Introduction-Gizmo 12yo MaineCoon - Pancreatitis, CKD (newly diag) and now Diabetes?

Hi, I am Liz and Gizmo is my wonderful, lovable, very sick kitty.

About 5-6 years ago he had increase water intake/output and was diagnosed with diabetes. We changed his diet from dry kibbles to wet along with insulin (very small amount). The insulin proved to be too much along with the diet change and a small amount of weight loss. He was removed from insulin and had no other episodes and seemed healthy and happy for about 3-4 years. In April 2015 he had his first Pancreatitis episode. He was hospitalized for 7 days and finally recovered. In April 2016 he had another and, again hospitalized for a week.

We have been trying to get him stabilized since. My vet has been primarily focused on the Panc and then 06/30/16 labs showed CKD which he wanted to monitor and and retest in a couple of weeks.

Labs from 06/30/16:
30-Jun-16 Results Range
WBC 6.96 5.5-19.5
LYM 0.64 1.5-7
MON 0.22 0.0-1.5
NEU 5.00 2.5-14
EOS 1.04 0.0-1.0
BAS 0.08 0.0-0.2
LY% 9.10 20-55
MO% 3.10 1.0-3.0
NE% 71.80 35-80
EO% 14.90 0.0-10
BA% 1.10 0.0-1

RBC 8.42 5.0-10
HGB 13.4 g/dl 8.0-15
HCT 39.62 24-45
MCV 47 fl 39-55
MCH 15.9pg 12.5-17.5
MCHC 33.7 g/dl 30-36
RDWc 20.3% none

PLT 410.00 300-800
PCT 0.48 % none
MVP 11.7 fl 12.0-17.0
PDWc 41.5 % none

ALB 5.0 + 2.2-4.4
ALP 14.00 10.0-90.0
ALT 78.00 20-100
AMY 941.00 300-1100
TBIL 0.30 0.1-0.6
BUN 34 + 10.0-30.0
CA 10.90 8.0-11.8
PHOS 3.70 3.4-8.5
CRE 2.60 0.3-2.1
GLU 308 + 70-150
NA + 148.00 142-164
K+ 3.90 3.7-5.8
TP 7.60 5.4-8.2
GLOB 2.60 1.5-5.7

QC OK
HEM 0.00
LIP 1 +
ICT 0.00
Snap FPL Negative - Fasting
^^these were run at the vets in-house lab

Labs from 07/18/16 here:
http://imgur.com/a/SSMy0
^^these were sent out and ran at outside lab

He has been very lethargic, wobbly on his legs, decreased appetite generally weak "looking/acting" and very depressed acting.

I have an appt to take him back to the vets today @ 5:00pm.

Looking for any input on what to pursue with him. Vet is very receptive to input and is willing to work with me regarding treatment.

I need to get him stabilized which may mean he has to stay. He is very aggressive to vet and vet staff. He will not eat at the vets.

Current meds is only digestive enzymes with food.

Food was primarily RAW diet up until last visit and with the CKD vet wanted him on k/d diet (which I have been feeding alternate with RAW and some Fancy Feast as he has decreased appetite.

He is NOT a picky eater but when he is not feeling well I just try until he decides he will eat.

Sorry for the rush post - just trying to get enough info posted so I can get some input before I go back tonight.

Thanks you
Liz (and Gizmo).

 

Glucose levels at the vet may be 100-200 mg/dL higher than at home. This is a reason we encourage home glucose testing, using human glucometers and feline-specific reference numbers for these. Pet meters are very expensive at $1.00 per test strip and 2 or more tests per day to keep your cat safe. Many of us in the US use a Walmart ReliOn Confirm, Confirm Micro, or Prime.
www.ADWDiabetes.com sells the unbranded Confirm models as Glucoard 01 and 01 Mini.

K/D food, if dry, tends to be somewhat high in carbohydrate, which will add to hyperglycemia.

Check out www.FelineCRF.org for terrific info on CRF.

You'll want to search this site (upper right of page) for a list of low phosphorus & low carb foods - Fancy Feast isn't. (I'm on my phone, or I'd search).

Also, see this Primer on Pancreatitis to see some additional options in helping your cat deal with that.

 

Hi Liz and Gizmo. Welcome to FDMB.

Ask the vet to prescribe a long acting insulin. Most cats respond better to them. ProZinc and BCP PZI are animal insulins that you can buy from your vet. If your vet goes to BCP's website, they can order the first vial free for you.

Other good long acting insulins are Lantus and Levemir. Both of these are human insulins that cats respond well to. If your vet prescribes either one of these, ask for the prescription for the pens instead of a vial. Because the pens are packaged in smaller containers, you will be able to use almost every drop before the insulin becomes ineffective. There are 5 pens in a package and you will use the pens as mini vials. The problem with a vial of insulin is that it becomes ineffective long before you can use it all. You will end up throwing away most of it. A package of pens could be enough insulin for 9 months or more depending on your dose. Since ProZinc and PZI are animal insulins, they do not have this issue and you can use the vials with these insulins.

 

I was refereed here from CRF for the diabetes.

I have been unable to successfully testing Gizmo at home. I have tried. I just can't do it. I do have the ReliOn from Walmart already (purchased about a few years ago).

As I had been able to manage the diabetes with diet (as near as I could tell) I was not too worried about the testing. The (recent) high numbers are just within the last couple of months, since his last panc attack (04/2016). Before that, 2015 (per the vet) his numbers were within range.

Thank you for the welcome and great information. This was exactly what I was looking for, for the upcoming visit. I know that BG shoots up with anxiety (and Gizmo has EXTREMELY HIGH anxiety at the vets).

Can anyone tell me how to find someone locally who can come to my house (willing to pay) to show me/help me test? I think once I (and Gizmo) have done it a few times that it will not be a big deal. I just can't seem to get blood from his ear and after trying a few times Mr. G looses patience with me.
I am truly hoping that I can get back to controlling via diet but the Pancreatitis and now CKD (low elevated numbers for now) I am not sure I will be able to.

I am still not sure that we are not dealing with a Panc attack but diabetes numbers were a little high (but he was stressed).

Another thing that may be going on is a tooth infection or issue of some sort. Gizmo is such a pain to deal with for the vet and vet techs that it is difficult for them to examine him well.

Headed home to pick him up and take him now. I will update when I have more information.

Thanks for the quick replies.
Liz

 

Some cats don't tolerate their ears being messed with (like mine) and it is possible to test from the paw pads. Information on how to is in my signature, but it does depend on the cat!

 

Hi. Welcome to FDMB. In case you see this, before you head off the vet's office, you could ask if one of the vet techs could come by your home to show you how to test. They already know how upset he is in the office so it would help you out and give the vet a better idea of exactly what Gizmo's BG is when in his "comfortable" environment.

If that isn't an option, you could post on the Health board here asking for help testing in Houston, TX. Use a "?" Prefix to get attention to your title. There may be other members in Houston or close by willing to help you learn to test.

Please do let us know how the appt. goes.

 

Thank you all. Just got home. Vet said absolutely no diabetes.

Not sure what is going on but vet not concerned with anything except kidneys right now.

His weight on 07/18 was 10.8. Today it was 10.0. He has dropped weight before and gained most of it back so we are going to feed k/d, watch his weight and reacces in a couple of weeks. If he has lost more then it is time for xrays and ultrasound to look at what is going on inside. He had ultrasound in April 2015 during the first pancreatitis attack, but he quit breathing and they couldn't get him to start on his own for a bit and gave us all a scare so I don't know how complete it was or if the aborted after confirming pancreatitis.

I guess I feel a bit better but still scared and emotional. He did eat two cans of fancy feast already today and I will give him another can of the k/d before bed tonight. Going to start maintenance of Zantac for stomach acid related to the pancreatitis.

His glucose was 226 on 07/18 and he had been there all day so vet attributes the number to the stress.

Vet checked blood pressure and heart and it was normal.

Gizmo may have arthritis in his hips which I am to give him same pain meds that are prescribed for his pancreatitis (due to kidney numbers) when needed.

Any input is welcome. I guess I need to find a pancreatitis forum as that seems to be the primary issue I am dealing with (along with the start of CKD).

Does anyone here feed RAW Diet? I am looking for input on that with regards to pancreatitis/ckd. I started it because of diabetes but would like to continue but don't want to damage his kidneys if it is not a good diet choice. Gizmo did so good on it but of course vet is pushing rx diet.

I appreciate the responses and kindness you all have shown us.

 

So very glad to hear diabetes is NOT in the picture! A big relief for you I'm sure. The website http://felinecrf.org/ would probably be the best place to get some input on RAW diets and kidney issues. I'd suggest you post a question on Health HERE regarding RAW diet and pancreatitis to get the most eyes on that part of your question.

 

Ha! Gizmo is the exact opposite. Rub his ears all day long but don't dare touch his feet. At least I don't have to worry about the testing for now.

 

Some thing to discuss with your vet: Pancreatitis is often associated with diabetes. Whatever processes are causing the inflammation may shut down (temporarily or permanently) the islet cells which produce insulin, causing the glucose to rise. These also may impair enzyme secretion, resulting in malabsorption issues (exocrine pancreatic insufficiency).

While you work on the home testing, take a look at my signature link Secondary Monitoring Tools for some other assessments to help evaluate your cat. Many of them are the kinds of things vets ask about at regular visits.