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Diabetic cat diet.

Species: Cat
Breed: Siamese cat
Age: 11-15 years
I am the owner of two siamese cats (female) from same litter - 11.5 years old. Both are diabetic.

Emma went into DKA 2.5 years old, which is how we found out she was diabetic. She was extremely sick at the time and very dehydrated. We fought hard for her at the vet and almost lost her. She even went on to become jaundice. She wouldn't eat at all and had to be force fed. However, she did recover and was discharged.

6 months later my other cat was diagnosed with diabetes, but we recognized the early signs so she never was in DKA.

They get 2 insulin injections a day with meals. We monitor their sugars, but only weekly as they hate the glucometer so much. It's often hard to monitor that they both ate, as they used to go right away and eat, but now they eat a bit, leave and come back. However, there haven't been any issues with this.

Emma is hard to recognize symptoms of low or high sugars in. As my vet says, Emma only shows when she is 'really sick'. She throws up weekly, but sugars still ok but go up and down a bit.

We went away for 17 days in July and trained a family member to give injections. First time we ever left them. they did great. We just went away for 10 days last week and on day 7, Emma died. I am devastated over it. Our family says they were alert and Emma was sitting with her feet tucked under her. Food was gone, but he had not seen them finish it each as like I mentioned, they take longer to eat now and go back and forth. There had been some small vomiting earlier in the week, which we often see and associate with higher sugars.

When he found Emma, he called immediately and we started to treat as hypoglecemic and got him to rub syrup on gums. Some response in twitching etc. Rushed her to emerg. Tried for an hour, but dehydrated, low body temp, dilated eyes and determined no brain activity, just faint heartbeat, so let her go.

I'm just still wanting to know why. There was nothing different this time from last time. I am beating myself up over not having him stay and watch longer to see if they ate, but never been a problem. They always go back later on, and typically one cat never finishes all the other's food as well. With all the food gone, I am left to assume that Emma gave up eating for some reason and Anna (other cat) ate the remainder before next feeding (her sugars were very high). They get the same amount of insulin.

She gets stressed easily but that's why we made sure she was in her own home with her sister and had been through same situation with same family member 3 months ago and we came back to her looking good as ever.

It looks to us like there is a pee stain on our chair. Very dry, but we can't see how we wouldn't have seen or smelled that before, so assuming that was her as well. Are we to assume she just gave up eating or something else went wrong?

She is 11.5 and went through a horrible battle with DKA 2.5 years ago. 1.5 years ago I did have her sugars bottom out and she seized but I was able to help her right away. When we test and she's extremely low, she often shows no signs where our other will. In the last month or so, I had noticed she had slowed down a little more at times, but just thought part of getting older for her.

Did we simply lose her because she was stressed and didn't eat or drink and no one saw the signs, she kept getting injections and went hypo or could there have been anything else to contribute. It's so unlike her to just give up eating and drinking like that and so unlike Anna to have taken all the food each meal.

We're having a horrible time grieving for her and worried for Anna as she doesn't know life without her sister.

A general blood test was run when they brough her in and didn't show anything out of ordinary, but just a normal blood screen.


Online vet, Dr. Marie

Dr. Marie replied:

I'm so sorry to hear that Emma has passed away. Diabetes is an extremely difficult disease to deal with. Having a cat survive DKA is quite an accomplishment.

Of course we will never know what happened on the day that Emma died, but I'll give you my thoughts on her situation.

Something doesn't seem to add up here for me. It sounds like the thinking is that Emma went on a hunger strike and because of that her insulin injection ended up causing her levels to go to a dangerously low level. However, if there was an empty food dish and Emma was sitting next to it then it doesn't sound like she was on a food strike.

Do you know if her blood sugars were taken at any point to actually confirm that she was hypoglycemic?

If not, then I would guess that there was something else that caused her to pass away. At 11.5 she was not geriatric but she was definitely a senior.

If, however, her sugars were indeed low then there are a few possibilities. Yes, it is possible that she stopped eating because of the stress of things being different (i.e. you being away.) If she was off food for long enough then her insulin could cause her to go into hypoglycemic shock. However, it usually takes more than just a single meal missed to do this. I would think that if she had completely stopped eating then it would have been more obvious.

Another possibility is if she accidentally got too much insulin. I have seen people be confused and sometimes instead of giving, say 1 unit they end up giving 10. This unfortunately happens often.

Another possibility is that her pancreas was too diseased or perhaps even had cancer.

Unfortunately we will never know.

I am so sorry for your loss. Please let me know if you have more questions.

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Customer reply:

Thanks so much for your quick response. We've gone over with it with our family member many times and insists that did not overdose. Cats were always in 2 different places, so didn't double dose and did it for 17 days this summer. So at this point, I have to take what he says at face value.

So - my only other conclusion is she stopped eating and drinking or eating and drinking as much for some reason. For pancreatitis, is that a sudden onset or something chronic? She was throwing up bile from time to time, but we were used to that with high sugars at times, so would always just check her and watch her insulin.

When a cat goes through DKA very extensively (to the point she almost died) and became fully jaundice and had to be force fed and hospitalized for 10 days, would there have been permanent damage to her pancreas or liver that would potentially shorten her life?

Thanks so much. I won't ask any more questions. just trying to get some closure. My husband and I feel so guilty right now. We hadn't thought of a scenario where one ate and the other didn't as it hadn't happened before.


Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome Sarah.

Pancreatitis definitely can be something that comes upon a cat very suddenly. If a cat with diabetes gets pancreatitis on top of the diabetes it can definitely make the diabetes go out of control and can lead to diabetic ketoacidosis. Similarly, pancreatic cancer can cause serious problems in a diabetic cat as well.

I'm not sure if going through DKA could cause permanent damage to the pancreas. I can certainly see that it is possible.

Please don't feel guilty about this. I really can't see any scenario where Emma's death would be your fault. Sad things like this happen all the time, and all too often we don't know the cause.


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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

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