Oberon diagnosed with diabetes and early stage kidney disease

[roguethecat]

Oberon went to have his teeth cleaned, and the bloodwork showed elevated blood sugar and creatinine. He is about 12 years old where such a diagnosis would not be a surprise, but it is! I do not notice any of the associated symptoms. He does not drink more than other cats, he is not lethargic and frequently gets the zoomies, he does not want food more than other cats (just attention and treats).
Admittedly he does like to go out and sit in the yard, so I can't monitor everything he does. He is quite active though, in and out, up and down cat trees and sniffing other cat's butts.
What he does is being scared of everything who is not a cat - every noise, human, dog, and definitely the vet. Once grabbed he gives up and the people at the vet thinks he is sweet, but he really is terrified and frozen.
The last vet (we did a dental last year as well) also saw a blood sugar spike, and we concluded it was just Oberon being terrified. Last year's vet office was completely disorganized, which is why we went to a fear-certified vet this time to have a mass on his leg checked out (this is being removed while the teeth are cleaned, apparently last year's vet also did not do a good job with the teeth ).
Question to you: did it happen to you that a cat was diagnosed diabetic and then it turned out just having a blood sugar spike because of vet terror?
Could the elevated creatinine be due to him not drinking and not having any food this morning?

 

[LTS3]

Many cats are super stressed at the vet's office so they almost always have a super high blood glucose level. A fructosamine test, which has to be specified on the paperwork when the vet submits the blood sample for analysis, is a much better indicator of blood glucose levels. It's similar to the AC1 test for Human diabetes. I personally would not worry about the blood glucose level that was done as part of a typical CBC / chem test.

Dehydration can cause elevated creatine levels. Your cat probably didn't drink much prior to having the dental procedure. I would have the vet repeat blood work in a few months to see if the kidney values have changed. Elevated BUN and creatine levels are usually what indicates kidney issues.

 

[pipperoo]

Yes to both I think!

Which bloodtest did your vet do? A1C?--it measures blood glucose over time and if this is elevated, it is more likely your cat has diabetes, than a 1 time bloodglucose test). A more accurate picture is home testing the blood over several days. Vets will often lend you a blood glucose monitor for a few days. I have some tricks and tips if you decide to home test - my cat would actually come to me for her blood test because she enjoyed the little ritual so much!! If blood testing is totally out of the question at this stage, then using urine glucose pee strips can at least give you an idea if he has too much sugar going on. You can get them at any pharmacy.

Creatinine can definitely be affected by dehydration so if he went to the vet without eating/drinking, it could impact results.

I hope your Oberon is A-okay. He's a lucky man to have someone who loves him so much!

 

[roguethecat]

they measured blood glucose several times, and in the notes it is 376 mg/dl. I've found that stress hyperglycemia can be up to 360 mg/dl, which would not be far off. So at home blood testing would be perfect to find that out... please share any tips about that!
Vet wants to start him on insulin and come back in 2 weeks for another blood work

 

[LTS3]

they measured blood glucose several times, and in the notes it is 376 mg/dl. I've found that stress hyperglycemia can be up to 360 mg/dl, which would not be far off. So at home blood testing would be perfect to find that out... please share any tips about that!
Vet wants to start him on insulin and come back in 2 weeks for another blood work

I honestly wouldn't worry about elevated blood glucose levels caused by a trip to the vet. I used to take a diabetic cat on insulin and diet to the vet monthly for an all day blood glucose curve and the levels were always way higher than a curve I would do at home.

Info on how to test a cat's blood glucose level: Home Testing Glucose Levels in Diabetic Cats All you need is a blood glucose meter (Human diabetic brand like OneTouch is fine), necessary supplies (test strips for the meter, lancets), and something to warm the cat's ear to help the blood flow better so you can stick with the lancet and get enough blood (microwaved rice sock is popular). And a treat reward for the cat after testing.

I would hold off on starting insulin. Learn how to test your cat's levels at home first. You may see more normal blood glucose levels because of your not-stressed out cat. Record the levels and the time you take them. If you can only get one test done in a day, that's fine. If you can get more spread out over the course of the day, even better. If you're computer savvy, you can track the levels on a spreadsheet and get fancy with graphing it out.

What are you feeding your cat? A high carb diet, either dry or canned, can cause some cats to be borderline diabetics. Simply changing the diet to low carb food, preferably canned food, is often enough to resolve the high blood glucose levels in cats. Low carb is anything under 10% carbs on this handy chart: https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf Lots of options from Fancy Feast Classic pates to higher end brands. Gravy / sauce based foods are too high in carbs because of the starches used to thicken the liquid. I'd give a new diet a solid two weeks to "work". Keep testing so you can see if the diet change is enough to lower blood glucose levels into the normal range. Show the results of your blood glucose level tracking with the vet and re-discuss the diabetes diagnosis and insulin treatment.

There isn't a similar chart for dry food but pretty much all dry food are high in carbs because of the starches and stuff used to hold ingredients in kibble shape. Some cats are super sensitive to carbs so even a little dry food (or even high carb treat) in the diet can keep blood glucose levels in the diabetic range. There is the Young Again dry food that claims to have zero carbs but that has been the topic of many debates on the FelineDiabetes.com message board.

 

[roguethecat]

to all of those whose cats are super stressed at the vet with high glucose levels, could you tell me how high the levels were?
I've ordered a blood glucometer (vet did not have one I could borrow)... Oberon is highly upset that I blocked the cat door for him to go outside. He is supposed to be out of it from anesthesia, but keeps running around looking for places to escape

 

[roguethecat]

also, he now is covered in dandruff that he did not had this morning. I've asked the vet tech if this can be due to anxiety and she did not know. Definitely looks like it though!

 

[roguethecat]

I honestly wouldn't worry about elevated blood glucose levels caused by a trip to the vet. I used to take a diabetic cat on insulin and diet to the vet monthly for an all day blood glucose curve and the levels were always way higher than a curve I would do at home.

you are so right!
I've purchased a cat glucose meter because I was worried the human one would not be accurate enough (apparently the distribution of glucose in the blood is different among species). Tried it on a healthy volunteer first to make sure I know how to do it... and it is hard to get blood out of those ears, even with using a flashlight to find the vein! Anyway, nope, Oberon is not diabetic if he is kept away from the vet.
As for food, he does eat some carbs since he does not like canned foods that don't have any like Ziwipeaks. Thankfully he also likes some raw food. Dry food is banned from the house but the next-door neighbor is feeding it to ferals and refuses to change the feeding spot to where my cats have less access, making fun of me for thinking she is giving food that makes anyone sick...

so, where does that leave me with the vet? Does anyone have any experience with getting a wrong diagnosis? I doubt I can return the insulin and syringes they sold me, not counting the scare and sleepless nights

 

[LTS3]

You can post the unneeded insulin and syringes and even the blood glucose meter and test strips to the FelineDiabetes.com message board to help a diabetic cat owner who is in need of supplies.

Did you get blood from the edge of the ear? You're not aiming directly for the vein, just the space between the vein that runs along the edge of the ear and the edge. Picture here. Warming the ear for a minute before poking helps the blood flow so you get a better sample. Many people use a "rice sock".

You can talk with your vet about the misdiagnosis. If your vet just shrugs you off, it may be time to look for a new vet.