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My nearly18 yr old cat was diagnosed with renal desiase 4…

Customer Question
HI Pearl, My nearly18...

HI Pearl, My nearly18 yr old cat was diagnosed with renal desiase 4 weeks ago, strated the sopecial diet food dropped alot of weight 2 weeks ago and has now been diagnosed with diabetes she had a 30mool...? shes not eating very or drinking very much, i have given her a unit of insiulin this morning... just trying to read up online how i can help her.

Veterinarian's Assistant: I'm sorry to hear that. I'm sure the Veterinarian can help with the diabetes. What is the cat's name?

Nala.

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Nala?

Hmm. No i think thats it...

Submitted: 10 months ago.Category: Cat Veterinary
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Answered in 19 hours by:
10/1/2017
Cat Veterinarian: Dr. B., Cat Veterinarian replied 10 months ago
Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 23,438
Experience: Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner, but can you tell me:

If she only on the special diet and insulin?

Will she eat if you offer other foods (not ideal but eating is most important since we cannot give insulin otherwise)?

Any gagging, retching, lip licking, drooling or vomiting?

Can she keep water down?

Are her gums pink or pale/white? Moist or sticky?

If you press on her belly, any discomfort, tenderness, or tensing?

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Customer reply replied 10 months ago
HI thankyou for the reply.She was on renal diet, which she wouldn't eat. so i have brought her fancy feast to get some food into her.
shes on 1 unit of lantus 2 x a day
there was a little bit of licking last night, but this morning she ate and seems a bit more spritley
She not vomitted or gagged anything like that
her gums are pink and moist
her tummy seems fine.
should i be purchasing a blood glucose meter and checking her levels to build a curve?
does her renal food she on't eat anyway, go against the diabetes requirements? Phospherous seems to be the high level in the fancy feast otherwise protien is high and carbs are low.
her back legs maybe suffereing from neuropath - do you advise trying methyl b12? of waiting for glusoce levels to get better.her levels were
GLU 550
BUN 306
CRE 1.76
Cat Veterinarian: Dr. B., Cat Veterinarian replied 10 months ago

Hello again,

Now that is fine as sometimes we tend to need to compromise with kitties to keep them eating but also reduce kidney workload. So, if that is all she will take, its fine for the moment. Though we may want to use a senior version or find a grocery store brand Nala likes with as close to the same protein/sodium/phosphorus levels as her renal diet. That way we can support those kidneys while keeping her happy and allowing us to give her insulin.

Otherwise, we could have her vet start kidney supportive medication (ie Semintra, Benazapril, Azodyl, phosphate binders) to just help kidney function directly and give us more wiggle room on the diet side. Furthermore if her appetite is down (common from kidney disease induced uremic gastritis) even without vomiting, you could try her with OTC Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid) or have her vet dispense an anti-nausea medication +/- gastroprotectants to counter that. And injectable Vitamin B12 could be started but GI formulations tend to be of limited benefit with cats. So, we'd focus on feeding as low protein/sodium/phosphorus as we can and use the above medication to support her renal function further. As we do that, of course we need to be doing blood glucose curves and slowly adjusting insulin as needed over the next few weeks. And if you are keen to do the curves at home (ideal since it takes the stress of vet visits out in skewing the curves and is great to have a glucometer on hand at home if she ever has any issues that make you think Nala is high or low), then we'd want to get her a pet specific one (ie Alphatrak, G-pet, etc) so we can ensure we are getting accurate readings as possible while stabilizing her.

Overall you were right to get her eating but from here, we want to aim for a slow protein/sodium/phosphorus in her diet as possible but also consider the above as those will help us stabilize her kidneys even if she won't have a special diet and ensure we kept hose signs in check as we stabilize her diabetes (ideal since unstable diabetes can damage kidneys) at the same time.

Kind regards,

Dr. B.

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Cat Veterinarian: Dr. B., Cat Veterinarian replied 10 months ago
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. B.
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