New to forum... Introducing Oliver

Status
Not open for further replies.

Wendy and Oliver

Member Since 2012
Hi everyone...

I just joined the board tonight and wanted to introduce myself and share our story. There's a lot to tell so I hope you will bear with me. My sweet boy, Oliver was officially diagnosed in July. He will be 10 years old in November. 

Oliver has been through quite a lot in the last 14 months or so. Back in May of 2011 he started getting eruptions and scabs on his face and ears. It was determined that he had some kind of allergies and was given a prednisone injection. It wasn't long before he was back to scratching his face and ears until they bled so he was put on daily oral prednisolone. Some days were better than others, but even with the meds and special allergy diet he was never fully controlled. 

This went on for 11 months before he had a really bad outbreak and ended up back at the vets for another depo injection. When even that didn't seem to make him comfortable we ended up taking him to see dermatologist. The derm put him on Atopica. That is some powerful stuff.

The Atopica worked at knocking the itch out of him, but Oliver had become lethargic and wasn't eating as well. He was never a fan of any of the hypoallergenic foods anyway and had begun losing a little weight. After 2 1/2 weeks on the Atopica I could see that this was not the med for him. Unfortunately it was too late... Oliver had become less and less interested in his food or any food for that matter and was losing weight rapidly. I thought he might be associating it with the nausea from the meds. He went several days where he barely ate at all. I was hand feeding him at that point and trying to tempt him with table food. 

I should tell you that Oliver and his brother had always been fed dry food. I know... shame on me! But neither one of them would ever eat canned cat food or even people food for that matter. Occasionally they might show a little interest in tuna water, but other than that they were both kibble crack heads. And believe me it wasn't for lack of trying. Especially after Oliver developed food allergies. We tried canned food, raw food, wild game like venison, ostrich, buffalo, brush tail... you name it.

Eventually Oliver was eating a bit on his own again, but still not nearly enough. Then after practically starving himself to death, the previous kibble lover was now begging at the table and would eat grilled chicken if it was hand fed. We thought we were over the hump but Oliver continued to lose weight despite his increased appetite. Blood tests showed he was anemic, had elevated liver enzymes and had lost 4 lbs in 2 months. Down to only 6.5 lbs. Yikes! 

The vet put him on Denamarin and told us to feed him whatever he would eat. At that point it was more important to fatten him up and worry about the itching later. Follow up blood work showed his liver had improved, but he still hadn't gained any weight and his BG was 400. The vet told us that Oliver was a diabetic and would need to be put on insulin.

Unfortunately we were not able to start injections immediately. I am self-employed and my business requires me to travel frequently and sometimes for extended periods of time. The vet didn't want me starting insulin unless I would be home to monitor Oliver all the time. I was having my cat sitter come in twice a day but that wouldn't be enough. So we decided to start with a diet change and start the insulin when I got back from my next trip.

As expected, Oliver agreed to eat the dry m/d but refused the canned. He was eating a lot of poached chicken too. The cat sitter reported that he was eating and doing well while I was away. Two weeks later we took Oliver back in for a follow up with the vet. His liver is out of whack again, he hadn't gained any weight and his BG was 140 now so the vet says Oliver is not diabetic. What?! Then the vet wants me to get a urine sample and see if that can tell us any more before we try anything else.

So the next morning (a Saturday) I drop off a urine sample. Nobody calls me with the results before they close for the day. So I wait until Monday afternoon and still no phone call. I call the vet's office. I am told that our regular vet is not in until Tuesday but someone else can call me back if I don't want to wait. The vet who calls tells me Oliver is diabetic and has ketones. WTHeck!! She also tells me that she will have my regular vet call me the next day and explain things more fully. So not impressed!

Now I am in panic mode. I call my cat sitter and decide to switch vets to the vet she uses (and also where my cat sitter works part time.) The next morning I call when they open and am told I can bring Oliver right in. BG is 400 again, he has ketones (but low, thankfully), low potassium, and pancreatitis. They want me to start Oliver on insulin asap and feed him anything he will eat to get his weight back up. Definitely not what you want to hear when you are leaving on a 7 day trip the next day!

I tell the new vet I will not be home to monitor Oliver, but she assures me he will be fine. Thankfully my cat sitter has experience with diabetic cats. She comes over the next day and shows me how easy it is to give him  insulin. Then I have to drive away. Needless to say I was worried sick and felt ill all day until she texted me to say he was doing fine. Those may have been the longest 7 days of my life.

While I was away my sitter took Oliver in to work with her. He spent the day there getting IV fluids, etc. and his ketones were resolved. They prescribed omeprazole, potassium, mirtazipine, a couple of other short term meds and daily sub q fluids along with 1 unit of Lantus twice a day. Talk about high maintenance... I'm glad my cat sitter loves Oliver so much! And she finally got him to eat some wet cat food... a horrible carb laden one, but a wet food nonetheless.

Since then Oliver's BG has been all over the charts. After first starting on the Lantus he was getting numbers in the 500's and 600's. We've been inching his dose up every week or two depending on my at home schedule so that I could monitor him more closely.  Eventually by 3u we were seeing numbers between 229 - 435.

During this time he has also graduated from the wet junk food to something a little more acceptable. He is now eating Wellness Grain Free Cubed Chicken. While it is grain free, it does have peas in it so it's not totally low carb but at least it's progress. He loves it and is putting on weight again. He also still nibbles on the dry m/d. I've managed to pack 2.5 lbs back on him in the last two months. Yay!!! Now that he has an appetite again I am hoping to get him off the dry food and on to a lower carb wet food soon. So far though he has refused all the pate style foods I've tried including the Fancy Feast Classics.

Since his numbers were still high, on 9/2 his dose was increased from 3 to 3.5 and then we were seeing him holding pretty steady in the 300's. Or at least I thought so. With the vet's blessing my cat sitter did not check Oliver's BG for the 11 days I was away. Scary!!

I should mention that while this new vet encourages home testing and sucked me into buying the AlphaTRAK2 she doesn't believe it is necessary to check BG daily until the numbers start to come down. I find this rather disturbing. Would a diabetic human inject insulin without checking first? NO! Anyway... The morning after I returned from my last trip Oliver's BG was 321 so I fed him and gave him his injection. Thankfully it appeared he was no worse for wear and holding steady from when I last tracked him. 

The next day I decided a curve was in order. So very glad that I choose that day and that my cat sitter wasn't on duty... He was 64 at 7am. An all time low. He was perky, alert and behaving normally. I was astonished by the low number though and thought there might be a problem with my meter. So I ran a test with the control solution and it came out normal. Oliver had eaten a little wet food at that point so I tested him again. This time it was 88. No injection necessary of course. He ate more wet food and a little dry too. I tested him a few hours later and he was up to 300. He continued climbing throughout the day and was up to 555 before his evening injection. I had spoken to the vet earlier in the day and she told me to drop his evening injection back to 3 units.

The following day he was 261 for his am pre shot. Then 100 at 5 1/2 hrs post shot and 262 for his pm pre shot. Really great numbers for him.

The next morning he tested at 141. Based on the numbers from the day before I thought it best not to give him an injection or at least a reduced dose. I wasn't able to reach the vet within shooting time so I skipped the injection altogether. I considered going with a lower dose but didn't dare because I was going to be away from home all day. Later in the day I heard back from the vet and she said I could lower him to 2.5 for his pm injection. 

Now ever since I skipped that morning injection and put him on 2.5u Oliver's running high again in the 300's and 400's. :( I feel like we're starting all over again. I sure hope his numbers come down and he levels out soon. It's only been two days so I suppose I need to be patient.

His pancreatitis must be resolving though. Despite his whacky numbers over the last few days he has been back to his old playful self this week... racing around the house putting on kitty rodeos with his brother. He still gets omeprazole and potassium every day. I had been giving daily subq fluids for a few weeks, then every other day for a couple weeks and now have tapered them off entirely. He is drinking a lot less and there are smaller and a lot fewer wet spots in the litter box too. Up to 9 lbs today! :)

Thank you for listening if you managed to make it all the way through my long winded post. This whole experience has been overwhelming but it is getting a little better and I think we are making progress. It is such a relief to find this board where others are going through the same thing and can share their knowledge. For the most part I am happy with our new vet, but I can see already that the information shared here will be invaluable. And the next time Oliver's numbers drop into my non-comfort zone I will look forward to your input.

Purrs to all your sugar babies, 
Wendy and Oliver
 
Hi Wendy! whew! long post! but what I did get out of it is you love Oliver and we can work out the rest bit by bit.

I don't use your insulin but you are jumping all over the place and you need to go to the Lantus group and have them help you work on your dosage. Lantus is very precise for it to work. That is why you are seeing all the bouncing.

As long as he eats dry food his numbers will not come down much, we call it crack for cats. I understand that he likes it but it is really bad for him being diabetic especially. Some cats have a hard time but there is much written here to help you switch him over.

Since he has had ketones you need to get some ketostix to check him urine, the LAST thing you want to deal with is DKA! I know ....

I am on the west coast so I am still up, many will answer tomorrow with lots of good advice. The lantus group is great and I would go there and introduce myself. You are doing good, it is a steep learning curve.
Nancy
 
Good work on the diet changes. It can take a while and you are making progress. Hang in there. For tips on transitioning to an all wet, low carb diet, check out Cat Info, written by a vet.

Lantus facts:
Lantus is a depot insulin; it builds up in the system to maintain a somewhat steady level if shots of the same amount are given every 12 hours.

You never adjust the dose based on the pre-shot test; you only decide if it is safe to shoot.

You adjust the dose based on the nadir, the lowest point between shots. This is usually around 6 hours after the shot (ie +6). The only way to find those values is by testing around that time, or by doing a curve where you test every 2 hours after giving insulin, until the next shot.

If the glucose level is less than 200 and you have not collected much data about how your cat reacts, we advise you not give the insulin. This is for safety; once the insulin is in, you can't get it out.
 
Welcome the two of you!

Lantus is a very good insulin and is based on the nadir (mid-cycle) number rather than the pre-shot number. It sounds like your dose might be a little high to begin with and is causing rebounds- which gets you too low to shoot pre-shots. Granted, with Ollie eating dry food that really shoots up his levels and most people dose to that if they don't understand how lantus works. It needs to be kept at the same dose 12 hours apart so a reduction may be in order- no WILL be in order- once the dry kibble is out.

While you are home testing (NEVER STOP!!!) you do have an alpha-track and the strips are very expensive. Getting a regular human meter that has cheaper strips might be a good step so you can test more frequently. Relion meters are good (Wal-Mart) and have the cheapest strips, and the Bayer Contour and Accu-check Avviva are also good and you can get cheaper strips on ebay than in the store. In the past the not so good ones were the generic brand with True in the name and the Freestyle Light meter with the butterfly strips- both of these had difficulty with bg's higher than 300. No one has recently bought and tried them to see if the technology has improved so they are still iffy ones. They will read 20-30 points below the alpha but that is okay as our advice is based on those lower numbers.

You are changing the food and that is great! There are some die-hard kibble fans sprinkled around the board and they will offer suggestions.

Because of the ketones you might want to buy some ketostixs and get a sample at least once a day. If you decide to drop the dose once the dry is gone you will need to keep an eye on those things. DKA is expensive to treat. The last DCIN kitty with ketones was $4000-$5000 to treat.

Heather
 
Thank you for the warm welcome and great advice everyone. I especially appreciate the explanation on nadir. My vet neglected to stress that point. That certianly puts a new spin on things! I will definitely have to keep a better eye on those mid cycle numbers now.

Where does one buy ketostix? And is there a primer someone on how to use them?

One bit of good has come out of all this. Oliver's brother, Simon, has never, ever agreed to eat anything other than dry food. But I guess seeing Oliver getting all this extra "attention" and a wide variety of foods lately was finally too much for him. Guess who just started eating from Oliver's plate? Simon is eating wet food this morning. Yay!! Maybe there is hope for them both after all. Of course, Oliver doesn't look too impressed by this latest development. ;-) Time for two plates of wet food!

Wendy
 
Well, that is great news in the household! Soon to be one feeding style for both of them. Envy is a great motivator in cats :lol:

Keto sticks- come in a little bottle, 50 for $6-9. When you notice Oliver going to the litter box follow him and stick the stick into the stream. Depending on the kind you get you count 15 seconds and see if the little square has changed color- and compare it to the colors on the bottle. Easy, peasy.

My cat threw ketones for months, just low level ones- trace to small. The only time she got into moderate was when she got stressed going to the vet or I did a fur shot. Some cats never show ketones at all. DKA is precipitated by 3 major things- 1- not enough insulin, 2- not eating enough, 3- infection.
 
Tips on the urine testing are in my signature link on supplemental monitoring techniques. It may not work to put the strip in the cat's urine stream while going!
 
Status
Not open for further replies.
Back
Top