Diabetic Cat Not Eating

Question
Before I make a trip to the Vet, thought I'd run this by you.  My cat Lucy is 14 years old; diagnosed last year with diabetes (although I'm sure she's had it longer). I did not want to go the insulin route so spent a lot of time researching feline diabetes...started her on a high protein, low carb wet food diet.  It help immediately as far as appearance and mobility were concerned. She became more animated and mobile - had hind leg issues that were completely corrected.  Her fur was ratty before and became softer and thicker.  She is fairly skinny but didn't gain any weight(she weighed 8.5 lbs - was obese 3-4 yrs ago but dropped weight about a yr before diagnosis).  She has been doing great; I've not visited the Vet since February last year. Pretty much have been feeding her turkey and chicken (Fancy Feast) but integrated a few new products here and there for variety - mostly kitten or senior food with poultry and liver.   She loved them at first.... about a week ago she stopped eating normally.  I put out two dishes of different stuff...she nibbles but is pretty much ignoring everything.  Last night she ate a few bits of pork off my plate.  She seems to want to eat and cries at me like she's hungry.  She's always been a nervous Nelly - started overgrooming this summer after we were gone and had a neighbor feeding her.  Things are settled now - we have no other animals.  But she's still a bit skittish.  Something's up.

Answer
Hi Judy.  Yes, I agree something's up.  Unfortunately, it is time to see the vet again.  A blood work up will probably be warranted, not only to check her blood sugar, but also to check her liver, kidney and pancreas function.  Kidney failure, liver disease and pancreatitis are some reasons why a cat may have loss of appetite.  

If it turns out that her blood sugar is still high, I would urge you to put her on insulin.  Most diabetic cats, more than 75%, end up needing insulin in addition to diet changes.  And long-term high blood sugar can cause kidney, liver and pancreatic disease which may lead to failure.  However, she won't be able to start insulin until she's eating something, so she may need to be force fed with a prescription diet.

Best wishes!

Jessica