? Does anyone have an anemic cat?

Hello!
I changed the vet as the old one did not know anything about diabetes. The new one should be and expert on diabetes. Appointment will be on the 4th of April. I think Sassu is going to die before that. I really do. I am drowning in my tears. Now I know that he might have anemia besides that and there is absolutely nothing I could do to help him...

 

Hello!

Although noone seems to be bothered with me I am still waiting for some advice as the next available time for a vet is on the 4th of April.
Thank you in advance!

 

Hi Lilian,

I don't know how things work where you are from, however, I know when I have had to get my kitties into a vet immediately a lot of them can make that work. Have you called and asked? Often times you can be seen between appointments and such. I have had to do that several times with my kitties, most recently with Hedwig. Please call and ask, let them know that it is an emergency and that you really need to be seen as soon as possible. If they can't do that, do you have other veterinary options in your area?

I wish I knew how things worked in your home country to be able to assist you better. Please keep posting, and keep asking the vets for help.

 

Thank you for your reply. I have visited 2 vets. Both knew nothing about diabetes. One thought that 437 is a good number for a cat, she did not know how to inject and she said Sassu's labs were fine although they were not. The other I do not even want to talk about. This vet (4th of April) should be the best diabetes specialist in Estonia. I begged them to give me an emergency time. They said that everybody wants an emergency time. I said that my cat might die before that. They said that there is nothing they can do about that. I really need to get some iron into my cat. Has anyone used
Liqui-Tinic 4x Flavored Vitamin and Iron Supplement? I could not read out is it safe for diabetic cats or not.

 

Hi Lillian. Please tell me how someone can help you. Do you need dosing advise?

 

Yes, I do. I increased today all by myself. Besides. I wonder if here is someone who has a diabetic cat who is also anemic. I really need to know about iron supplements. And it would be good if someone who is making cat food herself would share how they make it. I already ordered TC Premix.

 

Here is the link to yesterdays post
http://www.felinediabetes.com/FDMB/threads/423-before-injection-2h-473.154470/#post-1628867
And your earlier post today.
http://www.felinediabetes.com/FDMB/threads/advice-needed-vet-on-the-4th-of-april.154519/


Lilian

That's a long time to wait for the new vet, are they on holiday??
Is there another vet that you might be able to see regarding the BW results in the interim?

I am sorry I don't have any advice regarding the anemia, I have no experience with this. I hope someone can help guide you soon.
I really wish I had some wise words to say about his other possible health issues, I really do understand how frightening this must be for you.

I see that you have increased the dose tonight to 3units from 2units, I am guessing that's because you are concerned about the 546 just before your insulin shot, I am concerned that that is a big change, ~(I realise that this is because of the issues with the syringes) further more it is advisable to let the dose settle, 4 cycles isn't usually long enough, with lantus it takes a while for the depot to fill that is why we usually hold the dose for 6 consecutive cycles before we increase a dose, so we can see exactly where that dose is taking us. You need to keep in mind that the dosing with lantus is based on how low the dose is taking him and not on the preshot value.
When you shoot a dose part of the dose goes to work straight away and part of the dose fills a 'tank' and is slow released, every time we change a dose the depot/tank has to adjust, I haven't explained that very well please read this link where it is explained more clearly http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/

The TR protocol a lot of us follow is already an aggressive dosing protocol and changing quicker than that could land you in trouble with low sugars if you over shoot the ideal dose, I know it seems like you are not getting anywhere, when I started dosing George his numbers were high, all red and black, we started on the 28 october and it wasn't till the beginning of december that we saw any discernible improvement in his numbers, take a look at Georges ss (2015 tab), consistent dosing following the TR guidelines got us there.

Lots of hugs and prayers for Sassu

NB if you are not getting response and your thread has ended up down the list, the best thing to do is to just right bump so it get's bumped up to the top of the list, we try to avoid posting more than one thread a day so that all the replies end up in one thread otherwise it can get a bit confusing. We also always link the last thread to the post so that folk can look back at the history, a lot of us will do that when trying to help another member so it just makes life a little less complicated

I just see that Bobbie has posted

 

I just looked at your SS and I see that you increased. We recommend increasing in .25 increments, not 1 units as you could go past the correct dose that way. Also, if you could get a curve done when your schedule permits and it will help to see what the dose is doing better.

Hopefully, someone will weigh in with anemia experience and iron supplements and homemade food.

 

I am going to put a call out on the main forum for you see if anyone there has experience with anaemia, also lilian if you edit your thread title, to add advice on anemia needed please, it might catch someones eye that has experience.

 

Sorry about two posts, I just thought I am the only one here noone talks to I just cannot increase or decrease anything else than full units because I use the pen. There are no half-unit pens in Estonia and I am too afraid to use syringes (although you have explained and encouraged me a thousand times) as they have large needles and I am too afraid to get the dosing wrong. Sassu does not like 8 mm needles. He has started biting me even now when I use 4 mm one.

 

This is a very active forum so posts sometimes scoot down the list and can get overlooked, just bump yourself up that happens
I posted more than once a day when I joined and hadn't had a reply to a question so don't worry about it.

George went through a phase of yelping and not wanting his injection, personally I think he was just testing me seeing if he could get me to leave him alone, I didn't take any nonsense was firm but gentle with him, told him it was for his own good and he soon got over it.

Are you moving the injection sites? I try to change sides and move it about so he doesn't get sore in one spot.

Just a question is it the needle or is it when you push the plunger down that Sassu objects to?

 

Lilian, can you try and get a +2 test just in case you get a lot of movement with the increased dose you shot tonight, even if the +2 is high I would also make sure you get at least a before bed test.
I have some house chores to do I will check in on you later.
Gill

 

FYI: I have merged Lillian's threads.

 

It is the needle. But it does not happen every time. He has just started doing it the past few days. I have also been trying to test his glucose more often, so that might add to it. I am quite sure that 4 mm does not hurt him because most of the time he does not even move (for example when he eats), but sometimes he gets annoyed when I disturb his sleep etc. But I am quite sure that 8mm and 12 mm hurt him as he responded as if he would have been in pain. I mostly inject in 6 places. 3 places on the left, 3 on the right - 3 spots from his neck until his middle back. I call them the upper spot, the middle spot, the lower spot. And I try to move around them. And of course I cannot hit him in the same place every time even if it is the same area as all those 6 areas are quite big. I have also tried to inject in his sides, but I do not feel very comfortable with it yet

 

Hi Lillian.
Please find some way to overcome your fear of using syringes to administer insulin. I have not read back through all your threads, but I wanted to mention too much insulin can result in high numbers just as not enough insulin can result in high numbers. By not using the syringes to measure smaller doses, your cat may be throwing high numbers when you increase the dose in increments of 1 unit.

I'm sure someone will stop by soon with advice about treating anemia.

 

It is not only about my fear. It is Sassu's pain, too. And if he is in pain then he would not let me do it. I have to have someone at home who is holding Sassu to take glucose. It would be awful if I would have to have someone holding him also when I inject him as he would try to move and I would not be able to inject. I think it is better to keep him at least without pain so he would let me do it. He has such high numbers so I do not think he could go hypo. I have had a look at spreadsheets. I do not remember whose sheet I saw, but it was someone whose cat had kidney failure and whose cat had died. That cat had really high doses and those doses were increased and decreased almost every day and even by 2U or even more. I will not increase any more. I will try to test him at least twice a day and I will try to do a curve on Saturday.

 

+2 was 524 Going to bed now as I have not slept for 3 days because of Sassu's diabetes.

 

You must be exhausted!
Sleep well...

 

I believe that Gil gave you links to where you can purchase syringes on-line. If you can't track down that information, please ask him to provide it again.

Which of Sassu's lab values are outside of the normal range? Anemia can be caused by any number of factors so trying to give an iron supplement may not be the correct thing to do.

 

Hi Sienne Marje took a look at the results and this is what she said about the values

 

Hi Lilian,

How severe is the anemia? Do you know what his PCV (Packed Cell Volume) was? What other tests has your vet already done to determine the cause of the anemia?

Anemia can be caused by many different things, and it's necessary to first identify what is causing it before treatment can be started. Diabetes doesn't typically cause anemia, so there probably is something else going on. Anemia also isn't something that can be easily fixed with supplements or diet unless the underlying cause is found. In Bandit's case, his vet was able to determine through tests that he has a condition called autoimmune myelofibrosis--meaning his immune system attacks his own red blood cells.

Because Bandit's anemia is caused by an autoimmune disease, his treatment was a course of steroids and immunosuppressants. Steroids do mess with the blood sugar of diabetic cats big time, so he had to go back on Lantus while he was on the steroids. We were able to wean him successfully off the steroids, but not the immunosuppressants. Right now we are in our second course of immunosuppressants and hope a slower wean will be more successful this time. If it fails this time, he'll need to be on immunosuppressants the rest of his life.

Bandit would have died if his regular vet hadn't told me that she was stumped on the cause of his anemia from her tests and insisted I take him to an internal medicine specialist at Cornell for treatment. If your vet has ruled out the more common causes of the anemia (infection, parasites), then you may need to take him to a vet hospital that can do the additional tests needed (e.g. bone marrow biopsy).

I'm sorry my answer isn't an easy one--unfortunately, anemia is complicated and can be caused by many things and you need to work with a vet who is able to perform the necessary tests to determine the cause. The earlier you catch it and treat the underlying cause, the better your cat's chances (and you can possibly avoid a very expensive blood transfusion).

 

Hello!
Still not sleeping No, I do not. All I have are inserted in my labs. My vet did not say it is anemia. My vet said that his results were perfectly normal. I would like to give him an iron supplement until I see the new vet on the 4th of April. I read the reviews and they were superb. I am just wondering is there any sugar in it and how bad would it be for his glucose levels.

 

I just checked out his labs--his MCV is very low, but his RBC is normal. I'm not a vet, so I'm honestly not sure how that should be interpreted. Anemia is typically diagnosed with a PCV or HCT (Haematocrit). Since neither of those tests have yet been done, you can't really say for certain your cat is anemic. (EDIT: I missed that an HCT was done and was normal--this would not indicate anemia). Has he had a loss of appetite? Or have you seen him licking metal, concrete, or eating litter?

If your vet wasn't concerned with the value and didn't mention that he was anemic, then he may not be anemic. I would not give any iron supplements without first seeing a vet and having him tested (if the vet thinks it's needed). You should only use iron supplements when tests indicate that they are required, so your vet should tell you when and what to start with. Bandit's vet didn't want him on an iron supplement because he didn't want a supplement affecting his test results, which are telling him whether or not Bandit's treatment is working. Putting him on a supplement without the vet knowing may lead to inaccurate values in whatever future tests your vet wants to do.

However, I'm now uncertain that anemia is your problem at all, and until you are able to see a vet I agree with Jill that he would benefit a great deal by getting his blood sugar under better control by fine tuning his doses of Lantus using smaller syringes.

 

I had an anemic cat and her HTC dropped to 17%. This does not appear to be from kidney disease. Yes the HGB is low but there has to be another cause in my opinion. Other diseases can cause this. On her lab list the HCT is 35 but that was 2/17. Are there more recent labs?

 

I've never had an anemic cat but I personally have iron deficiency anemia and I can tell you a little bit about how *I* manage it to make myself more comfortable if you want some advice to maybe go off of and research

Fluids are the most important part. When my iron gets in the lower ranges I feel really thirsty. If he is drinking a lot, this may not only be because of the diabetes but because of the anemia as well.

I crave all kinds of foods as well that I usually don't want such as liver and dark green leafy vegetables. Oysters are a main craving of mine too.

When my levels drop down low I will get very tired. I sleep a lot. I am an active person usually and in shape, but when I get a flare up I will take 5 fast steps and feel out of breath. If I move around too much I feel like I will pass out and I start to sweat, HR increases, etc. Usually all I can do at this point is take it easy, calm down, drink plenty of fluids and wait it out.

Have you gotten a confirmed diagnosis of anemia? Ask the vet if a diet supplement or maybe implementing sub q fluids would help him. I saw somebody's post about you in the main forum so I swung by real quick to put my two cents in--havent had a chance yet to read through all of the messages. One thing I wouldn't do is give iron when you aren't instructed to do so. Even if he is anemic, you need to figure out if it's due to iron deficiency or not. Not too sure about cats but in humans, there is a certain type of anemia called thalessemia and iron is poison to these people.

 

I don't see anything that screams at me that it would be off limits for diabetics....now whether it would help or not, I really couldn't tell you, but most of these over the counter types of supplements don't have enough of any one ingredient to be "dangerous"


That being said, I think you should wait until you really know what you're dealing with before starting any kind of "supplements"

They can do more harm than good!

 

If there is any chance of infection you don't want to give iron. It will be sequestered and won't help. I really feel vet advice is needed here before self medicating.

 

Hi Lilian and greetings to Estonia from across the Baltic Sea, from Finland I have a cat who was severely anemic last year. However he's not my diabetic kitty. My other cat is the one who had anemia, and it nearly killed him in only one day. So it was very severe, his hematocrit was only 9% at its lowest point. With anemia you should always know what is causing it. My cat's anemia was immune mediated, also known as the deadly IMHA (immune mediated hemolytic anemia). The first signs were really pale gums, really pale skin and I couldn't see the blood vessels in his nails. Also when things got really bad, his urine turned red like wine and his nose started to bleed. By then he was so out of breath he could no longer stand or walk. He was treated with very high doses of Prednisolone, as immunosuppressants. The thing that saved him was that his bone marrow was making new red blood cells, so his anemia was regenerative. You can see this as the RETIC count from the blood test results. I was told that his type of anemia could not be treated with iron supplements. He was just treated with Pred. If your cat is anemic, you should seek immediate help from any vet so they can check the HCT (hematocrit). My cat's ALAT and ASAT also skyrocketed and he had jaundice. His liver was struggling to process all the red blood cells his own body was attacking, so eventually his skin turned yellow and the blood circulation in his extremities was so poor his tail had to be amputated and the tips of his ears died. But he survived by some miracle...

So hopefully your cat is not dealing with this, and at least the HCT with your kitty says normal. However the RETIC count says high, so your cat's bone marrow is making new rbc.

Also I'd like to encourage you to use the syringes with insulin. I was really scared to use them too at first and have been doing this for only a couple of weeks now, but it's so much easier than with the pen. I ordered syringes from VetUk online shop since in Finland those cost a LOT. Sending you hugs

 

Do you have HCT and RBC values. Demand that you be given AminoB Plex with Iron. Squeaker was critically anemic in the beginning (to the point a blood transfusion was being considered) and he was given AminoB-Plex with Iron for 2-3 months. Your vet can also begin just B12 injections.

 

Iron deficiency anemia in cats is pretty rare. I wouldn't start an iron supplement unless you have it confirmed that your cat has an iron deficiency. This article is a good read on anemia in cats http://www.vcahospitals.com/main/pet-health-information/article/animal-health/anemia-in-cats/51

If a cat's bloodwork shows anemia, usually the vet will want to rerun the blood work in a few days to see if the cat is correcting it on its own (if they are able to regenerate red blood cells on their own). If they are then no further intervention by you would be needed, you just need to monitor it. If it looks like the cat is not able to regenerate on their own, then a blood transfusion is usually needed if the cat is really low.

As Julia mentioned, finding the source of anemia is usually the first step in treating it.

 

I provided you the review of his labs as an observation but I am not a vet and I mentioned you need to discuss it with your vet. I am not a proponent of arbitrarily giving a cat a supplement without discussing the results of the labs with a vet you trust. However, for those who think that anemia is diagnosed solely on the hematocrit or RBCs, this is incorrect. Also, it is true that iron deficiency anemia is rare in cats but his hemoglobin, MCH, and MCV are all low and his reticulocytes and red cell width distribution are high.

From peteducation.com

From 2nd Chance Info:

Again, this is all provided so you may ask your vet but please don't start any supplements or meds until the type of anemia is diagnosed and the vet determines what he needs.

 

Thank you very much for the response. First of all, Sassu has been drinking a lot, sleeps all the time, I cannot see his blood vessels in his nails and he has eaten liver which he has never ever done before, he also has cravings for all sorts of human food which I do not give to him any more. Second of all, vet's appointment is on the 4th of April. He might get so anemic that he might need blood transfusion by then. I do not want that.
Third of all, I read the reviews and people were giving that supplement to their cats and dogs who were not anemic at all and they all described how it made them better. There were even comments that vet recommended that even if their pets were not anemic. Just to get their weight back and to make them more active. The drugs they use for real anemia are prescription injections of iron. The supplement I am talking about is just a supplement.

 

If your cat is so anemic he's in danger of needing a blood transfusion before April 4, then an iron supplement would not help him. I would not start an iron supplement without the supervision of your vet. As I mentioned, Bandit was severely anemic and his vet did not want him on an iron supplement for several reasons. An Iron supplement is not going to do anything if your cat does not have an iron deficiency, and most anemia is not caused by iron deficiency.

If Sassu starts exhibiting signs of anemia (low appetite or refusing to eat, licking metal, concrete, or eating litter, having little to no energy and refusing to get up to eat or use the litter box), then he needs to go to an emergency vet right away.

The symptoms you describe do not sound like anemia, it sounds like symptoms from high blood sugar (cats with uncontrolled high blood sugar drink a lot and are ravenously hungry). If you can get a better handle on his blood sugar, those symptoms will improve. I would focus on getting him better regulated in the coming weeks. Using small syringes for finer dosing, and getting tests in when you can will help you accomplish this.

 

Hi Lillian,

I just wanted to send you a little encouragement. Punkin also had anemia - it's important to treat it correctly. As I recall, we waited for his levels to get to a certain point before treatment. You definitely need your vet to help you with this. I wouldn't do anything yourself without the vet's advice.

big hugs for you and for Sassu! Please let us know what you learn.

julie