Okay, I hope this is the right spot, but I needed to ask a few questions. Let me start of with a little history as that always helps. Pig is a Manx and as such he has no tail. He also suffers certain things as a result of this. Consider this, a cat's spinal column typically extends to the tip of their tail, but with Pig his actually ends at the base of his hip bone. As a result, there are some neurological issues that he has had since birth such as a malformed, shaky, and wonky back leg. He also has always had small little butt spasms as in his muscles are always clenching and unclenching. He has always done this. Furthermore, this front legs tend shake when he is in a sitting position and this is also something that he has done his whole life. Additionally, his digestion has never been 'normal', but he has never been diagnosed with IBD. However, he does tend to cycle between runny and solid output. I have also noticed that it is runnier with stress and more solid in a quitter environment. Fast forward to several months ago. I noticed Pig was not feeling up to par. I take him to one of the local country vets who ran blood work, said he was fine and blamed it on arthritis. It was not, I could tell. I took him back to his vet which is over 2hrs away. She prescribed Adequan. I took him back because I noticed that there was a 'lump' in his abdomen that they missed. We did radiographs and found out that he was constipated from top to bottom and this was not allowing him to pee properly and what I felt was his enlarged bladder. Vet prescribed MiraLax, but I never really saw and great movement with it. Yes, he had explosive diarrhea, but the more solid pieces were not moving. After much convincing, I finally got him a prescription for Cisapride. This seems to help some, but he always seems so uncomfortable when moving more solid pieces, which are not ever really solid or large. However, despite all of this, his bladder is STILL enlarged. What does all of this mean? It means he leaks urine everywhere. I do not mind the clean up, but I want to figure this issue out as it has to be very uncomfortable. Now, when his numbers are lower he will simply get up and go pee, but he is an Acro and I am struggling to lower his numbers. So, here is how a typical day looks. I blend his food in a blender with water and give his morning meds of .25ml Cisapride, .5tsp Miralax, and 16u of Lantus insulin. He feels fine and grooms himself. Shortly after he lays on his side. Sometimes he goes under the couch, sometimes on top of the stairs. He will lay there for so long that his bladder contents just slowly leak out causing a massive puddle under him. His fur is sticky with his sugar pee. I can literally touch is bladder and it will just drip out. I am at a loss. I have asked and asked my vet and she just attributes it to higher BGs and constipation. Now, she is a very good vet and I trust her, but I do not trust my ability to communicate the issue at hand. I get very flustered and emotional when discussing these things. Adding to this is the neuropathy. He does not have it bad, but he does tend to favor his hind legs. He can still jump on beds and counters and climb the stairs, but he doesn't like to. I am giving 25u of b12 every week, but it is cyanocobalamin and not methylcobalamin. I feel that his neurological issues from the Manx syndrome, decreased energy from elevated BGs, and the neuropathy are giving him a triple whammy. What to do about it, though? That I do not know. His appetite is always fantastic and his blood work is clean save the glucose and IGF-1. His energy levels are terrible. He always seems so miserable about 15 minutes after eating. What am I doing wrong?? Has anyone ever had this issue?? I am really at a loss and have asked everyone I can think of, so I turned here... I apologize for the long post.