New Diagnosis - 007 asthmatic kitty losing hair, bummed

[nutritiongirl22]

I've been enjoying reading and posting now for about a week now and I think I've been avoiding my own introduction. I guess maybe I feel somewhat responsible for my cat's diabetes. 007 is 9 years old. He was diagnosed with asthma about 3 years ago. I had him on a mix of an inhaler and prednisolone when needed. Eventually I think the inhaler got so stressful for him he would just hide from me and get asthma attacks while he was trying to run away. It was just sad. He's the sweetest cat but he's a terror to pill. I've pilled him, watched him eat 10 treats, and then spit out a pill 5 minutes later. We finally came to a mutally happy place when I started pilling him with tuna flavored prednisolone chews. Yes, I have to even shove those down his throat. But we do it, he knows it's done, and then he's purring and happy afterwards.

Fast forward to August: 007 started peeing and drinking a lot. At first I thought it was the pred, I'd given him 5 mg instead of his usual 2.5 mg every other day for a week to try avoiding a burst & taper. The pee was crazy. I thought I was neglecting the litter box at first, until it kept happening and then he seemed to be parked at the kitty fountain. Inside I was freaking out because I do this with my pets but I was trying to be calm: maybe the pred, a UTI, kidneys? He'd had bloodwork 6 months earlier so I knew it couldn't be anything too progressive/chronic. Diabetes was the last thing on my mind. I know it shouldn't have been but it just was. He hadn't lost any weight but he sure was pigging it up. I didn't even notice that I'd stopped measuring his food those last few weeks.

So his blood sugar at diagnosis was 416. Started on 1 unit lantus twice a day. It was a little rough at first giving his shots but he's doing well. Symptom-wise I could tell a big difference the first week. The peeing and drinking is definitely decreased. He's eating less too. He had his first curve today. AM pre 318, 4h 277, 8h 292. He got increased to 2 units today. I only half transitioned him to the diabetic food. This is partly because the meter I had at home was telling me his BG was 160-180s so I was worried he was going to run low if I made too many changes at once. Bad meter - it is going bye bye.

This week, we are trying 2 units and I am going to transition him to his 100% diabetic diet. We'll do another curve after that. Here are the kinks....
1) 007 is losing hair, literally in the past week. He looks like he has bald eyebrows, like large bald spots. The vet is not really sure what this is and thinks it could be self-inflicted. This is so unlike him that it's hard for me to imagine. Any idea what is going on with this? Similar experience?
2) I can tell he feels bad. It seems like he feels worse than before, or maybe I am just picking up on it more now that I know what's going on? He doesn't come up to me for pets and follow me around like normal. He's just more of a lump. He is very alert, eating well, just seems depressed or something. His little sister taking total advantage, running in front of him if he does come up to me and running up to his food bowl to steal his food, which she would never normally do & he just lets her! That more than anything tells me how he's feeling. Is this normal?
3) It is possible that diabetes is pred-induced. Does anyone have a similar situation? He is now on daily pred (a lower dose 1.25 mg) per the vet school's recommendations to have a consistent dose but I'm thinking it would be worth trying the inhaler again...once we get his BG stabilized after this 2nd curve. I am concerned about the daily prednisone and if his diabetes is secondary to his pred, that isn't good. It's been over a year since I have used the inhaler and we also had another cat in the house that probably contributed to the stress in the environment at the time.

I work at a vet so I get a lot of support medically, but I don't have anyone going through it. I get really anxious whenever one of my pets is sick or having a problem. They are my babies. Thanks in advance for the help! I really appreciate any shared experiences

 

[Larry and Kitties]

The Prednisolone likely cause the diabetes. If it is given intermittently it will make finding the optimum insulin dose hard. Also, what inhaled med are you using? Some can also affect BG level.

It could be that the food change is causing the hair pulling due to an allergic reaction. What were you feeding before the problem?
Just what specific food is he eating with the hair pulling?

 

[Lisa and Witn (GA)]

This week, we are trying 2 units and I am going to transition him to his 100% diabetic diet.

Jumping from 1 unit to 2 is a large increase. I know it does not seem like it is, but it can have a significant impact on your cat's BG levels. I would suggest only increasing by 1/2 unit instead if you are not changing anything else. However, since you are also going to make a diet change, you should hold off increasing the insulin. Removing any high carb foods, such as dry, can drop your cats BG levels a lot. By increasing the insulin and lowering the carbs, your cat is at a great risk of becoming hypoglycemic. This could be dangerous or deadly.

A better plan would be to leave the insulin level at 1 unit and change the diet. Monitor the BG levels for at least one week before you determine if you need to increase it. If an increase is needed, only increase it by 1/4 to 1/2 unit and keep the new dose for at least one more week before increasing it again if needed. It takes at least one week for your cat's body to adjust to a dose increase.

 

[nutritiongirl22]

He's not on any inhaled meds right now. He's been off them for about a year. He is only on prednisolone now.

Before this, he was on Royal Canin Spay/Neuter. His sister pukes periodically and the kibble is shaped so that the cat has to chew it before swallowing, so that seems to work well for her. I was trying to transition her to a grain-free food called Dave's Pet Food http://davespetfood.com/catalog/for-cats/dry-for-cats/ but she stopped eating it so he did have a some of both and seemed to do fine before his diagnosis. She's really picky. In the past they've also been on Orijen but it's been a little while since they've eaten this. Those are pretty much the ones that work for us. These are all dry foods.

Now, he is on Royal Canin Diabetic dry food. Ingredient-wise the Royal Canin foods don't seem incredibly different, but who knows? What I like about this food (and Royal Canin in general) is that it's the only diabetic dry food that actually has a consistent amount of carbohydrate of 25% (and this is 25% of calories, not dry matter). All other foods just have minimum protein and fat levels so there's no real guarantee that you'll know how much carbohydrate is in the food from batch to batch. For initial treatment, in particular, this is quite useful. At the time of his curve, I had transitioned his food to 2/3 Diabetic and 1/3 old food. I did this over a week, so I'm not planning to do anything quickly. I also kept him on dry purposefully because it's higher in carb, so as not to make too much change at one time.

I have wondered if the combination of the pred and the higher carb in the Spay/Neuter food have contributed to his diabetes development. A year ago, it did help him lose 1.5 pounds that had been creeping up from the pred. At his diagnosis, he did not lose any weight. Ironically, he's lost 0.2 lbs in the past week, though. He also didn't need any fluids at the time of diagnosis. I have a Pioneer Pet fountain that he loves which seems to work well for him.

 

[nutritiongirl22]

Here are a couple of pictures of his face. He had completely normal hair (no thinning) a week ago and now it looks almost bald above his eyes. My avatar pic was actually taken the day of his diagnosis, for comparison.

 

[BJM]

How are his ears? I've a couple of cats with a tendency to wax buildup and the scratch a lot, resulting in fur loss.

 

[nutritiongirl22]

His ears actually look beautiful - the skin looks good, no wax in there. I can't catch him scratching at all. He does have a little scab on one side so something must have scratched it. I thought it might be my other cat but the vet thinks it looks self-inflicted. It looks like there might be some thinning of the hair on the outer tips of his ears but I can't tell if that's from BG pricks and me rubbing his fur off or it actually falling out on it's own. I guess it shouldn't be falling out regardless? Overall I do feel like his coat looks a little more scraggly than normal. He doesn't look like his usual pretty self but I also can't positively say that wasn't going on already. It would make sense that he wouldn't be grooming as well because of all the drinking and peeing. So much has gone on in the past couple of weeks!

I did find one new protein in his new diet: soy protein isolate. Ugh, I don't want to have to switch him again...