Vet says he is a strange case, thoughts?

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Mizuniful

Mizuniful

Member Since 2017
My vet says I have a very strange case.
Spork is an 11 year old neutered male, 14lbs. Blood work is completely normal except for the glucose. No other health issues, but his brother does have FIV (he keeps testing negative for it). I'm probably missing a lot of information here, so just let me know if you need me to clarify anything.

It started almost two months ago when little Sporky broke his tail and I brought him to the vet (I knew they couldn't do anything, but I worry anyway). They said yep, it's broken, but we might as well do a blood test while you're here. His glucose was somewhere around 450. They did a fructosamine test and it came back in the normal ranges. Vet said glucose can also spike with stress, so it was probably just because of the broken tail and bringing him here, but to come back in week to do a urinalysis to double check.

A week later, the urinalysis showed high glucose still. Told to come back in 2 weeks for another fructosamine test. That came back in the normal ranges, again. Yet he still has glucose in his urine/blood. I bought a home glucose meter (human) and have been testing multiple times a day, but haven't done a full curve yet. Most of the time it is around 270, but never higher than 330. No ketones.

We have decided not to start insulin yet, and to just change his diet. He gets 2 tablespoons of canned Hills WD at 5am and 4pm, and free choice dry WD all day (he doesn't eat much, maybe 1/3cup a day).
I tried to put him solely on canned twice a day, but any more than 2 tablespoons and he vomits it up afterwards. I tried for a month. He is a big cat, at 14lbs, and should be getting over 2 cans a day, and that just isn't possible with him.

Is this normal? Should I be doing insulin?
 
Hi and welcome. Looks like Sporky is definitely a diabetic. One thing you can do is change to a lower carb food. W/D canned is 25 carbs and the dry is even higher. We like to keep it under 10. Most of us use Friskies Pate or Fancy Feast Classics. As far as vomiting after eating the canned, if he's eating too fast it could be 'scarf and barf'. To help with that try feeding smaller amounts and spread it thinly over a plate to slow him down. Try the food change and keep testing him for ketones. If his BG is still high in a few days, you may need insulin.
 
Hi, welcome to FDMB, the nicest place you never wanted to be! I love your cat's name!

Your vet is right, "vet stress" can cause a kitty's blood glucose to rise as much as 200 pts or more.

The first thing that jumps out at me is your cat's diet. Hill's canned food typically is very high in carbs, as are just about all dry foods. Diabetic kitties need a wet-food diet that has less than 10% carbs. If you can wean Sporky onto an all wet, low carb diet, you may avoid the need for insulin. However, if not, he does definitely need insulin. The sooner you can get his bg under control the better his chances for remission are.
 
Thank you guys! I knew his glucose was high, but I wasn't sure if it was high enough to warrant insulin yet. Is Hill's MD any better? I get a really good deal on these, so I'd like to stay with Hills if I can.
I did try to wean him to only canned food twice a day, even spreading it on his plate, but he still vomits. I tried to slowly increase his portions over a month, and since he kept vomiting it up, he was losing weight :(. I will try again, though. 3 meals a day may be the better strategy this time.
 
I will try MD then! If that doesn't help, I will switch over to one of those I think. He LOVES canned food, so no problem there, he just can't handle feeding twice a day. I didn't realize you could feed multiple times a day, I felt like such a bad mom for not sticking to the 2 times a day schedule. Will definitely try 3 times a day.

How much canned do you feed your cat? All the calculators I've looked at say an ounce per pound, and that seems like a LOT. As a 14 pound guy, thats 2 1/2 5.5oz cans a day. It's going to take a bit to work up to that, haha.
 
The general formula for calories needed is:

cat's weight (or desired weight) x 13.5 + 70

So if your cat weighs 14 lbs it would be (14 x 13.5) +70, or 189 + 70, for a total of 259 calories. Obviously, this can be adjusted up or down to meet your particular kitty's needs.
 
Mizuniful said:
I will try MD then! If that doesn't help, I will switch over to one of those I think. He LOVES canned food, so no problem there, he just can't handle feeding twice a day. I didn't realize you could feed multiple times a day, I felt like such a bad mom for not sticking to the 2 times a day schedule. Will definitely try 3 times a day.

How much canned do you feed your cat? All the calculators I've looked at say an ounce per pound, and that seems like a LOT. As a 14 pound guy, thats 2 1/2 5.5oz cans a day. It's going to take a bit to work up to that, haha.
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Some feed as much as 5 or 6 mini meals in a 24 hour period. I have 6 cats and feed wet morning and night, and fed enough that they can graze on it throughout the day until the next feeding. (There's always a bit left).... And I leave out two low carb dry foods.... Young Again Zero carb (1%) and Evo Cat and Kitten in the purple bag (8%).
 
Mizuniful said:
I will try MD then! If that doesn't help, I will switch over to one of those I think. He LOVES canned food, so no problem there, he just can't handle feeding twice a day. I didn't realize you could feed multiple times a day, I felt like such a bad mom for not sticking to the 2 times a day schedule. Will definitely try 3 times a day.

How much canned do you feed your cat? All the calculators I've looked at say an ounce per pound, and that seems like a LOT. As a 14 pound guy, thats 2 1/2 5.5oz cans a day. It's going to take a bit to work up to that, haha.
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Cats that have uncontrolled diabetes need extra food because they can't properly utilize the nutrients in the food. They are literally starving. So until you get his bg down he will need to eat more.
 
Update! Went to the vet today to discuss insulin. Vet still wasn't comfortable giving insulin since his blood sugar is high, but it's not THAT high. Did blood work and a urinalysis. Blood work showed high liver enzymes. Her initial thoughts were that something is 'disturbing' the liver and/or pancreas (possible mass?). Decided to do xrays and a pancreatitis test. Not sure what the xrays showed, but the pancreatitis test came back abnormal, meaning he probably has some degree of pancreatitis.

Poor Sporky is still at the clinic, and I just got home. Just waiting on a call back to hear about final thoughts and a treatment plan.

It's just strange that he doesn't have any of the symptoms of liver disease/pancreatitis, other than the occasional vomiting. He is still a healthy weight, eating fine, normal stool, etc. He only has symptoms of high blood sugar like excessive drinking and urinating.
 
Another update (just got the call back). His liver values in February were 20, today they were 600. So SOMETHING is going on there. He also started panting when I left so she gave him some pain meds and fluids. Panting could be from pain, stress (doubt it, he's pretty chill, even at the vet, and he has stayed there before without problems), or a heart condition. She tried to check for a heart murmur but he wouldn't stop purring so she couldn't hear anything. She also mentioned something about heart problems affecting the liver, which could be causing those high values.

Mass in the abdomen is our primary suspect at the moment since both his liver and pancreas are affected. Calling another vet tomorrow to schedule an ultrasound.


I had to euthanize my 11 year old dog last Monday due to cancer (presented as a foreign body/mass in the stomach). I can't go through this again so soon...
 
Sending healing vines
vibes.gif
and hugs :bighug:
 
Mizuniful said:
Another update (just got the call back). His liver values in February were 20, today they were 600. So SOMETHING is going on there. He also started panting when I left so she gave him some pain meds and fluids. Panting could be from pain, stress (doubt it, he's pretty chill, even at the vet, and he has stayed there before without problems), or a heart condition. She tried to check for a heart murmur but he wouldn't stop purring so she couldn't hear anything. She also mentioned something about heart problems affecting the liver, which could be causing those high values.

Mass in the abdomen is our primary suspect at the moment since both his liver and pancreas are affected. Calling another vet tomorrow to schedule an ultrasound.


I had to euthanize my 11 year old dog last Monday due to cancer (presented as a foreign body/mass in the stomach). I can't go through this again so soon...
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oh man, I'm sorry you are going through this crisis so soon after loosing your dog. I will pray for wisdom for the vets that they can find the best way to treat your cat and get him feeling good again. :(
 
Please find a new vet. Uncontrolled diabetes causes the body to be unable to use the food. The body literally starves. This can cause weight loss and organ failure, and might be the reason you are seeing elevated liver values when he was fine a while back. You need insulin to allow him to utilize the food and prevent all the complications. When cats have uncontrolled diabetes, they get damage to the insulin producing cells in the pancreas. The insulin allows the pancreas to "rest" and heal. Only once the pancreas heals a little, can the disease be controlled with food only.

Diabetes usually happens for no specific reason in cats. It's very common.
 
Do you live near a university with a vet school or a city with a multi specialty vet hospital? It sounds like Sporky needs an ultrasound to determine what/where the mass is...and then a plan of care. Possible surgery? And he might even need an ultrasound of his heart if they are thinking it is involved. If the mass is messing up his liver and pancreas lab values, it needs to be addressed...but he may need day to day management of his blood sugars just to keep him going. He might need a anti nausea med--they really help, and an appetite stimulant (sorry, don't have drug names). Also, he might even be a candidate for a feeding tube if his vomiting gets out of hand? I'd suggest offering him some FAncy Feast or Friskies Pate to free feed--just a bite or 2 every little while may stay down better than just 2 or 3 meals. Sending prayers for you and him...
 
Thank you, everyone.

He is getting an ultrasound tomorrow, and if that doesn't show anything possibly an echocardiogram for his heart. I will definitely be doing surgery is he needs it, though I am hoping it won't come to that. He doesn't vomit a lot, which is strange. Maybe like once a week/every other week or if he eats too much in one sitting. Appetite is not an issue either thank goodness, haha. Cleans up his bowl every meal and then goes and meows at someone else pretending he didn't just eat (it's worked before!).

He received fluids, antibiotics, and some great pain meds, so he was pretty out of it for awhile after his appointment. I'm going back today to pick up some more pain meds. He's been hiding from me most of the time now (can't blame him), so I haven't been able to get a glucometer reading yet. Will try later on.

Edit: His blood sugar was at 445 at +6 :(. The highest it's ever been. I had just given him some not-so-good treats just before so I'm hoping that has something to do with it. The treats were Friskies Party Mix.
 
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Another update.

Ultrasound showed no mass! Just a very "bright" pancreas, which means scarring from a previous episode of pancreatitis. We adopted him when he was 4 years old, so I can only imagine that this happened before that. I'm so thankful that we are finally getting some answers.
 
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