May or may not be diabetic? Experiences please.

My cat had normal glucose levels literally 2 months ago. Due to various other health concerns, such as interstitial cystitis and one episode of pancreatitis, he has had two more blood draws since then. In these two more recent blood draws, his glucose levels were in the 200s but never broke 300. The first time we noticed his high glucose, my vet didn't seem concerned, thinking it was stress related as my cat can become quite combative at the vet.

I saw a new vet and recently got another blood draw because something didn't feel right to me. My new vet is concerned, but he isn't sure if it has something to do with my cat being on prednisolone coupled with being stressed out at the vet, having to deal with cystitis flares every 2-3 weeks, etc. He wants to do a frucosamine (spelling?) test to see if my cat is truly diabetic or not.

I want to know if anyone has had this experience with their cat and what was the result. I can't afford anymore tests for my cat for another week until I get paid again, but I'm scared and want some kind of answer sooner than that. My cat is a 13 year old neutered Male and he has been on corticosteroids since he was 7 due to skin allergies around his face. I have tried limited ingredient diets and they haven't helped.

 

Hello and welcome--

I'm sorry to say that yes, it's definitely possible for diabetes to appear that quickly, especially if there are steroids in the mix. However, as you say, the vet stress and infection can also raise BG numbers "in the moment"

The fructosamine test, which gives a longer-term average BG over weeks, will give you an answer yes/no on diabetes, but that's about it. If you are willing to learn to home-test blood glucose, you might be able to get an answer that way, and if he is diabetic, it will be very very helpful in managing the disease. Most of us here use human blood glucose meters for testing because the strips are much cheaper than those for pet meters.

 

Hello,
I am sorry to hear about your kitty.
'Nan & Amber' has given you some great advice.

Just another thought at this point (before your kitty starts on insulin - if the diabetes is confirmed)... If your kitty is currently on a high carbohydrate diet then lowering the carb content of the diet may help to reduce the blood glucose levels somewhat. What is your kitty eating at the moment?

Eliz

 

He was on the Hills science diet w/d but he recently started rejecting that food so I put him back on the natural balance limited ingredient diet. Its salmon based, which I learned recently not to have cats only on fish. He rejects wet food most of the time too or I'd have him on that instead. He's a very finicky eater. He was overweight at 13.5 lbs but I started him on a weight loss plan and he is down to 12.5 lbs. He has an ideal body weight score now, according to the most recent vet visit, so I hope that will help make a difference.

 

Dry food= kitty crack. Trouble was an addict. I got lucky he looked at wet food as a treat. It was much easier to ween him off the dry. These days there are foods like Dr Esleys and Young Again... they are lower carb. I used fortiflora its a probiotic made of the stuff they spray dry food with to attract cats to eat. (not the BEST probiotic but if it gets kitty to eat...)

 

I'm guessing your name is Tara..are you interested in learning more? We are happy to help in anyway we can.
New? How You Can Help Us Help You!

 

Hi there, and welcome to you.

Sorry to hear that your kitty had a bout of pancreatitis. It's an awful affliction. Allergies are tough too.

Firstly, there is such a thing as steroid-induced diabetes so your new vet is again correct to investigate whether it is affecting your cat. There's also the recent pancreatitis episode to consider, and whether the inflammation may have adversely affected the insulin-producing beta cells in the pancreas.

Secondly, your new vet is absolutely correct about wanting to run a fructosamine test: it's necessary for a sound diagnosis of feline diabetes. As the (new) vet correctly observes, the blood glucose (BG) level result from a standard blood draw only gives a snapshot of a kitty's BG at the moment it was drawn. Travel/vet stress can cause the BG level of any cat to be temporarily elevated, with non-diabetics returning to normal BG levels once they get back to their home environment. Conversely, the fructosamine test will give a measure of your cat's average blood glucose levels for the past couple of weeks, and it is not influenced by vet stress. A diabetic cat will have an elevated fructosamine result.

Clinical signs of diabetes should also be taken into account when considering a diabetes Dx. Hallmark signs include:

* Drinking and urinating more.

* Unusual hunger/excessive hunger.

* Losing weight despite eating more food.

* Lethargy.

* Low mood (depression).

* Poor hair coat condition.

The only other way that you might be able to determine what's happening with your kitty's BG levels is to test his BG levels daily at home. You can do this with a regular human glucometer (using a cat-specific reference range). We can help you learn how to do this. If you're in the US, Walmart carry meters with reasonably priced test strips in their Relion range. (IIRC the strips for the Prime are the cheapest.) I've no idea how much your vet charges for a fructosamine test but it might be worth comparing the cost of home testing with the fee your vet charges.

With a question mark hanging over your cat's glucose regulation - and given that his history makes him a potential candidate for feline diabetes - it's not really safe to leave him untreated. Would your vet be willing to run the test and let you defer payment till payday? if you're not in a position to go for blood testing or home testing till pay day, at MINIMUM you need to take the important safety precaution of checking his pee for ketones daily. A diabetic cat in need of insulin is at risk of developing a serious complication of the disease (diabetic ketoacidosis) and the simple daily test will help you keep him safe. Here are useful forum resources for you:

Testing your cat for ketones

Tips for collecting urine samples

Again assuming you're in the US, you can pick up reasonably priced ketone test strips at Walmart. You can get strips that test both glucose and ketones. If the glucose test turns positive then it means that blood sugars over the last few hours were high enough to spill over into the urine (renal threshold varies from cat to cat but, as a rough guide, BG levels would be over 200mg/dL). You could also monitor daily water consumption and urine output (watch for increases) and hunger. Here's a helpful document:

BJ's Secondary Monitoring Tools

By way of general information, given your kitty's history of allergies and the need for steroid treatment to control them, it is possible to work insulin treatment around his other medical needs if so required. It might also be worth checking out the ibdkitties.net website. While the site's key focus is inflammatory bowel disease, perhaps there might be some overlap and a helpful nugget or two?

Needless to say, you can come here any time and ask for help and suggestions. Please let us know how you get on.


Mogs
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Not sure about the wet version of this, but the dry w/d kibble has an insane amount of carbs. If you've removed that from your cat's diet and are now feeding a food with fewer carbs (not necessarily a food low enough in carbs for a diabetic cat in general) then that may have had a lowering effect on your kitty's BG levels. In the case where you do proceed with the fructosamine test, be sure to let your vets know the type of food your little fella has been eating during the period the test covers, and particularly if you reduced his carb load during that window. It will help your vet to better interpret the result.


Mogs
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My cat's only symptom of diabetes is high bg. Even that has never been higher than 280mg/dL (US). Granted I work 8 hours so if he drinks a lot of water I haven't witnessed it, but I scoop his cat box twice daily and I don't typically see more than 4 clumps all day about half the size of a tennis ball. His most recent UA showed negative ketones as well and this was done at the same time as his most recent bloodwork.

So if he is diabetic, would these other signs indicate he is only just becoming diabetic and putting him into remission would be easier? And I really appreciate the help from all of you. Its helping me relax a lot, as my biggest hurdle would be cost.

 

Hi there,

Sorry it has taken me so long to reply to your latest post. (The thread moved down the board and I missed it. )

This is just speculation on my part because my Saoirse was well and truly diabetic at time of Dx (peeing for Ireland, BG levels somewhere in the Oort cloud) but, applying general principles, the less time a cat's BG levels have been in the diabetic range, the less likely there is to be organ damage and the greater likelihood that there are more functioning insulin-producing beta cells remaining in the pancreas. Ergo it is fairly reasonable to hope that such a cat would have a good chance at remission.

In your case, the need for continued steroid treatment to help your little one's allergies complicates the picture somewhat. Also, if the cystitis is a chronic issue that will influence BG levels. Inflammation or infection is one of the most common reasons why cats fall out of diabetic remission (usually dental-related, but UTIs are another frequent culprit).

Choosing a long-acting insulin suited to cats (e.g. Lantus, Levemir, basaglar), starting treatment with such an insulin within 6 months of initial diagnosis, and feeding a low carb diet gives diabetic cats the greatest chance of achieving remission. Again, other conditions may take precedence over the diabetes in the treatment pecking order - the need for a special diet, for example.

WRT cost of treatment, we can help point you in the right direction on where to get supplies. For example, many of our members in the US order Lantus insulin from Canada (much cheaper!) and most cats only need a very small amount of insulin each day, so pen cartridges last a long time with proper handling.

Testing BG at home means that you would not have the expense of paying your vet to run glucose curves. We can help you learn how to test. Home testing is truly the best way to keep your kitty safe on insulin and it will help you optimise his treatment. Again, using the US as an example, a lot of members purchase Relion glucometers at Walmart because the test strips are quite reasonably priced. Typically three BG tests per day are enough (though some people test more than that). Two preshot tests will tell you whether it's safe to give each insulin dose, and one mid-cycle test round the time when the insulin is most active in the system will give you an indication of the safety of the dose (how low it takes the BG level).

We also have a Supply Closet here at FDMB where members offer supplies for sale (and sometimes free).

One of the best things you can do in terms of protecting your cat and minimising costs is to ensure your kitty remains ketone-free. DKA is very, very hard on the cat, is life-threatening, and is very expensive to treat. While your kitty is unregulated, a daily urine ketone test is the best way to avoid this complication of diabetes. Again I refer you to the links I posted earlier in this thread for tips on how to collect the small amount of urine needed for testing.

If you need help with start-up costs for treatment and you're in the US, Diabetic Cats In Need (DCIN) might be able to help with that. We can help you get in touch with them if you would like that.

Only time and treatment can really tell how your furchild will do. The key thing is that diabetes is eminently treatable, and insulin requirements can be worked around the need for steroid treatment, etc.

I hope some of the above answers your questions and reassures you about management of costs. Be sure to shout out for any help you need.


Mogs
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