Starbuck PMPS 96-- thinking of going OTJ for a couple days

[SarahNOLA]

Previously, cancer :-(

Would like advice from people who have given palliative care to a cat with a terminal non-diabetes disease. Starbuck's second biopsy doesn't come back till Wednesday, but the oncologist thinks it's likely squamous cell carcinoma, which has a <10% survival rate even with surgery and radiation. The tumor has taken over part of her jaw bone--all in less than 2 weeks. If this diagnosis is confirmed, I have chosen not to put her through treatment. I'm heartbroken, especially since she was doing so well with her diabetes, but I want to do what's best for her. I was told her life expectancy would be ~2-3 months even with the surgery.

In the meantime (since she's been at the vet so much getting prodded & getting pain meds 1x a day) I've been skipping some shots to see how she does. I also have pulled back on testing her as much... I just want her last weeks to be as happy as possible. I was out of town overnight & skipped two shots, and her PMPS was just 96. Her chart hasn't been all green, but she mostly tops out at 120-130.

I'm going to try skipping her shot tonight to see what happens. If she's doing 90-130 without insulin, do you think that's fine? (in light of the fact that she does not have much time left) She's still eating, acting normally, and very happy. I'm leaning towards trying her OTJ and testing her twice a day. I would put her back on the micro dose if she popped up, say, a 200.

 

[carfurby (GA)]

I think quality of life is most important under the circumstances. I don't see any reason to put her through testing and injections all of the time if she does have cancer and her numbers don't jump up and make her start feeling bad. My civvie Callie (GA) had stomach cancer. There were no options for treatment. I did what I could to make her as comfortable as possible, which included giving pain meds (buprenorhine) 3 times a day. I know it is very difficult to go through this, but I learned to focus on the day at hand and make the most of the time I had left with her and try not to think about the future. I hope you get better results then you think you will from the biopsy. Sending prayers.

 

[Tuxedo Mom]

Although it was never verified (he went downhill far too quickly before the tests could be run), my Tuxie kitty (GA 5 1/2 months) was suspected of having cancer. He also had a number of other health issues. When the decision was made by him and me to send him over the Bridge, I still gave his insulin and tested up until a few hours before (maybe just a habit after 2 1/2 years). My fear was that he would go too high and maybe go into DKA. Looking back now I really wish I had just let him be the last few days. His numbers were dropping ( common with cancer) and once I gave the shot, I was worried about him going into hypo. He really didn't seem to mind...he was SUCH a good kitty about his shots and testing, but I feel that it was all rather senseless when I knew I would be releasing him later that day. I did spend the last day laying with him and telling him how much I loved him and what a good kitty he was .

 

[tiffmaxee]

I’m so sorry. I know some who have treated this with radiation but I’m not sure you buy a lot of time.

 

[SarahNOLA]

I’m so sorry. I know some who have treated this with radiation but I’m not sure you buy a lot of time.

Yeah, I was told it was really iffy whether it would get her time or not. :-(

 

[SarahNOLA]

Although it was never verified (he went downhill far too quickly before the tests could be run), my Tuxie kitty (GA 5 1/2 months) was suspected of having cancer. He also had a number of other health issues. When the decision was made by him and me to send him over the Bridge, I still gave his insulin and tested up until a few hours before (maybe just a habit after 2 1/2 years). My fear was that he would go too high and maybe go into DKA. Looking back now I really wish I had just let him be the last few days. His numbers were dropping ( common with cancer) and once I gave the shot, I was worried about him going into hypo. He really didn't seem to mind...he was SUCH a good kitty about his shots and testing, but I feel that it was all rather senseless when I knew I would be releasing him later that day. I did spend the last day laying with him and telling him how much I loved him and what a good kitty he was .

Thank you so much. I'm sorry about your kitty. This is the kind of input I wanted. You raised another concern I've had--what if her usual numbers start to change when she gets sick? I don't want to prick her all the time, but I wouldn't want her to hypo because her patterns change.

 

[SarahNOLA]

I think quality of life is most important under the circumstances. I don't see any reason to put her through testing and injections all of the time if she does have cancer and her numbers don't jump up and make her start feeling bad. My civvie Callie (GA) had stomach cancer. There were no options for treatment. I did what I could to make her as comfortable as possible, which included giving pain meds (buprenorhine) 3 times a day. I know it is very difficult to go through this, but I learned to focus on the day at hand and make the most of the time I had left with her and try not to think about the future. I hope you get better results then you think you will from the biopsy. Sending prayers.

Thank you. I'm sorry about Callie. I'm having difficulty looking at my pretty much healthy cat & realizing her time is limited, but I've already had an awesome week cuddling her and I know so many people don't get that. So as the shock is wearing off, I'm trying to remind myself that I'm lucky.

 

[Tuxedo Mom]

Thank you so much. I'm sorry about your kitty. This is the kind of input I wanted. You raised another concern I've had--what if her usual numbers start to change when she gets sick? I don't want to prick her all the time, but I wouldn't want her to hypo because her patterns change.

As cancer becomes more active it can actually "eat" the glucose in the system and cause numbers to drop and become unpredictable. Tuxie went from a 578 preshot to a +6 of 106 the day he was released. Again...in retrospect...I would not have bothered with the shot and the tests. I can only "justify" my shot and tests as an ingrained part of what I had been doing for so long, but in hindsight I should have chose to let it be. Still your decision, but this is my take from my own experience.

 

[SarahNOLA]

As cancer becomes more active it can actually "eat" the glucose in the system and cause numbers to drop and become unpredictable. Tuxie went from a 578 preshot to a +6 of 106 the day he was released. Again...in retrospect...I would not have bothered with the shot and the tests. I can only "justify" my shot and tests as an ingrained part of what I had been doing for so long, but in hindsight I should have chose to let it be. Still your decision, but this is my take from my own experience.

Wow! On the one hand, Starbuck may have several weeks left. (Her bloodwork was still normal last week--the tumor is already bigger on her jaw, and I'm told it may be a situation where she refuses to eat eventually, but NOW she's perfectly okay.) But on the other hand, she was already only on a drop of insulin and I'd rather try her without. Especially with what you just said. Thank you.

 

[Tuxedo Mom]

Wow! On the one hand, Starbuck may have several weeks left. (Her bloodwork was still normal last week--the tumor is already bigger on her jaw, and I'm told it may be a situation where she refuses to eat eventually, but NOW she's perfectly okay.) But on the other hand, she was already only on a drop of insulin and I'd rather try her without. Especially with what you just said. Thank you.

My thoughts are to just play it day by day. Starbuck is very well regulated and on such a small dose right now, that a NS should not be a big concern. Each day is a new day and take it as it comes. In the meantime enjoy every minute...every second..you have and hope for as much time as you can get. Quality of life is the determining factor and as long as Starbuck has quality all is good.

 

[tiffmaxee]

Max didn’t have cancer. His kidney disease escalated quickly and then we learned he had heart disease. He was fine and eating well until the last couple of weeks but the last week was tough. His numbers went off the charts high. From what I’ve seen here that often happens.