Diabetes & IBS, Cat Not Eating, Going Downhill- Help!

My newest adoptee 4 months ago, is now a diabetic and appears to be an IBS kitty as well. One month into owning him he developed bad asthma and he had a Depo Medrol shot which appears to have brought on the diabetes. On his preadoption bloodwork his glucose was 172, very slightly above normal, which 2 different vet offices said was due to stress. Note- I own 10 other indoor cats. This one is 8 to 10 years old. It took a while to figure out he had diabetes, the first 10 days we tried him on a low carb diet and he went downhill so we put him on insulin. We started a 1 unit twice a day, he got worse, so after a vet visit we went to two units, and after yesterday's visit we did one night at 4 unist (per vet) and now we're at least temporarily on 3 twice a day. I started testing this a.m. Pre shot was 625, 4.5 hrs later it was 352. I cannot test 4 times a day, 2 will be the max and my vet says do it 6 hrs AFTER his shot, not before. His appetite is not good, his water consumption above normal, and his stool soft to diarrhea. He's not very easy to handle but not terrible. Last night we started him on Cerenia (anti inflammatory) for the IBS lplus Zenequin (antibiotic) in case he has a pancreatic infection. Bloodwork results from yesterday are pending. His food, Friskies and Fancy Feast pates, Royal Canin Gastro High Energy for his IBS because he keeps losing weight and he's already very thin, and white meat turkey as a last resort when I need to make sure he'll eat before his shots. I am seeing this cat wasting away before me so help! Suggestions please.

 

Hi, welcome to FDMB! You have come to the right place for help with diabetes.

Your vet is right, it’s important to test after a shot to see how the insulin is affecting your kitty, but it’s also essential that you test prior to a shot to make sure it is safe to give it. 4 units is a fairly large dose. Due to something we call “bouncing”, too much insulin can sometimes look like not enough. Simply put, if a kitty drops too fast, too low or lower than usual, a bounce into higher numbers can occur which would give higher readings. This can take a day or so to settle and increasing a dose based on one or two high numbers is not safe.

 

Thanks. I'm only giving 3 units now- not 4. We'll leave it at 3 if he remains no worse and do a fructosamine test in 2 weeks. Talked to the vet, white cell count is high, no urinary track infection. No ketones. Urea a bit high explained by the diabetes. We need to get him to eat food consistently which he is not doing. And until we can do that his diabetes will not be controlled. More pudding like stool tonight. I cannot test 3 or 4 times each day at this point- until I get better at getting the blood it is too traumatic. The cat doesn't stay still and he will bite hard. Giving the shot is more important. (I will test 1 or 2 times a day.)

 

Have you ever tried sprinkling Forti-flora on his food? It's supposed to be a probiotic, but it's really not a very good one, but most of us use it as a sprinkle to get our kitties to eat

I seriously think China would eat sawdust if I sprinkled it with Forti-flora!!

The Royal Canin is high in carbs so it's going to make it harder to get his blood glucose under control. Kitten food is higher in calories ….you might see if he likes it. Fancy Feast kitten is low carb too

 

Thanks. We realize that the Royal Canin is higher in carbs but we need to get food to stay in his body and the IBS isn't allowing that- hence the special Gastro food. I can try kitten food, but it's not just the protein we're after but special a gastro sensitive. As of this very early morning he vomited everything he ate last night and I just tired about 6 foods on him, including from the "no no" list and he's eating nothing- not even his favorite white meat turkey which is usually my last resort. I wanted to see how bad his glucose was and I can't even get blood to test. I guess I'll be back at the vet this a.m. so will see if they have Forti-Flora 'cos then can get it immediately.

 

Update- my cat is at the vet for a week or so as they run more tests regarding his IBS, coughing, and a leg issue and stabilize his diabetes/insulin. He was getting worse and worse here. He vomited up his food during the night and refused to eat more than a bite or 2 this a.m. so off again to the vet we went. I hope they can stabilize him and get him to consistently eat.

 

If he has an infection then that will also cause the glucose readings to be high. Like it was said above, it is important to test before shots especially since your dose is very high even at 3 units. As the infection starts to clear up his glucose levels will probably lower. If you continue giving 3 units without testing, it is possible your cat could become hypoglycemic. That is a very dangerous condition especially since your cat has other health issues. Most likely you will need to lower your insulin dose as the infection is cleared.

 

Thanks-

Thanks. I do understand what you are saying but I also know best my situation here. The cat is at the vets for the next week or so until he is stabilized- his insulin and his IBS, and a leg and asthma issue. Once he is home I will be doing as much testing as I can successfully do without stressing the cat too much. I don't want him to run when he sees me coming. My vet feels 6 hrs after the shot is the most important and then as I get better about the ear puncturing I'll go from there. If I am testing when his levels should be at the lowest, 6 hrs in, I do not understand why testing right before the shot is critical. Desirable yes, critical no. I would be surprised if the cat needs to stay on 3 units after he is stabilized. The vet desires the minimum needed and isn't happy about 3 units either. Once again, thanks.

 

I understand. The reason you test before every shot is to make sure it is safe to give the dose. For everyone that is starting home testing, we recommend not giving insulin if the reading is less than 200. The reason is to prevent the cats glucose levels from dropping too low and becoming hypoglycemic if they are given insulin. That is very dangerous for a cat. As the person becomes more experience d and know how their cat responds to the dose, they can lower their "don't shoot" number.

If you reward your cat with a low carb treat every time you time you test, he will associate testing with being rewarded and not be afraid of it. I have had 4 diabetic cats and when it was time to test they all would be waiting for me so they could get their treat.

 

I'm still unclear about one thing. If the glucose level is lowest 6 hrs after the shot (at least for Lantus) why would it be even lower right before the next shot. Wouldn't that be a real rarity? (I know the blood levels sometimes do go up and down.) And if it isn't the lowest 6 hrs after the shot why do I need to be concerned about that time? Low carb treats- I splurged and got the dehydrated chicken treats someone said were great. Most of my 11 cats won't touch them including the diabetic. (ha, ha) (I'll use chicken or turkey pieces.) Note- although I am vey good with cats in general, esp ferals, I do not have a nice smooth manner, so every time I have to learn a new procedure it takes me a lot of practice. Hence the ear piercing problem, My whole body just tightens before I have to do it. I'm sure in time it will get much easier.

 

Every cat is different on how they respond to insulin. Even how they respond to every dose can be different. While generally the lowest glucose level can be 4 to 6 hours after their shot it is not unusual for a cat to have a low glucose reading 12 hours after their previous shot. For example in my last two diabetic cats, at least once a week their pre-shot number would be too low to give insulin. This happened enough times to know that this was a pattern that would always occur each week. If I had not been testing, I would have given them insulin when they did not need it and it could have had serious consequences.

By testing before every shot you will know whether it is safe to give the dose. If you have to skip a dose, it will not harm your cat. It is better to have a higher glucose reading for a few hours than a few minutes with a glucose that has dropped too low.

We can help you learn how to home test. Initially it might seem hard but once you find the method that works best for you it will be much easier. Also other benefits of home testing are that you have more knowledge how the dose is working for your cat. If the dose needs to be changed we can help you with that to get to the next dose. Also, it eliminates the need to take your cat constantly to the vet just to be tested to see how well the insulin is working. Many of us can also tell you that the bond we have with our cats has become stronger because we test.

Some vets do try to discourage owners from home testing. Don't be surprised if this happens with your vet. They give a variety of reasons such as it's not necessary or it's too hard for you to learn how to do. But think of it this way, if your cat was your child and diabetic, would you give insulin to your child without knowing it is safe? You are the one who is responsible for providing the best care for your cat. Home testing is just another tool to be able to provide the best care and make sure he is safe.

 

I am on board with you! Dre has the same pattern--every now and then his pre shot is like 50 on AT--usually 200s
It is strange but I guess his depot is full-on lev

I also agree with vets discouraging testing and it drives me nuts-Dre would not be with me without this forum (thank you @Chris & China )
When he dropped the first time Chris stayed up with me very very late!
I paid a feline "specialist" in CA for a consult --300$ later she told me to leave his poor ears malpractice in my eyes!
His ears are perfect! and he is 19 and thriving

 

Once again , thanks. My vet didn't give me a hard time about testing once she knew I wanted to do it. They don't suggest their clients do it because they've seen too many emergency room visits when the client played around with the dosage. I asked and only 2% of their clients test. I told my vet I wouldn't INCREASE dosage without consulting with her. I've been going to the same vet practice for over 40 years and have developed a very trusting rapport with the vets there. The old vet there, who to me is as close to a God as a person can get for his treatment of animals and their owners, recently (he's in his 80s now but still practices) turned over his practice to a woman who started out in his office as a dog walker, and then worked her way up and is now a vet. He says they agree on how things should be done. She's great and is open to new ideas from her clients. But it is a 2 way trust. I have no problem questioning anything she says but I am unlikely to do something she specifically tells me not to do.

 

That is great that you have a good relationship with your vet.