Skin Punch biopsy depends on the doc.
I had one done on the 2nd visit to my neuro at Johns Hopkins.
Not being a diabetic, I guess its part of the intake diagnostic procedure.
Mine was taken at 3 sites- ankle, calf & upper leg towards the hip.
A positive result of SFN - axonal, sensory, length dependent, polyneuropathy.
Good news/bad news.
Nerve regrowth is evident.
Nerve degeneration is faster than the regrowth.
Treatment?
Rx's for pain & symptoms, check-ups annually at first, as needed- later.
My PCP is also part of the Hopkins system (as well as all of my docs)
& she is the one that follows-up.

Well, I will 'ditto' the statement that nerve degeneration is faster (at least in small fiber neuropathy). That is not pessimism either....it is realism. I am going to get to swallow some fat tubes in the next few months....due to small fiber neuropathy. Num, num.

Can you please clarify? You had NO symptoms before the infected cat scratch?

Sorry about the link that doesn't work....I have a professional registration and I guess you can't just link....anyway, it refers to Cat Scratch Disease, Bartonella and a few other infections that cats pass on to humans, and some of them have neuro manifestations....

Again, I apologize for the link mess up. Darn, it was a good article...you may be able to bring it up on google.

I looked up things and thought
 

similarly Cycleops...but there is really very little connections. SOOO what my thinking is maybe... Michelle did you get a tetanus shot afterwards? Or have you had a cold or pneumonia rite before or after the cat's scratch? Do you know the cat's history? Was it a pound cat, stray or do you know the 'family' the kitten came from?
Pound cats are usually checked out for most common and many esoteric diseases that may be common to your area.
Tetanus shots can cause reactions- tho quite quite rare. Any pneumonia or getting a flu shot at the same time mite have 'started' something, but again, it's quite quite rare.
Something else does seem to be 'going on', and I can sense the distress in your writing. I've walked in similar shoes [can't wear those anymore]. What I would do is go to the stickies and read posts here about the diagnosis of various PNs...and especially the diabetic and auto-immune aspects...Not to scare you, mind you! Not at all! Just to give you a handle on what kinds of testing should be done, and how docs normally do them [aside from glacially slowly-especially when numbness is marching thru your body]. Remember that stress with neuropathies is a rampant issue. Also, that eliminating soo ever many things is the key to neuropathy diagnoses. And, DUH? Who wouldn't be stressed out? Thing to do is read, learn figgure out things in your life that could add or not to this big problem and sort it all out in your mind. Tho far easier said than done. Be sure to get copies of all your tests and med records as you can get them! They will be invaluable to understanding things in the long run...[MRI's for example, come with summary sheets for the docs, sometimes you can get copies thru the doc offices, but others you have to go to the MRI places]
Bet you still have that cat! :hug:'s - j

mrsd
 

Are you talking about cat scratch fever,if i'm way off i'm sorry,
My Grand Mother rescued cats. She was strached in the pass,no problem.
She was strached on the arm,her neighbor went to visit her arm was
swollen,her temp.104,they rushed her to the hospital..She was a strong
woman,but she screamed and no matter what they gave her,nothing
helped pain was unbearable..She was in her 90's and they were her family,
but they were not sure she would live. I heard of it,never saw it before never
want to again. She made it ,but removed the cats,the .dr.was so upset.
Well the cats well you don't want to know. He gave her a kittten no claws.
He was shook,she kept this one in the house..She was in the hospital
for a while,went home,she always had pain,but wasn't going to get rid of
the kitten...Her arm was so huge ,red streaks very swollen..:eek: Sue

It is with all
 

neuropathies...either connected or not at all. I believe that all of us in our trying to understand what we have, and learning about what we might have - well we have probably expended enough energy to power a mid-sized city at times!
Not to mention the 'energy' expended in the whole pain process?
I for one have found that the trying to SIT and read medical papers and learn as much as possible about what I might have, well, can and DOES divert my whole self from the pain and new pains and different pains. I have found that the understanding helps me understand what is going on and when, and at times what to do about it all. Not always, but, often. I have also found that folks here have helped me thru it all. A LOT!
I do know that many have experienced what I have at times...that is, the consideration that really drastic [I mean drastic] measures might make it stop. My reading and learning has told me that drastic doesn't change the key nerve problems and what has caused them-from those who have chosen such routes. I do seriously respect those folks for not only trying, but sharing their outcomes, both pro and con.

I just fear Michelle that you mite have gotten a bacteria, parasite or virus from that dear creature/catliness that you really didn't need, and well, YOU might need the CAT to find out what you both have that's unpleasant in common? Honestly, you might get more lucky asking your vet! Vets are very keen on keeping such issues OUT of all our lives. Ask the vet to test the cat for the key bacteria, viruses or parasites that might 'connect' to your issues, and then YOU don't/won't have to go thru the plethora of tests of could-be's...as the vet can rule out cat could-be's and zero in to the 'ares'. Get vet to call doc and IF doc listens you could be home free? I sure hope! But that's the way I'd play it!

BTW I live in a West Nile/Lymes and other ilk area... I know many who have the 'iffy' diagnoses for those. I know I am clear of those issues 'ostensibly' but I for one will not rule them out. I know I've been exposed to it all for years and realize how these diseases can overlap with what I probably have.
I know that WN and Lymes are not what I have...too many connections to other stuffs. So, keep searching, be prepared to be confused, and then ask for help when you need it-BUT make your own decision. :hug:'s - j

I can't get the text of this article...but the title is kinda odd.

http://www.springerlink.com/content/q3286742tqw450k3/

I hope this one goes thru....might be worth looking at. I do not know if it is the same kind of Bartonella. This is a big problem with NOT culturing wounds.

At minimum, it sounds like a cellulitis may have been possible, and an autoimmune problem ensued. Then again, with diabetes, for is it 10 years? (if memory serves me correctly) It could be small fiber neuropathy.

Also, I had small fiber neuropathy for probably a decade before I figured out what was going on, because, I had no reason to even remotely consider that I could have small fiber neuropathy. My feet never really 'burned'. I had no concept that issues all over my body were related to small fiber neuropathy. (For example, I had no concept I was globally anhidrotic).

I agree if that cat is around, I would have him/her tested for all kinds of organisms. That said, what was on kitty's claw, may be long gone...and it is possible that kitty had no part in it at all.

I found the text---read this.

http://www.canlyme.com/bartonella_vasculitis.html

The only symptom was...
 

The only thing I had was just pain in my heels before the cat scratch, but I didn't think nothing of it. It wasn't bad pain, just a little bothersome. After they lanced the cat scratch is when the pain came on both feet.

Thanks,
Michele :hug: