New Member - Cat Just Diagnosed

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SaraMV

Member Since 2022
Hi, I'm not sure if I need advice, or just hope, but I feel lost right now and am looking for whatever help you can provide to me.

In early December, I noticed that the water bowl was emptying more than it should have been and there was a lot more pee in the potty box. We have two cats, so I wasn't sure which one was drinking more, but we have a lot of experience with cats and knew it wasn't a good sign if it continued. One of our cats, Taz, started noticeably licking his lips, but his nose was wet and he gets a kitty cold every year when the weather starts to change, so we didn't really think anything of it. He's almost 14 years old and we believe he has teeth issues because he's been eating sideways off and on for the past year (he had a couple of teeth pulled maybe 3 years ago). He hadn't been acting any different than normal, but I had noticed that he might have lost a tiny bit of weight over the last month or so (not enough to really be able to tell and my husband didn't notice it, even after mentioning it to him).

I've been off of work for the past 2 weeks and I was able to watch as Taz spent quite a bit of time at the water bowl every morning. Last Thursday he stopped wanting to finish his food. He would eat some, then walk away and come back later to finish it. It got progressively worse each day but of course vets were closed for the holiday. Taz gets fed 3 times a day, and only Friskies pate with the occasional little scoop of dry food. (Years ago my brother had a diabetic cat who would only eat dry food, so I stopped Taz from eating dry around that time because he was also obese.)

On Sunday, you could tell he was hungry but he wouldn't eat more than a bite or two. I offered dry food, and he came into the back porch because he wanted to eat. He looked at the food, turned around and I could tell he wasn't walking right. His legs started giving out and he was sliding across the floor. Once he made it to the carpet, he began panting really heavily. It lasted for about 3 minutes, before we got him calmed down enough to stop. He got up, walked normally to the potty box, used it and then ate half of the food I put down. It was like whatever happened, never happened.

We rushed him 87 miles away, to a 24 hour emergency vet. He was in his carrier from 2pm that afternoon, until midnight when they finally called us to the back. He was alert, so they didn't think it was life threatening. They did bloodwork, and a urinalysis (which we're still waiting for), and his blood sugar was between 500-600. She said he didn't appear to be in pain when she did his physical, so she gave him some fluids under the skin, and sent us home with a prescription for Lantus. I was worried about pancreatitis but she said he wasn't showing any signs of it and bloodwork didn't give her anything to be worried about, other than his sugar.

When we got home around 3:30am, he attacked the water bowl. We gave him food and he ate it sometime between 3:30 and 8:00, but he also vomited it up with tons of water three different times. He refused to touch any other food, or drink, and all he wanted to do was rest. I figured he was relaxing from all the stress from the prior day. But as the day went on, he threw up again around 11am, and he wasn't as alert. He also acted weak. He'd take a few steps, then lay down. We took him back to the ER yesterday and requested that he be hospitalized. They started him on an IV insulin and he responded really well to it with his numbers going down to around 200. He ate a little for them around midnight, and he's been alert. We requested that he have an ultrasound done today, and it shows that he has a moderate case of pancreatitis. He also has two small cysts and a 1.8cm one on his pancreas. One of his kidneys is also smaller than the other one, and he has a slight heart murmurwhich the first vet didn't catch.

They fed him around 10am this morning, and switched him from the IV insulin to the Lantus. They said he ate like a champ, but his blood sugar went back up to 500. The vet was trying to find a dose that would help bring it down and she ended up giving him 3 units. I'm scared this is too much, too fast, and that they'll make him go into hypoglycemia.

They are keeping him tonight and we're hoping he'll be well enough to come home tomorrow night, but I'm also really scared that he'll start declining again once he comes home if the pancreatitis isn't treated long enough. As of 4:30, he's still alert and interacting with them.

We have already purchased an AlphaTrak glucose meter, which will be here on Friday, and we had planned on changing him from eating Friskies pate to Fancy Feast Classic. But now that his kidneys are apparently affected, I don't know what to do. I know he needs high protein/low carb for diabetes, but low protein for kidney disease. Please if anyone has any advice, I would greatly appreciate it!
 
Hi and welcome to the forum.
Can you ask the ER vets to test for ketones in the urine or blood before Taz comes home?
I would also ask the vets to give you some antinausea medications such as cerenia and ondansetron to bring home with you as Taz may very well be nauseated over the next few days, even if he isn’t at the moment.
Have they given him anything for pain? Pancreatitis is painful so I would also ask the vets for some pain medication to bring home. Bupe is often given for pancreatitis.

It would be much better if you had a glucose meter before you bring Taz home. You Can pick up a human ReliOn meter for $9and a box of 100 test strips for $17.88 at Walmart. You will also need a box of 26 or 28 gauge lancets and some cotton balls to hold behind the ear to test. Human maters are much cheaper to run than pet meters and are just as good. Our dosing methods are based on the human meter.
3 units is a huge amount of insulin to start off with for a cat. If your cat is eating a low carb wet food, the normal starting dose is 1/2 unit twice a day. The exception to this is if Taz has ketones in the urine or blood in which case the dose may be higher. Always test before every shot and again during the cycle to see how low the dose is taking Taz.

Make sure you have some honey and some higher carb food available at home in case he drops low.
Here is a FOOD CHART look for carbs 10% or under for low carb …….and above 15% for high carb to have in your hypo box.
For the kidney you need high protein and low phosphorus. Low protein is old thinking, If you need to look for low phosphorus for his kidneys, that is also included in the chart. Look for ones that are under 200mg phosphorus/100kcals.

Here is another useful link HELP US HELP YOU

Pancreatitis is treated by giving support while the body heals. That is done with sub Q fluids, pain meds, antinausea medications and sometimes an appetite stimulant but always give an antinausea med before the appetite stimulant of he is nauseated.

A PRIMER ON PANCREATITIS gives information on pancreatitis.
 
Thank you so much for your reply. I know there were ketones but I don't know if they were in the blood or urine. I'm not sure how to read his blood work but in the area "ketones serum IHLAB", the number was 1.0 mmol/L.

I believe he is getting all of that medication right now and I'll make sure that I bring some home with us.

I have a question about using Lancers. Do they pierce all the way through the ear? Also, I was reading through this good chart that you provided. It confuses me a lot because I'm noy sure exactly what to look for. What would be your ideal food for a semi picky eater who is now diabetic and has kidney issues?
 
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have a question about using Lancers. Do they pierce all the way through the ear?
The lancets do not normally pierce right through the ear, but it is possible if the setting is set too deep.
Here is a link to HOMETESTING

for. What would be your ideal food for a semi picky eater who is now diabetic and has kidney issues?
Have a look at the Weruva brand of cat food. If you go onto their website they have all the lists and percentages of all the ingredients. Look for high protein, low carb (under 10%) and phosphorus with levels 200mg phosphorus/100kcals.

Are you able to post his pathology results here so that we can see them please?
 
Unfortunately I don't. Tomorrow I can try to write everything out after work, but it might take me a while.
 
Unfortunately I don't. Tomorrow I can try to write everything out after work, but it might take me a while.
I don’t own a Samsung phone so can’t help there. If you took a photo of the results, Could you copy that and paste it on the thread. Would that work?
 
So, deep breath.

Kidney issues - your cat's BUN (blood urea nitrogen) is the only kidney value that's elevated. The creatinine level and phosphorus levels are fine. What you need is a test called an SDMA. It's a predictor of kidney disease. It looks like the vet is doing all of the labs in house. Generally, they need to send out the labs for an SDMA. It will likely take a day or two to get SDMA results. If your cat eats a food that's a little higher in phosphorus for a couple of days, it's not going to have an impact on the kidneys.

Ketones are present but not at the level of diabetic ketoacidosis (DKA) and all of the other lab values which would be off in DKA are fine.

My guess is that the vet was using a shorter acting insulin to bring your cat's numbers down -- or using Lantus plus a short acting insulin. That combination is fairly typical - it's referred to a basal/bolus dosing. The Lantus is the base and they give it a bump with a bolus of a fast acting insulin.

You might want to get the vet to look at your cat's teeth while he's there. If he's having trouble eating due to a dental issue, that will complicate things since your cat needs to eat!

The inflammation of your cat's pancreas and the associated pain s likely contributing to blood glucose numbers being elevated. The information that Bron linked from the Primer on Pancreatitis should help you to know what to discuss with the vet. Pain medication -- we suggest buprenorphine and not an anti-inflammatory, anti-nausea meds (ondansatron or Cerenia), and an appetite stimulant will help.

Please remember that diabetes is a treatable condition.
 
Thank you so much Sienne and Gabby. Your post helped me to feel a bit better about his kidneys. Just a question, should I add a phosphorus blocker to his food to help with the amount? I'm confused about what to feed him now. I was going to move him to fancy feast classic because I like the lower carbs, but the phosphorus is higher in it than in the friskies pate that he currently eats (which has slightly more carbs). Also, should fat be considered now that he's had pancreatitis? They currently have him on Purina DM. I have no experience with that brand at all because our vets usually recommend Hills.

The emergency hospital wanted to keep him an extra night to help get his insulin right. The vet was hopeful that he'll be right around 1.5 units twice a day. She says it's so much because he's a big guy. He's not really obese I don't think? He's just a big cat (thick, tall, and long).

I need to get him in to his regular vet as soon as possible, because he'll be able to get more in depth about things with me. But with covid, their taking less people and appointments are pushed out. I hope in our case, it won't be too long.
 
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