? Shelley, lethargic and not drinking

My cat Shelley normally drinks a lot but today she hasn't had a drink for several hours and has been lethargic and not walking well. But she has eaten when I have taken food to her.
Her BG has been staying lower longer meaning I have delayed shots but today didn't respond to the shot.
Only saw the vet yesterday. Have spoken to him but he does not think its an emergency. Numbers today,
Amps 12.2
Delayed +2 16.6
Shot 1.0u
+5 14.1
+7 15.1
I would be grateful for any thoughts, thank you.
Cc @Diana&Tom

 

Could it be the heat, Anthony? A lot of cats will be finding this hot spell very tiring.

 

Hi, Diana,
Very good of you to respond. The heat may have something to do with it but she has always drank a lot even when her diabetes was well controlled. I did read that not drinking can be a symptom of ketoacidosis. I have never know her not drink but the vet says OK if she is eating?

 

How is her breathing?
Normal?
Fast?
Labored?

 

Hi Tanya,
I have observed her breathing and it seemed normal.
Thank you for responding!

 

When my kitty had DKA she was drinking/urinating A LOT. The vet is right in the way that cats get most of their hydration from food - since DKA I add up to 5 ml per each tsp of food she eats.

How do you mean not walking well? Drunken gait? Walking in circles? Or weak hind legs?
I agree the signs are worrying and worth watching but if she hasn't drank in a couple of hours v. the entire day it might be temporary thing. When she eats next time maybe you can try mixing more water into her food?

 

Thank you Tanya,
I have just woken her up to check on her and she has eaten a little.
She walks slowly and then stops as if she is wondering what to next. She was limping badly last weekend. I put it down to neuropathy as it seemed to improve when her BG numbers were lower.
Her hind legs are weak normally, she has muscle wastage and arthritis. The vet talked about pain meds but wanted to check her kidneys first.
Sorry. It takes me a while to type on this tablet.

 

When was the last time she had any blood work done? Has she had her potassium level checked? Kitties with FD can be prone to potassium deficiencies, which can present in a similar fashion to neuropathy. It is easily treated with a potassium supplement.

ETA: Also, how old is she?

 

Hi Squalliesmom

It was about 6 months ago since the blood work, all was OK then but I will certainly have that checked out.
I think she was very stressed by the visit to the vets yesterday,
Perhaps this had had an effect today and on her numbers?


Shelley has just been on her tray and the evidence shows she has been getting water from her food. I am thinking she is in pain from her mobility problems though.

Thanks for responding, I really appreciate the advice!

She was a full grown cat when adopted 10 years ago, I think she may be around 16 years.

 

Anthony, because my boy is also a senior citizen, I add a tablespoon of water to each meal for him (Actually, I add it to ALL my kitties' meals). It makes his food easier for him to eat and I know he (and they) is getting enough water. My cat has arthritis in his spine, as well; I give him Cosequin and it really seems to help him. THIS is the one I use but I'm horrified by the UK price-tag! I have also used this one, which is much closer to what I pay here in the US.

 

Thank you, I will look into that. Shelley's diabetes was under excellent control until she had a hypo in February.
Since then I have dosed her too little at times and I think that may have contributed to her problems now.
But even before February she was drinking about 1 pint a day.
That's why the last 12 hours concerned me but she had been eating Whiskas Jelly and her recent urination was normal for her.
Her numbers are very inconsistent at the moment and due to delaying shots when her pre shot number is low, her next shot is due at 2 am.

 

Is she on b12 supplements for the neuropathy or any meds like cosequine for the arthritis?

 

Hello Janet NJ,
No, she isn't on anything for mobility. She had a few days lameness a couple of months ago but it improved when I increased her insulin. Then it came back again last weekend but did seem to be improving but then today not limping as bad but more reluctant to move at all.
I asked my vet about the methyl b 12 yesterday and he wasn't aware of it being used for neuropathy. He suggested Metacam but wanted to check Shelley's kidney function first.
Thanks for replying!

 

B12 and cosequine are available without a prescription and are worth trying. B12 helps with neuropathy, energy, and appetite. I've started putting some on all my cats food.

Since she's still eating, you could add a bit of extra water to the food.

 

I had looked up about the B12, I shall have to source some. I thought I would have got it from the vet but as I said, he didn't think it appropriate.
Thank you!

 

If you click on the Blue links in my earlier post, they will take you to two types of cosequin on amazon.com.

 

Have you tested her for ketones?
For checking if her breathing is normal at home, you can count the breathes per minute. So for one minute count each inhale and exhale when she is resting. 24-42 breathes per minute is within normal range. You can also check her heart rate at home: Feel your cat's heartbeat with one hand over his left side, just behind his front leg. Count the number of beats in 15 seconds and multiply by four to get the heart rate in beats per minute (bpm). Normal heart rate is 140 - 220bpm.

 

Just catching up on overnight posts Anthony... you've had some great advice here! Def worth adding a little water to Shelley's food to keep her hydrated. Cats do have a low thirst drive so her "normal" level of water intake mainly indicates that her diabetes is not under control. At times when her numbers are lower, she may not drink quite as much... I've had a look at her ss a couple of times lately and she does seem to be getting some decent blues during the cycle. It's the pre-shot numbers that still need to come down...I know we have debated this, and dose changes before, with mixed success!

Particularly given Shelley's age, supplements of some kind are almost certainly going to be needed... Cosequin or B12 as you decide, again I think you have considered this before. I know you're reluctant to go against the vet's advice and this is always a dilemma when people here recommend certain things or courses of action. It's a case of weighing up what you can research and making a considered decision. The vet is correct however about being cautious about prescribing Metacam, it may be harmful especially if used on an ongoing basis. But again, you have to weigh things up - I know an extremely experienced member here who gives her elderly cat Metacam because it does the job with no apparent effects, and she wants the kitty to have the better, pain-free quality of life it provides.

Sorry not to be much practical help but those are my thoughts FWIW. Let us know if Shelley starts drinking again today, add a little water to her food and consider a supplement. If she only saw the vet a couple of days ago there is unlikely to be any sudden change in Shelley's overall health to pursue any further course of action at the moment... if it's as hot where you are as it is here in the south, I still say that my original guess about the heat causing lethargy might be a factor.

Good luck and keep us posted.

 

Thanks very much, had to sign off overnight.
Shelley seems more her usual self this morning. I wonder if I failed to dose her properly yesterday and this kept her BG higher and made her feel more unwell?
But I am going to look into these supplements as her mobility is not good at the best of times.
Thanks again, your help is much appreciated.

 

You are very welcome! Hope she is improving!Prayers she gets a lot of her mobility back.

 

Hello Yong,
Thank you for your comments. I did wonder about ketones but I didn't have any testing strips.
I did check her breathing and that seemed normal. I will try and check her heart rate. She does have high blood pressure and is on Amodip for that.
But fortunately she seems more her normal self this morning, moving better and drinking again. I am wondering if I dosed her incorrectly yesterday which made her feel unwell.
Many thanks!

 

Hello Diana,

Thank you for those comments, fortunately Shelley does seem more her normal self today. She is certainly moving better and drinking. Given that her BG did not respond yesterday I wonder if I didn't inject correctly and what with the extreme heat and the stress of the vets just made her feel ill.
I am certainty going to get one of the supplements. I have spoken to the vet again. Can't get any urine test till next week but he is going to prescibe the Metacam just to try.
Eddie is a younger cat with stomatitis, he was on Metacam for a couple of years until his fme with no side effects but I know some people have have had bad experiences.
I did think Shelley's vision was impaired last night. She also has cataracts and her pupils were widely dilated. They always are at night and when her blood sugar lowers. But her eyes seem normal again today.
Poor girl, she has a lot to deal with!
See how we go today, many thanks as always!

 

Thank you, that is very good of you!

 

How's Shelley now, Anthony? Still more like her normal self?
Her bg numbers seem to be a bit better in recent days so that's a good sign.

 

Hi Diana,
Thank you very much for looking in, it's very good of you.
Yes, I have had a couple of days of lower numbers and this has meant I have had to put off giving shots. I think at one point there was 22 hours between shots.
But I have just been out a couple of hours and the number had gone up to 17.0, so I gave about 0.75 u, rather than jump straight back to 1 u.
While Shelley is in this lower range she has been brighter and walking like she does normally. Her legs are still stiff but I have held off on the Metacam for now. I think this proves the really bad limping is due to neuropathy.
I have been wondering if a different insulin would improve Shelley's quality of life?

 

Sounds like you're well on top of this, Anthony, you've come a long way in the last few weeks! It's great that Shelley is so noticeably brighter when she's in decent numbers, that's what keeps us all going I'm sure - seeing these beautiful little creatures looking happier.

Different insulins... yes, it might be an idea to discuss this with the vet. If you can show him/her Shelley's spreadsheet, they might agree that a longer lasting insulin might be more appropriate. You could also look at dosing Caninsulin at different intervals to the usual 12 hours - eg. maybe three times a day, depending on BG... in some ways this is the ideal if you are prepared to test frequently as you can "catch" numbers when they are "on the rise" and shoot a dose accordingly... it's far from impossible but you have to be both confident and committed to that.

I suspect if you talk to the vet about this they will tell you to carry on as you are. Vets' training only really goes as far as what the Caninsulin manufacturers say. But what vets forget is that Caninsulin was formulated for dogs (the clue is in the name) and cats have a faster metabolism than dogs. Caninsulin can and does work for some cats, but they may be simply the lucky ones whose systems are more predictable.

This is SUCH a minefield, as you know... you can think about it until you're blue in the face and still not really come to a decision (about the insulin). Maybe the thing to do is carry on for a bit longer as you are and try to keep Shelley in these better numbers... if they shoot up for no apparent reason, use that as an excuse to talk to the vet. I'm sure they respect you as a committed and caring owner, and should listen to you and what you have achieved in recent weeks.

Of course, carry on posting here, too - as you've seen, you do tend to get more replies on a new more specific thread now and again. So you could start a thread called Time for a new insulin??? and see what responses you get... people can always see your spreadsheet, of course, and that's the main info they need to know.

Keep at it!

 

Thank you Diana, your comments and encouragement are greatly appreciated.
I will see how things go in the next few days. Shelley is due for a BP check, so I will be seeing the vet again. I will keep in touch with developments.
Best wishes!

 

Please be careful using Metacam (Meloxicam)! You might want to ask your vet for an alternative med, if possible. http://healthypets.mercola.com/sites/healthypets/archive/2013/05/01/meloxicam-dangers.aspx

 

Hello Squalliesmom,
Thank you, I know a lot of controversy exists about Metacam. It has been prescribed now but I haven't used it so far. You may have seen the previous few posts but Shelley's BG numbers have dropped into a lower range and her mobility has gone back too normal. Although she does have arthritis and a lot of muscle loss, I think the really bad limping was more to do with her diabetes. So I am going to try and get the supplement you recommended to see if that helps and also the methylcobalamin.
Shelley's BG numbers seem to fluctuate all the time and I have to keep changing her doseage which makes it hard to get proper regulation.
Thank you for looking in!

 

I'm glad she is doing better! I know how hard it can be to get your kitty regulated, it took me almost two years to get Squallie to where he is now! Sending prayers and healing vines to you and Shelley.

 

Thank you very much, that is so kind! You have obviously done wonderfully well with Squallie. Shelley had no problems for 6 years on Caninsulin and then she had a hypo which meant that her diabetes needed to be monitored much more closely.
There doesn't seem to be any consistency in her numbers but they are running lower. It is now 18 hours since her last shot and her BG is at 11.5. So I am not injecting yet and waiting for it to rise but when the time between shots varies it becomes much more tricky to manage. I just keep trying to get it right.
Kindest regards!