Zorrain
Member Since 2021
July 6 2020: at 11:00 pm I got home from work. Ruckus was being strange and he didn’t greet me at the door. I went to look for him and he started to make very strange awful sounds. He ran to the litter box back and forth. He then ran over to a blanket to try and pee on in front of me. I instantly knew something was seriously wrong. I started to call night emergency vet clinics. He was open mouth panting and still screaming. My boyfriend went over to him and he started to pet him and he started to purr but still was freaking out. Which was very weird and confusing. The vet told me that my boyfriend might have been comforting him so this was he was purring while in pain. When we went to bring him to the vet he peed all over me... and I mean a lot of pee. So after a blood tests, culture test, urinate test. He was found to be diabetic. The vet said he went into ketoacidosis. He was given to take home buprenorphine, prazosin, Lantus Glargine.
Sep 18 2020: his ears seemed to be bugging him for the past week, I noticed brown red color inside. I brought him to the vet and they suspected a ear infection, he was given Surolan ear drops. Five days later he still did not seem better so I brought him back and they gave me Amoxicillin.
Dec 10 2020: A group I was in for cat diabetes suggested I do a reset because they thought he was at too high of a dose. Ever since his ear infection he was not very regulated and did not seem to be 100 percent better. I did this suggestion of doing the reset which did not help him made him extremely worse.
Jan 25 2021: the emergency vet made a suggestion that I switch his insulin, which was Levemir at 2 units.
Feb 18 2021: I had brought ruckus to a cat only specialist clinic because he would not use his back legs and seemed extremely off. She run a full blood panel and uranalysis. It took a full week to get back and he was subscribed Cerenia, Probiotics, buprenorphine. These treatment were the result that we thought he had pancreatitis. She also suggested doing sub q fluids but wanted to do isolyte or plasmalyte. I wanted to lacated ringers but she thought theses were acidic. which was very strange because I did not find and research to support this. My regular vet (spray and neuter center) also thought we should lacated ringers so that what we did. I brought Ruckus to this vet because they said they specialized in cat diabetes but didn't go very well. This vet said she did not believe in Lantus or Levemir even though I called and asked if they did. She wanted to which to a faster acting insulin which I refused because we had just switched him to Levemir.
Vets email : have the results back on Ruckus. His cell counts are normal and no suggestion of infection causing a problem. His blood sugar, as expected was high – 20. He also had sugar in his urine but no ketones. His pancreas test is slightly high, suggesting possible pancreatitis, which is also not unexpected and could be contributing to lack of regulating. His folate is a little high, which points to a possible disrupted gut microbiome which can lead to inflammation in the body. A couple oddities – One of his liver enzymes, called AST, is high but all of the rest are very normal. AST comes from the mitochondria of the liver cells, suggesting deep damage to the cell, if present. If this was the case, we would expect to see an increase in his other liver enzymes, especially once called ALT and this is not the case. AST can also increase if red cells are broken – but there is no sign of this – or with muscle injury. Is there any chance you are hitting his muscle when giving the insulin injections? His chloride level is low (while his sodium and potassium are both normal). The most common cause of low chloride is vomiting. This is not the case here. One consideration is hyperadrenocorticism (also known as Cushings) can cause low chloride, and this is a very common cause of insulin resistance so should be kept in mind if we do decide/determine he is insulin resistant. Further diagnostics to consider would be: Abdominal ultrasound – this would enable us to learn more about the liver, pancreas, bowel and adrenal glands (adrenal tumors can cause hyperadrenocorticism). Abdominal ultrasound would cost approx. $600-700 or so. Low Dose Dexamethasone Suppression Test – to screen for hyperadrenocorticism. Approx cost $200. Measure growth factor to definitively rule out acromegaly (will have to get back to you on est cost as my nurse is not here right now to ask). Treatments to consider would be: A course of metronidazole and probiotic to address the possible disrupted gut microbiome. A course of cerenia and ursodiol to address the possible pancreatitis. The ursodiol could also help with the liver, depending upon what, if anything, is going on. I still do recommend you consider switching insulin to PZI, but if you want to work a bit longer with levemir, that is fine. Did you increase to 5 units this past weekend? If you are not seeing any response by next weekend, then increase to 6 units, and then the week after to 7 units. If we are not seeing a response by that point, we likely won’t and might be dealing with resistance, in which case revisiting the additional diagnostics is again worthwhile or we try switching to PZI, see how that goes, and then work up further if still not responding.
Mar 26 2021: He is finally going up in his cat tree and his eyes are less red. He seems to be getting used to the Levemir and he is finally in the yellow number but still seems to be extremely tired.
Side notes:
* I've had a extremely hard time finding a vet for him, he's been to 4 different vets and they all seem to be iffy of cat diabetes. My regular vet was very honest about this which was nice. They love Ruckus but don't specialize in it they said. Emergency vet suggested I put ruckus down which was a huge p*** off, they wouldn't even show me how to do needles. I had to throw a extreme fit to be shown and they said because covid. Its been extremely hard to learn all of this diabetes stuff but I joined a group and talk to Diabetic Cats in Needs, so I've been blessed with that.
*Ruckus was suggested to do another reset which I disagree with since it went so poorly last time
https://docs.google.com/spreadsheets/d/1bGhlU7KJYcwTscKTDqscflKTZ-Eg1XHP2nx7a9VK3MI/edit
Sep 18 2020: his ears seemed to be bugging him for the past week, I noticed brown red color inside. I brought him to the vet and they suspected a ear infection, he was given Surolan ear drops. Five days later he still did not seem better so I brought him back and they gave me Amoxicillin.
Dec 10 2020: A group I was in for cat diabetes suggested I do a reset because they thought he was at too high of a dose. Ever since his ear infection he was not very regulated and did not seem to be 100 percent better. I did this suggestion of doing the reset which did not help him made him extremely worse.
Jan 25 2021: the emergency vet made a suggestion that I switch his insulin, which was Levemir at 2 units.
Feb 18 2021: I had brought ruckus to a cat only specialist clinic because he would not use his back legs and seemed extremely off. She run a full blood panel and uranalysis. It took a full week to get back and he was subscribed Cerenia, Probiotics, buprenorphine. These treatment were the result that we thought he had pancreatitis. She also suggested doing sub q fluids but wanted to do isolyte or plasmalyte. I wanted to lacated ringers but she thought theses were acidic. which was very strange because I did not find and research to support this. My regular vet (spray and neuter center) also thought we should lacated ringers so that what we did. I brought Ruckus to this vet because they said they specialized in cat diabetes but didn't go very well. This vet said she did not believe in Lantus or Levemir even though I called and asked if they did. She wanted to which to a faster acting insulin which I refused because we had just switched him to Levemir.
Vets email : have the results back on Ruckus. His cell counts are normal and no suggestion of infection causing a problem. His blood sugar, as expected was high – 20. He also had sugar in his urine but no ketones. His pancreas test is slightly high, suggesting possible pancreatitis, which is also not unexpected and could be contributing to lack of regulating. His folate is a little high, which points to a possible disrupted gut microbiome which can lead to inflammation in the body. A couple oddities – One of his liver enzymes, called AST, is high but all of the rest are very normal. AST comes from the mitochondria of the liver cells, suggesting deep damage to the cell, if present. If this was the case, we would expect to see an increase in his other liver enzymes, especially once called ALT and this is not the case. AST can also increase if red cells are broken – but there is no sign of this – or with muscle injury. Is there any chance you are hitting his muscle when giving the insulin injections? His chloride level is low (while his sodium and potassium are both normal). The most common cause of low chloride is vomiting. This is not the case here. One consideration is hyperadrenocorticism (also known as Cushings) can cause low chloride, and this is a very common cause of insulin resistance so should be kept in mind if we do decide/determine he is insulin resistant. Further diagnostics to consider would be: Abdominal ultrasound – this would enable us to learn more about the liver, pancreas, bowel and adrenal glands (adrenal tumors can cause hyperadrenocorticism). Abdominal ultrasound would cost approx. $600-700 or so. Low Dose Dexamethasone Suppression Test – to screen for hyperadrenocorticism. Approx cost $200. Measure growth factor to definitively rule out acromegaly (will have to get back to you on est cost as my nurse is not here right now to ask). Treatments to consider would be: A course of metronidazole and probiotic to address the possible disrupted gut microbiome. A course of cerenia and ursodiol to address the possible pancreatitis. The ursodiol could also help with the liver, depending upon what, if anything, is going on. I still do recommend you consider switching insulin to PZI, but if you want to work a bit longer with levemir, that is fine. Did you increase to 5 units this past weekend? If you are not seeing any response by next weekend, then increase to 6 units, and then the week after to 7 units. If we are not seeing a response by that point, we likely won’t and might be dealing with resistance, in which case revisiting the additional diagnostics is again worthwhile or we try switching to PZI, see how that goes, and then work up further if still not responding.
Mar 26 2021: He is finally going up in his cat tree and his eyes are less red. He seems to be getting used to the Levemir and he is finally in the yellow number but still seems to be extremely tired.
Side notes:
* I've had a extremely hard time finding a vet for him, he's been to 4 different vets and they all seem to be iffy of cat diabetes. My regular vet was very honest about this which was nice. They love Ruckus but don't specialize in it they said. Emergency vet suggested I put ruckus down which was a huge p*** off, they wouldn't even show me how to do needles. I had to throw a extreme fit to be shown and they said because covid. Its been extremely hard to learn all of this diabetes stuff but I joined a group and talk to Diabetic Cats in Needs, so I've been blessed with that.
*Ruckus was suggested to do another reset which I disagree with since it went so poorly last time
https://docs.google.com/spreadsheets/d/1bGhlU7KJYcwTscKTDqscflKTZ-Eg1XHP2nx7a9VK3MI/edit
but suddenly one day you realize that it is sinking in. Welcome!
