Diabetes Regulated - but Dementia Symptoms

[lbeachstace]

We are very sad and worried about Buddy lately.

His diabetes is regulated but his dose is very high - 6 units of Lantus. The vet examined him and said he has no symptoms of acromegaly.

He had surgery, a couple of weeks ago, to have a cyst removed which turned out to be benign, with no fear that it would have turned to cancer. Our vet said, it's common in maine coon cats and while he isn't one, he may have some genes that are maine coon. (this was great news)

However, his mental well-being has taken a pretty rapid decline. He has all the symptoms of dementia, except for loss of appetite. He paces all day, stares at walls, doesn't come to us at all and most recently, he has been urinating outside of his litter box and is just a different cat (but extremely cuddly).

We aren't sure if it's age (he's 13), the diabetes or the high dose of Lantus that has caused it.

Does anyone have experience or suggestions on what we can do or any medications that are recommended to help?

Thanks - Stacey

 

[Ale & Bobo & Minnie (GA)]

You indicated in your spreadsheet you’re following TR but you’re not testing enough for TR and you haven’t been making any dose adjustments. That 47 the other day earned him a .25 reduction. I have a feeling he’s getting too much insulin and what you’re describing is the result of that. I’d take they reduction now and get his dose tonight down to 5.75. Can you do at least 4 tests a day consistently and can you try to take a +5 or +6 during the day?

 

[Ale & Bobo & Minnie (GA)]

Getting more eyes on this @Bron and Sheba (GA) and @Sienne and Gabby (GA)

 

[Wendy&Neko]

The vet examined him and said he has no symptoms of acromegaly.

Many cats with acromegaly do not show physical symptoms. Was an IGF-1 blood test run? If no IGF-1 test done, you cannot say he does not have acromegaly. If he does, there are treatments to help.

He saw a 47 a few nights ago, you should have reduced his dose. Since his dose is 6 units, I would actually take a 0.5 unit dose. Hypos can impact the brain and maybe explain what you are seeing.

 

[lbeachstace]

@Wendy&Neko - we were told that if he's over a year of treatment that he needs three tests below 50 in order to reduce. i will gladly reduce him by .5 units tonite!

No, the vet didn't recommend testing but i am going to call him tomorrow and will talk about the IGF-1 blood test.

 

[lbeachstace]

@Ale & Bobo & Minnie (GA) - i was mandated back the office making daytime testing really difficult.

we do 10 am and 10 pm feedings, so overall testing has been a challenge but yes, we can and will do the best we can.

 

[Ale & Bobo & Minnie (GA)]

@Wendy&Neko given that she’s struggling to get 4 tests a day, should she switch to SLGS?

 

[Wendy&Neko]

we were told that if he's over a year of treatment that he needs three tests below 50 in order to reduce. i will gladly reduce him by .5 units tonite!

With higher dose cat that might have a secondary condition causing that need for higher dose, I tend to be more conservative. Those conditions can change insulin resistance, and with a higher dose comes a higher depot, meaning leaving them at a higher dose can be risky. Note to any lurkers, my dose suggestions are for Buddy only.

As far as testing goes, how long during the day are you gone? Are the 10am/10pm your preshot times? Just wondering if we can figure something out so you can stay with TR. If not, the SLGS may be a better option.

 

[Larry and Kitties]

He had surgery, a couple of weeks ago, to have a cyst removed which turned out to be benign,

Did the pacing ect. start after the surgery?
What was the location of the surgery?
Was there any problem during the surgery or the recovery?

 

[lbeachstace]

With higher dose cat that might have a secondary condition causing that need for higher dose, I tend to be more conservative. Those conditions can change insulin resistance, and with a higher dose comes a higher depot, meaning leaving them at a higher dose can be risky. Note to any lurkers, my dose suggestions are for Buddy only.

As far as testing goes, how long during the day are you gone? Are the 10am/10pm your preshot times? Just wondering if we can figure something out so you can stay with TR. If not, the SLGS may be a better option.

@Wendy&Neko - I leave work after i feed them, usually around 10:30 and get home at around 5:30. his BG test is done btwn 9:30 and 9:45 and his shot is given btwn 10:15-10:30. I could test at +7, when i get home at 5:30. At night i can test at +2 or +3 before i go to bed. would that work?

 

[lbeachstace]

Did the pacing ect. start after the surgery?
What was the location of the surgery?
Was there any problem during the surgery or the recovery?

Hi @Larry and Kitties

1. The pacing started before the surgery. It's been going on for about 4-5 months, we think
2. It was on his right side, it was actually a nipple that grew the cyst.
3. There were zero issues during and after surgery. We actually picked him up earlier than expected because he was doing so well.

 

[Wendy&Neko]

I leave work after i feed them, usually around 10:30 and get home at around 5:30. his BG test is done btwn 9:30 and 9:45 and his shot is given btwn 10:15-10:30. I could test at +7, when i get home at 5:30. At night i can test at +2 or +3 before i go to bed. would that work?

First, why the delay between BG test and shot? Typically we test, feed, and shoot all within about 15 minutes. A +7 test on workdays and maybe earlier on weekends and a PM +2 or +3 would definitely work for TR.

 

[lbeachstace]

@Wendy&Neko - he takes about 1/2 hour or more to eat.

it's a whole routine with him - he eats, walks away and then needs constant redirection back to his food.

here's how it goes:

his brother eats in less than 5 minutes and is then ready to eat buddy's food (besides it not being his meal, he is not allowed it because he is allergic to poultry.)

and i, literally, sit on the floor next to Buddy and his bowl, clinking the bowl with a spoon and building piles with the food to get him to come back to it. this goes on at every meal. but he does, eventually, eat the entire meal.

 

[Hendrick Cuddleclaw]

So sorry to hear about Buddy's struggles lately. I hope the gurus here are able to help.

 

[Ale & Bobo & Minnie (GA)]

If you know he’s going to eat it all, you can test and shoot. It takes 2 hours for Lantus to start to work anyway.

 

[Bron and Sheba (GA)]

Have you checked to see he can see properly? I'm wondering if he could be blind.
I had a blind cat and she had no issues with anything...it actually took me ages to realise she was blind.
But it was just a thought with everything that is going on.
Is his blood pressure OK?

 

[Larry and Kitties]

How are Buddy's ears and hearing? Inneer ear problems can cause pacing

 

[lbeachstace]

How are Buddy's ears and hearing? Inneer ear problems can cause pacing

They are fine. He's been to the vet for check ups and all looked good. His ears react when we call him but like a cat, he usually just ignores us

 

[lbeachstace]

Have you checked to see he can see properly? I'm wondering if he could be blind.
I had a blind cat and she had no issues with anything...it actually took me ages to realise she was blind.
But it was just a thought with everything that is going on.
Is his blood pressure OK?

Yes, the vet checked his eyes and they are good. That was the vet's first question/concern.

Blood pressure has also been good. We haven't check post surgery but this behavior has been going on for a while.

 

[JL and Chip]

How long has he been getting Solensia injections?
Did the symptoms begin before or after starting it?

 

[lbeachstace]

@JL and Chip - his third shot was done June 7th, so three full months will be around July 7th.

Symptoms started before Solensia but it's a very good question and something we did think about.