Expert: Norman Auspitz - 7/22/2010

Question
I have a 10yrs old cat that was diagnosed as transient diabetes in 2009 after she presented of  excessive thirst, frequent  urination,vomiting and some loss of weight.The vet started her on NPH insulin but stopped it  after 3 months when her blood glucose turned out normal. Last March I brought her to the vet again for the same symptoms but this time with diarrhea and more weight loss.The superchem that was done shows only very mild anemia.The vet had an ultrasound of the abdomen done twice that shows as he told me " mild increase on the swelling of the intestines than the first ultrasound".Now he is telling me that he still not sure what she have and want a biopsy.She's been on Flagyl syrup and had taken a week of amoxicillin for the stinky stools.The stools smells 100% better after a week of antibiotics.She is still on Flagyl.The W/D diet canned food was prescribed and I tried to give it to her but she won't eat it.I have to give her Insulin and Flagyl so I am forced to give her the canned food that she eats after awhile. The diarrhea now seems less but her  ravenous appetite is also less for the last 3 days now.She still drinks a lot,urinate a lot.She lost about 10 lbs from the time the symptoms appeared and gained only 6oz inspite of the ravenous appetite. I don't want her to undergo surgery and suffer more if it is lymphoma but not sure if it is the right decision.Can she take the Prednisolone if she is really diabetic? The vet said her sugar could be elevated because of some other problem.Can't the 2 Ultrasound showed enough of the lymphoma or other intestinal problem? What other tests can be done to confirm a diagnosis?

Answer
Dolores,

Remember, I am not a vet.  Before I would worry about the possibility of Lymphoma, I would have your vet research and check for a nasty intestinal parasite called tritrichomonas foetus.  Dr. Judy Gookin, North Carolina State University, has done extensive research on this organism in cats and it can be tested and treated. Many IBD/IBS situations turn out to be this.  Flagyl will help some, but is not powerful enough to kill this organism.

http://www.cvm.ncsu.edu/docs/personnel/gookin_jody.html


The following link is to a lay guide to this disease:

http://www.cvm.ncsu.edu/docs/documents/ownersguide_tfoetus_revised_120909.pdf


When we have been faced with a possibility of lymphoma vs. other diseases, we treat for everything else first and then see if lymphoma is still possible.  When we are pretty sure that is what we have, we put the cat to sleep.

My understanding is that, in humans, diabetes causes excessive thirst, voracious appetite and weight loss.  As far as the prednisone, I cannot comment as I am not a vet.  I do know that there are cases that even insulin ceases to control blood sugar levels in some cats.  

You can also subscribe to an e-mail list called fanciers health (send an e-mail to:

fanciershealth-subscribe@yahoogroups.com  )

which is monitored by feline veterinarians.  This list should be much more helpful than I can be on this very complicated issue.

I am sorry I cannnot be of any more help.

Best regards... Norm.