diabetes, IBD and starving to death

[Rose L]

Hi all,

I've been on quite a health journey with my cat. I posted before about a month or two ago when it was recommended that I euthanize my cat by the vet. I so appreciated the replies, and it gave me the strength to keep going and not euthanize my lovely kitty...who is still alert walking around and fighting hard for life.

Anyway.. my 15 yr old cat has been diagnosed with diabetes, IBD and CKD (early stage of CKD), and I suspected EPI (which the specialist agreed was a strong possibility as he also has chronic pancreatitis).
He has had the diabetes for 2 years now. We were having trouble controlling his blood glucose as it varied, but changed insulin to glargine and that helped, although it was still a bit irregular but nothing crazy. However vet recommended that we didn't invest in another Libre until we figured out if he could actually gain weight, as her recco was to have him put down- mainly due to the IBD. She said the diabetes is the least of his concerns right now.

He was eating frequently, but not enough to sustain himself (mainly licking juices), and he had a feeding tube (E-tube) installed 2 months ago, and I give him 4 feedings a day through it (2 small cans worth). He had a UTI and a kidney infection, which took a LONG time to clear but finally did! We were so happy about that!

He also eats some on his own in addition to the feeding tube. Especially in the last few weeks, his nausea seems much better controlled with Cerenia and Ondanestron and he is a eating a fair amount.

Only problem is...he keeps losing weight and is hungry ALL the time...he has lost a huge amount in the last few months. He isn't absorbing the calories I am feeding him from the e-tube.

Then, a few days ago, he had a huge swelling where his feeding tube went in. The vet drained it, gave him an antibiotic injection and said the feeding tube should really come out, but he was probably too weak for that and he had lost weight again, so just to euthanize.

Again, I booked a euthanasia at the end of this week. BUT now I am freaking out again because he is so darn alert and relatively active (especially compared to what he was)!

But is there any way to help an IBD cat gain weight if they won't absorb calories through the feeding tube?

*Oh, I should add, at my suggestion, the vet helped us get pancreatic enzymes a few weeks ago, and I thoguht that was helping him gain...but I guess I was wrong. Maybe it only slightly slowed his weight loss, but he still lost 10% of his body weight over the last 3 weeks.

He is on steroids (budesonide) and B12 injections. they have not helped that much.

One thing we haven't tried is a novel protein diet. The thing is, if we have to remove the feeding tube (which we will if we don't euthanize), I highly doubt he would eat novel protein...he is super picky. But I guess we could try? He also likes a huge variety of foods and I don't know that there are very many novel protein diet options out there.

He is now crying at me for food constantly, even though I will have just fed him.

Does anyone think that a novel protein diet could truly reverse this? He is extremely thin. Specialist said his bowels are likely failing and just completely unable to absorb calories.

UGH...must we euthanize?

Thanks for listening. <3 <3 <3

 

[Wendy&Neko]

My Neko also was a complicated kitty. Diabetes (because of acromegaly), CKD, either IBD or small cell lymphoma and the IM vet and I suspected it was SCL. We couldn't diagnose properly because she also had a heart condition which meant no anaesthesia. She had been on a raw diet before hand, getting lots of different proteins. I did try a few novel ones for her, but that didn't make a difference. Another piece of evidence it was SCL, so she got chlorambucil to treat that. I also have experience with IBD in another cat. Sigh.

Has the vet done a biopsy or endocsopy to determine it was IBD and not SCL? Are you dealing with a regular vet or an internal medicine vet? IM vets are great at complicated cats and prioritizing what needs to be done. If for some reason your kitty (name?) needs more or different steroids, you'd just compensate with the insulin dose. IBD or another inflammation can cause insulin resistance meaning he might need more insulin.

If he still wants to eat and it losing weight, I'd feel him more. His glucose may be higher due to the steroids, which could also cause him to lose weight. Are you home testing him at all?

What food are you feeding him now?

 

[Bron and Sheba (GA)]

If he is alert and hungry I would not euthanise. I find some vets suggest this when they can’t find solutions.
Have you tried Visbiome probiotics? They are really good for cats with gut issues. One of my cats had loosish bowels and trouble gaining weight and I started using the probiotic and her bowels have been great ever since and she has gained weight.

 

[Suzanne & Darcy]

I 100 percent agree with trying Visbiome Vet probiotics for your cat. These have been extremely helpful for my IBD cats. They are expensive, bit they work. Have you tried the Hydrolyzed Protein foods like Hills Z/D (which is the only one that comes in a wet food formula.) Some cats do not respond well enough to Budesonide and need Prednisolone for IBD management.

 

[JL and Chip]

I also saw good results with Visbiome Vet. My kitty had IBD and/or SCL (he was too fragile to do extensive testing) and the things that helped were prednisolone, Visbiome Vet, and a novel protein diet. I can’t tell you which of, or perhaps all, those things made the biggest difference because he was in such crisis I was ready to euthanize so threw everything at him simultaneously. The novel protein I used was venison (Ziwipeak), primarily because he’d had rabbit, lamb, and most other proteins earlier in his life.

Have you sent off blood to Texas A&M for a GI panel? That can rule in/out EPI, pancreatitis, and also check folate and cobalamin levels, which are also important from a GI health standpoint.

As for EPI, it’s not one-size-fits-all for dosing so you sometimes have to tinker around to get it right. If he does have EPI, the enzymes are going to be critical to turning him around. What brand did you get? Are you still giving it?