Update #3

[H.M. Victor (GA)]

Hello all, I know it's been quite a while since I've posted anything here, but I finally felt up to giving an update as well as getting some advice for some new issues.

First off, for several months now I've been dealing with depression about just everything - Victor's diabetes and health, our financial situation that won't allow us to get him the better care he deserves, and just life in general. I honestly can't remember the last time I felt genuinely happy, and on top of that, I've always been one of those people who gets depressed during the holidays, so I really haven't been in a good place and just haven't had much if any motivation for anything, though I have still manged to keep up with BG testing, despite not really being able to do regular mid-cycle tests due to just not being able to afford going through test strips so fast.

And now regarding Victor, for over a month now he hasn't had his normal appetite, to the point where he would only eat a very small portion of his food or none at all, so we had to start offering him a portion of tuna to make up it so we could still give him his shot. But a couple of days ago he wouldn't eat at all, not even the tuna (which he normally goes nuts for), so we finally got him into the vet by taking a cab using a gift card that my dad had sent me for Christmas. They did blood work and our vet said everything came back okay except for his white blood cell count being high, possibly indicating an infection, so he prescribed Amoxicllin as well as Mirtazapine to stimulate his appetite. I added the blood work results to the labs tab of Victor's spreadsheet in hopes of getting some opinions here. I hope I put all the values in the correct places, but if anything looks off, I posted a screenshot of the full results here https://imgur.com/3twv2lG

I also wanted to mention some new issues that Victor is having and get some feedback.

1. He has started doing this thing where he paws around his water bowl like he's trying to pull the bowl out from where it is or something.

2. He has been sneezing quite a lot lately, and even having what I think are inverted sneezes every so often, as well as some discharge from his eyes. When our vet mentioned a possible infection, I naturally thought that could be the cause of these issues, so hopefully we'll see some improvement with the antibiotic.

3. He's down to 8.13 pounds and definitely looks skinny, especially in his hind quarters, so I'm a bit concerned that he's losing a bit too much weight. He is also still having issues with constipation/hard stools despite being given a teaspoon of pumpkin once a day.

So if anyone has advice, insight, etc; I'd appreciate it, particularly about the lab results, and I hope you all are having a Happy Holidays.

 

[Bron and Sheba (GA)]

Hello Heather, it is good to hear from you.
I am so sorry you are suffering from depression. Have you been able to get some professional help for it?

The lack of appetite would explain some of the weight loss.
But I am concerned that he is not eating much and that he has an infection.
I did see that the urine test was negative for ketones which is good but I do think it would be worthwhile keeping an eye on them.
Do you have any Ketostix at home that you could test his urine with to see if he has any ketones?
If you don't, I think it would be worth while to buy a bottle of Ketostix from Walmart or a pharmacy. They are only about $10.

It is possible Victor is nauseated and may need an antinausea medication such as cerenia, if he doesn't start eating with the appetite stimulant. Have you tried offering different foods.?
Here is a link to stimulating kitty's appetite
http://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

Are you still using humulin N insulin?
Would you be able to swap over to a longer lasting insulin? I do know they are more expensive but Victor may do better on one of the longer lasting insulins. I am concerned as a lot of the preshot are black and red and you have no tests being taken during the cycle? We don't know if he is dropping low and bouncing up high or if he needs more insulin.
Are you able to get any inbetween tests ?

You could try more than a teaspoon of pumpkin once a day for the constipation and see if that helps.
Are you giving extra fluids with his food?

If you are having financial difficulties with helping Victor, @Chris & China (GA) may be able to suggest something.
I will tag @Marje and Gracie to look at the lab results for you.

 

[H.M. Victor (GA)]

Have you been able to get some professional help for it?

I'm looking into it, trying to find a therapist that's close by.

Do you have any Ketostix at home that you could test his urine with to see if he has any ketones?

I have a NovaMax meter that does ketone testing, which I do every so often.

Have you tried offering different foods.?

Not yet, but we can try looking into that.

Are you still using humulin N insulin?
Would you be able to swap over to a longer lasting insulin? I do know they are more expensive but Victor may do better on one of the longer lasting insulins. I am concerned as a lot of the preshot are black and red and you have no tests being taken during the cycle? We don't know if he is dropping low and bouncing up high or if he needs more insulin.
Are you able to get any inbetween tests ?

Yes, we are still using Humulin N, and I have been in contact with someone at DCIN about getting financial help, and they were willing to help us with switching to Lantus, but we do need help with getting test strips as well, and the lady I've been in contact with said she would talk to our case manager about ongoing help for both insulin and test strips, but I haven't heard back from her yet. I can get some mid-cycle tests, but just don't like to risk running out of strips when I know we don't currently have the money to get more.

Are you giving extra fluids with his food?

Yes, we are.

 

[Red & Rover (GA)]

Yes, we are still using Humulin N, and I have been in contact with someone at DCIN about getting financial help, and they were willing to help us with switching to Lantus, but we do need help with getting test strips as well, and the lady I've been in contact with said she would talk to our case manager about ongoing help for both insulin and test strips, but I haven't heard back from her yet. I can get some mid-cycle tests, but just don't like to risk running out of strips when I know we don't currently have the money to get more.

@Chris & China (GA)

 

[Bama Kitty Mom (GA)]

Hi Heather, it's good to hear from you. I look for posts from you every few days. I have been concerned about you and Victor. I know the sadness that descends around this time of year. Sometimes it is a combination of weather--cold, dark or rainy days--old memories, current life challenges and general upheaval around the holidays. Having a cat with health issues just seems to pile on top of all the rest.

Bama does the pawing at his water bowl, too. He likes his water warm and for me to hold the bowl up so he can drink. I always heat about a cup of water before I mix a few tablespoons in with his food and pour the rest in his water bowl. After he eats, I offer to hold his bowl up and he usually will drink some more.

From the symptoms you described--sneezing and eye discharge--along with the elevated white blood cell count, Victor could have an upper respiratory infection so the antibiotic should deal with that. Take care of yourselves--you, your mom and Victor.

 

[Marje and Gracie]

His labs look pretty good except his white blood count, as you have remarked upon, and his glucose. The problem is, high WBCs can be from so many different things. Did he ever have the dental work done? He is definitely harboring an infection somewhere.

I agree with Bron that it’s good you are keeping an eye on his ketones and I would continue to test him daily, if you can. The issue that worries me is that it’s really hard to tell if his dose is too high or too low without mid cycle tests. You could have him overdosed or, his dose could be too low which, with infection, puts him at risk of DKA. If you switch to lantus, you are still going to need to get at list one other test during each cycle so we can see what dose he needs. His not eating and weight loss concern me; while your vet ran a really limited array of labs, there’s nothing else in there that would be indicative of why he’d be losing weight (e.g. liver, kidney, etc).

One other thing: you might try just a little bit of raw egg yolk to help with the constipation. Don’t go overboard....start with 1/8 tsp.

 

[H.M. Victor (GA)]

His labs look pretty good except his white blood count, as you have remarked upon, and his glucose. The problem is, high WBCs can be from so many different things. Did he ever have the dental work done? He is definitely harboring an infection somewhere.

I agree with Bron that it’s good you are keeping an eye on his ketones and I would continue to test him daily, if you can. The issue that worries me is that it’s really hard to tell if his dose is too high or too low without mid cycle tests. You could have him overdosed or, his dose could be too low which, with infection, puts him at risk of DKA. If you switch to lantus, you are still going to need to get at list one other test during each cycle so we can see what dose he needs. His not eating and weight loss concern me; while your vet ran a really limited array of labs, there’s nothing else in there that would be indicative of why he’d be losing weight (e.g. liver, kidney, etc).

One other thing: you might try just a little bit of raw egg yolk to help with the constipation. Don’t go overboard....start with 1/8 tsp.

He hasn't had the dental work yet because our vet wanted to wait until his BG was better controlled.

I will keep an eye on his ketones and will get some mid-cycle tests if we are actually able to give his shot, since he hasn't wanted to eat anything

Did you look at the screenshot I linked or just his spreadsheet? Because they did do the 5 tests at the bottom of the blood panel on the spreadsheet (Neutrophils, Lymphocytes, etc) but the lab results had two different listings for those, so I wasn't sure which ones needed to be put on the spreadsheet.

 

[Marje and Gracie]

He hasn't had the dental work yet because our vet wanted to wait until his BG was better controlled.

I will keep an eye on his ketones and will get some mid-cycle tests if we are actually able to give his shot, since he hasn't wanted to eat anything

Did you look at the screenshot I linked or just his spreadsheet? Because they did do the 5 tests at the bottom of the blood panel on the spreadsheet (Neutrophils, Lymphocytes, etc) but the lab results had two different listings for those, so I wasn't sure which ones needed to be put on the spreadsheet.

I wouldn’t wait on the BG to stabilize if his kidneys and liver are good and they do look fine. I did see the screenshot but there are so many things that can cause the different types of WBCs to be off.

BTW, I did notice he’s dumping protein in his urine. He needs a urine protein:creatinine test but it’s pricey.

 

[H.M. Victor (GA)]

I wouldn’t wait on the BG to stabilize if his kidneys and liver are good and they do look fine. I did see the screenshot but there are so many things that can cause the different types of WBCs to be off.

BTW, I did notice he’s dumping protein in his urine. He needs a urine protein:creatinine test but it’s pricey.

Okay, we'll bring these things up to our vet as soon as possible.

 

[Chris & China (GA)]

I have been in contact with someone at DCIN about getting financial help, and they were willing to help us with switching to Lantus, but we do need help with getting test strips as well, and the lady I've been in contact with said she would talk to our case manager about ongoing help for both insulin and test strips, but I haven't heard back from her yet.

I'll see what I can find out. I'm pretty sure I found you in our files and it doesn't list any particular person as your case manager. Shellie is only our intake manager and doesn't usually deal with clients personally once the file has been set up.

Feel free to contact me here by PM or if you're on Facebook, I'm usually on there dealing with the Feline Diabetes group associated with this board. My name on Facebook is Chris Ronkoski (and I'm pretty sure I'm the only one there but you should recognize China's picture)

 

[H.M. Victor (GA)]

I'll see what I can find out.

Thanks, I'd appreciate that. Shellie is the only one there I've talked to and I just know she said she'd talk to someone about ongoing help with both insulin and test strips. I'll be sure to contact you if anything else comes up.

 

[H.M. Victor (GA)]

Hey guys, can you give any suggestions for getting Victor to drink/get water in him? I did the test where you pull up on the skin of their neck to see if it returns to normal quickly, and his skin takes a couple of seconds, so he's obviously dehydrated, but he won't drink from his bowl and just lays there by it. We have a couple of syringes the vet gave us to use with his liquid antibiotic, could we use those to syringe water into his mouth? He has been eating a little bit of tuna, but for some reason he just won't drink anything.

I'm also concerned about if his current symptoms could be pancreatitis or vestibular disease, (I don't know if our vet tested for pancreatitis in the labs I posted) so I would like to know what you guys think. Really worried because I don't know if we can get him back into the vet if it's needed.

 

[Sienne and Gabby (GA)]

Are you adding water to his food? I add a fair amount of water to my cat's food. Often a pet water fountain can help.

The test for pancreatitis is a Snap or Spec fPLI. The Snap is done in the office -- it's like a pregnancy test in that you get a "+" or "-" result. The Spec is sent out and you get an actual number.

 

[H.M. Victor (GA)]

Are you adding water to his food? I add a fair amount of water to my cat's food. Often a pet water fountain can help.

Yes we do add water to his food, but since he hasn't had much of an appetite lately he hardly touches it. We tried a water fountain a few years ago before he was diagnosed with diabetes but he didn't seem to like it. He always preferred to drink from his bowl and from the tap in the bathtub - the latter which he won't do now either; he'll lay in the tub with the faucet dripping but won't drink.

 

[Sienne and Gabby (GA)]

Ultimately, you need to get your cat to the vet, especially if he's dehydrated.

 

[H.M. Victor (GA)]

Just wanted to make a quick update here that we did get Victor in to a different vet (one that we had been looking into if we weren't stuck in the Wellness Plan contract with Banfield) and he was in bad shape. After they did a physical exam and blood work of their own, the prognosis wasn't good, so we made the heart-wrenching decision to let him go. I'll make a separate post about it when I feel up to it, but for now...I'm in tears as I type this. Goodbye, Victor, our sweet baby boy, we'll love and miss you with all our hearts forever

 

[JanetNJ]

Just wanted to make a quick update here that we did get Victor in to a different vet (one that we had been looking into if we weren't stuck in the Wellness Plan contract with Banfield) and he was in bad shape. After they did a physical exam and blood work of their own, the prognosis wasn't good, so we made the heart-wrenching decision to let him go. I'll make a separate post about it when I feel up to it, but for now...I'm in tears as I type this. Goodbye, Victor, our sweet baby boy, we'll love and miss you with all our hearts forever

Oh no I'm so sorry

 

[Deb & Wink]

Heartfelt condolences as you had to make the decision to send your beloved cat Victor to the rainbow bridge.

Lighting a ring of candles in memory of Victor.

 

[Bama Kitty Mom (GA)]

Heather, I am so sorry about Victor. It is heart-wrenching to read. We all love our babies so much and it tears us all apart when one goes. Please take care and write more when you feel up to it.

 

[Sandi and Toby]

I'm sorry, Heather. Victor's such a beautiful boy, and he was very lucky to have had you to love and care for him. Rest in peace, sweet boy.