Treating peripheral neuropathy

Hello, all!

I'm fairly sure one of my new foster sugar kitties, Jibbit, is suffering from peripheral neuropathy. He walks mostly on his hocks and doesn't seem able to walk more than a few steps before he needs to lie down. I'm taking both Jibbit and Sunshine, my other new foster sugar kitty, to the vet on Saturday for vaccinations, snap tests, and insulin level adjustments, so I'll talk to her about it then.

My question for the board members is, is it okay to use injectable methylcobalamin with him? The things I've read only discuss using pills. There's a link to something about using injectable, but it goes to a "missing message" page. It's an odd thing for a needle-phobe to say, but I'd rather give him an injection. If this is okay, I'd like to ask the vet for a prescription on Saturday so I can go ahead and get it ordered. In the meantime, I have some xylitol-free capsules that I'm trying to use with him (I used then with my CKD kitty - mix the powder into her food), but he doesn't seem to like eating food that has something mixed into it. And I'm definitely not going to try to get him to swallow those things!!

Jibbit and Sunshine were both formerly on Glipizide, which doesn't seem to have done much to regulate them. When the vet took their initial BG readings on Sunday, his was just "high", no number. I have yet to succeed in extracting enough blood from either of them to do a home test, though I continue to torture them with trying! They're both currently getting 1 unit of Lantus BID. I'm feeding Wellness grain-free mixed with low-carb Friskies from Dr. Pierson's list. Also occasionally low-carb FF.

Thanks!

~Amy for Jibbit & Sunshine

 

Hello Amy,

Here are links to two threads, one recent and one much older that might interest you (they both include someone posting about injectable methylcobalamin):

http://www.felinediabetes.com/FDMB/viewtopic.php?p=182877#p184351

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=85291&p=914573&hilit=injectable B12#p914573

I should also mention that, while it is likely that the leg weakness is caused by the diabetic neuropathy, there are also other less likely causes (the details of which I can't think of at the moment... Duh!)

Oh, re the hometesting. It sounds like it's quite challenging for you... Can you talk us through your routine?

I thought I'd never be able to test my cat because he's not much of one for being handled, but I crumble a few of his favourite low carb treats and do the test quickly while he's eating them. Because of the treats he gets he loves to be tested! It can also help initially to put a teensy smear of vaseline on the outer edge of the ear, it helps the blood to 'bead up' and stops it disappearing into the fur. And two ear-pricks very close together can often produce enough blood for a test where one prick might not.

Edited to add: There's some really good hometesting info here:
http://www.sugarpet.net/bloodtst.html

Eliz

 

Thanks so much for fostering these 2!

Yes Methyl B12 is what you want, and most people give the pills because its hard to find the injectable stuff. Its also way more expensive for the injectables.
I usually dissolve it in water then add to food..too bad they wont eat stuff in food. Its a rather small pill.

Make sure the vet knows what you are asking for. I wanted regular cyanocobalamin injectable and the vet staff ordered me B Complex! Also if its a human source make sure nothing else is in it thats cat harmful.

 

Thanks, Eliz and Lisa!

I could try dissolving in water and mixing into food - hadn't thought about that!

Eliz, my routine generally consists of my being frantic and fumbly, because I'm terrified of needles AND I don't know what I'm doing yet! I go in their room and give both kitties some love, though what they really want is food, right then! I talk to them and tell them that I need to test their blood so I'll know how they're doing, then keep talking while I get the monitor, etc out. I try to use a low, calm voice. I just got a rice sock, so I'm trying that to warm their ears, though I'm fumbly with that, too. I start with Jibbit and try to poke his ear in the right place. I've never gotten any blood from his ear - and neither did the vet on Sunday. She resorted to poking his paw, which I did finally try last night. No blood from there, either! Once I apologize to Jibbit and get another lancet out, I try with Sunshine's ears (she has dark paws, so I haven't tried poking one of those yet). All I do is make her mad!

I think I'm being too tentative with the lancet. That was my big problem - well, that and terror - when I started trying to give subcutaneous fluids to my CKD cat. I also can't see the ear vein in either kitty, so I need to add a flashlight to my routine. I'm hoping the vet can help correct my technique tomorrow so I can finally get some blood from these poor kitties! I didn't give up on giving fluids, and I don't intend to give up on getting BG readings from these little ones. It's just that I have to overcome terror along with being inexperienced. And fear that I'll make these new kitties hate me...though they seem to forgive me very quickly for all the poking and prodding!

 

(((Amy))), your cats won't hate you for trying to test them. It can take a little time to get the hang of testing but a lot of people find that the testing and treat-giving routine actually strengthens the bond with their cats. cat_pet_icon

Are you using the lancing device or using the lancet freehand?

 

I hope it will strengthen the bond and that I'll get the hang of it soon!

I'm using the lancet freehand. I'm utterly terrified of the lancing device.

 

I actually find the lancing device the easier option by far. It's so quick! And my cat doesn't feel it at all. I did try the lancet freehand at first but my close vision isn't that great, and my hands shook too! Some people are really comfortable using just the lancet, but...it didn't work for me. With the lancing device it's only necessary to press the end of it against the outer edge of the cat's ear (while holding a little bit of cotton wool or tissue against the inside wall of the ear to give a little 'resistance') and 'click'.

I know it seems scary at first. But if you're not yet confident using just the lancet maybe it's worth a try...? It might work better for you....?

 

Anything's worth a try, I suppose! I'll ask the vet to give me a tutorial in using the device. She'd forgotten part of the device for the monitor she gave me to use, so she couldn't show me then, she just showed me freehand poking. And I guess I can give it a try on my own tonight, too. It couldn't be worse than what I've already been doing! Unless I *really* stab myself! :shock:

 

Yes, it can be helpful to try it on your own fingers, just to get a sense of how the thing works (and I also practiced on my OH! ) But the sensation you'll feel won't be what your cat feels. The edge of a cat's ear has very few nerve endings and so the cat should scarcely feel it at all. But cats are sometimes surprised by the clicking sound of the lancing device. And it can be worth getting the cat used to that sound by clicking the device near your cat's ear and then giving a little treat, so that the sound comes to be associated with happy stuff!
Now, with my cat, I just click the lancing device and he comes running! bcatrun_gif

 

The blood sugar numbers really need to be under control before the methylcobalamin can really help since the high blood glucose is still causing nerve damage. Plus the methylcobalmin can take a few months to repair the damage.

I got a pill and put it in the pill pockets. I actually broke the pill pocket into 2-3 bits and put the pill in once of them and gave Tiggy all 3 in a different order each time so he wouldnt associate them always tasting bad.

 

Maybe we were just lucky, but despite Bert's high numbers at the time (mostly 25-28 (450-500)) his neuropathy started to improve after just a couple of weeks on methyl B12; and in fact resolved completely even though his numbers remained high.

 

This is what the vet told me also, Wendy. She wants the get the BG under control before treating the neuropathy. Jibbit was still "high" (so over 600, I guess ), so she really wants us to work on getting that number down.

Do you think I should still try using pill B12 to start helping with it? I do have Pill Pockets I could try putting it in. Jibbit is turning out to be a picky eater after chowing down indiscriminately the first few days with me!

Eliz, I guess you would advise me to go ahead and start, given your experience!

 

Sure! it wont do any harm to start the B12 pills now.

 

Well, all I can say is that Bert's numbers remained really high for most of the 8 months immediately following his diagnosis (with just occasional drops into better numbers), and yet his neuropathy - which was pretty bad - completely resolved. I got through a bottle and a half of Zobaline tablets and didn't need any more... At the time a couple of ideas went through my mind about it; firstly that the methyl B12 had done it's job really well; and, secondly, that maybe insulin has a positive effect in the body that doesn't show up in the numbers themselves....?

 

I used it on Tiggy for 3 months and it didnt make a difference but his BG wasnt regulated.. so ECID (every cat is different).

 

Thank you, ladies! I'll go ahead and get him started. I need to research/buy some other pills first - the ones I have are capsules to be broken open and mixed into food. I was sort of counting on being able to get injectible B12 ASAP, so I haven't looked for pills yet. I'll check to see if the ones I use myself are suitable for cats.

Side-note: The vet showed me how to use the lancing device, which turns out not to be nearly as scary as I thought it was! I think I'll have more success with that than I have been trying to poke freehand. Wish me luck!! :smile:

 

Good luck! Keeping fingers and paws crossed for ya! :smile:

 

Thanks, Eliz!

I have some chronic issues myself, one of which is pernicious anemia (inability to absorb B12 properly), so I take 1000 mcg of methylcobalamin daily. I have sublingual tabs, which another thread said were okay to give cats. I wanted to see, though, if anyone knows if any of the ingredients in the ones I take are bad for cats: vegetable stearic acid, silica, vegetable magnesium stearate, natural cherry flavor, vegetable cellulose. Anything there that should keep me from giving these to Jibbit?

 

Ingredients sound ok to me - the key thing is no xylitol.

 

Thanks! :smile: