IBD & HYPERTHYROID & DIABETES

[Sharon w-r]

Hello I’m Sharon and my recently diabetes diagnosed sweet tempered cat is Gem who is roughly 6 yo.

We could use medical suggestion as she’s quite complex

Jan 2020 she was diagnosed with severe IBD after endoscopy/colonoscopy. As a result her diet was restricted and she was started on budesonide (steroid)

Oct. 2020 she was diagnosed with hyperthyroidism and started on methimazole


March bloodwork was normal

April her appetite started to lack with some vomiting and progressed to where cerenia and mirtaz not helping. Bloodwork showed high glucose level in blood and some in urine no keytones.
Here’s where things are complicated

Our general vrt is really out of her league but the specialist we’ve been seeing had limited to no availability even through ER … but they did manage to sync up enough to start a plan of weaning budesonide and starting insulin 1 unit am/pm. No change in restricted food diet

We saw the specialist we use finally this week. because of her continued lack of appetite he wants to go back to the higher dose of budesonide rather than continue to wean off, and increase her insulin to try to deal with the lack of appetite

he is completely pro using cerenia and mirtazapine… Whereas the reg vet is anti cerenia & mirtaz

She’s mainly running high. Her lows have been upper 200s and highs into 400s with one day regesteting over 500 but the free style libre sensor was on the fritz so it’s hard to know how real that was and we did not have an alphatrak to verify

The specialist upped her to 2 Unite and she had a near hypoglycemic event (no symptoms as she was sleeping) but she registered 64

she’s had a ton of blood pulled and does have elevated liver levels, an ultrasound, and xray

We are scheduled now for a fasted glucose test… not sure exactly what now they hope to discover With that next week

So effectively mo clear diagnosis for lack of appetite

Since her diabetes diagnosis we have been syringe feeding strained and diluted blue HF canned, Royal Canin PV, PD AND PR. All of which she detests

Her fav dry is Purina HA and Blue Buffalo HF both hydrolyzed… but if left to her own devices she would eat fish flavored foods. We’ve gone off diet to reward syringe feeding and insulin shots with CHURU tubes She’ll do almost anything for CHURU

We would really like to wean her off the IBD medicine completely and try to control the IBD via diet only. And thereby perhaps reverse the diabetes since it was called quickly

We keep taking flack from the vets about treating on our own a complaint I’m sure is often heard…

We really are stuck on the food front because of hydrolyzed protein being preferred. We would move her to a white fish diet but the fish is probably one of her triggers since it’s one of the top protein allergy foods


I know this is a lot of information but we could really use some thoughts from people who have had cats with complex and perhaps conflicting medical conditions like ours

 

[JL and Chip]

Hello Sharon and welcome!

I have much to say and am only doing a quick fly by right now, but will try to get back later to post more. Your story sounds very familiar — similar in many ways to my Charlie.

A couple of quick questions:
- what insulin?
- what are the IBD symptoms? (diarrhea, etc)
- has Gem been tested for pancreatitis? (fPLI test, for example)
- did the vomiting and inappetance start at the same time? Frequency of vomiting? Did it correlate with any other changes or diagnoses?
- any kidney issues?

 

[Sharon w-r]

Hello Sharon and welcome!

I have much to say and am only doing a quick fly by right now, but will try to get back later to post more. Your story sounds very familiar — similar in many ways to my Charlie.

A couple of quick questions:
- what insulin?
- what are the IBD symptoms? (diarrhea, etc)
- has Gem been tested for pancreatitis? (fPLI test, for example)
- did the vomiting and inappetance start at the same time? Frequency of vomiting? Did it correlate with any other changes or diagnoses?
- any kidney issues?

 

[Sharon w-r]

Hi and thanks for responding so quickly it is a lot of information

She had a full work up April 20 and her
glucose 369
SDMA 6
Albumin 4
ALT 201
AST 108
ALP 74
Creative 61
T4 1.6 (They had us increasing methomazole duting that time as it had been 3.2 prior at the half dose which we have returned to … don’t know that # now)
HBC 16
MCH 18
LYMPHOCYTE 549
Ketones negative
PH 7
FELV negative but she has been both positive and negative with the gold standard test saying feLV positive 3 years ago. Orig snap was negative at time of rescue aged 6 months by vet

pancreatitis testing Dash I’m not sure I don’t think so yet that might be next week when they do the fasting glucose

She has had vomiting since we took her in but not frequently until we ramped into the IBD diagnosis. She never had diarrhea until that time frame of the IBD diagnosis
there is a belief that during her annual exam of November 2019 when she got off her vaccines updated that he kicked off and immune response Savoretti D into motion the order until it became uncontrollable and she was hospitalized for the three days that led to the endoscopy colonoscopy and severe IBD diagnosis it is

We have had two other IBD cats one of them who did development, so we have some familiarity with that disease

 

[Sharon w-r]

Also insulin is Lantus u100. We have both vial and solostar pen to choose for dosing. Free style libre sensor Have received but not yet used alphatrak manual test so only going by libre numbers when the sensor is operating (first one failed by day 3, we are on second sensor so we do have some curve data)

 

[Sharon w-r]

Ultrasound show deliver mildly enlarged with mild increase in parenchymal ethogrnicity. Call bladder and mild to fine pancreas not enlarged and was smooth with no edema in surrounding mesentery Intestinal motility normal like thickening in a few portions of the bowel of 3 mm, The spleen was normal and uniform the left renal pelvis was eccentrically dilated and measure 2.7 mm, Blunting of the right renal crest but no swelling of bladder

 

[Ale & Bobo & Minnie (GA)]

Have you considered adding ondansetron to the mix? It’s anti nausea like Cerenia but works differently and can be given in conjunction.

 

[Katherine&Ruby]

Hi Sharon,

It would be helpful to us if you could share your Libre data on a spreadsheet so we can see where your kitty's numbers are going. Info on how to set that up as well as a signature is here: New? How You Can Help Us Help You!. Once you get acclimated you might want to post in the Lantus forum for dosing advice.

My kitty has suspected IBD as well as CKD and diabetes, and I've chosen to try to control her IBD through a raw diet. It's something you might want to think about. First I transitioned her away from all of the kibble she was eating before her diabetes diagnosis, then got her on wet food. Her ultrasound showed improvement after eating exclusively wet food and her blood glucose became tightly regulated. A few months ago I started buying boneless ground meat and mixing it with a meal completer (EZ Complete from foodfurlife.com) and most of her GI issues (nausea, vomiting, inappetance) have gone away or are under control without the use of medications. Raw meat is also nearly zero carbs so it's perfect for keeping her blood glucose numbers low. My vets had suggested a hydrolyzed soy kibble and I refused, opting for a homemade diet instead. Most vets aren't very well versed in feline nutrition and will usually be against raw feeding, but I have seen first hand the positive effects of this diet in my own cats. Lots of great info on raw feeding and IBD on the Raw Feeding for IBD Kitties website.

 

[THH & Snowcrash (GA)]

Hi,

I also have a cat with IBD, hyperthyroid, and pre-diabetic/diet-controlled. Emily has to be on prednisolone because of multiple inflammatory conditions, but for now her blood glucose levels have been well-controlled by diet alone.

She's on rabbit-protein only canned food. There are options other than Royal Canin for you to try, including Rawz, Hound and Gatos, Freely, and Lotus.

But her absolute favorite is Vital Essentials freeze-dried raw rabbit kibble. It's expensive, but it's basically no carb and it's super crunchy (she loved her dry!). It may be worth a try.

Also, is Gem on anything for pain relief? IBD and pancreatitis can both be very painful conditions. Pain can increase blood glucose levels too.

 

[Olive & Paula]

Hi,

I also have a cat with IBD, hyperthyroid, and pre-diabetic/diet-controlled. Emily has to be on prednisolone because of multiple inflammatory conditions, but for now her blood glucose levels have been well-controlled by diet alone.

She's on rabbit-protein only canned food. There are options other than Royal Canin for you to try, including Rawz, Hound and Gatos, Freely, and Lotus.

But her absolute favorite is Vital Essentials freeze-dried raw rabbit kibble. It's expensive, but it's basically no carb and it's super crunchy (she loved her dry!). It may be worth a try.

Also, is Gem on anything for pain relief? IBD and pancreatitis can both be very painful conditions. Pain can increase blood glucose levels too.

T, where sre you located? I have a mostly full bag of Vital in duck if you want it.

 

[Olive & Paula]

There is another freeze dried raw i just "discovered" Meaty Mates. They have beef, chicken, lamb and i think duck & turkey. My cats like the chicken, lamb. The beef not so much. Haven't tried thenother. They all like Vital Essentials turkey and chicken. VE changed the shape, packaging. I think but not truely sure they chsnged the food. I do not see bone listed in the ingredients anymore. Thats a good thing.

Absolutely nothing wrong with cerenia. It akso has anti imflammatory properties so it might actually be good for him.

I don't understand why fasting glucoses is needed. Fructosamine will give previous 2-3 week average.

You can test at home and not tell them yet. Once you have enough data then you show them. They can not deny (though they will try) the data you show them.

 

[THH & Snowcrash (GA)]

T, where sre you located? I have a mostly full bag of Vital in duck if you want it.

I appreciate that, but Emily is on strict rabbit-only protein. Most other proteins run right through her. (I'm in Maryland, USA though.)

 

[Olive & Paula]

I appreciate that, but Emily is on strict rabbit-only protein. Most other proteins run right through her. (I'm in Maryland, USA though.)

Ok. Last week I gave the rabbit to the deer, turkeys outside. I guess that is what I will do with the duck.

 

[Sharon w-r]

Hi,

(2Jews4ever)

Have you considered adding ondansetron to the mix? It’s anti nausea like Cerenia but works differently and can be given in conjunction.

But her absolute favorite is Vital Essentials freeze-dried raw rabbit kibble. It's expensive, but it's basically no carb and it's super crunchy (she loved her dry!). It may be worth a try.

Also, is Gem on anything for pain relief? IBD and pancreatitis can both be very painful conditions. Pain can increase blood glucose levels too.

Hi… the severe IBD diagnosis from the specialist was jan2020 Ayer 3 day hospital stay and endoscopy/ colonoscopy. That’s when she was started on hydrlyzed protein diet BUT as a street rescue she’s never been willing to eat wet food and on the occasions she went to another of our cats bowls it was only for fish related food (tiki, BFF) or salmon treats. She has been unfortunately a dry food eater (purina HA, BluE HF, and the Royal Canin Duck, venison, rabbit) with her fav prior to this situation being the two hydrolyzed

the bad thing is both are high in carbs

We have never considered a raw diet for her. Saw too many food pathogen related studies in my prior work life but that was for humans … I know nothing about how raw/ food pathogens and larvae would work with cats… would surely require research and a leap of faith

she is on cerenia. No official pancreatitis diagnosis. Fasted blood glucose this week Lantus upped to 2 units as her numbers have remained high

 

[Olive & Paula]

Just for possible options.

Vital Essentials has rabbit. In patties and kibble. However, if you buy the patties you can add water to it to make it any consistency kitty likes. It's dehydrated freeze dried raw. I have one who likes it as a topper on wet food. It is under 1% carbs.
One who likes it semi dry. I personally think the kibble is to hard and my cats don't like the kibble.

You can also homecook your own food as long as you add the nutrients. The IBD site has directions. Its actually cheaper in the long run than any commercial food. Especially if you have a freezer and get the meat when on sale. When it's a really good sale it costed me $0.06 a day for the 1 cat. You need time and freezer space though. But that's why slow cooker and a day off every two weeks was invented.