Introduction Post from Ollie's Mama, Cath.

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Thanks! I'm so pleased!

The vet ended up ringing me, and we had a 50 min (free!) consultation rather than bring Ollie in. She, and a colleague had me on speaker. They asked clever questions resulting in
me being given meloxicam for pain. Why? Well, Ollie had a dental clean Oct 2022. I brought him back 2 months later, and the same vet said 'oh, these teeth look bad!" I replied "How is that so? Your guys just cleaned them and praised his condition for a 14 year old.'

So this new vet asked me what Ollie sounded like when he eats. I explained he sounds like grinding rubber, and this past three days, its like he's throwing food into the back of his mouth as if to avoid touching it. We deducted that at no time did the 1st vet talk about a mouth exam, and discuss oral pain/issues, so she said let's put him on meloxicam for pain (two syringes) and see if his eating comes back.

With a follow up appointment Tuesday to decide if we're in the clear - or not.

I'm so excited. Ive given the medication immediately, with some roo. So Ollie has just jumped up, held his body high for a big wee, and then gone upstairs. (Both a first!)

Now I'm very excited to see if his mouth supports his appetite. This would seem reasonable. He is interested in the food, but can't eat it - and this may be WHY!

Either way, I'm changing vet. She was brilliant and they have a brilliant boarding facility if I ever need it.

Wish me luck!
Cath
 
This sounds really promising. If insulin is needed ask them for lantus. Of course wait until all is back to normal m:bighug::bighug::bighug:
 
I think i've fixed it, Tiff! I just offered Ollie some soft mushy food and he ate the whole lot. It's his mouth! He ate ALL of it, because he COULD!
And I gave him one of his favourite treats, in a fresh jiggle jiggle packet and he swallowed four WHOLE, therefore avoiding chewing.

Lantus - is that the same as Optisulin? Bron suggested Optisulin and yes, I'm going to ask to be changed.

I'm over the moon here, imagine if after paying $1600, discussions of euthanasia, and tumour that it was his gums/teeth?

I'm happy but furious.
 
Yes, it’s the same insulin Bron suggested. If it is his teeth his glucose might come back to normal quickly. :)
 
I’m not sure if it can cause diabetes but I know that the number one reason cats come out of remission is due to needing a dental.
 
Have just read the update.
I am Glad Ollie is responding to metacam. Make sure he eats well before you give it though. Metacam must be given with food.
I gave it to Sheba when she was very unwell and it made a massive difference within a few hours. She want from just lying around looking
wretched, to up and eating well and talking etc.
Many of the blood results are measured differently in Australia to they so are difficult to compare. Any results you get from the vet should have the normal range on the right hand side of the paper.
Cath, I would ask about swapping to the optisulin now as it is much easier to use than Caninsulin , longer lasting and so much better for cats.
 
Yes, I gave him some roo first, lucky for me it took it. Yes, the massive difference is evident here too.

Ollie ate a full sleeve of Fancy Feast Puree Kiss, because he can lick it, no chewing. Then, as a test, I gave him a little protein biscuit, he wanted it, and gulped it down
without crunching it, whole. He had four of these - again, avoiding crunching.

So he ate well, without stopping. Then he went up the stairs, which he always used to do. He likes to sit at the top where he can see everything. Then, he jumped up and laid on my bed - again, a normal behaviour. He's happier on metacam for sure.

I have an appointment on Tuesday with new vet at 10.30 am. I will insist on Optisulin for those reasons.

I'm going to try Sticking him tonight give that he's more comfortable.
 
Ollies Mama said:
No luck two jabs, and he swiped me. I feel like such an idiot. I don't know how many videos i've watched.
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Just keep trying. Are you offering him something yummy to eat as you do it?
If you are not giving the insulin, and you don’t know what the BG is, it is very important you are testing every day for ketones in the urine.
This is how I used to test Sheba in the beginning when I was doing it on my own.
I used to get everything ready…a treat to eat as I was testing, the testing equipment, and the strip in the mete…all I had to do was push it in just before I poked Sheba.
Then I knelt down on the ground, and sat back on my heels And put all the equipment and the food beside me. Then I got Sheba and put her in front of me so that her tail was facing me and she was looking the same way as me. So if she tried to back away she couldn’t. And I held her gently with one hand around her chest and gave her the treat. I then pushed the strip into the meter, as she had her face in the food, pricked her ear and milked it and got the blood into the strip. If you don’t have time to get the blood onto the strip, you can collect it onto your finger nail.
 
Update: I tested for ketones this morning, fed him (he had under 1/3 cup of slurry pate) with metacam. Ketones came up with 'traces' I caught his wee in a syringe easily now that he can hold his body up tall.

He is definitely avoiding crunching or using his teeth.

I rang the new vet, explained. She supported Optinsulin change on Tuesday and said to go ahead and do IUC, not a half dose. She had an audible response when I said I was prescribed Caninsulin.

I gave him 1UC at 10 am, as a response to his ketone traces. She said his body is calling for it. She said he will have those traces for 3 weeks now, so don't bother doing my head in testing every day.

She said to recommence 1UC as normal 6 am, 6 pm, and pick up another syringe (.02) of metacam this afternoon (for tomorrow, Monday) to get him through until
they see him. She explained hidden dental issues (needing an exray) is why the dental clean didn't pick it up from former vet.

She is wonderful, invested and a diabetes expert. I am over the moon. The best 11 mins on the phone.
 
Ollies Mama said:
Update: I tested for ketones this morning, fed him (he had under 1/3 cup of slurry pate) with metacam. Ketones came up with 'traces' I caught his wee in a syringe easily now that he can hold his body up tall.

He is definitely avoiding crunching or using his teeth.

I rang the new vet, explained. She supported Optinsulin change on Tuesday and said to go ahead and do IUC, not a half dose. She had an audible response when I said I was prescribed Caninsulin.

I gave him 1UC at 10 am, as a response to his ketone traces. She said his body is calling for it. She said he will have those traces for 3 weeks now, so don't bother doing my head in testing every day.

She said to recommence 1UC as normal 6 am, 6 pm, and pick up another syringe (.02) of metacam this afternoon (for tomorrow, Monday) to get him through until
they see him. She explained hidden dental issues (needing an exray) is why the dental clean didn't pick it up from former vet.

She is wonderful, invested and a diabetes expert. I am over the moon. The best 11 mins on the phone.
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Hi Cath,
I am glad your new vet is so responsive.
I agree that insulin needs to be started with the trace of ketones in the urine, but I would definitely be trying to get some BG tests done to make sure the BG is not dropping too low.
With the trace of ketones it is also really important to make sure Ollie is eating as much food as possible. The way to stop ketones from forming is to give insulin and to feed as much as possible and to make sure Ollie is drinking.

Ollies Mama said:
She said he will have those traces for 3 weeks now, so don't bother doing my head in testing every day.
Click to expand...
I'm sorry to disagree with your vet on this point. It is simply not true that Ollie will have traces of ketones in the urine for 3 weeks if he is getting enough insulin and enough food.
We have a lot of cats who arrive here having had DKA (which is a deadly disease which happens if ketones are not addressed and are allowed to progress) and are sent home to recover, and we frequently have cats who are showing either traces or more of ketones. The way to address that is with increasing the dose of insulin and increasing the amount of food. And sub Q fluids help here too.
We see a response to the level of ketones in the urine often within 12 hours of increasing the food and insulin unless there is something else going on that needs to be addressed.
I certainly have not seen a cat continue with traces of ketones for 3 weeks unless something else is going on.
I would really recommend you test every day for ketones. It is the way to see if you have the food and insulin balance right. I can't stress this enough.
 
hi Bron, thanks so much for your insights - as always.

I can test every day for Ketones, that's easy to do. I have a box of stix now. I will log the results on my spreadsheet to keep track.

Originally, I thought the urine strip was 'no ketones' but then, my mum and I both agreed the colour had changed to 'traces' after a few more mins. A nurse friend of mine said that ketones smell like sweet popcorn - do you think so? And she said keto acidosis smells like nail polish remover.

I am offering food to Ollie every 2 hours and he's nibbling away. Today he had some finely chopped chicken mixed in raw meow mix, some dried chicken krumble and a couple of teaspoons of fancy feast kisses. He is increasing more and more.

Today, he has also had 50 mil of water, not enough, but something. I syringed it into his cheek. For some reason, he isnt drinking water. Any ideas why?

I'll change the tea-cup that he normally uses and use a glass - that might entice him further.

Last night he slept with me, between my knees, which is normal for him so behaviourally he's more and more responsive.

And he's started meowing too, so that's more like him. I have not given up on BG and will persist.

I have uploaded a pic here, of a small round furry bump on his back. Mum and I thought it might be ringworm (especially after his stay in the kennel) but there isn't the typical red ring around it.

have you seen these with cats with diabetes before? He only just got this last week, so not sure if stress, or health related.

Cath
 
Pic of bump. I can send via email, or Facebook message if you'd like to see a video of it.
 

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Ollies Mama said:
Originally, I thought the urine strip was 'no ketones' but then, my mum and I both agreed the colour had changed to 'traces' after a few more mins. A nurse friend of mine said that ketones smell like sweet popcorn - do you think so? And she said keto acidosis smells like nail polish remover.
Click to expand...
You need to read the result of the ketostix on the side of the bottle exactly 15 seconds after you dip it into the urine.
It will change colour after that and will not be a true reading, so it is possible Ollie did not have any ketones.
You may not be able to smell a trace of ketones but any more than a trace and it can smell like nail polish remover. I have not heard it smell like popcorn, but that is not to say it doesn't.
I would ask the vet about the bump on Ollie's back. I doubt it is diabetic related.
It sounds as if Ollie is improving each day which is great. I'm glad to hear he is eating more food...very important.
 
Ok, I will set a 15 second timer next time he wee's. I'll do it tonight when he wee's.

Thanks so much. I will ask Vet about the bump, test ketones at next wee, and continue with trying to get BG.

He looks so much better you know. Less bedraggled and sick. He is awake more than he is asleep now, followed me and my mum around today in the house.

I could be imagining it, but I felt he was even better after the insulin at 10 am.

He IS improving each day, you're right.
 
update. Negative to ketosis, when I comply with 15 second clinical rules.
Ate half a tin of pate this morning.
Did a wee, all in his tray, holding his own weight up. I have noted that he hasn't missed the tray since he's been back - a change for the better.
I bought a camera for inside the house so I can watch him when I'm not home.
Will try BG before I leave the house this morning. He appears very stable to me, more awake than not now. No vomiting no diarrhoea
Vet tomorrow at 1045 am. I'm driving to the Whitsundays today (about an hour to visit a team of people) and will have limited access to forum but
I will check when I can.

Cheers,
Cath
 
hi, I left a half tin of pate out, he didn't touch.
When I got home at 4pm, I tapped a tin and he responded. He ate half a tin of food. Doesn't look as though he's touched the water.
No more wee's - only one between 6 am - 4 pm. Have recorded this all for vet tomorrow.

Also, the little weird thing on his back has started to lift. Pic attached. I can see a red ring around some of it, making me think it's ringworm. I am tempted to just get some anti-fungal cream myself, but I want the vet to see it to confirm. I'm also hopeful that it's not those lesions that come with Cushings. He has a pot belly but I thought that was just from being a piggy-eater.

I wish I could attach a video of him eating so you can hear the noises. Bron - I'll post this on the facebook forum for opinion if you want to view it there.

Vet tomorrow will determine if his eating avoidance is mouth-related. Also want them to do BG at 8 am. I will consent to an ex-ray to show damage that is beyond surface deep.

Fingers crossed it IS this and is easy to treat. I will do ketones tonight and tomorrow morning again.

Cath
 

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hi all,
Update.

Today Ollie's BG 10, no ketones x 2 tests, dental exam proved positive for likely abscess or rotten teeth. No wonder he can't eat, motivation to eat is strong.

He's on strong pain relief to get him to eat. If that pain relief tonight, plus dinner plus daily meloxicam STILL Doesn't get him to eat, they'll do feeding tube after the dental work.

Libre device being fitted on Monday while he's out getting his dental treatment. Could be one tooth extracted, or five teeth extracted.

staying with Caninsulin until after dental work, then they'll monitor it closely with the libre thing. Then happy to change to Optinsulin.

Maintaining 1UC for the moment.

Regarding the sore on his back, the vet lifted the little flap that had started to lift, and a circle of hair fell away, leaving inflammation and a dry scab. Under the microscope, it did not look like ringworm BUT could have been ringworm a month ago. Sent home with cream for it, meloxicam, and a very high cat.
 
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Update.
Ollie is licking slurry food at home, and drinking. Toileting too.
His condition over all is improving, he's in good spirits but he's not eating enough.
He eats better after the morning metacam has been administered.

Dental appointment on Monday. I have purchased the Libre.

I'm expecting once he is not in pain, that his appetite will return.

He is snuggly, vocal, but not 100%.

Diabetes being managed as usual with Caninsulin. I'm going to try and get a BG today now that he's feeling better.

Cath
 
Poor Ollie
I hope all goes well with the dental on Monday. I will be looking for an update.
A feeding tube after the dental might be a very good idea to get him over the hump post dental especially if he has teeth removed. They could put it in during the anaesthetic for the dental.
 
You have certainly been through more than your share with Ollie. I'm glad the veterinary care has improved. One thought to keep in mind. If you are anywhere near the University of Queensland? The vet school has a small animal hospital. Jacqui Rand, DVM, the veterinarian who did the groundbreaking work on using Lantus (glargine) for the treatment of feline diabetes was on faculty at UQ. She's now retired but their program should be up to date on diabetes (and other) treatment.
 
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