Sorry for your troubles and for you cat's health problems. It was a surprise to see this post show up in my email, as I have not been active on this site for some months. I don't know how, but first and foremost, as you know, you have got to get a BG reading since it would appear the one unit x 2 per day put your cat into hypoglycemia - potentially very dangerous. Lantus is very powerful, and the dose you describe put my cat Vivian at a BG as low as 30 which was way to low. Before you move forward with insulin, as you and your vet know, you must find a way to test this cat's blood. Best wishes with that. It was very hard for me and another person at first, took forever, stressed the cat, she fought it, we failed...eventually I could do it on my own and she barely moved, but I had two hands to work with -
As for the steroid, I suspect the reason your vet wants to continue is because it is a very basic form of cancer treatment, and if it's "only" IBD the steroid may be keeping inflammation down. If you stop pred, as I did, and inflammation and symptoms return, the cat can become resistant to it the second time around, such as happened with my Vivian. I didn't have a good experience with budesonide, but I think this will differ on a cat by cat basis and you won't know until you try. For instance, my cat's problems were in her large intestine/colon and budesonide was not effective b/c it probably didn't stay intact all the way through the digestive system to still be effective by the time it reached the large intestine. It didn't address inflammation, symptoms got worse, and it also didn't lower her BG. Diet change did that, I drastically reduced her carb intake, to the extent I was eventually able to get her off insulin even while she was back on pred.
I'm sad to say Vivian's story doesn't have a happy end. As mentioned, by the time I put her back on pred - after a month or so I think of ineffective budesonide - her symptoms of cramping and diarrhea had gotten pretty bad again, and pred no longer helped. She held her own for a few months longer but died December 14 presumably of a cascade of complications from her intestinal disease. My only remaining alternative was to try blood transfusions, imaging to locate internal bleeding and surgery if possible. I couldn't put her through anymore. She was suffering, her quality of life ahd vanished. Very tough decision with which I still struggle. She had biopsied negative for cancer last Feb., but ultrasound showed significant thickening and loss of layering in her large intestine. We do our best for our cat friends, I tried everything I could possibly think of, the budesonide was my idea, not the vet's who hadn't even heard of it. She warned me what might happen, but I was really focused on lowering Vivian's BG and getting her off the insulin. By the time I accepted she just needed to be on pred and I could treat diabetes it was too late.
She also had not responded well to Leukeran, another chemo drug used to treat both lymphoma and IBD, which I tried before a budesonide as a potential alternative to pred. Her best buddy Willis had fought nasal disease for two years and predeceased her on November 3. This was a huge stressor for Vivian, a crushing blow to both of us.
Anyway, get yourself a BG testing system first and foremost. Lantus can be dangerous. Since you don't know if you're dealing with IBD or lymphoma it may not be a bad idea to keep your cat on a steroid. Budesonide has apparently helped other cats in this situation. Leukeran - chlorambucil is the cheaper generic - can also help. Also keep in mind quality of life.
Best wishes..
Dear Laura,
Oh, I am so very sorry to hear what you have gone through . . . including the loss of little Vivian and Willis . . . Was this just last month/dec 2015?? My heart hurts for you . . . . . .
It sounds like you are an excellent kitty mama and always made the very best decision at the time with the information you had at that time. That is such a key for us all to understand. Of course we can see things differently when we look back -- but that has almost no value (only for applying to future decisions), because we can only act on the information we have at any given time. I totally understand that type of handwringing -- unfortunately I'm very good at doing that, second-guessing, etc. I have pretty much had to make what I just said a mantra to myself! I was a grief counselor with hospice for a while and I remember in one of our training sessions our instructor saying this: "Would've, could've, should've -- everyone plays that game and no one wins."
I, too, would've made that same decision to not put her through the transfusions, etc. I will do whatever I can for Callie and Theo, certainly to have as much time with them as possible – but never at the expense of THEIR well-being. I love them too much. When I took them in to the vet a few days ago, on the way home, I told them we're not going to keep doing that (going to the vet) -- that things going forward is going to be about ensuring their quality of life from every possible angle -- which means removing the stressor of vet runs, unless absolutely necessary for it to benefit THEM.
I feel like I have had a great deal of loss in life and I've had to make the call on so many souls I have loved dearly, including my own folks. And every once in a while, I still struggle and look back, wondering "what if" . . . Eventually, I catch myself (again), remind myself how toxic that really is, pray, and move on . . . until the next trigger down the road. Sigh. Somehow, all of these experiences have not seemed to help me deal (better) with the prospect of upcoming losses. You would think repeated exposure would help take off some type of "edge" off, if you will. Maybe on my end, it's some type of learning disability, because my anxiety has been through the roof! For someone with faith, I dishearten myself at times for my lack of peace. . . . Apparently that is just part of being human and for those of us with profound ability to care and love deeply, eh?
The vet had recommended chlorambucil for a little while, and I was really fighting it. Fortunately, the diarrhea resolved, getting me off the hook. I am never really a big fan of chemo, of a drug that destroys healthy tissues and affects other systems, supposedly while it helps "repair" another system. Heck, it's why am dealing with the diabetes now, because of the pred. Anyway, that's why with her not having vomiting or diarrhea right now, I'm just having a hard time buying into starting her on the budesonide. Especially while she's still receiving the pred . . .
My friend came over again this afternoon before leaving out of town, failed with a lancet again, and I convinced her to try the 25 gauge needle, as my vets office had shown me. I, too, didn't love the idea, because of it being a larger needle. But that's what finally did the trick to get a tiny droplet of blood. Maybe Callie's veins and capillaries are just so tiny, or blood pressure is low, or she wasn't hydrated enough, who knows -- for why a lancet isn't enough for her. I'm the one that needs to learn a way to test her blood a couple times a day, but my friend and I agreed at this point we just had to get a number, so I just let my friend do it. But I need to try again on my own later tonight. Her count was 250, so I went with the one unit of insulin.
Trying so hard to keep the fear at bay . . . I suspect you and others here know what I mean by that . . .
Thanks so much for writing, Laura, I really appreciate it! I will say a prayer for you, for true peace and healing. I pray that the memories and understanding of all the love and care you provided and received from Vivian and Willis warms your heart and soul, with immeasurable peace. (((HUGS))))
Oh these fussy funny lovely kitties with their quirks!!
