Medical advice - newly diagnosed

this is a repeat of my welcome message. Laila has had 3 shots of 2 iu of Lantus solostar. Laila hasn’t even noticed that she had the shot. I incorporated it into her daily combing. Now she gets 2 combing sessions a day - lucky girl!

hi all My 11 year old domestic short hair tabby cat Laila was diagnosed Saturday night in emergency ER visit. We came home on Sat and found her in pain, not moving. She has bad hind legs - cow hocked and slipping joints - and I thought she might have injured herself while we were out. (Note - found out she had been fed Hill’s WD wet for 2 meals on Friday/Saturday. Old can in the cupboard from a previous attempt to get her weight down. Wasn’t successful then and the food somehow never was tossed. We now think she was having acute gastric issues with the high fiber and sudden change in food from Instinct to Hills WD)

The ER vet clinic did a complete evaluation - xrays, labs, bladder punch for urine - and found that Laila’s glucose was 270. She had glucose and blood in her urine. We had noticed no changes at home but she is a BIG cat - 24lbs - and does pee a lot. She eats wet food - instinct rabbit and duck - with a few Hills TD dry for crunch treats and anything she can swipe from family members. She loves to clear up my daughter’s pop tart crumbs in the AM.

The vet has given us this protocol : 1. Get her to eat (she wouldn’t eat at the vets nor when she got home) (note - she has started eating again) 2. Start Lantus 2 iu twice a day. 3. Bring her back in on Friday for a glucose monitor day session. I am on both Lantus and Humalog so I had a pen at home and was able to give her a shot Sunday AM after she ate some chicken from my hand. 4. Switch her to feline diabetic wet diet food. I’m concerned about the food switch. (definitely since we have identified the diet switch as part of her problem on Saturday)

She definitely is not interested in food - HUGE change for her because she would always eat everything and get into your plate if you left food out. I hand fed her some warm chicken we had cooked for dinner - mixed with some water to make it juicy. She has eaten from her plate and walked to the litter box. She is not moving well.. She is walking bent and very slowly - not straightening her legs. We think she had a severe GI issue with too much fiber from the Hills WD. I have moved her around the house to her various safe spots - she doesn’t climb because of her legs so we fleece and memory foam pillows for her in all the have rooms. The vet says that cats with newly diagnosed diabetes often have trouble walking. I’m terrified that her mobility issue is permanent. Do cats who have problems walking from diabetes clear up? I have ordered the b12 recommended for feline neuropathy.

I’ve ordered a veterinary glucose monitor. I’m going to test on mine tomorrow. I have the Lantus pen I started her on but will switch her to her own Lantus script when we finish the pen. I wonder about the switch to Purina’s p(autocorrect made it Putin 3 times ) pro plan veterinary diet DM diabetic diet. Looking at the food forums I don’t see people talking about Purina DM. I’m comfortable doing insulin shots. My entire family (me, mom, dad, grandfather and aunt) are diabetic T2

 

Hi again, I responded to your post on this thread: http://www.felinediabetes.com/FDMB/threads/is-it-ok-to-do-the-glucose-test-on-me-first.203760/ Post #13. Did you see it? Might be helpful in learning to test on a cat.

 

Has anyone pointed you towards Dr Lisa Pierson's site? Very clear and helpful information about how to approach diabetes, and especially the role diet will play.

https://catinfo.org/feline-diabetes/

 

Hi and welcome again. I am so glad you posted here as there were a few things that concerned me about the information in your original post.

As I mentioned before, a BG of 270 in a cat not feeling well, at the vet's office is not particularly elevated. It also concerned me that you mentioned blood in her urine sample which could be indicative of a few things including a bladder or kidney infection. Infections often elevate BG too. Did the vet suggest an antibiotic or further tests to determine why there was blood in the urine?

Did the vet run a fructosamine test to confirm a diagnosis of diabetes or was that diagnosis based on that one BG test? You've indicated you had not noticed any symptoms other than Laila peeing a lot. Peeing a lot can be a sign of diabetes but without any other signs (commonly weight loss, voracious appetite), seems that symptom might be more likely related to the urine sample containing blood than diabetes.

Diabetic neuropathy is usually first noticed as the cat being clumsy, not jumping or walking down on their hocks. It can lead to severe weakness but it's usually not a sudden onset which it sounds like Laila's severe mobility issues were. Diabetic neuropathy progresses more gradually with uncontrolled BG.

I'm also not sure why the vet would have asked you to change diets. The Instinct Rabbit and Duck are perfectly acceptable foods even for a diabetic cat. The DM is just an expensive way to empty your wallet and pad the vet's. It is a dietary food prescribed but not specifically formulated for diabetics. There is nothing special about it and in fact the ingredients are not as good as Laila's normal diet.

I also have a concern because your vet prescribed 2u of Lantus twice daily. While Laila is a big cat at 24 lbs., 2 units is still a hefty dose of insulin when the BG was only 270. A usual starting dose would generally be around 1u or perhaps 1.5u at most given Laila's size.

I am glad to hear you are getting a BG monitor and are planning to test Laila. I would encourage you to be sure to test her after withholding food for 2 hours and before giving her any shots of Lantus to be sure her BG is high enough to warrant giving insulin at all. For those just starting to give insulin,and without any data to see how their cat reacts, a rule of thumb is to withhold insulin if BG is 200 or less using a human meter. If you ordered a pet meter from the vet, I would up that limit to about 250 as a minimum reading at which to give insulin until you see how Laila reacts.