Hi Donna,
Here is my history. It is very long and please don’t feel you have to read the whole thing if it is too much. I just reread it, but can’t bear to edit it. I guess the bottom line is that the diabetes was just a tiny blip among all her medical problems. Don’t get me wrong, I struggled with insulin doses (and Gator, Robin and Joanna were invaluable), but I knew she was in pain and probably dying, so mostly I just wanted to keep her as comfortable as possible, and the doses were not so important. I still struggle with the “what if’s” (what if I had given more insulin, what if I had hospitalized her, what if I had waited to euthanize her, what if I had euthanized her sooner), but when I realize that is what I am doing I look at myself in the mirror and I say “CUT IT OUT!!!” “You loved her and you took care of her the very best you knew how. Maybe someone else could have done it better, but even if that is so, you did all that you could do and you do not deserve to be tortured for what happened. Retire your internal slave driver and be nice to yourself!!!”
I am including a link to the Youtube video I made to show her symptoms. (it also shows how very beautiful she was). It can be searched for under Feline Orofacial Pain Syndrome . Squamee Oct 2010.
Hope this helps.
http://www.youtube.com/watch?v=4X4lrZgORIQ
Sept 21, 2010.
A year and a half ago Squamee developed what looked like a jaw symptom. She would start eating and then move her jaw around like she was trying to dislodge something stuck in her mouth, while pawing at the sides of her face. There was also a slight clicking noise. She would stop eating and return again a few minutes later. Sometimes she would then be able to eat. She was put on long acting steroids which resolved the problem and she developed diabetes. She was on insulin (PZI) for several months and then went OTJ on Aug 20 2009. This August (2010) the jaw symptom returned. It did not respond to oral medicam. My vet thought it might be a tooth or TMJ. I took her to a dental specialist who could find nothing amiss on oral examination, but with x-rays found a badly rotten tooth which was extracted on Sept 7. That night she was able to eat more freely (anaesthesia?) and in the following days was on buprenex, but the difficulty eating got worse.. Gave injections of Medicam and Buprenex which seemed to help for a short while. Then did x-rays of skull to look for bone spurs(?) and also sonogram of stomach which showed nothing. Said the next step would be endoscopy and if that showed nothing, a cat scan. These were with the idea that perhaps there was some form of cancer. On Sept 17 she had a seizure, which the vet believes is the result of a brain tumor, which would also account for the mouth problem. If we are willing to consider brain surgery, a cat scan is now in order. The scan would be $1000 and the surgery in the area of $5000. (and we have already spent several thousand). I am not in a position to do this, much as it breaks my heart.
So at the moment, I am testing her BG daily, and the vet says if it stabilizes in the mid 300’s he will put her on insulin. He doesn’t want to do it at lower numbers because low blood sugar increases the likelihood of seizures. At the moment she is staying in the mid to upper 200’s. He says if the seizures become frequent, he can try giving her phenobarbitol. Currently, she is able to eat, although I do see just a little of the mouth symptom. She sleeps a lot, and doesn’t really seem herself.
April 2011
Squamee’s jaw problem got much worse and interfered with her eating. Gave her steroids, which did not work. Diabetes returned full blast. Back on insulin. I discovered info on the internet which perfectly described her jaw symptom. It was called feline orofacial pain syndrome, and was thought to be a form of trigeminal neuralgia (which is excruciating in humans). Cause unkown, but frequently related to dental problems. Treatment is with Phenobarbital and gabapentin (neuroleptics which address nerve pain).
I worked with the vet to treat this, which was extremely difficult as Squamee was impossible to pill. She would fight and even if I managed to get it down her throat she would spit it up or vomit it. I tried hiding it in different foods, etc, which sometimes worked for days or even a few weeks, but then she would no longer take it. Tried compounded flavored liquids which she would spit out. Finally gave phenobarb in transdermal gel which worked enough so that she could eat some.
Meanwhile,she developed kidney problems, bowel problems, (and was equally impossible to medicate) and inappetance. Her BG levels were unregulated. Vet kept pushing me to increase, but since I was never sure if she was going to eat, I was reluctant.
She spent weeks lying on my couch under a blanket. She ate less and less and lost a considerable amount of weight. I began giving subQ fluids which did not seem to help.
She developed DKA. She spent hours standing over her water bowl---she looked like she was thirsty but unable to drink. Sometimes she would lie down next to her bowl. Othertimes she just stood over her bowl with her head drooping, and even in the water.
Vet said he could hospitalize her and might be able to get her through this episode, would take a week in the hospital. Squamee HATED the place. All the vets told me what a terror she was when she was there, they had great difficulty when she was originally diagnosed with diabetes and they could barely give her shots. She became a screaming hissing biting banshee. I could not do that to her when there was no reason to believe the underlying problem would be solved. We euthanized her on Dec 20, 2010.
