I'm new and in trouble.

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Dirac

Member Since 2023
My senior cat Darcey (15 yrs) has been diagnosed with diabetes (several weeks ago). He is very tiny and thin and has been for as long as I've known him. He's never had much of an appetite. He has lost weight and now weighs only about 8 lbs. My nerves are shot and can't think properly. He means the world to me, but I'm letting him down. I've been slow to get him on his meds, and have just recently been able to give him insulin. He is eating way less than he should each day; I have him on FF salmon pate. The vet said to give him 1U of Prozinc twice a day, which I've just recently started to do consistently. I give him 4 mg of Cerenia/day, 2 mg of ondansetron/day, and 2 mg Mirtazapine every other day, all to help with his eating. He was on low dose Prednisolone, 0.2 ml every other day, for quite some time (6mo -1year?) because I've been unable to teach him to use the inhaler. I suspect this is what has caused his diabetes. I've stopped giving it cold turkey. The vet gave me 100 mg of Theophylline (tablets). I then got the liquid form, 0.2 ml, twice a day. This was supposed to wean him off the steroid, but I've been unable to get him to take either. As this is for his asthma, I'm not too worried at the moment, because his asthma attacks are seldom, and not very intense, from what I can see. Now he looks very weak. A few hours ago he was falling over against the wall, but has recovered somewhat. At one point he tried a meow, but nothing came out. At that time I gave him 1U of insulin, not knowing if that might make it even worse. He's still eating, but not enough to "break even". I'm going to call the vet in the morning, when they first open, but have been told by a regular who goes there that there is no guarantee they will see him right away, either for treatment, or to be euthanized, should it come to that. I have bought a BG meter, but have only used it on myself so far. While it would be horrible to lose him, it would be far worse to have him suffer needlessly. I have neither the money nor the intention to drag this out, if he is unlikely to recover. If one more bout at the vet's can possibly turn this around, that would be worth a try. I have his 2 brothers to worry about as well. They all came from the same litter. Should I try to get a BG reading now? Depending on what the reading is, should I give him insulin, and how much. How often after that should I check his BG? How would I know if I should continue to give him more insulin, based on those readings? I've looked over this forum to know that the answers are here, but I don't have time to figure it all out at this point. What can I do to maximise his chances, until I can get in to see the vet? I'm desperate and would welcome any help you can suggest. If I can get him past this crisis, I believe I can learn what best to do from the info on this site. I forgot to mention that I give him 60mg of Gabapentin daily. I'm hoping that the weakness/instability is because of this. Thanks.
 
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Diabetes is a treatable condition. Please keep that in mind.

Given the size of your cat, I'm wondering if 1.0u is too much insulin especially since you're not home testing. I'd glad you bought a meter -- now would be a good time to start testing so you're certain that the dose of Prozinc isn't taking Darcey's numbers into too low of a range. This is a link on home testing.

You want to see that his pre-shot number is around 200. You'll also need to get at least one additional test several hours after you give a Darcey her dose of insulin. Please take a look at this information on how to dose Prozinc.

The gabapentin can be sedating. Also, it was really not a good idea to stop the steroids cold turkey. The prednisolone should be tapered.
 
Thanks for getting back to me. I didn't consider tapering the steroid. I just thought that if it did cause the diabetes, continuing its use would defeat any attempts at a successful treatment. Do you think I should give him a small dose of the Pred? He's been off it for a couple of days now. I will immediately read the info on the links you gave me. I have been feeding him as often as I can (bad?). The reason is that no matter what, he will only eat a small amount at any one time. I can often give him his food 10 to 30 mins after a "meal", and he will eat more, maybe as much as the previous amount. His weight loss has me worried. I will hold off the next feeding until I study your links, and see if I can get a good meter reading in the mean time. I really appreciate your help.
 
Hi and welcome to the forum.
I am wondering too if you might need to reduce the insulin dose. Getting some blood glucose data will help us to be able to help you.
Also if he has lost weight, the gabapentin dose may need to be reduced.
If he starts to fall against the wall or gets unsteady again i would rub a couple of drops of honey on his gums to see if that helps. It sounds as if his blood glucose may have dropped too low.
A lot of cats lose weight when they first get diabetes as they can't utilise the nutrients in the food. My Sheba got very thin but eventually put all the weight back on. Once the BGs come down to more normal numbers he should start to regain some weight. I would feed a little and often.
Have a look at this link HOW TO STIMULATE KITTIES APPETITE
 
You can and should feed him as much as he wants especially if he lost weight. We just say to withhold food 2 hours before the preshot tests so you know the number you get is not influenced by food and you know it’s safe to give the insulin. For any other tests after that you don’t have to worry about the food.

did you change his food after the diabetes diagnosis or has he always been on FF pate? It sounds to me also like he’s on either too much insulin or too much gabapentin. If you can get a reading please post and let us know. A reading at the vet is always elevated since the cat is stressed so testing at home is more valuable.
 
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I agree, it is good that you already have the meter and know how to test it on yourself. Going ahead and learning how to get a reading from Darcey would be good. If it helps, here are two videos that I made with our previous diabetic cat, as well as some useful tips after the videos from other members: https://www.felinediabetes.com/FDMB/threads/videos-of-testing-my-cats-bg.223609/#post-2501163

And in the reply right before mine here, I think that @Ale & Bobo & Minnie (GA) meant to say "A reading at the vet is always elevated" rather than "A reading at the vet is always not elevated"? Which I'll say is usually true, that readings are usually higher at the vet because of stress. There are a few rebel kitties whose readings actually drop at the vet, but they are the exception rather than the rule.
 
I changed his food right after his diagnosis, from IAMS dry to the FF. That was after trying almost every wet food out there. In his past (more than 2 years ago), he was fed mostly Friskies Pate so I think he will eat either. Along the way, I have put out his old dry food, along with any number of wet foods, and found he did NOT prefer the dry. I was prescribed Purina Pro Plan DM (yes, I now know better). I tried both the wet and dry, each of which he turned up his nose at. At the best of times, he is a picky eater that eats very little at one sitting. His twin brother is almost double his size and weight. He has always been small and thin (the runt of the litter). I will do my best to get a BG reading, and will post it if/when it happens. I'm confident on the "how" of testing, but applying it to a suspicious, nervous cat is another thing. I'll try my best. Could you tell me if the vain in the ear is the target (as some indicate), or should it be between the vain and the edge of the ear? Confusing.
 
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Sandi&Maxine&Whispy(GA) said:
I agree, it is good that you already have the meter and know how to test it on yourself. Going ahead and learning how to get a reading from Darcey would be good. If it helps, here are two videos that I made with our previous diabetic cat, as well as some useful tips after the videos from other members: https://www.felinediabetes.com/FDMB/threads/videos-of-testing-my-cats-bg.223609/#post-2501163

And in the reply right before mine here, I think that @Ale & Bobo & Minnie (GA) meant to say "A reading at the vet is always elevated" rather than "A reading at the vet is always not elevated"? Which I'll say is usually true, that readings are usually higher at the vet because of stress. There are a few rebel kitties whose readings actually drop at the vet, but they are the exception rather than the rule.
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Yes and fixed thanks!
 
So the change in food from dry to low carb can sometimes drop a cat’s bg by as much as 100 points and we don’t recommend doing that unless you’re home testing. I’m thinking he may be getting too much insulin. Warm up the ear first and aim for the sweet spot
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And some cats will go into remission just with the change in food in conjunction with stopping the steroids. Bobo is one of them. You also want to give a treat immediately after the test whether it’s a success or failure to start building positive association.

To warm up the ear, a lot of us use an old sock we fill with rice and nuke for about 30 seconds then hold the sock up to his ear till it’s warm to the touch. I also like to use a light source aimed at the spot so I can see what I’m doing.
 
I'm worried that it may be too late for Darcey, because of my failure to act sooner. I just had a horrible experience. Some background : I gave him 1U of insulin this morning at 6:00 AM. I have not been able to test his BG to date. He has been eating fairly well all day (still too little), and has been more like his old self. He ate quite a bit about a half hour ago, and seemed fine. He lay down in his carrier and seemed to be still asking for more (treats or food?). Suddenly , he fell sideways and was in obvious distress. He fell over on his back and was kicking and appeared to be having a seizure(?). Not having any honey on hand, I quickly mixed some regular sugar with water and filled a tiny syringe with it. I managed to get a little into the side of his mouth. I grabbed him and headed for my bed, and held him down. He was not struggling much, so I was able to get a drop of blood from his ear. It read 18.0 on the meter, which I think equals 324 in US numbers. So obviously this is not hypo, as he had just eaten a fair bit, and had not had insulin in 12 hours. That was the next thing I had planned for him, but this happened and I don't know if I should now give him a shot? He quite quickly returned to "normal", and is hiding behind a dresser, but seems to be OK at the moment. There's almost nothing I wouldn't do for this precious little guy, but I won't let him suffer needlessly, if his condition is hopeless. Please help me to do what is right for him. What could this episode mean? Something similar happened 2 days ago, but without the convulsions. Thinking the Gabapentin might be to blame, I stopped giving it to him since then. Does anyone know what might be happening?
 
I should also mention that I've been monitoring his ketones, with Ketostix, but have not seen anything above "None" or maybe "Trace". I don't know if that's important.
 
It’s good you are testing for ketones the urine. Keep doing it
If the BG was 18 (324) it was not a hypo.
How long ago did you stop the gabapentin? Stopping it suddenly is not a good idea. Reducing would be better, on vet advice.
It is possible your kitty has had a seizure. Seizures, which are sudden surges of electricity in the brain, can be treated successfully with medication. I would go to the vet and explain what has happened. I have a kitty that has seizures at times and is otherwise fine.
Things are not hopeless, you just need to get things sorted out.
You might do well, if you can afford it, to have a freestyle libre put on your kitty for 2 weeks to monitor the blood glucose until you can test yourself routinely.
 
That's great advice. His final does of gabapentin (60 mg) was yesterday at about 6:00 AM. I will follow up with my vet. The freestyle libre sounds like a good idea, at least until I can get the manual testing under control. Do you think it's safe to give him his evening insulin dose?
 
Dirac said:
That's great advice. His final does of gabapentin (60 mg) was yesterday at about 6:00 AM. I will follow up with my vet. The freestyle libre sounds like a good idea, at least until I can get the manual testing under control. Do you think it's safe to give him his evening insulin dose?
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It should be ok if the BG was 18. If you can’t monitor the BGs you could always give a half dose. Just make sure he eats well. Amd give him snacks.
You will get there. Sometimes it just takes time.
 
I called the vet, but she was not in today. The Dr. on hand said to just monitor the situation and wait for my vet to get back. All was well and good, until about 6:45 this evening. As has happened the previous 2 days, at around the same time, he appeared to have what looked like a seizure. Today and on Sunday, he was falling over sideways, and could not walk straight. But yesterday was much worse : He was on his back with his limbs thrashing about. An immediate BG test showed that he was not hypo at that point - 18 (324). These incidents came and went quickly (maybe 5 mins top). Because it was just before his next dose (12 hours apart, 1U Prozinc) could this in fact be the opposite to a hypo event, due to a very high glucose number, from an inadequate blood insulin level? Another theory was that these might be linked to me stupidly stopping his steroid and sedative meds, without properly tapering down first. This now seems unlikely, because of the timing of the incidents? Unfortunately, I have not yet established a proper testing/dosing routine, but intend to shortly. In the mean time, is there anything that might shed light on what's going on, or how to prevent it from happening again?
 
I doubt it would be because his BG was 324. That is not uncommonly high.
it could possible be due to stopping some of the medications too quickly. You need to be guided by the vet on this.
 
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