Help Needed - Wenchie is barely eating, Chewy failed me and I'm afraid she won't live until tomorrow

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JL and Chip said:
Will you able to monitor this cycle closely and get additional BG tests?

That’s a nice number, especially on an AlphaTrak. When you see an unexpectedly low number, it’s always good to retest (just in case you had a bad test strip or something).
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Yes, we had planned on doing additional BG tests today as we're not leaving the house today for the most part. How long should we wait to retest?

Also, retesting during the day, if we get a higher number, do we give her insulin then or wait until PMPS testing results?
 
JL and Chip said:
I’d recheck the BG now to confirm the 146 wasn’t a fluke.

Is that a food-influenced number? (i.e., did Wenchie eat in the last two hours?)
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145 and she's been eating like a maniac since AMPS. I'm leaning towards no insulin but retesting throughout the day.

What do you think?
 
Do you need to stay on the same shot schedule? One option is to stall, keep testing, and shoot later once her BG is rising. But that option changes your standard shot time — your “new” shot time would be 12 hours after whatever time you finally gave the AM shot. Also, it’s generally recommended to withhold food while stalling so the “rise” isn’t a temporary food bump. Wenchie has already had breakfast so even if the BG rises, the data is a bit harder to interpret. (Don’t feel bad that you fed; she desperately needs it)

The second option is to shoot, then buckle your seatbelt and check BGs closely through the cycle. You’ll want to have your hypo toolkit out and be ready to intervene if necessary. Make sure you have plenty of test strips if you go that route. Also, I’m not able to be online with you today so we’d want to find someone who could.

I rarely giving dosing advice but ... given that Wenchie has shown significant sensitivity to Lantus, you don’t have a lot of recent mid-cycle data, there’s no way to shoot less than your current “one drop” dose, she’s been eating like crazy with no significant BG increase, you’re using SLGS, and that 146 is from an AlphaTrak ... I think I’d skip the shot BUT get in some mid cycle tests today to help paint the picture of what’s happening. I’d start with +2 and probably try to get a few others — maybe a +5 and +8.

Ugh, that took me entirely too long to type.
 
JL and Chip said:
Do you need to stay on the same shot schedule? One option is to stall, keep testing, and shoot later once her BG is rising. But that option changes your standard shot time — your “new” shot time would be 12 hours after whatever time you finally gave the AM shot. Also, it’s generally recommended to withhold food while stalling so the “rise” isn’t a temporary food bump. Wenchie has already had breakfast so even if the BG rises, the data is a bit harder to interpret. (Don’t feel bad that you fed; she desperately needs it)

The second option is to shoot, then buckle your seatbelt and check BGs closely through the cycle. You’ll want to have your hypo toolkit out and be ready to intervene if necessary. Make sure you have plenty of test strips if you go that route. Also, I’m not able to be online with you today so we’d want to find someone who could.

I rarely giving dosing advice but ... given that Wenchie has shown significant sensitivity to Lantus, you don’t have a lot of recent mid-cycle data, there’s no way to shoot less than your current “one drop” dose, she’s been eating like crazy with no significant BG increase, you’re using SLGS, and that 146 is from an AlphaTrak ... I think I’d skip the shot BUT get in some mid cycle tests today to help paint the picture of what’s happening. I’d start with +2 and probably try to get a few others — maybe a +5 and +8.

Ugh, that took me entirely too long to type.
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Thank you so much! I will be retesting her through the day and am opting to not shoot her until her regular time tonight should her number warrant. I think going through hypo events is very hard on her body so I will err on the side of caution.

Have a great day!!!!!
 
Hi Diane,

Just saw your tag. Glad that JL and Chip were here to help that early in the morning.
I'll be here the rest of the day in case you need help.
Keep testing Wenchie throughout the day.
And feeding her as much as you can get into her.

p.s. 6 am EST is too darn early for me to be on the computer yet. Still doing other "stuff" in life at that time in the AM.
 
Deb & Wink said:
Hi Diane,

Just saw your tag. Glad that JL and Chip were here to help that early in the morning.
I'll be here the rest of the day in case you need help.
Keep testing Wenchie throughout the day.
And feeding her as much as you can get into her.

p.s. 6 am EST is too darn early for me to be on the computer yet. Still doing other "stuff" in life at that time in the AM.
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I figured it wasn't urgent so no worries! I knew someone would be here - there always is!

We will be testing her throughout the day. She's happy, purring, eating and napping. We will be retesting at +6.

As always, thank you so much - appreciate your help and handholding!!!
 
I had mentioned that my husband has a childhood friend who is a vet, as is his wife. He retired but Karen still practices. Despite being 40 minutes north of us, we decided to email her and ask her if she would give us a second opinion. I attached my spreadsheet and she read it and commented on it!! (I have my doubts that my current vet actually did.) She said of course, bring her in. In her email, she said all the right things and I'm relieved. I want my girl to start feeling better. I honestly think Lantus may not be the right insulin for her and Karen said as much without me saying anything.

Karen is calling her office and scheduling us in on Tuesday afternoon as her staff does the scheduling and we would be considered new and not be able to get as early of an appointment.

Everyone keep fingers and paws crossed. I love my girl so much and my heart breaks knowing she is so unwell.
 
Prozinc is another good option for cats. 10-14 hour duration.
Vetsulin, not so much. Made for dogs, doesn't usually last as long in cats. 8-10 hour duration.
NPH insulins, I have a personal prejudice against. Bad family incident. Someone died using it.
 
Deb & Wink said:
Prozinc is another good option for cats. 10-14 hour duration.
Vetsulin, not so much. Made for dogs, doesn't usually last as long in cats. 8-10 hour duration.
NPH insulins, I have a personal prejudice against. Bad family incident. Someone died using it.
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Believe it or not, Karen stated in her email that she thought Prozinc was a better insulin for cats. I immediately felt like I was on the right track!
 
Order the Prozinc from Chewy.com. They have the best price I know of. Your vet needs to send them a script, but once you place your order for a prescription medication, they will contact your vet for you.

Plus, they send the insulin very well wrapped, small cooler to protect it from hot and cold, plenty of padding, all that you could hope for with a mail order insulin.
 
Deb & Wink said:
Order the Prozinc from Chewy.com. They have the best price I know of. Your vet needs to send them a script, but once you place your order for a prescription medication, they will contact your vet for you.

Plus, they send the insulin very well wrapped, small cooler to protect it from hot and cold, plenty of padding, all that you could hope for with a mail order insulin.
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I will! Thank you! I love Chewy so I'm not surprised - I've ordered all our wet food from them and they do quite the packing job!

I will be continuing on with the 1 drop until I see Karen on Tuesday and then we'll start her new protocol as soon as I get the Prozinc. I don't expect miracles but I so want to do everything possible to help my girl feel better.
 
I wouldn’t judge Lantus too harshly just yet. It’s early in the journey and it takes time and data to figure out how things are working. Sometimes we just have to sit on our hands and be patient (I was told that when I started out and remember how hard that was!) Lantus is generally one of the “gentler” insulin options for cats and an excellent first choice. Most of the other insulins on the market, with the exception of maybe Levemir, can hit even harder and have bigger BG swings (not necessarily what you want with an already insulin-sensitive cat). I definitely wouldn’t consider Vetsulin or N as those are harsher and would likely be stressful for you to work with. Prozinc is a maybe but I just don’t know that it’ll give you what you’re hoping for.

Today was a valuable data collection day. It shows Wenchie does indeed need a touch of insulin, which we suspected, but which the data has now proven. It also reinforces what you saw the last time you saw a low pre-shot and skipped.

If it were me, I’d continue with the one drop dose of Lantus, let the depot refill, and catch some mid-cycle tests. And be patient as those numbers might be higher for a few days as you catch back up from the skipped dose. That’s not unexpected; remind yourself to sit on your hands. Then I’d wait excitedly for the next low pre-shot and steel myself, than shoot that low number and test a lot during the cycle to see what happens. You might be pleasantly surprised.

Remember, with Lantus you have to ”shoot low to stay low.” It’s just very important that you’re data-ready to do that and that means getting some mid-cycle BG tests ahead of time and being patient as you collect that data. Rome wasn’t built in a day.

If you go to the new vet, I’d try to rule out concurrent illnesses just to make sure there isn’t something else lurking. But like I said, I really, really think you should stick it out with Lantus just a little bit longer. :-)
 
@JL and Chip

What worries me is she seems to be getting more lethargic, not gaining any weight and still vomiting. I will definitely have Karen (the new vet) check for anything else that could be complicating her situation. I'm also wondering if something else is going on that we just haven't seen with her blood work.

I know Lantus is a good drug but I'm also worried that she just cannot tolerate it, perhaps the depot phenomenon keeps too much insulin in her body. She keeps bouncing all over the place and that worries me because it can't be good for her - it must make her feel crappy. I am anxious to see what her numbers are AMPS (she had her drop last night).
 
@Diane Engoron Wenchie does seem to be super sensitive to insulin — that’s a pretty strong reaction to a single drop of Lantus — but for what it’s worth, I don’t think her numbers look all that unusual for a recently diagnosed diabetic.

In your spreadsheet comments, I see that you’re questioning “why the big swings” and, yes, 324 to 143 (AlphaTrak numbers) is dramatic for one drop of insulin, but it shows that the Lantus is working. Often the swings settle down over time to a more gentle “surfing” in a narrower range of numbers but (and I’m being a broken record here) it’s oh so important to keep getting mid-cycle BG tests. For example, I’m curious how low Wenchie went in today’s cycle — did she stay high or dip down like yesterday? Knowing which she did helps decode tonight’s pre-shot number as well as fill in the blanks in the overall picture of how Lantus works for her. The mid-cycle values will ultimately also help determine whether you should increase Or decrease the dose. Remember, Lantus dosing is based on nadir (low point in the cycle) not pre-shot values.

My Charlie was also very sensitive to small amounts of insulin so I understand your stress and concerns. Charlie would get lethargic when his numbers were high and being patient as we sorted out his medical issues and diabetes was soooo hard.

I believe you’re thinking about changing insulins, maybe to Prozinc. In theory, I suppose the argument could be made that since Prozinc is a u-40 insulin, a drop of Prozinc would contain less insulin than a drop of Lantus. But Prozinc might have a steeper curve. The other possibility, though not particularly common, would be to look into diluting the Lantus. Just thinking out loud here. @Wendy&Neko do you have any thoughts on Wenchie’s numbers or any of this?

I’d not sure what your expectations are for how a Lantus curve typically looks, so here’s some info pulled from one of the stickies on the Lantus forum:

Learn how YOUR kitty is responding to insulin:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
Example of an ACTIVE Lantus cycle: ...
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

I hope you have a good, and enlightening, appointment with Karen on Tuesday. Please post again and let us know how things turn out.
 
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JL and Chip said:
@Diane Engoron Wenchie does seem to be super sensitive to insulin — that’s a pretty strong reaction to a single drop of Lantus — but for what it’s worth, I don’t think her numbers look all that unusual for a recently diagnosed diabetic.

In your spreadsheet comments, I see that you’re questioning “why the big swings” and, yes, 324 to 143 (AlphaTrak numbers) is dramatic for one drop of insulin, but it shows that the Lantus is working. Often the swings settle down over time to a more gentle “surfing” in a narrower range of numbers but (and I’m being a broken record here) it’s oh so important to keep getting mid-cycle BG tests. For example, I’m curious how low Wenchie went in today’s cycle — did she stay high or dip down like yesterday? Knowing which she did helps decode tonight’s pre-shot number as well as fill in the blanks in the overall picture of how Lantus works for her. The mid-cycle values will ultimately also help determine whether you should increase Or decrease the dose. Remember, Lantus dosing is based on nadir (low point in the cycle) not pre-shot values.

My Charlie was also very sensitive to small amounts of insulin so I understand your stress and concerns. Charlie would get lethargic when his numbers were high and being patient as we sorted out his medical issues and diabetes was soooo hard.

I hope you have a good, and enlightening, appointment with Karen on Tuesday. Please post again and let us know how things turn out.

goal.
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Thank you so much for all this info!!! Wow!

Poor Wenchie just vomited at 5:15 this morning - a lot. I've tried putting her on Pepcid AC and that's not helping. She's 15 1/2 years old and this has to be so hard on her. I know at 62, this has been really hard on us and we're healthy (not complaining, just comparing).

We're seeing Karen today at 3pm. I'm so hoping, as a long-established vet and friend, that she can help us get her stabilized, even if that means switching her to Prozinc. My heart is broken watching her so lethargic and vomiting, then constantly begging for food. She's been a wonderful cat and we need to do whatever we can to help her. This vet we were seeing is a fairly new vet and the practice is all about the money. When we were sitting there with Riley on Thursday, a Brinks truck pulled up in front - no kidding - and the armed guard came in just as they do in a bank or grocery store. I think that tells you all you need to know.

I will be back after Karen's visit hopefully with some good news and detail everything she told us. Please keep fingers and paws crossed - and thank you once again for being so helpful and so, so thoughtful. This forum is unbelievable!
 
JL and Chip said:
@Diane Engoron I see that you’re questioning “why the big swings” and, yes, 324 to 143 (AlphaTrak numbers) is dramatic for one drop of insulin, but it shows that the Lantus is working. Often the swings settle down over time to a more gentle “surfing” in a narrower range of numbers but (and I’m being a broken record here) it’s oh so important to keep getting mid-cycle BG tests. For example, I’m curious how low Wenchie went in today’s cycle — did she stay high or dip down like yesterday? Knowing which she did helps decode tonight’s pre-shot number as well as fill in the blanks in the overall picture of how Lantus works for her. The mid-cycle values will ultimately also help determine whether you should increase Or decrease the dose. Remember, Lantus dosing is based on nadir (low point in the cycle) not pre-shot values.
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Yesterday we weren't able to test mid-cycle. The problem is that sometimes we have to be out of the house - we just cannot sit at home every single day. I don't know how people who work (we're retired) can handle this.

Honestly, this has taken over our lives and not in a good way. We're exhausted, not sleeping, not seeing friends. It's not healthy for any of us. I've been up since 4am and am already wiped out. If we're not healthy, we cannot care for our animals. This is a vicious and bad cycle for all of us.

I'm willing to try whatever Karen suggests in the hopes that we can get a grip on this sooner rather than later. I'm always afraid of getting up and finding her gone. She's so weak. I know you know exactly how I'm feeling. It sucks, plain and simple.

Sigh.... whenever I lost an animal I would say never again, no more and then another one would show up in my life. I'm serious now when I say no more. My heart just can't take it.
 
I don’t know what tests Karen will want to run, but Charlie’s vomiting was tied to chronic pancreatitis, which isn’t uncommon in diabetics. The test for that is an fPLI; you might want to inquire whether that would be something to consider.
 
JL and Chip said:
I don’t know what tests Karen will want to run, but Charlie’s vomiting was tied to chronic pancreatitis, which isn’t uncommon in diabetics. The test for that is an fPLI; you might want to inquire whether that would be something to consider.
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Thank you - I am keeping running notes to take with me today - I will add this to my notes to ask Karen!
 
Maybe remember to ask about the possibility of hyperthyroidism too. That can suck weight off them like crazy and cause some of the symptoms you’re seeing.

Is Wenchie’s poop normal? You haven’t mentioned anything abnormal there but IBD can cause weight loss as well.

I loved Charlie dearly — he was with me nearly 18 years — and he had all of the above plus diabetes and kidney disease and a few other things. It was a rough ride at first. Really rough. And I was watching him fade away. I used to tell my IM vet at the university that I felt we were walking along the rim of the Grand Canyon and that the slightest wisp of wind would throw us over the edge. But we took one step at a time and finally had a few breakthroughs. Charlie was around 15 too when all of this started. He was with me nearly three more years and I eventually lost him to cancer, not diabetes.

It’s tough to be a caretaker of sick family members, be it human or animal. It’s even harder when one feels so helpless. You’ve been doing a stellar job under difficult circumstances. And I wasn’t scolding you about the mid cycle tests — just wanted you to understand why they can be so valuable.

Often times the worst days are at the beginning when the cat is so sick and you’re entering a strange new world and nothing makes sense. The stress can be stratospheric. But just like one of those old Polaroid photos, what starts out as blank and grey starts to slowly morph and come into relief. And just like that photo, you’ll start to grasp what’s happening and what it all means. It takes a bit of time, but it really does get easier. Hang in there. I really hope that Wenchie is “simply” diabetic.
 
JL and Chip said:
Maybe remember to ask about the possibility of hyperthyroidism too. That can suck weight off them like crazy and cause some of the symptoms you’re seeing.

Is Wenchie’s poop normal? You haven’t mentioned anything abnormal there but IBD can cause weight loss as well.
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She had extensive bloodwork done at the first vet - we had her records sent over to Karen and will ask her if her thyroid was tested. I believe it was but that seems like eons ago! She is pooping normally but A LOT and peeing a lot. We literally are scooping at least 20 times a day (we have 3 others that use the litter boxes).

JL and Chip said:
I loved Charlie dearly — he was with me nearly 18 years — and he had all of the above plus diabetes and kidney disease and a few other things. It was a rough ride at first. Really rough. And I was watching him fade away. I used to tell my IM vet at the university that I felt we were walking along the rim of the Grand Canyon and that the slightest wisp of wind would throw us over the edge. But we took one step at a time and finally had a few breakthroughs. Charlie was around 15 too when all of this started. He was with me nearly three more years and I eventually lost him to cancer, not diabetes.
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That's encouraging! This morning she was really going nuts begging for food - crying and pawing at my leg - something she hasn't done before. Heartbreaking.

JL and Chip said:
It’s tough to be a caretaker of sick family members, be it human or animal. It’s even harder when one feels so helpless. You’ve been doing a stellar job under difficult circumstances. And I wasn’t scolding you about the mid cycle tests — just wanted you to understand why they can be so valuable.
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Oh no - I never took it as scolding!!! You have no idea how much I appreciate all everyone has done for me. I'm just tired and frustrated. I'm not giving up but just questioning myself. I don't want her to suffer.

JL and Chip said:
Often times the worst days are at the beginning when the cat is so sick and you’re entering a strange new world and nothing makes sense. The stress can be stratospheric. But just like one of those old Polaroid photos, what starts out as blank and grey starts to slowly morph and come into relief. And just like that photo, you’ll start to grasp what’s happening and what it all means. It takes a bit of time, but it really does get easier. Hang in there. I really hope that Wenchie is “simply” diabetic.
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I so want to believe this. It honestly feels like we're never going to come out the other side but, like you, if it is simple diabetes, we will, whether it's on Lantus or Prozinc. We're definitely hanging in there. We owe it to our girl.

Thank you so, so much. I honestly cannot say this enough.
 
Wendy&Neko said:
Have you been testing for urinary ketones?

Good luck at the vet today. Depending on how that goes, I may have more comments/questions.
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I test her every day for ketones and always negative.

We went to the vet today and boarded her overnight for her pancreas test. Karen feels there’s something else going on and we agree. She has to be fasted 8 hours so it was easier in all of us to leave her overnight at the vet. She’s in really good hands. Karen and her husband are both vets and are childhood friends of my husband. I trust her implicitly.

she doesn’t think it’s cancer but there’s something not working in her pancreas. She’s eating 9-10 cans if food a day and not gaining an ounce. Her poop from the beginning has been light, ashy color. You would think our old vet would have picked up on that. Karen said that’s a sure sign something is not working in the pancreas.
 
So, Wenchie has been boarded at Karen's clinic overnight so she can be fasted and have her fPLI test. We'll pick her up at 9am tomorrow.

No signs of hyperthyroidism, as she had a major blood panel done with our first vet. Had we not boarded her, she literally would have kept us up all night - howling scratching at the door, jumping on us if we opened the door - and we both need a decent night of sleep. She's in really good hands.

Karen doesn't think it's cancer but there really is something not working right in her pancreas, which may explain why the insulin hasn't been able to take hold. She has no problem with us continuing with the Lantus but we first have to rule out any other issues. Her mouth dropped when I told her how much food she was eating a day - 8 to 10 cans a day - and not gaining an ounce. Her poop has been ashy in color, which is another sign that something isn't functioning correctly in her pancreas (or liver). However, her liver values in her blood work came back perfect so we're focusing on the pancreas.

This has been so exhausting but I honestly think making the switch to Karen is the right move. We actually should have been seeing her from the beginning.

Thank you everybody for your insights, your care for my girl, sharing all your knowledge.
 
Light ashy colored poops sounds like EPI Exocrine Pancreatic Insufficiency. Not common in diabetic cats, but it does happen. You'll need to get enzymes to add to the food if that is the case. Have your vet do a TLI test.

"Diarrhea/soft feces, particularly if paste colored or pale, that can be a sign of exocrine pancreatic insufficiency, or lack of pancreatic enzymes. The blood test for that needs to be done in a fasting state.
The treatment is to supply additional pancreatic enzymes to help the food break down."

"In exocrine pancreatic insufficiency, the stool is pasty-colored, foul smelling, and voluminous because there are not enough digestive enzymes produced by the pancreas. The same thing destroying the insulin-producing islet cells of the pancreas may also destroy the enzyme-producing cells.
Another possible diagnosis is inflammatory bowel disease which may be treated with an oral steroid, budesonide, which doesn't cause as much glucose elevation as the injections do."

So we aren't shy about talking about poop color or consistency around here. Wenchie's poops look like any of these?
upload_2020-2-7_16-1-15-jpeg.51117


EPI test has to be done fasted. If my mind is remembering correctly, giving the EPI enzymes and seeing improvements in the poops is an indication that the pancreas was not producing enough enzymes. Sort of an empirical test.

When the pancreas is not functioning well, that can affect both the production of insulin and the hormones that help with digestion. That is why the poop can be very loose, diarrhea, very smelly, very large, more of a tan or gray color.

It could be chronic pancreatitis also.
Ask your new vet if she thinks B12 injections could be helpful.

If it is EPI, the pancreatic enzymes taste HORRIBLE and need to be added to the food. It may be necessary to hand feed Wenchie the food with the enzymes mixed in, and then let her eat more food on her own.

p.s.Wish you had mentioned the ashy colored poops before. :(
 
Hopefully Karen will do the full GI panel, which includes fPLI, fTLI, folate, and cobalamin. They used to have to be sent out to Texas A&M but there might be more choices these days. The poop color/consistency is a clue we haven’t touched on before now.
 
Deb & Wink said:
Light ashy colored poops sounds like EPI Exocrine Pancreatic Insufficiency. Not common in diabetic cats, but it does happen. You'll need to get enzymes to add to the food if that is the case. Have your vet do a TLI test.

"Diarrhea/soft feces, particularly if paste colored or pale, that can be a sign of exocrine pancreatic insufficiency, or lack of pancreatic enzymes. The blood test for that needs to be done in a fasting state.
The treatment is to supply additional pancreatic enzymes to help the food break down."

"In exocrine pancreatic insufficiency, the stool is pasty-colored, foul smelling, and voluminous because there are not enough digestive enzymes produced by the pancreas. The same thing destroying the insulin-producing islet cells of the pancreas may also destroy the enzyme-producing cells.
Another possible diagnosis is inflammatory bowel disease which may be treated with an oral steroid, budesonide, which doesn't cause as much glucose elevation as the injections do."

So we aren't shy about talking about poop color or consistency around here. Wenchie's poops look like any of these?
upload_2020-2-7_16-1-15-jpeg.51117


EPI test has to be done fasted. If my mind is remembering correctly, giving the EPI enzymes and seeing improvements in the poops is an indication that the pancreas was not producing enough enzymes. Sort of an empirical test.

When the pancreas is not functioning well, that can affect both the production of insulin and the hormones that help with digestion. That is why the poop can be very loose, diarrhea, very smelly, very large, more of a tan or gray color.

It could be chronic pancreatitis also.
Ask your new vet if she thinks B12 injections could be helpful.

If it is EPI, the pancreatic enzymes taste HORRIBLE and need to be added to the food. It may be necessary to hand feed Wenchie the food with the enzymes mixed in, and then let her eat more food on her own.

p.s.Wish you had mentioned the ashy colored poops before. :(
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The reason I never mentioned it was this - I told my first vet about it immediately at our first visit and she didn't think it was anything!!!!! Now I'm even more pissed because Karen immediately knew what it was and said we will mostly likely have to add enzymes to the food. She's obviously not absorbing any nutrients and she would eventually have died from malnutrition. Because of this, I am moving ALL my animals to Karen's clinic. I don't care if she's 40 minutes from me.

""In exocrine pancreatic insufficiency, the stool is pasty-colored, foul smelling, and voluminous because there are not enough digestive enzymes produced by the pancreas." - THIS IS IT!!!

Karen also feels that Lantus will still work well once we get Wenchie's pancreas working better. Thankfully she doesn't think it's cancer (she palpated her deeply and felt nothing) so now we just wait for the test results. She's boarded overnight at Karen's clinic because she has to fast 8 hours and she would have kept us up all night. It's less stressful for her as she'll probably sleep all night and we'll get a good night's sleep. We pick her up at 9am tomorrow.

I'm so mad at myself for trusting this practice. My husband says I'm being too hard on myself. He says you can't know what you don't know. Well, now I know and I'm furious.

Anyway, more tomorrow. We pick up the packaged test and ship it Fed Ex overnight (there's a Fed Ex store in Saratoga Springs, which is between us and Karen's clinic). I will also ask her about B12 shots.

Thank you so much!!!!
 
JL and Chip said:
Hopefully Karen will do the full GI panel, which includes fPLI, fTLI, folate, and cobalamin. They used to have to be sent out to Texas A&M but there might be more choices these days. The poop color/consistency is a clue we haven’t touched on before now.
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She is doing it all to rule out anything and everything. I'm not sure where it's sent. I pick it up tomorrow with Wenchie, packaged and ready to go, and drop it off at the Fed Ex office, which is on the way home for us.

Karen also feels that with all this, THIS is why the Lantus wasn't working as it should. She said once she's on enzymes (most likely what she needs per the test results), we can proceed with the Lantus and she should start to feel better.

I never talked about the poop color because I mentioned it to my first vet and they didn't think it was anything!!!! I'm so pissed at them and mad at myself!!!

Anyway, I'm off to bed. I've been up between 3:30 and 4 the past two days and I'm fading fast!

Thank you so much for sharing all your wisdom and experience. What would I have done without this forum????
 
Hindsight is great isn't it?

We all live and learn. but now that you have your new vet Karen, I think Wenchie will do so much better.

Nothing is too small to mention to us here. We know a heck of a lot. Not as much as a vet knows about everything but we do know about EPI and other concurrent health issues that may be affecting a diabetic cat.

Swearing at your old vet. Vehemently and loudly. From hundreds of miles away.;)
 
The good news is that EPI is treatable and Karen doesn’t think it’s likely cancer. I’m glad @Deb & Wink got that EPI info posted so quickly. The minute you said ashy poop I thought of EPI. We had to have Charlie tested for that too and several of my GI cats have had to go through the TAMU protocol of B-12 injections.

You have a clue and a direction now, and more hope than you had 24 hours ago. Although there are no guarantees, I call that a win for now.

Hey, move over on that “guilt” chair and make room for me. I’m sorry I didn’t ask about the poop before last night. :-( By the way, try to cut yourself a break. You didn’t give up and take the original vet’s advice blindly — rather, you came here, persisted with follow up, listened to advice, and reached out to Karen for a second opinion. You deserve kudos, not guilt.

Get a good night’s sleep and I hope you have a bit more peace of mind.
 
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We had a member with a kitten earlier this year. Vet thought said kitten had Exocrine Pancreatic Insufficiency. EPI. Simply did a search on that thread and cut and pasted the info.
 
Deb & Wink said:
Hindsight is great isn't it?

We all live and learn. but now that you have your new vet Karen, I think Wenchie will do so much better.

Nothing is too small to mention to us here. We know a heck of a lot. Not as much as a vet knows about everything but we do know about EPI and other concurrent health issues that may be affecting a diabetic cat.

Swearing at your old vet. Vehemently and loudly. From hundreds of miles away.;)
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I too believe Wenchie will do a lot better now that she's in Karen's hands. I'm beyond pissed at this moment. Such unnecessary suffering for this sweet animal.

I will make sure I mention EVERYTHING from now on! I just hope some day I'll be able to help someone else the way you guys have helped me.
 
JL and Chip said:
The good news is that EPI is treatable and Karen doesn’t think it’s likely cancer. I’m glad @Deb & Wink got that EPI info posted so quickly. The minute you said ashy poop I thought of EPI. We had to have Charlie tested for that too and several of my GI cats have had to go through the TAMU protocol of B-12 injections.

You have a clue and a direction now, and more hope than you had 24 hours ago. Although there are no guarantees, I call that a win for now.

Hey, move over on that “guilt” chair and make room for me. I’m sorry I didn’t ask about the poop before last night. :-( By the way, try to cut yourself a break. You didn’t give up and take the original vet’s advice blindly — rather, you came here, persisted with follow up, listened to advice, and reached out to Karen for a second opinion. You deserve kudos, not guilt.

Get a good night’s sleep and I hope you have a bit more peace of mind.
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Thank you - you guys are the best!!!
 
Helping new members by giving them encouragement is one way that anyone can help. Share your experiences. It can really make an impact on someone new.

Pick one person in the Main Forum. Give them some encouraging words. Let them know that someone is paying attention and listening.

That is all it takes sometimes. Letting them know that feline diabetes is treatable, and that a cat can live a long and better life with treatment.
 
Deb & Wink said:
Helping new members by giving them encouragement is one way that anyone can help. Share your experiences. It can really make an impact on someone new.

Pick one person in the Main Forum. Give them some encouraging words. Let them know that someone is paying attention and listening.

That is all it takes sometimes. Letting them know that feline diabetes is treatable, and that a cat can live a long and better life with treatment.
Click to expand...

Exactly!
 
Diane, I just popped in to say that you are awesome. Your first vet wasn't good enough. You did research on your own, you realized the vet wasn't good enough, and you got Wenchie to a vet that knows what she's doing. Wenchie can't ask for any better mama than that. It's hard to realize one can't trust what a vet is saying. We are all used to trusting vets and following their instructions. You have nothing to feel guilty about. You are a rock star, and Wenchie is going to have a happier, healthier life because of it.
 
Juls and Billy said:
Diane, I just popped in to say that you are awesome. Your first vet wasn't good enough. You did research on your own, you realized the vet wasn't good enough, and you got Wenchie to a vet that knows what she's doing. Wenchie can't ask for any better mama than that. It's hard to realize one can't trust what a vet is saying. We are all used to trusting vets and following their instructions. You have nothing to feel guilty about. You are a rock star, and Wenchie is going to have a happier, healthier life because of it.
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Wow - now you made me cry!!! Thank you - I'm speechless, which is hard to do!
 
@Deb & Wink @Chris & China (GA) @Juls and Billy @toomanycats HELP!!!!

Wenchie is barely eating.... do I syringe feed her tonight?

Help - I'll try to make this concise. We took Wenchie to Karen on Tuesday. Karen called in the prescription for the pancreatic enzyme powder to Chewy at 9am, telling them it was really vital that they expedite this prescription. They had to speak with me first. I called, paid for the prescription and was told it would ship out later that day.

I called Chewy that afternoon because I hadn't gotten a shipping notice. I was told that the pharmacist didn't "approve" it until after 3pm so it wouldn't ship on Tuesday, it would on Wednesday.

Fast forward - it has not shipped until TODAY. The soonest I can get it is tomorrow at noon. I've pleaded and begged with Chewy to please, please, please ship it asap and it fell on deaf ears. Karen feels that even after the first dose Wenchie will begin to feel better.

Today she is very, very weak. This morning, I called all the emergency clinics in the area as well as other vets to find out if the enzyme powder was available there - no luck. One person at one of the clinics said she has heard that Chewy has been absolutely awful in filling prescriptions. This was my first prescription with them so I had nothing to compare it to.

Yesterday I had a total sobbing meltdown because I don't know what else to do. I'm afraid she won't make it until tomorrow.

Here is my question: If it arrives tomorrow, should I immediately mix it with food and syringe feed it to her? I want to get the first dosage down her as soon as I can. Tonight she ate a tiny bit, not enough to keep a bird alive, and I wanted to syringe feed her. My husband thought it was a bad idea and that it would stress her out. I need help. Please.
 
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Easily digestible food is good.

If you can find it, feeding her raw beef or lamb pancreas might provide the needed enzymes in the short term. My vet mentioned it but I’ve never tried it.
 
JL and Chip said:
Easily digestible food is good.

If you can find it, feeding her raw beef or lamb pancreas might provide the needed enzymes in the short term. My vet mentioned it but I’ve never tried it.
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toomanycats said:
This is definitely out of my knowledge area. But I'm here. Hugs
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Thank you both! I just pureed kitten pate with a lot of filtered water. I gave her 15 mils and slowly and gently and she didn't get stressed out. When I finished, she immediately went to her dish to start eating. I will do this again until I finish the can.

Chewy finally shipped the enzyme powder (bastards - I'm spitting mad) so I'll have it by 12:00 est tomorrow, Saturday. The vet said even 1 dose of the enzyme powder will start her feeling better. I need to give her that chance. This has been the week from hell. I will never buy anything from Chewy again!
 
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