“DANTE ROSENFELD”

This 12-year-old castrated male cat has had a history of being episodically diabetic for the last year. Sometimes when he was marginally diabetic, the disease could be controlled by oral antidiabetic medication- Glipizide (Glucatrol). Other times he needed insulin. He had been checked March 17, 2006 at the Animal Medical Center for loss of appetite and they found his blood glucose to be normal and noted a possible intestinal mass. They did an abdominal ultrasound, which was normal.

He was admitted to The Cat Practice on April 7, for vomiting with little appetite. He had a very gassy, tympanic stomach and thickened small intestines upon palpation and was moderately dehydrated. Most importantly, he was yellow! – connoting the build up of bilerubin in the blood. This most often comes from liver and/or gall bladder dysfunction. His admission blood tests showed normal blood glucose, but very high values in the liver-gall bladder section of his biochemical tests. We instituted aggressive treatment and found that he was ketotic as a result of a recent flare up in his diabetes (undetected and untreated by the client). His blood glucose was normal because he had not been eating.

Ketosis is when the diabetes deranges the normal biochemical reactions and ketones are formed (ketones are like acetone) and are very destructive to the liver and system in general.

Dante made some progress but had to be forced fed while we attempted to treat his liver, diabetes and secondary ketoacidosis. He was on 7 different medications for 12 days in the hospital here. Finally, his ketosis disappeared and blood tests showed the liver was improving. An ultrasound of his abdomen early in his stay here showed severe hepatic lipodosis (large amounts of fat choking the liver). This was a result of his diabetes, ketosis and inappetance.

Finally, his appetite returned. His liver was still seriously affected. Fatty liver syndrome can take weeks or months to resolve. His diabetes was regulated and the client was advised to take blood glucose tests twice per day at home. He was discharged on 6 different medications and new type of insulin and instructions were given to call us if there was any back-sliding and if not we would recheck him in 2 weeks.

At his recheck, blood was drawn and Dante looked good. The results showed good control of his diabetes and his elevated liver and gall bladder enzymes had all returned to normal! He had made a remarkably rapid recovery from a trifecta of serious problems.

Interestingly diabetes usually takes many weeks or months to cause ketosis, but Dante was apparently affected very quickly so it will be very important to regulate his diabetes very carefully. We had trained the client to use a blood glucose monitor and he had purchased one for about $70.00 dollars. It is easy to use by getting a single drop of blood from the ear veins (most cats don’t even feel this).
The client had continued checking his blood glucose levels frequently and Dante is doing great.

William Sullivan D.V.M 

CASES: DEMON BUCK | DANTE ROSENFELD | FRED BARGA