IBD + Diabetes + Hyper-T = Hell. Help!!!

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CarolinaGirl

Member Since 2020
Hi Everyone,

My 13-year old tabby, Maisy, had her hyperthyroidism controlled strictly through diet. Once she was dx with diabetes, the vet instructed me to give her 1/2 her hyperthyroidism prescription food (Y/D) plus 1/2 W/D (low-carb) prescription food 2 x per day along with 1 unit of insulin 2 x per day.

It's now been 2 weeks on this new regimen. There's been no change with her diabetes AND her hyperthyroidism has come roaring back. :( She's lost more weight and is now at a whopping 6 lbs. (she's 10 lbs at her heaviest). Vet advised I drop the W/D food and go back to only Y/D and feed her 3-4 times per day rather than 2, and then we'll check her levels in 2 weeks. She warned that the combination of hyper-T and diabetes is going to make this tricky to treat. I'm wondering if I should ask for the Rx gel to rub on Maisy's ears for hyper-T rather than trying to treat through diet. One prior issue we've had with the Y/D food is that is backs her up. She's getting Miralax with her breakfast, but she's not pooped since Sunday. The day she was dx with diabetes, the vet also had to give her an enema to clean her out.

Maisy puked 3 piles this morning, something she's not done since the vet gave her a steroid shot for her IBD a couple months ago. I don't know if this means the IBD is now not being controlled, or the hyperthyroidism is making her puke, or if it's due to her diabetes. She's going to need to eat in an hour to keep to her schedule, but do I feed her?

Honestly, I feel like everything has come crashing down on this kitty, and I'm feeling defeated.
 
I'm so sorry you are going through this!

CarolinaGirl said:
Maisy puked 3 piles this morning, something she's not done since the vet gave her a steroid shot for her IBD a couple months ago. I don't know if this means the IBD is now not being controlled, or the hyperthyroidism is making her puke, or if it's due to her diabetes. She's going to need to eat in an hour to keep to her schedule, but do I feed her?
Click to expand...

How is she behaving otherwise? There are a few things that could be causing this vomiting, some very worrying. I would definitely call the vet this morning and probably bring Maisy in. Not what you want to hear, I know, but vomiting three times is really not OK. Some things it could be:

1) the constipation could be severe enough to cause nausea. On the extreme end, she could have a blockage of some kind that would need to be addressed by the vet, and soon.

2) IBD or pancreatitis (but let's hope she hasn't added another issue to her collection :( )

3) (hopefully not) a crisis caused by low blood glucose. I mention this because you said she had a steroid shot a couple months ago, and sometimes steroids cause transient diabetes. Once the shot wears off, the insulin you are giving is "extra" and the cat's BG can plummet. If you are home-testing, I would test now to see where she is, and regardless, I would definitely offer her some food to see if she will eat now.

As for your general questions, I am unfortunately not able to offer any specific advice on this combination of issues. In general, though, for most kitties with multiple challenges it seems like the best course is to manage the "other" conditions first, and then dose insulin for the diabetes around that. So for example, if the Y/D diet was dong well controlling her hyper-T, probably best to keep with that diet even if it's not great for diabetics. But, let's see what your vet has to say about all of this.

Poor little Maisy. I hope she is feeling better soon!
 
It's not any help four you for we live in Sweden with a different medical practice to yours.

The Hyper T has her body on overdrive and some years ago an American food company came up wih the idea of a iodine deprived food.

No one in Sweden bought into that, and instead we go to, with our Diabetics to the Animal Hospitals specialist oncolog and get the Radioactive Iodine treatment.
Simba did it and while he was alone in his Treatment room and not taking to me on the phone, he listend to radio.
 
What are the diet requirements for hyperthyroidism? I know of some foods that are good for both IBD and diabetes, but I’m not sure how they work for the thyroid issue. And for what it’s worth, I would not feel bad about dropping the w/d - it is not a good choice at all for diabetic cats and your vet is mistaken about it being low carb. Ideally you want below 10% carbs and it is 25% if you’re feeding the wet, even more if it’s the dry. My cat started out on the w/d food and was getting a whopping 6 units of insulin 2x a day.

It sounds like you have quite a balancing act on your hands, but I agree with Nan that it might be easiest to work out her other two conditions and then deal with the diabetes. You can always adjust the insulin dosage to accommodate needing to feed a higher carb food.
 
Unfortunately I know this version of hell far too well.

First, take a deep breath. This might be a somewhat complicated combination of diagnoses but it’s not impossible.

I have many thoughts but don’t have time at the moment — will try to get back later. But for now, a few questions:

1) Are you sure the new food is w/d (not m/d)?
W/d is for theoretically for weight reduction and is quite high carb. M/d is what Hills typically recommends for diabetics; it’s a lower carb food but not what we would actually call low carb. Vets still sometimes prescribe w/d under the mistaken assumption that a high fiber content reduces blood sugar (not true in cats).

2) Are you feeding dry or canned?

3) What type of insulin?

4) How was the IBD diagnosed? What were the primary symptoms?

5) Any history of kidney disease/insufficiency or chronic pancreatitis? Have any tests been run for those?

6) How frequent were the steroid shots? When was the last one given?

7) Has the vet spoken to you about I-131 radiation treatment for the hyperthyroidism?

Now take another deep breath, k?

I’m sure others will be along soon to talk about hometesting, setting up a signature and spreadsheet, provide you with relevant links, etc.
 
Methimazole was already mentioned to her instead of the Y/D food. Much better way to go with the medication in my opinion than feeding a diabetic a high carb food and keeping kitty in high numbers all the time. Newbie trying to figure out the food thing

Methimazole medication comes in pill or transdermal form.
Best would be to do I 131 treatment.

You need to be proactive for your own cat. Selecting the best treatment for your HyperT and Diabetic and IBD cat is not going to be as simple as "Go back to using the Y/D food."

Your vet needs to treat "the whole cat", not just one aspect of her medical condition.

W/d is a weight loss food. No wonder your cat has lost weight. There is nothing "prescription" about those "veterinary" diets. The name "veterinary" only means that they are sold through vet offices/clincs. That is all.

From Sienne &n Gabby: This article is the 2016 AAFP Guidelines for the Management of Feline Hyperthyroidism. The Y/D food can have a positive effect on thyroid levels. However, from the guidelines, there appears that there is still a fair number of questions about the long term use of an iodine restricted diet. I suspect this is the case since the food company does not need to do any sort of clinical trial to substantiate their claims or investigate long term use.
 
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