New Member - 20200614 Re-diagnosis

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basilisk14

basilisk14

Member Since 2020
Good afternoon everyone. First and foremost, I would like to thank everyone on this board. My girl, Kiwi, had her first diagnosis of diabetes about 6-7 months ago. It was a scary time, in which I would just lie awake night after night with her while we started the regimen. This board really helped me get through some rough patches with her. Even though I never contributed, I did a lot of readings and everyone is amazing here!

Well, unfortunately I'm scared again. After 5 months of therapy, she went into remission. At 10 years old, she was like a kitten again. She has never been an overall healthy kitty. We adopted her when she was 6 and we've dealt with hyperthyroidism (I-151 tx), pancreatitis, and of course diabetes. I don't regret one minute of helping her, because believe me, she is the friendliest and most loving cat I have ever been a slave to.

One morning last week, she was acting a bit odd and she wasn't all that interested in food and was a bit lethargic. Well, with her history, I don't take chances. I took her to the vet and they ran a full blood panel and urinalysis (she is a favorite at my vet...all the techs love her and know her extremely well), as they knew I would request it. They diagnosed her with a UTI and gave her a shot of antibiotics and a shot of anti-nausea meds. Her blood work showed her kidneys, liver, pancreas, heart all perfect numbers. Her CBC showed only very slightly elevated WBC, which they attributed to being at the vet and not feeling well. However, they did find sugar in her urinalysis and her BG was high (250...not over the top, but it used to be around 550 the first go-around). Based on this, they said she came out of remission, which I know can definitely happen, even though we haven't changed her diet.

The problem is after 4-5 days, she still is not eating that well and still a bit lethargic and I feel like I did when she was first diagnosed 7 months ago. She's still using the bathroom and very affectionate and comforts me, even though she is the one not feeling well :-). I've tried tempting her with a bunch of different food...she has a few bites and then is done. She does show interest in dry food and will definitely eat some of that and has no issues with treats (I know I shouldn't give her any right now, but my main concern is her eating...the sugar I can deal with). I'm not sure if it is the antibiotics that are giving her a fit (I can't stop them as it was an injection...the vet never really informed of the potential side effects, which I'm not happy about) or the diabetes coming back. I am currently giving her 0.5U of PZI bid. This just all changed one day. The only other thing the vet suggested they can try is an ultrasound to look for other abnormalties. I just forgot how long it took her to feel better the initial go around with the diabetes. Her sugar is holding steady throughout the day between 150-250. Before this happened, it always spot checked around 90.
 
I have a few thoughts. First, I’d ask your vet for an antinausea med like Cerenia or ondansetron to get her over this rough patch and eating again. It could very well be that the antibiotics are messing with the healthy bacteria in her GI tract, which brings me to probiotics. Are you giving her any? I think just like humans it’s important to replenish the healthy gut bacteria killed off by the antibiotics with a good probiotic. Folks here swear by S Boulardii which I started giving to Minnie too for stool control. It’s a yeast based one, but since you mentioned pancreatitis I’d suggest Visbiome. It’s an IBD human probiotic but it would be a better one for colitis or pancreatitis too. I give Minnie 1/3 of a capsule once a day and it was indicated to me by her nutritionist even before we had diagnosed her IBD. Here’s the link to the site. Not super cheap but shipping is free and 60 capsules will last you a couple of months:

https://www.visbiome.com/collections/capsules
 
Aleluia Grugru & Minnie said:
I have a few thoughts. First, I’d ask your vet for an antinausea med like Cerenia or ondansetron to get her over this rough patch and eating again. It could very well be that the antibiotics are messing with the healthy bacteria in her GI tract, which brings me to probiotics. Are you giving her any? I think just like humans it’s important to replenish the healthy gut bacteria killed off by the antibiotics with a good probiotic. Folks here swear by S Boulardii which I started giving to Minnie too for stool control. It’s a yeast based one, but since you mentioned pancreatitis I’d suggest Visbiome. It’s an IBD human probiotic but it would be a better one for colitis or pancreatitis too. I give Minnie 1/3 of a capsule once a day and it was indicated to me by her nutritionist even before we had diagnosed her IBD. Here’s the link to the site. Not super cheap but shipping is free and 60 capsules will last you a couple of months:

https://www.visbiome.com/collections/capsules
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Thank you for your reply. The vet did give her 2 shots of Cerenia to help (one on Wednesday and one on Saturday). It didn't seem to do too much. I did start her on probiotics yesterday (Fortiflora). My apologies about the pancreatitis. Her pancreas is fully healed from that bout. That preceded her initial diagnosis of diabetes last year.
 
basilisk14 said:
Thank you for your reply. The vet did give her 2 shots of Cerenia to help (one on Wednesday and one on Saturday). It didn't seem to do too much. I did start her on probiotics yesterday (Fortiflora). My apologies about the pancreatitis. Her pancreas is fully healed from that bout. That preceded her initial diagnosis of diabetes last year.
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Cerenia never did work for Minnie either. You might want to ask about ondansetron. It can be given daily and it was what got Minnie eating for nearly 2 years until we started the steroid for the IBD this month. Fortaflora is great too :cat:
 
Thank you. I did start giving her some probiotics yesterday. The vet never told me the duration of the antibiotics (we cant meet face to face right now due to CoVid...a vet tech comes out and they call with everything to get permission and dx). Had I known, I would have opted for the oral meds.

Sounds like a good consensus is probiotics and it doesnt appear to be related to her newly re-emerging DM.

Unfortunately, its too late to start a different antibiotic until that is out of her system.

Glad to hear your baby is doing better!
 
basilisk14 said:
Unfortunately, its too late to start a different antibiotic until that is out of her system.
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Most of us have "NO Convenia/No Metacam" in big letters on our cat's files

She can be on another antibiotic if the Convenia isn't killing the bacteria causing the problem. That's why we always suggest that before your vet gives an antibiotic for a UTI, they do a culture and sensitivity first so you know exactly which bacteria you're dealing with and which antibiotic is most effective against it. Once the C&S is done, they can be started on a broad spectrum AB until the results come in and if the AB that had been started isn't the best, you can switch to the one that is.

basilisk14 said:
Her pancreas is fully healed from that bout. That preceded her initial diagnosis of diabetes last year.
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Pancreatitis can be acute or chronic and most diabetic cats probably have some degree of chronic pancreatitis all the time. When it becomes acute is when they start acting really sick and require lots of interventions to help them get over it. She may be telling you that her pancreatitis is flaring up again. Not wanting to eat is one of the signs.
 
Chris & China (GA) said:
Most of us have "NO Convenia/No Metacam" in big letters on our cat's files

She can be on another antibiotic if the Convenia isn't killing the bacteria causing the problem. That's why we always suggest that before your vet gives an antibiotic for a UTI, they do a culture and sensitivity first so you know exactly which bacteria you're dealing with and which antibiotic is most effective against it. Once the C&S is done, they can be started on a broad spectrum AB until the results come in and if the AB that had been started isn't the best, you can switch to the one that is.



Pancreatitis can be acute or chronic and most diabetic cats probably have some degree of chronic pancreatitis all the time. When it becomes acute is when they start acting really sick and require lots of interventions to help them get over it. She may be telling you that her pancreatitis is flaring up again. Not wanting to eat is one of the signs.
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Thank you. Ya, Im pretty much on board with the no Convenia. Whether or not that is the issue, Id rather have full control.

In terms of her pancreas, her Chem showed all pancreatic enzymes were good (I thought she may have had a flare up too, but her entire Chem panel was normal)
 
basilisk14 said:
In terms of her pancreas, her Chem showed all pancreatic enzymes were good (I thought she may have had a flare up too, but her entire Chem panel was normal)
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Unless there was a specific test for pancreatitis, a usual senior/complete blood panel doesn't include tests for pancreatitis.

There's a snap test that only gives a "yes or no" result and a Spec fPL that has to be sent to IDEXX that gives a more definite diagnosis of how bad it is.

Lots more to read in this Primer on Pancreatitis
 
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