Diabetic cat with possible IBD vs EPI vs something else

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Betsey & Whitey

Member Since 2014
Hey all, this is my 2nd big post. My cat Whitey was diagnosed in June with diabetes after he lost a fair amount of weight in a short period of time, and was less active. A couple of weeks before this, I brought a stool spec to the vet, b/c he had been having diarrhea. That was negative, and the vet suggested probiotics. When brought to the vet in June, lab work was all negative other than the blood sugar. Started on Prozinc at 1 unit, 2x/day. I was not checking sugars at this point, before I found the forum. About a month later, he dropped more weight, was more lethargic.. Back to the vet, and BS higher. Fructosamine level was done, and I was told it was ok, so not to increase the insulin. So we didn't. At this time, his appetite was Poor and he was given an appetite stimulant, and fluid. We used the stimulant for a few doses, and then he started eating fine on his own, and in fact, was ravenous.(another sign of high BS's or is it something else)? This was all during the summer when we were away on and off, and it was difficult to get him on a schedule. Plus I was really new at this! In July, I started testing his BS's and found that he was running pretty high and all over the place. Got him off hard kibble to canned only diet. He continued to lose weight during all this , has been very gassy, with liquid, light colored, foul smelling stools in large amounts, like 5-6 per day that are indoors, and who knows how many outdoors! Another trip to the vet in early September, showed hookworms in his stool and he was treated. I thought this was the miracle that I needed! At this point he was now down to 6 lbs from 12lbs in March, (about 2 more lbs from when the diabetes was diagnosed). But he was acting more himself, not perfect, but better than the lethargy all summer! Sugars still out of control, but the Vet was not not too concerned with his high preshot numbers. He WAS impressed with my spreadsheet, thx to the Forum for this!! :-D Tummy felt boggy, but still no appreciable masses felt, and believe me, you can feel every bone in his body, so if it were something obviously a mass, it would be felt. Around Labor day, I really thought I would be putting him to sleep since he just continued to lose weight and he had the light stools. I thought he had some kind of obstruction in the bile system, like a tumor. Although not totally ruled out at this point, there is no jaundice or other symptoms of that. Lab work also showed elevated BS of course, high BUN cause he was dehydrated and very slightly elevated ALT, but not a worrisome elevation according to the vet. Along with the dewormer, he was treated with flagyl for a week and SC fluids.
So I continued to do some more reading, and found out about EPI from some of the others on the Forum. Went to that forum and found out about enzymes. Decided to try treating empirically, since my financial situation is not good at this time. I did call the Vet, to see if I would be harming him if I tried these enzymes and he didn't think it would be a problem. Although he hadn't really heard about EPI in cats! I told him to check out the internet! So he has been on the enzymes for about 2 weeks or a little longer, and he DOES now seem to have improvement in the consistency of his stools. They are more formed, but still soft, and I think the color has improved. His repeat stool sample on October 5th, was negative for any parasites. So this gets me to the present. He is behaving a little more like himself, continues to look ghastly b/c of his tremendous weight loss (or maybe that's ghostly since it's almost Halloween, LOL)! It is making it difficult to give insulin, since he really has very little subcutaneous tissue left, and I have had a fe episodes of going thru the skin and probably not really getting the insulin. I have to be super careful now to make sure the needle is actually in the skin! He has had an enormous amount of muscle wasting. He is still ravenous, his belly is round and "firmish" and still has periods of foul smelling gas, but it has lessened. I constantly hear his belly churning/rumbling. It is very loud. It IS as if the food just goes right thru him. So the last few days, his sugars have been better on 3 units of prozinc. What I am wondering now, is thoughts on IBD or EPI. Anyone else experience the symptoms of Whitey? Weight loss, ravenous eating, foul gas and stools, and large amount of stools, round belly, sugars unregulated, rumbling tummy...... What is the treatment for IBD other than steroids which I know will send his sugars thru the roof? Thoughts on 1 disease vs the other? My funds are limited, and to get biopsies and other tests is really not feasible for me right now. (1 week ago, had to bring another cat to the vet for heavy breathing and found out that she, like her sister, who had to be put down in June, a week before Whitey was diagnosed, has the same heart problem. Her sister was 2 when she was diagnosed, and now this one is 4. We are hoping to get 2 more years of life, like her sister had, on medicine :sad: ) I just cannot afford anything else at this time! Now I have 2 cats to medicate at 4:45 each morning before work and after! Yikes, My husband says I am running a Hospice for pets right now!! :YMSIGH: Can anyone tell me about their cats symptoms of IBD or EPI and what they do for it along with the Diabetes?? BTW, he does NOT vomit. Only the stool issue! I know there is a lot of info in this post, sorry for rambling! It's been a very long and difficult summer! I would love to get Whitey back to his old self! As far as 5 P's... he is still preening, purring, peeing, not too much playing, and is def. pooping, but it isn't normal. Looking for any advice, for my skeletal cat! Thanks for taking the time to read this lengthy post! (interestingly enough, when I brought my heart problem girl to see the vet, he then asked about Whitey, said that he just went to a conference about EPI, and said that is it under-diagnosed! Funny, thats what I told him! Sometimes we DO know more than the Vets do)! :o Thanks everyone!
 
Our rule of thumb is that you treat whatever other diseases there are and adjust the insulin to handle it. That means if some budesonide will help with the IBD, do it and adjust the insulin dose.

Also, you might try adding a probiotic such as Forti Flora or Intelliflora. See our SHOP link above and use the Amazon link for your country/area.

Another issue could be food allergies. Review all the foods and treats you are feeding. Make a chart of food down the rows and ingredients across the top, then see if there are any ingredients that are common to all of them, or specific to some of them. Add a 2nd line to your spreadsheet for each day and note the food and the degree of symptoms. If a particular protein source is a problem, symptoms will likely get worse after eating it. Rotate through different protein sources a month at a time. When you reintroduce a protein, watch for increase symptoms. Likewise, if you stop a protein source for a month, watch for improved symptoms.

Some cats with IBD do better on a raw diet. Cat Info has a recipe, if you want to make your own.
 
You could talk to your vet about trying budesonide. It is a steroid but usually effects BG very little. I have used it in the pas and my MurrFee is currently using it. I get the 3 mg capsules form Thriving Pets and divide it unto three 1 mg portions and put that in a #3 gelcap with his other meds.

The best would be elplritry sugery and to take biopsies since it sounds like a GI problem. However, I have not done that with my MurFee. I dd have a ultrasound performed that showed thickening of the small intestines that suggest IDB or lymphoma.
 
Good morning Betsey and extra sweet Whitey!

May I suggest that you have a pancreatitis test done? Your whole description sounds like what we went thru with our KT Kitty (GA). He had most of the same symptoms - his was EPI but I suspect chronic pancreatitis too. Most of the time we could bring him thru it by adding both digestive enzymes and probiotics to his food for many days. He was very hungry because the food wasn't being absorbed, it was running straight through. He never gained any weight and was a walking skeleton. His poop was just as you described for Whitey. If it's pancreatitis, you'll need to provide subq fluids and something for pain. I'm glad to hear your vet learned about EPI, none of our vets knew cats suffered from EPI too....

Just my rambling thoughts...

HUGS!
 
A note on the biopsy surgery.

Only do the surgery if it is going to change how you manage your cat.

I did that with Spitzer. The week after his surgery, he threw a blood clot to his hind legs (saddle thrombus) and was euthanized. It could have been a clot from the incision. It could have been a clot due to the inflammatory condition. It could have been a clot due to something else. All I know is that the clot was horrendously painful and I never want to hear a cat howl like that again.
 
BJM said:
A note on the biopsy surgery.

Only do the surgery if it is going to change how you manage your cat.

I did that with Spitzer. The week after his surgery, he threw a blood clot to his hind legs (saddle thrombus) and was euthanized. It could have been a clot from the incision. It could have been a clot due to the inflammatory condition. It could have been a clot due to something else. All I know is that the clot was horrendously painful and I never want to hear a cat howl like that again.
Thank you for this info, I def. would avoid surgery for 2 reasons, cost and the fact that in his condition, I don't think he would survive it! Your experience just proves to me even further! Thank you, Thank you!!
 
Lots of info about cats and EPI at the following link. Have a look about 2/3 of the way down the page for the paper published by the Royal Veterinary College in the UK.

http://www.epi4dogs.com/catsgetepitoo.htm

In addition to the Spec fPL test for pancreatitis, there's also the feline Trypsin-like immunoreactivity (fTLI) test which is more relevant to diagnosiing EPI. As well as these tests, I would strongly recommend getting Whitey's B12 and folate levels checked. Saoirse has pancreatitis and she had a B12 deficiency. She has had a course of B12 injections and they helped her enormously. She has regained the weight she lost and her coat and body condition are great now.

Our vet prescribed Pro-Kolin for Saoirse when she had watery diarrhoea and it worked well. It's a thick paste made from kaolin and it contains a probiotic. It's messy but fairly effective. At the peak of her pancreatitis flare i fed her on poached chicken breast and broth for a couple of weeks. It's not a complete food but it kept her fed and hydrated. On an ongoing basis, I try to feed her very bland food. All strong-smelling cat foods seem to disagree with her.

Another thing that has helped Saoirse is cyproheptadine. It's typically used as an appetite stimulant (she needs a little help with appetite sometimes still) but from my observation of her clinical signs it seems to help her with digestive discomfort problems (it's an antihistamine and the Wikipedia article about it claims that it also has analgesic properties). I give her a tiny sliver of it once a day. (I suspect she has IBD and had a food allergy (her tummy was bald before treatment, fur has regrown) but neither our vet nor myself want to do the biopsy.)

Finally, at times when Saoirse looked uncomfortable after eating I would give her a catnip toy filled with freshly rubbed dry organic catnip (the toy is refillable). She likes to lick the toy and it seems to make her feel much more comfortable afterwards. Catnip has been used by humans for digestive upsets but I've not seen any research papers on possible benefits for cats: it's just my own empirical observations that lead me to believe that it eases Saoirse's digestive discomfort.

Hope some of the above helps.
 
Critter Mom said:
Lots of info about cats and EPI at the following link. Have a look about 2/3 of the way down the page for the paper published by the Royal Veterinary College in the UK.

http://www.epi4dogs.com/catsgetepitoo.htm

In addition to the Spec fPL test for pancreatitis, there's also the feline Trypsin-like immunoreactivity (fTLI) test which is more relevant to diagnosiing EPI. As well as these tests, I would strongly recommend getting Whitey's B12 and folate levels checked. Saoirse has pancreatitis and she had a B12 deficiency. She has had a course of B12 injections and they helped her enormously. She has regained the weight she lost and her coat and body condition are great now.

Our vet prescribed Pro-Kolin for Saoirse when she had watery diarrhoea and it worked well. It's a thick paste made from kaolin and it contains a probiotic. It's messy but fairly effective. At the peak of her pancreatitis flare i fed her on poached chicken breast and broth for a couple of weeks. It's not a complete food but it kept her fed and hydrated. On an ongoing basis, I try to feed her very bland food. All strong-smelling cat foods seem to disagree with her.

Another thing that has helped Saoirse is cyproheptadine. It's typically used as an appetite stimulant (she needs a little help with appetite sometimes still) but from my observation of her clinical signs it seems to help her with digestive discomfort problems (it's an antihistamine and the Wikipedia article about it claims that it also has analgesic properties). I give her a tiny sliver of it once a day. (I suspect she has IBD and had a food allergy (her tummy was bald before treatment, fur has regrown) but neither our vet nor myself want to do the biopsy.)

Finally, at times when Saoirse looked uncomfortable after eating I would give her a catnip toy filled with freshly rubbed dry organic catnip (the toy is refillable). She likes to lick the toy and it seems to make her feel much more comfortable afterwards. Catnip has been used by humans for digestive upsets but I've not seen any research papers on possible benefits for cats: it's just my own empirical observations that lead me to believe that it eases Saoirse's digestive discomfort.

Hope some of the above helps.
Thank you Critter mom! One thing he does not need help with is his appetite! It is non-stop. I can't keep up with the food!!! This morning I found him on the counter at 4:30am getting a piece of garlic bread out of some tinfoil! I tried to get it away from him, and he ran and growled at me. I got some of it out of his mouth but he did consume half a piece! He will eat anything! Immediately following the consumption of garlic bread I checked his sugar. It was 571. At 5 hours last night it was 75. I really don't think the BS could be reflecting the garlic bread that fast, so my only thoughts are that he had a bounce after the 75, and his sugar was up again, so he was ravenous! I gave a little extra insulin, and he came down to 215 at 4 hours, but after 8 hours, he is already back to 394. He does not appear to be in pain after a meal, but his tummy is def. round and more protruding than any other part of him. Like someone in another post reply stated, i would def. avoid the biopsy. BJM said unless it was going to change the way I treat Whitey, it's not worth it. I Def. do NOT have the $$ for this anyway. Whitey has already cost me an arm and leg! I am leaning towards the blood work which might be less $$ than the ultrasound. His BS's are still on a rollercoaster. Just when I think I have made headway, he will spike into the 500's! Man what a difficult time it has been since June, !st putting my 4 year old calico to sleep after 2 years o heart medications, then Whitey and the Diabetes and who knows what else, and now finding that Calico's sister has the same heart problem. She is 4, so she was diagnosed later. But I am on an emotional Cat roller coaster, constantly thinking of what else can be done for which cat.... :YMSIGH: ONe day at a time as they say....Thanks for your info!
 
Squeaky and KT said:
Good morning Betsey and extra sweet Whitey!

May I suggest that you have a pancreatitis test done? Your whole description sounds like what we went thru with our KT Kitty (GA). He had most of the same symptoms - his was EPI but I suspect chronic pancreatitis too. Most of the time we could bring him thru it by adding both digestive enzymes and probiotics to his food for many days. He was very hungry because the food wasn't being absorbed, it was running straight through. He never gained any weight and was a walking skeleton. His poop was just as you described for Whitey. If it's pancreatitis, you'll need to provide subq fluids and something for pain. I'm glad to hear your vet learned about EPI, none of our vets knew cats suffered from EPI too....

Just my rambling thoughts...

HUGS!

Thank you for your encouraging thoughts and hugs!!! It has been such a roller coaster between all this and my other 2 calico cats. (one that I lost in June just prior to Whitey's initial DX). I am going to check with my vet on all this and see what the cheapest route might be. He luckily does not appear to be in pain unless he is really hiding it. Hate to think that he IS! He did have a round of probiotics, the fortiflora, initially before the DM was diagnosed. At that time, I did not notice a difference, but can't hurt to try that again. Thanks again, Hugs to you too! And all of the wonderful members of this forum!!!
 
BJM said:
A note on the biopsy surgery.

Only do the surgery if it is going to change how you manage your cat.

I did that with Spitzer. The week after his surgery, he threw a blood clot to his hind legs (saddle thrombus) and was euthanized. It could have been a clot from the incision. It could have been a clot due to the inflammatory condition. It could have been a clot due to something else. All I know is that the clot was horrendously painful and I never want to hear a cat howl like that again.
Again, thank you for this info. I am sorry for your loss, and it must have been horrifying! I'm sorry I didn't say this the last post. I have to be concerned with my little calico. The heart problem can cause the same type of clot. I almost lost her the night we brought her to the vet a couple of weeks ago. I know that howl you heard. She was so pitiful, trying to get a breath in. It absolutely broke my heart! Somehow she pulled through. I guess the diuretic the vet gave and then I gave at home finally kicked in. She used up1 life that day. Hopefully she has 8 left.
Whitey on the other hand is not looking well. Weight is actually up, but it is all in his belly. He is bloated and completely muscle wasted. The vet is not giving him a good prognosis at this time. He went there tonight......belly very distended. I took him home to think about things realistically...... :sad:
 
I am on the same boat like you betsy. My chatran have all the symptoms of what whitey have. Vet suggested biopsy but I don't really want my chatran to go through that if no guarantee.

It's really heart breaking knowing what is happening with him since I did all possible test there is :cry:
 
Belly very distended makes me wonder if he has fluid in his abdomen. This can happen with a number of conditions and the prognosis isn't good with any of the ones I've heard of.
 
Hi Betsy & Whitey

Just wanted to let you know about my experience with EPI - there is really only one test to check for it, I believe it is called the feline trypsin-like immunoreactivity (fTLI) assay. It is a simple blood test. It will let you know yes or no about EPI. If it is EPI then regular enzymes won't help. My Jun (he just passed on 9-25-2014) was on a vet prescribed medication called Pancrea-Tabs Plus and he was on a 1/2 tablet morning and evening with his meals. It is ground up pancreas from other animals. It worked well. I purchased a 500 tablet bottle for around $100, which lasted a very, very long time with just one pill a day. Some cats will need B12 shots - Jun did not.

Prior to the diagnosis he was eating like a horse, vomiting, losing weight, diarrhea, foul smelling gas & poo, and just in an awful state, and also had IBD (whole track had been filled with fluids) and panceantitis. Everything you described with Whitey. That simple pill kept him on track and was amazing.

I wish you both well.

Rae & spirits Jun & Toll =^..^=
 
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