Fred turned 20 years old & Db/on Lantus almost 5 years!

Hi
I meant to post on Fred's actual birthday but I gave him a birthday party (not many cats reach this milestone) and so didn't get around to it. He also got a spa treatment (kitty acupressure) the next day.

So Fred has made it to 20 years! old confused_cat . (He's not confused, he's a Blue Burmese...well maybe he has some senility, actually.) His twin brother died of cancer at 14. Fred, as many of you know, has his issues. but he's still hangin' in there. (Thank god because I truly do not know if I'm going to cope when he's gone, he literally is my baby.)

He has (mild) heart disease (HCM), progressing kidney disease (dx about 4 years ago with mild, only started progressing recently and I NEVER put him on kidney food, he's been on low carb/hi pro/no grain for 5 years, and also distilled water and never any seafood flavors for the kidneys.

He's in diapers 24/7 now (he still walks to the litter box while wearing them, but sometimes he doesn't and he usually misses the litter box anyway. He doesn't mind them at all, but I think he has no idea of their purpose. He's wobbly a lot of the time (walks bad when BS is high, good when low, but now falling, so perhaps some arthritis or more permanent nerve damage in the hind legs.) So I'm now hiring full time cat sitters to come stay with him while I'm out at different points in the day. (This is all getting very pricey, needless to say.) He also almost died from heat stroke 6 weeks ago. My fault, I stupidly put him on the hot balcony to lie in the sun, not considering that he can't handle heat like he used to. I found him in respiratory distress and when I arrived the vet asked to put him to sleep saying he wouldn't recover or would be damaged given his age and illnesses. I said no and in 15 minutes after they got him and started cooling him off and giving him O2, he snapped back to alertness and within 45 minutes--to the shock of the vet, was back to normal and didn't even have to spend the night.

I thought I'd post to honor Fred but also for those of you with newly diagnosed cats who are worried about the diabetes and scared of what might happen. He's been on Lantus for 5 years in two months. Essentially he's been on a ranging dose of .5 to 1.5 over the 5 years.

I recently posted because he has been chronically high BS for the past few months and it was definitely affecting him--very bad peripheral nephropathy, not able to walk on days when it was super high. I was told to increase the dose--from what he was currently at 1ish unit to 1.5. I experimented with that but caught him at 3am on a curve at 100 and 95 a few hours later, but that was after I'd fed him ALOT in the middle of the night. If I had NOT fed him I have a feeling he would have crashed...And seeing as I can't get up more times a night for him than I already do I was not rushing to increase his dose.

So before I hiked up his dose, I decided to regulate his food a bit more--and this may have been the secret I needed to stumble on for the last 5 years.

So, Lantus users, this might be of interest. Fred was always a free-feeder, never on a regular schedule. First because I mostly work from home and so could feed him on demand, or leave food out. And second because--if you've ever heard a Burmese (or Siamese) meow--enough said, you give them what they want or get a nervous breakdown from the wailing! Also, I did curves occasionally but not much, mostly just PSs all these years.

For the past two weeks or so, I've been doing almost continuous curves to get a handle on what's going on--and also noting when he eats and whether it's a little or lot. This is what I've realized.

>If his PS is high--in the 400s or above and I let him eat, even a little, the Lantus dose (1unit) will barely do anything and he may be just as high, or higher at the next PS time.

>BUT if his PS is high--in the 400s or above and I hold off on him eating for 4 to 6 hours, the Lantus kicks in and drops him down and then when he eats in the 300s or so, it's still dropping and so he may stay in the 200-300 range and be there at the next PS. (The Lantus curve is so flat and doesn't drop that low so I think the trick for Fred is to only let him eat when the curve is at the desirable level, otherwise it will drop a little but stay at a higher overall range.

It seems as if the first couple of hours the BS drops 10 points/hour, but then it speeds up if he hasn't eaten to about 30/hr....so I can sort of calculate around where it might be at peak or when it's on it's way down and let him eat to hold it steady in a good place.

A few times he was in the 500s at PS, I let him eat but gave him the and the whole day and next PS he was 'HI' on the OTU...and that's 600+. So felt like the insulin never even did anything. Although it may have I just couldn't see it--started at 550--ate and had shot--food rose him up to say 700+ before insulin kicked in, it eventually may have dropped him to 600+, but still HI on the meter and not anywhere where it should be

> If his PS is low (and for us we consider that to be 200s-mid 300s, then I give him a tiny bit reduced unit (I've posted elsewhere on my minute drops of a different based on where I place the rubber stopped on the unit line on the syringe.) And I let him eat however much he wants. From what I've seen with this system, he stays in the mid 200s mid-cycle and next ps is only slightly higher.

In FIVE YEARS I've been trying to figure out his pattern but it appears that my ignoring the timing of his eating prevented me from identifying it. Hopefully this is real and predictable and reliable because he has so many other things going on the last thing I want is for him to feel terrible with high BS.

> One thing that seems to have happened is that the insulin SUDDENLY kicks off in the last part of the 12 hour cycle. This is new. I think that his pancreas may have worn out and totally stopped producing insulin now (at this age and with DB for this long) and this might explain it. It used to be that the insulin appeared to work for 24 hours sometimes, making it very difficult to know what to do with low PS numbers. Sometimes I"d skip them and he'd be fine on one shot for 24 hours. I think his own pancreas must have been helping out and now it's suddenly went kaput. If this is indeed the case, at least now he's more predictable--and I know I have to be very strict with 12/12 doses. What I've seen is that during a curve at +10 he was, say, 250, and then suddenly by +12 he was 500--but not haven eaten AND NOT, gone hypo or too low at peak. I think the insulin just wore off and there was none of his own floating around to hold things steady.

So I thought that info might be of interest to those of you who free feed who have had trouble spotting patterns to go by.

And in case you're interested--Fred is on:
> Pepsid a/c (1/4 10mg tab once a day) for nausea from the kidneys. I give it to him in a pill pocket. This prevents him from throwing up when he tries to poop and is constipated. Has GREATLY reduced throw up episodes. He is also on PLAVIX only.

> Plavix for blood clots. When he first got cardiac heart failure and HCM they put him on 4 heart drugs (two of which are bad for the kidneys), the 2nd day he was lifeless--no purring, no moving. I knew something was up and took him off one of the drugs. Then he started getting constipated (side effect of several of the drugs incl. Lasix). I took him off that but new I needed a 2nd opinion. Went to an amazing cardiologist, Dr Boileau who agreed that given his age and conditions it would be better to be conservative with the drugs. Apparently most of the drugs don't have a huge amount of research behind them proving that they are needed and they are often prescribed as a sort of standard protocol but not as a heavily evidence-based approach. My vet strongly disagreed but I knew my cat and trusted the cardiologist more. So Fred has now been on the 1 heart drug only for the past 7 months. Seven months ago my vet told me he had weeks, maybe a few months to live. (Listen to yourself over your doc if you really know your kitty!)

> Phosphorus binders--fiber added to food which has brought his Phos levels back to normal

> NO Sub Q fluids. I advise ANyONE he is told to do this for kidney disease to spend the money first to get an echocardiogram and check from heart disease. Sub Q fluids are BAD for heart disease. My vet put me on a very aggressive fluid program--150ml/day---and NEVER checked for heart (in a 19 year old cat) and never offered, and I had no clue. Well the first few months they certainly helped the kidney issue--but meanwhile were secretly stressing his heart until he ended up in cardiac heart failure after 6 months of fluids. I had lowered his dose to 10-30ml/day and skipped ays even in the 2-3 months prior because his legs would collapse every time after the fluids--even small amounts...no vet could explain why and essentially said to ignore--and then, the heart failure.

NOW, no fluids. And surprisingly, his kidney disease has NOT worsened much in 7 months off the fluids. I do squirt water into his mouth with a syringe. I also refused to give him kidney food, against the advice of my vet. His attitude was, 'well if his blood sugar goes up, just increase his insulin'....uh, no.

Anyway, that's Fred's status. I may paint a better picture of him than he really is since I'm wanting to see the best. He IS an old kitty (97 years by the calculators). But he is still purring, eating voraciously, pooping with some effort on some days, but still not ready to go, and not really in pain I don't think. he has some tough days, especially the past few weeks, so I'm getting worried about losing him. But anyway, just savoring every day I have with him.

Hope that's helpful for some of you!
Martica and Fred

 

party_cat Happy 20th Birthday to Fred. Great post, Martica, especially about checking the heart before going the sub-Q route. Wishing you and Fred all the best for the future.

 

Happy Birthday Fred! Best wishes to you both! Great job Martica!

Happy Birthday Hugs and Scritches!

Cat, Sweet Max, and gang

 

Hi Martica-

I think it's SO important for newbies to hear this. When Harley was diagnosed the vet told me that I would have 1 or 2 more years with her!!! :evil: I WAS DEVASTATED!! :cry: Needless to say, we don't go to that vet anymore! I'm appalled by the lack of information that veterinarians have about treating FD, as well as the lack of information given to newly diagnosed pet owners! Yes, before anyone starts yelling, I recognize that was a sweeping statement about vets, and that there are some out there that are good and knoledgeable....but the truth remains that most are not!

I'm full of love, respect, and gratitude for everyone on this board right now. The help we've received here has been beyond my wildest expectations!

Happy Birthday, Fred!!! And Kudos to you, Martica, for taking such amazing care of your boy!!

s

 

Sending many Kudos to you and Fred for hanging in there!! 20 is such an amazing milestone. My Merlyn missed it by 10 months. Wrapping you both in cyber hugs and sending "keep on truckin' " vibes to both of you.

((((((((((((((((((((((((((MARTICA and FRED))))))))))))))))))))))))))))))))))

Happy Birfday! party_cat flip_cat dancing_cat

 

Thank you and fantastic hug Lisa & Merlyn!!!!

Fred just has his Week 2 B12 shot, and gosh dangit, I think he's walking better! Could it be that immediate? I guess time will tell...

 

Happy Birthday Fred ! party_cat party_cat

 

OMG Dont know how I missed this. So sorry.

HAPPY BIRTHDAY FRED!!! This indeed is special.
jeanne

 

This is so nice to read since my Simba is 14 and soon reaching 15 years old. As far as I can tell he is fine, but that can change fast. But I hope I will be able to have Simba and his older (15 going on 16) best buddy at least until they are 20 years old.


Many hugs and kisses to you from Simba, Gustav and their human Ann all the way in arctic Sweden.

 

Wow - Happy 20th Birthday, Fred. What a fighter. And what a mom bean - you've seen him through so much and done so well. So much TLC and that's so important.

Posts like this are so important for newbies to see. And it even gives us "old-timers" a lot of positive reinforcement also.

Dude is 16 now - been on the "juice" for 6 years - and our vet (whom I love dearly and who is great) at the time of diagnosis told us we "might" keep Dude for another year. He credits this board with a lot.

Keep up the good work - scritches to Mr. Fred - and kudos to you.

Emmy & Dude (& Mittsi too)

 

Happy Birthday, Fred!

~M

 

Happy birthday, Fred!! You are amazing, and so is Martica for taking such wonderful care of you.

 

Thank you all!
My poor little guy... now he has a rash on his chest...I posted a new topic about it. Is this what happens, stuff just starts breaking down, even though you have these chronic diseases sort of under control? Poor baby, not sure what to do. Aging just SUCKS.