Diabetes and Anemic

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Tanya Joy

Tanya Joy

Member Since 2016
Hi All. I'm looking to get some opinions and advice about my cat, Pooh. Pooh is 18, almost 19, she was diagnosed with diabetes in November 2015. She was treated with insulin. She did very well on the treatment and sugar level was coming down. She ending up going into the honeymoon phase in October 2016. She recently decreased in her appetite last weekend. She was also just laying around a lot. I took her to the vet on Thursday and got her blood work all checked. Her sugar level was around 21 and she is anemic. I tested her sugar level before I took her to the vet and it was 25.1. The vet gave her sub q fluids to hydrate her, some anti nausea medication as well. We started her back on insulin treatment. Her liver is good, she is being treated for her thyroid and kidneys as well. Her level on her thyroid was good as well. Her kidneys did show a bit of decline since her last blood work but was still not too bad. We are treating her kidneys with Semintra and Royal Canin Feline Renal Support A and her thyroid with Methimazol Pen. I tested her sugar level yesterday and it had gone down to 22.7. She does seem to be eating a bit more then she was. She is throwing up a little liquid, but not constantly. I would like to know if other people have gone through this and if they think if her blood sugar level decreases then her appetite will get better and she won't be so weak. My vet said that we just take one day at a time with her and see how she makes out. It was either this or I would have to put her down. She just had a check up in June and she did so well. Her weight was up to 9.44 and her appetite was good. It's amazing how things can change so quickly. Her weight is now 7.80. Do u guys think that I'm doing the right thing by doing the insulin treatment or do u think that she may be too far gone? It is so hard to know what to do. Any help would be greatly appreciated. I'm currently just feeding her any type of wet food that will entice her. Some fancy feast pate, whiskas cutlets and gravy. I just want her to eat more. She is not eating any of her Renal A at this time. I try to give her the wet food about every hour so that she eats some. I go back to work tomorrow and I'm not sure how I'm going to feed her as I don't typically come home for lunch. Going to feed her before I leave and the as soon as I get home. I can't leave her food out as we have 4 other cats that will eat it on her. I don't really want to lock her in a room either while I'm gone. Again any advice would be great. Thanks everyone for listening to me.
 
It's hard to know what's going on in an older cat with other health issues. Let's start with the diabetes:
  1. What insulin are you using?
  2. What dose does she get?
  3. Do you test her blood glucose regularly at home?
  4. Have you tried vitamin B12 supplements? They can help with anemia. The methylcobalamin type is best.
The symptoms you describe can be part of unregulated diabetes. Getting her BG into better numbers might make her feel better.
 
Hi. Here are some answers to your questions:

1. Caninsulin for the type of insulin. She was on this before and it was successful.
2. She is currently getting 0.5 cc (Single) per dose (She gets 2 doses every 12 hours)
3. I'm testing her blood sugar every two to three days. So I tested it on Thursday and I just tested it yesterday. I will probably test her again either tomorrow or on Tuesday. Is there a better time to do the testing? Is morning before her insulin injection a better time to do it or should I test her in the afternoon?
4. I have not tries any B 12 supplements. Maybe I can ask my vet about these. Is this something that the vet gives or is this something that I can pick up somewhere to give her.

Yes I do think if her sugar level was down then she would start feeling better. I have seen a bit of improvement so far. She is eating a little more and is getting up more as well. Thanks a lot for replying back to me.
 
Tanya Joy said:
She is currently getting 0.5 cc (Single) per dose (She gets 2 doses every 12 hours)
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The black lines on the insulin syringes represent units of insulin. I'm not sure what you mean by 0.5 cc. The total capacity of an insulin syringe is generally 0.3 cc (mL). Are you using U40 insulin syringes? Caninsulin is a U40 insulin.

Tanya Joy said:
Is there a better time to do the testing? Is morning before her insulin injection a better time to do it or should I test her in the afternoon?
Click to expand...

We recommend a testing routine as follows:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture.
This is more testing than many people do or vets recommend but it a tested way of tracking BG in order to find the dose range that gives better control. Are you using a human meter or a pet meter?

Tanya Joy said:
I have not tries any B 12 supplements. Maybe I can ask my vet about these. Is this something that the vet gives or is this something that I can pick up somewhere to give her.
Click to expand...
These can be purchased in a human pharmacy. Some vets will suggest injectable B12. Might be worth asking about it.

On FDMB, we suggest you set up the spreadsheet we use here. It's viewable by all members and is the first thing we look at before offering advice. Testing BG as above and logging the data in the spreadsheet allows you to see your kitty's responses so you can plan dose changes as needed. We can help with all of that if you want to try it. :)
 
I do believe it is 0.5 of 1 unit. This is what she was on before she went into remission. When she had diabetes before, she ended up having a couple of mini-seizures because her sugar was too low. When we took her off of the insulin she didn't have anymore seizures and she active and eating perfectly. Then we discovered that her thyroid needed to be treated. I can start doing the testing everyday (am and pm) and track it. I have a alpha trak 2 for her that my vet got me. I will check with my vet on the B12 injections.
 
Tanya Joy said:
I do believe it is 0.5 of 1 unit. This is what she was on before she went into remission. When she had diabetes before, she ended up having a couple of mini-seizures because her sugar was too low. When we took her off of the insulin she didn't have anymore seizures and she active and eating perfectly. Then we discovered that her thyroid needed to be treated. I can start doing the testing everyday (am and pm) and track it. I have a alpha trak 2 for her that my vet got me. I will check with my vet on the B12 injections.
Click to expand...
That's a very small dose. It's possible she needs more insulin now, based on those BGs in the 20s stated in your first post. Their needs can change over time.
 
I just completed a test now and she is 12.1. I gave her insulin at 7:30 this morning. I'm so discouraged though because she is not eating much. I just don't know what else to do.
 
Did the blood test results include a value for Reticulocytes? Reticulocytes are immature red blood cells (RBCs). They're made in the bone marrow (the spongy material inside bone) and are released into the bloodstream, where they circulate for about 1-2 days before developing into mature red blood cells.
The reticulocyte count indicates if the cause of the anemia is due to not making enough red blood cells (non-regenerative anemia) or if the low blood cell count (anemia) is due to the red blood cells dying/leaving the blood stream prematurely (regenerative anemia). Kidney problems can cause non-regenerative anemia while internal bleeding or a blood disease can cause regenerative anemia.
 
Yes it did. Her RBC is 6.31. In May 2016, she was at 7 and then in December 2016 she was at 7.6.
 
I attached all her results of all her tests.
 

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Per the test results, reticulocytes are on the the low side.
What does your vet say is the cause of the anemia (low HCT/low RBC count)?
This
http://www.felinecrf.org/diagnosis_cbc.htm
includes:
Lymphocytes: Low

Lymphocytes are often low in cases of viral infection or when using steroids. They may also be low in cases of chronic bacterial infections.



CKD cats with uraemia (which tends to apply to most CKD cats) often have low lymphocytes.



A stress leukogram, which occurs when a cat has a chronic illness, means the cat may have a low lymphocyte count with a high neutrophil count.
 
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She really never gave me a reason as to why they were low. I think she thought it may have been because of her sugar being high. Last weekend is when Pooh started having issues. The only thing that I thought was going on was with her eye, I didn't even think there was anything wrong with her sugar level as she has been in remission for almost a year now. Pooh had a little lump under her left eye that was black. She always had some sort of gooey stuff in that eye that I cleaned out with a cotton ball and a little water. It wouldn't be everyday that I would have to clean it out just maybe every other day. Well last weekend at some point this lump busted. I didn't see it happen but I noticed it wasn't there anymore. She had a little liquid running from her eye. So I wiped it out. Since then her eye has been clear, haven't touched it since. But this is when she lost her appetite. So I don't know if it's related. I thought she might have a bacterial infection but I don't think my vet thinks that was it. She is saying it is her sugar level. She was doing great up till last weekend, had a good appetite.
 
Though rare, methimazole itself can cause anemia. Your options are few for alternatives to it, but you should be aware. We had a cat once with multiple issues, so we can't say for certain that the methimazole was the cause of his anemia, but his thyroid was borderline enough that we just chose to eliminate the methimazole.
 
Thanks so much everyone for your help. Unfortunately, I had to put my little Pooh down on Monday. It was the hardest thing to do but I didn't want her to suffer any further. I love and miss her so much. I have been treating her the last two years with all of her health issues, sugar, kidneys, and thyroid. I would have done anything for her. She just wouldn't eat for me and I had to let her go so that she could be a happy kitty again in kitty heaven. I hope I get to see her again someday.
Pooh's Memorial.jpg
 
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