Diabetic cat with bowel disease - treatments not working

Discussion in 'Feline Health - (The Main Forum)' started by Dee123, Dec 29, 2017.

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  1. Dee123

    Dee123 New Member

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    Dec 29, 2017
    Hi there,

    I am posting hoping someone else has encountered the problems poor Harry is having. He is currently at the vets having developed ketones from his diabetes being uncontrolled. He was not eating enough with an upset tummy. His intestinal lining is inflamed (ultrasound) and nutrients are not being absorbed due to that and the blood glucose levels. He was treated the following way: he was given the fast acting insulin to get him under control. First 24 hrs on CRI. Then remained on it for another 48 hours. the following day he went on Lantus. The next day he was transitioned back to CRI within 24 hrs alert but they continued for 72 hrs. Then he was transitioned to lantus again for 2 days and was bright and alert. Then he came home. He exhibited some shakiness of the hind quarters the next day at home. It turns out that this was the beginning of the potassium levels plummeting again. His blood glucose dropped from 16.1 at 10 p.m. to 1.9 at 9 am the next day. He is now on predisolone to reduce the intestinal inflammation.

    He is on lantus insulin, and is seeing an internal medicine specialist who also specializes in diabetes. We are exploring all angles and trying to figure out why his blood glucose is experiencing such highs and lows in short periods of time and how to fix the inflammation issue that is causing nutrients to not absorb. With so many issues I am starting to wonder if they are all related. All the regulation issues and diet issues seemed to flare up after dental surgery. I noticed that a previous vet encountered that too after dental surgery (Harry lived with a vet for 2 years while they tried to adopt him out). They tried all kinds of antibiotics to treat the diarrhea that occurred- could that have done something permanent?

    History:
    He had diabetes for many years. He had problems regulating it before and they finally stabilized him. He also had pancreatitus. He came to us with limited information from a Humane Society where he had recently been moved as the vet clinic where he lived could not adopt him out after 2 years. They hoped the Humane Society would have more luck as they have a high adoption rate. We recently received more information from that previous vet, that had not been passed along to us by the Human Society. They had diarrhea problems with him that persisted. The diarrhea persisted even when everything else cleared up (pancreatitis, stabilized blood glucose on 2 units for 2 months and then increased to 3 units. He was transferred then and I suspect now that the blood glucose was never resolved. They noted that switching him from DM to WD fixed the diarrhea. I’ve included information from a previous vet as it shows what they did to stabilize him.

    He has had slight diarrhea since we adopted him a year ago. It is not liquid diarrhea, about 3-4 on the fecal scoring chart - formed, somewhat solid, but not truly solid. The weight loss seemed to speed up after he had dental surgery to remove teeth. Post surgery he had a diabetic episode and almost went into a diabetic coma due to low blood glucose. He was then switched from 3 units to 1 unit, but the blood glucose remained very high (15 - 24). It was increased slowly back to 2.5 units. He also refused to eat at times and couldn’t be given insulin. Was eating FancyFeat from Blinkey’s list - the wrong ones that manufacturer changed formulation as we later discovered.

    We sought advice about the weight loss and they discovered he is not absorbing the food nutrients and an ultrasound revealed a severely inflamed intestinal lining. Could be cancer or bowel disease. He is not well enough to be sedated for a test to determine which. We all agreed to treat as bowel disease. Switched to DM. He was not gaining weight and blood glucose was still high. Switched him to a raw food diet - Stella & chewy and also tried some gluten free canned foods. Nothing worked. He liked it for a few days and stool would become normal, then he would stop eating and/or stool would slowly change back. He became tipsy due to ketones in his blood and low potassium and was taken to a specialist in internal cat medicine and diabetes.

    Most recently he has been on 3 units of Lantus every 12 hours after being treated for ketones in his blood, low potassium and uncontrolled diabetes at the vet’s. He was on IV CRI and later Lantus there attached to some kind of special pump on an IV pole. He did really well as it was monitored hourly and his blood glucose regulated at 8 metric or 144 Imperial. He came home on 3 units of Lantus. He has lots of gas and did not like to eat due to discomfort at times. Rubbing his belly released gas and he ate. Stool normal consistency, but dark brown. He seems like he is not pooping as much. Potassium dropped again. Specialist investigating Somogyi effect.

    Let me know if I forgot anything. He is at the vet's now so we can't do much, but it would be good to hear what people think is going on. We are all stumped. I can post more details about what the previous vet treated him with.
    Thank you,
    Harry & Deea
     
  2. Sharon14

    Sharon14 Well-Known Member

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    Poor Harry :bighug: I’ll tag @Wendy&Neko hopefully she can give you some ideas on how to best help him.
     
  3. Dee123

    Dee123 New Member

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    Dec 29, 2017
    Thank you so much!
     
  4. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Hi Deea, welcome!

    Don't want to pretend - you have a lot going on with poor Harry, no doubts!

    My cat had ketones and other things and she pulled thru with a lot of home nursing. I don't want to lie - it was not easy but she pulled thru, and so have many other cats on here.

    Before I go into any details I want to urge to get prepared for Harry to be home treated: 1st is to fight off the ketones.
    For that you'll need to be prepared to:
    1. insulin - Lantus is very good for cats - X unit dose 12 hours apart.
    2. he has to eat. Force fed by syringe (or via esophagus tube like my girls had) is the must.
    3. when ketone's development is in the picture than electrolytes balance is a key - if the clinic was able to stabilize it - good - but you might be required to continue sub quat. fluids therapy at home - like Lactose Ringers solution daily for some time - talk to your vet about it.
    4. make sure you have Insulin, syringes to administer it, the testing supplies - lancets, meter (human is OK), strips and cotton balls ready.

    These I think we re the basics. I'll post more later.

    But most important - hang on, it is manageable and Harry can pull it thru.
    I say it because my cat Ducia did - and I have no medical training whatsoever, and no money for the vets.
     
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  5. Critter Mom

    Critter Mom Well-Known Member

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    Couple of questions:

    - Have his B12/folate levels been checked?

    - How is his thyroid function?

    - Is he underweight? If yes, how badly so?

    - How are his liver values?

    - Has the vet ever discussed triaditis?

    - Have pancreas assays been run recently? (Spec fPL (for inflammation) and fTLI (for possibly diagnosing feline exocrine pancreatic insufficieny (EPI)).

    - Have any food allergy blood tests been run?

    Useful sites for cats with GI problems/dysfunction:

    IBDkitties.net (be sure to look at the B12 info there)

    felineconstipation.org (excellent general information on anatomy and function of feline GI tract plus much info on treatments)


    Mogs
    .
     
    Last edited: Dec 29, 2017
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  6. Dee123

    Dee123 New Member

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    Thank you - yes we have him on lantus and have been injecting him for a year at home and doing home glucose curves. He was eating well. We did syringe feed him post dental surgery (messy!) and can do it again if needed. The issue became that even when he was ravenous, 3 cans/day, eating on his own he was not gaining weight due to either diabetes or bowel disease. Luckily the vet noted that after day 2 the ketones were gone and have not reappeared. He came home ketones free and even though we had to bring him back today due to the low glucose and low potassium, he is still ketones free. We have our meter and and are ready to go.
    Thank you so much. It is good to know that Ducia pulled through! It gives me hopes for Harry.
     
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  7. Dee123

    Dee123 New Member

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  8. Dee123

    Dee123 New Member

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    Dec 29, 2017
    All great questions. I believe B12 was checked in the past and he was given B12 injections. I need to look and see if it was this time.
    Thyroid is fine.
    Ill get the latest weight but he was around 6 lbs. not much fat at all. Muscle wasting. but he has started to gain while at vets and insulin under control. or maybe it is due to inflammation being down?
    No, no one mentioned triditis? Googling now.
    Yes pancreas was completely checked. He did have two episodes of pancreatitis before he came to us. I know they checked the EPI and it was negative.
    No food allergy tests. This was suggested today and I was wondering if it should wait or could it be a cause of this all?

    Thank you. This is very helpful.


    lbs I think?

    - Have his B12/folate levels been checked?

    - How is his thyroid function?

    - Is he underweight? If yes, how badly so?

    - Has the vet ever discussed triaditis?

    - Have pancreas assays been run recently? (Spec fPL (for inflammation) and fTLI (for possibly diagnosing feline exocrine pancreatic insufficieny (EPI)).

    - Have any food allergy blood tests been run?

    Useful sites for cats with GI problems/dysfunction:

    IBDkitties.net (be sure to look at the B12 info there)

    felineconstipation.org (excellent general information on anatomy and function of feline GI tract plus much info on treatments)


    Mogs
    .[/QUOTE]
     
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  9. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    mine restored it after better ( far from perfect) Blood Glucose (BG) level control. She has nice lean muscle legs now.
    Don't waste your time - whatever it is which is inflamed at the moment- the treatment is the same - eating enough calories , timely insulin doses + no infection/ inflammation going on. I , too, was offered a barrage of fancy tests - only to tell me eating + insulin+ antibiotics was all what was necessary. Ha, as if I didn't know before testing. Whatever is at fault - the treatment is the same - no infection, food + insulin. My experience tells me that the most fancy tests returns "inconclusive". And only "suggest" more testing...$$...

    Dee, I really hate to push it all on you but if you test at home and keep good record of it in a way we are used to read (spreadsheets) Henry will get so much more experienced eyes on him - people here have seen more medical cases of feline diabetes than any vet can possible (physically) do in his/ her lifetime! And they are happy to share.

    If you are wiling to take charge of this condition (diabetes) we are willing to share whatever we know about it.
     
  10. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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  11. Dee123

    Dee123 New Member

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    Dec 29, 2017
    Yes I'll definitely get on that spread sheet. We do test at home already.

    Thank you!

     
  12. Wendy&Neko

    Wendy&Neko Well-Known Member

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  13. JanetNJ

    JanetNJ Well-Known Member

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    Cats with ibd usually benefit from probiotics and b12 supplements. Some have said adding curcumin (active ingredient in tumeric) also helps.
     
  14. Dee123

    Dee123 New Member

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    Dec 29, 2017
    Hi, Posting to let you all know that Harry has passed away. I hope it is okay I posted in more than one spot as a few different people were helping me with his many issues. He had a seizure in the early morning (not blood glucose related) and passed at home. I really cannot write more at this point. I am too grief-stricken and wonder what else I could have done or when I should have noticed sooner. Poor sweet Harry.
     
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  15. Sharon14

    Sharon14 Well-Known Member

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    I’m so sorry:bighug:
    Fly Free Sweet Harry, Land Softly:rb_icon:
     
  16. JanetNJ

    JanetNJ Well-Known Member

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    Oh no....so sorry for your loss. :(
     
  17. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Very sad to read your news, Dee. I'm so sorry for your loss. If only love were medicine ... :(

    Easier to say than do, but please try not to dwell on the 'what ifs'. Harry could not have been more loved or better cared for.

    (((Dee and Spirit Harry)))

    :bighug::bighug::bighug::bighug:


    Mogs
    .
     
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  18. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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  19. Sandi & Whisper

    Sandi & Whisper Member

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    Oct 2, 2015
    I believe in the concept of the Rainbow Bridge wholeheartedly, because I think I so badly NEED to, but I have to admit that the poem/story itself shatters me :(

    The simple phrase that has given me comfort in times when I've lost my babies is as follows -- I know not to whom it should be attributed:

    "If love could have saved you, you would have lived forever"

    I've just been watching your story all along because I didn't know how to help, but your love for Harry comes through clear as day. For me, this phrase reminds me that everything that I did was done with pure love, and I am able to let go of the What Ifs because of that. Whatever I did, it was the best that I knew or could do. I hope you can feel the same.

    I am so sorry. Fly on your new wings sweet Harry. cat_wings>o

    Sandi.
     
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  20. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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    I'm so sorry Harry is gone. :bighug::rb_icon:
    downloadfile-6.jpg
     
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