@Bron and Sheba (GA) Thank you so much for your response! Scout had been a healthy cat until his DM diagnosis (the only exception is that he had one incidence of urinary crystals several years ago). He is 11 years old. About 2-3 weeks before his diagnosis, he became slower and slower in eating his food, though he still finished it all. He has always been on a twice/day canned food diet - Hill's c/d due to the crystal incident. He also was drinking more water and peeing more often. He then started walking away from his food bowl before finishing. I was able to get him to return and finish his food with a lot of encouragement for awhile. During the 5 days before his diagnosis, he did not completely finish all of his food at his feedings and then refused to eat a meal. I took him to the vet at that point and they did blood and urine tests. The results came in the next day with high blood sugar levels (300+), presence of ketones, and concerning numbers for his liver. I took him back to the vet that same day and he had another blood test. His blood sugar was just over 400. The vet immediately located an opening at an emergency animal hospital for that day due to the test results and his continued refusal to eat.
The hospital placed a feeding tube, began insulin, and ran more tests including an ultrasound. He was diagnosed with diabetes, hepatic lipidosis, and anorexia. The ultrasound also showed that his intestinal track is a bit thickened so there is a question of whether he may also have irritable bowel syndrome or cancer, or it just may be related to the diabetes not yet being stabilized. He was discharged from the hospital with prescriptions for two appetite stimulants (Mirtazapine & Cerenia), Denamarin for his liver, and Ursodiol for his liver. He also had a Freestyle Libre 14-day sensor placed on him for me to monitor his blood glucose levels. The insulin he is on is Lantus and his starting dose was 1 unit 2x/day. The hospital prescribed Purina DM canned food. After he came home, he continued to refuse to eat so I had to feed him specific amounts of pureed food every 6 hours through the feeding tube. This was exhausting; one of the feedings was in the middle of night and each feeding took about an hour and a half which including the preparation, actual feeding time (20 - 30 minutes), and clean-up afterward. I keep a journal tracking his medication regimen, feedings, glucose levels, etc. He was listless and limp for the first 7 days after being discharged. He pretty much hid under my bed the whole time and I had to pull him out for his feedings. It was really scary.
After about 5 days, he began to eat some on his own so I had to monitor how much he ate and then supplement it with continuing to feed him through the tube. Even when he ate small bits on his own, he would take 30 minutes to do so and needed a lot of encouragement and help from me to continue. A week ago, he started eating all of his food consistently on his own and finishes now in 5-10 minutes. That's why he was able to have the feeding tube removed today. He is now on a twice/day feeding schedule aligned with his insulin injections.
His blood sugar levels remained high throughout that time and his insulin dose was increased to 1-1/2 units on 05/04. His levels did not reach the 100-200 range until last Friday night and remained consistently within that range all day last Saturday. When I woke up Sunday morning and did a reading, his level was so low that the sensor didn't even give it a number (which meant is was under 40). I called the animal hospital and was advised to rub Karo syrup on his gums, feed him his regular amount of food, and not to give him his usual morning insulin injection. Within half an hour, his blood sugar level was 70. Two hours later, his blood sugar level was over 400. Unfortunately, the Libre stopped operating later that night so I wasn't able to monitor his blood sugar anymore. The internal medicine doctor decreased his insulin dose back down to 1 unit on 05/11. Another Freestyle Libre 14 was placed today; his levels were over 300 for a few hours after leaving the vet and before his evening feeding & insulin shot. It's now 2 hours later and his reading is 281.
I'm feeling much less overwhelmed than I was the first 10 days after he was discharged; he's eating on his own, I don't have to wake up with him for a lengthy time in the middle of the night, his behaviors are all back to pre-diagnosis normal, and as I learn more about diabetes, I feel more hopeful that it can be managed. I do worry about being able to continue to afford ongoing tests and numerous appointments before he's stabilized. I believe it will be affordable for me to manage his condition once he is stabilized. I'm a single person so the twice/day insulin regimen at specific intervals is a concern as the world begins to open up from COVID quarantine and I eventually return to working out of my office, having more of a social life again, and periodically going on vacation. I have two people in my life who have experience with giving insulin injections to animals and have offered to help me.
