GA Tuvok 12/27 AMPS 350

KrustiKakes

KrustiKakes

Member Since 2020
My cat Tuvok has Small Cell Lymphoma. He was diagnosed in January 2021. He was on Chlorambucil and Prednisolone. He has teetered with high glucose for a while with the Prednisolone. This past spring he saw an Internal Medicine doctor (he sees an Oncologist for his lymphoma) and she took him off the prednisolone. His numbers improved and everything was fine. In September he was diagnosed with Pancreatitis and Hepatic lipidosis we have been struggling since then. The new internal medicine doctor wanted him back on prednisolone to control his symptoms. He was doing fine on a small dose (around .1 ml per day), but we noticed he has been more thirsty the past 2ish weeks. We completely stopped the Prednisolone about 1.5 weeks ago.

On Wednesday he had a followup and they found an abcess at his feeding tube site. He had sugery to have it drained and was put on antibiotics. Since then he has been feeling awful and his glucose has been climbing. He was a little under the weather before the surgery, but since then he has felt awful.

He is spending his time sleeping by his water dish and not really moving except sometimes getting up to go to the litter box.

We are tube feeding him and he has ZERO interest on eating food on his own.

We took him back to the ER vet on 12/24 and we were sent home because he was stable and no one from internal medicine was working. We saw his internal medicine vet yesterday who decided it was time to start him on insulin.

We started him on .5 units of Glargine last night at 8 pm.

He is still just sleeping and miserable. Is this enough? Should he be hospitalized? I am not sure what to do. Is there something else going on?

It's frustrating as I have spent THOUSANDS to get help from the professionals at this animal hospital andi t just feels like there are no real answers. My father also just passed away on Christmas and I have been not doing well. I have been doing my best to research all I can, but I am exhausted both physically and emotionally.

I am calling his internal medicine doctor now to let them know, but I also trust the experts here as you helped me out a couple of years ago with my cat Freya.

Thank you.
 
I'm so sorry for your loss of your father. I understand how much you must be exhausted physically and emotionally.
Be sure to mention the trace ketones to the IM doctor. Can you give him a little extra water in his feedings to help flush the ketones?
Sending prayers that Tuvok is feeling better as the day wears on.
 
I am so sorry about everything you have been through. My heart goes out to you. Simon also developed high blood glucose from prednisolone. We switched to budesonide and he quickly went into remission. Simon also took chlorambucil for a short time and it made him very nauseous and inappetant. Are you using the pulsed dose protocol (once every 2 weeks)? It seems to cause fewer side effects and works just as well. Cats with SCL can have a very good prognosis so please don’t lose hope! :bighug::bighug:
 
I am really sorry for everything that you are going through right now….losing your father and having all of this going on with Tuvok. You must be very sad and exhausted.

Do you have any up to date labwork on Tuvok? It would be helpful to see. When was the last time they did an abdominal ultrasound on Tuvok? Was the SCL well controlled? I have had cats on both Pred and Chlorambucil and they did very well. But your boy has additional problems. Do you think his pancreatitis could be flaring up? I am sure that you already know that feeding him is important due to prevent a recurrence of the hepatic lipidosis.
Now, since you have started him on insulin, it is really important to begin home testing his blood glucose in order to keep him safe. I see in your signature that you have a meter. It’s important to test his BG before every insulin injection and to get some tests during the cycle. His excess thirst may be due to high glucose numbers or it could be something else. Are you sure his infection is eliminated? Can you share with us any information that you have on his BG? What was his fructosamine number at diagnosis? We need to get you set up with a spreadsheet to log his BG readings so that we can help you more.

He may really need the steroid. Have you spoken with your vet(s) about Budesonide instead of Prednisolone? It will help with SCL in some situations and has less impact on BG.
 
I just wanted to add that steroids can be absolutely life saving even with the side effects. You can manage fd - but without a steroid many cats will deteriorate quickly. I will be thinking about you and Tuvok and hoping you find something that works for him :bighug:
 
Poor Tuvok it sounds like he is having a tough go of things. You mentioned that he had been diagnosed with pancreatitis this past September, and I’m wondering if he is having another bout. Pancreatitis can be very painful, and might be the cause of some of the symptoms you are seeing. You may want to discuss pain meds with the vet as well as seeing about giving fluids to help with dehydration and electrolyte imbalances.

Here is the Primer on Pancreatitis
 
Our older cat Vesta who also had SCL but passed away from a secondary cancer also developed diabetes from the pred and her old diet. We did switch her to a new diet which was able to control the diabetes without insulin. But I would basically never stop her pred, pred and Chlorambucil and the only real ways to help the SCL. Our oncologist and IM vet both said you have to basically rank each condition. SCL would be at the top, followed by others issues and diabetes. Since diabetes can be managed and in general isn't as life threatening as SCL, especially once its managed, it makes sense to go that route. Treat the cancer with whatever they need, even if higher pred and manage the other issues as best you can.

when Tivok was on the higher pred, did he eat/seem better? It made a big difference for Vesta, better appetite and overall just seemed more herself.
 
I'm so sorry for all of difficulties especially over a holiday. Please take care of yourself.

I suspect the abscess put Tuvok's system over the edge. There were only so many things a kitty (or any of us) can handle. Hopefully, once he's feeling better things will get back on track.

With Lantus, you want to start just where your vet started Tuvok. You need to let the insulin begin to build up in his system -- it will take 5 - 7 days for the insulin to stabilize. This is a link to information on glargine dosing.

Are you testing for ketones? As a preventative measure and since Tuvok is fighting off an infection, I'd encourage you to do so. You can purchase Ketostix at any pharmacy. You dip the strip in your cat's urine. Any time a cat seems to be "off," it's wise to test. Ketones can result if your cat's not getting enough calories, not getting enough insulin, and there's an infection or inflammation. Ketones can be dangerous if there's more than a trace level.
 
Hanging over the water dish and no interest in food sounds like nausea. Is Tuvok on any anti-nausea meds? Ondansetron in particular is the best for this.

Also, how often is he getting chlorambucil? Some vets do a slightly older protocol which is harder on cats and makes them more nauseous. Two out of my three cats with SCL started on the older every other day protocol, and did much better on the every two weeks protocol. My Neko was also diabetic with SCL, and couldn't take pred due to her heart condition, so she got budesonide. Which did not impact her blood sugar numbers and did help her bowel inflammation.
 
Update: Unfortunately we had to put Tuvok to sleep shortly after my post. It turns out he has congestive heart failure. The surgery he has last week and extra fluids just made everything worse. He was barely alive by the time we rushed him to the ER. He was the greastest cat I have ever known and will ever know. He was my soul kitty. It was an honor to get to be his mommy and nurse him through all his ailments. He was so loved and will forever be so loved. I hope somehow somewhere he and my dad are together.
 
My deepest sympathy. :bighug::bighug: It is hard dealing with heart issues. Which can also cause nausea.

Fly free Tuvok. cat_wings>o
 
KrustiKakes said:
Update: Unfortunately we had to put Tuvok to sleep shortly after my post. It turns out he has congestive heart failure. The surgery he has last week and extra fluids just made everything worse. He was barely alive by the time we rushed him to the ER. He was the greastest cat I have ever known and will ever know. He was my soul kitty. It was an honor to get to be his mommy and nurse him through all his ailments. He was so loved and will forever be so loved. I hope somehow somewhere he and my dad are together.
Click to expand...
So sorry for your loss, I always said that Molly is my soul kitty. Take care
 
I’m so very sorry. Sometimes too many things go wrong at the same time, and there just isn’t anything you can do. Doesn’t make the loss any easier, but sending hugs :bighug::bighug:.
 
Oh, I am so sad to read this about Tuvok. I know what a tremendous heartbreak it is for you. You have my deepest sympathy. Thank you for letting us know. I thought about Tuvok several times today and had checked for updates. Again, I am very very sorry.
 
I am so sorry for your loss, losing your dad and Tuvok in such a short period of time must be heartbreaking, may both of them rest in peace :bighug: take care of yourself :bighug:
cat_wings>o
 
I am so sorry for your loss, and the loss of your dad :bighug:
Tuvok knows he was loved and you did everything you have done
Fly high sweet boy, you will be missed but never forgotten ♥
upload_2022-8-5_11-46-16-jpeg.65085

1038070627-74203d65c120c6deff7a216de7886e75.jpg
 
Last edited:
KrustiKakes said:
Update: Unfortunately we had to put Tuvok to sleep shortly after my post. It turns out he has congestive heart failure. The surgery he has last week and extra fluids just made everything worse. He was barely alive by the time we rushed him to the ER. He was the greastest cat I have ever known and will ever know. He was my soul kitty. It was an honor to get to be his mommy and nurse him through all his ailments. He was so loved and will forever be so loved. I hope somehow somewhere he and my dad are together.
Click to expand...
:bighug::bighug::bighug:I am thinking of you, I made the devastating decision to put my Whiskey to sleep earlier this month; and also lost my soul cat in 2021, so I know how it feels.

On top of your dad passing, it is a lot, so please be kind to yourself.
 
I am so sorry to read that you lost your dad and your precious Tuvok so close to the same time. You are so right. It is an honor to be owned by our fur babies, it is an honor to serve them, no matter their special needs. I have no doubt there are two new stars in the skies, one is Tuvok and the other is your father. :bighug::bighug::bighug::bighug::bighug::bighug:
 
You must log in or register to reply here.
Back
Top