Anyone with experience of D'betic Sensory Nuropathy

Bailey is in trouble again, he suffered a tail tip trauma last summer which was cleared up by a course of AB's all fine until 3 weeks ago he started intermittently licking and then nibbling the tip of his tail he seems to do it as a part of his grooming routine. He doesn't do it all the time,maybe only two or three times a day but the tip is now red raw and it isn't being given a chance to heal.

Took him to vets when he first started nibbling it and he's benn on another dose of AB's for the past three weeks to avoid infection. The last vet visit was yesterday,,I saw a different vet and he thought it could be Sensory Diabetic Nuropathy a (shadow complication of FD)and that he will be feeling tingling or intermittent pain causing him to nibble it. Vet gave some topical anaesthetic cream which he said to apply to his tail three times daily which I did. At first he left it alone until this morning and now it is bleeding again very red and very raw and he cries whilst he nibbles it. I am so worried about this as it will eventually become infected.

He seems happy in himself but his numbers are also up well above average which i assume may be down to the condition if this is what it is.

Does anyone else have any experience of this.?

Thanks DIane & Bailey

 

Hi Diane,

I'm so sorry to hear this about Bailey, and sorry too that I can't offer any help. I've never previously even heard of diabetic sensory neuropathy. And I sincerely hope this can be treated, and that folks here can offer some ideas.

If this is nerve damage, is it possible that methylcobalamin might help, I wonder?
Or maybe this is something that could respond to acupuncture..?

Bailey's symptoms do remind me slightly of another condition, feline hyperesthesia. A common symptom is skin rippling, but it can also involve fur-pulling, licking and biting. @KPassa 's cat had this. And in that instance it seemed to be caused/triggered by the Lantus, because a switch to Levemir resolved it as I recall..?
(Although Bailey has been on Lantus for quite a while and presumably the symptoms of any sensitivity might have become apparent before now..?) Here's a link to some info on that anyway...
http://consciouscat.net/2012/05/07/feline-hyperesthesia-syndrome/

So sorry not to be more help...

Hugs to you, (((Diane))),
Keeping fingers and paws crossed here that the situation soon resolves for dear Bailey.

Eliz

 

If it is diabetic neuropathy, then methylcobalamin (a specific form of Vitamin B-12) will help, in addition to good glucose control. Pick a product with no added sweeteners. A capsule may be opened up and mixed into food. It is a water soluble vitamin, so any excess will be excreted through the kidneys.

 

Thanks Elizabeth & BJM for your reply.
I have read about Hyperesthesia,the vet did ask if he chases his tail & runs around appearing to be spooked out,but he never has done,he is not agressive the only symptom is the tail licking that turns into nibbling.

 

Diane, just wondering; have allergies been ruled out..?

 

He hasn't been tested for allergies,but nothing has changed in what he gets to eat since he was diagnosed with FD which is now 2 years ago.

 

Hi Diane,

Sorry to hear that Bailey's worrying at his tail again. I'd suggest asking your vet whether it might be an idea for you to apply a little of the aloe vera juice you already give Bailey to the affected area of the tail. Its anti-inflammatory action can be very soothing for skin irritation and may also help reduce risk of infection.

With the pancreatitis in play, Bailey may very well have nutrient malabsorption problems and that may adversely affect his B12 levels. I second BJ's recommendation about checking Bailey's B12 levels and supplementing if appropriate. (IDEXX and TAMU also recommend B12 supplementation for pancreatitis. I think you need to double-check with your vet to make sure B12 supplementation is not contra-indicated first.)

 

Hello Aine,thanks for your thoughts on Baileys tail problems.
The vet tested him for pancreatic malabsorption (if this is the test you mean they cannot test in UK he sent it to Texas)
they came back normal,saying that I have since read that it is a fasting test and this was not done!
He had a B12 shot three weeks ago even though his blood tests normal. I am taking him back to the vet on Tuesday,so will run all comments past him.The odd thing is he is only going to nibble a couple of times a day,but then the damage is done.
Hope you are feeling better and that Saoirse is well. Diane

 

I hope your vet is able to sort things out for Bailey. I understand how upsetting this must be for you, and I feel very sorry for Bailey.

When Saoirse had her fTLI test she hadn't fasted either (I didn't know it was necessary and vet didn't tell me). Hers came back positive but without the necessary fast I guess the results aren't reliable. She still produces stools that are dark tan inside and her coat is starting to rust again so I'm fairly sure that she has malabsorption problems, even though her physical discomfort is only intermittent at the moment provided I stick to Liquivite (not ideal). Saoirse's last Spec fPL was done at the same time, so I don't know how valid that result is either.

I'm worried about Saoirse. She's going to the small animal hospital at Bristol veterinary college on Tuesday week for more diagnostic testing.

 

Have also read in a few places online just now that this can be caused by stress; and in that case anti-anxiety meds may help.

This may be 'grasping at straws' but I'm pretty sure some people have found Bach Rescue Remedy (the one specifically for pets) to be helpful for relieving stress in kitties.
And I've used Zylkene capsules as a calming agent when first bringing foster kitties home. (The latter is milk-derived, and I don't know if it would affect blood glucose.) If you'd like some of that I can send you some capsules, Diane.

 

Hi Aine,I did some research on the FTLI test apparently it is a fasting test (I am not sure but think they said for 12 hours before blood draw) I might be mistaken but am sure this information was on the Labs website. Might be worth having it done again,only another £100!!
Elizabeth, you are so very kind but Bailey has always been lactose intolerant,so I can't give the Zylkene
But am interested in the Bach rescue remedy,thats a good idea,can't do any harm,I will get onto that tomorrow.I started giving him Slippery Elm Bark for his gastric issues,I can't see it can be anything to do with that,it says it is very safe with no side affects,don't know if I should stop giving it to him for a while.
I really do appreciate your thoughts and help, many thanks.

 

Slippery elm can interfere with absorption of meds, Diane. I'm not sure about whether it might also affect absorption of nutrients. How often do you administer the SEB?

 

He has 1/4 t.spoon a day - 4 hours after his insulin,are you still giving it to Saoirse?

 

I trialled it for a week and she seemed to do OK with it. She really likes it. I stopped it because I was concerned her stools were getting a little dry and also she was due for her dental and ultrasound. I wanted to make sure that her system was as clear as possible so that the vet would be dealing with 'known quantities' for safety (to eliminate any possibility of unexpected drug interactions). As luck would have it, I've had no choice but to start Saoirse back on SEB because with the discovery of liver problems I decided with our vet that we would stop her ondansetron. Just as well. Since Thursday's discovery I did a double-check of side effects of everything she was taking recently and I discovered that ondansetron has jaundice as a possible side effect.

I don't know for how long it's OK to give SEB continuously. Over how long a period have you been giving it to Bailey, Diane?

 

He has been on SEB for about two weeks now.I didn't give him any last night just incase the introduction of it has anything to do with his tail biting,it's so difficult to know what to do for the best.
So sorry to hear that Saoirse has liver problems.

 

Oh, how I hear you, Diane.

.

 

Diane,
Any update from today's vet visit..?
Did the vet have any other suggestions for Bailey..?

 

I've had very good results with Bach's products. The only difference between the human and pet version of rescue remedy is that the human version uses brandy as a preservative, while the pet version uses glycerin. The preservative is 1/5 of the total mixture. Considering that you only use 4 drops at a time, either version is fine to use in pets. The human version is often easier to find and cheaper.

@BJM just mentioned feline hyperesthesia to me on another thread. Turns out my cat's not just extra nutty. He has all the symptoms and watching a few videos of other cats with this issue made it very clear that Edwin is definitely dealing with this too. In his case it has been going on for the majority of his life. @KPassa, your kitty has had this too? Any suggestions?

 

With Mikey, he had what I now call "Lantus-induced hyperesthesia." He had twitchy, rolly skin and hated to be touched, almost like it hurt him. He would have these random bursts of activity like he'd gotten a bug up his arse and was in a generally irritable mood. Poor little guy!

I switched to Levemir and he's now practically normal. The Lantus has a negative pH that I think can affect some cats adversely, but if your cat was doing it before the insulin, then it's most likely something else.

 

Bailey went back to see the vet today.
We went through all the possibilities of what could be causing the problem.
Allergies food /litter/ Insulin. Been on the same food for over a year& been on Lantus for 18 months so he doesn't think this is the problem.
Fleas/ ring/tape worms Bailey obliged just before we left to vet so took his poo with us!! Doesn't think he has worms,but is sending it for analysis and gave him worming pill.
He examined bailey under spotlight and found no evidence of flea dirt but started him on flea treatment.,what he did find was a small outbreak of stud tail (waxy skin and fur at top of tail) he said this would not be causing irritation and thought best not to cleanse and shampoo as this might make him more aware of his tail,so for the time being we a leaving that alone.
Hyperesthesia Bailey isnt showing classic sighs,he isn't biting at his tail,he isn't spooked,and chasing his tail.
He licks the tip of his tail in his grooming process,maybe only once a day,but then the damage is done,he isn't giving it a chance to heal.
Vet applied Flamazine cream ( silver sulfadiazine used for burns and bed ulcers) and bandaged it up.we go back on Friday. I am so worried that if it doesn't heal and becomes infected the only option is amputation.he has been through so much over the past 2 years since diagnosed with FD at the age of 15 I couldn't put him through that.
Many thanks to each and every one of you for your thoughts and suggestions,I appreciate more than I can say.
The strange thing is that over the past few days Baileys bg numbers have been good- what I would give to just have the FD to worry about! Diane

 

Forgot to mention,does Edwin bite himself, If so how do you go about healing the wound?
I have Bachs rescue remedy on order,have been advised against giving the human one as the alcohol can be dangerous.

 

You may have to use an e-collar until it heals.

 

That's a strange Lantus reaction. I'm glad to hear that Mikey is "mostly" normal now. Edwin's "fits" don't seem to hurt him, but he does get really wacky and it's advisable not to touch him when he's flipping out. He's never done any physical damage to himself and it doesn't last for a long time.
Who knew this was an actual condition? Edwin's has had it for most of his 16 1/2 years. I always just assumed it was the devil poking and chasing him (you know how that can happen ).

 

Edwin's never bit himself or even licked a bald patch from the feline hyperesthesia, which is why I just assumed it was wacky cat behavior. As @BJM suggested, an e-collar might help. They make soft e-collars these days that don't look as bad as the old hard plastic ones. Can you loosely bandage the wound? That might help too. Also, is there a cat version of the icky apple stuff that they put on dogs' wounds to keep them away from it?

As for the Bach's Rescue Remedy human versus pet version, it's your cat so it's your call. However, people have been using the human version in pets for years (the pet version is relatively new) without any issues that I'm aware of. That being said, when I make Edwin's specific mix, with individual Bach remedies, I use glycerin as the preservative (but it's booze for my mix ).

Another calming formula I use on Edwin is True-Dose calming. It has valerian and ginger extract with chamomile and tryptophan. I also use a calming collar on Edwin and that seems to help too. If that all doesn't dope him up enough, I've used the feliway spray also. Most of this is just because Edwin has always been a bit of a 'fraidy cat not because of his odd "fits."

 

BJM The vet says his tail is so long (Maine coon) that he would still be able to get to the tip where the sore is.

 

You could put a long collar/tube over his tail instead. I'm mostly joking about this as I'm not sure if restricting his tail like that would be a good idea. I'd try bandaging with icky stuff on the bandage to keep him away from it.

Edit: One other thought, have you tried any bandages that have silver impregnated in them? The silver often helps in healing hard to heal wounds. I think you can also just use colloidal silver on a regular bandage too, but I've never tried that.

2nd Edit: oops, I missed the part where the vet is already trying silver.

 

Depends on how wide in diameter the e-collar is and if it is soft vs stiff.