New diabetic, off his food, hiding; advice please.

[Elizabeth and Bertie]

Newcomer, Lisa, posted for advice in the PZI forum, but has general health questions that may get 'more eyes' here.

(Have copied the content of her post below)

"My kitty - Sammy - who is 10 years old was diagnosed 7 weeks ago with diabetes - (he was pre diabetic about 4 years ago but by switching his food to canned we avoided insulin until now.

He as first put on Lantis and his numbers were continually high (over 500) so he is now on PZI (he has only been on it for 5 days- so not sure how it will work either) - BUT my most pressing concern is his appetite - I have tried all sorts of canned foods and even Dry (Purina DM - even though I know not recommended) and all he really does is lick the canned food - Does anyone have an suggestions? I also have another cat in the home that is constantly stalking him (they used to be best buddies) but since he has been sick the other well kitty - was at first attacking him - now after much separation - he just stalks him.

Also a friend suggested I take him to an internist - as opposed to his regular vet - has anyone else done that - to get him regulated?

Thanks in advance for your help...I am just so concerned - he has taken to hiding now (which he had never done before) and it seems his quality of life is terrible"

The link to the original post is here:
Some Guidance needed - newly diagnosed Diabetic Cat

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[Lori&Scout]

Sounds like something else may be wrong with him, given persistent high insulin and lack of appetite. Hiding is a sign of pain. I think it's time for the vet.

Try tuna or (cooked) chicken as a treat, whatever he will eat.

A diabetic not eating for more than a day is serious, because of the possibility of DKA or fatty liver disease.

Sorry you're having so much trouble, good luck.

Lori

 

[Critter Mom]

Hi Lisa,

Insulin can upset human tummies and I think it used to upset my Saoirse's tum. First up, I'd suggest looking at this nausea symptom checker from Tanya's site. If you recognise any of the behaviours (e.g. licking food then walking away, licking lips or 'pulling faces' when trying to eat) then it might be an idea to discuss treatment with an anti-nausea medication with your vet . Generic ondansetron works well (the branded Zofran is hideously expensive, btw). If the inappetence persists, an appetite stimulant such as cyproheptadine is another possible treatment you might discuss with your vet should the need arise. As Lori said above, inappetence is something that needs to be addressed very promptly in all cats, but doubly so with diabetics. It is also a very good idea to check Sammy's urine for ketones, especially while he's struggling to eat. You can test with Ketodiastix strips or similar (should be available from regular pharmacies). To test you dip the strip into some fresh urine. Anything more than trace ketones requires very prompt veterinary attention.

The hiding could be due to stress from being stalked, pain, or again it could be a reaction to the start of insulin treatment. Is there any correlation between the times Sammy hides and the time of his most recent insulin injection? It may take a little time for a cat's body to adjust to receiving insulin, or sometimes a particular insulin doesn't agree with a particular cat. Saoirse's first insulin (Caninsulin) didn't agree with her at all and she spent most of her day hiding while being treated with it. She became perkier and more sociable as the dose wore off. Lantus agreed with her much better. As you will see here frequently, every cat is different! (Note: Caninsulin (aka Vetsulin) is quite a harsh insulin in cats and the BG can swing widely during each cycle so that might be a reason why it disagreed with my little one. Lantus and PZI at appropriate doses are gentler.) Which brings me to dosage. Is there any chance that you could post the doses of Lantus and PZI that you have been giving to Sammy, and also his current weight (plus his ideal body weight if different to his current weight). That information will be very helpful to other experienced members who may be able to make better suggestions based on it. Too much insulin can cause high numbers as well as too little insulin.

 

[phlika29]

I agree with what @Critter Mom said. An underlying issue such as pancreatitis could be the cause of the hiding, lack of interest in food an high blood glucose.

You need to address the lack of food and would take him to the vet to see if you can get some anti nausea medication, perhaps some sub q's if the vet thinks he needs it and to discuss whether he might be in pain. There is a test called a spec fPL test to check for pancreatitis.

https://www.idexx.com/files/small-a...pec-fpl-treatment-for-feline-pancreatitis.pdf

 

[Lisa A]

Thanks very much for alot of invaluable info - I have been to the vet numerous times (in the past week) but she never suggested anti-nausea meds (and from that last you sent - he has alot of those symtoms) I have used cyproheptadine but doesn;t seem to help much. He has been checked for pancreatitis also and he does not have that
His urine was just check at the vet so we are ok there - The Insulin he is on is the PZI and I have noticed about 3 - 4 hours after he receives it he is feeling better for 5 hours - he gets 2 doses per day (3) each time. He weight 14 lbs (down from his high of 16 lbs). I am trying all sorts of food (canned) just to get him to eat anything - he really only licks the water - I also put down Purina DM and he eats a little of that

 

[Lisa A]

Just called my vet they are giving me Cerenia - anyone ever used that for Nausea?

 

[phlika29]

Yes. It is used for nausea and is particularly good if there is also vomiting. Remi has used both cerenia and ondansetron.

 

[Critter Mom]

Yep. Saoirse had one Cerenia injection when she was first treated for nausea and inappetence. Saoirse has also been treated with cyproheptadine. With nauseated cats sometimes it may be necessary to treat with both anti-nausea and appy stimulant meds for a while. Saoirse did well with cyproheptadine and ondansetron in tandem. Neither medication helped her as much on their own. After a little while she no longer needed the cypro, but still needed the ondansetron, As her flare subsided she needed less and less ondansetron, too. She's back on it at the moment because a new batch of her regular food isn't as good quality and it started spiking her BG levels. The food I'm giving as a stopgap doesn't agree with her system as well hence the need for anti-nausea support. Having ondansetron on hand at home to be given ad hoc (dose size and daily maximum set by our vet, and treatment is under his supervision) has stopped potential bouts of inappetence in their tracks a number of times since Saoirse was first prescribed it.

Can Sammy eat chicken OK? When Saoirse was at her queasiest last year I managed to keep her going on chicken breast poached gently in water and minced finely in a mini food processor thingy. I also gave her a 50:50 mix of the poaching broth and water to keep her hydrated. It helped a lot when I fed her very small meals very often (once an hour at one stage - timed feeders are a gift from the gods!). As she improved, I gradually migrated to bigger meals with a somewhat longer interval between.

Thanks very much for alot of invaluable info - I have been to the vet numerous times (in the past week) but she never suggested anti-nausea meds (and from that last you sent - he has alot of those symtoms) I have used cyproheptadine but doesn;t seem to help much. He has been checked for pancreatitis also and he does not have that
His urine was just check at the vet so we are ok there - The Insulin he is on is the PZI and I have noticed about 3 - 4 hours after he receives it he is feeling better for 5 hours - he gets 2 doses per day (3) each time. He weight 14 lbs (down from his high of 16 lbs). I am trying all sorts of food (canned) just to get him to eat anything - he really only licks the water - I also put down Purina DM and he eats a little of that

I'm really glad to hear that Sammy got the all-clear for pancreatitis. It can be really tough to deal with.

I have diddly squat experience of PZI, but as best I know it's an in-out type of insulin (cf. depot insulins such as Lantus). From the clinical signs you describe about where in the cycle , it sounds like the period between 3-4 and 8-9 hours after injection time may be the period where the PZI dose is most active in Sammy's system, but only BG data could confirm that.