New to diabetes diagnosis/cat wont eat

Discussion in 'Feline Health - (The Main Forum)' started by McShep, Aug 12, 2018 at 6:51 AM.

  1. McShep

    McShep New Member

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    Sunday
    Hi there,

    Our cat was diagnosed with diabetes at the end of July. Our vet put him on Purina Pro Plan Diabetic Management (DM) dry cat food and Prozinx (2xday/1.0 dosage). He suddenly hates the food the vet put him on and barely ate after his very small breakfast yesterday. Last night we gave him his appetite stimulant pill and he threw it up and refused to eat. This morning he is going for tuna (zero carbs) but he’s acting like he’s a bit weak and stammering a bit. I’m guessing due to eating.

    His dosage schedule is about 6:30AM and 6:30PM so I’m going to try and get him to eat a full course of tuna.

    So I give him a dosage of insulin if he eats a decent amount? I feel like just getting him to eat is my main priority right now. Also, he seems to have a hard time chewing the kibbles. Can I switch him to something else and check back in with the vet on Monday about it? Trying to avoid a massive emergency vet bill on a Sunday since my vet is closed.

    Any advice would be much appreciated.
    Molly
     
  2. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Are you home testing his blood glucose? I'm concerned about this:

    That sounds like symptoms of hypoglycemia to me. Going from DM dry (which actually is fairly high-carb for a diabetic cat) to not eating much plus some zero-carb tuna, and then doing the usual insulin dose might have made his blood glucose plummet.

    Assuming you aren't home-testing blood glucose, let's try getting some carbs into him. If you still have some of his "old" food and it is higher in carbs (particularly gravy-containing canned foods, or most any kibble), see if he will eat some of that. If not, see if he will let you rub a bit of honey on his gums, and see if that improves the symptoms.

    More in a follow-up, just wanted to get this out quickly.
     
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  3. Nan & Amber

    Nan & Amber Well-Known Member

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    OK, following up: again, the most immediate concern is his behavior/symptoms. If it is hypoglycemia, it can be "treated" with carbs as I said in the previous post, but it's more difficult if you aren't able to monitor his blood glucose to see how he's doing, and I'm worried that he's showing those symptoms (if they are indeed hypoglycemia symptoms and not something else). Taking him to the emergency vet would definitely be safer, though I understand the concerns about expense. Try getting some carbs into him, let us know if that seems to help. How many hours since his morning shot, now?

    Another possibility is ketones/diabetic ketoacidosis (DKA). That's more of a consequence of a diabetic cat not eating for a while, and the fact that he was happy to eat the tuna makes me think it somewhat less likely, but it is something to keep in mind, especially if he's vomiting as well.

    First step is to get him eating again, and for right now, basically anything he'll eat is good. The fact that he was happy to eat tuna is a really good sign-- he might just be sick of the DM (and, as I said earlier, it's not really ideal for a diabetic anyway, despite the name). Most of us here feed supermarket canned pates that are low in carbs-- much cheaper, and actually better for them. The big caution there is that if you do switch to low-carb while giving insulin, you really should be home testing blood glucose. Insulin needs can go way, way down after a food switch-- some lucky cats can even go off insulin altogether just by switching to low-carb-- so keeping the same dose risks hypoglycemia, which can be very dangerous.
     
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  4. McShep

    McShep New Member

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    Wow. Thank you so much for the thorough and thoughtful response! I really can’t tell you how much I appreciate this. I am heading to the store now to get some other food with carbs and will try that within the next half hour.

    If he does eat an entire meal of that, do I give him insulin and start that back up again? He hasn’t had his insulin since yesterday morning 6AMish because he didn’t eat last night.
     
  5. Nan & Amber

    Nan & Amber Well-Known Member

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    Oh-- he hasn't had insulin for 24hrs? Hmmm, that takes hypoglycemia off the table and makes me much more worried about ketones/DKA.

    While you are out, try to pick up some ketone tester sticks-- you can find them in pharmacies with other human diabetic supplies. To test, you have to dip in urine (we can help with tips to do this for a cat!). Let's hope that's not in the picture, though-- ketones can quickly turn life-threatening but can be treated in early stages. So if that's going on, it would definitely mean a trip to the emergency vet to get on it as quickly as possible.

    In the meantime, let's get him eating. And yes, given that hypo is less of a worry and DKA more, give him his shot if he gets some food into him. The "recipe" for ketones/DKA is: not enough food + not enough insulin + inflammatory "trigger" (infection or pain or even sometimes just stress).
     
  6. McShep

    McShep New Member

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    Okay. What a mess.

    He is eating his old kibbles like a champ. I have no idea what the carb count in his old food is since it’s a special Rx food called Hills Metabolic weight/urinalysis care.

    Speaking of infection, he is being treated for a UTI
     
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  7. McShep

    McShep New Member

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    Also just gave him insulin followed by some fancy feast since he ditched old kibbles half way through eating.

    Will need to hunt down ketone testers now.
     
  8. Nan & Amber

    Nan & Amber Well-Known Member

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    Eating is great news!!!!! It really sounds like the DM just didn't agree with him for some reason. No big loss, really.

    I think you can assume that the carb count is pretty high in the old food :rolleyes:, but one thing at a time.

    While you're thinking about the ketone testers-- are you willing to learn to home test blood glucose? We're huge advocates of that here-- it's really the best way to keep your cat safe and to make sure they're on the right insulin dose.
     
  9. McShep

    McShep New Member

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    Yes, it’s really put a ton of stress on our household not having a clear picture of what is going on at all times. I took him to th me vet last Monday because my cat, Jack Snapple, wasn’t acting right and he didn’t mention anything about ketone testers or at home testing or other types of food that may help. He isn’t our normal vet but was the soonest we could get in for his diagnosis and random follow up last week. He gets his blood curve(?) testing done next week but thus far this process has been a total fiasco. Anything that can make us all feel more in control of the situation would be great!
     
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  10. Nan & Amber

    Nan & Amber Well-Known Member

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    A lot of times vets don't discuss home testing or the really scary possibilities like ketones, particularly on first diagnosis, because many people will choose to put the cat to sleep rather than deal with all of that :(. The vets figure, not unreasonably, that since most diabetic cats don't get ketones, and many will do OK with just occasional curves, better to present things this way and keep owners from giving up. But if you're willing to do it, most cats do much better with home testing. And as you say, it gives you, the owner, a much greater sense of control over the situation.

    __________________________
    When you're ready to try it, some basics: you'll need a meter, testing strips, lancets to do the poke, tissues/cotton ball to press on the poke site to stop bleeding and prevent bruising, maybe a neosporin/polysporin ointment, and definitely treats to reward Jack for being such a good kitty for the process!

    Most of us here test on the edge of the ear (paw pads are an alternate). You aim for the 'sweet spot' between the edge and the main vein (the vein gives lots of blood, but you only need a tiny bit and the vein might hurt a little).

    [​IMG]

    Meters: you can use a meter calibrated for humans-- the numbers won't match pet meters your vet might use, but all you really need to know is what is "too low" (50 and below on a human meter), what is "normal" (approx 50-120), and then your own cat's relative numbers (going up? going down?). The big expense on supplies will be the strips, so shop around before choosing a meter to figure out what works for you. Many in the US use one of the Walmart Relion meters because strips are pretty cheap and Walmarts are open all the time for emergency buys, but you can also often get good deals on strips for other meters on Amazon or eBay.

    Lancets: when starting out, use the bigger size (smaller gauge, 26 or 28) lancets. As the ears grow more capillaries, you can switch to the thinner (30+) gauge.
    ___________________________

    How is Jack feeling now? It really is encouraging that he's eating better-- reduces so many worries. :cat:
     
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  11. McShep

    McShep New Member

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    It’s an overwhelming diagnosis that is for sure!

    Thanks for walking me through the home testing stuff. We are probably going to give it a whirl but I’m horrible with needles so it’ll be on my other half to do it for now.

    I just drove all over town and every place is wiped out of keto strips. Probably because it’s such a fad diet right now. Frustrating. When I do get those are there any tricks with how to utilize these with cats?

    Jack is on round two of eating a small snack of his old kibbles. Maybe getting him to eat plus the insulin this morning helped his appetite? He has been refusing the DM food for the last day until now. When I came home he was laying in the middle of the living room instead of under the bed or dining room table (his go to “I don’t feel well” places) so that is good. He is a little bit brighter behind the eyes, if that makes sense.

    I really appreciate you talking me through all of this today. If I could hug you, I would, because I was at my wits end trying to figure this out all night without a vet hospital trip. If I can prevent any vet trips, it’s helpful. Jack hates the carrier, hates the car, and then pees all over the carrier and it is quite the ordeal. So, thank you. This has been a very tough couple weeks on our little guy. And us.

    And now the other cat who needs to be on his own Rx urinary food due to bladder crystals is refusing to eat his kibbles because Jack gets tuna and fancy feast. Insert eye rolling emoji here.

    Thank you again. This forum has been a gift today.
     
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  12. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    I am just wondering if a low carb wet diet would also benefit the kitty with bladder crystals, because of the moisture content. My mom's cat had crystals and he was completely restricted from eating kibble at all, even the "Rx" brands, as there is the moisture issue.
     
  13. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    The hills is high in carbs. The ingredients are:
    Brewers Rice, Corn Gluten Meal, Powdered Cellulose, Wheat Gluten, Chicken Meal, Dried Tomato Pomace, Chicken Liver Flavor, Soybean Oil, Flaxseed, Coconut Oil, L-Lysine, Fish Oil, Lactic Acid, Potassium Citrate, Potassium Chloride, DL-Methionine, Carrots, Choline Chloride , Taurine, Iodized Salt, vitamins (Vitamin E Supplement, Niacin Supplement, Thiamine Mononitrate, Pyridoxine Hydrochloride, Calcium Pantothenate, Riboflavin Supplement, Biotin, Vitamin B12 Supplement, Vitamin A Supplement, Folic Acid, Vitamin D3 Supplement), L-Carnitine, minerals (Ferrous Sulfate, Zinc Oxide, Copper Sulfate, Manganous Oxide, Calcium Iodate, Sodium Selenite), Calcium Sulfate, Mixed Tocopherols for freshness, Natural Flavors, Beta-Carotene

    The nutrient brekdown is:
    Nutrient Dry Matter1
    %

    Protein 38.1
    Fat 12.9
    Crude Fiber 13.2
    Carbohydrate / NFE 30.5
    Calcium 0.70
    Phosphorous 0.60
    Sodium 0.33
    Potassium 0.88
    Magnesium 0.075
    Taurine 0.46
    Vitamin E 748 IU/kg
    Total Omega-3 FA 1.35

    Above from:
    https://www.hillspet.com/cat-food/pd-metabolic-plus-urinary-feline-dry

    The values except for the penultimate and maybe the last value appear to be in weight% vice the % of calories. If that is the case and considering that fat hasa little over twice the calories per unit weight that carbs and protein, the % calories from carbs should be lower that 30%
     
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  14. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    Molly, just wanted to welcome you and send big hugs your way :bighug: This is the most wonderful place for you to be to gain knowledge, wisdom and be loved on !! You will learn things here you could learn no place else . Welcome :bighug:
     
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  15. McShep

    McShep New Member

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    Thanks! I will look into this!
     
  16. McShep

    McShep New Member

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    Sunday
    Hi all,

    Thanks for all of the support today. I really can’t thank you all enough. I finally got the ketosis strips and the result is attached to my post. Can anyone tell me what this means now or if this “trace” amount warrants going to the vet hospital?

    Edit: he is lethargic right now and still drinking the same amount of water he has been which is excessive. He ate his meals earlier today and got his insulin. Otherwise he has been sleeping but isn’t walking like he is out of it like earlier.

    Just not sure if I need to take him in to vet hospital today or not.
     

    Attached Files:

    Last edited: Aug 12, 2018 at 3:29 PM
    Reason for edit: Adding info
  17. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Hmmm.... that does look more like "trace" than negative to me, it is tricky to tell at the low end (but much better to be at that end!). One thing to keep in mind is that they do darken over time, and are only supposed to be read at a certain point (usually something like 15 seconds, but depends on the manufacturer).

    We usually say better safe than sorry when there are any ketones present, but in this case, if he's still eating well and isn't vomiting or lethargic or showing other signs of illness, I think you can hold off on the ER visit. But if you can catch him peeing again tonight (good job on that, by the way!), try to grab another test to make sure it's not increasing. And, if he starts to seem very unwell again, I would take him in to get checked out, if you can.

    My guess is that this is the remnant effects of going 24hrs without insulin or much food-- he might have been on a path to developing ketones this morning before his shot, and you're seeing that now in the urine. Getting food and insulin into him should definitely have helped tamp down anything that was developing, the question is his current trajectory, which you can't know for a while. With the UTI going on, best to be extra-vigilant, but I'm hopeful that this reading is just a ghost from the past. Fingers crossed!
     
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  18. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Ah, just saw this edit:

    I think what I would say on this is that if it's only lethargy, just keep an eye on any improvements or deteriorations. A bit of lethargy could either be a warning sign that he's getting very sick... or just him feeling yucky from being in high BG numbers, having a UTI, and not eating all yesterday. As long as he's still eating and drinking now, I think I'd just stay watchful, but it's your call all the way.
     
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  19. McShep

    McShep New Member

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    The crappy part is he couldn’t have his antibiotic last night because he didn’t eat and threw up so now I’m worried about that too. The good thing (I think) is that he has been on the antibiotic for almost a week and a half. So hoping the infection is tapered down over that week or so before this happened.

    I’m calling my vet either way as soon as they open in the morning to see if we can’t get into them. I’m just still unsure of the vet hospital today but think I’ll follow your advice. He’s drinking throughout the day and eating as of earlier today and not throwing up. I’ll do a keto strips near dinner time and see what the reading is then and make a decision at that point. I imagine he could be tuckered out from his body going through hell over the last 24 hours but I also feel like we are not to fool around with the keto reading too much.

    Thanks for the guidance. My wife says thank you too. We both aren’t sure what we would do or would have done without this thread today.
     
  20. Nan & Amber

    Nan & Amber Well-Known Member

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    I think it's a very good idea to call your vet tomorrow.

    Keep us posted on how he does tonight!
     
  21. McShep

    McShep New Member

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    Did a keto test and it was in the “trace” category again. New test pic attached.

    He’s pretty out of it but he is getting excited about his dinner. I’m wondering what you all do as far as fancy feast (FF) portion for your cats? Should I mix diabetic kibbles with FF or just straight up FF?
     

    Attached Files:

  22. Nan & Amber

    Nan & Amber Well-Known Member

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    At this point, anything he'll eat. The FF pates are low-carb (which is what you want in general for a diabetic cat), the kibble has a bit more carbs than that, but really the important thing is that he keeps eating, and keeps getting the insulin. Worry about carbs later-- in fact, it's better to wait until you are home testing blood glucose before you go totally low-carb.

    That secod trace reading is disappointing to see (wish they were gone completely), but I'm so glad he's feeling well enough to really want to eat. Food + insulin is what he needs to nip the nasty ketones in the bud. Make sure he also has plenty of water available.
     
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  23. McShep

    McShep New Member

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    Sorry to ask so many questions. I really appreciate your patience with me. I know he needs at least two meals a day with the insulin. However, do you feed your cat more between meals? Clearly our vet didn’t really set us up really well and I’ll be requesting a different one in the morning!
     
  24. Nan & Amber

    Nan & Amber Well-Known Member

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    A lot of us feed multiple meals during the day-- it seems to be easier on the cat pancreas. There's a lot of flexibility in feeding depending on your schedule and what Jack prefers.

    And, no such thing as too many questions here! Though, I have to admit, it's getting close to my bedtime here, so if you don't get an answer from me to other q's, that's why!
     
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  25. McShep

    McShep New Member

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    Thank you so much! You’ve been so helpful!
     
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  26. Nan & Amber

    Nan & Amber Well-Known Member

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    Checking in-- how'd he do last night?
     
  27. McShep

    McShep New Member

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    Hi there,

    Thanks for checking in. He ate his breakfast, drank a lot of water, got his insulin and then ate more breakfast. His keto strip is still showing up with "trace" results. We called our vet this morning and left him a voicemail and have yet to hear back.

    I played hooky from work today because I was worried about him. He seems more with it...just hoping we hear from vet.
     
  28. Nan & Amber

    Nan & Amber Well-Known Member

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    Hmmmm.... it's so hard to tell on the low end on the keto strips, it would be nice to get him in to the vet to confirm (or not, which would be great!) with (more precise) blood ketone readings. But it's really good that he seems a bit more himself :cat:, and that he continues to eat and drink. The only other thing that a vet might be able to do at this stage (if he does have a trace amount of ketones brewing) might be to give him some fluids (IV or sub-cutaneous) to help flush them out.

    Is he still on the antibiotic? How much longer for that?

    Any progress on testing blood glucose?
     
  29. McShep

    McShep New Member

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    My wife talked with the vet right after I posted earlier. He said that at this point of an early diagnosis there’s commonly small amounts of ketones. He wants us to take him to ER if they go up at all into the next category on the strips.

    We have an appointment on Monday for his blood work. The vet is certain that Jack is just whacked out from the weekend. Our normal vet comes back from vacation on Wednesday—thank goodness.

    He has maybe two doses left on antibiotic. We asked about that and he said he to finish the course and we will revisit if necessary.

    The vet said to continue testing the ketones and that he was glad we were doing that. I need to purchase the at home test supplies, just really freaked out to do it
     
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  30. Kris & Teasel

    Kris & Teasel Well-Known Member

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  31. Nan & Amber

    Nan & Amber Well-Known Member

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    That really is quite possible-- you know he was feeling lousy enough to not want to eat (or at least, to not want to eat the DM!). And, putting the whole question of ketones aside, being in high blood glucose numbers alone (which he likely is, given the excessive water-drinking) can make them feel yucky. And we don't really know what this dose of insulin is doing for him yet-- if he's having a strong response to it, so that his numbers are diving down and then coming back up, that yo-yoing can also be contributing. It's so hard to see them feeling bad :(.

    Kris is right-- the testing is a very steep learning curve in the very beginning, but becomes routine for both you and your cat very quickly. We can help along the way with whatever tips and tricks we know to make things easier!
     
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  32. Butterball

    Butterball Member

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    Feb 2, 2018
    The only way you know for sure is if you test his blood. Otherwise it's just guessing based on the symptoms. If he's still drinking a lot of water it suggests that he's still not regulated (though some cats do go for the water bowl if their BG is getting too low). So I would try my best to start doing that. It's very daunting at first but that's just because you've never done it before. It will lead to an immediate improvement of your cat's well being and your sanity as well
     
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  33. McShep

    McShep New Member

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    Hi All,

    Sorry I haven't been able to respond all day. Just wanted to send out an update real quick. Jack Snapple is a totally different cat today. He's back to his old self--very sassy and begging for food with relentless meowing. These are the behaviors that drove us crazy that we realized were quickly missing once he was feeling ill. The Fancy Feast has totally changed everything for us. I am positive that when he didn't eat much that one day over the weekend, it just sent his health into a tailspin. His fur looks better and his eyes look clearer. I am super relieved and I can tell my other cat and our golden retriever are too as everyone is back to socializing again. I'd say Jack is 85% back to his pre-diabetic self.

    Anyway, we are going to start doing in home testing as soon as we can. We have some time off that would allow us to pick all the stuff we need. His blood curve appointment is on Monday morning so hoping that will tell us more too but not really sure what to expect either.

    Just wanted to let y'all know how Jack is doing :)
     

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  34. McShep

    McShep New Member

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  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I love his asymmetric white splotch on his face! Very cute kitty! :smuggrin:
     

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