Cat was just diagnosed by vet... but doesn't have symptoms

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robo

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I took my cat Batman to the vet two days ago to see about his sensitive stomach - he throws up often (several times a week), and sometimes even when he hasn't eaten. Other than that, he seemed pretty healthy. He's an indoor apartment cat, but he runs around, eats normally, and seems to drink water and pee normally. The throwing up has been going on for ages - since he didn't seem to have other problems I just chalked it up to a sensitive stomach and tried changing foods (he always gets 'premium' wet and dry foods, not supermarket stuff). He's 5 now and it seemed like time for a checkup and a professional opinion along the way on the vomiting.

The vet did blood and urine tests, and while all the physical checks at the vet office looked normal, called me back the next day to tell me Batman was diabetic and needed to go on insulin. Apparently Batman's blood surgar levels were "in the 200s" when they should have been in the 70s (not sure what units are being used here), and his urine sugar levels were too high as well.

The one symptom he did have (vomiting) is apparently _not_ a diabetes symptom, they said, and he hasn't had any noticeable health changes for a long time (he did lose some weight and get a bit depressed when I introduced a new cat 2 years ago, but he got over that after 6 months or so and seemed to go back to normal).

I'm going back to the vet tomorrow morning where they want to show me how to start administering the insulin, but I'm just puzzled. He doesn't drink or pee excessively, he eats normally (pretty lightly actually), and he's 9-10 pounds - not big but not too skinny either. Overall he seems healthy...


This was my first visit to this vet office (Inwood Animal Clinic in NYC) and they seem to have good reviews online.

I wonder if anyone has any ideas or insight here. Is it normal to go straight to insulin injections for an apparently healthy animal, rather than trying diet change etc?
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

BG in the 200's could totally be accounted for by 'vet stress'.

The BG goes up just from the stress of going to the vet. 100 points or more.
Does your kitty get very stressed at the vet ?

You need to request a Fructosamine test. That will determine if the
BG has been high, on average, over the past two weeks.

I wouldn't start insulin without the results of the Fructosamine test.

What are you currently feeding?
Please read the very good article by Dr. Lisa Pierson, here:
http://catinfo.org/

If your kitty does turn out to be diabetic, the 200's is not terribly high...caught early possibly.

Please come here for more advice before starting insulin. It worries me your vet came to
this conclusion on the basis of ONE spot-check of the blood. Not the best basis for
diagnosis.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

i wouldn't be one to rush to start insulin just yet either.

first i would want to ask if a fructosamine test was done. if not, do it first before starting insulin.
second, most kitties are initially diagnosed with levels of 400+ so to be honest, factoring in possible vet stress, etc.....a number obtained at the clinic only in the 200's is not that bad. as a matter of fact, it's good enough i would actually want to try a diet change first before hopping right on insulin too.

now, about the diet change. you would want to change to a low carbohydrate wet food diet. and believe it or not, alot of the store bought foods are the ones you will want to feed actually. check out http://www.catinfo.org for the most comprehensive info on feline nutrition
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

I would try the diet changes first... if you remove all the DRY foods, and pay attention to the carbs, you may not need to give you cat any insulin at all. There are plenty of cats diet controlled.

Here are some food links for you:
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition


Now before you start on insulin, you can pick up a human BG meter at the pharmacy and start testing Batman's BG numbers.
Test him before he eats, then feed and wait about 30min and test him again. If his numbers drop a bit, you will know he's likely got a functioning pancreas.

There are plenty of things that can cause high BG numbers. You say that Batman's been vomiting and being off for some time, so I think you should look into the cause of that problem as well. Also, dental problems can cause high numbers, as well as infections. Just stress alone can cause the high numbers and who likes going to some strange place and getting poked?

There's plenty you can check and change before you need to jump right in and give insulin.

What did the vet say about the vomiting? That's a pretty big problem so I would want something done about that.
Check on the link above for Binky's and check if the food you feed is on the list to find the carb %. You want to stay below 10% and many aim for around 5%. Dump the dry because it's not good and may be contributing to Batman's high numbers.

You can talk to your vet on the next visit about delaying any insulin until the diet change is tried and the vomiting issue is resolved because it's not FD related.
Finally, get a copy of the blood work results and ask the vet how it was determined that Batman was diabetic? If it was based on just a single value for glucose, it does not mean much. If the vet included a fructosamine test in the bloodwork done, ask what that number was. That test tells you how Batman's BG numbers have averaged out for the last few weeks or so, and if that number is high, then maybe Batman may need insulin.
But not before ruling out all the other problems that could be causing high BG.

I hope you get to the bottom of the vomiting problem.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

200's and the vet is suggesting insulin woth out having a fructosamine test? I would start looking for a new vet too. Or see if this one has any knowlege about trying a diet change first. Don't let him/her force you. Read all about feline diabetes here so you know what you are dealing with, and that this disease is treatable.
My cat was one of the lucky ones to control it with diet alone, with a higher original reading. Thanks to all the information, and smart caring people, on this board.
Get Janet & Binky's food list, get the lowest carb foods and give it a try. I would bet you got it in time.
(PS, I had a cat that used to always throw up all the time... when I changed her food: absolutely no dry food, it stopped...)

Paws crossed.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

My Megan was also found by the vet to have BG in the 200s and significant urine glucose (and even ketones, but not ketoacidosis). It turns out that she gets spikes like that when she is ill or injured or stressed, but with a low-carbohydrate diet, she is usually fine (BG in the 60s, most commonly). I just watch the situation, check her BG once every couple of weeks or so, and keep her vet up on what I am finding, so that we can catch any true problem early.

I definitely would not start insulin on the basis of a one-time at-the-vet BG in the 200s, even with urine glucose. This situation requires more testing (if possible, including testing BG at home, where vet-stress isn't an issue), a diet change to low-carb, and a lot of watchfulness.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

I would not look for a new vet yet. The high blood glucose TOGETHER with the glucose in the urine highly suggests diabetes. However, I would get a confirmation from a fruitosimine test before starting insulin. Also, there is likely something else wrong with Batman that may be the primary problem and maybe should be addressed first based on the BG only being in the 200's.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

Thanks everyone for the advice so far. I just spoke to the vet again on the phone. I mentioned fructosamine and she said they could do a test, but that they usually used that after treatment had started to see how things had been going, not so much for the initial diagnosis. She also said that stress could have explained the blood sugar levels, but that the urine sugar levels were a pretty firm indication of diabetes that shouldn't have been affected by stress.

She also said that while it was possible to try treating with diet, it often didn't work, and was likely to be a problem with Batman's vomiting (they prescribed Hill's I/D diet after the initial visit, but she said that this wasn't suitable for diabetes treatment).

Anyway, she suggested that they re-do the tests, and also do an ultrasound tomorrow.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

I hate to repeat what was already said, but in case you overlooked it, note that Megan *did* have urine glucose but did not have to go onto insulin shots. A diet change did the trick for her.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

robo said:
Thanks everyone for the advice so far. I just spoke to the vet again on the phone. I mentioned fructosamine and she said they could do a test, but that they usually used that after treatment had started to see how things had been going, not so much for the initial diagnosis. She also said that stress could have explained the blood sugar levels, but that the urine sugar levels were a pretty firm indication of diabetes that shouldn't have been affected by stress.
/quote]

While I agree the glucose in the urine is significant, I DISAGREE with the vet's approach with the fructosamine.

After starting insulin, the best way to know what is going on is home glucose testing. Fructosamine tests
(and stressful, expensive vet visits) are then unnecessary.

I'll bet this vet is gonna discourage you from home-testing also.

We can teach you here how to home test, using a blood glucose meter obtainable without prescription
from any pharmacy.

So....where do you and Batman live ? (city/state).
Click to expand...
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

Larry and Kitties said:
I would not look for a new vet yet.
Click to expand...

I, personally, would suspect this vet's judgment though, Larry, that she needs insulin right away. As I did mine when this same situation happened to me. Vet said diabetic from the office BG test alone. I had to ask for the Fructos test too after finding out about it here, or she would have started her on insulin. Fructosmine showed borderline (487) and diet change alone worked for us. It is possible - I hope you are another case!

See what your vet thinks about the wet food diet to control carbohydrates. And hometesting. I knew I had to get another vet when mine laughed at it...

But - You know now, that your cat is carb sensitive. If you continue to feed her high carb food - she WILL need insulin, eventually.
Here's hoping you number is low! :)
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

Jean and Megan said:
I hate to repeat what was already said, but in case you overlooked it, note that Megan *did* have urine glucose but did not have to go onto insulin shots. A diet change did the trick for her.
Click to expand...

Thanks - I did note what you'd said, but when I mentioned this to the vet (the possibility of treating with just diet) the vet sounded doubtful and also said she thought it might be a problem with the vomiting problems (ie. sensitive stomach, unless there is another cause).

I didn't feel in a position to argue with the vet over the phone, but I am going in for another visit with Batman tomorrow morning. I'll ask about home blood glucose testing too.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

If it were me, I'd buy the glucose meter and strips, and switch exclusively to a low-carb diet and test for a week before starting any insulin. I agree that the borderline # (200's) could possibly be a result of vet stress. My cat's numbers dropped a full 100 points from the vet's office to home... You could hometest during this time, and see what the numbers reveal. If they don't improve, then you'll likely have to go on a very low dose of insulin...

Fructosamine tests let you know the approximate glucose levels for the few weeks prior, I believe. Thus, I would think it'd make sense to get this test done, so you know if that one reading was a fluke or not.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

Just a note - my NYC vet, with 30 years in practice, told me that my cat had little to no chance of going into remission. Ever. I ended up ignoring his instructions and instead used the protocol endorsed here (Lantus insulin), along with daily consultation from Dr. Lisa Pierson. Cat was 600+ at diagnosis, and was on insulin for 12 days only. I was lucky that he responded perfectly to a short course of insulin and ultra-low-carb diet.

We're trained to look to people in white coats as the end-all be-all, but most of us have realized, sadly, that most vets have no clue to treat diabetes with a modern approach. It's even harder to listen to a bunch of faceless strangers on the internet. But if you read through pages of the old threads, you'll find endless stories similar to mine.

Good luck!!

robo said:
Jean and Megan said:
I hate to repeat what was already said, but in case you overlooked it, note that Megan *did* have urine glucose but did not have to go onto insulin shots. A diet change did the trick for her.
Click to expand...

Thanks - I did note what you'd said, but when I mentioned this to the vet (the possibility of treating with just diet) the vet sounded doubtful and also said she thought it might be a problem with the vomiting problems (ie. sensitive stomach, unless there is another cause).

I didn't feel in a position to argue with the vet over the phone, but I am going in for another visit with Batman tomorrow morning. I'll ask about home blood glucose testing too.
Click to expand...
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

The reason your vet says do the fructosamine test AFTER being on insulin for awhile would be for people who do not home test and would have no clue if the insulin is working or not, and that's just dangerous.

Best to have the frustosamine test done and then you know how the cat's BG has been on average, but once you get a meter and strips, you won't need to pay for a vet visit and the fructosamine test because the meter can give you an average from your own testing!

Ask the vet why the ultrasound test and also what tests need to be redone? Ask for copies of the last tests done so you can keep a record at home and so you can compare the numbers to the next test results.

I would not ask the vet about home testing; I would just tell the vet that I intend to do home testing for the safety of the cat. Mention that you want to watch for possible hypo situations which can happen if cat BG numbers go too low from the insulin shots. Actually I would not even mention home testing because you are not starting insulin right away.

There are many cats who are diet controlled so what's to say that Batman is not another one? Give it a try first and start home testing to see what his numbers are while he is in his own home and once he starts eating proper diet.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

For the vomiting apparently from "sensitive stomach," I have some experience with that. Not the transient diabetic but another of my cats. Darwin vomited the first time about 12 hours after I got him (fed him Purina Kitten Chow that first day). I changed to another food, the one he was used to, as fast as I could get it, and things got better but the vomiting remained a fixture for this cat. After a number of years of this - not terribly frequent vomiting, but several times a week - Megan developed the transient diabetes and I started giving her Wellness Chicken. Turned out that wasn't the best choice for her - she's one of the rare cats that can't handle high fat very well - but when Darwin snitched a bit of her food and did fine, I decided to try him on slowly increased amounts of it. His vomiting disappeared, as did the mild asthma he had developed (well, the asthma is still there, but barely).

His current vet (the original one retired) has decided that the asthma is from food allergies - rare, but not unknown. As long as we stick to Wellness Chicken or Turkey, there is *no* vomiting and very little asthma (x-rays have confirmed that the asthma is there but is hardly progressing at all).

It was sheer chance that I found how well he did on Wellness Chicken. I had previously tried him on a venison and green pea canned food, in an attempt to find a canned food that agreed with him - I don't recall now why I had decided canned was the way to go, though it was a good decision, it turns out - but the venison food caused his asthma to get vastly worse and didn't help the vomiting. But for some cats venison is a great choice, because it is a novel protein.

Trying different foods until you find the "magic" one may be a way to go. Choose foods with as few different ingredients as possible, so that your chances are increased of avoiding whatever the trigger is. I still don't know exactly what it is for Darwin, which makes food changes a nightmare, but as long as Wellness is working and is available, I will keep him on that. I have figured out that the trigger is one of the "way down the list" ingredients, not the major protein, but beyond that I don't know what the culprit is.

Good luck with figuring out the vomiting. It may be entirely unconnected with the diabetes (if indeed that is what you are dealing with).
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

robo said:
she said they could do a test, but that they usually used that after treatment had started to see how things had been going, not so much for the initial diagnosis.
Click to expand...

This is the opposite of what well-versed colleagues - including the specialists on VIN - would recommend.

The fructosamine is of VERY little value for monitoring cats after the start of treatment since it will not tell you anything about how high or low the cat's glucose level is going. It only reflects an *average* which is not all that useful.

The fructosamine test is of far more value BEFORE we start them on insulin...ie...it aids in the primary diagnosis of the disease.

On another note, I also strongly disagree with the use of the Hill's Rx diets for pretty much anything - including GI problems. There are far better ways to feed a cat than the Rx diets which are high in carbohydrates and low in quality.

Sadly, my colleagues are completely 'married' to the Big Three...Hill's, Purina, and Royal Canin yet many of their patients would be so much healthier on better diets.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

robo said:
I'm going back to the vet tomorrow morning where they want to show me how to start administering the insulin, but I'm just puzzled. He doesn't drink or pee excessively, he eats normally (pretty lightly actually), and he's 9-10 pounds - not big but not too skinny either. Overall he seems healthy...


This was my first visit to this vet office (Inwood Animal Clinic in NYC) and they seem to have good reviews online.

I wonder if anyone has any ideas or insight here. Is it normal to go straight to insulin injections for an apparently healthy animal, rather than trying diet change etc?
Click to expand...

You are going there this morning? To start insulin? I would not do this, especially with questionable numbers. Please heed the advice provided to you on this thread. We're going into the holiday, vet offices will be closed, you are not up and hometesting ...

If your cat truly doesn't need the insulin and those 200's are caused by vet stress...you could kill your cat over Christmas. Demand a fructosamine test with results before treatment begins. Do not allow them to give your cat an insulin shot today, especially as vet offices are going to be closed later this afternoon.

Am I trying to scare you? Well, honestly....just a little. I'd rather scare you a bit now, than find you here posting your cat is sounding hypoglycemic on Christmas Eve. I want you thinking things through. Better high for a few more days...than low and dead. Low blood glucose kills fast.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

Yeah, I have to agree that this is a lousy time to start insulin when you will have little or no support if you have any problems. There is no reason to start insulin before you have had the fructosamine test done to confirm you even need to start insulin.
Better to start home testing over the holidays, and switch up the diet, then after the holidays, decide if insulin is needed.

Have a joyous holidays and avoid any problems or tragedies.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

SaraJaye said:
If it were me, I'd buy the glucose meter and strips, and switch exclusively to a low-carb diet and test for a week before starting any insulin. I agree that the borderline # (200's) could possibly be a result of vet stress. My cat's numbers dropped a full 100 points from the vet's office to home... You could hometest during this time, and see what the numbers reveal. If they don't improve, then you'll likely have to go on a very low dose of insulin...

Fructosamine tests let you know the approximate glucose levels for the few weeks prior, I believe. Thus, I would think it'd make sense to get this test done, so you know if that one reading was a fluke or not.
Click to expand...


And when and IF you start insulin, please, please, PLEASE do not start any higher than
1/2unit to 1unit 2x per day.

No matter what the vet says.

A number in the 200s at diagnosis and if you start on low-carb canned food just does not
justify a higher starting dose.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

Wow.. Just got back from the vet. At my insistence she agreed to check the urine one more time... she drew some urine and did an on-the-spot glucose test, and lo and behold it came back negative.

The vet said it was totally mysterious - and that perhaps the lab screwed up the first urinalysis. She was adamant that a mixup was impossible, but the upshot is that she now says that it's very unlikely that he has diabetes at all (especially combined with showing no symptoms).

She said that a fructosamine test would be interesting, but she said that with the negative urine test today, she didn't think it was worth bothering, as urine glucose levels just don't tend to fluctuate that much over a day or two.

There is of course the frequent vomiting, but it seems that at this point we are back to trying a diet change before trying further things like an x-ray or ultrasound if the diet doesn't help.

Anyway, I just wanted to say thanks to everyone here for the advice and concern, and I'll keep my fingers crossed for Batman's other issues.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

robo said:
Wow.. Just got back from the vet. At my insistence she agreed to check the urine one more time... she drew some urine and did an on-the-spot glucose test, and lo and behold it came back negative.
Click to expand...

I know over the internet and may be not so PC with someone who might never need Feline Diabetes dot com ....ever again....


But...

Merry Christmas!

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Re: Cat was just diagnosed by vet... but doesn't have sympto

Congrats on being vigilant - if you hadn't, you could've had a disaster on your hands. Great job.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

this is great!

nice job to you and all who helped!!

celi & binks
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

Well this is a great Christmas present...Batman does not have diabetes.

As you chase the vomiting problem, be aware that if Batman is prescribed
steroids at any time (like prednisolone or prednisone)....they
can cause steroid-induced diabetes.

Just so you know...

Merry Christmas, and especially to you, Batman.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

robo said:
The vet said it was totally mysterious - and that perhaps the lab screwed up the first urinalysis. as urine glucose levels just don't tend to fluctuate that much over a day or two.
Click to expand...


While Batman may very well not have diabetes (and he probably does not), I disagree with the above statement. Urine glucose *can* fluctuate from sample to sample.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

Lisa dvm said:
robo said:
The vet said it was totally mysterious - and that perhaps the lab screwed up the first urinalysis. as urine glucose levels just don't tend to fluctuate that much over a day or two.
Click to expand...


While Batman may very well not have diabetes (and he probably does not), I disagree with the above statement. Urine glucose *can* fluctuate from sample to sample.
Click to expand...

I guess perhaps I'm incorrectly paraphrasing what she said, but the gist of it was that his urine glucose as indicated by the test she did on the spot in front of both of us was completely normal, and that just didn't fit with diabetes, especially compared with what the lab reported from two days before. Since the test yesterday was done in front of both of us, while the test on Tuesday was from urine taken by a different vet and a tech out of my sight (they had me wait in the waiting room while they took the samples from Batman the last time) and then sent off to an outside lab for testing, the inclination is to believe the test we both saw from start to finish.

This has been an educational experience anyhow, and I certainly now know to keep my eyes open for diabetes symptoms should they show up in the future.


Anyhow, thanks again to everyone here, and Merry Christmas!
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

was that his urine glucose as indicated by the test she did on the spot in front of both of us was completely normal, and that just didn't fit with diabetes,
Click to expand...

I just want to make sure that you fully understand that diabetic cats do NOT always have sugar in their urine since the blood glucose may not always be high enough to spill into the urine - especially in bordeline diabetics.
 
Re: Cat was just diagnosed by vet... but doesn't have sympto

I'm glad that things look better for Batman now! And so glad that you hadn't given him any insulin yet!

As for the frequent vomiting -- has your vet mentioned the possibility that Batman has IBD? Does Batman show signs of constipation as well as vomiting? Angel suffered from IBD and also vomited several times per week, but the wrong steroids given for that made her diabetic. I tried different kinds of food for her, but nothing seemed to help.

Then an internist prescribed Miralax (stool softener) and cisapride (for intestinal motility), and this finally stopped the vomiting. It just took the right vet to figure out the solution.

I hope you can get Batman feeling better very soon.
 
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