Starving...

Casper has been diabetic for 2 1/2 years. His blood sugar numbers have been good lately (right at 300 pre-shot, in the low 100's at the lowest point in the curve). However, for the past three months he's been gradually losing weight. He's gone from 15 to 10 pounds. The vet has tested for pretty much everything. He's not throwing up or having trouble using the litterbox. His blood levels are all good. His physical exam showed no problems at all, and he's as active as usual. Considering he's 13, he's not particularly energetic to begin with. He just plain and simply doesn't want to eat enough to maintain his weight. He eats halfheartedly, and I've tried almost everything I know to try. I did just print out the wet food list again, to see if I can find something on the list that interests him. Does anyone know of something I can sprinkle on or pour on his food that will make it irresistable (that's also ok for a diabetic)? Thanks! I'm headed to PetSmart tomorrow...

 

Did your vet give you an appetite stimulant?? Cyproheptadine or Mirtazipine? It sounds like he may need it.

What I would do for my Merlyn was puree his normal food (canned wellness, with a little babyfood... using a stick immersion blender it came out like babyfood and he would lick it up. If he didnt eat, I would syringe the puree. Most of the time, I could get him started with a syringe full and then he would eat.

I am going thru this now with my oldie Janeway. She just doesnt want to eat much so I am helping with cypro now and then.

Does he seem to have nausea? Dental issues I assume have been checked for?

Sending many eating vibes!

 

including thyroid ?
an fPLI for pancreatitis ? ( some cats only symptom is decrease in appy and wt loss)
texas a &m lab is one that tests:
http://www.cvm.tamu.edu/gilab/research/ ... itis.shtml
the other is idexx
http://www.idexx.com/animalhealth/labor ... /index.jsp
they both have general info there

x rays?

have you considered an abdominal ultra sound?

Of course, getting to the bottom of it is ideal.
in the meantime.........

trying different foods is a great idea.
sometimes in order to get a cat to eat you even have to resort to dry :shock:
is more important that they eat. there are a couple low carb / grain free brands -- EVO and wellness core.
If you go to the wellness website and sign up for their mailing list once in awhile they send out some nice coupons. usu 1x a month. if this gets him to eat you can always adjust your insulin if needed.

making a buffet to give him choices

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food -- my Wolfie loves this stuff.
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
- I do not have a trader joes -- but others swear by trader joe tuna for cats
- powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

have you talked to your vet about appetite stimulents ?
mirtazapine has become a favorite b/c you dose only 1x every 3 days.
here is info on that:
http://www.veterinarypartner.com/Content.plx?P=A&A=2552

the other appy stim is cyproheptidine given every 12 hrs.
http://www.marvistavet.com/html/body_cy ... adine.html

I hope some of these ideas help.
in the meantime, please keep trying to get to the bottom of this.
I will look for your post back. am very interested if any of those help and if the tests I mentioned were included.

 

I agree with Cheryl that x-ray and/or ultrasound might be in order.

 

Thanks everyone! Pancreas and thyroid checked out Ok. He is absolutely pitiful/miserable on mirtazapine - we had to stop that - he would just cry. I did get some Sophisticat today, and I'm picking up the forti-flora tomorrow - the vet thought that was a great suggestion. I do also have some baby food - I can try mixing that in as well. She's going to look at him again to see if anything has changed from her perspective. Thanks again - I really appreciate the suggestions.

 

Hi Lori - I'm sorry to hear Casper isn't eating so well and i hope it's nothing serious.

Did i already miss your PetSmart run? They carry freeze dried treats by a company called BeefEaters that my cats will literally jump through hoops for (i buy them for my diabetic girl but the civvie boys love them also). If for some reason someone doesn't eat around here, i sprinkle some of the powder from the bottom of the container and walla, works like a charm every time.

BeefEaters makes a lot of freeze dried treats and while my babies love them all - i find the chicken livers and salmon are the biggest fan faves....

http://www.petsmart.com/search/index.js ... aters&sr=1

Here are the freeze dried snacks i'm talking about. Don't worry that some say for dogs and others for cats - it's 100% freeze dried meat or fish and nothing else.

It's worth a shot if you're going anyway. Good luck!

p.s. please pick me up a freeze dried chicken liver tub since your going anyway

 

I think I'd try to tighten up that regulation a bit first before adding more drugs to the mix. spending half the day over 200 means half the day with much less insulin than he needs, meaning glucose isn't getting into the cells for a large part of the day, which could lead to weight loss.

Any way you can crank those numbers down to a range of 80-240 or even 80-200?

If that's not helping, and thyroid comes out okay, then consider checking for various cancers, which you may be able to catch and fix if you're early enough.

 

re the mirtazapine: i'm sorry he had a bad reaction to it. my civie yowls on it( btw --I shave the dose to decrease side effects) but still eats UNLESS he is also nauseous and /or in pain. I give him his nausea med and/or pain med and he then eats w. the mirtz.
of course he is dx'd w/ p-titis and liver cysts. and those meds should not be given w/o a dx. I am throwing that out there thinking perhaps he *might* have nausea or pain from some yet unknown source. and I am not suggesting you give him mirtz again if he had a bad reaction -- just part of my trying to illustrate a point.
something to ask your vet about. also when you go back in make sure she used fPLI test to check pancreas -- or do you have a copy of the labs? some vets are not familiar w/ fPLI. ( see lab links in my previous post)

what type of insulin are you using? do you have a spread sheet of numbers you can post? many include that in their signature lines.or if you can just post your last curve/mini curve would really help us to have a better understanding of his fd. thanks.

please post back and let us know what happens at the vets tomorrow. ask if she/he will do x-rays and /or ultra sound ok ? IMHO, they would be the next step.

I hope Casper's appy pics up and the vet can figure out what is going on.

 

Update...
He's still not eating. Interestingly enough, when we went to the vet last week he has absolutely no sugar in his urine. Usually he has at least a little. We are reducing the insulin a little bit, and that is working Ok for the blood sugar numbers. However, he's still not wanting to eat.

He likes the forti-flora, but only licks for a while then gives up.

My babies love Beefeaters' freeze dried Cod.

The vet did not encourage an xray or ultrasound. Probably because we have an agreement that he cannot undergo another invasive surgery. Last time he had to be "put under" we almost lost him. His system is just too fragile to do it again. So, with that in mind... I can just do my best to try to get him to eat and have a high quality of life for as long as possible. I do have some hope since his kidney function and blood sugar levels are good, but the weight loss is certainly proving to be a challenge!

 

much or at all? can you assist feed him? syringe or make little meatballs and put in his mouth?


Interestingly enough, when we went to the vet last week he has absolutely no sugar in his urine. Usually he has at least a little. We are reducing the insulin a little bit, and that is working Ok for the blood sugar numbers.

what insulin is he on? is the vet dosing based on urine test? or your home testing? do you have a curve or mini curve of numbers to share?


However, he's still not wanting to eat.

He likes the forti-flora, but only licks for a while then gives up.

usually licking at food but not eating indicates nausea. has your vet treated for that? 1/4 pepcid ac (original pepcid) is very safe. if it helps you know you are on the right track. ( but if the nausea is strong it may not be enough -- and yes cats can be nauseous w/o vomiting)
it is very dangerous for your cat to not be eating. or to be eating a severely reduced amount.
HL (hepatic lipidosis ) can easily develop when a cat stops eating.

My babies love Beefeaters' freeze dried Cod.

does that mean he is eating this? what about fishy food or sprinkling those treats on food?
did you try a buffet?

The vet did not encourage an xray or ultrasound. Probably because we have an agreement that he cannot undergo another invasive surgery. Last time he had to be "put under" we almost lost him. His system is just too fragile to do it again.


there are health issues that show up in u/s and xray that do not require surgery for treatment.
and if it is something that needs surgery you can at least have a dx and know what palliative/ supportive measures can be used to make your kitty happy.

one example of the helpfulness of and u/s that did not require invasive procedure. my civie wolfie had one a couple months ago. found 2 issues: his fPLI showed mild p-titis, but the u/s showed much more inflammation
it also showed benign lesions on his liver. now I give supportive supplements for his liver which have helped and treat his p-titis more aggressively.

please post back and let us know how Casper is doing. sending eating vibes.

 

I've been making "meatballs" and popping them in his mouth. He doesn't fight me, he's just unimpressed. The Beefeaters Cod doesn't really excite him either, although he will sometimes munch on one. He snacks occasionally and licks for a few seconds. I called the vet after your post and suggested nausea. She said that was a good idea to try to work with. I'm picking up something that starts with an "m" tomorrow. Thanks! I'll keep you posted. We're trying to work with his insulin now (which is hard with him not eating much). His numbers are mostly from 100-300. Right now, I'm only giving the insulin at night when I force the food. He's on less than 1 unit of PZI. Last night, pre shot, it was around 300 after having no insulin for 24 hours. I know I could regulate it tighter, but I could also make him hypo pretty fast since his eating is so poor. He's pretty sensitive to the insulin. We're actually trying to see if he will adjust to a lower dose. Lately, every time we lower it a little, he's been eventually adjusting to it and having numbers mostly in the 100's. My vet is suspicious that the nausea may be caused by "crashes" we aren't catching or mild/moderate hypoglycemic episodes. Sooooo we're trying to (gradually) find out if he can become diet controlled, and if reducing the insulin will reduce his nausea. Hasn't happened yet, but his numbers are tolerable, so we'll see. I haven't seen a number below 100 in a few months, so I'm not sure that's really what's happening.

 

Laurie,

I expect that they took a look at his teeth, right. I know you are concerned about something invasive, but a sore tooth can be a reason why a cat doesn't eat. Sometimes, they can have one that hurts but isn't discovered until a dental is done.

Then the bs come back into line.

Just a thought! Good luck,

Claudia

 

Get those levels down...

Totally agree with Steve and Jock. When my Kip had some regulation problems (my fault, not his) he dropped 2 pounds in a week. He did not want to eat. You need much tighter control to keep the appetite going. There may be all the other reasons and little tricks that work, sometimes, but those blood glucose levels that high almost all the time are what is affecting his appetite and his weight.

Sorry I did not look to see what you are feeding or what insulin you are using or what regimen.

Kipper will not be tempted to eat when his BG is 200 or higher. When he is running 40 to 100 he porks up to a normal weight and eats.

 

this might not be relevant, but when my kitty was losing weight I wasn't happy with the answers my vet gave me, which was that even though the thyroid numbers were in the normal range she was probably having thyroid issues and put her on thyroid medication - which made no difference.

She then developed cancer and I went to a different vet for a second opinion. I got the same diagnosis, but I got a new piece of information regarding the weight loss. She is a cat only vet, and told me that round worm eggs can sit dormant in a cat for years, and health issue can cause them to hatch and infest the cat. A general deworming for round worms was done on Em, and she immediately stopped losing weight.



Connie