New Member - Senior Cat with FIP & Diabetes

Hi Everyone

I am seeking some comfort and advice for my cat - Donut, a 13 year old ginger since I rarely see cases like this online. My cat has been diagnosed as diabetic since 2024 and has been receiving regular insulin shots - 1 unit of insulin shots, twice a day. 3 months ago, he was diagnosed with FIP since he was losing weight, constantly sleeping and losing strength. Throughout his treatment, his weight remained the same - 3 kg. Based on my previous experience with another cat that was diagnosed with FIP and successfully recovered, their weight would usually go back to normal after a month. When he was brought back to the vet for a check-up after his FIP treatment was completed, the doctor advised to onboard him since the FIP was still not fully cured. They suspected the diabetes was in the way of the FIP medicine being absorbed by the body. Ever since then, it feels like he's gotten worse.

January 1: Before admission to hospital


Was grooming, playing, eating wet food and slowly going up stairs on his own

January 16: In hospital for 5 days since 11 January.

Currently receiving treatment for FIP relapse & Diabetes

He is not grooming himself and only eats wet food. He didn't eat today but he ate wet food yesterday and was on a feeding tube for the days prior - being fed blended up diabetic kibbles. His blood glucose reading today was 30 mmol/L. Yesterday it was 6 mmol/L. The doctors are trying out different insulin brands to see which is compatible with him and using 3 units for now.

His prime years - 2020. Before his diabetes diagnosis and FIP. This chonker was a whole 6 kg of pure joy.



Its's sad to see how much he has devolved. It hurts to see him the way he is now. I'm hoping he'll make a turn for the better and he's able to fully heal from the FIP and get into remission. Right now, I'm hoping he lives to see another day at least. He meowed at me yesterday and the day before when I went to see him - I'm taking that as a sign that he's still fighting. A part of me feels like he wants to just go home. But taking him home right now would risk him having a seizure and passing. If any of you has experienced this, I hope you are able to provide some advice because I'm not sure whether to take him home or keep him at the clinic for longer. Could the treatment be contributing to his decline, or is this progression from FIP?

Welcome to FDMB
He's such a beauty, I am sorry you are going thru this , I was reading about FIP, at least he's getting treated, You do not mention the insulin the Vet is giving, but in the meantime I will tag a member that has an extensive knowledge in cats' medical issues and illnesses and can answers your concerns
@Sienne and Gabby (GA)

Update: his blood glucose reading today is 19 mmol/L. He is getting 2 units of Novomix. The vets are saying that this brand seems to be working for him as it's lowering his reading. He's still responsive and is on a feeding tube now.

Hi everyone,

His weight has dropped to 2.5 kgs from 3.4 from when he was onboarded. His blood glucose readings so far (mmol/L):

17/1
Morning - 16
Night - 24

18/1
Morning - 10.1
Night - 11.7

19/1
Morning - 23.7
Night - 18.5

20/1
Morning - 23
Night - 24.7

21/2
Morning - 28

Not sure why his numbers are going up. It could be the Somogyi effect. Right now, we're thinking of bringing him home since it feels like the numbers are worsening at the vet. It's a big risk and we're hoping to have some at home care advice. What should we prepare and what food should we provide. The vets do not recommend wet food and to put him entirely on diabetic kibbles. Problem is he doesn't enjoy eating diabetic kibbles and enjoys wet food more. They did mention that anything we give him might not be processed by the body.

I don't think too many members are familiar with Novomix insulin. What country are you in? @Sienne and Gabby (GA) @Wendy&Neko do you know how Novomix works for cats?

Many people ignore the vet about food and feed canned food (wet) food only. Vets don't really have a good education or knowledge about diet and how it can affect the health. Diabetic dry food is high in carbs which keeps blood glucose levels high.

Novomix is a combination of a short- and intermediate acting insulins. I did a quick search. I didn't find anything about it's use in cats and quite honestly, I've not seen it used in humans (or at least not any of humans whose medical charts I've read). That said, there are times when a quick acting and a longer acting insulin are combined with good results.

Somogyi rebound is not a real phenomenon. It was coined in 1938 based on a small sample of humans and has never been replicated in humans or cats. There has actually been a study looking at Somogyi in cats prescribed Lantus (glargine). There was no evidence. What I suspect you're seeing is a response to the lower numbers. We refer to this as a "bounce." If the blood glucose level drops low, drops fast, or simply drops into a range your cat is no longer used to, the liver and pancreas release a stored form of glucose along with counterregulatory hormones. These cause a spike in blood glucose. The elevated levels can be there for a few days. Also, while you may be thinking that "diabetic" kibble is low in carbs, it's not. The Purina "diabetic" kibble is 18% carb. We consider low carb as less than 10%. High carb is over 15%. It may be the food that's elevating the numbers.

We do have one member @Cindy loves Tansi whose kitty was treated for FIP while diabetic and went into remission. And just recently went into remission a second time. He was on Lantus/glargine.

What other types of insulin have you tried?

Turtle & Donut said:

Hi Everyone

I am seeking some comfort and advice for my cat - Donut, a 13 year old ginger since I rarely see cases like this online. My cat has been diagnosed as diabetic since 2024 and has been receiving regular insulin shots - 1 unit of insulin shots, twice a day. 3 months ago, he was diagnosed with FIP since he was losing weight, constantly sleeping and losing strength. Throughout his treatment, his weight remained the same - 3 kg. Based on my previous experience with another cat that was diagnosed with FIP and successfully recovered, their weight would usually go back to normal after a month. When he was brought back to the vet for a check-up after his FIP treatment was completed, the doctor advised to onboard him since the FIP was still not fully cured. They suspected the diabetes was in the way of the FIP medicine being absorbed by the body. Ever since then, it feels like he's gotten worse.

January 1: Before admission to hospital
View attachment 76512 View attachment 76514

Was grooming, playing, eating wet food and slowly going up stairs on his own

January 16: In hospital for 5 days since 11 January.
View attachment 76511
Currently receiving treatment for FIP relapse & Diabetes

He is not grooming himself and only eats wet food. He didn't eat today but he ate wet food yesterday and was on a feeding tube for the days prior - being fed blended up diabetic kibbles. His blood glucose reading today was 30 mmol/L. Yesterday it was 6 mmol/L. The doctors are trying out different insulin brands to see which is compatible with him and using 3 units for now.

His prime years - 2020. Before his diabetes diagnosis and FIP. This chonker was a whole 6 kg of pure joy.

View attachment 76513

Its's sad to see how much he has devolved. It hurts to see him the way he is now. I'm hoping he'll make a turn for the better and he's able to fully heal from the FIP and get into remission. Right now, I'm hoping he lives to see another day at least. He meowed at me yesterday and the day before when I went to see him - I'm taking that as a sign that he's still fighting. A part of me feels like he wants to just go home. But taking him home right now would risk him having a seizure and passing. If any of you has experienced this, I hope you are able to provide some advice because I'm not sure whether to take him home or keep him at the clinic for longer. Could the treatment be contributing to his decline, or is this progression from FIP?

Click to expand...

Oh I am so sorry to hear about donut, I am sending healing vibes. My cat Tansi was 16 and had diabetes when he got fip and was in very rough shape also.
He was on lantus. I'm not sure how it happened but somehow while on the fip meds he went into remission ftom diabetes.
Due to his age, it took much longer for the fip medicine to work but he completely recovered.
Please get in touch if I can gelp in any way.
Hugs

Thank you everyone for the helpful and kind messages. The country we're in is Malaysia. We're not so sure also about how diabetic treatment for cats here differ from other countries. The vets did say they were experimenting what brands would work with him.

@Cindy loves Tansi Can I know how long Tansi was boarded for? Donut has been in the vet for almost 11 days now. We are thinking of switching to home care. He is currently in the oxygen chamber as he looked weak. He is still peeing and pooping. Should we keep the feeding tube on him? We're not sure whether to fully transition to Fancy Feast wet food or continue feeding him the blended up diabetic kibbles through syringe. If you're ok, I'll send you a direct message to ask you more since our situation is similar.

We did consider that the food might be the culprit of this situation + the FIP taking a toll on his pancreas or organs. Just scared that feeding him the wet food might spike his blood glucose readings more.

Update: He has been in the oxygen chamber because he had a crash and his blood glucose reading dropped to 3 mmol/L in the morning. His latest blood glucose reading is 8.9 mmol/L.

Update again:
Ultrasound shows swelling/masses in the liver and pancreas. While tumors can't be ruled out without a biopsy, the vet is treating these as FIP pyogranulomas (inflammatory clumps) because a biopsy is currently too risky for him. We're hoping the FIP medicine will work it's way within next few days. Does anyone have any advice on what to feed him, calorie wise and timing of the feed for him to regain enough protein and energy back?

I am so sorry, I hope he gets better, you are doing everything possible, you are a champ!

Turtle & Donut said:

Update again:
Ultrasound shows swelling/masses in the liver and pancreas. While tumors can't be ruled out without a biopsy, the vet is treating these as FIP pyogranulomas (inflammatory clumps) because a biopsy is currently too risky for him. We're hoping the FIP medicine will work it's way within next few days. Does anyone have any advice on what to feed him, calorie wise and timing of the feed for him to regain enough protein and energy back?

Click to expand...

Although it's more important he eat something instead of nothing, if anything increases his glucose it is kibble. (unless you have managed to find a low carb kibble like Dr. Elsey) In general wet food such as Fancy Feast Pate, or Friskies Pate is a good low carb choice. Avoid wet food with gravy in general, it is higher in carbohydrates and should be reserved for a very low glucose event. There is a special file in the data base here with an extensive list of different wet foods and their carb content. I will reply to your direct message shortly and I hope Donut has a good day. We are all rooting for him.

I do not believe that They have Fancy Feast in Malaysia, that would be great, I will tag a couple of member that may be able to find a member from there or a food list
@Marje and Gracie
@Wendy&Neko

Turtle & Donut said:

Thank you everyone for the helpful and kind messages. The country we're in is Malaysia. We're not so sure also about how diabetic treatment for cats here differ from other countries. The vets did say they were experimenting what brands would work with him.

@Cindy loves Tansi Can I know how long Tansi was boarded for? Donut has been in the vet for almost 11 days now. We are thinking of switching to home care. He is currently in the oxygen chamber as he looked weak. He is still peeing and pooping. Should we keep the feeding tube on him? We're not sure whether to fully transition to Fancy Feast wet food or continue feeding him the blended up diabetic kibbles through syringe. If you're ok, I'll send you a direct message to ask you more since our situation is similar.

We did consider that the food might be the culprit of this situation + the FIP taking a toll on his pancreas or organs. Just scared that feeding him the wet food might spike his blood glucose readings more.

Click to expand...

I think that it might be risky to bring him home if the oxygen seems to be helping him. But also he can't stay there forever so I would definitely get in touch with Fip Warriors for their opinion. Tansi was only boarded for a day and was sent home with the understanding he would be euthanized in a few days, as I described in the private message.

There are some old threads with suggestions on food available in Malaysia:

Pls help. Canned food for diabetes cat.
I am new here and wanting advice on care for my diabetic cat
Can Sheba canned Replace Fancy Feast Classic?

Hi everyone. Our furry friend has crossed the rainbow bridge early morning (in our timezone at around 6:45 AM). My fiancee was able to be there for him as he let out his last breathe, stroking his back and consoling him. Donut had been wanting to go out of his cage to reach my fiancee during odd hours of the night. We believe he knew it was his time to go.

There is some guilt I feel that we weren't able to understand what exactly he was trying to say until the last moment. We're glad he didn't pass alone on his own in the vet. I feel like he really held on to see my fiancee one last time at home before he passed. There's a lot of things we wished we could've done right or better. But id like to believe Donut enjoyed his 13 years with us - especially my fiancee.

We just finished burying him and currently spending time with family. Thank you everyone for your advice.

Rest in peace Donut in a heaven full of chicken together with your brothers and mother, Muffin, Zuzu and Ginger.

I’m so sorry for you loss Rest in peace Donut

So sorry to hear about Donut You did the best you could for him. It sounds like he was ready and you made the right decision for him. Even with treatment, FIP is still a very brutal condition and many complications during treatment are still entirely new ground for the best vets. It's not your fault, please be gentle with yourself during this time