Newly Diagnosed Diabetic Cat...heavy breathing but no ketone

Hello everyone!

Man, what an emotional few weeks this has been with our cat Bootie (10 years old, indoor cat). We noticed that he was drinking/peeing a lot more than normal, so I did some research online and saw that was a common symptom of diabetes. took him to the vet, and sure enough...my boy's got it. :YMSIGH:

We first just switched his diet to the Purina diabetic food (D/M maybe?) and let that run for a week. He seemed to be doing better, maybe still a bit lazier than normal, so we brought him back to the vet to see if his diabetes was under control just with a new diet (it happens sometimes!) Unfortunately, the blood sugar levels didn't go down enough...so we began the insulin injections.

We've got him on 1 unit (I can't remember the specific insulin, I just know it's a human one) twice a day after meal feeding him. He continued to get more lethargic...usually if we sit on the couch, this guy immediately comes and lays next to you for a petting. And usually, he likes to be COMFY...if you lay a piece of clothing on the bed or couch, he lays on it. Now he's completely the opposite...lays on hard surfaces only, in the corner of the room, etc.

Two days ago he started to have labored breathing with a couple of those "I don't feel so good" yowls that they do. Again I did my research online and saw that this might be a sign of his blood sugar being too low and him having ketones in his system. It sounded serious, so I took him to the vet again. Did the check, no keytones. Now here's where things get iffy for me...

The doctor hears a heart murmur. We've know about this for 2 years now, and it hasn't really affected the cat at all. They do an x-ray and the vet *thinks* that his heart is bigger than normal (he said there's never a good way to tell because there's no point of reference???). There was also no real signs of fluid in the lungs. In any case, he says "well maybe he could handle his heart murmur before, but now that he has diabetes too...maybe it's too much for him and now he's breathing heavy". That's a lot of maybes for me...I'm an Electrical Engineer, I respond well to "maybe" ;-)

So anyway, he suggests that we do an EKG on the cat to see if there's an issue with his heart not getting enough oxygen to his body (weak heart, thick heart walls, etc) and sends us to some emergency hospital an hour away (seems that all the normal vets that do EKGs are at some convention in California this week). We go there, and long story short (who am I kidding, i'm wordy!) they want $2500-$3500 for this EKG! They added hundreds of dollars for just unbelievable stuff, all for one test! We told them we would speak with our vet in the morning about finding a non-emergency doctor to perform the test.

None of this feels right to me...I'm *very* skeptical of doctors in general, and in the past I have been gouged with both vets and human doctors alike. In my logical brain, I'm thinking "cat gets diabetes, cat starts taking insulin, cat starts breathing heavy...must be something either diabetes or insulin related". I love my cat, but I just can't justify spending that much on a test that feels has nothing to do with the current situation at hand.

Anyone have some feedback/insight on this? Thank you SO much in advance!

 

Are you testing his blood sugars at home? That's the MOST important first step...find out what his sugars are. When you know that, you have a better control/handle on things.

You can get a decent meter from Walmart - and their test strips are also fairly priced. I've used it, and do enjoy it. The only thing a ketone test will tell you is if ketones are present in the urine, not the sugars in his blood stream. Grab a meter, start home testing, and see what you find out, all right?

Also, I don't particularly care for the D/M stuff...I use Evo 95 and Wellness for the most part; better quality protein, low/ultra low carbs, and good moisture content. And I'd suggest while he's getting established on a new diet, to really test his sugars; often, diet changes can drastically drop sugars.

More experienced people will be on shortly; I just wanted to say "hi" and make sure you were hometesting.

Best-
Michele

 

Wow! You are doing a great job so far of researching and being proactive. I'm afraid I've no experience in the area of heart issues, but we do have a few folks who do, including 2 vet techs, so hopefully they will see this thread and add their thoughts.

Meanwhile, I agree that you should start testing blood glucose levels at home to determine whether your giving the right dose or not...might as well do the best job treating the diabetes while you figure out the rest.

Regarding insulin type...could be humulin N or it could be lantus/glargine...the two act VERY differently so you need to know which you are using and pronto
Jen

 

Welcome! Sounds like Bootie has someone who cares deeply about him and is in his corner!

It is possible that there is an underlying heart condition and a EKG would help diagnose that. But the first and easiest thing you can do is to take Bootie's blood sugar levels at home. That will tell you whether he is getting the right amount of insulin or whether too much or too little is the problem Once you know his insulin needs are met, you can deal with the other issue. Others will give you more advice and maybe some doctor recommendations.

It's easy and it's fast. We use human glucometers on the cat's ear. Here is a good site that gives you a general overview: http://www.sugarcats.net/sites/harry/bgtest.htm and here is a video that shows you how: http://www.youtube.com/watch?v=_zE12-4fVn Lots of people buy the ReliOn from Walmart as it is cheap and the strips are inexpensive. Other meters are fine also (just get one that sips and takes a small sampling of blood) and may even be free from the drugstore. It's the strips that are expensive but they are half the price on ebay.

So, if you get a number, come back on and we can help you figure this out.

Also, Purina DM is called prescription food but contains no special ingredients and is not better (and really is worse) than any commercial foods. It's just more expensive. We urge you to feed wet, lo carb foods (http://www.catinfo.org). You want to buy non gravy, under 10% carbs. Lots of us feed Fancy Feast, Friskies or Wellness - depending on what your cat will eat and what you can afford. The wet lo carb food can bring down cat's bg levels dramatically so don't change until you are hometesting.

There is tons of great information on this site. Read and read some more. Ask questions and start hometesting!

 

Do you remember how much the insulin costs? We may be help you figure out what you have.

Humulin is much cheaper than Glargine (brand name Lantus). Another humulin insuilin, however not normally prescribed at first is Levemir.

My Tucker was dx with an enlarged heart. Xray, a three ultrasounds over the years have shown no growth so heart issues were ruled out, vet says he just has a big heart (I could have told her that).

The heavy breathing could be hypo or ketones, I see the vet ruled out ketones, did the vet tell you what the blood sugar was at the time?

I agree that you need to start hometesting so you can check for hypo. I wouldn't give insulin again without checking the BG (blood glucose number).


ETA: I mentioned Tucker's heart being enlarged, but forgot to note that you should try to set up the EKG if you can.

 

Thanks for all the awesome feedback so far! I feel really comforted knowing there's a community that understands and supports like this.

I called my wife to check the insulin, it is indeed lantus/glargine. Is it possible that he has a "bad reaction" to that type of insulin? Is there such a thing?

The vet checked his BG levels yesterday and said they were still high (in the 300s if i remember right), but it was later in the day and he was just about due for his next meal feeding and injection.

Oddly enough, my wife and I decided to not give him insulin last night (since it was so late from being at the emergency clinic and his eating schedule was messed up), and I didn't give it to him this morning. While the heavy breathing isn't entirely gone, he sure does seem to be feeling better! He's actually laying on the couch with his head up, he's eating, and coming over for attention every once in a while.

I know he's a diabetic, so foregoing his insulin is not a good longterm strategy. I'll definitely start testing his blood sugar levels at home. I guess then I can start posting his numbers here so we can get him on the right path?

Thank you all again so much!

 

hmmm... sounds like to me his bg was possibly going too low. A 300 reading at the vet is a stressed number, and the real unstressed reading could very well be in the high 100's. My Oscar's glucose went up 200 points last time it was checked at the vet. It might be that your kitty is one that needs less than 1 unit of Lantus twice a day. As others have already suggested - hometesting will be the best way to figure this all out! Welcome to the board! cat_pet_icon

 

Here is my boy Bootie by the way...I guess all those sweet cookies and espresso is the cause for his diabetes! (kidding lol :lol: )



A funny story...last night we were at the emergency clinic, and one of the ladies that worked there came into waiting room (which was pretty full) and in a loud voice said "Who's here for Bootie?"

And then she realized what she said and got sooo embarrassed! Everyone in the place was laughing and clapping :lol:

 

He's handsome.

Love the Bootie story, that's too funny.

Lantus is a fantastic insulin, I think once you start getting some BGs at home things may be different.

What kind of food was he eating when he was diagnosed? Dry food eater or canned/raw? If he was a dry food eater and you plan on switching to canned only or raw, the BGs will start to come down naturally. Some cats can be controlled via diet alone, others will be insulin dependent.

The "I don't feel good" yowls have me concerned. Since you stopped the insulin has that stopped too?

 

he was 100% dry food. This cat is so goofy, you could put a plate of tuna on the floor and he won't know what to do with it! ohmygod_smile We just gave him the regular Meow Mix dry food and he loves it.

When he was diagnosed with diabetes, the vet gave us both dry and canned D/M food. He *sorta* eats at the canned stuff, but loves the dry stuff. Now I just started exclusively feeding him the D/M dry because I know that's what he likes. You think I should try to wean him over to a canned diet?

And yep, the yowls have stopped. He only did it twice...the first time he was doing it while laying on his side, breathing really heavy. He wasn't responding to us at all (wouldn't lift his head if we called him, etc). But that was at his worst point (Monday night)...tuesday he was more responsive but still breathing heavy. Today, now that I've temporarily stopped with the insulin, his breathing is still kinda heavy but I can definitely see improvements.

 

I have one diabetic, Tucker, he's been insulin dependent since 2005, going off insulin for about a year during that time (in '06). But I have two other FDs right now that went off insulin due in large part to being weaned off dry and put on canned only. Both were being given insulin before they came to my home, both were dry food eaters.

Mr. Darcy started his transition to canned a few weeks before the transport and was actually off insulin the day he arrived. Bean went off insulin within the first couple of days, I believe I got her Saturday, May 22nd and she was off insulin Monday night, the 24th. This just happened, you'd think I'd remember correctly

Mr. Darcy was on Vetsulin, Bean on Lantus, both are now off dry and eating canned only although Mr. likes his raw food medallions and Bean prefers Wellness canned food. Most of my cats eat Fancy Feast gluten free varieties as Tucker has an allergy to gluten.

If you have a cat that is on insulin for life, like Tucker, taking dry food out of the mix makes it easier to regulate and keep his numbers in a good range. If you have a cat like Bean or Mr. Darcy who go into remission just by eating a good diet, all the better.

I would recommend that you switch over to canned.

Check out Dr. Lisa Pierson's site:
http://www.catinfo.org/

More specifically, tips for transitioning to canned: http://www.catinfo.org/#Transitioning_D ... nned_Food_

 

Wow, this is the most helpful website ever...why can't the entire internet be like this???

thank you thank you thank you!

 

Hi there, I am not sure why the price for an ekg would be that much. A cardiac ultrasound would run around 400 dollars and would tell if there is thickening of the heart muscles, what type of heart disease is present, if any. Some murmurs are benign, and others arent.

this is a good link about heart murmurs-a little technical perhaps.
http://maxshouse.com/heart_murmurs.htm

My Merlyn had severe Hypertrophic cardiomyopathy but no heart murmur.

 

Just wanted to say Hello and Welcome.
Bootie is gorgeous ... and great story from last night!

The others have covered the basics and probably given you tons to think about already, so I'll leave it at that. It's a lot to take in the first few days, but it gets easier. Really!

Feel free to ask lots of questions

Odiesmom

 

It really made me angry...they itemized it all out for me, and I honestly felt I was going to a used car dealership.

A couple of highlights:
* the cardiologist wasn't there at night, so they wanted to keep him overnight at the hospital...so they decided "hey, let's charge them for a full 48 hours of ICU" - $550. I offered to take him home and bring him back in tomorrow for an appt, but they basically told me that the doctor was booked tomorrow, so the only way to see him was to put the cat in the hospital overnight @-)
* we MAY have to give him some medicine along the way like Lasix to reduce the fluid in his lungs (although the Xrays my vet did an hour earlier showed no fluid) - $200 x 2 days (!!!) = $400!!! They ended up giving him a Lasix shot before we took him home, and it was only $18. Why charge me $400???
* we MAY have to perform other procedures on him (besides the EKG? ok...), so let's slap on another $200 x 2 days = $400

etc etc, it was just so out of hand. I know that vets have the animals' health in mind, but to charge me so much for just one test is ridiculous. If they told me "hey we know exactly what's wrong with Bootie, and we can fix him for $3500", that would be a whole 'nother story.

 

Bootie looks like Niko. Russian Blue?

The charges do seem unfair. My experience (which may have no relevance to Bootie) is that Oliver had cardiomyopathy. It was very apparent that he had a fluid buildup as he gained weight in just a few days. They did an ultrasound/Xray and could see the fluid. They drained the fluid and he was put on Lastix. Unfortunately, the lastix did not help, nor did further draining of the fluid. But my point is that if he has fluid, it might be apparent with the ultrasound?

If Bootie turns his nose up at the wet, you can try mixing the wet and dry - eventually going to all wet. You can also warm it in the microwave until nice and stinky, or sprinkle parmesan cheese on top (no idea why this is popular....) But Don't Change over to all wet without hometesting.

For now, get that meter and get a reading. This problem might all be related to too much or too little insulin and it is easy to find that out.

 

Hi generikb

While your cat is resting, can you count his breaths per minute? It shouldn't be more than 30-35 max, while he's just sitting around.

I'm worried about your cat's heart. Based on the itemized breakdown you gave, it sounds like they thought your cat was in congestive heart failure, a very serious condition. The $$$ wasn't for an EKG but rather hospitalization, diagnostics, and treatment for CHF. Did they look at the x-rays from your vet? Did they take any x-rays? I'm very concerned that your cat is in CHF, and you're seeing a temporary improvement because of the Lasix shot. Laying down on the side and yowling is very worrisome.

To clarify a few things: an EKG (also abbreviated ECG) is a tracing of the electrical signals of the heart. This is what is on the monitors in the ER shows on TV. An echocardiogram is an ultrasound of the heart, and unless an animal has audible irregular heartbeats, it's a much better test for heart disease. It is more expensive, of course but if you have to choose one or the other, choose the echo unless there are irregular beats.

Heart murmurs in cats can be benign or a symptom of heart disease. In cats, the most common heart disease is hypertrophic cardiomyopathy, such as Lisa's Merlyn had. This disease may or may not cause a murmur. HCM progresses whenever it wants to--I've seen cats plateau for a long time, and other cats live only a few months past diagnosis. Cats tend to be sensitive to stress, both psychological and physical, so it wouldn't surprise me that heart failure would occur along with another major illness. Did your cat get fluids at the vet by any chance?

Are you able to make an appointment to see the cardiologist tomorrow? You can find a list of cardiologists at ACVIM.org (the organization that certifies veterinary specialists).

 

ANy update here?

 

Yes! back with an update!

I bought a home test kit, but I'm really not good at it...I tested it on myself first and had to poke myself like 4 times to draw enough blood! ohmygod_smile tried it on the cat, got enough blood but forgot to hold his ear still, and of course he shook his head and flung the nice drop of blood off his ear. Oh well, I'll still practice!

It's been about a week since we took Bootie off of the insulin, and he's 100% back to normal. We've got him eating the D/M food (since we bought a bunch of it, might as well have him finish it up!) and he's doing great...the breathing is completely back to a normal rate.

We took him to another vet this morning and he was *awesome*. He agreed with us that the cat sounded like he was going into a low blood sugar state with the insulin injections, and is putting us on a monitoring plan to see how well he does with just his new diet. We're also going to have him take a look at Booties heart (he noticed the murmur as well)

So things are looking up! So happy my buddy is feeling better!

 

:RAHCAT yaay! So happy Bootie is doing better!
Keep us posted

Odiesmom

 

Welcome Zonetice. You've posted this under a very old thread from 2010. How about starting your own new thread so everyone can welcome you and answer your questions.

HUGS