Diabetic cat has diarrhea for three months...PLEASE HELP

[Mai & Dad]

Hi all,

Thank you in advance for reading this message and help me help my cat. My cat is 11 years ago, male Siamese, was diagnosed diabetes last October. Since then, I have been adjusting his insulin dosage, from 1 unit twice per day, to 2 units x2 , to 4 units x2, to 5 units x2, and then back to 4 units x2 now. But even now he is still not well-regulated as in his last vet visit (last week), his glucose level was ~340 at 3pm. He was not there for a curve so we only had data point at 3pm.

But what worries me more is that he has been having really bad diarrhea for almost three months now. I have been to the vet for at least 6 times at this point but so far we got nothing except vet bills.

Symptoms:
1. Almost always explosive
2. Color ranges from pale yellow to yellow to between yellow and brown
3. Comes in large quantity
4. He still eats well and plays

Ruled out:
pancreatitis, hyperthyroidism, and parasites.
There is no food change. He is eating the same can that he has been on for most of his life.

Tried and did not work:
1. Followed the forum and tried florastor for two weeks
2. Vet Pro-biotics combined with Metronidazole for a week but it did not work at all.

Most recent: Last week, his X-ray showed no objects but lots of gas. Current trying Enrofloxacin with Metronidazole for 10 days. This is the 3rd day and so far I have seen no improvement. The vet called me today telling me his liver value is now elevated (~330, while the normal range is 10-100). This was not the case perhaps two months ago.

Have any of you seen this with diabetic cats? I am so worried and I am trying everything I can but nothing has worked so far. Please do help. Any suggestion helps.

 

[Diane Tyler's Mom GA]

@Wendy&Neko
@Marje and Gracie
@Suzanne & Darcy

 

[Wendy&Neko]

Has your kitty ever had a GI Panel test done? The Texas A&M GI panel is a popular one. It includes testing for B12 levels and also for a condition called EPI. If kitty has low B12 levels, s. boullardi (Florastor) will not work. Metronidazole might not work either, and can disrupt the gut biome as well. Has kitty ever been on a good general purpose probiotic? I give Visbiome to my kitty.

What brand/type of food is your kitty getting now?

Side note, I'm concerned about the insulin dosing. Your vet is changing doses by a lot larger amounts than we would. Are you home testing your cat's blood sugars at all? Testing at the vet where they are stressed is not adequate to say how they are really doing on a particular dose.

 

[Marje and Gracie]

I also think a GI Panel through Texas A&M would be warranted. It’s a six hour fast for diabetic kitties.

Here is some info on exocrine pancreatic insufficiency.

An ALT in the 300 range is just mild but something to monitor and to give some liver support. I use Adored Beast’s liver tonic as it has milk thistle and is an easy to give liquid. I also agree with Wendy about Metronidazole. Instead, the vet should be thinking of really good probiotics like Visbiome Vet. Adored Beast also has some excellent products in Healthy Gut and Gut Soothe. If he has EPI, those won’t address it; he will have to have prescription pancreatic enzymes but if he doesn’t have EPI, the more intestinal support you can give him for things that support his gut, the better.

Also, Animal Biome does fecal testing (you have to send it to them) to tell you what his gut biome looks like. Use of Metronidazole and other antibiotics can really disrupt his gut biome. They can test the sample you send and then they make recommendations based on what they see there. I did my kitty just because he had some inflammation in terms of allergies and many health issues go back to the gut microbiome. Luckily for him, he had all the good stuff and only a tiny bit of one undesirable and it was a simple fix of increasing the dose on one of his probiotics.

While I am an advocate of definitely giving probiotics all the time and increasing them if the kitty has to have antibiotics, you must give those two several hours apart. If given at the same time, it’s defeating the purpose.

 

[Mai & Dad]

@Wendy&Neko
@Marje and Gracie
@Suzanne & Darcy

Thank you for getting my post to the right people! I appreciate it!

 

[Diane Tyler's Mom GA]

Thank you for getting my post to the right people! I appreciate it!

You're very welcome

 

[Mai & Dad]

Has your kitty ever had a GI Panel test done? The Texas A&M GI panel is a popular one. It includes testing for B12 levels and also for a condition called EPI. If kitty has low B12 levels, s. boullardi (Florastor) will not work. Metronidazole might not work either, and can disrupt the gut biome as well. Has kitty ever been on a good general purpose probiotic? I give Visbiome to my kitty.

What brand/type of food is your kitty getting now?

Side note, I'm concerned about the insulin dosing. Your vet is changing doses by a lot larger amounts than we would. Are you home testing your cat's blood sugars at all? Testing at the vet where they are stressed is not adequate to say how they are really doing on a particular dose.

First, sorry for my late response. I was traveling for work to Alabama and just returned home.

I am not 100% sure whether a GI panel has been done but given how often the doctor mentions the word GI, I'd be rather surprised one hasn't been done. I will confirm this tomorrow with the vet. But I know his B12 level was normal, at least as of 12/20/2023 (about a month ago). The doctor mentioned this specifically and said since the B12 level is normal, he is more hopeful this is not lymphoma related.

I am going to give Visbiome a try even though I suspect this is the one the vet prescribed us.

I am giving him Earthborn Holistic Chicken Cattciatori (See link: https://www.chewy.com/earthborn-holistic-chicken/dp/36435)

I am not doing home testing at the moment. I have repeatedly asked my vet whether I can do it at home. But they first told me they don't feel comfortable with me poking his ear and then they told me the other one doesn't work well either since it falls off a lot? At this point, I am kinda willing to go against their advice and just give it a go though.

Thank you again!

 

[Mai & Dad]

I also think a GI Panel through Texas A&M would be warranted. It’s a six hour fast for diabetic kitties.

Here is some info on exocrine pancreatic insufficiency.

An ALT in the 300 range is just mild but something to monitor and to give some liver support. I use Adored Beast’s liver tonic as it has milk thistle and is an easy to give liquid. I also agree with Wendy about Metronidazole. Instead, the vet should be thinking of really good probiotics like Visbiome Vet. Adored Beast also has some excellent products in Healthy Gut and Gut Soothe. If he has EPI, those won’t address it; he will have to have prescription pancreatic enzymes but if he doesn’t have EPI, the more intestinal support you can give him for things that support his gut, the better.

Also, Animal Biome does fecal testing (you have to send it to them) to tell you what his gut biome looks like. Use of Metronidazole and other antibiotics can really disrupt his gut biome. They can test the sample you send and then they make recommendations based on what they see there. I did my kitty just because he had some inflammation in terms of allergies and many health issues go back to the gut microbiome. Luckily for him, he had all the good stuff and only a tiny bit of one undesirable and it was a simple fix of increasing the dose on one of his probiotics.

While I am an advocate of definitely giving probiotics all the time and increasing them if the kitty has to have antibiotics, you must give those two several hours apart. If given at the same time, it’s defeating the purpose.

First, sorry for my late response. I was traveling for work to Alabama and just returned home.

I am not 100% sure whether a GI panel has been done but given how often the doctor mentions the word GI, I'd be rather surprised one hasn't been done. I will confirm this tomorrow with the vet. But I know his B12 level was normal, at least as of 12/20/2023 (about a month ago). The doctor mentioned this specifically and said since the B12 level is normal, he is more hopeful this is not lymphoma related.

I am going to give Visbiome a try even though I suspect this is the one the vet prescribed us. I will get some healthy gut and gut soothe for him as well. I appreciate it!

I will capture his next poo and send it to Animal Biome as well! Also appreciate this tip.

How far apart do you think the Probiotics and Antibiotics have to be? I am doing one hour in between or is this not even? The issue is the vet asked me to give the antibiotics with food but I also give him probiotics mixed in food. Currently I am giving him probiotics with food then antibiotics in an hour following that. Is this too short a gap still?

Thank you again!

 

[Mai & Dad]

A follow-up response to everyone and @Marje and Gracie and @Wendy&Neko:

GI Panel was done on 12/20/2023. The vet told me there is nothing abnormal.
The probiotics the vet prescribed was Proviable DC. Though I was giving him the probiotics and Mentronidazole at the same time the whole time.

New Question1: Given that is GI panel has been done and shows no issue and he was on Proviable, should I still proceed with Visbiome Vet? Could this still be helpful?
New Question2: Has any of you been through this after your kitty becomes a diabetic?

I want to thank everyone who has been responding to this thread again. We went through a lot getting him back from his DKAs and then getting him to eat on his own again. He is finally doing well and the diarrhea hits right away. It has been three months and I have been working with the internist as well as our regular vet now (the one before DKA), but so far nothing is helping him. So I definitely feel a bit hopeless at the moment, which is why I do really appreciate everyone's input and suggestions.

 

[Wendy&Neko]

The doctor mentioned this specifically and said since the B12 level is normal, he is more hopeful this is not lymphoma related.

I've had three cats with small cell lymphoma, 2 had their B12 levels tested and were both normal.

Earthborn Chicken Catcciatori is 20% carbs, we generally recommend 10% or less for diabetics. But don't change his diet yet if you aren't home testing as his needs for insulin could drop a lot. For options with lower carbs, check out this food list.

As for home testing, I can't understand vets who are against it. If they had a diabetic child would they not home test to keep them safe? The other one, the Libre can fall off some cats. But some people get good at putting them on themselves. The problem is they need to be replaced every 2 weeks, but it's easier on you. Hundreds of people here have home tested with no problems. Cats have very little feeling in their ear tips. Once kitty associates a treat with home testing, they'll often come running when you get the test kit out.

Antibiotics and probiotics should be at least 2 hours apart. You can give the antibiotics with food, and give a small snack with probiotics a couple hours later.

Marje gave you a link to information on EPI - I would look that up to see if it looks familiar.

 

[Mai & Dad]

I've had three cats with small cell lymphoma, 2 had their B12 levels tested and were both normal.

Earthborn Chicken Catcciatori is 20% carbs, we generally recommend 10% or less for diabetics. But don't change his diet yet if you aren't home testing as his needs for insulin could drop a lot. For options with lower carbs, check out this food list.

As for home testing, I can't understand vets who are against it. If they had a diabetic child would they not home test to keep them safe? The other one, the Libre can fall off some cats. But some people get good at putting them on themselves. The problem is they need to be replaced every 2 weeks, but it's easier on you. Hundreds of people here have home tested with no problems. Cats have very little feeling in their ear tips. Once kitty associates a treat with home testing, they'll often come running when you get the test kit out.

Antibiotics and probiotics should be at least 2 hours apart. You can give the antibiotics with food, and give a small snack with probiotics a couple hours later.

Marje gave you a link to information on EPI - I would look that up to see if it looks familiar.

Hi Wendy,

Thank you for your swift response. I will read the instructions of home test tonight and get it going starting next week. I will check out EPI as well but I somehow remembered the doctor has tested this before.

Quick follow up questions: 1. do you think I should still give Visbiome a try? 2. I am so sorry that three of your cats went through that. But based on your experiences, do you think his symptoms warrants a endoscopy?

 

[Wendy&Neko]

Check for EPI first. If that, you don't need an endoscopy.

Small cell lymphoma kitties can go in remission on a good protocol. Current kitty is almost 6 years since diagnosis.

Proviable Forte gel can help with diarrhea. You need more Proviable by quantity than Visbiome, so Visbiome is easier to give.

 

[Charlie's Mum]

Hi all,

Thank you in advance for reading this message and help me help my cat. My cat is 11 years ago, male Siamese, was diagnosed diabetes last October. Since then, I have been adjusting his insulin dosage, from 1 unit twice per day, to 2 units x2 , to 4 units x2, to 5 units x2, and then back to 4 units x2 now. But even now he is still not well-regulated as in his last vet visit (last week), his glucose level was ~340 at 3pm. He was not there for a curve so we only had data point at 3pm.

But what worries me more is that he has been having really bad diarrhea for almost three months now. I have been to the vet for at least 6 times at this point but so far we got nothing except vet bills.

Symptoms:
1. Almost always explosive
2. Color ranges from pale yellow to yellow to between yellow and brown
3. Comes in large quantity
4. He still eats well and plays

Ruled out:
pancreatitis, hyperthyroidism, and parasites.
There is no food change. He is eating the same can that he has been on for most of his life.

Tried and did not work:
1. Followed the forum and tried florastor for two weeks
2. Vet Pro-biotics combined with Metronidazole for a week but it did not work at all.

Most recent: Last week, his X-ray showed no objects but lots of gas. Current trying Enrofloxacin with Metronidazole for 10 days. This is the 3rd day and so far I have seen no improvement. The vet called me today telling me his liver value is now elevated (~330, while the normal range is 10-100). This was not the case perhaps two months ago.

Have any of you seen this with diabetic cats? I am so worried and I am trying everything I can but nothing has worked so far. Please do help. Any suggestion helps.

My diabetic cat has diabetes too and had bad diarrhea. The doctor gave antibiotics and florastor. Nothing worked. I then found a site with cat owners and someone recommended
Nutramax Proviable Digestive Health Supplement Multi-Strain Probiotics and Prebiotics for Cats and Dogs - With 7 Strains of Bacteria, 30 Capsules. Here is the link on Amazon: https://www.amazon.com/gp/product/B0050JM626/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1

This was the only thing that helped my cat get better. You can open the capsule and mix it in their food. Within 3 days, his bowel movements were getting normal. This is the only thing I use now for all my cats when they have an upset stomach. I also learned that antibiotics make things worse for intestinal/gut issues. I don't think veterinarians have any/much training on nutrition for cats...unfortunately.

As for the pale yellow color -my cat had that at one time. At the time, one of the foods I was giving him was low carb but it also had high fat content. I think I read online that too much fat could cause the yellow bowel movements. I've discontinued that food. His bowel movements went back to normal. I don't know if high fat causes this (I just made this assumption). Also, I've read that it is important to not just feed your cat one food because doing this can cause them to be allergic to that type of protein. I had never heard of this before but my diabetic cat started having a lot of stomach upset after years of making his food with chicken thighs. I can't give him chicken thighs anymore but I make sure I rotate different proteins in his meals so he is less likely to develop an allergy to one (rabbit, turkey, different fish, birds). I am lucky that Charlie loves food so he will eat almost anything (except pumpkin). I'm keeping you and your feline in my thoughts and prayers that he/she starts feeling better soon.

 

[Mai & Dad]

Check for EPI first. If that, you don't need an endoscopy.

Small cell lymphoma kitties can go in remission on a good protocol. Current kitty is almost 6 years since diagnosis.

Proviable Forte gel can help with diarrhea. You need more Proviable by quantity than Visbiome, so Visbiome is easier to give.

Thank you again! I have made an order for Visbiome with overnight delivery so hopefully it will get him some relief.

I am checking in with the vet to see if we have tested for EPI. I am certain that we had his pancreas tested but I am not sure if was for Pancreatitis or EPI.

 

[Mai & Dad]

My diabetic cat has diabetes too and had bad diarrhea. The doctor gave antibiotics and florastor. Nothing worked. I then found a site with cat owners and someone recommended
Nutramax Proviable Digestive Health Supplement Multi-Strain Probiotics and Prebiotics for Cats and Dogs - With 7 Strains of Bacteria, 30 Capsules. Here is the link on Amazon: https://www.amazon.com/gp/product/B0050JM626/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1

This was the only thing that helped my cat get better. You can open the capsule and mix it in their food. Within 3 days, his bowel movements were getting normal. This is the only thing I use now for all my cats when they have an upset stomach. I also learned that antibiotics make things worse for intestinal/gut issues. I don't think veterinarians have any/much training on nutrition for cats...unfortunately.

As for the pale yellow color -my cat had that at one time. At the time, one of the foods I was giving him was low carb but it also had high fat content. I think I read online that too much fat could cause the yellow bowel movements. I've discontinued that food. His bowel movements went back to normal. I don't know if high fat causes this (I just made this assumption). Also, I've read that it is important to not just feed your cat one food because doing this can cause them to be allergic to that type of protein. I had never heard of this before but my diabetic cat started having a lot of stomach upset after years of making his food with chicken thighs. I can't give him chicken thighs anymore but I make sure I rotate different proteins in his meals so he is less likely to develop an allergy to one (rabbit, turkey, different fish, birds). I am lucky that Charlie loves food so he will eat almost anything (except pumpkin). I'm keeping you and your feline in my thoughts and prayers that he/she starts feeling better soon.

Thank you so much for your response!

I have ordered VisBiome so I will give that a go first. And based on the response above yours, it seems like they serve similar purpose. But I will definitely give the one you mentioned a try if it doesn't work.

I have considered the possibility of he is somehow now "allergic" to his food. I tried to switch to fish but it did not really help him.

Thank you for keeping him in your thoughts and prayers! We definitely appreciate it!

 

[Wendy&Neko]

Fish is a common allergy, also for some cats chicken or beef.

 

[Charlie's Mum]

Thank you so much for your response!

I have ordered VisBiome so I will give that a go first. And based on the response above yours, it seems like they serve similar purpose. But I will definitely give the one you mentioned a try if it doesn't work.

I have considered the possibility of he is somehow now "allergic" to his food. I tried to switch to fish but it did not really help him.

Thank you for keeping him in your thoughts and prayers! We definitely appreciate it!

You're welcome, Hal. Also, my cat, Charlie, had diarrhea for several months too before getting these probiotics. I had taken him to the doctors multiple times. He was throwing up and having diarrhea. I really didn't know what to do and luckily, I just googled it and found these feline parents talking about the same problem. I told my vet about this probiotic and now this is the only probiotic that my vet uses so I think the doctors also think it is good. It used to only be made in the UK but it looks like now they make it in the US. I hope your kitty starts to feel better soon.

 

[Charlie's Mum]

Also, I only feed Charlie Limited Ingredient Diet (LID) wet food -when I'm giving him store bought food. He doesn't love the food but he is able to eat it, not vomit and have normal stools. Charlie has a very sensitive stomach (not sure if it is due to allergy) and although he will eat almost anything, if he eats food that isn't LID, he will typically vomit everything up an hour or more after eating. But he is fine with the LID food. Instinct Turkey is one LID that he eats and this one I believe has 7% carbs. Also, I give Charlie a B-12 shot once a week. He will be 20 years old this year. He can't see or hear well but he seems happy and is engaged each day with me and his feline siblings.

 

[Charlie's Mum]

Hi all,

Thank you in advance for reading this message and help me help my cat. My cat is 11 years ago, male Siamese, was diagnosed diabetes last October. Since then, I have been adjusting his insulin dosage, from 1 unit twice per day, to 2 units x2 , to 4 units x2, to 5 units x2, and then back to 4 units x2 now. But even now he is still not well-regulated as in his last vet visit (last week), his glucose level was ~340 at 3pm. He was not there for a curve so we only had data point at 3pm.

But what worries me more is that he has been having really bad diarrhea for almost three months now. I have been to the vet for at least 6 times at this point but so far we got nothing except vet bills.

Symptoms:
1. Almost always explosive
2. Color ranges from pale yellow to yellow to between yellow and brown
3. Comes in large quantity
4. He still eats well and plays

Ruled out:
pancreatitis, hyperthyroidism, and parasites.
There is no food change. He is eating the same can that he has been on for most of his life.

Tried and did not work:
1. Followed the forum and tried florastor for two weeks
2. Vet Pro-biotics combined with Metronidazole for a week but it did not work at all.

Most recent: Last week, his X-ray showed no objects but lots of gas. Current trying Enrofloxacin with Metronidazole for 10 days. This is the 3rd day and so far I have seen no improvement. The vet called me today telling me his liver value is now elevated (~330, while the normal range is 10-100). This was not the case perhaps two months ago.

Have any of you seen this with diabetic cats? I am so worried and I am trying everything I can but nothing has worked so far. Please do help. Any suggestion helps.

How is your kitty doing? I just wanted to share that I learned of a pet sensitivity testing kit called "Comprehensive at-home intolerance testing kit for pets" from UCARI.com. Here is the link to the pet sensitivity test: https://ucari.com/pet-test I've brought my cats in to the vet because of what I felt were food related issues but the vet had no advice to give. I saw this kit at a local pet food store and decided to get it for all three cats. The cost online and at the store was $89.99 for one test. I know it is a lot but I thought about how much I've paid seeing the vet and getting no answers. The test seems very easy -you just need to send them 10-15 pieces of your cat's hair (the hair doesn't have to be pulled from the root). It looks like a comprehensive test: food & environmental intolerances, skin sensitivities, as well as nutritional imbalances. Just thought I would share. I hope your kitty is better. I hope the probiotics helped.

 

[squeem3]

Could it be a food intolerance / sensitivity? Try novel proteins such as pork or lamb or rabbit for a few weeks to see if that helps the diarrhea. You'll have to check the food chart to see which ones are low enough in carbs for the diabetes, https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Did the vet rule out IBD?

 

[Wendy&Neko]

@Charlie's Mum Be careful - there isn't any solid evidence that those food sensitivity tests work. In fact, some have been tested anonymously and shown to not work. Medical and vet associations recommend against them. Unfortunately, for food allergies, elimination diets are the best way.

 

[Charlie's Mum]

@Charlie's Mum Be careful - there isn't any solid evidence that those food sensitivity tests work. In fact, some have been tested anonymously and shown to not work. Medical and vet associations recommend against them. Unfortunately, for food allergies, elimination diets are the best way.

Thanks, Wendy! I think that is a good advice. The testing I purchased did explain the difference between allergies and intolerances (although it was in the sealed box) and this test only tests for intolerances. Since I haven't been able to find very good pet care near me (at least not for issues related to felines stomach/digestive issues and dietary help, I wanted to try the test. But I agree, I probably need to look up the science behind this. I can let you know how it goes -if the test shows an intolerance and then taking that out of their diet, what happens. Thank you.