WooWoo the Bengal... neuropathy symptoms?

Hello Friends and Felines,

My 13 year old Bengal, Woo Woo, was diagnosed with diabetes 6 weeks ago. His insulin (Lantas Solostar) was increased from a starting dose of 2 units to 3 units after his first glucose curve still showed a high BG of 366.

Thanks to this forum I have learned a great deal and recently started testing his BG at home - using an EverPaw glucometer. Yesterday I also started him on B12 methylcobalamin. His diet has always been strictly wet food, but I am gradually changing to wet food brands that are no carbs (just protein).

Woo is suffering from neuropathy in his hind legs. He stopped jumping and was limping before his diabetes diagnosis. We thought it was arthritis of the hips (like his mother and grandmother) but x-rays revealed a bone chip and inoperable cyst in his left stifle (no arthritis). Neuropathy has made it difficult for him to walk and both back legs/feet seem to hurt. Like many of the cats on this forum, he rests after just a few steps, and struggles getting into & out of the litter box.

My first question is related to his difficulty squatting. It's obviously painful for him to hold a squatting position when defecating. He gets lower and lower in the litter as the feces comes out, until he is literally sitting in or on his feces. He is not constipated and his feces looks normal. I have been helping him by holding him up while he squats and lifting him out of the litter box to keep him from sitting in the feces. This situation is not improving.

Is painful squatting and defecation most likely related to the neuropathy in his hind legs? If not, what else should I consider?

Thank you for your continued guidance.

 

Hi Cindra and Woo Woo! Hope the diet change is going well . My boy had diabetic neuropathy in his hind legs and front paws, so he was walking on hocks and partially on front wrists. In the litter box, he couldn't really squat so he had a tendency to be kind of sitting in his urine and feces . He'd hobble out with hind paws covered in urine and litter. So neuropathy is painful but it takes a lot of time for nerves to "heal" and while Methyl B12 can help with recovery, the best thing is getting BG under control, does not necessarily mean regulated . Without Methyl B12, it took about 4 months before I saw a noticeable improvement in my boys neuropathy and now at month 7, I can barely tell he ever had it.

Are you planning on posting on the forum for anything else related to his diabetes? If so, I'll give you some links to get you setup . If not, good luck with Woo Woo, and remember this is a marathon, not a sprint .

 

welcome. Sorry to hear his legs are hurting. Glad you already have him on the b12... so now we just have to get the BG down. If you set up our spreadsheet like you see in our signatures we can help with dosing advice. going from 2 to 3 is a big jump. usually we do no more than half unit raises at a time. when you jump whole units you might skip the ideal dose.

 

btw, now that you are testing at home you don't have to pay the vet to do it. curves at home are more accurate.

 

Thank you! Woo has easily adjusted to the new foods. He's weaning off Fancy Feast and onto TruFood and Blue Wilderness. Plus I've been cooking chicken livers for him.

It's hard to watch him struggle. I'd love to look at the links you mentioned because I will probably post again... I still haven't officially introduced Woo Woo.

 

I agree, Janet. He didn't move, eat or drink water at the vet when they did his curve. When I got him home he couldn't walk because he just stayed in his carrier for 8 hours.

He's been pretty good about letting me take drops of blood from his ears... I'm still learning though and get an error reading when the drop of blood isn't big enough.

 

what meter are you using? Maybe you need a meter that requires a smaller amount of blood.

 

Woo is a handsome boy! I have two Bengal civvies, love the breed!

When was the last time Woo had bloodwork done? Low potassium is not uncommon in diabetic kitties and can also cause hind leg weakness. It is very easily treated with the proper supplements.

 

I'm using the EverPaw meter (recommended by the vet tech that showed me how to test his BG). Is there a meter requiring significantly less blood?

 

Woo's potassium was okay in early June. Should I get him re-tested?

 

Everpaw doesn't like to give the specific amount of a "tiny sample" so guessing that's between 0.3µl and 0.5µl.

As for the links, let's get your Signature setup with some more information about Woo Woo: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/
This is the Spreadsheet (SS) template we use to track and share BG numbers, just need a Google account: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Understanding how to use the SS: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

If you need help with setting anything up, just ask

 

I tried to find out too. If it was.3 they would probably be proud of that. I bet it's 0.5-0.6. Maybe email the company and find out

 

Is AlphaTrak the glucometer you recommend? If it's easier to use, I will order it.
60-70% of the time EverPaw gives me an error code. I'm ready to try a different system.

 

If Woo's potassium was checked in June it's probably okay.

A lot of us here use human meters, they are much less expensive to operate (cheaper strips!) and the strips are readily available locally, you don't have to wait for them to be delivered from somewhere online. The Walmart Relion Confirm is a very popular model, and it uses very little blood. The strips are about $36/100; the meter itself is about $15.

 

If you really want a pet meter I like my alphatrak. I rarely get error messages and it's accurate. However it's also very expensive at about $50 for 50 strips. I spent about $150/month on strips before remission. If that's OK with you go for it.

Most on the board use a human meter such as the relion micro or confirm meter. A box of 100 strips is $36. Human meters run lower then pet meters but will still be able to tell you if your cat is high or low.


Both the Alphatrak 2 and Relion micro or confirm (not the prime) take the smallest sample size of 0.3.

 

Thank you, Janet. I ordered the AlphaTrak 2.
I want to test Woo's glucose levels at home without both of us getting frustrated.
It'll still be cheaper than paying the vet clinic do it once a week, and I can test more often with accurate results.

 

Just saw Squallies Mom's post about the human test meters (after I ordered the AlphaTrak).
This has been an expensive ordeal, but I want to give Woo every chance to recover and hopefully go into remission (or at least be stable on insulin).
If I can get accurate glucose curves to report to the vet, the clinic wont expect me to bring him in to them.
He's been so sweet and cooperative... still drinking a lot of water though and having trouble walking & asking for "people help" before squatting in the litter.
Thank you so much for your guidance.

 

Just want to mention be careful of how much liver you give. I believe it should be no more than 2% of their diet. Vitamin A toxicity can result if to much liver.

http://m.petmd.com/cat/conditions/toxicity/c_ct_vitamin_a_toxicity

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790081/

https://www.cathealth.com/toxic-items/vitamin-a-toxicity-in-cats?_escaped_fragment_=/ccomment

 

Just wanted to say beautiful kitty!!! welcome

 

Thank you for the links on liver and vitamin A. Fortunately we don't feed Woo raw liver or beef liver.
I had no idea Vitamin A toxicity could be an issue. I am learning so much on this forum.

 

Hi Cindra, just wondering how the handsome Woo is doing. Give us an update when you get a chance!

 

Greetings,

Using the AlphaTrak II is much easier than the EverPaw glucometer.

With a dosage of 3 units (mL) from the Lantas Solostar pen his highest glucose reading was 482. So I have continued to increase his insulin while monitoring his numbers and keeping him on a NO carb diet.

After dropping into the mid-300's, Woo's BG numbers just seemed to stay the same.

I have gradually increased his dosage up to 6 units without seeing much of a change. When I increase his insulin, I give the new dose to him in the morning so I can monitor him all day. I've been afraid he could suddenly respond and become hypo.... but that hasn't happened. Instead his numbers hover around 350 (range of 260 - 380).

Six units seems like a high dosage (we started at 2 units), but his neuropathy isn't improving and his BG won't go down.

Do I continue to increase his insulin again? When is it time to ask for another type of insulin?

Thank you, Cindra and WooWoo

 

I can't comment on the dose. I don't see a spreadsheet, how often are you increasing and by how much?

Zobaline is really good for the neuropathy. A lot of us use it here. It takes time to see improvement. I started with 2 pills a day then once improved gave 1 day.

http://www.ilifelink.com/zobaline-for_diabetic_cats-3_mg_x_60_tablets.html

 

I'm sorry I haven't compiled Woo's spreadsheet.

He's been getting about 3mg of Zobaline everyday. Just when I think he's having a good day and moving around a little better, he has a rough day or two.

Regardless of his mood and mobility, I haven't been able to get his sugar below 264.
When I increase his dosage, I have kept him at the increased dose for at least 3 - 4 days to see if his glucose goes down. I'm wondering if I need to increase him to 6.5 units tomorrow (?)

Isn't this an unusually large dose of Lantas? Do I continue to increase the insulin based on testing his glucose levels until his BG stays below 150?

When is it time to ask for another type of insulin? I know our Bengals have had odd reactions to medications over the years (and even to anesthesia during surgery).
So I've wondered if I just don't have the insulin that will work for him.

And... this is a scary question. Are there cats that don't respond to insulin? It scares me that his glucose level just stays in the mid-300's and we have gone from 3 units up to 6 units.

 

There are a few medical conditions where insulin doses need to be high. The dose is based on the nadir (lowest reading) in a 12 hr cycle. For most cats on Lantus that's 5-7 hrs after the injection. Without your spreadsheet no one can say what is happening.

Since you are up to 6u and again with no data available, you might want to ask the vet to run the blood tests for Acromegaly and insulin resistance. There is info on these conditions in the main menu.

 

Hi and welcome!
Any type of liver (beef, chicken, lamb etc) is still toxic if too much is given and both raw and cooked can be toxic if too much is given. I feed my cat a raw diet and I don't give him more than about 80 to 100 grams of liver a week. It is a great food but must be given in the correct portions.
My FD kitty Sheba was very affected with neuropathy in the beginning and had trouble getting up and down and got tired very quickly when squatting to go the the toilet. But the Methyl B12 worked for her and she got back to normal after about 6 months. It usually takes the BSLs to go back to near normal before an improvement will happen.

It would be very helpful if you could start a spreadsheet as we are unable to help with dosing if we can't see previous BSLs and how he responds