Refractory diabetes? & lack of appetite...

[SVAFR]

First, thank you to anyone who is reading this & also who has any experience to share. From reading prior posts, this seems like an incredibly supportive community, and right now, I could use some of that... :(

Ok, so...Strasti was diagnosed as diabetic in March. He was put on PZI and apparently, he was doing so well on it, that sadly enough, he had a massive grand mal hypoglycemic seizure this past Sat (I swear to you, he showed no symptoms prior to the seizure...he is the most stoic kitty I know, that being his fourth seizure ever...). He spent the weekend in kitty ICU, on Valium and a dextrose drip, and then stayed at the vet's until Tues; he has been completely taken off insulin. He returned to the vet on Thurs due to -- finally! -- signs of hypoglycemia: lack of appetite, lethargy, and my testing his BG at 47. On Thurs, he was given Clavamox to clear up an infection that seemed to be troubling his bladder, Pepcid AC to settle his stomach and getting him eating again, fluids to clear up dehydration and his BG seemed to register at 105...which may in part have been due to my giving him honey an hour & half prior to the vet testing him.

I get him home and he *seems* to perk up a bit...he ate a bit. His food stayed down. Then, today -- no food, no water, cranky as all hell. Honestly, I would be too if my bladder irritated me, my stomach was aching and I hadn't really had proper sleep in almost a week! So, I tried force feeding him...6 hours later he vomited it all over my bed. He licked a little food off of my fingers and I gave him his second dosage of Pepcid...and then his Clavamox. 45 minutes later, he vomits a little -- what looked like -- stomach acid or mucous, and then he proceeds to the litter box to excrete a puddle of diarrhea. Not exactly completely fluid-esque, but the consistency of pudding, I guess (sorry, gross image). I give him a little time and I run out to the grocery store after talking to my mom and I get him some pumpkin -- which he loved and I discontinued giving him due to his diabetes diagnosis -- and baby food. He eats a tbsp of the pumpkin, turkey baby food and chicken & rice baby food. I'm praying that he keeps this down & that the pumpkin bulks him up a bit. I have not given him anymore Clavamox or Pepcid as I think that that may have been what was initially irritating his belly...but my fear is also that the Clavamox -- which was his 4th dosage by this point -- hadn't had enough time to be absorbed into his system.

Has anyone had a kitty go refractory with their diabetes and then had to cope with trying to balance him back out again? I haven't tested his BG since he's eaten -- as I don't want to stress him out anymore & I want the food to stay down -- but after his first vomit (which was quite a lot) this afternoon, he was at 84. I'd like for him to stay at least 100, but I'll take 84. I will call the vet tomorrow morning no matter what, but any thoughts from anyone -- good or sad -- would be appreciated. I feel very much in the soggy (I can't stop crying, all week long...) dark right now...many thanks for your patience in reading this & your consideration.

[Catty1]

Give your baby lots of love, and do your best to give him good vibes. Hard to do right now...but it will help him and you.

I have no experience with this particular issue...but it will be up and down for a bit, it seems...a roller-coaster.

My mom's cat has a hard time with Clavamox - so another antibiotic might be in order.

Also - see if some of the meds can be in the form of a paste that is rubbed into the cat's ear.

I know of chromium supplements that can be mixed in a cat's food, and greatly cut down on diabetes meds(used by humans also). Again, ask the vet.

hugs and I hope your baby is better soon! (and you too!)

[SVAFR]

Strasti has had Clavamox before, so I didn't suspect that it was it right away -- but I took him off of it, and voila, he's happier now. :) I've been feeding him Hill's AD and he has eaten 1/2 can over the past 3+ hours. I'm thrilled. :) He got a nice brushing and he's been more actively "engaged" in what's going on around him. I'm hoping that this upward trend continues. :)

Thank you for your thought. :)

[Catty1]

Awww, WHAT a sweetie! He is GORGEOUS.

I am SO glad to hear he is better.

Clavamox makes my mom's cat ill also - except he starts scratching like mad and meowing!

Yet my cat tolerated it fine (though I gave frequent treats of plain yogurt to restore the flora to the digestive tract, which the antibiotics kill - good bacteria, bad bacteria, they don't care! :D )

Hope it's all upwards from here...and you don't have to cry any more! :)

[smokey the elder]

Clavamox seems to interfere with insulin somehow. My Mobius was at one unit once a day, and stable, then had clavamox. Her insulin requirements spiked to 3-4 units twice a day!

How old is your cat? Is he on insulin at all? My vet would say not to give him insulin if he can't eat. Moby is on PZI.

I haven't had any problems with her going hypoglycemic. Her insulin needs go up and down gradually.

PM me if you have any questions. Moby was diagnosed in January, and has no hyper or hypoglycemic episodes (Knock wood). She's 12 years old.

[SVAFR]

I will be calling my vet on the Clavamox issue tomorrow morning...once Strasti threw it up again yesterday morning, he found his appetite and began to eat again...and then today, wow! He is taking it slow & easy with eating, but his energy level is increasing, he's perky again, he's my Strasti again. :) While he's not out of the dark yet, he's blowing me away by his sheer determination. :)

Strasti will be 6 in Sept, and he was on 4 units @ 2x daily of PZI until Sat morning, the 22nd. That afternoon he had his seizure and has not had any insulin since. In testing him at home, his BG has wavered between 60 (after vomiting) and 100 over the past week.

My fault lies in that I wasn't more vigilant with hometesting prior to each dosage of PZI since his last vet appt when he was deemed to be doing beautifully on his insulin. Anytime Strasti has been majorly ill, he has never shown any signs until literally the actual worst happens. His stoicism awes me, as well. I had no idea that he was going hypo, as he always ate like a horse, was behaving as usual, all of the above. Then I come home, and he's convulsing in the closet for what the vet predicted to be around 4 hours. Now, the goal has simply been to get him eating again, then combat his infection and from there, get a curve done, get him on W/D and DM, and figure out what to do next for him...if it means a gradual reintroduction to insulin or whatnot, then so be it. However, I do know when I've made a mistake and I will not be making it again; lesson learned!

Thank you for your response; I appreciate it! :) Good luck to you & Moby! :)

[Catty1]

Just to be a pest....ask your vet about the chromium. It regulates blood sugar, and might be of help here.

hugs!

[smokey the elder]

I find that insulin needs cycle, and especially at the higher doses (3-4 units 2x/day) testing is especially critical. Within a week Moby went from needing 4 units to 0 units (this can happen once in awhile; no one quite understands why.) I think that may be what happened to your precious baby. I'm glad he's doing well.

My vet actually prefers people to use the urine test strips. He thinks blood testing is stressful. But if you're used to doing that (and the cat is) it's probably more accurate.

[SVAFR]

Good to know...I had no idea that by going to 4 units how much more serious it had become. My vets have been really low-key with me -- perhaps because I've been so anxious -- and neither really advocates for hometesting, but I keep on it any way, especially now, at least. Thanks again. :)

[smokey the elder]

The vet doesn't advocate daily monitoring? I'm afraid I don't agree with that. You might want to consult with a feline diabetes specialist. My vet consults closely with one, and says I should test at least once a day.

[SVAFR]

In thinking back as to why the vet told me that about homestesting, my thought is that she didn't agree with it not because of its obvious advantages, but I think that she's dealt with too many owners who have tried it as well and botched it up because her response was, "You're tearing up his ear? Awww..." My other thought is that with so many monitors being on the market, it's hard to know which is a good one to buy that will give an accurate score, as well as pet owners not realizing that BG can fluctuate throughout the day & creating false alarms when seeing a low score. From judging my vet's reaction, I think that she's just dealt with too many uninformed clients...my other vet hasn't told me not to hometest and he listens when I tell him what BG scores I get. Both vets do listen, but I really give the first vet the benefit of the doubt because she's currently dealing with 6 different cases of feline diabetes, and only my cat responded to the insulin -- to the point of going the opposite direction. As for the other 5, I'm sure that she's beside herself trying to help her other clients.

[smokey the elder]

I think that's why my vet likes the urine test strips. It's more of a "composite" result over time, and changes much more slowly. People on the feline diabetes web site are big fans of the blood glucose meters, but I always wondered how you calibrated them for a cat.

[Freedom]

I have no direct experience with cats with diabetes. What I DO have is a father who lives with me, is diabetic, and doesn't pay attention so I have to. I subscribe to several diabetes magazines, and they have all, at one time or another, run an article on feline diabetes. (Apparently diabetes is more common in cats than in dogs.) I agree, you need to find a diabetes specialist vet, even if it is for just once or twice. Monitoring blood glucose levels is important, I can't believe ANY medical professional (human or otherwise) would not advocate it. Particularly if you are giving insulin.

There are guidelines out there, you need to find them. Here is what to look for: times of the day to test, frequency of testing, how long before / after eating to test, how long before / after giving medications to test. Parts of the body to test, - the ear is NOT the only place! That I DO know. Whether or not to leave food out and available all day / night long. How much food to give, how often. Humans have fully digested a meal in about 2 hours, so Dad tests 2 hours after a meal as that "should" be his highest reading. I don't know what it is for cats, but you need to find out, is it 2 hours, half an hour, etc. I assure you, the information is out there.

In terms of which meter to use, with humans a lot of that is dictated by what your health insurance will cover and what your doctor wants you to use. Some can let you download the results onto your PC and get graphs to see how things are going. If you have the opportunity, contact the senior center in your city or town and see if they have a diabetes educator available. That person can give you the best info on meters!

Good luck
Freedom

[Freedom]

I am just now reading the November 2006 issue of Cat Fancy magazine. There is a new hand-held blood glucose monitoring system for easy testing of cats with diabetes. The article says it costs $80, and more info is at ww.abbottanimalhealth.com.

[smokey the elder]

Nice! Thanks. I definitely need to check this out.

I just went on the web site. This looks like an impressive product. I can't believe how far human meters are off!

[bijou0304]

Hello -

I had a question about Clavamox - my cat Bijou is on PZI too and appeared to have gone off the charts on BG after taking 2 doses of Clavamox 12 hours apart. He had an infected paw - what was wrong with Mobius when he was prescribed Clavamox? I was closely monitoring his BG as he just was put on it a week ago and there was no major increase that appeared due to the infection, just after he was on Clavamox. I appreciate any input - thank you for your help! :D

Barb & Bijou



Clavamox seems to interfere with insulin somehow. My Mobius was at one unit once a day, and stable, then had clavamox. Her insulin requirements spiked to 3-4 units twice a day!

How old is your cat? Is he on insulin at all? My vet would say not to give him insulin if he can't eat. Moby is on PZI.

I haven't had any problems with her going hypoglycemic. Her insulin needs go up and down gradually.

PM me if you have any questions. Moby was diagnosed in January, and has no hyper or hypoglycemic episodes (Knock wood). She's 12 years old.

[smokey the elder]

Moby had a urinary tract infection. Fortunately, she has not had any sicknesses (other than her diabetes) and is stable on 2 units PZI twice a day. Her weight has stabilized as well. She gained weight very rapidly at first.