Sissy pic 30 days apart & can we discuss her road to diabetes?

I can't believe how much better Sissy looks compared to a month ago. I've thought a lot lately about how we ended up with such a sick cat. And I've said this before...I really believe it was the Hills z/d food we put her on that started this spiral. Sissy has been healthy as a horse up until last year when she started licking her fur off...ruling out parasites and other issues, they said it was a food allergy. Even then it was ONLY the licking...otherwise she was normal. So rather than jump into expensive rx food we tried several other things but nothing worked so end of February this year she was missing a lot of hair so we got the rx food. By the end of April most of her hair was coming in well but she had started refusing food, was vomiting, she hadn't urinated in a day and a half so we went to the ER thinking she had a blockage. She was dehydrated, had a yeast infection in her vulva and just a few white cells in urine and xray showed she was full of poop. They told us that when she went it would likely be diarrhea. Her blood work was perfectly normal. She also had a mass in her abdomen pushing her organs to the side. That scared me because one of her litter mates I hand raised died of pancreatic cancer and her other one of cancer too. We were sent home with her having a shot of abx , and told to follow up with our vet. We went on the next morning. Sissy had one regular bowel movement and then nothing but diarrhea for 2 months. (only stopped after I started giving her benefiber) The vet had her x ray sent out to read and they came back and said it was a fatty tumor. The vet said there was no need to ultrasound to make sure. (but I still wonder) For two months we tried appetite stimulants, they tried a different antibiotic thinking it was some specific thing causing her runs, but it didn't help, cerenia for her nausea...she was still refusing most food and low out put in the box. In July I had called several times and said she was getting worse..I could tell she'd lost weight and they put it off seeing her twice wanting me to try different things first. She was drinking a ton and peeing HUGE amounts at that point. Last time I called they said to bring her in...they did more blood work, she had lost 1.5 pounds. The next day they called and said her sugars were in the 400's and she was likely diabetic, so did a fructosamine and confirmed it. From there we started insulin a few days later and here we are on day 23 of that and she looks SOOO much better, she's eating weruva foods and pretty much back to her old self personality wise.

So, what I have been thinking about and wanting to discuss, is was it possible she was only diabetic for a couple weeks before diagnosed? And was it brought on by food making her sick and then the meds on top of it? I just can't believe it was a coincidence that her health took such a dive so shortly after starting that food. I have read so many similar stories on consumer reports pages, I think it's very possible.
And is there any difference in her possible outcome based on how short of a time it was that she was diabetic before diagnosis? Does it make it easier to get under control or does it matter?

And about that mass in her abdomen...should I insist they follow up to make sure it's a fatty tumor? Can a mass/tumor like that effect her BG? My friend who is a vet tech said usually if something is big enough to displace organs it's not good. But the vet and the ER vet didn't seem super concerned but I've somewhat lost faith in our vet. She's not on board with how I want to treat her diabetes and I don't feel I have support there.

I'm sorry this is so long, but these are things I've been thinking about and hope it's okay to ask here.

The picture on the footstool is Sissy now...the other a month ago.

 

She’s such a cutie pie and I’m so happy she’s feeling better!!

a few thoughts. She may have been diabetic for a while before diagnosis. When was the last time her blood was checked before the diagnosis, meaning how much time in between the lab tests? I have to be honest, I’d probably opt for the ultrasound. As we all know based on vets and diabetes, we have to be the advocates for them and push when we think push is needed. Knowing what that mass is for sure might also give you peace of mind. Tests early on may help prevent a down spiral later. Just my two cents. Remission is possible especially when the diabetes is treated correctly early on and on a good insulin like Lantus.

can you add a few other things to your signature? Like meter and food she’s on and any other meds too. Here’s the info we like to see:

Make sure your signature is up-to-date.

• On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
  • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add any other text, such as
  • Caregiver & kitty's name (optional)
  • DX: Date
  • Name of Insulin
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
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Thank you!

 

I'm sorry but I can't answer any of your questions but I have to say boy she looks great now.

 

Generally speaking, the sooner you start treatment after diagnosis, the more likely your cat will go into remission. They say that if it hasn't happened in about 6 months, it's not going to, but we know better! (although it is more rare)

If it concerns YOU, that's reason enough for them to follow up on it. Insist on the US for your own peace of mind.

 

Her last blood work before her diagnosis was May 4th, 2020. She had blood work done for her senior check up last year and it was normal. Her next blood work was July 28, 2020 and at that point she was diabetic. After the weeks of illness I mentioned above. :/ So just a couple months.

I made the edits to my signature. I don't know how to make the link to her spreadsheet just clickable words or I'd do that too.

 

I'll have to start calling around to interview vets on Monday. I do want to have that mass checked out just to make sure. She's so precious...such a snuggly girl. I want to do everything I can for her.

 

Hi
I can't comment on your queries as I am to new to all this and will leave that to all the expert sugar baby parents out there.
But I just had to say how wonderful it is to see Sissy's "now" photo - she looks so good, like a different cat.
All credit to you for supporting your sick kitty so well for all these months when others may have just have given up on her. Massive rounds of applause for you.
I hope your other issues with the mass are resolved soon for your peace of mind - Mac & I send our best wishes to you both.

 

Can I come over and snuggle too?? I just love her!

the ultrasound is not super complicated and I think it’s worth to get more insight hopefully!!

there’s a list here somewhere with questions when interviewing a new vet @Chris & China (GA) ?

 

Found it!

https://www.felinediabetes.com/FDMB/threads/vet-interview-screening-topics-check-list.156663/

I’ve never had any luck speaking to a vet before an appt. I’ve always been told you need to make an appt. to speak with the vet, but I hope you have better luck than me!!

 

Hi. I am so sorry she’s having such a tough time. I too vote for an ultrasound. There’s no way to definitively diagnose what type the mass is from an X-ray. Based on the US the radiologist would then say if a biopsy is suggested. I would not waste my money on having anyone but a board certified radiologist do the US. I made that mistake once. The vet I went to had a mobile vet do it on Max. He found everything BUT pancreatitis wrong and recommended exploratory surgery. I wen back to my internist for a second opinion. He had his radiologist do another US and ran the test for pancreatitis that I had fasted him for but was not done by the first vet plus a GI panel and it was only pancreatitis. The rest was perfectly normal. Max never had cancer and never had any surgery.

 

Love the snuggle pic! (((Sissy)))

Mandy, Sissy is looking wonderful! I'm so pleased for you both.

On diet, before becoming diabetic, our previous vet prescribed RC Urinary s/o Dry for Saoirse (she had had oxalate uroliths removed). The vet said she needed to stay on it for good. I was more naïve in those days and just followed the vet's recommendation.

Saoirse was never a greedy cat but she started gaining weight on the above food so I switched her to the Moderate Calorie s/o Dry version. While on the RC s/o dry foods she started grooming the fur from her abdomen and it ended up bare. At repeated check-ups when I asked about what was wrong the vet said it was probably due to boredom or stress because she was an indoor cat. The vet also said she needed to lose some weight and recommended the RC Satiety dry food. After a week or so Saoirse's coat was in tatters and she just wasn't right in herself so I switched her back to the moderate calorie s/o diet. The coat condition improved straight away. I have a horrible feeling I had been feeding my cat the nutritional equivalent of cardboard.

For years Saoirse was on starvation rations but still couldn't lose weight, and had a bald tummy. No answers from the vet.

Then came the diabetes. Saoirse's coat condition was bad again and she had the hallmark PU/PD and polyphagia clinical signs. Plus the naked tummy. The vet point blank refused to run any diagnostics (no hyperbole here), gave Saoirse a Dx of "old lady" who'd "had a good innings" (she had just turned fourteen), administered a steroid jab and packed us out the door. FDMB, another week, evidence gathered and a different vet at the practice secured the FD diagnosis. A subsequent ultrasound scan revealed Saoirse also had an inflamed pancreas.

With insulin treatment and a switch to wet, low carb food all the fur on Saoirse's tummy grew back in weeks! WEEKS!!! The only two changes were the insulin and the food. My girl had something wrong that could have been addressed and the vet completely missed it - FOR YEARS!!! When Saoirse was in remission she did not lose the fur on her tummy so the only consistent change was her food.

I know this is only anecdotal but I am convinced that the RC food was a causal factor in her development of pancreatitis and diabetes. I've been a member here since 2014. In the time I've been active on the board I've been struck by the number of cats that had been on RC Urinary dry food prior to developing diabetes.

I fed my little ones dry foods on a vet's recommendation: he said it was much better for them than wet food. It was only when I was pointed in the direction of catinfo.org did I discover that the urinary tract issues my cats had had were very likely to have been caused by their dry diet. I lost one cat to urinary tract issues (and an atrocious vet) and very nearly lost her brother a couple of months later (saved by a wonderful vet - had to be catheterised for a blocked urethra).

Do I think some foods can cause health problems in cats? Absolutely. Can I prove it? Alas, no.

I wish to God I had found catinfo.org when my furchilder were young.


Mogs
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That website is amazing. Couldn’t agree more!

It’s sadly a common misconception that dry food is better for them. I believed that until a vet made the analogy of a human eating chips or crackers only. Hindsight is 2020. We can and should focus on looking forward

 

I still feel like carp about it. I think I always will.

All I ever wanted was to give my little ones things that would do them good, and for them to have long, happy and healthy lives. I completely trusted the vets instead of finding out for myself.


Mogs
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I have a couple of thoughts to add. Whether you change vets depends on how much you like your vet. If you like your vet for most things, tell your vet (not ask, but politely tell) that you would like a referral so you can get a second opinion about the tumor since you're losing sleep worrying about it. You could also ask if it would be appropriate to get a fine needle biopsy given that there's a history of cancer in your cat's littermate. I'm attaching an article on the Tight Regulation Protocol for Lantus. It's from a leading veterinary journal. Perhaps it will convince your vet that you are doing your homework. It may help to keep in mind that in vet school, vets get about an hour of training in diabetes and it covers all species. I tend to look at any doctor as my partner. We need to collaborate. If they can't collaborate, we're not going to work well together. You're Sissy's caretaker and you're the one paying the vet bills.

We've seen any number of cats whose diabetes is induced by some other medical condition. The big trigger is typically that the kitty was put on a course of steroids. But there are other conditions which can get a cat into diabetic numbers -- hyperthyroid, Cushings disease, any infection or chronic source of stress. Infections are a source of stress and cause corticosteroids (stress hormones) to be released and it can tip the balance into diabetes. If your cat had been eating a high carbohydrate diet, that likely doesn't help. And sometimes, there's no discernible way to know why a cat becomes diabetic any more than there can be for a human.

Like Chris indicated, the sooner you can identify that your cat is diabetic and get the numbers into a better range, the better the chance is for remission. The German Lantus group, which is the group that provided the kitties for the development of the Tight Regulation Protocol, indicated that a "newly" diagnosed cat is within a year of diagnosis. Roughly 80% of their cats were tightly regulated or in remission within that year.

I'm surprised no one directed you to probiotics for the problems with diarrhea. S. boulardii is a probiotic I always have in the house. (I also have a kitty with IBD.) Either ReNew or Jarrow's S. boulardii with MOS are 2 good options. It sounds like you found a food that doesn't upset Sissy's GI track. Did you try to sort out why the Weuva is working? Were there certain proteins that were a problem? Frankly, most of the prescription foods are not made with quality products. Weruva is a high quality food.

I'd also like to make a suggestion. If you've not already looked at the sticky notes in the Lantus, Basaglar, and Levemir forum, you may want to do so. There is information on how Lantus works as well as on dosing. You may want to consider posting there.

 

Thank you all so much for sharing your thoughts and stories. I can't reply to each, but I do appreciate it so much!!

I'll touch on a few things mentioned in the last several posts. Do I like my vet? Yes and no. She is "one of a few feline specialists in the country". I posted her bio from their website in one of my other threads. She's been a feline specialist for over 30 years I believe. I copied the dosing methods and info from the Lantus board and gave to her so she'd know I wasn't just taking the advice of just anyone. She looked at it and then told me she was amused they were using an outdated study, and that I can find all kinds of info on the internet. After looking it over she wanted me to give Sissy 2 units of insulin in the mornings and 1 at night based on her morning highs. I decided to do just the .25 increase and I haven't talked to her since that day. I changed spreadsheets so the one she had access to isn't good anymore. I don't think I will be able to have a collaboration with her. I think my best bet is to possibly go back to our old vet. We had been with him over 20 years, but we moved a few years ago and it was a little bit of a drive so we started seeing this lady because she was closer and was a specialist in cats. We will be moving again in the next couple months...moving back to where we consider home...and will be closer to our old vet. I'll probably call his office tomorrow and see if I can find anything out.
I do want to have the ultrasound. I just want to make sure she's okay. Her brother did die of cancer, and her other brother died last fall of suspected cancer. He had been sick and they did some x rays and found lungs full of calcium deposits. We were waiting on the follow up from that appt and he threw a blood clot...and before we could get him to the ER he had thrown more. We lost him that day and that story is so heartbreaking I can barely think of it. I got the 3 of them as 1 day old bottle babies two months before my youngest was born..and Tiger, the one we lost in the fall, immediately attached himself to her when she came home from the hospital. We found out shortly after birth she has a neuro disorder and some other issues...Tiger was her constant companion. They had a bond like nothing I've ever seen. My daughter was devastated when we lost him...it's been so very hard. We're coming up on a year next month. Anyway...there is a history of cancer with my little kitty babies...Our vet knows all this though, so it's sad I wold have to push.

The vet gave us flora something to put on her food for the runs. She wouldn't eat it. She wouldn't eat anything we tried mixing in..she was barely eating anything though...the one thing she didn't notice was that benefiber. And it worked...within like 2 days.

We still aren't sure what was the cause of her licking her hair off. She was completely bald on her belly, forearms both of her sides leaving a mohawk strip up her back she couldn't reach. I took her to the vet when I noticed the first little missing patch and they did blood work and looked her over and didn't see anything everything was normal, no fleas or anything. So they suggested we try limited ingredient foods and to stay away from top allergens. The list as insane though...She had been eating Fancy Feast and Friskies most of her life...with a very little bit of Nutrish chicken dry at night to keep them happy so we could sleep. We tried a bunch of things but it was frustrating. Now I look back and realize we didn't give it long enough each trial. When we gave up and started the z/d they said it would take 6-8 weeks to work...and sure enough about 6 weeks in she had peach fuzz everywhere and it just came in great after that. But she did start getting sick a few weeks later...not wanting to eat etc. After her diagnosis the only thing she'd eat was boiled chicken. So we just started giving her limited ingredient food with only chicken...and she ate some but eventually refused that and the boiled chicken and wouldn't eat. So we looked at the ingredients on the FF and Friskies she used to eat and avoided all but the chicken and got her some weruva with chicken, rabbit, lamb...things she had never had before other than chicken. So far so good. I stress every time I see her grooming, but I can't see anything weird in her coat yet so hoping beyond hope we don't have issues...cause I really don't know what I'd feed her..she is SOOO picky. It makes me crazy trying to find something she'll eat, with the right proteins and right carbs...I've about lost my mind the last few weeks reading food labels.

I'd like to start posting in the Lantus group, it feels a bit intimidating so I haven't yet. lol

Again, thank you all so much. I don't know what I would have done the last several weeks without this group.

 

Gotta laugh at that one....there's a whole website dedicated to feline specialists

China went to one of the feline specialists too....she wanted me to put her on Royal Canin Glycobalance and told me it wasn't necessary for me to test her at home.

 

They didn't even mention testing at home. Just that We needed to come to learn how to shoot and that they'd have us bring her for the next week. She was out of town, so the vet tech of another doctor showed us how to do it...and nobody even mentioned hypo or hpo symptoms or anything. Just instructions to shoot and that's it. Thank goodness I found this sight the day before and I asked them about home testing. He didn't know anything...so I just went home and read here.

This is about our vet.."he is known as “The Cat Doctor” and is one of the few Feline Specialists in the country, board certified in Feline Practice since 1995. She has worked specifically with cats for over 30 years and understands their unique needs". I was unable to convince her that the information found here was sound...and after discussing this sight and her looking at the info I sent and telling me basically the info was flawed...to go ahead and give her the 2 units in the morning because in her experience her methods work. I know that she is VERY well liked and highly recommended in our area. That's why we went there...and up till the issue with Sissy getting sick and all that's followed we've been okay there.

 

She may indeed understand felines' unique needs in some cases, perhaps, but ...

... she categorically does not understand how depot insulins work, and her understanding of certain mammalian circadian rhythms is a tad patchy (e.g. dawn phenomenon).

[Emphasis mine]

So the vet dismisses a peer-reviewed study, offers no peer-reviewed studies she considers suitably up-to-date to support her own claims. and instead relies on her own empirical experience because "[her] methods work." How well do they work? Anecdote is not the singular of data.


Mogs
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I look at it like this: She doesnt know EVERY CAT hence ECID
Here you have the benefit of ALLLL these insulin veterans and their working skills and stories.
You make the call.
j