Hi! I was here about a year ago when my kitty was pre diabetic. He’s been though so much lately and I’m hoping he can recover. He’s 16 He got very sick recently suddenly and got all kinds of tests. All his organs look great for his age but he was extremely constipated and had to stay overnight in the hospital to get cleared out. Plus he’s diabetic. Slightly. So he’s on 1ml insulin twice a day for now. He’s also on Royal Canin Gastrointestinal Fiber response food to help with his constipation issue plus laxatives. This is a dry food so I asked if I can mix it with wet and the Dr. said yes as long as it’s still the majority of his food. He was on the verge of dying and hiding and not eating prior to all his tests. And now he is slightly better and I mean slightly. He’s eating which I’m happy about. But he’s still laying around and seems weak. He got down to 8lbs of skin and bones. I’m doing everything the vet says. My question for you all is, am I being impatient with his recovery? I was hoping he would have perked up a bit by now. It’s been a week. I’m just not ready to loose him, although if it’s going that way I’m confident we did all we good and he’s very loved. im really hoping I see him perk up and gain some weight back. And his bowel movements back on track. He’s only gone once since his clean out and it was very loose from his laxatives. And that was 2 days ago. Any advice would be great thanks.
I'm so sorry that you didn't get a reply to this message. I've just had the worst week with cats and several surgeries so I have been so busy and exhausted. I'm just trying to catch up today. I would love to know how your TJ is doing. Did he have diabetic ketoacidosis (DKA?) Is that what happened? or what did the vet think was wrong? Do you have any bloodwork that you can share with us? Do you have a spreadsheet for BG testing... are you home testing his BG? I understand about the Fiber Response? Don't they make a wet version of that cat food? Constipation can be very dangerous, as I am sure you have found out, but I am wondering what else could be going on and what his blood glucose values are/have been recently. I am assuming that he is on ProZinc, since you have posted on this forum. One unit? Please reply with any information that you can provide so we can try to help you. Were you given anything like Mirataz (transdermal mirtazapine that is rubbed on the inner ear) to help stimulate his appetite? Cerenia? Ondansetron? For any nausea?
Hi! Thank you so much for responding! This may take a few replies to answer all of your questions. bare with me: TJ seems to be doing better, but still not leaving the bathroom where we had him as his “ hospital” for a while. I didn’t want him hiding where I couldn’t get him when he was super sick. So I think that’s his new safe spot. And if I let him go he defining wants to go back under the bed and it’s impossible to get him out. His normal schedule before this was under the bed most of the day to sleep but he would come out for dinner. But I’m still not 100% that he would come out. he’s eating very well and using the litter box. He’s on miralax and laculos to make sure he doesn’t stop up again and the fiber response food. I do have to wet it with a broth of some sort to get him to eat it so I’m using Tiki cat broth. They do not make a wet version of the fiber response. He is on proZinc 1 unit twice a day. It’s so small that sometimes I feel like I didn’t get it in! Sometimes it feels very “ correct” and sometimes I’m not sure. I hate that feeling. But I never feel wetness on his fur but again, it’s so tiny I’m not sure I would, so I hope I’m doing a good job for him. The vet didn’t tell me to check his numbers, but just to keep an eye on him. I can see if I can get a copy of his numbers for you. He didnt have ketoacidosis as far as I know. Just he wasn’t eating because he was so backed up. But had also gotten skinnier and was drinking a lot of water and urinating a lot for a bit prior. sorry you have been so stressed and I hope everything is ok.
Well, the drinking a lot and urinating a lot can simply be from diabetes. I don’t know what his blood glucose numbers are right now, so I can’t say for sure. His weight loss may also just be from the diabetes. Let’s hope so because we can really do something to help regulate that! It can also be from other things, but I don’t want to go into that right now, since we know he is diabetic. I would like to know more about his blood work and the tests that they ran and the therapies that they administered for him. We need to help this boy! If you are giving insulin, then please try to start home testing. We can help! I would recommend getting a ReliOn blood glucose meter from Walmart if possible. They are reliable and the test strips are some of the least expensive. Believe me, I know how daunting this can all be. I cried the first week or two that I tried to get blood from my sweet Darcy boy’s ear. I said that I would never be able to do it. I said that I never would be able to start or manage a spreadsheet for him, etc. I think I was emotionally just overwhelmed at that point. I hope that we can be with you from this point forward and help you on this journey. ❤️
I just wanted to add that I totally understand the need to keep them in a confined space in order to be able to care for them. I get that. I have a lot of cats and also foster kittens. We have to do what we have to do. You are doing well!
I will check in with you tomorrow, I promise. You can vent or emotionally dump here or just ask questions or share worries and concerns. We are here for you and we understand! Please bear with us too as we ask questions to try to help. Hang in there! Caring for a sick cat is rough, and can be an emotional roller coaster as well as physically and emotionally draining and financially draining as well.
Thank you! Tomorrow I will look for the sheets from the vet with the numbers. I think I didn’t want to lancet his ear initially because I was giving him injections now PLUS we were giving him fluids everyday to try and get him to pass a bowel movement and keep him hydrated. He started to not love seeing me because he was sick of getting poked. Even though I’m giving him love without pokes as well. It just seemed like I didn’t want to only be the bearer of needles. So get this at the first vet they didn’t test him and assumed it was kidney failure and she didn’t believe in euthanizing animals so he was dying and she said that was nature and she doesn’t do much for very old cats. I actually took him for a second opinion and I was 95% sure I was saying goodbye that day. I was devistated, but also couldn’t just watch him suffer. Went home with hope that he could pull through. That week though, took a big toll on him. His kidneys aren’t perfect but they are fine. His diabetic numbers are high but it wasn’t stress. Then they did an X-ray to make sure he didn’t have cancer or anything before they started an expensive insulin regimen. That’s how they found the bad constipation. Then they did a fructose-amine test and that showed that his numbers were actually pretty normal. So the vet said he would say pre-diabetic but the drinking and weight loss makes him lean toward a small dose of insulin to help regulate him.
If his numbers are “pretty normal” I would not be giving insulin at all unless you can verify that he needs it. You actually need to know what his blood glucose levels are if you are giving one unit of ProZinc twice a day. If he doesn’t have very high BG even one unit could cause him to hypo. What kind of syringes are you using? They should be U40 syringes with half unit markings. You should be able to see the insulin in the syringe. Would you be able to take a photo of your syringe and show where you are drawing it back? The last thing he needs right now is a hypo event. Do you know what his Fructosamine test number was? Blood work would perhaps help shes some light on things. Can you get a copy?
I got copies of his numbers. It’s not letting me upload a photo though. Can I get you any specific number?
The upload function does not work. I usually copy and paste photos from my phone. How do you do it @Diane Tyler's Mom ?
Oh, I have also saved things to my desktop on the big computer and dragged and dropped them into a message from there.
I went over this bloodwork several times last night in my mind. I almost thought that I had replied! but I went out to feed the feral cats and forgot to actually put "pen to paper" ... fingers to keyboard really... and reply. So here goes... next post.
My first thought is that TJ may have been mildly dehydrated at the time the blood was taken. This was prior to hospitalization? Overall his kidneys look good. The fructosamine is really not that high... all the more reason why I would not give insulin without doing testing. And with a fructosamine like that, I would not have started at one unit of insulin. I am concerned about the insulin. The urinalysis indicates that he has blood and protein in his urine. This could just be cystitis, but I would repeat the urinalysis in a month. Is he having any problems urinating? Anything unusual? What kind of litter do you use? If you try a white, crystal litter like Sustainably Yours Multi Cat PLUS litter, you can easily see if the urine looks pink. That stuff makes rock hard clumps in seconds (it's a little messy though since it's like sand.) You've probably already seen the Pretty Litter stuff. Both a lot of red cells and protein in the urine are a concern, but it could improve as his BG improves (although we don't know what his BG is right now.) Perhaps... and maybe I mentioned this before.. you would consider getting a Freestyle Libre put on him so you can easily monitor his blood glucose.
How is he doing now overall? Is he eating well? Is he pooping regularly? Is he lethargic? Any ketones in his urine? Has he ever had the Spec fPL blood test for pancreatitis? I'm trying to think of anything that really got him down. A viral or bacterial infection (not that I see signs of it in his bloodwork). Is he on any medication at this time (other than insulin?)
Hi thank you! I’m going to address all your points best I can * he was extremely dehydrated and constipated on the evening of that test. * the dr. Did say at first, that’s because of the fructosamine test, that we were NOT going to start him on insulin, but then when I talked to him again after he was hospitalized, I mentioned that he had lost SO much weight and was drinking a ton of water. Then he said yeah that does sound like he is diabetic so let’s try the tiny bit of insulin and see how he does. I just called yesterday and asked if they wanted me to be testing his blood and they said no, what they do is take him in for an entire day after he’s been treated for a couple of weeks, and test his BG several times and see if there needs to be any adjustments made. they call it a blood glucose curve. He is urinating fine. And he has a couple of times on a pee pad because he didn’t feel like moving and I haven’t noticed any pink. As of now I’m just wishing he would gain some weight and not seem down. Maybe it’s because he is in a secluded area. But on a normal day he would go under the bed all day anyway. and I would let him, if I thought he would come out for dinner which he did right before he got really sick and all of a sudden one day hid and wouldn’t come out. He was feeling pretty bad but I went to the wrong vet first ( story above) then he didn’t get proper help for a week. probably took a huge toll on him. He is eating ok. But I make him a mix and put it in front of his face. Then he will eat all of it. This morning he had seconds. Not sure if he would go to it on his own though. He’s pretty much laying in the same corner. Unless he uses the litter box or I pull him out. He’s having good bowel movements now so he’s not stopped up anymore which is great. He should be feeling better. And he is slightly, because he’s eating well. Just not seeming like he wants to be normal again. And he’s still so skinny. He didn’t take a pancreatic test. he’s not lethargic, he’s a lot more alert. He’s sleeping most of the day but that was his normal as an old dude anyway. He doesn’t like me coming to get him, he tried so stay in a ball but I poke him a lot so I get it. He’s fighting more about getting a jab, so maybe some strength is returning. We were also giving him fluids everyday for a week and a half. I’m out now and the vet said to see how he is without that everyday so he was getting a shot 3 times everyday so I’m sure he hated all of that. The only other things he’s on besides the insulin is laculous and myralax. But I’m bringing those down a bit to see how that goes. Thanks for replaying!
I should add that he has bad teeth issues. He has one tooth at least that should be pulled but he needs to gain weight to do that.
His T4 should be checked to make sure he is not hyperthyroid. It’s not uncommon in older cats. It can cause excessive thirst and, of course, weight loss. It should be ruled out. Also the Spec fPL test for pancreatitis. There are some vets who do not want people testing their cats blood glucose at home. I have no idea why. Perhaps they are want to maintain all control. Do they think people are too incompetent to test the blood? I don’t get it. I’ve been around here long enough now to have seen some really tragic consequences from cats going hypoglycemic. So I get a little mad at vets who say not to test. Anyway, I do recall that my vet in the beginning did not recommend home testing. I just bought myself a meter and started on my own without even mentioning it to her. I started tracking his numbers, and she could see that there was no need to do a glucose curve their at the hospital because I already had far more information than their one day (expensive) curve would ever yield. My BG readings were more accurate anyway since stress elevates BG in cats so the readings taken at the vet are almost always higher than those you would get at home. So my vet accepted it and decided to work with me. I even showed her my spreadsheet. They were fine with my meter (ReliOn Premier from Walmart) as well since they told me they also used a human meter and not a pet meter.
Bad teeth do also raise blood glucose. We see that here a lot. That could be causing him pain and will result in him not eating. He should probably be put on a course of Antirobe (Clindamycin) for the tooth/teeth. I have had cats with bad teeth before who were not in good enough shape to undergo anesthesia. They were given pulsed antibiotics where they were on the antibiotic for one week out of every month…. Three weeks off and one week on. This worked to control the problem. I would also ask for Mirataz (mirtazapine ointment applied to the inner ear) to stimulate his appetite. I would start with a small amount (much less than the strip length that they show on the box that the tube of medication comes in.) Many cats are sensitive to Mirtazapine so it is always best to start with about half or one third of the strip of ointment in order to avoid unwanted side effects (restlessness, aggression toward other animals, excessive meowing, etc.)
Thanks I’m going to ask for another round of antibiotics for this week when I call tomorrow. Should I skip an insulin dose to see if he’s any different?
Do you mean different in the way that he acts? I'm not sure. Since you have no idea what his BG is, it's hard to say what the right thing to do is. Sorry that is not helpful, but you are basically shooting blind at this point.
