New to diabetes, and this board

[tizercat]

Hello. I'm new here, and even though I work as a lab tech at a vet clinic, now that it's my kitty who's sick all my usual professional calm and common sense have flown out the window. This board looks extremely helpful and I wanted to introduce myself and my newly-diagnosed sugarcat.

My cat, Tizer, is 10 years old and suffers from IBD. He's been treated for it with 5mg prednisolone BID and and 8mg maropitant (Cerenia) EOD for 6 months now, which has been the only combination that controls his vomiting in particular. Whenever we've tried to decrease the pred or discontinue the maropitant he starts vomiting again. He also suffers from osteoarthritis in his spine, which I treat with laser therapy. He's been doing really well, and I had no complaints regarding his health for the last couple months... until I took him to work with me last week for a laser treatment.

When I brought him into the clinic, one of my coworkers looked at him and declared "What's wrong with Tizer? He looks yellow." I immediately panicked and said "He does?! OMG... draw blood right now, let's do a total body panel" even though he looked like his normal self to me. Being a lab tech, I tend to immediately respond to things with "test test test". Even though Tizer had bloodwork done in May that was all perfectly normal, I pulled out the big guns and had a complete blood and urine profile run. His blood was, just like in May, perfectly normal except for a slightly elevated BG (8.8 mmol/L, or 158 mg/dL) which I didn't worry about since cats often have slightly elevated BG when they're stressed, and Tizer hates blood draws. He didn't have any urine in his bladder on ultrasound, so I gave him some SQ fluids and let him chill in a kennel for an hour while the blood was processed. When we tested his urine however, there was glucose present. Odd... but maybe he's just really stressed, right? I mean, urine glucose isn't usually affected by stress-induced hyperglycemia, but maybe... I decided to take him home, wait a couple days, and get a urine sample at home with collection litter to test with no stress. And order a fructosamine test, which came back normal.

I have 2 cats, so convincing Tizer to use the collection sand litterbox and keeping Wigwam out of it ended up taking a while and it was a week later before I took another urine sample to work. Stress-free, it still showed moderate glucosuria. During a bit of a "duh" moment, the vet and I were discussing him yesterday when she suddenly said "wait... he's on pred isn't he?" Oh yeah... maybe it's not so surprising that my always-normal, not overweight, not pu/pd kitty is having sugar issues. Right now we're being very conservative in our treatment.

We aren't starting him on insulin yet. We're going to try to decrease the pred again to 2.5mg BID and treat him for Helicobacter since I haven't done a therapeutic trial for it before. I'm monitoring his urine glucose at home with Purina Glucotest strips, and on Tuesday I plan on doing a 12 hour curve since I have the day off and can borrow a glucometer from work. Depending on how Tuesday goes, we'll format the next step. This all seemed reasonable when I was discussing it with the vet at work yesterday, though of course today I'm thinking "I need to take him to work with me today and do a curve NOW and start insulin and change his diet (he's currently on MediCal/Royal Canin Gastrointenstinal Moderate Calorie dry and and High Energy canned because of the IBD) and and and" My borrowed glucometer last night showed him with a BG of 9.4 mmol/L (169 mg/dL) immediately after he finished his dinner. I made myself not test him this morning and I'm taking the glucometer back to work today since I can't keep it indefinitely and have already made arrangements to have it Tuesday.

Must not panic. He's showing no symptoms and his BG isn't astronomical. He's acting like his normal self, though we still don't know why he looks kind of yellow since his liver values are all perfectly normal. If he was anyone else's cat, I would be perfectly relaxed right now. But he's my baby. And I may have done this to him. The risk of pred seemed minimal when I chose to try it out, and truthfully, diabetes is better than him vomiting every day, every time he eats but... I still may have done this to him. Poor Tiz.

 

[Vicky & Gandalf (GA) & Murrlin]

Thank you for all the wonderful detail in your introductory post!

His BG values are not really high enough to warrant insulin management at this time. Many people here have had great success with a diet change, with or without using insulin.

Since Tizer has IBD you are kind of stuck between a rock and a hard place. A diet change is probably going to disrupt his system, but his current diet is very poor for any cat. I know, I know it's a "veterinary diet." Most of us here say "whoop-dee-do" to those, especially thanks to this vet and her website, Dr. Lisa Pierson, http://www.catinfo.org

The first ingredients of his current dry food are as follows: Chicken meal, chicken fat, brown rice, corn gluten meal, rice, wheat gluten The ones I have italicized are inappropriate for an obligate carnivore to start with and fuel to the fire of his growing intolerance for carbohydrates, which results in elevated BGs. And wheat gluten can be an allergen for some cats, in addition to being a poor source of protein.

I hope you will read through Dr. Lisa's website and consider getting Tizer on a species appropriate diet, and please consider raw food, either pre-made or make your own. The positive experiences among those who have used raw food for IBD kitties outweighs any bacterial threat which your vet or the pet food nutritionists can claim. Changing his food to something more species appropriate may also allow you to stop the prednisolone, which is only playing a part in his elevated BGs, it is not the sole culprit given his current diet.

Have you run a bile acids test on his liver? I would not rule out liver problems if you have not.

Another item you might add to your list of osteoarthritis treatment is B12 injections. It is helpful with IBD as well.

:YMHUG: We understand it's hard when it's your baby who is hurting. The wealth of experience you will find here can help you help Tizer, I'm very glad you found us! flip_cat

 

[tuckers mom]

Hi and welcome.

I can't add to what Vicky already wrote except maybe to encourage you to get your own glucometer and that way you can check him whenever you want and maybe feel a little more at ease. We use human glucometers and I've brought mine to the clinic and it's so close to the vet's that I'm fine with using it and trust the numbers.

 

[KSAkitties]

Welcome to FDMB!

Like Vicky said Tizer's BG number is not too bad but I would keep a close eye so the numbers don't keep going up. A low carb, grain free, wet food diet may help bring his BG back to a more normal range AND help with his IBD. His current diet (MediCal/Royal Canin Gastrointenstinal Moderate Calorie dry and and High Energy canned food) is really not good.

I have two IBD kitties. Both of my IBD kitties are now doing well after I changed their diet to raw and started giving them injectiable B12 (1000mcg/ml which you can get at any pharmacy in Canada without a prescription. Make sure it's Cyanocobalamin B12 not Methyl B12) once a week. I didn't want to put my kitties on prednisolone so I opted the diet change, and it's working.

This is the B12 protocol I follow:
http://vetmed.tamu.edu/gilab/research/cobalamin-information#dosing

After doing lots of tests including two ultrasound, we found out that one of my IBD kitties has intolerance to chicken, turkey, beef, and lamb. He is currently on rabbit and pork diet. His IBD (symptoms: diarrhea and vomiting) was primarily caused by food intolerance. If you want to know whether or not Tizer also has food intolerance which is causing him to vomit, please send me a private message. I can give you more details on where to get the test done. It's a simple fur sample test. We did the traditional food allergy test (blood test) but the results were inconclusive.

My other IBD kitty (symptom: diarrhea) has intolerence to grains.

Here's a website with lots of good info on caring for IBD kitties: http://www.ibdkitties.net
The website owner, Lisa has poured her heart and soul to put the site together, and she is always willing to help another IBD kitty.

One of my IBD kitties has elevated BG if he has IBD flareup even before his IBD symptoms show up.

BTW, Pet's West pet food store in Broadmead Village in Victoria (http://www.petswest.ca/) has a very good selection of canned food and pre-made raw food for cats. If you are not quite ready to make your own raw food, then you may want to try the pre-made raw food. I used to visit Victoria a lot so I had done some research on pet food stores and veterinary clinics in Victoria. As sad as it may sound, my 'must visit' touristy destinations are local pet food stores and pharmacy whenever I visit a new place. If I can check out the local veterinary clinics, that will make my trip even better!

 

[Karen & Angus(GA)]

Welcome! How was the IBD diagnosed? Are the liver and pancreas involved as well? If not, you might try changing from prednisolone to budesonide. It is suppose to have less side effects outside of the digestive tract.

I have an IBD kitty with cholangiohepatitis and helicobacter diagnosed by biopsies. We tried several combinations of antibiotics and acid reducers to eliminate the helicobacter without success. Her IM specialist told me most cats have a recurrence of the heliocobacter within 6 months even if the treatment is successful, so we gave up on the a/bs and started prednisolone. Because the of liver involvement, she has to stay on prednisolone. I make sure she gets low carb, canned food only. Even so, her BG is climbing. But, of the two, diabetes is the easier to treat. Angus was my diabetic and did great on PZI for 4 1/2 years. He died of lymphoma, totally unrelated to his diabetes.

 

[tizercat]

Thanks so much for all of the welcomes and replies. As I mentioned, I logically *know* a lot of stuff about feline diabetes because of my job and if it was anyone else's cat in my Tizer's place right now I'd be totally relaxed and calm about everything. But he's my baby and therefore I'm feeling a bit of "must make everything perfect and back to normal immediately!" I'll try to answer a couple of questions that were asked.

Tizer's IBD was diagnosed (technically, it's a working diagnosis) after blood work, including fPLi, cobalamine, folate, TLI, and pre/postprandial bile acids, radiographs including a barium study, abdominal ultrasound, and a few diet trials which were all strictly adhered to for a minimum of 3 months. I haven't done biopsies on him and don't intend to at this point. It's been well-managed with 5mg prednisolone BID and 8mg maropitant EOD, though I've recently begun vit B12 injections weekly (which are now switching to monthly). He's also been on famotidine, omeprazole, metoclopramide and ranitidine to try to control it but they all had limited effects. One of the options that my vet and I may pursue after we've done a therapeutic trial for Helicobacter with amoxicillin, metronidazole, and clarithromycin is switching him to budesonide instead of the pred. In the meantime I'm decreasing the pred to 2.5mg BID and monitoring his IBD symptoms. Another of the options is adding leukeron to his treatment plan, either with the pred or while still switching to budesonide. I've already switched him to all canned food instead of a combo of canned and kibble (yay for guarantees that let me return the bag of kibble that I just bought and opened!) I'm really hopeful that it will be enough to regulate his sugar, since I know (again, logically if not emotionally) his BG levels are very minimally elevated right now. I'm hoping to get a glucometer of my own soon, though finances are a bit of an issue, and I'm borrowing one to do a home curve tomorrow so I can get a picture of what his sugar does throughout the day.

I'm trying to look at Tizer logically and professionally. The cats and dogs I see at work all come in with BG values >20mmol/L and Tizer's so far not even reached 10. If it wasn't for the fact that he's been sitting on my lap half-asleep when I tested him I'd put it down completely to stress hyperglycemia and not even think about it. His urine glucose has also only been in the moderate range, and the animals I see at work are always in the extreme range. Of course, I'm now noticing every time he's sleeping and thinking "is he being lethargic?!" instead of thinking "awww, he's so cute" like I usually do. Thank goodness for that post from our kitties telling us to relax!

Thanks again for the warm welcome!

 

[Carl & Polly & Bob (GA)]

Have you seen the sticky thread on the index page titled " newbie kits"? Lori can set you up with a meter and test strips along with other items to get you started with home testing.
Welcome to the family!
Carl