? Comfort care for my 13 yr old diabetic?

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Quexoz

Quexoz

Member Since 2021
Edit: 03 May 2021. Pixie has passed. She did well for a couple more months after this thread started, then began passing blood in her urine. Meaning just peeing blood every minute or two and I decided it was time.

Long story short, I CAN NOT afford proper treatment. She WILL NOT ALLOW proper treatment. She was a feral (and I mean feral, not stray) ~5 week old kitten that showed up in my back yard in Mesa AZ. 13 years ago. We caught her in a trap, released her in the house and were unable to even touch her for 1.5 months. She is now a very lovable, affectionate, but one owner (me) 'kitteh'. No one else touches her or gets near her. Any attempts to take her to the vet require a week of preparation and a lot of luck. She just knows and goes "feral" again. No method of holding her works, she will fight to the point of injuring herself and most definitely me. Same goes for proper diabetic testing and shots.

So a year+ ago she was diagnosed as diabetic, and has been doing fairly well with regular feeding every ~4 hours and keeping her stress to a minimum. We gave her the vet recommended/exclusive low grain food for a while but she decided that is simply not food after a few weeks. Tried some other recommended low grain foods and after ~10 minutes those caused her to throw up, all of it, and then fall over and have a siezure, twice. So now she is back on regular Friskies Fancy Feast Classic Pate. 1/4 can every 4 hours.

She seems ~OK, but has had the mentioned seizures, and is acting very needy, meowing and pawing at me non stop. I would love to hear any advice that may reduce her discomfort and help her feel as normal as possible for her final stretch. Also, when do you know "it's time"....****, can't type through tears.

Edit: This is her...just sitting next to my desk chair "talking" at me.
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she is not overweight, just a fur ball.
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Oh, I *completely* understand this fear.... When my cat Emily was diagnosed diabetic 3 years ago, insulin injections would have been next to impossible--never mind testing! I was very lucky that her blood glucose levels responded well to diet change and she hasn't thus far needed insulin.

How long did you change to the Friskies pates? Any vomiting or seizures since then?

When she was diagnosed diabetic, did she have any ketones?

Adding some additional thoughts.... Am I understanding correctly that even if you had financial help, it wouldn't be possible to give your cat injections, etc., because of her feral history?

And also: THANK YOU for caring for and working with a feral cat! Ferals are also a passion of mine.
 
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She (and the others) has always gotten the Friskies Fancy Feast Pate as a "treat" twice a day, but now more frequently to keep her dry food to a minimum and help with her constant thirst for water. She seems to do fine (considering diabetes) with that. I changed to the low grain diabetic food, but she won't have any of that, and one type, Tiny Tiger, grain free pate, in particular caused prompt vomiting followed immediately by a seizure (very unpleasant to see) twice. She vomits hard, then falls in it and seizes for about 5 seconds. No more of that!

Ketones = unknown. They just said she's diabetic and started telling me about the blood tests and injections twice a day, and I stopped them and told them she would not tolerate all that. That would stress her to death faster than the diabetes, not exaggerating. She has to be anesthetized to receive any kind of care, even trimming mats. She goes absolutely wide eyed feral from anything out of the normal. In her condition now, it would kill her.

So, comfort care it is, for as long as possible.
 
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Could you ask your vet for her lab results?

For diet change to be effective, she would need to have NO access to dry. Any dry at all will make her blood glucose levels too high.
 
Lab results, I suppose I could, though I'm not sure what point there is in knowing when all I can do is comfort care anyway? Hell, the vet prescribed a "diabetic" dry food (forgot the name), but she eats very little of it and I could remove it if needed? So no dry food even if it's "for diabetic cats"?
 
Correct, even the diabetic dry is too high carb.

For the labs, it's partially so we can be sure she was tested for everything that can cause those symptoms. Hyperthyroid for example also causes increased thirst, increased urination, and increased appetite--and it's treatable with a medication that can be transdermal (gel applied on the inside of the ear), which your kitty hopefully would tolerate.

It's also to check for ketones. If she had ketones, it's less likely (and maybe impossible) for her diabetes to be controlled without insulin.
 
Oh, thanks for that. Will call vet and see what I can get.

Another note: One day about 4 months ago, I was eating ice cream, and she WANTED some in an uncharacteristic way (she is not usually a beggar for food), and knowing cats + dairy is not so great, I let her lick out the bowl anyway. Oddly, she did not pee so much that night, more like a normal cat amount. I wonder if her instinct was telling her she needed some of that corn syrup in the ice cream?
 
Quexoz said:
Lab results, I suppose I could, though I'm not sure what point there is in knowing when all I can do is comfort care anyway? Hell, the vet prescribed a "diabetic" dry food (forgot the name), but she eats very little of it and I could remove it if needed? So no dry food even if it's "for diabetic cats"?
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The diabetic dry food is about 15% carb.... stick with the pate friskies... they are all under 10 carb. to help her get more water I would say to put extra water in the wet food, and maybe invest in a water fountain for cats. Sometimes the running water encourages them to drink more. I totally understand your problem. All five of the cats I currently have were backyard finds. 1 is 5 YO and still hardly lets us touch her. (although she will sometimes rub on my leg when I'm opening cans of food. hahaha) I had to drug my cat with gabepentin before a groomer could help us with mats. Even with the Gabapentin a groomer said she just couldn't do it... a different groomer she bit... finally found one nearby that sometimes works with ferals and knew how to take care of her. No idea how I would be able to give her shots if she ever needed it. Luckily my diabetic was really chill. No chance you could even do one shot a day?
 
I do put water in her wet food, and mix it in a bit. She doesn't need help drinking water, she does that constantly. The problem is she pees it right back out, and the hope was eating it in her food may help her retain a bit more and feel less thirsty.

One shot a day...for one day, maybe. After that it would be a week of her running from me on sight, same as if I even brush against her "going to the vet" Cat Box, which I leave out as a bed at all times, so I don't have to bang it around when it's needed. At this point I think she is fragile enough, anything like that may induce a seizure.

Think I will remove her dry food then and just feed her religiously with the wet food.

I can tell you one thing, mourning a cat that is not even gone yet, sucks. This one is going to be hard.
 
I'm so sorry - we've had to make the difficult decision to not treat a couple of cats, not for diabetes but for other things, because it was just too hard on the cat. I completely understand your reservations. All we were able to do was shower the cats with love in the way that they wanted and know that we were doing right by them and the only way we could.

It does suck.
 
Quexoz said:
I do put water in her wet food, and mix it in a bit. She doesn't need help drinking water, she does that constantly. The problem is she pees it right back out, and the hope was eating it in her food may help her retain a bit more and feel less thirsty.

One shot a day...for one day, maybe. After that it would be a week of her running from me on sight, same as if I even brush against her "going to the vet" Cat Box, which I leave out as a bed at all times, so I don't have to bang it around when it's needed. At this point I think she is fragile enough, anything like that may induce a seizure.

Think I will remove her dry food then and just feed her religiously with the wet food.

I can tell you one thing, mourning a cat that is not even gone yet, sucks. This one is going to be hard.
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Ugh, yes it is SO SO hard. I think switching to all wet is a very good plan. Have you tried slipping her some gabapentin when it's time for a vet visit?

Here's a food chart to help you know the carb count of various flavors. staying as low as you can will be helpful. https://catinfo.org/chart/index.php
 
Thanks for all the info. Also a correction to the O/P. Her food is Fancy Feast Classic Pate, not Friskies. Whoops. From the chart above it seems even lower in carbs at 0-3 as opposed to 3-5 anyway. Wheew!

Another question: Food portions? I've been giving her 1/4 of the small 3 oz. cans per serving about every 3-4 hours (except 8 hours at night). That is the amount at which most of our cats tend to walk off and leave a few morsels in the dish (and not lick it clean), and about the time where she is crying for more (usually for a half hour or so) and she is not gaining weight, so I figured it was a good place to start. Does that sound alright or should I be doing it different?
 
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FF patés have about 90-ish kilocalories per can. As a very rough rule of thumb, 20kcals/lb/day is a good starting point to work out a kitty's energy requirements. If losing weight or if kitty needs to gain weight, feed more; if gaining too much, feed less. Do what you can to weigh once a week. Also, here's a helpful resource:

Body condition scoring tool

Body condition assessment

I wonder whether the following might have anything helpful to you:

Secondary monitoring tools


Mogs
.
 
Quexoz said:
Thanks for all the info. Also a correction to the O/P. Her food is Fancy Feast Classic Pate, not Friskies. Whoops. From the chart above it seems even lower in carbs at 0-3 as opposed to 3-5 anyway. Wheew!

Another question: Food portions? I've been giving her 1/4 of the small 3 oz. cans per serving about every 3-4 hours (except 8 hours at night). That is the amount at which most of our cats tend to walk off and leave a few morsels in the dish (and not lick it clean), and about the time where she is crying for more (usually for a half hour or so) and she is not gaining weight, so I figured it was a good place to start. Does that sound alright or should I be doing it different?
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my cats are all grazers too. The rule of thumb is generally 20 calories per pound of ideal weight... but unregulated diabetics often need more. Just feed him as much as he is willing to eat.
 
If her glucose levels are not under control she cannot process food properly. So that is why she is so hungry. You probably will need to feed extra just to try to maintain her weight.

Have you asked the vet about prescribing kitty prozac (not sure what the animal version is called)? That may make vet visits and giving insulin easier. I don't know if it is something that can be slipped in her food or if there is a transdermal option.
 
Lisa and Witn (GA) said:
Have you asked the vet about prescribing kitty prozac...
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Prozac is usually the first choice for cats that need a long-term attitude adjustment, but I have read about a number of other medications that people try when that doesn't work.

For immediate results, which it sounds like you might need, try a light 50mg-dose of gabapentin. Another possibility is an antihistamine like Chlorpheniramine Maleate, available without a prescription. Either should nicely mellow out your cat shortly after administration, hopefully enough for you to test and shoot.

All of the above are available in the form of pills that can be ground up and mixed in with your cat's wet food.

See what options your vet would recommend.
 
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I, too, am curious about the lab results, including which exact tests were run and how she was initially diagnosed as diabetic.

Do you know if a fructosamine test was run? It’s similar to a human A1c and basically gives the average blood glucose (BG) over a several week period. I ask because one of my former strays got so freaked out at the vet clinic that her BG came back at 386 on the blood work. I tested her at home the next day and she was 70, and continues to test in normal ranges at home. The abnormally high BG at the clinic was stress induced. Although that’s a much more dramatic stress response than we normally see, it can happen. Fortunately my vet didn’t diagnose her as diabetic based on one test alone, but some do.

I’m also curious about the seizure. How many times has that happened? Does it only seem to be associated with the Tiny Tiger food? Any additional info about that would be helpful. I’m skeptical that the seizure is related to diabetes given that you’re not giving insulin shots. (You’re not mixing any diabetes medication in her food, are you?). There is an exceedingly rare (in cats) reason that a cat’s BG can go low without insulin shots, but I won’t mention it just yet because it’s so uncommon and I don’t want to detour the conversation.

As has been mentioned, there are also other diseases that can cause symptoms similar to diabetes. I hope you post the blood work results.

Most of my crew are former strays or ferals. I get it. I’m thankful that a couple of them remain healthy because they too would be virtually impossible to work with.

Thank you for caring enough to take in a feral and for coming here seeking input. Hopefully we can help you figure something out.
 
JL and Chip said:
*snip* for brevity
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Lab results and tests done = working on it. I can tell you it was not over a long period. If memory serves me, they kept her 3 days for testing.

She is on no medications at all. Her symptoms for taking her to vet and getting the diagnosis about 14 mo ago were, needing mats removed, and drinking and peeing ~5x the normal amount suddenly. No seizures yet at that point. Drinking and urinating 5x continues now.

Seizures = happened twice that I know of. First one, only caught out corner of my eye was not positive it was a seizure but figured I'd just missed one due to her being immobile in an awkward position looking wide eyed and scared. Both times 10-15 after feeding her "special" low grain foods but may be coincidence. Second time was after extreme stress, right after I got back from a week+ out of town where the folks who were taking care of her (at our home), did NOT follow my instructions and only fed her wet food once a day. When I got back she looked thin, scruffy, terrified, eyes dilated huge, and feral. I'm pretty sure she was hours from dying then. She even ran from me for a couple hours. Next day, seizure #2 after low grain food and resuming normal feeding though, so yet another change. Both times, she vomits large style, then falls over stiff as a board for ~5 seconds, mouth wide open in silent scream, then comes to, sits a second looking terrified, then low crawls away to hide.

The photos above in the O/P were taken 2-3 days later. she is looking better in them but still a bit scruffy. the one in my avatar is a few years ago when she was healthy.

EDIT: Vet was helpful, going to get lab results from them now...see ya in a bit.
 
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Lab results from June 2019 (little longer than I thought).
Page #2: Keytones = Negative!

lab01.jpg lab02.jpg lab03.jpg

Also, I decided to try 1/3+ (vs 1/4) can of food every 4-6 hours (vs 3-4) and removed the dry food completely. So far she seems much more happy with that. She was crying for more after about 30 min, but now she's been happily balled up and cat napping for almost 3 hours. I guess I was not giving her enough to fill her up. She is looking much better than a few days ago when I returned from my trip.

...and THANKS again for all the info and support.

Happy kitteh = happy human!
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awe... she looks happy in this picture. Other than the high glucose, the other numbers look good! Kidneys aren't bad... no infections... We just gotta get the glucose down. ONE THING no one has suggested is EXERCISE! EXERCISE helps lower levels. Will she chase a string or a laser pointer? Get her moving! I'm glad you cut out the higher carb kibble. :D

and to help with her anxiety, try playing some Healing Music for Cats https://www.youtube.com/results?search_query=healing+music+for+cats
 
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Quexoz said:
Will not come up to be a "lap cat", but if I come down to her...this is the routine.

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One other thing you can try for her anxiety are feliway diffusers. I have three going at all times because my cat Julie is so high strung and will over react to everything. She's soooo much better with the plug-ins... I can always tell when one runs out from her behavior.
 
I think she's pretty calm now that things are back to 'normal' around her. Still meowing at me a lot, and I'm not sure what she wants. So every so often, I plop myself down on the floor and she does the above routine. So "feral".
 
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Did you read the info by DR. Pierson on dry food On the Health Forum ?
"Info Dry Food - PLEASE consider more than just carbohydrate content"
No dry food is good for any of your cats.

I've been on the Lantus forum over 3 1/2 years. I've seen kitties go into remission when all dry food was stopped.
Something else to keep in mind, Veterinarians get only a few hours training in diabetes. The people on the forums who have been here a long time have A LOT MORE EXPERIENCE & KNOWLEDGE ABOUT WHAT TO DO.
I'm on social security (low income) & alone. When my cat Ravan got diabetes I never thought I could afford the insulin & all but Little by little it all worked out. I did a lot of reading. Bought insulin from the Supply Closet here. The Relion Prime meter from Walmart is only $9 & 100 strips to test are $17. You don't need a "special expensive meter just for cats"

Most kitties here get Fancy Feast Classic Pate It's very inexpensive cat food. Your kitty needs Low Carb food as much as she wants if she's losing weight.
There's a food chart here that you can check the different brands & the carbs. Keep carbs below 10% (Fancy Feast Classic Salmon is only 1% carbs)

I've had many "feral" cats & with a lot of patience it's possible to test & give insulin even to them.
I wish you the best of Luck. Your kitty is a Dilute Calico, what's the pretty little girls name?

images

 
Name is Pixie. And yes, I read it. The other cats are not mine, I am caring for them while she is in a nursing home, but I will inform the owner...and I imagine all dry food will cease. Without explaining everything in detail, I am 55, and my income is literally zero. I live off the graces of someone else on social security by helping them with household upkeep, cat care, taking out garbage, cooking meals, and shoveling snow, etc. Long story short, my trip to Arizona a few weeks ago was to start a new job/life for myself, and days after I left, things went to sh** here and I had to come back. That put me $3000 in debt (I'll never be able to repay). If I had not, Pixie would surely be dead now.

Do the tests/treatments involve pricking the paw for blood or shots, or anything invasive like that? If so I may be able to pull it off once, but from then on she will go "feral" and stress/fight to the death. If it were something I could rub on her ear or put in food, OK, but anything else is simply not doable by any means I know of. Just to take her to the vet for mat trimming involves, careful positioning and behavior so as not to alert her it's coming, sometimes failing and having to call the vet to reschedule, and then tossing a pillow case over her and within 2 seconds getting her in the nearby box and slamming the door before she comes out like the Tasmanian Devil Tornado. The vet has to "gas" her in the box before taking her out to anesthetize her to do anything else. All this is dangerous to her health, usually more so than the thing we want to treat and very risky. F' flight, this cat will FIGHT!

Meanwhile when left alone, she is a total sweetheart. She lives upstairs (as do I) and will not come down (avatar pic is her on the stairs refusing to come further) where the other cats/people are...unless there is a storm. She is terrified of storms and runs downstairs and under the couch until it passes, then right back up.

Back when she was only 3 yr old and healthy, when I brought her to Michigan from Arizona she totally shut down in the cat box right next to me in the moving truck seat. She buried her head in the back corner and did not move, not once for 4 days (truck had trouble, made 3 day trip 4). She did not eat or drink water even once in that time. After arriving here she hid in the walls of the house via an unknown at the time hole near the open "attic area" around the chimney upstairs. I did not see her for 2 months, just the shine of her eyes in the darkness when placing her food there. That trip nearly killed her as well.
 
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Update: Pixie is doing much better now. Very regular feeding and reduced changes and stress does wonders. Doing pretty well actually, even feeling frisky enough to dash around the house playfully now and then.
 
Quexoz said:
Update: Pixie is doing much better now. Very regular feeding and reduced changes and stress does wonders. Doing pretty well actually, even feeling frisky enough to dash around the house playfully now and then.
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I don't see t4 on the labs that were done. You may want to have that done to test for hyperthyroid, which can cause similar symptoms to diabetes but can be treated with a transdermal medication (it's a cream that gets rubbed on the inside of her ears).

(EDIT: oops I missed it, t4 is on the top of the second page and normal. So disregard my comments above.)
 
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