Old member with a "new" cat

[Ele & Blackie (GA)]

Hello all,
I was an active member of the Lantus group more than 10 years ago and I'm afraid I've forgotten a lot of what I learned back then. My cat, Josie, was at the vets on Monday with a glucose of 282 and glucose in her urine. I tested her this morning before breakfast and she was at 242. Josie is 15 and has a lot of health issues. She is currently on 5mg of prednesolone daily, cyproheptadine 2mg 3/day, pepcid, 6mg Cerenia daily. She had a feline herpes ulcer on her eye 2 months ago. The ulcer has healed, but her cornea is still covered with a gray film and her face is swollen around her eye. We started Clavamox on Monday to see if that will take care of it, but so far it's no better. Josie has chronic pancreatitis, kidney disease, disc disease, and IBD. She has a very poor appetite even with the cyproheptadine and she's losing weight. I feed her Fancy Feast, but she doesn't really like the pates. She will eat a little of Medleys, and any fish that has gravy. I've tried other brands with no more success. I feed her multiple times a day because she will only eat a small amount at one time. Our vet didn't want to start insulin right away unless her numbers were over 500 and I just don't know what to do. I have another vet appointment next week and we may take an xray of her head then. She is too fragile to go under anesthesia, so we won't do a CT scan.

If you've read this far, thank you. I could really use some suggestions to help her.

 

[Chris & China (GA)]

Welcome back to the FDMB! Sorry you find yourself back again though!

Is the Prednisilone for the IBD?

Have you ever tried Mirtazapine or Mirataz (topical) instead of cyproheptadine? There's also a newer appetite stimulant out there called Entyce.

The ulcer has healed, but her cornea is still covered with a gray film and her face is swollen around her eye. We started Clavamox on Monday to see if that will take care of it, but so far it's no better.

May want to ask to be referred to an eye specialist if there's no improvement.

Also, Clavamox is infamous for causing nausea and inappetence in our kitties. Who wants to eat when they feel sick to their stomach? The cerenia may not be the best medication for nausea...it's more for vomiting. Ondansetron (Zofran) seems to work better for nausea (it's a human med used for nausea in chemo patients). You can actually give both Cerenia and Ondansetron since they work in different ways. Sometimes using both works better than one or the other does.

she doesn't really like the pates

You might try some of the Weruva or TikiCat foods. Most of them are low carb and come in different textures and flavors. Texture can make a big difference in whether a particular cat will eat it or not.

Our vet didn't want to start insulin right away unless her numbers were over 500 and I just don't know what to do

That's crazy....anything over renal threshold is causing the kidneys to work harder than they need to. If there was glucose spilling over into her urine, that's a sign that her kidneys couldn't filter enough of it out. Do you know what kind of insulin they'd prescribe (if they would prescribe it?)

Hope you can find some things that will help improve her quality of life! I know the people here will do what they can to offer suggestions!

 

[Ele & Blackie (GA)]

Thank you for you thoughts on Josie. She's been on the pred for more than 4 years and I don't think it's something we can stop. She was on Mirataz for more than a year and it worked well until it stopped working. We could try it again though. The cerenia seems to have helped her eating in the past, but I do have ondasetron on hand and can add that to the mix. I'm going to the store tomorrow and see if I can find a few foods including Tiki cat that she'll eat. How often should I be testing her now since she's not on insulin? I'll be talking to the vet again tomorrow. Her glucose was 190 at noon after eating a few very small meals.

 

[Chris & China (GA)]

How often should I be testing her now since she's not on insulin?

You can try doing what we suggest during an OTJ trial. Test at your usual shot time (or when you would if you were started on insulin in this case). If over 100, feed and test again in about 3 hours. If the number goes down, the pancreas has to be doing at least some of the work.

 

[Ele & Blackie (GA)]

Thanks. She was at 242 at 5:30 am and 190 at noon, so I took that as a good sign.

 

[Sienne and Gabby (GA)]

(((Ele)))

I'm sorry to see you back here. Josie is in good hand! Let us know how we can help. There are still several of us who are still around whose names will be familiar.

 

[Bron and Sheba (GA)]

Hi and welcome back!
If you are not starting insulin straight away and Josie is not eating all that well and has some inflammation, I would suggest testing daily for ketones in the urine. You will need a bottle of Ketostix from Walmart or a pharmacy and test the urine with a test strip and compare it to the colours on the side of the bottle exactly 15 seconds later. if there are any ketones there I would tell the vet as Josie will need to start insulin.

 

[Lisa and Witn (GA)]

Hi and welcome back!
If you are not starting insulin straight away and Josie is not eating all that well and has some inflammation, I would suggest testing daily for ketones in the urine. You will need a bottle of Ketostix from Walmart or a pharmacy and test the urine with a test strip and compare it to the colours on the side of the bottle exactly 15 seconds later. if there are any ketones there I would tell the vet as Josie will need to start insulin.

I agree.

If she is in pain or has an infection, that could also cause higher glucose numbers. You may want to see if she will eat either the Hills A/D or Purina CN prescription foods. Both are lower in carbs and would provide the extra nutrition she may need. Even my pickiest cats seem to always like these foods when they need them. It is important that she eats and if needed, you can mix water with these to syringe feed her.

 

[Ele & Blackie (GA)]

I syringe fed some wellness 95% turkey and that went well. It supplemented the small amounts Josie had for breakfast. I also bought several different kinds of Tiki cat food and she loved the sardines. I don't know if she'll continue to like it, but it gave me hope for her to eat more on her own. I tested about an hour after she had the syringe food and she was at 191. I am going to keep monitoring and keep getting food into her. She seems okay, doing her usual changing beds multiple times a day and coming to us for food periodically. Thank you all for your help.