New Worried Diabetic Cat Parents

[JennieKevin]

Someone recommended posting in this forum rather than the welcome. My husband, Kevin, and I just received a diabetic diagnosis for one of our cats, Panda. We took him to the vet because he hurt is back leg and seemed to be in a lot of pain, but was his happy self just pretty immobile. The vet did some blood work on him and discovered he was diabetic. She gave him insulin and an antibiotic while he was there on Friday, but he hasn't acted himself since. His leg still seems to be bothering him, but now he is being antisocial, sleeping constantly, not eating normally, and just a moody cat. We go back to the vet Monday. Thanks to this site and many, many more I feel pretty prepared to talk about the diagnosis and treatment course we are comfortable with - I am just afraid the diabetic diagnosis is distracting from the hurt leg.
Also I am concerned that my cat went from his happy self with a hurt leg, to a very unhappy, moody cat with a hurt leg. Do some cats respond poorly to insulin? Are there any questions I should be asking the vet? Any advice before we go in tomorrow would be welcomed. I am a very worried cat mom right now.
The Vet gave Panda a Concenia injection, Humilin Insulin R and PZI Insulin. Panda is part Maine Coone and over the last year we worked to get his weight down - which we did with food that I now realize was not very good for him since it was dry food incredibly high in carbs. He currently is down to 19 pounds - our new goal weight is 15 pounds. According to my husband the Vet told him Panda's blood sugars were 600. Upon reading a ton over this weekend we started home monitoring and they are around 340 now, which I know is still high. The vet hasn't prescribe insulin for us to inject yet.
If anyone has advice or what kind of questions we should bring to the vet I am all ears.

 

[MrWorfMen's Mom]

I responded over yonder but I see you already made your way over here.
What insulin was prescribed?
What dose and how frequently is it being given?
What diet is Panda on? Have you recently changed his diet?
What antibiotic was prescribed and why?
Does Panda have an open wound on his leg?
What investigations did the vet do for his leg?
Does he have any other medical problems?
When you tested and got a reading of 340, how many hours post insulin was that reading taken?

There is an adjustment period for our kitties when they start insulin and sometimes that can make them feel unwell but it's not usually such a stark change as you are describing. Often kitty has been a bit lethargic before diagnosis and they will often tend to sleep more after starting on insulin until they get better regulated. Some types of insulin may cause this effect to be a little more pronounced than others.

If you can fill us in with a little more info, we can suggest things you might want to discuss with the vet tomorrow.

 

[JennieKevin]

What insulin was prescribed? The Vet gave him Humulin Insulin R 100U (2 units) and PZI Insulin In house (2 units) on Friday.
What dose and how frequently is it being given? The vet wants us back Monday to decide this - we haven't been prescribe anything perminately yet.
What diet is Panda on? Have you recently changed his diet? Panda was on Royal Canian Satiety dry food and then friskes wet food alternating days, but after all the research and reading I have done this week I am pretty sure I am changing him to a high protein low carb wet food diet - I am favoring the Fancy Feast classic, roasted, and flake kinds with the research I have done. But I am going to discuss this with his vet more in depth.
What antibiotic was prescribed and why? The vet thought he might have an infection since he was running a very small temp, I believe it was called Cnvenia.
Does Panda have an open wound on his leg? No open wound, but it is swollen, he won't put weight on it, and if you touch it he whines.
What investigations did the vet do for his leg? She said it seemed like a sprain, but didn't go into much detail - I feel like she got side tracked or tunnel vision with the diabetes diagnosis.
Does he have any other medical problems? Over the last year we have worked to get Panda's weight down. He is part Maine Coone and we have him down to 19 pounds, but the vet would like to see him down to 15. For his weight loss the vet put him on a dry food which I think may have lead to the diabetes problems because it turns out to be fairly high in carbs.
When you tested and got a reading of 340, how many hours post insulin was that reading taken? The last reading was 341 at 6:30pm it had been about 57 hours since he had gotten the insulin and about 4 hours since he even tried to eat (we gave him fancy feast ocean whitefish pate). He ate a bit more tonight about 7pm - more than he had been eating.

 

[MrWorfMen's Mom]

Thanks for the information. Sounds like the vet tried to get Panda's BG down quickly with the Humulin R which is generally only used in emergency situations. This strikes me as odd unless Panda had ketones. Humulin R is never prescribed for daily use in our cats as it's action is swift but short lived. PZI would be acceptable. We generally recommend a dose of 1 unit to start off with increases being made in 0.25 to 0.5u increments. 2 units is a hefty dose to be given initially for most cats. With no insulin since Friday, it's highly unlikely the insulin has anything to do with the behavioural changes. I would however make sure the vet checks Panda for ketones as that could be causing him to feel poorly. Even better, if you can obtain ketone test strips from a nearby store tonight, it would be a good idea to check Panda before tomorrow. Ketones can quickly lead to DKA and that is an emergency and very expensive to treat.

Since you have recently changed foods to a lower carb option, I would definitely make sure to mention the change to the vet and discuss dose if they are still recommending 2 units. Diet change can lower BG substantially and in some lucky cases, actually put the cat into remission so starting the dose low and working up slowly is safer and ensures you do not jump over the ideal dose for Panda.

Not sure why the vet would have given Convenia, an antibiotic (originally marketed for skin conditions) on the suspicion that there was an infection. Vets these days seem to think Convenia is appropriate for anything and many of us here have given our vets express orders to never give it to our cats. Convenia has been known to cause side effects in some cats and in some cases they are serious. While I don't think what you have seen with Panda is necessarily related to the Convenia, I would definitely think twice about giving it again just in case. If Panda has not had insulin since Friday, then I doubt it's the insulin causing any change in behaviour.

I would insist on an Xray of Panda's leg to ensure he doesn't have a fracture. It's quite possible the poor guy is feeling off because of the diabetes and the pain of his leg. I'd also ask the vet for a pain medication to make Panda more comfortable while his leg heals even if it is just a sprain.

Good luck with the vet tomorrow and please let us know how it goes and how Panda is doing.