Advice please! Rufus relapsed HARD after remission

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injuredrabbit

injuredrabbit

Member Since 2018
Hey all -
It's been a while since I posted because Rufus went into a very lovely and fairly lengthy remission last year. Well, the diabetes came back like gangbusters, accompanied by (or perhaps partially because of) a UTI.
So far he's had 2 rounds of blood/urinalyses in the past month, and an antibiotic injection (the 2-week duration kind) on his first visit, oral antibiotic on second visit (even though he was asymptomatic for UTI this time) and Cerenia scrip both visits. He's currently on Vetsulin, 1.5u.
Last week was the second visit to vet as he was definitely obviously feeling 'off,' though not to the extent that he was for the first visit. He rebounded for a few days after that trip (residual adrenaline??) and now he's back to his lethargy/listlessness, inappetance, and vomiting. Vet can't see him until Monday (it's Saturday here).

So two questions. Is it possible he's developed pancreatitis, or would that (or something pointing to a possibility of that) have been detected in blood work? The research I did was not really specific regarding that. Secondly, should I be giving him the Vetsulin if he's hardly eaten in the past 18 or so hours? I haven't done a glucose test but both times before administering yesterday it was hovering around 400, which is high for him - baseline high is normally about 350.

I know emergency vet is a possibility, but I'd prefer to see someone who knows his history. And also, as much as I abhor bringing $ into the equation, I have dropped a LOT of money on him (over $1K) in the past month, to no avail.

He does still purr when petted, but honestly his quality of life doesn't seem like it's been great since his relapse. He sleeps most of the time.

Any advice is most welcomed and appreciated. Thanks for reading my long post.
 
UTIs can be tricky. Did the vet do a sterile urine test (i.e., a cystocentesis where they get a sample by putting a needle into the blade) and then get a culture and sensitivity done. This is really the only way to know what antibiotic will work. It sounds like the first round, the vet gave a shot of Convenia. If this is the case, it's not the best antibiotic for a UTI. Convenia's only indication is for skin infections. Apparently, vets like to use it because you don't have to pill your cat. If a cycstocentesis and a C & S wasn't done, you really need this if Rufus still isn't feeling well. It can take a while for the C & S to yield results.

The other issue is that what sometimes seems like a UTI may, in fact be a kidney infection. These take a longer course of antibiotics. This is a link to information on UTIs that you may find helpful.

Pancreatitis is always a possibility. The test you would need is either a Spec or a Snap fPLI. The Snap form is much like a pregnancy text with a + or - result and can be done in the vet's office. The Spec version is sent out to a lab.

The food issue is also tricky. I would encourage you to go and get some Ketostix and test Rusfus' urine for ketones. With an infection/inflammation, not enough calories, and the potential of skipping insulin, you increase the risk for ketones developing. Not only is DKA an expensive condition to treat, it can be life threatening. I would do whatever you can such as assist (syringe) feeding in order to get both food and insulin into your cat. The lethargy concerns me. It is often a sign of ketones developing.
 
Thanks for the reply. I will get the Ketostix. I neglected to mention above that he has been vomiting as well. I gave him 8 mg Cerenia tab and less than 10 minutes later he vomited it back up, along with some liquid. If he is nauseated and vomiting, I don't think that even if I syringe feed him he'll keep it down.
Also, what is the best way to do a urine sample if you can't be monitoring your cat every minute? I'm assuming you have to somehow hold it under the pee stream before it hits the litter.
 
Yes, UTI's can throw a cat out of remission and that looks like what has happened to Rufus.

Have you tried hand feeding Rufus to get some food into him so he can then have some insulin? Hand feeding is messy, so be forewarned. Maybe add a bit of water to his normal canned food to help it go down better. Not soupy, but easier for you to handle. Place tiny pieces (think pinky thumbnail size or small olive size). Recommend you do this on a floor that is easy to clean and put a towel over your lap. Using a flavor of food that he doesn't like as much can be helpful, so if he goes back to eating on his own, he'll still eat one of his favorite food flavors. Go slow, give him time to swallow. Then next little bite.

Go get some ketostik at any drugstore as Cheryl suggested, to test the urine.
 
Cross posted. Just saw your vomiting post. Hand feeding not likely to help. Is it safe to try another dose of the cerenia?

Worst case, stick the ketostik right in the wet litter clump.

Put some plastic wrap down in the spot of the litter box where he usually pees.
 
I don't have a lot of experience with this, but I hope you get some answers soon. Sometimes animal shelters have a sliding scale vet. Some vets do house calls. You could call around. If he's lethargic, has an infection, and can't keep food or pills down, it would seem the only option left would be IV medication and IV fluids, but if you feel that he's not got much time left, I can see why you wouldn't want to go that route, especially since it will probably involve plenty of invasive tests.
 
You are the best judge of your cat and their quality of life. Decisions are always in your hands. To keep treating or if it's time to stop and euthanize your pet is one of those extremely difficult choices we make for our pets.

I use this quality of life scale to help guide me and help assess. Ohio State University link for things to think of when it might be time to euthanize your pet.

I hope some of this information may help you.

For me, the last time was when my cat Wink's breathing became labored, he could not lay down, looked and acted absolutely miserable. His heart disease had progressed too far so it was time to let him go. I've had to put 4 cats to death over the last 8 years. It's never an easy decision. Still miss them all, every day.
 
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