Diabetic Cat - Will not pee in litter box, glucose never going down.

Discussion in 'Feline Health - (The Main Forum)' started by CrevLM - Lisa, Dec 24, 2017.

  1. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017
    Hi everyone,

    Just a bit of backstory, as I'm brand new to this forum.

    My name is Lisa and I have two cats at home at the age of 8. One of which is Lily the diabetic and was diagnosed about a year and a half ago. Here's as much details as I can think of at the moment, please ask if there is anything I left out that may be important


    -She lost a lot of weight and has had diarrhea since day one (never been solid stool since) (about soft serve consistency if that helps anyone answering)
    -She was in the high 500s when we first started treatment with our first vet.
    -First vet provided us with a pen insulin and started at 1-2 units and we ended up around 7-8 within about 3 months ( I apologize I don't remember the name of the first insulin, but it was a pen version)
    -First vet was incredibly rude and then took an unannounced trip to China and would no longer fill prescription.

    -Found a new vet that told me he had no experience with that insulin so he moved her over to ProZinc. Started low and ended up around 18 units, I felt like I was getting nowhere and spending a fortune on needles, and prozinc, (about 2.5 bottles per month at $180 a bottle) I felt like the vet was ripping me off, and not really do anything but making it harder and harder to afford her. Told me I shouldn't be alarmed at the dosages etc. So I continued at the 18.
    -(Side note, she did respond to the prozinc at first, and then when we raised it, then she would become immune to it and it stopped working until a much higher dose and so forth.

    -My dad watched my cats for about 5 weeks while I was off at a TDY (Military) so he took her to our family vet back home, who wanted to move her to Vetsulin. She started on 5 units, responded, and then again same thing tolerance built and it stopped working, went up to 10, same thing.

    -When I got the girls back I knew I had to find a different vet up here, and that brought me to my current vet who was absolutely alarmed at the high dosage she was on. Told me I immediately needed to bring her to a specialist...

    -Brought her to the specialist. She has pancreatitis and a kidney infection, they gave me an antibiotic to try and treat the diarrhea that did absolutely nothing.

    -They insisted that I switch over to Glargine (Landus) which is absolutely ABSURD in price. $300 a bottle... at 1 unit. I laughed because it has done absolutely nothing.. in fact since she's been on Landus is when the current problem has come to light which is the below...


    She's always had accidents outside the box. Or missed the box or whatever the case may be.. but since she's been on the Landus she REFUSES to pee in the litter box.. still uses it for number 2, but she has destroyed my couch.. Four - Five times while I'm asleep peeing on it. All over my wood floor, destroyed that in several spots. I have tried everything from putting spices that cats don't like, to citrus smells, to calming sprays, to blocking sprays, double sided tape on the furniture etc. She destroyed two rugs. My townhouse is all wood linoleum and tile except my guest bedroom that stays shut. I have tried multiple litter boxes, multiple types of litter, all the corn cob litter did was infest my house with disgusting flies. And the others didn't clump at all so cleaning it was impossible.

    I can't handle it, It's been two months like this.. I spend 3-4 hours a day steam cleaning my couch, mopping my floors, scrubbing everything. Just for her to turn around and destroy it five minutes after cleaning.. I can't handle this anymore and I'm getting more than a few people telling me to put her down. I am at my wits end. I've had two major meltdowns in the last few days, my mental health is suffering, and I'm deeply considering putting her down if this is the quality of life she has.

    Does anyone have experience with this at all? I'm so tired of being asked if she has a UTI or if there are other underlying conditions.. she's been at the vet numerous times and no one can give me an answer on why she isn't responding to it, why she's peeing out of the box, why she hasn't had a solid stool in 1.5-2 years.

    I'm sorry for the huge book, I was recommended to check out this forum by a friend of mine, and I just need people to talk to that are dealing with or have dealt with this kind of thing in the past or present.

    Lisa
     
  2. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Welcome! It sounds like you and your baby have been having a very rough time of it. Peeing outside the litter box usually does indicate an underlying health issue (sorry, but that is the truth) unless the box is not being kept clean which does not sound like an issue here. It sounds like you have had to turn into a cleaning machine lately. What is the status of her pancreatitis and kidney infection? Have her teeth been checked for issues? You said peeing outside the box has become an issue since she was put on Lantus, so maybe it is a reaction to that. I am not personally familiar with Lantus but a lot of people here are, so I am sure you will get input about that. Does she have hyperthyroidism? Has she been tested for acromegaly? Please share what her glucose numbers have been lately and where she is on dose (still 1 on Lantus?). Do you test her glucose at home?

    Lots of things can result in runny poop. What do you feed her? It sounds like she has a lot going on with her, so it could be related to any of that, but it could also be a food allergy/sensitivity or IBD. My sister's cat's poop had become a real, ongoing issue (he is otherwise healthy). The vet put him on Metronidazole for it (which, I assume, is the antibiotic Lily was given for it), but it had no impact at all. She also had him on Fortiflora but no impact there either. She then put him on a novel protein diet (rabbit). After several days on it, his poop started being more normal. He is on his second month of the food, and the poop issues have not returned.

    I am glad someone sent you to this forum. You will see that there are a lot of great people here with an incredible amount of experience with just about anything cat-related. You will get lots of advice and support.
     
  3. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Welcome! You've been through the wringer haven't you? You're obviously a devoted kitty parent and have come to the best place for help with all of your kitty's issues.

    I suggest you go straight over to the Lantus forum to get some insulin-specific help. It's a large forum with many very experienced members. Some have kitties who have high dose conditions, some with GI problems - the list is endless. They can get you on track with a good plan to address the insulin, pooping, etc. BTW - many order their Lantus from a reputable Canadian pharmacy in Vancouver, Marks Marine Pharmacy, at about half the cost in the US.

    Their approach wrt your kitties diabetes will be to get you on a structured BG testing/dosing plan that can look onerous when you're just starting out. Believe me, though, it's the best way to get some semblance of control. :)
     
  4. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Welcome! You poor thing, it sounds like you have been absolutely put through the wringer [edit: @Kris & Teasel 's post just appeared-- I swear we didn't coordinate our terminology!!!] on this! FurBabiesMama gave you a lot of good information, I just want to highlight a couple things:

    1) In addition to acromegaly, there are a couple of other conditions that can require high (sometimes very high-- 20, 30, more units!) doses of insulin in cats. We have a forum called "Acromegaly/IAA/Cushings Cats" where these issues are discussed and there's some good general information in the "stickies" up top. Given how high Lily's dose went on two different insulins, testing for these conditions to rule them in or out might be helpful.

    2) We can help you save money on Lantus and other supplies. My initial guess is that the peeing outside the box since she was put on it is more likely to be a reaction to the drastically reduced dose (and thus skyrocketing BG numbers) than the specific insulin, so it might be worthwhile to stick with Lantus for a while. It's generally considered a good insulin for cats, as is ProZinc.

    I hope we can help you here. There is a wealth of knowledge and experience on this forum. Hang in there!
     
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  5. donnalea

    donnalea Member

    Joined:
    Jun 18, 2016
    I agree with all the above posts. There are a few things that you need to do, no matter what insulin. First, you need to rest his BG before you give him his insulin shot. Have any if the vets talked to you about this?

    Second, you need to get your kitty on the right food. A canned, low carb food. You might have to try several flavors before you can find one that agrees with his stool problems. My Callie can only eat chicken or turkey.

    To get started, we need you to put all your information in your signature. What insulin you are using now and how much, what meter and what are you feeding him. The wonderful person on this forum will be able to help.
     
  6. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Great advice above. Are you testing his bg at home? That will be key in getting it under control. I have a video in my signature showing how I test my cat CC at home. If you would like a shopping list let me know.

    Are you in the US? Many people here that are on lantus and live in the US fill their lantus perscription through a Canadian pharmacy online called Mark's Marine Pharmacy. You can get five 3 ml pens of lantus 15 ml total) for $150... Less then half of what you are paying now.

    Your cat may have box aversion from painful experiences in the past. Try putting puppy training pads down. You also must get rid of any trace of past accidents. My absolute favorite one is called Anti Icky Poo Unscented. You can buy it by the gallon on amazon. Hands down best cleaner ever.

    The tummy trouble. What are you feeding? She may have an allergy. Try a limited ingredient novel protien. Also add a good probiotic to the diet. It also wouldn't hurt to add vitamin b 12 methylcobalamin supplements as it can ward off diabetic neuropathy, but also if she has irritable bowel syndrome, they usually are b12 deficit.
     
  7. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    (((Lisa)))

    Re the peeing issue (I feel for you!), is your cat having even slight trouble walking/jumping at all, even a tiny bit 'flat-footed'?

    If yes to any of the above, your kitty may have issues with diabetic neuropathy (nerve damage caused by high BG levels). Some cats with neuropathy may start urinating inappropriately. The good news is that neuropathy is reversible through better BG regulation and also supplementation with B12 methylcobalamin (need a diabetic-friendly preparation like Zobaline - available online). As Janet notes above, cats with GI issues are frequently found to be deficient in B12 (and B12 certainly helps with pancreatitis symptoms).

    WRT BG dosing and improving regulation, if you're not already doing so I really can't recommend strongly enough that you learn to home test. I'm on the same page as your 'Lantus vet'; those doses of Prozinc and Vetsulin are very high. (Note: it may be that your cat has a high-dose condition but there are tests a vet can run with a view to diagnosing these - see the 'sticky' posts at the top of the Acromegaly/IAA/Cushings Cats sub-forum for more information.)

    If your vet has put your cat on a significantly lower starting dose of Lantus that might initially worsen any neuropathy issues. Working up the dosing scale is gradual and it can take a little while to find that 'breakthrough dose' - not ideal in your current predicament, but please don't lose hope. There is a very active Lantus/Levemir support group here and experienced members there will be able to offer you a great deal of help and support to improve your cat's BG regulation. When your kitty's regulation improves any underlying neuropathy problems should also improve and that would help with the inappropriate elimination issues.

    Should it be the case that your cat has a tolerance problem with Lantus, Levemir is an alternative choice of long-acting insulin.

    In the meantime, puppy pads can help somewhat in reducing clean-up time. I don't know whether or not it's available in the US but I use OKO Plus Cat's Best wood-based clumping litter. It produces well-formed clumps that are easy to remove from the box (compared to the cement-like lumps formed by mineral-based cat litters). Perhaps try a lower-sided litter tray to see if that might make it easier for your cat to get in and out of?

    Re the 'soft serve' poop, I feel your pain even more. First up, has your cat been checked for thyroid dysfunction in addition to the FD and pancreatitis tests? I ask this because I've had to deal with both chronic pancreatitis and hyperthyroidism and both conditions can cause GI issues, as can inflammatory bowel disease (IBD). In both cases it took me months of trialling different foods months to find a diet that agreed with the cat. (If anything it was harder to resolve the runny poop problems for my hyper-T kitty!). If you can find a food that better agrees with your cat that may help the diarrhoea. Also, plain canned pumpkin and slippery elm bark can help treat soft poop/diarrhoea.

    Once I got Saoirse onto a food that she would eat readily I found that nausea control was key to successfully managing her chronic pancreatitis (some batches of the same food might upset her a bit) but prompt home treatment with the right meds made her day-to-day care relatively straightforward.

    If your cat is producing foul-smelling faeces that are somewhat 'fluffy' in appearance (e.g. like a runny marshmallow texture) or if they are any way pale or greyish in colour then ask your vet to run an fTLI test for exocrine pancreatic insufficiency (treatable with pancreatic enzymes).

    Another thing to look at is food allergies. Blood tests are available. While the test results are not definitive they may give you some pointers about foods to avoid.

    Here are some links that I found very helpful for dealing with GI issues:

    IDEXX Pancreatitis Treatment Guidelines

    Feline Constipation (great info on gut health and dietary fibre)

    IBD Kitties (extremely helpful site for kitties with GI problems)

    I hope some of the above helps you and your kitty.


    Mogs
    .
     
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  8. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Hi Lisa and Lily. You have been treated unfairly by a vet, not a surprise here. Let us get you through the next few days and we'll do the best we can. No one likes cat pee or wasting money, we've all been there.
     
  9. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017

    The problem I had with it was people not listening to me when she's already been checked for a UTI several times. That was more where I was going with that. She was being treated with Metronidazole and the Fortiflora but it did not have any effect what so ever with her. Apparently Lantus/Glargine is also a people insulin. I do not test at home, because she has never stabilized, I was going to purchase one if and when I was comfortable not seeing a vet for it. I have no idea about the Hyperthyroidism or what that really is. I don't know if she has been tested for Acromegaly or what that is either.

    They stopped pulling glucose tests recently, but the most recents were upward in the low to mid 500s, she has only been down below 300 once. And that was with a curve scale on 5 units of Vetsulin, which worked the longest, but then she yet again got immune to it, (lasted about 2-3 weeks before ravenous hunger, hyper thirst and such came back)

    I have had her all the way up to 5-6 units on Lantus no change at all just like the 1 unit.

    As far as diet I've tried everything the vets have recommended. We started with the ID diet try food to try to help the diarrhea, that made no change. Tried numerous high protein dry foods, the ID wet food, science diet wet foods for sensitive stomachs, high protein wet foods and more. Really the only different type of diet I haven't tried was the raw diet.

    They said it could be IBS/IBD so far she's has an ultrasound and other cultures, blood tests etc done. The vet is sending me back to the specialist to get an endoscopy done.. which will be another small fortune for what my guess will be like the last..little actual result.
     
  10. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017
    Hi Mogs,

    Lily has been tested for Cushings it was one of the first things we suggested to the vet because my brother just had a cat diagnosed with diabetes but in reality he ended up with cushings and passed away shortly afterwards. So I wanted to rule that out first. That test came back negative back almost two years ago.

    She has some issues, but I see that more when it appears she may be dehydrated, rather than a more consistent basis if that makes sense.. or I could just be reading that wrong which is incredibly possible. I tried 3 or 4 different boxes of varying sizes and styles of litter.. I made the terrible mistake of trying corn cob litter and it infested my house with flies in a 24 hour period (I cleaned the box every time they used it to see if she would adopt one of the new litters) so it wasn't a.. like lack of cleaning issue.. I'm still trying to get the flies out of my house and that was 3 days ago.. My house feels so disgusting fighting them off and trying to kill them. So I am very very hesitant to try anything else like that again. My house is disgusting enough with her destroying my furniture and floors last thing I need is flies and bugs to make my house a total waste land.

    I've been trying to get her to go outside more because she will pee in the grass in my backyard on occasion, and for everytime she does that that's one less time I have to steam clean the couch that day. But I can't always do that unfortunately.

    The feces is incredibly foul, she also does not cover her feces either. So it's like getting hit with the smell of death across the house when she does use the box. I would say it's a light brown/yellow/greenish kind of color. Fluffy I'm not sure would be the adjective I would use to describe it. It's about the consistency of soft serve would be my best guess. I guess a little less airy if that makes sense.
     
  11. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017
    I am in the US yes, and no I am not testing at home. I was planning on moving to that once her levels had become more stable. I have heard of the over the border options, however I don't use the pens, I use the vial and needles, it's 100ml total so that would not be a better deal price wise as I'd be getting far less insulin for more money and it would be the pens not the bottle and needles.

    I haven't yet tried the puppy pads, hesitant to use them actually. Unfortunately there is no way to get the accidents fully out of my couch as I cannot remove my seat cushions and it has seeped all the way down the bottom of the cushion into the base of the couch.. I'm going to have to throw away this couch, but I'm not going to waste my money for her to destroy another couch as soon as I buy it. I have already tried protein diets they did nothing sadly. Various types with different add ons as well.
     
  12. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017

    It's a little impossible to do that considering she gets extremely worked up when she knows she's getting fed. I have been through 17 different types of food, from generic dry foods, high protein dry foods, sensitive stomach dry foods, ID wet food, and dry food, High protein wet food, science diet prescription wet food and others. She right now is on a combination of a high protein wet food with a tiny amount of high protein dry food mixed in.

    I don't know how to edit the signature. Sorry I'm brand new, not really sure how to do anything on this forum... also how do I change my name from my real name? I'd prefer to remove my last name but can't seem to figure out how
     
  13. donnalea

    donnalea Member

    Joined:
    Jun 18, 2016
    It took a while to figure out what cat food that Callie could eat. I had taken her I into the vet because I thought she had IBD. The vet suggested I keep track of each food she ate with at least a week between different foods. We found that she could eat any poultry. We feed back her Fancy Feast, Friskies or Sheba. Fish, especially salmon makes her very ill. She can eat beef or mixed grill as long as it's only once in a while. It took a lot of patience, but now she is well. She doesn't seem to get tired of eating the same food every.
     
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  14. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Perhaps put a waterproof sheet on the couch like a fitted sheet. Sorry your couch got ruined. The puppy pads worked well for me when I had a cat with kidney disease. Although when he first started peeing out of the box he didn't have ckd, but that did make it worse. He used pee pads for the last three years of his life. It really saved my sanity! And my home!


    Whatever diet you choose, absolutely NO DRY FOOD unless it is Young Again Zero carb (they have a limited ingredient pork based one, might be worth asking for a free sample. You can write them at Youngagainpetfood.com ). We say no dry because even the perscription diabetic dry food is about 14-16 percent carb and it's important that they stay under 10 percent carb. Most of us feed canned fancy feast classic or Friskies pate foods.

    It may be worth it to home test.... That's when you will see progress on a day to day basis and know what's working or not working. It's easy and not super expensive. I have a video in my signature showing how I test my cat CC at home.
     
  15. Lesliejm

    Lesliejm Member

    Joined:
    Dec 1, 2017
    I went on Lantus website and printed a 100$ off coupon on Lantus. It worked at my pharmacy. Hang in there and let us help you!
     
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  16. Tracey&Jones

    Tracey&Jones Well-Known Member

    Joined:
    Dec 12, 2016
    First off :bighug::bighug::bighug::bighug:. Very stressful circumstances indeed.


    Is Lily on any other medications right now?

    Jones has IBD/pancreatitis and he had/has the poop you describe. He ended up on a steroid for the IBD and Metronidazole for the diarrhea. Does Lily have any issues eating? I have never been able to get his poop problem totally fixed but I don't get those goose poops any more. Outside of the meds, food is a big factor as mentioned in previous posts. I did try raw with Jones, and that was a no go. I ended up using Rawz canned Turkey and Chicken. I did get an allergy test and he is really allergic to Tuna. 2 licks of tuna water from the can will give him the runs in no time.


    He also went through about a 2 week period of going outside the litter box. It seemed once I got his BG's under better control, that stopped. And oddly enough that was after he started insulin. I wasn't home testing then and I think I was sending him into to some incredible high numbers as my dose was too high and was actually making his numbers worse. That does not rule out high numbers in your case as it seems you have another issue going on.

    As for home testing....IMHO....that is not wait to be stable situation....that is a tool you use to get kitty stable. Takes a lot of effort up front but it does pay off eventually.

    Also, I use the pen as the vial and just draw from it using a syringe.
     
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  17. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Lisa, a few posts up I said "We've all been there" which now looks like a really flippant remark. I can't imagine what this is like for you so no more cheerleading from me. Is there any possible way Lily could be put in a space where she has food, water and litter and you could regain some sanity? At least some little thing?
    I tore my hair out dealing with a family member when everyone else was sunning themselves on a rock in Florida and totally resented it, got no help at all. And that someone peed in my car. I really, truly hope we can get you through this. There are a lot of smart people here with years of experience who are eager to help you.
     
  18. Stephanie & Quintus

    Stephanie & Quintus Member

    Joined:
    Dec 9, 2017
    So, signature and name: http://www.felinediabetes.com/FDMB/account/signature and http://www.felinediabetes.com/FDMB/cz-changeusername/edit

    Then: it's a bit daunting to arrive on these forums because you end up getting a ton of advice which basically asks you to change pretty much everything you've been doing. I've been here a few weeks, here's my "newbie to newbie" advice:

    - don't get worked up about the food right now; Quintus doesn't do well with food changes and when I moved him over to "diabetes special" wet food upon diagnosis, he had diarrhea, stepped in it (he's blind), then stepped on my face at 4am. when I arrived here I absolutely didn't want to change his food. as I started measuring his BG, and saw how high it was, I realised I needed to rethink the food issue, and am now transitioning from HC kibble to LC wet. Quintus is stuck on a mix for the time being, which helps keep his BG down and his poop happy. All this to say: this is not the first thing I'd invite you to deal with, particularly if changing food is stressful. A day might come when you will want to do it, and it's easier to go through changes when we are completely on board.
    - home testing is what I'd start with. you don't need him to be stable to home test. on the contrary, home testing might give you valuable data that can help you (and your vet if they are on board) get to "stable".
    - when I started Lantus (home-testing) I was appalled! It seemed to be doing nothing. Then we upped the dose (from 1 to 2) and I woke up to a cat with "normal" BG levels, only this was 12 hours after the shot, not when he was supposed to be at the lowest. When I slowly started the food transition (1/3 and 2/3) things definitely improved (we were up to 3 units then). Now we're down to 2, a few weeks later, and his BG has really taken a (good) plunge. Have a look at my spreadsheet in my signature. So... could be worth sticking with Lantus. Be warned, though, it really needs to be administered pretty much 12 hours apart (give or take 15 minutes). And if you remove carbs from her food, be prepared to see BG levels drop possibly dramatically and have to reduce the dose. I hear that ProZinc is good if your schedule doesn't allow for strict 12/12 injections.
    - peeing: gosh, what a nightmare! has anybody suggested it could be a behavioural issue? some friends of mine had a cat who absolutely peed everywhere. In bed. On the desk. On the kitchen table. On the floor. He also would meow loudly every night at 3am. After checking all the physical stuff they ended up seeing a behaviour specialist who put the cat on a small dose of Prozac. Prozac is a very efficient anti-anxiety medication for felines. In a few days, the nightmare peeing and night-time meowing were history. The cat was still himself, just without the crazy peeing. So: are there any signs your cat could be anxious/stressed? Might be worth a last ditch try, doesn't cost much compared to a couch...

    Hope this helps!
     
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  19. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Member

    Joined:
    Sep 15, 2017
    All I can say is that you’ve gotten a lot of really good information from the kind people here! I bought Dr. Elzys cat attract litter & it really stoped Baby from peeing elsewhere. That being said... I still have to wonder if there is another issue with her health going on. It took a month of the right antibiotic to get rid of her UTI. If they’ve had it a long time; it takes a long time to get rid of it. When I switched to all wet Friskies pate, mostly poultry & mixed grill... Baby’s numbers decreased. I have some YA food for treats. Low carb all. Most have told you that testing before each shot & mid cycle is necessary no matter what a vet may say! I wouldn’t give my grandmother a shot if insulin without first testing her bg, and quickly learned how to do this with Baby. I didn’t like it at all at first, but Baby soon seemed to realise that I’m doing it for her own good! Remain calm, treats afterward!
    She also had diapoo in the beginning. She was on the 2 items you have given. Eventually as her numbers got a little more even, that went away. Coincidence ? I don’t know. Uncontrolled numbers & many other factors could play a role in this part. Or the antibiotic, or no more dry food, or....
    I’ve also had a thyroid kitty & they eat ravenously & never get full. Lizzie lost wait & her stomach growled like extreme hunger noises. That’s when we went to the vet. You can hear the grumbling from 5 feet away! I did with Lizzie anyway. There are great treatments for that & easy if this sounds familiar?!? They usually begin checking thyroid at age 10-12... especially if eating a lot & loosing weight. (Like diabetes)
    I don’t know if anything I’ve said here has helped & you’re probably tired of reading but hang in there! You’re asking the most knowledgeable people on this planet here at FDMB!! Many :bighug::bighug: to you & thanks for being such a great determined kitty momma!
    :cat:
     
  20. Stephanie & Quintus

    Stephanie & Quintus Member

    Joined:
    Dec 9, 2017
    Oh! liquipoo: has she ever been tested for giardiasis? https://en.wikipedia.org/wiki/Giardiasis (a parasite that can give chronic diarrhea and is not eliminated by normal worming pills). Has she ever had a stool analysis?
     
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  21. Lesliejm

    Lesliejm Member

    Joined:
    Dec 1, 2017
    I was in your shoes a few weeks ago and was in panic mode. Trust me it will get easier. I have read most of the stickies and I have learned so much. Get a spreadsheet going so you are able to see the numbers. That helps me so much. It might take a while to get your kitty regulated at the right dose. I learned that this forum knows more than a vet. People on this forum have experience. Most vets don't deal with this on a daily basis like we do. I really use this forum for help rather than my vet. It makes a difference. This forum is great and I wouldn't know what I would of done without all these great people! One of the vet techs at my vets office said that she has only seen 2 cats go into remission in the last 20 years so don't get your hopes up. That is not true. I think I will be her third. Changing food has brought his numbers down tremendously and I am hoping he will be in remission soon. Not all kitties will go into remission, but we always try.
     
  22. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Member

    Joined:
    Sep 15, 2017
    Lisa, My cat, Baby is in remission but is starving at 4:00 am! Waking me up. No one really knows why these symptoms are still present; even though she no longer needs insulin. (Knock on wood) I wish I knew!
    ......I freeze her bowl, about an hour or 2 before bed. I put it out when lights out. She eats this sometime in the night & doesn’t need to wake me. I leave a small amt of ya dry low carb food some nights instead & that works. The vet said (as did members here first) maybe acid reflux because she would vomit liquid before I started doing the nighttime feedings. I did not get any Pepsid since this (feeding) has remedied the problem. But if it didn’t fix it then I could give her Pepsid. She meows loudly if I don’t feed her when her tummy’s empty! She’s pretty vocal anyway! :)
     
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  23. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017

    Right now she is just on the Lantus. The vet refuses to give her a steroid because of the diabetes, they apparently have to treat it with an antibiotic. Lily for the most part is a ravenous eater. She starts screaming her head off when she knows she's about to eat and then will growl into the bowl as I give it to her.
     
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  24. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017
    She has, tests came back normal. They did that on the most recent visit to the specialist.
     
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  25. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017

    The food changing to me is not very stressful. I do however have an issue with sometimes making the 12/12 hits. I'm active duty military and I work in a secure environment. So if something happens I have to stay and sort it out before I can go home. Prozinc she was all the way up to 18 units every 12 hours, which was absolutely absurd and was draining me financially.. over $450 a month just on insulin, and $300 vet appointments every two weeks to test levels and get 'check ups' at the old vet. Which is mostly the reason I moved. He had absolutely no sympathy and was marking up his insulin from $100 market cost to $180 a bottle.. my home vet back in FL charges $120.. like that to me was absolutely ridiculous. So I changed vets.

    Is there a particular meter I should use? I don't know the first thing about home testing. I don't mind giving it a shot, but I'm really in the dark with this one.

    The peeing has been there for a long time, she'll have these like one off issues every few weeks. But since the Lantus switch it's been several times daily. I work 10 hour shifts, not including the 30 minute commute on either end, I come home walk in and there are 2 floods on the floor and 2-3 pee spots all over my couch (I blocked off my bedroom, the guest bedroom, and now the guest bathroom, because I got sick and tired of stepping on any soft fabric to find my foot in a flood of pee..) It wouldn't be so bad if it was just like.. normal cat pee.. a little circle. But she literally floods my floors it's the most disgusting thing.. and my house is just in this continuous state of ruin.

    As far as the behavior issues, I had a feeling it might be something like separation anxiety that has developed recently.. I lock myself in my room to sleep (because I don't want my bed, and rug and blankets all peed on again..) and then I'm gone for work. When I'm home she's usually in the same room as me or in my lap. But the vet kinda laughed at me and said no one knows about that kind of stuff. I'm just so frustrated with these moronic vets who either look at me like I'm stupid, or just stupidity runs out of their mouths.
     
  26. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017
    I have a small master bathroom, but I feel bad just locking her up without her sister.. And I feel like she'll just act out without her there. And then when I do put them together she's incredibly noisy and I don't get any sleep. I tried this the other day christmas eve while I slept during the day before my dad and brother showed up for christmas eve.
     
  27. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017

    Also thank you for the signature information. I've added info to the signature now. Will do a spreadsheet I suppose once I learn more about what all is included in that.
     
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  28. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017

    Yeah if she didn't already destroy it that might have helped. I hate the couch because I can't remove the cushions and she's peed between the cushions and I have like no hope of cleaning or getting it clean in between there. I need to buy a new one, but there just is little point to buy another till she gets her stuff under control. I think I'm about to just have them come and take it away and be couchless for a bit. Because I've just hit my tolerance cap with how much I can take cleaning the stupid thing multiple times a day. No one can sit on it, it looks awful, no point I guess.
     
  29. Stephanie & Quintus

    Stephanie & Quintus Member

    Joined:
    Dec 9, 2017
    People in the US get the cheap human ones from Walmart or the like. Look at the price of strips because that is where the cost will be. Human meters work "well enough" to tell you if your cats BG is going up or down or low, and most people on the forum use those (and the guidelines and "cut off" numbers you'll find here are given for human meters).

    Is it possible her BG is higher since the switch? Peeing a lot is linked to drinking a lot. If a cat's BG is high, they will drink a lot to try and "dilute" it and flush it out with pee. Are you filling up water bowls more often?

    One thing you might try is to add more litter boxes in various places in the house. She might be a little fastidious about the state of her toilets, and if she's peeing a lot she might find the litter box "not clean enough"? Particularly if it's a multi-cat household. The general guideline is that the number of litter boxes for healthy cats in a house should be "number of cats +1". If you have "peeing all over the place" issues the first thing I'd do is get 3-4 cheap open litter boxes and put them in various strategic places. It sucks having litter boxes all over the place but it sucks even more having cat pee all over the place.

    ETA: cats usually do not like to do #1 and #2 in the same place. Hence the recommendation of 2 litter boxes for one cat, 3 for two, etc. Many cats will be accommodating -- in general, cats can put up with a lot without making a fuss, but it doesn't mean they're happy with it. If you have only one litter box this is definitely absolutely the first thing to do: multiply litter boxes. Specially as you say she poops in the box but won't pee in it: this is in fact perfectly normal textbook cat behaviour.

    If the excess peeing is due to badly regulated diabetes then this would be a temporary situation (before diagnosis Quintus was peeing 10-15 times a day and I had to change his soaked litter pretty much every two days, now he's back down to much more manageable amounts).

    Cat behaviour is "way behind" compared to "dog behaviour", and most of the advances have been done these last 10 years. Even today vets will probably only get a few days of training on the topic. So it's not surprising to have a vet "not up to speed" on behaviour issues.

    If your cat is alone all day and alone all night, even if there is another cat, she is very certainly "under-occupied". Particularly if she is ill -- she is probably feeling crappy AND bored out of her mind. Can she observe the outdoors from a perch? is there anything out there to observe? (cars moving, trees, "stuff happening") Can you play with her in the morning and the evening, to give her some activity? Running around isn't the most important: if you're playing with a cat and she is "following" the toy with her eyes, that's already an activity. Toss a ball of paper or a cork or anything in her direction when you walk by. Consider getting a timed feeder so that she eats multiple times a day, or seeing if a neighbour can drop in in the middle of the day to cuddle, pet, play, and simply just "make stuff happen" in your cat's living space. Just some ideas, happy to discuss more if you think this is an interesting avenue (I've followed a few classes and consulted extensively with a behaviour specialist vet for one of my previous cats, so I've picked up a few things.)
     
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  30. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017


    I would assume it is a higher level, but my vet has pretty much refused to test her there, because she's a growling 'thing' and just gets hyper angry. So there was little point in testing her levels that would have been skyrocketing. Is what I've been told recently. By 'well enough' do you mean it isn't super reliable? I'm not sure I understand the different between the people ones and the pet ones. The problem is I have to get these massive cat boxes because she doesn't put her butt down when she pees. So the 'little' cat boxes are absolutely pointless, she misses doesn't get a single bit of pee in the box and just makes the floor, the underside of the box and everything around it super disgusting. So I have to buy these giant boxes, and frankly I'm running out of room. My home unfortunately is not that large. I could maybe squeeze in a third somewhere. But it would be challenging.. and not exactly practical.

    As far as the alone time, she does have access to the kitchen window which shows to the front of my house, with the street..not a whole lot of action unfortunately, but some. As well as the two back windows to my backyard but it's a small backyard with not a lot of action.

    The problem with having someone come over.. is that I'm graveyards here in the states. I work 9p-7am so it's not exactly easy finding someone who can come over at like 2-3am to play with her.
     
  31. Stephanie & Quintus

    Stephanie & Quintus Member

    Joined:
    Dec 9, 2017
    In that case it is perfectly normal she is peeing like a leaky bucket. If we manage to get that BG under control your peeing problem will probably sort itself out.

    Glucose in cats and humans is in different concentrations in the plasma and non-plasma parts of the blood. Pet-specific meters take that into account. For years there were no "pet meters" so human meters were used instead. It doesn't make a huge difference. The main difference if you get a human meter is that your numbers might be different from your vet's "real" numbers, particularly in low numbers. For example 50 on a human meter is roughly 68 on a pet meter. These differences are important when your cat is nearly regulated or diving down in low numbers. When he's in the hundreds, and it's 120 rather than 130 or 550 rather than 500, doesn't change anything. Plus, whatever the meter, there is a 15-20% possible error on the measurement. If I were in the US and had Walmart handy I'd probably have gone out to buy a human meter already.

    It might be worth it. Also, see if changing the placement of your current boxes is an option. The "ideal" place for a litter box is open on three sides, and not where there is a lot of passage. (I say ideal because in many cases our houses don't really allow this, but it's useful to know what the cat would tend to prefer, particularly when faced with litter box refusal.)

    Ouch, indeed! And I guess when you're sleeping you don't want somebody sneaking in to hang out with the kitty... understandable.

    Did you mention she was very food-motivated? You might want to look into the various devices that can either serve food at specific times (timed feeders with multiple compartments), or, for kibble, you have things like this https://www.amazon.com/PetSafe-SlimCat-Meal-Dispensing-Blue/dp/B0018CG40O which allow them to "hunt" their food. Slower eating, smaller meals, more active cat, less bored cat.
     
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  32. CrevLM - Lisa

    CrevLM - Lisa New Member

    Joined:
    Dec 24, 2017
    [QUOTE="
    Did you mention she was very food-motivated? You might want to look into the various devices that can either serve food at specific times (timed feeders with multiple compartments), or, for kibble, you have things like this https://www.amazon.com/PetSafe-SlimCat-Meal-Dispensing-Blue/dp/B0018CG40O which allow them to "hunt" their food. Slower eating, smaller meals, more active cat, less bored cat.[/QUOTE]

    She is, if I rustle a bag anywhere in the house she comes sprinting across the floor and screaming her head off. So this could definitely be an option, the only thing I'd be concerned about would be feeding off of her normal schedule. Would this mess with her BC negatively as I've been told? Or am I reading too much into it?
     
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  33. Stephanie & Quintus

    Stephanie & Quintus Member

    Joined:
    Dec 9, 2017
    So, cats are naturally "grazers". Lie in the grass watching out for a prey, pounce, eat grasshopper, lie in wait again, pounce, chase, eat mouse... 10-15 times a day. ECID (Every Cat Is Different) but biologically many small meals is what the cat is made for. Particularly if you have a cat that is food-obsessed, breaking up daily food into lots of small meals will ease the tension and make her life more interesting.

    Now, regarding feeding and diabetes: you don't have to give two big meals at shot time and nothing in between, particularly with a depot insulin like lantus. What's important is that the cat has some food around shot time, so that when the insulin starts kicking in the cat's BG is also rising a little from the food. Other than that, people try to avoid feeding in the two hours before a pre-shot test, so that the value measured is the "baseline" value and not a "oh I'm now digesting a lot of food" value. BG tends to rise after eating, though if I'm not mistaken I've read that cats don't get big food spikes (like we do). This is also one of the interests in home testing, is that after some time, once you've gathered some data, you get a better idea of how your cat reacts to food and insulin.

    In your case, if I summarize correctly, you have a cat who is on 5ui of Lantus and not regulated (super high BG), peeing all over the place, and crazy for food. What could be worth trying (see if you're comfortable with the idea):

    - get a cheap human glucose meter (you're looking for ups and downs rather than "real" numbers anyway at this stage) and try and get some tests in. you'll probably struggle with the first ones, but it really does get easier as cat and human get used to it (and as she is food motivated you can treat her after the test). so in the beginning, just try and get some readings, and jot them down in the spreadsheet. don't worry too much about getting the right ones or enough or whatever at first
    - spread her food out over the day

    Once you're comfier with the testing then we can move on to interpreting the numbers you're getting and making some changes based on that.

    Also: you might or might not have heard about "bouncing". I was a bit skeptical at first, but a human diabetic friend told me it happened to humans as well. If you have a cat with very high BG, in the 500s, and an insulin shot makes the BG go down to "relative-low" numbers for the cat, say in the 300s, what often happens is that the cats body "panics" and the glucose level shoots up. So we might read high numbers later on, think that there was not enough insulin, when in fact there is. Or it could even be too much insulin, depending on how low the cat went.

    This is just a wild hypothesis, but if your cat is wolfing down all her food at shot time, and then not eating anything the rest of the 12 hours of the cycle, AND is on 5ui of Lantus (which is not super high dose but still quite a bit), I'd be curious to check that her BG isn't by any chance crashing down during the day, and then coming back up. This is the kind of thing one could check while home-testing. (On a day/night when you're off work, of course.)

    I can't remember if you mentioned when the last curve was done. Has there been one since she was switched to Lantus? If so, it would be interesting to have the date and see the numbers or get a copy of the curve.
     
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  34. Stephanie & Quintus

    Stephanie & Quintus Member

    Joined:
    Dec 9, 2017
    Another basic thing regarding food: you can also portion up the food into tiny bowls that you put in various places in the flat. Depending on how fast/easily she learns, you might have to go in stages. But this is also a way you can make your cat "hunt". (Don't forget high places!)
     
  35. Stephanie & Quintus

    Stephanie & Quintus Member

    Joined:
    Dec 9, 2017
    Another idea coming to me while I reread the thread: insuline resistance? I don't know much about it, but I'm wondering if there is a different course of treatment if the problem is insuline resistance (ie, insuline is there but the body is not able to use it well) or not enough insulin (the pancreas is not producing enough). Is this a hypothesis that has been discussed?

    FWIW when we diagnosed Quintus's pancreatitis, the ultrasound showed us it was worse than what the symptoms suggested (he was eating fine, not puking, didn't seem in pain, just tired and out of shape) and, more importantly, that the gallbladder was "jellifying". The gallbladder and the pancreas are linked (I'm not certain of the details), so the upset gallbladder was in fact harming the pancreas. So amongst the other things we did for the pancreatitis we gave him ursochol and marbocyl (an AB) to help the gallbladder. It had improved a month later by the time we did the second ultrasound, so we gave him another course of the same.

    Ultrasounds can be useful, when done well by somebody competent.
     
  36. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    The pens can be used like smaller vials. You can use a syringe with them. Many here do.
     
  37. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    I've never seen a cat that wants to be locked up in another room (my earlier suggestion) but that's what silicone ear plugs are for. You need your sanity and your sleep to get through this. Cats are the experts in making you feel guilty and are quite the little manipulators. My standard answers to Lewis are "I live here too" and "You'll live!"
     
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  38. Juliet

    Juliet Well-Known Member

    Joined:
    Sep 8, 2017
    Hi Lisa. Re getting insulin in Canada - it’s $80 for a vial of 10ml which is 100 units. I believe they order from Marks Pharmacy and there is free shipping. Insulin is cheaper here by far.
     
  39. donnalea

    donnalea Member

    Joined:
    Jun 18, 2016
    Since you have more than one litter box, you might try different litters in them. My vet suggested that when Callie was peeing everywhere and tests showed no UTI. It worked. She uses both boxes, I don't know why, but it worked.
     
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  40. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    I may be wrong, as it's been a while since I had a cat on insulin, but I think it's 100 units per ml, with is 1000 units per vial. A couple of times I got 6 months out of a vial, and would get about a year with the box of 5 pens.
    I have all carpeting. When J.D. peed all over, I used Nature's Miracle and it got all the smell out. I also used puppy pads all around his litter box.
     

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