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KittyKats

KittyKats

Member Since 2024
Hi Friends - I desperately need your knowledge and support.

My name is KittyKats and my cat's name is Archie. He's about 8 years old and was diagnosed with diabetes about two years ago. He's also had a history of urinary crystals so he's been on the prescription urinary food lines for a while now, too (truthfully I can't remember how long that's been).

When he was first diagnosed with diabetes, he went on 2 units of ProZinc twice a day and then gradually went up to 3 units. The vet was doing blood curves in their hospital and he had been well regulated, no issues.

Then August 2023, I relocated out of state for my job and my first priority was establishing care for Archie. When it came time for a refill of ProZinc (January 2024), the new vet here wanted to do a curve (understandable) and they use the Freestyle Libre. He absolutely hated it -- but I will say the first 8 hours was when he most tolerated and was totally normal behavior wise and I was getting a curve that made sense. He started 400ish and then dropped to 150 over the course of the evening after 3 units ProZinc and food. Then after 8 hours, he couldn't tolerate the Libre and just became completely lethargic I was getting consistently high 200 readings and then one night it went very low and we went straight to the ER where he was 60. The new vet used these readings as a sign he wasn't very well regulated and suggested we switch to Glargine.

If I could go back in time and change this...I didn't know much and wanted the best for him so I agreed. Over the next few months we we started at 1 unit Glargine twice a day, then 2 and then recently going up to 3. However, I knew it wasn't working like the ProZinc. He'd be drinking constantly and had an insatiable appetite.

It all culminated to this past weekend when he started having diarrhea and threw up in the middle of the night. When I looked up what that could mean, we rushed to the ER as I was afraid he was in a ketoacidosis state. Thankfully he wasn't but they recommended switching his care to an "Internal Veterinary" specialist which we did by means of admitting him to the ER there. They kept him overnight etc and then the internal vet had no problems switching him to his Prozinc. They were doing blood sugar readings there but it was all over the place. Would range from 150-400 and he wasn't eating (doesn't surprise me, he's anxious and wouldn't want to eat there).

It's been 36 hours since he's been back home. He's now again on 3 units ProZinc but today has diaharreah and is a bit lethargic. He did eat but not with the same gusto.

I am at my wit's end and I can't bear to see him like this. Any ideas? I'm sure I left out critical details but I"m not thinking straight with all the worry and anxiety. Does it just take some time for him to adjust to being back on the ProZinc?
 
It will take a few days for the Lantus to fully work its way out of Archie's system.

As for the diarrhea, I would suggest picking up a particular probiotic. S. boullardi is wonderful for controlling diarrhea. It comes in capsules. You use about 1/4 to 1/3 of a capsule mixed into Archie's canned food. If the diarrhea isn't improved in a day or two, increase the amount. This is a link to information on managing diarrhea in cats. I've used brands either from ReNew or Jarrows. They are available on Amazon. ReNew products are available at Whole Foods but I don't know if they stock S. boulardii.

Has the vet ruled out what may be causing the diarrhea? Typically, insulin doesn't cause GI problems. One other thing you may want to try is feeding your cat a novel protein. I fed my cat poultry flavors for years. He then developed inflammatory bowel problems which has been largely controlled with a diet of novel proteins (e.g., pork, venison, rabbit, lamb). The only way to definitively diagnose whether there is a GI problem is a biopsy although an ultrasound may be a reasonable first step.

We can be more helpful if we have some basic information about your cat. What are you feeding Archie? Much of the information we need is listed out in this post on helping us to help you. It provides instructions for setting up your signature along with a spreadsheet. We strongly encourage home testing and the spreadsheet is a way to keep track of your cat's progress.

FWIW, both glargine and Prozinc are very good insulins for feline diabetes. It does sound like Archie's glargine dose was raised a bit aggressively. If he's back on Prozinc, we do have information on dosing that you may want to look at.

Please let us know how we can help.
 
Thank yo so much for your reply, I am working to update my signature and have added the info details below. I don't know what to do. It's been two days that he's been back home after being hospitalized (without finding anything except the high blood sugar and intestinal inflammation via ultrasound) and now we've switched back to Prozinc. He's lethargic, wants to eat but doesn't really eat and then still has diaharreah. I didn't give him his evening insulin as he didn't eat much. I don't understand.
  • Caregiver & kitty's name: Yasmine & Archie
  • Name of Insulin: Prozinc (just got off Glargine)
  • Name of your meter: TBD
  • Diet: Combo urinary prescription wet food and dry food (C/D, SO, StOX)
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable): intestinal inflammation and high blood sugar but was not DKA - all blood results were normal
  • Bexacat or Senvelgo (if applicable) and dates: N/A
  • Acro, IAA, or Cushings (if applicable) : N/A
 
I'm sorry my above reply probably didn't provide too much insight. I'm just not even sure what to think. He's worse than before I took him to the emergency room. Now he pretty much just sleeps and doesn't express interest in anything.

He just went again to the litter box with diarrhea so I'm really just hoping what's making him feel off is his digestion and the diabetes can be regulated...I don't know what to think.
 
Did they rule out pancreatitis? I agree that an ultra sound would be the next step to figure out if he has any GI tract issues like IBD. An IM should have brought up all these options with you. Did they?
 
Yes while he was hospitalized they did an ultrasound and found inflammation in his upper intestine but found the pancreas appeared normal so they didn’t think Pancreatitis was the culprit.

Based on the ultrasound, the IM then did go into the IBS or GI lymphoma explanation but they couldn’t be sure without endoscopy or additional blood work. To be completely honest, I was so overwhelmed when they were explaining this to me I was still so focused on getting his diabetes regulated that I forwent the additional testing to be able to bring him home and start the new (well his original) ProZinc regimen.

Now that we’re a few days out from his hospitalization, he’s still having diarrhea and though expresses desire to eat, it’s a battle to actually get him to really eat anything.

we went to his regular vet again yesterday and they gave him fluids and an appetite stimulant.

I think I’m starting to understand the circumstance (not the “why”) of two issues when in my mind I kept grouping them as one issue (ex: “if I can get his insulin/diabetes regulated again, he’ll be fine). And I will say even the IM said while there is intestinal inflammation he’s clearly not well regulated after the switch and it’s ok I focus on that for now.

I literally cannot take this stress. I can’t afford another hospitalization stay right now. I could even barely afford his vet visit yesterday. Ugh. I just wish there was a light at the end of the tunnel but it’s just dark and confusing every minute of the day.
 
I'm still new to diabetes and don't have insight on what to do. But I know sometimes things can seem overwhelming. I wish money grew on trees for all our fur babies.
:bighug:
 
If there’s a chance of GI tract issues and he’s not eating ask the IM or the vet or both for prescriptions for Cerenia and ondansetron. He can take both simultaneously as they work differently. If he’s nauseated, he won’t eat and the meds will help with that. Your vet should also be able to prescribe something for the diarrhea like metronidazole. It would also be a good idea to start giving him a probiotics like S Boulardii.
 
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