A newcomer saying hello

Status
Not open for further replies.

Rebekah + Joe

Member Since 2024
Hi there. I've been a lurker of this site for the past three weeks or so and thought it time to finally say hello. My 12 year old cat Joe is just beginning his diabetes journey and I've already learned so much from going through the posts and information here, so thank you for this treasure trove of community and content.

So Joe has not yet been formally diagnosed as diabetic but all signs point in that direction. He's had IBD for about 3.5 years, which seems to be triggered by proteins. He's been on hydrolised food and varying dosages of prednisolone for much of those three and a half years.

In November and December of 2023 Joe began to have symptoms of vomiting and diarrhoea. Assuming this to be an IBD flare up, he went up to a 5mg daily dose of prednisolone which had no real impact. An ultrasound on 14th December revealed a mottled liver and a shadow that could be an enlarged lymph node, angry pancreas or neoplasm. Blood tests showed no concerns with organ functioning or blood cell count, but his glucose was 27 mmol/L. A urinalysis the following week confirmed the high glucose reading.

Joe is now waiting on a fructosamine test. This should have happened yesterday but apparently he is very difficult to handle at the clinic and the vet and vet nurse couldn't obtain a sample between them. They will try again next Wednesday, and they've given me gabapentin to give him before we attend the office. Even so, the vet said it is unlikely that Joe will be able to have his intial glucose curve done at the clinic - which is their standard procedure - because they cannot sedate him all day and he is hard to handle. So it looks like I will be doing it here at home.

To be honest, I'm a bit frustrated at having to wait another week. It was the only time the vet and the nurse could be availale at the same time. We're now into our third week of being reasonably confident that Joe has diabetes and yet no treatment has begun. Maybe these delays are normal, but meanwhile he is losing 150g of weight per week. He's gone from being ~6kg in October, when he had dental cleaning, down to 5.5. While we wait he is quite a ferocious eater, and I am letting him eat as much as he wants (somewhere in the region of 500g-600g of food per day). I work from home and Joe's an indoor cat, so as long as I'm awake I test every wee with Ketostix or Diastix. If anyone has any suggestions as to how else I can manage this interim period between suspicion and confirmation, please do share your ideas. This is my best friend in the whole world and I want nothing more than for him to be healthy, or at least have his illnesses under control.

Managing the diabetes and IBD together may be a bit of a challenge. One dictates low carbs, the other has primarily been managed by hydrolised dry food.Since I received Joe's blood glucose result a few weeks ago, I stopped feeding him the IBD food. I have to be selective with the proteins he has in order not to trigger the inflammation, but for these past few weeks he's been having James Wellbeloved Grain-Free Turkey in gravy (we're in the UK, in case that brand is unfamiliar to you). Touch wood, we have not had any vomiting or diarrhoea since changing food. He is alert, lively, affectionate. He's both drinking and urinating less frequently. In fact, apart from being underweight and hungry, you wouldn't know anything was wrong when you're around him. His urine consistently tests negative for ketones, but glucose is showing up every time.

Long exposure to prednisolone is a risk factor in diabetes and the vet seems confident that this is the main factor in Joe's case. However, I can't help but feel that three years on hydrolised food is an equal, if not bigger, contributor. It's just a gut feeling I have, considering he was throwing up every day (sometimes as often as eight times a day) in November/December before I switched him to the wet food. It's the only change we have made at this point but his symtoms have improved. The long-term aim is to switch him to a difference immunosuppressant for the IBD, and we have begun to taper down his prednisolone. The vet is also keen for Joe to switch to Purina's diabetes food but it contains chicken, which is a common allergen and one that caused problems for Joe back when he was first diagnosed with IBD. James Wellbeloved is not ideal, at 10% carbs, but it was something readily available on Christmas Eve. I'm now looking at the excellent UK food list for single-source protein alternatives with even fewer carbs. It can be a challenge to get Joe to eat wet food that isn't gravy based, but it will be easier to get him on board while he is this hungry.

Once the diagnosis has been confirmed, the vet has suggested we treat Joe with insulin. Senvelgo was touted as an option but an intermal medicine specialist at a referral centre says that considering it is so new to the market, and there is greater experience in using insulin alongside IBD, that insulin is the better treatment option.

As for me, I've been a little stressed out (mostly by the delays caused by Christmas closures and vet availability) but I think I'm taking it reasonably well. I was so worried that it would be cancer and that nothing could be done. Diabetes might be a little labour intensive to manage (and a bit costly, if you're doing this without insurance like I am) but there's nothing I won't do for this little guy. I've had a couple of vets say to me "Wow, you must really love this cat" and, while that statement's as plain as the features on my face, it makes me really sad. Sometimes I feel the statement implies that all the time, effort and money is not worth it for a 12 year old with comorbidities. But there's no alternative: Joe is everything to me. And fractious though he may be when taken off to back room at the clinic for testing, at home he is nothing but a happy, loving boy with a largely very good quality of life. I will make hard choices for him when the day comes, as I have had to do for other animals in my care in the past, but this is not that day. Joe has so much more life to live; my job is to make it as comfortable and fulfilling as possible.
 
Last edited:
Welcome! This group is amazing! I've learned so much and yet have so much more to learn!

That really stinks to have to wait so long. Ugh! While you wait, maybe start getting your boy used to having his ears handled. You could just massage the area you'll need to be poking. You could order your glucose monitor and test strips, too. Also, have you thought about raw feeding? It's low carb and you can choose your protein to avoid allergens. Also, over age 10 you should avoid high phosphorus to protect his kidneys. I use EZ Complete, which is super easy.

Just some thoughts!
 
Hello and welcome. Having managed both IBD and diabetes, I personally found diabetes easier to handle, once I'd gotten over the initial learning curve. With my blood glucose meter, I can see what is going on inside. Whereas with IBD kitty, I can't tell what is going on inside without an ultrasound.

Some files that might be handy for you in the UK:
You want foods under 10% carb as his primary food. Some people make their own food, as a way to ensure you are feeding proteins on the approved by kitty list. This website has a wealth of information on feeding: https://www.rawfeedingforibdcats.org/ A good probiotic and a prebiotic, such as psyllium husk powder, can also help.

The Diabetic info list above has the names of some of the common blood glucose (BG) meters in the UK. I agree with the above that getting started on testing is a good way to go. You'll be able to see the impact of switching to lower carb food. And your test results might be enough to get the vet moving on getting insulin going without Joe having to go in the clinic.

Another option that works for some IBD kitties is to switch from prednisolone to budesonide. Budesonide is a more locally acting steroid and for many kitties (like my Neko) did not impact blood sugar values.
 
I'm going to tag one of our experienced members who's in the UK (@Elizabeth and Bertie). She's very up to date on foods and supplies that are available.

The only challenge with managing a cat with diabetes and IBD is knowing which proteins to avoid. Most cats will do fine if you can source novel proteins. Most often this includes venison, rabbit, lamb, kangaroo, or pork but there may be other proteins that are fine for your kitty. The other challenge is that you really need to read the cat food labels. While a food may be labeled "chicken" for example, it may also contain fish. As Wendy noted, you can prepare a raw food diet. It requires that you add supplements to make the raw food nutritionally complete. The product that Maria referred to, EZ Complete, is a pre-mix but it is not available in the UK. There may be something comparable, though.\

If at all possible, I would encourage you to ask your vet to prescribe Prozinc. Caninsulin was the required first line choice of insulin for cats and it's not a great insulin for feline diabetes. The UK has broadened their approach but I'm guessing that many vets still prescribe Caninsulin.

I'd also suggest that you begin to learn how to home test. We are huge advocates for home testing. It is the best way to keep Joe safe and to monitor his progress. This is a link to information on home testing.

The other bit of information that we ask of new members is in this post on helping us to help you. There are instructions on dealing with hypoglycemia as well as how to set up your signature and spreadsheet. These items may be a bit premature but I wanted you to have the information handy.

I think you will find a community of cat lovers here who are as devoted to their cats (and other member's cats) as you are to Joe. Many of us have been here for a long time -- well past our cat's lifetime -- paying forward the help we received. The members here are incredibly generous with their time and knowledge and support.
 
Thank you very much for the warm response and the advice. I've been studying the videos on testing/injecting and have a monitor on the way. We were able to take a blood sample from Joe yesterday so we're just waiting on the results of the fructosamine test. That said, we also did a spot test yesterday too and his glucose was 12 mmol/L. This supports the Diastix readings I've been getting for the past 3/4 days, none of which have showed any glucose in the urine (and I'm testing every time he urinates and I'm awake). So, on a change of diet alone, Joe has gone 27 to 12 mmol/L in about three weeks. The vet will give me a call when the results are in and we'll take it from there, but I will remember the Prozinc recommendation. I have started tapering his dose of prednisolone and that seems to have triggered the vomiting and regurgitation again. At yesterday's appointment the vet expressed interest in switching him to chlorambucil - budesonide was not mentioned although another immunosuppressant was, but the vet ruled it out as being high risk for diabetes.

Joe's weight has been stable for this past week, touch wood. I give him a B12 supplement on days when he vomits (every 2/3 days). I've got more food arriving to see if that makes a difference. We tried raw food three years ago and he wouldn't touch the stuff. It seems like, right now, the IBD is the bigger enemy between that and diabetes. As ever, I live in fear that his IBD has evolved to small cell lymphoma as, after all these years on prednicare, I understand it would be impossible to tell the difference between the two. At least chlorambucil would be a step in the right direction if that is the case.
 
Status
Not open for further replies.
Back
Top