? Cat meowing A LOT but normal glycemia

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kimouette

kimouette

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Hi guys,

I am helping someone with a long term diabetic cat (has been on Lantus for over 3 years). She's 14 years old and otherwise healthy.

During the pas couple of months, the owner has been complaining about her cat always being super hungry and meowing a lot (even during the night) while her glycemic test results are normal.

She even got into remission for 3 months and the meowing seemed to have calmed down a little (but not completely). As soon as she started to give insulin again, the meowing became unbearable and it always freaks me and the owner out cuz we suspect a hypoglycemia (results around 60-90 at nadir should not trigger this kind of reaction!)

She brought the cat to the vet for a complete blood count and exam, and the results all came back normal. Including T4, SDMA, kidney and liver values etc. everything looks fine.

She has almost doubled the amount of food the cat eats, but still, she wont gain any weight.

And even though the cat does not go outside, the owner decided to give her a deworming pill (just in case) and the vet has not found any mass or anything suspicious about the cat.

Any of you knows what might be happening here?
 
Is she on any other meds, perhaps gabapentin?

Have they done a GI panel? Any diarrhea, vomiting?

No arthritis, neuropathy, that sort of stuff? Mouth is ok?

Does she home test daily?

Low BG in and of itself doesn't always cause hunger, but sometimes the drops in BG do. But if she's just always hungry I suspect there's (1) another underlying issue like IBD or SCL, (2) she isn't feeding enough (have you calculated calories required?), and/or (3) her BG is hyperglycemic more often than not.
 
FrostD said:
Is she on any other meds, perhaps gabapentin?

Have they done a GI panel? Any diarrhea, vomiting?

No arthritis, neuropathy, that sort of stuff? Mouth is ok?

Does she home test daily?

Low BG in and of itself doesn't always cause hunger, but sometimes the drops in BG do. But if she's just always hungry I suspect there's (1) another underlying issue like IBD or SCL, (2) she isn't feeding enough (have you calculated calories required?), and/or (3) her BG is hyperglycemic more often than not.
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Thanks a lot for the quick reply FrostD!
Here are the answers....
Ni GI panel was done, but everything about her digestion is normal (no diarrhea or vomiting + normal stool).
She does not take any med.
No arthritis or known neuropathy. Mouth is ok (had a dental procedure done about 6 months ok but no teeth needed to me removed).
She does test her daily but wont fill the damn spreadsheet like I asked her to! She shares with me the pictures of the paper on which she writes the BG levels.
I understand that the drop in BG can cause hunger, but since it also occurred while she was OTJ (it was milder, but clearly still happening), I wonder if it has anything to do with her diabetes.

Just a quick search gave me this for IBD and SCL : Common signs of feline IBD include vomiting, weight loss, diarrhea, bloody stools, lethargy, and decreased appetite. These signs can vary in severity and frequency, and the predominant signs depend on which parts of the GI tract are affected.

Except for the weight loss, none of these fits the current situation (especially the fact that with these disease, the cat has an increased appetite).

I'll count the calories but I suspect it's going to be fine since she has been feeding her the exact same food for many years, but now twice the amount she used to!
 
I second the thyroid check. Lewis just howls for food, it's his thyroid and nothing else other than being a selfish 'me first' cat. Marco was an outdoor cat before we rescued him, he'll circle the door howling to be let out. Other times he's like a dementia patient, the meowing stops the instant I rub his head.
 
Me too, the thyroid was the first thing I suspected. But like I said in my initial post, the T4 result is right in the middle of the normal range and nothing was noticed during the physical exam.

If it is dementia... is there any way to confirm it? And any natural treatment to help?
 
Dementia is possible, but if she is eating and not gaining weight, that sounds like there may be another issue. What is the owner feeding her and how much? It may still not be enough food. Also, were her teeth checked? When was the last time they did a full blood panel?
 
Deafness can also cause meowing.

The cat might benefit from multi meals a day. Main meals at shot time and snacks throughout.
 
Dementia is a whole other thing and should only be looked at when all else has failed. Some vets will even deny dementia is possible in dogs and cats.
We had a dog with dementia, it was awful. She walked off leash through the neighborhood for 12 years without a single complaint. One day she got halfway down the block and didn't know where she was anymore. There's no clinical test and no matter what people say there is no magical supplement.
 
The last full blood panel was about 3 weeks ago, but symptoms have been going on for months now.
The teeth were taken care of (and the fact that the cat eats TOO MUCH kind of proves that the teeth are fine).
She is is already fed multiple meals a day (and she is using an automatic feeder for the night that offers a fresh meal of paté every 2 hours).
I just told her to go back to the vet and ask for a fT4ed test.
Dementia might be a part of the problem, but it wouldn't justify the ravenous appetite + loss of weight

Thanks guys for all the suggestions, it's really helping!
 
Was the dewormer broad-spectrum and cover tapeworm as well? Was it done more than once? Tapeworms (acquired from ingesting an infected flea) can be difficult to catch in a fecal. Deworming often requires two doses a couple of weeks apart to catch all stages of the lifecycle.

Are you sure the cat’s BG isn’t dropping low and just not being caught? The nadir can move around, so it’s important to rule out surprise lows.

Is the poop normal color

I also agree with getting a more thorough thyroid function test— if not a full panel, at least a test called “Free T4 (by ED).” The T4 alone isn’t always definitive.

Finally, it wouldn’t hurt to check the cat’s blood pressure and eyes/eyesight. Are the cat’s pupils normal or do they appear overly large even in direct light? Hypertension is often secondary to another issue (such as kidney disease), but it doesn’t hurt to rule it out. Vision issues can sometimes cause vocalization.

Ditto the prior comment about hearing — wouldn’t hurt to verify the cat isn’t deaf or having hearing problems.

It would be helpful to have a spreadsheet, as you know. Since the owner shares with you the handwritten notes, is there any chance you’d have the time /be willing to update the spreadsheet for her?
 
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My cat had very severe IBD (?SCL) and his only symptom was weight loss. He was eating a ton but lost about 2 pounds. I was skeptical about even running the GI Panel (expensive) when he had no GI symptoms but was shocked when his folate and B12 came back severely low and once put on pred, he gained his weight back within 6 months. There is also a pretty rare condition called EPI where the cats are ravenous and losing weight because their pancreas isn't making digestive enzymes so they can't absorb the food correctly. It's usually associated with diarrhea but not always. It's also more common in dogs so a lot of vets think it can't happen in cats, so you have to convince them to run the test, but there were a few cases on my IBD forum where adding pancreatic enzymes saved their cat's lives.
 
The GI panel is a send out (bloodwork) to Texas A&M University (TAMU) and includes the fPLI, fTLI, folate, and cobalamin levels.

The fPLI tests for pancreatitis; fTLI for exocrine pancreatic insufficiency (EPI). Folate and cobalamin are related to GI health and it’s not uncommon to have to supplement if there are GI issues.

If X-rays or ultrasound haven’t been done, that’s worth considering too.
 
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