Moo’s Too Skinny

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MOOS MOM

MOOS MOM

Member Since 2020
Hi all. I’ve been in this group for a while but havent posted. I’m so baffled on what to do. My kitty Moo is 14 and has been diabetic for 6 years. She’s on Lantus 3 units in AM and 2 units in PM. She eats FF pate free feed because she won’t have it any other way. . But over the past 2 months she is ravenous and eats constantly with consuming 5 to 6 cans a day. She’s lost so much weight and looks skinny. Weighs only 9 lbs at last weigh in. Had all labs done and everything normal. Fructosamine was 400 but vet said she wasn’t concerned too much about that. I take her toBanfield which is a drag. The vet didn’t change her insulin dose and we gave her clavamox thinking it might be some kind of infection. That gave her diarrhea so we stopped that. And she still eats a ton. No diarrhea anymore. I do her curve but because she free feeds all day the readings are always arounf the same. She measures at around 300 all the time. The vet doesn’t want to make any adjustments and wants me to get an ultrasound to see if it’s cancer or something. I don’t have $400 for an ultrasound and it seems to me that her diabetes is prob needing to be more aggressively treated. I’m at a loss. I know I should find a different vet but I’m locked into Banfield on their wellness plan. Ugh. I’m not sure what to do. Does 300 sound like it should be treated w more insulin?
 
Hi and welcome to the forum to you and Moo.
Are you home testing the Blood glucose levels?
If not I would strongly suggest you do as that will give us insight into what’s happening on a daily basis. .
We can help you with that.

If you are testing do you think you could set up a spreadsheet and add the last months numbers in please?. If you have trouble setting it up we can help you. ask lots of questions we are very happy to help you and Moo
Here is the link to SS
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Glad to see you over here from the Facebook group Michele!

If you have any trouble with the spreadsheet, you can send me a PM either on Facebook or here. To do it here just click on my name and choose "start a conversation". It only takes me about a minute to set it up once I have some information so don't think you're putting me out or anything.

As I said on FB, I think your vet just doesn't understand how to use Lantus correctly. It looks like the doses have been increased by whole units instead of in .25 to .5 increments. You can blow past what could be a "perfect" dose that way. Also, Lantus craves consistency so both the AM and PM doses should be the same in most cases.

Let's get you a spreadsheet and start gathering some data....that's the best way to figure out what's going on with Moo.

As for the vet....there are lots of us here that gave up listening to our vet long ago. Once I got my script for lantus from my vet, China never went back again for her diabetes. I trusted the people here over the vet. The people here live and breathe this disease 24/7/365 so they know what works.
 
Moo labs
 

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Did Moo have the thyroid tests done as well? Do you have those results? If so can you post those as well please?

I have no idea where your vet got the idea that if a cat goes over 3 units of Glargine, there is something else wrong.
I would not get the ultrasound done at this point.
I would get the SS set up and filled out with recent readings.
And I would change the dose of insulin to 2.5 units twice a day. That will give Moo the same amount of insulin each day but the doses will be the same. Glargine likes consistent dosing because it is a depot insulin and when you give different doses all the time it messes up the depot and you will get wonky numbers.
We can see how he goes with that to start with.
What do you think of that @Chris & China (GA).
 
Bron and Sheba (GA) said:
Did Moo have the thyroid tests done as well? Do you have those results? If so can you post those as well please?
Click to expand...

She said thyroid was normal in the FB group.

Bron and Sheba (GA) said:
I have no idea where your vet got the idea that if a cat goes over 3 units of Glargine, there is something else wrong
Click to expand...

I agree....Your vet is an idiot. If Moo were to go over 6 units twice a day (and her dose was increased correctly), we'd suggest having her tested for high dose conditions like acromegaly and IAA, but those are just specialized blood tests......but it's too early to worry about that anyway.

Bron and Sheba (GA) said:
And I would change the dose of insulin to 2.5 units twice a day
Click to expand...

I agree!!

Michele....I'd go with the 2.5 and test before every shot and then if possible, test at least 2-3 times in between the shots. We need to find out how low a consistent dose takes Moo. Be sure to get at least a "before bed" test on the PM cycle (but if you can get a couple tests, that's even better!)
 
This is the written report stating her thyroid normal and fructosamine comment. I’m just so worried since she eats so much and is so thin. She had a fecal test done and it came out normal. If she had worms wouldn’t her fecal be abnormal
 

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I’m sorry to
Post so many but I can only upload one at a time
 

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MOOS MOM said:
I’m sorry to
Post so many but I can only upload one at a time
Click to expand...
That’s absolutely fine...thank you for posting them.
Most of them look ok. The MCH and the MCV are both a bit low. I’m going to ask @Marje and Gracie if she can look at Moo’s labs. Marj is very good at interpreting them.
The white cell count looks normal (the high end of normal)so I’m not sure why your vet thought there might be an infection and ordered clavomax. Maybe she was trying to cover all bases.
Have you tried any different foods? I’d look at the number of calories in the food and try and get some that are higher in calories.
What about some plain cooked chicken or a raw egg yoke (once a week) in addition to the canned food.
 
Did your vet test for pancreatic insufficiency? The symptoms are the same as you describe. They think my cat had a pancreatic attack last month so I checked out the EPI website.
Have your vet do a spec fpl and a snap fpl blood test to check your cat's pancreas. Pancreatic conditions can cause diabetes. Check out the feline epi website and see what you think.
 
Speaking from personal experience, Freckles had lost a lot of weight but had a ravenous appetite before I found out she had diabetes. The loss of weight and appetite were the concerns that I brought to my vet for the initial diagnosis. Since being on a good insulin dose for Freckles, she has gained her weight back. I followed the protocol on this forum for insulin increases/decreases. I also got an automatic feeder so Freckles gets her meals split between several snacks throughout the day/night. I add a little bit of water to each of her meals and I think it makes her feel less hungry.
 
Hard to read those tiny printouts--where is the thyroid test results? Would not take just the vet's word for it.
Also, we have a hyperthyroid cat, and I can definitively tell you that the in-house (vet runs on his own machine) thyroid tests are not reliable. Just before we moved, our HT (hyperthyroid) cat was getting higher and higher numbers, despite increasing his meds. Went to a new vet as soon as we got settled, and the first time her machine ran his thyroid numbers as PERFECTLY NORMAL, like the value was 2 (normal is 1-4). Now, we all knew that was not possible. So she sent them out to the outside lab, and he came back, run twice, at 13.8, which is extremely high but exactly what was expected based on his symptoms and when we stopped his meds in preparation for the I-131 treatment, he measured at 22! Yet the vet's machine had told us he was perfectly normal; good thing we knew better.

A ravenously hungry cat who is still losing weight should have a proper set of thyroid tests run, sent to the professional lab, not just the vet's in-house machine. Has she had behavorial changes also? Like howling more, very restless, roaming the house at night, and our cat was always at the water bowl.
 
I'm late to this thread but when I see "Too skinny" it always gets my attention.
First off you can upload more than one image at a time. Simply repeat the Upload a File process, both images will appear at the bottom of the screen and then you choose thumbnail or full image.
Gracie85 said:
Hard to read those tiny printouts
Click to expand...
In Windows right click the image and save it. You can then open the image in Photo Gallery (or anything similar) and enlarge the view.
Some of your comments Michele;
Moo is 14 and has been diabetic for 6 years. Weighs only 9 lbs at last weigh in. Gave her Clavamox, that gave her diarrhea. Get an ultrasound to see if it’s cancer or something.
Okay, I understand a simple dose of Clavamox and the diarrhea, it can be a side effect. Give her some probiotics or yogurt with active cultures. We give Daniel unflavored probiotic yogurt in moderation. What was Moo's previous or ideal weight before the drop to 9 pounds? Not wanting to scare you but I've had weight loss very slowly sneak up on senior cats before and it's not good. Eating that much food and losing weight can't be just the product of diarrhea.
Your vet wants an ultrasound to look for cancer? That's a big leap from where she is now. It's your right to know where that reasoning comes from, no vet can treat you like a dummy and jump into ultrasound/cancer territory. Start with a series of X-rays and go from there.
I've been doing this a long time and Chris has as well. I've had a botched cancer diagnosis and two cats diagnosed with GI problems that died a needless death because their diagnosis was completely wrong. That's how I learned to ask questions and demand a logical answer. When Chris says your vet is an idiot it's not a flippant remark, she's the rational one. I get a bit more emotional in public but everything I say is meant with Moo's best interest at heart.
Good luck my friend, keep posting.
 
MOOS MOM said:
Hi all. I’ve been in this group for a while but havent posted. I’m so baffled on what to do. My kitty Moo is 14 and has been diabetic for 6 years. She’s on Lantus 3 units in AM and 2 units in PM. She eats FF pate free feed because she won’t have it any other way. . But over the past 2 months she is ravenous and eats constantly with consuming 5 to 6 cans a day. She’s lost so much weight and looks skinny. Weighs only 9 lbs at last weigh in. Had all labs done and everything normal. Fructosamine was 400 but vet said she wasn’t concerned too much about that. I take her toBanfield which is a drag. The vet didn’t change her insulin dose and we gave her clavamox thinking it might be some kind of infection. That gave her diarrhea so we stopped that. And she still eats a ton. No diarrhea anymore. I do her curve but because she free feeds all day the readings are always arounf the same. She measures at around 300 all the time. The vet doesn’t want to make any adjustments and wants me to get an ultrasound to see if it’s cancer or something. I don’t have $400 for an ultrasound and it seems to me that her diabetes is prob needing to be more aggressively treated. I’m at a loss. I know I should find a different vet but I’m locked into Banfield on their wellness plan. Ugh. I’m not sure what to do. Does 300 sound like it should be treated w more insulin?
Click to expand...
 
Your spreadsheet link works....Now we just need to get it into your "Signature" (and get your Signature filled out)

Go to the top right of the page and find your sign on name....there will be a drop down menu where you can choose "Signature". When you click there, a new box will pop up.
upload_2020-4-22_17-56-8.png


When the new box pops up, enter information like:

Your name/Cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues/medications?

Then copy the link to your spreadsheet and paste it into the Signature and hit "save changes"
upload_2020-4-22_17-58-24.png


Your link doesn't have to look "pretty"...it just needs to be there.
 

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Yeah! Good job on getting the spreadsheet linked into your signature! Chris is good with those screen shots from her phone.

Will Moo eat more food, if you give it to her? I see from her SS, that she went from eating 6 cans down to 3. Is she turning her head away, and walking away from the food? Or finishing what you have down for her?

Next step, is some mid-cycle tests, to see how far this dose of Lantus insulin is dropping Moo.
Somewhere in the +5 to +7 hour range is where most kitties have their nadir, or drop the lowest in the cycle.
Random times, to help flesh out the SS, not all the same time every cycle.

Chris will tell you how important that +2 test is also, won't you Chris?
 
MOOS MOM said:
I'm just so worried about Moo because her Lantus going down seems to have calmed her eating down but she's still so skinny and it scares me.
Click to expand...

As you get her diabetes under control, her eating should reduce and she should start to put on weight. Diabetic cats who aren't getting insulin are basically starving to death because no matter how much they eat, they can't get the nutrition into the cells.

Think of insulin like it's a key and on every cell in the body there's a lock. Without the right number of keys, no matter how much food is eaten (which breaks down into glucose), the glucose the cells need to survive can't get in.

This was China when she was first diagnosed...under 7lbs
China before diagnosis.jpg


This was China after about 6 months of Lantus and the help from the people here...about 14lbs
China after diagnosis.jpg
 

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China so cute!!!! To answer the food question she always eats but when she was eating ravenously 6 cans a day it was as if she could not get enough. Now in the past 6 days she is still demanding of food but she doesn’t beg for it as much and a can will last a while. She’s eating approx 4 cans now
 
So Moo's numbers are very even but they are in the mid to high 200s. Her eating seems less ravenous but she's still skinny. I think she might be evening out a bit. Could it be that changing her lantus to 2 units AM and PM actually helped? Can you take a look at her spreadsheet and let me know what you think?
 
Your SS only shows 1 cycle on a 3U dose. So there isn't anything we can look at, no BG tests, to compare the 2U dose to a different dose.

Which dosing method are you using? SLGS or TR? Neither your signature or the spreadsheet say which protocol you have chosen.

With holding the 2U dose for 27 cycles, and still only seeing the yellows (200-299 mg/dL) at mid-cycle nadir, this does not look like enough insulin for Moo. I'd suggest that you increase the dose by 0.25U.

You really don't want to hold the dose for so long. Even if you are doing SLGS, you should do a curve once a week, and reevaluate the dose at that point. Come back and ask us again about the dose, after the next curve. Please don't wait so long to ask for our feedback.

p.s. Please add the meter you are using to your User Id "Signature" .
 
Deb & Wink said:
I'd suggest that you increase the dose by 0.25U.
Click to expand...

I agree....go up to 2.25 on your next shot.

You don't want to hold the dose longer than a week (except under very certain circumstances) because it gives the body time to get used to living in those higher numbers despite the insulin. We call it "glucose toxicity".

It's really important to get some mid-cycle tests in on every cycle (if at all possible)...if you work away from home during the day, we understand you can't always get them but that makes it more important to get at least 1-2 tests on the PM cycle and on any days off, do a curve (test every 2 hours for 12 hours or every 3 hours for 18 hours).

Deb & Wink said:
Please add the meter you are using to your User Id "Signature" .
Click to expand...

It's the One Touch...it's on her spreadsheet (but it would be nice to have it listed in your signature too Michele)
 
Judy and Freckles said:
Speaking from personal experience, Freckles had lost a lot of weight but had a ravenous appetite before I found out she had diabetes. The loss of weight and appetite were the concerns that I brought to my vet for the initial diagnosis. Since being on a good insulin dose for Freckles, she has gained her weight back. I followed the protocol on this forum for insulin increases/decreases. I also got an automatic feeder so Freckles gets her meals split between several snacks throughout the day/night. I add a little bit of water to each of her meals and I think it makes her feel less hungry.
Click to expand...

Hi, I am new and diving into the enormous amount of information but am an the same boat of ravenous appetite but continued weight loss (thyroid tests show healthy) but I am wondering what you are referring to regarding the protocol? is it a specific formula? thanks so much!
 
We use guidelines, written by many experienced members here, for each of the insulins.
Each insulin has different dosing Protocols, that are used for that specific insulin.
The protocols help to guide you with how YOUR cat is doing, when to increase, when to decrease, when to skip or stall or do something else and for how long.

Keep reading. There is a wealth of information here.

Sticky New? How You Can Help Us Help You!

@Heather Bentley If you start your own thread, we'll be able to customize our responses to your situation.
You've made a good start, by getting a SS up and attached to your signature.

Plus with your own thread, we won't get Moo's mom sidetracked with someone else's cat's information.
 
@Heather Bentley
All you need to do to create your own thread is go to the top of the Feline Health forum. This should be the first place you post.
Over on the right hand side, you will see an icon labeled "Post New Thread".
Click on that.
Give your post a title in the "Thread Title" box, start typing away in the text box below that.
Then go to the bottom of the text box and click on the "Create Thread" icon.
That is all there is to it.

There is a thread in the Announcements & How to use the FDMB forum, with lot's more info.

Sticky HOW-TO USE THE FDMB: The Basics

That was one of the links included in your welcome email.
Click on the blue highlighted text, to open the link.

Hope that helps you Heather.

p.s. Sorry for sidetracking your thread again Moo's Mom.
 
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