Newly Diabetic cat mom- questions about neuropathy

Hello everyone,

I am a brand new member on this forum and have some questions about Zobaline and diabetic neuropathy in my cat.
My 14 year old cat named Mr. Kitty, (big grey cat in photo) started slowing down about two months ago. I wasn’t anything crazy, just noticed he was moving a little slower and having trouble jumping on things. I knew he was getting old and wrote it off to that. Well, as time went on it got worse and worse until I could see he was having serious trouble walking and had a few bouts of inappropriate urination. I took him to the vet and found out his BG was in the high 300’s.
Around this time he also started getting picky about his food and didn’t want to eat his kibble without encouragement. Per my vet I started him on 1 unit BID of insulin. Due to his increased disinterest in food I had to switch him to canned chicken and tuna to keep him eating.
As of Monday, he’ll have been on the insulin for two weeks. Last week his BG was retested and it was down to 116, a huge improvement on such a small dose.
But since getting his BG down, his neuropathy is not getting better, and his inappetitence has increased. He’s taking two days to eat a single can of tuna, and that’s with me sitting and encouraging him to eat.
All his other bloodwork has come back normal, so I’m not sure what’s going on. I’ve read about Zobaline, but the only place online I’ve found it is Amazon for almost $40 plus shipping, which isn’t the big deal, but it won’t get here for 2-4 weeks. I don’t want to wait that long. Does anyone else know where I can order Zobaline?

Thanks for any help in advance!

 

Hi Tiffany and Mr Kitty....he is gorgeous!
Welcome to the forum.
It is concerning he is still not wanting to eat. Do you think he may be nauseated? Does he sniff the food the turn away, or does he smack or lick his lips?
It is really important he eats and eats well, otherwise you will run into other problems. I would offer him whatever he wants to eat at this point as he needs to eat.
I think it would be a good idea if you could go out to a pharmacy and buy a bottle of Ketostix and test his urine for ketones to make sure he doesn’t have any. All you need to do is collect a urine sample from Mr Kitty and then dip the test strip into the urine and read it against the colours on the side of the bottle exactly 15 seconds later. Eliminating ketones is important in diabetic cats what won’t eat.

Can you tell me what type of insulin you are using please?

It sounds as if you are getting him tested at the vet for his blood glucose levels? Is that correct?
I would strongly recommend you think about home testing as that is the only way to really keep Mr Kitty safe and to know how the insulin is working in his body. We can show you have to do it. It’s not hard and Mr Kitty won’t hate you for doing it.

As far as the diabetic neuropathy goes, it is going to take time for it to heal. It won’t do it overnight or even in a month. High BG levels Contribute to the neuropathy and it’s true that Zobaline helps a lot. My Sheba had it badly. She couldn’t jump, she had to stop and sit down every few steps, she slipped and slid as she walked but with the help of Zobaline and getting the BG down she fully recovered but it took at least 6 months. You can also try lifelink.com for the Zobaline. There are other brands which other people can tell you about, I don’t know them as I used Zobaline.
I don’t think the 2 week wait for the Zobaline is an issue. I am much more concerned Mr Kitty won’t eat. I’m not sure where you live and if it’s night or morning there but I would make a vet apt ASAP and ask for an injection of cerenia for the nausea and some cerenia and ondansetron to take home so you can continue them at home. Nauseated cats won’t eat and cats must eat, especially diabetic cats.

Swapping from dry food to low carb wet food can drop the BG levels considerably so please be aware of that if you are giving the same dose of insulin and not testing the BG.

So at this point the 2 things you need to do as a priority are

• Buy some Ketostix or keto diastix from the pharmacy and test his urine to eliminate ketones
• Make a vet apt to get a cerenia injection for the nausea and some tablets to bring home. Getting him to eat and eat well is really important.

 

You can order zobaline on amazon or direct from the manufacturer. I've done both. It always arrived within the week. BUT in the meantime you can pick up a human brand of b12 methylcobalamin. I've used vitacost brand with another cat as well. And I use it for myself.

Of the bg dropped that much in concerned your dose might be too high. Get rid of the kibble food and pick up some fancy feast classic or Friskies pate foods I find FortiFlora will sometimes get a picky cat to eat. At this point though you may want to ask for an appetite stimulant from the vet!! Had the cat been tested for pancreatitis??? If not all for them to test. Until he's eating enough calories in his own you may have to water down the food and syringe feed into the mouth. Not eating can cause fatty liver to develops rather quickly as well as ketones.

So if it were my cat I would

1. Ask for a pancratitis test
2. Ask for an appetite stimulant
3. Try FortiFlora on the food
4 switch to a low carb pate foods (kitten foods are often higher in calorie so like fancy feast kitten) and assist feed if she won't eat on her own.
5. Get a glucose meter and learn to test bg at home. I have a video in my signature showing how I test my cat CC at home.
6. Get ketone strips or a ketone blood meter to test

 

WELCOME TO FDMB! You will get answers here. The folks here are amazing and just want to help any kitty navigate this disease called diabetes.
Youve already been helped by some of our best. I just thought I'd say welcome to the best darn site to help you help Mr Kitty.
After reading your story, I 'd be worried about keytones

 

Welcome to you and Mr Kitty!!

I agree with what everyone has said so far. Also if he’s not eating and you're giving him insulin without home testing you’re risking his glucose level going too low and having a hypo episode so eating is a must. Ask for the antinausea meds. Does your vet know he’s not eating? Because you may be able to get him/her to prescribe the med without a visit since a vet should be concerned about a diabetic cat not eating. Minnie was on ondansetron for almost 2 years and it helped to get her eating when her IBD made her nauseated. Within 30 minutes of being pilled, she eat. Have you tried baby food or chicken breast too? But tuna should be enticing so he may really need help to eat right now - top priority for sure.

like Sheba, Minnie also had severe neuropathy and like Bron said it takes a few months for them to recover. Once her diabetes was regulated, it took about 3 months. And that’s the other issue, even with Zobaline if the diabetes is not under control you won’t se any improvements. So I’d also strongly suggest you consider home testing so you can monitor the diabetes at home. Removing the dry food can bring the levels down a lot so that alone could have gotten him at a level where he needs less insulin and the 116 at the vet was probably lower since cats are super stressed at the vet. Anyway, I switched from Zobaline to the vitacost human b12 methyl because I needed to give Minnie 2 zobalines to get her the 6mg a day and it got to be too expensive with everything else. She recovered completely on the vitacost brand so my experience is that it works just as well. It comes in capsules though so you’d have to mix it with the food which is an issue if Mr. Kitty is not eating unless you think you can pill the capsule. At any rate, I just want to emphasize that it’s a long road for the neuropathy recovery but it’s possible so don’t be discouraged, but also don’t expect to see improvements until Mr Kitty is on the right dose and the diabetes is under control. Link to vitacost below

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-60-capsules-5

 

Hi everyone,

thank you for all the help! Bron and Sheba to answer your question about the insulin, he is on Lantus, 1 unit twice a day.
So about his appetite, it’s strange. He seems hungry, he gets up and meows like he wants food, and especially if I put down a fresh can of tuna, he digs in. He loved the juice. I guess it’s a few things, the quantity he’s eating is low. He’ll eat well for a few minutes then walk away and lay down. If I sit there with him and move the food back in front of his face I can get him to eat more. And then he’ll get up and walk away, I’ll move the food again to his new spot, and again he’ll eat for another minute or two. After about ten minutes of this, and maybe a fourth of a can of tuna he’s had enough and won’t eat any more when I move the can.
I feel like it’s partly due to the fact that he stands when he eats, and the neuropathy is painful, so he walks away to lay down. So without me constantly sitting with him during meal time he would only eat a tiny amount.
The other issue is the pickiness. At first I used canned chicken breast, he loved it. Then after a few days he wouldn’t even eat a fresh can. So I switched to some canned wellness, same thing, and now the tuna- again loves a fresh can, but out of the fridge, will need coaxing to eat more than a few bits.
I am going to the store and buying a whole slew of different wet foods, everything from friskies to the $2 canned stuff.
I will also text me Vet- he is a close personal friend who has been really helpful in this process.
I am a little unsure about the home BG testing though, not because I can’t do it, but because of the reliability.
At the vet clinic when my friend did the BG test in their monitor Mr.Kittys blood work was only in the low 200’s, but when he sent it off to the lab it came back in the high 300’s. This is the same day, the same blood. My vet friend said that the little testers often come back much lower than the more accurate testing at the lab. So that makes me worry any results I got at home might be unreliable.
I will text him today and ask for an appetite stimulant though, but I think Kitty is at the point he needs it.
I am bummed it will take 3-6-12 months for his neuropathy to heal. We have a large house and I have two dogs, the poor guy wasn’t able to get to his litter box in time and was having accidents on carpet and furniture. I couldn’t move the boxes closer due to the dogs. So for now, he is confined to my master bathroom with a bed, a litter box and his food and water. He can only take a few steps before needing to lay down, and I couldn’t think of any other solution to keep him close to the things he needs, while also keeping my dogs out of his stuff. Poor buddy, I just want to let him back into the rest of the house soon.
I was thinking about cat physical therapy for him. Has anyone had experience with this in regards to neuropathy? Do you think it would help him recover faster?
Thank for all the help!!

 

First, get the antinausea meds as well. The apetite stimulant alone won’t do it. It’s great that you trust your vet but I believe in the opposite. I think that by the time the blood got to the lab it was no longer fresh and I wouldn’t actually trust that result. Also meters, whether it’s a pet or human one like the one I use, have a 10-15% normal variance so that could also explain the difference in the numbers, but let’s see why others think about this

I can tell you I was reluctant about home testing too at first and some of the members here can testify to that. I now can’t imagine not doing it. Think of it this way, if you were diabetic or you had a human child who is diabetic would you inject insulin without pricking your finger and taking a reading? If you speak with any diabetic they’ll tell you they wouldn’t dream of it. It’s the same for cats. An insulin overdose can kill, it’s that serious. Not trying to scare you, but it’s the only way to monitor your cat daily and to control his diabetes so he can start to feel better soon. Take a look at any of our spreadsheets linked in our signatures so you can see how much the glucose level can fluctuate in just one day, let alone a week. It’s mind blowing. Lantus is a great insulin for cats and starting with 1 unit is also good so you’re on the right track but it takes diligence to keep your cat healthy and for the neuropathy to subside.

I’d recommend placing pee pads out as well because the issue with the litter box is sometimes they can’t get inside because lifting their legs is too painful.

also, have you tried feeding him while he’s laying down? I’ve had to do that with Minnie to get her to eat. I basically would have to hold the dish up to her mouth while she was laying down so she could eat. These are some of the work arounds for the neuropathy I’m afraid. If you want him to recover fast, the best thing you can do is again to home test. More important even than the b12 because the neuropathy will continue to get worse I’m afraid if the diabetes is not regulated

 

Also I’m afraid PT would not help since the issue is the nerves that are being attacked by the excess glucose. The nerves will need to regenerate before and that’s what the b12 methyl helps with since it works directly into the spinal fluid. It may just be more painful for him to force the legs to do something they can’t right now since it’s not a muscle or bone issue but a nerve issue...

 

There will be a difference between tests that you do and the lab tests because of the equipment and then there is the variance of 20%.
Home testing is by far the most reliable way to test the BG. If you are using the same meter, it is the changes as well as the drops low you are looking for. Also almost all cats have higher BG levels at the vet because of stress. At home you get the true reading. The concern is that if the dose is raised at the vet because of a higher BG then the cat comes home and the BG drops lower because the stress has gone, the dose may prove too high.
These are things we see all the time here.
I would strongly recommend home testing. BGs change all the time and don’t stay the same as the one test every few weeks at the vet. You will progress much quicker with home testing.

Also please get an antinausea medication before you use an appetite stimulant. The appetite stimulant will force Mr Kitty to eat when he is nauseated which would be horrible for him.
Keep asking questions.

 

Also, I'm wondering if we're looking at the difference between a BG test at the clinic and a fructosamine test at the lab.
A glucose test with a handheld meter is an immediate snapshot of kitty's blood glucose at that moment in time.
A fructosamine test shows you the average blood glucose level over the past two to three weeks.
If it was the two different types of tests, it's not apples to apples, they don't compare.

 

Great point as the fructosamine is a 3-week average!

 

Any updates on Mr Kitty?