Help Please! Urination Outside of Box and Uncontrolled Blood Sugar

[FireAngel16]

Hi everyone! I've been lurking for a bit and this is my first post. Quick backstory. My cat, Diego, 14 in July, was diagnosed with diabetes in August 2021. We have been on ProZync since this week where were switched to Lantus by a specialist because the other was not working, levels consistently in the 400-500's. High when he figured out how to open the bread box and eat parts of a bagel, tops of the bread, and some cookies. We just found out that his pancreas is severely enlarged. We're hoping that once we get the blood sugar more regulated, the inflammation will go down. Doctor said treatment for a inflamed pancreas aren't very or at all effective. He has lost 6 pounds since April last year, he's ravenous, and always hungry. He basically has no fat left on him. He's at a cup a day of Glycobalance and is not gaining any weight.

So, the reason I'm making this post is because after his diagnosis, which included a mild bladder infection which has since cleared, he has been peeing on the floor just outside of his litter box. I clean it twice a day. He does pee and poop in the boxes, but he still pees literally in front of it on the floor. I have put down pee pads in an attempt to save my wood floor and prevent the urine from dripping into my basement. He will uses the pads but also will pee off the pads. I have also been catching him drunk the urine on both the pee pad and floor. He has fresh, fully stocked water. Everything is upstairs and in the same area so he doesn't have far to go when he needs to go or get a drink. My house is not large and he's not peeing anywhere else but the room where the litter boxes are stored.

I am at a complete loss with what to do. I'm a behaviorist and I am even treating him when he uses his litter box, but if I'm not in the room when he needs to pee, he'll pee on the floor. I'm hoping the new insulin, being more potent, will help, but I understand it's not going to be a quick improvement.

I appreciate any thoughts, suggestions, or shared experiences. I am desperate and will try anything!

Thanks so much!

 

[Wendy&Neko]

Hello and welcome. My girl started out as a breadaholic too (muffins, banana bread, baquette). With my girl, it turned out she had a condition called acromegaly, which is a benign tumour that sends out excess growth hormone. If you think growing teenager and their appetites, sort of like that. This condition can mean it's harder to regulate the cat.

Can you tell me what dose of Prozinc you were giving and what dose of Lantus you are now giving? Are you home testing his blood sugars? Getting a kitty to a dose where they are in much better blood sugar values will help the peeing problem. Giving dry food is also not the best choice, as we think that low carb wet or raw food is better than higher carb dry food. The so called "vet foods" aren't anything special. Most of us feed commercially available food. Lower carb food will also help his blood sugars. However, I wouldn't go switching his food unless you are home testing his blood sugars. Moving to a species appropriate diet can make a big difference in the amount of insulin needed.

Do you have a litter box with tall sides on it? What have you used to clean up the pee smell near the box?

 

[Sienne and Gabby (GA)]

I agree with Wendy. If your cat is unregulated, Diego is going to be hungry all the time and his water intake and urination are likely to be large. I'd try to clean the box as often as humanly possible so you know that's not the issue.

One of the issues with diabetes is that insulin is the hormone that helps the product of metabolism (i.e., glucose) move from the bloodstream to the cells. A diabetic isn't manufacturing insulin so the glucose keeps floating around in the blood. As a result, since nutrition isn't getting into the cells, your cat is hungry all the time and will lose weight. If you've started to test your cat's blood glucose levels at home, you'll have a clearer idea of how well a particular dose o insulin is working.

The dry food is surprisingly high in carbohydrates. Despite glycobalance being touted as a "diabetic" food, it's nothing short of amazing that the manufacturer and vets don't recognize that it's quite high in carbs (15% on the Hill's website). We consider food that's 15% carb or greater as "high carb." Below 10% is low carb and most members here feed their cat in the 5% range. In addition, dry food has minimal moisture content which is suboptimal for kidney health. We recommend a low carb, canned food or raw diet as Wendy mentioned. Many people here feed their cats Fancy Feast or Friskies pate style food. This chart contains a list of most of the canned foods available in the US along with their nutritional information.

Please let us know how we can help.

 

[FireAngel16]

Hello and welcome. My girl started out as a breadaholic too (muffins, banana bread, baquette). With my girl, it turned out she had a condition called acromegaly, which is a benign tumour that sends out excess growth hormone. If you think growing teenager and their appetites, sort of like that. This condition can mean it's harder to regulate the cat.

Can you tell me what dose of Prozinc you were giving and what dose of Lantus you are now giving? Are you home testing his blood sugars? Getting a kitty to a dose where they are in much better blood sugar values will help the peeing problem. Giving dry food is also not the best choice, as we think that low carb wet or raw food is better than higher carb dry food. The so called "vet foods" aren't anything special. Most of us feed commercially available food. Lower carb food will also help his blood sugars. However, I wouldn't go switching his food unless you are home testing his blood sugars. Moving to a species appropriate diet can make a big difference in the amount of insulin needed.

Do you have a litter box with tall sides on it? What have you used to clean up the pee smell near the box?

Thank you for the reply! Poor baby! It is so sad to see them so hungry all the time. I took him to a specialist who did an ultrasound and luckily found no tumors. He seems to think the culprit is the pancreas and not being able to absorb nutrients.

For ProZinc, in the end, we were at 4 units in the morning and 3 in the evening. How on Lantus, we're on 2 and 2 to start. I'm doing a curve the first weekend of March when I get back from vacation. On ProZinc, the lowest number I ever saw was 510. I don't do daily readings or anything like that. I have been told when we change the dosage to then do another curve in a couple of weeks. Doctors keep telling me that the peeing will improve once his numbers improve, but numbers haven't been improving. I'm sooooooo hoping this new med will help! As far as the food, I do switch between the dry and wet food and have been getting ready to explore the raw food diet. I have a friend who is a vet assistant and a certified pet nutrition coach, so I'm going to connect with her about this diet. If I didn't do the raw food diet, I'm not sure what else I could try other than the Glycobalance. The nutrition labels are different from what I'm used to reading. hahaha.

As far as the box, yes, it's tall with covers because he will basically pee over the edges if I don't. The cleaner I use is Nature's Miracle Advanced, Severe Mess Enzymatic Formula, Stain and Odor Eliminator to try and get that smell out so he doesn't keep peeing in the spot. Clearly, it's not working, so maybe I should explore a different one?

 

[FireAngel16]

I agree with Wendy. If your cat is unregulated, Diego is going to be hungry all the time and his water intake and urination are likely to be large. I'd try to clean the box as often as humanly possible so you know that's not the issue.

One of the issues with diabetes is that insulin is the hormone that helps the product of metabolism (i.e., glucose) move from the bloodstream to the cells. A diabetic isn't manufacturing insulin so the glucose keeps floating around in the blood. As a result, since nutrition isn't getting into the cells, your cat is hungry all the time and will lose weight. If you've started to test your cat's blood glucose levels at home, you'll have a clearer idea of how well a particular dose o insulin is working.

The dry food is surprisingly high in carbohydrates. Despite glycobalance being touted as a "diabetic" food, it's nothing short of amazing that the manufacturer and vets don't recognize that it's quite high in carbs (15% on the Hill's website). We consider food that's 15% carb or greater as "high carb." Below 10% is low carb and most members here feed their cat in the 5% range. In addition, dry food has minimal moisture content which is suboptimal for kidney health. We recommend a low carb, canned food or raw diet as Wendy mentioned. Many people here feed their cats Fancy Feast or Friskies pate style food. This chart contains a list of most of the canned foods available in the US along with their nutritional information.

Please let us know how we can help.

Thank you for the reply!

Yes, and that's what I keep hearing too. Other than positive reinforcement and waiting out his blood sugar levels, I was hoping for an alternative to get him to only pee in the box again.

I haven't his curve on this new med yet because we just started in on Tuesday. The plan is to do a full day curve after I get back from vacation the weekend of March, since I'll be home all day, and see how things are progressing. So far, I don't see anything changes, but again, it's only been a few day.

Thank you so much for the link to the food! I definitely want to explore other options for him. I mentioned in my reply to Wendy that I have a friend who is a vet assistant and is a certified pet nutrition coach, so I think I'm going to chat with her more about diet options or even the raw food diet. Whatever I can do to help my baby boy!!! It's so heartbreaking to see him lose all this weight and be hungry all the time, even though he's getting food. I agree that it is nuts that vets don't realize how many carbs are their food. I was keto for a couple of years and they are everywhere! Not to mention the fact that they put food grade cardboard in dry food!!! Yuck!!!

Thank you again! I really appreciate it!

 

[Wendy&Neko]

I took him to a specialist who did an ultrasound and luckily found no tumors.

The tumour I was referring to is on the pituitary gland, and not one you find via ultrasound.

Are you doing any blood sugar testing other than an occasional curve? Most of us test daily, at a minimum before each shot to make sure it's safe to shoot, plus spot checks at other times. You can do a curve on Lantus 7 days after starting it. Waiting so long will not be easy for him. Some people get a Freestyle Libre put on their cat to get blood test data, at least until they get comfy doing their own testing. It's really quite easy to do once you have the hang of it. And much cheaper than going to the vet.

It also sounds like your vet started you on too low a Lantus dose. Another reason he's high now.

Do you have a second litter box he can use if the first one gets full?

 

[FireAngel16]

The tumour I was referring to is on the pituitary gland, and not one you find via ultrasound.

Are you doing any blood sugar testing other than an occasional curve? Most of us test daily, at a minimum before each shot to make sure it's safe to shoot, plus spot checks at other times. You can do a curve on Lantus 7 days after starting it. Waiting so long will not be easy for him. Some people get a Freestyle Libre put on their cat to get blood test data, at least until they get comfy doing their own testing. It's really quite easy to do once you have the hang of it. And much cheaper than going to the vet.

It also sounds like your vet started you on too low a Lantus dose. Another reason he's high now.

Do you have a second litter box he can use if the first one gets full?

Gotcha! Would something like that show any abnormalities in blood work at all?

Unfortunately, I am leaving Friday for a trip and because I work, I won't be able to do a curve until I get back. Even with 7 units a day on ProZinc, his numbers never went below 500 so the specialist wanted to start out with just 4 units a day so that we didn't see a huge drop right away and end up giving him too much. I definitely don't have any issues with taking his readings as long as my reader actually works. I think I got a batch of defective strips and have to order more. I don't test everyday, but I test often just to see where he is at any given point.

And yes, we have two boxes for him to use and I clean them at least twice a day. Sometimes less when he's using the floor instead of the box and there's nothing to clean out, and sometimes more when I'm watching him like a hawk when he makes that turn to the litter and run in to make sure he's using his box. Haha.

 

[Wendy&Neko]

Would something like that show any abnormalities in blood work at all?

Yes, there a couple special blood tests, not part of the regular package of blood work.

 

[Suzanne & Darcy]

Has he been tested for pancreatitis? That is a specific blood test fPLI. The most accurate will send blood to an outside lab and is called Spec fPL. Check your bloodwork. You should have a copy. If not, get copies of all bloodwork from your vet.

There is a lot that can be done to help a cat with pancreatitis feel better. This would include regular subcutaneous fluids, usually pain medication (Buprenorphine), anti-nausea meds (zofran). Some cats also do well on Cerenia.

I am concerned that your kitty may be in pain or very uncomfortable and that is causing the litter box avoidance. The people here can really help you safely get your cat to better blood glucose levels.

Dr. Elsey’s makes a cat litter that I highly recommend for helping a cat go back to the litter box — it is called Cat Attract and I have had a great deal of success in using this litter.

I hope your cat will be better soon.