Long-term effects of Neuropathy

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Kathy and Kitty

Kathy and Kitty

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Kitty is happily about 2 months OTJ! :-D

He was never a very active kitty, but he's less so now. He seems not to have a lot of strength; I thought it was arthritis in his front legs, but I've wondered whether it might be leftover weakness from his neuropathy last year. He had severe neuropathy for a couple of months, couldn't walk more than a few steps. Now, he walks just fine, especially to the food dish! But he mostly sits.

I give him Cosamine for cats. I also gave methylcobalamine, though I have eased up on that since he went OTJ.

Anyone know whether neuropathy has long-term effects.
 
I'd suggest seeing your vet and getting an official diagnosis; I can think of several things this could be and there's no way to tell whether any of them is actually the problem.

Besides the arthritis and neuropathy that you've already suggested, Kitty could have some other problem going on that would affect his energy levels. Some might be things you've already thought of (the arthritis), and other you might not have thought of and might only show up through a vet exam -- low potassium, for example, would be diagnosed with a blood test.

I know that when Gwyn had arthritis, my regular vet showed it to me on x-rays (for hind legs and lower spine), and the neurologist said she had it in her front legs based on range-of-motion tests. I would assume that your vet would be able to make some sort of informed diagnosis as well.

AFAIK, diabetic neuropathy in cats tends to start healing once the diabetes is under control, and methylcobalamin can help speed the healing once the diabetes is under control (methyl-B12 will not stop/heal neuropathy on it's own). Are Kitty's problems getting worse in the past couple months (the neuropathy should've stopped progressing once the diabetes was under control, so if it's getting worse it shouldn't be neuropathy); or is that Kitty isn't getting better as quickly as you hoped (which could be neuropathy or it could be some other problem)?

Also, besides the general form of neuropathy that most of us are familiar with (weak legs), there's also diabetic retinopathy. That's when the diabetes causes damage to the retina in the eyes due to high blood sugar; unfortunately, the damage to the retina is often permanent. If Kitty had diabetic retinopathy and now has impaired vision, he may be less willing to move around than he used to be. I'm not positive if a regular vet could diagnose it, but an animal opthalmologist should be able to (Gwyn's opthalmologist did).

[And, just for completeness' sake, the other form of diabetic neuropathy is gastroparesis, which causes a slowing of food through the digestive tract. I understand that this is one of the forms of neuropathy that may improve as the diabetes is brought under control. Almost certainly not the problem here, but I figured I'd bring it up to complete the neuropathy info.]
 
Thank you so much for taking the time to respond so thoughtfully.

There is nothing that is getting worse. His neuropathy improved relatively quickly after we got his numbers under control. He moves around fine, he comes upstairs to wake us up - :mrgreen: - when he wants to get out on the porch.

I thought about it as a possible neuropathy-related problem because it seems like he drags himself up using his front legs, not by using strength from his back -- and his front joints are where the vet spotted "mild" arthritis on physical exam. We did not do an x-ray at that time for arthritis, but we could. That vet didn't want to be Adequan, which she reserves for dogs.

Kitty had full bloodwork in February; everything was good. He eats and grooms well. But if he wants to play, he rolls over on his side while I dangle something. He rarely runs, although he can.

We had two vets look at his eyes. One said, no diabetic damage. The other said, there may be some diabetic-related loss.

I've wanted to give him some breathing room since he went OTJ in April -- a time not to be poked and stuck. He hates his carrier and the car, so I avoid the vet unless it's necessary. (Wow, do I wish I had a vet who would make house calls!!!!!!!!!) And I just don't have a vet who is really pro-active and a creative diagnostician.

I guess I thought there might be a supplement for muscle strength.
 
> I guess I thought there might be a supplement for muscle strength.

Well, if it's something like low potassium, Kitty should be getting potassium supplements. While one of the most obvious symptoms of hypokalemia is muscle weakness, it can have more serious side effects as well, like causing an irrgeular heartbeat. But too *much* potassium is also a problem, so you'd need to get the current potassium levels through a blood test. (Again, just using low potassium as an example; there are other things it could be.) But I can understand wanting to give Kitty some non-vet breathing space as well ;)


> That vet didn't want to be Adequan, which she reserves for dogs.

A lot of vets are having success with Adequan use in cats. While I can't cite any articles on it, you might try googling and seeing if anything comes up and passing the information on to your vet.

Besides Adequan, have you tried other things like Cosequin or Adequan to help alleviate the arthritis? Acupuncture's also worked very well for some cats. And some folks use massage to help increase motion and relieve pain.

Resting on hard surfaces can aggravate arthritis, and having a warm place to rest can help (cold stiffens the joints), so you might consider putting cat beds in Kitty's favorite resting places, or putting down a few layers of polar fleece to make a cushioned, self-warming cat bed. A warming bed would be nice in the winter months, and possibly other times of year as well.

Is Kitty having problems lifting his legs when he walks? If so, you might consider switching litterboxes. There are litterboxes out there with ramps on them, or lowered lips across one side, so it's easier for arthritic cats to get in and out.

After one of Gwyn's strokes, we switching to this litterbox here. We liked it because the lowered lip across the front is a lot wider than the lowered lip on most cat boxes, so it was a *lot* easier for Gwyn to get in and out. It's also bigger than a normal cat-sized box, which meant it was easier for her to maneveur around inside without having to worry about stepping in a used spot. (I thought I was over-reacting in getting the new box, but it made going to the bathroom *SO* much easier for Gwyn. I was stunned at the difference it made for her. YMMV.)


Ear scritches to Kitty!

-- Jean and her Gwyn
 
my understanding and I don't recall who told me, but once they are off insulin the MB12 no longer works. Meaning that the neuropathy should be healed once off insulin. So, like JJ said, maybe there is something else going on.

I asked the question, do I continue with the mb12 and was told no, once off insulin, no need to continue it.
 
I was wondering if I needed to continue the B12. Thanks, Hillary.

I think Kitty's potassium was fine when we did bloodwork in February, but I should check that.

JJ, these are all great suggestions. I am proud that I have thought of them! :-D

I've been giving the Cosequin for months, and honestly, I don't see any difference. That's why I thought about Adequan.

Kitty has soft, fleecy, warm beds EVERYWHERE. In the winter, he lives in them (aided by self-heating pads and warmed socks wrapped in a fleece to preserve the heat). He also likes the soft couch with a warm sock and a blanket over him. (Spoiled? Who?) In the summer, he lives on the porch, on cushiony chairs heated by the sun.

I've given him a step for his litterbox for years. He's a big kitty, so we have an oversized box. I have stairs for him everywhere, and he definitely uses them. (Sometimes he just jumps from the couch, and then I put him back on the couch and have him go down via the steps, just to remind him they're there. :mrgreen: )

I think a vet visit will be in order soon-ish.
 
> I asked the question, do I continue with the mb12 and was told no, once off insulin, no
> need to continue it.

It can take longer to heal neuropathy than it takes to achieve regulation (either regulated on insulin or OTJ). I suspect what was said was that once they're regulated AND the neuropathy symptoms have disappeared, there's no need to continue with the methyl-B12.


> I think Kitty's potassium was fine when we did bloodwork in February, but I should check that.

It doesn't have to be potassium, but there are things that can cause muscle weakness (or joint stiffness, or other things that might look like you describe) that should be checked out by a vet.


> JJ, these are all great suggestions. I am proud that I have thought of them! :-D

No problem :)


> I've been giving the Cosequin for months, and honestly, I don't see any difference. That's why I
> thought about Adequan.

We switched from Cosequin to Dasuquin, which was much more effective for Gwyn. It also has anti-inflammatory properties, which I believe helped both her arthritis and her IBD. Also, IIRC, both Cosequin and Dasuquin require frontloading -- you have to give heightened doses initially for the changes to work most effectively, and then you taper off to a maintenance dose.


Fleecy beds, heated beds, adaptive litterboxes, steps and stairs ... you sure do take good care of Kitty!!
 
Fleecy beds, heated beds, adaptive litterboxes, steps and stairs ... you sure do take good care of Kitty!!
Click to expand...

Thanks. I am trying very hard!

This convinces me. Time for vet, and for Dasuquin at least.
 
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