How long can a cat have diabetes before diagnosis?

[Sabs]

A long history: I adopted Cocoa (well, a catsitting situation turned into a permanent situation when I realized how neglectful her previous owners were) at age 8. She had some obvious health issues from the beginning: obesity and peeing outside the litterbox, which I and the vet mainly chalked up to poor treatment by her previous owners, who front-declawed her, let her go outside for weeks at a time, and may have abused or neglected her in other ways. I take her to the vet regularly for checkups and she's had a full senior cat blood workup as soon as the vet started recommending it.

In the past few years, she's lost a lot of weight. At first my old vet ignored this and said it was healthy, since she'd been obese before (and it started happening around the time that I got a new cat, who is much more active and they play together). Then she went from missing the litterbox to peeing on my bed. I brought her to the emergency vet, who diagnosed her with early CKD and anorexia. We started on mirtazapine and k/d food. I then brought her for a followup to my old vet, who completely overmedicated her with gabapentin. She also thought that Cocoa had a tumour and started ranting about new advances in veterinary oncology before I had even taken her for an ultrasound, which found no tumour.

After that experience (and knowing that she had CKD), I moved to a new vet, who's closer and had a great reputation. There are four vets who work in that clinic and they sometimes differ greatly on their assessment. The big thing that they noticed was tooth reabsorption and said that she had to have extensive dental surgery. This was either something that my previous vet hadn't noticed or really recent. Given the CKD, they didn't feel comfortable doing it, so they sent her to a dental expert at the veterinary hospital, who again did a full blood workup. They extracted the teeth but she almost died anyway from just not eating. She was back and forth to that hospital for a month, during which they also diagnosed her with calicivirus (something I doubt and my regular vet is skeptical about).

Eventually she seemed to get on a more stable footing. She still had to have the mirtazapine about once a week and was still a reluctant eater, but at least she mostly ate.

At this point (this is a few months ago) I started noticing that she was limping a lot, and asked the vet if it could be arthritis, given her age and the fact that her previous owners had declawed her. The vet thought it was a good possibility and we switched her to k/d + mobility.

Then she started losing weight again. I brought her in for a full blood workup and they diagnosed hyperthyroidism. Started her on the Felimazole pills, then there were a few weeks of adjusting the pills, and we got her levels stable. The vet was still suspicious because she was still losing weight and didn't think it was either her thyroid or her kidneys. At that point she asked for a urine test, which revealed an infection and glucose. Tested her for diabetes and here we are.

Now that I'm looking back on this whole history, I'm really curious. Hind leg weakness, excessive drinking and urination, lethargy, loss of appetite, loss of weight—all of this seems to add up to a diabetes diagnoses well before now. I know she was tested for it multiple times and multiple vets ruled it out. Can it just creep up like that?

Nothing against any of the vets (except for the one who overmedicated her). They've all been super helpful. The current vet thinks that the latest infection caused the diabetes and that it's very recent. Hindsight is 50/50 but I want to know how many of her previous issues were likely caused by diabetes and might potentially be helped now that she's getting treatment for it.

Any thoughts?

 

[Larry and Kitties]

the emergency vet, who diagnosed her with early CKD

Assuming bloodwork was done that shouod have showed up diabetes if present unless the vet overlooked it. It is hard to overlook since the bloodwork results shood have included a "H" by that value.

veterinary hospital, who again did a full blood workup

Same as above.

Also if urine analysis was performed that shood have shown glucose in the urine if the cat was diabetic.

One think is that the other medical problems may have only recently trigger the diabetes.

 

[THH & Snowcrash (GA)]

Hyperthyroid and diabetes have almost identical symptoms. Hyperthyroid also makes a cat more likely to become diabetic, so my guess is there could have been some overlap between the two diagnoses in-between test results. High blood glucose levels don't always mean a diabetes diagnosis, but usually vets will notice those results and either jump to diabetes diagnosis or (ideally) do more tests to confirm it.