Stinkyboy, newly diagnosed, about 14 years old. HALP!

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colleenlindsay

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Hi everyone!

Glad I found this board.

I live in New York City. My little guy, Stinkyboy, a 14 year old formerly-feral tabby, was diagnosed about two weeks ago and we've been having a very hard time. He's on 1 unit of insulin (ProZinc) twice a day, but about every three days he has a severe bout of vomiting and stops eating. I haven't been able to successfully test his blood on a regular basis. He gets absolutely insane, bites and hisses and hides, all of which is unusual behavior for him. I finally was able to get a blood sample last Saturday night, and found his blood level to be about 468. But he was so stressed from the blood test that he began puking, and he was puking so much (eight times) and falling over that I worried about keto and took him into the emergency vet. (I had no diastix at the time because the five pharmacies near my work and my home don't carry them, so I had to special order them.)

The vet said that he had no ketones, but he was severely dehydrated and needed to gain weight. (Stinky has always been thin, but he's gone from 15 pounds to about 12.5 in the last year, which is worrisome. He sent me home and told me to see my regular vet in the morning, which I did. My regular vet doesn't want to increase the insulin yet, but told me to add Renal K+ GEL to his regimen, twice a day, to get his potassium levels up. He also did an ultrasound on his abdomen, which was clear.

I've been trying to get Stinky on a twice a day eating schedule but it hasn't been easy. I have two cats, and they have always gotten a 1.5 ounces of wet food in the morning, and 1.5 ounces at night, with a small bowl of EVO dry left out during the day. I have tried to take away the EVO and feed just wet food twice a day but Stinky has never been a big eater, so he nibbles and then walks away.

Also, the Renal K+ Gel is pretty much impossible to get him to eat. I've just added another stressor to his life, because I must open his mouth forcibly and pop it inside with a finger. The vet assured me that he would eat it but it tastes like maple; what the hell? Why not flavor it like tuna? He really hates it and it makes me feel incredibly guilty to keep forcing it on him.

Anyway....

I'm babbling mostly because I am super tired. Stinky has been waking me up at 3:00, 4:00, 5:00 AM, looking for food but then when I give him his breakfast at 7:00, he won't eat it. Tonight he ate almost nothing at his 7:00 PM dinner, either.

I can't go earlier or later, because his feedings and his shots are scheduled around when I leave and come home from work. The earliest I can get home is about 7:00 PM. Every day when I come home from the office I worry that I'll be walking into a nightmare situation at home, that Stinky will be in a coma or something. And I am really worried because I travel for work at least once a month, days at a time. I can't stop worrying about my little guy.

I want to test his blood regularly, but I am super worried about stressing him out again. And I need to reduce my own stress levels; I've recently finished chemo for breast cancer (about six months ago), so I'm not at 100% just yet, still have a lot of fatigue. I'm just exhausted and worried all the time.

How long does it normally take to regulate a cat's blood sugar? What kind of meter do you guys use? I borrowed a One Touch Ultra 2 from a friend, but I'm wondering if there is a better one?

Advice, reassurance, and jokes welcome. I'm not ready to lose Stinkyboy yet!

Cheers,

Colleen

Edited to add: The vet told me to try to feed him baby food, which has been hit or miss.
 
IMHO, I think you seemed to have a good feeding schedule before - but better yet if you fed low carb wet food in the morning and night and then the low carb EVO in between. Especially now since you just have start learning it all.


There is really nothing saying how long it can take to normally to regulate a cat's blood sugar, because every cat is different and so are their mommas and daddys. It took well over 2-2½ years before I had Simba's blood sugar regulated minus the time he had been in remission. I use a Bayer Ascencia Contour meter.


Btw, welcome to you two! Just stress down and breathe and take it slow, we are here to help.

Ann
 
Hi Colleen,
Wow. You've got a pretty full plate. I can't answer all of it, but luckily I'm not the only person who will jump in to welcome you to the board!

I can touch on a few things though -
The insulin - Prozinc is a good choice, and one I am fairly familiar with. My cat, Bob was on PZI, and they are very similar. Your vet also started with a nice "normal" low dose. Most kitties are started on 1u, but we've seen people come here with doses much higher or only told to shoot once a day. So, one unit, twice a day, 12 hours apart is "good".

The vomiting thing is a concern. Was there anything else going on at diagnosis other than "just diabetes"? Pancreatitis? They did an entire blood panel? Were any of the other numbers off the chart or odd? Sometimes, if a cat is hypoglycemic for instance, there might be vomiting, but with BGs that are high, that shouldn't be the case with Stinkyboy.

The testing - have you watched any videos on blood testing (you can find some on youtube)? Some cats are definitely a challenge to test at first, and it sounds like you might have one of them. All sorts of tricks to make it easier. I didn't have much trouble with Bob, other than my own incompetence at getting a successful poke the first few times. He was pretty docile about it. Some people wrap kitty up in a towel (called the kitty burrito). A key to success is to offer treats after a test (successful or not) so that he will learn to associate the indignity of being restrained and poked with something sharp with a positive outcome. Plenty of good low-carb kitty treats available for that. All I can tell you is that it does get easier. It may take a few days to get there. Things that help.... warming the ear before poking. You can use a sock filled with rice, microwaved to warm, then hold it on his ear for a bit to warm the ear up. Are you using a lancet device, or just free handing the lancet? I free handed it and I felt I had more control over it that way. Do you know what size/gauge the lancets are? Most meters come with tiny 30-30g needles, and I couldn't get blood with one of those at first. So I bought a box of 26g at walmart and had a lot better success rate with blood on the first try. In time, his ear will "learn to bleed" and it won't be so hard to get blood.

The vet said that he had no ketones, but he was severely dehydrated and needed to gain weight.
Click to expand...
Well, duh. Weight loss is one of the primary symptoms of diabetes, and if he's been puking a lot....dehydration sort of goes along with that too. Excessive drinking, peeing, weight loss even though eating more... the 3 big diabetes give aways. Did the vet mention sub-q fluids at all for the dehydration? Bob had the same trouble, although he also went DKA a couple days after the initial diagnosis. The reason I ask about fluids.... I had to administer lots of them, and you mentioned potassium being low. Bob had that problem too, so they just added potassium to the fluids, and took care of both problems with one treatment method. I wasn't a big fan of giving the fluids, nor did Bob enjoy it much, but it took care of the dehydration quickly.

The Renal Kgel, which is supposed to taste yummy (maple syrup?)... wondering if it contains any source of sugar/glucose to make it taste so good. I know you can get Potassium supplements in tablet form that can be crushed and mixed into food, but they apparently taste terrible. So they sweeten it up to make it taste good, but if there is any sort of sugar in it, then it's sort of fighting the effort to lower blood glucose. Do the ingredients list any form of glucose/sugar?

Food - what type of wet food does he eat? Low carb canned food is the key to a good diabetes diet. Some popular brands here are Fancy Feast (Classics only, no gravy styles), Friskees Pates, Special Kitty. You want a food that has a low "% of calories from carbs" value. 7% or less. Many choices can be found at the grocery store or pet stores. Here's a couple links to some food charts. Look at the "carbs" column primarily.
http://binkyspage.tripod.com/CanFoodOld.html
http://binkyspage.tripod.com/CanFoodNew.html

Right now, the most important thing is to get him to eat well. You need food in his belly in order to give him insulin shots. And you want to hydrate him. Don't worry about only feeding twice a day. He should eat before shots, but he can also eat at other times during the day. Ideally, you will want all dry food out of the picture. Most is way too high in carbs, plus dry food is just not good for any cat. Great page on feline nutrition, by a vet who posts here occasionally:
http://catinfo.org/?link=felinediabetes

OK, I'll let others tell you more. Bottom line, Colleen. He didn't get diabetes over night, and it doesn't go away over night. Small steps, one day a time. BUT... you have found the greatest place in the world to help you deal with this. This board is full of experienced, very helpful wonderful people. Every one of us has been in your shoes, we remember the day we first posted here, and we like nothing better than to help new members. So ask questions, read a lot, vent, scream, whatever you need to do. Somebody is here around the clock to listen and help.

Carl
 
Welcome to the FDMB family, Colleen and Stinkyboy (LOVE the name!) from Poopy and me! cat_pet_icon

You've already received great suggestions and advice so I won't repeat it. Just know you aren't alone! :-D The folks here are super friendly and knowledgeable, so don't be hesitant to ask anything. :smile:
 
You might see if pill pockets would help getting the potassium in.

First, take a pocket and split it into 2 or 3 pieces. Make little balls and offer them as treats, with nothing else in them.

Then take a bit of powdered potassium (not the gel stuff - check with your vet on dose) and mash into about 1/4-1/3 of the pill pocket. Surround this by a layer of plain pill pocket. Try to keep it small, so the cat is less likely to chew a lot and taste the potassium.

And maybe do a spot of reading on pancreatitis and on inflammatory bowel disease, as both of those can cause the vomiting, among other things.
 
Thanks for the welcome and the advice, everyone!

Okay, to answer a couple of questions: They've been eating low-carb, grain-free wet and dry food since about 2005. EVO dry switched out occasionally with Wellness. Wet food has been Wellness, Friskies Classic, Friskies Elegant Medley Shredded Chicken and Turkey only, and occasionally Instinct Lamb. And of course I have now been supplementing it with Gerber Turkey baby food! (FYI: also tried the Hill's m/d wet food which only the non-diabetic one will eat. Of course, he'll eat pretty much anything you put in front of him! LOL!)

I know I need to get them off the dry food eventually, but between the two of them they eat maybe a quarter cup a day of the dry each right now, so the vet isn't as concerned as I was about it, and he said the EVO is better than the Hill's m/d dry because the Hill's contains corn, and corn makes both my guys super sick.

I spoke with the vet this morning again and he said I need to leave the bowl of dry down as I have always done so that Stinky will eat something during the day. He's more concerned with Stinky eating at all than with him eating on a fixed schedule and we've figured out that Stinky actually has a much better appetite for his twice a day wet food and pukes less often if he is nibbling something through the day.

I asked about the Renal K+ gel and the reason he chose that over the powder or pills is that it has less sugar in it that either the powder or the pill. So as of today they are back on their regular eating schedule: half a 3 ounce can of wet food each, twice a day, and a small bowl of dry left out to graze on.

Someone asked about pancreatitis: the vet did do an ultrasound and said that his pancreas didn't seem inflamed, nor were there any masses in his abdomen. But Stinky has always has a weak gut. (Possibly from when he was feral? He had a lot of GI problems when I first adopted him in 1998.) I had to take him off all products that contained corn, or corn starch, and all beef and fish, as all of these things make him vomit or give him the runs. Since I did that in 2005, he's puked only when he seems super stressed.

I need to start trying to test his blood sugar regularly now, at least once a day to start, to minimize the stress. The vet wants me to touch base with him again on Wednesday to see how his appetite is, and to see how his blood sugar is so he can determine whether his insulin should be adjusted or not.

Last night Stinky pulled his "I'm an insane animal and I will destroy all of the things!" routine at about 2:45 AM, and it continued for two hours. He gets super hyper because he wants food so he'll shred books, papers, plants. (People!) He's only done this since I stopped leaving the dry food out during the evening, another good reason to leave it out. I think I slept maybe three hours last night.

Anyway, thanks for the support and encouragement. I know this is gonna sound weird but I was WAY more upset when I found out that Stinky was diabetic than when I found out I had cancer. I was more or less just annoyed by that, as I'd just started a new job, but I wasn't ever really scared. But this? I've been a bawling idiot, convinced I did something wrong and made Stinky sick. But the fact is, he has never been obese and has never eaten junk food, so...I guess it's just genetic? Who knows.
 
If it's EVO Chicken/Turkey dry, it's only 8% carbs so is OK to feed him. KT eats it, doesn't spike him.

BIG HUGS!!! You didn't do ANYTHING wrong!!! And you're trying to do something right! TREATS for pokies, shots, even just ear rubs...we use freeze dried chicken or freeze dried liver that I get in the dog treat section at PetSmart.
 
Yes, it's EVO Chicken/Turkey Dry. That's why the vet said it was okay to keep feeding them this. He said it was better than the Hill's m/d dry in terms of carbs and it's grain-free, unlike the Hill's m/d. (They do love the stuff.)
 
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