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April 97 Fletcher: Regulated for 3 years & now hyperglycemic again

Amazed we are not alone.......thanks for website and all of you who write in. My 11-year old black & white cat (Rebecca, is this "pie bald"- I have heard term "tuxedo cat" for black and white), Fletcher, was diagnosed in 1-94 with diabetes. For almost 3 years, things were semi-normal on 7 to 7.5 units every am of ultralente. In last 6 months, he has lost 1/3 of body weight & around 4/1, weighed 8.1 lbs. We have had weekly date with our vet, Larry, since 2nd week of Jan. this year. We are now at 10 units of ultralente, having increased dosage each week on average .5 units. Blood sugars at initial 1/97 visit were close to 600 and as of 4/2, 286 m/l (this later proves to be a fluke). My biggest fear now (4/20) has abated - I am at moment not concerned diabetes is masking signs of another more serious disease. Blood tests in early 2/97 did show liver enzymes were up a bit which could make insulin ineffective, although he may have developed a resistance to ultralente. I do fear that returning home 12 hours after am shot, I may find expired cat (commute by ferry and cannot be here to ensure no hypoglycemia incurs). To reiterate, this little guy means the world to me, emotionally, because he was a gift as a kitten from my late husband and Fletcher pulled me through emotionally after my husband was killed in an auto accident 7 years ago. Fletcher and I have been through some tough stuff - a lot more than what one would expect to share with a non-human.
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Fletchito (Fletcher) Update, April 97

The unhappy news is Fletcher is still giving an am blood sugar reading of 387 (this is down from almost 600 in January). Hard to believe that he was fairly well regulated for three years when first diagnosed in Jan of 1994. He has lost .2 lbs in one week - he's down to 7.7 and I am really down. We have increased his dosage to 11 units of ultralente at 5 am (I commute so darn early). He is pretty chipper however, for a sugar kitty on a sugar high.....I thought he was sick Thursday because he only gulped a few bites of food and took forever that evening to finish his dinner. So I locked both cats in on Friday (chagrined that it was a gorgeous day they missed) to see if he had bowel movement. A predecessor of a sort illness was last summer with severe constipation of hairballs to the point that with my wonderful neighbor Pam, we were giving him enemas (easier to give a shot). So, we continue with our weekly date with Larry our vet next Saturday. Oh, your website has saved my life in another way - until about 5 weeks ago, we had to knock Fletcher out which was hard on his little body (in fact, on the way home, I thought he had checked out several times and I nearly drove off the road using cellphone from work and trying to resuccitate - sp?- him....but not for the webstie, I do not think the vet would have tried earsticks because Fletcher can be a feisty footch. Nevertheless, it has been a week of many and I must now sign off because I have to run to see my aunt (actually, my late husband's aunt) who goes in for serious cancer surgery on Tuesday.

Bless you all.........Fletcher is going to make it if my determination and love will out and everyone's positive energy and conern is just hearwarming. Adios from the three lone Flynn survivivors! I will stay in touch now. Thank you, thank you thank you.

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Jake: Is he cured?, 4/20/97

Jake, my sweet, good-natured, eleven year-old, sixteen pound, all-black male cat is an unusual creature. He has developed a somewhat small but exclusive fan club of humans who regularly drop by to visit and catch up with him. Unusual for a cat, he accompanies me for evening strolls. We walk around the block side-by-side engaged in mutual conversation. Jake has me so well-trained I don’t even require a leash.

One evening while I was sitting at my computer Jake called out to me in distress. He was going in and out of his litter box and appeared to have difficulty urinating. He then produced two tiny droplets of urine with a speck of blood. I rushed him to an after-hours Emergency Veterinary Clinic and got the news that he was suffering from acute cystitis, accompanied by a high concentration of sugar in his urine which suggested that he might be diabetic. I elected to have his blood checked and he was diagnosed as diabetic. Before the diagnosis I hadn’t noticed *much* difference in his demeanour, except that I found myself filling his water dish more frequently in recent weeks.

The glucose curve over the following day at his regular Veterinary Clinic confirmed that diagnosis. The standard insulin, needles, prescription food, and strict instructions followed with the addition of antibiotic pills for cystitis. A single four unit dosage every day *with food*. We were told he *must* lose weight - so we should slowly but surely replace his dry Iams and Friskies with (wet and dry) RD high-fibre diet food.

Over the next fourteen days Jake and I adjusted to a daily routine of pills, scheduled feedings and injections. (Except for the day I mistook my finger for a bit of his skin tissue and injected *myself* with insulin. I started to feel dizzy and ate some chocolate cake!) Over this time Jake appeared somewhat listless and was vomiting the new diet food once or twice a day. We attributed the vomiting to either the new food or the antibiotics he was taking - we *now* know it was a tell-tale sign of too much insulin.

Two weeks later (to the day), I found Jake collapsed in his own vomit and barely able to hold his weight: hypoglycemia. We rushed to apply maple syrup to his gums (minor catastrophe - we only had *diet* maple syrup in the house which is not really ideal!) and to get him to the Vet. He seizured (with complete loss of blatter control) in the cab on route. At the Vet his blood sugar level was 1.8 ml (we’re told 3.5 is normal). After 6 international units of 50% dextrose his glucose shot up to 17.3. We were told to take him to the Emergency Vet Clinic for overnight monitoring. I kissed him goodnight just after midnight.

The following morning I went back to the hospital to shuttle him (IV in tow) to his regular Veterinary clinic. While the emergency visits alone at this point amounted to well over five hundred Canadian dollars, the Vet only had ten seconds to talk to me. She told me that despite another strong dose of dextrose his blood sugar had inexplicably `dipped’ that morning.

When we went to pick him up late that evening we were told that "Jake is no longer diabetic". No more insulin shots. Evidently twenty percent of cats are 'transient' diabetics. Nix the diet food and give him "whatever his little heart desires". Given the erratic tendency of his blood glucose to go down we should feed him "anything he’ll eat".

What next? I’m told to watch him closely for signs of hypoglycemia or excessive thirst. I’m told his glucose production is ‘erratic’. I’d like to hear from others who may have had similar experiences of ‘transient’ or misdiagnosed diabetes. We are taking him back in six days for a glucose check and routine vaccination.

I am left wondering what has happened over the past two weeks. The only thing I know for certain is that so far his treatment has cost well over a thousand dollars, of which I can ill-afford. Is Jake no longer diabetic? Was the 4 units/day dosage too high given the introduction of a new diet? Or did the vomiting contribute to the hypoglycemia? Most importantly, I’m worried about Jake’s future. It seems like one moment he is suffering from hyperglycemia and the next hypoglycemia. The choice is a sudden death from insulin-shock, or a slow and painful one from hyperglycemia, with its attendant problems such as heart disease, loss of eyesight, and loss of limbs due to poor circulation.

With confusion and worry,

Andrea (& Richard)
Toronto, Canada
See the April 1997 Message Board for some dialog about Jake.
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McNugget: Cat With an Attitude!, 4/23/97

I just read your diary of Austin and Eugene, and thoroughly enjoyed it. I have 2 cats, McKenzie and McNugget. They are both about 10 years old. In December I noticed McNugget was peeing a lot and drinking a ton of water. I laughed at your comments about changing the litter box so much. I should buy stock in the Kitty litte business.

I took him in to the vet, and at first he thought it was a bladder infection. My cat is wild at the vet and labeled "CWA", (cat with an attitude), so he doesn't cooperate with giving urine or blood. So he wanted me to give him an antibiotic for 10 days, and if he didn't improve, then bring him back. I brought him back and they did a complete blood workup. And he was diagnosed with diabetes. His blood sugar was 500. So I started giving him 4 units of insulin twice a day. His clinical symptons improved some, and the vet wanted me to measure his urine glucose with dipsticks. Luckily, my cat pee's in the same spot in the litter box, so I put a little container there,and he pee's in it. His urine was still maxed out with glucose, so we gradually went up to 5, and then 6 units.

Once a month the vet had me bring him in for blood work. The lowest his blood glucose got was 239. Then he started peeing alot and drinking alot again, and I could tell he was feeling bad, so I took him in, and his blood sugar was over 400. So they had me increase his insulin to 7 units twice a day, and then 8. Finally, in March, I noticed his urine had no glucose and I was thrilled. I took him in and they checked his blood at 6:00 at night, (time for his next insulin shot), and the glucose was 139. We went down to one dose of 8 units once a day, and after a few days took him in again late, and it was 90. So we dropped down to 6 units once a day. And then 3 days later I took him in first thing in the morning to check his level before I gave him his insulin, and it was 60. The vet was very concerned. So we stopped his insulin. 2 days later, I took him back and it was 79, still on the low side.

So McNugget has also reached the ranks of being a non-insulin dependent diabetic cat. I am thrilled. But I have been concerned about why his levels have dropped so low after being so high. Now I worry more about his hypoglycemic states. That's why I found your diary so interesting. Especially, the possibility of pancreatic cancer. I wondered if there might be something like that causing the fluctuation of his glucose.

I couldn't believe about Eugene. You know I started noticing that my other cat McKenzie didn't seem himself, and took him in for a check up last week. But everything checked out AOK. Guess I was a little overly concerned, but I feel better having made sure. Now that I've read about Eugene, I'm so glad I took him in.

It's so encouraging to hear other people's stories about their cats. I love mine like they're my own kids, and I would do anything for them. In December, I didn't know if McNugget would live till 1997, but now he's completely off insulin. Your story helped me realistically understand that he may not stay off permanently. Thanks so much for your story. It has encouraged me greatly. I will keep up with your diary. And I'm praying for both Austin and Eugene.

A fellow cat owner,
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Moses: calico love hog, 5/8/97

Greetings, well, I found "the" place to write our story. As I noted in the guest book, Moses (Moselle) is a 15 yr old female, calico love hog although spayed she has helped to raise (and endured) every other cat that has come into our household. traditionally she has always been the first to meet me when i come home...a joy all around. In her hayday she weighed 23 pounds and although she had lost 11 of these before being diagnosed, I believe this extra weight had stressed her system over the years and was a definite contributing factor to the problems she has today. Food is the motivating factor in her life and she still tries to sneak it from the other cats although great pains have been taken to make the other bowls inaccessible.

She began therapy when diagnosed, Thankgiving 96, worked up to 5 units 1x day to a low of 1/2 unit 2xday at present. I find the diastix-bayer are marginal at best as her blood tests consistantly lower glucose levels at vet. We have had no seriously dangerous hypoglycemic episodes at this point but they have gone as low as 40. I watch her water intake, urine output but most of all her behavior. If she twitches or becomes lethargic, &/or her coat becomes dry and loses it's sheen, I give her a finger tip of kayo and she feels better within an hour.

Pee samples are hard to get as she is bull-headed about my invading her privacy but I get them a couple of times a week. She is good about her shots. I feed her purina cnm available from vet which she loathes. I sprinkle brewer's yeast on it at night and she chows down (2 of my other three cats love this treat too). I will occassionly mix a little regular dry food with it. I give her 1/4 tablet of tumil-k potassium almost every day.

I can't stress enough the importance of learning your cat's behavior. My noticing changes in her saved her life. And all the information I have gleened here will probably help to save it again. I plan on telling my vet about this site and looking in to a blood moniter too. Thanks to all of you for your time and support. and the best to your kits!
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Tigger: New Diabetic offers encouragement, 5/12/97

I have been the proud parent of a wonderful cat named Tigger. Adopted at 10 weeks from the humane society, Tigger has brought me enormous pleasure and has been the love of my life for the last six years. He has had a very hard life, though. Shortly after I brought him home, he became quite ill with an upper-respiratory infection. The vet I brought him to noticed enlarged lymph nodes and proceeded to remove one in his throat for testing. The vet told me Tigger had lymphosarcoma (cancer of the lymph nodes) and would be dead in a matter of months. Needless to say, the doctor was wrong and Tigger did not have cancer at all (even felines need second opinions! and I am certainly glad I got a third opinion as well!). Tigger did, however, come down with feline asthma at the age of two and has been treated for the last four years off-and-on with steroids.

Tigger was diagnosed in January 1997, at the age of 6.5, with feline diabetes. I am assuming that the steroids he has been on almost constantly for the past year caused the diabetes. In retrospect, I wish I had been told more firmly the direct link between steroids and diabetes as I think I would have undermedicated Tigger's asthma in order to avoid this much more horrible disease. (I could have also become vigilant about eliminating all allergy-causing agents from the house and we could have lived with closed windows in order to help Tigger's asthma) In November, 1996, Tigger started chasing me into the bathroom in order to get me to turn on the tub faucet or the sink faucet. I was amused by his newfound love of water and never thought that water consumption could be that bad (after all, we humans are always told to drink as much water as we possibly can). I went so far as to buy him a little gizmo with an aquarium pump in it which creates a little waterfall and he loved it. Anyway, he started losing weight and became quite bony (although I have to admit he was a stout 16 pounds, so he needed to lose some weight). When I rushed him to the vet for an asthma attack, they noticed he had lost quite a bit of weight and decided to test his blood. His blood sugar was 680, an enormous figure and definitely shocking to me. His large amounts of peeing and drinking seemed like a normal cycle to me. The more he drank, the more I expected him to pee, etc....

Tigger began his treatment on Humulin (once a day) but the vet quickly realized he was not responding. When I brought him home for the first time since diagnosis (he was at the vet for almost three days trying to get stabilized), he was on NPH Iletin twice a day. He remained on NPH for two hard months. Tigger could not seem to get regulated, experienced terrible diarrhea for a period of time, and even experienced his first hypoglycemic episode. In additon, each time we brought him to the vet for a glucose curve, he would become so agitated in the car on the way there, that he would test falsely high and we would overmedicate him with insulin at which point he would crash. We tried numerous urine strips and found them to be rather unreliable since Tigger's high BG did not register on the strips at all. In addition, Tigger was quite upset at the invasion into his litter box and I had to devise a new contraption (taping the strip to a chop stick ) in order to be less invasive into his private affairs. We spent many sleepless nights trying for a urine test (I think he held his pee in order to avoid me! :) )

Finally, my wonderful doctor found a new Fructosamine test that we have tried with Tigger. It is successful because rapid rises in BG do not appear on this test, so his agitation does not register. In addition, we have switched Tigger to Lente (after trying Ultralente) and he is on 4 units 2Xday. Unfortunately, it seems as if this dose is effective for only a short period of time and then he seems to "outgrow" this quantity, needing more insulin. This whole process of regulating Tigger has been an extremely frustrating one for all of us involved. I am still hopeful that we will someday find the perfect dose of insulin for Tigger.

I do not know what my life would be like without Tigger. The thought makes me sick. He has been my constant companion through some really rough times and I have spent many many many many hours wishing him better.

We all love Tigger so much and find solace in this Web Site. Knowing others know what we are experiencing and can help us gives us comfort.

Monica, Tigger & sister Eeyore
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