7/23 New member, recently diagnosed, things not working

[snk]

I have had Martin for nearly 7 years, he is almost 10 (estimated, he was a shelter cat) and he is just the sweetest, nicest, best kitty anyone could ever ask for.

He has a had rough year. He has had IBD/digestive problems since I rescued him. At the beginning of the year he was having a lot of GI and UTI problems. Finally in April, his vet referred him to a specialist. The specialist is two hours from where we live. He saw the specialist in May and was found to have a pretty bad case of pancreatitis. We started treatment for that and his PLI levels came down.

But then right before his recheck towards the beginning of June he was really sick. I took him to his primary vet because he was just acting so unlike himself. They ran tests and his blood sugar was "Hi" on their small meter, so they had to run through lab equipment and it was 599 and he had trace ketones in his blood. He's always been between 9.5 and 10.5 lbs (fluctuates a little because of the IBD), but he was down to 8.8 lbs. His primary vet started him on Vetsulin.

Looking back he had all the classic signs of diabetes: drinking/urinating a lot more, losing weight despite eating, etc.

He had already had a recheck with the specialist scheduled for two days later. She took over his diabetes treatment, switched him to 1 U of glargine twice a day and switched to Purina DM, which thankfully he tolerates GI-wise, since there is so much he can't eat. His fructosamine came back as in the 500s.

He had a recheck two weeks later right after the 4th of July, and his blood sugar again came back "Hi," his fructosamine was checked and was 776. He was down to 7.6 pounds. She increased his insulin to 1.5 units twice a day.

Last week he was at his primary vet for nasal congestion. The did some blood work and his glucose was 827, he was down to 6.8 pounds. The specialist increased him to 2 units twice a day. He gets his weight, glucose, and fructosamine checked tomorrow. But I'm just concerned that this still isn't working. He seems like he has lost more weight since last week.

He is on quite a bit right now, the insulin; cerenia, zofran, metronidazole, mirataz and buprenorphine for the pancreatitis. The specialist also wanted to start Atopica because his pancreatitis is flared up a lot again, but that seems to have made his appetite drop.

He acts fairly normal and like himself still (chatty, snuggly, and so on),

His specialist has said she doesn't believe in "chasing the numbers" and doesn't have him have spot glucose checks (she does have me check his urine for glucose and ketones), and even told the primary vet last week she wasn't concerned with his glucose number when they called her office last week (because they were worried with it that high). But this just really isn't working. His blood sugar is unbelievably high, he is still losing weight despite the insulin and eating well, and still drinking a lot (but not quite as much) water.

Any advice, insight, thoughts, are greatly appreciated. I'm just so concerned that his is going to literally waste away if this doesn't get under better control and soon.


Thanks

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
I am sorry you are having such a different time getting Martin sorted out.
He is on a good insulin. I am glad his tummy issues seem to have settled.

His specialist has said she doesn't believe in "chasing the numbers" and doesn't have him have spot glucose checks (she does have me check his urine for glucose and ketones), and even told the primary vet last week she wasn't concerned with his glucose number when they called her office last week (because they were worried with it that high)

I disagree with the specialist. Hometesting and knowing how well the insulin is working is, in my opinion, not chasing the numbers. It is keeping Martin safe and seeing how well the dose is working. Putting one’s head in the sand and hoping for the best does not work with diabetic cats.
It is good you are testing for ketones…please keep doing that.

Here is what I would recommend you do to help Martin get back on track.

• Get yourself a human glucose meter and start hometesting the blood glucose. If you live in the US you can get a ReliOn premier meter at Walmart cheaply. You will also need 100 test strips to go with the meter, a box of 100 lancets size 26 or 28, and some cotton balls to hold behind the ear when testing.
  We can help you with learning to hometest. Then you test before every dose to see it is safe to give the dose. So you would test, feed and the give the insulin. Then we recommend you test at least once during every cycle to see how low the dose is taking Martin. Lantus dosing is based on how low the dose takes the cat.
• Set up our spreadsheet and start adding the BG data to it. I’ll give you the link below how to set it up.
• Set up your signature…it’s easy. Link below.
• Look at our two dosing methods and then follow one of them. If you post daily here for awhile, we will help you with that…no problem at all.
• Give snacks during the cycles as well a the 2 main meals. A snack is a teaspoon or two of low carb food.

Here is the link to the SS, signature and the hypo kit…make sure you have a hypo kit set up please in case of low numbers.
HELP US HELP YOU
Make sure when you set up the signature that you put in ‘history of ketones’ please as this is important for us to know when helping you.
I’ll give you more links later. I don’t want to overwhelm you first up
Bron

 

[snk]

Thanks so much for all of the information!

I just dropped him off for his fructosamine check with his primary vet. He lost nearly another half-pound since last week, (down to 6.4 pounds ). So they are going to keep him through the day and do blood sugar checks every couple of hours until I can pick him up. We will see what the day brings and work on the other things

 

[Sienne and Gabby (GA)]

Welcome to FDMB.

Which version of DM are you feeding Martin -- canned food or dry? First, DM is not necessary. It is not "diabetic" food regardless of what the vet thinks. In fact, the pet food manufacturers lost a class action suit for calling their foods "prescription" food since there is nothing in most of those foods that are specific to treating any disease. The canned DM is lower in carbohydrates. It's about 7%. The dry food, on the other hand, is very high in carbs. It can easily be contributing to why Martin's numbers are as high as they are. The carbohydrates in your cat's food are a major factor in treating diabetes. We consider low carb as less than 10% although most members here feed their cat in the 5% range. This is a link to a chart that contains most of the canned foods available in the US along with nutritional information, including carbs.

If he does have IBD, you will want to consider foods that are novel proteins. Proteins such as venison, rabbit, lamb, or pork and anything else that hasn't been a part of your cat's usual diet will help enormously. ZiwiPeak is a very good food and does have varieties that are novel protein.

Also, if the vet has suggested only twice a day feeding, you can ignore that, as well. Your cat needs to eat and gain back some of the weight he's lost. If he's hungry, feed him!

 

[snk]

He is on the wet DM; he doesn't care for the dry version. He is free-feed throughout the day to try to stop the weight lost. Prior to the diabetes diagnosis he was on Royal Canin Hydrolyzed protein dry (which he liked). We have tried so many different foods, and unfortunately his IBD is really sensitive to most of them. I have tried rabbit and lamb food in the past and it aggravates the IBD, unfortunately. It could be worth a try again though now that the IBD is under better control.

Thanks!