VIN consultants with the date of their comments noted:
5/18/10 VIN consultant #1:
The ACTH stim has much lower sensitivity than the LDDS in cats. 60% of cats with hyperadrenocorticism return normal ACTH stim results.
That is, most cats with Cushings will not be picked up by a stim.
(LDDS = low dose dexamethasone suppression test)
6/25/10 VIN consultant #1:
The ACTH stim test is not recommended; it has very low sensitivity for Cushings in cats. The test of choice is a dexamethasone suppression test using the canine high dose.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other VIN consultants have recommended a UCCR...Urine Cortisol:Creatinine Ratio and while cushings can't be diagnosed simply by an elevation in the UCCR, it can be a useful tool.
The UCCR is a SENSITIVE test for Cushing's (e.g. very few animals with Cushing's would have a negative UCCR), but it is not a SPECIFIC test (e.g. many other diseases will make the UCCR elevate e.g. uncontrolled diabetes could).
So among the screening tests, we usually pick a LDDS to screen cats (using the 'high' dose for a dog DSP).
Adrenal ultrasound is also used since false positives and false negatives can be seen with the LDDS.
So, as you can see, the Dx of cushings is not straight-forward so you should probably keep going with your 'hunt' for answers....IF you and your vet are still concerned about cushings.

For the tests for acromegaly and IAA, have both the IGF-1 and the IAA tests done.... both are done only at MSU so they will have to be FEDEX'd and you won't have the results for a week or more.

Glad the heart looks OK; usually an echocardiogram is to be done to be sure.

Gayle

 

The vet wants to test for Cushings because a lot of the symptoms match (insulin resistance, increased thirst/urination, weight loss, poor coat, distended belly, lethargy). The Cushings test is inexpensive (about $100). If it comes up negative, then I can test for acro with the thought that there's a higher probability of it coming back positive.

I'll pass along the info from VIN, thanks. I'll let you know how it goes.

 

I took Casey in this morning, and the vet is going to do the LDDS test. I should have the results tomorrow.

 

I got a call from the vet's office, and it looks like Casey does indeed have Cushings.

The vet who's been looking after her is out of the office until Thursday, but when she comes back she's going to give me a call to go over treatment options.

I'll let you know what we get figured out. Thanks for the happy kitty thoughts!

 

I'm sorry to hear this, but it's always better to know what you are dealing with. Give Casey some head scratches from me!

 

At least you know what you are dealing with now. There is a board on here too dedicated to high dose conditions you might want to check out too: http://felinediabetes.com/FDMB/viewforum.php?f=12

 

I posted in the Facebook group for acro/high dose and hope some of the cushings owners will respond. They will know how the condition progressed for them and their cats, in particular the skin issues. I don't think they post on FDMB, but Linda and Bearman does.

Gayle

 

Thanks, Gayle!

I stopped by the vet's today and picked up some Vetoryl (trilostane) for Casey. Anyone know how to get these capsules into a cat? Can I open them, or do I need to get them down Casey's throat somehow? Like most cats, she is none too fond of pills,and these babies are capsules...

 

My guys never really liked pill pockets but they loved laughing cow soft butter cheese.
Some capsules can be opened and mixed in with food; maybe you can ask about that?

 

Any chance of mid cycle tests this weekend? Wondering what her nadir is..

 

Sure, I can probably do that.

ET I took her BG at +6 and it was 75! That's the first green I've ever gotten that wasn't tied in to her not eating or having other problems.

 

Hows she doing now? Did she really get those greens on 1.75? I might have tried that a bit longer...

 

Hi Wendy! Thanks for asking about Casey!

Casey's doing pretty good, it turned out pilling her isn't that hard. She lost interest in eating the 9 Lives I've always fed her, so I'm trying Sheba. So far she loves it! Wolfs it right down. Her appetite's coming back, which is great.

What's NOT great is she's still peeing on the carpet - not as much as she was, but it's still happening. And something's giving her diarrhea. I don't know if it's the Vetoryl, or the Sheba, or what, but her trips to the litterbox have been messy and a couple of times she's pooped on the living room carpet. It's not a lot of poop, just like a regular BM but liquid (sorry to be gross). This has been going on for about 3 days and I'm not sure what to do about it. Any suggestions?

Her numbers have been weird - she's been low in the morning, too low to shoot (63 this morning, 49 yesterday morning!) but by the afternoon when I get home and give her some more food, by dinnertime she's up in the low 100s so I've been giving her 3.5u at those points.

PS Debby, Casey says thanks for the head scratches!

 

Maybe the pills or food is helping.. Do you want to try the protocol again? I think she might be able to handle consistent dosing and reductions.

 

I'd love to, but her AM ps is too low to shoot. I'm not going to give her insulin at 63 and 49. This morning she was 27! Either the meter's off or something else is going on, but in any case I don't want to give her even a token dose when she's below 75. I might try giving her a smaller dose in the PM and see what happens.

 

27 is hypo! - I hope you gave syrup or HC to bring her up!!!. Remember Lantus can last more than the 12 hours.This seriously tells me you need to reduce the dose. I think her numbers look great and I would hate for her to have another hypo say when you arent home.

My thoughts with the protocol was more that you need to start reducing the dose when she earns it (goes under 40 once or under 50 three times), plus do consistent dosing. Now I know you arent shooting the full dose when she is low, so you need to find a dose you can shoot consistently to get the best effects out of lantus! I think her numbers are great and she might not need as much insulin now and you might be missing an opportunity to ease her into remission even. ( which is surprising given the Cushings)

So here are my thoughts

1. lets try to take her to 1.75 and hold her for three days
2. Reduce the dose immediately to 1.5 if she drops below 40 at all ( or under 50 three times) and then hold the new dose of 1.5 for three days
3. Skip if you see a preshot under 100 and cant be home to test. Otherwise give the shot and measure a +3 and more if she starts to drop. Be ready with syrup.
4. can you update your sheet?

Wendy
Wendy

 

I am wondering from what you said if she is going into remission already... can you update the sheet?