@Roberta and Chloe I’m sorry I wasn’t online earlier but am glad others jumped in to help out.
First, I too think you should hold steady and not increase dose for at least a day or two to see what happens with the new pen. I think it’s usually wise to change one thing at a time.
If you don’t mind, please remind me (any anyone else reading), about a couple of things:
1) How is Chloe’s appetite? If you recall, I think you said she’s a hearty eater?
2) About how much does she eat in a day?
3) What is her poop like? Is it normal color and consistency?
4) Does she have any other known medical issues, such as IBD, constipation, kidney disease, hyperthyroidism, etc?
I’m concerned about the ongoing weight loss. If she’s losing ground and getting weaker and more wobbly, there might be something in addition to diabetes going on. Yes, FD can make them emaciated but it’s not at all uncommon these guys to have other issues too.
As for peeing and pooping on the bed... has she done that throughout her life or is that a more recent occurrence? I highly doubt it’s spite for not letting her sleep with you. Rather, I’d suspect one of three things: either she has a UTI and peeing/pooping on the bed is her way of pleading for help, or she is so weak and unstable that she can’t physically navigate off the bed easily to use the litter box, or she has lost some sensation in the hind end and doesn’t always realize it’s happening. Also, cats who are weak and wobbly don’t always feel stable in the litter box — the litter is like shifting sand — and so prefer a more solid or flat place to do their business.
If you want suggestions, I’d consider taking Chloe to the vet for a urine sample to check for a UTI. If she has any issues with IBD or soft stools, I’d try to address those as well because those things can suck the weight right off. By the way, UTIs are very common in diabetics and can cause increased BGs, so it’s possible that’s what you’re seeing in the data. While you’re at the vet, if wouldn’t hurt to get some blood work done to check kidney and liver values, and especially thyroid values to rule out hyperthyroidism.
To mitigate the soiled bed, I’d try a couple of things. First, I’d get some steps to put next to the bed for Chloe to use to get up and down, or alternatively rig up some boxes or totes that served as steps. I’d get some disposable underpads (chux) to put on top of the bed to catch any accidents, then put a litter box on the bed to see if she would use it if it’s close by. I’d put an extra litter box on the floor but line it with a puppy pad rather than litter (perhaps sprinkle a quarter cup of litter around the perimeter just to “mark”it as a litter box). I’d also watch to see whether she had intent or not — does she intentionally squat on the bed or does she just wake up and there’s an accident there?
You can also request an X-ray of her spine and hind legs to see if any bridging of the spine or arthritis is present. Certain pain meds can make a world of difference. I helped once with a cat who had significant arthritis and spinal issues and it was a matter of experimenting and tweaking until we found what worked. The right pain meds, Miralax for constipation, adding a litter box where the cat hung out, and offering a variety of substrates (including a pee pad rather than litter), finally solved the problem of her peeing and pooping in inappropriate locations.
I’m concerned that Chloe spent the day under the bed. Poor girl. She obviously doesn’t feel well. :-(