Rusty not doing well

[emilyrose]

It's been a while since posting. I was trying to be active here and on the CKD forums, but after his last vet visit it seems like everyone from the vet to even my partner has given up on him. It got to a point where I stopped updating his diabetic journal because I knew nobody was looking, and it seemed like insulin made him worse.

I've continued with his supplements, but now it seems all 4 of his feet don't want to work. It doesn't matter what I give him. I'm following all instructions but nothing is working. Then yesterday he started to seem to "grunt" when I would pick him up. Today he seems like he has increased breathing rate. Not alarming, but enough to make me think he may have aspirated during feeding.

The small cloudy spot on his eye from that sinus infection decided to get bigger, even with terramycin, after finishing the oral antibiotics.

Not sure why I'm posting at all. Will probably post the same message on the other forum. I guess I'm not coping well with feeling like the only person trying to save him for months, or at least make sure his feet work. The whole ordeal just seems like it's been for nothing.

 

[Red & Rover (GA)]

When looking after a multiple issues cat, it is important to look after yourself as well.

I looked at your spreadsheet. An increase of 0.25 is needed.

 

[emilyrose]

When looking after a multiple issues cat, it is important to look after yourself as well.

I looked at your spreadsheet. An increase of 0.25 is needed.

I have discussed this in the past w/ dvm. Part of his increased BG is due to being approved to not give insulin on the days he's really not feeling well, as there is a correlation between me giving him insulin and his appetite dropping. However now, his appetite is non-existent even with Mirataz
The concern with increasing his insulin is that his fructosamine test indicated that he was well controlled and when he does receive insulin it generally tends to cut his numbers in half already. The vet was concerned that any further increases might cause crashes. I feel like we are past the point of reversing diabetic or kidney damage with or without insulin

 

[JL and Chip]

I don’t see any lab work in the spreadsheet. Has his potassium level been checked recently? Low potassium isn’t uncommon in CKD cats. It can definitely affect mobility, appetite, energy level, as well as how they feel. Does he hang his head? Also, insulin pushes potassium out of the bloodstream and into the cells, which means the blood potassium is even lower. That could theoretically explain why he seems to feel worse when given insulin injections.

My cat’s potassium dropped to levels that were nearly inconsistent with life. We had to do an IV drip and supplements. It’s a delicate management issue because potassium that’s too high can cause problems as well. Anyway, just something to consider. Google low potassium levels in cats and see if the symptoms fit.

I hope you get some answers. Please let us know what happens.

Edited to add: I wouldn’t trust a fructosamine test to accurately assess regulation. It’s the average BG over several weeks, which is great diagnostic tool when you haven’t started insulin yet. But once you’re giving insulin, you could theoretically show a “good” average (i.e., well managed) when the BG is actually running, for example, from 300 to 20. The average of 160 isn’t terrible, but it certainly doesn’t let you know that his BG is going dangerously low.

 

[emilyrose]

I don’t see any lab work in the spreadsheet. Has his potassium level been checked recently? Low potassium isn’t uncommon in CKD cats. It can definitely affect mobility, appetite, energy level, as well as how they feel. Does he hang his head? Also, insulin pushes potassium out of the bloodstream and into the cells, which means the blood potassium is even lower. That could theoretically explain why he seems to feel worse when given insulin injections.

My cat’s potassium dropped to levels that were nearly inconsistent with life. We had to do an IV drip and supplements. It’s a delicate management issue because potassium that’s too high can cause problems as well. Anyway, just something to consider. Google low potassium levels in cats and see if the symptoms fit.

I hope you get some answers. Please let us know what happens.

We've been on his potassium and continuing to supplement in the food when he eats it. I'm not sure where to attach labs to the insulin spreadsheet. He was on fluids infused with potassium for a while as well but could never get it or his BG managed no matter how I followed instructions to the letter

His lack of potassium and the supplements should be in some of my other posts. But he was previously on 1L LR w/either 2 or 3 vials of potassium infused, as well as oral Vetrinoquel K+ supplement powder in food, about 3 scoops per day.

 

[JL and Chip]

There’s a Lab tab in the spreadsheet. You just go to that tab and manually type in date at the top of the column and then the values in the appropriate cells.

I edited my last post to add a comment about fructosamine tests — sorry, I did that before I saw your response.