What's missing here - Just 'diagnosed' - need help

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joejsullivan

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What's missing on this forum is a "your cat is sick, the vet thinks it's diabetic, you can expect this".

I am having trouble being convinced that the correct things are being done for the cat. I know what and how this would be done in a human but don't know what things, like how often the patient is tested, how soon he will be up and around, etc... is acceptable for a feilne.

He is a stray in the neighborhood that we have taken in, so mostly an outdoor cat. Saturday he was very lethargic, had a bowel movement inthe house (which has never happened), lots of urine passing Saturday night. We took him to a 24 hour vet that xray'd and did some blood work. Didn't find anything except elevated white blood cell. Said he should be admitted and given IV fluids. My fault here, I didn't agree and said let's take the medicine and take him home, he can stay inside.

By Monday he was no better. We brought him to another vet that admitted him and they have now (on Tuesday) said he is diabedic. My wife went to visit him yesterday and said he was still lethargic, sleeping, etc... The wife said they don't appear to be very on top of things.

WHAT I NEED TO KNOW:

How quickly should he respond to treatment?
Should he be more alert?
How often should they be checking his glucose level?
He hasn't eatten since Saturday, should they be feeding him?
Any other things this community may know that I don't?

Thanks,
Joe
 
Hi Joe,

The FAQs may give you a lot of answers: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=2501

Your vet should do a fructosamine test to determine whether your cat has diabetes. It's the definitive blood test. Just taking blood glucose levels in the vet's office can be inaccurate. Many cats are stressed at the vet and stress raises bg levels. So do other things like infection, bad teeth, etc.

If he is not eating, they need to start him on fluids and a feeding tube asap. Cats who don't eat are at risk for several other complications. IMHO, if that vet won't do it, take him to one who will or do it at home. Did they say he might be DKA?

You can treat some of this at home but you will really have to get up to speed fast. Feeding tubes and SubQ fluids can be done at home. Home blood glucose tests are more likely to give you accurate numbers.
 
What town do you live in? Maybe someone is nearby to recommend a vet that is familiar with diabetes.

Did your vet tell you why they think your cat is FD? Did they runa frutosimine test? When my FD, Cedric, ----->
was diagnosed last year, I had taken him in for his annual check up and told them he was drinking alot of water. Has your cat been drinking a lot of water in the past week weeks?
 
How quickly should he respond to treatment?
Should he be more alert?
How often should they be checking his glucose level?
He hasn't eatten since Saturday, should they be feeding him?
Any other things this community may know that I don't?

1 - It depends on his overall condition, how high his BG is, and what they are doing about it. Usually if they are administering fluids, he must be pretty dehydrated. If they mentioned "DKA", that's a pretty big deal. If he's just dehydrated, his condition should improve from that rather quickly.
2 - Again, it depends on the diagnosis. Sub-q fluids, if he's dehydrated, should perk him up some quickly, like after a couple treatments.
3 - Sorry to sound like a broken record. If his BG is very high, or he's DKA, they would be giving him fluids and short duration, quick acting shots of insulin to try to get his numbers lower quickly. In that case, they would be testing his BG every couple hours I think. Before giving insulin, so they know what the last dose did and can figure out the next dose. The need to get his BG down, and get any ketones out of his system as quickly as possible. Here's a link that explains "diabetic Ketoacidosis" :
http://petdiabetes.wikia.com/wiki/Ketoacidosis

4 - If he's gone that long without food, they should be forcing the issue, either by syringe feeding or by putting in a feeding tube. He could develop "fatty liver" or "hepatic lipidosis", a liver related condition caused by not eating, in which the liver attempts to convert fat to energy, but it results in excess fat in the liver itself. This, and DKA can be fatal if not treated. The treatment for fatty liver is feeding any way possible. Judging by what you said about his current condition, that would mean force feeding or tube feeding, IMO.

Please let us know what you can find out as far as what the latest diagnosis is. Lots of kitties here have survived DKA, fatty liver, and of course, just plain old diabetes. Lots and lots of experience and knowledge for you and kitty on the board...

Carl
 
Yes, I agree with Sue, a fructosamine test will give the average of the blood sugars for the past two weeks, and that is how to tell if the cat is really diabetic or just stressed from the vet or having pain or something.
Also, it is very very important that your cat eat. You do not want your cat to develop fatty liver (hepatic lipidosis).
If the cat is not eating on his own, then either syringe feeding or a feeding tube will save his life. I'm going to send a PM to Karrie and Maverick, and hopefully she will be by soon to help you discuss getting some food into him.
I wish you the Best Of Luck getting your cat all better again.
 
Cats can't go without food for very long without a crisis. Their livers when they use body fat for energy - when they don't get enough calories via food develop Feline Hepatic Lipidosis/Fatty Liver which is liver failure. My cat Maverick almost died - he lived through the help of wonderful forums such as this. If we listened to the vet who got us in that situation he would have died. His story is in my signature. So based on a cats biology food and enough calories to maintain weight and not lose weight is critical. Many people can syringe feed their cats but if you can't get enough calories in by syringe you have to go with an e-tube - which is a feeding tube. Cats that are recovering from DKA need even more calories than just maintenance calories.

It sounds overwhelming but take it one step at a time. This board will help you manage diabetes. They are the diabetes experts.

There is a yahoo group you need to join - the Feline Assisted Feeding Forum. It is dedicated to helping owners assist feed their cats so they get through these crises. When you join - there is a video on the home page of an owner assist feeding their cat with syringe. You will be sent an auto-file on how to safely assist feed which gives you the crash course and ideas on what may work better for your individual cat - spoon feeding, finger feeding etc.

There are many reasons why cats go off food - one is stress. Anything that causes them stress - renovations, changes in cat litter, changes in food, additions or losses to the family unit, boarding/vacation, undiagnosed illnesses, weight loss/FHL, pancreatitis etc.

Food and calories right now is critical for your cat. Lots of them. Iams MaxCal from your vet is 330 calories a can and only 3% carbs. It is worth its weight in gold in calories per ml.

Nausea may be a problem - symptoms of nausea in cats are showing interest in food but just licking or sniffing and walking away, lip licking, lip smacking and teeth grinding. Do you see any of this?

So join the Yahoo group tonight and read the autofiles that you are sent starting with assist feeding. The sooner you get the calories in, the liver will recover or not be damaged further and you can hopefully avoid DKA on top of that. Unfortunately vets seem to be very behind the forums, but they are experts because they help thousands of cats with specific issues. Vets may see a handful a year.

Good for you finding the forum and doing what you need to do for your cat. This board is absolutely amazing. You are in great hands.
 
Thank you all very much for the follow up. It is very appreciated.

We visited the cat tonight and he was much better. A few minutes after we started to scratch the side of his head he stood up, walked to his food and ate all of it.

BTW, the FAQ covers none of this that I could find, it's all about once the cat has been taken home, not while the cat is fighting in a vet's cage.

Sue and Oliver, carlinsc, you hit it exactly. I have a vet friend and she did get in touch with me shortly after writing my initial post. Everything you told me is identical to what I was told and asked by her.
Dyana, thanks for the interest and word of support.
Karrie and Maveric, great info on eating, thanks a ton.


Never having been through this it's hard to say "the cat drinks a lot". What's a lot? Other literature you read will tell you depending on food they may drink more water or less water. Thinking back on it now, yes, he probably would eat and drink more than normal.

Thanks all for your help. Hopefully he gets to come home tomorrow.

Joe
 
I'm glad to hear that your kitty is starting to feel better and especially starting to eat again.

We are very new here too...I've had so much great advice and information from everyone. They are great and we've been thankful to have such a great cheering squad in our corner.

All the best for you and your kitty!

T
 
joejsullivan said:
Never having been through this it's hard to say "the cat drinks a lot". What's a lot? Other literature you read will tell you depending on food they may drink more water or less water. Thinking back on it now, yes, he probably would eat and drink more than normal.

Thanks all for your help. Hopefully he gets to come home tomorrow.

Joe

Well, I had never been through it either, but I felt that getting up in the morning to find an empty water dish "a lot of water drinking." :shock: this was not happening every day, but I could tell his water intake was more than normal by what was left int he dish in the morning (I refill with fresh water every morning). I had Cedric for 5 years at that point (adopted him at 7 months from SPCA) so I knew his habits. fortunately for me it was happening in late March, right after I had bought the house and was getting ready to move, but right before his annual checkup.
 
Hi Joe welcome to FD! What is your cats name?
Is he home yet?

We are all waiting for a update.

Jenn & Baxter cat_pet_icon
 
Sue and Oliver (GA) said:
Let us know how he is doing, Joe.

He wants to go back outside really, really bad. When we got home he leaped out of the box.

Oh, and his tests came back normal today! We are watching how much he eats and is drinking. Antibiotics for 10 days, slight bladder infection. He's urinated maybe 4 times in 7 hours.

thanks for asking!

Joe
 
Joe this is good news. A infection will cause BG to higher. Give the antibiotics sometime to work. Some antibiotics give cats a upset stomach or will cause diaheria. Just letting you know up front. Once his BG comes down he will stop urinating so much.
Now that he is home with you & you have meds & know about diet. You can remove the 911 icon by your post. don't delete your post though.

Post as much as you want. There is always someone on here that will be able to answer a question.
Keep us updated.
Jenn & Baxter cat_pet_icon
 
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