New Member, Mijo may not be diabetic?

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Sweet Mijo

Sweet Mijo

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Hi, I just joined this forum in hopes of helping my 10yo kitty Mijo. I have so many questions, starting with not being clear he actually IS diabetic. Mijo was only 4.5kg weeks ago and is now down to 4.2kg. The vet has suggested putting Mijo on the (Ozempic-like) GLP-1 med for cats, I am definitely questioning that. She did NOT want to consider insulin without in-hospital glucose curve. I'll try to keep this short.

My instinct is saying 'pancreatitis' not diabetes, but does this description match up with anybody else's newly diagnosed diabetic kitty?

17Oct2024, took Mijo for a progress visit for suspected IBD/GI Lymphoma. He was treated with 1mg/day budesonide since March for suspected IBD. He weight has been stable, but seemed to be losing a little muscle. We did senior blood and urine tests, the tech commented it was very hard to draw blood from him. Not hyper-T, kidneys look fine, Calcium was low, Albumin was low, all other blood tests were in normal mid-range EXCEPT Blood glucose was 239, glucose in the urine and protein in the urine- the vet did not share the in-house urine assay numbers.
Fructosamine was not tested. Neither was cobalamin, nor folate. Test for fPL pancreas test not done. I suggested B12 shots back in March on the basis that it 'wouldn't hurt, and might help' but she refused.

So- I agreed to taper and stop the budesonide, start feeding DM, and move him towards 2 meals rather than snacking every 3 hours or so. He was a kibble fiend (Cat Chow complete, at 40%carb).
I added fortiflora, in hopes of getting ahead of any GI trouble
Now, 28Oct, his demeanor seems like a cat in moderate pain- sitting straight up, whiskers forward, ears spread and a little flat sideways, eyes squinted closed. He doesn't like the DM canned. He is enjoying Dr. Elsey's Clean Protein chicken flavor kibble, which is 4.7% carb on a dry matter basis (with the 'good' fiber). DM canned is about 12% carb on a dry matter basis. Mijo is eating about 70g of Elseys, so >250kcal/day.
I'm at my wit's end- the testing was so expensive and the most informative tests were not done!
Thanks for reading if you got this far.
 
Hi and welcome to the forum.
The best test to see if Mijo is a diabetic is a fructosamine test. That will give you the average BG from the last couple of weeks.
I would swap to a low carb canned diet if you can. It is not necessary to feed DM.
Here is a link to low carb foods. Look for 10% or under carbs. If you need to you can feed the low carb dry. It is not as good for the cat overall as canned but at least it is low carb.
FOOD CHART
And I would go back to 2 meals a day and snacks in between.

If you think he is in pain I would ask for an fPL spec test to see if he has pancreatitis. It is a separate test to the routine blood tests done.
if your vet is not willing to work with you to sort things out you might need to look for a new vet.
You might like to try Visbiome probiotics which is good for cats with IBD.

Have you thought of hometesting the blood glucose to see if it is high or normal?
If the fructosaine test comes back she is a diabetic I would look into that if I were you. We can help you with that.
I would also follow up in the protein in the urine.
Keep asking Questions. :)
Bron
 
Thank you for your reply and suggestions! I think a confounding factor is the budesonide, though it should not have systemic effects to the extent of prednisolone, it can interfere with insulin function. I'll have to research how long it stays before total washout- it should not take long, only a few days I expect. It's probably gone by now.

Yes I agree I want him on canned, he just likes the dry better. He can always have some of the canned pate I give the other kitties- it is very low carb, no gravies. I give the other kitties their canned food on the floor, and put Mijo up on the counter with his Elsey's so the others won't steal it. He can jump down and eat the canned when he wants. I feed at 6:30am, noon, 4-5pm, and half portion at about 8pm. It's a full time job around here! I'm trying to lighten the noon, and eliminate the 8pm, and have almost done that 100%.

What home blood test meter would you recommend? I'd be willing to try that, I have some related experience giving SQ fluids, doing keto testing on myself when I was dieting..
I asked vet about home testing and she told me I needed the alphatrak vet test and strips, that a human setup would not work. I've read things to the contrary, so now I'm uncertain. The alphatrak test strips are pricey compared to human versions. She also mentioned possibly putting a continuous monitor that's good for 2 weeks. Mijo is an anxious boy, so I'm not sure if he will tolerate an implantable.

As for the GLP-1 oral meds, I've read some research and I'm not finding any positive studies other than those where the cat was overweight to start, so those were not especially convincing. Mijo does NOT need weight loss! I'll try to upload one of the papers I found over the weekend, in case you're interested.

I haven't been very satisfied with the vet office anyway given some unrelated experiences, and I've been asking locals again for a better vet. The pandemic made most of the best vets retire, leave the area, or change practice from routine to emergency or teaching etc.
thanks again for your guidance, I see from your signature line you've gone through this wringer too.
oops, I see I don't have permissions to upload the file.
 
We have cats here that use budesonide and it doesn’t affect the BG. If he needs it please give it and we can work around it.
Feeding 2 main meals and snacks during the day and evening is the way to go for all cats, whether diabetic or not. That’s what I do for my cats. They are happier and never bother me for food.

Don’t bother with the alpha meter. It is not necessary and is a lot more expensive to run than human meters. Our dosing methods are based on human meters. Some cats do have the libre freestyle for 2 weeks ( that’s a human meter). It’s good when the caregiver is learning to test if they are having any trouble but it is not cheap and can sometimes stop after a few days. But that’s up to you if you want to try it. I’d get the fructosamine test done first to see if he is actually is a diabetic. That test will test you different he is or not.

If you want to upload a file just copy and paste it. The ‘upload a file’ Is not working.
 
Thank you again.
The vet does not want to approve Rx for continuing budesonide, we already went around in circles on that.
I will do the feeding as you advise.
I agree fructosamine assay makes most sense as a next step.
I will keep close watch to see if he is looking painful more often than not, or if it is correlated with eating/not eating etc. Thank God his appetite is holding steady. I do have some mirtazapine if that becomes an issue.

The paper is large to copy and paste, here is a link out to the Elsevier publication; it's outside their paywall. The URL may look strange because it is from University of Zurich (the uzh.ch ) https://www.zora.uzh.ch/id/eprint/260931/1/ZORA260931.pdf
 
Bron and Sheba (GA) said:
It says I don’t have permission to access the link. :(
Click to expand...

I can't seem to get the printed document to copy, maybe the pdf is copy protected. The Elsevier embargo period is over, and you should be able to view print etc the article here-
https://www.sciencedirect.com/science/article/pii/S0739724024000328?via=ihub
This is the landing site of link listed on the U of Zurich Open Repository website

Maybe easier to go to the U of Zurich Open Repository here: https://www.zora.uzh.ch/
enter into search box: Incretin therapy in feline diabetes mellitus A review of the current state of research
The paper from Haller, Nina from 2024 is the first one listed when I do that.

Sorry for the complications, there are various ways to export and share via email, X, facebook etc, but apparently you can't copy the pdf!
 
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