hello, and seeking guidance

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tara

Member Since 2013
Hi all,

I'm looking for any guidance in how to proceed with treating my kitty's diabetes and irritable bowel. We have been struggling for 4 months and I'm have to admit I'm pretty discouraged right now.

Juniper is nearly 13 and was diagnosed with diabetes back in September. A couple years ago he was also diagnosed with irritable bowel -- we tried various low allergy (dry) foods and ultimately treated him with budesonide, a steroid that has likely caused or contributed to his diabetes. We tried to take him off it but the irritable bowel is quite severe without it.

Juniper is currently on 4.75 U of insulin twice a day, along with 62.5mg of metronidazole twice a day and 0.5 mg budesonide once a day. I test his blood sugar levels at home with an AlphaTrak 2 glucometer -- his most recent curve ranged from 433 to 637, and I have clearance from my vet to increase his dosage to 5.5 U, which I will be doing over the coming days.

Juniper is currently on Hills w/d dry food. I know this is a problem, and I am more than willing to make changes here with the exception of going raw. I'm vegetarian and can't stand cooking for myself, so I can't see myself managing with raw.

My vet and I have a great relationship, and I trust him extensively, but food is the one thing that I and my vet don't see eye to eye on. And it has been a real struggle with Juniper. Without going into too much detail, other dry foods did not improve Juniper's irritable bowel, and he refused to eat wet, possibly due to some dental issues that have since been resolved. Once Juniper went onto budesonide, his quality of life greatly improved and so I conceded to the Hills diet at my vet's recommendation.

A few weeks ago I decided to try wet food again, having read how crucial this is for the diabetes. I decided to try the wet Hills w/d. I hoped to move to a different wet food from there, but starting with the Hills kept my vet on board and I hoped would be the easiest change for his irritable bowel. To my delight, he was interested in it and ate it regularly. I started slow and about a week in (he was on perhaps 1/4 or so can twice a day along with unlimited dry food) his irritable bowel came back with a vengeance. I stopped the wet food and it improved immediately, though I still don't feel he is 100% back to normal. I have been waiting to feel like he has stabilized in order to try again with a different food.

Juniper is also showing signs of weakness in his rear legs, which I understand to be nerve damage.

Right now I'm primarily looking at two fronts -- continuing to increase his insulin and changing his diet. I would love any recommendations on wet food particularly in light of the irritable bowel and any tricks for making that transition successful. Left to my own devices I will probably try the Wellness grain free wet food, and try to make the transition very very slowly (also monitoring his blood sugar of course -- I'm aware that the diet change could bring on hypoglycemia if it improved his blood sugar levels and the insulin dosage wasn't dropped accordingly).

I'd also welcome any thoughts on anything I can do to make him more comfortable, and how to evaluate his pain level. He seems lethargic and does not look as well as he used to, but still cuddles next to me, purrs, and takes all the shots and pricking extremely well here at home (going to the vet on the other hand sends him into panic mode). I want to do anything I can but I also don't want to keep him lingering if he is in pain. I can tell when he is uncomfortable due to the irritable bowel, but it is harder to gauge general lethargy. I really feel trapped between the diabetes and irritable bowel -- can't make progress on one without worsening the other.

Thanks greatly for any thoughts and advice!

-- Tara
 
What inslion is Juniper on ?
Can you post recent BG numbers including the curve. Include when BG was taken with respect to shot, eating and budesonide dosing.
How was the IBD diagnosed?
 
Let us know about the insulin type. Also how the IBD was diagnosed .did the vet mention exocrine pancreatic insufficiency?

It sounds like he can't handle the wet food although you could experiment with other types of wet, it could take a long time to find one he can handle.. Especially since it takes a week to see any change.

Can you provide more test data? I would want to check that he isn't bouncing just to be sure so would need to see preshot tests plus various mid cycle spot checks over a period of a few days.


Assuming it's not bouncing then I think you would probably need to continue to slowly increase the insulin to find a better dose. Some cats on here have conditions that take them to over 30units of lantus twice a day so 5.5 really isn't that high in comparison.. Although he may not get anywhere near that. Once the blood sugar is under control his legs should improve but many people here also use a methylcobalamin b12 supplement called zobaline which can help. Takes a few weeks though.


Wendy
 
Thanks for the responses! Here's some additional info as requested:

Juniper is on ProZinc insulin.

His most recent curve was on 2/15. I gave him his budesonide, metranidazole and first shot all (4.75 U at that time) at about 10:15am. Then I took the following numbers:
10:30am 637
12:30pm 433
2:30pm 461
4:30pm 517
6:30pm 594

Juniper is free-fed throughout the day so I can't correlate food intake, however, I do make a point of giving him some fiber treats that he loves before giving him the shot to ensure he is eating. He's eating about 1 cup of w/d throughout the course of a day. He is definitely eating and drinking (and urinating) a lot.

I don't recall exactly how the IBD was diagnosed, but I do recall my vet wanted to confirm that it wasn't lymphoma before starting the budesonide. I believe he took a biopsy. I don't recall ever hearing anything about exocrine pancreatic insufficiency.

Thanks for the references to the b12 and IBD info -- I will investigate those further.

I hadn't heard of bouncing before and just read a bit about it. It doesn't seem likely to me that bouncing is happening here -- I have never gotten a reading lower than the 433 above, and previous curves have been solidly in the 500 and 600 ranges. Is it possible to bounce down and up in under 2 hours? Should I be testing the blood sugar before giving the shot? In terms of getting other data points outside of the curve, is there a particularly notable time to do that? I did one spot check in the night about 2 hours after his evening shot, and that was reasonably consistent with the above curve (467). I just wanted to confirm it wasn't dramatically different than the daytime readings since he doesn't get budesonide at night. But I didn't go so far as waking up every two hours to do a full curve.

One concern I have is Juniper becoming resistant to being tested. On the last curve, he seemed to be getting impatient/less cooperative. Nothing too bad, and I was having trouble getting a read a couple times during the day. In terms of the vet, he used to be nervous at the vet but not too bad, and he has dramatically changed since this started -- he now freaks at the cat carrier to the point that he peed last time in fright, and the vet's feedback on his 2nd or 3rd curve at the vet office (before I started home testing) was that it wasn't working -- he was too stressed to get accurate readings. Point being, I don't want to overtest him to the point that it causes him that distress. I don't know what I'd do if he became super uncooperative. I try to include treats, petting, and a generally positive/upbeat attitude, but I have already noticed a decrease in enthusiasm for the whole process (he was actually quite eager for his shot in the beginning, probably due to the treats).

I also work during the day so I usually have to find a weekend day in terms of getting a full curve.

Thanks for the feedback so far and thanks in advance for any further feedback. I will continue to increase the dosage (with guidance from my vet) and plan to try wet food again. I'll also read up further on the b12 and IBD.

Thanks,

Tara
 
Hello Tara & Juniper,welcome to the club!
I see you are already getting good advise from the forum,my boy Bailey suffers from pancreatitis,I did a lot of research and found out that aloe vera was very beneficial for panc.and IBS.Bailey has been on it for over 2 months,and it has helped him enormously.It MUST be the right type of aloe vera juice,if you are interested to know more let me know,and I will fill you in on the details. Good luck,things will get better for you both. Diane
 
Bouncing can last up to 72 hours so unless you are doing tests over a few days in succession, you might not catch it. For example he will drop low for a few hours one day and then sit high for a few days after that. If you do infrequent curves you might miss the low as you might only be testing the high days. Plus many cats drop lower at night and it sounds like you are missing half your data.

Best way to know for sure is to do tests over a few days in a row. It is pretty much mandatory to always get a test before every shot as you don't want to shoot when too low. So for the next few days I would get a test before every shot and then 1-2 spot checks in the middle of the cycle. Then a test before bed (2-3 hours after the nighttime shot). If you see any numbers that look like they are dropping then start to test more often.

Make sure you always give a treat after each test - do you restrain him when testing to have a special testing spot? Let us know your process and we may be able to refine it.

Wendy
 
tara said:
Juniper is also showing signs of weakness in his rear legs, which I understand to be nerve damage.
Click to expand...

Better regulation and methyl-B12 should help with his neuropathy. Zobaline is the cat version but you can also get the human version, just make sure it doesn't contain xylitol or sugar. It's perfectly safe to give and they'll pee out any excess.
 
Hello - I was just reading your post about using aloe vera juice for your IBS cat. I am very interested in learning what you are doing, since our big Maine Coon kitty had IBS when we first adopted him in December 2013, and while we have that under control with diet (Prescription ID) and medication (he was on prednisolene and metronidizole for about five months - and is still on the metronidizole), in June he was diagnosed with diabetes. Having read a lot on this forum since I joined a few days ago, I see how important it would be to switch him to a low carb canned diet - but am worried about causing another bout of the IBS. Any information you can share will be greatly appreciated.
Thanks!
 
Hi Tara and Juniper and welcome! And a special welcome to a fellow vegetarian--I'm one too!
I also have an IBD cat, Noodle, and we struggled with his constant diarrhea, mucus and blood in stools, a real mess. We tried vet-prescribed diet after vet-prescribed diet to no avail.
You name it, we tried it and I'm totally convinced that the dry foods the vets had Noodle on caused his diabetes. Finally, in desperation we got another opinion and that vet said just MAYBE his IBD was triggered by food allergies. So we had him tested and found out he was allergic to tuna, salmon, corn and soy and brewers rice which is in nearly all Hills dry foods and Royal Canin also. (It is a cheap filler and very common allergen.) When I started reading cat food cans with a magnifying glass, I found out how very many foods contain those ingredients; even many of the premium grain-free have tuna or salmon. The vet also gave him a trial of a digestive enzyme called Epizyme. It was like someone threw a switch. Between the diet change (no more dry) and foods eliminating his allergens, he has not had one episode of diarrhea in the 2 months since we made the changes. The vet said after Noodle became stable to withdraw the enzymes to see how he did without them, which we did, and Noodle has had no recurrence of his IBD. Since we adopted him 5 years ago he has never had solid stools till now. I know there are a lot of people, vets included, who really don't put much faith in allergy testing. Our vet did believe in it and removing the troublesome foods from Noodle's diet have put the IBD into remission, permanently we hope. I'm a newbie here myself and know how difficult it is to handle diabetes (I'm learning every day) but throwing IBD into the mix is really, really difficult. But you have come to the right place and you will get a lot of help here and I hope very much that you can get Juniper stable, happy and healthy.

Christi
 
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