DIAGNOSED TODAY DUE TO PREDNISONE

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anwahs23

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Hello,

My 14 year old IBD cat, Kalvin was diagnosed with Diabetes. My vet said this is because of the steroid, Prednisone that he was on for his IBD.

I am terrified. The pred helped his IBD, but now he can barely walk and this happened over a couple days. I have been reading a lot about feline diabetes and will go forth with treatment, but my concern is how I can control the IBD and the diabetes if he can't have the steroid? Does anyone have any advice? This is all brand new to me and very scary. I have been reading non stop for 10 hours.

Thank You
Shawna T
 
Hi Shawna,
First, know we all arrive here with very sick kitties and we are scared, crying often, nervous wrecks.
Many kitties arrive becuase of steroids.
I don't know what to tell you about the steroids...but I will tell you this.
You will want to start insulin and diet change.
I can get you the list of low carb foods you want to be feeding.
And perhaps best of all, we will teach you to test you're cat's blood glucose at home.
This will be your finest tool in helping him regain his strength and health.
And dear Shawna, they all bounce back with treatment...it will be ok.
Lori
 
My vet stated that while she is 90% sure it's Diabetes, we need to wait for the lab results tomorrow morning. I feel like such a horrible person not seeing the signs. (Excessive water drinking, excessive urinating). I told my vet numerous times about it, but they thought it was due to the prednisone. That it increased his thirst. Two days ago his legs turned wobbly. He is having a hard time walking straight, stumbles, and trips a lot. It doesn't seem like its painful, but its tearing apart my heart watching him. This has happened in two days. He is hardly eating and my vet said he HAS to eat to have the insulin. He wants to sleep all day. I'm afraid this is a quality of life issue? I don't know? I don't know how I can tell and its killing me.

I will know more tomorrow.
Thank You for your kindness.
 
Shawna, if you have been reading all day, no wonder you are overwhelmed. Take a deep breath. You are among people who understand how overwhelming this all is.

We have a number of kitties who have to stay on steroids, and we have kitties with IBD who are being treated without steroids. Be patient until those people see your post and tell you their experiences.

As far as the diabetes, it can be the simplest part of this. Pretty basic - you give a mild, long lasting insulin. You test at home so you can see how the insulin is working. And you think about how you might change the diet (more about those possibilities when IBD parents chime in.

For now, I hope you read some inspiring threads that showed how once a person learns about this process, they feel empowered. This is a true support group full of people paying it forward for help they received in those first worry-filled days.

Breathe, Honey, breathe.
 
If he has a favorite food, give him that. It sounds silly, but sometimes they will start eating again if you put some food on your finger and hand feed for awhile. You can try tuna, if he likes it. You also can get some baby food (no spices or onions) and see if he will eat that.
 
You might try sprinkling parmesan cheese over his food....
anything he will eat...anything at all.

You can even get some baby food...purely chicken or turkey....no added ingrediantes. You can finger feed him that.

Also, tomorow if the results come back as diabetes. That is going to be OK!
I would like to send you a free newbie kit if the diagnosis is positive.
It will have all you need to start testing your cat at home.
It will be your most empowering tool.

Many cats get well almost immediately.
I thought for sure my cat was going to die 5 years ago.
In only 2 days he regained his strength and in a few more days he was back to his old self.

Do you know if the vet is checking for urine ketones?

Lori
 
Thank you all for your support. I will post tomorrow after the "official results." I am emotionally drained and have been studying this all day. I truly thank you all from the bottom of my heart for supporting others out there that know the love for our pets.

Thank You,
Shawna Tracy and my little Kalvin
 
Folks, we have to tailor our advice to the fact that this cat has IBD.

Shawna, did your vet do a thorough set of tests? are his potassium levels ok? any other issues show up? how long ago did he start showing symptoms and how quickly did things progress? You can't be blamed, you asked your vet and they thought it was the pred...well, it was, but not the way the vet thought. The thing is, cats are pretty resilient so let's stay positive, ok?

You may well have to continue with the pred and whatever foods you were feeding to keep his IBD under control. That said, sometimes foods for IBD and diabetes are the same...ie grain free, etc. Often people find a good raw diet is helpful. for food info, see www.catinfo.org

For now, you have to get him eating and stabilized and on insulin. Keep giving the pred unless your VET tells you to stop. If he won't eat, syringe feed, don't wait more than a day or he's at risk for hepatic lipidosis and ketones.
 
Yes Jen is right, keep giving the pred for now. A species appropriate low carb canned diet may help with the IBD as well as the diabetes.

As far as steroids, ask your vet about Budesonide, its a steroid that is supposed to target the intestines and isnt as systemic as the pred.
http://www.marvistavet.com/html/budesonide.html

The stumbling and walking issues may be due to Neuropathy. Is Kalvin down on his hocks?
http://www.felinediabetes.com/weak-back-rear-legs.htm

Breathe! And welcome aboard!
 
Thank You all for your words. Here is what I know.

Kalvin was officially diagnosed with Diabetes. My vet wants to start him on Lantus Insulin. He is to start getting one unit twice a day. The vet specifically told me to stop the pred. She is starting him on a low dose so we can also focus on treating his IBD flare up. He's not eating much and he's weak. She told me that we cannot give him insulin if he is not eating. She wants him on a raw food diet. I bought it, but he's not really taking to it. At this point, he needs to eat anything. I did get him to eat a little, so I gave him the insulin. She told me I won't have to monitor his diabetes at home? I think I will be going in every week? I'm not sure. I have so many questions still. Do you all know if the insulin should be kept in the fridge? What if I give him insulin and he didn't eat much? What effects are there.

I am overwhelmed and haven't slept so I'm tired and emotionally exhausted. Kalvin is strong and we'll get through this. The biggest concern is how to treat the IBD since we are not doing the pred anymore. He needs to feel better. It will be a quality of life issue if not.
 
Eating is important because of the way that insulin and food interact. Simply put, eating food, after it is digested, puts glucose into his system. Insulin, once injected, drops the glucose levels in his system. Without food, the insulin, in effect, is "stronger", has a greater effect than it would if food were pushing up his blood glucose.
Your vet started him on a good dose. 1 unit, 2 times a day (12 hours apart) is a good starting dose.
What did your vet say his BG was when he was last tested?

If your vet told you to stop the pred, that is fine to do that. Your vet must have a plan, once his BG numbers are better controlled, to restart treating his IBD. Did your vet prescribe or recommend a food for Kalvin? Just "raw", or did she give you some options to try? There are people here who feed a raw diet to their sugarcats. Some make it themselves at home. Some buy it. They can give you ideas on that.

If Kalvin is going to be going to the vet every week, is the purpose of that so the vet can check his BG? If that is the primary reason, then you can do that yourself at home. The home testing will be more accurate in fact, because at home, he won't be as stressed out as he is at the vet. Stress raised BG too. If Kalvin is all stressed when his BG gets checked, that would result in a possible misdiagnosis, and an increase of his doses, when they aren't really needed. If you test at home, you can just give the vet your results, and let her do whatever else she needs to do for these scheduled visits. In the long run, home testing will save you a ton of money.

I don't know about keeping Lantus in the fridge. I was a PZI user, and that had to be kept cold. Somebody who uses Lantus can tell you though.

One really important thing in the days ahead, especially as you start this "sugar dance" is that you also take care of you. You need to sleep. You don't want to be getting up half awake every day trying to give insulin and end up getting sick yourself. Kalvin needs you at top form! You can't possible absorb even 1% of the information on this site by staying up all night. But you don't need to "know it all" right now. You just need to know as much as is necessary for you to start out. People are here 24 hours a day. From all over the world. And they have each and every one been in "your shoes", so we know how you feel. We know how much you love your dear kitty. And we'll do whatever we can to help you and Kalvin get past these first few terrible days. A couple weeks from now, you'll look back on today and think "wow, this is nowhere near as bad as I feared". It's a "dance". You don't know the steps yet, but you will.

Carl
 
Your cat needs to eat, period. If he's not eating much, he likely needs an appetite stimulant (cyproheptadine or mirtazapine) and perhaps syringe feeding if there aren't any foods he will eat. Don't bother transitioning to raw until he's back to more his normal self, and note that not al cats like raw anyways.

Please talk with your vet about the other med mentioned earlier for IBD

Please test his urine for ketones on a daily basis

Please get him to eat a little before shot time and try very hard not to skip shots

Please do monitor his levels at home. Testing at hte clinic does not replicate normal conditions, stress can inflate blood glucose levels and you need to be able to test prior to giving shots to make sure he's not gone too low. Human diabetics do it, we do it, you can do it :) Trust me, I am an original home testing avoider :)
 
I'm just here to mention that my Smokey had IBD when I adopted him at age 14.
He we were never able to wean him off pred, and he got steroid-induced diabetes.

He also had CRF, and of the three issues, the diabetes was the easiest to mamage.
He passed away from cancer at age 17-1/2.

So, I just want to tell you, you can manage the diabetes on top of the IBD/pred.
 
awwww Shawna! I remember being exactly in your spot. Its tough, but as you absorb the info it will get easier.

My Latte had IBD/lymphoma. I tried grain free foods which worked for a while. We had to move to a tx for the ibd eventually (she didnt eat and vomited...also had kidney disease). I had to go with prednisOLONE (that is recommended over prednisone) due to cost. The other alternative, which many ibd kitties find success with is budesonide. It is absorbed differently thus often reducing the risk of diabetes. Some kitties also find a chemo drug, leukran to be helpful.

Here is a link with info on budesonide. Its also an educational site on IBD:
http://www.ibdkitties.net/Medications.html

I know there is a yahoo group out there. I will have to come back with that one.

Latte did great on the pred for about 9 months. Then she got an UTI. That is when the diabetes was confirmed. After much reading, posting, and going back and forth in my head I decided to stop the steroid in hopes the FD was transient. Unfortunately her IBD got MUCH worse...and yes, she stopped eating. I made a desperate attempt with leukeran, which did not work out at all for her. I then put her back on prednisolone and attempted to manage her diabetes. She did pretty well until a multitude of issues arose about 9 months later, leaving us at the age of 18.

Here are my red flags from your post:
*not giving insulin if the cat is not eating*
Sometimes that is a route you need to take. BUT, if your kitty has very high blood sugar, is not getting insulin, not eating = a set up for another problem. Ketoacidosis. The BEST way to see if your kitty needs insulin is to do home testing. Yes, that means monitoring on a daily basis, despite your vet insisting you do not need to. there are a lot of people on the board who can guide you on that and even help get you started with a testing kit!

*Not monitoring/not giving pred/giving insulin*
If the diabetes is transient, you stop the pred, give insulin, do not monitor...it could be a set up for TOO LOW blood sugar. Its similar to when people find their cats are diabetic and switch them from dry food to wet.

*low dose*
What is weight of your cat and dose recommended by your vet?

Other thoughts:
Im sorry if I missed what you are feeding. There are some grain free/low carb varieties of fancy feast (chicken pate, turkey pate, chicken/liver..would not recommend the beef for an ibd kitty). Wellness has some great grain free varieties which are lo carb and kitties eat.

IF kitty is not eating, things you can try are:
-gerbers meat only baby food (turkey, chicken, ham)
-treats
-puree food and syringe feed (last resort)
-rotisarre chicken
-appetite stimulant
-dry food only if you must (EVO and wellness core are good choices)

Kitty has to eat. There is a yahoo group with great information and tips on getting cats to eat when sick. I will come back with that link as well.

Few questions:
-what tests were done to determine iBD
-has the vet thought kitty has neuropathy and that being the reason for having difficulty walking?
-was there a sterile test done for a Urinary tract infection?
-Has kitty been checked for ketones at the vet? You can check them at home, too! Pharmacies will have ketostix you can purchase.
-since you gave insulin tonight, is there ANY way you can try and test her? How much did you give? did she have a dose of pred tonight?
-Is your vet tapering kitty of the pred or did they tell you to stop cold turkey?

As you probably know, there are a lot of topics to cover and get through to help you answer your own questions. Hopefully between the collective knowledge of the group, we can help make this as painless and stress free as possible so kitty and YOU can feel well again.
 
Helpful links:

yahoo IBD forum:
http://pets.groups.yahoo.com/group/felineibd1/

Feline assist feeding (many cats on there have ibd):
http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/?yguid=6606790

How to treat hypos (low blood sugar). Please read and print this tonight if you can!:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887
http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354

Monitoring for ketones (good to get these on hand and start testing asap, until kitty feels better):
http://binkyspage.tripod.com/faq.html#ketones

General info on other issues (not eating, neuropathy):
http://binkyspage.tripod.com/faq.html#problems

Hometesting:
http://binkyspage.tripod.com/faq.html#glucose
http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=287

Lantus Insulin (information...take it in slowly and refer back to it often):
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139

I hope some of these links help and dont overwhelm too much. They are great resources as you go through this song and dance.
 
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