An update on Bat-Bat

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Robin&BB

Robin&BB

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Hello, ProZinc friends,

After more than a year on ProZinc - and most of that time on a really dinky dose (btwn. 0.10-0.20 U), Bat-Bat continued to nadir early @+3.5 no matter what I tried, and I think the longest she ever went without insulin was 6 cycles

So today we returned to Lantus, the insulin I used successfully back in 2013 before I was actively involved with FDMB.

Just so you know: I still think ProZinc is a very good insulin and I know that many of our sugar kitties have gone into remission using it. But as we so often say here at FDMB, ECID (every cat is different) - and fractious ol' Bat-Bat has been a real challenge to get OTJ again. (Can you say, "So close and yet so far?") And while I may have to accept the idea that she may never achieve remission a second time around, I'm not giving up on that goal quite yet; hence, we're giving Lantus another try.

Some of you may be wondering why I didn't just return to Lantus when she lost remission in 2014 … the short answer: She had a raging UTI at the time with high BG - a very sick kitty (vet didn't think she'd survive). He assured me that ProZinc would work well for her (that's the insulin he had on hand.) But as my 2nd open vial of ProZinc recently passed the 6 month mark, when I found out I could secure Lantus from Mark's Marine in Vancouver for less than Prozinc costs us down here, it was a no-brainer.

So … I have my fingers and toes crossed, and a hopeful heart that Lantus will make the difference for her.

Hugs to all!:bighug::bighug::bighug::bighug::bighug::bighug:- Robin
 
Robin, so good to hear from you! We miss you! I hope you are feeling better. Good luck with the Lantus. I hope Bat-Bat responds as well as she did previously.:bighug::bighug::bighug:
ETA just saw your other thread-YOW! Welcome to Lantus!!!!
 
@Sharon14 , @Carol & Murphy - Oh, I miss you, too!!! I hope Colin & Murphy are doing well these days.:cat:

The illness is a long, winding road with no instant fixes. I am so tired of being ... so tired all the time. And the periods of brain-fog really bum me out. You'd laugh if you saw my phone, though - I have so many alarms set, between Bat-Bat's test times & my medication times (I'm on 4 right now, and 3 of them have to be kept well away from the one that I have to take 4x/day:confused:), that it's beyond ridiculous.:rolleyes:
 
@Robin&BB So great to have you on this forum again, Robin - I'm sure Sue and Rachel would love to see more of you here (me, too)
take good care and know your friends here are thinking of you and want you back!!:kiss::bighug:
 
It is so good to hear from you again. Sending lots of get well vines to you. Take care of yourself, and please try to check in more often.:bighug::bighug::bighug:
 
Robin! This is so funny, I'd just booted up the computer today to write to you when my husband called needing some info that took me FOREVER to find. So nice to hear from you! Goof's numbers are climbing again for some reason (he's had 2 UTI's in the last 6 months and a sore that won't heal) :banghead:. I'm seriously considering trying Lantus.

My cat Shita has the same swinging belly, first being spayed, hen 2 abdominal surgeries in 2 days. (Long story involving curling ribbon). :confused:
 
Mogmom and Goofus said:
My cat Shita has the same swinging belly, first being spayed, hen 2 abdominal surgeries in 2 days. (Long story involving curling ribbon). :confused:
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Great to "see" you, too, Tammy. Whoa, you'll have to tell us that curling ribbon story some time!!! Little Bat was found trapped under a house in a heating duct, abandoned @ one month of age by her feral mother. The vet opined at the time about her tummy flap: "Could be that this poor baby probably had a great, big belly full of worms. But after her food supply was cut off & she began to starve, the worms exited her body - leaving a deflated 'sack' behind!"
 
I'm trying to get my vet to approve Levemir - I think it is really indicated in Murphy's case but his fructosamine was normal so my vet said no
 
Carol & Murphy said:
I'm trying to get my vet to approve Levemir - I think it is really indicated in Murphy's case but his fructosamine was normal so my vet said no
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Perhaps it would help if you printed out a good article or two (from veterinary sources, I mean, which might carry more weight with your vet) so as to better help him understand that sometimes a cat responds better to one type of insulin over another . (While his fructosamine may have been "normal," appears to me that his SS #s are yielding a somewhat different story ...;))
 
Carol & Murphy said:
Tammy - I am so envious of your spreadsheet
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Thanks Carol. My vet always says that Goof is doing great when he sees his SS, but I LOVED it when Goof was in remission (a bad tooth and UTI spoiled that for us), I felt like I had my cat and my life back. He still has a sore that won't heal and I'm wondering if that's not what is keeping him on the juice.
 
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Mogmom and Goofus said:
He still has a sore that won't heal and I'm wondering if that's not what is keeping him on the juice.
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Could be, 'cause inflammation is, well ... inflammation. No matter where it's occurring in the body, it can throw his system out of whack, because it makes the body's pro-inflammatory cytokines kick into high gear. Hopefully once his sore gets to healing up, his #s will settle back down. (Fingers & toes crossed for you!) What caused his sore, Tammy - and where is it?
 
Robin&BB said:
Could be, 'cause inflammation is, well ... inflammation. No matter where it's occurring in the body, it can throw his system out of whack, because it makes the body's pro-inflammatory cytokines kick into high gear. Hopefully once his sore gets to healing up, his #s will settle back down. (Fingers & toes crossed for you!) What caused his sore, Tammy - and where is it?
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I'm not sure what caused the sore, it's on the lower part of his left shoulder. Its not in an area where a shot would be given. But Goof and Sweetie Cat play quite a lot, sometimes a little rough, and it's possible it started from a bite or claw scratch. Bactoderm wasn't working so I took him to the vet, he shaved the spot and it turned out that he had staph infection, it was red and blotchy for about 1&1/2 inches all around the sore. The spray they gave me to use cleared the staph, but the sore just won't heal.
 
Robin so good to see you! We truly have missed you. I'm sorry you're still feeling poorly. Know that you're always in our thoughts!

I hope Lantus works well for Bat-Bat!
 
Mogmom and Goofus said:
The spray they gave me to use cleared the staph, but the sore just won't heal.
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Just flashed on something about human diabetics: They often have trouble with wounds healing, too. (Recalling lower leg ulcers in some of the diabetic patients that the doc I used to work with was treating ...)

So I'm wondering: Would some of the tricks of the trade in wound care for human diabetics translate to a kitty patient? Might be worth checking into that, Tammy --- although maybe you already thought of that? (:bighug:)
 
Oh, you're right, Carol - those diabetic lower leg/foot ulcers in people are from circulatory problems. (And boy, did we see some really BAD ones in the doctor's office:eek: - freaked me out the very first time I had to deal with cleaning/dressing those wounds!)

Just found this from a New Mexico-based vet @ www.drjeffnichol.com (Please note I'm not at all suggesting that Goofus has Cushing's; rather it's that I found the vet's remarks re: the addition of corticosteroids in some antibiotic ointments pretty darned interesting!) ;)

Poor Wound Healing in a Diabetic Cat
Uncontrolled Diabetes can cause Skin Infections but Cushing’s Syndrome is a Major Cause of Thin Fragile Skin

Question:
My 15 year diabetic cat got a scratch behind her ear. She continued to scratch at it making it go to a gaping wound. A vet gave us antibiotic ointment and got it healed. She opened it up again. We’re now dealing with an e-collar and after 3 tries at leaving it on for 4-6 weeks whenever we take it off she opens it again. Will her e-collar become a permanent part of her dress – or is it her diabetes that prevents this from healing?

Dr. Nichol:
Your kitty may have serious problems. Diabetes that is not well controlled can cause skin infections that lead to poor wound healing. Some diabetic cats also have a disease of the adrenal glands called Cushing’s syndrome. Cushing’s causes thin, fragile skin. It’s also possible that the antibiotic ointment may be entirely to blame.

Check the label. Many prescription ointments contain a corticosteroid (like triamcinolone, dexamethasone, or hydrocortisone) to reduce inflammation. Unfortunately these topical steroids can delay healing if used long term. Provided that your cat’s diabetes is well controlled and stable, and she is otherwise healthy, simply discontinuing the ointment could solve her problem.


Diabetic cats have special needs, especially if they also have the high levels of the hormone cortisol that is seen in Cushing’s syndrome. Not only do these kitties struggle with skin disease, they may drink and urinate excessively, and develop liver and joint disease. To be safe your cat needs a follow-up exam and current lab work. Sorry this is complicated. While most diabetic cats do OK with careful feeding and insulin dosing those with concurrent Cushing’s syndrome usually need surgery of the adrenal glands to get lasting relief.
 
I did actually look at Cushings already, but the pictures don't look the same at all. The only hair loss was on the sore itself. The doc shaved the area so the hair wouldn't get into it and that's when we found staph infection that had spread out on the skin under the fur.

Doc says the slow healing is in part due to the diabetes because of the compromised immune system. But, also because when something is healing it usually itches and he keeps scratching it open. A collar won't help as the sore is to low on the shoulder and if I put something in him to keep him from scratching, he just tips over, lays on the floor and won't move. He'll meow the most awful sound that is just heart wrenching.

It was doing better when the area was shaved, maybe I need to have that done again.
 
I just did a thorough inspection of Goofs skin, checked over his muscles and looked again at info regarding Cushings, and now I'm scared. I'm thinking you may be right Robin, he has several patches now, his appetite is off the charts, the muscles in his hind legs are diminished and my husband says he thinks Goof looks like he's wasting away. Oh God, I just lost my Lil Mouse, I'm not ready for this!
 
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Tammy, :bighug: Sending positive vines for you and Goof. As Carol said, try not to worry until you can get him checked. I think MaryAnn -Tuxedo Mom-has a kitty with cushings, maybe she could give you some insight as to what to look for.:bighug:
 
Tammy, sending you hugs! I know how hard it is not to worry (trust me...I suck at it) but do your best. I'd post on health and ask for advice on kitty's with cushings. Get some info and get Goof checked out and take it from there. You can do this!
 
Carol & Murphy said:
Oh Robin sorry we are hijacking your posts (but you know how these thing go
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No, no - don't apologize ... I don't mind one bit. I just hope & pray that Goofus will start feeling better soon!
@Mogmom and Goofus - Gee, Tammy, I really wasn't even thinking about Cushing's (nor do I have any experience with that disorder) when I posted the Dr. Nichol piece; I just noticed his warning re: the possibility that corticosteroids contained in an antibiotic ointment can delay healing. Can totally understand why you're worried about Goof, given the symptoms you've just described. (But it could be that he needs a completely different antibiotic to get the staph under control and is dealing with a bout of neuopathy at the same time.)

I will be thinking good strong, positive thoughts; will be anxious to hear what you find out from the vet. Sending many healing vibes your way.:bighug::bighug::bighug:
 
Spoke to Dr, Britt today, she's the vet in the office with a strong cat background and advanced cat education. I told her about all of the stuff I've read and Goofs symptoms, she agrees that it sounds pretty suspicious for Cushing's. But she said not to get too freaked out as it is very rare, but I does happen. She said it could be in its early stages at this point, but tomorrow I have to get a urine sample from Goof.

I bought some aquarium gravel and we're going to try that first. If I put Saran Wrap in the sandbox, he'd freak out he second he stepped in it. Doc says to get a sample this way will be more accurate as the stress from the trip can change the levels.

I have to take my mom in law to a appt tomorrow that'll take a few hours so I'm going to put Goof in my bedroom (he likes it in there anyway ) with the clean box and hope he gives me a sample. Hopefully he won't give me a sample of something else in there too :nailbiting::rolleyes: and contaminate the urine. :confused:
 
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