Lymphoma AND Diabetes!!! Need advise

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oreosmom

oreosmom

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Greetings,

We are new to all of this....and need some advise. Our cat Oreo was just diagnosed with intestinal lymphoma. He is on Prednisilone and Lukeron. After two weeks, he started showing great thirst, voracious appetite and he is lethargic. He has glucose in his urine. On Monday, the vet changed him to Purina DM , canned (and some kibble- Purina DM) . He wanted to test him again in two weeks. Yesterday we noticed he was really lethargic so I brought the cat back to the vet. There were luckily no ketones, but glucose in the urine.
The vet advised testing the urine and blood in one week to see if the diet change is working. He has been on the diet five days. I wondered if we should do it sooner?

Is lethargy common at the early stage of diabetes? We are really worried!!! We appreciate any advise.

Thanks, Oreo's Mom
 
Lethargy may occur with hyperglycemia/high blood sugar.

Here's some of what we tell all newcomers:

This is manageable at home, with the majority of testing and doseage adjustment done by YOU, with some reading.

Since Oreo is on insulin, glucose and ketone testing are the first order of business. For Safety, don't change the food until you are able to test consistently to see what happens! The dry food isn't helping, but eliminating that without testing could result in a hypo.

1) get a human glucometer and test strips here for shipping and handling costs, or from our shopping partners listed above. The WalMart ReliOn Confirm is the same thing as the Arkray Glucocard 01, which may be ordered from American Diabetes Wholesale at the shopping partners link above. It is one of the least expensive to purchase, and uses a tiny amount of blood for the testing. Although there are pet-specific glucometers, they are expensive, you can't get strips locally without going to the vet, and the strips are very expensive. There are veterinary documents which explain how to use the values from human glucometers correctly.

2) ketone testing - at a local pharmacy, pick up some urine test strips - ex Ketodiastix - so that you can watch for ketones. If these are very high, it could indicate diabetic ketoacidosis, a fatal condition if untreated and extremely expensive to treat. You use this to test fresh urine. If your cat is agreeable, you place the test strip or a soupspoon/ladle under the cat while urinating. For the spoon, you then dip the strip in the spoon. Within about 1 minute, the strip will change color IF there are any ketones. The darker it gets, the more there are. For the bashful cat, you use clean acquarium gravel in the litterbox, let the cat use it, push the gravel over, tilt the pan, and dip, within 30 minutes after use. If necessary, you can wash and re-use the gravel, although it is time-consuming!

Testing after starting insulin will determine if it is safe to give insulin, and how to adjust the dose. Lantus, Levemir, ProZinc, and PZI are all gentle insulins which will work wel for most cats. If the vet wants to use Humulin N, this suggests the vet is woefully out of date with contemporary feline diabetes care.

Testing after changing the food will determine IF Oreo will continue to need insulin or if he can be diet controlled.
 
Hello Oreo's Mom!
I am sorry you are needing this resource, but glad you found us!

My cat had IBD and suspected lymphoma. I was unable to afford the procedure to differentiate between the two and get a specific diagnosis. We first started with a diet change (grain free/novel protein), which helped for a while. Eventually I had to start her on prednisolone. About six months later she was diabetic. I tried changing her to leukeran, but we had horrid results. She would not eat. She became very lethargic and unresponsive. After about 1.5 weeks I stopped the leukeran and went back to the pred, accepting the fate that she would likely be diabetic the rest of her life. And she was.
*Not all cats respond so negatively to leukeran*

How did they come about the diagnosis of lymphoma?

It is quite possible the pred induced diabetes. The symptoms you described can be common. The sugar in urine is another sign. Just so you know, some of the side effects to the steroid includes excessive hunger and thirst. Some side effects with the leukeran can be lack of appetite and very lethargic.

The DM is not a great choice for food. One prevention for diabetes, and way to help stabilize or eliminate the disease is a reduction in carbs. DM is much higher carb and lower quality than many choices you can get from the store. I am not sure if a cat with GI lymphoma will benefit from a grain free./novel protein diet. I had already chosen that route due to the IBD, so I never explored lymphoma appropriate diets. Again, I will say the DM is not the most appropriate for Diabetes. You want to look at foods such as fancy feast, wellness, merriks, Evo, etc. Here is a link to a food chart that will show you carb quantities, so you can maybe start looking into other options:
http://binkyspage.tripod.com/canfood.html

A bit of good news...you can cut your costs by blood sugar at home vs bringing Oreo to the vet every week. It will also be more accurate, since Oreo will be more comfortable in his surroundings vs the vet. Here is a link to information on hometesting:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=287
You can get a test kit at minimal cost here:
http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=60261
If you have any difficulties with home testing, you can always post here for advice. If there is anyone in the group who lives nearby, we can often call on them to help you out in person!

I am glad there were no ketones. You can also check for this at home by going to the pharmacy and buying ketostix. They will look like this:
300.jpg

Steroids reduce the immune system. Add sugar in the urine and there is a greater possibility of infection through the urinary tract. We unfortunately played the UTI game way too often. It is good to get regular urinalysis via Cystocentesis. Here is a link that explains a bit more about Urinalysis and UTI's in cats:
http://www.cat-world.com.au/urinalysis
http://www.marvistavet.com/html/urinary_tract_infection.html

If Oreo develops an infection and has high blood sugar (especially not being tx with insulin) than he will be more prone to ketones.

One last thing I would recommend is joining the yahoo feline lymphoma group:
http://pets.groups.yahoo.com/group/feline_lymphoma/
They are also chocked full of information.

Keep asking questions. We are here to help/support in any way we can.
 
Reply from Oreo's Mom

Thanks to all who replied. Oreo insn't on insulin yet, but should be on it by Saturday. We will post and let you know how it goes. God Bless
 
If NOT on insulin, go right to the dietary changes to get him down as much as possible with a low carb, moderately high protein canned food diet.

And focus on the testing, so you can see what effect the food change has.
 
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