? Is Yum losing regulation or is it constipation? PMPS 283 (AT2)

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MJW

MJW

Member Since 2017
Yum gave me a 283 preshot on an AT2 this evening. She hasn't gone that high since April. She had been well regulated since April/May.

In August she was diagnosed with kidney disease and I started experimenting with her diet, reducing fancy feast and introducing RadCat raw lamb (seeking a low carb/low phosphorus diet). I put her on a phosphorus binder (aluminum hydroxide).

She developed intermittent diarrhea (bad), but her insulin dose dropped to .5 to .75 units twice a day (WOOHOO). Thoughts of remission danced in my head.
Week before last the diarrhea was really bad and she lost her appetite. I withdrew the raw lamb and gave her Wellness Core Beef/Venison/Lamb, which is another low carb/low phosphorus alternative.
The diarrhea got worse.
I withdrew the mammal meat and introduced RadCat raw chicken . That seemed to do the trick. She had 5 days of normal bowel movements and then she became constipated. The constipation could be due to the phosphorus binders Al(OH)3.
Her blood glucose numbers have been rising since she became constipated.
She had a bowel movement this morning after 3 days of total constipation. It didn't look like 3 days' worth of poo, though, so maybe some is still in there.
I added slippery elm bark to her food this afternoon and evening. She had some during her diarrhea bout with no dramatic side effects.
I put her on B12 cyanocobalamin shots a week and a half ago, because her hematocrit has been dropping.
The vet gave me cyanocobalamin; I will ask for methylcobalamin soon.

Coincidentally, she had a complete blood workup this morning, as I am desperately trying to get her blood phosphorus down. I don't have the results yet.

1. So, could the blood glucose rise be due to constipation?
2. I guess I have to respond to the rise with dose increases and not wait it out?
3. I could put her back on radcat lamb to give her mild diarrhea. Is that good or bad? Is it like too rich for her or is she allergic to mammal meat?
4. I think it will take a while to get results with slippery elm bark. Maybe I should take her in for enemas or suppositories or something. We only saw a tech today for the blood draw.
5. Such a roller coaster. I am going out of town next week for 6 days. I was going to leave her off insulin at home.
 
I don't have suggestions for the other stuff, but we recently switched to RadCat and for #3, it says so on their website that some cats have trouble with red meat and it just doesn't agree with them, I think the person who started the company said her cat had that problem at first, but would occasionally eat little bits of lamb off of another cat's plate and can now eat red meat. So either it's not a good protein fit or you have to introduce it more slowly. Hope you sort it all out.
 
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Toebeans said:
I don't have suggestions for the other stuff, but we recently switched to RadCat and for #3, it says so on their website that some cats have trouble with red meat and it just doesn't agree with them, I think the person who started the company said her cat had that problem at first, but would occasionally eat little bits of lamb off of another cat's plate and can now eat red meat. So either it's not a good protein fit or you have to introduce it more slowly. Hope you sort it all out.
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I introduced the lamb slowly starting in August. She only got diarrhea when I made it the dominant food. The first time she got diarrhea we gave her metronidazole, an antibiotic, not suspecting the protein but contamination. Thanks so much for that information---if I read it on the radcat site, I forgot it. I just gave her some lamb with the chicken, in the hope of loosening her bowels.
 
MJW said:
Wow! Congratulations on having a 21 year old cat! Good job!
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Thanks :cat: I'm fairly convinced when you get to be this senior of a senior, it's mostly because of genetics, but we love her enough that she should live forever ;)
 
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This is from the FAQ on RadCat's website, I know they speak of barfing, but as far as I can tell barfing and diarrhea are pretty much the same thing out of different ends of the system :rolleyes:

Why does my cat throw up when eating the lamb, beef or venison?
Sometimes kitties have sensitivities to red meat and this reveals itself by vomiting the meal right after they consume it. It's not uncommon for cats to eat too fast and then vomit - a phenomenon we refer to as 'scarf and barf'. If this has been ruled out, then most likely it is a sensitivity to the protein - not a reaction to the presence of pathogenic bacteria. This has a bit of a different presentation, if it were to happen.

Sometimes these sensitivities show up immediately and sometimes they show up after a few meals, especially if they've been fed the same new, red protein, in a row.

If you suspect your kitty has a sensitivity to red meat, or a particular red meat protein, there are a few things to try:

- Try a small portion of another protein (like a tablespoon) and see if there is a similar reaction. Some kitties can eat the venison, but not the lamb, for instance.

- Try serving tiny bits of the new protein as a treat, occasionally. Some kitties need time to adjust to digesting red meat.

- Don't serve whole meals of a new protein several times in a row. Try one meal, see how they react, and then try it again the next day or after a couple of days.

Some kitties can adjust to eating red meats and some never do. Juno (our spokes-kitty) couldn't eat lamb for the longest time. She gradually started snacking from her sisters' plates, a little at a time, and now she eats the lamb and beef just fine. But, we had another kitty that loved the lamb and would vomit every time she ate it. She never adjusted to the protein and she couldn't eat any red meat at all - ever! She could eat red meat cooked, but not raw, which is interesting.

There have been many reports of this happening over the years, so I thought posting a FAQ would be helpful!
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MJW said:
So, could the blood glucose rise be due to constipation?
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Constipation can raise the numbers. I see you raised the dose, which is OK, since it'd been 10 cycles since green so you had room for the increase. And you don't want her to develop glucose toxicity.

Are you giving Yum pumkin or babyfood squash? That can help with both diarrhea and constipation.
 
I thought I'd given a fur shot before, but then - like today - Girlie dropped, so the insulin had to have gotten in - it couldn't have been a fur shot. Ever since my fur shot that wasn't a fur shot, I sniff Girlie after the injection. Lantus and Levemir smell awful, and if I smell that, then I think "darn! - possible fur shot."

The other thing I did was gently (not pushing at all or rubbing) felt the area to see if it felt wet: it was absolutely dry; even at 0.5, if it had been a fur shot, something would have been a little wet.

Maybe this is something your DH or you can try the next time this happens? I'm feeling for the guy...hope he's re-employed soon. :smuggrin:
 
I think you posted this one to the wrong thread!
I used to check for the insulin smell. Now I just jam the needle in. I don't think I've ever had a fur shot. I don't put my finger on the plunger until the needle is jammed in.
 
The vet did x-rays on Yum today. She's not constipated. She must be avoiding the litter box and going outside??? I have to find another "reason" for her BG increase. I know there are rarely clear reasons. Maybe it is her rapid weight gain post diarrhea. I have been feeding her close to 300 calories a day, way too much. I updated her Labs. Her BUN is through the roof at 96. The vet thinks she has bleeding in her stomach from CKD. I suggested it was due to the blood in her raw food, but I see raw-fed cats on the forum don't have BUN's of 96. Her phosphorus is still over 6. I cut out her Fancy Feast: she squinted at me with an expression of disappointment and betrayal.
 
I'm glad you could at least rule out the constipation. That BUN is troubling, did vet offer any suggestions on how to figure out what is going on with that? Do you add extra water to her food? Hope some of this gets sorted soon, I know how frustrating it is. :bighug:
 
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Toebeans said:
I'm glad you could at least rule out the constipation. That BUN is troubling, did vet offer any suggestions on how to figure out what is going on with that? Do you add extra water to her food? Hope some of this gets sorted soon, I know how frustrating it is. :bighug:
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She said they would have to do anesthesia and endoscopy to nail down stomach bleeding. She recommended Pepcid AC. I am trying slippery elm bark first.
 
MJW said:
She said they would have to do anesthesia and endoscopy to nail down stomach bleeding. She recommended Pepcid AC. I am trying slippery elm bark first.
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That sounds pretty invasive just to diagnose something that you could treat anyway without knowing for sure. I like the alternative slippery elm bark idea, all those stomach acid preventives can cause brittle bone issues. You fix one thing and break something else. :banghead: I hope the diet change helps some, I don't know how long those changes take to show up in blood work.
 
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