Expert: Jessica - 12/16/2009

Question
My cat was recently diagnosed with diabetes.  He received his first insulin injection yesterday and spent all day at the vet for observation.  He hasn't wanted to eat since he came home and his engery level is dimishing slowly.   I already called the vet and they told me to monitor her tonight and if she didn't eat to take her into the office tomorrow morning which I plan to do.   I thought that perhaps she was hypoglycemic so I gave her a tablespoon of karo syrup but even after that she was still weak and didn't want to eat. Now she is licking her lips alot and   I'm wondering if these are signs of something more serious and if she needs to go to the emergency room?

Answer
Hi Sandra.  She could be licking her lips due nausea, and this would explain her reluctance to eat.  It may be just a coincidence that she's got a stomach bug on the same day that she started insulin.  But licking the lips could also be due to the Karo syrup.  It can leave a very sticky residue in the mouth.  Additionally, Karo syrup can cause additional dehydration in diabetic cats, and this can cause their lips and gums to be tacky.  I would recommend to try feeding her a little bit of water with a syringe or eye dropper and see if this helps.  

Hypoglycemia is extremely dangerous, as you know.  If you suspect hypoglycemia may be setting in, one teaspoon of Karo syrup is generally enough to raise blood sugar to a safe level.  Many vets recommend giving the cat 1 ml (1/5 teaspoon) every 15 minutes rather than giving the whole teaspoon at once.  Some people do advise giving as much as a tablespoon to cats, but this can cause a sugar spike that makes the cat feel even more poorly.  My own vets recommend starting out with just 1 ml, and to administer more every 15 minutes if required.  Obviously, skip the next dose of insulin and resume only after the cat is eating normally.

It sounds like if this was hypoglycemia, you have treated it in time.  My experience has been that emergency vets have found it unnecessary to treat cats who had mild symptoms of hypoglycemia any further, and they tend to suggest monitoring at home.  Nevertheless, and I tend to err on the side of caution, and as it's her first day on insulin and this behavior has developed, it may be wise to get her to an emergency hospital.  You could have her glucose checked, and have her examined for other possible causes of her behavior.  At the worst, you will have spent some extra money to find out it could have waited until morning.  But it will be well worth it if something serious IS found.  With my first diabetic cat, I did make a couple trips to the emergency room because I wasn't very familiar with the behavior of a hypoglycemic cat.  This is always a safer move to make than staying home through a potentially life-threatening situation.  In time, you will begin to pick up on subtle behaviors and will be able interpret them on your own.  

I hope she's feeling better soon!

Jessica