Question Details
Diabetic In A Cat
by TropicalVet - October 12, 2014    View Case Report
A cat was referred to me:
A 14yo DSH neutered male. He has been a stabilized diabetic (mellitus) with very compliant owners that are able to do glucose curves at home.
Recently the cat needed a canine tooth to be extracted and had a full dental.
At the time it was discovered that he was FIV positive, but pre-anaesthetic blood work was normal. Cat recovered well, but developed diarrhoea a week after surgery. He now gets diarrhoea on and off, particularly after finishing antibiotics and despite the owner giving probiotics.
He is described as "unwell" by his owners, is less active and his appetite decreased. His glucose levels have been running high as well.

On examination the cat was lethargic (suspect glucose was elevated into 20's at the time of visit), had pronounced gingivitis and ears and head felt hot. His third eyelids were drawn across and his femoral pulses were very weak. The cat is overweight, but only slightly (6kg).

What would you suggest to start him on?
What is the significance of the new FIV diagnosis and what is the best way to address this?

Thank you
Replies
by naturevet
October 14, 2014
Hi there,

It looks like you have a challenging case on your hands. In general, it seems the cat is "hot and deficient", which implies a diagnosis of Yin deficiency with Empty Heat. Specifically, I wonder if there is Stomach Fire, with secondary nausea or at least damage to the Spleen Qi.

Findings that indicate a need to cool:
- stomatitis/gingivitis
- hot head and ears
- diabetes in general in cats
- improvement on antibiotics (which are cold) and worsening off them
The pulse suggests we not be too exuberant in clearing Heat, which to my mind rules out a lot of the traditional treatments like Yu Nu Jian and Qing Wei San, both of which contain Shi Gao, which potently suppresses appetite in small animals

I'd look at Zhi Bai Di Huang Wan, which has some heat-clearing properties, is indicated for diarrhea (esp. colitis) in Yin deficiency, and contains herbs to stabilize diabetics, including Cornus and Rehmannia. It is the classic basic formula indicated in Empty Heat and Fire affecting the entire body. It can be very helpful in feline diabetics and is our go-to for diabetic neuropathy. I'd give it a try. If you need help sourcing it, you can contact Barbara Fougere through CIVT

Hope that helps,

Steve
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