Seems weak and difficulty walking

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CassWTribby

CassWTribby

Member Since 2017
Morning everyone,

I woke this morning to the sound of Tribby falling off the table I put her wet food on at night so she can eat if she needs too. I got up right away and took her BGL. It was 10 with a human meter. Not terribly low for her. It's typically 1-2 when she in in hy hypo. I gave her some honey just in case.

She's eating and drinking well. Doesn't seem stressed but having a lot of difficulty getting around. Seems to loose her balance and cannot walk straight or jump up or down safely. She has recovered from hypos well in the past but I'm not sure if this is one or not. I'm going to do another BGL check in a bit. I did not give her insulin this morning.
Thoughts? Anyone been through something similar?
My vet is open today but funds are limited...

Thanks,

Cass and Tribby
 
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Is she still having difficulties? Have you tested her for ketones? I know your funds are limited but I'm afraid this may warrant a vetty visit.
 
A urine test? I have hydrophobic sand and test strips. Not sure if they are for ketones.
Should I give her insulin?
 
Is the sand part of a kit you got from the vet? The packaging on the strips should say what they test for. You need strips that test for ketones or ketones and glucose. If they are for glucose only, they are not the right ones.

As long as Tribby is eating and her BG is high enough which it seems to be, it should be safe to give her insulin. Has Tribby shown any signs of leg weakness prior to this morning? Has she been eating well? Is she still peeing copious amounts? Her weakness could be a sign of diabetic neuropathy or low potassium or a combination of both. Low potassium is dangerous and I too would highly recommend a vet visit especially if this is sudden onset rather than a worsening of a previous weakness.
 
Is she walking in her hocks? I'm wondering if she's developing neuropathy in her back legs.
 
I'm not sure what test strips. I bought the kit at a pet store when she first was diagnosed. I did give her insulin 1/2 u less as her BGL was 14.4 and she was eating well.

Just back from the vet. He wasn't sure. Took blood for a thorough check and will call after hours as soon as the results are in. Possibly tonight or tomorrow.

Dr said it could be liver or kidney? He doesnt think it's ketones at all or a hypo. To continue insulin, prednisolone and flagyl as per usual.
I'm worries! Need to figure out a way to keep her safe from falling or getting hurt while walking around. She's very wobbly and unbalanced. Her legs are normal and she's using them normally. Just not able to walk in a straight line, kind of leans towards the left side. She cannot jump up at all, better going down.
Fingers crossed....
Thanks everyone.
 
CassWTribby said:
I'm not sure what test strips. I bought the kit at a pet store when she first was diagnosed. I did give her insulin 1/2 u less as her BGL was 14.4 and she was eating well.

Just back from the vet. He wasn't sure. Took blood for a thorough check and will call after hours as soon as the results are in. Possibly tonight or tomorrow.

Dr said it could be liver or kidney? He doesnt think it's ketones at all or a hypo. To continue insulin, prednisolone and flagyl as per usual.
I'm worries! Need to figure out a way to keep her safe from falling or getting hurt while walking around. She's very wobbly and unbalanced. Her legs are normal and she's using them normally. Just not able to walk in a straight line, kind of leans towards the left side. She cannot jump up at all, better going down.
Fingers crossed....
Thanks everyone.
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goodness... I'm wondering then if it was a neurological event.... like a stroke. or high blood pressure.
 
JanetNJ said:
goodness... I'm wondering then if it was a neurological event.... like a stroke. or high blood pressure.
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That's what I wondered at first. He gave her a full exam and doesn't think its anything like that. He suspects liver or kidney. Hopefully the blood work will show what it is.
 
MrWorfMen's Mom said:
I would suggest you call the vet just to ensure they are checking electrolytes as the symptoms you describe could be low potassium related. Sad as it sounds, it's not always something that comes to mind for all vets so it doesn't hurt to be sure this gets covered.
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Ah yes, low potassium is possible. That should show in the blood work.
 
I called and confirmed they are checking potassium and electrolytes. Is there a supplement I could give her for potassium? Or a type of food to boost potassium. She just had some tuna juice as was a bit dehydrated. It is finally hot here as well.
 
CassWTribby said:
He doesnt think it's ketones at all
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Did he actually test for ketones? The only way to know is to test the blood or urine.
CassWTribby said:
Is there a supplement I could give her for potassium?
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Yes, but potassium should only be given under the supervision of your vet. Kitty must be monitored carefully by the vet when giving potassium. Wait for the test results and discuss with your vet before doing anything about potassium.
 
CassWTribby said:
I called and confirmed they are checking potassium and electrolytes. Is there a supplement I could give her for potassium? Or a type of food to boost potassium. She just had some tuna juice as was a bit dehydrated. It is finally hot here as well.
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There is a supplement for potassium, if it is indeed low potassium. My kitty is on a regular maintenance of potassium supplement, gets it twice a day with meals. They're manufactured by different companies, the one my vet put Squallie on is Vetoquinal Renal K powder. As Jill said, it needs to monitored by the vet.
 
I'm waiting on results from the vet today. Technically they are closed but he said he would call if they come in.

Poor Tribby seems a bit worse this morning. :(. She is very unsteady. Fell off the side table first thing and then fell into the kitchen sink. I've moved all her dishes to the floor and put a litter box near by. She seems worse then yesterday poor kitteh. I'm hoping we get results and a treatment ASAP because I cannot leave her like this for long. I'll post as soon as I know.
 
Sending healing vines and positive waves to you and Tribby
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Sending positive thoughts for Tribby and :bighug::bighug::bighug::bighug: for you! Do you have an after hours telephone number for your vet? Might be worth calling and letting him know she seems to be worse this AM.
 
I'm so sorry. If she's in distress is there an emergency vet near you? It's really looking like a stroke to me. I hope you get answers one way or another. :(
 
Bad news. Loohs like kidney failure and the IBS is affecting her blood levels as well. My Vet is recommending IV fluids which I can do at home.
Any idea where I can get an IV kit for sub q fluids at home?
I'm thinking it's time to euthanize. She cannot be comfortable at the current stage of her immobility. I don't want to postpone the inevitable and end up with her suffering.
Thoughts?
 
JanetNJ said:
I'm so sorry. If she's in distress is there an emergency vet near you? It's really looking like a stroke to me. I hope you get answers one way or another. :(
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She's not in distress exactly. Eating and drinking well. But she cannot jump or keep her balance. She falls from counters etc and does not walk well. Her kidney values have worsened since Feb BW.
 
CassWTribby said:
She's not in distress exactly. Eating and drinking well. But she cannot jump or keep her balance. She falls from counters etc and does not walk well. Her kidney values have worsened since Feb BW.
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I don't see how kidney failure would put her off balance though.
 
JanetNJ said:
Can the vet email you a copy of the labs?
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I asked him to. Her blood work values where much worse across the board since her last in Feb. she's older so it's a combination of things. Fluids may help. More meds may help but that's only prolonging the inevitable. He thinks her system is overwhelmed by the Diabeties and IBS.
 
Kidney disease doesn't cause this walking problem - don't let your vet convince you it does. Dakota's been going thru kidney failure for 2 years now - stable at low stage 3 for last year. It's never made him nor any others that I've read have this walking problem. If nothing else, ask what the potassium level is...low potassium can cause terrible weakness and can be an issue with diabetics as there's a tie between glucose and potassium...this vet isn't doing you or your kitty any good... :(

HUGS and prayers...
 
CassWTribby said:
I asked him to. Her blood work values where much worse across the board since her last in Feb. she's older so it's a combination of things. Fluids may help. More meds may help but that's only prolonging the inevitable. He thinks her system is overwhelmed by the Diabeties and IBS.
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Cats with IBS often need vitamin B12 supplements. If you aren't already giving them, start. Dehydration is a possibility as well. Until you start fluids, put extra water in her food. Do you know what stage kidney failure it is? i started doing sub q's at home when my cat was stage 2... it really prolonged the progression of the disease. Did he check for an inner ear infection? that could throw balance off as well. although it would show as high white blood cell count in the blood work I would think.
 
Squeaky and KT (GA) said:
Kidney disease doesn't cause this walking problem - don't let your vet convince you it does. Dakota's been going thru kidney failure for 2 years now - stable at low stage 3 for last year. It's never made him nor any others that I've read have this walking problem. If nothing else, ask what the potassium level is...low potassium can cause terrible weakness and can be an issue with diabetics as there's a tie between glucose and potassium...this vet isn't doing you or your kitty any good... :(

HUGS and prayers...
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I agree completely. Before you decide for sure it's her time, I would advise a second opinion at another vet... bringing the bloodwork results with you. the vet isn't investigating the cause of the symptoms. :/
 
If you can post the labs, there are some people here who are very good at reading them. I had 2 kidney cats and balance wasn't an issue.

Hard to buy fluids and a kit on a Sunday in Ontario. An ER vet clinic might sell you one at jacked-up prices. Then you could see if it helps.

Long term, you can order from somewhere like Stevens or Surgo or Sands. I spent a little more and ordered from Pets Drug Mart last time. Their shipping was fast.
 
I'm so sorry to hear Tribby's kidneys are failing but like Janet and Lyresa, I am not convinced that is what is causing this sudden onset of imbalance. Kidneys don't usually fail all of a sudden unless there was some toxic substance involved or a major infection/other major illness involved and if the labs were showing substantial kidney issues in Feb. such that complete failure were likely to occur within a few months, I'd expect the vet would have suggested subQ fluids back then. The sudden onset of this seems to suggest a potassium imbalance, vestibular problems or like Janet mentioned something neurological aside from diabetic neuropathy and the potassium would be the most likely if Tribby is still peeing copious amounts. I'd ask for copies of all the lab results from both Feb. and current blood draws for comparison. Yes Tribby is 15 yrs. old but it's not about age.....I have a 19 yr. old whose kidney values were first off a bit several years ago. Yes they have gotten worse but he's still with me and not on Sub Q fluids yet.

You can probably get the lactated Ringers at any pharmacy but likely need a prescription for the IV set up. I would however caution that if this is a case of low potassium, adding more fluid to Tribby's system may actually make the problem worse by flushing her system unless she is provided with a potassium supplement at the same time.
 
I will post the labs once I get them. Her potassium level was fine. That's what I was thinking it may be. I'm just concerned that she will hurt herself falling in the meantime. She's had severe Diarhhea since last October. We have tried many, many things to treat that and have had no luck.
 
Hi everyone. I have her labs. Could someone post them for me? I'm at work and have an older phone. I can forward them to an email.
 
Cass, I only got the June report so I am posting it here. I sent you another private message asking about the Feb report so we have something for comparison. I don't see anything suggestive of kidney issues on the June report. Tribby's BUN is up slightly but Creatinine/SDMA are both OK. Tribby's RBC, Hemoglobin and Hematocrit are down and his WBC is top of normal so there may be something else going on but I don't think this is a kidney issue...maybe an infection but not failure. That said, I do not profess to be an expert on feline lab results but my human experience as an R.N. would make me want a second opinion.

Can someone else take a peak and see if I've missed something?
 

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It would help tremendously if you could limit falls. Move everything to the floor and limit access to tables and counters.

To test for dehydration, you tent the scruff of the neck with your fingers, then let go. If the skin falls back into place almost immediately, then your cat is not dehydrated. If the skin takes more than, say, 2 or 3 seconds, then your cat is dehydrated. Also, you can run your finger along the cat's gum line. It should be moist and not dry or tacky. Adding water to wet food (you cannot add water to dry food) will help.
 
MrWorfMen's Mom said:
I'm so sorry to hear Tribby's kidneys are failing but like Janet and Lyresa, I am not convinced that is what is causing this sudden onset of imbalance. Kidneys don't usually fail all of a sudden unless there was some toxic substance involved or a major infection/other major illness involved and if the labs were showing substantial kidney issues in Feb. such that complete failure were likely to occur within a few months, I'd expect the vet would have suggested subQ fluids back then. The sudden onset of this seems to suggest a potassium imbalance, vestibular problems or like Janet mentioned something neurological aside from diabetic neuropathy and the potassium would be the most likely if Tribby is still peeing copious amounts. I'd ask for copies of all the lab results from both Feb. and current blood draws for comparison. Yes Tribby is 15 yrs. old but it's not about age.....I have a 19 yr. old whose kidney values were first off a bit several years ago. Yes they have gotten worse but he's still with me and not on Sub Q fluids yet.

You can probably get the lactated Ringers at any pharmacy but likely need a prescription for the IV set up. I would however caution that if this is a case of low potassium, adding more fluid to Tribby's system may actually make the problem worse by flushing her system unless she is provided with a potassium supplement at the same time.
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Her potassium is normal. I'm going to try normal pedialyte today. She is slightly dehydrated. I have been adding water to her food.
 
Unfortunately funds are very limited to be seeking another vet. My husband is on disability and I work as a nanny because I can take my young daughter with me. I've used this vet for years so he allows me to pay when I can if needed. A new vet will not offer that option.
 
Did your vet check Tribby's ears? I am wondering if Tribby could have an ear infection which could certainly play havoc with her balance. Her labs are such that an infection is a possibility. Is she on any other medication other than insulin? Any chance she chewed a toxic plant?
 
The bun is elevated, but creatnine is normal. This could simply indicate dehydration. The kidneys aren't bad at all.
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She is however anemic! So get going on the b12 right away!!

The eosinophis levels are very high.... I've never seen that before.... This is what I saw when googleing that.
 
Monocystis is your white blood cell count.... Did the vet give an antibiotic? It seems there could be an infection. Did he look in the ears? Ask about it!!!


Could also be wobbling from the anemia! It makes them weak!!!!!!
 
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Here is a photo of the February labs I'm not sure if it will be legible or not. If not I will summarize it and post again.

There is no kidney function testing on this lab report for comparison. Is there another page they didn't send I wonder? Interestingly, it appears the CBC results, while not identical, do share some suggestions of an infection. With a history of chronic diarrhea, IBD seems a possibility and could be an explanation for at least some of the lab results.

Tribby lab photo.JPG
 
Here is a summary of the Feb. lab results as best I can see. The photo is a bit fuzzy in places.
WBC -20.3 (high)
RBC - 8.3 (normal)
HGB - 11.3 (normal)
HCT - 0.34 (normal)
MCV - 41.0 (normal)
MCH - 13.6 (normal)
MCHC - 332 (normal)
RDW - 23.2 (normal)
Platelets - 337 (normal)
Abs Neutrophils - 18.3 (high)
Abs Lymphocytes - 0.6 (low)
Abs Monocytes - 1.0 (high)
Abs Eosinophils - 0.4 (normal)
Abs Basophils - 0 (normal)
 
So Tribby has had about 40 ml pedialyte and some b12 sprinkled on her food. She is drinking and eating well. He did a full exam. She has had serious diarrhea IBS starting last October. She is on flagyl for her bowel. Also on prednisolone as well. Insulin too. We have tried many, many things for the diarrhea with no success. She was actually at the vet for treatment of the IBS when diabetes was discovered.
She does not have fleas and has been recently dewormed at the start of the diarrhea. No parasites. She's an inside cat so toxic plants are not a concern.
 
I was asked to look at the labs and provide some input.

Actually, I disagree with everyone who thinks the kidney levels are normal :) Sorry about that but the creatinine and the SDMA are at the upper end of the reference interval. This tells me she is potentially in Stage 2 of CKD or has acute renal failure (most likely CKD). Here is some info on CKD Staging in cats.

If you read IDEXX’s comments, it also specifically states:
If SDMA and/or CREA are at the upper end of the reference interval, early kidney disease cannot be ruled out.
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I say “potentially” because there can be other issues that can raise the creatinine but with the SDMA and the creatinine at the upper end of normal, it certainly raises a red flag for me. Having said that, I absolutely do not think this is what is causing her issues.

She is anemic; that is certain. Whether she is anemic enough to cause those symptoms, it’s hard to say. I had a cat at that level of anemia for years and he never had any symptoms but ECID. When we really get worried about anemia and need to add some “heavy guns” is when the hematocrit gets below 20%. That's not to say you don't need to get this figured out...you do because if she has GI bleeding, it must be addressed.

Because she’s got something going on wth her RBCs and Hemoglobin, there is definitely an issue. Perhaps internal bleeding? The low %reticulocytes indicates non-regenerative anemia (most common) but your vet is going to have to do some work to figure out why. Infection/inflammation of some sort can also cause non-regenerative anemia.

I think that is an absolute priority because it could be causing her issues. BTW....CKD (abnormal potassium levels comes to mind) can definitely cause these symptoms but we know that is not an issue here.

How was she diagnosed with IBD? Unless they did an ultrasound or biopsy and they are just assuming she has IBD because she has diarrhea, you don’t know for certain if her B12 levels are low. Usually, with IBD cats, they are and there are tests specifically to determine if B12 is low. A lot of vets give B12 shots without even checking to see if the B12 is low which is not harmful to the cat. B12 sprinkled on her food is not going to address intestinal issues. It needs to be given as an injection.

Did he actually check her blood pressure? IF a GI bleed was causing the anemia, her BP is likely low which can cause weakness. What color is her stools....ever see anything that looks black or like tar?

Have you ever tried Saccharomyces boulardii for the diarrhea? Here is some info you might want to read on IBD and stopping chronic diarrhea. Just scroll down until you get to the heading of "Saccharomyces boulardii”.
 
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