Confused and concerned- need an expert!!

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Wendy&Tiggy(GA)

Wendy&Tiggy(GA)

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My cat Tiggy has been diabetic for about 6 weeks now. He is on lantus insulin. I have a home glucometer and test him regularly. He started on 3iu twice a day and we saw his BG levels drop from the 300s down to the 50s last week or so.

Seeing this drop my vet said let's start reducing the insulin and moved him to 2iu maybe a week ago. Then a few days ago he started to have intermittent diarrhea and his BG levels were still 50s so she said lets try taking him to 1iu now. That was day before yesterday and starting last night he stopped eating and drinking entirely and his diarrhea is worse- it's like pale yellow liquid today, although he had a dark brown slightly soft poo as well earlier in the day.

His BG last night was 97 and this morning was 66. We have been force feeding him karo syrup and tempting him with anything but he isn't interested. I managed to get his BG up to 100 after the karo syrup but he still won't eat. We stopped his insulin today because of this, He seems interested in food and will sniff it and make lip smacking noises but then just walks away. Any idea what's going on? Is his BG too low? Or could it be something else? The vet believes its hypoglycemia but I thought his BG had to be lower than 40 for that? She dismissed tooth problems (although he does have an issue with one tooth we want to address later) and said not pancreatitis.. Help?!
 
Thank God you were hometesting and that you didn't give any insulin today. You can stop the Karo.....that alone could be contributing to the diarrhea. Does he act nauseous at all when he sniffs the food? Can you flip back and look at the color of the skin on inside of his ears? I'm looking for any signs of jaundice(yellowing) because that means a problem with the liver, possible going into fatty liver (hepatic lipidosis). I would leave him be for the night unless you are in another country and it is daylight there. Then I might consider going to a new vet that might be more concerned with his lack of eating. Please do not give any more insulin till he goes over 200.....if he goes over...he may have just gone into remission and yes, it can happen that quickly with a good insulin like Lantus.

You could also try seeing if he will eat any food off your finger and if he keeps the food down. He should not be allowed to go too long with the diarrhea because he could become dehydrated. There is a test that can be done for pancreatitis and no way to rule it in or out without that test. Please keep in touch on this board for any new changes and let us know. Others will also chime in. What state are you in also? We might have someone near you.
 
Great thanks. The diarrhea started before the karo syrup so don't think it was that. Does hypoglycemia cause diarrhea? No sign of jaundice fortunately, he hasn't been eating for 24 hours yet so can see why the vet isn't concerned yet.
 
Great job at monitoring your baby!

If this baby were mine...I'd take him to the er vet...based on the basic symptoms (diarrhea/lethargy/no eating or drinking) it is very likely he is dehydrated...he may need a saline bolus(sp?) If the concern is also him being hypo, they can help regulate that (others on here have more info/experience on this one).

No eating or drinking can affect the liver pretty quickly in cats...I wouldn't mess around with it...
 
No way of knowing if he did go too low and that upset his system but amazed the vet didn't stop the insulin when he was showing in the 50's. Did you change the brand of food? Is he showing signs of dehydration? Pick skin up at scruff of neck......it should snap back down. May also have infection starting. Is he urinating okay?
 
Does he gag at the smell of food? Just gag, no throwing up. Does his breath smell like nail polish remover? I dont' think it would be ketones but anything is possible.
 
The vet wanted to wait on the fructose mine levels before changing his insulin levels, and they are now completely normal which is why she is changing it. We haven't changed his food recently, and his urine levels are less right now so probably is a little dehydrated but I am still trying to find the diarrhea cause.. Unless this is a catch 22 situation? His BG got too low, caused diarrhea which is now causing dehydration which is making him not want to eat? But then surely wouldn't this all resolve when the BG goes back to normal with the syrup? Wouldn't his appetite and thirst come back?
 
He is Occasinally gagging- and I checked his urine for ketones with keto-diastix but they are clear. His breath isn't great but no nail varnish smell..
 
Reason for asking was all of mine that I've dealt fatty liver with all started with not eating and even the smell of dry food would make them gag. Please have him looked at tomorrow. Fatty liver doesn't take long to start when a cat stops eating. If nothing else, he could probably use some fluids a the least.
 
The diarrhea can become problematic and I would suggest a vet appointment. At the very least, you need to have the vet determine if the diarrhea is the result of an infection, your cat having eaten something problematic, irritable/inflammatory bowel problems or any number of other issues. (And you should probably bring a stool sample.) You cat may need antibiotics. At the very least, you may want to consider talking to your vet about whether to give your cat a probiotic to help get his gut back to normal. Many of us use FortiFlora or other probiotics.

More than a day's problem with diarrhea is a vet visit, IMHO.
 
Saw the vet today.. got Sub-Q fluids, antibiotics, pain killers, special high calorie recovery food and a big syringe for force feeding. She also gave him a 24 hour anti nausea shot. This will cover either pancreatitis, or , she thinks he went into remission really quick and this is a result of hypoglycaemia. Is off the insulin till he gets better. Got enough to do us over the Christmas period.. keep your fingers crossed for him!
 
The symptoms made me think kidney stuff too, so good on the antibiotics. Thankful that you stopped the insulin. It very well could have been hypo. 50's is a very low number, especially if you don't know if that number is still going to go lower. In the tight protocol for Lantus every time a kitty goes in the 50's they get a reduction.

I hope this means the your baby will recover and not need any more insulin! Kind of scary way to go OTJ, but it is OTJ none the less.
I hope everything goes alright now, and kitty starts feeling better really soon. Fingers and paws crossed!!!!
 
good news! After all the TLC and help from this forum, Tiggy is now back to normal eating drinking and pooping, and has been off insulin for a week now. His BG levels are 70-100. Took 50 days from diagnosis although likely it happened a week or two prior to that which is why he got sick.

So is this it now or is he likely to suddenly become diabetic again? (We are never going to feed dry again.. ever!!)
 
Once a diabetic, always a diabetic. Tiggy is now simply a diet controlled diabetic, he can never go back to things like dry kibble, gravy laden canned food, high carb treats etc. There is also always a chance that he will come out of remission even if nothing changes in his diet, especially with things like bad teeth, infection or high stress, and may once again need some insulin support. Since none of us have a crystal ball there is no way of knowing if he will stay in remission or be one of those cats that go off and on insulin.

But the good news is you now know how to test him at home, you know what clinical signs to watch for like excessive hunger, thirst, flooded litter box etc. When in doubt or if he seems a big off for any reason, just whip out the meter and test.

My Maxwell has been in remission now for over a year, and I still test him twice a month just to keep an eye on how he is doing, and so that if he ever does come out of remission I will be able to catch it quickly.

Mel, Maxwell, Musette & The Fur Gang
 
dancing_cat dancing_cat Fantastic news to read. Tiggy is now a diet controlled diabetic and may never need insulin again or......at some point in time may go back to needing insulin. If he did have a true hypo, that could have sent Tiggy into remission also. There are times when a hypo,for some reason, will actually put a cat into remission if the cat pulls through the hypo. Just make sure Tiggy never gets into the carbs again.
 
gm_thomson said:
So is this it now or is he likely to suddenly become diabetic again? (We are never going to feed dry again.. ever!!)
Click to expand...

It's important to remember that diabetes cannot be cured, so he is still a diabetic, he's just diet controlled. So good news all around, and you're right - no dry food again, ever! It's a good idea to periodically check his BGs and remember that illness, bad teeth, stress, or just time can cause the BGs to rise again to the point where insulin may be needed. But for now, you have a healthy, happy, diet-controlled sugarkitty and that is worth celebrating!
 
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