New to this forum, steroid-induced diabetic boy

imcguigan

imcguigan

Member Since 2026
Wow so I'm overwhelmed.

This morning I thought I'd lose my cat. I'm currently in the overwhelming process of what to do. He barely wants to eat.

Anyway hello, I'm new here. I have my 19 year old man, Riku, who has IBD/suspected small cell lymphoma. He's allergic to chicken/turkey and hates fish, beef, and venison.

He started prednisolone in August and as of today was diagnosed with steroid induced diabetes and needs to be stabilized via hydration, consistent eating, and insulin before we taper his steroids off.

I'm very overwhelmed, I've had HCM/hyperthyroid/CKD cats but never diabetic cats. So I'm in the process of learning about diabetes in cats and ended up here.

I can barely get him to eat but vet said he needs start insulin, but he also needs antibiotic too to rid of his UTI he got, but also needs pred because he can't suddenly stop..... he's uncomfortable and doesn't want to really eat. as you can see I'm, like many here, overwhelmed.

I hope to learn from here and try and make it less overwhelming


  • Riku, 19 (2008), male
  • Diagnosed 10/26/26, steroid-induced (pred for IBD/SCL)
  • Generic Lantus
  • Are you hometesting? I hope to do it for data
    • Human - Accu-Chek Guide
    • How often do you test kitty's blood glucose? - Plan on before big meals and 2 other times in the day but I'm new so it's a WIP
  • Has kitty experienced any complications from diabetes? YES:
    • Polyuria or PU (urinating a lot)
    • Polydipsia or PD (drinking a lot)
    • SUGAR in urine
    • Neuropathy (difficulty walking on hind legs/feet)
    • Nephropathy/CRF (kidney involvement)
    • Pot belly
    • Muscle loss in spine and back legs
  • Is kitty currently taking any other medications or supplements? Pred - 5.5mg/SID, as needed: ondansetron, appetite stimulant
  • Does kitty have any health issues (current or in the past)? IBD/suspected SCL
  • Has kitty ever taken corticosteroids? PRED
  • Food: What are you currently feeding kitty?
    • Both wet and dry foods. He's very picky so at the moment he's eating RC selected protein PR, but he's not stable as of 10/2026, so I can't change his food quite yet I don't want to add too much stress to his body
  • Other information:
    • Allergic to chicken/turkey
    • Hates beef and fish
    • Tried maybe every clean limited ingredient wet food OtC and he either A: didn't like it or B: had an IBD flare up. In process of trying KOHA limited ingredient
    • Goal I think is to transition to Budesonide and see how he does and maybe add tyrosine or something to help the budesonide help his IBD
    • Hoping once he's off pred his sugar levels drop too
Riku's Sheet
 
Last edited:
Hello and welcome. Sounds like you've got a lot to deal with. My Neko started out diabetic and added CKD, HCM, and probably SCL to the mix and once I learned enough about diabetes, I found it easier to handle. However, there's quite a bit to learn to start. Which is why so many of us stick around. We remember what it was like to start.

Let's start with the diabetes stuff. What insulin is your vet suggesting? Are you open to home testing his blood sugars? Knowing what your cat's blood sugar are, how they respond to insulin and food goes a long way to feeling more comfortable handling the diabetes.

Since you mention lethargy and inappetance, are you home testing him for ketones? You can do urine dipstick testing or blood ketones meters. Were there any ketones detected in him at the vet? The presence of ketones can be an early warning sign that can help prevent DKA. Which is treatable but you have to get right on it. Fluids will help flush out ketones.

Some tips about how to help the appetite: Suggestions on How to Stimulate Kitty's Appetite. Do you think your cat is feeling nausea? Would the vet prescribe ondansetron for you to give? I like it best for treating nausea. With the antibiotic, you should probably add a probiotic into the mix, to replace the good bacteria.

I've also got experience with cats with small cell lymphoma (SCL) and one with SCL and IBD. Ideally you do want to be feeding diabetics low carb food under 10% carbs. None of the vet food fits that criteria. Does Riku like lamb or rabbit or pork? What country are you in? We may be able to suggest options. My IBD girl wasn't fond of the Koha (fish and beef allergy) because she didn't like anything with green lipped mussels in it.

My diabetic Neko went on budesonide, cause her heart condition could not handle prednisolone. Budesonide did not impact her blood sugars, though it does for some. My other SCL kitties were on prednisolone and thankfully it did not impact their blood sugars.
 
Wendy&Neko said:
Hello and welcome. Sounds like you've got a lot to deal with. My Neko started out diabetic and added CKD, HCM, and probably SCL to the mix and once I learned enough about diabetes, I found it easier to handle. However, there's quite a bit to learn to start. Which is why so many of us stick around. We remember what it was like to start.

Let's start with the diabetes stuff. What insulin is your vet suggesting? Are you open to home testing his blood sugars? Knowing what your cat's blood sugar are, how they respond to insulin and food goes a long way to feeling more comfortable handling the diabetes.

Since you mention lethargy and inappetance, are you home testing him for ketones? You can do urine dipstick testing or blood ketones meters. Were there any ketones detected in him at the vet? The presence of ketones can be an early warning sign that can help prevent DKA. Which is treatable but you have to get right on it. Fluids will help flush out ketones.

Some tips about how to help the appetite: Suggestions on How to Stimulate Kitty's Appetite. Do you think your cat is feeling nausea? Would the vet prescribe ondansetron for you to give? I like it best for treating nausea. With the antibiotic, you should probably add a probiotic into the mix, to replace the good bacteria.

I've also got experience with cats with small cell lymphoma (SCL) and one with SCL and IBD. Ideally you do want to be feeding diabetics low carb food under 10% carbs. None of the vet food fits that criteria. Does Riku like lamb or rabbit or pork? What country are you in? We may be able to suggest options. My IBD girl wasn't fond of the Koha (fish and beef allergy) because she didn't like anything with green lipped mussels in it.

My diabetic Neko went on budesonide, cause her heart condition could not handle prednisolone. Budesonide did not impact her blood sugars, though it does for some. My other SCL kitties were on prednisolone and thankfully it did not impact their blood sugars.
Click to expand...
Hello! Yeah, my last kitty was HCM/CKD/HyperT/Arthritic and ended up with large cell lymphoma, so I have a good handle on all of those ailments, but diabetes is a new realm for me. I have been doing the readings, set up his sheet, and am trying to learn how to poke him to test, but that is a work in progress. I really am glad so many of you stick around and help people like us who are overwhelmed and scared that we are going to lose our babies! It's amazing, I am already learning so much.

He is starting Lantus since I found this forum and saw it was recommended, the vet that saw him yesterday isn't his normal vet since it was urgent. She didn't seem to know much about diabetes, and like the intro guide said, she gave me insulin and put me on my way. Told me I didn't need to measure and we'd do a curve next week, but I was reading and I agree, doing it at home would be waaayyy better! I want to do home testing but I am struggling right now to poke his paw: seems too thick and his ear: sweet spot didn't really give me much but I am using standard lancets not the big ones. Even with rice sock I didn't get a drop, paw I got a bit but not enough for the strip.

Yesterday at the vet his fasting BG was 293 and last night at the ER it was 457. I gave him his first unit this morning, vet wants me to start 1u every 12hrs and see how he does. Ideally I would like to test his BG 4 times a day

He was tested twice for ketones, both negative. My at home urine dipstick also was negative, I plan on getting the meter that this forum suggests. I was told that we caught things early and a UTI is what is driving this worse. He had fluids yesterday and I am giving another 100ml Thursday. He is on Clavimoxx for his UTI as of today so hoping that also gets him peeing less. I posted his labs on his sheet, its clear his pancreas and bladder are angry!

He is nauseous and while I do liquid compound Ondansetron as needed, I am thjinking he may benefit from twice a day. I am wondering if he would benefit from injectable Ondansetron over liquid since liquid may not be absorbed with his GI inflammation. I am not sure what probiotic to use since he is IBD and constipated but the antibiotics will give him diarrhea here any day now. I am hoping once he is stable he can get off his Pred and go to Budesonide + probiotic (hoping to avoid chlorambucil if I can) but vet said we cannot talk about that until his BG is stable, he is eating, hydrated, and his UTI is gone.

He is veeerrryyy picky about his food. Lamb is too tough, pork I tried all the OtC stuff and his gut cant keep it down but I think it's the gums more than anything - he liked FIrstMate Pork for a bit but I dont think his GI could process it, unfortunately. I am in the US. He is trying KOHA duck right now but I am not sure if he doesnt like it or he just doesnt feel good and doesn't want it since right now all he will eat is pork baby food. I am hoping once he is stable he can be like your Neko and try Budesonide to get his sugars down and keep his gut in check.
 
Have you tried ear testing? Lots of tips and videos here: Hometesting Links and Tips Starting with the small number but bigger lancets like the 26 or 28 will really help. Their ears do learn to bleed over time, so it can be frustrating at first. Warming the ears and a very small smear of Vaseline helped me. Black ears meant the blood became almost invisible.

The 1 unit is a good start given that you are feeding high carb food.

Ondansetron doesn't last long in the cat. You can give the oral meds up to 3-4 times per day. Some people do injectable cause it's easier in a cat not wanting to eat. But it does sting in some cats. Injectable dosing is half that of the oral.

Visbiome was my go-to for IBD probiotic. For diarrhea, s. boulardii can help. You can give both, s. boulardii is a probiotic fungus and can be given at the same time as the antibiotic, unlike regular probiotics which should be separated in time from the antibiotic. More info, including dosing, on s. boulardii here: Probiotics – IBDKitties

I've done the chlorambucil in three cats now. Can't say I miss it. 🤣 Or the temporary nausea it causes.

Which lamb did you try? I was feeding the Nature's Variety Instinct watered down. Lots of oral water is good for diabetics anyway. I also tried Canada Fresh lamb and I know that Identity has some and I think it is softer. Rabbit was the fav with my IBD girl. Good luck finding a food he likes and cat eat. It is frustrating until you figure it out.
 
We tried for the first time this evening, we weren't too successful since he moved around but we got a paw. I think with practice and like you said, the ear learns, we will get it! The vaseline trick you suggested helped. We are going to try poking from the back next time, he didnt like when I did it from the front and had to bend his ear back. I got some blood but it spread across since he got impatient. I also found it easier to just poke his ear with the lancet myself.

For poking, I did see in a post somewhere that putting cream on it to help with soreness is a thing. Because if I have to poke him ~5-7 times a day on the ears, wont the ears get sore and he get tired of all the poking?

So we did 1 unit in the am but I noticed at his pre-shot before his 6pm meal, it went down to 110. So we didn't give him his dose. Is it better to do 1u in the AM and not do it in the PM if his sugar is good, or if it becomes consistent, transition to 0.5u in the morning and 0.5u in the afternoon? I hope I worded that correctly. My fear is if he only ends up needing insulin 1x a day, would that risk too many ups and downs, rather than a nice consistent level through the day that 2x a day gives?

I will mention injectable, my last cat didnt tolerate it so she did oral. I wonder if he would prefer injectable, I will ask his vet next week if he can try it. That and Visbiome. I don't want to change too much all at once.

He did beg for food today so it seems the insulin is helping! Probably feels better being at 110 sugar and not 450. Haha.

We tried almost every brand of lamb but I found a new one today from Feline Natural. I also picked up the venison for him to try. Seems good since theres no oils, gums, or random filler. He ate it up real good! He prefers rabbit but I bought every rabbit and it seems I am finding out his gut hates gums and oils (has me wondering is he ACTUALLY allergic to chicken or is it the BS they add to the food since I never tried just chicken).

Anyway, he actually asked for food today so its already improvement. Sugar went down from ~450 not fasted and ~290 fasted down to the 100s so he actually asked for food, ate his food, and purred like a motor. For some reason his vet is very hesitant and not optimistic about budesonide as alternative for pred but we shall see.
 
Lantus does best with two shots a day, it doesn't last 24 hours in cats like it does in humans. If you keep getting numbers too low to shoot, best to reduce the dose and give two shots a day.

You reminded me that I did try the Feline Natural lamb too. Back in the day, it wasn't just lamb but had chicken in it too. Have you tried plain baked or boiled chicken? If he's good with it, you can always use it for test treat rewards.

Begging for food is a great sign!

Regarding testing, well done! Some people put the blood on their fingernail, and test if from there. That works if kitty is squirmy after the poke. Do try to hold the poke spot for 15 or so seconds after. That little bit of pressure will help. The cream you might have seen mentioned is Emla, I think you get it from the vet. My cat never got tired of testing once she realized it resulted in a treat. She even got to the point of walking over to where I kept the test kit when she was feeling low sometimes. And sometimes not low, just wanted a treat. 🤣
 
If he does get his appetite back, you might try a small carb free treat to help associate the testing with something good. Crowley is, in general, a wild child, but he's very good with the testing, generally comes when I call, and has been known to remind me if I'm late on testing! (And my other cat is VERY JEALOUS he does not get regular tests!!)
 
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