Looking for some Reassurance...

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MMM

Member Since 2015
Hi everyone. I can’t believe it was April 27 that I first posted here. We are only now getting to the point of starting Bailey on insulin - in a couple of days. She wasn't started right after diagnosis because we first tried to get her off prednisolone and onto cyclosporine in the hopes she would immediately go into remission. We had tried her on cyclosporine a couple of years ago when she was first diagnosed with pancreatitis and it made her violently ill, so we took it easy, first getting her onto an anti-nausea drug, then introducing the cyclosporine very, very slowly (as in - it took over a week). Unfortunately once she got to the target dose (and even then, it was lower than usual) it still made her ill. In addition, she has been exhibiting intermittent episodes of pain. Once the drug switch failed, she also went off her food - sort of. Some days she eats nearly a whole can (I was advised she should have a can and 3/8th) other days maybe half a can. And for the most part, if it has any of her pred. in it, she won’t eat it (or much of it) so I’m not sure she’s getting her full dose of that every day. So she has lost quite a bit of weight, and wasn’t a big cat to begin with. Because of the other symptoms she was exhibiting, after we backed off the cyclosporine the next thing was to get an ultrasound and further blood work done to see if that would determine what was going on. Between a holiday weekend and other scheduling, that took the better part of another week to set up and get done. Then it took a couple of days to get the results, which of course I got last Friday, meaning I didn’t really have a chance to talk with my vet until Monday. Delay, delay, delay. And, it turns out that in addition to everything else, she has gallstones! Screech! Between all this and the intermittent pain (now being controlled - I hope - by bupermorphine) she has lost a lot of energy and it has been days since she has been her usual playful self. Plus she fights when I give it to her. Anyway, she will be seen by a specialist around June 11 or so, (typical of the way things are going - I don't have the appointment yet) but in the meantime we will start with insulin (at last). I’m not blaming anyone (but still feel guilty). If it hadn’t made her sick, the drug switch could have worked - her numbers have dropped quite a bit since she’s been on the new food. I have determined that she can’t really wait for the specialist though, so I will take her to the clinic to get some training on Friday, then I will take her to the hospital on Saturday so they can do the curve. This is an expensive way to go, but there have been so many things that have gone wrong (more stuff than just her bad reaction to the attempted drug switch, loss of appetite etc.) that I would feel better if experienced people get her started. I feel bad because I know the hospital scares her, but I have been under so much stress the last five weeks (!) being hopeful and disappointed with each slight improvement and setback etc. and especially after seeing her decline the last week or so, that I am too exhausted and have no confidence in doing it myself. It’s not like this is the only stressful thing in my life, as various changes and being short staffed at work are also wearisome. So she will get insulin on Saturday and I will start giving her injections on Sunday. I know. More delay. But what can I do - there is only so much time I can take off work.

Anyway, I guess what I would like to know is - do you generally see some improvement soon after insulin therapy begins? Like, really soon? I know I still have to face dealing with the gallstones (possible surgery..sigh) and getting weight back on her, but it would be nice to know that I could expect to see some improvement. Or do I have to dig deep and find reserves of patience that I’m not sure I possess any longer?

If you've read this far - thanks. It's been a bad few weeks - I lost it at work today.
 
The first sign that China was really feeling better came about 2 weeks into treatment....I caught her sitting in a sunbeam, grooming! I realized right then that I hadn't seen her groom in a very long time, so I knew we were getting somewhere! Soon after that, she started playing games she hadn't played in forever. I'd thought she was just getting too old to play, but once she started feeling better, she acted like she was getting shots from the Fountain of Youth instead of insulin.

And because I think a picture is worth 1000 words, here's China at diagnosis China before diagnosis.jpg at less than 8lbs

And here's China about 4 months later China after 4 months insulin therapy_zpsf9fd87af.jpg...at close to 13lbs
 
It will depend on the insulin - we like ProZinc, BCP PZI, Levemir, and Lantus as they all last about 12 hours per shot.

Vetsulin/Caninsulin generally lasts only 8-10 hours and Humulin or Novolin NPH or N only last about 6-8 hours in the cat, so you're likely to continue seeing symptoms when the insulin has worn off.
 
The first sign that China was really feeling better came about 2 weeks into treatment....I caught her sitting in a sunbeam, grooming! I realized right then that I hadn't seen her groom in a very long time, so I knew we were getting somewhere! Soon after that, she started playing games she hadn't played in forever. I'd thought she was just getting too old to play, but once she started feeling better, she acted like she was getting shots from the Fountain of Youth instead of insulin.

And because I think a picture is worth 1000 words, here's China at diagnosis View attachment 15062 at less than 8lbs

And here's China about 4 months later View attachment 15063...at close to 13lbs
Thanks for that. Bailey was about nine pounds before this started and is about seven now. I think. I've been "practising" with the scruff of her neck (because I've watched some videos) and there doesn't seem to be much there. But when I go to the clinic I get to practise for real with saline solution. I hope it goes better than trying to give her the painkiller - she pulls away and it is hard to hold her still long enough to get the syringe up against her gums and push. I'm feeling very discouraged at the moment and because so many things haven't gone well, very apprehensive. So seeing your before and after pics are very encouraging - I really appreciate that. Thanks.
 
It will depend on the insulin - we like ProZinc, BCP PZI, Levemir, and Lantus as they all last about 12 hours per shot.

Vetsulin/Caninsulin generally lasts only 8-10 hours and Humulin or Novolin NPH or N only last about 6-8 hours in the cat, so you're likely to continue seeing symptoms when the insulin has worn off.
I don't know what it will be yet, but I will keep that in mind when I do know. Thanks for the info. We've had so many setbacks that if I wasn't expecting it (if it is any of the 8-10 hour or shorter lasting ones) seeing a return of symptoms would be just so discouraging. And I am already discouraged enough. I hope I can do this (administering the buprenorphine isn't going so well, getting her to eat is hit and miss) so I feel like I am not being a very effective guardian. There has to be a point where things either get better, or it is time to call it a day. I'm not at that point yet, but I'm afraid the time is getting closer. Maybe that's because she's was doing okay, more or less until the last couple of days. Sigh. This is hard. So I appreciate the information.
 
Just got back from the training session with the vet so now I know it will be Caninsulin. He thinks it will be one unit - but it will depend how she does with the curve tomorrow, it could be half a unit. Poor thing shook so badly today I almost called the whole thing off. Since she has these other issues, I'm wondering it is worth putting her through all this. I may just be feeling this way because she's had diarrhea yesterday and today and threw up at 4 a.m. so I'm feeling very tired and discouraged. I mean, yes, maybe we can get the diabetes under control, in spite of the pancreatitis, but there are still the gall stones to consider. She's 12 years old, maybe this is too much to put her through. But it's hard - maybe the specialist will have some ideas that will be tailor made to her situation. Maybe getting the diabetes under control will get her to start putting weight back on (I'm scared to weigh her right now and I notice my vet didn't report to me what her weight was). Maybe she will feel so much better that other things going on with her will settle down. The trouble is, I'm suffering from an over abundance of "maybe" right now. One way, it could go well and she will be feeling better - the other way is I could be putting her through all this and still need to "call it a day". In the end, I feel I should try something before giving up. So, tomorrow she is going to the hospital and they will do the curve. Then it will be up to me. I don't know. I did one ineffective injection of saline solution and one that went much better. Bailey reacted, but didn't pull away - mind you that's on the table at the vet's where she was quite scared. I don't know how it is going to go at home - she pulls away when I go to give her buprenorphine, so... anyway I guess I'll find out soon enough. But I do wonder why the choice is Caninsulin. I forgot whether it was a long lasting one or not when I was there, so I didn't ask him.
 
Ursodiol can be used to treat gallstones.

Caninsulin tends to wear off by +10 hours post shot. If you're lucky, it'll last longer. Otherwise, you may need to shoot every 8 hours for good control. There's one other option, but we'll wait to see how she does with it.

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Insulin is a palliative measure as well. A diabetic that's uncontrolled will have a lot of symptoms, some of them not so pleasant (constant hunger and thirst). So giving her insulin is a measure that you can look at as relieving symptoms. Weather you choose to treat other things as they come up or only treat symptoms, you can bet the insulin is going to make her more comfortable overall.

If you get small needles 31g or smaller, most cats won't even feel the insulin shots. As for blood sugar testing if you choose, there aren't many nerves in the ear. My cat max actually likes getting his blood sugar tested because I let him up on my bed (he's not usually allowed). When he sees the meter he knows he's gonna get some cuddles.
 
Ursodiol can be used to treat gallstones.

Caninsulin tends to wear off by +10 hours post shot. If you're lucky, it'll last longer. Otherwise, you may need to shoot every 8 hours for good control. There's one other option, but we'll wait to see how she does with it.
Perhaps I am putting too much hope in the internist (who I don't even have a confirmed appointment with yet) but I would like to think she would know something like this. I'm not sure if there is a particular reason, as I forgot to ask, for this particular choice but I would like to believe there is one. Could it have anything to do with how her numbers improved by the diet switch? In his email report, he told me:

" The random Blood Glucose level has decreased from 22.4 to 15.6 (normal = 4.0-9.7) while the random fructosamine has decreased from 462 to 375 (normal = 191-349) and the fPL has decreased from 37.1 to 9.1 (normal = 0-3.5, grey zone 3.6 - 5.3). The liver enzyme abbreviated ALP has however increased over time from 22 to 82 to 92 (normal = 12-59)."

The improvement in the fPL was a bit of a surprise - the switch away from hypoallergenic food has brought back some of her itching, but not the visible dermatitis. Since we thought her food sensitivity was a possible cause of her pancreatitis, it is good to see that this number is better, not worse, on the new diet. The ALP increase "probably reflects inflammation in the biliary tree secondary to the stones". She also has "a thickened/enlarged duodenum papilla" that he said "could be a result of chronic inflammation most likely from the pancreatitis but could also be due to an infiltrative process that is in the early stages of forming a nodule or mass. "

Not sure if any of that factors into the choice of type of insulin. I would think when being advised to administer it every 12 hours that it would last 12 hours. But it seems I would think wrong.
 
The ALP also could be due to fat breakdown for calories going to the liver and causing it to swell a bit and get irritated. Time will tell.
Vets get a lot of marketing and tend to have limited time for specific research. Vetsulin was originally named Caninsulin, as it was developed for dogs which have a slower metabolic rate than cats.
 
Vets see a lot more diabetic dogs than they do cats too, and the insulin of choice for dogs is Caninsulin. It's very common for vets to treat cats as if they were little dogs instead of taking the time to keep up to date on the latest treatments for every disease in every different animal they see.

It's not the best choice, but some cats do OK on it....it's just very important that you make sure Bailey is going to eat normally before giving it because it generally hits hard and fast and if he hasn't eaten, it could cause problems

Maybe you could send your vet the information on Management of Diabetic Cats and see if he's willing to learn...the information is at the very bottom of the "Lantus and Levemir Tight Regulation Protocol" thread
 
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Insulin is a palliative measure as well. A diabetic that's uncontrolled will have a lot of symptoms, some of them not so pleasant (constant hunger and thirst). So giving her insulin is a measure that you can look at as relieving symptoms. Weather you choose to treat other things as they come up or only treat symptoms, you can bet the insulin is going to make her more comfortable overall.

If you get small needles 31g or smaller, most cats won't even feel the insulin shots. As for blood sugar testing if you choose, there aren't many nerves in the ear. My cat max actually likes getting his blood sugar tested because I let him up on my bed (he's not usually allowed). When he sees the meter he knows he's gonna get some cuddles.
That's a helpful way for me to look at it. Her hunger was not that bad and her thirst improved almost immediately after her diet change. All was going quite well until she got sick when we tried to switch her to cyclosporine and it hasn't been very good since. She does eat, but not as much as she should so she has lost weight more rapidly the last couple of weeks (she was losing some already) she's started exhibiting intermittent pain, etc. If doing this helps with her symptoms, it will be worth it. Thanks for the perspective.

The needles are quite small. I didn't bring them home with me because I was swapping out her food (she prefers the "savoury" to the pate) and it was going to be too much to carry the insulin, needles, food and her, so I can't confirm the gauge. The regular needle the vet used for demonstrating drawing the insulin, holding it properly etc. looked enormous in comparison. I suspect she felt it because she was tense, I was tense, etc. I'm going to be extremely tense the first time I do this by myself, so we will see how it goes. I know it is for her benefit, so I have to make it work.
 
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In people who aren't surgical candidates, a course of antibiotics can decrease inflammation with gallstones and improve liver function. I'm not sure if this approach works in cats.
 
The ALP also could be due to fat breakdown for calories going to the liver and causing it to swell a bit and get irritated. Time will tell.
Vets get a lot of marketing and tend to have limited time for specific research. Vetsulin was originally named Caninsulin, as it was developed for dogs which have a slower metabolic rate than cats.
Another reason to hold out for the specialist. I actually appreciate that my vet is willing to admit he doesn't know it all (my GP could learn a thing or two in that department). So I will go along with this treatment plan until she is seen by the specialist, if she is seen by the specialist - the way paper work keeps getting fouled up, by the clinic, by the hospital, by the compounding pharmacy, I've had issues with them all - I won't be certain until I'm shaking hands with her.
 
Vets see a lot more diabetic dogs than they do cats too, and the insulin of choice for dogs is Caninsulin. It's very common for vets to treat cats as if they were little dogs instead of taking the time to keep up to date on the latest treatments for every disease in every different animal they see.

It's not the best choice, but some cats do OK on it....it's just very important that you make sure Bailey is going to eat normally before giving it because it generally hits hard and fast and if he hasn't eaten, it could cause problems

Maybe you could send your vet the information on Management of Diabetic Cats and see if he's willing to learn...the information is at the very bottom of the "Lantus and Levemir Tight Regulation Protocol" thread
This thread is acting weird, I only saw this now. My vet advised that making sure she eats is important and that the amount she eats should be consistent. Unfortunately she has been going on and off eating. I hope this therapy will help with that. If she flat out refuses to eat I had understood I would still give her the shot - but I could be confused (a little tired right now). I will clarify that when I pick her up at the hospital tomorrow.
 
No, if you're using Caninsulin, it's important that she's eating normally before she gets her shot or when it "hits", there won't be anything for it to "work on" and it could take her blood glucose way too low

Lantus and Levemir are better that way because the "onset" is more gentle and several hours after the shot, so if they won't eat right at shot-time, you still have several hours to get food into them
 
If her pre-test glucose is very high - 400s and up - you may be safe giving some insulin to bring it down, even if she has not eaten. Once you get some test numbers and know how the insulin works in her, you may be able to figure out a safe token dose.
 
Well, I took her in to the hospital a couple of hours ago so we will see. Hopefully she is more of a trooper than I am. It was hard enough to see how scared she was yesterday, it was absolutely devastating this morning to see her reaction when I got the carrier ready for her - she usually resists a bit, but she was over my shoulder trying to get away when I picked her up and her eyes were enormous. Then as I was leaving a woman came in with her dog, tears streaming down her face and I heard the assistant say to the other one that this was the lady who was in to get her dog euthanized (poor little thing didn't look good). Seeing this woman's emotion pretty much did me in. Rough, rough morning. Anyway if I understand the conversion chart here correctly, the number a week and a half ago was 280 (15.6). Hopefully it has stayed in that range, though it seems to me she has started drinking more water and eating more the last few days. Which could be a change in that number, or could be that she is getting over her suspicion of the food (since the cyclosporine made her sick).
 
Yup 280-281-ish. How'd it go?
She's still there. I should be picking her up around 7:30 this evening (I opted for 6:30 as the time for shots). That's Pacific Standard Time. I will let you know. Is 280 very bad?
 
Actually, 280 mg/dL was where Gracie normally pre-tested before getting insulin. Then the insulin would bring her down from there, when it was working.
 
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She developed pancreatitis, her glucose went up and up as did the dose, she stopped eating, spent 5 days at the vet, I tried to feed her at home 1 day, and she died this morning.
 
I am so sorry. I don't know what else to say, except I admire that you are still here trying to help others. That's impressive. She obviously had the ideal pet guardian. My friend whose cat died recently of kidney disease asked people on FaceBook to share happy stories about her cat so she didn't dwell on the end - many of us sent funny stories which she said helped a lot. Obviously I don't know any of your funny Gracie stories, but please think of them. My deepest condolences.
 
I just called the hospital as it should be another half an hour or so before her second injection and I wanted to know approximately when I could pick her up. The technician reported that her BG was 20 something (so back around where it was before the diet change). The lowest it went for the first shot was about 15, so not normal. Also, she's been hiding all day and won't eat. My vet will phone after she's had the next shot to discuss if she should stay in the hospital overnight. I hadn't counted on this. I wanted to do this in the hopes of stabilizing her so she would be going through less trauma (throwing up etc.) not to go through more. I'm not sure I am willing to put her through more stress. I have been having a growing feeling that there isn't going to be a good outcome, but I felt that the balance (making things better vs making things worse) was about even. Now I feel it has tipped, and not in her favour. Through out this whole thing, I've never felt as discouraged as I do right now.
 
A lot of cats won't eat at the vet...it's a high stress environment which ALSO raises their blood glucose

I think you should bring her home and see how she's doing before making any kind of decision
 
Well, the not eating doesn't surprise me - that's been a difficult road for a while now. But I don't want to see her shaking and terrified again. I am sick to know she hasn't adjusted to being there since she's been there all day - that she's been scared all day. If things had gone smoothly, I might have felt that was worth it, but now I'm not so sure. After all, there is more than diabetes going on with her. I've watched her lose ground, particularly the last week or so when at first it seemed there was improvement. It has been a one step forward two steps back thing and I don't want to keep seeing her backslide until she is really miserable and sick. Right now, I truly feel it will be better to get her home and comfortable and arrange for the vet to come. I would rather say goodbye to her now, once she is home again and over the two days of fear I've put her through, then to watch her continue to deteriorate. Yes, maybe she will improve if I keep going with this, but she may not and that is a chance I am no longer willing to take.

I haven't heard from my vet yet though. It is possible he will be more positive about things. But that's the way I feel right now. Every time I remember how she climbed up on my shoulders (something she's never done before) to get away when I picked her up to put her in the carrier this morning, it hurts more than I think saying goodbye will. She was terrified. I don't want to see her that way again. And putting her in a situation where she may feel that way again is by no means providing her with quality of life. I don't want to say goodbye, but I don't want her to linger either.
 
Well you're not seeing her at her best....being shoved into a carrier is terrifying for lots of kitties so don't let that be your last picture of her. I know she has other health problems, but I think it's really worth a try to see if you can get her diabetes more stable before making any decisions on her quality of life.

Remember my pictures of China? That first one, she was so weak and frail and I had really wondered if that was going to be the end for her too....When you look at the picture just a few months later, the improvement is remarkable ....and over 2 years later, she's still here driving me crazy (in the best kind of ways!)

If you didn't do it last time, go back and click ON each picture to expand it...I think you'll see that at first, she was one very sick little girl
 
Well that was a fiasco. Nothing goes right so I am not surprised. After waiting a couple of hours to hear from the vet, I got a call (around 9:30) from the hospital saying she was ready to be picked up. Her 12 hours were up as of 6:30. When I asked about speaking to the vet, I was told he had gone home. I then told them that I wanted to talk to him because I didn't want to do this anymore (I have been sleep deprived with worry the last few days and up since 5:00 a.m. so I could drop her off at 6:oo and so I was very, very tired at this point). So she said she would page the vet and either he or she would call me back. After another half hour I phoned them back and was told they couldn't get a hold of him and maybe I would like to talk with the doctor on call there. so I went up and when I got there they were so busy I wouldn't have been able to see the doctor for another hour or more. So an assistant (the same one I saw this morning when I dropped Bailey off, she was starting her next shift, that's how long this has been) and it turns out that he told the other tech that he would phone me within 48 hours to discuss the results, not before Bailey was to go home. There was nothing about keeping her overnight (which I had been told was a possibility) and her numbers apparently aren't all that bad (am a bit confused now). So by the time all this was dealt with, I didn't get home until after midnight (the hospital is not that close and it was a Saturday night, there were police cars etc. which slowed down the traffic). It also turns out that she only got the one shot at 6:30 a.m. They never gave her another one at 6:30 p.m. (and they phoned me to pick her up at 9:30 p.m.). If I gave her an injection when I got home, her next one would be at noon and noon to midnight will not work for my schedule. In addition, I am so sleep deprived already and have now been up for almost 18 hours - there is no way I am in any shape to give her the first injection I've done (for real) in five or so hours. So the tech explained it would be better, in that case to either go 8:oo a.m., 7:30 p.m. then 7:00 a.m., or if I'm still feeling too tired to be confident enough, to just wait until 6:30 p.m. tomorrow.

This has been the most frustrating, exhausting day of one of the most frustrating, exhausting times of my life. This kind of foul up is not the first. The clinic has messed up, the compounding pharmacy has as well and the foul ups all create delays. I'm not sure how much longer I can cope - I am emotionally spent and we haven't even really started treatment yet. Sorry to vent but it is just so frustrating. I would yell and scream and throw things if I thought it would help, but it would only disturb my neighbours (it is after midnight) and scare Bailey. So I am venting here.
 
Vent away.......This is a safe place for venting and we all understand!!

Get as good a night's sleep as you can tonight and don't worry about anything else

Tomorrow is a new day and let's just concentrate on getting a good test in for her next shot and get her eating!

Sending lots of vines and hugs tonight!
 
If they haven't given her a shot since 6:30am yesterday morning, you can shoot whenever it is best for you this morning. Just consider last night's missed shot a "furshot" and start over this morning

Sounds like you had a very stressful day yesterday filled with fear, questions and a good deal of incompetence by the vet and his staff so please don't feel bad about venting here! We're not only here for the cats, but for the caretakers too. We all understand how hard this dance can be, especially at first and when you're being pulled 6 different ways and being told different things from people all around you.

Take a deep breath, look into your dear sweet kitties eyes, and say "we can do this....together", and let the dance begin! We'll be here every step of the way for you
 
Thanks. It wasn't the vet's fault, from what I understand. He never said he was going to phone me last night, but within 48 hours. Which to me means Monday. He is entitled to his weekend, I don't really have a problem with that, but the rest - yeah, when I feel a bit better (so I can be coherent) I will complain. But I work in an office and I know how it can be when you get really busy. They had two critical care cases come in (they are the 24 hour emergency hospital in the area) and there were a couple of other dogs in the waiting room. That is why it would have been even longer if I waited to talk to the vet on call, who of course, doesn't really know all the background. I know these things happen - they just always seem to in connection with Bailey's case.

I don't have the equipment to test her before her shot yet but have been instructed to give her one unit. From what her numbers have been, I doubt it will be too much (though I do have corn syrup on hand. She's been eating since she got home (almost the whole can) and I just fed her again now. I'm too tired (to the point I feel nauseous) to do my first shot now. The assistant advised that I could do it at 8:00 a.m. (so in an hour) then do the next one at 7:30 pm and then 7:00 am the following day (before I go to work) or start tonight at 7:00 p.m. I am a bit too rattled to try this morning I am sorry to say so I will start this evening at what will be the regular time. Besides, this is the most I've seen her eat in days. I also want to make sure she doesn't throw up. So it's not ideal, but as I have mentioned above, nothing ever is with this situation. Thanks for the support. This has been an awful time.
 
While you wait to get the blood testing going, check out my signature link Secondary Monitoring Tools. These are some other assessments you might use to evaluate how she is doing. In particular, watch food and water intake and output, plus check for dehydration, urine ketones and urine glucose (plastic wrap crumpled around the perimeter of the litter box can work, if you get the sample right after she goes!)
 
Sounds like you have had a pretty stressful couple of days. Get some rest & don't forget to take care of yourself or you won't be able to take care of your fur baby.

If it helps, my vegetable was diagnosed on Thursday & she is already showing signs of improvement just a couple of days later after being on caninsulin.
 
While you wait to get the blood testing going, check out my signature link Secondary Monitoring Tools. These are some other assessments you might use to evaluate how she is doing. In particular, watch food and water intake and output, plus check for dehydration, urine ketones and urine glucose (plastic wrap crumpled around the perimeter of the litter box can work, if you get the sample right after she goes!)
I have had her home for about nine hours now, and as I indicated above, opted not to give her the shot this a.m. She has eaten nearly a can of food. She doesn't drink from containers, I've tried different sized bowls, the fountain type things etc. but unless she is particularly desperate, she will only drink the running water from the tap (this has been so since before she even had pancreatitis). So going by the length of time she drinks, I would say she is drinking a lot today but I suppose that is due to at least in part to her probably not drinking much yesterday. She has peed enough to make three half cup sized clumps but so far no poop. But again, she hadn't eaten almost all day yesterday, so that could still take some time. Also, to see how it would work, since this is my plan for when I am at work, I froze a portion of her food and put it down for during the day. She started licking it and trying to eat it, but did kind of give up on it, so hopefully she will go back to it once it has thawed. She has a "thing" about food that has sat out too long though, so if she doesn't I will have to give her about half her day's worth of food in the morning before I go, rather than have it portioned out a bit. Maybe that will work out better anyway, so she will eat as soon as I get home so I can give her the shot.
 
@MMM I think you are doing a fabulous job given that we are not robots and do have emotions and need to sleep, work, eat and get other things done too. You are entitled to feel as you do as well as vent. I think every last one of us in here, can relate to the emotional drain, frustration as well as fear. None of us are singing and skipping all of the time. We try our best but, we also have to watch out for our own health as well. If we get sick, our Sugar Kitties aren't going to get looked after at all or very little so, it's important that we also take some time to look after our own health, mentally, physically and emotionally.

Ok, so she's eating and drinking, peeing and I'm sure a bowel movement will be next. :) Then, you will give her her shot and start onto her pattern with her and keep on that one that suits your schedule as well.

You're doing your very best and you need to try to do something that's relaxing for you today. As much as we're all here to look after our babies, we're also in need of support for each other as well. That's an important part of the equation too.

Vets also need a life but, when we're in crisis, tired, exhausted, frustrated, panicked, it's not comforting to not be able to get ahold of the vet who was looking after our babes, is it? I know that feeling too as I'm sure all of us do. We put trust into the vet giving our babies the most care and hope we can count on them to do what is right so, when they're not there, it's like taking a safety net out from under us, isn't it? But, everyone is here and there are other vets available too for you 24/7 (which hopefully, knock on wood, you won't need).

We all want to do whatever we can for our kitties and we do. But, there also comes a point where we need to take a breath and just calm down a bit so that we can continue. So, do something nice for yourself today if you can. Perhaps, pick up the equipment needed to do your own testing at home (BJM has given you some excellent secondary monitoring ideas) and try to get some R&R, giving her the shot when you are next scheduled to do so.

HUGS!!! :bighug:
 
Thank you Louellen, that's very sweet. I have a tendency to get migraines when I am stressed and have the beginnings of one now, so I will take it pretty easy today.

I do want to do what's best for Bailey and one thing the situation yesterday has done is made me realize just how far I am willing to go. Farther than I thought before I had a cat, but I also know now where my limits are. I will treat her diabetes so she can feel more comfortable. I will see the internist to see if she has any better options for Bailey's other conditions. If she suggests another drug rather than sticking with prednisolone I will try that, but if it makes her sick like the cyclosporine did, then we're done. I won't watch her go off her food again and lose more weight and become listless etc. the way she is now. If a drug to dissolve her gallstones is suggested - fine. But I will not put her through surgery. It is bad enough I have to put her through more trips to the clinic to be monitored (and one more to the hospital since that's where the specialist will be). But at least I will be with her. To leave her there alone again, to probably have to stay overnight to recover from surgery etc. so that maybe she will feel better. Not likely. Even if I could afford it (and I am rapidly reaching my limits in that department) I won't do that to her.

Since she has been with me, Bailey has had a calm and quiet life. Disrupting that by putting her through something like yesterday, when I feel there is a chance for her to feel better is something I was willing to do. But now, I'm not. I ask myself - even if there is a chance - is it worth it? And after holding her - shaking, trembling and utterly terrified in the hospital, I can't say the answer is yes. After seeing her slide off the sofa the other day - I can't say that it is. I'm not going to try this thing and that thing because "maybe" it will help, until it reaches a point where she is so obviously sick there is no other choice. I would rather make that choice when she is still relatively comfortable. Because the big problem with maybe is that it could turn out well. But it might not. And after seeing her reaction to the ordeal of yesterday, I just don't want to put her through that again for "might turn out".
 
@MMM I know exactly what you mean and for some, there are limits as to what we can/should do. That includes our own sense of what is "right/wrong" for our babies. It's the uncertainty that we're left with that leaves us in more of a mess than anything, isn't it?

Perhaps, right now, you are overwhelmed and in days to come, you may be feeling/thinking a little differently or, perhaps...not??? You will go by your heart and gut and what docs have to say, I'm sure. Whatever you do, don't make any decision while exhausted or in the midst of a horrid migraine with lack of proper sleep/rest. "Sleep on it" so to speak and you *may* find more clarity in your emotions and thinking that *may* change how you approach this or what you decide to do or, it may just strengthen your resolve to stay the course that you are going on??? Time will tell but, in the meantime, the caregiver has to also take care of herself. :)

You ARE following through and you ARE going to get other opinions...which is all good. That will certainly help you get a larger picture of what you are dealing with/can deal with. And, I DO understand the financial limitations as well because I am there, myself and literally, scraping from one area to put into another to keep going as best that I can. Specialists are expensive but, I guess that experience has taught me that sometimes, we have to do what we have to do in order to have "peace of mind" no matter WHAT we decide/Nature decides for us sometimes.

Having been one to even sell possessions of my own to pay off HUGE ER vet bills in trying to save pets, I know the strain it can add to an already overstressed emotional system. It's totally overwhelming, isn't it? Add to that, decisions that need to be made and wondering if we're making the right ones and, we've got a nuclear bomb ready to go off somewhere within us.

I do know one thing. Vets HAVE to offer us every possible and reasonable thing that they can do for our pets. It's when you get to the bottom line of, "if this were your pet...what would you do" type of question that we can *sometimes* get an answer that helps us make up our minds as to how to proceed or not proceed. Their "quotes" for their services are also another mechanism by which we are often finding decisions made for us. So, it's all still wide open as to what to do or not do at this moment and sometimes, just taking things day by day, is the best way to approach these situations, not looking ahead and assuming either way what we think is the outcome. It's far less stressful that way. Fear is going to be there no matter what we do or don't do so, may as well try to stop projecting ahead as to what may or may not be the case.

But, I do want to say one thing here about the fear of being in the vet's. I'm sure that none of our kitties or dogs WANT to be in a vet's office and I have spent hundreds of hours, in knots, sick to my stomach, crying, popping headache pills and Gaviscon as well as not sleeping, worrying about my babies being in the vet's clinics for stays, day or overnight and some for a week or more. It's like leaving our children in a hospital by themselves, isn't it? And, no...a lot of them haven't eaten while in there either. Some of them have come home and hidden for hours or even a day or two. Most of them freak out when they see the carrier coming out...even if it's just to re-arrange a closet where it's kept! :woot:
Heck, mention the word hospital to me and I want to shove myself under a bed! :p No one likes being in a hospital and they don't like being in a vet's clinic/animal hospital either. But, it's necessary sometimes to save their lives. The alternative is sometimes, death if we don't do it.

So, take it one day at a time right now, doing what you need to do for yourself first and kitty along with that and go from there, taking it one moment/hour/day at a time and seeing where you're at. Just remember that sometimes, the most sickly of cats and dogs have been dealt with successfully and gone on to live full and normal lives. Yes, there has been upset on their parts at having to go to the vet's and even stay but, in the end, they've been around for a lot longer because of it and in spite of it. Don't let their fear be the deciding factor for you but, rather, give yourself a chance to settle down as I can assure you that she is getting over this "fright" much more easily than YOU are! :)

HUGS with love and patient understanding for what you're going through. :bighug::bighug::)
 
Thanks. That is true. One of the first things she did when we got home was to play with a piece of paper on the floor, then eat almost an entire can of food. Today she has spent a lot of time in my lap today. My pants are covered in dandruff which she produces quite a lot of when she's been stressed. A friend came over and she not only jumped into her lap as well, but was checking out her glass of water and she was a bit playful again during that visit. So she seems fine, in spite of yesterday, although she does react when I pick her up to get her out the way of something. I suppose she thinks I'm going to put her back in the carrier. I'm a couple of hours away from giving her the first shot and I'm sure once we get that under our belts, it will get better. Also, my friend dropped off some of her mom's chocolate brownies - that will help too. :)
 
Chocolate. Yes, I've been doing some of that lately myself.
You can add a bit of water to the canned food to help with the fluid intake. Start small to make sure she'll still eat it.
 
Thanks. Her mom is an awesome baker, so they are going to be very, very good.

Bailey has been drinking water - I think she just wanted someone else's - a nice flash of her formerly mischevious self. She has been peeing and finally pooped. It is a bit on the squishy side, but she's been through a lot.

My vet's instructions are to feed her as to her regular schedule, which hasn't been regular since she got sick on the cyclosporine. She has eaten a can and a half of food since midnight last night. I stopped feeding her anything at 3 p.m. so she will eat at 6:15 p.m. and she's looking for food so I hope that works. I plan to give her the injection at 6:45 . I was going to do it at 6:30 but I think I will need the extra 15 minutes sleep now. Since she seems enthusiastic about food again, I will attempt a schedule. I'm thinking half the food in the morning and almost half at night (minus a portion that will have the prednisolone in it). At this point, I think it is more important that she eat than get the pred. and if I put the pred. in first, she might not eat. So then later in the evening I will give her the pred. laced portion. Does this sound like a good schedule (assuming she cooperates...)?
 
We find that mini-meals throughout the day put less stress on the pancreas, allowing it to heal and possibly resume full functioning.
 
Okay. I've administered the first shot. Flipped flopped back to 6:30 - I think I just wanted to get on with it. When I grabbed her ruff she knew something was up, so she tried to pull away, so I blocked her with my knee and went for it. She made a protesting sound, then went back to the food dish. I pet her and didn't feel anything wet, so I think I did it (it is a very small amount and doesn't even feel like the plunger plunges). So now I will be watching her like a hawk all evening. Tomorrow will be worse since I will have to go to work, but this is life.

As for the feeding, perhaps the best way then would be to divide up her food into four portions. One would go in the freezer overnight, then she would get one in the morning with the shot, the frozen one before I leave for work, one when I get home, with her shot, then the last one with the pred. later in the evening. Do you think that would work?
 
Well, it seems to me that Bailey does feel it - maybe I'm not doing it right, though I don't see how. But she started to pull away as soon as I knelt beside her so I had to restrain her to do it and now she won't let me pet her. Hopefully she will go back to eating - she did eat some before I gave her the shot. But I think the next shot is going to be particularly difficult, now that she's on to me. Maybe if she gains a little weight she will feel it less?
 
@MMM You know...they are smart. They figure things out very quickly. One of the things that I found was that Morrigan didn't like me pulling her fur up or skin. It was the feeling of THAT which she hated. Mind you, I have a cat who starts going bonkers the moment I try to clip her claws and haven't even gotten the clippers close to her nails yet! It's the not wanting to be prodded that makes her go nuts and I'm sure Bailey is doing the same thing....thus, the squirming, fussing and wanting to run portions. o_O

One thing that you might want to do is, since she's already jumping onto your lap etc., while there, try patting and pulling up her fur/skin a bit so, that she associates the feeling with just being loved. Another idea is to offer her a treat after she's let you pull up the fur/skin (whatever method you've been taught and feel comfortable with). She will then associate the fur/skin pull with something enjoyable. It takes time but, really...not that long.

Now, if you want to be reassured as to what Bailey is really feeling...let me tell you about my own crazy experiment.
I was like you, a MESS over what I was doing to Morrigan and what she might be feeling so, I got out one of her insulin needles (nothing to inject) and I stuck it into myself, 3 times in a row...just the way that I would do for Morrigan. Guess what? Even KNOWING that poke was coming and not being distracted by food or treats or anything...I felt literally nothing. I've had mosquito bites worse than that! Really! If you don't believe me...try it on yourself and you'll know what Bailey is feeling. Hubby nearly vomited as I was doing it to myself but, I said..."hey...KIDS get this done to them every day...several times a day for their diabetes!" It really doesn't hurt. Honestly! I can't give a better endorsement on that statement than by self-trial. :)

Also, if you want a better association (which I found seems to be key here), try offering up a treat that she'll eat and putting it in front of her. If that drive towards that treat is great enough, it won't matter what you do with her. Get her to associate "treat" and pats with that fur pull/skin grab. I'm certain that's what she's grumbling about...NOT the shot. :)

Your schedule is your schedule. Whatever works for you, is what works for her as well. Lots of people choose to do their shots and testings very early in the mornings (like you) because of work factors. Others, like me, find that I'm home for lunch between noon and 12:30 so, that works for me AND, if I want to go out in the evenings, or have a function to attend on weekends etc., midnight/12:30 work so that I don't have to leave too early from events as I found out the hard way with a previous diabetic cat over a decade ago. I had a 7 a.m. and 7 p.m. schedule for shots. (We didn't home test in those days as the cost of a meter back then was astronomical and no one did it then) Now, things have changed in protocols and I do home test (don't get me started on how much that was a pain in the you know where and still is to some extent though much better now. I think I chipped my teeth from chattering them while shaking! :rolleyes:)

As for feeding...you can try various things to see what works for you and Bailey. None of us get it right the first try and it takes some working out. A lot of us are still fiddling with it all and watching numbers on home tests to see what works and what doesn't. It also depends upon our cats. :) They are going to be the biggest deciders of what works and what doesn't. In the meantime...keep your friend bring over those brownies and enjoy! :p
 
@MMM
I had to do a search but, I wanted you to read this because members in here helped me tremendously with it when I first came into this forum a total basket case.
I laughed until I couldn't sit up.

Letter From Kitty To You

May I add a second letter to this one?

Dear Mom:

I know you are a total wreck over me, putting me in my crate and taking me to the vet's then, make yourself sick while I'm in there, being fed, patted, talked to and fussed over by vet techs.
But, if you put down a cardboard box or a shopping bag, I'll gladly go into it and you'll have trouble getting me out of it again!

Mom, I am a cat. I like things MY way. I want to do as I please, not do what you want me to do or when you want me to do it. I do it when I want to and on my schedule, in between naps, pats, eating and playing.
I'm the equivalent of a spoiled brat child who gets their own way and I'm going to throw a temper tantrum when you try to change anything in my routine or like factor.

I am not human, Mom. I don't think the way that you do. Really!
I don't like change but, that doesn't mean that it's horrendous for me. I just like what I like and will protest as much as I can when I'm not getting what it is that I like or things done my way. I'm usually in control of what I do or don't do so, when I'm in the vet's office, I'm not in control the way I like to be. That's why I get so uppity over it all.
I don't hate you for taking me there. I just don't like not being in control like usual and I would rather be in my favourite spot, lounging around until I feel like I want to get up or have some attention. They pick me up when I don't want them to and I get ticked off at that.
But, once you bring me home again, I go back to my usual routines and am ok the moment my paws hit the familiar floor and I'm back in control again.

I get over things much more quickly than you do, Mom. You think too much. You think more than I do! You're more of a mess than I am while I'm in the vet's!
Yes, I refuse to eat sometimes when I'm in there but, that's because I am in control of that and I am asserting myself as cats do. You know that even at home, I have my fussy times. I do it to them too.

I know that the minute you put me into my crate, I'm usually going to the vet's and I will protest because I would rather be doing what I normally do in a day and where I usually do it all but, Mom...I also recognize that you are doing this for my own good...even if I behave like a little brat while you do it for me. I quickly forget it and am happy to be back home with you again, feeling much better because you loved me enough to do what you needed to do for me to allow me to be with you longer and feeling better. Thank you, Mom.

I know that I put you through a lot, Mom but, I am a cat. That's what cats do to their human moms and dads. Deep down inside, I know that you love me and I love you too. Just ignore my tirades and shenanigans and do what you need to do to help me feel better and stay with you. Just don't expect me to act like a human because I am going to continue being a cat, thinking like one and acting like all cats do.

Love you, Mom
Your spoiled Kitty Child
XO XO XO
 
She developed pancreatitis, her glucose went up and up as did the dose, she stopped eating, spent 5 days at the vet, I tried to feed her at home 1 day, and she died this morning.
I'm so sorry about Gracie cat_wings>o ...you are an amazing person for continuing to provide help here! She was a lucky furkid!
 
Thanks for the support, suggestions and "Letter from Kitty". :) It is much appreciated. I tried a little cooked chicken with the shot tonight. Obviously since it was the first time she still did the pull away, protest thing. She does catch on quick so I am hoping she will make the connection between this and "treat" soon. My vet wasn't at the clinic today (which makes sense, since he works Saturdays) and will call me tomorrow. I will hopefully get the truth about her curve (since I got two versions on Saturday) and will see about starting the monitoring. I hope I can do the "chicken treat" thing with that too. :) Again, thanks all.
 
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