Don't know where to go from here.....

Status
Not open for further replies.
LindaLogan

LindaLogan

Member Since 2021
Hello, I'm new here. I'm so glad to have found this forum and hoping that someone can give me some advice !
Apologies - this is going to be a long one, but here goes :
I have a 12 and a half year old cat, Monstie. (My husband is an expert at giving our pets terrible names that stick). I rescued him as a sickly kitten in Portugal at 10 weeks old. Six years ago, he had a bad episode of pancreatitis. He pulled through after treatment, but the vet reckoned it would probably be a chronic condition. I think this was true as he had a history of intermittent vomiting. Over two years ago, he was diagnosed with diabetes. He responded well to treatment initially and eventually only needed half a unit of Caninsulin twice a day. His symptoms returned after a few months, and the dose was slowly increased to 2 units twice a day.
A couple of months ago, his diabetes became uncontrolled. Turned out he'd developed a urine infection, and as he's the kind of cat that goes absolutely beserk if I try to pill him (he won't even let the vets examine him and has to be sedated to have his bloods taken), the only solution was for him to have 2 consecutive Convenia injections, which cleared the infection. His bloods, taken a few weeks ago showed stage 2 kidney disease and high glucose, so his insulin was increased to 2 and a half units, but to no avail.
Up until today, he's continued eating ravenously, drinking a lot and soaking his litter tray within 24 hours. Then he got a seasonal allergy (which he's had before), and unfortunately, right before I had to put him in a cattery for two weeks. I was so worried about him, he was plucking his fur out, scratching like mad, and was covered in scabs and bald spots. I was given a steroid spray to dab on his sore patches for a few days, and the lady at the cattery did a great job in administering that and his insulin. When I picked him up three days ago, his skin was more or less completely healed and his fur has grown back.
However, he was still eating, drinking and peeing far too much. I'd bought a blood glucose monitor, but he runs like hell as soon as I try to prick his ear, no matter how relaxed I get him beforehand. (He's actually very cuddly and affectionate until you try to do anything to him !).
I've got urine/keytone testing strips and today he tested highest on the chart for glucose. I couldn't really tell if ketones were either negative, or trace.
And here's the problem - I live in the middle of nowhere, my husband is away and my car has just given up the ghost. So, I phoned the vet and had a long chat with her. He's on a low-carb, high quality wet diet and Royal Canin Diabetic dry. I asked her if I should supplement with Ipackitine to help his kidneys and she reckoned it wouldn't do any harm. He's had it in 2 meals so far. She also recommended I up his insulin dose to 3 units twice a day, to see if it would resolve the drinking, peeing and ravenous appetite.
Anyway, I'd literally just put the phone down when he threw up his food (I can't remember the last time he'd vomited !). He then proceeded to vomit twice more and the last time it was worrying - clear with a pink tinge. Now, after eating like a horse up until this afternoon, he's eaten nothing since being sick and is looking very lethargic and sorry for himself. I didn't think it would be a good idea to give him a dose of 3 units on an empty stomach, so gave him one and a half.
I have a feeling his insulin should have been increased a while ago. Is two and a half units enough for a poorly regulated cat ? Do you think he's suffering because his glucose has been high for some time now and that's why he's suddenly been sick ? I'm hoping the pink tinged vomit is because he'd been retching quite violently, but I can't help thinking the worst. My poor little boy, he's been through such a lot lately and I don't know what to do for the best. Thanks for reading this.
 
Welcome to FDMB. We're here to help.

First, I would not give Caninsulin until your cat has eaten and you wait 20 - 30 min. Caninsulin can drop blood glucose numbers hard and fast. This is a link to our guide to using Caninsulin/Vetsulin. Quite honestly, the American Animal Hospital Assn no longer recommends it for the treatment of feline diabetes. Lantus (glargine or one of the biosimilars) or Prozinc are what's recommended.

I do suspect the red tinge was from a broken capillary. If it was something more dire, you'd see a lot of very red blood. There's no way to know what the effect of his high blood glucose may be. You also don't know what it's been since you haven't been able to home test. From how you describe how stressed your kitty is at the vet, the tests take there are likely to be very inflated by stress. It's one of the reasons why home testing is so important.

As for home testing, are you giving Monstie treats when you attempt a test? The best way to desensitize your cat to home testing is to select a place where you will ultimately want to test. Put your cat at the testing spot and give a treat. Scratch your cat's ears there and give a treat. Hold his ear like you're going to test, give a treat. I think you get the idea. You want your cat to associate testing with treats. Most of the people here use a low carb treat -- freeze dried chicken or some other freeze dried protein. An alternative to home testing is to talk to your vet about a Freestyle Libre. It's a sensor that is attached to your kitty and should last 2 weeks. You get readings of his blood glucose on your phone.

As for food, the Royal Canin dry food is wildly high in carbohydrates. It may say it's a diabetic food but it's the equivalent of feeding your cat cookies. Can you ditch the dry food? Given that you've got some concerns about kidneys, we can help you with low carb, low phosphorus foods.

Have you been testing for ketones? If your cat's numbers have been high, I would get some Ketostix at the pharmacy. When your cat is in the litter box, you either use a spoon/ladle to get a urine sample or put the strip in his urine stream and get a reading. I always get concerned if someone describes their cat as lethargic that ketones may be developing.

We have all sorts of resources we can help with. Please ask questions and let. us know what you need.
 
Thank you so much for your reply, your advice is greatly appreciated.
The vet sends his blood off to test his fructose levels every month or so, which has resulted in his dose increases.. I will certainly ask for a change to one of the insulins you recommend, but not quite sure if the vets use them here in the UK.
I so wish that home testing was as easy as it sounds - Monstie is absolutely impossible and although he's been eating his own weight in food, he's just not treat motivated at all and won't tolerate his ears being fiddled with. Even putting flea treatment on him is a major operation. (I once put a collar on him and ended up having to unhook all his own claws from his gums !). If he sees anything suspicious, even something as innocent as a piece of cotton wool - he's off like a shot ! Although I'm not very hopeful, I promise to persevere. Strangely enough, he tolerates his insulin shots no problem at all - probably because I've perfected my technique so that he doesn't get to see the needle and doesn't even seem to feel it. The vets at our practice can't believe I can actually jab him, that's how bad his reputation is !
I did a urine glucose and ketone stick test today. The glucose was highest on the chart, but I couldn't really tell if the ketones were negative or trace, the colours were too similar.
I'll definitely ditch the dry diabetic food and give him only his wet "Untamed" low carb, zero sugar, high quality protein chicken recipe food that I buy online from a super helpful company here in the UK.
So relieved that you think the slightly pink vomit probably isn't as bad as I'd thought !
He's come downstairs and has just jumped up onto my knee for a cuddle, he's had a drink of water, but nothing to eat as yet. He doesn't show any sign of being dehydrated, his fur springs back quite quickly when I pull it up, so that's a plus. I'm just hoping he's a bit better tomorrow and has something to eat.
Many, many thanks again,
Linda and Monstie
 
LindaLogan said:
I will certainly ask for a change to one of the insulins you recommend, but not quite sure if the vets use them here in the UK.
Click to expand...

It used to be that vets in the UK were required to start with Caninsulin, but several years ago, ProZinc was also approved as a "starter" insulin. When Caninsulin was the only insulin, if you could prove (through testing) that it wasn't doing a good job for your cat, then your vet could try a different insulin like Lantus/Basaglar or Levemir (they are human insulin's that work amazingly well in cats).

LindaLogan said:
I'll definitely ditch the dry diabetic food and give him only his wet "Untamed" low carb, zero sugar, high quality protein chicken recipe food that I buy online from a super helpful company here in the UK.
Click to expand...

Here's a list of low carb foods available in the UK as well as a post that has pretty much every type of supply you might need for a sugarcat.

LindaLogan said:
Monstie is absolutely impossible
Click to expand...

Keep trying...if he jumps up on you for cuddles, could you work your way towards his head until you're able to rub his ears (even if it means getting him used to feeling your hands on him 1 inch closer at a time)? Have you ever heard of burrito wrapping?

You've found the best place you never wanted to be here so keep asking questions! The people here are very good about sharing their time and experience! We want all our sugarcats to be as happy and healthy as possible!
 
Thank you all so much for the info !
Interesting to read about the Lantus, etc., I intend speaking to my vet about changing over from Caninsulin.
I'll definitely introduce his wet food slowly and keep trying with the BG monitor.
The vet and her most experienced, calm nurse tried the burrito method, resulting in them both getting scratched, peed and pooped on (how embarrassing ! ). You've never seen a cat struggling like it - but he's as laid back and affectionate as can be until he's required to cooperate in any way. He used to be very calm at the vet's up until about a year ago. The vet suspects it might be because there's something else going on besides the diabetes, but we can't get to the bottom of it.
I do wonder if it's possible that there'd been an occasion when they'd hurt him when taking bloods or something. He won't even tolerate a manual examination now.
He seems brighter this morning and ate all his first meal -phew ! I gave him the three units and so far, so good. He hasn't peed yet, but when he does, I'll test his urine again.
Very grateful to you all,
Best wishes,
Linda and Monstie
 
P.s.....I remember reading somewhere that cats with hyperthyroidism hate being restrained - he was tested for that a year ago, but I'm wondering whether it might be a good idea to retest (as soon as I get some transport!).
OMG - imagine it - diabetes, pancreatitis AND hyperthyroidism in a cat impossible to pill !
 
I suspect that your cat associates being at the vet's office with something "bad" happening. Bad is loosely defined. He's outside of his territory which immediately makes a cat wary and hypervigilent. He's not in his usual routine and cat's are creatures of habit. The smells and sounds are all wrong especially if your vet is a general practice (i.e., dog smells and sounds). In addition, he's being handled by strangers and they are doing things like giving shots, taking blood, etc. and it's worse if he's not feeling well. Of course he's unhappy and aggressive at the vet's office because he thinks they're trying to kill him!
 
Wooo hooo - managed it ! I watched the video made by one of your members (Janet ?) that was in a newbie's thread. Actually pricked his ear and got a reading ! Not using the lancet was the key, I crept up on him and just used the needle. The reading was 18.4 mmol/L. This was 5 hours after his first increased 3 unit dose. Is this high please ? I don't really know what the numbers mean, they don't seem to correspond with any I can see on here. Thank you !
Just to add, he is sleeping at the moment and hasn't eaten since 8.30 this morning.
 
Congratulations on getting your first test! I never used the lancet device either. I always just freehanded with the lancet (needle).

The majority of the people posting don't speak mmol/L since most of us are in the US. We use mg/dL which is why the numbers you're seeing on the board seem odd. You multiply your number by 18 for the conversion. The BG level is 331. It's high -- normal is 50 - 120 mg/dL (or 2.8 - 6.67 mmol/L) but not awful. All of these numbers are based on a human glucometer.

So, now that you're testing, you have homework. You've probably noticed that we all have a signature at the bottom of our posts and in the signature is a link to our kitty's spreadsheet. The signature provides some basic information about your cat. It's there because without it, anybody who is attempting to help you will ask and it's likely that we will ask repeatedly and annoy you with the multiple, incessant requests. Hence, the importance of a signature. The spreadsheet is a place to log all of your test data. This allows you to see Monstie's progress and it allows us to see how the dosing is working and provide informed feedback. We're very data driven. Without a spreadsheet, the vast majority of members will not provide any input regarding dosing out of fear that we could harm your cat. This is my longwinded way of saying here's the link to a post on helping us to help you that provides the basics of how to get all of this set up along with some additional information on getting started.

I'm tagging @Bandit's Mom who can help you with your spreadsheet. Be advised that there are two spreadsheet templates. You want the "World" template. It will allow you to input your data in mmol/L format and on a second tab, will automatically convert your numbers into US format.
 
Hi Bandit's Mom,

Thank you so much for offering to help me with my spreadsheet, but I'm more than a little deflated today - I tried taking a sample from Monstie, but he went berserk when I tried and he kept shaking his head - he wouldn't even let me touch his ear !
I thought it was too good to be true when I actually managed it yesterday.
Oh well, back to the drawing board ! I'll keep trying, but he's a little devil and extremely difficult to handle in these situations.
After I increased his dose to 3 units, his excessive eating, drinking and peeing seem to have stopped, he's looking so much brighter and hasn't vomited since the other day.
I will persevere and let you know if I can find a way to test him without him totally freaking out.
Until then, many thanks again !
 
LindaLogan said:
Wooo hooo - managed it ! I watched the video made by one of your members (Janet ?) that was in a newbie's thread. Actually pricked his ear and got a reading ! Not using the lancet was the key, I crept up on him and just used the needle. The reading was 18.4 mmol/L.
Click to expand...
Hi Linda, waving from Surrey! :bighug:
Well done with getting that test. Hometesting can be a bit of a challenge at first for some of us. But do stick with it.

I'm copying some info below on 'desensitising' cats to being hometested. These kinds of things helped enormously with both of my diabetics.
If you need any help or have any questions please do shout out.

Hugs to you,
Eliz

- - -
"GETTING KITTY USED TO BEING TESTED - ‘DESENSITISATION’

Some kitties take to being tested like proverbial ‘ducks to water’, they are just not bothered by it at all. Other kitties take a bit more work, and with a minority of kitties it can take a quite a bit of dedicated effort to get them used to the process. Please be reassured that ‘most’ kitties can be tested, and ‘most’ people can learn to do it.

One really useful way to get kitties used to testing is to ‘desensitise’ them to the sensations and sounds involved in the test process. And a really good thing to do at first is to get them more used to having their ears touched.
So, whenever you are stroking or cuddling the kitty, or the kitty is trying to wake you at 4am by sitting on your chest and patting your face, use that opportunity to include very gentle ‘ear touching’ when you stroke them, just for a second at first. Make ear touching ‘ordinary’ and nothing to fear...
...You can also go to wherever the cat is chilling out, then stroke them, hold or massage an ear for a second or two, and then immediately reward with a cat treat and some praise. This starts to condition them to associate ear touching with rewards.

You can also get them used to the test kit itself. For example, you can rattle the test strip container, or click the lancing device a few times (it can be used a bit like a training clicker), and immediately give the kitty a treat. Then just walk away, leaving them with their reward. They can soon come to associate those sounds with rewards just like when they hear the sound of the can opener... ;)
I did these kinds of desensitisation techniques with my kitties about 6 or 7 times a day at first during the first couple of weeks. It only takes a minute or two each time, maybe only seconds. But that repetition is key to success. Repetition, repetition, repetition...

It can be often be helpful at first to test in the same place so as to establish a routine. I tested my first diabetic on a table top. I test my current girl in her favourite armchair. You can get the kitty used to the test spot by taking or calling them there and just rewarding them with strokes or brushing, or treats - anything that they really enjoy.
Make the test spot a place where nice things happen. :cat:
If you can get the kitty to the test spot and hold or massage an ear for a second or two and then reward with a treat and praise, you really are most of the way to being able to test."
 
LindaLogan said:
Wooo hooo - managed it ! I watched the video made by one of your members (Janet ?) that was in a newbie's thread. Actually pricked his ear and got a reading ! Not using the lancet was the key, I crept up on him and just used the needle. The reading was 18.4 mmol/L. This was 5 hours after his first increased 3 unit dose. Is this high please ? I don't really know what the numbers mean, they don't seem to correspond with any I can see on here. Thank you !
Just to add, he is sleeping at the moment and hasn't eaten since 8.30 this morning.
Click to expand...

Hi there, here's a glucose conversion chart so you don't have to keep doing the math. http://www.catsanddiabetes.com/wp-c.../Blood-Glucose-Conversion-Chart-9-3-13-A4.pdf
 
Status
Not open for further replies.
Back
Top