New and looking for advice dealing with infection

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MelanieAndJosh

MelanieAndJosh

Member Since 2020
Hello and thanks for reading!

While this is not our first time with a diabetic kitty, it is our first time trying to "do it right". We are in the very early stages of trying to be more informed and offer the best care, but are learning as quick as possible.

I'm writing today because kitty had a setback due to a UTI. Hoping to hear if we are "OK" as-is until we work through this UTI or if we should consider increasing insulin.

We are on day 13 of Clavamox. After one week on Clavamox we returned to the vet. We noticed clinical improvement (making it to or "close" to the box) and she showed improved numbers on urinalysis. However, the vet prescribed another course of Clavamox because the infection was not totally cleared up. This week we seem to have a setback. Her blood sugar levels are high. Urination in random locations (not near her box) has gotten much better over the last 2 days.

It's really stressful over here and looking for any input - even if it is just hold on =) We know that an infection can raise blood sugar levels and/or impact the effectiveness of the insulin.


Background:

Kitty is 16 years old

Weight is 8.5-8.8lbs

She was doing well on 2U 2x daily of prozinc

She has a food alergy and eats Hills zd or kd wet food

About 2 months ago we had an episode that we think was related to a bad case of food. Her intake went way down and she lost over a half pound of weight. Once we figured it out (feel so bad), her intake went way up and the weight came back on.

Recent fructosamine was "high" but vet was "OK" with it. Sorry I don't have values. Vet did say that we could increase insulin dosage to 2.5U 2x daily if we wanted to, which we did 7 days ago.

Here is where we are right now: Kitty is really sluggish, limited standing and walking. When she walks, it isn't far and she stalls quite a bit. Appetite remains high. Drinking quite a bit.

Most recent readings from Alphatrak (just got a human meter today and did a compare - if 60-70% on the high end is valid, the results look correct). Please note that she is eating throughout the day so these results are impacted by food:

Insulin given at 6am and 6pm (we will now be testing before every shoot)

Today 7/19/20: 458@5:45am, 433@8am, 426@10am [Food eaten slowly throughout the morning]

7/18/20: 347@5:45am, 270@10:15am, 371@730pm
7/17/20: 379@12pm, 425@5pm
7/16/20: 401@4:30pm

We did move to a new vial of Prozinc.

Thanks again for reading, we appreciate any advice anyone might have, which I understand could be to keep working at the UTI.
 
WELCOME TO FDMB! We are SO glad you found us!!! Its so good that you are testing BG at home. That is a huge hurdle GOOD FOR YOU! I am not an expert but can give support. We are a dedicated community of kitty cat lovers all dealing with diabetes. Theres a WEALTH of information here, with good folk to help you navigate these problems. PLEASE HOLD ON FOR MORE REPLIES

While you are holding it would benefit you and Josh to set up a spread sheet (so our experts can see where the insulin takes kitty and to make the best decisions for advice.) Also your signature so our experts can see at a glance, insulin type, food he eats, the type of meter used. (Its easier than reading through a whole thread to get this info)
you can find out how to do all that here:
Suggestions, Tech Support & Testing Area

Again WELCOME Melanie, to the best site on this planet to help you help Josh!:bighug:
jeanne:coffee:
 
Hi Melanie & Josh

Welcome to FDMB. Here's a sticky that will help you with how to set-up your spreadsheet and signature. https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
We are really data-driven here and would need to see BG readings to recommend any changes in dose.

This is the Prozinc forum (https://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/) and the stickies at the top provide a lot of information on diet, dosing, testing etc.

I don't know very much about food allergies, but is there a low-carb wet food that would work for her? What is she allergic to? Prescription food is not usually low carb. Dr. Lisa Piersons's food chart has a list of foods with their nutritional information present. Often, a switch to a low-carb diet can see a significant reduction in the kitty's blood sugar numbers. Therefore you should take care while transitioning her to ensure that her insulin requirements are adjusted accordingly.

Diabetes causes excessive hunger, excessive thirst and excess urination. All of these symptoms reduce/go away as the kitty sees better numbers. Some kitties also develop hind leg neuropathy as a result of diabetes which alters their gait and makes them less mobile. They cannot walk very far, their leg slip from under them and they need to frequently sit down in between.

I see that you have both the Alphatrak as well as a human meter. The dosing protocols here are written for human meters. Human meters are also significantly cheaper. Human meters read lower than Alphatrak but there isn't a one-on-one comparison between the readings. Also, I would encourage you to test during the PM cycle as well as the AM. Many cats often drop lower at night. If you can get a before bed test in every night that would be good. If that test is lower than the preshot number I would set an alarm and test later to see that kitty has no dropped too low.

I don't want to overwhelm you by providing too much information all at once! :-) I would suggest that you begin by setting-up the spread-sheet and signature. Next look at testing as much as possible and a transition to a low carb food.

Lastly, I do not know much about UTI, but I would think that it should have cleared up by now? Maybe I am wrong. I am wondering if the excess urination is being misdiagnosed as UTI? I have also heard of cats not being able to get to the litter box on account of the neuropathy. Hopefully someone senior will come around and advice you on the UTI.

Please feel free to ask any questions you may have! :-)
Bhooma
 
Hi and welcome Melanie and Josh!

you already got great advice from Bhooma so the only thing I want to add/ask is if you’re making sure she is not eating 2 hours prior to the preshot tests. It’s important that those tests are not influenced by food. It doesn’t matter the rest of the day, but since you’re basing the insulin on those preshot numbers they need to be true without the influence of food.

Do you know her ideal weight? And how much are you feeding daily? Diabetic cats tend to need more calories because they can’t process the nutrients in the food they eat as well and as Bhooma pointed out, if there’s a way to introduce food with less than 10% carbs, that would be ideal and it’s what we recommend for diabetic kitties :cat:

I’m happy you’re testing! That’s huge in getting your cat regulated and if you can transfer the info you have to out spreadsheet format, it would make a lot easier for more experienced members here to help you. Speaking of which, I’m tagging our prozync expert in residence @Deb & Wink she usually signs on in the evenings do hang on and welcome again! :bighug::bighug::bighug:
 
Bandit's Mom said:
Next look at testing as much as possible and a transition to a low carb food.
Click to expand...

Bandit's Mom said:
I just looked at Dr. Pierson's food chart and Hills Z/D wet food is 35% carbs and KD is 27-29% carbs. These are high carb food.
Click to expand...

We have been scared to death to switch food because of the skin problems she had before, but we are going to give it a shot. Appreciate the feedback on that

Bandit's Mom said:
Lastly, I do not know much about UTI, but I would think that it should have cleared up by now? Maybe I am wrong. I am wondering if the excess urination is being misdiagnosed as UTI?
Click to expand...

Vet did test this to confirm, along with a second visit after the first course of ABs. Apparently they can be tough to sort out. It was getting better after the first course, hoping we are getting there.

Will get started on the spreadsheet!
 
Did the vet ever test Josh, to find out what ingredient was causing the food allergies, to cause the skin issues?

The Hill's Z/d wet is mostly chicken liver, and corn starch with vitamins and minerals. So if Josh is doing ok on that food, another food with corn and chicken should be ok for her I'd think.

Does Josh eat the Hill's K/d chicken or the tuna flavor? Or both? Trying to find foods with some ingredients in common with what is in the foods that she already eats, but lower in carbs.

You might try only one food at a time, to see if that one food is ok with her system, and not causing her skin to break out.

You might consider raw food also. Either commercially available or make your own. Many cats do well on raw food diets, and there aren't the excess ingredients in the raw diets that usually cause allergies.
 
Quick update (Will get the spreadsheet going tomorrow, have a big project at work today):

Last night we saw 316 at insulin time. Thankfully we dropped down to 2U (should have gone lower) as we tested 164 and then 110. This morning we saw 238 at insulin time and decided to go to 1U to be safe given the food change and the possibility that the UTI may be clearing up and impacting values.

I have read that the food change can drop scores pretty quickly - it's amazing to think it's happened so quickly but if it's not that or the UTI, what could it be? Safer to end up high than low, right?

Deb & Wink said:
The Hill's Z/d wet is mostly chicken liver, and corn starch with vitamins and minerals. So if Josh is doing ok on that food, another food with corn and chicken should be ok for her I'd think.

Does Josh eat the Hill's K/d chicken or the tuna flavor? Or both? Trying to find foods with some ingredients in common with what is in the foods that she already eats, but lower in carbs.
You might try only one food at a time, to see if that one food is ok with her system, and not causing her skin to break out.
You might consider raw food also. Either commercially available or make your own. Many cats do well on raw food diets, and there aren't the excess ingredients in the raw diets that usually cause allergies.
Click to expand...

That's the plan - one food at a time and some that looks as close to the Hill's as possible. I only grabbed a few in case she wouldn't eat the first choices.

We have another cat we just rescued (all of our cats seem to be road leavings) and he is on raw and really doing well. We are worried about trying it with her but seriously considering it!
 
A couple of thoughts...

How was the UTI diagnosed? Did the vet do a cystocentesis (got a urine sample via a needle into the bladder) and a culture and sensitivity? This is the only way to figure out what the bacteria is and which antibiotic is appropriate. Also, it's possible that if antibiotics aren't doing their job, the problem is a kidney infection and not a UTI. It takes longer for antibiotics to treat a kidney infection.

With a raw diet, you have a great deal more control over what's in the food. You may need a novel protein if your cat is having an allergic response to some foods.
 
Sorry for not updating this thread.

I want to say THANK YOU SO MUCH for encouraging us to switch to low carb food. Our numbers are way down while reducing insulin at the same time. I need to get the spreadsheet going, but we have been testing and keep tracking. Looking so much better.

We added some B12 methylcobalamin to the mix. This morning she walked further than she has in weeks. Really starting to show meaningful improvement.

She goes to the vet today for a checkup on the UTI. Based on visible changes, we have to assume that we are much improved in that area.

Thanks again! Will get the spreadsheet going now.

*** EDIT - We added some pumpkin mixed in to diet as stool has become harder and smaller after switch to low carb diet
 
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Well we just got back from the vet and it turns out the UTI is NOT under control.

Urinalysis was coded as "Sediview" - certainly not sent out for lab work. We knew that Clavimox had been working at the prior checkup, so we are going to try again on that. Hopefully we are two steps forward and only one step back =)
 
MelanieAndJosh said:
We added some pumpkin mixed in to diet as stool has become harder and smaller after switch to low carb diet
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Good idea! A switch to low carb food often means there isn't enough fiber in a cat's diet. The plain canned pumpkin can often do the trick, to make the stools less hard.

Since the clavamox is a general antibiotic, and doesn't seem to be clearing up the infection/inflammation, you probably want to have your vet do a "clean catch" or a cystocentesis to draw the urine directly from the bladder and have that sample sent to an outside lab to culture the bacteria. Once the specific bacteria is identified, an antibiotic tailored to kill that specific bacteria will get the infection cleared up. A general antibiotic doesn't always do the trick.

Would it be possible for you to get at least 1 more test in each PM cycle? A "before bed" test is a good one to get. The more books we can add to the bookshelves, between the bookends (the pre-shot tests), the better idea we have of what is going on.

Low carb food is making a noticeable difference. Betting that Weenie will need a dose reduction soon. Our dosing protocols base dose changes on the mid-cycle numbers, the nadirs.
 
Weenie has been doing really well on low carb - thanks SO much for the advice! We seem to have the UTI looking better now that we switch to a different AB. Numbers coming way down (about to start a thread in the ProZinc forum for advice). Neuropathy (or what we assume was) is improving a bit now, giving her B12. Stool doing pretty good, still on pumpkin and a little fiber. Would love for her to start waking up at night to pee instead of peeing on her bedding but one step at a time!

Thanks again!
 
MelanieAndJosh said:
Would love for her to start waking up at night to pee instead of peeing on her bedding but one step at a time!
Click to expand...
Neuropathy can sometimes affect bladder control. Hopefully the continued B12 treatment may help with the overnight accidents. Length of treatment is usually dependent on the level of neuropathy at start of treatment. Here's a vid of how a cat called Tootsie did with the help of B12 supplements:





Mogs
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MelanieAndJosh said:
Thanks for sharing that!
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I'm very grateful to Tootsie's human for sharing that video with the world. It's a story of hope for our sugars. Hope can be much needed at times, especially in the early days.

It can be easy to miss neuropathy symptoms. Saoirse was only mildly affected by it, but I didn't know that it was an issue for her until after she started insulin treatment. Like many diabetic cats she had become quite lethargic before she was diagnosed. She started to get more active as her BG levels started to improve. One day she went to jump up onto a wide windowsill about 2 feet off the ground - and 'missed'. Cried my eyes out at the time. :(

With the addition of methylcobalamin as an adjunct to her treatment regimen, it wasn't long before she was able to make the jump with ease. :)


Mogs
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