? Steroid induced diabetes, decreased appetite, chlorambucil,

Not only did my cat Vivian start insulin last Friday, she also started chlorambucil. It is believed that her diabetes is steroid induced and if I can get her off prednisolone the blood glucose can return to normal. She needs to be on an immune suppressant to address intestinal inflammation and related symptoms. Only trouble is, where the pred increased her appetite, chlorambucil has decreased her desire to eat to just about none. Had to follow her around last night and this a.m. pestering her to eat something so I could give her the insulin. She was also sick in the night last night and is just not herself. She gets the pill M-W-F. Has anyone had experience giving insulin to a cat who doesn't want to eat? What do you do? At what point do you not give the dose of insulin? Does anyone have experience with a cat on chlorambucil and decreased appetite? Does it eventually come back? Any success stories of getting steroid-induced diabetics off insulin? How did you do it?

 

Hi Laura! Vivian MUST eat to get insulin. How much and when varies a bit depending on what type of insulin you use. For Lantus, she needs to eat about 2 tablespoons of food within an hour before taking the insulin.

If she still won't eat, you can try an appetite stimulant. We use Cyproheptadine, which is actually an antihistamine. The appetite stimulant is a side effect, but it works. When Tisha wasn't sick, she was starving on cypro. We also use cypro because it can be made into a transdermal gel that can be rubbed onto her ear, which is very useful for a cat who is difficult to pill. Mirtazapine (sp?) is another appetite stimulant, but some here have not had good results with it.

There are some other things you can try to get her to eat, if her dietary restrictions allow. For Tisha, the vet said eating anything is better than not eating, so we've learned lots. Playing with her in a way that simulates hunting activities can help stimulate the natural cycle of hunt, kill, eat. You can add parmesan to the top of her food. Try a different kind of food - which helps surprisingly often. Wellness makes a food that Tisha loved the last time she stopped eating. This time, she won't eat it, so it just depends. Cheese and yogurt can be used to get her to eat (although they are certainly not recommended as a long-term food.) If you give her food to lick off of your fingers, sometimes it may coax her to eat when she won't eat from a bowl. You can also use a large syringe to feed her diluted food.

BJ will probably chime in. She has lots of helpful suggestions in this area. Not eating at all, or eating very little, is very dangerous for a diabetic cat, so keep trying!

 

Does Vivian have small cell intestinal lymphoma?
How was the intestinal problem diagnosed?

 

Vivian has had two ultrasounds that showed extreme thickening the length of the large intestine/colon and loss of layering. One ultrasound was suggestive of thickening and loss of layering in the lower part of the small intestine and an inflamed lymph node. A needle aspirate biopsy of the colon was not conclusive for lymphoma, so it is neither ruled in (no tissue evidence) nor out (it looks and acts like cancer). In any case, her large intestine is in pretty bad shape and causes her a lot of trouble in the litter box including loose and frequent stool with fresh blood and weight loss.

 

My Mario has decrease appetite with and that is not uncommon. For lymphoma the thought now is to use pulse dosing, one high dose every two weeks or so.
https://www.google.com/url?sa=t&rct...=E-8MSXqVMgumrOUxQQUkuA&bvm=bv.95277229,d.b2w
That way there is less of a period of inappetance.

 

Is Mario also diabetic? How do you get him to eat when he doesn't have an appetite?

 

If the glucose is over about 300 mg/dL on a human glucometer, you CAN give some insulin so the body can use the glucose for energy, even if the cat is not eating. Of course, you want to be careful not to give too much, so look at your data and evaluate how much of a drop you get on the dose you've been giving when the cat was eating and consider 1/4 to 1/2 of that. Keep notes on the side of your spreadsheet so you know what dose worked best under those conditions..

 

Yes, Mario was also diabetic. Because of that the vet would not use pred as part of the treatment.
When not eating that much I either syringe fed or gave reduced dose of insulin