SCARILY fast decline of back legs

Pasha (who may be 9-10 yrs old, we don't know) was diagnosed at the end of May and we have not yet been able to get his sugar under control. Now at 4 units of Lantus 2x per day. His last curve, a week ago, ranged from 422 before his morning shot to 300 before his evening shot. He has never been under 300 and mostly in the 400s.

We (and the vet) noticed significant muscle wasting in his back legs 2 years ago, shortly after we adopted him, but he was only limping a little and he could climb stairs well, etc. The wasting never seemed to improve, but his limping did improve.

In the last few weeks his back-leg strength declined dramatically, and just in the past week his haunches have begun falling--his back-leg strength is declining dramatically. The neurologist we saw yesterday says the longtime wasting and recent weakness are not due to a spinal problem--probably some underlying muscle problem (perhaps related to his FIV), but the diabetic neuropathy is now clearly causing the weakness and falling haunches.

What worries me is how FAST this is progressing. It seems like every day is worse.

Our vet is scared to increase his insulin, so yesterday she advised me to switch him to wet kitten food (he's been on Purina DM dry), do another curve in a week, and if his numbers don't improve she wants to switch to a different insulin.

I don't think we will get him to eat more than tiny amounts of wet food (though we'll try), and I'm really worried that he's going to totally lose the ability to walk if we wait another week to see what happens ... and that if we have to start on another insulin, won't we have to start at 1 unit again and wait many more precious weeks before we can hope to get his sugar under control??

So I guess my (desperate) question is, can diabetic cats become totally unable to walk in a matter of weeks? Do we need to do something drastic next week? I know the risks of hypoglycemia, but what about the risk of totally losing the ability to walk??

 

if it is diabetic neuropathy, it can be helped by Methyl B12 but the best way to reverse it is better regulation. If its happening scarily fast tho, make sure its not a potassium deficiency.

Does he have kidney disease as well? Muscle wasting can happen with CRD.

You mentioned his last curve, but can I ask if you are hometesting blood glucose levels regularly yourself?
I notice you joined in June so forgive me if theres a backstory that I am not aware of.

 

Smokey's old vet told me that not only do high BGs result in neuropathy, but also wild swings in
the BG can cause it.

With that dose, I'm wondering what his low point is.

Is it possible the dose is too high, and he is experiencing Symogi Rebound ?

You only quote two numbers from his last curve. 442 amps and 300 pmps.

What were the in-between numbers from the curve.

Testing at the vet, numbers can be 100 points higher than his normal environment
at home due to vet stress.

Are you home-testing ?

 

Lisa and Karen covered the hometesting. Re the food. Check out this vet by a vet to get ideas about transitioning from dry to wet: http://www.catinfo.org and this food chart: http://www.felinediabetes.com/diabetic-cat-diets.htm We feed between 8-10% carbs, with fish given only once or twice a week. Food can make a huge difference. Oliver's blood glucose levels went down 100 points overnight when we changed from dry to wet.

 

Lisa--I asked both the neurologist and our regular vet about B-12 shots; they said we COULD do it, but getting his sugar under control is what we really need to concentrate on now. The neurologist also stressed the importance of avoiding the swings.

Pasha does not have kidney disease; he had TONS of bloodwork three months ago when diagnosed with the diabetes and just had more about 10 days ago, because we HAD been planning to put him under for an infected tooth (or teeth) in hopes that would help with BG control, but then the vet decided against the surgery at this point after talking to a couple of internists. I don't know whether potassium would have been checked in that batch of bloodwork. I will ask the vet. All his bloodwork has been fine, except for FIV.

His numbers at his last curve (at the vet's) were:
10:00 am (pre-shot): 422
1:00 388
4:00 380
6:00 354
9:00 (at home) 301

I do have the AlphaTrak but have only succeeded in doing occasional spot checks, not entire curves. I will try to do his next curve at home. His paws seem to be bleeding better than they did when I first tried the home testing in June (he was a turnip-cat, despite my trying all the tricks for ears and paws offered here!).

Karen: I don't think the dose is too high, because we have gone up SLOWLY in half-unit increments--over 3 months.

Sue: thank you VERY much for the links to all that info. I printed out the info from Dr. Pierson and am about to read it, as we try to get him on wet food. It's all so much to absorb; I feel a little overwhelmed--but we aren't going to give up on Pashie! We had no trouble getting our previous diabetic kitty regulated, but with Pasha it's been unbelievably frustrating (with the difficulty home-testing, his lack of response to the insulin, and his complicating factors)--but of course you cannot give up on the sweetie-pies.

THANK YOU everyone for the information and encouragement.

 

Nancy, it is not B12 shots......please read Jasper's story that started it all years ago. http://www.laurieulrich.com/jasper/

 

Thank you for the information, Hope! That is an amazing story!

 

WOW--Pasha had an AMAZING drop as we've switched him partly over from dry to canned food this week! I CANNOT BELIEVE IT!!!

Since my husband was home to help today, we did a mini-curve at home:

8:15 am, pre-shot: 326 (that's 100 pts lower than two weeks ago at the vet's!)--then gave him his 4 units of Lantus.
1:00 pm: 204
5:15 pm: 121
8:30 pm: 150

With that low 8:30 pm number, I consulted one of the extremely helpful sticky notes by Jill (thank you!) on the Lantus board, advising what to do for 150-200. I decided to give him 1 unit tonight and will try to test before every shot until I can talk to the vet, hopefully Monday.

Just this week--since cutting his dry food way down (gradually) and giving him canned--his drinking and urination went from bad to normal, his energy is up quite a bit, and most importantly his scarily fast back-leg-strength decline has been halted!!

What a difference canned food made!! He'd been on 4 units since early August with VERY little improvement over his initial high numbers in June, and it only took a week to make his numbers drop like a stone. Since I didn't test him earlier in the week (except one pre-shot a.m. test on Monday, which was 319), I don't know when they started dropping, but it must have been very soon.

Wow!! thank you everyone!!

But I guess now comes a trickier part: not going hypoglycemic. Til now, that has been the least of my worries. Now, clearly, it's going to be the biggest. Will consult with vet and try to do twice-daily testing if I can manage it. Today everything was perfect--monitor didn't misbehave, husband helped hold cat, I didn't screw up, and his blood drop came out very nicely, in contrast to previous difficulties with "Turnip-cat". I hope Pasha and I will be able to get into the testing groove better now!


Thx again,
Nancy

 

With the new diet, it may take some time to "dial in" the correct new dosage. Also, as you get her more regulated and her organs can come out of panic mode, then she will hopefully start digesting better. If she is digesting better, then she will need to eat less and numbers will go down even more.

As for leg weakness, when Podo was first diagnosed she lost a lot of muscles as well. She couldn't jump up hardly at all. I had to build some "steps" for her to get up on the bed. She had some hind leg issues, where she didn't walk on back feet, but her whole hind leg. This caused some fur wear patterns behind her rear paws. But, I am happy to report that after getting her regulated, her muscles came back. She can jump fine now. And those worn patches of fur have grown back.

So, keep your spirits up. You are doing great and Pasha will thank you for it.

 

this is the methyl b12 I used and recommend: http://www.vitacost.com/NSI-Vitamin-B-1 ... cobalamin/

reasons:

1) doesn't contain sugar
2) easy to open and mix into food

instructions:

take one capsule open and mix into wet food daily, what doesn't get consumed no worries, as normal daily dose is 3-5 mg and this is 5.

 

Hillary, thanks for the link. I will check with our vet but I'm sure she'll say this is fine--so I'll give it a try!!

Brian, thanks so much for the encouragement. I am really hoping his legs will get back to normal!

I couldn't get a reading this morning--he's a very big cat and wiggled his way out of my arms before I could get a big enough sample--but I took a deep breath and gave him his 4 units anyway, since he only got a tiny dose last night. Someone should invent a nice comfy Cat Immobilizing Trap for this purpose!

 

I "sit" on my cat to test her. With her laying on the floor on her stomach, I kneel with my knees around her shoulders (close but not squeezing). I use my feet and butt to keep her from backing out. This also has the advantage of freeing both your hands to wrangle ears and prevent head shakes while testing.