A Year later...

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riebejamen

Member Since 2020
It's been a year since I joined FDMB; I haven't posted much. I thought I had a handle on Oliver's diabetes; now, not so sure. Could use advice. And maybe more anti-anxiety drugs for me. LOL

After Oliver's initial diagnosis last year, I dutifully gave him insulin shots for months; recorded everything he ate and when, and did multiple glucose readings a day. After the sting of disapproval regarding the use of the ReLion meter and Fancy Feast (FF) pate, and hurried vet appointments from the parking lot, not to mention covid, I did not actively pursue w/ his vet. I gave him his anti-nausea med every day, and continued to monitor and feed him FF. Some days he has more balance issues (ie wobbily walk) than others, but overall doing well. The multiple glucose curves at the vet were not productive and expensive. Home testing gave more consistent results, but could not regulate insulin dosage, so stopped.
Two weeks ago my husband broke Oliver's food bowl. Oliver has also been eating more of the regular dry food that sibling gets, and less of the FF and kidney diet food of another sib.
Last couple days, he has barely eaten. FF or dry. He's vomiting occasionally. Small amounts of saliva. He puked up his meds Fri morning, as well as the small treats I gave him. Hubs is a home, and said he did not observe Oliver drinking, nor did he ask for FF. But hubs is not observant. When I got home, I used meter , and pre tested with control solution for first time in months. I was definitely not good at getting blood. I stopped counting at 8 sticks. His reading was 293. Vet had said she wanted between 100-300. Don't remember if she knew meter was 'human'.
One of the issues he has, is major teeth issues. Last dental advice (last June) was full extraction. That is when diabetes was discovered. No symptoms otherwise. Nothing dental has been done because of the balance issues and irregular glucose readings. Vet felt it was too risky. Couple months ago, Oliver coughed up his morning pill, and a tooth. It literally fell out of his mouth. Best described as 'icky.'

I don't believe that his eating pattern has changed just b/c his bowl was broken. He sniffs, and then walks away from FF flavor he likes. I'm worried that it is his mouth that is causingthe trouble. Ie, It hurts to eat, so he doesn't eat. Maybe drinking hurts too. I'm head to get better variety of FF flavors tomorrow.
He does not seem dehydrated, but he is not peeing as much as usual. And not hanging out in his super favorite places.
After vomiting very small amounts of saliva twice today, I gave him a 1/4 tab of 10 mg famotidine. It stayed down, and as a precaution, smeared honey on his lips. Better to be high than low. Did not give sub q fluids.
I will call the vet on Monday, dread calling ER vet. Appts are hard to find. I had a really bad experience in January with another cat who couldn't be seen, or euthanized at any ER clinic for 8 hours+, and no vet would come to the house. That was a rough weekend.

Am I missing something diabetic with Oliver? His body language, lack of activity, and not eating suggests something is going on, and he does not feel well. If the Relion meter isn't reliable, should I continue to take readings? When he was first diagnosed, he had minimal to zero symptoms, so I think current behavior is something different. I haven't tried syringe feeding.
(Sorry for the long post, I seemed to have a lot to say!)

Thanks for help in advance.
 
Sniffing and walking away is a classic sign of nausea. Though mouth pain may also be a contributor. I think this needs a vet visit. If he needs a dental, you might see if there is a dental specialist nearby. They are more used to handling "complicated" animals.

A couple links that might help you:
Suggestions on How to Stimulate Kitty's Appetite and Feline Pain Scale

Could you update your signature to say which insulin you are using? The Relion meter should be perfectly reliable. Many people use that brand. Just make sure your test strips haven't expired.
 
You don't have a spreadsheet?
I do. Logging has been sporadic the last couple months; readings are fairly consistent in mid to upper 200's. Sometimes low low 300's.
He woke me up this morning with dry heaves. His glucose is 310. Gave him his daily meclizine, and 150ml of sub q fluids. No vomiting since this morning. I think we're going from bad to worse, as his ears and skin on head look yellow-y. Hubby doesn't see the color; Oliver usually has white skin under his black fur. Reviewing spreadsheet from a year ago, he had something similar, w/o the yellow. Could he have developed fatty liver from eating his previous dry food?
 
Sniffing and walking away is a classic sign of nausea. Though mouth pain may also be a contributor. I think this needs a vet visit. If he needs a dental, you might see if there is a dental specialist nearby. They are more used to handling "complicated" animals.

A couple links that might help you:
Suggestions on How to Stimulate Kitty's Appetite and Feline Pain Scale

Could you update your signature to say which insulin you are using? The Relion meter should be perfectly reliable. Many people use that brand. Just make sure your test strips haven't expired.
Not currently dosing insulin. BG stable with food. Specialty dental was not available when diagnosed. Vet advised against in house staff. Based on Grimace Scale, pain level varies between 3 & 8.
 
Five days later, and after much lighter pocketbook, Oliver and I went to newly opened animal hospital that wasn't overwhelmed with a min 8 hour delay. He has developed pancreatitis, IBS, diabetes/glucose issues. and another one of two "i -tisises". He was hospitalized Mon-Wed. They ran labs and he has an ng tube for feeding. Keytones are negative, and I needed to buy an AlphaTrak2 glucometer. His values at release were in the 200's. Dr is happy with that. And the dosage is 1u twice a day. He has 7 various medications for the next few days. I've clogged the ng tube twice, now looking at a third time. :arghh::banghead::(:mad::confused:. First one was a pain in the ass. Took me hours to clear it, and only b/c hubby came in with super hand strength at the end. And broke the funnel in the process. Second, I managed to clear myself. WOOT!
Not facing a third, I am frustrated and tired. Slept 3 hours last night. I think I am up to a 500 pops of water in the face, in trying to push and pull the clogs with warm water, and/or soda carbonation. He's not eating food, so I have to use the ng tube to give supplements. And since he is not eating, it makes giving him pills impossible by mouth. I successfully gave him all of them yesterday, today, I've feed him twice. Suppose to be 4x a day. Given insulin once; he's suppose to get twice a day. I crushed pills yesterday, and dosed with warm water. Today. nope. Pretty sure that is the latest clog.
I need a nap.
 
You do not need an AlphaTrack meter. A human meter is just fine. The strips for the AT meter are prohibitively expensive. I suspect the vet is clueless as to cost (about $1.00 per strip).

I'm curious how they came up with all of these diagnoses. Pancreatitis is easy -- there's either an in office test (Snap fPLI) or they can sent the bloodwork out and a Spec fPLI is the test. IBS is harder -- maybe by ultrasound but it's not definitive. The only way to be absolutely certain is through a biopsy/endoscopy and the sample needs to be reviewed by a pathologist.

What medications were prescribed? And I hope they prescribed buprenorphine for pain. It's a liquid and is you put it under your kitty's tongue/side of the mouth and it's absorbed that way.. Pancreatitis is quite painful.
 
Bad, sad news. Oliver passed away yesterday (Tues 6/15) morning. I think he waited until I was up and out of bed. I'd taken off his cone of shame, and had his meds ready. I was about to start morning feeding, and he started vomiting. There were no pills in it, from the night before, or food from early morning feeding. A couple of quiet stress meows, and he went limp.
my heart is breaking.
 
Bad, sad news. Oliver passed away yesterday (Tues 6/15) morning. I think he waited until I was up and out of bed. I'd taken off his cone of shame, and had his meds ready. I was about to start morning feeding, and he started vomiting. There were no pills in it, from the night before, or food from early morning feeding. A couple of quiet stress meows, and he went limp.
my heart is breaking.
I am so sorry to hear of your loss of Oliver. I hope you know how much he appreciated all that you did to take the best care possible for him. He knows he was loved. Big hugs to you and your family.
 
Sometimes it sounds like a silly cliché when we say "He knew he was loved" after all we put them through. The blood, poking around, another trip to the vet. They do know otherwise they'd be hiding behind the furnace in the basement. I can't be the only one that has apologized over and over again to a cat or a dog for what I've done but the truth is they know it's something that has to be done and it's for the best.
I've been where you are now, the diabetic cat with a mouthful of rotten teeth, cardiomyopathy and an enlarged heart. No vet could explain why he was still alive but I knew. The two of us had an agreement; I kept him pain free, away from the car he hated so much and ignored the never ending weight loss. For that he lived at least three years longer than anyone expected. It sounds like you and Oliver went through a lot together, you need to know you did everything right and Oliver loved you for that. Be kind to yourself over the coming days and know you're not alone. :bighug:
 
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