? Elmo (Moe) update - advice appreciated

Discussion in 'Feline Health - (Welcome & Main Forum)' started by GregH, Mar 16, 2017.

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  1. GregH

    GregH Member

    Joined:
    Jan 6, 2017
    I've posted in here several times before but never gave a complete update on Moe because until now I really didn't want to talk about because it took some time for me to come to terms with what is going on with him.

    After having exploratory abdominal surgery 5 weeks ago, we found our beloved Moe has adenocarcinoma in his small intestine. During the surgery they resected the tumor and were able to get good margins but the surrounding tissues still contain cancer cells. There is no evidence of cancer in the lymph nodes, although they have always been enlarged every time the internist that Moe sees does an ultrasound.

    We've been fighting his diabetes since November, when I suspect in hindsight, is the time around when the cancer had progressed enough to start affecting his digestive tract, and therefore, his glucose levels. After 2 weeks into dosing him between 2 and 3 units, we had a serious hypo event on 11/23. Since then we've been home testing him. As you can see from the spreadsheet his numbers are all over the place.

    We've been having to increase the dose to 3-3.5 units the past week to accommodate whatever has been going on with him lately. He's had diarrhea (which has stopped in the past day or two) and generally not feeling well until the last few days. Now all of the sudden he's feeling better and this morning when I came home from work I was seriously expecting to test him and get a 500 or a Hi reading, but it was 53!! I immediately fed him his dinner, waited an hour and a half and he was almost up to 300 so I gave him 2.25 units instead of the 3-ish we have been giving him. 3 hours later I test him again and he's down to 105, so I fed him another half a can because he still has 3 hours until the low point, 6 hours in, and I really don't want him to bounce.

    I made another post in which we started using R this past week when his numbers seemed like they were getting out of control on the upper end to try and keep it below 500. That's been pretty successful. We've been successful controlling some of the higher numbers, I was just curious if anyone could provide any advice or safety tips to try and help avoid him having a hypo event while we are away. We are still cautious dosing him, but the stakes are REALLY high right now, it seems with whatever is going on with his condition makes him seriously prone to high numbers, he'll cut back on eating, and then get ketones and his numbers will be stuck and not moving until we jack up his dose. So in a way there's no way to know what his dose should be because its consistent for a few days and then we have to adjust to a completely new dose without much warning when we end up with a near hypo catastrophe or a near ketone-hell hospital admission.

    He's on palladia to try and keep the cancer from progressing any further and hopefully reduce/eliminate the cancer cells in the surrounding tissues. The internist says its a 50/50 shot at the palladia working, and he's been on it for a month now and seems to be doing okay, at least for now. We're heartbroken about the whole situation, but committed to keeping him as happy and as healthy for as long as possible. And he's also a really, really good patient too and tolerates treatments very well. The internists assistant tells me that he's the best patient ever. :) He's loving life right now and we're taking him outside and trying to keep his spirits up as much as possible.

    Any tips or advice welcome, but again I know this is a difficult situation that we are trying very hard to make the best of. Thanks for listening.
     
  2. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Wow, you certainly have been dealing with a lot! I'm glad that Moe is feeling better and loving life! Unfortunately, I can't offer any advice for ensuring he doesn't have a hypo event while you are not there, except to leave food out for him. A lot of cats will automatically look for food when their BG starts to drop too low.

    I can offer a few suggestions for his diarrhea (check with his vet, first, since he has other things going on), should it return. Sometimes mixing a small amount of pure pumpkin puree into the food will help. Probiotics can sometimes help, too, and s.boulardii. I have also used slippery elm bark (SEB), which worked wonders, but you have to be careful not to give any oral meds within two hours of the SEB because it coats the lining of the stomach and will keep medications from being properly absorbed. I have a cat with IBD who gets terrible diarrhea that can last for months at a time, so I have tried all of these myself, at some point! (She stays on probiotics all the time, now, as it does seem to help prevent her from getting diarrhea as frequently.) I hope maybe one of them will help your Moe. Prayers for him. :bighug:
     
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