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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 30299
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My 15-16 year old cat was diagnosed with diabetes. Classic

Customer Question

My 15-16 year old cat was diagnosed with diabetes. Classic symptoms: increased thirst, urination, dehydrated, eating but still having weight loss. Initially was started on saline drip because of the dehydration, then taken off once diabetes diagnosed. 1 week ago put on VETSULIN, 1 unit / 2x day plus Purina DM Diabetic Formula food. Weighed in at 10 pounds (probably down from 14 or 15). Went to wash her two days ago and she was so horribly upset that she starting panting to excess, and I thought she was going to have a heart attack. Two days later, she still has somewhat heaving sides, labored breathing. I'm certain there's something much more serious going on than just diabetes.
Submitted: 1 year ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 1 year ago.

I agree with you. While uncontrolled diabetes mellitus is certainly a dangerous and life-threatening disease her abdominal breathing and dyspnea (difficulty breathing) isn't consistent with a cat being well-controlled on her current insulin dose.

How well she's responding to 1 unit of Vetsulin needs to be determined. When is she scheduled for a glucose curve? Her breathing is most important and a dangerous symptom which needs to be investigated. If her respiratory rate exceeds 40 breaths/minute at rest, she's in trouble. Advanced heart disease (heart muscle disease/cardiomyopathy is most common), a thoracic effusion (collection of fluid in the thoracic cavity), and primary lung disease (neoplasia/cancer is an important differential diagnosis at her age) all need to be considered. You've described a critically ill patient who would be best attended to by an on-call/ER vet at this time. If you don't have access to such a vet, I encourage your being at the door of her veterinary hospital when it opens in the morning.

Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Thanks. I was hoping for a better understanding of what is going on. After the panting attack 2 days ago, she rested so is not in distress. But she does have labored breathing when she walks across the room, then sits and rests. Her breathing is not any faster than the other, healthier cats. Could the diabetes be out of control and creating a strain on her heart? Could a failure in her pancreas lead to the diabetes and the labored breathing? Should I be looking at treatment for a heart condition or pancreas with the diabetes only being a secondary issue, and resulting from the heart / pancreas? The vet I now utilize since my regular one retired isn't bad, but their staff makes alot of mistakes and the specialist is an hour drive away.
Customer: replied 1 year ago.
Or maybe I;'m just not giving the insulin time to stabilize her system. No, she has not yet had a glucose curve and they recommended that in approximately 2 weeks from the start of the insulin treatment.
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you for the additional information. While not as critical as I imagined, her still experiencing heaving sides, labored breathing, and exercise intolerance concerns me. To answer you directly...

Yes, uncontrolled diabetes can cause heart disease in pets and people.

If there's a concomitant pancreatitis - and that's relatively common in our diabetic cats - it could be painful and cause tachypnea (increased respiratory rate) and it could cause a metabolic acidosis (low blood pH) which also can result in heavier breathing. Hence, yes, investigating her heart and lungs is important at this time. X-rays of her heart and lungs +/- echocardiogram (ultrasound of her heart) should be considered.

Yes, she may be underdosed and without a curve we're in the dark. I usually perform a curve 5-7 days after initiating insulin therapy.

Please continue our conversation if you wish.

Expert:  Dr. Michael Salkin replied 1 year ago.
I'm just following up on our conversation about Cat. How is everything going?
Dr. Michael Salkin