Cleo declining

[Cleocatra]

I'm sorry to start a negative thread, but we are not seeing anything positive at this time.
Our internist vet who we've been working with has her up to 13U 2x Prozinc after seeing some slight decrease in #'s. But, Cleo's activity level, intense hunger, bad behavior (nipping, begging, leave me alone etc) has not been good the past several days. I can't believe a cat can eat so much and do so little. Today we had the talk w/ our family vet who initially dx'd her w/ diabetes last August, and she said we are getting to the point of letting go might be the best thing. She praised us for our diligence through all of this, and said we've done more than most cat owners. At this point, we can't travel and board poor Cleo because of her hunger, litterbox maintenance issues and insulin needs, plus she would get so stressed out having to stay at a vets kennel for a week I think the cat would just be in misery if we left her.
If you look at her SS you'll see hardly any change in relation to the increase in insulin dose. It seems the harder we push w/ insulin, the harder the disease pushes back. The cabergoline and zobaline seems to have no effect. Since I work from home now, I've been able to monitor Cleo much more than if she was by herself normally during the work week so she's getting lots of attention. We can tell she doesn't feel good and has no energy. She holds urine then pee's a big puddle in the box. Her thirst is a little above normal. She's still using the box ok, but tracks urine and wipes her bottom on the towels we leave around the box at night.
I'm getting prepared and it's very hard.

 

[Karen&Rocket]

Hi Chris -- I'm really sorry to hear what you Cleo are going through. I know you're thinking of letting go, but I just have one question --- would you consider switching to Levemir? I'm sure I or someone else has asked you about it before. Rocket was on ProZinc before his Acro was diagnosed, and it did nothing. His SS was all pinks and blacks. Rocket has been on Lev now for around 10 months, and while still bouncy, has quite a few blue cycles (he's surfing in blue as we speak) and is a MUCH happier cat. Almost one year into diagnosis and he's playful, chases bugs, and is sweet and snuggly in the mornings. Prozinc is an in-and-out insulin and just doesn't have enough staying-power for most acrokitties. Acro is heartbreaking, and difficult to deal with... but is somewhat treatable. Please let us know what you think.

 

[Wendy&Neko]

I am sorry to hear Cleo isn't having a good quality of life. It could be she is one of those kitties that needs a lot more insulin and the increases just aren't coming fast enough. It does look like you are no where near a good dose. At this point I would have been tempted to try 2 unit increases. You were also giving cabergoline at the low end of the dosing range. Most kitties had to go to double that to see any response.

If you do try Levemir, I definitely would NOT go back to a lower dose like you did with Prozinc. That was a waste of a month and a half getting her back to the same dose as she had been on Lantus. With acromegaly, you do have to be aggressive (yet safe) with dosing. Especially as the tumour can be pulsing up quickly.

 

[Cleocatra]

Hi Chris -- I'm really sorry to hear what you Cleo are going through. I know you're thinking of letting go, but I just have one question --- would you consider switching to Levemir? I'm sure I or someone else has asked you about it before. Rocket was on ProZinc before his Acro was diagnosed, and it did nothing. His SS was all pinks and blacks. Rocket has been on Lev now for around 10 months, and while still bouncy, has quite a few blue cycles (he's surfing in blue as we speak) and is a MUCH happier cat. Almost one year into diagnosis and he's playful, chases bugs, and is sweet and snuggly in the mornings. Prozinc is an in-and-out insulin and just doesn't have enough staying-power for most acrokitties. Acro is heartbreaking, and difficult to deal with... but is somewhat treatable. Please let us know what you think.

yes, but Rocket had SRT so the tumor had some mitigation to allow insulin to have more effect. You really think Levemir would make that much of a difference? Both my vets are giving us the option to put her down at this point and haven't mentioned Levemir as an option.

 

[Cleocatra]

I am sorry to hear Cleo isn't having a good quality of life. It could be she is one of those kitties that needs a lot more insulin and the increases just aren't coming fast enough. It does look like you are no where near a good dose. At this point I would have been tempted to try 2 unit increases. You were also giving cabergoline at the low end of the dosing range. Most kitties had to go to double that to see any response.

If you do try Levemir, I definitely would go back to a lower dose like you did with Prozinc. That was a waste of a month and a half getting her back to the same dose as she had been on Lantus. With acromegaly, you do have to be aggressive (yet safe) with dosing. Especially as the tumour can be pulsing up quickly.

So, at this point where she's just laying around, should I start up-dosing 2U every couple days just to see if it does anything...kind of a last ditch experiment?? This cat just sits there all day, only goes to the box when she really has to go, won't let us mess w/ her unless she's stuffed w/ food and then just lays there. The past few days, the writing just seems to be on the wall by looking at her. Today was a tough day of realization after talking to both vets.

 

[Karen&Rocket]

yes, but Rocket had SRT so the tumor had some mitigation to allow insulin to have more effect. You really think Levemir would make that much of a difference? Both my vets are giving us the option to put her down at this point and haven't mentioned Levemir as an option.

We were our vet's first known Acro case, and he had never used Lev on a cat until we asked for it. He knew I had done my homework, and was happy to write a prescription for it. Anyway... yeah, I know Cleo isn't in the same situation, but I still think Levemir is worth trying, especially if you feel like you're out of options. It works differently than ProZinc and generally produces flatter curves. Other folks here can explain it better than I can. But it breaks my heart to hear that she's doing so poorly, especially if she just needs more insulin. Perhaps the best thing to do for the time being would be to increase her Prozinc dose (I'll leave the exact advice to Wendy; I'm not comfortable giving dosing advice), but please be sure you're testing enough in case you do find that magic dose. Please give Cleo a hug for me.

 

[Wendy&Neko]

Both my vets are giving us the option to put her down at this point and haven't mentioned Levemir as an option.

Yes, but both your vets have shown their lack of knowledge about how to deal with acromegalic cats.

should I start up-dosing 2U every couple days just to see if it does anything...kind of a last ditch experiment??

Since you are monitoring frequently, the Libre I believe?, it wouldn't hurt to up her dose by 2 units every couple of days to see if you see any movement. I would definitely slow down the increases if you see low 200's regularly.

 

[Cleocatra]

Yes, but both your vets have shown their lack of knowledge about how to deal with acromegalic cats.


Since you are monitoring frequently, the Libre I believe?, it wouldn't hurt to up her dose by 2 units every couple of days to see if you see any movement. I would definitely slow down the increases if you see low 200's regularly.

Got up early this morning after tough discussion w/ the Mrs late last night. I've come to the realization she's not gonna get better and it is time to let her go. If I could do it right now, I would. I gave her 15U this morning and a gabapentin to calm her down today. All she wants to do is EAT! She can't help it so we're gonna just make her comfortable and see when we can take her in. She was 432 at 6:00am PS. When she's begging for food, we cannot pick her up or manually handle her without a warning strike or hiss. Both our vets have concurred we have gone above & beyond and they're ready when we are.

 

[Cleocatra]

We have made Cleo's last appointment w/ her vet for Monday 4:30pm. She's still in mid 400's. She just lays around w/ her head down until she wants to eat. Took her out on the patio this morning for breakfast. We will try to give her 2 days of comfort and I'll try to keep it together until then, and after....

 

[Wendy&Neko]

I am so sorry it got to this point for you. Do love on her as much as she will let you. Hopefully the little bit of extra insulin will also help to make her as comfortable as possible.

 

[JanetNJ]

I am sorry to hear Cleo isn't having a good quality of life. It could be she is one of those kitties that needs a lot more insulin and the increases just aren't coming fast enough. It does look like you are no where near a good dose. At this point I would have been tempted to try 2 unit increases. You were also giving cabergoline at the low end of the dosing range. Most kitties had to go to double that to see any response.

If you do try Levemir, I definitely would go back to a lower dose like you did with Prozinc. That was a waste of a month and a half getting her back to the same dose as she had been on Lantus. With acromegaly, you do have to be aggressive (yet safe) with dosing. Especially as the tumour can be pulsing up quickly.

Do you mean NOT go back to a lower dose?

 

[JanetNJ]

We have made Cleo's last appointment w/ her vet for Monday 4:30pm. She's still in mid 400's. She just lays around w/ her head down until she wants to eat. Took her out on the patio this morning for breakfast. We will try to give her 2 days of comfort and I'll try to keep it together until then, and after....

Maybe try raising to 15-16 these next couple of days and see if there’s any change?

 

[Wendy&Neko]

Do you mean NOT go back to a lower dose?

Sorry, my typo, I will correct it. Thanks for the catch.

 

[Karen & Lily]

This is so sad. Please re-consider putting Cleo down. Its not the kitty's fault. She isn't at the correct insulin dose yet. My Lily also has acro. She did not have any kind of treatment other than insulin. At one time I was giving Lily 55 units of Lantus twice a day! Before we got to the dose that was right for her, she was eating everything and anything.

 

[Cleocatra]

This is so sad. Please re-consider putting Cleo down. Its not the kitty's fault. She isn't at the correct insulin dose yet. My Lily also has acro. She did not have any kind of treatment other than insulin. At one time I was giving Lily 55 units of Lantus twice a day! Before we got to the dose that was right for her, she was eating everything and anything.

I remember Lily and mentioned her high dose to my vet. Remember Lily is 3 years younger than Cleo. Cleo's neuropathy is taking it's toll on her. She doesn't look happy, only walks a few feet then lays down, eats like crazy, poops and pees like crazy at night and then I have mess to clean up every morning and both vets said she's not going to get better. Every now and then she'll come over to me and lay at my feet, and we talk to her a lot and she just sits there. I mean, I'm the last person that wants to put down a pet. I'll try to fix anything w/ all my energy- cars, houses, computers, cats.... I guess I can't really hurt her at this point if I step up the next dose to 17U.

 

[JanetNJ]

I remember Lily and mentioned her high dose to my vet. Remember Lily is 3 years younger than Cleo. Cleo's neuropathy is taking it's toll on her. She doesn't look happy, only walks a few feet then lays down, eats like crazy, poops and pees like crazy at night and then I have mess to clean up every morning and both vets said she's not going to get better. Every now and then she'll come over to me and lay at my feet, and we talk to her a lot and she just sits there. I mean, I'm the last person that wants to put down a pet. I'll try to fix anything w/ all my energy- cars, houses, computers, cats.... I guess I can't really hurt her at this point if I step up the next dose to 17U.

If you see some progress with a higher dose, consider giving her zobaline (b12) supplements for the neuropathy... it helps. Also I've read that while Neuropathy looks so sad, it isn't painful for cats.

 

[Wendy&Neko]

I guess I can't really hurt her at this point if I step up the next dose to 17U.

Give it a try, you've got the ability to test a lot to keep her safe.

We've had plenty of people with acrocats older than 10 when diagnosed. I remember Tommy, he was 14 when diagnosed, passed at almost 19 from kidney failure. Lauren did nothing to treat but get him well regulated with Lantus. I'm sure I could find lots more examples - the average age of diagnosis is around 11, which was Neko's age at dx. I think all of us have found it very trying until our acrokitties got to a decent dose. The hunger drive is crazy - I had to toss treats instead of handing them to her for fear of my fingers.

 

[JanetNJ]

Give it a try, you've got the ability to test a lot to keep her safe.

We've had plenty of people with acrocats older than 10 when diagnosed. I remember Tommy, he was 14 when diagnosed, passed at almost 19 from kidney failure. Lauren did nothing to treat but get him well regulated with Lantus. I'm sure I could find lots more examples - the average age of diagnosis is around 11, which was Neko's age at dx. I think all of us have found it very trying until our acrokitties got to a decent dose. The hunger drive is crazy - I had to toss treats instead of handing them to her for fear of my fingers.

CC was 15.

 

[Cleocatra]

Give it a try, you've got the ability to test a lot to keep her safe.

We've had plenty of people with acrocats older than 10 when diagnosed. I remember Tommy, he was 14 when diagnosed, passed at almost 19 from kidney failure. Lauren did nothing to treat but get him well regulated with Lantus. I'm sure I could find lots more examples - the average age of diagnosis is around 11, which was Neko's age at dx. I think all of us have found it very trying until our acrokitties got to a decent dose. The hunger drive is crazy - I had to toss treats instead of handing them to her for fear of my fingers.

I shot 16U this evening. She's still nipping at momma's ankles for more food. BG was 379 just now (9:30pm cdt) Just laying in the kitchen waiting to be fed- again.
Wendy- how can a cat have any decent quality of life when it's ravenously hungry and will bite at people when they pet them? Our vets said that is a big sign that it's "time". Sure we can keep her alive for several weeks like this, she will just be an eating & pooping machine. Only when her belly is full will she be calm and content. While I love this cat, we can't keep going on like this. Do you really think if I up the doses to 20, 30, 40U she will magically start walking better, not wanting to eat all day, and be back to a somewhat normal cat? Come on, let's be real here.

Oh, yeah, Lantus at 10U wasn't doing squat!!! Still in the 500's frequently.

 

[Wendy&Neko]

This is a call only you can make - you are there with her. We are just telling you that for our kitties, getting them into better numbers was the key to quality of life.

 

[Judy and Freckles]

Freckles' appetite is still more intense than my civvies, but she is on a strict calorie counting diet because my thought is if I feed her constantly, she will get overweight which isn't good for the diabetes, plus the carbs from all of the food will keep her numbers higher.

Freckles' appetite has decreased somewhat since she has been in better numbers.

Chris: I would suggest that you post on this forum everyday and ask for dosing help from the members. Remember, the experienced people on this forum have far more experience dealing with acrocats that the vets. The vets that you have paid lots of $$ have not been able to help you or Cleo - in my opinion, it's time to put your faith with the people who have lived this acro life and have a track record of helping many, many caregivers with their diabetic/acro kitties.

 

[Karen & Lily]

@Cleocatra, yes when you get to the correct dose your cat will feel and act better. It took me awhile to get Lily to the correct dose of 55 units, it didn't happen overnight. And I have this board to thank for that, especially @Wendy&Neko who helped me more than my vet, who doesn't have much experience with acro at all. Lily is the only acro cat at my vet's practice. Lily is now 12 yrs old and still here with me!

 

[JanetNJ]

@Cleocatra, yes when you get to the correct dose your cat will feel and act better. It took me awhile to get Lily to the correct dose of 55 units, it didn't happen overnight. And I have this board to thank for that, especially @Wendy&Neko who helped me more than my vet, who doesn't have much experience with acro at all. Lily is the only acro cat at my vet's practice. Lily is now 12 yrs old and still here with me!

Wow her spreadsheet is amazing. I looked at her numbers from last year at 15 units and now she's in remission?? That's amazing

 

[Cleocatra]

Thank you all for your support through this tough process. We're still not seeing any good results and her same behavior just continues on. We can't keep running a cat nursing home here as it is really affecting our lives and causing unbelievable stress, especially after the loss of both our Dad's, all the covid BS and trying to concentrate on keeping my job, and sanity the past 9 months. Cleo's at 10 months since original dx. Last summer this time we were seeing all the bad stuff begin and kind of realized she was coming down w/ a metabolic disorder. Didn't realize it would be this stubborn. Didn't realize it would upset us this much, but we soldiered on, made sacrifices and focused on our cat's quality of life 100%, but there have been no positive returns. Nothing has improved. She has just been in a slow, agonizing decline for us and the vets agree it's time but have left the decision to Susan and me, as they always do. I'm a 62 yo guy w/ a big soft heart for pets and this has torn me up. Every time she would get sick and we'd have to go to the vet years ago, I would get upset thinking if she's getting some life threatening disease, and she would bounce back and all would be good. But in the back of my mind, I had this premonition that this cat would not go the distance, something I really wanted after the last cat. My last 3 cats were all great pets and they all died prematurely- peritonitis, coyote attack and now this acromegaly sh!t. Just bad luck of the draw for cats, I guess. Life's not fair some times.
I'll keep y'all posted. thanks for listening.

 

[Karen & Lily]

Wow her spreadsheet is amazing. I looked at her numbers from last year at 15 units and now she's in remission?? That's amazing

@JanetNJ, The tumor causing the acro decided to stop pulsing. Lily hasn't needed insulin since January 2020. Thankfully I was home testing otherwise I would have killed her with an insulin overdose.
I wish @Cleocatra would switch his kitty to Lantus or Levemir like I did with Lily. I was originally using Prozinc but it didn't work as well as Lantus did for us.

 

[Cleocatra]

@JanetNJ, The tumor causing the acro decided to stop pulsing. Lily hasn't needed insulin since January 2020. Thankfully I was home testing otherwise I would have killed her with an insulin overdose.
I wish @Cleocatra would switch his kitty to Lantus or Levemir like I did with Lily. I was originally using Prozinc but it didn't work as well as Lantus did for us.

Karen, we were on Lantus since August, dosed up to 10U 2xday. She was still in the 500's. It's like it did nothing most of the time. See the SS. Now we're in the 300's & hi 400's almost daily since dosing Prozinc @ 9U and on up. At this rate I'd have to dose up 20U, 30U.... or who knows. Meanwhile, the cat is still unhappy with all the damage that's been done for past year. This disease was probably active for more than the past year or so and it's finally coming to a head with this cat. Who knows, it could've been why Cleo has been such a headstrong badass cat her whole life. We'd be spending $600+/month on Prozinc or Lantus, + supplies and the cat probably won't be back to her old self or even somewhat happy. We really don't think she can be fixed. The Mrs said it would like keeping her on life support. Good analogy, Susan. I really wish God would just take her one night, but that's not gonna happen anytime soon and the cat would still be living in misery. I just have to man-up and do this.

 

[JanetNJ]

@JanetNJ, The tumor causing the acro decided to stop pulsing. Lily hasn't needed insulin since January 2020. Thankfully I was home testing otherwise I would have killed her with an insulin overdose.
I wish @Cleocatra would switch his kitty to Lantus or Levemir like I did with Lily. I was originally using Prozinc but it didn't work as well as Lantus did for us.

. That’s great! My CC has been doing better too lately. Down to 6.25 units! Her most was 12.5-13. I’m glad I’m home right now too... her dose went down two units quickly and if I wasn’t home that would have been scary. I use prozinc and like it, but if it wasn’t working I’d try switching.

 

[Wendy&Neko]

We'd be spending $600+/month on Prozinc or Lantus, + supplies

A lot of American's buy their cats insulin at Mark's Marine online. They are a bricks and mortar store about 25 minutes from me, but do a large business on line too. A 5 pack of Levemir pens is $169.99 US. They are making a bundle - locally it costs around $125 Canadian, but still way cheaper than in the US. Anyway, that gives you 1500 units, and even if your cat was at 30 units twice a day, you'd still have 25 days worth of insulin. Lantus at 10 units was also too little insulin. Lantus and Lev you usually need similar doses, but the Levemir seems to have a bit better duration and doesn't sting at higher doses with Lantus can. Experience here has shown Lev is the better choice for those higher dose cats.

Great news Janet on CC! Prozinc does seem to be working well for her. So true that having an acro means you need to test regularly. I read somewhere the number one cause of death of acros was a hypo.

Chris - you are right - all this time in high numbers has not been kind to poor Cleo's body. I hope you find peace with your decision.

 

[Cleocatra]

Chris - you are right - all this time in high numbers has not been kind to poor Cleo's body. I hope you find peace with your decision.

Thank you so much for the support and advice for my Cleo. Thank you to everyone here. I've tracked her #'s up thru this morning and she was always floating in the mid 400's. I wish they can find a successful, affordable treatment for this insidious disease. Everyone close to us and both vets said we're doing the right thing at this point. This poor cat was not going to rebound after 10 months of hi BG#'s. Our lives have been just full of stress the past 3 months and we have to move on. So once again, thank you all so much for your help. Maybe we've better educated 2 veterinarians here in Dallas on acromegaly treatment thanks to Cleo and the FDMB forums!

 

[Karen&Rocket]

I'm in tears. Please give her the biggest hug from me.

 

[Cleocatra]

My heart hurts when I think of Cleo... I don't know what to say, but I was just wondering if you're keeping the vet appt. today? Whatever your decision... please give her a long hug from me.

Oh, we've cried and cried and loved on that damn cat for the past several days. Sometimes she's sweet and purrs and other times she snaps and nips to get fed so this disease is running her life.
We are cleaning up the house and getting rid of all cat stuff. I'm so sick of seeing cat litter and cleaning cat boxes and the carpet smelling of cat poop, washing towels and chunking huge bags of cat litter in the trash. Her area literally smells like a nursing home.
We and our daughter are going to the vet's at 4:30.
This poor baby is not getting better. She's done. We're not keeping her on life support any longer because it's just tearing our lives up. But thanks to covid, I got to spend a lot of time w/ Cleo, but she wasn't much fun to be with. We both need to get some decent sleep and calm down so we can get through all the BS that life is throwing at us rt now. 2020 so far has SUCKED!!!

 

[JanetNJ]

so so so sorry for your loss. I'm sure it was not an easy decision.

A couple of great cleaners for getting out the smell, both found on amazon... Anti Icky Poo Unscented ... literally no smell. The other I like is Angry Orange concentrate.

 

[Cleocatra]

so so so sorry for your loss. I'm sure it was not an easy decision.

A couple of great cleaners for getting out the smell, both found on amazon... Anti Icky Poo Unscented ... literally no smell. The other I like is Angry Orange concentrate.

Thanks, Janet. Your Youtube on how to test blood was very helpful several months ago when I was having trouble w/ it, so I'm very appreciative of your kindness to make that video.
We are still decompressing and trying to get over the guilt, sorry, anxiety and anger of what we had to do to that little cat because of this horrible disease. But, our lives will be better, we have a clean house now and can stop worrying about nursing poor Cleo. I can't believe how much it was affecting us but we were determined to give her the best fighting chance we could. But her little body was not fixable and it was time.
We got very nice notes & pics from the owner of 2 of Cleo's kittens and that made us feel a little better. One said that Smudgie cat from litter #4 was upset all day yesterday and then they heard that Cleo passed away so they sent a note through to our friend that gave us Cleo. I just hope those cats don't get this sh!t as they are 2 & 4 years younger than Cleo.

 

[JanetNJ]

Thanks, Janet. Your Youtube on how to test blood was very helpful several months ago when I was having trouble w/ it, so I'm very appreciative of your kindness to make that video.
We are still decompressing and trying to get over the guilt, sorry, anxiety and anger of what we had to do to that little cat because of this horrible disease. But, our lives will be better, we have a clean house now and can stop worrying about nursing poor Cleo. I can't believe how much it was affecting us but we were determined to give her the best fighting chance we could. But her little body was not fixable and it was time.
We got very nice notes & pics from the owner of 2 of Cleo's kittens and that made us feel a little better. One said that Smudgie cat from litter #4 was upset all day yesterday and then they heard that Cleo passed away so they sent a note through to our friend that gave us Cleo. I just hope those cats don't get this sh!t as they are 2 & 4 years younger than Cleo.

It is so hard... even when you know it was for the best. Remember her in happier times.