Please help, cat paralyzed

Our 9 yr old neutered male DSH cat that has had diabetes for three years controlled with Lantus insulin is now dragging both legs behind him. He can feel them and sometimes use them but not well at all. We took him to a new vet yesterday who x-rayed him and said its diabetic neuropathy but to keep him on the same dose of insulin which was 4 units, we just reduced it from 4.5 and I think he needs to go up. The glucose test yesterday showed 104 but my stupid b/f gave him 5 units that morning without my knowledge, its his cat. The glucose level last week was 164 on his blood test but they said he had a normal curve that day. I'm so frustrated and don't know what to do for him and can't find a meter that works at all, we have had 5 of them now and none were accurate enough to even use. Thanks!

Susan/Toney
Riverside, CA

 

Another thing, the vet said Toney's bloodwork last week was normal but I just got it faxed to me and its not. Everything is in the normal ranges except for:

WBC low at 5.22 K/ul
GLU high at 167 mg/dL
TP high at 9.3 g/dL
GLOB high at 6.3 g/dL
AMYL high at 2294 U/L

Susan/Toney
Riverside, CA

 

I'm having troubles getting my post to go. 3rd try....

For the neuropathy we all use B-12 methylcolbamin .... here's a link to order what many use.... zobaline

There is also a capsule version from vitacost if you prefer to sprinkle it on the food. I use this one myself and can give you that link if you want. It does have a trace
of rice flour.

We have someone who knows her stuff on the bloodwork so I'll get her to come take a look when she can.

 

I have a Bayer Contour Next EZ meter but the strips are 40 cents each.

Many here use the Relion from Walmart because the strips are cheaper.


I am posting bit by bit because of the difficulties online right now.

 

hi there neighbor, i'm in corona myself

when you say you've had 5 meters now and none were accurate enough to use what do you mean? which meters were they and how did you figure out they weren't accurate?

personally i don't see why the dose would need to go up as those glucose numbers are really good numbers. do you have any more numbers you can share since he's been diabetic as long as he has? more insulin isn't going to necessarily help his back legs is why i ask. i actually think it's a bit wierd to see numbers like that AND neuropathy in a long term diabetic at the same time but i can't say it's unheard of either soooooooooo just want to make sure we're not dealing with too much insulin and hypo causing the rear leg problems

 

He's never had bloodwork before, only insulin curves which we would just adjust the insulin .5 as we went. He reduced it .5 right before this happened and I begged the vet to let me bring it back up but she said no and I don't really agree with her, but since all our meters were checked by the vet's office with theirs and all were horribly off (WAY OFF) I don't know what else to do but bring him back there tomorrow to a different vet. She charged us $250 and he's not any better. She gave us Cobalamin shots to give him once a week and he had his first one yesterday - is that enough?

SUSAN/Toney
Riverside, CA

 

Colbamin doesn't work on neuropathy, it has to be methylcolbamine.

And I thought you said bloodwork here.

If you are willing, we can all help you here. We love helping.
My cat is in remission because of everyone here who helped me when I first showed up. We like to pay it forward.

You have more collective experience here than most vets have.
We all live FD 24/7.

You don't need the vets insulin curves.
They are a waste of money and you can monitor better yourself... less stress for Toney at home, less cost for you paying the vet to do them.

 

Hello Susan,

I'm about 1 hour away from you. Please start the kitty on zobaline (methylcobalamine B12 - or any brand but without sugar will do). In short, you can give as much as you wish or can afford to the cat, as what's not used is peed out. It does not build up in the body. It might start helping quickly or it may take months or even longer, but it will help with diabetic neuropathy either gradually or dramatically fast as every cat is different... If you use the pill form, you can purchase a pill crusher & mix the powder in wet food. Rite Aid sells pill crushers for about $5.
Best wishes, Sophie

 

see this link neuropathy and methylcolbamin

 

Fortunately the methylcobalamin can help reverse the neuropathy however it does take 4-6weeks and it helps if the cats blood sugar is regulated.. Why don't you work with us to see if we can get him regulated.

First thing is let us know what meters you have, and we will recommend one of them, then we start to get some tests so we can see what's going on with him.

Meters vary by 20% so I am not concerned, I am sure one will be good enough for us at least to get an idea of what's going on ..

Wendy

 

Did this leg dragging come on all of a sudden, or has it been gradual?

Please describe in more detail how the back legs are functioning. He may have had a clot that lodged in the blood vessels that go to the back legs.

Is he in pain?

 

Susan,
in case you ever need fast service on diabetic supplies, here's a phone number for DiabeticCorner.com located in Corona: 951-847-7022
I ordered some testing strips before 1 or 2 pm & had them via US postal service the next day! Don't know if it's only a warehouse or if you can go there. Good prices, too.
All my best wishes, Sophie

 

Thanks, Everyone, I REALLY appreciate this. It isn't a clot because he can and does stand sometimes. He tries to walk sometimes and has on a few occasions. It started about a week ago, he was walking weird but nothing like the plantar walking from diabetic neuropathy he's had twice before when we had to adjust his insulin and it went right away. This is different - lame on both hind legs and just looking weird, no plantar walking at all. We took him right to the vet and had a curve done which they said was normal and they had us reduce his insulin by .5, which we did - and then after about a week of that he all of a sudden was pulling himself around by his front legs. He can move his hind legs and has feeling there. Back to the vet, did x-rays, can't find anything but impaction so I gave him a cat enema and he pooped but I dont' know if he's peed, we have another cat in with him we can't remove anywhere else. I don't even know if he pooped today. I'm so beyond frustrated with this because this is my b/f's cat and he is lazy and I have my own pancreatitis cat to deal with, a ranch full of animals and an old dog to medicate who wont' take his meds easily and my own health issues which are very severe right now. We tried five meters, four Ipets (pieces of junk, all of them) and one other one the vet tested that was so off each time in either direction I just threw it out, I think it was reli-on. I don't know what to do and don't trust any meters anymore but we need one desperately - I'm going to have to take this cat back in tomorrow just for another glucose check. I won't use any human meter that isn't calibrated by our vet's office first and none of them work well enough to ever use. UGH!

 

Susan

Rhiannon asked me to pop over to help you with the bloodwork.

But first, a couple thoughts. Like Deb, I wonder if the paralysis came on suddenly or gradually? If it occurred spontaneously, I would also be concerned about a blood clot, or saddle thrombosis. The only thing about a blood clot is that it is typically very painful and the kitty will cry in pain. If the paralysis came on gradually after increasing muscle weakness, it is likely neuropathy.

Insofar as meters, pick one you can afford the strips for and stick with it. As Rhiannon said, the Relion meters have affordable strips. You can search this site to see which are the better meters from Relion but I see alot of members using the Confirm. You shouldn't expect that your meter will read the same as the vets. Vets typically use a meter specifically designed for pets called an Alpha Trak. The strips are very expensive. Results between a human glucometer and AT will vary but are on average about 30 mg/dL variance. The variance is more at higher numbers, less at lower ones. But you also have to compare apples to apples and that includes whether a meter is plasma calibrated or whole blood calibrated and what assay method is used. So, instead of worrying about how it compares to the vet, select a meter and stick with it. Also remember that cats often experience stress at the vet so numbers might be higher there. To compare your number with the vet, you would need a meter that is calibrated the same, uses the same assay, uses the same blood sample, etc.

On the bloodwork, the glucose is pretty decent! High TP can indicate inflammation or dehydration; high globulin can also indicate inflammation. Low WBCs can indicate infection because the WBCs are at the site of infection instead of being in the blood. I wouldn't worry about the amylase. How are his kidney values?

 

What was the potassium value on the blood work?
Also, although 167 is above normal blood glucose, it's just barely so. Certainly not considered high. How long after the shot was that reading taken?

 

Don't suppose you could take some video of your cat walking or dragging and post it on youtube. Then you could post a link to it here.

 

His BUN is 22 mg/DL, creatinine 1.8 mg/dL, GGT <0 U/L, K 3.7 mmol/L, MCV 42.8 fL, MCH 13.8 pg, NEU 3.22 K/uL, LYM 1.29 K/uL, MONO .30 K/uL everything else is normal to me except for the off values I posted before. One reason for this is could be he was on metronidazole for a suspected UTI that I later found out from the new vet tested neg. at the old vet and they STILL put him on it so we left that office (for good reasons) where he had been treating for 3 years and took him to the vet I normally use.

Oh and yes, we never had another bloodwork besides this one run on this cat for over 3 years now - he has been healthy other than the diabetes which has been under control with the Lantus until now, I don't know what the heck is going on. He doesn't seem in pain unless I touch his hind end harder and I think that was from the impaction and he is better now that he pooped. I'm just beyond frustrated and don't want to put him down without trying first as long as he's using the litterbox, he's good here - he's only 9 years old and had a hard life. He wasn't born normal, he's mentally challeged a bit and could never jump well onto things as well as the other cats do but he jumps off the bed even now but of course can't get up there unless we pick him up right now. He could a week ago.

SUSAN/Toney
Riverside, CA

 

What is potassium listed as, I can't find it on the bloodwork? I can't take a video and post it anywhere, don't know how, sorry. Also, I just checked his shots the vet gave us and it does say Cobalamin and NOT methylcobalamin, which frustrates the heck out of me and pisses me off really badly too. I'm going to call them tomorrow and let them know, he got a shot of that yesterday at the vet and we were supposed to give them once a week but I'm returning them now - I should have checked, I know its supposed to be methylcobalamin too, I'm just so stressed right now from other stuff you have no idea. I walked out without even a copy of his records which I NEVER do and had to get them faxed to me - how the heck does a vet have the nerve to tell you this is normal bloodwork when it looks to me like there's at least 5-8 things that definitely are NOT in the normal range. Our regular vet wasn't there yesterday, we had a totally new person but the regular vet is the one who told me the boodwork was normal last week!

 

Potassium is listed as "K". Looks like Toney is at 3.7. Unless it drops under 3.0, it can not show any outward signs of being low.

I asked about low K because that's what my cat had. But Toney is within the normal range of 3.5 - 5.1. Bob was below 3, and suffered from muscle weakness for months until he got up into normal range with supplements. His primary symptom was muscle weakness in his back legs, which is why I asked.

 

Thanks, Carl!

 

If his potassium is below 4, that could be the problem. The blood test indicates the level of potassium in the blood; potassium at the cellular level will be lower than blood potassium. It could definitely result in hind limb weakness.

Also...metronidazole is not an a/b for UTIs. Its given for GI issues.

Good thought, Carl.

 

THANKS, Marje! You are totally right too, I am exhausted - it was liquid Baytril he was on for the UTI at the time of this bloodwork. Could that have affected any of these levels? How do you guys give potassium - I know its dangerous to overdose on it because I had low potassium myself and got heatstroke several times as a result. Thanks so much, everyone!

SUSAN/Toney
RIverside, CA

 

What dose of Zobaline or other brand do you guys use and for how long? Life? I really want to get it ASAP, can you buy it locally anwhere?

Susan/Toney
Riverside, CA

 

Is this good for diabetic cats? http://www.iherb.com/Natural-Factors-B1 ... blets/2521 What dose/mgs. do you need daily?

SUSAN/Toney
Riverside, CA

 

its 3 -5 mg or 3000mcg -5000mcg

You would need at least 3 of those pills you ask about.

here's is the Vitacost one that some of us use here.
It does have a trace of rice flour in it but my cat wasn't carb sensitive so it didn't affect her really. She eats a large amount of friskies canned which also has some rice.


Edited to add:
As I understand it, potassium should be monitored with bloodwork.
There are ugly consequences if they have too much as well as if they don't have enough.

 

Many people here use the Zobaline. Link here for one seller http://www.ilifelink.com/zobaline-for_diabetic_cats-3_mg_x_60_tablets.html

 

Any methylcobalamin pills are fine, just double check when you buy them that it doesnt have xylitol in it (toxic), or any sugar.

 

The zobaline is good for diabetic kitties. I use the vitacost one for my non diabetic cat because he has chronic kidney disease and methylcobalamine and a multi B vitamin help keep anemia under control.

You must discuss potassium supplementation with your vet. Normally, one would use something like Tumil-K but it absolutely must be monitored. Too much potassium is as dangerous as too little.

Although this material on Potassium Imbalance is on the gold standard CKD site, it's still invaluable info to help you with your vet.

Good luck! And please don't be afraid to get a human meter. We all use them quite successfully here. Pls let us know if you have questions.

 

So what meters do you have right now? Lets pick one!

 

I don't have ANY meters, they were all returned because they were completely useless. They would go both high AND low and didn't work at all.

Susan/Toney
Riverside, CA

 

I just wanted to stress what Marje said about potassium supplementation - you'd need to consult your vet first. When Bob was treated he had to be monitored every two weeks by a blood test at the vet. The danger is too much, too soon. If the K value goes too high it can cause heart failure or other problems. That link to the CKD site have great information.

Bob didn't get pills or powders. His potassium was added to lactated ringers at a low concentration. I had to administer sub-q fluids to him to "deliver" the potassium. At first, daily, then less often as time went by. I did that for weeks. I went through four bags of fluids, so somewhere around forty treatments. Fluid therapy is also one of those things you need your vet to be okay with.

Bob was sort of a "special case". His treatment while on insulin was not "standard" compared to most of the cats I have read about here. Which is why I hesitate at times to advise people to do things the way that I did. I usually tell people "this is what I did. But talk to your vet about it first".

 

All meters go high and low. Look at any spreadsheet attached to people's sigs.
I used a relion micro. A typical 12 hour cycle for Bob was a 400 to 150 to 350 curve at times. It wasn't until he was nearly off insulin that his curves flattened out. If I tested him and got a 350, and two minutes later it said he was at 90, I would have thought it was a piece of junk. Or that something was up with the strips. But if I got a 350 and a 400 within two minutes, I would have figured it was just the 20% FDA allowed "meter variance" and gone with the 350 for safety sake. My meter always ran lower than my vet's meter. But that was expected and not an issue.

With Lantus, the most important test numbers are the nadir numbers. Because those are what determines the appropriateness of a dose. Whether it's you at home or the vet in his office, if Toney's dose is not being adjusted based on his nadirs, then it isn't being determined based on the way the insulin works based on AAHA guidelines or "protocols".

Can you give examples of what you mean by "both high and low" and your meters?

 

I use a liquid methyl B-12 that I purchased from amazon. It's a 1 oz bottle. Sherbert gets 1 dropper 3 times a day. I also give him 1/2 tsp. of Dia-ionx, it's a 4 oz bottle, in the morning. This is a liquid too. We just give it to him orally as He is very stubborn. He will fight us when we give the drops but find that's good because it means he's using his muscles. His feline neuropathy is extensive but some days it doesn't seem as harsh as most. It pains me to see how he struggles to walk. If you buy 2 or more you get free shipping & it took 2 days. We ordered it on a Sunday repeat a Sunday and got it Tuesday. I bought 2 Dia-ionx bottles with a 3rd bottle free. Ordered on the 10th had it by the 12th. Still to soon as to it's affects but at this point I'll try just about anything. I ordered 2 bottles of Blood Sugar Gold this morning. I should have them by Tuesday.
hugs
Skinni

 

Many of us here use the Relion Micro or Confirm. They are reliable and cheap to use. Why dont you try one of those?

Also what are you currently feeding? brand/type/wet/dry? that will impact his blood sugar levels depending on how high carb it is..

Wendy

 

Okay, I just did a blood test a few hours after he ate his canned Fancy Feast Classic and got a reading of 37. Now I'm even more confused as I don't know if it is even accurate.

SUSAN/Toney

 

First, test again now. If you get a number like a 37, you have to treat it like it's accurate because there's no room for error. If you get a number close to that, you need to give some food right away. Do you have any karo syrup or honey on hand?

 

When was that test of 37 in relation to his shot? One hour after? Two hours after? 4 hours after the shot of insulin?

He may be going too low. If you are not sure that was a valid test, please get another one ASAP.

If it is still that low and it is early in the cycle, we need to bring those numbers up ASAP.

Do you have karo syrup or honey or maple syrup or something similar?
Plenty of test strips?
HC (high carb) food like Fancy Feast gravy lovers?

 

Oh my gosh, now I'm getting worried but I would never treat using a meter I don't trust and I don't trust ANY meters yet. I had a hard time getting this blood and refuse to put this cat through that again but I think I got it in time for it to read correctly but am unsure. I hate this. I have no idea when he got his shot since by the time I got home and read the meter manual and got it working and set up, the b/f who gives the shots was asleep with this cat next to him on the bed. I have no idea when he ate but am going to go give him some more food right now just in case. Thanks!

SUSAN/Toney
Riverside, CA

 

Lantus is a long duration insulin and low numbers which can become hypoglycemia can last up to 16 hours. Since you don't know when he got his shot or what he has eaten, if he were my cat, I'd go to the ER. You might be able to get his numbers up with karo but that usually wears off and numbers come back down.

You have no data on how he reacts to foods, how long his duration is with Lantus, when he nadirs,etc. IMHO, he needs to go to the ER.

 

When you get a number like a 37, you really don't have any option BUT to trust it. It's "hypoglycemic", even if there are no outward visible signs.

I would advise high carb food. If you don't have any, then mix some karo or honey, a few drops, into the low carb. But you really need to test again within a few minutes. If he is at 37, and drops any lower, you could be looking at a seizure or worse.

Or you can call a vet ER and let them know you're on the way in with a cat that just read 37 BG.

Can you wake the BF and find out when the shot was, and what the dose was?

 

That BG of 37 earned your cat an automatic 0.25U dose reduction.

You might want to keep a notebook and write down information in it. Like what times you gave the shot, how many units, what foods you fed and when, how his appetite is, how the 5 P's are (peeing, pooping, purring, preening, playing).

It would save you having to wake up the BF and you would both know what is going on and what had been done for your cat.

There is also a spreadsheet we have that really helps us to help you better.

 

We have two threads going at once - please use this one only : http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=100371