Expertise Needed for Newly Diagnosed Cat

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KarenLuvsBandit

Member Since 2013
Hello, My cat Bandit has just been diagnosed with diabetes, the onset was caused by prolonged use of light doses of L-Prednisolone. Bandit has an original complication of an autoimmune disorder which is called Lymphorysis Plamachtic Stomatitis. When the immune system wanes, the entire gumline is inflamed, red, and ulcers will result if Bandit doesn't get her dosage levels resolved. As a result of the autoimmune disorder all her teeth had to be removed. The steroid suppresses insulin, thus damage to organs. Now we will need to somehow administer insulin and take her off the steroid which has prolonged a pretty stable quality of life for 13 years. We tried many antibiotics and steroid types, but she only responded to the one she's been on all this time. She is part feral and prefers to be outdoors. The gained trust from her over this time is a HUGE compliment to me, and I am her humble servant. I am up to the task of trying to work the insulin thing. None of us knows how she will adapt to being indoors now and me trying to work with a cat that doesn't like to be restrained. Taking her to recent multiple vet visits and blood draws have made her very nervous and skiddish and avoiding my touching her. She becomes Tigger, Edward Scissorhands, and a pogo stick all at once. Stress alone can invoke an insulin crises. We don't even know how we'll balance levels with any other drug, because she has to be taken off the steroid. My vet has recommended to not make any changes and allow her to grow into a state where she will have to go to sleep. She gave me a 50/50 chance. I have made an appointment with an internest tomorrow for second opinion. I wondered if anyone had ever treated a cat with these combinations of challenges. Any words of support would be helpful. Thank you for listening.
 
Why do you need to take her off the steroid? We know that steroids exacerbate diabetes and make it difficult to control, so we recommend not using them if possible. But in Bandits case maybe thats not an option. So you could keep her on the steroids and just add insulin too - just be aware its likely going to be at a higher dose of insulin than some people here.. but saying that my Tiggy is on 7units twice a day and he isnt on steroids...

What food /brand is she getting?

We have tips for testing a cat that doesnt like to be restrained. or you could shoot and use secondary monitoring tools instead of ear or paw pad testing.

I think there are solutions here.. I disagree with your vet. I would at least give it a try. she sounds like she has some character and strength in her and wouldnt want to give up!

Wendy
 
My vet has recommended to not make any changes and allow her to grow into a state where she will have to go to sleep
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Your vet is wrong. There are ways to adapt a kitty to hometesting and if she needs steroids, then you use them and work the insulin dose around the numbers that may be higher because of the steroids. In her case, the mouth being helped with her receiving steroids would come first, diabetes would come second. Let us know what insulin the second vet recommends and post back here for more help. It is doable and others will chime in with their advice and help also. I have one on steroids and insulin. Have you ever tried Budesonide for her?
 
Your vet may be concerned about the amount of handling that would be required to test her blood glucose and inject her twice a day. We, however, have ways to make your cat cooperate :smile:

Treats will be key; begin teaching her the word 'treats' means come to a particular place (where you think you might be able to test her eventually) and give her a yummy low carb treat, like freeze-dried fish or a small bit of raw or cooked chicken. Repetition will be key. We'll get to the next step once you let us know she's learned "treats".

And, until you get blood glucose testing managed, there are a number of Secondary Monitoring Tools in my signature link that you can start doing right now. Pop over to your local pharmacy and pick up urine ketone/glucose test strips (ex ketodiastix). They will give you very rough indicators of whether or not there are ketones (serious!) and glucose (uncontrolled diabetes) in the urine. Tips for collecting the urine are in that link, too.

Although these are rough indicators, it is possible to very s l o w l y monitor and adjust the insulin dose using these.
 
Appears to Be MisDiagnosis

Thank you All for your feedback. The expert internist ran a barrage of tests combined with reading all the previous notes of her chart, and as of right now states that there is no diabetes. We are scheduled for a recheck in 6 mos. I gave Wendy several detailed Replies on the subject. It is nice to have supportive people. Thank you again for noticing our story.
 
Great news!

To help prevent diabetes, obesity, and renal disease, read the nutrition info at Cat Info and print out the food list for shopping.
 
Let me know about the fructosamine test. Was the specialist for diabetes specifically? many vets are generalists so they dont understand anything in a lot of detail and that includes diabetes unfortunately.

Take her off dry as much you can. Friskies pate is a good choice.

You dont need the prescription stuff - its expensive and many cats will try it and then stop eating it later! Dry food can cause diabetes and isnt good for her kidneys. Cats dont drink enough water and it strains their kidneys so wet food supports them.

But if she cant tolerate solely wet due to her health issues , try a low carb dry.. i dont normally recommend it but this is an unusual situation ! here are some ideas http://felinediabetes.com/FDMB/viewtopic.php?f=22&t=86715!
 
Monitoring for Stomatitis Cat

Hello All, Thank you again for weighing in and caring about Bandit and my intentions to do right by her life. I got 3 main brands of diabetic food to try---I had already ordered it b4 finding this Forum. I ordered both dry and canned. She actually ate both of them. I am not calling it a success. I am glad that it is felt that Friskies is not horrible. She has been getting a blend of 3 senior dry food mix: IAMS 7+ years pro health; Blue Senior; and Royal Canin 32 Senior regular not prescription diabetic. I have always given her filtered water, not tap. I have trained her to come inside the house. She will do this reluctantly when the pet sitters come. We rarely get away for more than an overnight. This is frequent because we caretake my fiancee's parents who live 110 miles away. The dad is a stroke patient. I am not sure I communicated this, but as a result of the ravages of the stomatitis Bandit's teeth were infected below the gum line, and she had to have all her teeth removed. I didn't think she was going to make it through the surgery, and the doc gave her a 50/50 chance. Usually the steroids put these patients into remission, and they don't have to stay on the meds. In just a very narrow percentage of cases, they don't respond, and this is where Bandit falls into that category. I wondered if the person who has cats on steroids if they have stomatitis too? I wonder by now if there is any research going on for that disease or any alternatives to steroids? To the person who asked if my internal medicine vet is specialized for diabetes treatment, Yes she is. In fact, she only treats this disease or chronic ongoing diseases. However, she doesn't have expertise for stomatitis specifically. She does have experience with patients who are on steroids, but those patients are not affected with their mouths, and she mentioned dogs not cats specifically. I am relieved to have a respite to be more aware and proactive. If the consensus is that dry food for cats is so bad why is it allowed to be on the market? Looks like by now with the health awareness and holistic movements for both people and animals we'd be into a better phase. I wondered if anyone had any success "making" their own cat food? For cats it must be harder because they are not as omnivorous as dogs. Bandit is very funny. She came up with this method of reaching up and squinching her body to be able to open the patio screen door. Even during the week when she was under the weather with the UTI she limped over there and still managed to open the door to come in and eat. I left her food out overnight after the emergency room visit and slept on the couch where I could watch her all night. I didn't make her come inside because she was so freaked by the four vet visits and four days inside with blood getting drawn from her little leg. She has stayed with us all these years because it has been by her choice. She is by all accounts a feral cat. She is free to roam the yard and the greenbelt. I will appreciate all constructive suggestions for her senior care. I appreciate all efforts. We reside in San Diego, CA area.
 
I am still a little confused on whether she is diabetic or not. Can you find out her fructosamine level from the vet?

I think they sell dry food because its cheap, not all cats develop diabetes (mind you not all smokers develop lung cancer), and the old thinking was that dry food cleaned their teeth ( yeah well anyone who has had a cat throw up knows they dont chew it.. and anyway isnt that like saying eating peanut brittle will clean our teeth?).

Making food is a good idea and Dr Pierson has recipes to make sure the food is balanced: http://www.catinfo.org/?link=makingcatfood.

Remember that some of the diabetic dry is too high carb. See this list. http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf.

Wendy
 
I don't think pet food is regulated. Mind you, look at all the human food scandals - they don't do a very good job with that so I guess pet food has no chance!
I have 2 young kids that love it when they get junk food but are not so happy with my healthy cooked-from scratch meals - cats must be the same :-D
 
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