*New Member* Help! 4yo cat - Advice on vet visit and “prediabetic” diagnosis - BG 330

[Poppy1990]

Hi All,

I am so relieved to have found this forum and am writing at the end of an unexpectedly tough day (literally in tears). Hoping to find some sage wisdom from this wonderful group!

Today I took my 4 year old cat Poppy to the vet for a routine check up and vaccination. I love Poppy to the moon, but Per usual, it was the same awful vet experience complete with pooping in her carrier, sedation, vomiting, crying, etc.

I had fasted her the night prior in hopes we could get a blood test done, which we did. I had no reason to request this other than I realized I had never done one and thought “why not have a baseline for the future”.

After we wrapped up the awful experience, we went home (cue poop in carrier round 2) for Poppy to commence her post vet routine of ignoring me.

My relief was cut short when I realized I had missed a call from my vet stating he was glad I suggested the bloodwork as Poppy’s glucose had come back very high - 330 to be exact. We played phone tag this afternoon, which gave me a chance to do some research. When I finally spoke to the vet, his diagnosis was “prediabetic” with diabetic numbers (?) and he suggested we treat by removing dry food and going with low carb wet food only before retesting glucose.

I cannot overstate how much of a shock this call was. Poppy has exhibited no symptoms - eats, drinks, plays normally and no weight loss (if anything, slight weight gain). She eats Wellness pate and does free feed some Merrick dry food, but she’s not a “scarfer”. She is active during day running around house. She IS overweight at 14 lbs. She has been on two short (10 day) stints of prednisolone in the past for unexplained bleeding in stool that has since resolved with diet change. No long term use of it.

Questions for the forum:

1. Is the absence of symptoms odd when compared to this high of glucose levels?
2. Is it possible that the complete emotional freak out she had at the vet elevated her numbers?
3. 4 years old seems very young for this diagnosis - could something else be off?
4. Is there even such a thing as “prediabetes”? Her numbers seem solidly in “diabetes” range.
5. Am I doing something dangerous by trying the food approach first?

Poppy is the absolutely light of my life and I am so thankful to have the financial means to take care of her no matter what happens. I’m concerned with this “prediabetes” diagnosis; on the one hand, it seems scary to add insulin into her life when she is happy and seemingly feels great, but on the other I don’t want to neglect treating her if this is a serious situation, especially given her young age.

Any advice would be so appreciated!!! Hugs

-Caroline & Poppy-

 

[Bron and Sheba (GA)]

Hi Caroline and Poppy and welcome to the forum. Poppy is beautiful!!

• Is the absence of symptoms odd when compared to this high of glucose levels?

• Is it possible that the complete emotional freak out she had at the vet elevated her numbers?

Many cats get stressed when they go to the vet, and Poppy certainly seems to be very stressed. Vet stress definitely elevates the blood glucose.
It is most likely your vet just did a routine blood test and the blood glucose was measured. What is needed is for him to get a fructosamine test done.
This test measures the blood glucose over the last 2 weeks and is the best way to find out if poppy has diabetes.
I would ring him now and ask if he can get that test done with the blood which was collected from your vet visit.

4 years old seems very young for this diagnosis - could something else be off?

It is young but some cats do get FD at that age or younger but it is more common later.

Is there even such a thing as “prediabetes”? Her numbers seem solidly in “diabetes” range.

Yes there is. If I were you I would swap to a low carb wet diet over a period of a week or so. Don't do it cold turkey or Poppy may get an upset tummy.
I would go out and buy a human glucose test meter and start testing the BG yourself. If you live in the US you can get a ReliOn meter from Walmart. I will send you a link to home testing at the end for this.
I will also send you a link to suitable foods. Look for foods 10% or less of carbohydrates. Don't let the vet give you prescription diets....they are expensive and definitely no better and are often higher carb.

Am I doing something dangerous by trying the food approach first?

No you are not BUT I would strongly suggest you buy a bottle of Ketostix from the pharmacy (or Walmart if you are in the US) and test Poppy's urine for ketones. Ketones can form in diabetic cats if they are not getting enough insulin. If you are testing while you are trialing the food option first, you will be safe. If any ketones appear, you will need to tell the vet and insulin would need to be started.

Keep asking questions. We are happy to help. It is possible that the high BG is only from vet stress. But this is a wake up call for you to swap to a low carb diet anyway....all cats should eat only a low carb diet. If Poppy does need insulin, make sure your vet prescribes a suitable insulin such as Lantus. Don't let him prescribe vetsulin, Caninsulin or Novolin.
Link to suitable foods.https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Link to home testing https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Bron

 

[Chris & China (GA)]

Is it possible that the complete emotional freak out she had at the vet elevated her numbers?

Yes...absolutely. Vet stress can raise the blood glucose by as much as 200 points.

Am I doing something dangerous by trying the food approach first

As long as there were no ketones in blood or urine at diagnosis, it's perfectly fine to do a diet change first. It will also give you some time to learn how to home test so you can get more accurate numbers.

On your other questions, the fact that she is so young and not showing any symptoms leads me to believe her 300 at the vet was a stressed out number and she may not be diabetic at all. By learning to home test, you'll be able to answer that question very easily.

The other option would be to take her back to the vet for a fructosamine test which gives an average blood glucose number over the past 2-3 weeks but it sounds like taking her back would be a lot more traumatic than just learning to home test. Also, IF she does end up diabetic (now or in the future) you'll be ready to test her to keep her safe.

You can use a human meter...you don't need a special pet meter. Most of us here use the Relion Prime from WalMart. It's $9 and 100 strips are $17.88. A box of lancets runs between about $2 to $12 depending on brand (which makes no difference as far as your ability to test). You do want to look for "alternate site testing" lancets which are 25-28 gauge. The Relion lancets that are marked "Thin" are 26 gauge. You don't want extra-thin or ultra-thin because they are too small for new ears. The lower gauge pokes a slightly larger hole so you're more likely to get a blood sample. Most of us freehand the lancet but you can get a lancet device if you really want one. (I couldn't see where I was poking with the device).

A package of cotton cosmetic pads is nice to have too. You can put it behind the ear so you protect your finger and then once you have your sample, you can apply pressure to help prevent bruising and to stop the bleeding.

We test on the edge of the ear (usually) but it can take time for the ears to "learn to bleed" so it's important to make sure the ear is warm before poking. A sock with some dry rice in it and then tied off makes a good way to heat the ear. Just stick it in the microwave to warm (test on your wrist to check the temp). You can also use a small pill bottle filled with warm water or a washrag rinsed in warm water and placed inside a baggie.

Keep asking questions! The people here are very generous with their time and advice. We're all in this together!

 

[Sienne and Gabby (GA)]

One additional thought....

is there a local vet who does house calls? It may not be that a house call is practical. due to Covid but it sounds like Poppy might do better if the vet is at your house versus taking Poppy to the vet. My FD cat was similarly stressed by car rides. Lining the carrier with puppy pee pads was a life saver.

 

[THH & Snowcrash (GA)]

Two thoughts:

one, if you're in the US, it may be worth looking into a "fear-free" or cat-only vet practice. You can search for one here: https://catfriendly.com/find-a-veterinarian/

otherwise I second what everyone else has already said. Switching her diet to canned only should help her blood glucose values and her weight.

Two: You may want to buy a baby scale to monitor her weight at home. It's important she lose weight very slowly.

 

[JoyBee&Ravan]

Feeding cats dry food could increase their risk of developing feline diabetes, according to new research.
https://www.diabetes.co.uk/news/201...d-increase-feline-diabetes-risk-90802694.html