6.26 - *NEW MEMBER* Confusing Diagnosis

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Amanda - Adrien Binky

Member Since 2020
Hello All! I first have to say how much I admire all of you for jumping in to help one another. I thank you in advance for any thoughts on my cat's case.

I noticed Adrien Binky starting to drink a lot of water and urinating in big, muddy clumps. I took her to the vet in January, where her BG was 236. She is overweight, so the weight told me that I needed to switch to Senior food (I have 2 other cats, who are also seniors) and needed to go back sometime for a urine test. I switched them all to Purina One Senior food in February.

Binky continued to show excessive thirst/urination. In early June, I noticed her back legs were weak and not totally on her toes. On June 10, I took her back to the vet and her BG was 324 (dipstick). The vet said she is diabetic and needed to start insulin treatment. I was/am terrified of having to inject my cat, so the vet said to try Glipizide for a month and then insulin if she did not get better with Glipizide. I researched Glipizide, found this forum, and decided to get a second opinion on Binky. I also immediately switched her to FF wet food and started methyl b12. The frequent thirst and urination ceased almost immediately after the diet change. The neuropathy seems to have gotten worse and she is walking on her wrists.

June 22, I went to a different vet - got bloodwork done and a fructosamine test. The bloodwork showed her BG to be at 116, and her fructosamine at 384. The vet recommended NOT starting insulin as it might cause her to go downhill if her BG is okay. He questioned her fructosamine level and due to her neuropathy, recommended that I see an internal medicine specialist.

My question is: Is it possible the diet caused her BG to go down and possibly into remission even though her BG was never super high? If that is the case, wouldn't she start to show improvement in her neuropathy? Or are these symptoms that may not actually be diabetes, but maybe a vitamin deficiency?
 
Hello and welcome to FDMB! :)

Hmm I'm hearing more and more of Glipizide lately. It's extremely hard on the pancreas, I hope she is not on it anymore.
Fructosamines are used to diagnose diabetes but are otherwise useless. It gives an average but doesn't show the highs and lows which are more important. That 116 BG could have been a low - we don't know. We can't tell from a fructosamine.

Yes, an appropriate diet change can lower BG. Is she on Purina One now?

I don't have experience with neuropathy but hopefully some more experienced members will chime in soon. Is she on insulin at all? My advice would be to purchase a glucometer and strips and do your own curve at home to see where she's at, that's going to be the most accurate way to tell if she needs insulin or not.

Injecting insulin really isn't scary at all. At first I was thinking it would be something like having to find a vein etc., and if I did it wrong it'd be horrible. But it's very different from that - painless and just under the skin, not going into muscle or anything. It's very easy.
 
Hello and welcome. I can’t offer much advice as Max is newly diagnosed so I’m still learning. I do know reducing carb intake (ie getting off dry food) alone can reduce BG. My first diabetic cat had bad neuropathy. We did the weekly b12 injections and she did improve, but never fully recovered. She did go into remission after on insulin for 6 weeks. I’ve learned on this forum that ECID (every cat is different).
 
Panic said:
Hello and welcome to FDMB! :)

Hmm I'm hearing more and more of Glipizide lately. It's extremely hard on the pancreas, I hope she is not on it anymore.
Fructosamines are used to diagnose diabetes but are otherwise useless. It gives an average but doesn't show the highs and lows which are more important. That 116 BG could have been a low - we don't know. We can't tell from a fructosamine.

Yes, an appropriate diet change can lower BG. Is she on Purina One now?

I don't have experience with neuropathy but hopefully some more experienced members will chime in soon. Is she on insulin at all? My advice would be to purchase a glucometer and strips and do your own curve at home to see where she's at, that's going to be the most accurate way to tell if she needs insulin or not.

Injecting insulin really isn't scary at all. At first I was thinking it would be something like having to find a vein etc., and if I did it wrong it'd be horrible. But it's very different from that - painless and just under the skin, not going into muscle or anything. It's very easy.
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Thank you, Panic! I never filled her Glipizide prescription as I read it could do more harm than good. I decided to change her diet first, since I knew I would need to do that anyway. I got rid of her dry food and she is 100% on fancy feast classic pates.
 
NoahFL said:
Hello and welcome. I can’t offer much advice as Max is newly diagnosed so I’m still learning. I do know reducing carb intake (ie getting off dry food) alone can reduce BG. My first diabetic cat had bad neuropathy. We did the weekly b12 injections and she did improve, but never fully recovered. She did go into remission after on insulin for 6 weeks. I’ve learned on this forum that ECID (every cat is different).
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Thanks, NoahFL. So even when she went into remission, she still had neuropathy?
 
Amanda - Adrien Binky said:
Thanks, NoahFL. So even when she went into remission, she still had neuropathy?
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Yes she did, but it never seemed to bother her. From what I understand it’s nerve damage, The vet thought she was getting sensations back in her back legs, but she started to pull her hair out. She was on Gabapentin for several months before that subsided. We lost her early this year to cancer, but she got to live 2 years in remission,
 
NoahFL said:
Yes she did, but it never seemed to bother her. From what I understand it’s nerve damage, The vet thought she was getting sensations back in her back legs, but she started to pull her hair out. She was on Gabapentin for several months before that subsided. We lost her early this year to cancer, but she got to live 2 years in remission,
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I’m so sorry for your loss. It’s so hard to lose a family member, but I’m glad her last two years were in remission.
 
Yes, changing her diet to all wet low carb food can greatly reduce the blood glucose so it's possible that you caught that in time, like pre-diabetes in humans. 116 is a normal number so no insulin is needed.

Neuropathy occurs when a cat has had elevated blood glucose for some time and usually presents in the rear legs so walking on her wrists could be something else. How overweight is Binky? And is she declawed?

If there's a chance she injured herself, like jumping down and landing wrong, she could have carpal hyperextension.
 
WELCOME TO FDMB! I am SO glad you found us. I think you are going to find answers to your questions here. Hang on for more replies theres a wealth of information here with good people to help you decipher it all.
btw this post will jump your thread to the top of the list. ;):coffee:

Again welcome to the best site on this planet to help you help Binky!
jeanne
 
Even with a cat that is on insulin, neuropathy doesn't disappear immediately after blood glucose numbers improve. It can take some time. If you haven't done so already, I'd add methylcobalamin (also called methyl-B12) to your cat's diet. Many people here use Zobaline. I've linked a product that is formulated for diabetic cats.

I'd suggest getting a glucometer and doing some home testing. It could easily be that your kitty is completely diet controlled at this point but it might also be good to know if that's the case. A glucometer, like Walmart's Relion brand is inexpensive, as are the strips. If your kitty's numbers are normal range (50 - 120) without insulin, you'll know your cat is diet controlled. Just don't go back to dry or high carb food.
 
Hi Amanda and welcome to you and Adrien Binky!

Minnie developed severe neuropathy because her diabetes was unregulated for too long. It was so bad she couldn’t take more than 2-3 steps without having to stop to rest, couldn’t jump and couldn’t use the litterbox. I had to carry her everywhere and I had pee pads all over the house and on my bed too. I bought these cheap dog beds so she could pee in them while laying down and I just washed them every morning. It was heartbreaking to see her that way. Once the diabetes was under control, it took about 3 months for her to recover about 90% and then she slowly recovered even more. The first morning she was able to jump on my bed again to wake me up, I cried like a baby and she probably thought I was nuts lol! I think b12 methyl helped a lot because it works directly in the spinal fluid to regenerate the nerves. I started with the Zobaline suggested by Sienne but since I was giving her 2 a day so she’d get 6mg, it got pretty expensive. Other members here suggested the Vitacost brand that comes in capsules. It actually worked better for us because I could just open the capsule and mix it in her food. Each capsule has 5mg and the bottle with 120 is about $17 I think. I still give her one a day for maintenance. Don’t confuse b12methyl with regular b12 liquid injections as they’re not the same. The injections don’t do anything for the neuropathy. I also saw a nutritionist who recommended an antioxidant to help stop the oxidation caused by the glucose and Minnie was on that for about 6 months too Most cats do recover from neuropathy so hang in there!!
 
Deborah & Muffy(GA) & Wendall said:
Yes, changing her diet to all wet low carb food can greatly reduce the blood glucose so it's possible that you caught that in time, like pre-diabetes in humans. 116 is a normal number so no insulin is needed.

Neuropathy occurs when a cat has had elevated blood glucose for some time and usually presents in the rear legs so walking on her wrists could be something else. How overweight is Binky? And is she declawed?

If there's a chance she injured herself, like jumping down and landing wrong, she could have carpal hyperextension.
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She was about 15 lbs in January and is now 13 something pounds. I know she has another 2 lbs or so to lose. I have her sister (litter mate) who is 10.8 lbs, so if I can get Binky to 11 lbs, I'll be happy with that. She's not declawed - I think that's illegal here. I've had her on Zobaline for two weeks now - her back legs aren't as low (still weak), but her front legs have worsened.
 
Aleluia Grugru & Minnie said:
Hi Amanda and welcome to you and Adrien Binky!

Minnie developed severe neuropathy because her diabetes was unregulated for too long. It was so bad she couldn’t take more than 2-3 steps without having to stop to rest, couldn’t jump and couldn’t use the litterbox. I had to carry her everywhere and I had pee pads all over the house and on my bed too. I bought these cheap dog beds so she could pee in them while laying down and I just washed them every morning. It was heartbreaking to see her that way. Once the diabetes was under control, it took about 3 months for her to recover about 90% and then she slowly recovered even more. The first morning she was able to jump on my bed again to wake me up, I cried like a baby and she probably thought I was nuts lol! I think b12 methyl helped a lot because it works directly in the spinal fluid to regenerate the nerves. I started with the Zobaline suggested by Sienne but since I was giving her 2 a day so she’d get 6mg, it got pretty expensive. Other members here suggested the Vitacost brand that comes in capsules. It actually worked better for us because I could just open the capsule and mix it in her food. Each capsule has 5mg and the bottle with 120 is about $17 I think. I still give her one a day for maintenance. Don’t confuse b12methyl with regular b12 liquid injections as they’re not the same. The injections don’t do anything for the neuropathy. I also saw a nutritionist who recommended an antioxidant to help stop the oxidation caused by the glucose and Minnie was on that for about 6 months too Most cats do recover from neuropathy so hang in there!!
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Thanks, Aleluia Grugru & Minnie! I've had my cat on Zobaline for two weeks and I'm so nervous because it looks like her front paws and steadiness has gotten worse. I've read that vitamin deficiency can also cause neuropathy, although I know she's getting vitamins from wet food & her potassium levels are normal. I just thought her neuropathy would stay the same or better on Zobaline, not worse.

I would cry if she were back on her toes, so I understand you crying when your cat jumped!!
 
Deborah & Muffy(GA) & Wendall said:
Yes, changing her diet to all wet low carb food can greatly reduce the blood glucose so it's possible that you caught that in time, like pre-diabetes in humans. 116 is a normal number so no insulin is needed.

Neuropathy occurs when a cat has had elevated blood glucose for some time and usually presents in the rear legs so walking on her wrists could be something else. How overweight is Binky? And is she declawed?

If there's a chance she injured herself, like jumping down and landing wrong, she could have carpal hyperextension.
Click to expand...
If she was pre-diabetic, would it be normal for her to have diabetic symptoms such as the excessive thirst/urination & neuropathy?
 
Amanda - Adrien Binky said:
Thanks, Aleluia Grugru & Minnie! I've had my cat on Zobaline for two weeks and I'm so nervous because it looks like her front paws and steadiness has gotten worse. I've read that vitamin deficiency can also cause neuropathy, although I know she's getting vitamins from wet food & her potassium levels are normal. I just thought her neuropathy would stay the same or better on Zobaline, not worse.

I would cry if she were back on her toes, so I understand you crying when your cat jumped!!
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I can’t explain why but I can tell you that I started a Minnie on Zobaline early on too and it didn’t really do anything until the diabetes was under control. Maybe the glucose does more damage than the b12 can manage and it can only work once the glucose stops attacking the nerves. I do suggest that you give 2 a day once the diabetes is regulated. It works faster on the neuropathy especially if it’s severe and then you can go down to 1 once it’s almost gone. If you want to try the antioxidants, it’s called Thorne for small animals. I was giving Minnie one capsule a day but it’s a big size so you have to wrap it in a pill pocket or open and add to the food. I tried the latter but Minnie wouldn’t it it because it’s not completely tasteless like the Zobaline
 
Btw, when you have a chance Amanda can you please take a look at this link for new members:

http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

it explains about how to setup your signature, you see I have mine, so folks here can see at a glance the main info about Adrien without having to scroll to the beginning of the post and you don’t have to repeat yourself in new posts :cat:
 
Amanda - Adrien Binky said:
She was about 15 lbs in January and is now 13 something pounds. I know she has another 2 lbs or so to lose. I have her sister (litter mate) who is 10.8 lbs, so if I can get Binky to 11 lbs, I'll be happy with that. She's not declawed - I think that's illegal here. I've had her on Zobaline for two weeks now - her back legs aren't as low (still weak), but her front legs have worsened.
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13 pounds isn't awful unless she's a very small cat. Since her blood glucose was not real high for a long period of time, I wonder if neuropathy is even the culprit. Might be worth having her wrists x-rayed to rule out arthritis, ligament damage or something else. I don't know of any vitamin deficiency that would cause it but continuing with Zobaline certainly won't hurt.

Declawing should be illegal everywhere.
 
Amanda - Adrien Binky said:
If she was pre-diabetic, would it be normal for her to have diabetic symptoms such as the excessive thirst/urination & neuropathy?
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Maybe, and if she was eating dry food at that time she would have been drinking and peeing more. You probably got lucky catching it just as she was heading in that direction and changing her diet pulled her back off the cliff.
 
Deborah & Muffy(GA) & Wendall said:
Maybe, and if she was eating dry food at that time she would have been drinking and peeing more. You probably got lucky catching it just as she was heading in that direction and changing her diet pulled her back off the cliff.
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I’ll be so grateful if that’s the case. I wouldn’t be so worried if her neuropathy wasn’t so bad. Since her potassium levels are normal, I’ll continue with the Zobaline and she if she gets better. Thank you!!!
 
Here’s a photo of her front legs
 

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That doesn't look like neuropathy to me. I'm still leaning toward carpal hyperextension or some form of degenerative ligament damage, possibly age related. With little to back this up, I wonder if being overweight may have contributed to weakening the carpal ligaments. Getting her weight down will reduce the stress on her wrists but this could be a permanent thing. You might consider having stress radiographs done by a vet with experience in orthopedics.

I had asked previously about declawing because I've seen something similar in a diabetic declaw that came to me weighing over 18 lbs. She was down on her wrists and could only take a few steps without pausing to rest. Getting her weight down to about 12 lbs. helped a lot (and got her into remission) but she never really got back to a fully normal gait because, well, her toes were gone.
 
Deborah & Muffy(GA) & Wendall said:
That doesn't look like neuropathy to me. I'm still leaning toward carpal hyperextension or some form of degenerative ligament damage, possibly age related. With little to back this up, I wonder if being overweight may have contributed to weakening the carpal ligaments. Getting her weight down will reduce the stress on her wrists but this could be a permanent thing. You might consider having stress radiographs done by a vet with experience in orthopedics.

I had asked previously about declawing because I've seen something similar in a diabetic declaw that came to me weighing over 18 lbs. She was down on her wrists and could only take a few steps without pausing to rest. Getting her weight down to about 12 lbs. helped a lot (and got her into remission) but she never really got back to a fully normal gait because, well, her toes were gone.
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Ohhh interesting. She’s not limping or anything, but I’ll have to do some more research. Thank you!
 
Amanda - Adrien Binky said:
I want to help her exercise, but I don’t want to force it if she’s in any pain from walking on her wrists. Her back legs are wobbly, too.
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I wouldn’t do anything until you figure out the cause so you don’t risk making it worse. I’m still thinking neuropathy especially if the back legs are also affected. It’s just uncommon to see it in the front legs too. The back legs are typically the are more affected but Minnie’s front legs started to bend as well it progressed and they’d even shake when she was trying to put weight on them :(

maybe ask the vet for an orthopedic referral to get the xrays done?
 
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