JINGLEBELLS

[kkoka1]

Hi,
I have posted a few times before, but haven't been on in awhile. Here is the story in a nutshell:

Jinglebells had always been a healthy cat--ate well/loved life. Only thing we ever noticed was some weird hair loss on her feet. We thought thyroid issues, but it never tested definitely. About 2 years ago, she began slushing down the water at a rapid weight. BG's were in the low 300's. Did my research and switched over to appropriate wet food. A few months later, she was not looking good. Took her in and new vet was pissed--told me I was killing my cat by not giving her insulin. So, we put her in for 24 hour monitoring on PZI. Two days after coming home, she had a massive anal gland rupture with puss like I have never seen. Thought it was coincidental. She had emergency surgery. Two days after that, she wasn't looking right. Took her back in. 2nd vet thankfully checked her BG--she was at 25! Doc said that the high BG's could be the result of the massive infection (i.e. pancreas stopped working...infection fixed...pancreas now working). And so we went along. Perfect blood tests for awhile. Then, a bit of increased drinking. 1st vet says again--diabetes. Need to get her back on insulin. We do. She tanks again--BG monitoring at home. She does horrible on insulin. At even the lowest dose, she gets very spacey, twitches, lethargic, barely picks up her head. Minute she is off insulin, she goes back to her happy, purring self. We decided to keep monitoring without insulin. We've done fine for quite some while, but her anal glands were a continued struggle. Every 3 weeks for the last 2 years into the vet for a traumatic squeezing and more blood tests to check on BG's fructosime, etc. BG's always in the high 250's to 310. We finally consulted the best surgeon in San Diego. We both believed anal gland infections might be keeping the BG up. So, she underwent anal gland removal surgery. We were worried she wouldn't make it through the surgery. She has lost so much weight. But she did...like a trooper. Now all healed up and surgery was a must--they were completely closed over with no exit surgeon said. Now...the problem. She just keeps dropping weight. We feed her all the right foods according to the list for diabetic and KD combo kitties (kidney function is always on the borderline for her). She also is at the very highest marker for thyroid, but never goes over the top to where they can treat her for thryroid. As you all know, thyroid and diabetes BOTH can cause the weight loss. Thyroid can also cause the BG to rise. Despite non-treatment via insulin, Jinglebells' BG stay fairly constant over the last two years. She also has vomiting occasionally. It was super bad right before the surgery...completely went away for 2 weeks after the surgery...but is creeping back now. She literally vomits the minute she licks the plate clean! You wouldn't think it could have even hit her stomach yet! It is usually in the am if she does vomit. We aren't sure if it is from the lactalose (I know...sugar to make her poop cuz the surgery caused a bit of constipation issues) which I hear is not good longterm either.

We are at our wits end. If we go back to the vet that has been following her, it is surely going to be put her on Glargagine (or whatever that is--Lantus?) and try again. We are so afraid it will kill her. She tanks without notice and is miserable on insulin. If we go to a new vet, we incur even more costs--we've spent so many thousands of dollars the last two years that they feel sorry for us at the vet office and help us out with lower costs sometimes. We just want what is best for her, but she keeps dropping weight and it is to the point where I'm really getting worried. We are with her 24/7, diligent about feeding, and monitoring her every move.

Can someone tell me if the vomiting is something the diabetic cats do? Does the immediate vomiting sound like something you all have encountered? Can some cats do better on one insulin than another--she's so allergic to the PZI. Any thoughts would be appreciated. She's our baby and we've tried everything we know. Oh...home monitoring was miserable for all of us. Jingles ears get so incredibly sore, she hates the process, we hate the process...but we managed the shots without incident. It is the after effects that kill us and quite literally almost kill her. Work full-time so can't stay home to watch her during the day which also makes us worry and I don't think at this weight (7 pounds 14 oz) that she will make it to my next long-term vacation. She is happy, purring, etc. all the time unless trying to poop (after this surgery--painful at times).

Thanks for any help. Sigh. :YMSIGH:

 

[terri1962]

I will let the others comment on the insulin part. My cat Andy(GA) had chronic constipation and was on Lactulose for a long period. In my opinion this medicine is very hard on the cat. My cat eventually died from liver failure, he just stopped eating. I do believe the Lactulose had a part in that. I now have a cat with constipation issues and I give him Miralax mixed in with his wet cat food. Personally I would never give one of my cats Lactulose again.
I hope you get Jinglebells on the right track, it just could be she needs a different kind of insulin.
Also my cat Arthur used to vomit a lot. I took him to the vet I thought he might be in kidney failure as he is elderly. They checked his thyroid and his levels were high. He now takes Methimazole for it, I have not had one vomiting incident since he has been on the thyroid medicine. He also gets 10 mg of Pepcid once a day as well. So have them check her thyroid again, Arthur presented the same way for awhile, he was at the highest level, like 4.7 but not quite high enough to treat and then the last time they checked him he was just high, so most likely she is heading that way.

Terri

 

[Larry and Kitties]

What was the thyroid value? It is not clear cut on older cats. here is what the bloodwork showed on for my Lightning
Interpretive ranges:
<0.8 Subnormal
0.8-4.7 Normal
2.3-4.7 Grey zone in old or symptomatic cats
>4.7 Consistent with hyperthyroidism
Cats with subnormal T4 values are almost exclusively euthyroid sick or
overtreated for their hyperthyroidism. Older cats with consistent
clinical signs and T4 values in the grey zone may have early
hyperthyroidism or a concurrent non-thyroidal illness. Hyperthyroidism
may be confirmed in these cats by adding on a free T4 or by performing
a T3 suppression test. Following treatment with methimazole, T4 values
will generally fall within the lower end of the reference range
(0.8 - 2.3).

What specific "PZI" insulin are you using?
I would likely opt for a change in type insulin.

 

[Deb & Wink]

My 11 year old civie Libby was in the gray zone as far as the thyroid tests went but the free T4 values were high. Because of this and the fact that she could never gain weight, no matter how much she ate, was drinking 2 cups of water a day, her vet and I decided to put her on the Methamizole. She did get better on the medication and was able to gain back a bit of weight.

She also needed to be tested for her thyroid values every 3 months, to see if the medication needed to be adjusted up of down. We did adjust it a couple of times.

Two of my cats have constipation issues. They both get 1/8t Miralax and 1/16 t plain Psyllium powder added to their food once a day.

Never had an issue with my diabetic cat Wink vomiting.

 

[BJM]

Another idea: she may have a somewhat acid stomach. If so, 1/4 of a tablet of Pepcid about 20-30 minutes before eating may help. I dissolve it in an oral syringe since that helps avoid a pill sticking in the esophagus and causing irritation. Cats with renal failure are prone to GI upsets, so the site Feline CRF has lots of tips for that which may be helpful.

 

[Wendy&Tiggy(GA)]

I wonder if her issue with insulin is that she is dropping too low at times. You can monitor and prevent that by home testing her blood sugar. Many of us here do.. You want to know more? It will help keep her safe and give you control over her health..