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Emergency and Critical Care Vet
Emergency and Critical Care Vet, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 29
Experience:  8 years experience - general practice, emergency care, and rabbit medicine
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I have a 12 year old cat, diabetic @ 1.5 years, got off kilter

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I have a 12 year old cat, diabetic @ 1.5 years, got off kilter 6 months ago and we are struggling t get him back. Now on 12 u bid, md cans of food. Last week started increased urination, missing litter box. Today he had gone sharply downhill and now is not eating, appears to be constipated and is extremely lethargic. Don't want to take him to an emergency vet - woudl rather see our own in the morning so any advice? Would an enema help? (I can't blame my husband for letting it get this far this week while I had to be away taking care of a relative) Thanks in advance for your advice

I am sorry to hear about Thomas' difficulties with is a very challenging disease!

A couple of questions to help me if you could:
1. What type of insulin are you using?
2. What is Thomas doing that makes it appear he is constipated?
3. Has Thomas ever been well regulated?
4. Any other significant past medical history?

Customer: replied 8 years ago.


1. Our Vet XXXXX XXXXX prescribes Protomine Zinc Insulin (PZI) 11u/ml, veterinary use only.

2. He struggled to get into his high wall litter box and tried to have a bowel movement and nothing. He did have one yesterday I know.

3. He was until I used a friend's deceased cat's insulin 9 months ago and mis-read the strength. He WAS on 1 unit bid until I messed up. I'm embarrassed since long ago I was a vet tech for large animals.

4. none


Customer: replied 8 years ago.

!. Correction - that's 100u/ml

Thank you for the answers...they are very helpful!

So, don't feel embarassed about the mix up on insulin -- diabetes is a labor intensive problem to manage, and there are many different types out there.

12 units of PZI insulin twice daily is a lot for a cat. Often when a cat is on this high of a dose, and is still not regulated (especially when on an appropriate diet like you have Thomas on) there are other factors at work. Some possibilities:
-Thomas has developed an insulin resistance, possibly from the friend's insulin event.
-Thomas is actually over-dosed, but his body is releasing extra stored glucose, so his readings are continually high.
-Thomas has a secondary illness.
These are all difficult scenarios to parcel out, and take some time. My suspicion is that some one or combination of the above is occurring with Thomas.

However, more to the point of your question this evening. When we have diabetic patients that have an acute decline in status (for example, not eating, lethargic, vomiting, etc.) we start to worry about diabetic complications such as ketosis or ketoacidosis. These can be life-threatening. So, overall my best advice is to see the veterinarian this evening to rule this problem out. It could be that Thomas just has an upset stomach or a bladder infection (maybe he was going to urinate rather than defecate...), but you will sleep much better knowing it is something minor like that rather than the more serious complications mentioned above.

If going to to the emergency clinic is not a possibility, then things like syringe feeding food and water would be supportive steps until the morning; however, I would highly recommend you head over to the E-Clinic.

Hope that helps!
Emergency and Critical Care Vet and 2 other Cat Veterinary Specialists are ready to help you
Customer: replied 8 years ago.
I do worry about ketosis/ketoacidosis and if his age is just working against him at his point. For the last 2 months he's been ravenously hungry. When he was 1st diagnosed long ago he had large bowel obstruction and tonight he's looking similar with a distended belly and dehydrated. It's 10:00 here and the ER is pretty far away. Anything else I coudl try her to settle his stomach?
Customer: replied 8 years ago.

Just wanted to know if you had a suggestion to settle him out other than the syringe feeding. Thank you.

Cats can take over the counter famotidine (Pepcid) as an acid reducer. In general, a cat would take about 2.5 mg (1/4 of the standard Pepcid) once daily.

Other than syringing water, I do not have a good home remedy for dehydration. Sometimes cats will be more likely to drink water if you add some chicken broth or tuna juice. Half strength Pedialyte is often recommend for rehydration, but I would not recommend that in this case due to the sugar content.

Performing enemas in cats is tricky, and not something I recommend at home. The standard Fleet enema can actually make a dehydrated cat much more ill. Rapid enema administration and stretching of the large intestine can make them vomit, and perforation of the bowel wall is always a risk. Most kitties also strongly resent having an enema as well Wink.