End of life care for diabetic cat not eating

Status
Not open for further replies.
Jan D & Squeaky

Jan D & Squeaky

Member Since 2020
Hi everybody,

We have not visited our lantus group for a long time. I have pretty well understood the mechanics of diabetes and we haven't need advice (until now), and are stressed by many other things so time is limited.

Anyway, Squeaky is nearing end of life and his numbers (not his nadirs, but the numbers just before shooting) have been all over the map, but I'm concerned about the ones that are, for example, in the 80s at times when he isn't eating much.

He told the animal communicator he didn't want food syringed and I could override his wishes but don't really want to.

He's eating a little bit once or twice a day. Sometimes his pre-shot numbers are in the low 80s and sometimes in the high 400s. So I know he is going low and bouncing. Sometimes his numbers are beautifully in the 100s and 200s, a safe range.

Yes I've been trying every trick in the book to keep him eating. We have at least 40 different foods and treats and rotate them to see what he is eating.

I am not sure if there are any instructions for end of life care? If so would you kindly provide a link? Thank you so much.
 
Hi Jan, I am sorry to hear that Squeaky is not eating well. I am assuming you have tried ondansetron and cerenia for nausea.
What does the vet say?
Is he still walking around and communicating with you?
It does look as if he could be dropping during the day and bouncing back up at PMPS.
Are you able to get any tests in during the cycle to see if this is happening?
 
Bron and Sheba (GA) said:
Hi Jan, I am sorry to hear that Squeaky is not eating well. I am assuming you have tried ondansetron and cerenia for nausea.
What does the vet say?
Is he still walking around and communicating with you?
It does look as if he could be dropping during the day and bouncing back up at PMPS.
Are you able to get any tests in during the cycle to see if this is happening?
Click to expand...
Lisa and Witn (GA) said:
Has he been seen by the vet recently and any tests done? It may be due to additional health issues instead of diabetes.
Click to expand...

Thank you Bron and Sheba, Lisa and Witn. Yes he has so many ailments he is very close to end of life. Vet has declared him in home hospice and we have made connections with euthenasia vets in case they are needed. I just hope he doesn't go via diabetic coma! He is taking above the max dose of cerenia and budesonide. Plus he's on chlorambucil (plus insulin, plus asthma inhaler, plus B12, plus buprenorphine, plus fluids.... he's highly medicated).

I only test his BG twice a day, pre-shot. It just works best this way for us so he is not in fear of getting his ear pricked all day and all night long. But I wondered if there are any specific instructions for pre-death, when a cat stops or slows eating. Because that certainly affects the numbers.
 
Hi Jan. I have missed "seeing" you. I'm so sorry you are going through this with Squeaky. I can't see your spreadsheet past April 2022, so I'm not of any help with that. I think you know what you are doing and when to reduce his dose if you think he's bouncing and then dropping. I will be thinking about you both. Hugs and love being sent your way.
 
I’m sorry for what you’re going through. My Charlie was on a lot of the same meds and I remember well those final months and days and trying hard to “do right” by him.

As for insulin, if you truly believe Squeaky is going low and bouncing, then perhaps you’ve answered your own question. Going low warrants a dose reduction, as you know. When they’re not eating enough, dosing needs can change. You’d need mid-cycle tests to prove it, of course, but if you don’t want to do that, then you’ll have to decide where your comfort level is with guessing. Charlie was a trouper even at the end, and he trusted me, so I got the extra tests in and titrated dose accordingly. I have seen hypo seizures and, given your obvious concern about Squeaky’s quality of life, I strongly encourage you to be cautious about the insulin dose. Seizures are awful.

When you know they’re nearing end of life, I think there are clues in their attitude, food intake, and litter box use. Due to his complicated medical issues, getting Charlie to eat was a challenge in his later years. I didn’t like to resort to syringe feeding either, but sometimes it “primed the pump” a bit and so was helpful in that regard to do on occasion. I’m a big believer in syringe feeding when there’s a real hope recovery from an event or illness. In end of life, it’s a more delicate decision, as you also know. Sometimes just because we can do something, doesn’t mean we should. Charlie defied the odds and cheated death so many times that it was hard to decide where to draw the line, when to give up. Famotidine (Pepcid AC) was the go-to back then and it helped Charlie somewhat. With all Squeaky is already on, it doesn’t sound like there are too many other options.

A lot of cats hang on for us. When their eyes start to dull, they quit eating, and they start missing the litterbox (especially if they pee where they’re lying), then that’s pretty compelling that their time is winding down.

Perhaps none of this is helpful or even the type of info you were looking for. Give Squeaky a scratch for me. I’ll be thinking about you. :bighug:
 
Suzanne & Darcy said:
Hi Jan. I have missed "seeing" you. I'm so sorry you are going through this with Squeaky. I can't see your spreadsheet past April 2022, so I'm not of any help with that. I think you know what you are doing and when to reduce his dose if you think he's bouncing and then dropping. I will be thinking about you both. Hugs and love being sent your way.
Click to expand...

Hi Suzanne, thank you! I posted a joke today..... I went ahead and filled in some spreadsheet numbers, see if that helps. Mostly the problem is he does not want to eat. https://felinediabetes.com/FDMB/thr...pmps-394-amps-47-end-of-life-question.270167/

Although he is not peeing in his box any more, he is sitting over there with his head up and played chase with me before his meds. Sigh, it's tough being a mom. Thanks in advance for your thoughts.
 
JL and Chip said:
I’m sorry for what you’re going through. My Charlie was on a lot of the same meds and I remember well those final months and days and trying hard to “do right” by him.

As for insulin, if you truly believe Squeaky is going low and bouncing, then perhaps you’ve answered your own question. Going low warrants a dose reduction, as you know. When they’re not eating enough, dosing needs can change. You’d need mid-cycle tests to prove it, of course, but if you don’t want to do that, then you’ll have to decide where your comfort level is with guessing. Charlie was a trouper even at the end, and he trusted me, so I got the extra tests in and titrated dose accordingly. I have seen hypo seizures and, given your obvious concern about Squeaky’s quality of life, I strongly encourage you to be cautious about the insulin dose. Seizures are awful.

When you know they’re nearing end of life, I think there are clues in their attitude, food intake, and litter box use. Due to his complicated medical issues, getting Charlie to eat was a challenge in his later years. I didn’t like to resort to syringe feeding either, but sometimes it “primed the pump” a bit and so was helpful in that regard to do on occasion. I’m a big believer in syringe feeding when there’s a real hope recovery from an event or illness. In end of life, it’s a more delicate decision, as you also know. Sometimes just because we can do something, doesn’t mean we should. Charlie defied the odds and cheated death so many times that it was hard to decide where to draw the line, when to give up. Famotidine (Pepcid AC) was the go-to back then and it helped Charlie somewhat. With all Squeaky is already on, it doesn’t sound like there are too many other options.

A lot of cats hang on for us. When their eyes start to dull, they quit eating, and they start missing the litterbox (especially if they pee where they’re lying), then that’s pretty compelling that their time is winding down.

Perhaps none of this is helpful or even the type of info you were looking for. Give Squeaky a scratch for me. I’ll be thinking about you. :bighug:
Click to expand...

Dear JL,

Your reply was perfect, it sounds like you have traveled this same road. Thank you so much for your response. He is not using the litterbox but not yet peeing where he is lying. Still trying to eat and had some organs and kibble last night but obviously it was not enough as he tested at 47 this morning. Yes his time is winding down.

However he grabbed his sparkle ball, let me chase him before meds, and is sitting with head up instead of lying down. I think it is this part that I'm not sure about. We have two end of life coaches (nonprofits: BrightHaven is one of them) to dialogue with, but of course the diabetic issue requires a lot more knowledge than I'm sure they have.

Please also see my post from this morning and if you have further thoughts I'd love to hear them. https://felinediabetes.com/FDMB/thr...pmps-394-amps-47-end-of-life-question.270167/

We hope to try for a natural home death.

Thank you so much,
Jan and Squeaky
 
I don't know if there is any scientific backing to this but I've noticed that an end-of-life diabetic cat's numbers become wonky with a lot of them travelling downwards quickly.

I carry you and Squeaky in my thoughts. Enjoy him. Play. Smell. Scritches galore. But mostly just enjoy being with each other. :bighug:
 
Wow. I see he went lime. If it were me, I'd probably reduce that dose down quite a bit. I doubt if you are going to be able to stop the wild swings, but I'd probably pick a reduced dose and stick with it, unless he goes lime again, of course. I'd also let him eat whatever he likes to eat... even if it's kibble or whatever he likes. It will make him happy. Darcy loved the Dr. Elsey's Clean Protein kibble in any flavor (duck, rabbit, chicken) so that wasn't too bad since it was fairly low carb. But I also had him on high-ish carb renal food at the end, too -- whatever he would eat. Even on the last day of his life, he was eating that Dr. Elsey's quite happily (which was weird.) Big hugs to you, Jan. I really feel for you. I feel tears welling up in my eyes now.
 
Suzanne & Darcy said:
Wow. I see he went lime. If it were me, I'd probably reduce that dose down quite a bit. I doubt if you are going to be able to stop the wild swings, but I'd probably pick a reduced dose and stick with it, unless he goes lime again, of course. I'd also let him eat whatever he likes to eat... even if it's kibble or whatever he likes. It will make him happy. Darcy loved the Dr. Elsey's Clean Protein kibble in any flavor (duck, rabbit, chicken) so that wasn't too bad since it was fairly low carb. But I also had him on high-ish carb renal food at the end, too -- whatever he would eat. Even on the last day of his life, he was eating that Dr. Elsey's quite happily (which was weird.) Big hugs to you, Jan. I really feel for you. I feel tears welling up in my eyes now.
Click to expand...

Thanks Suzanne, that makes sense to reduce his dose of insulin even when he's in the 400s. I will do so. Oh, he stopped eating 36 hours ago and about 12 hours ago told me to stop offering him food completely. Our hospice coach says that some cats die one day after stopping eating; but others can last for 3 weeks.

Night before last he peed 4 times (out of box) but last night, only 2 times. So he is winding down.

This morning, early, he came over and woke me with a purr. I thought it might be his time so I sang his song and we breathed together for an hour or two. But, then he got up and got a drink so we have another day together! It will be sunny and I can take him outside. He sure isn't moving very much this morning so far.

Thanks for your message and caring. Yes it is so hard to lose a friend..... a best friend..... Sending hugs to you too..... How are things going with you? :bighug::bighug::bighug:
 
Oh, I feel sad to read this about Squeaky. How did he let you know he didn’t want to be offered food anymore? It does sound like he’s winding down. You have a hospice coach? I’ve never even heard of that before (well for humans I have.). I’m happy you have support. Squeaky always did like it outside. Didn’t you take him camping? Or I recall your neighbor said you could go over to his yard with Squeaky too?
 
Suzanne & Darcy said:
I’m okay, thanks for asking. Cats are sick right now with a virus. One cat gets over it and another gets sick. Hope it will be over soon.
Click to expand...

Hi Suzanne, wow I have not heard of cats catching viruses like that! Egads! I hope it will be over soon for you!

Yes the hospice coach is called Bright Haven, they are a nonprofit organization helping caregivers with end of life pets. Trying to help the critters go naturally, at home, without euthenasia if possible. There is another one called Spirits in Transition. Both free and accepting donations.

So that goofball. Recently, he stops going to his dish to eat. I put food under his nose and he eats. Then lately he doesn't eat, doesn't eat, doesn't eat.... then one day I put the food under his nose and he looks really mad and runs away. I get the message. He wants to stop eating. So FINE. I stop offering food, although there is some food out for him if he changes his mind. That night passes, the next day passes, no eating. Oh, one bite. The next night passes, no eating, he comes and says good bye to me (cuddles and purrs). I sing his song, then we breathe together for a couple of hours. Next day he is really weak, but wants to go outside. Comes back in, goes over to his dish and EATS. So I give him some liver and he eats more. Today, he has been eating several times. Go figure. This is the cat that will not die.

I wonder if he was just fasting, knowing that often time without food, the body will heal itself......

Well he is still skinny and weak. Still peeing on the bed but sometimes in the box. I call him the cat with 109 lives. :p
 
You are wonderful, Jan. Squeaky is a really special, I can tell. No wonder you love him so much. I am on board with letting them pass as long as they’re not suffering a lot, but I know you love him and will do the very best for him… as you already are doing. Lots of love is coming your and Squeaky’s way!
 
Status
Not open for further replies.
Back
Top