Newbie - meet billy large male cow cat

My super sweet (formerly huge,now just kind of big) DSH male was recently diagnosed with Diabetes, and more worryingly, hyper calcemia. After many additional blood tests it appears he has cancer somewhere - we just don't know where. It could not be identified with an ultrasound. Needless to say, some of the vets at my cat only practice are fascinated by this case.

Anyway, he is happy, eats a lot (even though he lost 3 lbs in 6 months before his blood sugar was under control), not in pain. In short, he does not know he is sick.

But his insulin dose is huge - 3.5 units 2x per day. He weighs 13.5 lbs. Is this normal? Or is it just a sign that we may not be able to regulate this? PS -the ultrasound and other tests seemed to indicated that he does not (or if he does it is microscopic) pancreatic cancer.

It took three weeks to get his blood sugar regulated. Does this sound normal? I love and trust my vets, BTW (and they sincerely love him as well).

Thanks for reading this!

-Chris in Washington, DC

 

Welcome to FDMB.

He is a large-ish cat, so 3.5 units isn't outrageous ... but what insulin, what food, how were dose and increases determined? Those are all factors which play into the management.

 

He is getting vetsulin? Don't what that is and eating science diet wet food for now (he is boarding at the vet this week)

 

Vetsulin, aka Caninsulin, was developed on dogs. It often lasts less than 10-12 hours in the cat.
Vet stress may elevate the glucose numbers at the vet and doses based on those may be too high when you get home.
Over the counter, low carb food may be fed; it need not be prescription food. Go to Cat Info to read what vet Dr Pierson has to say about feline nutrition..

 

thank you! He boards frequently at this vet and knows everyone (in fact, they let him roam free fairly often). He hates the car trip but he's got all the techs and his doctor well trained! I wonder why they chose that type? BTW he is very good about getting his tests and injection (as opposed to getting his nails cut which evokes his urge to kill me)

 

the unknown cancer is more worrying to me than his diabetes……..

 

I looked in the Merck Veterinary Manual online and found these statements:
"In cats, idiopathic hypercalcemia appears to be the most frequent cause of a high total calcium concentration, followed by renal failure and malignancy."
"In cats, chronic renal failure (usually associated with chronic interstitial nephritis) appears to be the most common cause of hypercalcemia."
A more extensive list of causes appears in this table.

And I'd want a 2nd opinion. Get copies of all the lab work and post them here; some of the folks have experience with various tests.

 

Hi and welcome

Vetsulin is often the first insulin prescribed (I a, in the uk). It was for my cat remi, it bought down his blood glucose but we got much better and longer control when we switched over to lantus.

Have a read of the document contained within this link and perhaps discuss it with your vet

http://www.felinediabetes.com/FDMB/...-from-aaha-convert-your-vet-if-needed.131187/

 

Thanks! I did red this and my Vets are cat only, and very familiar with diabetes and I believe they followed the treatment protocols it described (at least when they explained what they were doing, particularly adjusting the dosage and giving it enough time, it sounded exactly like this paper). Of greater concern to me than the diabetes is the idea that he has cancer. So I guess every two months we will go back for an ultrasound until it manifests itself in such a way that I can make decision about treatment (for example, I am not going to subject him to surgery to remove part of a lung just to get 8-10 more weeks of life, etc). I am trying to get the blood test that showed hypercalcemia, and the elevated hormone levels and what they called cancer "markers" (PTHrP) that apparently were identified and evaluated by an endocrinologist at a veterinary school.

 

It may not be cancer. See my post above.

 

yes. The vet hoped that the hypercalcemia was idiopathic (and his kidneys are fine, btw I recently lost a 19 yr old cat to CRF so I am super familiar with this). As soon as get all the tests I will post the results here. The ultrasound did show that the walls of his large intestine were slightly thicker than normal, but other than that nothing. A puzzle to be sure. He is a big, rambunctious, busy cat. I cannot imagine him sick or infirm. Also, my cat who died recently cost me thousands of dollars in vet bills, so I am kind of sad to be right back where I was worrying about a pet I love and setting aside lots of money for care. He's only 7 years old.

 

General inflammation may thicken the intestinal walls; does he seem to have any GI issues like occasional vomiting or diarrhea?

And with regard to the Vetsulin - the nadir (lowest glucose) is usually sometime in the +4 to +5 hours post-shot. Those numbers are used to adjust the dose, not the pre-shot numbers.