Hello All: My furball was diagnosed with diabetes two years ago. Over the past 4-5 months, neuropathy has really taken hold. These days, it's a huge win if she can stand up on her own. I've researched and read here and Tanya's. I don't have a spreadsheet, but can give you an overview of where she is and what we've done. Nothing seems to be working. Posting to see if anyone has any thoughts we haven't tried. 1. BG: Nadirs average around 120-150 these days. She starts to exhibit mild hypo around 100 and last week we hit 80 and entered moderate hypo symptoms, so I try to keep her a little higher than 100. That episode set me back a week. 2. She was hospitalized about 6 weeks ago...the first "she can't walk" day. I could not get her regulated during that time and she ate less and less. Hospital tests = high BUN/CREA + high BG + low K + high PHOS. Hospitalized for days with fluids + K. Sent home with AlOH for PHOS. Walked out normal and strong. Within 24 hours not eating again and K crashed. Within days, got spasms...sometimes scary (looked like mini seizures). I discovered K + SubQ would eliminate them within 1.5 hours. Those stopped after a week of daily K + SubQ. I pushed fluids strong for a few weeks. 3. Tests 2 weeks ago were beautiful: BUN the lowest in years, CREA < 2, PHOS just a little high (7), K just a little low...but, she couldn't walk. 4. Since then, I give SubQ most days (even though she has heart murmur), K+ (~4-5 mEQ), and Methyl B12 liquid (2.5-3mg). Recently I added Zobaline (aim to keep total B12 to ~3mg). I've read recently that I might should cut back on MB12 due to kidneys. She's getting worse and worse. She has knuckling/pillow foot and drags her back legs. Every few days she can stand on her own. She pees everywhere because she can't control it. I created a "Leg" scale to track how well she's doing with her legs. 10 = can't stand up on her own, can't / barely can stay standing/ pees wherever she is. Most days she is a 10+. I'll get an 8.5-9 (looks like a toddler taking her first steps and MADE IT TO THE LITTER BOX!) about once every two days...and most always in the morning. It lasts for about and hour and the rest of the day is 10+. I keep detailed logs but cannot find the pattern. I'm not so sure she didn't have a stroke tonight. I read on Tanya's that low magnesium, low calcium, and high PHOS can also contribute to neuropathy. I admit I have not been good at the aluminum...I was shoving so much in her and poking her all the time that I just put one thing on the burner (#facepalm). I am getting her tests anew tomorrow, including Mg and Ca. Reaching out for any straws that could help. Oh, and this lovebug is 17. TIA.
And to add: Six weeks ago in the hospital--when she went in barely able to walk and came out walking almost normal--her BG was really high the entire time. Vet numbers were like 400-700 (!). The vet gave her food for her kidney disease while hospitalized (she had kibble for the first time in 2.5 years)...and despite that her neuropathy regressed/disappeared while she was there. I left that week thinking, "Oh, it's not diabetic neuropathy...it must have been K or something with kidneys leading to neuropathy." But now, with BG in a decent range, her neuropathy is worse than ever. What am I missing? Who's got the needle? Am I even in the haystack?
I’m so so sorry that I never saw this message. What a horrible time you and your baby are going through. High phosphorus is definitely a problem for walking. 7 is way too high. You should be feeding the renal wet food and adjusting insulin as necessary. I strongly recommend joining the tanyackd support group (from the felinecrf website). They can really help you. It is also very risky to give sub-q fluids with a compromised heart — If it were my cat, I would get a cardiac ultrasound to see the exact state of her heart. I have had cats go into pleural effusion with sub-q fluids because the cat had kidney disease but undiagnosed dilated cardiomyopathy.
Oh, you want the phosphorus closer to 4. Feeding high phosphorus foods without the binder is further damaging to the kidneys because they have to process all that.
And you already know that low potassium can cause weakness and lethargy. I have used Vetoquinol Renal-K powder in my cats’ food with su. My heart disease kitty is up to 3 scoops per day due to the fact that she takes Lasix and excretes out so much potassium in her urine. Same can happen with kidney cats as you know. Of course, when their potassium is super low, it’s best managed at the vet in IV fluids. So many of the electrolytes affect the other electrolytes that it can be complicated. Add insulin into that mix and it further complicates things. I hope you have a super vet.
Thank you. Yes, we are on aluminum hydroxide and Renal K. Also joined Tanya's and saw that phosphorus needs to be closer to 4.5. Her labs 2 days ago were good on kidneys, K/all electrolytes, and 7.7 PHOS so we decided to aggressively go after the PHOS with more binder. Yesterday, she took a turn and we're not sure if she'll make it much longer. She's having what look like mini strikes/ seizures/ heart attacks and almost violent sneezing fits, and maybe that's why her neuropathy was accelerating the last 4-5 days despite all the treatments. The first one I saw was 2-3 weeks ago, but it was mild and I wasn't sure if/what it was. I've seen 2-3 in the last few days. Hoping for a Christmas miracle; prepared for the big "see ya soon."
Did they check her blood pressure? That is urgent. I have had two cats who had high blood pressure which caused seizures.
I don't think so. We're you able to treat the seizures and prolong life? What did the seizures look like? These look more like human stroke/ heart attack: Like time slows, eyes get very big, front arm stretches out and jerks, and she moves her head in slow robotic motion. She's still here, strong in her front legs. She pulled at me all night with her front paws; alert.
Yes. I was able to get their blood pressure under control with Amlodipine. They had gone blind, but it resolved after a few weeks. The seizures looked like the cat lying down and moving uncontrollably— paddling the limbs, etc. more of a classic seizure. Have you taken a video of the episodes to show the vet? What does the vet say? I’m so upset about this— I just know how I would feel.
That almost sounds like a Transient Ischemic Attack in a human. How many times have you seen this happen?
Blood pressure not high. She's just about crashed and is really wasted. Her labs look horrible today compared to 3 days ago. Barely ate last 24 hours. Seizures are happened a few times per day. They mentioned hypoglycemia could be a trigger. They've felt like the numbers typically posted in this forum are low, and, at home I've noted she can't go as low as 90-100. Really, below 120 and she starts getting drunk. The first one of the seizures was mild and I had just gotten her nadirs down to ~ 150 a few days before. Since then nadirs average 120-160 and the seizures have accelerated in that time. Not sure if connected, but hypoglycemia Isa possible root cause. You mentioned paddling... yes, she does that. At vet now and her labs are all over, but highlighting her ionized Ca is low and they are going to treat. I'm going to leave her for IV for one day and start seizure medicine. Still no idea what's triggering the seizures but she's quickly crashed as they ramped up.
I wonder if she should be on a blood thinner? If she actually has some heart disease like Hypertrophic Cardiomyopathy or Dilated Cardiomyopathy, etc. It could help with stroke prevention. It’s something to ask the vets but I just wish they could do an ultrasound. I’m so sorry you are at the vet with her again. I was so hoping she was going to do better.
Thank you, Suzanne. Little fartknocker is still with us. Spent a night on IV fluids and then brought her home. Wasn't sure she'd make it, but eating well and pretty stable. New seizure meds + ramped up the binder. Severe neuropathy even worse than when I first wrote this. She's crazy weak, can't push herself up, can't stand by herself, never moves her back legs. She's 100% immobile. It's like the seizures took it to jumangi level. So, now that we're out of critical mode, it's back to going after the neuropathy and praying/ fighting to help her get use of her legs again. Attacking with AlOH binder + Zobaline + K supplement. She's also severely dehydrated. Doing SubQs, which I know are a risk for her heart, but she'll go critical again if we don't keep her hydrated. She's down to 5.5 lbs. Fluids seem to pass right through. Any input on increasing hydration? Eating only wet food, adding water to it, drinking well.
There is a product called HydraCare that is recommended for hydration. Have you heard of it. Some of us recently had a discussion about it. I will find the thread and link it here. Of course, she would have to eat/drink it. Some cats like it.
I was just thinking about HydaCare too. I have an ancient girl who is always severely dehydrated regardless of subQ fluids, whatever. She seems to feel and act better with HydraCare (and loves it). I figured if it won’t hurt, and might help a bit, it’s worth trying. I too had a cat who had seizure-like symptoms. Did X-rays, bloodwork, EKG and proBNP….never did figure it out. Sadly it was beyond what my local vet was well versed in but he really tried. Anyway, Im also curious if anything has changed — specifically to rule out toxins or use of new candles or essential oils. The latter in particular can cause problems in cats. And I assume Jenga is indoor only? (So no risk of outside toxins, toads, fleas/ticks, etc)
Yes, I have Hydracare. She goes through phases with it and never drinks it consistently, so I've never seen an impact, but I can syringe. No heart meds. Has had small irregular heart beat most of her life. Yes, indoor. No toxins / new I can think of. Vet thinks could have been triggered by hypoglycemia... he thinks he nadirs may have been too low for her. "The brain needs sugar."
Well maybe she has a condition that would cause her to need more sugar than the average cat? I don’t know. I do know that I periodically test my non-diabetic cats, and their BG is in the 40s 50s and 60s a lot - rarely ever over 80 for sure. What kind of symptoms did you see in her when her BG got into the 80-100 range? I assume that was a human meter and not a pet meter? I pray she won’t have any more seizures- whatever the reason! Is she pooping? If she’s dehydrated, you will really need to make sure that she keeps passing stool on a regular basis (if she’s eating food, of course, and I am sure you will syringe feed if necessary.). If she needs to eat the renal food, just don’t worry about it. It may be better for her. The Royal Canin E (enticing) is one I have used and Darcy liked it. Also the Science Diet Tuna or Chicken with vegetables.
She gets mild hypo symptoms with < 115 BG (human meter) and moderate symptoms 80- 100. Yes, she's pooping... give her Fortiflora SA. She did try to push up multiple times today (!!) and even was able to stay standing at her food bowl when I set her feet. That was HUGE! I'll take the micro improvements at this stage.
Is Jenga anemic? I’ve read that anemia can cause the BG to read artificially high (meaning it’s actually lower than we think), but I’ve never seen it make a significant difference … at least not to the degree you’re describing. Do you have a backup meter you can use (to rule out the possibility that you have a wonky meter or strips)? You can test yourself too, just as a reality check. It’s probably unlikely there’s a problem with the meter/strips but this is enough of a puzzle that it might be worth verifying. The body is such a complex organism … and as you’ve already been pondering, low potassium, high phosphorus, calcium and magnesium levels, dehydration, etc… all of it can have neurological effects. I’m wondering if the improvement immediately after hospitalization had anything to do with fluids flushing something out of the system and/or the meds/supplemental things Jenga received “rebalancing” the system, so to speak. Hmmm. Such a puzzle. Final question: has Jenga received any Solensia injections? (Just asking out of curiosity)
She has had Solensia-- why do you ask? Do you know of any adverse neurological affects? Now that you ask it, I'm remembering her 2nd shot, we got home and she had real problems standing up/ getting her back legs to cooperate for about 2 days. She didn't have any Solensia shots after that for four months (travel, etc.) until November, and now she's had two in a row monthly, during which time she's accelerated in her neurological digression.
This probably isn't that helpful because I never figured it out either, but my cat experienced this. EXACTLY like you're describing. He had a dental in dec. 2022, first "seizure" in february 2023 like you described. Rushed him to the vet, got bloodwork done- all fine. 2 weeks later, another seizure. Got more bloodwork done. Got blood pressure checked. All good. I even went as far as to get him an MRI, ALL GOOD. There was NO REASON that could be found. Diagnosis: idiopathic epilepsy. Shouldn't happen in a 12 year old cat, but there you have it. He had another seizure 3 weeks later- a fullblown tonic-clonic episode this time. He was fine for 2 months, then had 2 more seizures (one the stiffening type, the other tonic-clonic) in a week. We discussed putting him on anti-seizure meds, but decided against it because they were still happening so infrequently. And after that? Nothing. He hasn't had a single seizure since. Vet is baffled, so are we (but happy). We think the dental anaesthesia triggered it in him. He recently had his vaccines, but so far that hasn't triggered him. Like I said, I don't know how helpful this is since I never found the cause either. But I hope it makes you feel less alone to know another has been through this... he is still happy and healthy now. Btw, what's her response to the anti-seizure meds? My vet sent me home with some emergency Valium to administer rectally to my cat if he ever gets "stuck" in a seizure. This is supposed to stop a seizure in it's tracks. Haven't needed it so far, but I'm curious if it'd stop the seizures in your case. If it doesn't, that could suggest it is something that mimics a seizure, but is not actually one.
I spent a lot of time researching things that looks likes a seizure but isn't one... have you heard of syncope? This is when the brain doesn't get enough oxygen rich blood, which leads to fainting. Often caused by cardiac disease. This can resemble a seizure, including paddling and twitching, and is really difficult to diagnose as it's only measurable when the syncope is actively happening. Generally, cats with syncope seem fine most of the time and recover quickly afterwards. But your cat has so many issues that could be contributing and making it worse. Dehydration causes hypovolemia (not enough fluid (blood) volume circulating in your body). If your cat is chronically dehydrated, she might constantly be close to syncope. This could explain why she was better when she was hospitalised- I assume she had IV fluids in at the time? That means the dehydration was fixed (temporarily). If she has low blood volume = low blood supply to the brain, that could explain why she goes hypo even with safe glucose numbers (not all of that glucose is able to reach her brain). Low potassium and calcium and high phosphorus isn't helping either. Idk, this doesn't sound like diabetic neuropathy to me. There's a really good webinar on syncope by a world-class cardiologist. Here's the link: https://academy-wsava.thinkific.com/courses/cats-with-syncope you do need to create an account, but it's completely free to view.
Lastly, Solensia. Two of my cats have been on it, to relatively good results. But there have been some complaints about it causing neurological symptoms in cats. Most of this info is through conversation with my vet (whom I trust, but can't source). I did stumble upon a facebook page about it recently. Now keep in mind, this is facebook. Unsourced, anecdotal, potentially false information posted for drama. The title alone shows it is very very biased. Many many cats are on Solensia with zero side effects, doing very well. But it is a new drug, and thus, not fully understood yet. I do wish to share it with you, because stories on there resemble yours and I do not feel it is right to withold this from you: https://www.facebook.com/groups/272573645454040/
I’m not sure what I think of Solensia. I can say that I don’t like at all how my own cat responded to it, so he won’t be receiving it again. I also wonder about potential neuro and kidney impacts as well as consequences of longer term use. The fact that the human version of the drug wasn’t approved due to adverse impacts also bounces around in the recesses of my mind. Too many unknowns so far, a big marketing push, lots of money involved, and some anecdotal stories of neuro and other issues … all make me cautious. Here’s some interesting reading: https://vetspace.2ndchance.info/solensia-a-new-approaches-to-arthritis-pain-in-cats/?amp=1 The Owner’s Feedback Page is also an interesting read. Some of the stories might feel familiar. I found more links and info but that’s a start for now. And to echo @Lisa and Angel … it’s the internet, so maybe true, maybe not, but food for thought…
Wow. What a journey for you guys. Glad to hear they stopped, even if you don't understand why. Oh, and her seizures have, I think, mostly stopped. I say I think because she still spaces out multiple times per day, and I'm not sure if that's a seizure, but the obvious ones... we've only had one of those since she started the meds.
I have not heard of that... I'll check it out. Yeah, what we have now is definitely not diabetic neuropathy. I don't know why she can't stand or walk. It went so downhill so fast. But, she's on a plane right now, living her best life, lol. First plane ride and handling like a champ. We're starting some physical therapy at home to see if we can retrain her legs, her brain. PHOS down below 6 now... binders working great. K at 4. Keeping her nadirs around 200. Hydracare + daily fluids. Magnesium is fine, as is blood pressure. Creatine at 1.2, BUN at 50. The almost paralysis doesn't make sense.
Thank you for the thoughts... sincerely. Gradual downward slope at this point. Has lost a lot of weight. More seizures. Can't stand much less walk. Feeling like I'm playing a game of whack-a-mole between gods. The root cause is elusive. If she could just walk... she's eating, peeing, pooping, drinking. Continuing to fight the good fight and keeping up with all the regimens. Honestly surprised she's still here but happy for all the cuddles until her time to go. Thanks again for the support.
You are a wonderful caregiver for her. I’m sorry about her still not walking. Did any of the vets suggest an MRI or CT scan? I guess it would be extremely expensive if there’s even a facility near you. I’m sending all kinds of positive thoughts and prayers for you both. Oh, and hugs!
They didn't. They're was always something else to solve that should improve her neuropathy (diabetes, phosphorous, K). It was only with the seizures a few weeks ago that we entered her being 100% immobile. An interesting theory: we arrived at family's a week ago. She recognized the house and was so excited, trying to get around for the first day and ate a huge amount of food. Since then, she slid downhill fast: seizures have returned and multiplied, legs significantly weaker, lost a lot of weight. I remembered yesterday reading something on this forum about seafood, which is what I've been feeding her since we arrived at family's. I removed it yesterday and today, and I haven't noticed a seizure either day. Could be happening and I'm not catching, but I was catching multiple per day the last 3-5 days.
Well. they do talk about the mercury in seafood and other contaminants like PCBs. It is worth a try to stop the seafood.
Just to reiterate a previous thought … the in-laws don’t have any candles, plug-in diffusers, scent added to a Christmas tree, etc that have essential oils in the them?? Certain oils can definitely cause neurological issues/seizures in cats … Seafood is an interesting variable … I knew about mercury risk, which is why Dr Lisa (catinfo.org) recommended feeding it no more than once a week, but will have to read up on the seizure possibility.
Re-read some on Tanya's today and saw that a high fish diet can result in B1 deficiency, which can result in seizures, among other neurological effects that she has developed in the last week. Upping her B complex and have lots of meat liver, heart, etc. coming (high in B1). No candles or oils.
