Newbie - should I treat him for diabetes

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Scully1995

Member Since 2013
Hi. My 18 year old cat has just been diagnosed with diabetes. He has had various complications in the last few months, he has been on Ipakitine since his sister was diagnosed with kidney problems 5 years ago (subsequently lost her) and his kidneys have been fine up until last week. We started treating him for liver problems in June and the levels have dropped even though a couple of weeks ago he started refusing to take his tablet for the liver problems. He has been having regular blood tests to check all his functions, but three weeks ago his right eye started going bloodshot, the vet didn't seem to know exactly what was causing it and did a blood pressure test which was borderline. At the same time they tested his blood glucose levels and they were also borderline. Just over a week later his bloodshot eye was completely bloodshot and the left eye was also showing signs. The vets gave him a steroid injection and blood pressure tablets, two weeks later the blood is half way down the eye, it has improved but neither eye have returned to normal. He is now having problems with his kidneys and has been diagnosed as diabetic, he is very thin and weighs just 3.15kg. What should we do for him? By treating the diabetes will this improve his quality of life or should we just call it a day due to his age. He's a pedigree exotic shorthair doesn't go out and up until he was poorly the most affectionate cat you could ever meet, but we still love him to bits and what to do the right thing for him.
Thanks Sue
 
Only you can make that decision. I myself would likely treat the diabetes. The steroid injections very likely brought upon the diabetes. What every decision you make would be the right one.
 
What is he eating? A renal cat should be eating a wet, low phosphorus diet. A diabetic cat should be eating a wet, low carb diet. And a diabetic and renal cat will need a wet, low phosphorus, low carb diet. There are some options available over the counter. A diet change may help if he is on dry or high carb food.

Did they tell you what stage of renal disease he has? Late stage CRF can make the cat feel quite ill. Tanya's Feline CRF is a good resource for renal diseas info.

He has a lot going on. Do you think he is suffering right now? That's the hard one, I know, but that is the most important question to ask yourself. Is he purring at all? Preening or grooming himself? Playing? Is he peeing and pooping ok (I know with the renal, he may be flooding the litterbox)?
 
Hi BJM
In answers to your questions. I think he is in stage one renal
(according to the website you recommended)
British recording of 45 for his kidneys.
He has been eating cooked chicken breast, cooked plain cod
fillet and Royal Canin Chicken and Rice for Sensitive stomach.
He had dry food available to him but has hardly touched it in
weeks and we have taken it away from him now. We're in
England and I'm not sure what food alternatives are available
here, finding it hard to work out what to feed him.
The last few days he has been pretty unhappy and I can't bear
to see him so low. He purrs sometimes if you pick him up and
pet him, but he doesn't like it for long. He hasn't lap cuddled
for a few weeks. He's not groomed for a couple of weeks,
doesn't want to play. He's peeing loads and he's been constipated
for about a week, he is pooing but only small amounts and it
obviously hurts as he is dragging his bum along the floor
we've tried giving him tuna in sunflower oil and sardines in
sunflower oil but he didn't want to eat them.
We have decided to take him to the vets on Monday to start
the insulin injections and see how he goes.
Any ideas on what food we should put him on?
Thanks Sue
 
This might help you to find some appropriate food for him. http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=64843&hilit=International+food+list I just did a Search on the board for "International Food List" You can search for things you want to know about, and ask in your thread.
When you're at the vet, I would ask them to have a look at his anal glands as scooting on the carpet could be a sign that his BMs aren't cleaning his anal secretions well enough and he may need them expressed. I would also mention the constipation to your vet. Hopefully, he can help get things moving, in that regard.
I wish the best of luck to you in getting your kitty to feel better.
 
Stage 1 renal disease isn't very bad and diabetes is very treatable; I'd go for it. Recommended insulins for cats include Lantus, Levemir, PZI, and ProZinc (the last one may be US only). Avoid Caninsulin/Vetsulin, as it was designed for dogs; cats metabolisms are faster and it usually won't last a full 12 hours. Humulin, Novolin, Humalog, and Novalog last about 8 hours in the cat, so good control may require shots every 8 hours with those. Start low - 0.5 to 1.0 units - especially if you are making any food changes (Rx foods are no better than many over the counter foods). Many vets start too high!

Home glucose testing is vital to keep your cat safe. An inexpensive human glucometer you can get at any chemist/pharmacy should do. I believe both Abbot and Bayer have brands you may buy. If there is a One Touch Ultra, that is a good one (I used it on Dusty, who is currently off insulin) The cost of test strips for pet specific meters is positively larcenous, so I wouldn't use one if money is a concern.

Urine test strips for ketones or ketones and glucose help identify if too many ketoes are being produced. Ketones are a by-product of fat breakdown for calories; too many may lead to diabetic ketoacidosis, which is expensive to treat and may be fatal if not caught in time.

Check the food thread linked above for ideas. Pick both low carb AND low phosphorus foods. If you're up for it, consider making your own. There is a recipe at Cat Info that may be adapted for renal sparing if you wanted to consult Dr Pierson (who writes the site).

Try using 1-3 teaspoons distilled water added to the canned food and in his water dish; it doesn't have anything in it for the kidneys to handle and may help them flush out other solute.

The previous note about checking the anal glands is a good one. In addition, check out Feline Constipation to understand more about constipation and what things may help (ex 1/8 to 1/4 teaspoon of plain, unflavored, unsweetened psyllium powder may be added to the food along with the water mentioned previously to provide some softened bulk to gently move things through.
 
Hello and welcome to the board

I am sorry to hear he is having issues but as BJ said, if the renal issue is treatable, the diabetes certainly is! I have two diabetic cats and they are happy and normal. Like humans, if you didnt know they were diabetic - you couldnt tell by looking at them.

I believe in the UK the vets are required to start you on Caninsulin or other animal insulin first. But this is better than nothing and we can switch it later. I will ask some Brits to chip in and comment.

Wendy
 
Hello from Surrey, UK!

(((Hugs))) to you, it sounds like you have a lot going on there.

You've had some great advice already but BJ and Wendy alerted me to your thread to get some input from a fellow Brit.

Diabetes is very treatable. And yes, it is the case that the first insulin you'd be prescribed is Caninsulin in the UK. Although it has a reputation here for being not the best insulin for cats don't let that put you off at all. Many UK cats do fine on it, and some on this forum have gone into remission (become diet-controlled diabetics) while using it. If you start out with it and it doesn't work then you will be able to switch to another insulin.

I think BJ also gave you the link to the 'Tanya' website for cats with CRF. There is a list there of foods available in the UK, some of which are fairly low phosphorous and suitable for diabetics. Two that come immediately to mind are Lily's Kitchen organic fish foils (available at Waitrose and elsewhere), and Feringa chicken with squash/pumpkin (which you'd need to get online). Some of the Applaws and Porta 21 varieties are also fairly low phosphorous but are not complete foods so couldn't be fed long term on their own.

I also have a poorly elderly cat who seems to have a number of issues going in (including weight loss) and I've concluded that the 'best food' for him is 'whatever he will eat' right now! And I've found that by getting him to eat a little amount of something he finds palatable (even though it may not be deemed an 'ideal' food) he may then go on to eat other 'proper' food. Things I've tried to tempt him are: his favourite cat treats crushed onto a small amount of food, crushed brewer's yeast tablets, yeast and vitamin flakes sprinkled onto food (available from Zooplus), and cat treat stuff that is soft and comes in tubes (I found a cheesy flavoured one that he goes crazy for.) I'm also trying to increase the calorie content of his diet by increasing the fat content, in an effort to stave off further weight loss. And I'm adding a little grated fat/suet (the local butcher gave me a chunk!) to whatever wet food he eats. He's not diabetic, but if he were then any elevation in blood glucose levels caused by the treats I'm giving could be offset by altering the insulin dosage. As I say, I figure the most important thing is that the cat eats.

I've also found that raising the food dish (to about his chest level) makes it much more likely that he will eat. Food that he won't touch when it's on the floor seems to take on new appeal when raised up a bit. (I don't know why that is. Maybe he can smell the food more easily, or maybe he gets acid reflux that worsens when he bends down...?)

My cat has also stopped washing, and I've bought some pet wipes that I go over his fur with to clean it up for him and make it less greasy-looking. It does help a bit, I think (although he's not too thrilled about the process! ;-) )

I fully understand your wondering whether it is time to 'let your cat go'. It is such a tough call, isn't it? But you know your cat, and you will know when that time is right. Meanwhile, maybe it's worth seeing what difference the insulin makes....?

If you would like to learn to test your cat's blood glucose at home (not nearly as hard as it sounds!) then FDMB can give you a lot of help and support with that. And, if you're willing to give it a go, I could send you a test kit to get you started.

Whereabouts are you in the UK?

Best wishes,

Eliz
 
Many thanks for all the advice we received from everyone. Sadly we lost Mulder this morning. He had started on insulin last Tuesday and was responding well and we took over doing his injections on Wednesday. By yesterday he was a much happier cat, purring when petted, grooming occasionally and he even gave me a lap cuddle for a couple of hours yesterday afternoon (hasn't done for a couple of months. The howling at night had virtually stopped and he was also eating the special diet of renal food, although he still lost a bit more weight this past week. We had started to feel optimistic about his prognosis, he went for a check up at the vets this morning and they were pleased with his progress but decided that his insulin needed to be upped from one unit to two. He came home and settled under his favourite table, but three quarters of an hour later he was gone. We rushed him to the vets but think he was probably gone before we even left home. The vets think it was probably either his kidneys or heart that packed up, and not anything to do with diabetes.
We're going to miss him so much, but were really grateful that he was happier in the last week of his life. I'm glad we went down the road of treating his diabetes and that was thanks to the wonderful ladies here. Sue xx.
I've tried to load a picture but its too large. Will try again tomorrow.
 

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Oh, you poor love...

I am SO very sorry that Mulder has passed.
Mulder was very lucky though to have you care for him, and I am sure he knew that he was loved.

I hope that, in time, memories of him will help to lighten your sadness.

Best wishes to you,

Elizabeth x
 
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