2/9 Midas AMPS 158 *Blood in stool

C

colin72

Member Since 2014
Hi

Midas has been doing great the last couple days and I'm cautiously optimistic he's finally on the right rack.

However, this AM there was blood in his stool. He eats alone in the bathroom (I have 4 other cats) and when I went in to let him out, he had pooped in the bath.

I read a little online about what this could mean and since the description seems to matter, here it is... the stool was very dark, it's hard, there's not much moisture at all, and the blood is bright red.

Because I've had to constantly increase his insulin (to 6 units), I've been worried that he may have some underlying condition. Or is the high dose of insulin causing him to have hard stool that could be causing some irritation and bleeding?

I should add that besides seeing blood in this stool, he seems perfectly fine. He's not dehydrated and there have been no behavioral changes.

Any help is greatly appreciated!
 
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Take the stool sample to your vet for analysis.

I doubt it has anything to do with the insulin dose but blood in the stool warrants a call to the vet.
 
Sandy and Black Kitty said:
Take the stool sample to your vet for analysis.

I doubt it has anything to do with the insulin dose but blood in the stool warrants a call to the vet.
Click to expand...

Thanks for the reply.

The vet will run some type of test(s) on the sample?

What type of test(s) can be done? The only type of tests I'm aware of is something for parasites/worms.
 
colin72 said:
Thanks for the reply.

The vet will run some type of test(s) on the sample?

What type of test(s) can be done? The only type of tests I'm aware of is something for parasites/worms.
Click to expand...

Call your vet. Blood in the stool is not normal. Let them know you have a stool sample should they want to check it.
 
I second Sandy's suggestion, call the vet. He/she may also want to see Midas or do other diagnostics like an xray.

On a side note, I see you are up to 6 units of glargine. When a cat gets to that size dose, we suggest getting them testing for some conditions that mean kitty can need higher doses. Two of the more common ones we suggest people get tests done for are acromegaly (a benign tumour in the pituitary gland) or IAA (insulin auto antibodies). Both require blood tests be sent to Michigan State University. If the vet wants to do a blood test anyway, might as well tag those ones on too.

For continuity, the link to your last post here: https://www.felinediabetes.com/FDMB/threads/2-6-midas-amps-239-4-278-8-457.258975/
 
Wendy&Neko said:
I second Sandy's suggestion, call the vet. He/she may also want to see Midas or do other diagnostics like an xray.

On a side note, I see you are up to 6 units of glargine. When a cat gets to that size dose, we suggest getting them testing for some conditions that mean kitty can need higher doses. Two of the more common ones we suggest people get tests done for are acromegaly (a benign tumour in the pituitary gland) or IAA (insulin auto antibodies). Both require blood tests be sent to Michigan State University. If the vet wants to do a blood test anyway, might as well tag those ones on too.

For continuity, the link to your last post here: https://www.felinediabetes.com/FDMB/threads/2-6-midas-amps-239-4-278-8-457.258975/
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Thanks for the reply.

So, I’m trying to figure out how to handle this. I last spoke to my vet 5 weeks ago when Midas went to 3 units. Now I have to tell him I’ve taken advice from this forum (which I don’t regret and believe was the best decision) and Midas is up to 6 units, has blood in his stool and I would like tests done and sent to Michigan U.

How does it work getting tests done at Michigan? I doubt my vet knows anything about these test being done there. What’s the process of getting it done? What’s the approximate cost and timetable?

Thanks!
 
What I did was tell my vet what dosing method I was using, and sent her a copy of the protocol, along with my spreadsheet so she could see what I was doing.

If the vet hasn't done this test before, it's not that different from sending blood to other places for testing. Sometimes labs like Idexs will even do the sending to MSU for the vet, but of course for an added fee. Details on how to do the test are in this Sticky Note that has links to the MSU catalog. I just looked up the cost and it's $68 for the IGF-1 test (acromegaly test) and $21 for the IAA one. Plus whatever the shipping costs are and what the vet charges for a blood draw. If you can do the blood draw the same time as other blood work, you save that fee.

However, if this is too much to think about now, don't worry about it. You can do it later. The blood in stool is higher priority.
 
Wendy&Neko said:
What I did was tell my vet what dosing method I was using, and sent her a copy of the protocol, along with my spreadsheet so she could see what I was doing.

If the vet hasn't done this test before, it's not that different from sending blood to other places for testing. Sometimes labs like Idexs will even do the sending to MSU for the vet, but of course for an added fee. Details on how to do the test are in this Sticky Note that has links to the MSU catalog. I just looked up the cost and it's $68 for the IGF-1 test (acromegaly test) and $21 for the IAA one. Plus whatever the shipping costs are and what the vet charges for a blood draw. If you can do the blood draw the same time as other blood work, you save that fee.

However, if this is too much to think about now, don't worry about it. You can do it later. The blood in stool is higher priority.
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Thank you so much for the response.

I have a call in to my vet concerning the stool.

I was trying to do some research on the tests. I don’t have a problem paying for them, etc, but want to understand what positive results would mean and what could be done.

If a cat does have acromegaly, cancer in the pituitary gland, it seems like not much can be done. So, I guess knowing what’s going on is good but the prognosis seems poor. It that your experience?

As for the insulin autoantibodies test, I read a feline specific vet saying she didn’t recommend the test because of its lack of usability. She says any cat receiving insulin will have antibodies and even a high test result doesn’t mean the cat isn’t able to use the insulin. She says the test doesn’t test for response to insulin or measure insulin effectiveness.

I don’t know if you agree but I’m not clear on if a cat does have a high test result, what can be done with that info?

Thanks again
 
Acromegaly is not cancer, it's a benign tumour that sends out excess growth hormone. There are options for treatment, of varying costs, and one option is just to treat with as much insulin as they need. You also wouldn't pursue treatment without a diagnosis. What diagnosis also give you is a heads up on what possible side effects you might see. For example, if a vet hears a heart murmur I'd recommend an echocardiogram. Heart issues can sneak up on you but can be treated if caught in time. My Neko lived for almost 5 more years after her diabetes diagnosis.

colin72 said:
As for the insulin autoantibodies test, I read a feline specific vet saying she didn’t recommend the test because of its lack of usability.
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And this particular vet has had a cat with IAA before? Both Sandy and I would disagree with that vet, and both of us had kitties with IAA. IAA does tend to resolve over time, but can have an impact on dosing in the mean time. That's why it's important to know what you are dealing with.
 
I can understand that vet re:IAA from one perspective - the majority of FD caregivers do not take things by the reins like we do here. Having an IAA and acro cat, I'm honestly on the fence about the IAA test, I may be the only "dissenter" in that respect. The usability is when it ultimately starts to resolve, it's usually larger/faster decreases than our methods dictate. For me - I'm a cautious reducer anyway when I see trends of hanging low numbers that are hard to bring up, so I don't think knowing would have really changed anything for me. If you can afford it, do it is what I'd say.
 
My boy Black Kitty was the first kitty here at the FDMB to get tested for IAA.

After testing negative for acro and then testing negative for Cushings it was a last ditch effort at trying to figure out why his BG remained high in spite of ever increasing insulin dose amounts. The test results (82%) confirmed extreme insulin resistance due to IAA.

Had I known it could be done back when we were in the thick of it I would have tested for IAA at the same time as acro.
 
What Sandy said. BK was the first but not last cat to be diagnosed negative for acromegaly when a $21 add on would have pinpointed the reason for higher dose right away. Do it later and you have an additional blood draw and shipping charge.
 
Sandy and Black Kitty said:
My boy Black Kitty was the first kitty here at the FDMB to get tested for IAA.

After testing negative for acro and then testing negative for Cushings it was a last ditch effort at trying to figure out why his BG remained high in spite of ever increasing insulin dose amounts. The test results (82%) confirmed extreme insulin resistance due to IAA.
Click to expand...


If I understand it correctly, there's no treatment for IAA. So, after finding out he had insulin resistance due to IAA, how did that information help you?


I also wanted to ask... Midas has not had his urine checked. Could you tell me the proper test/tests he should have done.

Thank you!
 
For me, if negative for the more serious underlying conditions like acro, Cushing's, thyroid, and everything else all good, I'd have just assumed IAA. I don't feel the need to have a reason or a label, as long as everything checks out it is what it is. But like Wendy said, you're there for a blood draw, might as well do it all at once...I think for most of us what's another $30 on top of everything else we're shelling out :rolleyes:

Just offering a different perspective
 
Yes, but then you'd have to add a Cushings test. IAA so much easier and cheaper if done the same time as IGF-1 test. I'm all about minimizing costs and vet visits for the cat.
 
colin72 said:
If I understand it correctly, there's no treatment for IAA. So, after finding out he had insulin resistance due to IAA, how did that information help you?


Thank you!
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It helped me tremendously to know why his bg would not budge. And the treatment while waiting for IAA to resolve is to overwhelm the antibodies with larger doses, in the interest of closing the door on ketone development and also for the sake of his kidneys (by getting BG down below the renal threshold as much as possible).

Early on BK was hospitalized twice with DKA and down to 7lbs and a few oz -we nearly lost him. To recover he needed a lot of calories, like 1.5 to 2 times the calories needed to maintain ideal weight (which was 10-11 lbs) and he needed insulin to convert those calories to usable energy and deliver that energy to all the cells of his body. That was not going to happen in the 300-500bg range and ketone development remained a threat. Although behind us, ketone development was still visible in the rear view mirror.

How resistant was he? It was 6 months before we saw green. That was using fast acting insulin on top of Lantus to the tune of some 25u (combined) each 24 hours.
That green lasted for about 3 hours. It was another 6 weeks (and 3u of increases) before we saw green again. It was a year before he had his first taste of HC

Knowing he had IAA gave me the courage to keep giving higher doses. It took about 45u each 24 hours to lose the red for 3 weeks.

Knowing that the antibodies could go away with little warning, releasing previously bound up insulin into circulation in the blood stream was sobering and frightening - we were always in uncharted territory, walking on a high-wire.

We kept on the path and after 21 months the last cat anyone thought would go OTJ did just that. It lasted 6.5years, which was the rest of his life.

BK blazed the IAA trail here at the FDMB, (stumbling and tumbling along the way)
It was a wild ride.
check out the tribute video (link in my signature box)
 
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