My cat seems so sick

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Jennifer and Spot (GA)

Jennifer and Spot (GA)

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The past two days, Spot is drinking water like he did when first diagnosed, breathing kind of hard, lethargic. His BG dropped to 95 yesterday in the AM and so we did not give him a shot. Maybe we should have? We waited until last night at 7:30. Spot is not acting right. He tested in the 300's twice so far today. Please don't tell me to take him to the vet, we just took him to a new onethis morning who didn't know about Lantus, which is what we give him (vet only uses Prozinc).

Also, how can we get his BG down? Seems no matter what we do, it's too high. That is probably why he acts sick. Because he is.

Jennifer
 
Sickness from furballs to infections, CAN raise BG numbers. I'm sorry but I think you should take him in, to rule out sickness. jmo

All my best,
jeanne
 
Unfortunately, this isn't a quick thing to control. and if there are complicating additional conditions, it can be very difficult.

Are you testing for ketones? Please read the link in my signature about secondary monitoring tools, and do that. When the insulin level is too low for the carbs consumed, the body breaks down fat for energy. This can cause diabetic ketoacidosis, which is potentially fatal and very expensive to treat.

Are you following the Tight Regulation protocol in Lantus IGlargine) - Tight Reg? If you follow that, you have your best chance at getting good control, and possibly diet-controlled diabetes. When following Tight Reg, there are rules to follow for safely adjusting the dose.
 
Yes, it can be a number of things. I would check for ketones first. I would also call the vet again and tell them Spot is not any better and can you bring him back in(no charge) and see if they can figure it out this time. Good luck and I really hope he is better soon!
 
Sorry, I think we're doing more the Start Low, Go Slow protocol. We can't test as much as they want you to test for tight regulation. We can test 3 times during the week and more during the weekend but not every day. We do give him Lantus every 12 hrs. I'm guessing he's not getting enough? Though we had him on more and his numbers still bounced high.
 
Jennifer,
To test for ketones, you pretty much have to catch him in the act of peeing if he's sharing a box. If you can isolate him to a box of his own, there are other tricks you can try. Like put aquarium gravel in it instead of litter, which won't absorb the urine. Then you can dip the stick in the puddle. Or you can put saran wrap just under the the top layer of litter to get a puddle.

Generally, the numbers I can see on the spreadsheet seem to indicate that a higher dose than the current .75 is needed. The big thing that makes me hesitant to say that for sure (besides the fact that I've no Lantus experience) is that green AMPS you got yesterday. Maybe somebody with a lot of Lantus experience can look and see if they can explain where THAT number might have come from? I think that the numbers you have seen since then may be due to A) that you had to skip a shot due to the low number, and B) they are a bounce because of that low number. I know that SLGS advises that you keep with the same dose for a week. I would do that. Then see if you can figure out if an increase is needed based on the SLGS protocol.
http://felinediabetes.com/start-low-go-slow.htm

Not much help, sorry...
Carl
 
Oh, the other thing that concerns me is this:

breathing kind of hard, lethargic.
Click to expand...

Does he appear to be dehydrated at all? If you press (gently) on his abdomen, does he act like it causes him any pain?

Carl
 
Not sure about pain, I haven't pressed his tummy. I really want to leave him be for a while. He is stressed. He is drinking lots and lots of water.

We had him at a different vet this morning but he seemed pretty useless. I asked him if he could check his ketones and he brushed it off.

I am tired of being the vet.

Husband's pressing to increase the dose to 1 unit, and ignorant vet with no Lantus experience advised the same. We did that before and his numbers were all over the place, but husband has a short memory.

From what I've read, treatment with Lantus takes patience and I think my husband thinks it should be fixed quickly, and patience was never my virtue.
 
Jennifer,
Try to assure your husband that there isn't a "quick fix" with diabetes. Yes, a few cats can go into remission quickly. But Bob was "quick" in comparison to others and he was on insulin for 10 weeks. It isn't like an infection or some simple illness where you just give meds and it goes away. And insulin isn't a drug, it is a hormone. It takes time for the damage to the pancreas to heal so that it can regulate his blood glucose like it used to. The best way I've heard someone here say it is "He didn't get diabetes overnight, and he it won't go away overnight either".
It can be an extremely frustrating disease, because there isn't a text book "cure". If there was such a thing, FDMB wouldn't exist, and it wouldn't matter that "every cat is different".

Carl

P.S. Not sure if anyone has ever asked this, but has Spot ever taken steroids for anything?
 
He took steroids about a year ago because he chews himself raw. I am not sure what it was.

He had to have 3 teeth pulled in August and when they checked his blood it was 246. They did not tell me anything about diabetes. This March it was 440 when he was diagnosed.
 
hi jennifer! i'm sorry spot seems sick. that's no fun for anyone.

i looked at spot's spreadsheet - one thing i can tell you is that if you can change his feeding pattern so that he gets most of his food (and therefore, carbs) with his shots and in the first few hours after, his numbers will improve just from that. you're feeding him at 2pm, which looks like it's 7 hrs after the shot. that puts a load of carbs in his body as the lantus effect is less strong. try moving it up to 10 or 11am, then keep the amount of food minimal after noon. if you feel like you have to give him a snack in the afternoon, maybe just a tablespoon or so.

it can make a big difference. some cats are grazers and if they eat small amounts, they may do ok eating around the clock, but many cats do better with most of the carbs at the beginning of the cycle. we also shoot at 7am/pm and we feed punkin at shot and at 10am/pm, so 4 or so times a day. other than that, i just give him a tiny piece of chicken when we get tests.

i think it's possible that you've also got some bouncing going on. i would not increase the dose right now. when he had the 93 at preshot yesterday, that tells you that he was lower than that in the hours previous. he is not used to being in those wonderful green numbers, so his body responded. here's a link i just gave someone else that explains 2 things that can happen with lantus. right now, you're seeing a bounce - it can last up to 72 hrs. so you may see constant high numbers until the morning of the 30th even. it can clear sooner than that, just depends on the cat. when the bounce clears you'll see numbers that are lower again. then the dose can be re-evaluated and you can decide about increasing.

the first post below is about what can happen when you increase a dose, scroll down 1/2way to see about bouncing.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=46012

by the way, 3 tests a day is enough to follow the TR protocol. most people work and can still follow it. we can teach you these things about how lantus works and how to read spot's ss so you know when to increase/decrease a dose.
 
Thanks Julie! He is so hungry that we thought we'd give him a "snack" (not a full meal of FF) at 2:00 because it helps him wait out until 7:30 pm to eat. We can move his snack time up to 11:00 AM and see if that improves but I'm sure he'll be starving. We did not increase his insulin. He was at 144 this morning. I gave him .75 after he ate.

He appears much better today.

Thanks for your post and the link. Yes, I think he was bouncing some.
 
how is spot this morning?

i want to explore more about what you said in your very first post, that he's breathing hard and seems lethargic. is he that way today?

one thing many of us have notice is that our cats settle into a particular range of blood sugar and whenever they get into a new range, they get lethargic and don't feel as good. i liken it to my caffeine habit - uncaffeinated is the natural human state, but i have my daily diet dr pepper (i know i know) and THAT is my normal state. uncaffeinated and i feel like yuck and want to sit in a chair.

cats get accustomed to higher blood sugar ranges. almost everyone reports that their cat seems to feel better in 200's. but a non-diabetic cat's natural range is 50-120 on a human glucometer - so 200's aren't natural. the more the cat is in lower numbers, the more it will get adjusted to it and the better it will feel.

however, breathing hard isn't something i've heard described as part of it, so if that has continued, that would be a concern.

if your own vet isn't helping you, there are others around, i'm sure. if you need a suggestion for a good vet in your area, you can post here and ask. we come from all over the world and often someone will know another vet to suggest.

a 141 at preshot tells you that spot has cleared yesterday's bounce. he may bounce again. make sure when you shoot tonight you are doing it at 8:00-:15 or so. you can work back to your regular time, but generally you want 12ish hours between shots unless a cat is high enough to just move back at once to the regular shot time.

i would encourage you to post on the TR support group forum. you are testing plenty for following the TR guidelines, and a steroid-induced cat has the very best chance of healing and going back off of insulin. i'd love to help give you that chance. you can open a new thread here, and then you will have multiple people looking out for spot and helping you learn what to do to help him. http://www.felinediabetes.com/FDMB/viewforum.php?f=9
 
Hi Julie,

I will post on TR; I have been on the relaxed one sometimes.

Spot seems much better today. His BG's after the 144 have been 200's. Tried not to feed him after noon but he will definitely seem like he's starving. He might have been very stressed by going to the vets. His breathing, since he's been diagnosed really, has been heavier than it used to be. I just can't take him to a vet anymore, can't seem to find one who's reasonable. We spent almost $900 at the one vet's and can't afford any more trips to see her. The other ones I looked into give cats ProZinc, not Lantus, and don't know about Lantus.

He had the steroids probably back a year ago for chewing his back, maybe it was Cortisone? do you think that would have affected him? I never gave him dry food primarily, more like premium canned food and a bit of dry way back before I discovered you guys, so I wondered why he got diabetes. The canned probably had rice or potatoes and other carbs though. And the "little bit" of dry did not help I'm sure. I also realized I used to give him a decent lick of Laxatone--that has corn syrup! Shees!

Yes, I'll try to shoot/feed him around 8 tonight. Thanks!
 
it's not uncommon for a cat to develop diabetes after a steroid shot. that might have done it. who knows, but cats who are steroid induced are *usually* easier to get off of insulin once their pancreas has healed.

all of that stuff - the food, the shot, the laxatone - we've all done it. none of us knew any better. i find hindsight to be pretty cruel (to me) and try not to look back with what i know now. the best thing imo is to just look forward to how you help him now.

i'm glad to hear he's doing better today.

what did you get for that $900? that seems outrageous - i had just about every test done on punkin before i took him to be treated for his acromegaly and that cost $600ish. i bout died when i saw that bill. i'm in a smaller city, though, so maybe things are more expensive where you are.

if you can keep posting, maybe we can help you get to the bottom of what's going on and get him better regulated. today looks better. if he keeps rising, that tells you he's started another bounce from that 144. the way to get the bouncing to stop is to keep showing him the lower numbers. at some point his liver will decide they are safe and he will stop bouncing. again, don't increase the dose during this time just because he's higher. count 3 days from this morning before even considering an increase.

if you have to feed him after the middle of the cycle, make it small, like a teaspoon-tablespoon, at a time instead of 1/4 or 1/2 cans of ff, and don't feed anything within the 2 hours before a shot. that let's you get a preshot test that has not been influenced by carbs so you can see what the insulin is really doing.
 
Hi Jennifer,
Sorry I didn't get back to you sooner. Yes, the question I asked about steroids is what I was getting at - what Julie has already explained - that sometimes a cat who has been given steroids can become diabetic, and from I have seen here, those cats are prone to going into remission (and fairly quickly).

The other thing I mentioned, if she was dehydrated or if her abdomen was tender. The symptoms you listed - lethargic and breathing hard - I have seen those mentioned in cases where either acute or chronic pancreatitis is happening. Hard/rapid breathing also gets noted a lot when cats are in pain.

Carl
 
Julie - back when Spot was first diagnosed about a month ago, the vet had him stay over 3 nights I think and it cost that much to test, regulate, curve him, whatever else they did. I think she ran some test on his thyroid, checked ketones too. I did not know about you guys then. After we got him home I went on the forum.

A pet with pancreatitis will exhibit some or all of the following signs: lack of appetite, frequent vomiting and diarrhea which may contain blood. A pet may also drink more water than usual and vomit it soon after consumption. Weakness, inability to walk and abdominal tenderness or pain may be present. Body temperature will vary in pets with pancreatitis, but usually the temperature will be higher than normal at the onset of the disease and then fall to below normal as the condition continues. The eyes may become sunken, and the mouth and eyes may become very dry, indicating dehydration.
Click to expand...

Spot's temp at the vet #3's yesterday was normal. His eyes do look sunken, but in general he looks so thin to me (he weighed 11.5 lbs) and his face is thin. He is able to go up and down the stairs fine. He is hungry, not vomiting, has not vomited. But his breathing is labored. I am going to take him to the expensive vet on Tuesday. I don't know where else to take him. Other vets I've called work with ProZinc. She did put him on Lantus at least.

He's been in the 200's today. Begging to be fed. I don't know how I'll hold out his food until 8:00. I feel awful doing that.
 
He needs to eat; let him eat.

Until he is regulated, he is getting no benefit from his food, ie starving. Feeding small amounts helps to take the edge off.
 
it's ok to feed him some - did you see where i said just to keep it a small amount? as bjm said, any cat that is unregulated doesn't get the value of the nutrients they are eating - that's why they have high blood sugar. the glucose is floating around in their body instead of getting into their cells. i didn't mean you to have a desperate situation! in everything that you hear, please trust your gut as well. you are there with your cat - we can give you general advice with what works on most diabetic cats, but we don't see your cat and can't diagnose or treat problems over the internet.

many cats that are diabetic have ongoing problems with pancreatitis. there is a test specifically for that - i think the newest test is called the "specific fPL", i believe. here is a link from an old post by JoJo - a vet tech who was a former advisor here and really knew her stuff: http://www.felinediabetes.com/phorum5/read.php?8,876722,876722 there is a test that can be done in the vet's office that just gives you a "yes/no the cat has pancreatitis" and there is a more involved test that gives you a number.

i'm concerned when you say that he's in the 200's with breathing hard and not feeling good. that isn't high enough for most cats to have much in the way of reaction to it. i think a vet visit sounds really smart.
 
The chewing himself raw could be due to an allergy with dry food. This is exactly the same problem Maui had her entire life, and I did everything, steroid shots, shampoos, etc. Everything that is, except have a vet ask me about food and say, hmmm there could be a food allergy here.

Once, she was diagnosed with FD and I found this board, I removed the dry food and her skin issues cleared up very quickly. She hasn't had that crazy itchiness where she chews herself raw, no more shampoos and certainly no more steriod shots.

I never did find out what in the food caused the problems and at this point, don't care. I just know that any type of dry kibbles is a no-no for Maui.

Try removing all the dry food and see if that helps clear up the skin issues.
 
Hillary, that is a very interesting story. I had the same thing happen with my dog - she chewed holes in herself. i kept taking her to the vet and they'd give her cortisone injections. they told us it was an allergy to fleas - this was pre-frontline days. one time i was in the locally owned pet store and they asked me if i'd tried a hypoallergenic diet - which i hadn't. never even occurred to me it might be her food - i was buying it at the vet's!

switched to innova and she never bit herself again.

my diabetic cat, punkin, used to have chronic bladder infections. i bought the vet-prescribed "easy on your bladder" crunchies. my non-diabetic cat, anya, has chronic diarrhea problems. she was on the vet-prescribed "easy on your gut" crunchies.

i switched both of them to canned food when punkin was diagnosed 1.5 years ago. Punkin hasn't had a bladder infection since. anya's diarrhea is 90% better and now i add fortiflora sprinkles all the time and that completely eliminates any problem.

the food matters a lot.
 
Wow Julie. Dog, cat, it doesn't seem to matter, there is something in the dry food that for more sensitive animals causes huge problems. And sadly, most vets (mine back then anyway) only treated the symptoms, rather than search for the root cause.
 
Jennifer,
I understand that. And he was off dry food before he was diagnosed diabetic, right?
I did have a question about the steroids though. You said it was because he was chewing on his back? Did the steroid shots fix that problem? I'm asking because ever since I moved into this house a month ago, I can no longer let my non-diabetic cat, Mullet, outside. And I don't know if it is because of that or not, but he's started chewing and removing bits of fur from his back and legs. I've looked for the obvious causes (fleas, ticks) but haven't found them. Plus he was more likely to have that problem when he was mostly outdoors at the other house. He gets Frontline Plus as well. Maybe it's just a response to being in the house when he wants to be outside? Anyway, my question is, did the steroids stop him from chewing like he had been doing?

Carl
 
The steroids really didn't help. The vet who gave him the shot said it should help for maybe two weeks. It might have, but he was chewing himself again not long after. I did not get a lot of these shots for him, I think maybe once or twice. Spot did this chewing/over-grooming years ago when I lived in NYC also. I believe it's behavioral, but notice he chews/pulls hair out of his legs or back especially right before he gets fed. Maybe because he's hungry. The only thing that sort of works is amitriptyline. But even a little bit makes him groggy. Mullet may be chewing because of the change he's experiencing, and chewing/over-grooming makes him feel better. It's like biting your nails, crazily comforting, and a hard habit to break. Since Spot was diagnosed, I've enjoyed chewing mine.

My old vet suggested fleas, mites, bugs, but wouldn't the other cat have these issues if that were the case? I have never seen a flea on either cat, and I comb them.

One of the side effects of amitriptyline is cats' appetites increase. Not good. Neither is drowsiness. I think you can also give Prozac to cats for this problem, but am not sure of the effects. Both drugs are actually people drugs. I am tempted to take one of Spot's pills, but they are very bitter. Giving him a pill (part of a pill) is not easy. I stopped giving it to him lately, too much other stuff to bother him with.
 
sorry the point was muddled - what hillary and i were saying is that it could be a food allergy causing the biting. not specific to dry food.
 
I am not trying to say your situation is the same as mine, because it is probably not, but my cat was also lethargic when first diagnosed with FD. (She was also not eating) and eventually started breathing hard and fast. It turned out she had advanced heart disease, which is what was making her numbers go higher, and had to be put to sleep. This was diagnosed with an X-ray. I know there are financial issues that make the vet difficult or impossible in some cases, but if your cat is having trouble breathing, he could be in pain or could have another health problem. I agree that a vet visit is a good idea.

ETA: I say this because I think she was in significant discomfort near the end, and I just didn't see it or didn't want to see it because I didn't want to lose her, and it kills me now. I can't even think about it.
 
Right, as Julie said, there are ingredients in food that can cause these kinds of reactions. While a lot may be found in dry food (and that was Maui's issue), there are others who found that some ingredients in wet/canned food can be problematic as well.

For example, beef can be an allergen. Some people turn to the "novel" foods suchs as venison, lamb or rabbit and for them that seems to have resolved the problem.

It's just something else to consider.
 
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