Diabetic cat not eating - again.

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FantasticJungleCat

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Just another statistic to add to what appears to be some sort of cat diabetes epidemic. My name is Jaz and I'm from the UK. I've had my cat Shady for over two years, and he's almost 10 years old. In December Shady was diagnosed as "borderline diabetic" and initially given *sigh* Caninsulin - just 0.5 units twice daily. He appeared to be stable for a few weeks, then towards the end of December/January he struggled to eat, even though he was hungry. A trip to the vets during the first week of January revealed a urinary infection, and my concerns regarding his liver were confirmed as a blood test revealed that it "wasn't great". But I was assured it could recover and after a few hours stay and having been given fluids, he was sent home with a course of antibiotics for two weeks. He was his old self again - until two weeks ago. The exact same problems with him not eating again. This time he stayed for over 24 hours at the vets on fluids and was later gobbling up food like no tomorrow. This time his urea levels were worryingly high. It's barely been a week since his overnight stay at the vets and again he's lost his appetite since this morning. He continues to drink copious amounts of water, and urinates even more. Vets not only strongly suggesting but hinting that I'm being irresponsible for not giving him Royal Canin (wet) diabetic food. I'm certain that it be a waste of money, as he doesn't eat canned/pouch food anymore. He's been fed a raw diet but the vets were disappointed to hear of that, saying that this Royal Canin food contains electrolytes and other things that supposedly helps his condition. Although a part of me is now willing to try...

The cause of his diabetes is a complete mystery; a couple of months before his diagnosis he would regularly go out every evening at roughly the same time and come back exhausted, licking his mouth, with his belly resembling a little barrel. I'm convinced either he'd help himself to leftovers from peoples garbage, or someone would put out food for him. I've always fed him based on how he looked, and never overfed him. He has never been fond of dry food and seldom ate it. Prior to the home-made raw diet, the pouches I bought him consisted of food that contained a minimum of 55% meat, as he would refuse to eat anything else, or would vomit shortly after eating most other brands, so I gradually starting feeding him a raw diet from October.

I desperately want him to eat regularly again and it's destroying me to see him like, especially since he's always been a healthy eater and he loves to eat. Any help would be greatly appreciated. Thank-you in advance folks.
 

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Welcome Jaz and sugardude Shady and welcome to the message board.

Borderline diabetic? Which means his BG (blood glucose) was what?

Why is he getting fluids at the vets? Is he getting dehydrated?

Vets not only strongly suggesting but hinting that I'm being irresponsible for not giving him Royal Canin (wet) diabetic food. I'm certain that it be a waste of money, as he doesn't eat canned/pouch food anymore. He's been fed a raw diet but the vets were disappointed to hear of that, saying that this Royal Canin food contains electrolytes and other things that supposedly helps his condition.
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Helps according to who? The food manufacturer?

Electrolytes in the Royal Canin diabetic cat food? I never heard of that. Here is the ingredients list and I don't see anything special in here, just the standard vitamins and minerals.
Ingredients: Water sufficient for processing, pork by-products, chicken liver, chicken, wheat gluten, powdered cellulose, gelatin by-products, wheat flour, corn starch modified, natural flavors, calcium sulfate, guar gum, calcium carbonate, fish oil, potassium chloride, taurine, sodium silico aluminate, potassium phosphate, carrageenan, vitamins [DL-alpha-tocopherol acetate (source of vitamin E), L-ascorbyl-2- polyphosphate (source of vitamin C), thiamine mononitrate (vitamin B1), niacin supplement, biotin, D-calcium pantothenate, riboflavin supplement (vitamin B2), pyridoxine hydrochloride (Vitamin B6), vitamin B12 supplement, folic acid, vitamin D3 supplement], L-carnitine, marigold extract (Tagetes erecta L.), trace minerals (zinc proteinate, zinc oxide, ferrous sulfate, copper sulfate, manganous oxide, sodium selenite, calcium iodate).
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I don't see anything special in here.

A raw food diet is a very good one for diabetic cats. I recommend you stick with that. As long as you are adding supplements to the food or it comes prepared with the supplements already added, you should be fine nutritionally.

I know you have to use the Caninsulin as the first insulin in the UK. How about asking for the 'cascade' to take affect and get Shady on Lantus or Levimir or an insulin that works better for a cat , since it's obvious the Caninsulin is not working for your Shady.
 
Hi Deb & Wink; many thanks for replying.

His initial blood glucose reading at it's highest was at the 20 mark; but I think being in a stressful environment would've contributed to it being a bit higher than normal... He's been very dehydrated, hence the fluids and he appears to be dehydrated yet again :cry:

I mentioned that Caninsulin is one of the least effective insulins but according to him none of of the others are available on the market as apparently they're not suitable for cats! Vets seem to think some of us pet owners are just morons... I'm so fed up having to put my poor little dude through all this unnecessary amount of distress, as he's already been through a lot in the last few years.

His urea levels have got me extremely worried, especially as he's urinating a LOT.
 
Member Elizabeth and Bertie live over there in the UK and wrote this in another person's topic recently, about insulins in the UK and other stuff. http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=113646&p=1197700&hilit=cascade#p1197700

Elizabeth and Bertie said:
Hi Nick, and welcome (from yet another UK'er!),

As Deb pointed out vets in the UK almost always prescribe Caninsulin as a first insulin, because the law requires them to prescribe a veterinary medicine first (and Caninsulin is currently the only suitable veterinary insulin for cats in the UK). Caninsulin is what's called a 'U40' insulin, which means there are 40 units of insulin per ml. Caninsulin requires syringes that are compatible with U40 insulin, so, the syinges that are suitable for Lantus (which is a U100 insulin, or 100 units of insulin per ml) are not suitable for Caninsulin.

Your vet can supply you with Caninsulin syringes but you will probably find them much cheaper online.

If it becomes evident that Caninsulin isn't working well for your cat then you should have the right, under the 'cascade system', to 'cascade' to the next medicine on the list that could be of benefit. In your case that would mean opting for a 'human use' insulin for your cat. In the UK that can mean either Lantus, Levemir, or Hypurin Bovine PZI. Since you are familiar with Lantus your vet may be happy for you to use that....

If you do get to use Lantus for your cat then, again, you can buy syringes online. You can get .3ml U100 syringes that measure half units (very useful for measuring small doses) from several sources including vetuk.co.uk here: http://www.vetuk.co.uk/veterinary-suppl ... demi-p-296 (They also sell Caninsulin syringes :-) )

Regarding the vet wanting to keep your cat in the clinic while the insulin dosage is established; well, there seems to be no 'hard and fast' rule about this in the UK. It varies from vet to vet. The vet who diagnosed my cat's diabetes just wanted to prescribe a starting dose of insulin and see how my cat coped with that. The second vet I saw wanted to keep my cat in the clinic for a day to establish what a given dose of insulin did over the course of an 8 hour period. (These days, that same vet just asks me for the blood glucose data that I've collected from my cat myself...!)

Probably the most useful thing you can do for your cat is to learn to test her blood glucose yourself. It's not as hard as it sounds. Most folks test on the outer edge of the cat's ear. There are very few nerve endings there, so it's nothing at all like the sensation of testing your own fingers. And, by rewarding each test (or attempted test) with a treat or two, or a cuddle/grooming session, this can actually become a really positive experience for your cat and one they can come to enjoy. Honestly!

Oh, yes, and regarding food, if you can possibly wean your cat onto low carb wet/canned before starting on insulin that can be very beneficial.

Incidentally, my own diabetic boy, Bertie, was also a stray who moved in with us... ;-)

Again, welcome to FDMB, and do ask any questions at all that you want to.

Eliz
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I don't know much about the "cascade" system you have over there in the UK, but I do not that others have been successful in getting their vets to prescribe other insulins for their cats.

Do they know what is causing the dehydration? Well, beyond his peeing so much, that is.

You can try adding extra water to his food, seeing if he'll eat it. I add extra water to the canned food I feed my kitties, about a tablespoon per ounce of food.
 
Thank-you for that link, I shall read it later.

I've always added water to his food so that it resembles a broth like texture. I cannot think of what else may be making him so dehydrated. I just want to know why he keeps losing his appetite, and how he manages to get it back after being at the vets, but it appears to be temporary.
 
Any chance of pancreatitis? That often puts a cat off their food.

Any current antibiotic use? Antibiotics can suppress the appetite.

A URI(upper respiratory infection)? Can't smell the food, so he doesn't want to eat it.

That's all I can think of for now as possibilities as to why he isn't eating.

You tempt him however you can, so he eats more. Or you assist feed to get enough food into Shady.

Food suggestions for poor appetite
sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stimulate their appetite:
- trader joe tuna for cats (only available in the US)
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium
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Excessive urination, weight loss, and lack of appetite with elevated urea in the blood suggest renal compromise, possibly due to infection or some other degenerative process. Renal disease causes inappetance and nausea. Here is an excellent resource on Chronic Renal Failure. Pepcid, 1/4 tablet, 20-30 minutes before feeding may reduce upset stomach enough for the cat to eat.

Regardless of cause, he may need subcutaneous fluids which can be given at home, to help offset the extra water needed to process toxins out of the body. Ask about doing that.
 
Thanks for your reply BJM. CRF appears to be a plausible explanation, I wonder why the vets didn't mention that.... I will certainly look into being able to getting subcutaneous fluids at home.

@ Deb & Wink; currently he isn't on antibiotics, but was on them for about two weeks in January, which cleared up his infection and contributed to getting his appetite back.

Shady suffered from a Urinary Tract Infection last year, so I'm well aware that he's susceptible to that again. That was also a horrific battle we managed to fight through.
 
A severe and/or chronic UTI can damage the kidneys, so that does seem like a possible diagnosis, unfortunately.
 
Hi Jaz & Shady!

I'm in the UK too. I managed to persuade my vet to prescribe Hypurin Bovine PZI after my Milo wouldn't stabilise on Caninsulin. Elizabeth's Bertie is on this insulin, which is what made me suggest it to my vet. I could put your vet in touch with mine if they want to speak to an 'expert'?

What are his blood glucose numbers like? Are you hometesting?

I couldn't get Milo to eat despite him being diabetic when he was really sick & I fed him chicken broth (tinned chicken 'Thrive' in warm water). Eventually his appetite came back when the insulin kicked in.

If his kidneys are damaged, you may want to put him on a low carb low phosphorus diet. I have one cat with kidney disease, and one diabetic. They are both indoor cats & grazers, so I can't feed them separately & leave food out all day for them. I feed them a mix of Kattovit Renal Diet, Animonda Integra Renal, raw and other cold-filled tinned food. You can buy both renal products from Zooplus: http://www.zooplus.co.uk/shop/cats/canned_cat_food_pouches/integra & http://www.zooplus.co.uk/shop/cats/canned_cat_food_pouches/kattovit. It looks so unlike their lovely raw meat, but surprisngly enough they find the renal stuff extremely palatable. :roll:

I must admit I had to go a bit 'rogue' on my vet. Once they actually saw the blood glucose data I was collecting at home, they were convinced that I wasn't just some 'moron pet owner'!

Good luck!

Juliet

cat_pet_icon
 
Hi Juliet. I'm from the West Midlands :smile:

His appetite has been so-so since I last posted in this thread; I resorted to feeding him pouches, bit of Sheba and Encore (which he absolutely loves.) He's had a couple of days this week where he struggled to finish his food, but asks for more and is clearly hungry. He doesn't seem to be too keen on chicken at the moment, and I've finally managed to buy a couple of kilos' of turkey thigh meat (skin on), some turkey hearts and small amount of lamb liver, which I've just minced through the grinder, and he's been enjoying it; just wondering how long this will last this time... I just get the impressions he's being finicky?

I don't quite know just how damaged his kidneys are but I was told his kidneys were "over worked" because of the amount of urinating due to the amounts of water he was drinking. However, the amount of urinating has actually decreased, as has the amount of water he's been drinking.

I spoke to a specialist vet who reviewed Shady regarding the other insulins, but he said they've been taken off the market as they're not appropriate for use in animals :? I bought a Accu-Chek Aviva blood glucose system a few weeks ago, and am going to figure out how to use it tomorrow. If his condition hasn't improved then I will also go rogue with the vets lol I will bookmark the food in the links for future reference.

Thank-you all for your help!
 
I spoke to a specialist vet who reviewed Shady regarding the other insulins, but he said they've been taken off the market as they're not appropriate for use in animals :?
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I don't know where this "specialist vet" is getting his information, but many people use other insulins for their cats. Lantus and Levimir use are very common in the US and Canada and people get great results.

We can point you to some vet journal articles if that would help?
 
I knew this wouldn't last; he hasn't eaten in three days, and as a result hasn't had an insulin shot... He was eating ravenously on Wednesday morning and suddenly by next mealtime he completely lost interest. Since then he's been getting excited at meal times, and attempting to eat but sniffs his food only to shun it. He had been drinking less water and urinating a lot less over the past week, but that has since increased again, He's become frail and is losing balance. I picked him up and he felt like a fur bag of bones, and his bottom was soaked in urine :cry: It's so upsetting to see him like this, especially when I haven't been given any answers as to what has been causing his loss of appetite. Feel utterly helpless and am struggling to decide just how much more of this pain I can put him through tbh.
 
When a cat doesn't eat for 2 or more days, it is at severe risk for hepatic lipidosis.
Please take your cat to the vet.
 
We've just arrived back from the vets; I didn't take him yesterday as he managed to eat a small amount yesterday morning ; the first in two days. He's been given fluids, which I was advised to administer a couple of times a week at home, and a dose of anabolic steroids. I was told I need to closely monitor his BG levels as sometimes the insulin isn't absorbed by the tissue which then affects his appetite. I'm to give him his insulin regardless of whether not he has eaten, so we'll see how that goes.
 
Famotadine, 1/4 of a 10 mg tablet, given 20-30 minutes before feeding may help if the stomach is upset/over acidic. The brand here is Pepcid AC.

Have you done assisted feeding?

Get an oral syringe.

Take a tablespoon of food, well mashed up, and add enough water to make a paste/slurry. You want to be able tp squeeze out small amounts in a controlled manner.

You may need to wrap the cat in a towel for restraint.

To feed, aim the oral syringe towards the side and back of the mouth, and squeeze in small amounts (pea-sized) at a time so the cat can swallow.

Small, spaced amounts done frequently, may be tolerated more easily than large volumes.
 
I'm so sorry you're going through this. What did the vet say about why he isn't eating? Did they suggest any appetite stimulants? Has he been vomiting at all?

My cat went through this once so I know how frightening it is. Syringe feeding is a viable option. I never did it but others have with success. It's important to get him some food. Let us know how things go! I be rooting for you!
 
I've considered assisted feeding but will unable to feed him small amounts over regular intervals, as unfortunately I'm away from home at work for up to thirteen hours a day, which is extremely frustrating and makes the situation even more difficult... I'm currently looking as to whether he may require Pepcid type tablets. The vet seems to thinks the absorption of the insulin by the tissue is affecting his appetite (if that makes any sense) :?
 
What about hiring a pet sitter, or vet tech, or college student to do some mid-day feeding?
 
Looks like I'm going to have to put him to sleep; I don't seem to be getting any answers and his BG continues to increase.

Thanks for all your help.
 
There are meds for nausea and there are appetite stimulants meds, besides steroids. Discuss with your vet. Also, if giving an appetite stimulant, be sure the cat is NOT nauseous, because that doesn't work - the cat may eat and then vomit.

For an acid stomach, 1/4 of a Pepcid, about 20-30minutes before feeding can improve appetite.
 
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