Steroid induced diabeties please help.

Hi,
I am new here someone kindly pointed me in the direction of this site and wonder if someone can help. My 19 year old cat paige has been on steroid injections for over a year now every 4 weeks. Had her urine tested as she was eating and drinking more it showed glucose 4+ and ketones 2+ we then tested taking blood from her ear and it showed 15.9. We can't stop the steroids because she will start vomiting losing her hair and develop lots of scabs. I've been told by the vets that if we started insulin it wouldnt work as the steroids probably caused it and unless we stopped them the unsulin would be useless. I've been told to come to terms with having her put to sleep. Is that really the only option? thank you. KATY.

 

THE VET IS WRONG WRONG WRONG!!!!!

There are a number of kitties on this site that require steroids for one condition or another and are still able to control the glucose levels with insulin. If steroids are required then that is the first concern and adjusting the dose of the insulin is the next step. You may have to use a higher dose than if Paige were not on steroids, but both conditions CAN be handled together. You do need to deal with the ketone issue though. She needs to be a a proper vet and receiving treatment for that ASAP. The ketone issue is a pressing concern right now. She needs to be an animal hospital on the proper IVs and receiving a fast acting insulin in order for her not to get to a critical point.

To get more feedback and advice from people who have diabetic kitties on steroids you will get more notice on this forum:

http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/


And BTW Welcome to the site and so glad you have come here. There is LOTS of hope for Paige to have healthy happy life. Time to switch vets though. He should be strongly admonished for even suggesting that you put your baby to sleep.

 

Welcome. The ketones need to be treated first and foremost.

If Paige needs the steroids then she needs them. Insulin can be adjusted around it. The dose could be a little higher than normal but that's okay. I think the type of insulin used could be a big factor. You will probably need a longer duration insulin once the ketones are addressed.

If you decide to give treatment a try, do not delay. Start immediately. Ketones are very serious and can be treated if caught early. If Paige is healthy otherwise no need to PTS.

My guy is 18 1/2. This year alone we have been through so much. A few months ago I thought it was time to let him go. Husband said give him another day or two. Glad I listened to my hubby. The cardiologist earlier this month says he should see his 19 yr from the cardiac side.

We are here to support you no matter what you decide.

 

Some extra thoughts that you can possibly start now.

If Paige is getting dry food. AND NOT receiving insulin yet, switch to wet pate food but ONLY if not getting insulin yet.

If insulin has been started DO NOT change food unless you are home testing. It could result in serious consequences.

You will need to home test regardless what your vet says. It's the only way to keep Paige safe and catch any potential future problems with diabetes.

Regardless of the country you are in. There is someone here who can advise as to food and human meter for testing (pet meter not necessary, regardless what vet tells you).

 

@Paige19

Have food allergies been ruled out that caused the vomiting, hair loss and scabs? Those symptoms sound as if it's an allergy.

I had 2 cats that were sensitive to fish. Once I removed all food containing fish or fish meal the scabs and loss of hair stopped. One of my current kitties can only have grain free food and no poultry flavors or she will throw up.

 

I see that the OP has not been back since the first post. I truly hope she has taken Paige to a PROPER vet and started treatment for DKA. With a reading of 2 on the ketodiastix it is reaching a crucial stage.

 

I hope so too. I really hate when they post once and never come back. I'm thinking they are not in the US as she posted the "15.9" number.

 

Hi,
I am in the UK, I have 7 dogs and two cats and our vet has always been fine, I wanted info so I can go back to the vet with other people's opinions who have the same problem( where steroids need to carry on) we use James wellbeloved house cat dried food and looking at the packet it says it's a good diabetic food. (it's duck so I doubt it's a food allergy issue) it can be bought in wet though. I will do that if that will help
Her quality of life I guess isn't great as she lives in the sittingroom basically from sofa to litter tray and food then back to sofa. Her feet are now flat like a rabbit but she can jump back onto the sofa. I think maybe my vet feels it's just another thing for my cat to have to deal with on top of how her life is already? Maybe I am being cruel trying to prolong her life. I just don't know x

 

The ketones can turn deadly in a very very short time. You MUST get help for that immediately. Usually extra fluids and insulin and food have to be maintained. Normally in hospital stay is required. That's how serious it is.

Smokey was in horrendous shape when I got him 2 yrs ago. He was my parents cat for 14 yrs. He always threw up as long as I can remember.

Fast forward to recently. I removed him from their house as he was totally neglected. His vomiting constantly was a combination of things. One by one I changed things and it stopped. His recent bout was because of pancreatitis which now resolved.

Anyway, cats can be sensitive to many ingredients in food. Grains (corn, barley etc.), gluten, whey, the main protein itself, poultry, the fillers used. Manufacturers change the recipes frequently and what was acceptable to kitty once might not be now. One of the flavors I gave my cats just changed. I noticed it smelled fishy and the color was different. I called the company. Yes they changed it. One cat throws up, the other 2 cats won't eat it. I now make my own food for them.

Changing to all wet food will help the diabetes aspect if it's low carb under 10%. Dry food is way to high in carbs for diabetics. We're you ever given a diagnosis for the hair loss, scabs, etc? Or just given prednisone to see if it helped?

Regarding the feet that could be neuropathy which will get better once diabetes is treated. There are some over the counter supplement that will help with that.

Prednisone and insulin can be done. The type of insulin will be very important.

 

This is the dry food ingredients etc...
There is no mention of carb content
We tried different foods because because of her skin and sickness ages ago but nothing helped so she had the steroid injections.. First she could go a couple of months between them then it went to monthly then four weekly as she would start to vomit sooner, the steroids stop the sickness straight away x


Composition
duck meal (27.5%), white rice, brown rice, duck fat, maize gluten, poultry gravy, tomato pomace (2.5%), potato protein, whole linseed, natural clay (1.0%), potassium chloride, chicory extract (0.25%), omega oil supplement, calcium carbonate, carrot, sodium chloride, cranberry extract (0.05%), yucca extract (0.02%)

Additives per kg

antioxidants: E306/Natural antioxidant, 200mg, Vitamins: E672/Vitamin A, 30,000 iu, E671/Vitamin D3, 2,250 iu, Amino acids: taurine, 1000mg. Trace elements: E1/iron, 40mg, E2/iodine, 2mg, E4/copper, 5mg, E5/manganese, 25mg, E6/zinc, 100mg, E8/selenium, 0.2mg

Analytical Constituents

protein 31.0%, crude fibres 1.5%, fat content 14.5%, crude ash 8.2%, Vitamin E 600mg/kg, omega-3 fatty acids 0.5%, omega-6 fatty acids 2.8%

 

So based on % you listed. It's close 44.9% carbs. That's from the guarantee analysis. Normally we go by As Fed to calculate. You can only get that info from calling the manufacturers. You need to be under 10% carbs for diabetes.

The ingredients you list have white and brown rice as 2nd and 3rd ingredients. All carbs. Also maize (corn) gluten, gravy and potato (carb) are red flags. Any food with gravy or sauce are to high in carbs.

http://fnae.org/carbcalorie.html has a good calculator to use when in the store.

Keep an eye on the ketones, do you have ketone sticks to keep checking? Any higher you need to see the vet immediately.

 

RIGHT NOW..The main issue which needs to be dealt with is the ketones. Prescence of ketones ANYTHING OVER A TRACE AMOUNT in the urine can indicate a possible DKA (diabetic ketoacidosis) which can be fatal if not dealt with promptly. As far as the steroids and the high glucose those can be dealt with quite easily. HOWEVER THE CURRENT INDICATION OF KETONES CAN MAKE YOU KITTY VERY SICK AND POSSIBLY KILL HER. YOU MUST DEAL WITH THAT..IF NEEDED GO TO AN ER VET.

 

I don't think there is such a thing in the UK as a animal ER. Certainly not where we live. So the only way to reduce the ketones is what? No vets are open here at the weekends we live in a small town in South Devon. I have nothing to test the ketones here but I am going to the city today where there is a big pet shop so I will be able to find wet food and see if they have ketone testers. For things like a colonoscopy for a pet the closest place is over 100 miles away and only through referral from your own vet. It seems things are very different here x

 

To test ketones, you need some ketone test strips that can be purchase at any pharmacy. You just dip the strip in the cats urine. For ketones when you can not get to a vet, food, water, insulin are important. If she won't eat enough, syringe feed her some wet food with added water. Be sure to syringe into the side of her mouth, not straight in where she could aspirate. Please keep us posted. Maybe start a thread on Health Forum where more people with ketone experience might see and be able to help.

 

Hi,

Thanks. I just bought some wet food. She's still eating and drinking fine. More than usual. I got the most natural one I can find. I will go to the chemist for ketone strips then but I'll need different litter as mine absorbs all the urine.

 

Try putting plastic wrap on top of the litter, then when she goes you can dip the stick. You can use aquarium gravel in the box it won't absorb and you can rinse and 're-use it. Some people just slide a big spoon or ladle under them when they are going.

 

Great thanks x

 

Link to new thread on main Feline Health board:

http://www.felinediabetes.com/FDMB/threads/steroid-induced-diabieies.165583/

.

 

Hi Katy,

As advised above your kitty really needs to be seen by a vet ASAP to get insulin and flush out the ketones from her system. PLEASE DON'T WAIT.

Here is an emergency vet service in your area:

http://www.exoniavets.co.uk/about-us.html

Tel: 01392 284217. If they aren't ideal geographically they may be able to point you to a service nearer you.

Here's a websearch results page of other links for you to try:

https://duckduckgo.com/?q=south devon emergency vets&t=ffab&ia=web

You need to get the ketones treated and insulin support in place. If Paige has good quality of life on the steroids then I think you should give serious consideration to treating her diabetes. There is a steep learning curve at first but once you both find a routine that works for you it is very much a treatable condition. It's harder to pill a cat than give a kitty its insulin.

By starting insulin straight away you have the chance to get the ketones under control and buy both of you some breathing space where you can learn what's involved in insulin treatment and therefore make a better informed decision about what's right for your girl. You'd be able to hear from other members managing both steroid treatment and insulin treatment successfully and find out how their kitties are doing.

We'd appreciate it if, when you can manage it, you could post a short message to let us know how things are going. We care deeply about all the people and kitties who come here, we worry, and we may be able to offer additional help.

Sending prayers you'll be able to find a vet ASAP.


Mogs
.

 

Thank you so much x

 

If you're bringing her in (and I hope you are) be sure to take plenty of her own food with you in case she might need to stay in. It's critical that cats at risk of DKA eat plenty so having her regular food available would reduce any risk of her being given something that she might get finnicky about and not want to eat. Bring a T-shirt or jumper with your scent on it, too, for comfort and reassurance.


Mogs
.

 

It sounds like your cat has diabetic neuropathy. This can be treated with methyl B 12 (methylcobalamin). The Lifelink Zobaline product is the most often used one for cats: http://www.lifelinknet.com/siteResources/Products/Zobaline.asp I'm not sure if you can get this particular brand in the UK but you should be able to get methyl B12 at most vitamin / health food type store. You can discuss with the vet about using methyl B12 to help the neuropathy.

 

Hi,
Her legs started doing this a long time ago, they started before and diabeties problems because she's had a urine infection in that time. I think it's caused by the steroids but could still be the same thing so I'll look into that thanks.
As foe ketone testers there are no chemists that sell them in the UK so I'll have to order on eBay which takes time to come. I'll see if the vet will give me some.
Thank you.

 

Latest from Katy is now on Feline Health in this thread:

http://www.felinediabetes.com/FDMB/threads/steroid-induced-diabieies.165583/

Exeter vet would not help last night; Katy's practice not on their list. (I'm sure those who know me can imagine the colour the air in this room went after I read that. )

(((Katy)))

I suggest posting all further replies to Katy on the Feline Health thread because that board gets more traffic than the Welcome section.

Katy - when you're posting updates or need more help, please reply on the thread in the link above (helps to keep current stuff just in the one place).


Mogs
.

 

Although in the UK we do not have animal ERs, look in the Yellow Pages for a 24 hour vet. My normal vet is a 24 hour vet, so therefore deals with emergencies.