Thinking about giving up :(

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RooLette

Member Since 2014
Our middle cat, Athena, has had a rough year. Last Feb she developed stomatitis and we did several rounds of steroid injections to try to save her teeth (not to mention 4 diet changes) to no avail. We ended up having to get all but 4 pulled. She was healthy after that for all of 2 weeks before diabetes happened. No big deal, I thought: I have a family history of diabetes and had gestational myself, so it didn't freak me out too badly (though the additional costs on top of everything thing else did).
But getting her regulated has been a nightmare. She only weighs 7lbs so we started on .5 units of ProZinc 2/day and the prescription diet - no effect. I asked about home testing and was told it was impractical. So 1 unit twice a day, again no improvement. I found this site, switched her to wet food over a week, and started testing her when I could...but while she tolerates injections, she actively fights glucose tests so I don't get one every time she needs a shot. Anyway, the tests I was able to get consistently showed her running around 400bgl. Then we went through an episode of kidney/liver failure and had to start the Denosyl pills too. After keeping her a day to test her, the vet agreed we should raise her slowly to 4 units twice a day...even though that seems crazy for 7lbs...but she's still peeing everywhere, constantly eating and drinking, sometimes vomiting, unkempt, etc. Over the past 12 hours her appetite dropped rather suddenly (again) but I didn't realize it until I'd given her the 4 unit shot, and then she didn't eat enough. So I've spent tonight nursing her through a hypo episode while my 1-year old (youngest of 4) cries and refuses to go back to sleep.

Athena and I are exhausted. I begin to wonder if we're at the point where it's selfish to make her keep going through this, or if letting her go is actually the more selfish thing. We've run up almost $6,000 on credit cards trying to help her, and she hasn't gotten better. The diabetes diagnosis was in May, and we haven't been able to get her regulated in all that time. Our other 2 cats have started being super mean to her. She pretty much hates me these days, because I'm always poking her or shoving a pill down her throat. She's still miserable. Any ideas? What are we doing wrong? Is it time to let her go?
 
I cannot address the other health problems you are having with your cat but I can says that they maybe causing your cat to need a higher dose, my 9 pound cat got up to 15 units of ProZinc twice a day and never had a blood glucose under 300, I put him on Levemir and was up to 6.5 units before he started regulating, now I have him regulated on 1.75 units and fully expect he will go into remission, you cannot compare the amount of insulin you would take by your weights to a cats, they just use more. I don't post here much and do not want to give you any dosing advice, there are people here who have much more experience at that then me but I just want to tell you not to give up just because your cat is diabetic, my cat was on the ProZinc for 6 months then took 3 months to regulate on Levemir. He is completely healthy besides the diabetes, if you can resolve the other health problems your cat has I would not give up because of the diabetes.
 
What prescription diet is Athena on? She needs to be on very low carb wet food. How old is she?
It should be possible to get the diabetes under control, really her prognosis depends more on her other problems. I would have a chat with your vet, I usually ask 'if it was your cat, what would you do?' If you can get her to the stage where she has a decent quality of life, then give her a chance, if she is suffering and not going to get any better, the ultimate gift of love is to let her go.
I'm thinking of you and hoping for a positive outcome
xxx
 
Hi

It sounds like you have to cope with a lot with Athena and are obviously trying your best. I am fairly new on these boards and I don't use prozinc so cant advise there but I wonder if it might be worth considering a different insulin such as Lantus or Levemir. Other much more experienced members should be able to give you more advice but whilst reading various threads I have come across kitties that do terribly on one insulin but much better on another.

It is great that you are home testing but I totally understand that the poking and pilling can be quite difficult. I find that getting them into a routine so that you always do things in the same place at the same time and always follow with a nice treat and lots of praise really helps. With regards getting blood out of their ear I make sure I heat the ear with a rice sock I made up really helps the process. If you don't already you could just put a small handful of rice in a sock and tie it up. Heat for a few seconds (usually 10-20 depending on the strength of your microwave) and then hold against the ear edge and then poke it and squeeze either side of the puncture. Follow with a low carb treat and lots of strokes.

With regards pilling I put all of remi's pills in an empty gelatin capsule and follow it with 5ml of water carefully syringed into the side of remi's mouth. That way you can do more than one pill at a time and there is no taste. It must be followed with at least 3 ml of water to make sure it doesn't get stuck.
 
I took her off the Hill's prescription dry diet back in July. We did some experimenting with a couple of wet food brands/recipes and now she gets one of the Friskies Pate varieties twice a day.

I just never expected her bgl to be so hard to get under control. It's impossible to get "good" numbers! We do the rice sock thing to test but she is NOT cool with it. I have to have a second person hold her down to get a test; for some reason none of my kids can keep her still, and hubby's work schedule makes it hard for us both to be available to test at the same time. So, of 14 injections per week, I probably get a test before just 6 of them. It's nothing like the calm cats in the YouTube videos who get tested all the time and don't even notice. But even when we get under 200bgl she's still lethargic and peeing everywhere. Which is just exhausting with 4 kids.

I just can't imagine that pills and injections twice a day, while clearly not feeling right and being bullied by other cats, is a great quality of life...even though (or maybe especially because) she's only 7 years old.
 
When dealing with multiple issues it can get very stressful. When I had Spitzer, at one point I had meds to give before feeding on an empty stomach, meds to give after eating, and insulin . Some meds were 2 times a day, some were 3. I ended up making a schedule in order to keep track.

Because testing is not going well, please see my signature link Secondary Monitoring Tools. These assessments are less precise than glucose test, yet may be helpful in identifying issues such as dehydration, ketones (may indicate diabetic ketoacidosis or DKA), glucose in the urine, water consumption, and more. They have been used in an older protocol for managing diabetes.

Using low carb treats or a desirable activity (brushing? Interactive toys?) as a reward after testing may be helpful in reducing the resistance. Begin by bringing the cat to the testing location, treating, then releasing. Do this several times today before your next attempted test.
 
BJM said:
Using low carb treats or a desirable activity (brushing? Interactive toys?) as a reward after testing may be helpful in reducing the resistance. Begin by bringing the cat to the testing location, treating, then releasing. Do this several times today before your next attempted test.

This was a huge help in getting my cat to comply with testing and shots. She was not very happy at first but is now like the calm cats on YouTube. She even comes running to the test site when she hears me getting out the supplies because she knows she is going to get a treat.
 
JennyBankers said:
BJM said:
Using low carb treats or a desirable activity (brushing? Interactive toys?) as a reward after testing may be helpful in reducing the resistance. Begin by bringing the cat to the testing location, treating, then releasing. Do this several times today before your next attempted test.

This was a huge help in getting my cat to comply with testing and shots. She was not very happy at first but is now like the calm cats on YouTube. She even comes running to the test site when she hears me getting out the supplies because she knows she is going to get a treat.

I agree. Find something they really like, like freeze dried chicken or fish. It is amazing how quickly some cats will learn to associate hometesting with getting their favorite treats. Some even begin to remind us that it is time to test. :lol:
 
I am still getting my cat Neko regulated, so unfortunately I can't help with that. In regards to the BG testing, Neko fought quite a bit, and she is not a cat-treat kind of kitty. We finally found that she likes boiled chicken, so she only gets that treat after her test. We also took the forum advice and do her testing in the same spot every time. We lock away our other cat during each test, to make it her special "Neko time." We bring everything into the testing room, including the baggy of chicken, and she now comes willingly. She still doesn't care for the testing, and if we didn't hold her, it is unlikely she would just sit still for it like the cats in the video, but she is much more compliant because we found something she wants. We use the rice sock, and Neosporin, and we pet her, scratch her neck, and use baby talk (which she loves), before, during, and after. She's actually taken to sleeping in the testing room now (aka our office), which she never did before. I think because it is sort of her room now. Even though she gets tested there, she also gets treats and 1:1 time, so it seems to outweigh the negative.

Despite all that, I completely understand questioning quality of life and wondering if we're holding on for ourselves rather than our cats. I've had several cats with many long-term, debilitating conditions, and none of them passed "naturally" so to speak. I've had to make the decision every time on when the quality of life was gone. It is tough. I would suggest giving yourself a deadline for seeing any kind of improvement (even the smallest improvement gives hope, I think), and if by that point no improvement or small victory has been seen, reconsider, keeping in mind that not getting worse can be a victory in itself.

We had a cat who had a stroke during a routine surgery, and as with diabetes, cats who have had strokes have some chance of making a full recovery. But she seemed pretty badly off and every hour we questioned her quality of life. We gave ourselves a deadline of a week to make a decision, taking into account the research, vet advice and prognosis, and our own feelings. We did everything we could in that week to make her comfortable and try to heal her. When the deadline came, it was clear she had made no noticeable improvement, and we felt comforted in knowing we did what we could to improve her quality of life, and when it did not, we could send her to a better place without guilt.

Hopefully you'll get some excellent advice on this forum, that you can try, that will start making some improvement in your cat's quality of life.
 
Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

After you've set that up, you can put it in your signature, along with other details that may help us give you feedback.

Go to the top left of the screen.
Click on User Control Panel.
Click on Profile
Click on Edit Signature
A text box displays.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name, cat's name,
city and state,
date of Dx (diagnosis)
insulin
meter
any other pertinent issues like food issues, allergies, IBD, etc.
 
Hi RooLette,

I'm sorry to hear that things have been so rough for yourself and little Athena.

:YMHUG: cat_pet_icon


RooLette said:
We do the rice sock thing to test but she is NOT cool with it.

Saoirse didn't like the rice sock either. I started using a little plastic test tube with a bung on the top. I fill it with warm water to help warm Saoirse's ear. I find it much easier to get a feel for how warm it is and Saoirse is much more comfortable with it. It's small, so all I have to do is curl the edge of her ear around it and hold it there for a little while before testing. A small pill bottle with warm water could do the same thing. I think Saoirse got on better with it because it wasn't bulky. Maybe it's something you could try to make testing easier for you both?
 
Sorry so much is going on and it is all wearing on you. It can get very exhausting. Is there someone who can take care of her for a day or two and you and the family can get away for a short break? Sometimes that can help.

Our Smokey was on so many meds. She had liver hepatitis, pancreatitis, diabetes, CHF, CKD, and had a double mastectomy 10 months before we lost her to the CHF/CKD. We were lucky in that for the most part the meds and shots were her bonding time with us - except flagyl, we could take our flagyl and stuff it she thought. For shots and testing she came running. It didn't start that way, it started out with her under the bed and me laying beside it sobbing for the first week. Then we all got used to the routine and often we just needed to open the fridge and she came to get her meds. (When she went into remission, she still expected testing and shot before meals). The DO learn you are helping them. When they still feel crappy though, they might not realize that. Smokey and Cecil both learned to just go running to their testing spot. Chris has just learned to go running to his food dish and try to get out of testing and go straight to the eating :lol:

For warming the ear, I never did that much on any of the cats. When I did, I either just rub the ear between my finger and thumb briskly, or I put warm water in an old strip canister and wrap their ear around that while I poke.

It doesn't sound like you have a vet that is very knowledgeable about FD, that doesn't help matters a whole lot. Hometesting is absolutely the best thing you can do. You will better be able to know what is going on, and then better treat what is going on. Hopefully getting the BGs under control can bring some of the other things into control too. Make sure you spend time with her outside of the poking, proding, medicine time. I know it is hard to find time in the day for everything, but just a few quiet times to sit and snuggle will let her know everything you do for her is out of love.
 
If she likes to be petted and have her head scratched, you may want to try massaging the ears instead of using the rice sock. Both will help to get the blood flowing. Massage both ears and massage towards the tip.
 
( I had this written once but it disappeared)


I'm so sorry that things have been so hard for you and Athena.

I'm a firm believer in quality-of-life. Working in the hospital I see how hard it is for people when they can't make the right decisions for their family. One of the privileges of being a pet owner is being able to make end-of-life decisions for animals based on the quality of their lives.

I've always promised my chronically ill pets that I would not fight them to keep them alive. I have a saying on the box that my pets' ashes are in. "I sent you to a place free from pain not because I didn't love you but because I loved you too much to make you stay. "

It's a decision only you can make but this group will support you regardless. You have been a great caregiver

Lots of hugs.
Lisa and Ben
 
Hi,

I've been thinking about Athena and the 4IU BID dosing. As you moved up the dosing scale, were there any times when she was on a lower dose that she appeared to feel a bit better in herself even though her numbers might not have been ideal?
 
if she's only 7, I would be tempted to give her a chance, depending on how quickly her other problems are progressing. Try the low carb treats. I'm still not great at testing but I make myself do it, sometimes I have to prick Angel's ears a few times. Which glucometer are you using? I find the lancing device from the alphatrack is much easier on Angel than the other one I had. It's just me so what I do with the rice sock is caress his ear with it, then hold the sock taught against the inside of the ear and prick the outside of the ear. It makes it easier to get blood. I usually put some treats in front of him to distract him.

Hoping for the best for you and Athena xx
 
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