Almost 22 years

Max just diagnosed with Diabetes sugar levels 526. This number came about from normal in June 2015 to Jan 2016. Many discussions with vet all other blood work was fine. Vet is saying any course of action would be okay because of age. Max has lost mass but diet is fine. Has been on a steroid due to arthritis and stomach issues for the last three years on an as needed basis based on symptoms. Vet has been consistent and excellent in care. Diabetes was discussed when prepping for a surgery to remove a growth on lower jaw that burst and started bleeding. Very torn on prolonging the inevitable, based on what a couple of good friends have gone through with their elderly cats. Any encouragement/expectations as to how long we could extend Max's quality of life if we start on an insulin regimen would be appreciated.

 

Hi and welcome to FDMB. Wow! Max is almost 22 years old?! You are to be commended for the wonderful care and love your cat has and continues to enjoy. While I can certainly understand you questioning what to do at his age, diabetics can live long quality lives so if I were in your shoes I think I'd be basing decisions on a more global level as Max may be aiming for a spot in the Guinness Book of World records! Seriously though, I think the decision has to be about quality of life.

Questions I'd ask would be:

• can you get Max off the steroids completely (may be the cause of the diabetes) and use some alternative meds to help his tummy and arthritis? If he comes off the steroids, and that is what caused this, there is a higher chance he could go into remission with nothing more than a change of diet?
• what are you currently feeding Max and if kibble, would you be able to get him to eat canned food only?
• what if any other health concerns are at play?
• what was his quality of life like before the diabetic symptoms (assuming he might be peeing excessively, hungry all the time, coat looking rough, etc.)?
• is the arthritis severe or is he still relatively active given his age?
• what is his temperament.....would he accept you giving injections and testing his glucose? Just to be clear, most cats have no issue with this stuff and many actually come at testing/shot time to remind their caregivers. My cat doesn't like being picked up and absolutely HATES being held against her will and yet she is the most wonderful patient kitty when it comes to testing and shots. I think they understand what you are doing is helping them. And they really don't experience any pain from either testing or the shots!

You know your kitty better than anyone but diabetes certainly doesn't need to be a death sentence. Maybe you could try changing his diet and see if that helps, before making a final decision. Please note that blood glucose readings taken at the vet are usually elevated due to stress so Max's readings may not be as high as they seem. If you could also do some home testing, you would be able to see his true readings and judge better what effect a diet change is having. And maybe (fingers and paws crossed) he will go into remission on diet alone and your concerns will be a thing of the past!

We can help you find an appropriate food and testing supplies and assist you to learn how to test if you choose to give this a try!

Thank you for being such a good pet parent!

 

Diabetes is easily treatable and I would start treatment with insulin. The steroids likely pushed Max into diabetes. One can still treat the diabetes while continuing the steroids. Steroids increase insulin needs.
What concerns me is your statement "a surgery to remove a growth on lower jaw that burst and started bleeding."
Sometimes such tumors are squamous cell carcinoma. There really is not cure and when surgically removed they just come back. If that is the case hospice care might be the best option.

 

Welcome to FDMB.
Home blood glucose monitoring is very important to ensure the glucose doesn't go too low if you decide to start insulin.
Other useful assessments may be found in my signature link Secondary Monitoring Tools.

 

Max was on steroids intermittently for the last 3-4 years. They were only given when the symptoms of vomiting and slowing movement were extreme. The vet has been very good at providing treatment information. Max would go 2-3 months without an injection. Max is also a very social and outgoing. Everyone that has met him was always surprised how vocal and attentive he is and surprisingly he's really not one to get stressed over anything. He's an indoor cat and always has been since we adopted him at the age of three and just shy of 19 years ago. He's really great at the vet.The shocker was his jump in sugar to 526, even the Vet was taken aback that the jump from normal to 526 within six months. Keeping in mind that last June when Max's blood work was done the Vet jokingly said that Max could outlive us because everything was perfect for a cat his age. Concerning the diabetes issue, the Vet stated that the steroids probably had been a factor but then Max might not have been able to live as long as he has because of the arthritis and intestinal problems. If it hadn't been for the surgery to remove the growth, which was a squamous cell carcinoma which the Vet said it was deep and quite nasty, we would not have even found out about the diabetes issue. The Vet recommended to wait a couple of weeks and when we bring him back in a couple of weeks to remove the stitches, we will discuss the insulin issues. The Vet recommended that if we agree, we would start him on the lowest dose of insulin and after a couple of weeks retest his blood. He did not recommend daily testing right away. All in all Max has had a great long life and it is so sad to see him with all these items happening at once but he's been a trooper. Max is also a cat that knows dignity and he can really display his sadness when something is wrong. We want him to be with us for as long as he can without him suffering, it's not fair to him to go out in pain to keep us in comfort of his presence.

 

Sounds like Max is quite the trooper with a wonderful disposition. I think if I were in your shoes, I would at least give the insulin a try but I would definitely home test to keep Max safe. It's really the only way to see how Max is responding and ensure he doesn't end up having his BG numbers go too low.

If all this was discovered when Max was undergoing surgery for the growth, I'd assume his glucose levels might have been elevated somewhat just by the stress of the exams and surgery as well any existing inflammation from the growth. Even a low dose of insulin can send a cat's BG levels dangerously low so at the very least, I'd have the vet recheck his numbers at his follow up appt. before deciding to go forward with insulin.

Please keep us posted on what you decide and how Max is doing!

 

Congratulations on doing such a good job of taking care of Max! And welcome to the forum I wouldn't wait too long to start home testing and to get him on insulin. He is, after all a VERY senior citizen, so a delay of weeks and months ...time is not on his side.

Since he has such a strong constitution I think he'd do well on insulin. I have a special interest in this kitty because I had a cat who also made it to age 22. We moved from Baltimore to New York, and it stressed him out so much his health suffered from the stress of the move. The vet we had at that time told us that JJ had developed diabetes, but he didn't tell us that insulin was available for him..(and that may be true..this was 28 years ago, folks) We had to euthanize him...I'd had the cat longer than my son. It was very painful for us.

I'd like to see Max keep going to break that Guiness World Record..and so you could have him a few years longer. So go for it. I agree with Larry though...did they do a biopsy on the growth?

Other than the concern about the growth..Tell the vet yes, you'll do it. Everyone here will help you learn the ropes. This is a great message board..there's almost always someone online to help. And home testing is not at all hard..and the way to go, since at his age, Max needs to be very stable as soon as possible...testing with urine strips is too iffy for a venerable kitty as he.

Do you have a picture of this old fella? We'd love to see him. And what would you want us to call you?

 

If Max was a good enough candidate for surgery at 22, treating with insulin is almost a no brainer. The only proviso for me is wondering about the tumor. You need to ask your vet to be honest with you about Max's prognisis discounting the diabetes, which is really easily treatable. If the prognosis is good, then I would treat the diabetes if Max was mine.

I do hope the high glucose is due to the infection and surgery, but if you need to start insulin, please consider home-testing. Many vets do not suggest home-testing either because they don't think their clients will do it or because they really don't know how effective it can be. I've had 3 diabetics over the years, and home-testing made all the difference with Maggie.

Good luck.

 

Only reason on waiting till the sutures come out is to also get results of the tumor and recheck the blood panel. What everyone is saying about starting insulin right away is really good information and appreciated. Our hope at this point is that having the tumor removed and allowing Max to get back to normalcy and change up the diet a little will actually bring the levels down. The Vet is being very cautious with good reason. There could be a problem with cancer.

 

You could consider beginning home testing now before deciding whether to start insulin. Testing now would help establish a baseline where the readings are unaffected by a vet office visit. You could also get an idea of whether the numbers are trending up or down which could help determine if the stress of the tumor and the surgery were contributing to the higher blood glucose levels.

 

Took Max back to the vet today to have his sutures removed and re-do the blood work. The vet was amazed at how the numbers went down in just 2 weeks. Though the numbers could be better the vet said the decision to not do insulin is the correct path for Max at his age. The changes I made are as follows.....I took him off the Fancy Feast canned food with gravy and eliminated the Purina Cat Chow Gentle, no dry cat food from here on out. I provide him with a can of Fancy Feast Classic in the morning (7 am) and evening (5-6 pm) of which he generally only eats three quarters of at each feeding. I make sure I remove the food after 4 or 5 hours. He generally only drinks 5 oz. of water over a 24 hour period. I didn't second guess starting insulin from the beginning because he shows no signs of Diabetes other than loss of mass, his weight has been constant for the last year and a half. Now the Numbers....his Glucose level is still above normal (71-159) at 240 but went down from 526 to 240 in 2 weeks, last June the level was 190. The vet thinks it will probably come down a little more if the feeding schedule and type is maintained. We were giving him a steroid shot approximately every 60 days for a vomiting and arthritis issue. The vet says the shot probably contributed to or could be the cause of the high glucose number. The vet says for being 22 Max is doing great, but his age is rapidly catching up with him. He's wobbly and cautious when walking but he's a trooper and we'll just pamper him a little more than usual and we will let him proceed through the rest of his life as he wants to and of course hopefully without pain.

 

Thank you for giving us an update on Max. That significant improvement in his glucose levels from diet alone is wonderful news! I have a 17yr. who is a little less steady on his feet these days too but is otherwise trucking along. He however has to be sedated at all vet visits so if he were diagnosed with diabetes, I think I too would consider quality of life as most important and act accordingly. Cuddle and pamper him and let him live out his days knowing how loved he is. Fingers and paws crossed that Max continues to improve and that all the cancer has been removed and he gets that Guinness Book of World Records!

 

Wonderful update. Just a thought here. You could try Zobaline (b12) for his weak, wobbly legs. It's easily crushed and can be added to his food. You do not need a prescription.

 

Max is handling life on his own. Vet is amazed that he is so vibrant yet fragile. Vet says not worry about the diabetes #'s (low end) for the way he has responded to the diet change. Yeah he's still a little wobbly but still makes it up the three steps to get onto the couch for his daily siestas in the sunroom. Everyone is just amazed how he stays social when there's a crowd over. He doesn't want to miss out on anything. He really demonstrates he just wants to live his life to the fullest. He has days when he looses his voice and we just joke and call him the whisperer. 22 years and looking for more. There's people that don't have his zest

 

Thank you so much for the update on Max. It is absolutely wonderful to hear that he's enjoying life at 22 years young!


Mogs
.

 

I'm glad you are taking this path with Max. At some point, you just want him to live out his life with as little intervention as possible. If he's happy, that's all that counts, right?

You're doing a great job.