Increase insulin dosage and diarrhea?

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Pat Altstatt

Pat Altstatt

Member Since 2015
My 8-10 year old kitty is a fairly new diabetes diagnosis. We started him on two units of ProZinc twice a day and left him on dry food (W/D prescription) he had been eating (he was extremely overweight). After he lost the weight he then was diagnosed with the diabetes. They tested him last week and numbers were still not where they wanted so increased dosage to three units twice a day. He has been experiencing extremely loose stool and due to atrophy in his hind legs he cannot support himself to stay out of the poo. Could the increase in insulin cause this? It broke my heart this morning to have to clean him up but once he got out of the box he just laid down. I have called the vet and left a message; waiting to hear her thoughts as well but thought someone here might have prior experience or thoughts. Thank you.
 
Hi Pat. Do you know the cause of the atrophy in his hind legs? It sounds like it could possibly be diabetic neuropathy, which can be treated fairly easily. Please mention this to your vet, if she doesn't know the cause of the problem.

How long has he been eating the W/D dry food? Typically, dry food is much too high in carbohydrates for a diabetic kitty, and is definitely lacking in moisture. If he no longer needs it for weight loss, I would seriously consider changing him slowly over to a lower carb, canned food. Here is a link to a very good article, written by a vet, that will help you understand feline nutrition and requirements: www.catinfo.com. After you read the article, if you click on the highlighted link Cat Food Composition, it will give you a list of foods and their percentage of carbs as well as other components. For diabetic kitties we definitely recommend you stay under 10% carbs.

I understand that feeding a spoonful of pure pumpkin puree (not the pie filling, which has sugar added!) can be helpful for diarrhea but have no personal knowledge of this.

Good luck, and please keep us posted, let us know how the visit to the vet goes! I hope you get some answers!

Lucy :)
 
Pat Altstatt said:
He has been experiencing extremely loose stool and due to atrophy in his hind legs he cannot support himself to stay out of the poo.
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Hi Pat! I don't want to freak you out, but there were some alarm bells that went off in my head when I read your post. How long has the diarrhea been going on? Diabetic cats are prone to pancreatitis; so if it's been a while, I would get him tested for pancreatitis. Is the poo at all yellowish? With him having diarrhea and being on W/D, which is a dehydrating food (regardless of if you're using the dry W/D kibbles or the W/D canned), I would be somewhat concerned about dehydration. You should probably "tent test" him once a day to check for that. (I can find some youtube videos of that if you aren't familiar with it.)

For the neuropathy, I would start him on either B12 shots from the vet or Zobaline (would suggest starting with two pills a day- one in the morning and one at night, crushed into his food- and then reduce to 1 pill per day once you see improvement).

If he does have pancreatitis, they will give you a pain med (often Buprenex), an appetite stimulant (cyproheptadine or mirtazapine) in case he starts being fussy about eating, some antacids (Pepcid A/C), and anti-nausea meds, like Cerenia or ondans (to use if he starts licking his lips a lot, gagging, or throwing up). Hopefully, it's just some colitis though. Let us know if he has any other symptoms.
 
Pat Altstatt said:
My 8-10 year old kitty is a fairly new diabetes diagnosis. We started him on two units of ProZinc twice a day and left him on dry food (W/D prescription) he had been eating (he was extremely overweight). After he lost the weight he then was diagnosed with the diabetes. They tested him last week and numbers were still not where they wanted so increased dosage to three units twice a day. He has been experiencing extremely loose stool and due to atrophy in his hind legs he cannot support himself to stay out of the poo. Could the increase in insulin cause this? It broke my heart this morning to have to clean him up but once he got out of the box he just laid down. I have called the vet and left a message; waiting to hear her thoughts as well but thought someone here might have prior experience or thoughts. Thank you.
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Oh kitty! Hope kitty is feeling better soon. Lucky to have you looking out!

I cannot speak to the other conditions, but if it was my kitty, I would go ahead and try give 1 teaspoon pumpkin. Diarrhea can be hard on kitties when it lasts for more than 24 hours so it is important to get under control. Just posted this on another thread so I will repeat here:

I would start on 1 teaspoon 2x a day, right after preshot test and before meal. Try give it to kitty on your finger at room temp. Try to get them excited about it. Make some squeaky noises or whatever sound you make when giving your cats a treat. :p Slowly work up to 1 tablespoon with each meal.

This is how I got my kitty interested the first time. Also, I keep the unused pumpkin refrigerated and I have noticed that he does not like it when it's cold. I will microwave it for 5 seconds and check the temp with my finger before mixing it with his Fancy Feast Classics.

I used to only give the pumpkin when there was a digestive upset, but I am thinking I am going to continue giving it all the time now as it is great for diabetics as well.

Also wanted to add that my kitty was on w/d canned until I recently made the switch to Fancy Feast Classics and now FFC with pumpkin (you can see in his chart this has seemed to have made a huge difference).

Good Luck!
 
The flat-footed walk was what sent us to the vet. He is an acrobat, and my first thought was he had fallen and hurt his back legs (he used to get on the upstairs banister overlooking the entryway). After a couple days of no improvement, took him to the vet, and he received the diabetic diagnosis. He had been extremely overweight (22+ pounds) so was put on a diet in late February/early March this year. He had a full blood panel done at that time and everything was normal. He went back in August for his six-month check, but no blood work at that visit. He was diagnosed diabetic on September 9. The increased dosage of insulin started last Wednesday, I noticed the diarrhea pile Sunday night, and a second big pile this morning. And yes, it is yellowish. He eats well, but is still drinking a lot of water. Getting around is difficult for him as his back legs flail. We use the W/D food as we have three other cats, one who had most of his colon removed due to mega colon. We had gone back to the dry after the canned food caused the mega colon kitty to drip.
 
PS, the vet has not yet given me instructions on self-testing as they are still trying to get him stabilized. This is all new to me so following their instructions.
 
Pat Altstatt said:
PS, the vet has not yet given me instructions on self-testing as they are still trying to get him stabilized. This is all new to me so following their instructions.
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I learned the most about home testing by watching every youtube video I could. Every body has a little bit of a different technique and watching a lot of different styles helped me tremendously.

First time is the worst. It gets to be where it's a piece of cake. And my cat is not the type who likes to even be pet the wrong way!

You can do it! IMO, home-testing is a must. I would have absolutely sent my kitty hypo or worse if I had not been testing.
 
Oh my, you really have your hands full!

So the vet hasn't said anything about his hind leg weakness/paralysis? Here is a very good video that shows the progress of diabetic neuropathy:

https://www.google.com/search?client=opera&q=Tootsie's+neuropathy&sourceid=opera&ie=UTF-8&oe=UTF-8

It is very treatable, especially if it is caught early. Most people here use Zobaline, synonymous with Methylcobalamin (Methyl B12).

I'm so sorry to hear about your mega-colon kitty. But I can tell you that Hill's W/D canned food is about 25% carbohydrates, so I would think the dry must be considerably higher, which will keep your diabetic kitty's BG high. Also, for what it's worth, when my little Bengal was diagnosed with IBD, several people here told me that Hill's (which my vet had put her on) of any variety, is NOT good for kitties with diarrhea as it contributes greatly to dehydration. And I would definitely ask the vet to rule out pancreatitis, as @SpecklesandMe suggest.

I don't understand why vets tell their clients to wait to home test until kitty is "stablized." A trip to the vet is very stressful for most cats, and in some cases "vet stress" has been known to raise a kitty's BG by 100-200 points! Home testing is not difficult, especially once you get the hang of it, is a lot less stressful on your cat, and is a lot cheaper than a trip to the vet to have BG tested! It is also pretty vital to the health of your kitty; if you don't know what the BG level is, how can you make sure you are not administering too much insulin? My cat has had several hypoglycemic episodes; if I didn't home test I could have killed him by giving too much insulin when he didn't need it, or not being aware that he was hypoglycemic. It is always best to test before you give a shot. If you know any people who are diabetic they will tell you the would never give themselves a shot with out checking their blood glucose first. Let us know when you are ready to begin home testing and anybody here can help you learn!

I don't mean to throw a lot of "scary stuff" at you, but these are some of the things you should be aware of to best treat your diabetic kitty. Also, what is his name, please? I hate to have to keep referring to him as just "kitty"!

Once again, please do keep us posted, and good luck at the vet's! Let us know what they diagnose!
 
Pat Altstatt said:
And yes, it is yellowish.
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Yellower poo than usual is often a tell-tale sign of pancreatitis. Please go to the vet and get him tested if this diarrhea doesn't resolve within a couple days. The test is called Spec fPL. Diabetes that is not well regulated leads to an increased risk of pancreatitis- so it all goes together.
 
Pat Altstatt said:
PS, the vet has not yet given me instructions on self-testing as they are still trying to get him stabilized. This is all new to me so following their instructions.
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Hi there, I just wanted to weigh in about home testing. My vet told me he would teach me once my cat was regulated. Well, it's been 4 months and he is not regulated. I was not comfortable giving him insulin without knowing what his preshot number was. I watched videos and circumvented the vet and made an appointment with the vet tech to show me how to test and thank Goodness I did as I would have probably killed him on about 6 occasions giving him insulin when he was all ready very low. Here is a couple of links for you to look at to learn how and if you have any questions please ask us and we will help.
http://s106.photobucket.com/user/chupie_2006/media/testingear/sweetspot.jpg.html
Hope this helps.
 
WOW, thank you all so much. I will be looking at video and speaking to the vet tomorrow. I wonder if sometimes it is not all about the "power" and not knowing anything, I hated to push. I just want Houdini (his name, because he was quite the escape artist) to feel better. It all came on quite suddenly, and after a couple days of his flat foot walking I took him to the vet. What other foods might be considered, especially with the mega colon kitty who needs extremely high fiber. Oh my, so much information to try and absorb.
 
Also, I might not have mentioned that the diabetic diagnosis was based on his gait and flat-foot walk as well as blood work; so she is very much aware. He is not paralyzed, just walks very awkward and slowly. :(
 
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Pat Altstatt said:
Also, I might not have mentioned that the diabetic diagnosis was based on his gait and flat-foot walk as well as blood work; so she is very much aware. He is not paralyzed, just walks very awkward and slowly. :(
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The methyl-B12 is good for the walking issue and could be helpful in case you actually are dealing with pancreatitis. As long as he doesn't have kidney issues, he'll just pee out any extra you give him.
What about just adding fiber to the megacolon kitty's food? I think someone mentioned pumpkin, and there's always psyllium or Benefiber.
 
A quick update; after last check at end of 9/30, they increased insulin dosage to 3 units every 12 hours. They had scheduled him for another check this week (Thursday), but I am not seeing any improvement. I have questioned the care (seem more interested in selling wellness plans the past few years), and I have selected a new vet for a second opinion as to treatment, prognosis and outcome. She is very much of self-testing to be aware of his condition on a day-to-day basis which the other clinic was not. The diarrhea must have been a short event as it has not occurred again. Will update after I meet with vet this evening.
 
Pat Altstatt said:
A quick update; after last check at end of 9/30, they increased insulin dosage to 3 units every 12 hours. They had scheduled him for another check this week (Thursday), but I am not seeing any improvement. I have questioned the care (seem more interested in selling wellness plans the past few years), and I have selected a new vet for a second opinion as to treatment, prognosis and outcome. She is very much of self-testing to be aware of his condition on a day-to-day basis which the other clinic was not. The diarrhea must have been a short event as it has not occurred again. Will update after I meet with vet this evening.
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Good luck with your vet interview! She sounds like she might be a good fit for you and Houdini, fingers and paws crossed for you! :):)
 
Just a bit of advice--W/D dry is very, very high in carbs and you're not likely to see much improvement without large insulin doses on that food. I'm fairly certain that food is what caused Bandit's diabetes to begin with. If you change to a low carb, canned diet, you'll get much better control of his diabetes. You can always add pumpkin or psyllium as others suggested for fiber. HOWEVER, and this is very important, you need make sure you're testing him and lowering the insulin dose if you're changing the diet, as cats need dramatically less insulin on low carb canned food. If you change the diet and do not lower the insulin dose, you could have a dangerous hypoglycemic incident.

Good luck with the new vet!
 
The net vet has put him on Royal Canin diabetic kitty food, and he likes it (a plus). She has suggested today due to some other test results that we move him from ProZinc to Glargine. Anyone with any experience? I posted on another thread, not sure where the best input will be received. She said I could buy it at any local pharmacy?
 
Glargine is the insulin brand Lantus. It is a depot insulin and the effects overlap shot to shot. It works best when you shoot a consistent 12 hour schedule and test the nadir period to monitor dose effectiveness.

Just a thought with the megacolon - ask the vet if you could mix plain psyllium powder into low carb food to manage the condition. Tat would keep the carbs down, yet the insoluble fiber up.

For great feline GI info, check out Feline Constipation
 
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