My diabetic cat is compulsively walking in circles. What should I do?
September 27, 2013 6:54 PM   Subscribe

My cat has been walking in counterclockwise circles pretty much constantly for an hour and a half. He seems a little agitated but basically okay, not shaking or crying or hyperventilating or anything like that. An hour ago he ate his normal dinner, circling between bites. From time to time he lies down, but even lying down he keeps looking over his shoulder to the left, then after a minute or so he rolls over (always in the same direction) and resumes circling. This kitty is 9 1/2 years old and was diagnosed with diabetes about a year and a half ago; I give him insulin shots twice daily. I thought this circling business might be hypoglycemia and mixed some syrup in with his food, but it doesn't seem to have helped much if at all. Google suggests everything from vestibular disease to an abscessed tooth to a stroke. What's going on? What should I do? Can I wait until my vet reopens at 8:00 tomorrow morning, or should I try to find an all-night animal hospital?

Possibly relevant: about a year ago this cat had a major diabetes-related health crisis (ketoacidosis etc) that landed him in the kitty ICU for almost a week; the most visible symptoms were extreme weakness and listlessness. This seems like a very different thing, but I thought it might be worth mentioning.
posted by DaDaDaDave to Pets & Animals (15 answers total)
I am a people doctor, not an animal doctor, but I would be concerned about stroke (I would expect a vestibular issue to cause balance problems/vomiting, and an abscessed tooth to cause pain, but again with the caveat that I don't know veterinary medicine). One thing you could try is to wave something at him on the right side, to see if he seems to notice or flinch when it approaches his eye, which should be reflex unless he has a loss of visual field.

I don't see this as something you necessarily need to rush to the vet for, though, if he doesn't seem to be in any distress, because I doubt there is anything that can really be done for a suspected feline stroke. Honestly though, I am kind of a crazy cat person and I would probably take my cat in to an animal ER if there was one anywhere reasonably close by, just to make sure they were OK. Because I love them dearly... hope your kitty gets better.
posted by treehorn+bunny at 7:10 PM on September 27, 2013 [1 favorite]

Can you phone an emergency vet, describe the symptoms and ask if you need to bring him in? We have a system of on call vets and the emerge line pages them so you can describe the symptoms. Depending on the situation I've been told to bring the pet in immediately, bring the pet in first thing in the morning, or keep an eye on the symptoms and bring them in if it doesn't improve within 48 hours. Our emergency vets, at least, don't always default to "bring them in ASAP".

Second best: check the Cat Clinic of Norman Is It An Emergency? resource. It says to bring him in within 24 hours with those symptoms. But personally I'd bring him in to emergency because of the diabetes. Good luck to you and your kitty--I hope he's better soon.
posted by hurdy gurdy girl at 7:15 PM on September 27, 2013 [1 favorite]

This might sound a little insensitive, but I don't mean it that way, I'm just sharing with you what I would tell a friend who asked me this. If you feel like she's had a good run and is at the end of a difficult illness and it might just be "her time", or your finances can't handle a pet emergency just now, I think it would be OK to wait to bring her to the vet.

If you would be frantic and distraught if she passed tonight, I'd bring her to an emergency vet now. It doesn't sound good to me, I'd be worried. (not a vet, just a cat owner).
posted by bleep at 7:38 PM on September 27, 2013

Seconding that this sounds like a stroke - parent's elderly poodle would circle the backyard for hours after two small strokes in a row. Sounds really distressing for YOU, and in my case I would definitely go to the vet as soon as possible for my own sanity va staying up worrying about kitty. Best thoughts to you and kitty!
posted by theweasel at 7:49 PM on September 27, 2013

My elderly dog had idiopathic vestibular syndrome earlier this year. Her symptoms were much as you describe, plus vomiting. We were sure she was having a stroke; she was not. She was treated at the emergency vet with fluids (and I think an anti-nausea med), but the only thing to do was wait it out. (We had her stay there because we have a toddler.)

I would call the emergency vet to see what they say.
posted by purpleclover at 8:09 PM on September 27, 2013

Oh, she was back to normal within 36 hours (with a head tilt, that's gradually gone away.)
posted by purpleclover at 8:11 PM on September 27, 2013

I have a diabetic cat, but she has never had a hypoglycemic emergency. However, I am just going to point out that this site suggests that walking in circles is a symptom of "moderate hypoglycemia", and the instructions are:

Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food. IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

I found that interesting- I would have thought giving syrup once would be good enough.
posted by Secretariat at 8:20 PM on September 27, 2013

You know your cat and his health better than I do, but my understanding is that hypoglycemia can easily kill a cat, but it takes a prolonged period of hyperglycemia to cause permanent damage. I think if it were me, and I had no way to test the cat's blood (owning a cat glucose meter is what keeps me sane in situations like this) I would probably try another dose of sugar and some food and see if it helps. If there's a number you can call at an animal hospital, they could probably reassure you about what it is most likely the situation is.
posted by Secretariat at 8:26 PM on September 27, 2013 [1 favorite]

For what it's worth, and add standard WebMD disclaimer, but diabetes is mentioned in this "cat walking in circles" article.
posted by rhizome at 9:51 PM on September 27, 2013

A number of years ago I had a poodle who had the exact same symptoms. It turned out to be a stroke, for which very little could be done. I don't know that rushing to an all-night animal medical center will help any more than waiting until morning, but considering that your cat is diabetic and this could be hypoglycemia, perhaps if there is one in your area they might be able to discuss a course of action with you by phone.

Good luck.
posted by zarq at 9:57 PM on September 27, 2013

Whereas when I had a cat with very similar symptoms it was encephalopathy, which was immediately treatable and the fast treatment saved his life.

Your cat is having very serious neurological symptoms. This isn't something you should ignore or hope will go away. At the very least you need to ring the emergency vet and ask them if he needs to go in now (if not default to getting treatment right away).
posted by shelleycat at 2:03 AM on September 28, 2013 [1 favorite]

Thanks for the answers, everyone. I ended up bringing the cat to his regular vet this morning. The vet diagnosed him with idiopathic vestibular disease (possibly caused by a very small stroke, possibly by an inner-ear infection) and prescribed an anti-nausea pill and an antibiotic. Except for the walking in circles he seems fine, no apparent loss of vision, no trouble eating, sleeping, going to the bathroom, etc., so we're going to give it a couple of days and see if the meds help.
posted by DaDaDaDave at 7:23 AM on September 28, 2013 [8 favorites]

Glad the cat is doing relatively well.

I am unfamiliar with feline diabetes; do you have a way to check her blood sugar? It seems potentially dangerous to try and correct for blood sugar issues that may or may not be there. I would also have your vet give you some kind of chart or rule of thumb regarding how much glucose to give in response to a low blood sugar.
posted by gjc at 11:37 AM on September 28, 2013

Our diabetic cat's blood sugar level is all over the lot, so a couple of years ago we started checking it with a glucose meter designed for humans, and adjusting the insulin dose to his varying needs. Since insulin poisoning is more dangerous than hypoglycemia, we're conservative:

< 200 no insulin
225 1/4
250 1/2
275 3/4
300 1

He's a 14-pound cat. It's probably necessary to adjust the dosage for weight.

In the rare instances when his behavior is strange, we do a glucose check. If the level is well under 100, we smear Nutri-Cal on his gums and keep measuring and smearing until the level gets up to around 100. This has always brought him back to normal.

The most sensitive (meaning you need the least amount of blood) and least expensive system is Wal-Mart's ReliOn Confirm. We have a sock filled with rice that we microwave for 15 seconds, until it's about the temperature of baby formula. We fold it over his ear and hold it there for about a minute to enlarge the capillaries. Then we test the outer edge of his ear.

Normally, my wife immobilizes him on a tabletop and I do the measuring, but we've learned to manage it without a partner when necessary. After a couple of years of this, he's inured and doesn't protest too much.

The twice-a-day testing is kind of a pain, but we feel it helps keep him safe, so it's worth it.

Good luck with your cat. We do love them, don't we?
posted by markcmyers at 3:50 PM on September 28, 2013 [1 favorite]

Sorry. I meant to say that insulin poisoning is more dangerous than hyperglycemia.
posted by markcmyers at 4:00 PM on September 28, 2013

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