Male diabetic won’t stop urinating outside litter box

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Kam & Mowgli

Member Since 2024
Hello! First time posting here but have been reading countless threads since my boy was diagnosed in April. My name is Kam (she/her), and my 7 year old, male black cat Mowgli was diagnosed with diabetes after dropping a noticeable amount of weight very suddenly. I spent about a week complaining to my partner that I could feel his spine, then finally scheduled an emergency vet appointment after noticing his urine smelled sweet. Within 24 hours, we were back at the vet learning how to give him insulin shots.

Around the same time, we noticed a strong smell of urine in the house, bought a nanny cam, and discovered that he had been peeing around the baseboards of our front room. Our vet insisted that he was spraying, because it was along an outside wall. I considered this, but explained that he has never sprayed before. He was neutered before I rescued him, and we have 2 female cats at home that do not have any territorial conflict with him. We moved into this home last August, and he never sprayed or urinated out of the box until now. I also told her that the part of our wall he is peeing against is 3 feet off the ground on the exterior of our house (our basement comes above ground level), and I investigated with blacklights but saw no signs of other animals’ urine out there. After some hefty cleaning and starting insulin, he stopped doing this for about 2 weeks, then kicked back up again. We have since placed 2 litter boxes in that room, which he frequently uses. They are cleaned at least once daily. There are 2 additional litter boxes upstairs, so 4 total for our 3 cats.

Since his diagnosis, we have gone back to the vet monthly to check his fructosamine and glucose levels. Mowgli drinks a LOT of water, and I’ve counted him urinating up to 8 times per day. Some days are more than others, some are less. He has been tested for a UTI and kidney issues multiple times but has come back fine. Every time, his levels for fructosamine and glucose are very high. At our vet’s recommendation, we have increased him up to 3 units, twice per day. He receives his insulin on time, with treats or Fancy Feast pates since I read here that those are good for diabetics. Most of his diet consists of Purina Cat Chow Naturals dry food in either the Indoor or Classic formulas. I would like him to eat mostly wet food, but switching 3 cats to a fully wet food diet is very difficult and I wouldn’t be able to keep him from the dry food. Plus, with dry food we are able to keep an automatic feeder running to ensure he always has access to food, as our vet recommended. He is maintaining weight, last we checked he was about 10.5 pounds. This is low for him since he was once a 16 pound boy, but considered a healthy weight for his size.

It feels like nothing we are doing is stopping him from urinating outside the box. Moreover, there is not a clear triggering event that causes him to do it. He was on a streak of not going at all, but since went last night and today. He always picks a spot along the same wall, and will even be standing directly next to the litter box to do it. We have tried puppy pads, painter’s plastic on the carpet and walls, blocking the area with objects, pheromone diffusers, a calming collar, different types of litter boxes and litter box placement, No More Spraying spray by Nature’s Miracle, and currently we have a large rubber boot tray along much of the wall he likes to go on. We use enzymatic cleaners and a Little Green Machine to clean the carpet. I have scrubbed the baseboards so much that the sealant has come off. I don’t know how to help him. I am feeling so defeated because I want him to feel better and I don’t know what will do that for him. The increased insulin has clearly improved his mood, but the urination continues.

We plan to call a different vet and schedule to get a second opinion and some testing done. I am more than happy to elaborate if you need more information—I am writing this exhausted in the dead of night after just running down to stop him from peeing on the wall again (thank you nanny cam motion alerts), so it may be sort of disorganized.

He has not shown signs of diabetic neuropathy, but I know cats can hide pain. He currently prefers to use an open top, stainless steel litter box with clay Dr. Elsey’s litter. I have tried to switch him to softer corn litters in the past, but he refuses to use the box entirely when I do that, so we have stuck with clay.

What advice can you give me? Have any of you experienced this? What helped? I just want my boy to feel better. I’m willing to try anything.
 
Hi and welcome to the forum!
I’m sure we can help you with Mowgli. We do have some diabetic cats who will urinate outside the box. Hopefully it should improve as things get under control. Did the vet send away the urine sample or just say it I was ok. I would ask for it to be sent away if it wasn’t.
And how many little litter boxes do you have? If he is peeing a lot, do you need to empty them more often. Some cats can be very fussy about the LB. Sometimes cats will go outside the box as they associate it with pain.
Can you tell me what insulin you are giving please?

There are several things I would suggest.
  • I would look at swapping the food to a low carb alternative. Feeding a high carb dry food to a diabetic cat is like feeding a human diabetic cake and ice cream all the time. I will list below some low carb dry food alternatives. But I would think about also feeding him some low carb canned food, especially at meal time when you may have more control over what he eats. Friskies is a relative cheaper food I think in the US. Have a look at this FOOD CHART. Look for foods that are 10% or under carbs
  • I would think about hometesting the blood glucose. It is much cheaper than having to go to the vet every few weeks. It is not hard and Mowgli won’t hate you and you will have a lot more co from over things than you do now. You can buy a ReliOn glucose meter at Walmart, some test strips, lancets size26 or 28 and some cotton balls to help behind the ear.
HOMETESTING HINTS AND LINKS
  • Set up a spreadsheet and a signature so we can learn about Mowgli.the signature will appear at the bottom of all your posts.
HELP US HELP YOU

Here is some information about low carb dry food written by @Diane Tyler's Mom

these are about 5 or 6% carbs
Dr Elseys you can buy on chewey site
https://www.chewy.com/dr-elseys-cleanprotein-chicken/dp/146269?utm_source=google-product&utm_medium=cpc&utm_campaign=12791446238&utm_content=Dr. Elsey's&utm_term=&show-search=1&gclid=EAIaIQobChMI0PvU2Zj79wIVRIdbCh3JawEkEAQYASABEgIInfD_Bw


Dr Elsey's also at Walmart
https://www.walmart.com/ip/Dr-Elsey...ViI3ICh0suwO_EAQYAiABEgJrOPD_BwE&gclsrc=aw.ds

Dr Elsey's Amazon
https://www.amazon.com/dp/B07FCJHDPR/ref=twister_B09GHFJY65?_encoding=UTF8&psc=1

From what I have read on our site they are 5 or 6% carbs so that's ok
I read the same thing about The Young Again Kibble stinky poops

Dr Elsey's will send you a sample . You can see if Callie likes them before buying them ,get the chicken flavor. Dr Elsey's Clean Protein

Dr Elsey's web site
https://www.drelseys.com

I think this is there phone number
Phone: 877-311-2287

I hope this has been some hope. Keep posting so we can help you.
Bron
 
Hi Bron!

The vet did send away the sample twice. These are his most recent results from bloodwork and urine on 6/4/2024.

Bloodwork
Fructosamine: 708 umol/L (HIGH)
Total Protein: 8.0 g/dL
Albumin: 3.5 g/dL
Globulin: 4.5 g/dL
A/G Ratio: 0.8
AST (SGOT): 68 IU/L
ALT (SGPT): 115 IU/L (HIGH)
Alk Phosphatase: 76 IU/L
GGT: 1 IU/L
Total Bilirubin: 0.1 mg/dL
BUN: 24 mg/dL
Creatinine: 0.7 mg/dL - very close to low but I am not sure what this is
SDMA: 17.1 UG/dL (Mild Inc.)
BUN/CREAT RATIO: 34 (HIGH)
Phosphorus: 3.2 mg/dL
Glucose: 422 mg/dL (HIGH)
Calcium: 9.0 mg/dL
Magnesium: 1.5 MEQ/L
Sodium: 150 MEQ/L
Potassium: 4.3 MEQ/L
NA/K RATIO: 35
Chloride: 114 MEQ/L
Cholesterol: 215 mg/dL
Triglyceride: 50 mg/dL
Amylase: 626 IU/L
PrecisionPSL: 11 U/L
CPK: 90 IU/L

Urine
Glucose Strip: 3+ (HIGH)
Ketones: NEGATIVE
Bilirubin: NEGATIVE
Occult Blood: NEGATIVE
WBC: NONE HBF
RBC: NONE HBF
Casts: NONE SEEN LPF
Crystals: NONE SEEN HPF
Bacteria: NONE SEEN HPF
Epithelial Cells: NONE SEEN HPF
Fat Droplets: 21-50 HPF
Microalbuminuria: 0.4 mg/dL - Normal

His previous fructosamine on 4/30/2024 was 557 umol/L. This is lower than the June test, which was confusing because he had gone from 1 unit twice daily in April to 2 units twice daily for May. Vet asked if I missed a dose of insulin and I have not. I asked if there was anything else that could be contributing to the high fructosamine and she said mixing well, storage, proper amount, schedule. I feel that all of those are fine.

We use ProZinc 40 units per mL insulin. It's just what the vet gave us when he was diagnosed and we are about to finish his first bottle, so if a different brand would be better now is a good time to switch.

You asked about litter boxes, we currently have 4 for 3 cats. 2 are upstairs and 2 are downstairs in the room he likes to go in. 2 of them are stainless steel with open tops, and 2 are large covered plastic boxes. We get pretty big sizes so they have plenty of room to turn around. Mowgli always has liked to go right against the edge or a wall of a box, even prior to his diagnosis.

I'll work on a spreadsheet!
 
I think once you can get the spreadsheet set up and start hometesting, we will be able to see what is happening. Fructosamine tests are great to get a diagnosis, but after that, hometesting gives a much better view of what is happening. A frustosamine test is just an average of a couple of weeks blood glucose numbers. It doesn’t tell you if the BGs have been low or high or normal. Hometesting will tell you that.
If you can get the signature set up as well, that will be helpful to us. When we help you we always look at the signature and the spreadsheets for information.

Prozinc is a good cat insulin. I have not used it. I used Lantus and Levemir so am biased. We usually tell people to give an insulin (if it is a good cat insulin) 6 months before swapping. You have only been using Prozinc for a short time. I really think we can help you get sorted once we see what is happening on a day to day basic with the BGs.
What dose of Prozinc are you giving?
 
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