Question about Diabetic Neuropathy Treatments

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blove7

blove7

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Hi all,

It's been awhile since I've been on here. We've just been keeping on, trying to regulate Corduroy's blood sugar levels. We do good, and then he throws us off again, of course!

I have a question about treatments for diabetic neuropathy in his back legs. It seems to be getting worse, and I really don't want him to be going through pain. We've been giving him zobaline every morning for I would say over a year now, but I'm wondering about pain medication to alleviate his pain (if indeed he's having any). It's so hard to tell with animals. But this is what I just read on petmd.com and it has me concerned:

Some of the symptoms of neuropathic pain may include:

Limping or dragging a limb
Shaking or twitching of the skin
Chewing on the affected area
Muscle wasting (atrophy)
Crying out (vocalizing)
Decreased appetite
Urinating and defecating inappropriately (incontinence)

It seems that he exhibits all of these except I haven't really seen him chewing on his hind legs any more than normal to clean himself. Also, his appetite increases and decreases, it just depends on the day.

I'm really afraid that he's in pain and, although he seems to still want to go on walks when I bring out his leash, he still cleans himself, and occasionally he'll get a wild hair and kind of jump up the wall in the hallway (which is so cute to me), it's come to the time when I think about his quality of life, like should I try pain medications or should I start thinking about the unmentionable?

Has anyone else tried pain medications for this with a diabetic cat? How did it work?

Thanks for your time,

Brigitte
 
Morning, Brigitte, ~O)

My vet recommended that I try massage therapy, laser treatments, or Tramadol topical 2x/day (the latter is too costly, in fact, the last 2 are too costly). I showed my vet a video (taken by my cell phone) of Blackie walking instead of taking her there so that I didn't stress her out.

I went to her to inquire about the Cosequin for Cats that I give Blackie, and she suggested that I up the capsules to 3x/day instead of the 2 that I've been giving her.

Also, and this by doing my own research online, I found out about Nordic Naturals Omega 3-Pet (can be found on Amazon), which is a natural oil made from both sardines, and anchovies. It's given 1x/day, and dosed depending on the cat's weight (for instance, Blackie get 0.75 mL 1x/day). This will help with reducing the inflammation in the joints after some time (the person at the company said about 2 weeks, give or take, which the product needs to build up in the body), and it's great for overall health. Blackie's been on it since August 11th, and tonight will be her 12th dose. The first thing that you may notice after some time is that the fur and skin are better. Blackie has dander problems due to dry skin, and I've started to notice that her fur is losing it's coarseness. She's also starting to move around a bit better, too. Not much, but a bit.

I suggest calling, or making an appointment to see your vet and discuss what can be done for your kitty with him/her. I know that my vet will not recommend Meticam, and told me that she's against it. Hence the recommendation for the Tramadol, which I'd still like to get, but it's not financially feasible for us right now. So, that's why I've chosen the Omega 3-Pet by Nordic Naturals for Blackie, on top of the Zobaline, and the Cosequin for Cats (all purchased at Amazon).

Good luck with your research, and hopefully you'll be able to discuss treatment options for your kitty.
 
Has he been x-rayed?

He may have arthritis and an x-ray is the best way to confirm it.

Shadow didn't have to be sedated for hers.... she sat still for the minute it took them to snap it...
She is on Adequan ( canine) and gets a shot every 3 weeks ( from me) .
It has made a tremendous difference.
She also gets buprenex every evening. I have her on the smallest dose because pain meds tend to aggravate her at normal doses. She experiences dysphoria.
I have learned that the pain from arthritis definitely affects their numbers. As soon as I addressed Shadow's pain, her numbers got much better even after she went into remission.

Corduroy has been on insulin now more than a year.
You may find that he needs to go under 50 three times to earn a reduction. If he goes under 40, it's a definite reduction.
From the protocol, you can also shave the dose.....

Reducing the dose:
•If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
Click to expand...

It looks like he's doing pretty well.
His body still overreacts to the greens but his bounces are short.
 
there are lots of choices. i think you're not really asking about just neuropathy, but about pain relief in general. arthritis is very common in older cats - i read somewhere that most cats over age 7 show some signs of arthritis.

yes, pain relief is important. we gave punkin Buprinex twice a day for ages. it helps. you can tweak the dose to avoid side effects - we never had any.

tramadol and gabapentin both work on pain from nerve damage and are safe for cats. i thought the Bupe worked best for punkin.

we used cold laser therapy as well - it's incredibly good for arthritis.

acupuncture can help cats with pain - there's a video in my signature line of punkin getting acupuncture.

Adequan is great too - we gave punkin shots of that. You start with frequent shots and then reduce the frequency.

what exactly are you calling neuropathy - is Corduroy walking down on his hocks? Often getting the blood sugar under control and getting the Zobaline (methylcobalamin) is sufficient to get a cat back up to walking on their toes. If he's on his toes, but still having pain, it might be arthritis.
 
Just curious...is it just me or is the last entry on your spreadsheet on June 4th?

You've gotten lots of suggestions on things to try. I don't know any more to offer, but I hope you find something that will help make Corduroy more comfortable!

How's he doing otherwise? Sounds like if he still enjoys his walks, grooms himself and chases those "wild hairs", he's feeling pretty good!
 
Good morning everyone!

Thanks for the suggestions. I've had Corduroy x-rayed before for other things, but not specifically to see if he has arthritis in his back legs. The vet did tell me that he has it in his front legs, so I'm thinking that it's a 99.9% possibility. I'm going to call him to see what options I have. For now, the buprenex and the adequan sound like the way to go. I'm pretty sure the only pain med he can take is buprenex. I'm pretty sure gabapentin makes his blood sugar go up even higher.

I've been giving him Zobaline every day since 9/28/13. It seemed to make a difference for awhile, but as of the last couple months, his neuropathy seems to be getting worse. Julie, in answer to your question, yes, he's walking on his hocks pretty much all the time now. It used to be most of the time, with intermittent breaks in between, but now, we can even hear him walking when we're in another part of the house. It's almost like he's having such a hard time, that his legs just thud on the floor. With this said, like I mentioned before, he still wants to go on walks, still grooms himself (although he does have knots in his undercarriage a lot more these days that I have to get out), and still sometimes gets a wild hair and kind of jumps up the wall in our hallway, although I haven't seen him do that for about two weeks at this point.

Rhiannon, did you get the go-ahead from your vet to give Shadow the adequan, or did you just buy it online and start giving to her by your own judgement? Also, where did you buy it? Another point I want to address is regarding the dose reduction:

You may find that he needs to go under 50 three times to earn a reduction. If he goes under 40, it's a definite reduction.
Click to expand...

As you know, Corduroy is a very difficult one to pin down as far as dosing goes (it's been said on here by other members that he's a definite challenge). So, at this juncture, we're giving him .75 most of the time, and when that doesn't take his bg levels down after six cycles (which it hasn't been lately), we'll go with 1 unit. I also might add that the last time we had to take him to the vet (a dental specialist actually to have almost all of his teeth pulled except for four small ones), when she did his blood work, she informed us that his kidney failure was progressing, stating that he has lost about 75% of his kidney functioning now, so I'm not sure if this has anything to do with the higher doses not working as well or not. However, then when we've given him the 1 unit for a little while, he inevitably goes shooting down too low. Of course, I'm always testing him, so I usually nip it in the bud by either giving him regular intervals of medium-carb food or high-carb, so I don't allow it to go below 40 most of the time. My question is this: Do I give him a dose reduction if I don't allow it to go under 40, but I know it would probably head that way if I didn't stop it?

Also, does shaving the dose mean to take it either up or down by say .10 or .15 units?

Lastly, Chris, no it's not just you, I haven't been keeping his numbers on the ss because I feel that it hasn't been necessary. I still keep it documented in my notebook every day. I find that I don't have time to record it in both places, plus I feel that in regards to doses, I know what to do now, so, with the exception of this current question, I'm not constantly having to ask advice in regards to that.

Thanks again everyone for the suggestions! I'll be sure to follow up on them.
 
slide down on this page to the pictures of the syringes.... there is a fine dosing gradation from steve and jock.
the fine dose pictorial guide link isn't working so I'll go report that.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139



I got the adequan from my vet. They gave me different syringes which I hated, very dull harpoons.
I give the adequan in the insulin syringes instead.
For the buprenex, have your vet call /fax the prescription to diamondbackdrugs.com ....
My vet was charging me $110 for 30 preloaded syringes of 0.1 ml.... I can get a vial for $35 from that website.

And for the kidney failure, I'm sure you already know this website but if you don't.....
it tells you everything to make his life better. http://www.felinecrf.org/
 
gabapentin shouldn't make his BGs increase, unless it was compounded with something sugary. it works specifically on nerves, so might be worth trying after you are assured that there's no sugar compounded in the pill.

punkin had hallucinations with the first dose of tramadol, so he didn't get it again. but some cats do fine on it.

when we were looking for pain relief for him, we went through things one at a time. Give enough time on each one to see if they help, and if not, move on to the next one. Punkin got the best relief from adequan, acupuncture, bupe and the cold laser. the only issue about the cold laser is that if there is any chance of cancer, the laser can accelerate it. i'd be careful how frequently it was used and pay attention to the angle and how it might overlap inside, for example if he got laser on each hip and on his back, that might mean a lot of laser beam was hitting his colon.

are his blood sugars under control? because getting them there would be important in controlling the neuropathy.
 
Hi Rhiannon and Julie,

Thanks for the replies!

Thanks Rhiannon, for the fine dosing gradation from Steve and Jock. We have been doing this for quite awhile now because Corduroy is usually so sensitive to changes in the amount of insulin we give him, but it helps to reflect back and make sure that I'm doing it correctly. Also, thanks for the tip on getting my vet to call in the bupe prescription to diamondbackdrugs.com. That's super helpful! And, lastly, thanks for the link to felinecrf.org. I've been on there multiple times in the past, but I'm currently reading through it again.

Julie, I'm going to ask my vet again about gabapentin, especially if it helps with nerves. I'm a little afraid of the laser therapy nailbite_smile

And, no, we cannot seem to get his blood sugar under control lately. It's so frustrating! As I said in my earlier post, I've stopped recording the numbers on the ss because at this point, I feel confident that I know what to do (I'm definitely not trying to sound too cocky here, so hopefully it doesn't come across that way). We still keep a very close vigil on his numbers however in a notebook and record them multiple times a day.

A few weeks ago we were giving him .75 and that wasn't working, so at that time, we upped it to 1 unit and it shot him down from the mid-300s to around 69 at +2! And, it just kept going lower, but I stopped it from going under 40 by giving him high carb. So, of course we lowered the dose by .25 (back to .75), which didn't take his bg levels down enough at all. I'm up to 1 unit again now for the past five cycles, but it's not taking his bg levels anywhere near where they should be (his lowest has been around 250). Tonight will be his six cycle on 1 unit, so I think I'll try 1.25 tomorrow morning.

Again, thanks for the suggestions and advice! I hope all is well with both of you today!

p.s. - A little off-topic, but Julie, do you have any other kitties at this time? Just wondering! Punkin was such a cutey :smile:
 
yes, punkin died in May 2013 and we got 2 kittens that following August. Frodo is a medium hair orange kitty, who didn't look much like punkin when we got him, but his coloring darkened and now, everything except his face looks like punkin. It's a little weird - from the back he looks just like him. McGee is a tuxedo kitty - he's a lap guy and purrs loudly. They are both a year and a half now. We still have Anya, who's a Norwegian Forest cat blend - she's a little nuisance, but we love her. If she didn't bite people in the head it woud be better. :lol: she'll sit on the back of your chair like a little vulture, waiting for someone to not notice, then she opens her mouth and CHOMP. :shock:

I can understand you being leery of the laser. I suspect now that punkin had cancer and it accelerated it. But . . . it did a lot of good and made him very comfortable for quite a while. i might still use it again, just not as frequently. With the acromegaly, he was dealt a bad hand, so i don't know that we can just blame the laser for his death.

i hope you can find something that helps Corduroy be comfortable. Sometimes when you lose control it's because there is something else going on - pancreatitis, an infection (has he had a dental recently? possibility of bladder infections?), thyroid off, even pain from arthritis can drive up numbers. A blood test might help reveal if there's anything obvious.
 
Haha! That's so funny about Anya! Our other cat Joe is a bit of a nuisance too, so I understand! He likes to "make his mark" (aka, spray) on any wall that he can get ahold of. He's even been neutered, so I don't know. It's been a real challenge, let me tell ya!

I have to say, I love cats and can't imagine not having one in my life, but I'm afraid that the next cat I would get would have diabetes too. It's such a life-changing diagnosis for everyone involved. It's hard to imagine going through this all over again. But, knowing me, I probably won't be able to deal without a cat companion cat_pet_icon I think after having Corduroy, I would always get a Maine Coon.

We've given Corduroy laser therapy before in the past, but we didn't keep it up. I didn't really not keep it up for any reason, just slacked off I guess. Now, I'm not sure if what they were giving him was cold therapy or not though. :?:

I called my vet yesterday about the possibility of giving him gabapentin for his neuropathy and adequan for his arthritis, but they have yet to call me back. They probably will today. I also called http://www.diamondbackdrugs.com and found out that they sell the Lantus pens one at a time. It's no less expensive, being that they're $94.50 each, but it's nice for us because buying five at a time (which is the smallest it comes at our local pharmacies) takes a huge chunk out of our money.

I'm not sure if there is anything else going on with Corduroy to cause his numbers to be so high. He had all of his teeth pulled in May, except for four little baby ones, and he has seemed to be doing much better in that area since then. I just bought a Drinkwell water fountain bowl yesterday so that they will hopefully drink more to prevent UTIs, bladder problems, etc., but of course, Corduroy doesn't want anything to do with it, choosing to only drink out of his old bowl. I'm hoping if I can get this medication for the neuropathy and arthritis, it will alleviate some of his pain, which might be causing those numbers to stay up there.

Yesterday, I continued to give him 1 unit and he finally came down to about 130, which was his lowest. He promptly went back up to 217 a couple hours later. But, at least I was glad to finally get him somewhere in the near vicinity of normalcy. Today, after six cycles of 1 unit, I decided to give him 1.25 to see how that goes.

Have a great day! :-D
 
after having punkin, i also thought i'd only get another maine coon. he was the most awesome cat i'd ever had - with his psychic powers and all. what a communicator! No cat could replace him, though - he was so unique. I miss him like crazy. but we went to the shelter and they didn't have any, and there were a zillion kittens that needed to be adopted. so we got these two. i'm not sorry- they're adorable.

I've read that there is some connection between norwegian forest cats and maine coons back early in the breeds, and anya has some similar characteristics. she's definitely a communicator as well, just not nearly as mellow as punkin was. She definitely has character coming out of her pores, though!

The laser therapy was probably cold laser.

let us know how corduroy does - i think of him often! His name always reminds me of the kids' book "Corduroy" - i loved that one, especially about Corduroy and his pocket. Is that why you named him that?
 
Hi everyone,

Well, after all of your replies and some research, I went to my vet to ask about the gabapentin and adequan. They actually had a compounded mixture of gabapentin that had just "expired" the day before, so they gave it to me. I've been giving Corduroy about a 1/4 ml twice a day, but the last few days, I've been holding off because it seems to make his back legs worse. I just looked up information on the side effects of it, and I read where it actually can make them exhibit odd movements or loss of coordination.

I thought maybe I'd give adequan a try; however, I'm now reading that both of these meds aren't really suggested for cats with kidney problems. So, now I'm kind of at a loss of what to do. I mean, I surely don't want to make his kidney functioning worse nailbite_smile

Angela, you mentioned the Nordic Naturals Omega 3-Pet, which I'm considering, especially if the adequan and gabapentin are bad for his kidneys. I see it's available in liquid form. I'm assuming if you give Blackie .75 ml/day, you probably buy it in this form, correct? Also, what is the difference between this and cosequin? It's a lot cheaper than the other two meds as well! But, mainly, I just want to ease whatever pain he may be having and at the same time, have it be safe.

So, my question to all of you is: Has anyone else heard of adequan and gabapentin being hard on the kidneys, and if so, did you notice a demise in your kitties health at all after having given it?

Julie, that's so sweet that you think about him! I actually named him because I used to be WAY into grunge music and wore corduroy pants ALL the time. I thought I was gonna move to Seattle and all! Corduroy was my favorite material! It was just something comfortable to me, just as he has been a comfort to me his whole life. In my eyes, he's the best cat in the whole world, as I'm sure you can relate, given your love for Punkin. No other cat will ever come close cat_pet_icon

I hope everyone is having a great Monday!
 
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