Is my cat truly diabetic?

[sandra]

Oscar is my mom's cat. He's 10 years old, neutered, and until April, extremely healthy.

Oscar developed an infection on his stomach in April. We're told it's a mycobacterial infection, but I don't know the name of the specific bacteria right now. My mom has the paperwork. The infection is causing the skin to become thickened and tight. There are also some oozing sores when Oscar licks too much. The vet assures us this is not contagious to people or animals.

The vet prescribed a broad-spectrum antibiotic in April, pending lab results. When the results arrived, the vet switched Oscar to Cipro. The Cipro initially helped. On July 28, the vet said Oscar was actually getting worse and added Biaxin. Oscar was taking Cipro and Biaxin twice a day for a month, a total of 500mg each.

Oscar saw the vet yesterday (a dermatology specialist at a highly-respected clinic in town). Oscar had lost 20% of his body weight and was running a slight temperature of 103. I felt like the vet completely downplayed the weight loss (she referred to the weight loss as "slight") and made a big deal out of the temperature. She said she wanted to run blood work because the temperature was "high". Personally, I wouldn't think that 103 in a cat with a chronic infection is alarming enough to run blood work.

At any rate, Oscar's glucose level in April was 122. His glucose level yesterday was 498. The dermatologist referred us to an internist in the same clinic who saw Oscar today. Oscar is starting special food and insulin tonight. The dermatologist also switched Oscar to zeniquin.

Here's my question. Could the antibiotics have triggered the diabetes? Both vets are saying no, but we are having a difficult time believing that there isn't a connection. Oscar was fine until we added the Biaxin.

This isn't about pointing fingers or placing blame. We just want Oscar to get better and that won't happen if we continue down the wrong path with regard to his treatment. Oscar is seeing a different specialist next week, but I'm worried that "professional courtesy" will keep the new vet from disagreeing with the old vets.

[Traci]

In reading the literature for Biaxin, there were rare reports of HYPO-glycemia, related to oral hypoglycemic agents or insulin administration, but no mention of induced diabetes.

I would be concerned with the first vet prescribing this, as he was extrapolating it from human use, and typical adult human loading doses start from 250-500 mg, he was giving your cat 500 mg per day, doesn't seem appropriate for a cat. Also, there are various side effects with this medication, most are from mixing other medications, but in experimental stages, numerous reactions and adverse effects were reported (including allergic dermal reactions and skin eruptions, might want to make sure the current problems are not associated with the drug rather than the mycobacteria).

Curious how you vet diagnosed the mycobacteria, did he mention staph or helicobactor? (staph would probably be resistant to biaxin)

The second vet had reason to be concerned about the fever, any time a health condition is a concern, fever becomes a concern as well, she needed to determine the source of the fever, and rule out the medication as a potential problem or secondary infection somewhere (after all, your kitty had been on antibiotics, obviously they didn't target the fever). Bloodwork, such as a CBC can help determine the source, as well as degree of hydration.

I would proceed with the new specialist, you need another opinion altogether, and find out how the mycobacteria was diagnosed. Might also want to rule out fungal disease as well. Any chance you can up the new specialist's appointment sooner?