Help! Chronic foul-smelling diarrhea and insulin-resistant?

[TommyCat]

Hi! I have a difficult case, I think, and could use any and all advice. My 14-year-old cat, Tommy, was diagnosed with diabetes about two years ago. He is a LARGE cat -- about 20 pds. In the beginning, we started him on Lantus at 3 units twice a day, and eventually started to see his counts stabilize (125-150) around 8 units. But after about a year, the Lantus seemed to stop working. The vet believes he is now insulin-resistant. Tommy is now up to 10 units 2x day, which is obviously a very large dosage, but his sugars are still routinely 400-450. He had neuropathy in one leg that seems to have gone away (he was limping for a while but now back to normal). Otherwise, he does not have any complications, has a VERY healthy appetite, drinks a lot of water (as would be expected), and otherwise seems content. He does have HORRIBLE diarrhea, however, which is EXTREMELY foul-smelling. We have tried multiple antibiotics to address the diarrhea but to no avail. He eats Royal Canin diabetic cat formula. He's always had a pretty sensitive stomach, but my guess is that the diarrhea is a function of his out-of-control glucose levels, so if we could just get that down! .... Anyway, Tommy *seems okay, but I'm a Type 1 diabetic myself and I know how awful it feels to have high blood sugars, so it's all just very frustrating...

 

[Wendy&Neko]

Hello and welcome. When kitties get to over 6 units dose, we recommend testing them for for high dose conditions. One in four diabetic cats has acromegaly, caused by a benign pituitary tumour that sends out excess growth hormone, that in turn causes the diabetes. Amongst the characteristics of cats with acromegaly are size, hunger (think growing teenage boys), and need for higher doses. The pituitary tumour can pulse up and down, causing changes in insulin needs. We do have acromegalic kitties here on more than 10 units, though not all are higher dose cats. Are you home testing his blood sugars?

Is the Royal Canin wet or dry food? You don't need to feed the "prescription" diet foods, but can feed any low carb wet or raw food. If you are feeding higher carb vet food, switching to a commercially available wet or raw may help the blood sugar. And maybe you can find a food that agrees with his digestive system better. Has the vet ever talked about IBD? Diarrhea can be a symptom. The website http://www.ibdkitties.net/ has lots of information.

 

[StephG]

I had good luck with s boulardi that's suggested on ibdkitties website.

 

[Sandy and Black Kitty]

The vet believes he is now insulin-resistant.

There is a test for that - IAA (insulin auto antibodies) , an idiopathic condition where antibodies to insulin are being produced - it is another condition that requires high doses. My Black Kitty had IAA.