New diagnosis and UTI

[Bubba and Melissa]

My cat was diagnosed 7/9 with a BG of 540 and ketones in his urine. Also has a UTI. We did 1 week of Amoxicillin that didn't do anything and just finished a 7 day course of Entrofloxacin. His second UA a week ago didn't show ketones.

Vet started him on 2U twice a day of Vetsulin. His blood sugars are almost all super high (400-500 range). He is eating Fancy Feast Pate 2 cans per day. He won't eat more (previously was on dry Purina Indoor). He is peeing all over my house also. I called the vet about his high blood sugars last week and unresolved UTI and she thought the chart looked good for the 13th through 16th and wouldn't change anything except I could increase to 2.5U if I wanted.

Tonight his blood sugar read HI on the meter. I gave him insulin and food and checked again 15 minutes later and it read 589. What do I need to do?

Thanks for any advice. He is barely moving around (walking slowly on his hocks) and has lost 2 pounds in the past 6 months.

 

[Idjit's mom]

Tagging a more experienced member for help Melissa
@MrWorfMen's Mom

Has a urine culture been done to be sure the right treatment has been applied? I would make sure to add water to his wet food, make it soupy, get water in to help flush the urinary tract. And offer more frequent small meals throughout the day, freeze some food soup in ice cube trays and leave a couple of food cubes out for him at night.

You can test for ketones at home, don't wait for a vet visit, if DKA is developing, you want to know and take action. You can get Ketostix at any pharmacy, they are not expensive.
Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):
put the end of the test strip right in his urine stream as he's peeing
slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the color change in very good light.

It may be that vetsulin is not working well for him, and you might consider using a different insulin like Lantus, Levemir or Prozinc.

It also sounds like he has neuropathy which occurs with unregulated cats, especially with high BGs
Here is some info on neuropathy:

• Neuropathy: Feline Diabetic Neuropathy (weak back legs)

 

[MrWorfMen's Mom]

Just saw your post over on Vetsulin. Sorry for the delay getting back to you.

Like others said, I would not increase the dose of insulin at this point. A starting does of 2u is higher than we would normally recommend but it does appear that initially it was bringing BG down to much better levels. It appears the increase to 2.25u may have cause an increase rather than decrease in BG so I would at least go back to 2u.

I would definitely check for ketones, and if they are negative, then you could try lowering the dose to 1.75u to see if that evens out the AM and PM a bit more and brings BG down. If ketones are still present, it would be a good idea to have your vet check Bubba out again and ensure the urine infection has been completely dealt with. If you try lowering and BG stays high, I think it would be worth having the vet do a sterile sample and send it off for culturing particularly if that was not done prior to prescribing either of the antibiotics Bubba has been on and the inappropriate elimination continues.

Bubba may have developed an aversion to the litter box due to discomfort from the UTI so it might be worth trying the special attraction litter or a totally different litter that Bubba doesn't equate with any discomfort.

I noticed a couple of folks mentioning neuropathy but don't see anything about him walking on his hocks or such in your post. Is Bubba having difficulties walking, jumping etc.? If so, then a lower sided litter box might help as well.

 

[Veronica & Babu-chiri]

UTI's are hard to take rid of in diabetic cats, was a culture done? You will need to wait 10 days after he finished the antibiotic and get another urianalisis done but make sure they ask for a culture so that you are shure he is infection free or you can know exactly what the virus or bacteria is and give him the specific antibiotic for it, if he comes out clean after a month you will have to make another culture to make sure UTI is not back, if he still has infection that can be raising his blood glucose numbers.

For now make sure he gets a lot of water as they mentioned