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travismom01

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Hi everyone. My 3 year old tabby named Travis was just diagnosed last week with Feline Diabetes. I am still semi-questioning this diagnosis. I originally took him to the vet for a cough I had noticed along with weight loss. The vet did a veinpuncture and called back with the results of "he is diabetic. his glucose is high. everything else looks good. " We went and picked up the vet-recommended food along with medication (Glipizide 5mg- 1/2 tablet twice a day). They also gave him a cortisone shot for cough and said it was most likely upper respiratory allergies.

I had noticed no symptoms other than weight loss (3lbs) in him. He is lovable, playful, and didn't notice him eating or drinking more often. Although we do have other cats, so sometimes it's hard to keep up. However, he is just not acting right now. He is lethargic, hiding, no real appetite, and his eyes are droopy. He did drink a good bit of water this morning, but I am wondering if it is not something else that caused the high blood glucose? Do you think he is truly diabetic? I guess the bloodwork would have shown kidney problems? We just lost one a few months ago to kidney failure and it was hard to watch. Giving him IV fluid infusions at home, etc. I took his blood sugar this morning and it was 227 so I know that is high especially at home in his own environment.

What do you think? Where do I start? I'm very worried about him as he is completely out of character since the vet 3 days ago.
 
Hi and welcome to FDMB

Sounds like you have had a rough time of it lately with Travis.

First...if Travis had any sort of infection that can certainly cause glucose levels to be higher. Did they give any antibiotics for the suspected respiratory infection? If they gave a shot of cortisone that will also push up his glucose levels.

Next..what sort of food are you feeding. For any cat a low carb WET only food is best, but especially for a cat with high blood sugars. Dry food. prescription or not is not a good choice although many vets unfortunately do push it. Also any low carb wet such as Friskies pate of Fancy Feast pate will be less than 10% carbs, which is suitable for a diabetic cat. You do not need the expensive prescription foods,

I see you have been doing some home testing...GREAT!!! Glipizide pills are not a good choice for cats, as they cause the pancreas to work harder, when the best approach is to "rest" the pancreas and let it heal. Unlike humans cats are able to heal their pancreas and can very possibly go into remission. I might suggest doing a number of tests through the day. A morning test before you give the pill, then a test at maybe 4-6 hours after. I am not sure how quickly glipizide enters the system and begins to work, but having some tests spread apart would tell how it is actually working for Travis.

If you are using dry food and decide to transition to an all wet low carb food, then you may have to reconsider whether to give the pills at that point. Some kitties can drop 100s of points just from changing from dry to wet low carb.

If you have other questions you can post on the Main Feline Health forum here:

http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

It gets a lot more "traffic" and there will be lots of people who can assist you and answer questions. :)
 
Welcome to you and Travis. I am still new here so I don't have any advice to give, but the acting out of sorts could definately be the higher BG from what I've seen from my Cooter. It just seems to make them feel crappy :( Hope you can get your guy on the road to remission, the folks here are wonderful!
 
I don't want to scare you but I would be very careful giving him the glipizide. Unlike insulin injections which wear off after a certain period of time, glipizide just keeps pushing the pancreas to work harder and has the potential to cause scvere hypoglycemia. If Travis has had the glipizide this morning and he's not eating well, it's even more vital that you check his BG throughout the day (as suggested by Mary Ann) to make sure his BG doesn't drop too low. From your description, assuming that Travis was not lethargic, eating well etc. before starting the glipizide, I wonder if that 227 you got this morning is a bounce from having his BG drop too low yesterday. Just speculating but I would be careful because glipizide doesn't have an off switch and the usual interventions we use with insulin to reverse low BG levels do not work with Glipizide and you'll have to take him to the vet for treatment.
 
MrWorfMen's Mom said:
Just speculating but I would be careful because glipizide doesn't have an off switch and the usual interventions we use with insulin to reverse low BG levels do not work with Glipizide and you'll have to take him to the vet for treatment.
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Thank you for mentioning this. I had forgotten that a glipizide induced hypo could not be treated at home with the usual methods and would require a trip to ER.
 
Thank you very much everyone! Such great information! I am a nurse, but oftentimes am not sure how much of my human knowledge can cross over to my kitty knowledge. I'm going to try to keep a BG curve for a day or so. He has only had one of the Glipizide which was this morning. He is just walking slow almost like he's hurting and very lethargic. He did eat a good bit of tuna and drank the water from it, but I'm not sure if it's not something else completely that we're dealing with....all I have to go on is those words, "he's diabetic. everything else looked good." from the blood work.

He has been on wet food--Friskies--once a day and then a bowl of dry food out for him to munch on during the day. The dry food is disappearing as I have read such bad things about it! I had no idea! And I'm hoping this will change our glucose problems. I don't want his little pancreas to have to work any harder! Would you get a second opinion?
 
Tuxedo Mom said:
Thank you for mentioning this. I had forgotten that a glipizide induced hypo could not be treated at home with the usual methods and would require a trip to ER.
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This is very good to know as this was definitely not told to us at the time we got the medicine!
 
travismom01 said:
This is very good to know as this was definitely not told to us at the time we got the medicine!
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Glipizide is not recommended for kitties. First it cause the pancreas to work harder, when in reality you want to pancreas to rest and heal. Second as Linda posted (thanks Linda) you cannot control a glipizide hypo with syrup and high carb food the same way you can with an insulin hypo. Some insulin hypos may require ER intervention if they are low enough but with glipizide it continues forcing the pancreas to produce more insulin, which will cause the numbers to go lower until the glipizide actually wears off.
 
Tuxedo Mom said:
Glipizide is not recommended for kitties. First it cause the pancreas to work harder, when in reality you want to pancreas to rest and heal. Second as Linda posted (thanks Linda) you cannot control a glipizide hypo with syrup and high carb food the same way you can with an insulin hypo. Some insulin hypos may require ER intervention if they are low enough but with glipizide it continues forcing the pancreas to produce more insulin, which will cause the numbers to go lower until the glipizide actually wears off.
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Sounds like I'm going to need a second opinion! Would you guys recommend that I try solely switching food and checking BG trends or get him into another vet immediately?
 
travismom01 said:
I am a nurse, but oftentimes am not sure how much of my human knowledge can cross over to my kitty knowledge.
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Same here but I have learned that those instincts that worked with humans usually work with my kitties too! Trust yourself. You know your cat better than anyone else.

I am curious as to why the vet prescribed glipizide as opposed to insulin. While some vets do prescribe it, it's more often when the pet parent doesn't like needles or refuses to do them. It's pretty common knowledge that it's not the optimal choice for cats and I'm going to go out on a limb here, since you are using the pet meter, and assume that your vet recommended home testing. Most "out of date" vets do not do that and even frown upon home testing.

It certainly wouldn't hurt to get a second opinion but as long as Travis doesn't get bad enough you feel he must see the vet, I'd be inclined to skip the glipizide tonight and tomorrow and do spot checks of his BG at different times through the day before going that route. That 227 is not terribly high and if he does have an infection, that could explain the elevation. Did the vet check his urine for glucose or run a fructosamine test? He also was given a shot of prednisone which could cause some BG elevation. In short, I think your instincts about the diagnosis being incorrect could be right and only by getting some spot tests without any glipizide on board, will you get a true picture of what his BG levels are in his normal environment.

And yes ditch the dry food and stick with low carb canned. Better for them all round anyway!
 
travismom01 said:
He has been on wet food--Friskies--once a day and then a bowl of dry food out for him to munch on during the day. The dry food is disappearing as I have read such bad things about it! I had no idea! And I'm hoping this will change our glucose problems. I don't want his little pancreas to have to work any harder! Would you get a second opinion?
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If you are changing from some dry food to an all wet food...Friskies is fine as long as it is the pate form...the Friskies with gravy or sauce is higher carb.....then you might ask you vet (hopefully she is experienced enough with FD) whether it might be better to stop the glipizide and do some home monitoring for a short while to see how the numbers are without dry food. We have actually had cases where a kitty has gone off insulin within a week or two just from removing dry food and feeding a low carb wet food. With having had the cortisone shot that could also keep glucose levels up for a period of time and when the effect wear off the numbers could drop. Just throwing some thoughts out there :)
 
MrWorfMen's Mom said:
Same here but I have learned that those instincts that worked with humans usually work with my kitties too! Trust yourself. You know your cat better than anyone else.

I am curious as to why the vet prescribed glipizide as opposed to insulin. While some vets do prescribe it, it's more often when the pet parent doesn't like needles or refuses to do them. It's pretty common knowledge that it's not the optimal choice for cats and I'm going to go out on a limb here, since you are using the pet meter, and assume that your vet recommended home testing. Most "out of date" vets do not do that and even frown upon home testing.

It certainly wouldn't hurt to get a second opinion but as long as Travis doesn't get bad enough you feel he must see the vet, I'd be inclined to skip the glipizide tonight and tomorrow and do spot checks of his BG at different times through the day before going that route. That 227 is not terribly high and if he does have an infection, that could explain the elevation. Did the vet check his urine for glucose or run a fructosamine test? He also was given a shot of prednisone which could cause some BG elevation. In short, I think your instincts about the diagnosis being incorrect could be right and only by getting some spot tests without any glipizide on board, will you get a true picture of what his BG levels are in his normal environment.

And yes ditch the dry food and stick with low carb canned. Better for them all round anyway!
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Again Linda you and I are on the same page with our advice. ;)
 
Oops! :oops:I think I wrongly assumed you were using a pet meter. Must have looked at Mary Ann's signature! My bad! Anyway just so we are all on the same page, can you let us know what meter you are using? Human meters are fine but they do read lower than pet meters so this is important info so we can advice you properly. :)
 
MrWorfMen's Mom said:
Oops! :oops:I think I wrongly assumed you were using a pet meter. Must have looked at Mary Ann's signature! My bad! Anyway just so we are all on the same page, can you let us know what meter you are using? Human meters are fine but they do read lower than pet meters so this is important info so we can advice you properly. :)
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Actually that was with a human meter! I tried to get another sample just now to test (8 hrs post Glipizide) but he wasn't cooperating at the moment!
 
Ok, that's fine. I just wanted to give you some guidelines.

Normally while using insulin, we consider a reading of 50 on a human meter to be warning of a possible hypo situation and we intervene with a little low carb food and re-test in about 20 minutes to see if the number is rising. We continue to test/feed until we get 3 readings that are rising without having to give more food. Personally (and I admit I tend to be overly cautious), I'd probably make my warning number 80 or 90 to leave some extra breathing room with the glipizide. You likely won't need any of this but better to be prepared.

Here are the directions for dealing with low numbers.

Again though, these procedures won't work as effectively with the glipizide so early intervention is key.

Let us know what the reading is when you do manage to get him to co-operate!:cat:
 
MrWorfMen's Mom said:
Ok, that's fine. I just wanted to give you some guidelines.

Normally while using insulin, we consider a reading of 50 on a human meter to be warning of a possible hypo situation and we intervene with a little low carb food and re-test in about 20 minutes to see if the number is rising. We continue to test/feed until we get 3 readings that are rising without having to give more food. Personally (and I admit I tend to be overly cautious), I'd probably make my warning number 80 or 90 to leave some extra breathing room with the glipizide. You likely won't need any of this but better to be prepared.

Here are the directions for dealing with low numbers.

Again though, these procedures won't work as effectively with the glipizide so early intervention is key.

Let us know what the reading is when you do manage to get him to co-operate!:cat:
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So we are at 202 with the human meter...he has not been to the bathroom all day. Just been laying looking out the door watching birds and squirrels and cuddling with his sister...
 
202 is high but not horribly high and could result from an infection and/or the cortisone he was given. That said since he had the glipizide this morning, no telling how high he might have been without it. I'd still be inclined to withhold the glipizide tonight and get some spot checks tomorrow including a couple when food has been withheld for at least 2 hours and a couple an hour or so after he has eaten to get a feel for how his BG fluctuates. It's likely that just removing the dry food alone will result in a lowering of his BG too, although how much effect it will have will depend on the ratio of soft to hard food he has been eating up till now.

Do you mean no urine and/or no bowel movement? If no urine, I would check him for dehydration. If you pinch up his scruff it should immediately bounce back into place. If it seems slow to do so, then he is dehydrated. If he seems dehydrated, then perhaps a trip to the vet might be your best choice. With you saying he has suddenly become lethargic, decreased appetite, and if he is not peeing, and possibly has an infection, I'd be concerned about ketones and possible diabetic ketoacidosis. If he has not peed all day and is still acting poorly, I would take him back to the vet ASAP. Ketoacidosis can be very expensive to treat and can be fatal if not caught early.
 
Until the glipizide wears off don't change his food to low carb; it would increase the risk of a hypo.

I'm with Linda on the recommendation to get a vet to look Travis over - especially as he's not peeing and doesn't seem right in himself. Given that Travis seems off his food, if ketones aren't an issue ask if they can run a SNAP fPL test to determine whether or not pancreatitis may be a factor. If Travis is dehydrated that would make him feel lousy. Your vet may be able to administer fluids to help with that.

Keep an eye on him in the meantime for signs of nausea. Helpful symptom checker link below:

Nausea symptoms and treatments

Once the glipizide dose has worn off you may be able to check for pancreas function by doing the following:

1. Lift all food and wait 2 hours then test to get a fasting BG level.

2. Feed (assuming Travis will eat) then lift the food again.

3. Test at +1, +2, and +3 hours after the meal.

If the BG levels are lower after the food it would give some indication of pancreas function. (Note: the steroid in the system may complicate things a bit.)


Mogs
.
 
UPDATE: Travis ate 1/4 of a can of albacore tuna and drank a good bit of water. He went down to the litter boxes and did his business. His BG 2 hours after eating was 216. But, he really hasn't had any carbohydrates all day. How long do you think the Glipizide will be in his system?

Do you think the lethargy is caused more by a side effect of the Cortisone perhaps? I know this is most likely creating a false high. They did take the blood test at the vet before administering the shot, however, poor little guy was so stressed out.

I'm going to get a baseline BG in the morning and then feed him some FF pate and get a BG 2 hours later. Do you think I will just need to use the higher "normal" and measure the variancy with the cortisone effect?

If he is not better in the morning, I am going to take him to a cat specialist vet locally and have some more testing done. I'm also going to call my vet and get some numbers as far as his test results from Friday. I'm curious about his kidney function. It would make me feel better for a U/A to be run anyways.

Thank you for all of your help! I will keep you updated!
 
Do you by any chance know what type of cortisone shot Travis received and when was it given? Some of the shots are long lasting and can takes several weeks to clear the system completely.


ETA You should get a copy of ALL tests that were done at the vets. You have the right to ask for them since you paid for them. There are a few people here who are able to read lab results pretty efficiently.
 
Be sure to get the +3 test after food, too. Sometimes the BG can still be a little food-influenced at the +2 mark.

Very glad to hear that Travis has been eating and peeing. :)


Mogs
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Tuxedo Mom said:
Do you by any chance know what type of cortisone shot Travis received and when was it given? Some of the shots are long lasting and can takes several weeks to clear the system completely.


ETA You should get a copy of ALL tests that were done at the vets. You have the right to ask for them since you paid for them. There are a few people here who are able to read lab results pretty efficiently.
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I'm going to definitely get a copy in the morning. The steroid says 0.75 Methylprednisolone 20mg/mL. The tests run were Adult Annual Plus Chem 18/CBC/T4
 
travismom01 said:
How long do you think the Glipizide will be in his system?
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Cats have a faster metabolism than humans so best guess, based on dosing twice a day would be roughly 12 hours give or take. I think it's safe to assume it will no longer be active by tomorrow morning. Otherwise there would be a cumulative effect and no way to control it.

travismom01 said:
Do you think the lethargy is caused more by a side effect of the Cortisone perhaps?
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A lot of things can cause lethargy .....an infection, high BG, medication so it may be a combination of a number of things.

travismom01 said:
Do you think I will just need to use the higher "normal" and measure the variancy with the cortisone effect?
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Not sure exactly what you mean by this. A normal BG for a cat goes up and down depending on food intake, carb load of that food, activity, stress of any sort including feeling punky and of course the excitement of watching birds and squirrels from a window, so while you could assume some BG increase from the prednisolone, what that increase would be is anybody's guess. Too many things come into play including every cat being different. Normal BG on a human meter is roughly 50 to 120. If Travis does have an infection brewing given the cough, then that too could be raising his BG.

See what his numbers look like tomorrow and how Travis is feeling and then you can decide next steps. :)
 
travismom01 said:
I'm going to definitely get a copy in the morning. The steroid says 0.75 Methylprednisolone 20mg/mL. The tests run were Adult Annual Plus Chem 18/CBC/T4
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I believe the usual Methylprednisolone injection is Depo-Medrol. From what I could find on duration of action it lasts for several weeks in the system:

"
Injectable
Methylprednisolone 5 3-5 weeks"

http://www.peteducation.com/article.cfm?c=26+1303&aid=1422

This being the case the glucose numbers could take quite a while to recover just from the steroid shot.
 
Tuxedo Mom said:
I believe the usual Methylprednisolone injection is Depo-Medrol. From what I could find on duration of action it lasts for several weeks in the system:

"
Injectable
Methylprednisolone 5 3-5 weeks"

http://www.peteducation.com/article.cfm?c=26 1303&aid=1422

This being the case the glucose numbers could take quite a while to recover just from the steroid shot.
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I read this as well : "Methylprednisolone is a slow release “repositol” steroid that is largely no longer used in cats since the risk is much greater for potential adverse effects than with thee shorter acting oral steroids. Once given, a long acting injection can’t be reversed." BG was 190 this morning after eating a tiny bit of cat food to aid in cooperation. :cat: His eyes seem to be a bit brighter this morning, so we will see how this morning goes. Definitely still calling and getting the lab results to have you guys interpret. Thank you so much to everyone! You have no idea the anxiety you have relieved. I hate not knowing what's wrong with my little guy, but you guys have eased some of my worries!
 
travismom01 said:
I read this as well : "Methylprednisolone is a slow release “repositol” steroid that is largely no longer used in cats since the risk is much greater for potential adverse effects than with thee shorter acting oral steroids. Once given, a long acting injection can’t be reversed." BG was 190 this morning after eating a tiny bit of cat food to aid in cooperation. :cat: His eyes seem to be a bit brighter this morning, so we will see how this morning goes. Definitely still calling and getting the lab results to have you guys interpret. Thank you so much to everyone! You have no idea the anxiety you have relieved. I hate not knowing what's wrong with my little guy, but you guys have eased some of my worries!
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The long acting steroid shot can certainly affect Travis for an extended period of time so this can be having effects on both the glucose levels and his overall demeanour. Your morning glucose of 190 is a bit lower than it was yesterday, which is good. When was the last time you gave glipizide? I was reading through the posts but probably missed whether you were going to withhold the glipizide for the time being. If you have decided to withhold the glipizide then it would be safe to try to transition Travis off the dry food to all wet low carb. HOWEVER if you are still giving the glipizide it would not be safe to make the transition until you have more data.

Poor Travis is dealing with steroids and high carb food at the same time, but this will all get sorted out. It is good to see that he is feeling more himself this morning. You can also be keeping track of how much water he drinks and how much peeing he is doing, since those are also ways of tracking how he is doing, :)
 
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The last time I gave the glipizide was yesterday morning and I do not plan to give it again. He ate some FF pate like a champ this morning. I'm going to keep a close eye on him today. He is still not completely himself this morning, still moving slowly and lethargic, but the appetite does make me feel better. Will keep track of him and let you know the lab results today. Thank you so much!
 
travismom01 said:
The last time I gave the glipizide was yesterday morning and I do not plan to give it again. He ate some FF pate like a champ this morning. I'm going to keep a close eye on him today. He is still not completely himself this morning, still moving slowly and lethargic, but the appetite does make me feel better. Will keep track of him and let you know the lab results today. Thank you so much!
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Thank you for your reply. If it has been 24 hours since you gave the glipizide then most/all the effects of the pill should have either worn off or be close to it. I don't know the half-life of glipizide but it shouldn't stay in the system much past 24 hours. It is promising to see the glucose levels staying in the same range even without glipizide. It may very well be that the steroid shot is still affecting the glucose levels.

Since you are discontinuing the glipizide this would be a good time to start the transition to wet low carb food. You would still want to be doing some monitoring to keep track of Travis's glucose levels and see how they change during the day, especially after eating.

Glad you are getting the lab results today!! :)
 
That 190 this morning is encouraging especially if you had to bribe him with food to co-operate. That might even have a bit of stress influence mixed in. How is Travis' cough? Has the shot of Methylprednisolone made any difference?
 
MrWorfMen's Mom said:
That 190 this morning is encouraging especially if you had to bribe him with food to co-operate. That might even have a bit of stress influence mixed in. How is Travis' cough? Has the shot of Methylprednisolone made any difference?
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His cough has disappeared since the shot. I talked to the vet just now. Original BG was 351. They said ALT was slightly elevated. Potassium slightly elevated. BUN was normal, and Chloride was a little low but nothing extreme. He ate really well this morning. Did drink a good bit of water. All the bases are covered he's just not acting like himself. Acts very sore, lethargic, and when you pick him up he's limp-ish. They said to watch him that it was probably just the high glucose....
 
travismom01 said:
His cough has disappeared since the shot. I talked to the vet just now. Original BG was 351. They said ALT was slightly elevated. Potassium slightly elevated. BUN was normal, and Chloride was a little low but nothing extreme. He ate really well this morning. Did drink a good bit of water. All the bases are covered he's just not acting like himself. Acts very sore, lethargic, and when you pick him up he's limp-ish. They said to watch him that it was probably just the high glucose....
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Where the test done before or after the shot of steroids?

I would continue to check the glucose levels, but at this point the are better than when they were originally done
 
Tuxedo Mom said:
Where the test done before or after the shot of steroids?

I would continue to check the glucose levels, but at this point the are better than when they were originally done
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I agree. The test was done right before he got the shot of steroids. But he was very stressed out. Not a happy kitty. So, I'm sure stress played a part in it. I will just continue to monitor his BG and his behavior. Thanks everybody!
 
travismom01 said:
They said to watch him that it was probably just the high glucose....
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UMMMM, :confused: am I missing something here or is that a rather silly remark? If he was at 351 at the vet's and stressed out and is now at 190 and acting worse now than then, how would one logically attribute the change to the "high" BG? If anything one would expect him to feel better.
The prednisolone could be knocking down some inflammation and improving the cough but that still doesn't rule out an infection. Is his abdomen tender at all? Just wondering if he could have a mild pancreatitis?
 
Exactly!!! No, no tenderness in the abdomen. She said WBC was normal on Friday, but that doesn't mean it hasn't gone up since then...I was thinking pancreatitis, too, but no tenderness, vomiting, etc. but he's so lethargic it still makes me lean towards that. He acts like his joints are hurting.
 
A slightly raise ALT is not too worrisome. ALT can be slightly elevated just from the higher glucose levels or as Linda suggested from mild pancreatitis. Potassium can also be slightly elevated from high glucose, but it is important to make sure the potassium does not become too high or too low.

If you can get actual copies of the test results and post the actual readings it may tell a better story.
 
travismom01 said:
Exactly!!! No, no tenderness in the abdomen. She said WBC was normal on Friday, but that doesn't mean it hasn't gone up since then...I was thinking pancreatitis, too, but no tenderness, vomiting, etc. but he's so lethargic it still makes me lean towards that. He acts like his joints are hurting.
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My Tuxie has chronic pancreatitis with a very high fPLI reading because of his early Cushing's disease. He has only had 2 acute attacks in the last 17 months that required any intervention with fluids and pain relief. Most vets can do a snap fPLI test that will either say yes or no to pancreatitis. This can be done in the office and will give immediate results. However if the test is positive it won't tell how high the numbers are...just a yes or no. There is another test the specific fPLI test that can be done but this has to be sent to an outside lab, such as IDEXX to have the test done. I have had 2 of the specific fPLI tests done but never the snap test, but I imagine the snap test is much cheaper. Something to keep in mind.
 
MrWorfMen's Mom said:
UMMMM, :confused: am I missing something here or is that a rather silly remark? If he was at 351 at the vet's and stressed out and is now at 190 and acting worse now than then, how would one logically attribute the change to the "high" BG? If anything one would expect him to feel better.
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I totally agree with Linda. Travis has better numbers now than previous so if anything the lower glucose SHOULD be making him feel better. I wonder if this is still a carry over from the steroid shot???
 
Tuxedo Mom said:
I totally agree with Linda. Travis has better numbers now than previous so if anything the lower glucose SHOULD be making him feel better. I wonder if this is still a carry over from the steroid shot???
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I mentioned it to them and they were like "well normally it's used to treat sickness, not cause it..." I am getting frustrated...makes me more empathetic for my patients' families! He's hiding in the curtains sleeping now. That's where he goes in the winter time when he's cold. (hiding cats always make me uncomfortable) Everything I've read about the possible side effects of the steroid shot points straight toward that part...but IF the diabetes happens to be a misdiagnosis, then what caused the 3lbs weight loss in the first place?
 
I hate to say it but this is beginning to sound like another questionable vet. First they prescribe glipizide not recommended for cats unless there is a specific reason to try it (phobia of needles etc. which obviously doesn't apply here). They diagnosed diabetes on basis of blood work only and didn't check urine for glucose or do a fructosamine to see what levels have been over past week or two. Correct me if I am wrong on those last two points! They give a cat they just diagnosed as diabetic, long acting prednisolone for a "suspected" allergic condition which unless absolutely necessary, would normally be counter indicated. And then they attribute a lower BG as the cause of increased lethargy and more symptoms of illness. To boot, while it does happen (my cat was only 4), it's the exception not the rule for a 3 year old cat to be diagnosed with diabetes. I think I'd be looking for another vet about now.

I'd check his BG a few more times today and keep a record and if he is not feeling better by tomorrow, my inclination would be to pursue that second opinion., If he is diabetic, he needs to get on appropriate treatment ASAP but that diagnosis still remains a big question mark though within the realm of possibility. If there is something else going on, it needs to be identified as so many things can and do elevate BG. The weight loss and cough could be due to something else.
 
travismom01 said:
I mentioned it to them and they were like "well normally it's used to treat sickness, not cause it..." I am getting frustrated...makes me more empathetic for my patients' families! He's hiding in the curtains sleeping now. That's where he goes in the winter time when he's cold. (hiding cats always make me uncomfortable) Everything I've read about the possible side effects of the steroid shot points straight toward that part...but IF the diabetes happens to be a misdiagnosis, then what caused the 3lbs weight loss in the first place?
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And how many medications are people taking that cause other complications which end up requiring more medications to correct the problem caused by the first medication and so on and so on. SHEESH!!!

I agree with Linda that looking for a new vet is looking like the best idea at this point.
 
Also, now that some time has elapsed since you have given the glipizide. starting to transition Travis to a wet low carb diet might be another thing to start. Dry foods which are high carb will cause glucose levels to be higher and also keep them high.
 
travismom01 said:
You have no idea the anxiety you have relieved.
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Ooh, I think we might have just an inkling! ;) Most of us arrive here in a panicked heap. It's so hard that our little furry ones can't tell us what's up, but thanks to this wonderful community it has helped me to 'listen' to what my beloved girl's body is telling me. :bighug:

travismom01 said:
He's hiding in the curtains sleeping now. [...] (hiding cats always make me uncomfortable)
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Saoirse did that when she was on the blood glucose roller coaster that is typical of treatment with Caninsulin. I think it was possibly hammering her pancreas and liver. She was a different cat - my cat - on Lantus which has a much gentler action. I wonder whether the combination of the steroid and glipizide might have put quite a strain on Travis' system? (Brainstorming here.)

In case it proves that pancreatitis were at the root of all this, first up absence of vomiting and diarrhoea does not rule out pancreatic inflammation. Secondly, here are some links that I have found extremely helpful for managing Saoirse's pancreatitis issues:

Nausea symptoms and treatments

IDEXX pancreatitis guidelines

I'm on the same page as Linda (@MrWorfMen's Mom) in terms of wondering about the soundness of the diabetes Dx. I'd also like to know whether the Dx was based on proper diagnostics (BG tests, urine glucose tests and, critically, a fructosamine test.) I, too, have alarm bells ringing about the soundness of your vet's knowledge of and expertise in the treatment of feline diabetes. I base this concern upon the fact that your vet reached for glipizide as a first line treatment; in the absence of resistance of the caregiver to administering insulin injections it was a very poor clinical decision.


Mogs
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