Hi, all.
This is my first post, so I hope I'm doing it right...
My cat, Pippin, is a 7 year old neutered male tuxedo cat. On Oct 31 this year, he was diagnosed with diabetes and pancreatitis. He spent two days in the hospital - fortunately he never became ketoacidotic and they were able to get his blood sugars under control pretty quickly.
We were doing well for a while on 2 units of Lantus twice daily, and then we brought him to our vet for a glucose curve. He failed that miserably, so we upped his dose to 3 units twice daily on 11/15. He had been doing okay on that, and then I dropped the Lantus pretty hard, and it seemed to stop working. I'm a nurse, so I like to think I know how to handle insulins - I didn't think it'd make that big of a difference but his sugars started improving when we switched to a new vial.
He had an overnight stay on 11/18 - his appetite was very poor and he was dehydrated. With an appetite stimulant and overnight IV fluids, he's improved. However....
One of the issues we had prior to all this was that he had diarrhea for a couple weeks. It remained uncontrolled until after the second hospitalization, when we switched him to W/D. Since then, his diarrhea has been gone. However, Pippin continues to lose weight. Prior to his first hospitalization, he was 19 lbs. This was down from 21, and it's that weight loss and some lethargy and not acting right that caused us to bring him to the emergency vet in the first place when we got him diagnosed. Pippin is now 16-16.5 lbs.
I feel like I'm probably doing everything wrong, here. His blood sugars aren't yet well-regulated - we did a fructosamine level last week and it was in the 500s, but the vet wanted to wait and watch him on the 3 units bid. He's losing weight. I don't know what I should be feeding him or when, any more. We have to give the insulin at noon and midnight, because my husband's schedule varies daily and I work evenings. But then we feed him (and his three kitty siblings) four small meals a day - one around 7-9 AM, one at noon before I go to work, one at 7-8 PM when the husband gets home and then one at midnight.
Over the past day, his appetite has been off. He wasn't that into breakfast (which was the W/D we had him on), but then we tried DM at lunch. He ate that really well, then ate well again at the 7 PM feeding. The midnight feeding, he didn't want the DM. He ate a bunch of what the other cats eat, which is Tiki Cat or a Weruva canned food. I am at a loss, and I don't know if he's just being finicky now (which he never used to be) or if something's wrong. He's active, he played with me today, he's urinating, he's drinking.... His coat looks good. His blood sugars were 277 at 9 AM and then 364 at 6:30 PM. Those were both before that particular meal, with insulin at noon and then midnight tonight.
In terms of diagnostics, when he was first diagnosed, they did an abdominal ultrasound, and they found his pancreas was inflammed, but no thickening of the gut wall or anything suggestive of lymphoma. His kidneys were hyperechoic, and although they didn't find bacteria in his urine, we treated him for a presumptive UTI. The second hospitalization, they did a chest x-ray just to make sure there was nothing suggestive of cancer there - it was clean. We've done a TLI, and it came back normal (that was around the second hospitalization).
Tomorrow is weighing day, and I'm terrified he'll have lost more weight.
I am completely overwhelmed and I don't know what to do to make him better. I don't know when I should worry and when I shouldn't. I've talked to my vet, and he's really fantastic, calls back immediately - we were assuming this latest appetite weirdness was because he had gotten sick of the W/D. I can't stop crying because I'm so worried that I'm going to lose Pippin. Logically, I think that he's doing okay, since he's active, playing, doing all the things that he wasn't doing when he was first diagnosed. But then there are the little things, like his sudden pickiness over food, and the weight loss... I'm sick with worry.
Do I just need to be patient and accept this is a chronic illness, and that there are going to be good days and bad days? I just want him to be better.
I'm so sorry to make my first post such a giant info-dump and freak out, but I don't know where else to go. Please be kind in your replies, and thank you so much in advance for any support or suggestions you can offer.
This is my first post, so I hope I'm doing it right...
My cat, Pippin, is a 7 year old neutered male tuxedo cat. On Oct 31 this year, he was diagnosed with diabetes and pancreatitis. He spent two days in the hospital - fortunately he never became ketoacidotic and they were able to get his blood sugars under control pretty quickly.
We were doing well for a while on 2 units of Lantus twice daily, and then we brought him to our vet for a glucose curve. He failed that miserably, so we upped his dose to 3 units twice daily on 11/15. He had been doing okay on that, and then I dropped the Lantus pretty hard, and it seemed to stop working. I'm a nurse, so I like to think I know how to handle insulins - I didn't think it'd make that big of a difference but his sugars started improving when we switched to a new vial.
He had an overnight stay on 11/18 - his appetite was very poor and he was dehydrated. With an appetite stimulant and overnight IV fluids, he's improved. However....
One of the issues we had prior to all this was that he had diarrhea for a couple weeks. It remained uncontrolled until after the second hospitalization, when we switched him to W/D. Since then, his diarrhea has been gone. However, Pippin continues to lose weight. Prior to his first hospitalization, he was 19 lbs. This was down from 21, and it's that weight loss and some lethargy and not acting right that caused us to bring him to the emergency vet in the first place when we got him diagnosed. Pippin is now 16-16.5 lbs.
I feel like I'm probably doing everything wrong, here. His blood sugars aren't yet well-regulated - we did a fructosamine level last week and it was in the 500s, but the vet wanted to wait and watch him on the 3 units bid. He's losing weight. I don't know what I should be feeding him or when, any more. We have to give the insulin at noon and midnight, because my husband's schedule varies daily and I work evenings. But then we feed him (and his three kitty siblings) four small meals a day - one around 7-9 AM, one at noon before I go to work, one at 7-8 PM when the husband gets home and then one at midnight.
Over the past day, his appetite has been off. He wasn't that into breakfast (which was the W/D we had him on), but then we tried DM at lunch. He ate that really well, then ate well again at the 7 PM feeding. The midnight feeding, he didn't want the DM. He ate a bunch of what the other cats eat, which is Tiki Cat or a Weruva canned food. I am at a loss, and I don't know if he's just being finicky now (which he never used to be) or if something's wrong. He's active, he played with me today, he's urinating, he's drinking.... His coat looks good. His blood sugars were 277 at 9 AM and then 364 at 6:30 PM. Those were both before that particular meal, with insulin at noon and then midnight tonight.
In terms of diagnostics, when he was first diagnosed, they did an abdominal ultrasound, and they found his pancreas was inflammed, but no thickening of the gut wall or anything suggestive of lymphoma. His kidneys were hyperechoic, and although they didn't find bacteria in his urine, we treated him for a presumptive UTI. The second hospitalization, they did a chest x-ray just to make sure there was nothing suggestive of cancer there - it was clean. We've done a TLI, and it came back normal (that was around the second hospitalization).
Tomorrow is weighing day, and I'm terrified he'll have lost more weight.

Do I just need to be patient and accept this is a chronic illness, and that there are going to be good days and bad days? I just want him to be better.

I'm so sorry to make my first post such a giant info-dump and freak out, but I don't know where else to go. Please be kind in your replies, and thank you so much in advance for any support or suggestions you can offer.