Newly Diagnosed 8yo Cat Not Eating

[Tiffany and Pepper]

Hi everyone. My 8yo cat got diagnosed with diabetes today after getting some bloodwork done last week after I noticed decreased appetite, energy levels, and grooming on top of increase water intake and peeing. We went in for the follow up appointment at 9am this morning so I could learn how to inject her with the insulin. The vet prescribed 1 unit of Glargine twice a day. Her BG levels were at 516 this morning after eating a tiny bit of treats. I have a blood glucose monitor coming in the mail tomorrow and plan to monitor that daily. The vet also gave her anti-nausea medication, pain medication (buprenorphine - 2x/day; 4 days worth), and an appetite stimulant (Elura - 1x/day; 4 days worth). I gave her all of the required medication today.

Despite giving her all of that medication, she has barely eaten anything which worries me. I expected her to at least eat something due to the appetite stimulant. I am hoping the reason she isn't eating is because she gets stressed easily and everything is new. She does not really like wet food which is what the vet gave me to try but I don't know if it's because she's still not feeling well. She has no interest in her old dry food and will only eat a few treats then walk away. I've tried different wet foods, adding treats to her food, etc. but nothing seems to work. Should I be worried?

Thank you in advance to everyone who interacts with this post. I know feline diabetes is manageable but I'm just so worried about her and everything feels so overwhelming. We both find change very difficult so any advice about this is more than welcome. Please let me know if you need any additional information.

 

[Bron and Sheba (GA)]

Hi Tiffany and your kitty and welcome.
It is very overwhelming in the beginning while you find out what needs to be done. But it does get much easier and soon becomes routine.
You have been given a great insulin for feline diabetes.
It is not uncommon for newly diagnosed kitties to not have much of an appetite. My Sheba took a few days to start eating properly again when first diagnosed and she was a food motivated kitty.
In saying that, it is really important that diabetic cats eat and eat well.
Did the vet mention if they tested the urine and if your kitty had any ketones in the urine? This is important to know.
There are a couple of things I would do.

• I would ring up and ask the vet if there were any ketones in the urine.
• I would go out and buy a bottle of Ketostix from Walmart or a pharmacy and test the urine for ketones. Make sure you read the test at exactly 15 seconds after dipping the strip into the urine as it will change colour after 15 seconds. There should be NO ketones at all. If there are any ketones I would tell the vet and it is very important that your kitty eats well, as it is food and insulin that keeps ketones away.
• I would go out and buy some fancy feast pates canned food or some tiki canned food as they are low carb and are absolutely fine to feed diabetic cats. Weruva is also good and it has all the nutritional information on its website. A lot of cats won’t eat the prescription food which is not necessary.
• If all else fails let her eat whatever she will eat for a few days while she settles into it all. Eating any food is better than not eating.

I am going to give you a link to our FOOD CHART. Look for canned food which is 10% carbs or under. Around 5-7% is great.
These food are just as good or better than the prescription foods and are a lot cheaper. Make sure she eats well before the insulin dose and then give a few snacks during the cycles. It is fine she eats during the cycles….in fact we recommend it.

Here is a link to HELP US HELP YOU which will give you information for new members.
You will see we use a spreadsheet to help with keeping track of the blood glucose and helps with dosing which we are happy to help you with. If you have any trouble with it let me know.
Also if you could set up your signature which will tell us about your kitty and will appear below all your posts.

Absolutely great you are going to home test the BGs! Always test before every shot to make sure it is safe to give the dose and then around the middle of the cycles to see how far down the dose is taking your kitty.
Make sure you have a hypo kit set up in case of low numbers. Info on that is also in the link above.
Keep asking questions, we are very happy to help you.

 

[Sienne and Gabby (GA)]

I second Bron's suggestions. Ketones can develop if there's an underlying infection or inflammation and there's not enough insulin on board and your cat isn't eating. Asking your vet if ketones were present when labs were done may be helpful but they may not have tested. Getting Ketostix will allow you to test. If the results indicate more than trace ketones on a urine test strip, please call your vet.

I'm wondering whether your cat was also diagnosed with pancreatitis. Generally, a diabetic cat isn't prescribed pain medication. Pancreatitis is not uncommon with a diabetic cat, especially a newly diagnosed diabetic. Pain medication is essential in managing pancreatitis since it's really painful.

I'd also see if you can tempt her with baby food --Stage 2 of either Gerber or Beechnut and be sure there are no onions or other veggies in the food. Alternatively, Churros type treats are really popular with kitties.

 

[Tiffany and Pepper]

Hi everyone,

Thank you for your words of support and suggestions. I forgot to mention her name is Pepper! I am not sure if the vet tested for ketones, but I will call later today and ask. She is a pretty anxious cat, so I worry about how to test her urine without stressing her out too much. Like I said before, she does not do well to change, so I do think me attempting to put the Ketostix in her urine stream or a change in litter will induce anxiety for her. Regarding the pain medication and pancreatitis, the vet said her pancreas levels were generally okay, so I'm not totally sure why she was given pain medication. I think it kind of mellowed her out a lot yesterday as she stayed in her bed for most of the night.

As of this morning, she still has not eaten anything which is really worrisome to me. I gave her the Elura this morning and it caused her to drool and foam at the mouth a bit. She did not eat anything while I was home this morning or last night. I offered multiple types of food (e.g., dry, wet, mix of dry and wet). I also worry that I'm pushing too much on her which is making her more averse to eating anything. She has been eating the same food (Hill's Prescription C/D Stress for urinary issues) for the last 7 years, so this is a huge change. Unfortunately, I am not home during the day so I can't keep an eye on her as much as I would like to.

 

[Sienne and Gabby (GA)]

Drooling is side effect of Elura. This is a note from the FDA about using Elura:

Some cats on Elura become less active and may have weakness. Also watch for digestive problems, such as vomiting, diarrhea, drooling. Elura may increase blood sugar levels for several hours after a dose, so it may not be appropriate to use in cats that currently have diabetes mellitus or have had diabetes in the past.

You might want to discuss this with your vet. Aside from the excessive salivation which is the 2nd most common side effect of this drug, it does cause a rise in blood glucose levels. The blood glucose safety study was conducted on a small number of cats, though. In addition, it has on ly been approved for cats that are diagnosed with kidney disease (which can cause a loss of appetite). I believe this information is on the package insert and should be something your vet is familiar with. A commonly used appetite stimulant for cats is mirtazapine. Mirtazapine is available as a transdermal gel or as a pill.

 

[Tiffany and Pepper]

Okay, that is good to know. I reached out to my vet, but they were not available to speak so I am waiting on their call. We were only give 4 days worth of Elura because the main priority right now is to get Pepper to eat something, so maybe that is why she prescribed it to us.

Do you have any advice on how to get her to eat something? I worry that her anxiety is interfering with her appetite as well.

 

[Sienne and Gabby (GA)]

This is an oldie but goodie link to a post on how to stimulate a cat's appetite. There are lots of suggestions. Frankly, I'm generally of the mid to feed your cat whatever she wants that will get her to eat. You may need to think of things that are particularly smelly or that you know she likes. Something like bonito (tuna) flakes may work but to be honest, what works may be unique to Pepper.

 

[Deborah & Muffy(GA) & Wendall]

I think Pepper needs fluids and soon. Is she drinking? Hyperglycemia causes dehydration and nausea so they don't want to eat and the medications probably aren't helping, especially as she's getting them on an empty stomach. Fluids will help flush out excess sugar and possible ketones that may be starting to build up. Sub-q fluids might work if you have them and know how to use them but if she goes on like this for too long she'll need to be hospitalized and put on an IV. I would probably consider admitting her to the hospital for a day of IV fluids if she hasn't started eating by tomorrow. If she'll eat her old food, let her, and switch to a better diet when she's feeling better. Right now it's more critical that she eat.

It's important to address her nausea before using an appetite stimulant as it often doesn't work for cats that have completely stopped eating and can cause food aversion. CBD oil and B-12 shots can help with appetite and are safer.

You've already gotten some good suggestions for foods and stimulating Pepper's appetite. My go-to is Nature's Variety Instinct, Original chicken formula dry food. It's low carb and most cats find it irresistible. I've found with my cats that the odor of some wet foods can be off-putting to a sick, nauseous cat and that sometimes dry food is better tolerated.

 

[Tiffany and Pepper]

Hi everyone, just a quick update about Pepper. She ate 1/4 can of Fancy Feast Chicken Feast pate after I added some Fortiflora onto it. Hopefully that does the trick for the next few days as she gets acclimated to everything. Pepper has never been a wet food girl so this is a big change for her. I've let her vet know about her eating and will call them tomorrow morning to follow up and see if I need to bring her into the clinic.