King and his diabetes

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Justin Papa of King

Member Since 2019
Hi everyone,
So, King was initially peeing a LOT one day and was lethargic and not eating much so I took him to the vet expecting a diabetes diagnosis (My brother has Type 1) and it was confirmed. He was tested around 5pm at 21.7 mmol/L on 06/12/19 and was 16.5 mmol/L on 08/12/19 4 hours before he left the hospital. I got an Accu-check Aviva Nano the next day and began testing his blood sugars as you can see in the SS. He's still not eating well, but will eat a few bites every few minutes if I bring his food to him. The vet has said that he needs about 276 calories per day and on Fancy Feast that's about 3 cans and he's only eating about 1 can per day for the last 2 days. I gave him 1/4 of a tab of Remeron for his appetite at 9am on 09/12/19 to stimulate his appetite but I'm not sure it's working.
I guess I just want to know the best possible steps I can take to help him live his best life. How soon should I do a BG curve? When can i switch to Lantus as I read here that's the best for remission. Should I switch my cat from a fountain to a bowl so I can more accurately determine water consumption? Should I start ketone testing?
Thanks again for your kind hearts and wise words.
 
Hi Justin and King and welcome and well done testing the blood sugars.
Yes I would test for ketones especially if Kings appetite is not great.
Maybe King is nauseated and that could be why he’s not eating much. It is not good to give an appetite stimulant if they are nauseated. You need to give an antinausea med first such as cerenia or ondansetron. Ask your vet for some.
It is important King eats well so you can give the insulin.
I would try the anti nausea meds first and if they are not the issue then try some different foods.
I will look for the link to suggestions to stimulate appetite and post it for you. keep asking lots of questions.
always test before every shot to see it is save to give the insulin and then test at different times during the cycle +3 to +7 to see how low the insulin takes King.
Also always get a before bed test and if it’s lower than the Preshot then it will probably be an active cycle and you will need to set the alarm and test a bit later in the cycle to ensure King is safe
Lantus is a better insulin so swap when you feel ready and the vet is happy to swap over.

I think a fountain is fine. It encourages drinking.

link to stimulating appetite
http://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/
 
I wasn't expecting such nice numbers on King's spreadsheet!

Was King hospitalized for a particular reason -- like diabetic ketoacidosis? If so, could you add that to your signature?

It would be important to know if DKA was part of the picture if you want to switch too Lantus. It can take a week for the Lantus depot to form and stabilize. It may mean that King's numbers would run a bit higher. Given that he's not eating as well as you would like, it may be prudent to wait until he's back to eating better before switching insulin.
 
Hey everyone, thanks so much for the replies. It has been quite the whirlwind past few days trying to sort out King's eating. I tried almost every single thing listed in that link @Bron and Sheba (GA) and he didn't take to any of it :( I took him into the vet on Friday and he got subcutaneous fluid and a shot of Cerenia. He ate pretty decently (~1 can of Fancy Feast) in the evening when i kept putting the dish in front of him, but did not eat at all over night. He ate maybe 3 or 4 bites on Saturday morning and shirks from food now if i push it towards him. Everything else has been normal and he is back to his regular habits except for the eating. If you haven't checked my SS, you should know that I haven't given him any insulin over the past 2.5 days as his BG has been too low to give a dose.
I just finished speaking to the vet on the phone and she wants me to force feed the cat, give him his last 1/4 tablet of remeron and inject 0.5 units of insulin at the regular time tonight and tomorrow morning and call them tomorrow. She says she doesn't want to give more anti-nausea medication because the cat is not vomiting, but it's the only thing that worked! I can't find a cause for his nausea (Litterbox, house smells, food always out, Diabetes?) but I can find no other reason he wouldn't be eating.
I first noticed his decreased appetite almost 2 weeks ago, a few days before his diabetes diagnosis as he stopped eating the Iams dry food we were feeding him (Though the bag was almost empty so I thought it was stale). Now that it has progressed to the point where he is not even drinking the juice out of canned tuna, which he used to love, I am worried. Does anyone have any suggestions as to h ow I should proceed? Are there any other remedies I can try for him?
To answer the questions asked above: I have tested his urine for ketones 3 times in the past 3 days and he is definitely negative. @Sienne and Gabby (GA) I brought him into the vet initially (9 days ago) because of inappetence, his high urine volume, and a sense that he was unwell (unkempt fur etc.). The vet said he had no ketones, so wasn't in DKA. As i mentioned above he doesn't have ketones in his urine so I don't believe he is in DKA right now either. My main concern is hepatic lipidosis, but I'm not sure how to proceed from here. I don't think the vet is correct in telling me to administer any amount of insulin if his BG is in a normal range. Should i demand some pill form anti-nausea medication?
Thank you guys again, in advance, for your help and support.
 
Did the vet test for pancreatitis? The test is either an Snap fPLI or a Spec fPLI. The Snap version is done in the office -- it's like a pregnancy test with a "+" or "-" result. The Spec is sent out and you get a numerical result. Pancreatitis is not uncommon in FD cats. This Primer on Pancreatitis has a great deal of information.

It might be worth pointing out to your vet that just because you're nauseated doesn't mean you're vomiting. You have empirical evidence that the Cerenia worked!
 
I'm at the vet right now without king and they did not do the pancreatitis test so I've booked him in tomorrow for that. I'm also pushing them hard for an oral anti-nausea medication but I will try assist feeding him tonight. Worst case scenario I can buy the meds online and have them rushed to me.

Edit: Got 2 days worth of oral Cerenia and will try assist feeding tonight if he doesn't go for any food himself.
 
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I’m glad you were able to get some oral cerenia. Well done!just don’t understand the logic in saying because there is no vomiting, no need for cerenia when it obviously worked for the nausea:banghead:
Please keep us updated and best wishes to King.
 
Hi Justin & King--on the water drinking thing, M'row has a small water bowl. I put water in it so total weight (bowl + water) is 8 ounces. Then I re-weigh bowl + water after 24 hours. He eats fancy feast pate (some water in there, of course) and also drinks 1 to 2.5 oz water in 24 hours. I use a postal/kitchen type scale, total capacity of scale is 5 pounds. Obviously a bathroom scale for weighing humans wouldn't give the needed precision. Mine's a repurposed vintage scale.
 
Have you tried feeding King any dry food, or only wet? When my Sophie was nauseous during IBD/pancreatitis flare ups, she wouldn’t eat any of the multiple types of wet food I tried unless it was out of my hand, and even then she would only eat a little bit. The only thing she wanted to eat was dry food and I’ve seen other people say the same when their cats had pancreatitis for some reason! It’s obviously not ideal, but better than eating nothing in my opinion. She would eat Tiki Cat born carnivore which I don’t think is too horrible carb wise
 
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