Overwhelmed and have questions

[Rardito]

I originally had posted this in my thread about neuropathy on the main forum, but I decided to make it it's own post and post it on this board.

So I've been on the forums a lot today, just exploring and trying to learn as much as I can. However... it got me thinking that Mitsy might have something else wrong with her. I was reading the acromelagy and cushing's forums and I can't help but think it sounds like her. The pot belly, the hair loss around her stomach, the muscle wasting... she has had one pupil that is slightly bigger than the other one for a few years and the vet had thought she may have a brain tumor but said it would be $2000 and an out of county trip to diagnose. That was in June of 2016 when she had been peeing outside of the litterbox. She was otherwise acting fine. A couple months later she stopped peeing outside of the box and all was normal again. (note that they did not do bloodwork at that time because she had just had her senior bloodwork in March of that year)

Well the peeing outside of the litterbox started this year again (in June again) which is what ultimately led to the diabetes diagnosis. However this time she had hair loss and muscle wasting and was acting disoriented constantly. They thought her hair loss and peeing were behavior issues. But now I'm wondering if she actually has one of these other diseases. She is still peeing outside of the box and still acts disoriented a lot of the time, and also leans to one side a lot.

I thought she would start to show some improvement by now (I mean just a little, I know she only started insulin 7/16). At least with the disorientation. I came home today to a flood of urine on the laminate floor again. She had used the litterbox a couple of days and now is back to the floor as of overnight last night. She doesn't groom anymore and walks in her puddles.

I don't know if I'm just being crazy or what. This is all so overwhelming. I just want to make sure she has been properly diagnosed...I don't have much confidence in the vet's office at this point. (I even emailed them for her labs two days ago and still haven't even gotten a reply.)

I'm adding a picture of her leaning that I am talking about. And this was over 9 hours after her insulin so she wasn't low or anything. And also adding pictures of what I assumed was neuropathy - but who knows after reading this forum (not the vets apparently).

Thank you in advance for offering any thoughts on this!

 

[Sharon14]

The leaning and disorientation would lead me to think about vestibular problems. Either an inner ear infection, or possible tumor. The test your vet is referring to is probably an MRI.
My cat had Acro, and I don’t remember hearing of disorientation or leaning being a symptom, but I don’t know anything about Cushing. Is she circling at all? Has your vet run bloodwork or checked Mitsy’s ears preferably with a scope?

 

[Marshmallow's Mom]

Oh my. I'm so sorry. There is a lot I see in her overall condition that reminds me of Marvin. She looks a bit more advanced in muscle loss than Marvin. I would agree, there is something else going on but I'm really new to this, diagnoses June 1, so please take what I say with a grain of salt. There are people here who have dealing with this and have much more knowledge.

I'm also starting to think that Marvin has something else going on. He has many of the Cushing's symptoms. I have an appointment to take him in on Thursday.

Marvin doesn't have the peeing issue right now, but there has been times this spring where he peed in my bedroom. I think it was he didn't want to go down 2 flights of stairs to the litterbox so I added one to my bedroom (not ideal, but better than waking up to pee on the bed). That solved the issue.

But with Misty peeing right outside of the litterbox - isn't that a symptom of UTI? I wonder if it hurts her to climb into the litterbox. Does it have tall sides? You've probably thought of this, but did you do a recent litter change?

One bright spot is that it seems you have pretty good numbers, looking at her spreadsheet.

I'll post back with what I find with the vet. I hope there is an easy test for Cushing's and/or they recognize what this "else" is going on.

 

[Rardito]

The leaning and disorientation would lead me to think about vestibular problems. Either an inner ear infection, or possible tumor. The test your vet is referring to is probably an MRI.
My cat had Acro, and I don’t remember hearing of disorientation or leaning being a symptom, but I don’t know anything about Cushing. Is she circling at all? Has your vet run bloodwork or checked Mitsy’s ears preferably with a scope?

Thanks for the response. I don't believe he really looked in her ears this last time. She isn't circling, she only leans when she sits like that. When she walks she's a little shaky and sometimes slinks closer to the ground but doesn't lean. She did get bloodwork this month when they diagnosed her with diabetes. I actually posted her labs in the main forum a little bit ago because I just received them today.

 

[Ana & Frosty (GA)]

I originally had posted this in my thread about neuropathy on the main forum, but I decided to make it it's own post and post it on this board.

So I've been on the forums a lot today, just exploring and trying to learn as much as I can. However... it got me thinking that Mitsy might have something else wrong with her. I was reading the acromelagy and cushing's forums and I can't help but think it sounds like her. The pot belly, the hair loss around her stomach, the muscle wasting... she has had one pupil that is slightly bigger than the other one for a few years and the vet had thought she may have a brain tumor but said it would be $2000 and an out of county trip to diagnose. That was in June of 2016 when she had been peeing outside of the litterbox. She was otherwise acting fine. A couple months later she stopped peeing outside of the box and all was normal again. (note that they did not do bloodwork at that time because she had just had her senior bloodwork in March of that year)

Well the peeing outside of the litterbox started this year again (in June again) which is what ultimately led to the diabetes diagnosis. However this time she had hair loss and muscle wasting and was acting disoriented constantly. They thought her hair loss and peeing were behavior issues. But now I'm wondering if she actually has one of these other diseases. She is still peeing outside of the box and still acts disoriented a lot of the time, and also leans to one side a lot.

I thought she would start to show some improvement by now (I mean just a little, I know she only started insulin 7/16). At least with the disorientation. I came home today to a flood of urine on the laminate floor again. She had used the litterbox a couple of days and now is back to the floor as of overnight last night. She doesn't groom anymore and walks in her puddles.

I don't know if I'm just being crazy or what. This is all so overwhelming. I just want to make sure she has been properly diagnosed...I don't have much confidence in the vet's office at this point. (I even emailed them for her labs two days ago and still haven't even gotten a reply.)

I'm adding a picture of her leaning that I am talking about. And this was over 9 hours after her insulin so she wasn't low or anything. And also adding pictures of what I assumed was neuropathy - but who knows after reading this forum (not the vets apparently).View attachment 37870 View attachment 37871 View attachment 37872

Thank you in advance for offering any thoughts on this!

So based on the pictures, I am 99% sure the kitty has Cushing's. She has the exact same patchy hair pattern as Frosty, and same big belly. The leaning of head to the side and disorientation sounds neurologic though - could still be caused by a pituitary tumor if it's large enough (which is what causes Cushing's), or could be something else. The "neuropathy" could actually be just weakness from muscle wasting. Poor baby!!

I would definitely consider a Cushing's work-up. I personally would recommend going to an Internal Medicine vet instead of a regular vet - they are a LOT more familiar with Cushing's, neuropathy, diabetes, and all kinds of other diseases, and I think they might be able to help. That's where Frosty goes now.

Hugs to you and your little baby

 

[Rardito]

Oh my. I'm so sorry. There is a lot I see in her overall condition that reminds me of Marvin. She looks a bit more advanced in muscle loss than Marvin. I would agree, there is something else going on but I'm really new to this, diagnoses June 1, so please take what I say with a grain of salt. There are people here who have dealing with this and have much more knowledge.

I'm also starting to think that Marvin has something else going on. He has many of the Cushing's symptoms. I have an appointment to take him in on Thursday.

Marvin doesn't have the peeing issue right now, but there has been times this spring where he peed in my bedroom. I think it was he didn't want to go down 2 flights of stairs to the litterbox so I added one to my bedroom (not ideal, but better than waking up to pee on the bed). That solved the issue.

But with Misty peeing right outside of the litterbox - isn't that a symptom of UTI? I wonder if it hurts her to climb into the litterbox. Does it have tall sides? You've probably thought of this, but did you do a recent litter change?

One bright spot is that it seems you have pretty good numbers, looking at her spreadsheet.

I'll post back with what I find with the vet. I hope there is an easy test for Cushing's and/or they recognize what this "else" is going on.

I actually switched to senior litterboxes when this started happening in case it was arthritis. But it didn't help unfortunately. That was right before she was diagnosed with diabetes.

I forgot to add that she started digging around her water dish when the peeing started happening too.

Good luck with your kitty, I hope everything goes well at the vet!

 

[Rardito]

So based on the pictures, I am 99% sure the kitty has Cushing's. She has the exact same patchy hair pattern as Frosty, and same big belly. The leaning of head to the side and disorientation sounds neurologic though - could still be caused by a pituitary tumor if it's large enough (which is what causes Cushing's), or could be something else. The "neuropathy" could actually be just weakness from muscle wasting. Poor baby!!

I would definitely consider a Cushing's work-up. I personally would recommend going to an Internal Medicine vet instead of a regular vet - they are a LOT more familiar with Cushing's, neuropathy, diabetes, and all kinds of other diseases, and I think they might be able to help. That's where Frosty goes now.

Hugs to you and your little baby

I'll have to look into that. Thank you so much!

 

[Rardito]

http://www.felinediabetes.com/FDMB/threads/lab-readers-i-finally-got-mitsys-labs.200415/

That is the link to the post with her labs.

 

[Rardito]

I emailed her vet today with my suspicions and they said they can test her for cushing's, so I'll be making that appointment shortly. Then depending on the results I'll have to decide what's best for little Mitsy

 

[Ana & Frosty (GA)]

I emailed her vet today with my suspicions and they said they can test her for cushing's, so I'll be making that appointment shortly. Then depending on the results I'll have to decide what's best for little Mitsy

Understandable. Qualify of life is important. However, read over my posts about Frosty and Vetoryl - he has actually been doing very well and many symptoms of cushungs symptoms resolved or significantly improved! When I took off his clothes to change them yesterday, he looked like a normal cat! His muscle wasting around spine and legs resolved, and he sort of grew into his belly - he almost looks chunky-ish! His fur also looks so much better - you can actually see the pattern now - before it was patchy and thin. It may be worth a try. Please keep us posted on the results.

 

[Rardito]

Understandable. Qualify of life is important. However, read over my posts about Frosty and Vetoryl - he has actually been doing very well and many symptoms of cushungs symptoms resolved or significantly improved! When I took off his clothes to change them yesterday, he looked like a normal cat! His muscle wasting around spine and legs resolved, and he sort of grew into his belly - he almost looks chunky-ish! His fur also looks so much better - you can actually see the pattern now - before it was patchy and thin. It may be worth a try. Please keep us posted on the results.

I'm going to hope that I can afford it, unfortunately I'm living paycheck to paycheck. But she's only 9 so I want to do everything I can for her.

Did they give you a life expectancy for cushing's with the medication treatment?

 

[Ana & Frosty (GA)]

I'm going to hope that I can afford it, unfortunately I'm living paycheck to paycheck. But she's only 9 so I want to do everything I can for her.

Did they give you a life expectancy for cushing's with the medication treatment?

So online it’s much cheaper thank the vet’s office. Depending on the dose and frequency per day, a box online is 40-50$ which is 30 pills. At the vet one box was $100. Crazy difference. I know that may be a lot, but it’s actuallt cheaper than insulin and if all goes well maybe she can come off insulin? I know it’s jumping way ahead of everything, but @Wendy&Neko just posted an article in one of my posts about a case study of a cat coming off insulin after a year of treatment.

Prognosis is unknown. I was told fair, whatever that means . Because of skin tears that frosty had my vet said prognosis is always worse. No time frame is available really. In studies I’ve read, some cats did well for up to 1.5 years that they were followed. Some cats developed severe neurological symptoms from the tumor getting too big which is my big fear in the future. But since the medication is mean for dogs, we are all case studies at this point.

The other concern with your baby of course is the neurological part - what is causing the head leaning. If the pituitary tumor becomes large it could cause neurological symptoms. Or could be something else. Could be just muscle weakness of the neck even since his weakness in the legs is so severe. I don’t know for sure if it could be reversed but there may be hope. Either way I definitely understand it’s a difficult decision, and you also can’t become homeless while taking care of your cat either.

Let’s wait and see what the results are. Get their opinion about the head leaning also. If they think whatever this is is treatable and Vetoryl might help, you could start a Go Fund Me page where family and friends (or even strangers) online could donate to help with the medication expenses.

Fingers crossed for u and ur baby

 

[Ana & Frosty (GA)]

As a side note, dogs can live for years on Vetoryl treatment. Someone on here said her dog lived 5 years on the treatment. The dog was like 5-6 at diagnosis and made it all the way to 10- 11. Not too bad for a dog I think. I WISH for 5 more years for Frosty, but I don’t know what’s gonna happen. He’s the same age as your kitty, it sucks this disease affects cats in their middle age, when they could potentially still have like another 10 years. I think the reason Frosty lost his home was bc of his diabetes and insatiable hunger which is caused by Cushing’s. Thy probably couldn’t handle it and dropped him off in Central Park. Breaks my heart. He is declawed too, they just left him there to fend for himself. Whatever happens I know I gave him a good life for these last 7 months. We just try to celebrate every day that he’s doing well.

 

[Rardito]

That is a relief about the medication price at least. I do think the tumor is causing neurological issues (she has uneven sized pupils). But I will get her the test and see what is says. I will update this thread when I know more.

Much appreciation to you for sharing your experience! I hope Frosty does well!

 

[Rardito]

As a side note, dogs can live for years on Vetoryl treatment. Someone on here said her dog lived 5 years on the treatment. The dog was like 5-6 at diagnosis and made it all the way to 10- 11. Not too bad for a dog I think. I WISH for 5 more years for Frosty, but I don’t know what’s gonna happen. He’s the same age as your kitty, it sucks this disease affects cats in their middle age, when they could potentially still have like another 10 years. I think the reason Frosty lost his home was bc of his diabetes and insatiable hunger which is caused by Cushing’s. Thy probably couldn’t handle it and dropped him off in Central Park. Breaks my heart. He is declawed too, they just let him there to fend for himself. Whatever happens I know I gave him a good license for these last 7 months. We just try to celebrate every day that he’s doing well.

Oh my goodness, he's so lucky to have you! I can't believe people would do that.
I found Mitsy on my doorstep when she was a kitten. She had a severe upper respiratory infection and I got her medicine and she's been with me ever since.

 

[Rardito]

I just spoke to the vet's office and I'm dropping her off at 9am tomorrow for testing. I'm not sure how long it takes to get the results, but I'll update this thread when I get them.

 

[Ana & Frosty (GA)]

I just spoke to the vet's office and I'm dropping her off at 9am tomorrow for testing. I'm not sure how long it takes to get the results, but I'll update this thread when I get them.

Might take a couple of days, depending on where they send it out, etc. I’ll be checking this forum regularly since it seems email notifications aren’t working

 

[Rardito]

Oh my. I'm so sorry. There is a lot I see in her overall condition that reminds me of Marvin. She looks a bit more advanced in muscle loss than Marvin. I would agree, there is something else going on but I'm really new to this, diagnoses June 1, so please take what I say with a grain of salt. There are people here who have dealing with this and have much more knowledge.

I'm also starting to think that Marvin has something else going on. He has many of the Cushing's symptoms. I have an appointment to take him in on Thursday.

Marvin doesn't have the peeing issue right now, but there has been times this spring where he peed in my bedroom. I think it was he didn't want to go down 2 flights of stairs to the litterbox so I added one to my bedroom (not ideal, but better than waking up to pee on the bed). That solved the issue.

But with Misty peeing right outside of the litterbox - isn't that a symptom of UTI? I wonder if it hurts her to climb into the litterbox. Does it have tall sides? You've probably thought of this, but did you do a recent litter change?

One bright spot is that it seems you have pretty good numbers, looking at her spreadsheet.

I'll post back with what I find with the vet. I hope there is an easy test for Cushing's and/or they recognize what this "else" is going on.

Did you take Marvin today? I hope he did well! I'll be picking Mitsy up from her testing in a few hours.

 

[Rardito]

Update: Mitsy is home from her testing. They told me to call after 11am tomorrow to see if the results are in.

Her PMPS is 191... how is it lower after a full day at the vet's? She must not mind being there

 

[Ana & Frosty (GA)]

Did you take Marvin today? I hope he did well! I'll be picking Mitsy up from her testing in a few hours.

Frosty has awful anxiety issues that make him pee. He still has them despite the Vetoryl unfortunately. He pees and hollers AS SOON as he gets in the car. And if we close the door to the kitchen, he freaks out and pees on the dining room table (on top of all of our stuff). I spoke to Dr. McCue from Animal medical center tonight about possible surgery, and he said these personality changes may not go away with medication, but usually go away with surgery. (I’ll make a post about surgery for Cushing’s this weekend with mor details)

It sounds to me though that your kitties have more of a muscle weakness problem than anxiety. I think frosty has “steroid induced psychosis” - not an official diagnosis in cats from what I know, but it’s a real thing in people with Cushing. Doesn’t happen to everyone but can happen to some. He’s unlike any cat I’ve every seen behavior-wise.

But anyway, I can definitely commiserate with the inappropriate peeing issue

 

[Rardito]

Frosty has awful anxiety issues that make him pee. He still has them despite the Vetoryl unfortunately. He pees and hollers AS SOON as he gets in the car. And if we close the door to the kitchen, he freaks out and pees on the dining room table (on top of all of our stuff). I spoke to Dr. McCue from Animal medical center tonight about possible surgery, and he said these personality changes may not go away with medication, but usually go away with surgery. (I’ll make a post about surgery for Cushing’s this weekend with mor details)

It sounds to me though that your kitties have more of a muscle weakness problem than anxiety. I think frosty has “steroid induced psychosis” - not an official diagnosis in cats from what I know, but it’s a real thing in people with Cushing. Doesn’t happen to everyone but can happen to some. He’s unlike any cat I’ve every seen behavior-wise.

But anyway, I can definitely commiserate with the inappropriate peeing issue

I'll be looking forward to that post!

Yeah, Mitsy peed on the floor next to the litterbox for two months in 2016 then just stopped one day. Then exactly 2 years later started again. I really think (because of her uneven pupils) that she has a tumor, so maybe she's forgetting how to do it or something. She seems to forget a lot lately. Or she's just trying to tell me that she still feels terrible

 

[Marshmallow's Mom]

Hello,

I'm sorry I haven't updated for a while. I took Marvin to the vet last week and they didn't seem too concerned about the 'non response' to the insulin. They said it can go as high as 1 unit per pound of cat, although they hope it is much less. So, I'm continuing on. I've decided to do 0.5 unit changes every 6 days. This is the best compromise between what my vets are telling me and what I would like to do and what I'm hearing on this site.

At any rate, about the Cushing's, the vet didn't think that was the issue. However, Marvin also has a dilated pupil (glaucoma, has pressure) since I adopted him. In recent years it seems to have gotten worse. Glaucoma can be very painful. Back in December, Marvin was given Timolol drops. But I thought it was these drops that was giving him diarrhea so I stopped. I tried them a couple of times and thought they were connected to his horrible bout of the trots, but there were a lot of things going on for him then and I can't be sure. So I have tried them again as of last night. It is almost immediate effect - he seems calmer and less freaked/irritated.

The vet thought the eye might be inflamed due to toxmoplatosis. Which she gave me 5 syringes of an oral suspension called Ponazuril/Marquis paste. She thought that could also me an issue with high BG numbers. So we went through the course of the Ponazuril/Marquis paste and no changes.

So that's where we are. Stepped up to 4.5 units of Prozinc this morning. Ordered another vial from Chewy today as well.

Who knows what the deal is with this cat. I guess I'll just take care of him best I can and hope for the best.

I'm still a bit suspect on the Cushing's, but we'll see. One thing that is interesting is that Marvin's cholesterol went from normal to very high (with no diet change) between pre dx and post dx for diabetis. One thing I have read is that cholesterol is a measure used for detecting Cushing's. Hm...

On one hand I would say, maybe I need a third opinion! But these two vets, both exclusive cat hospital vets, are really the best game in town. So I'll keep trying to work with them.

Oh, I am in the process of switching to Dr. Elsey's Senior cat litter (silica crystals). I thought maybe less clay dust fumes couldn't hurt. I've left one cat box with the old stuff. Seems Marvin prefers the siilica!