Between the proverbial rock & hard place (long intro)

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Hello!

My name is Sharon (I'm from Virginia) and my recently diagnosed kitty is Riley. Up until six months ago, Riley was my healthiest and most low-maintenance cat, in a household of 7 indoor cats. In early May he developed a very hoarse meow, stopped eating and when he did try to eat (kibble), he would often run, as if it hurt his throat. He'd never eaten canned food, even though the other 6 have eaten equal amounts of dry and canned.

I took him to the vet, saying there was a problem in his throat. I feel his care was seriously mismanaged at that point because after doing a bazillion tests (which showed nothing--and some were absolutely unnecessary) and not trying to assist-feed him during the 3 days he was in the hospital (combined with the lack of food at home for about a week prior to his hospitalization), he developed FHL (fatty liver disease). When they finally sedated him to put in a feeding tube (and I'd reluctantly given permission for them to do exploratory surgery on his belly!!) they got a good look at his throat. The vet called me after he was sedated and said it looked like he'd somehow punctured the back of this throat on a stick or something (indoor cat...how??) and I said I that I did NOT want them to proceed with the exploratory surgery--I'd been saying all along that the problem was in his throat. Anyhow, much frustration about his early care....

The tube feeding went well after the first few days and his liver values improved. As he got stronger, he started eating some dry food on his own, making me feel that his throat was healing. All went well until he managed to pull out the tube on June 4th. He still wasn't eating enough food (dry or canned) and so tube #2 was put in on June 8th.

A different vet did the 2nd tube placement and she said that instead of a "puncture" wound in his throat, that he had stomatitis--a condition I'm all too familiar with. How/why the first vet "missed" that in May, I'll never know, but it would have saved putting him through countless (useless) tests initially and well over $1000....

This time he came home with a new feeding tube, antibiotics and Prednisolone to try to get the stomatitis under control. Again he improved.

He pulled out tube #2 on July 22nd, after I'd invested in a special collar to hold the tube in place--for most cats. At this time Riley was dubbed "Houdini Cat"...

On July 23rd tube #3 was placed and 3 teeth were removed; in retrospect, I wish I'd insisted that ALL teeth behind the canines be removed, because that's often the only thing that "cures" stomatitis (been there, done that; I have 3 toothless cats...)

Again, things went well (after he got past the worst of the effects of the anesthesia...) but tube #3 only lasted a week--we got into an emergency situation and *I* had to pull it out. He ate fair after that (me assist-feeding canned) but he was still losing ground and I could tell that his throat was still bothering him (he wouldn't even yawn widely because it hurt to open his mouth). On August 15th the vet prescribed Dexamethasone and after starting on that steroid, he had a very good late August-early September.

He started crashing around September 23rd to the point that I thought I was losing him. No eating, hiding, hissing at me. Thinking of all I'd put him through and knowing that I'd almost maxed out my credit card in trying to care for him, I'd decided he was telling me he'd had enough. But then there was a little rally late in the weekend and I decided to take him back to the vet to let them test to see what was going on. Aside from his liver values seriously going south again from not eating, his blood glucose level was 394. Most worrisome were the ketones (we agreed to stop the Dexamethasone right then) and the vet (a different one in the clinic--he's seen them all since May) said she needed to admit him to try to get him stabilized. The estimate I got was just under $1000. I said I couldn't do it, she gave him a pat on the head and we left. I told her I'd be back to have him PTS if he got too bad.

When this vet called 2 days later (using very somber tones, fully expecting me to say that he'd died) I said he was doing great--eating well (dry and canned), very active, running up and down the stairs, etc. and she paused a beat then said that "shouldn't" be happening. He had a great week and a half +, which was absolutely amazing since he'd literally been at death's door.

But then he started eating less again, even though (ironically) his mouth/throat did NOT seem to be causing him any problem. I was suspicious about blood sugar levels so I took him to the vet this past Wednesday (20th) and his BG was 384. The vet I saw this time (the one who diagnosed stomatitis--and my favorite one there) suggested insulin and I agreed. While I'm out of money for huge heroics (especially since we're still suspicious of some underlying cause of ALL of this) I hoped that a low, cautious dose of insulin might help him eat better and make him more comfortable.

I gave him his first injection Wednesday night (1U Lantus, 2x day) and by Friday evening he seemed to be feeling much better. He's had a good weekend, too, and while I haven't tested him (yet), I've noticed far fewer trips to the water bowls, less peeing and *much* more interest in food.

So here we are.... I've read through a lot of messages here, researched on the internet, etc. and understand the reasons why cats with diabetes should be on a canned food only diet. Riley still maintains that he doesn't LIKE canned food, (though I'm still assist-feeding him canned at least 3 times a day). But right now it's critically important for him to EAT!!!! to avoid developing FHL again and when he's actually ASKING for food (dry) I feel I need to give it to him. I've read about ways to try to switch everyone over to canned and how it takes time and I'll work on it.... Again I'm seeing NO throat issues or pain associated with eating the dry food, so I'm not sure if he actually has stomatitis. All we've done through ALL of this is treat symptoms (and there have been more I haven't mentioned, which *may* indicate some weird autoimmune thing).

A friend who recently lost her very old diabetic cat is going to give me her meter tomorrow. I don't think I'll be testing as much as some of you do (I'm cool giving injections, not too cool at the thought of poking him in the ear) but I think it would be very helpful to do home testing. My primary vet is very supportive of however I want to go about this.

I apologize for writing a novelette as an introduction, but I figured it might help to throw all the information/history out there!
 
Hi Sharon and WELCOME to the best site on the planet. Boy you two have been through it!
There is a wealth of information and experience here at your fingertips. Many willing to help.

I hope you change your mind about home testing. It's really the only way to know just what is going on with your kitty.
Others will be by to welcome you and answer your questions.
jeanne
 
Welcome, Sharon (and Riley, too!)...Both of you have been through alot, and we're all here to try and help and support you.

You are right, diabetic cats nees to eat low carb wet food. Janet & Binky's food chart is here http://www.felinediabetes.com/diabetic-cat-diets.htm and lists a number of different brands and varieties that are low carb. However, you are also right about the FLD and what is most important right now is that Riley eats (especially since he is also receiving insulin). Information about transitioning Riley to wet food is here http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=956; however, a word of warning - as Riley transitions to low carb wet food, his BG levels will drop (some have reported a drop of 100+ on diet change alone) and you will need to monitor those levels to make informed decisions about his insulin dose.

We do encourage home testing and information about that is here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=287. It is very important to test now, especially since Riley is being difficult about eating, is transitioning to wet food, and you've just started insulin. The one thing nobody needs is for Riley to have a hypo incident. However, since hypos do happen, there are some things you need to have on hand http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354 and have information as to how to treat a hypo if one occurs http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122. If Riley just isn't going to let you mess with his ears (I have one like that!), then you can use a paw pad for testing. The most important thing is that you test, not where you test.

Many of us here use Lantus, and it sounds like your vet has started you on a very reasonable dose (1 unit BID). Please know that the 28 day viability of the insulin only applies to human users. For felines, Lantus remains viable much longer than 28 days. Many of us also purchase the SoloStar pens, rather than vials of Lantus. While less expensive on the front end, there is so much insulin in a vial that it loses its punch before you can use it all. Pens, on the other hand, are a bit more expensive up front; however, the amount of insulin in each pen is such that most of us use it all before it loses viability. If you decide to use the pens, you do NOT have to purchase the single-use needles that attach to the pen - you can use your regular syringes.

I'm sure you are going to have many, many questions...please post back and we'll do our best to help you and Riley.
 
Hi Sharon,

I just joined this forum this week. Maverick starts insulin on Tuesday. I know someone here is selling newbie kits. I wonder if its more cost affordable for newly diagnosed. I haven't read the details on this as I had already bought Maverick's meter on Friday. Too scared to test until we get the tutorial at his vets on Tuesday.

Please give Riley a hug from me.

Karrie and Maverick.
 
The newbie kits are free. Lori just asks for a minor donation if possible to help with shipping.
Please contact Lori and Tom vis PM for details.
jeanne
 
Most vets draw blood from a vein, and do not know the method that we use, of pricking the edge of the ear for a tiny blood sample.

Please watch the home testing videos linked here before you go, so you are not shown something that we consider cruel - clipping a claw too short to make it bleed. OW!
 
Thanks so much for the welcome and advice!

Jeanne, I DO plan to test at home. I was just saying that I've found giving the injections to be very, very easy, but I'm creeped out just a bit about doing the ear prick, probably because I've never liked having my finger pricked for blood tests! But I'm sure it will just eventually be part of our regular routine....

Jana, thanks for all the links. I'd already found/read some of them, but not all.

Karrie & Phoebe (? not sure if that's your name or one of your kitties!), my vet demonstrated doing an ear prick when we were there on Wednesday. I'll watch the video before I try it the first time, but if all goes well, I should have the meter and supplies tomorrow.

Riley had a round of nausea/vomiting this afternoon, which was unusual. I'm still not sure what was going on--blood sugar too high? Too low? Nauseated due to liver problems? Eat a bug on the porch??? He literally gagged when I brought out canned food and so I gave him a few pieces of kibble (yes, I know...) and he ate them well. I gave him a few more pieces and he started eating even better.

Again, you have to understand the mixed emotions and confusion about all of this because he simply couldn't/wouldn't eat any dry food once things started happening in May. To see him ASK for food is such a good thing right now and the only thing I can attribute it to is starting the low dose of insulin 2x a day. (We'd hoped that his blood sugar levels would stabilize once he was off the Dexamethasone the end of September, but unfortunately that didn't happen.)

Right now it's so vitally important for him to eat. Before he got sick in May, he weighed 14 pounds. He dropped to just slightly over 12 when he developed FHL (do you use the abbreviation FLD on this board??), gained some of it back with the tube feeding but he'd dropped to 11.5 pounds when I took him to the vet last Wednesday.

So while I'm not sure what happened this afternoon, since Friday he's been SO much better than he's been in the last couple of weeks. All we can do is take it a day at a time.
 
You are right, first and foremost Riley must eat. It's impossible to know what upset his stomach this afternoon, but the good news is you were able to interest him in some kibble. Hopefully his stomach will settle down and he'll begin to show some interest in food that is good for him.

Hang in there...this all does get better and less overwhelming!
 
if what he'll eat is dry, then see if you can upgrade the dry

for example, from Binky's page
the calorie percentages of 2 high quality dry foods
Innova EVO Cat & Kitten
44% protein
47% fat
8% carb

Wellness Core
47% protein
42% fat
11% carb

And if he's eating dry, really push water - many cats tend to be chronically dehydrated on dry food.
 
Jana + BK + Chester said:
You are right, first and foremost Riley must eat .... Hopefully his stomach will settle down and he'll begin to show some interest in food that is good for him.

He was hanging out in the kitchen a few minutes so I scooped him up and took him to the bathroom (the feeding room) and he ate a decent quantity of Fancy Feast (though at first he made quite the show about trying to cover it up!) I'm glad I was able to get more canned food in him tonight. I don't have a digital scale (as recommended on the feline assisted feeding forum) but just by looking at him, I can see that he's gained some weight since Wednesday.

Riley-AniPic4.jpg
 
artrageous said:
Thanks so much for the welcome and advice!

Jeanne, I DO plan to test at home. I was just saying that I've found giving the injections to be very, very easy, but I'm creeped out just a bit about doing the ear prick, probably because I've never liked having my finger pricked for blood tests!

Try it out on yourself when you get the meter. I think you will find it is much less painful than those
blood-test sticks they do for blood donation, for example. The lancets for BG testing are smaller.
 
artrageous said:
Jana + BK + Chester said:
You are right, first and foremost Riley must eat .... Hopefully his stomach will settle down and he'll begin to show some interest in food that is good for him.

He was hanging out in the kitchen a few minutes so I scooped him up and took him to the bathroom (the feeding room) and he ate a decent quantity of Fancy Feast (though at first he made quite the show about trying to cover it up!) I'm glad I was able to get more canned food in him tonight. I don't have a digital scale (as recommended on the feline assisted feeding forum) but just by looking at him, I can see that he's gained some weight since Wednesday.

Riley-AniPic4.jpg
Riley is certainly one handsome gentleman! cat_pet_icon

Between the FF and the kibble, it sounds like Riley had a good dinner - now let's hope he wakes up in the morning ready for a nice big breakfast.
 
Just stopping in to welcome you and Riley to the Board. It certainly sounds like you have done your homework!!
 
BJM said:
if what he'll eat is dry, then see if you can upgrade the dry

A local pet food place carries other Wellness and Evo products so I'll see if they have either of the foods you mentioned.

The challenge here, ASIDE from getting Riley to eat lower carb food, is that there are a whole lot of others who have to be convinced to eat differently. The first step in the process has involved putting a small amount of canned food in the bowls of dry food. (Some are already certain that I'm trying to poison them, because canned food has *always* been served separately.) There's been much scratching and "covering" behavior so I think they're pretty clear in communicating their opinion: "You expect me to eat THAT?!"

I've got pics of the rest of the crew on my website: http://www.art-rageous.net/Pets.html. While no one else is showing any obvious signs of diabetes (and again, I think that Riley's condition was brought on by steroids) I want to test a couple of the other cats because some may be more at risk for developing it. Simon is huge and mainly eats dry food; Kai had a big shot of steroids in late July when he had all of HIS teeth removed for stomatitis and Cirrus is a big girl who's currently the oldest member of the household.
 
It may work better not to mix the wet with the dry, but to set it on a plate nearby and just slightly reduce the dry rations. They may get a little hungry, but not too much.

I have a household of 11 which I switched to completely canned, though I was already feeding both canned and dry, when Spitzer was diagnosed with diabetes.

How's it going so far?
 
Hi, BJ--thanks for checking on us. :-)

Riley seems to be doing pretty well. I bought some EVO dry food ($$) this evening and mixed it in with their regular dry. Everyone was curious and ate some of it, so that's step #1.

I'm still putting some of the canned in the bowls with the dry food, but instead of chopping it up to mix it together, I'm just kind of putting it side by side. Everything was gone when I got home, so I did the same thing this evening.

The friend with the meter is going to try to get it to me tomorrow, so we'll see....
 
If you're up for it, come on over to the Lantus forum and post how you're doing; you'll get lots of support in monitoring Riley and tips from those who've been doing it for quite a while
Lantus

And, remember, as you change the food to less carbs, the insulin requirements may decrease drastically. Decreases in blood glucose of 100 point have been reported. My Spitzer came home on 3 units twice a day and is now somewhere around .5 units twice a day (still titrating to find the right dose!)
 
BJM said:
If you're up for it, come on over to the Lantus forum and post how you're doing; you'll get lots of support in monitoring Riley and tips from those who've been doing it for quite a while
Lantus

Thanks! I've read through some of the posts on the Lantus forum but haven't had a chance to post yet. My work schedule is just nuts (and then some) but Riley and I really do appreciate all the support we've found here!
 
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