Newly Diagnosed, Hospitalized (& Freaking Out)

Hi, So my cat's been diagnosed diabetic as of Jan 28 and has had low-grade gastro-intestinal cancer since Oct/Nov last year. Probably steroid-induced (depo-medrol) - also on chlorambucil. She was extremely lethargic last night so I brought her to the ER and had her hospitalized when her sugar came back at around 600. When diagnosed, she was over 400 and has been on 1, then 2 units of Lantus twice a day for the last two weeks. So far 3 units of Lantus still has her at 500 and they're trying "regular" insulin this afternoon. I'll get another update tomorrow.

Any advice from anyone who's had to deal with diabetes on top of cancer would be appreciated! I just found this site and have yet to scan the threads.

 

Hi. First of all Take a deep breathe.

Sorry you are going through this.
I just had my diabetic boy that had cancer last month too.
He had large cell lymphoma of the kidney.
I heard gastro is better than the rest.
My advice is get some CBD oil for pets as it is supposed to help with appetite and nausea.
The steroid shots will raise the bg. Since you got all the diagnosis together knowing the right dose will be hard. If you are able to monitor during each cycle then I would change dose after 3 days(6 cycles) till you get in at least 200s for midcycle lows.
Lantus is a depot insulin so it takes at least a few days to fill that depot & see what the dose does.
With the cancer you may need to have appy stim on hand...I think cyproheptidine works the best. Famotidine for upset belly, and ondansetron or cerenia for nausea.
And if pills are hard then get these meds compounded into liquid. Roadrunner is good as you can get a 6month supply for sometimes the same price as 30day supply.
Wedgewood is good and another on Houston Tx.
If your in US, that is.
You can also post in the Lantus forum for quicker response.
I will tag a few people I know that are experienced.
@Chris & China
@Barbara & Uncle (GA)
@Wendy&Neko
@Squeaky and KT (GA)
Ok thats all I remember.
I would also look up pet cancer fb groups. I am in some & they were helpful too.
Also in the lantus forum there are 'stickies' you can read that tell you how lantus works.

Hope your kitty is better as I type.
Hugs!

 

My girl had diabetes and later small cell lymphoma (GI lymphoma). I would suggest seeing an internal medicine vet, if you can. They are good at helping you manage multiple conditions. For small cell, your kitty should be on prednisolone pills, not the shots. And since diabetic, you might want to try budesonide instead. It is also a steroid but more localized to the gut and less likely to impact blood sugar.

Don’t give an appetite stimulant unless you are addressing nausea first.

For more help it’s best to post on the Feline Health forum.

 

Ugh. I’m so mad at myself. The Internal Medicine doctor who did her biopsy prescribed prednisolone pills, but when I went back to her normal General Practitioner (same animal hospital) I asked if anything could be given as a shot since she hates taking pills. That’s the cause of the switch.

So as of this morning she’s still in the 400s. May have to stay another night and they don’t release patients on Sunday, so Monday pick up. I had made an appointment (before she wound up hospitalized) with the oncologist for Tuesday to see if he had any ideas, now I wonder what to do. She’d hate me taking her back again the next day. Should I see the oncologist or try to get the Internal Med guy again???

I feel like in trying to make her better I still made mistakes and made her worse.

Her GP is the attending physician while she’s hospitalized. Do I try to get the IM doctor to see her (probably too late) or is that throwing too much into the mix at the same time?

 

Dont be mad at yourself. The lymphoma is first then diabetes. The insulin can be adjusted to cover any steroid needed.
We had shots for my boy but it was kidney (renal, large cell) lymphoma. It was called dexamethasone. Its stronger than the pred.

I would go to the oncologist as they are the specialist to the cancer. He/she will be able to make a good plan for your kitty. Oncologist appts are hard to get so keep it.
Think about how much your willing to spend. They will as if you want chemo which is expensive & can be alot to do. Ask about peoples experiences with chemo on main forum & think about the options ahead of time so your not overwhelmed at the appt.

Update us when ya hear how kitty is doing.
hugs

 

Oh, she’s been on chemo since the start of all this. Chlorambucil (3x a week with the steroids). She was fine initially until the diabetes complications started getting her down. I wish I spotted it sooner. I rationalized, well, yes, of course she’s slowing down - she’s older and on chemo. Ugh.

 

ok. sorry forgot it was steroid induced. Well steroids wont stop so the insulin dose will just be adjusted and you keep testing. Once you get a better dose just keep him in safe bgs. 100-250bg is best.
If he gets through chemo and goes to remission then the diabetes may get better. The dose will always need to be adjusted. Monitor bg.
Dont stress over the past. Concentrate on what you can do now.
What vet put him on chemo? the internist?
I would go to oncologist to make sure on the right track.
How is kittys bgs today?
Have them give you copies of all tests and bgs too.

 

An internal medicine vet may be better than the oncologist for small cell lymphoma, that’s who handled Neko’s SCL and the other conditions she also had. He consulted an oncologist when needed, which I think was once. The oncologist won’t do anything for the diabetes. Steroid shots can have a peak then wear off. You kitties blood sugar numbers may improve after 7-10 days.

You can get prednisolone compounded into chew treats. My girl loves her chicken pred chews, looks forward to those treats.

And I repeat, best to post over on the Feline Health forum. This one is just for introductions.

 

I would discuss with Esperanza's internist or oncologist of changing the chlorambucil dosing to a larger dose every two weeks vice the smaller dose three times a week. See:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092124/