Jacques and Pumpkin
Member Since 2023
My 12 year-old cat Pumpkin just got diagnosed with DM.
Pumpkin had issues 2.5 years ago that ended up being root caused to entropnion (eyelid rolling into the eyeball, not fun at all). That set off a bit of a rollercoaster for her, where we started with steroids before the entropnion Dx, that failed, we tapered her, saw an oncologist, got the Dx, did a surgery. The surgery wasn't fully successful, the surgeon didn't believe me, we tried steroids again to get her to stop scratching, finally I caught a bit of hair on camera poking into the eyeball, we did a followup surgery (on the surgeon's tab, thankfully), and then tried to taper her off the steroids. The tapering worked for a bit, but her "scarf and barf" tendencies flared up to the point she was vomiting multiple times a day and not eating. She ended up in the hospital to be stabilized, we did more steroids, got the vomiting a bit under control but still elevated. We finally tried hydrolyzed protein diet and she stopped vomiting entirely. Whew.
By this point Pumpkin, who had long been a little chunky, topped out at 13 lbs about a year ago. So, I got a scale, got even more strict with portion control (this cat's appetite only turns off when she's sick), and sloowly got her down to 11.25 lbs. Double whew.
Cue an annual wellness appointment. Blood glucose level comes back elevated (had been 76 a year ago, now 163), also glucose in the urine (2+ or 500 mg/dL). Could be stress hyperglycemia, she needed dental work anyway, so we planned to follow up then.
Doctor was happy with her weight and suggested concluding her weight loss program. I upped her intake by about 30 calories of dry HP food.
No idea whether or not it was a coincidence or not, but over the next two weeks Pumpkin got very thirsty (2-3x water intake, 2-3x urine) and started losing weight. She shed 0.5 lbs in just two weeks, the fastest weight loss I've ever seen from her (I usually weigh her every 1-3 weeks).
Took her back into the vet, blood glucose levels were still high (I've asked but don't have the reading yet), and urine glucose was 3+ or 1000 mg/dL, negative for ketones.
Vet called and said high blood glucose, glucose in urine, thirst, weight loss = diabetes.
We're going to start her on insulin (I don't have the name yet, need to find where the prescription went) and try adjusting her diet. That's very nervewracking given her history, but we're going to try introducing a bit of Instinct Limited Ingredient Rabbit (novel to her, she's already had duck from a different brand) and see if there's any relapse of vomiting before trying to switch more over. Otherwise we're stuck with the high carb HP foods (the wet food is 40% carb by dry matter and my best guess for the dry food is 50%, but I'm not sure; either way it's pick your poison when it comes to carbs). I have switched more of her diet to wet food on the theory that every bit of carb reduction helps.
Anyway, that's my story still trying to figure out all the next steps.
I have a couple of questions:
- I don't know what the followup reading was, but 163 seems pretty borderline for a DM diagnosis. Reading the AAHA guidelines it does something to the effect of "when in doubt, look at the clinical signs" and we've got thirst, weight loss, lots of urination, and glucose in the urine. But, 163 also seems close to the level where you would reduce the dose, presumably to nothing in my case.
- Does the switch to Instinct Limited Ingredient make sense? Any other recommendation for serious food allergies in diabetic cats?
Pumpkin had issues 2.5 years ago that ended up being root caused to entropnion (eyelid rolling into the eyeball, not fun at all). That set off a bit of a rollercoaster for her, where we started with steroids before the entropnion Dx, that failed, we tapered her, saw an oncologist, got the Dx, did a surgery. The surgery wasn't fully successful, the surgeon didn't believe me, we tried steroids again to get her to stop scratching, finally I caught a bit of hair on camera poking into the eyeball, we did a followup surgery (on the surgeon's tab, thankfully), and then tried to taper her off the steroids. The tapering worked for a bit, but her "scarf and barf" tendencies flared up to the point she was vomiting multiple times a day and not eating. She ended up in the hospital to be stabilized, we did more steroids, got the vomiting a bit under control but still elevated. We finally tried hydrolyzed protein diet and she stopped vomiting entirely. Whew.
By this point Pumpkin, who had long been a little chunky, topped out at 13 lbs about a year ago. So, I got a scale, got even more strict with portion control (this cat's appetite only turns off when she's sick), and sloowly got her down to 11.25 lbs. Double whew.
Cue an annual wellness appointment. Blood glucose level comes back elevated (had been 76 a year ago, now 163), also glucose in the urine (2+ or 500 mg/dL). Could be stress hyperglycemia, she needed dental work anyway, so we planned to follow up then.
Doctor was happy with her weight and suggested concluding her weight loss program. I upped her intake by about 30 calories of dry HP food.
No idea whether or not it was a coincidence or not, but over the next two weeks Pumpkin got very thirsty (2-3x water intake, 2-3x urine) and started losing weight. She shed 0.5 lbs in just two weeks, the fastest weight loss I've ever seen from her (I usually weigh her every 1-3 weeks).
Took her back into the vet, blood glucose levels were still high (I've asked but don't have the reading yet), and urine glucose was 3+ or 1000 mg/dL, negative for ketones.
Vet called and said high blood glucose, glucose in urine, thirst, weight loss = diabetes.
We're going to start her on insulin (I don't have the name yet, need to find where the prescription went) and try adjusting her diet. That's very nervewracking given her history, but we're going to try introducing a bit of Instinct Limited Ingredient Rabbit (novel to her, she's already had duck from a different brand) and see if there's any relapse of vomiting before trying to switch more over. Otherwise we're stuck with the high carb HP foods (the wet food is 40% carb by dry matter and my best guess for the dry food is 50%, but I'm not sure; either way it's pick your poison when it comes to carbs). I have switched more of her diet to wet food on the theory that every bit of carb reduction helps.
Anyway, that's my story still trying to figure out all the next steps.
I have a couple of questions:
- I don't know what the followup reading was, but 163 seems pretty borderline for a DM diagnosis. Reading the AAHA guidelines it does something to the effect of "when in doubt, look at the clinical signs" and we've got thirst, weight loss, lots of urination, and glucose in the urine. But, 163 also seems close to the level where you would reduce the dose, presumably to nothing in my case.
- Does the switch to Instinct Limited Ingredient make sense? Any other recommendation for serious food allergies in diabetic cats?
Yes, you can trust Dr. Pierson's list over the calculated % using the Guaranteed Analysis. However, Dr. Pierson's list is a few years so old, so the carb% might be slightly higher or lower than 14%
