Hi Ashley,
Welcome to you and Lahomay.
Is it possible the tooth could have influenced his levels and he has been misdiagnosed?
Yes, the infected tooth will be playing into elevated numbers and, as Janet notes above, vet stress can also falsely elevate BG levels very temporarily hence the benefit/necessity of including fructosamine test as part of the initial diagnostic work up. Dehydration can also result in 'falsely' elevated numbers (BG needs to be checked again after cat is properly hydrated). For initial diagnosis the vet should not rely on a one-off blood test to make a Dx of feline diabetes. Normally a urine test should be done to see whether the cat has been passing glucose into its urine in the previous few hours (this will not be affected by vet stress) and, as mentioned above, a fructosamine test is run to check whether or not BG levels have been abnormally high over the previous two weeks or so.
However blood and urine tests aren't the whole story; all history and clinical signs need to be considered alongside the results when making a diagnosis. With the history of
months of excessive peeing and drinking (polyuria/polydipsia - PU/PD) plus the weight loss it does point to a longer-term problem. PU/PD can be symptomatic of other cat health problems, not just diabetes. For general info, here are some other clinical signs untreated/unregulated diabetics may present with:
* increased appetite - may range from pestering for food to insatiable hunger (polyphagia).
* Poor body condition (
see chart) - unexplained weight loss is frequently noted (often in spite of increased appetite).
* Poor hair coat condition (possibly dull/greasy, much dander).
* Low mood/depression.
* Less inclined to jump up to higher surfaces, e.g. bed, windowsill (possible mild neuropathy)
* 'Flat-footed' stance or walking on hocks (again neuropathy -may be very slight, may be severe)
* Nausea / loss of appetite / fruity breath (possible ketosis/diabetic ketoacodosis - a medical emergency needing immediate veterinary treatment)
In a few cases a switch to a low carb, wet, species-appropriate diet alone may bring about remission in some cats but more typically newly-diagnosed cats need at least
some insulin therapy alongside the dietary change in order to allow the pancreas to rest and recover some beta cell function before achieving remission (i.e. becoming a diet-controlled diabetic). Treating any underlying illnesses and infections (dental issues being a common problem) can also help move a kitty back to better numbers. Some cats never achieve remission but can go on to live full and happy lives for many, many years as an insulin-dependent diabetic.
According to one scientific study, the best remission rates are achieved by cats who, within 6 months of initial diagnosis, are treated with the longer-acting insulins, Lantus or Levemir, following the Tight Regulation Protocol. See the attached document below for further information. Prozinc is another long-lasting insulin used to treat feline diabetes but according to the study remission rates, while good, are not as high as for the 'L' insulins.
As Janet recommends above, learning to home test your cat's BG will help you learn more about what's really going on with his blood sugar levels and it is the best way of keeping him safe and improving his regulation should he need insulin treatment.
While there is the slightest suspicion that your cat is diabetic (and there is!) note that although your diet change trial is producing a reduction in PU/PD symptoms there is the possibility that his BG levels are still too high (home BG testing will tell you more) and he may actually need some insulin. During this time it is especially important that you regularly monitor your kitty's urine for the presence of ketones (using Ketostix, for example). Ketones can be produced when there is insufficient insulin in the body to support the proper use of glucose to provide energy for normal cell metabolic functions. If ketones show as anything higher than 'trace' it is a medical emergency and the cat needs to be taken to a vet straight away for treatment. If your cat shows any sign of nausea or poor appetite, check for ketones straight away (at home or at vets). Here are some helpful forum 'sticky' posts with further information:
Are you testing your cat for ketones?
Tips for collecting urine samples
There is a wealth of Feline Diabetes educational material on this site (the main forum FAQ section is a good place to start reading) and we have cats here of all ages, shapes and sizes with all manner of backgrounds.
In addition to the reading materials, there is a wealth of knowledge and experience in our member community. Any questions you have or any other help you need, just shout and we'll do all we can to help.
Mogs
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