Urgent help with newly diagnosed and (possible) neuropathy & low potassium

Status
Not open for further replies.

Tania c

Member Since 2019
Dear all,

I have previously posted on here before with Stanley our diabetic cat (who is doing ok!! Need to update his thread it’s been a while) However I’m posting for advice on another one of our cats, Princess.

Princess is approx 20 years old and until recently has been doing great despite various conditions. She is hyper thyroid, stage 2 kidney disease, blind and high blood pressure, however all have been well managed.

Several months ago she started having random spikes in her glucose picked up on her regular bloods at vets so I stared home testing. Most of the time she was at the high end of normal, so BG ranging from 6-11. Then it would shoot up in the twenties for a day and then be back to normal same with her urine. I started to cut out any dry food and give her low carb diet just incase she committed to being a full blown diabetic.

She was doing great but still odd spikes in glucose, then she had a few neurological issues, confused and eyes moving to one side. I tested her bg at around the same time and it was kind of high at 16.

Anyway I got a referral for a full investigation because she really was doing great despite this and wanted to try catch anything more sinister early. Vets decided to do an MRI to rule out brain tumor and she got the all clear, I was worried if it was too much to put her through :(

However she seemed to come out fine and they did a fructosomine that was normal. Past few weeks she has been on great form, then unfortunately I went out for the day (a rare occurrence with all our animals) and noticed when I got back she was unable to walk on her front leg, her paw was buckled under her and she was walking on her wrist.

I thought she might have damaged it from some trauma. So tried to rest her have her some painkillers but it still did not get better. Took her to the vets who could not find any breaks, at this point she didn’t seem too painful on it but now she does. They suspected a blood clot and told me to bring her in next day for more investigations and heart scan. She does have a heart murmur that they also diagnosed.

They couldn’t find anything obvious but finally they took her bloods again (possibly should have done that straight away! But they seemed happy she had them only a few months ago) Anyway found out that her potassium was really low at 2.6 also very dehydrated, I did ask them to check if she needed fluids while she was in for the say but they didn’t, grrrr. Really didn’t want to leave her there on a drip overnight as no one checks them.

So I took her home and started oral
Potassium and plan to take her to vets in the morning to have fluids and potassium for the day and see how she gets on.

They managed to get her potassium up a little to 3.1 but basically told me she was a lost cause and to either pts now or take her home and bring her back after the wknd :-( they were not prepared to carry on with her potassium which she so desperately needed overnight, only keep her on normal fluids. Again thought this would be dangerous for her so picked her up as late as I could and bright her home, and she was great!!!

Meanwhile I had been chatting to the referral vets who also agreed with me bringing her home and starting on the oral potassium will be the best for her so I can monitor her. Then the plan was to arrange to take her there for more investigations on Monday all being well.

She seems really well after the fluids and potassium, leg still the same. However on Sunday I felt like she was crashing again, the referral vets said get my normal vet to check potassium. Which they wouldn’t do until Monday :( so I drove 3 hours to my referral vet (she actually loves a car trip so I wasn’t too worried about that)

Thankfully referral vets have been incredible with her!!!! And deff think we should keep trying and see if we can get her past this.

Ok so being an older lady they did find she does have multiple things going on as I knew however the main thing was to get her potassium up at the moment. Which we now have done and she has been up and down but for the past few days improving and potassium is now 4. BUT this morning her back leg went too I checked her glucose and it was 33!!! I called the referral vets and asked if they are happy for me to give her insulin as we knew she might become diabetic.
So I’ve given her .5 unit of prozinc and 3 hours after her bg was at 9.9.

So I guess my main question is does this sound like neuropathy? She is already on 500mg meth B12 once a day and B complex.

It’s really sad to see as she is struggling now to get in the litter tray etc…it’s crazy as this morning she went for an outside potter and seemed on such good form I thought we had gotten her over one of her issues at least.

There is a lot going on with her but until now her quality of life for her age has been great and I do feel confident I can help her through it. I’m just worried her glucose has been high for the past two weeks and effectively her diabetes has not been treated.
The other issues is her low potassium and I understand insulin will lower her potassium now just as I got it to the right level! Does anyone have any experience of this? I’m wondering if I need to increase her potassium dose to accommodate for the insulin.

I’m so sorry this is such a long post so much has gone on with her the past few weeks, but I’m just grateful she is still fighting and as long as she does, I will!

I’ll be so grateful for any advice or help!

oh forgot to say referral vet is treating her front leg lameness for cellulitis & possible infection so she is on antibiotics. Ofcourse the back leg is new, so wondering if both legs could be neuropathy but doesn’t explain swelling and cellulitis on front leg.
Thank you xxx
 
Hi and welcome to the forum
I’m sorry no one has answered your post sooner. I wil read it now and get back to you as soon as I can:)
 
Low potassium in cats can cause difficulty walking and weakness as well as lethargy, diarrhoea and vomiting and lack of appetite, so the leg weakness is more likely to be from the diagnosed low potassium I would think but I could be wrong.

I would ask for another fructosamine test as that will tell you what the BG has been doing over the past few weeks. That should give you an idea if it is only an occasional thing or if it’s happening all the time.
I would also set up a spreadsheet for Princess and start testing her on a regular basis to see what is happening with the BGs.
If she does have an infection in the front leg that could cause the BGs to rise.

I am going to tag @Wendy&Neko to see if she has any ideas.
 
If she has an infection, that would contribute to the higher glucose readings. You may also want to have the vet check her spine to make sure there is nothing there that may be causing the problems with her back legs.
 
To me it sounds like leg issues caused by low potassium. Lots of other things can cause high BG's, such as uncontrolled hyperthyroid, heart issues. Did she get an echocardiogram and get seen by a cardiologist? Just want to make sure it's OK for her heart for her to have fluids. Also, heart issues can spike BG numbers.

How are her phosphorus numbers? Is she eating OK now?
 
Thank you all so much for taking the time to reply.

I also thought was potassium so wanted to get on top of that first to see how she was, thankfully I think we have as her last test on Wednesday was 4, previously 2.6. It was clear she was feeling better & holding her head up, not as weak etc etc. I really thought we had turned a milestone, until her back leg went yesterday too. She had just gone for a little walk I’m wondering too if it is possibly a slipped disc. We have done all the checks possible without being too invasive for her. She did have an MRI but they only scanned her brain unfortunately so can’t tell what’s happening with the spine. She looks a little more comfortable on it today so I’m going to try the strict rest option and make sure she’s not going up the stairs (which she likes to do!) it’s the pain that really worries me, she is on gaba & bupe 3 x a day so hope that will help. I actually skipped a bupe dose the other night and she seemed fine without it until this happened with her back leg.

Her appetite is a bit hit and Miss past few days but been good last week. I think it’s the pain, but yesterday she ate ravenously, but sure that was because of her high BG. Last night she only went up to 11bg & this morning it’s 14.6. The vet said only dose her if above 15 at the moment. Her fructosomine was at 227, I think that’s ok. Vet said possibly Pre- diabetic. Only thing is she constantly has glucose in her urine too.

However I do agree these spikes in her glucose sound like could be to do with pain, or infection, her white blood cells are raised so hence the antibiotics.

Her thyroid has been really well controlled the past 6 months, if anything possibly a little low but this could be due to an underlying illness.

Yes she has had a heart scan, details below.


‘Volume overloaded heart.
▪ Left atrial dilation (LA/Ao 1.85, RI < 1.6; LA minor 16.1 mm, RI < 16 mm).
▪ Subjective mild right ventricle and right atrial dilation.
o There was no spontaneous echocontrast.
o Left ventricular wall thickness was within normal limits.
o Mild pericardial effusion (which may occur secondary to inflammation).
The cardiac changes may be secondary to systemic disease e.g. hyperthyroidism. Furosemide and pimobendan could be considered if Princess has evidence of respiratory compromise.’

Phosphorus was 1.48

Paws crossed she has a better day today! Thank you for all your help and can you point me in the right direction please to make a spreadsheet for her?

thank you. X
 
Hi just giving this a bump to see if you could help me with a spreadsheet for Princess & also a new one for Stanley?! Many Thanks x
 
@Bandit's Mom are you able to help with a SS for Princess and Stanley please?
Sorry! Don't know how I missed this!

Hi just giving this a bump to see if you could help me with a spreadsheet for Princess & also a new one for Stanley?! Many Thanks x
Hi Tania, will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.
 
Status
Not open for further replies.
Back
Top