Diabetes remission & tongue amputation

Hi,

Hope some one can give me some advice. My cat burmese Jim has been diabetic for 2 years or so, and was doing generally well on lantus, apart from recurring ear infections. He has however, in the last few days used up 4 of his lives.. one of those was an op for a hematoma on his ear.

He was boarding at the vets during the weekend as myself and husband were away working. While there he had a big hypo episode - had seziures and injured his tongue so badly most of it, or a large part of it (not entirely sure) has been amputated. He has recovered well from the hypo - luckily no brain damage. It seems he had gone into spontanous remission, as his blood sugars since have been normal since.

At the moment he has a feeding tube while his tongue (whats left of it) heals.

We are hoping he can relearn learn to eat and and drink - so am looking for ideas. We are going to help him with grooming - he loves being patted and fussed over. He will stay on the feeding tube while we see if he can adapt. I am really really hoping he can. We visit him at the vets he is bright eyed and smoochy. We are bringing him home for the weekend.

Anyone got any advice, experience or thoughts ? anything would be much appreciated.

thanks,

Bird

 

Sorry, wish I had some advice. The board is quiet this afternoon. Be sure to check back in for responses later this evening. I know we have people very experienced with feeding tubes. The tongue amputation is a problem I haven't heard of, but your little guy seems willing to overcome any difficulties.

 

Wow, Jim is such a brave cat!

Just a grooming comment because I don't have any feeding tube experience--when my cat Gabby couldn't groom herself properly anymore I used bathing wipes that I found at PetSmart. They worked very well in conjunction with daily brushing. I used one on her every three or four days (as she needed it, but she was still grooming herself some.) I think they recommend that you don't use them more than once a day so that you don't strip the coat of its natural oils.

 

I found a cat years ago that only had a part of a tongue (it was like the front and one whole side was missing), his lower mouth was broken in the front and never healed so it moved independently of the other side. He managed to eat fine, although a little sloppily, and died of kidney failure at a ripe old age rather than from malnutrition. I learned to feed him canned food that I heaped up into a mountain shape. I stayed with him when he ate so I could constantly heap the food up. He ate dry but it was so much harder for him and you heard him banging his mouth in the bowl while he tried to get his remaining part of the tongue to scoop it up. Thankfully he liked canned best. Lapping up milk didn't work so well. While I know it's sloppy, maybe think about syringe feeding him at times.

You'll find a way that works for you and your kitty. Give him a chance.

 

Poor baby..........sounds so painful. A hypo can in some cases put a cat into remission. Are you hometesting? Sounds to me like someone wasn't testing him at your vet clinic. Hope he continues to improve and cats are amazing creatures. He'll learn to eat and adapt just fine.

 

hi there, welcome to FDMB. i was asked to stop by and see if i had any suggestions for this situation, just a few thoughts.....

so sorry your kitty had such a bad hypo while at vet's. weren't they checking his blood sugar levels there before they gave the insulin shot?
it is very possible that your cat has gone into remission, however checking his BG at home every couple of days to make sure would be a very good idea. we all home test our cats, it is not hard to do at all. would you like to learn? we can teach ya easy, just say the word.

now about the tongue...it depends on how much is gone as to how much adapting your kitty will have to do. but i've been working with feral cats for many many years and have seen some pretty extensive mouth/jaw injuries out there and they do manage. of course feeding canned food is best. water drinking is what they have the most problems with so adding as much water as you can to his canned food (some cats will only tolerate it so wet before they reject it while others don't care if you make it into 'soup') so that he doesn't have to deal with water bowl is good idea. most cats fed wet food only, if no other health issues, don't ever bother with the water bowl at all. they get all the liquid intake they need from the canned food. plus all diabetic cats, even those in remission should be fed only wet food.
when you think the tongue has healed enough, or if the cat asks for it, start offering little bits of food. feeding tube must stay in until cat is able to get the adequate amount of calories in orally. (you can use janet and binky's food charts located on this site to calculate how many calories are getting in). felines have a strong tendency to acquire a condition called hepatic lipadosis (aka fatty liver disease) in a short period of time if they are not getting enough calories in, be mindful of that. if you need help with the feeding tube at any time, just start a new thread here, plenty of us have experience with them.

for grooming i would suggest getting yourself one of those all metal flea combs. like this: http://www.fourpaws.com/products/fine-f ... -coats.htm (has a picture of a dog on package but is for felines too). it is able to really get down to the skin and remove dead hair and clean the coat due to the fact that the metal teeth are so tightly spaced. a damp paper towel will work to scrub the face, same with the back end area. you know how much time a cat spends grooming a day, there is a very good reason for that, hence daily combing/cleaning of coat must be done.

i hope your cat will be getting pain management at home for the first few days or however long he needs it. i bit through my tongue many years ago in a bad car accident and can tell you from personal experience it hurts! SQ shots of buprenex or a duragesic patch would be best so that you don't have to mess with his mouth trying to pill him.

wishing your cat a speedy recovery. we are here if you have any issues you need help with or questions.
~jojo

 

It might also help him to eat if you use a feeding dish that is almost the height of his mouth. When Vinnie had 3 canines pulled he had trouble getting the food picked up. Giving him an easy dish to eat out of and at the same height of his mouth he had a much easier time learning to get food without having his teeth to pick it up.

 

Thank you all so much for the replies! very very much appreciated. great ideas and optimism.

I went in and saw Jim today he seems to be improving every day. Tomorrow we are able to take him home for the weekend, rather than have him stay at the after hours vet. He will go back in on monday.

The feeding tube is working well - my husband has been going in and giving him his dinner. Jim purrs when he has his food. He is also having some of his medication via the tube in his food as obviously pills are out for a while. He has always been a right little b*ggar to pill. We will be giving him one medication via injection. He needs another 5 days at least of feeding via tube only to allow the mouth to heal before we slowly introduce food.

Blood sugar testing - I tried initually when he was diagnosed - trying to get blood from the ear, it was a complete and utter disaster as he has on and off ear troubles and hates having his ears messed around with. And the stick pen made a clacking sound he quickly learnt to run from. I didn't get one sample, for all my efforts although managed once to smear blood over his ear and my hand. He was having curves done at the vet which came back very smooth.

Now, I'm keen as to monitor his blood sugar: so will be looking for techniques to do so, that don't involve the ear! I do have ketone sticks so can check his wizz. He will be continued to be monitored at the vet next week.

pain relief... he is on a fentantal patch which runs out tomorrow evening, then the vet wants to switch him to tramadol, which he would have every 12 hours. He had a freakout on temgesic recently with his ear hematoma. Hopefully the Tramadol will be fine for him.

And I'm going to start him off with a soft baby brush, a baby tooth brush and a sea sponge to introduce cleaning, and do it gently and endevour to make it something he will love. I hadn't thought of a flea comb thanks for that - or pet wipes. I have had a look online for wipes - I live in New Zealand and havn't seen any yet, but have found ear and eye wipes.

again, thanks so much for the support and will update on his progress.

Bird

 

I'm so sorry Jim had to go through all that especially the tongue. Not to long ago my Blue point siamese who is well known to be a paper eater sliced his tongue underneath where the tongue connects to the floor of the mouth (think very deep paper cut) and had to have stitches for several days. He adapted fine to eating, but those first few days I just added extra water to his food. As his mouth was so swollen he couldn't open it to eat normally. And many many years ago when I was just a very young girl we had a cat that had no tongue at all, we found her that way so have no idea what happened to her, but she ate just fine, she had learned to use her teeth to pick up her food and just kind of swallowed it whole, so we just fed her canned food. She did fine and past away at a ripe old age.

Cats are highly adaptable creatures, they figure out ways to get around just about every type of handicap.

Wishing you and Jim many more years together and a speedy recovery for Jim.

Mel, Max & The Fur Gang

 

Hi Birdi!

You are doing great things for Jim, and there is good advice here, eh!

I can't really offer any help, but as a fellow-Kiwi, I am just saying welcome to this great Board!
My diabetic cat Myrtle got cancer in 2007 and I had to put her to sleep. I still hang out here however! :smile: I have a non-diabetic rescue cat, Murray, adopted from the SPCA when he got lost after our Sept. earthquake. Thankfully he didn't run away after Feb. 22!

 

To alternate with pet cleaning wipes, a simple damp washcloth may be used to "mom cat" and help clean and groom. My civvie, Buster, who hates being messed with, will let me use one to gently swab out his continually waxy ears and even damped with plain warm water, it is working well!

 

We got Jim home yesterday and the tube feeding is going well. He went to his food bowl area this morning and mewed a bit, so he has an appetite. And he is pooping and peeing normally. Currently sleeping stretched out in the sun on the sofa.

He is starting to attempt to groom - which is great. At this stage involves knawing with his teeth and gobbing spit. I'm going to start to get him used to brushing him today. Can see that his tongue (whats left of it) does get quite forward in the mouth.

And hi Allie! thats fantastic you took in an earthquake refugee! glad Murray didn't run again after the Feb one. Hope you and yours fared ok. Its been a bit of a weird time with the moon man and all. I'm in Wellington.

& thanks Mel, thats encouraging to hear about the kitty from your childhood.


Bird.

 

I'm glad Jim is home and enjoying the sun. You sound like a good mom.