Hi Jill,
we got this cat almost three years ago. He was diagnosed at 7 months of age. No vet has ever seen this and no one seems to understand how to treat it. This does not work like Type 2.
I've seen posts by one member here whose kitty, Michelangelo, was diagnosed diabetic when he was a baby and, IIRC, she faced certain unusual treatment challenges. I believe that when she changed his insulin to Levemir he did much better. Try doing a forum search for posts by member
@KPassa. (It may require a lot of digging but you may find information in Kay's posts to help you and your little one.)
They did a curve on him and his fasting a.m. blood sugar was about 378. By 4 pm it was 40. I know that tight control is the way to go. I simply don't know what to do. I cannot keep weight on this cat.
It can be trickier to regulate an underweight cat because of wide swings like this because the body doesn't have the usual reserves to increase blood glucose levels if needed. The low drops can make it more difficult to find a dose that keeps the kitty regulated but which doesn't also make it drop too low. I've seen advice from some very experienced members here that low- or ultra-low-carb diets can make getting enough insulin into an underweight kitty more difficult. Member
@Marje and Gracie recently suggested that feeding a diet closer to the 10% calories from carbs mark may be better for a particular underweight kitty who had similar BG swings to your little one. Member
@Meya14 has also posted here that it can be easier for a kitty with a little more carbs in their diet to be able to more safely receive sufficient insulin for their needs and, due to the way that they're metabolised, the additional carbs may help a kitty to regain weight a bit faster.
As with others above, I agree with the second vet's advice about feeding: the general recommendation is not to restrict access to food (with the exception of the 2-hour period immediately prior to each preshot BG test) if a cat is underweight and not yet well-regulated.
Question: I see the vets performed the latest curve. Do you monitor your kitty's blood glucose levels at home at all? If yes, can you please let us know how frequently you test and when (preshot / mid-cycle tests?).
He soils outside the box.
Is there any weakness in his legs? For example: does not jump up onto things as much as before, or is hesitant about it; seems even slightly 'flat-footed'; walking on hocks (more noticeable with hind legs).
If yes to any of the above, then diabetic neuropathy may be the issue (although inappropriate elimination may happen when a cat is just running in high numbers). Neuropathy improves with better regulation and also dietary supplementation with a diabetic-friendly B12 methylcobalamin supplement, e.g. Zobaline (available online). I've made this suggestion because we do see cats with neuropathy here who have problems with inappropriate elimination - even when neuropathy symptoms are relatively mild and hard to spot unless one is actually looking for them - but the behaviour goes away when regulation improves and the neuropathy resolves. Tip: if you're not already using them, puppy pads can be a godsend in situations like this.
The vet actually told me he was comfortable with a blood sugar well over 300. Can you believe that?
Sadly, yes. Hence FDMB.
Mogs
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