New to forum, less than 1mo diagnosed

hello all,
I want to say first that I don't have a lot of internet access but I'm going to try and make the most of this with occasional posts.
I have a long-haired guy, 15 yrs, was always small dog sized but probably started losing alot of weight last year some time and having hair-matting issues. We also had a weird summer in MA so I thought it was heat-related and just tried to make sure he was drinking enough water. Before diagnosis he'd mostly been eating dry food: Iams (a long time ago), then Wellness/ Castor&Pollux/ Tender&True brands and we have since switched to "Blue" (there's a buffalo logo) but I'd like to get to homemade/ raw.
This past fall or so my schedule got a big crunch and I thought he seemed stressed out because I was out of the house more. I think since December he seemed to be having problems releasing his bowels into his litter box - he'd go nearby instead. In January 2018 he started passing urine outside his litter box for the first time ever, although he'd also go in sometimes. By February he was doing that almost every day, including next to me on the bed/ on the couch/ everywhere and I'm just crying while cleaning it up. We did all the bedding laundry every other day. I had a nearly full gallon of Nature's Miracle that I'd bought more than 5 years ago and I went through the rest in less than a month. First week of March I made an appointment with a vet - he hadn't been to one in years because until recently I couldn't afford things like that - and the first thing the guy says is a suggestion to put him down because "he's so sick". I felt the implication that he was sick because I was neglecting him. I left immediately, made an appointment with a different vet and cried some more.
Next vet was somewhat of an improvement but also suggested that if managing diabetes wasn't something I could handle I shouldn't feel bad about ... (giving up?) I said no way.
Prescott's been on Prozinc for almost three weeks I think - 1u at first. They gave us the AT2 but we were told to wait for 7 consistent days of injections to start testing BG, so we didnt. He also has the eye goop, being treated by more goop (ointment.) About a week into treatment he stops urinating voluntarily, yet leaks in his sleep so he wakes up all wet, and apparently scalded. At a follow up appt the vet suggests we help him express the bladder... so we are doing the best we can. He has patches of bare skin because of the matts.
Then last Saturday 3/24 we were told that he was doing better (w the diabetes) so we could increase to 2u. One dose Sat night (7p), one Sunday morning (7a) on 2u. I leave the house about 1030a Sunday and return ~350p to the poor guy covered in feces having a seizure. Finally test BG: 29. Needless to say we rushed to the ER and we're in the lobby sobbing. ICU vet tells us about 3hrs later that he can't control his body temp, they've catheterized him, are pumping him full of pure sugar and that depending on how long he was seizing for he might have permanent neurological issues, so we "should think very hard about his quality of life". We left him in the ICU only to get a call in two hours that we "should come in and have a frank conversation"...and eventually used The E Word. We say no.
* I'm willing to give this particular vet (at this very shiny 24/7 hospital) the benefit of the doubt that she was overworked and having a bad night, but we were extremely upset to be asked to consider murdering this guy at 11p *
So, the shifts switch and the next vet is more of a neutral personality. She backs off of the sugar little by little and an hour later he's in much more stable shape. We're still crying, but go home for real this time.
Next morning we get a call he's doing well and starting to eat again, just having a little trouble walking and they'd like to keep him for one more night - still catheterized.
Tuesday we get the debrief and take him home. He's to be on 1/2u insulin - plus a urethra relaxer and several eye meds from the previous vets.
Wednesday I am at work two hours later than usual, I get home about 630p instead of 430 and I find Prescott hunched next to a floor pillow bobbing his head, back end covered in diarrhea. Feces a few feet away looks like he may have slipped in it. I try to check his BG but cant get a good sample and waste 4 strips. So, I put food out and with a bit of coaxing he hops up and starts chowing. An hour later you'd never know the odd behavior ever happened.
He's currently eating normally 3.5-4oz per meal and not drinking so much water, but he does have our help emptying the bladder.
It's been a whirlwind for sure. Any and all help is appreciated.

 

I'm sorry you and Prescott have had such a tough time of it.

It's late for me and I'm heading to bed. This is a short version. Others will weigh in the diabetes and on the multiple issues.

Since Prescott has had at least one (likely two) major hypos, it is imperative that you test before giving any insulin whatsoever. A member had put together an excellent video about how to test:
Video I made showing how to test your cat's blood sugar

In Prescott's case, I would not give any insulin without getting a test done first. Many cats become insulin sensitive after a hypo event. The only way to keep your cat safe is to test so that Prescott never gets so low that you are headed to emerg with a life endangering situation.

Here is a link about handling hypos: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Also, here is a list of things to have on hand during a hypo event: http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

If you could tell us what insulin you are using, that would help tremendously.

Did you give a shot this evening?

 

Wow, poor Prescott and poor you! I agree that testing is imperative. Has the has the vet given any reason why he’s voiding in his sleep? Prozinc is a great insulin and we have several people here that can help you with it. HERES some info on it. I’m glad you’re giving Prescott a chance despite the vets advice and I’m glad you’ve found us!

 

Poor Prescott.. and you. I agree with the others that testing is very important. I would test before every insulin shot and get mid-cycle test when you can. 1/2 unit is a low dose, but it sounds like he may still go to low on it. Does he have access to food when you are not home? That might help. If he starts getting low, he may start eating and that may prevent him from having another hypo episode.

 

Thank you. He's on Prozinc. I did read the hypo resources before I posted.

Yesterday he had a shot at 6:50p that probably missed his skin, but one this morning for sure around 6:50a.

I still don't quite have the hang of testing him without someone else helping because he resists it - even as a cat burrito and with bribes. About 45min ago his BG was 749. At 4p yesterday I had a failed testing attempt, but at 6:30a 3/30 he was at 649. Failed testing attempt at 4:30p on Thursday 3/29 also. Wed 3/28 11:30p BG 641 and earlier (6:45p) I had a failed attempt when I found him bobbing his head.

I was told to get him used to meal time so I have not been leaving any food out. I try to give him "fresh" food every time because he does not like when I save the "leftovers" and feed it to him later. It's better if I give him bits more than put a whole can in his dish only have him reject the "old" food later.

 

The voiding while asleep is potentially neuropathy. They say he probably has "bladder over-fill", which doesn't sound very scientific, and that his bladder walls are weak from being distended. The urethra relaxer seems to help somewhat.

 

Thank you.
I realize testing is important so I am trying to get the hang of it like I said. I appreciate the advice.

 

Maybe you could consider giving him Zobaline. I have not used it but have seen others here say it works well.

 

Thank you, I can't really afford to pay for more insulin right now but I'll ask the vets.

 

Zobaline isn’t insulin, it’s methyl B12 and folic acid that can help with the neuropathy.
https://www.amazon.com/ZobalineTM-Diabetic-Cats-60-tabs/dp/B008G3LI2M

 

Zobaline is a b12 methylcobalamin supplement, not insulin. Sorry your guy is struggling.

They can get very sensitive to insulin after a hypo. My cat hypoed in Jan (no symptoms thankfully) and I brought her to the er. Didn't give insulin the next day. The day after that I have less than half her usual dose and she hypoed again. After that I didn't give her any for over a week.

If you could set up a spreadsheet like the one you see in our signatures that would be helpful.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Here's a handout I made up for new members:
______________________________________________________________________________________________

It would help us if you set up your signature (light grey text under a post). Here's how:

• click on your name in the upper right corner of this page
• click on "signature" in the men that drops down
• type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.

Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

.................................................................................................................................................................................................................................

Here's the basic testing routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

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Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:

1. BG goes low OR lower than usual OR drops too quickly.
2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

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Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):

• put the end of the test strip right in his urine stream as he's peeing
• slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
• put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.

Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

 

Wow, great info everyone!
I do have a spreadsheet, but it's in a notebook so I'll transcribe it at some point soon. I think I did the signature bit right - someone let me know.

Also my guy has been eating great ...so I'm not worried about that. We did switch his food to turkey+eggs+Total Cat raw supplement and he really enjoys it. Snubbed the wet canned stuff even.
More soon!

 

Thank you I'll take a look!!

 

Good job getting the signature up so quickly.