? Hoping for some advice

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C.W. Gortner

C.W. Gortner

Member Since 2016
Hi, I posted an introduction on this forum last year regarding my cat, Mommy. I know I've been absent since then. This isn't an easy post for me to write, but I'm hoping for some helpful advice and forgiveness for my ignorance.

Per my last post: Because everyone, my idiot ex-vet included, seemed unsure as to whether our Mommy Cat was diabetic or not, we made the preventive measure of switching her and our other cat Boy to a low carb wet food exclusively last year (Friskies Classic Pate). She did fine on it, and continued acting normally. She never developed the excessive urination or drinking often associated with diabetes, as I kept a close eye on that. Nor was her appetite more increased than usual.

Last month, however, we went on an extended vacation (two and 1/2 weeks) and employed our usual cat sitter. No issues with the sitter, as my two former ferals don't let anyone but us near them, yet once we returned home, we noticed Mommy was looking very frail and underweight - as in, extremely bony around her hips and spine, a marked shift in her. Her gait also seemed impaired. She's moving slowly, not on her hocks, but as if she's in pain, like arthritis. I thought maybe she'd been eating less due to our absence, though the sitter assured me she'd been eating, based on the empty plates, so I upped her feeding to four times daily; I'm a novelist and work at home, so that's easy to do. Mommy kept eating, but gained no weight. She also gradually became more lethargic throughout November, which was hard to quantify at first as she's always been a sedate cat who stays upstairs in her Princess Suite (the extra bedroom) and she tends to sleeps most of the day as a rule.

Last week, however, her lethargy turned pronounced and her appetite waned considerably, so I called the vet. I became furious when the vet again requested that I home-test her urine for glucose "to be sure", because really, at this point, based on her initial blood-work and her current state, it seems clear to me that she must be diabetic and uncontrolled, at that. I searched for another vet in a panic and found one that only treats cats; we go in today at 3:30 pm. Getting ASAP appointments at vets these days in San Francisco is a nightmare, they're all booked out weeks in advance. I also enticed her appetite with tuna; she resumed eating some of her wet food with added tuna sprinkles for a while, but yesterday only a little and today not at all. She's still joining us in bed at night and comes out when we call her, she purrs and wants affection, but she's obviously not feeling well at all. And she's gotten so very thin, even her fur looks depleted. She's a ghost of the cat she was.

In any event, I've been reading this forum diligently, all the stickies and info I can absorb. I know that with some practice and patience, I can home-test her glucose levels and do insulin shots, as well as needed curves. My questions are: If she's been an untreated diabetic for nearly two years, as now seems to be the case, is there any hope we can get her stabilized? I don't expect remission at this point, I'm aware that window may well be closed, but I'd like to try to save her and provide her with a few more years of quality life. She's a senior cat, but probably not yet in her mid-teens, maybe 12 or 13 at the most. Most likely, she's 11 or 12, based on when I first found / trapped her in the park, had her spayed, and the length of time she's lived at home with us and her son, Boy, which would be 7 years now.

Also, is Lentus the preferred insulin to start? I realize it all depends on the cat and their response, but from all my reading, Lentus appears to be the least "harsh" initiation insulin. She may well require hospitalization today, I'm worried she might have ketatones, which would explain what looks like nausea to me when she approaches the food dish, so I'm trying to take this one step at a time. I broke down yesterday, crying like a child. I adore my cats, I rescued them, and have always been proactive in my pet care. I should never have heeded my ex-vet's "wait and see" approach. I feel guilty that my ignorance and lack of incentive aggravated Mommy's condition, though I also realize other pet owners must face this dilemma. It all felt so overwhelming at first that I seized on the diet change as the one thing I could control. Which was stupid of me, in hindsight.

I hope we might be able to save her.
 
C.W. Gortner said:
If she's been an untreated diabetic for nearly two years, as now seems to be the case, is there any hope we can get her stabilized?
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Absolutely. It may take some more time and patience, but it can be done. When are you planning on starting insulin?

I don't use Lantus or Lev but from what I understand Lantus doesn't sting as much as Lev, especially at higher doses. But every cat is different. Most of us start off with whatever insulin our vets first prescribe and then, possibly switch if we haven't seen progress over several months.

If you're worried about ketones TAKE HER IN NOW. I don't mean to yell, but DKA can come on fast and hard. The sooner you get her in, the better.

Don't feel guilty. You were going by what a VET said. Most of us have been in the same place, and now, ignore most of what they say regarding our sugar cats. You obviously care for her. Hindsight is 20/20.

Edit - I see you're taking her in at 3:30. I must have read over that. Just let us know how things go.
Keep us updated. :bighug: Hope all goes well at the vets.
 
Well, just as I suspected, she's an uncontrolled diabetic. Her overworked pancreas was starting to shut down as a result and she's now in early-stage kidney failure, too, which I didn't expect and really blew me apart. She's hospitalized for 24 to possibly 48 hours: IV fluids, insulin, a glucose curve, and battery of other tests to see how she responds to treatment. That said, she had no fever. No ketatones in her urine. She was alert, non-combative with the vet or at the overnight clinic (we had to drive her to the hospital after the vet visit, as our new cat vet doesn't do overnight hospitalization). The new cat vet was very kind and understanding; of course, I cried and said it was my fault for not intervening earlier. He reassured me that her first fructosamine test result was borderline but within "normal range" and she had no indication of any kidney impairment at that time, based on her blood work. What he did point out was that her pancreatic enzymes were already elevated last year and that value, coupled with her elevated blood glucose, should have alerted my ex-vet to a diagnosis of diabetes and prompted at the very least a request for follow-up blood work within 3 months. My ex-vet never requested that or even mentioned it to me.

I'm struggling with all this, as you can imagine. The new vet told me Mommy was most likely in early onset diabetes at the time of our visit to my ex-vet last year; but, he added, it can be challenging to determine that, at said time, taking into account her overall blood values. In other words, he didn't outright denigrate my ex-vet for negligence, but he did sound perturbed by the way things had been handled. Which of course just made me crazy, because had I known, I could have intervened and prevented this. Still, she's my cat. I should have sought a second opinion much earlier. He also said she's extremely underweight, but otherwise strong, no heart murmur or respiratory issues, and he believed it was worth trying to stabilize her. He was also clear with us: She's in acute distress right now, but should 24-hour hospitalization manage to lower her values, we might enjoy several more good years with her. When I mentioned quality of life, he said time would tell, but diabetes isn't cheap or easy to treat. No kidding. Welcome to San Francisco. Today's grand total is $3,500, hospitalization for 24 hours included. Should she need to remain in the hospital for another 24 hours, add $3000. Whatever. I'll pay. My primary concern is her welfare.

Thanks everyone for your kindness. This is just a dreadful disease. I'll keep posting as I know more.
 
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Keep the spirits up. Sometimes when our kittehs get down, we can get them back up.

Leo has had a few real low points where we were evaluating quality of life. It took money and a lot of dedicated time to get him back into shape. In each case, we got Leo back to good health. You are at a good point with your kitteh, and it sounds like you have the resources financially and emotionally to get Mommy back to good health. The rewards are great.
 
Forgot to add, my new vet made his statement that Mommy had lost 2/3 of her kidney function and was therefore in kidney failure based on her urine sample and a few other abnormal test results. But the specialist at the hospital told me that while it's quite likely she is in early stage renal failure, it's also quite possible her renal values are adversely impacted by her current crisis and may lower and/or restore somewhat once she's been stabilized. The specialist said she has seen cases where cats present with all the blood and urine values of kidney failure but really, it's that their kidneys are overworked because of an underlying health condition that, once treated, normalizes/ lowers renal values. She cited a case of hers, a cat with repeated acute urinary blockages. All his values at the time indicated he was in kidney failure, but once the blockages were removed by surgery and his condition resolved, his renal values did, too. Hopefully, once Mommy's diabetes can be stabilized, her kidney values might lower, too, if not normalize. The specialist vet did say she'd be watching this trend as part of her overall treatment plan for the next 24 hours.

Also UPDATE: I just called the hospital. They gave Mommy a bolus of fluids and she's tolerating it well, holding her own. Her glucose reading at the time was 700 - ! - and so they'll start insulin in the next hour, once she's better hydrated. So far, the specialist said, she's doing alright but her severe dehydration must be addressed first.
 
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I once had a cat diagnosed with kidney failure, but when I took her for a second opinion I was told she had diabetes and was dehydrated. Sure enough kidneys were fine after fluid and insulin treatment. Good luck and keep us posted!
 
Update: The hospital called me this morning. Mommy is still holding her own. She did well overnight, according to the doc. They started insulin and her glucose values are gradually lowering, which is precisely what they want. She still is not eating however, which they also say is to be expected, so they're giving her an appetite stimulant today. She did show mild ketatones in her urine and blood late last night, so borderline acidosis. Good thing we took her in when we did. There's also concern over the state of her pancreas, which is inflamed; it could be her diabetes or it could be something else, they said, but as she had no pancreatic abnormalities on her 2016 blood-work, most likely the current inflammation is part of her crisis. Nevertheless, to be sure there isn't another underlying pathology, they'll perform an ultrasound tomorrow. She therefore must remain in the hospital for another 24 hours, which we'd anticipated. I'm setting up a GoFundMe page - kidding, but oy, the prices here! How do others without resources manage this? $8000 to save my beloved cat.
 
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Juliet said:
They get heavily in debt with loans like me.
Hope Mommy continues to recover.
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Honestly. I understand medical care is very costly, but this has me in total price-tag shock. in addition to $3500 for the first overnight stay, another nearly $4000 for the next 24 hours, with ultra-sound included. So many cats must be put down by bereaved, desperate owners because they can't afford to save them. It explains why our first attending specialist at the hospital last night cited euthanasia as an option, saying many cat owners just can't deal with a diagnosis of diabetes. We're very fortunate indeed to have the resources, even if there goes our Xmas travel this year. It doesn't matter, I couldn't go anyway because my cat sitter won't be able to inject Mommy and it's far too early after this crisis to then turn around and leave Mommy boarded somewhere for 5 days. I'll stay home and do whatever I must to help my cat, but these vet bills are outrageous. I had my dog insured since I'd adopted her as a wee puppy, which helped a lot when she later developed medical issues, but I never insured Boy and Mommy. Lesson learned. On many fronts.

The good news is that Mommy's still holding her own. I really feared we were going to lose her yesterday. I could sense her spirit diminishing. Clearly, she has a lot of fight left in her.
 
I had to go to the UK last month and my pet sitter couldn’t test either. Wasn’t a holiday. My mom had a stroke. But I halved Silver’s dose and she shot blind. It was better that than no dose at all or keep safe and risk hypo.

I’m in Canada and discovered iFinance PetCare. High interest rates but they pay your vet bill and then you owe them in monthly installments. I couldn’t bear not being able to treat him just because I couldn’t afford it.
 
I'm an historical novelist and do well with my books, knock on wood. My husband has a high-paying job, too. No kids. House recently paid off. Two indoor-only cats. And several feral residents in the garden. We can afford this for now, even if it will take a bite out of other areas. I would take out a loan, however, if I couldn't pay. The mere thought of putting her down is inconceivable, given that if she's stabilized, she can then be treated and regulated at home. I'll admit, I'm scared of what lies ahead - the blood testing and shots, making sure she's responding and doesn't fall into another crisis like this - but I guess it's perfectly normal to feel this overwhelmed at first. Because hubby goes to an office and I stay at home writing, most of the challenge of her daily care will fall on me. But once we can get her regulated, I assume it'll get easier. We'll develop a routine. The learning curve is just so steep at first. My head is exploding right now with insulin doses, curves, needle gauges, diet, and all that jazz, plus worry about her.

Travel will present another challenge. Our cat sitter is great, she stays here in the house with the cats, but being ex-ferals, my freaks dislike everyone but us. They eat and do their thing, but in the 7 years they've lived here, they have never let the sitter or any other person touch them or even get near enough to touch them. So, unless Mommy shows a sudden change in personality and will let herself be injected by the sitter, when we go away - which is unavoidable - I'm going to have to board her for the duration. I loathe the idea, as she and Boy have never been apart (this hospital stay is a first and so far, Boy seems to be okay without her) but what else can I do? If she won't let herself be treated at home when we're away, I can't risk it.

One step at a time. As a writer, I tend to project and in this situation, projecting is a recipe for disaster. I can't deal with everything at once. Thank you all for your support! At times like these, you feel really lost and helpless.
 
Cross that bridge when it happens. Maybe get your sitter over when you are testing. See if your cat will let her hold while you inject. And you never know - may be OTJ before you need to go away.
 
Please please please start your baby on insulin. It's never too late :); we all make mistakes (and in your case it was your vet's instructions), but it sounds like you have a good chance of giving Mommy some quality years of life. Our vet had declared that Angel was dying as he was at 5.8 lb :( two years ago -- but then I switched vets, and the new one literally saved his life, putting him on Lantus (I absolutely love Lantus). I learned to home test, and to administer shots myself -- at the beginning the home testing seemed daunting, but I watched a ton of videos on YouTube + got tips from this site and what they all said was TRUE -- that you can make it into a bonding experience with your kitty, one they actually look forward to! Angel pesters me each morning and night to be tested, believe it or not! He loves the kisses and cuddles and treats, although not the poking, which luckily only takes a few seconds. Of course it's difficult in the beginning, but I swear it gets easier and in a few days/weeks you'll be a pro.

The Lantus literally saved Angel's life. He is now a healthy, happy cat as long as he gets his meds. I tried getting him into remission, but he's a long term diabetic who'd been in remission once before, so I gave up after trying for a few months and have simply reconciled to the fact that we have a diabetic cat whom we will almost certainly need to test and give insulin to twice a day for the rest of his life -- and that's fine by us :). He is a darling and a joy! Good luck to you!

PS: We travel a lot, so we have a lovely vet tech who comes to give him his meds. While we're traveling we only do lantus once a day, too expensive to do twice a day visits from her.
 
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Question about home testing: My vets are all recommending the Alpha Trak 2. I don't mind but I hear test strips are much pricier, and you can user FreeStyle Freedom Lite Strips instead, just ignore the code error, as the result is the same. Does that sound right or should I just get another monitor? I hear human monitors run lower results for cats, so I'd prefer higher accuracy at least to start so as to not have one extra hurdle to overcome.
 
Angel's mommie said:
Please please please start your baby on insulin. It's never too late :); we all make mistakes (and in your case it was your vet's instructions), but it sounds like you have a good chance of giving Mommy some quality years of life. Our vet had declared that Angel was dying as he was at 5.8 lb :( two years ago -- but then I switched vets, and the new one literally saved his life, putting him on Lantus (I absolutely love Lantus). I learned to home test, and to administer shots myself -- at the beginning the home testing seemed daunting, but I watched a ton of videos on YouTube + got tips from this site and what they all said was TRUE -- that you can make it into a bonding experience with your kitty, one they actually look forward to! Angel pesters me each morning and night to be tested, believe it or not! He loves the kisses and cuddles and treats, although not the poking, which luckily only takes a few seconds. Of course it's difficult in the beginning, but I swear it gets easier and in a few days/weeks you'll be a pro.

The Lantus literally saved Angel's life. He is now a healthy, happy cat. I tried getting him into remission, but he's a long term diabetic who'd been in remission once before, so I gave up after trying for a few months and have simply reconciled to the fact that we have a diabetic cat whom we will almost certainly need to test and give insulin to twice a day for the rest of his life -- and that's fine by us :). He is a darling and a joy! Good luck to you!

PS: We travel a lot, so we have a lovely vet tech who comes to give him his meds. While we're traveling we only do lantus once a day, too expensive to do twice a day visits from her.
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Thanks! She's now insulin at the hospital.
 
C.W. Gortner said:
Question about home testing: My vets are all recommending the Alpha Trak 2. I don't mind but I hear test strips are much pricier, and you can user FreeStyle Freedom Lite Strips instead, just ignore the code error, as the result is the same. Does that sound right or should I just get another monitor? I hear human monitors run lower results for cats, so I'd prefer higher accuracy at least to start so as to not have one extra hurdle to overcome.
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My opinion is that it's a whole lot easier to use a human meter, learn what the too high/good/too low reference ranges are on it and not bother with an AlphaTrak pet meter. If your vet insists, buy one for doing at home curves to give your vet the data. Use a human meter day to day.

You can put Freestyle Lite strips into the AT meter but you have to do same drop comparison testing every time you open a new vial of strips. There can be different magnitudes of variation with every vial.
 
Glad to hear that Mommy kitteh is doing better. I hope you can bring her home tomorrow, and then take over the health care.
 
C.W. Gortner said:
Question about home testing: My vets are all recommending the Alpha Trak 2. I don't mind but I hear test strips are much pricier, and you can user FreeStyle Freedom Lite Strips instead, just ignore the code error, as the result is the same. Does that sound right or should I just get another monitor? I hear human monitors run lower results for cats, so I'd prefer higher accuracy at least to start so as to not have one extra hurdle to overcome.
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I began with Alphatrak and used it for over a year because of the same reason you mention (wanted accuracy at the beginning + was trying for remission for a while), but then switched to human strips/meter -- SO much cheaper! I use Bayer Contour Next EZ. If I were to do it again, I might start with the human meter from the beginning. I spent hundreds on Alphatrak strips, especially since one inevitably ends up wasting several while learning (and even after), and now wish I'd just got the human meter as so many sensible folk on this forum do ;-).
 
Kris & Teasel said:
My opinion is that it's a whole lot easier to use a human meter, learn what the too high/good/too low reference ranges are on it and not bother with an AlphaTrak pet meter. If your vet insists, buy one for doing at home curves to give your vet the data. Use a human meter day to day.

You can put Freestyle Lite strips into the AT meter but you have to do same drop comparison testing every time you open a new vial of strips. There can be different magnitudes of variation with every vial.
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What is the variation on human meters? Is it individual to the cat or are there generalized ranges to look it, i.e., a human test meter on a cat will give X points lower or higher? I own a OneTouch Ultra 2 already that a friend sent me.
 
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Some useful tips I read/discovered :):
(1) establish a regular testing place. Sofas are great, as you can use the arm of the sofa to hold kitty in place.
(2) I mostly test on the inside of ear (along the edge) as there's so much less fur there and also the blood droplet shows up so much more easily.
(3) Poke holding the lancet by hand (not that little lancet machine) -- that way you have better control and kitty does not get scared by the clicking sound
 
C.W. Gortner said:
What is the variation on human meters? Is it individual to the cat or are there generalized ranges to look it, i.e., a human test meter on a cat will give X points lower or higher? I have a OneTouch Ultra here already.
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Human meters will read lower than pet meters. The difference is fairly large (100 points +) at high BG levels but less at low BG levels. There's no simple conversion to be done because it isn't a linear relationship. The key thing to know is that the "take action" BG number is 50 on a human meter and 68 on a pet meter. That means the BG is getting too low and it's time to prop it up with a snack that's higher in carbs.
 
C.W. Gortner said:
What is the variation on human meters? Is it individual to the cat or are there generalized ranges to look it, i.e., a human test meter on a cat will give X points lower or higher? I have a OneTouch Ultra here already.
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The numbers are pretty close together at low numbers and more of a difference at high numbers. Normal on a human meter is 50-120 and on a pet meter it's 68-150. So while they may only be 20 digits apart at low numbers they could be 100 points or more different at high numbers. Either one will tell you if you are too high or low though.
 
C.W. Gortner said:
Question about home testing: My vets are all recommending the Alpha Trak 2. I don't mind but I hear test strips are much pricier, and you can user FreeStyle Freedom Lite Strips instead, just ignore the code error, as the result is the same. Does that sound right or should I just get another monitor? I hear human monitors run lower results for cats, so I'd prefer higher accuracy at least to start so as to not have one extra hurdle to overcome.
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I personally love the Alphatrak meter, despite the cost. If the cost isn't an issue then it's a great meter. I generally spend about $100 pet month on test strips. Adwdiabetes.com is where I get them and I always use coupon codes from Retailmenot.com
 
Thanks. I'm probably going to try the AlphaTrak to start.

I called the hospital just now. Good news is, Mommy's glucose dropped from an outrageous high of 700+ last night to 245. But they added dextrose in the midday because they didn't want her dropping too fast, so she bumped up to 345. They discontinued the dextrose and will re-test her BG in an hour or so. She is responding to the insulin. However, she's still not eating. They tell me it's not uncommon, simply because she's not feeling well, but basically she has not eaten since Friday night. I'm not sure how concerning this is, given her overall state. They gave her an appetite stimulant about an hour ago and so far, it hasn't kicked in. The fact that she's not eating does worry me but I realize that in her condition, food probably just doesn't interest her right now.
 
C.W. Gortner said:
Thanks. I'm probably going to try the AlphaTrak to start.

I called the hospital just now. Good news is, Mommy's glucose dropped from an outrageous high of 700+ last night to 245. But they added dextrose in the midday because they didn't want her dropping too fast, so she bumped up to 345. They discontinued the dextrose and will re-test her BG in an hour or so. She is responding to the insulin. However, she's still not eating. They tell me it's not uncommon, simply because she's not feeling well, but basically she has not eaten since Friday night. I'm not sure how concerning this is, given her overall state. They gave her an appetite stimulant about an hour ago and so far, it hasn't kicked in. The fact that she's not eating does worry me but I realize that in her condition, food probably just doesn't interest her right now.
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Can you bring her some of her regular food? Or a treat like fresh chicken or tuna?
 
JanetNJ said:
Can you bring her some of her regular food? Or a treat like fresh chicken or tuna?
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We just got into the car and went to visit her. I had this sense that she's refusing to eat because she's stressed out and she needs to know we haven't just left her there forever. Sure enough, as soon as she heard/ saw us, we caressed her and gave her kisses - she loves kisses - she ate nearly a full can of Fancy Feast for us. She was hungry. The specialist doc was very relieved, too, because they'd been considering a feeding tube if she continued to not eat. We'll go back again at 9:00 p.m. to coax her to dinner. Whatever it takes.
 
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C.W. Gortner said:
We just got into the car and went to visit her. I had this sense that she's refusing to eat because she's stressed out and she needs to know we haven't just left her there forever. Sure enough, as soon as she heard/ saw us, we caressed her and gave her kisses - she loves kisses - she ate nearly a full can of Fancy Feast for us. She was hungry. The specialist doc was very relieved, too, because they'd been considering a feeding tube if she continued to not eat. We'll go back again at 9:00 p.m. to coax her to dinner. Whatever it takes.
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Oh good! I'm relieved to hear she ate well!!!
 
C.W. Gortner said:
We just got into the car and went to visit her. I had this sense that she's refusing to eat because she's stressed out and she needs to know we haven't just left her there forever. Sure enough, as soon as she heard/ saw us, we caressed her and gave her kisses - she loves kisses - she ate nearly a full can of Fancy Feast for us. She was hungry. The specialist doc was very relieved, too, because they'd been considering a feeding tube if she continued to not eat. We'll go back again at 9:00 p.m. to coax her to dinner. Whatever it takes.
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That's exactly what I was going to suggest....Our kitties will eat for us a lot of the time when they won't eat for anyone else!!

When you go back, since she's staying another night, take in a nightshirt or pajama's so she has something that smells like you while she's there. Stuff that you wear at night has the most "smell" of you.

Sending prayers that she'll be much better tomorrow and able to come home to you!!
 
We went back to the hospital tonight, with one of our sleeping T-shirts to leave with her, and she was so happy to see us, she ate a full can of food. She had been eating Friskies Classic Pate flavors, a low-carb wet food (she never was much of a dry food cat) but to entice her now-fickle appetite, we brought instead Fancy Feast Classic Beef Feast and Classic Salmon. She loved those - and we really need her to eat, as she's lost 3.5 lbs since last year! Her BC is now down to 245, with food, so she is responding well to the insulin. She has a ways to go yet, of course, but I think we're on the right path. Coincidentally, I found a random thread on this forum that stated FF Classic recently underwent a formula change and are now over 10% carbs. Well, according to this carbs calculator, that's not true. Even the FF Classic Beef is only 3% carb or so. See here: http://fnae.org/carbcalorie.html

Is FF Classic (non-gravy) okay to feed her when she comes home? She seems to really like it and the 3.oz serving size is ideal for me to manage her actual food intake as I work out her regulation cycle and curves. My other cat Boy will eat it, too.
 
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There's a misconception going around the message board regarding the FF classics.....yes, they did change their recipe awhile back, but what happened with some cats was diarrhea or they just wouldn't eat it....the vast majority of cats that ate it before had no issues with raising of BG

It's fine for her ....and if she likes it, that's a bonus!!
 
Chris & China said:
There's a misconception going around the message board regarding the FF classics.....yes, they did change their recipe awhile back, but what happened with some cats was diarrhea or they just wouldn't eat it....the vast majority of cats that ate it before had no issues with raising of BG

It's fine for her ....and if she likes it, that's a bonus!!
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Thank you!! Too much reading online info in too short a span of time has done fried my brain. She loved the FF and basically, if she eats well, then we can better manage her insulin dosage. The hospital staff was so thrilled that we got her to eat twice today, they applauded us as we left. She's in great hands there, but once she comes home (we have one more in-hospital hurdle tomorrow, her pancreas ultra sound, but I'm not too worried about that; I think the inflammation is part of this crisis, not a neoplasia) then we must keep her eating. She had gone off the Friskies Pate when she started to slide into this abyss, so a new food that excites her is just what she needs now.
 
Little Dude is not diabetic. But he was at the cat hospital for a week this year. He would not eat at all there. Some cats are like that. Your kitteh will feel lots better at home.
 
C.W. Gortner said:
Thank you!! Too much reading online info in too short a span of time has done fried my brain. She loved the FF and basically, if she eats well, then we can better manage her insulin dosage. The hospital staff was so thrilled that we got her to eat twice today, they applauded us as we left. She's in great hands there, but once she comes home (we have one more in-hospital hurdle tomorrow, her pancreas ultra sound, but I'm not too worried about that; I think the inflammation is part of this crisis, not a neoplasia) then we must keep her eating. She had gone off the Friskies Pate when she started to slide into this abyss, so a new food that excites her is just what she needs now.
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Are they determining if it's pancratitis? If so once she's stabilized the treatment is generally cerenia for nausea, bupe for pain,and sub q fluids for dehydration. All of that can be done at home. I'm so glad she's eating well now. Ff classic and Friskies pate foods are what most of us feed.
 
It was a horrible roller coaster day today. King Specialist Dick Doc called me in the mid-afternoon with the results of Mommy's ultrasound: her kidneys are impacted, she has pancreatitis with some fluid in her abdomen, and hepatic acidosis; he basically presented a very dour clinical picture, which devastated me. He said she needed another 24 hours in the hospital or we could take her home tonight, but cats with her concurrent conditions "fare very poorly at home." He intimated that should we decide to bring her home tonight, she'd keel over within 3 hours. I asked what another night in the hospital would accomplish if she was so bad off and he said, tersely, "We'd continue our supportive treatment, of course." I asked him if she had any signs of infection in her urine. No, her culture was clear. Is she in pain? No, she is not. She's resting comfortably. She's shown no sign or need for pain meds, though she is on a preventive course of antibiotics.

Okay.

So, of course, as soon as I hung up with him, I fell apart and called my husband at work. We both decided, in tears, that it was best for her to let her go. But I had the ultrasound values sent to my new regular vet anyway, and while I waited for her to call back, I phoned the hospital again to schedule an euthanasia time so we can be both with Mommy when she passes. Dick Doc got on the phone and said, sounding taken aback, "Wait. I wanted to have you a full clinical picture." I replied, "And you gave it to me. She's in severe kidney failure." "No," he corrected, "she has kidney 'insufficiency', which is quite common in cats her age, and her values aren't that bad, actually." Of course, then I got upset and retorted, "I don't get it. You tell me she's in kidney failure, but now her values aren't that bad?" And he said, "After I hung up with you, she ate voluntarily on her own, so she's eaten twice today on her own, and her BG is now 245, which is right where we'd like to see it at this stage." I told him that I needed a straight answer because while we want to do everything we can for her, it's not cheap and we don't want her to suffer unnecessarily, especially if there's no hope . . . He replied, quietly this time, and finally showing a hint of humanity, "Let me put it this way: If she was my cat and money wasn't an issue, I'd give her another night in the hospital." Which, to me, doesn't sound like a ringing endorsement for euthanasia. He went on to add, "There are no right or wrong choices, or any guarantees. Her long-term clinical picture and prognosis aren't great, but she is rallying thus far." No ****, Sherlock: she has acute FD and pancreatitis, but she's obviously not at death's door yet.

Then the new regular vet called me to confirm that while the pancreatitis is indeed concerning, there are no structural changes in her stomach, which is good; her renal values are indeed within the expected "impaired" range of a senior cat, and she said (she's a very kind woman): "You must do what is best for you and for her, but she might surprise us. Your little Mommy is a fighter. Her BG has gone from astronomical to manageable, and her other values are falling slowly but steadily. I don't want to give you false hope or expectations, because the situation is serious, but just like when people are sick, each case is individual. Her prognosis long-term is poor based on her clinical picture now. Does that mean she'll die next week or in three years? No one knows. If you put her down tonight, you can't resurrect her. Should the time come sooner rather than later, or later rather than sooner, you can always make the decision then."

So, I phone my husband again and we decide to give Mommy a chance. We love her. We can't put her down because of money, though we're not rich. I called the hospital back to pay for another night. And guess what? It's only another $748! That's right. Mr Specialist Dick had me in agony for hours, thinking my cat was dying and should be put down, and NEVER once did he mention the extra night is $2000 less than what we've paid so far.

I'm a wreck, but I'm going to see my cat tonight. Mommy is a fighter. And we're fighting with her. I just hate vets. Their impersonal approach is like ice water thrown in your face. Don't they understand that while it might be another patient for them, to us, it's our beloved animal companion? It's as if being human or warm is a crime in their profession.
 
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I am sooo sorry to hear you are going through this but please be encouraged. Docs DO NOT know everything and a lot of medical treatment is guesswork so you did the right thing. Let Mommy guide you. If she’s rallying then she wants to live. I’ll tell you what happened to us this past couple weeks to let you know I understand. My mum (reasonably young at 70) suffered a major stroke followed by a brain bleed (caused by docs putting her on Warfarin instead of the newer, better blood thinner). Two days later the family is called to say she is now in palliative care and will not survive the night. She’s in the UK. I’m in Canada. Needless to say we are devastated. I jumped on a plane expecting to attend her funeral. The docs took her off all water and food and sedated her waiting for her to pass. SIX DAYS LATER she is still alive and asking for water. Docs changed their minds took her out of palliative care and started actively treating her. She is now up and about and making phone calls.

I say this to say - trust Mommy to lead and take what the vet says with a pinch of salt. My vet prescribed steroids and three days later asked me why she was on them! I have very little faith in the medical practice. Human and vet.
Your regular vet sounds a lot more human tho. Can you move Mommy to her care?

Hugs and please keep us posted.
 
Another $750 is not horrible. It seems like much of the care can be delivered at home.

Leo was in a real bad spot earlier this year. We went the extra mile. It cost money and a bunch of my time. But now he's doing great. It's hard making decisions when they get in bad shape.
 
Juliet said:
I am sooo sorry to hear you are going through this but please be encouraged. Docs DO NOT know everything and a lot of medical treatment is guesswork so you did the right thing. Let Mommy guide you. If she’s rallying then she wants to live. I’ll tell you what happened to us this past couple weeks to let you know I understand. My mum (reasonably young at 70) suffered a major stroke followed by a brain bleed (caused by docs putting her on Warfarin instead of the newer, better blood thinner). Two days later the family is called to say she is now in palliative care and will not survive the night. She’s in the UK. I’m in Canada. Needless to say we are devastated. I jumped on a plane expecting to attend her funeral. The docs took her off all water and food and sedated her waiting for her to pass. SIX DAYS LATER she is still alive and asking for water. Docs changed their minds took her out of palliative care and started actively treating her. She is now up and about and making phone calls.

I say this to say - trust Mommy to lead and take what the vet says with a pinch of salt. My vet prescribed steroids and three days later asked me why she was on them! I have very little faith in the medical practice. Human and vet.
Your regular vet sounds a lot more human tho. Can you move Mommy to her care?

Hugs and please keep us posted.
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Unfortunately, I can't move her to the new regular vet yet. She needs a specialist for the foreseeable future, but I am going to request another internist at the practice that my new regular vet suggested. She told me this other internal specialist is warmer and more personable; that while King Doc is a respected and well regarded specialist, obviously he and I have "communication" issues. You think? But vets, like many other professions, never denigrate each other, though this guy is prime-A asshole. He heard me falling apart on the phone and it never occurred to him to say, "Hey, look. If you're unsure here, the extra night is $748. If you can do that . . .?"

I could just strangle him.
 
Pancratitis is treatable. FD is treatable. Kidney failure, while there's no cure, can be allowed down with treatments.

My cat Zimmy had pancratitis (and ckd)... He needed cerenia pills for nausea for 4-5 days, bupe for pain for a week, and we did daily sub q's for about 2 weeks. He was back to his normal self in about a week.

FD is very treatable and we are here to guide you through that.

Ckd can be delayed with lower phosphorus food /or a binder and extra fluids.

I always said I'd my cat is willing to fight so am I.
 
I’m so sorry you are going through this BUT a cat that is eating does not sound like she is giving up. A cat that sick won’t eat on her own even if given an appetite stimulant. Hepatic lipidosis is from not eating. That will go away. Kidney insufficiency can be controlled. I can send you to a site and a crf list for guidance. My cat had pancreatitis for several years. It led to diabetes. That too can be treated. Neither of my cats would eat when hospitalized. Thank goodness you visited. I’m hoping for an even better report tomorrow.
 
We went to see Mommy tonight. She's looking and acting so much better, brighter and very alert. She ate a full can of FF Salmon, too. She was hungry. She's now on Lantus 1u 2x day, just starting today, and her BG has been bouncing around a bit; it hit 330 at one point, but then dropped to 255. Still, she was first hospitalized at a skyrocketing 700+, so even 330, while not ideal, is a definite improvement. The attending vet tonight - thankfully, Dr Dick had gone home - mentioned to me that Mommy might be "hard to regulate". Excuse my French, but it's been less than 24 hours since she was taken off the insulin pump and onto subcutaneous injection. How the **** can they know if she's hard to regulate at this stage? If Lantus doesn't get her BG low enough, then try Lemevir. Try Vetsulin. DO your jobs! I was about to read them the riot act, but seeing as she's there for another 24 hours, I held my rapier tongue. Honestly, you'd think I was the vet. Just by being on this forum for a week, I seem to have a better grip on the situation than they do, with all their diplomas and credentials.

FYI: Here's a picture from tonight of my cat-at-death's-door (not); the beauty we almost decided to euthanize because of Dr Dick's dour prognosis. As you can see, she is nowhere near dying at this point - though she did pee on me, as they brought us to see her in a little visiting room with no litter box and she'd been hydrated like a hippo.
 

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