Hi all,
Thanks for the responses and sorry for the delay. Between my family life (including my 5-year-old) and doing some more research/thinking, I needed to take some time.
Just to clarify, I'm not new to the FDMB, I'm just a new MEMBER as of this month. Our 14-year-old kitty was diagnosed a couple of summers ago with steroid-induced diabetes. I took over her care at the end of summer 2014, at which point I frequented this site, as well as catinfo.org, often for research, Q & A, peace of mind, making wet food and so on. So I am very familiar with all of the tools here, streams of thought, ways of thinking, dos and don'ts, yeses and nos. All invaluable resources.
When I took over Tucker's care, she was freely feeding on a Hill's dry m/d diet and five units of Lantus two times a day! Yikes! She was simply...fat, sluggish, poorly managed. I immediately went to canned wet food until I thoroughly researched making my own food (which I still do), started home testing (which I am currently not doing), took her off of her insulin for a bit to see what her body would do with its own insulin, and waited for a while. Through wet food, testing, using the low-and-slow approach, Tucker managed to require only one unit of Lantus, sometimes two, twice a day through the fall. We were doing awesome: she lost lots of weight, her fur shown glossy, she played and jumped and gobbled her wet food.
However, by end of fall/beginning of winter, I began to notice that her BG levels were staying at relative high levels. I increased her insulin dosage. She stayed the same. Other things began to change: more rapid breathing, in-and-out of interest in food, needy, tired. So many new things, no change in her BG, except that it stayed in the mid-to-high 200s. Once she hit 310. By January, she was sneezing a bit, a few other things, clearly not well.
When she started vomiting, it was mostly spittle, and she would do it at the same time everyday, around 5 PM. Now she was steady high 200s and I couldn't bring her down and, I felt, I was guessing at what to do. Nothing on this site really helped, except the emotional support, because every owner is different, every cat, and there are various opinions by experts and experienced/seasoned diabetic cat owners alike, and...we are just guessing often. She showed no other signs of anything else -- no smelly urine or missing, no foul or sweet breath, no dilated pupils, etc. Her vomiting kept her stomach empty, which likely created more vomiting as a hungry diabetic. It was my duty to seek medical attention.
When I took her into the vet, he happily (with relief) diagnosed her with a respiratory infection (rattle in lungs, swollen lymph nodes, fever) and gave us an antibiotic. He knew I was home testing and seemed okay with it, but I suspected he didn't love the idea. He also knows how stressful and high maintenance it can be to have a diabetic cat. He is hugely empathetic and, I believe, wants to achieve balance for everyone.
Anyway, the rest of this story is on the Zen thread in the Think Tank, so I'll spare you the details. But it ends with two prolonged stays at two different vets (on at ER), with two different approaches, one pro-Lantus and one con, one keeping her on the antibiotic and the other taking her off. They both agreed to keep Tucker at high levels of Lantus (five and four respectively) for awhile as it was/is clear that Tucker wasn't regulating, especially due to the infection.
I think they both also agree/suspect that she is an older, diabetic cat and/or will remain difficult to regulate, so keep her units high (my vet did keep her for three nights and managed to keep her regulated at four units, once trying only one time one day, which sent her into the 400s). I'm not sure that I disagree. They both suggested that I no longer test; this has caused some consternation for me. They both also like wet m/d. I do not; I continue to feed her my homemade food, which she loves. They both suggested about 2/3 can/portion per feeding; I do not do this either, as Tucker has vomited from having run out of food in the early mornings. I give her 5.5-6 oz of food each feeding. She does not need to go hungry and can freely feed.
It is the testing/no testing part with which I struggle. I know that I can/could have more control over her diabetes, but maybe not. Steve and Yochi just posted a Think Tank thread regarding Dr. Hodgkins approach of tight regulation. Her site offers a scale for insulin dosage, like many others out there. She also recommends testing after 6-8 hours of eating(?) or dosing (?) (can't remember), or ideally every 3-4 hours. Others say just test, feed, shoot. Still others test all of the time and can do little else in his/her life because of it. What kind of life is that? My vet says, look, I achieved regulation after several days of testing and says four units. I know that the stress of testing, waiting, watching is maddening, and I need to consider everyone in the family regarding Tucker's regulation. She acts normally, although she seems tired. But what do I know what it's like to be a 14-year-old diabetic cat? She has been through a lot, and I'm going on faith right now that we will walk the road slowly until I know something needs to change. Panic, stress, emotional overload, worry do not help Tucker's situation, nor mine. Sometimes over-research doesn't either. Help from this site comes in the form of reassurance always and some solid info often. Dr. Pierson's site is invaluable for its detail and food knowledge. I also believe that she is correct in her assessment of her colleagues' disinterest in a more holistic approach to feline diabetes, but aren't we dealing with that culturally with regard to human medicine, mental health and so on? Furthermore, I believe that my vet has our best interest in mind (even while he is choosing processed food), especially when it comes to stress management. I do wish I were more educated/confident about testing and what that SHOULD look like, but I am pretty confused right now by so many ways of thinking. So what I am doing is incorporating the best of all worlds, finally becoming a member of FMDB and being involved more to better educated and listen to myself. I do not doubt that many of you experience all of these fluctuating emotions and ideas. For that, I am grateful and can vent/talk, too.
So, in answering how I am doing (today), I would say that I'm still thinking, trying to decide what else to do, but we are moving forward with keen eyes. We are holding steady.
Any further conversation/ideas about this will be well received. Thanks for participating.
Liza and Tucker
