Tuxedo Cat Update

[bmmg39]

I'm sorry. I won't reprint the whole thing here so as not to spam the board, but if people could please read and respond to the other thread about "Tuxedo Cat" and the switch to Glargine I would greatly appreciate it. The situation has become dire and I'm looking for help anywhere I can find it.

Thank you.

 

[Diane Tyler's Mom GA]

Here's your previous post
https://felinediabetes.com/FDMB/thr...o-hills-w-d-and-glargine.274499/#post-3051433

I see Bron has replied back to it
Just tap on the link I just gave you
@bmmg39

Here is what you wrote

1. Hello. I hope you are all doing well. Six months have passed since my first post here, and the last month or so since I've posted, I'm afraid, has been quite eventful. Please bear with me, as this has been a very emotional day. I'm looking for any shred of hope I can find.
   
   Our cat, Charmer, went to see his regular vet about a month ago. His fructosamine number had again improved from 535 to 505. His weight had dropped more, to 7.2 pounds. (He was now less than half of what he'd been a year and a half ago.) The vet told me that Charmer's kidney values, once very good, were now up a little bit, so he was in the category of mild kidney failure. We were to bump up the dosage of Novolin N. I also received a list of specialists so that we could get extra help in fighting the diabetes. At the beginning of this month, I called one of these based on proximity and availability, and made an appointment for August 3. Charmer had not been eating well, and that night I showed him to family members by placing him on the floor near his food, and one of his legs buckled. This happened twice, upsetting us, and so I took him to the hospital with the internist that evening, instead. We were told that Charmer had ketoacidosis and was dehydrated. Over the two days and nights he was there, he responded well to the fluids, and was discharged on August 3. He had a UTI, and, more worrisome, an abdominal ultrasound revealed an intestinal mass near his ilium. The results revealed that it has low cellularity but appeared to be lymphocytes. The internist said that Charmer wasn't a great candidate for surgery, even though the surgeon told her that removal might be possible, given its location. We were given amoxicillin for the UTI, predisolone for the intestinal mass, and, finally, Glargine for the diabetes, plus a switch to Purina DM.
   
   At his follow-up appointment the next week, Charmer didn't have ketoacidosis but was again dehydrated. He came home that night after more fluid therapy, and began eating well again. (BG was a little high, but not ridiculous, and his weight was the same as when he was discharged.) Kidney numbers were a little higher, but that may have been due to the dehydration. The internist raised the prospect of doing sub-Q fluids at home, but we decided to wait another week. At last week's follow-up, he wasn't dehydrated, but his BG was shown as simply "HIGH," and he had lost more weight. The internist said she wasn't sure we'd be able to get weight on him. She gave us mirtazapine to help him to eat more and to fight nausea. A fructosamine-test appointment was scheduled for September 2.
   
   Charmer had eaten well until around Saturday evening, when his appetite decreased. By Sunday (two days ago), he wasn't eating at all, and (I was told over the phone) fell over when my dad put him in front of a food dish. We took him to a 24-hour hospital where he'd gone in December when he had the hypoglycemia episode. This time, he had ketoacidosis again, and was dehydrated, and had lost even more weight. Yesterday, I was told that his kidney values were still very high, as well as a high liver value, in spite of the fluid therapy. We transferred him to another facility that is much farther away (about a 45-minute drive) in another county, as that place has several internists and a criticalist. He stayed there last night.
   
   Today, I spoke with a vet there, who said that Charmer still has extremely high kidney values, and still will not eat. She said they are running out of options...and, for the first time, the issue of euthanasia was raised.
   
   I have been the "numbers person" representing the family this whole time, asking umpteen questions and writing things down. At this point today, I was just listening, and staring out into space, at a loss for words. They seemed to suggest our coming in today. I said I'd talk to my family and then call back. We'll talk to more people tomorrow...
   
   As I'm writing, I'm worried that my tone is coming across as too breezy and casual. I'm trying to give you as much information as I can. We're all worried sick, and have never dealt with a situation like this before. (This is a first pet for my adult siblings and me, as we all live in different towns but all love our other brother, Charmer, very much.) My parents are deeply affected, and my mother, in particular, is beside herself. They'd had pets much earlier in their lives, and never had to make a decision like this. I'm generally always on the side of "rage against the dying of the light" and will want to think long and hard before making such a decision.
   
   The vets believe that we are dealing with chronic kidney failure, not acute kidney failure, in spite of the very fast, very large increase in the kidney numbers, but I am trying to find some cause. I'd bought cat grass for Charmer last week, as a vet told me it would be okay, and he had been nibbling on that here and there. For two and a half weeks, he'd been half on the older Purina UR and half on the Purina DM (lower in carbs but higher in phosphorous). I'm even thinking now that he had a cyst on the side of his body a year and a half ago, when he as much healthier. I doubt that has anything to do with anything, but I'm grasping at straws here.
   
   I've written all of this out of desperation, in case someone should have an idea no one has thought of yet, has had a similar experience, or can give us something -- anything -- that we might be able to latch onto here and now. Your support, guidance, and prayers are all appreciated. Thank you.
   
   Yesterday at 11:24 PMReport
   #20LikeReply
   
   
2. 
   Bron and Sheba (GA)
   Joined:
   Feb 21, 2015
   I'm sorry we have not got to you sooner.
   And I am very sorry Charmer has had DKA again.
   As far as the kidney failure is concerned, being dehydrated and having DKA will affect the values, so I would wait until he has recovered somewhat before worrying too much about that.
   If he is not eating, are they giving him as antinausea medication?. giving mirtazapine, which is an appetite stimulant, is no good if he is nauseated. He needs either cerenia or ondansetron for the nausea.
   Also if he is not eating, why are they not suggesting a feeding tube for him? Ask them about that.
   Do they have him on an IV drip.
   Have they told you what his electrolytes are doing? Have they improved? Ask them about that as well.
   I would not consider euthanasia at this point. Vets are too ready to suggest that in my experience.
   Once he improves and is ready to come home, we can help you with what you have to do.
   Lets get through the next few days first.
   Please keep us updated. and lots of hugs
   
   
   Dx April 2011, OTJ July 2011. Relapsed Nov 2013. Levemir. TR. Abbott Freestyle Optium. Flares of chronic pancreatitis; Meds: Benazepril, Tramadol. Dx pancreatic cancer early Jan 2017. Died 18 Jan 2017. RIP beautiful girl.