? NEW - Neuro Symptoms - Phoebe - Diagnosed 10/23 - not sure what to do

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Maggie&Phoebe

Maggie&Phoebe

Member Since 2020
Hello All (and sorry this is so long) -

In September we returned from a weekend away and noticed that Phoebe (11 yr old, spayed) had lost a fair amount of weight (i suspect it had been happening gradually, and we just weren't seeing it since we see her everyday). I also noticed that she was drinking a lot more, and seemed lethargic. We set a vet appointment, but unfortunately, my vet office books 3 weeks out pretty regularly. We managed to get an appointment 10/21. Vet reported that she had lost 5 lbs since her last appointment in 2018 (13 down to 8.9) and did a full blood and urine panel. On 10/23 the vet left me a voicemail and sent me her test results. He said that she had diabetes and said we could reconnect on Monday, but that i should "look into getting some Lantus."

On Sunday, I was feeding her again, she ate (FF fishy pate) and then almost immediately fell over, yowled for about 20 seconds, and then "zoned out" for about 10 minutes. By 'zoned out' I mean that her eyes were open but she was completely non-responsive, didn't react to us calling her name, or petting her. She came out of it about 15 minutes later. I freaked and brought her to the ER vet. She was hospitalized overnight and they started her on insulin. They said she had low levels of ketones in her urine (which weren't present on her tests on 10/21). We brought her home on Monday and were told to give her 1 unit of Lantus 2x per day. We were also told that we should only be feeding her twice a day.

I have read through a lot of posts, and I know that we should be testing her BG at home, but this is all very new to us, so I wanted to get a handle on the insulin injections before attempting the BG sticks too.

I've already disregarded the feeding twice per day thing as it's almost impossible to get her to eat more than 1/4 c of wet food at a time - she just won't. So i've been doing 1/2 a can before her insulin shots (as much as she will eat) and then reserving it to feed her the leftovers later, with a little DM kibble added in. She's bounced back a little personality wise, but we are noticing that she's fairly wobbly (not a new symptom, but a continuing symptom) and are worried that we are missing something or should be doing something differently.

I'm concerned about ensuring she gets enough calories and also don't want to spike her BG by feeding her too much or at the wrong times. Her previous diet was free feeding Science Diet C/D dry and 1 or 2 servings of UR wet food per day. She has an oxylate crystal problem and had bladder surgery to remove stones in 2018. At that point her diet was free feeding iams hairball dry and 1 to 2 servings of fancy feast wet per day. Should I be feeding her even more frequently than I am? I know the dry isn't great for her, but it's a quick way to get her calories, and she really likes to eat it - is it folly to give it to her?

I'm also struggling with how to adjust the feeding situation for my boys, who are both healthy, and are suddenly having to adjust away from free feeding to a more regimented meal situation - and getting them enough food, since one is a scarf and barfer, and the other is a chunky 15 lbs (and should be getting at least 3 cans of FF a day).

Any advice would be appreciated.
 
WELCOME TO FDMB Maggie and Phoebe. Sounds like its a good thing you found us. First off a diabetic cat is NOT peroperly metabolizing her food properly thats why shes hungry all the time. The Vet tell you to feed only twice a day to make sure she doesnt hypo from insulin and no food. Well Phoebe needs BOTH food and insulin that will keep her ketones down. Did you buy any ketostix? If not that is a number one thing you need to have on hand. Since shes been hospitalized for ketones she now prone to them. Food and insulin is the remedy to keytones. We recommend seeding two main meals with snacks in between those meals
Lantus is an excellent insulin for cats.
I'm going to tag some people to come help as I need to get dinner started
@Diane Tyler's Mom
[USER=28971]@Aleluia Grugru & Minnie
@Deb & Wink

Please keep checking you DO NEED more information.

WELCOME TO OUR FAMILY:bighug:[/USER]
 
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You sure have a lot to cope with. This is a great place to find help. My Oliver also dropped a lot of weight and started peeing more and drinking more before I noticed and got him to the vet for a diagnosis. I had to separate my diabetic cat from my other one at first (long story). The two cats no longer share the same litter box or night-time space or food. With a bit of creativity you will be surprised how things will work out. Hang in there! Problems will get solved one by one. I think you are wise to master injections before testing blood glucose. Lots of learning curves here. Listen to your gut instinct and do what works for you. If you get stuck, ask. Lots of helpful folk are in this forum.

You asked about feeding. Every cat and owner is different. I switched Oliver to Fancy Feast Classic Pate from Kirkland dry. I trained him to ring a bell when he wants to eat so that's one less decision I have to make and so far it's working well. Oliver has gained 1 full pound back! And the other cat--who is fat and like yours he's a scarf & barfer--has lost a pound because I let him lick Oliver's bowls and give him bits here and there. He has an automatic feeding machine with dry food but would rather beg for Oliver's Fancy Feast now.

Oliver now never visits the automatic feeder because he loves Fancy Feast. Oliver also loves his Breeze litter box and never goes near the old ones, which are still used by the other cat (who by the way has never even looked at Oliver's new Breeze box. Go figure! Everything is working out.

Good luck!
 
I'm just feeding Phoebe her evening meal in preparation for giving her the second insulin shot. She is eating for a little bit and then shaking her head, which caused her to fall over (this happened each successive time she ate). She is also trying to hide. She tried to jump on the bed and couldn't make it so she fell off the bed side table. I don't know what to do. My gut is saying not to give her her shot, but I'm not sure and I'm pretty freaked out. As I said, she has been wobbly, but it hasn't been this bad. She had her last insulin at 8:40AM CST, a snack at about 12 and a snack at about 7PM (a couple kibble). She just ate (in 3 phases) about 1/3 a can of FF with 3ish Temptations.

I don't know if I'm over-reacting or if this is really serious.
 
This could potentially be diabetic ketoacidosis (DKA) which is very very serious. The low levels of ketones noted at the vet previously could have increased as her diabetes is not yet regulated. Withholding insulin is not what you’d want to be doing if this is the case. I would get her to the vet.
 
That’s the most urgent bit - as far as feeding times. Vyktor was always free fed wet food and remained free fed on wet food when he became diabetic and went on lantus. This is no problem at all. When you’re home testing you need to remove the food two hours prior to shot time to make sure you get a non food influenced BG test so you know if it’s safe to shoot. I think even before you’re home testing it would be a good idea to get into that habit. This will also help make sure she’s got an appetite for after the shot.

As for dry food it really isn’t good for her but since you’ve started the insulin before you’ve started home testing it’s best to keep giving it to her for now. Removal of dry food can reduce insulin needs significantly so you want to be home testing to catch that if it happens.
 
Sorry everybody - i think she was actually hypo last night and that was the problem. I did call the ER vet and have two lengthy conversations with the vet tech. They said if we were comfortable monitoring her at home, we could, but if things got worse, we needed to come in.

She is doing significantly better this morning after reintroducing her old HC dry food and a hit of HC wet food. Her mobility is better and she's used the box a couple of times. I think the issue is that the vet was not clear that she needs to have a pretty significant chunk of her calories before we give the first shot of the day, which we were not doing. If she is supposed to be eating 200kcals a day, we were getting her to consume maybe 30 before shooting, which clearly isn't enough and is probably a big reason why she was having these symptoms.

The feeding situation is going to be very difficult because since she is absolutely a grazer - she eats little bits over time (unlike my boys who will mow down as much wet food as we put in front of them). I'm going to get a meter today so I can start testing her at home. I'm not giving her anymore insulin until I know what her sugars are at before I shoot her.
 
Lantus doesn’t kick in until +2 so I don’t understand the need for that many calories early. Most of us feed many small meals during the first half of the cycle because it has a slow onset. That advice is for other fast acting insulin. I believe what’s happening is more food is needed at +2 and +3. It makes no sense to need high carb food. If that’s the case the dose is too high.
 
I think many of the things we've been told by the vet weren't exactly correct.

I made a mistake and shifted to all LC food while starting insulin AND not testing at home. And as I'm hearing from folks, the LC diet can resolve some of the high BG on it's own, meaning 1 unit 2x per day was/is too much.

I talked through giving her back her HC dry food and giving her some HC wet food while she was at her worst last night trying to get her symptoms to abate with folks on the other thread. I am leaving the dry food out for her to graze, but fed FF pate wet food this morning. I'm going now to get a meter and supplies so I can test her and figure out what is happening.

I'm infuriated that we spent close to $1000 at the vet and were given such bad advice (i.e. feed her only 2x per, shortly before her shot; don't worry about BG testing at home for now; 1 unit is such a low dose, you shouldn't have a problem) - when I spoke to the ER tech last night, she made it more clear that it's most important that Phoebe is eating, whatever and whenever it is. I can't force feed my cat larger meals - she just won't eat them. So I'm a little stuck at the moment. I'm hoping i can get some luck with testing her at home and that will relieve some of my (obviously warranted) anxiety about all of this.
 
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