Introducing Mimi - Asthma and Diabetes

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mimilefromme

Member Since 2016
Happy 4th of July. My name is Tracy and I would like to share Mimi's story. FYI, Mimi is not my only cat as I am that crazy cat lady, but she is defiantly a kindred spirit and the owner of my heart.

Mimi was born July 8, 2008 and was the only female in a litter of 6. Mimi's mom did not go into labor and so this litter had to be born via C-Section and as a result Mimi's mom rejected her entire litter. Due to this circumstance I was was entrusted with their care and spent the next 6 weeks feeding these kittens round the clock with an eyedropper and then a bottle, making them go to the bathroom until they began going on their own, keeping them warm, and keeping them clean until they eventually became a little older and more independent.

Upon turning a month old, Jack, one of Mimi's brothers, suddenly had a decline in health. I rushed him to the emergency clinic in which it was determined that Jack had an abnormal pancreas and was not expected to survive but a few more days. In a complete state of shock and attached to these kittens due to the care that I had been providing to ensure their survival, I was devastated and refused to accept Jack's grim prognosis. Sadly, however, Jack passed away at home that night in those darkest of hours right before the sun came up.

A few weeks later, Danny, another of Mimi's brothers began showing the same signs as Jack and so we took him to the Vet. It was determined that Danny had an enlarged heart and that his lungs weren't functioning properly and due to the rarity of his condition, he would not survive past 3 months of age. Again, I refused to believe this was not only happening, but I had yet to get over the loss of Jack. I took Danny home and he died in my arms two days later.

Absolutely besides myself after these two losses, I took the remaining 4 kittens to the vet for a check up where it was determined that they all suffered the same organ genetic abnormalities as Jack and Danny. The vet told me that there was a great probability that I would lose the entire litter and suggested the possibility of euthanizing the remaining 4 to avoid their suffering and my prolonged grief. Sadly, and while it may sound selfish, I couldn't bring myself to do it. Reuben passed away that same night and Maverick passed away a month later. He was 3 months old. I still cry when I relive this time in my life and I believe that heaven has 4 little angles waiting for me.

At this time we were left with Ben and Mimi. When they were 6 months old, we took them back to the vet for a checkup and he was baffled to say that not only was their health improving, but that both of their abnormal hearts seemed to be adapting. He gave them a life expectancy of three years. He said they seemed to be defying great odds and to be thankful for the extra time that I might have with them. I am blessed to say that Ben and Mimi will celebrate their 8th birthday on July 8, 2016.

This past September, Ben and Mimi came down with URI's which led to their hospitalization. Ben was a trooper and recovered quicker than Mimi and Mimi wound up with Pneumonia and had to stay almost an entire month in the hospital. Still, she came home but when she did she was diagnosed with Asthma and prescribed Prednisone for her breathing. Anyone using prednisone on their cats for a variety of reasons will agree that many of the warning signs of diabetes are similar to the side effects of predisone and so Mimi's excessive thirst, frequent urination, and increased appetite were believed to be side effects and medication related. Mimi is also overweight and the fact that she had not lost a significant amount of weight was another "indication" that Mimi was only presenting the side effects of the medication, and not the warning signs of diabetes. Mimi has been on prednisone for her Asthma since September of 2015.

Last weekend (End June) I was awakened by Mimi vomiting in which afterward she collapsed. I rushed her to the 24 hour emergency facility and they immediately placed her in oxygen. I was convinced that she had suffered a severe asthmatic attack but of course her abnormal heart always weighs in the back of my mind. Needless to say that when I was told that Mimi's BG was 677 and she had sugar in her urine I reminded the staff that I was a teacher and not a doctor and to break it down in terms that I could understand. Simply stated, and as the rest of you probably already know, Mimi was diagnosed with diabetes.

So, Mimi spent another 8 days in the hospital trying to get her diabetes regulated as well as her asthma under control. She was released from the hospital a few days ago but I had to take her back this afternoon for another round of oxygen and another breathing treatment. My mother in law; a member of this community (Jan and Buddy) has been a Godsend helping me every step of the way and going over and beyond the call of duty to lend 24 hour support and love. She suggested that I join this online community for a network of support and a wealth of information crucial to Mimi's health and well being. I strongly feel that with the love, knowledge, experience, and support from my mother in law as well as this online community and medical attention , that Mimi's diabetes will be manageable and as you can see, she is a fighter and survivor.

My biggest concern, at this time, however, is Mimi's asthma. You see, she can't breathe and not to discount diabetes, but in my mind, proper lung function is the priority because if she can't breathe, the diabetes won't matter. Mimi has no lung disease and her "abnormal" heart is functioning properly without any type of heart disease present. Mimi can no longer take the prednisone to open her lungs due to her diabetes and her rescue inhaler (used via the Aero Kat inhaler made just for cats with asthma) can only do so much. The diabetes and asthma feed off of each other and when her numbers are high.....her breathing is impaired and when her breathing is impaired.......her numbers go up......so its an extremely challenging situation.

My plea is to anyone within this online community who has a furry baby with both Asthma as well as diabetes to reach out to me or direct me to a forum where I can go to get help for Mimi. Though I feel so discouraged right now, I know that there is hope and that someone here can give it to me. I would like to know about all of the treatment options for Mimi's asthma that won't worsen her diabetes. Oxygen and breathing treatments at the vets work wonders, but neither myself nor Mimi can live at the Vet and so I would live to know what I can do at home to help her Asthma which won't worsen her diabetes and discuss these options with her Vet.

I would also like to say that many of you might be cringing at some of the medical care (or lack of) that in your opinion Mimi has been receiving and may even feel that the fact that Mimi was on prednisone for 10 months may have led to her diabetes. I hear you and share these concerns. However, at this particular time, and at the risk of not making a good first impression, I would like to say that I am not interested in bashing Mimi's medical care or hearing about all of the things that may have been done to lead to her worsened condition. Those comments (which I have plenty of my own) will not help Mimi right now and all that I want is t0 find people who can help me get out of the problem and into the solution. We can share any comments of disgust later, when Mimi is holding her own. So right now I need help with Asthma first, and Diabetes second, even though they both feed off of one another.

I can be emailed at mimandben08@yahoo.com as well.

Thank you for your time and help,

Tracy

PS - Mimi is currently taking Lantus for her diabetes (2.5 units 2X daily). She also uses a rescue inhaler 3X daily for her asthma and has been receiving oxygen and breathing treatments from the Vet, and I am using the AT2 tracker to monitor her BG.
 
Tracy have you looked into the chambers with oxygen that you do at home? It sounds to me that Mimi's asthma is much more advanced than Fritz my kitty.
You mentioned only albertoul daily not the Flovent. It is my understanding that albertoul alone will make the asthma worse. Albertoul is a rescue and Flovent to manage daily.
 
No words of wisdom, just support and (((hugs))) from another with an asthmatic/diabetic kitty. Plum is still on a very low dose of prednisolone. It likely was the cause of his diabetes, combined with my ignorance about feeding and carbohydrates - but I can't change the past, just look to do better in the future. It sounds to me like you've done all your best for every one of the furkids. I really do not know what we have done (if indeed it was us) to improve his asthma other than the obvious precautions about low-dust litter, no perfumes, wood fires, etc. etc. for optimal air quality.

I second DebG, though - it was my understanding that albuterol is a rescue medication only and oral or inhaled corticosteroids are the treatment of choice. I'm sure you've probably already seen this site but just in case: http://www.fritzthebrave.com/meds/other.html

Holding good thoughts for Mimi and you.
 
Welcome Tracy and extra sweet Mimi!!

Nobody here will have anything negative to say about how you've been treating Mimi, so please don't worry about that! A lot of people are here due to steroid induced diabetes and as you said, you're not a doctor so how could you know?

Besides that, we will always tell you here that you treat the most severe disease first...In this case, Mimi's asthma....and you just adjust the insulin around it!

I don't have any great words of wisdom about the asthma, but I know we have quite a few other kitties that have the dual diagnosis of asthma/diabetes here so I'm sure you'll be hearing from some of them.

What are you feeding Mimi? It's important that you feed a low carb canned or raw diet to help with the diabetes. Just like humans can't eat potato chips all day and expect their blood glucose to be controlled, it's the same with our kitties and high carb foods....especially dry. We want them eating less than 10% carbs. Fancy Feast Classics, Friskies pates and 9-Lives ground are all affordable, low carb foods, but there are lots of others to choose from.

It's good that you're home testing too, although if you want to save a good chunk of money, you might want to consider using a human meter instead of the AlphaTrak....at $1 per strip, it adds up quickly and all our protocols were designed with human meters in mind anyway.

We have a great spreadsheet we use here that will really help us to help you with dosing advice. Here are Instructions on getting the FDMB spreadsheet. If you have any test results already for Mimi, it'll help for you to go ahead and enter them. If you have any problems with the spreadsheet, let us know! We can help set it up for you!

It's important that you always test before shooting to make sure she's high enough for insulin, and then get a mid-cycle test (like 5 to 7 hours later) on the AM cycle and at least a "before bed" test on the PM cycle. Most cats go lower at night, so it's important to check before you head to bed!

There's lots to learn, but it sounds like you're a wonderful caregiver for Mimi and you're ready to do whatever you need to do to keep her as comfortable as possible and live as long as the Lord has planned for her!
 
Thank you to everyone for all of the kind replies and data. I value everything and this is a learning experience for me. To Fritz's mom, I just picked Mimi up from breathing treatment and had a prescription written for the Flovent as you suggested. Also to Chris, thank you for the fool list. My mother and law has been helpful as well but you added a few new selections. :)
 
My Turbo was diag with chronic bronchitis/asthma, she also went through the preslidone treatment but I found it wasnt enough and finally bought her an aerokat aerosol chamber and switched her to an inhaled chorticosteroid as a daily, and albueturol for sudden attacks. it makes quite a difference. You could also get a home air purifier as turbos asthma is always affected by the pollen count. Its really hard watching them have an attack and feel so helpless so I have been there before. When the weather changes real bad Ive had to give her a benadryl it seems to help but you cant give for too long. There was one other capsule we were giving her but I cant remember the name it would open the airways its used by people with heart issues. You have to treat like you would a human with asthma decreasing dust and pollen as much as possible a humidifier can also help. If you can afford the inhaled corticosteroid and albueterol it may help, turbos refills are up to $240 for the inhaled steroid. You've come to the right place for diabetes question the folks here are awesome. I pray your kitty gets better I know how hard it is to see my fur baby's sick
 
I sincerely thank you for all of the advice and kind words. I am picking up the flovent this afternoon and her Aero-Kat chamber should arrive this evening. So, as I understand it is flovent to open the lungs ans albuterol as the rescue breather?
Mimi is having a down day and I hate to see her like this. Her numbers have been consistently high (Mid 400s) for a few days now and the Vet wanted me to increase her from 2.5 units of Lantus to 4 units! I was not comfortable with this especially since I am at work and not there to monitor her. So, as she has been on 2.5 units of Lantus for over 3 days now with no positive change (decrease in BG) I am thinking that I should increase her to 3 units (a .5 increase) this evening and wait another 3 days to see how she responds. The vet also forgot to administer her insulin while she was in the oxygen kennel and so rather than getting her schedule completely messed up, I opted to not give her any insulin until her morning dose this morning. Perhaps that is an additional factor to her "down day." Mimi also is doing that constant machine gun sneezing bu the vet said that she was given an antibiotic injections during hospitalization and that he didn;t want to give her any more medication that she is already on. I hope that this sneezing doesn't turn into something else because the last thing that she needs right now is an URI.
 
My Smokey has asthma, however not as serious as Mimi. Smokey does well on albuterol (rescue inhaler) and only needs it once every 3 days or so. Air conditioning must be on for him and the ceiling fans. I know when he is laying by the entry doors is when I need to give inhaler or increase the a/c

Have you thought about making (don't know if you can buy) your own oxygen chamber, box, tent or cage? If it's possible to acquire an infant incubator or isolette it would be easy to outfit it, as they have ports for tubing. A large glass aquarium could be adapted. I'm sure your vet or ER would tell you the specific as to the rate and concentration of O2 you would need.

Asthma relief is priority at this time, you will adjust the insulin dose accordingly. Flovent is a form of steroid and may increase glucose level. I'm sure you are aware of this, just reminding.

Do you know what antibiotic injection was given. If you search this forum for zrytec, I think a few people use it occasionally for allergy symptoms with their cats. Something to ask your vet about.

Please keep us posted on your babes.
 
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I have not used Lantus in years (my most recent sugar cat was on ProZinc), but going from 2.5 units to 4 units is a huge jump. Typically increases are done in much smaller increments and doses have to be held for a certain length of time (5-7 days generally; sometimes only 3 depending on how the numbers look) before you'll see how Mimi is responding to the insulin dose. Also, Lantus is a depot insulin (it actually builds up a depot in the body which is slowly absorbed over time) - missing a shot will affect that depot and her numbers. If Mimi has been on the same dose for 3 days but missed one of the shots, you may not be seeing her true response to that dose. Please check the information in the Lantus forum and I'd highly recommend posting there for dosing advice.

Fingers crossed the Flovent helps your baby!
 
Bless you. I have cats with asthma and I have cats with diabetes. I don't have any cat with both. Flovent is the daily maintenance drug and Albuterol is the rescue drug. I have a severely asthmatic cat who I just switched from prednisolone, which wasn't working, to Flovent. A dramatic improvement! It can take up to 2 weeks for the Flovent to build up and start working. You usually need the overlapping coverage of a systemic steroid during the build up phase. My cat takes 2 puffs AM and PM of the maximum strength Flovent. I will let other members who have cats with both conditions advise you on insulin dosing while on steroids.

You can order Flovent from Marks Marine Pharmacy for much cheaper than you can buy it in a US pharmacy. This is the same place many people here use for their insulin.
 
No words of wisdom, just support and (((hugs))) from another with an asthmatic/diabetic kitty. Plum is still on a very low dose of prednisolone. It likely was the cause of his diabetes, combined with my ignorance about feeding and carbohydrates - but I can't change the past, just look to do better in the future. It sounds to me like you've done all your best for every one of the furkids. I really do not know what we have done (if indeed it was us) to improve his asthma other than the obvious precautions about low-dust litter, no perfumes, wood fires, etc. etc. for optimal air quality.

I second DebG, though - it was my understanding that albuterol is a rescue medication only and oral or inhaled corticosteroids are the treatment of choice. I'm sure you've probably already seen this site but just in case: http://www.fritzthebrave.com/meds/other.html

Holding good thoughts for Mimi and you.
 
Thank you everyone for all of your support and insight. Mimi has come down with a URI on top of everything else and so I am dealing with that. I actually posted some questions in a new thread within the health forum entitled Lysine and Amino B complex. I am looking into a doctor that will prescribe oxygen for the home so that my father in law can make her an oxygen chamber at home as suggested, and I started her on the flovent tonight via the AeroKat chamber and she wasn't having it so this is going to be an adventure. Any tips on how to do so without it being more problem than its worth? Mimi's levels have been extremely high....400 and 500's and using hte alpha 2 tracker with 2.75 units of Lantus twice daily.
 
It was a challenge when I first started giving Turbo her inhaled corticosteroid. Im not sure how your kitty will feel seeing that she has a uri. I know I rinsed out the new inhaler to get rid of any fumes, and some times I would place the aero kat on her with no inhaler attached to get her used to it, I would just put her on my lap and hold the chamber with one hand and her neck with the other hand. just watch that flap. They pull back at first when you spray put be encouraging and shower her with love after each spray, eventually they get used to the routine. Dont forget to rinse it out with warm water and mild soap at least once a week especially the mouth piece. I just remembered the other med they gave turbo check with your vet its called theophylline it helps relax the air way muscles dont know what interactions it has with the diabetes though, more prayers for your kitty to get better.
 
There are some helpful groups on Yahoo for feline asthma. This is one of them and they may be able to offer more advice on getting Mimi used to the AeroKat. https://groups.yahoo.com/neo/groups/felineasthma_inhaledmeds/info

For some cats it helps to let them eat treats out of the face mask so they associate it with something positive. That may be really difficult with diabetes and a URI. My newest asthmatic (run a rescue and frequently get cats with issues) started the AeroKat treatments with Albuterol, the rescue drug, and it seemed to click in his head that the mask made him feel better. He is coming to me when it's time for his puffs.

He's also had URI issues. All nasal, no eye issues. I had him PCR tested and he was negative for herpes but positive for mycoplasma felis. Mycoplasma is a bacteria that can cause issues for asthmatic cats. He's taking doxycycline and it really helps.

Hang in there.
 
Thank you for the information and additional support groups. I will be asking about the things that were mentioned when I see the doctor today.
 
I would first like to say thank you for all of the advice, sharing your stories, and the support. I am happy to say that Mimi is doing much better after seeing her regular vet (non emergency and hospital vet) yesterday. Her BG has been consistently in the 300s for 4 readings which is a huge improvement from the high 400 and 500s that had become her norm. The doctor says that she finally seems to be responding to the Lantus and does not feel the need to give her more than 3 units each injection. Quite the opposite he believes that her dosage will eventually decrease as she hopefully continues to regulate while getting healthier in other areas of her life. Regarding her URI, the Orbox (antibiotic) seems to be kicking in and while she is still sick, she is beginning to seem less congested. Her doctor also sent me home with Terbutaline injections for her asthma which has worked wonders. Today is the first day is about two weeks that I actually feel "good" about Mimi. She has a long road ahead of her but I do beleive that she has finally been given all of the tools necessary to continue on her journey with as much comfort as possible. Thank you to all and Happy 8th Birthday to my sweet Mimi!
 
Rough night with high numbers (saw 688) but today has stayed in the 200s (doing mini curve). Terbutaline really helping with her asthma and now that she seems to be feeling better I will begin training her with the AeroKat chamber so that perhaps she can use that instead of the injections of terbutaline (twice daily) . Is anyone able to instruct me as to how to share her spreadsheet link as a part of my profile or perhaps another way?

Thank you.
 
Glad things are improving all around. I see your spreadsheet so it looks like you figured that out. It would help if you could add your insulin type, meter, and food to your signature too. The people who advise on dosing will need to know that information.

Slow and steady and I'm betting she will eventually accept the AeroKat. Maybe try the AeroKat around the same time you're giving her the Terbutaline injections. If she associates it with feeling better it might help.
 
Thank you. Mimi actually has an asthma attack today and I was able to give her a rescue breather via the AeroKat. She hated it, but it seemed like once she realized it was helping her she stopped fighting it.
 
It's heartbreaking when they have an attack. It always made me feel helpless. My current guy with asthma struggled every day and I wanted to cry listening to him. Neither injected or oral steroids helped him at all. About 3 weeks into Flovent I wanted to cry because I realized he hadn't been struggling to breathe ;). Stick with it, it takes some of them longer than others.
 
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