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Melissa Whitmore

Melissa Whitmore

Member Since 2020
I need some advice please. Freckles saw a new vet practicing at our normal office the last 2 times she had blood work. This past time I was told she has diabetes and hyperthyroidism. They put her on 2 units twice a day and M/D. A week later she jad a curve. Her first test, an hour after dosage, she was at 57. Later she was in 150s and I don't know her last test with them. Sunday night she was close to becoming hypo if I didn't react. They told me no need to home test because their patients don't. I decided to test. Since then she has not needed insulin. I test her every 12 hours. 7am and 7pm. Looking at her test results from 6 months ago and this month. Do you really think she is diabetic? Her symptoms were drinking water constantly and a litterbox full. She had a ravenous appetite. Since I switched her to wet food these have all stopped and she just feels better. She is also on methimazole for her hyperT.
 

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The diet change to a low carb canned food diet can significantly drop glucose levels. It also may be due to the insulin giving a kick to the pancreas to get it working again. Or a combination of the two. When she was diagnosed did she also have any infection? That can also cause glucose levels to be high.

The vet is wrong about home testing. As you have found, it is needed to prevent hypoglycemia. Also 2 units is too high of a starting dose for most cats. If for some reason Freckles does need insulin again, I would recommend starting with 1unit instead of 2. By starting low and if after at least a week of testing you determine you need to increase the dose, only increase it by .25 or .5 unit. Test another week before raising it again if needed. This will allow you to find the best dose that works well to keep Freckles glucose levels under control.
 
The numbers on your spreadsheet are normal blood glucose numbers...looks like the change to low carb canned has done the trick but keep testing for at least 2 weeks

Also, on your spreadsheet, there's a tab for "labs"....since you can see them, you could enter them there
 
Melissa Whitmore said:
I have it on drive and used a screenshot to post on here.
Click to expand...
Try pinching out/zooming on a portion of the BW results and then doing a screenshot. Another, more complicated way would be to make a copy of the BW results and use a a PDF editor to redact your personal information. Then post the redacted BW results.
 
Hyperthyroidism can also cause ravenous hunger, increased drinking/urination, and weight loss.

For some cats, a diet change to low-carb food is all it takes for the cat to no longer need insulin. They’re often called “diet-controlled diabetics.”

Yes, some cats are misdiagnosed, especially if the diagnosis is based on a single blood test rather than a fructosamine and when there are concurrent illnesses identified. I wouldn’t recommend switching back to a higher carb food to test that theory, though. :-)
 
Im not up in the protocols as I havent had a diabetic in years. One thing I do know is the advice given here is priceless. I can attest to the fact that removing carbs from diet works. I took away the dry and Trouble was OTJ in a couple of weeks. GOOD LUCK AND CONTINUE TO ASK QUESTIONS. The knowledge you find here will help both you and kitty navigate though this disease.
jeanne
 
There is a good treatment for Hyperthyroids tumors - and that's Radioactive Iodine treatment.

While Simba was diabetic he also got the Hyperthyroids tumor, but we did the Radioactive Iodoine treatment so he became well from that one.

I wouldn't have done it anyway and it is worth considering for you.
 
My
Ann & Scatcats said:
There is a good treatment for Hyperthyroids tumors - and that's Radioactive Iodine treatment.

While Simba was diabetic he also got the Hyperthyroids tumor, but we did the Radioactive Iodoine treatment so he became well from that one.

I wouldn't have done it anyway and it is worth considering for you.
Click to expand...
cat has hyperthyroidism. Unfortunately she’s not a candidate because of a heart murmur and ckd
 
I'm not looking in I131 treatment for her thyroid. I'm concerned with getting that and diabetes under control first. But im intrested in y'alls opinions on her diabetes diagnosis.
 
My bad, won't bother you anymore with any unsolicited advice whether it be diabetes or something else.
 
Last edited:
Some questions I would be asking myself (if this were my cat) and questions to be asking your vet are:
  • What other symptoms did Freckles have?
  • In other words, what was the diagnosis of diabetes based on?
  • Where there other medical conditions that could have caused the same symptoms?
  • Is it worth doing a fructosamine test?
  • Did the vet rule out other possibilities? How? Which other medical conditions?
  • Could the food change have made a big difference?
  • Did the very low BG reading of 57 "kick start" her pancreas into working and pumping out some insulin? "Her first test, an hour after dosage, she was at 57."
  • Where there steroids involved? Steroid induced diabetes can sometimes be resolved very quickly.
  • Could the vet have misdiagnosed your cat? We've seen it happen.
  • Kidney disease cats also exhibit the "drinking tons of water" and "peeing lakes in the litter box".
  • Coat condition can also be a clue to a diabetic cat, as is diabetic neuropathy (walking on hocks.)
  • Weight loss is another big clue to a diabetic cat, but not the only medical condition where this can occur. Hyper-T is one of those "other conditions".
  • Pain from the mis-formed hips you mentioned might raise BG levels.
  • Stress at the vet can give false readings of BG readings. Study on cats being bathed for 5 minutes showed BG levels raised 80+ basis points. Unless your cat is very 'chill' about the car ride there, the clinic and all the chaos that ensues at a clinic, stress could have accounted for some of the higher BG levels.
  • The ravenous appetite comes with Hyper-T too.
I don't think we can pinpoint this with any precision. Not sure if you think a Fructosamine test would help. That shows average of BG levels over the past couple of weeks. Pros and cons to doing that test.

Simply doing some brainstorming here, to think of questions to ask your vet.

"Once a diabetic, always a diabetic." Quite possible that Freckles is now a diet controlled diabetic. Even if she was not, she may have been pre-diabetic and the lower carb food can stave off diabetes in the future.
 
Ann & Scatcats said:
My bad, won't bother you anymore with any unsolicited advice whether it be diabetes or something else.
Click to expand...

I'm sorry. I didn't mean for that to come off rude at all. I just noticed this was heading into a discussion about hyperT and it was not my intention or what I was needing advice for at this moment.
 
Deb & Wink said:
Some questions I would be asking myself (if this were my cat) and questions to be asking your vet are:
  • What other symptoms did Freckles have?
  • In other words, what was the diagnosis of diabetes based on?
  • Where there other medical conditions that could have caused the same symptoms?
  • Is it worth doing a fructosamine test?
  • Did the vet rule out other possibilities? How? Which other medical conditions?
  • Could the food change have made a big difference?
  • Did the very low BG reading of 57 "kick start" her pancreas into working and pumping out some insulin? "Her first test, an hour after dosage, she was at 57."
  • Where there steroids involved? Steroid induced diabetes can sometimes be resolved very quickly.
  • Could the vet have misdiagnosed your cat? We've seen it happen.
  • Kidney disease cats also exhibit the "drinking tons of water" and "peeing lakes in the litter box".
  • Coat condition can also be a clue to a diabetic cat, as is diabetic neuropathy (walking on hocks.)
  • Weight loss is another big clue to a diabetic cat, but not the only medical condition where this can occur. Hyper-T is one of those "other conditions".
  • Pain from the mis-formed hips you mentioned might raise BG levels.
  • Stress at the vet can give false readings of BG readings. Study on cats being bathed for 5 minutes showed BG levels raised 80+ basis points. Unless your cat is very 'chill' about the car ride there, the clinic and all the chaos that ensues at a clinic, stress could have accounted for some of the higher BG levels.
  • The ravenous appetite comes with Hyper-T too.
I don't think we can pinpoint this with any precision. Not sure if you think a Fructosamine test would help. That shows average of BG levels over the past couple of weeks. Pros and cons to doing that test.

Simply doing some brainstorming here, to think of questions to ask your vet.

"Once a diabetic, always a diabetic." Quite possible that Freckles is now a diet controlled diabetic. Even if she was not, she may have been pre-diabetic and the lower carb food can stave off diabetes in the future.
Click to expand...

I'm afraid they will tell me yes for anything that gets them money because for someone I can never see her vet she started with. I am for sure going to take some questions to her next week when I cancel her curve. I can answer some of those.

Symptoms: I took her into the vet for normal bloodwork to continue her pain management for hips. I mentioned her thirst. I had started to begin to see her excessive thirst. The vet came in and said her weight loss, dehydration, BG levels and liver were concerning. They then did a urinalysis and she came back talking about diabetes. She also wanted me to spend another $500 in test and sonograms for her liver. But then she said lets check her thyroid because that and diabetes can raise the liver. That is how she diagnosed her with diabetes.

Now that I have researched I see diabetes and hyperT show the same symptoms and she has exhibited all of them. Excessive thirst and frequent urination. She started waking me up to go pee. Her box was full of pee. "1 month litter" lasts 1 week for me. Always hungry and yowling. Her weightloss was me trying for 2 or 3 years and over the years she didnt lose 1 lb. Since the past 6 months she has lost ounces because I switched her diet to perfect weight. I told the vet this and she still stuck with diabetes.

Her first twst was the first teat on her curve a weel after diagnosis. Not her very first test after insulin.

No steriods were involved.

I think I got it all. Haha

Does this bloodwork scream diabetes to you though?
 
The labs are too Blurry to see. Your readings in the spreadsheet are great numbers. Looks like she's diet controlled.

Can you enter the numbers into the lab tab on the spreadsheet?
 
JanetNJ said:
Definitly am infection going on. Very high wbc
Click to expand...

Infection? They never said they think she has one and wanted to test. All they said was they typically test for one when diagnosing diabetes because they are more prone. I declined because I was already at $600 and she never acted like she had one. She still doesn't. If theu told me they fear she one then I would have. They said nothing to me about her WBC being high.
 
Melissa Whitmore said:
Infection? They never said they think she has one and wanted to test. All they said was they typically test for one when diagnosing diabetes because they are more prone. I declined because I was already at $600 and she never acted like she had one. She still doesn't. If theu told me they fear she one then I would have. They said nothing to me about her WBC being high.
Click to expand...
Let me tag someone good at reading labs.

@Marje and Gracie
 
Oh wait I was
Melissa Whitmore said:
Infection? They never said they think she has one and wanted to test. All they said was they typically test for one when diagnosing diabetes because they are more prone. I declined because I was already at $600 and she never acted like she had one. She still doesn't. If theu told me they fear she one then I would have. They said nothing to me about her WBC being high.
Click to expand...
looking at the first column of labs. The wbc isn't too too high at 8.... I saw the 60.

272 is high but if there's something else going on in not sure that number is high enough to definitly say diabetic.
 
JanetNJ said:
The glucose was only 203? That's not diabetic high, that's I'm nervous at the vet high.
Click to expand...
I read the Labs section of Freckles SS as glucose 201 on 7/15/19 and 272 on 1/9/2020
JanetNJ said:
Definitly am infection going on. Very high wbc
Click to expand...
I read the Labs section of Freckles SS as WBC 60.7 on 7/15/19 and 8.05 on 1/9/2020, Normal range is 3.5-16.0. That indicates an likely infection in July 2019 but not in in January 2020.

The HTC us a little high 50.1 on 7/15/19 and 55.1 on 1/9/2020, Normal range is 29-48% I suspect that the HTC being high is due to dehydration.
The UA for 1/9/22020 (there is no UA values listed previously) includes:
WBC 0-3 HPF 3
RBC 0-3 HPF 31
The high RBC (red blood cells) could indicate something amis.

For Milissa, how was the urine sample collected? The actual lab results should indicate the method. If done by sticking needle in bladder (Cystocentesis ) the high RBCs could be due to a bad needle
stick
 
Larry and Kitties said:
I read the Labs section of Freckles SS as glucose 201 on 7/15/19 and 272 on 1/9/2020

I read the Labs section of Freckles SS as WBC 60.7 on 7/15/19 and 8.05 on 1/9/2020, Normal range is 3.5-16.0. That indicates an likely infection in July 2019 but not in in January 2020.

The HTC us a little high 50.1 on 7/15/19 and 55.1 on 1/9/2020, Normal range is 29-48% I suspect that the HTC being high is due to dehydration.
The UA for 1/9/22020 (there is no UA values listed previously) includes:
WBC 0-3 HPF 3
RBC 0-3 HPF 31
The high RBC (red blood cells) could indicate something amis.

For Milissa, how was the urine sample collected? The actual lab results should indicate the method. If done by sticking needle in bladder (Cystocentesis ) the high RBCs could be due to a bad needle
stick
Click to expand...
Yes I realize I was looking at the older lab
 
Melissa,

It's as if you are asking us for a second opinion on the diabetes diagnosis and everything else your vet did.

Vets want to check for infection with a diabetes diagnosis because infection/inflammation + not eating enough + not enough insulin is the classic setup for ketones to develop and that can lead to DKA (diabetic ketoacidosis). Very dangerous and life threatening. Your vet was trying to rule out that immediate possibility with more bloodwork. Not to say that DKA or other co-morbidities can't/won't develop later with a cat.

In my mind, I have absolutely zero doubt my foster cat had diabetes. And he had the diabetes for months and developed severe diabetic neuropathy and could hardly walk.

Blood glucose high enough to dump excess glucose into the urine is one sign of diabetes, but the vet was also testing your cat Freckles urine for specific gravity, for color and clarity, for all sorts of other "clues" that could help in the complete treatment of your cat and all her conditions. "Treat the whole cat."

The change to a low carb food could have made all the difference with the diabetes. Yes, we have seen the BG numbers improve that quickly with a change to low carb food. Open my cat's SS in my signature. You'll have to go over to the right and click on the 2012-2013 tab. Look down after 1/15/13 and start looking a the BG readings and the notes. He was a dry food addict at that point. Then keep looking down the SS as I was transitioning him to low carb wet food and you'll see how rapidly he dropped into 'normal' BG ranges.

Not the best example of a SS to look at, because I was fighting, literally fighting, against the shelter and their vets to 1. test more and 2. get him off the high carb Hill's W/d dry food they had prescribed. 3. lower the dose more rapidly than the shelter wanted me too. Good thing I did, or he would have died.

Remember, we are not vets, only laypeople that have had cats that were diabetic.

I think the best thing you can do now is keep your kitty on the low carb food, try to keep testing and ask your vets any questions you may have via a phone call or at your next appointment.
 
Larry and Kitties said:
I read the Labs section of Freckles SS as glucose 201 on 7/15/19 and 272 on 1/9/2020

I read the Labs section of Freckles SS as WBC 60.7 on 7/15/19 and 8.05 on 1/9/2020, Normal range is 3.5-16.0. That indicates an likely infection in July 2019 but not in in January 2020.

The HTC us a little high 50.1 on 7/15/19 and 55.1 on 1/9/2020, Normal range is 29-48% I suspect that the HTC being high is due to dehydration.
The UA for 1/9/22020 (there is no UA values listed previously) includes:
WBC 0-3 HPF 3
RBC 0-3 HPF 31
The high RBC (red blood cells) could indicate something amis.

For Milissa, how was the urine sample collected? The actual lab results should indicate the method. If done by sticking needle in bladder (Cystocentesis ) the high RBCs could be due to a bad needle
stick
Click to expand...

Sample was collected by cystocentesis
 
Deb & Wink said:
Melissa,

It's as if you are asking us for a second opinion on the diabetes diagnosis and everything else your vet did.

Vets want to check for infection with a diabetes diagnosis because infection/inflammation + not eating enough + not enough insulin is the classic setup for ketones to develop and that can lead to DKA (diabetic ketoacidosis). Very dangerous and life threatening. Your vet was trying to rule out that immediate possibility with more bloodwork. Not to say that DKA or other co-morbidities can't/won't develop later with a cat.

In my mind, I have absolutely zero doubt my foster cat had diabetes. And he had the diabetes for months and developed severe diabetic neuropathy and could hardly walk.

Blood glucose high enough to dump excess glucose into the urine is one sign of diabetes, but the vet was also testing your cat Freckles urine for specific gravity, for color and clarity, for all sorts of other "clues" that could help in the complete treatment of your cat and all her conditions. "Treat the whole cat."

The change to a low carb food could have made all the difference with the diabetes. Yes, we have seen the BG numbers improve that quickly with a change to low carb food. Open my cat's SS in my signature. You'll have to go over to the right and click on the 2012-2013 tab. Look down after 1/15/13 and start looking a the BG readings and the notes. He was a dry food addict at that point. Then keep looking down the SS as I was transitioning him to low carb wet food and you'll see how rapidly he dropped into 'normal' BG ranges.

Not the best example of a SS to look at, because I was fighting, literally fighting, against the shelter and their vets to 1. test more and 2. get him off the high carb Hill's W/d dry food they had prescribed. 3. lower the dose more rapidly than the shelter wanted me too. Good thing I did, or he would have died.

Remember, we are not vets, only laypeople that have had cats that were diabetic.

I think the best thing you can do now is keep your kitty on the low carb food, try to keep testing and ask your vets any questions you may have via a phone call or at your next appointment.
Click to expand...

Thank you for making me feel better. I had someone else in my ear saying she didn't believe my cat was diabetic. I was trying to ignore it but I kept researching. I havent since she was diagnosed. I started second guessing things. I needed reassurance and you helped you a lot. Reading your spreadsheet gave me hope. I just don't want Freckles to die at my hands because I listen to my vet and we both be wrong. I know things can happen. I have already had to put my foot down and demand to speak to my vet before about my dog and her pain pills. Maybe I need to do this again.
 
Hi there! Well her home testing looks great. I would recheck a urine strip on her. She shouldn’t have had that much glucose in her urine from stress only. Her pH was quite low as well. Typically the pH should be 6.5-7.0. Too low or too high pH can precipitate crystal formation. It can be variable from one check to another but persistently low or high pH can become a problem as well.
 
I would say she’s definitely diabetic but looks like she’s diet controlled. I’m glad you are getting the hyperT addressed.

Her urine specific gravity is lower than normal due to all the drinking and peeing. She does have protein in her urine. You might want to see about a urine protein:creatinine ratio to be sure she’s not proteinuric.

That’s a really mild elevation in her ALT which is a liver enzyme. I don’t think I’d do an ultrasound for that mild of an elevation but I’d have her retested in three months.
 
Charlotte’s mom said:
Hi there! Well her home testing looks great. I would recheck a urine strip on her. She shouldn’t have had that much glucose in her urine from stress only. Her pH was quite low as well. Typically the pH should be 6.5-7.0. Too low or too high pH can precipitate crystal formation. It can be variable from one check to another but persistently low or high pH can become a problem as well.
Click to expand...

I plan on buying home test and should get those next week. Been waiting on her to pee in a certain litter box where she pees out of it. I have a bag set up where it catches urine.
 
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