? Diabetic wont eat or drink.

Hello,

Our cat was diagnosed with diabetes I think around 3-4 months ago.
We had to give him a high dose of around 3 ml insuline twice a day which made him feel good again. Then, around 3 weeks ago, he started to suddenly become slow again and the vet said his sugar level was very low, and we had to give him less insuline(1,5).
From there on out he didnt want to eat or drink anymore and he got spazzes from the insuline we gave him. We tried to feed him too by giving him wet food or water drenched dry food, but he really dislikes being forcefed and tries to spit it out.
Hes getting weaker and skinnier by the day, and my mother thinks that he has kidney failure and doesnt want to put our cat through all the trouble just to prolong his life by a few months and wants to put him out of his misery soon.
What I wanna know if it is possible that his kidneys arent a lost cause yet and that perhaps his body might just really be out of balance by wrong insuline intake, or anything else really, and that we might still be able to save him or drag him into balance again, without putting him through all the crap terminal beings go through. Or maybe some of you know the symptoms my cat is showing and could point me to some things i could also try. Any help would be appreciated.

If you have any questions or if you need more details feel free to ask too,

Thanks for your time in advance,

 

Are you testing at home? If so what have his preshot numbers been?

 

Absolutely it's possible that his kidneys aren't a lost cause. There could be any number of reasons for his behavior.

It'd help if we knew whether or not you're home testing, it's really important to do so. If your vet tells you it's not neccesary, he/she would be very wrong. Also, what type of food are you feeding, (almost all dry food is too high in carbs) what meter are you using (if you're home testing) and what insulin are you using? I'm hoping a few more people will chime in soon!

 

Home testing is a must! My kitty can have a 448 number and 5 hours later have a 99. If you are only having your kitty tested at the vet there is no way to know what is happening before or after that test. If your kitty has shown low numbers then it is much more important to be testing the glucose levels at home. This behaviour may not have anything to do with his kidneys, unless blood work has shown poor test results.

 

Thanks for your quick responses everyone i will try to answer all your questions as best i can:

Ferndoc: im not entirely what you mean by ''preshot numbers'' but i assume you mean his glucose level before he started taking insuline; it was a high 27.
Also we never tested at home and our vet never brought testing at home up apparently. My mother found out about it by searching on the internet though, and says you have to put a needle in the toe of the cat which she isnt comfortable with since she thinks itll cause great pain, and she doesnt think its necessary since the vet never bought it up.

Mogmom and Goofus: We dont test home, see above for more info.
We are using food ordered at our vet: Hill's, prescription diet m/d feline weight loss - low carbohydrate - diabetic and it says its: clinically proven weight control. diabetic glucose control.
The insulin we use is: Caninsulin, and i think it says it contains pig insuline, whatever that may mean

Tuxedo Mom: The kidneys were tested once right before he first started taking insuline and they were perfectly fine back then.

Also i wanna add that our cat had what our vet thinks was a hypoglycemia coma or something of the sort.
Also on a sidenote i would like to add that im not english and im trying to translate our terms to english terms as best I can but there might be some terms that are wrong.

Edit: I'd like to add that our top priority right now is some way we might get him to eat and drink again without us forcing it down on him too much. He really doesnt want to, but hes really starting to get weak from not eating and drinking and seemingly starts to retch from just having the food near to him.

 

27 is very low….
PLEASE begin home testing…. your cat could be in remission or in desperate need of a lower dose-
hypo is very dangerous and there is no way to know without testing at home-
I am going to bump this post for more experienced eyes to help you…
@Chris & China @Sienne and Gabby (GA) @Wendy&Neko @julie & punkin (ga)
BUMP

 

@GTS @Asrael
bump

 

@Carl & Polly & Bob (GA)

 

@AZJenks

 

edited the last section of my previous post incase people havent seen it!

jayla: I searched at google and apparently we use different measuring tool here in europe than in america and I read that 27 could be compared to 486!
Also we stopped giving him Insuline altogether because he started to spaz out and get into a coma from it. Thats why were at an impasse right now; We cant give him anything because hes not eating and drinking.
Since everyone here really seems to say that testing at home is very important ill definitely go look into that asap.
And thanks for calling out the experts!

 

Omg, I'm so glad others are seeing this! This poor bean has been so misinformed.

Faas, its only a TINY poke with a lancet that's about 1/16th of an inch long, it doesn't hurt them at all! Cats have VERY LITTLE feeling in the paw pads, its the large pad that you poke.

I know its sounds strange, but the prescription food your vet sold you is way too high in carbohydrates, it needs to be 10% or LESS.

It would help us also if we knew where you're located, it helps with the numbers and their meaning.

 

Is the 27 mmol (rest of world), or mg/dl (US) ?

What type of insulin is he getting?
3 u twice a day is a very high starting dose.
The kidneys aren't necessarily a lost cause.
But to help your cat need to start home testing. Most people use human meters you can get them at a pharmacy, the important thing to look for is one where the test strips are more economical and those that require a small test sample. In the sticky at the forum New to the Group there are links and info on home testing, I really would strongly encourage you to start home testing.
The Hills dry kibble you have been recommended is too high in carbohydrates, of the top of my head, I think it's around 20%, he needs to be having less than 10% carbohydrate. I too was recommended to use it, but I refused. With his kidneys being a problem dehydration can make matters worse so you need to look at getting wet food into him. Where do you live in Europe? I am in Spain.

 

Faas, have you tried maybe meat baby food with syrup mixed in? Worst case it is an easy food to syringe feed.

 

I can help with suggesting food that is low in Carbohydrate that is readily available in Europe I get mine delivered using an online supplier ZOOPLUS they deliver all over Europe.
But I am not sure what the implication of CKD on his diet are. I haven't got the experience to offer advice on that front, but I know that there are many here who have cats with kidney problems that may be able to offer better advice.
Please change the title on your thread to reflect the kidney problems.
something like 'Newly Diagnosed Diabetic wont eat or drink CKD advice please' then you will be more likely to get members with experience helping, hang in there.

You can change the title by clicking on edit title at the right at the top of the thread. also select the prefix with a question mark that will let members know that you have a question.

ETA I have made the assumption that he has been diagnosed with CKD, but you haven't exactly said what the problem is with his kidneys???

Are you testing for ketones?? you can do this using Keto Stix again you can purchase these from a pharmacy.

 

Mogmom and Goofus: Im from the netherlands in europe and looking at GTSes options; were using mmol here.
Also it is indeed kinda strange that you are saying that the vets prescriped food isnt low enough since it says it has low carbohydrate but ill go look into this.
Also glad to hear that the needle probably isnt so bad as it sounds, seeing as everyone here says its very important!

GTS: 27 mmol/l & 486 mg/dl
Im not sure what kind of details you want about the insuline. What i can gather from the bottle is; caninsulin 40 IE/ml.
We actually started with 2 ml insuline at the beginning but his glucose level stayed high when we did tests at the vet. so we then rose it to 2,5ml and finally when it would still be too high, to 3ml. But then after a few months when we would check back again at the vet his glucose level was a low 10 mmol but the vet did say it could be stress and recommended going to 1,5 ml. After that he didnt want to eat and drink anymore, and thus reacted really bad to insuline by spazzing out and having a small coma so we stopped giving him insuline.

Tomorrow well go on a hunt to get less than 10% carbohydrate food to. And try injecting it in his mouth, watered down, with a injection thingy(cant come up with the name atm)if he wont eat it, and heres hoping his body wont reject it and hell start to puke it out... But right now ill go to bed since its almost 1 am. Ill respond tomorrow asap and thanks for all your helpfulness so far everyone. its good to see so much dedication for our little friends here. when out in the world; there barely is any tolerance for cats whatsoever.

 

your doing good--we are here to help--I am sure some of the experts will drop in to offer advice--please do not be overwhelmed as it will be second nature in no time… hang in there you will be glad you did! So glad you found this forum

 

I recommend you look at doctor Lisa Piersons website very informative about feline nutrition,I would read through it before you go out hunting for food, it will save you time and money, it will explain all about protein, the con of 'prescription diets', what to look for and how to calculate carb content of cat food, as you will find that the carbohydrate content won't be specified on the packaging, on my signature there is a link for cat food nutrition calculator, I have found it to be a very useful tool when researching foods to buy.

Here is a food list for the UK that another member put together you may find it helpful, I am sure some of the foods are available to you in the Netherlands UKfood List

I would post up on the forum for caninsulin for advice that is specific for that type of insulin. edited (sorry best continue asking for advice on this forum there are not many users on the caninsulin formum)

My George was diagnosed in October, but he is on Lantus, its a human insulin, slower acting than Canninsulin I believe which sometimes works better for cats, the canninsulin is faster acting and in some cats doesn't last long enough.

You really need to start testing at home (from what you are saying I don't think you are)
10mmol is quite a low reading at the vets as usually most people find that their cats BG is about 6mmol (100mg/dl) higher due to stress at the vets than at home, it sounds like that was your case as what you are reporting is with your cat spazzing out sounds like a symptomatic hypo event.

I would not give anymore insulin for the moment, as he had a hypo event, get yourself set up testing at home asap with a human glucose meter and some ketostix (to test for ketones in his urine), and ask for dosing advice on caninsulin.

When my cat was diagnosed I asked my vet to put him on to Lantus, because I had read that as a general rule, lantus was more successful at getting a cat's Blood Glucose well regulated and studies had also shown that there was a better chance of remission from diabetes.


speak to you tomorrow

Gill

 

It's hard to say a cat has kidney issues without blood work being done. I recommend talking to your vet and getting blood tests done. He/she may also want a urinalysis to see how well the kidneys are concentrating the urine. My Neko started on Caninsulin - it didn't last very long on her, so we switched insulins. She also has early stage kidney disease. The main difference in food for kitties with kidney issues, should the blood tests confirm that, is that you want something with low phosphorus. The website Tanya's Guide to CRF is a good one for kidney disease.

If cats go too long without food, then you have to worry about hepatic lipidosis (fatty liver disease). The vet can give you high caloric easy to syringe foods (such as Iams MaxCal or Royal Canin Recover RS).

A lot of us home test our cats on the edge of the ears. There are very few nerves there. Here is a post on Hometesting Links and Tips. It includes videos links.

 

Just saw this- Thanks for the tag @jayla . Looks like you have gotten lots of good info from everyone here And glad the 27 was not the American version

Hoping you get some answers soon and can get the blood testing figured out- It will help alot, and it is easier than you think.

You are definitely in the right space for help and support- people here are amazing, so much good advice, kindness and support in all ways!

 

It is important not to jump to conclusions for which there is no solid evidence base. Your cat could have lost its appetite for any number of reasons. If his kidney values were fine a couple of months ago that is a good thing. It is impossible to tell whether the appetite problems are anything to do with your cat possibly having CKD. You need proper diagnostics run to determine how your kitty's kidneys are functioning.

Without blood glucose data it is impossible to determine your cat's diabetic status but it's clinical signs are concerning. All cats need to eat regularly or it can cause serious problems such as hepatic lipidosis (potentially life-threatening). It is even more important for a diabetic cat to have regular food intake because diabetics are at greater risk of developing ketones and subsequently diabetic ketoacidosis (DKA - also potentially life-threatening). With your cat not drinking either that is likely to make him dehydrated and that will make him feel poorly too.

I recommend in the strongest terms that you call your vet in the morning to get an immediate appointment. Don't delay.

Ask your vet to test for ketones (if they're present they will need immediate treatment by the vet) and also to run a fructosamine test to determine what has been happening with your cat's BG levels over the past week or so. Your vet will need to draw blood for the fructosamine test so will be able to check kidney function at the same time. I'd also suggest asking your vet to order tests for B12 and folate levels.

Ask your vet about giving your cat a B12 injection. It may help with appetite stimulation and give him a general boost.

Your cat may be nauseated for some reason (e.g. pancreatitis, food intolerance, other cause) and that could be putting him off eating. Also because he's not getting much food there is a possibility that his tum may be irritated by excess stomach acid. Does he vomit at all? Here is a very useful link to information on nausea symptoms and treatments from Tanya's Site:*

There are very effective anti-nausea and appetite stimulant medications available for cats which could help a great deal in getting him to eat again. I strongly recommend that you get your cat to the vet tomorrow. Cerenia injections can help with nausea and vomiting. Generic ondansetron, also for nausea, can be easily administered at home. For appetite, mirtazapine and cyproheptadine can both stimulate appetite. Some things to bear in mind:

1. Mirtazapine is very strong - a dose of 1/8 of a 15g tablet can last three days. It can induce serotonin syndrome (a potentially life-threatening condition - antidote is cyproheptadine). Very, very conservative dosing is best in order to determine the cat's response. Close attention needs to be given to potential interactions with drugs that affect serotonin levels.

2. Cyproheptadine is milder and a dose doesn't last as long but that has the advantage of allowing more control over how much appetite stimulation is needed, but caution is needed regarding liver issues. Again conservative dosing is a good idea (e.g. 1/8 of a 4g tablet for a 4.5kg cat) to determine the cat's reaction as cyproheptadine can cause drowsiness and depressed mood if the dose is too strong.

If your vet thinks stomach acid might be a problem then famotidine or ranitidine can help with that (more info on the Tanya's Site link). At the far end of the scale, you could always ask your vet about putting a feeding tube in place.


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UNDER NO CIRCUMSTANCES change your cat's food to a lower carbohydrate food until his diabetic status is determined and until you are home testing his blood glucose. Changing from a higher carb food like Hill's m/d to a food with less than 10% of kilocalories from carbs can drop blood glucose levels significantly and quickly so if your cat goes back on insulin doing the food change without testing could increase the risk of hypo. Doing a gradual changeover with home BG monitoring is safer and also less likely to cause further digestive problems. We can help you with that later.

I am very concerned about your cat's status at the moment. It is possible that as a result of its initial insulin treatment your cat's pancreas may have started to recover some of its function hence testing at 10mmol/L in your vet's office and the vet subsequently reducing the Caninsulin dose. It is impossible to know what is happening with your kitty's blood glucose and insulin levels in real time without home testing so I am speculating here. Caninsulin can produce some very steep drops in blood glucose levels when it kicks in. If your cat's pancreas had started working then the combination of Caninsulin and its own insulin working in concert could be the cause of the suspected hypo episodes. Again, daily home testing would give you the information you need to adjust the dose of Caninsulin or to skip a dose if the pre-injection blood glucose level is too low to safely give insulin. Finally, it can be the case when a cat has had a symptomatic hypo episode (e.g. twitching, coma) it can become much more sensitive to insulin afterwards. This means that a previously OK dose may end up being much too high for the cat's new insulin needs. Continuing with the dose could lead to further hypo episodes.

There is also another problem that can occur if an insulin dose is too high; it can result in BG numbers being driven higher as the cat's body will start to release stored sugars and counter-regulatory hormones into the bloodstream in an effort to protect the cat from dropping too low. This can result in the return of excessive drinking, peeing and hunger symptoms and, if the high numbers persist, to further diabetic complications.

As other members have advised, home testing can tell you what's happening to your kitty's blood glucose in real time and it helps so much in determining insulin requirements and is the best thing for helping you keep your kitty safe. Paw pad testing has been mentioned, but it is also possible to get blood samples from a kitty's ear. Indeed, ear testing is probably the more popular method. If you would like to learn how to test (and I think it would be very, very helpful to you if you do) there are lots of education resources here and also we're around to give hints and tips if you need specific help.

For future reference, Tanya's Site has a wealth of information about CKD and how to treat it. Should it turn out that your kitty were to have kidney issues there are plenty of things that can help CKD kitties feel much better, have a good quality of life, and slow down progression of the condition.



Mogs
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Hi guys im back,
We actually brought our cat to the vet this morning because his skin and mouth were getting yellow they are going to do some tests for his kidneys and liver, feed him and give him something against the nausea. He might be there for a few days but well be updates inbetween about their findings.

Ill try to go through all your stuff now and answer and ask question:

ferndoc: Do you mean just regular human baby meat food? With the kind of syrup we put on our pancakes?

GTS: We actually arent sure if he has chronic kidney disease(we are getting it tested right now). My mother thought he had it since we had a previous cat who also had it, and apparently our cat now shows similar signs.
Also thanks for the advice about adjusting the threat title but we arent sure if he has CKD yet but i atleast added the little ''?''
And ill look into ketones too, thanks for the suggestion.

jayla: thanks, its definitely a bit to take in for me since its more my moms cat, and she was more into the whole diabetic rhythm. I only gave him some insuline now and then. But since she cant speak english, and i think some international help could be more insightful, i stumbled upon this. So far im really impressed and thankful by the dedication for animals you guys show, so im glad i found this too!

Ill answer more later but we got word of the vet and he said that his organs are in awful shape and we have to visit a specialist asap.

 

Yes Faas regular human baby food just make sure there is no onions or garlic in it. (try to get just meat and water but meat a thickener (such as cornstarch) and water is fine also). I actually mentioned this minus the syrup to my parents who just had a cat recovering from surgery and not eating. When they told their vet at the follow-up their vet said that's what the vet does sometimes. If it is Hypo and you want short acting carbs yes pancake syrup works, so does honey or Karo (corn) syrup. Because I keep it in my house regularly my plan is to use maple syrup.

 

Sending Prayers for your little guy

Keep us updated. I hope the vet can offer some solution for him.

 

Sending hugs and prayers for your fur baby.

 

Faas:

Depending on how long your cat hasn't been eating and that you're noticing that his skin has a yellow color (i.e., jaundice), there is likely a liver issue. Cats need to eat or within a few days they an develop hepatic lipidosis or "fatty liver" problems. This can be serious. I'm concerned that your vet is very casual in his approach to the treatment of your kitty.

You may need to start assist feeding your cat. There is a Yahoo assist feeding group that can help you with this.

Also, this particular part of the FDMB site is for people whose cats are prescribed Lantus or Levemir. These two types of insulin are very different than Caninsulin. Frankly, can insulin is not an insulin that is best suited for cats. You may want to post on the general Health board since there are more people there who have expertise with the kind of insulin you're using.

 

Hey guys,

We are currently leaving our cat in the care of the vet liver specialist(something like that). He is on infusion and most likely has liver fattening in a medium(ish) stage. So what theyre doing now is: theyre giving him potassium and theyll try to get him to eat naturally, by getting the cycle in motion again. So right now were kinda hoping that hell get an appetite again, but its not sure hell pull through. He said this might take up to 5 days.
Ill read what you guys wrote thoroughly through later though, hope you dont mind. And ill keep you guys updated. Thanks again for everything so far!

 

Prayers for your kitty to pull through, and for a wise vet to help him do it.

 

Five days may be much, much too long to wait when there is another - potentially much better - treatment option available: a feeding tube.

Here is an article about feeding tubes written by internationally respected veterinarian Dr Lisa Pierson:

Feeding Tubes for Cats

From the article:

A few years ago one of my cats went off her food and developed hepatic lipidosis. Her vets put her on a drip, gave her appetite stimulants and adopted a 'wait and see' approach to her treatment. By the time I found out about feeding tubes (from the internet, not from the vet ) it was day 4 of her hospitalisation. After I asked them about giving Danú a feeding tube it took another 24 hours before they finally agreed to put one in. It was a weekend so, instead of treating my girl's case as the emergency it was, they scheduled the procedure for the Monday. I lost my little one at lunchtime on the Sunday. They waited too long.

I hope you will ask your vets about the option to give your cat a feeding tube. As Dr Pierson advises, if a tube is an option then it is better to do it sooner in order to reduce anaesthesia risks. If ever I had another cat with hepatic lipidosis a feeding tube is the very first thing I would ask the vet about. Speedy treatment really is critical: the faster you can get food into the cat, the better.

Fingers and paws crossed for your kitty.



Mogs
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I've been gone and have just now see the tag . . . and your sweet kitty is staying at the vet's now. Just wanted to wish you the best of luck! I hope he rallies and is home soon.

 

Hi Faas,

I'm wondering how you and your kitty got on.


Mogs
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Sending prayers and healing vibes to you and your kitty.

 

Hope your kitty is doing ok.