? What's going on with Rocky?

I first posted here in January about help with my newly diagnosed Rocky. Since then he's been doing pretty well. But for the past 3-4 weeks, several times a week, he's been howling and craving food late at night.

At first I thought it was because his BG was dropping too low too fast (he's on Novolin) and it's usually always 3-4 hours after his shot when he reaches his nadir. This can be typical behavior for him, I feed him, he's fine afterwards. But these past few weeks it hasn't been enough. He'll be content for a few moments but begin howling again. It's also accompanied by erratic, hyperactive behavior such as sprinting through the house, playing with random objects, and coming into my bedroom staring at the ceiling while yowling. The staring at the ceiling in an agitated state is a new thing, he just spent a few minutes doing it tonight (which is why I'm up at 3 in the morning typing this). I don't remember this kind of behavior this consistently in the weeks before he was diagnosed with diabetes. This happens almost always at night, a few hours after his shot. Very rarely during the day. In fact the only time he exhibited this same behavior during the day was a few days ago. It's also accompanied by an increased appetite. Though it's usually a picky increased appetite as he only picks at his wet food and eat all the dry food I'll give him (Which I am totally not a fan of doing, but I've been desperate to figure out what's wrong with him). Typically when his BG is getting too low he'll eat anything and not be picky about it.

This all led me to wonder if he had developed hyperthyroidism. So about two weeks ago we took him to the vet and showed him the spreadsheet I had been keeping, described all the symptoms. He felt that Rocky was doing this because his BG had been too high. I considered it a possibility, because we had still been using a vial of insulin we got in January (vet said at this point the insulin may have been at half potency) and we stopped testing him in the middle of the day for a while, so didn't truly know if he was being regulated. I assumed he was because the mid-day numbers were good when we stopped testing. He advised us to give him 1.5 units, and increase by 0.5 units every 5 days if things didn't change (and get a new vial of insulin which we did). I asked him if he felt we should do a blood test to check for hyperthyroid and he said he didn't think it was necessary. As he didn't exhibit symptoms of weight loss, and his hunger only seemed enhanced during these episodes at night (he's relatively normal during the day), and the blood results in January were all normal aside from BG. So we didn't do blood. In hindsight I don't know why we didn't anyway. We were already there and it wouldn't hurt anything

But we've begun testing mid-day again recently, and he's been in the double digits. So is it possible Rocky could be behaving like this because his BG might be too low? Months ago his BG would be double digits during the day with higher doses I've been giving him now and he didn't act this way. Is it possible for a cat to develop hyperthyroidism in 5-6 months from their last normal blood test?

It's a double frustrating situation because I don't know what's wrong with him, what to do with him, and when these episodes occur I hardly get any sleep at night. What do you guys think? Have any of you ever experienced these issues before? I've read about cat cognitive disorder but I don't think that might be the problem. His behavior outside of these episodes hasn't changed and the distress is typically all focused around me (or anyone passing him by) giving him some dry food.

I considered one night if his numbers aren't too high I just skip a dose and see how he reacts to it. Is that a good idea?

If he continues doing it through the week I'll probably take him next week to get the blood test no matter what the vet says

 

I'd test him while he's doing the behavior. That should either confirm or eliminate an issue right there. Also, a thyroid test is never a bad idea. Especially if the cat is older.

Or he could just be singing to his ancestors. Cat's do that.

 

I've been able to test him twice recently when he's has a howling episode, both times in the double digits. However he's been in double digits before and acted relatively normal. Last night during an episode, he ate a whole 3 oz can which he normally doesn't do, he typically likes smaller more frequent meals. But it wasn't enough because a few minutes later more howling and he finished off another 1.5 oz. I went and did some stuff, came back into the kitchen where he usually hangs out and he was passed out cold in his bed like nothing happened.

He's got a reading of 274 tonight and under normal circumstances I would give him 0.5 units at that number because I like the tight regulation regimen but I'll skip a dose and see how he behaves later. For most of his life I don't recall him being a "night cat" (I have two others who definitely are). So this is all pretty odd behavior for him

 

What age is he?

 

13 I would say

No frantic behavior so far tonight. He was howling loudly earlier but I'm not sure if it's just because he didn't like the wet food I gave him and wants dry instead. He's been laying in the hallway though and that suggests to me he's uncomfortable in some way

 

Still experiencing some late night howling but no hyperactive behavior

This morning he had a reading of 314 and a +4 of 84

I just did his PM test, 256, and fed him. But he threw it all back up a few minutes after eating, went under the table for a few minutes, then laid back in his bed. He's never vomited before. It could be the food itself- it's some weird Fancy Feast thing with rich and veggies in it. He's been eating it all week because it's all we have until we get some new stuff from Amazon and he didn't seem to have a problem with it. But to me a vomiting animal is always an alarming signal. I think if nothing really improves over the weekend I'll take him for a blood screening

I've never had him vomit before so I don't know what the protocol is. Should I feed him again if he asks for it? Should I give him his shot tonight?

Quick edit: I just cleaned litter box (which is shared by 3 other cats) and there's some light brown stool among the rest of the dark brown stool. It's formed and long but not exactly hard. Does this constitute diarrhea?