Suggestions on steps forward?

Hello Everyone

I’ve only just joined as a member but have read various posts as I google things. A little introduction and backstory and then I’ll come to my current issue.

My fur baby is a 8.5yo white domestic female who was diagnosed with diabetes in Dec 2018. We traveled along ok for quite awhile and aside from a couple of lows and highs she was stable.

Typically her glucose was monitored with a free libre sensor every few months. We recently added in ketodiastix at home also.

In Dec 2019 (so a few months ago) we started having multiple bouts of vomiting and food refusal. Since then we’ve changed her food from the diabetic wet to various seafood/gravy based foods (she refused everything else!) and we have anti nausea tablets and pain relief on hand to help combat the vomiting.

Our vet has been running on the assumption we were dealing with pancreatitis given her original ultrasound on Dec 2018 had shown some signs of it.


Fast track to today...

* We’re on day 5 of vomiting
* Anti nausea once daily (1/4 tablet) doesn’t seem to be helping
* Normal insulin dosing is 1 unit of Lantus twice daily but since Monday she’s only had insulin once, Thursday morning, because it was the only day she managed to eat decently and keep it down.
* I’ve been very reluctant to dose as we had a urine glucose reading of only 2.5 on Tuesday and we’ve always been told better to be high than low.
* Getting glucose readings has been tricky as we don’t have a blood meter and rely on urine and she’s notoriously shy about peeing.

The vomiting doesn’t seem to be slowing and getting her to eat anything is getting harder.
Hydration still seems good (pinch test, gums, temp of paws all fine).
Really hoping to get a glucose reading today.
We’ve had quite a weight drop (usually around 5kg+ and currently 4.47kg)

I’ve spoken to the vet and given dehydration doesn’t seem to be occurring they’re happy for her to stay home. They’re finding a time for an ultrasound and will call me back.

She’s still happy in her personality, if somewhat more cuddly, no lethargy.
Just vomiting and not eating.

Now I know that’s all been really long and I really appreciate anyone who has gotten to the end. I wanted to try and give as much of our story as is practical.

Which brings me to my question:
With the combined knowledge and experience in here... am I doing everything I should be? Does anyone else have any ideas of what could be going on? Has anyone been through similar? Any ideas on stopping the vomiting and getting her to eat?

I often feel at a loose end with her and worry I’m not doing everything we can, especially since funds are limited. It feels so unknown and combine it with everything else going on in the world at the moment I’m struggling to see light at the end of this particular tunnel.

I just want my baby to be well

 

Hi Jessie and welcome to the forum....not sure if Jessie is the human if the fur baby.....can you tell us please

First of all I would be concerned about ketones forming if there is vomiting, not eating and no insulin.
Are you testing every day for ketones?....this is really important. Catching the formation of ketones early saves the kitty getting worse and developing ketoacidosis (DKA) and saves a huge amount of money. So get daily tests in and let us know what they say please.

What antinausea tablet are you using? Is it cerenia?
There is another antinausea med called ondansetron which works on a different pathway and may work better for your kitty. It can be given at the same time as cerenia and can be given three times a day if needed. The other name for ondansetron is zofran. Ask the vet to give you some of those. He may need to write a script and you can get it at the pharmacy as it is a human drug but safe for cats...I've used it for Sheba.

If the vet thinks it might be pancreatitis I would ask for a pancreatic test first before an ultrasound. There is a Snap fPL which is done in the vet office and will tell you yes or no if there is pancreatitis or there is the SpecfPL which is sent away and gives you a number a see to how severe it is. Then you will know if you are dealing with pancreatitis or not.
If it is pancreatitis the usual teatment is an antinausea injection (and home with oral antinausea meds), a pain injection ( And home with oral pain meds) and some sub Q fluids at the vet...and if needed more at home. Most cats who have pancreatitis do have some degree of dehydration and benefit with SubQ fluids.

I would also STRONGLY advise you to think about starting to home test the blood glucose. It is much more reliable then urine testing and will keep your kitty safe and you will know exactly where you are with the insulin dosing. It is not hard to do, your kitty won't hate you and it will save you money spent at the vet.
Here is a link for you to look at....we will help you get started. Test kits are available at most pharmacies and Walmart. I would recommend a human test monitor. They are much cheaper to run and most of use them here.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Keep asking lots of questions. We are more than happy to help you try and sort out your precious kitty.
Bron

 

Hi Bron

Thanks so much for your reply

I’m Jess and my fur baby is Selene I wasn’t sure how to add her name into my profile.

Because we have the ketodiastix they check for both glucose and ketones but it’s very tricky to catch her urinating. She’ll deliberately wait until the middle of the night often. She’s always been like that unfortunately, very shy of toileting!

It is cerenia we are using, that’s good to know there is another option so I’ll definitely mention that to the vet and see if we can give that a go as well.
We’ve had both anti nausea and pain relief injections in the past and when we found we were having to go back so often they finally agreed to let us have a larger supply of cerenia and buprenorfen at home.

This is the first time we haven’t been able to nip it in the bud by day 3-4. I did read up only the other day about subQ fluids at home which if necessary and they’re happy for us to do so I’m more than happy to go ahead. It’d certainly be a more cost effective option than IV and admission.

Re the Snap fPL test I’m not sure if they may have already done this? When she first presented in December with the vomiting I know there were bloods done but I’m not 100% what they were. I have a vague memory of something being “borderline” so perhaps that was it? It was at that point they said they wanted an ultrasound to confirm and we simply didn’t have the money.

I asked if they would treat her differently if we had an ultrasound or did further diagnostics and they said no it’d be the same so we decided to abstain from them and focus our funds on the treatment.
I’ll definitely call and check if they did do that test.

I suppose one of my concerns is that it’s not actually pancreatitis and in fact something like an obstruction or cancer.

She doesn’t have any tenderness in the abdomen or bloating which she did back in the December.
Cats are so hard to diagnose!!

I don’t have any probs with doing blood glucose checks at home, just don’t have the equipment for it and I’m based in Australia so they’re a tad more expensive than the US (from what I’ve seen).

When I’ve mentioned it to the vet they’ve said to stick with the freelibre every few months and the ketodiastix. In saying that given she’s being so tricky with the urine tests we may have to move to a blood monitor regardless. I’ll have a look at which ones we have in Australia would be suitable to use for cats.

 

Hi Jess and Selene!
I live in Australia too! Sydney.
I can give you lots of information. Here is a link to information for Australian caregivers I put together.
http://www.felinediabetes.com/FDMB/threads/information-for-aussie-feline-diabetic-caregivers.217781/

If Selene is shy in the LB you can try putting either a little dish in her favourite pee spot or crumpling some plastic in the LB to catch some pee.

With the ondansetron (zofran) your vet may not have heard of it being used for cats. I know my vet didn't know about it but was happy to prescribe after I told him and he read up on it. He then wrote a script and I filled it at the chemist.
Out here zofran comes in wafer form and the wafers are 4 mg and you give 1/2 a wafer 8 hourly if needed. If you pop it on their tongue it will melt so you need to make sure your hands are dry when you handle them. It takes 1/2 hour to start working.
Is Selene showing any signs of nausea such as smacking her lips, sniffing the food and walking away?

The pancreatic tests are not in with the normal blood tests done at the vet. They are specific tests done separately.
Sheba used to suffer from pancreatic flares as well, so I understand your concerns.

Is Selene still having her bowels opened? If she is I doubt it is an obstruction.

I bought my glucose meter from a chemist, also the first lot of strips and the lancets (get 26 or 28 gauge as they are easier to use in the beginning) and some cotton balls to put behind the ear when testing.
When I knew what type of test strips to buy....you have to use the specific ones that go with your meter.....I bought them on eBay for half the price of the chemist ones.

Have you tried offering her some steamed chicken breast? You could also give her the juice the chicken is cooked in.

 

Well, the good news is that Bron is also in Australia! If you click on a member's avatar/photo, it gives you a bit of info about the member.

One thought that I had, especially if this isn't pancreatitis, is whether there may be some inflammatory bowel issues going on. One of the symptoms is nausea/vomiting. Are there any other GI issues like diarrhea? Trying novel proteins may help.

I second Bron's recommendation that you opt for blood glucose testing. Urine glucose testing is problematic and generally not recommended. One big issue is that you don't know if numbers are way high or very low -- the test strips don't give you good information at either end of the test range. It's less of an issue with high numbers but could be dangerous with low numbers. In addition, you are not getting readings that reflect that the glucose level is at the time you're testing urine. It is literally hours for your cat to eat, digest the food, and produce and collect and excrete waste. Blood glucose is to the minute.

 

Oh great to hear your in Australia too! When you mentioned Walmart I assumed US
I’ll have a read of the link. Good to know about ordering test strips online, I used to do the same for my coaguchek (blood monitor for human INR).

Definitely signs of nausea; all eager to eat, waiting at her bowl, starts to sniff and then it’s like ‘argh, actually no’ and walks off ... reminds me of myself atm as I’m pregnant; get all excited to eat and then can’t bring myself to!!
Still opening bowels, we have 2 cats but have caught her in the act so know it’s her. Hubby did mention a couple have been on the softer side but not diarrhea, still formed.

The last vet visit a couple of months ago was when they mentioned her tummy may be reacting to the diabetic food but because she’s been so incredibly fussy with what she’d eat we got to the point of “anything goes, as long as she eats it!”
I’ll try some chicken today. I know in the past it hasn’t been a favorite. We’ve got a rag doll with a sensitive tummy who has been on chicken previously and Selene wasn’t the biggest fan then.

 

Thanks Sienne!
Here I’d hoped adding urine testing would be helpful (and inexpensive).
At least it gave us a way to check for ketones as we had a stage there where we were flying so blind and it was really stressing us all out!

Looks like I’ll be investing in a BGM

 

It certainly does sound as if she is nauseated.

It isn’t necessary to feed diabetic food to her. There are plenty of canned options on the market. I have listed several that are available in the link about ‘suitable foods in Australia’ that is within the link I sent you. Look for foods that are 10% or less carbs.
I fed Sheba a raw diet but also had some Weruva cans as well for emergencies. You can get that brand at Petbarn and they have all the carb content in their website (Weruva website). We have ‘cats in the kitchen’out here in the Weruva brand and ‘BFF’.
If she doesn’t like chicken you can try another food such as beef or lamb or some mince ( but make sure it is fresh and hasn’t got anything added.

Do you also have some higher carb food available in case of a hypo? Options are also in the food link as well. Also always have some honey in case of an emergency...you can rub that on the gums if signs of a hypo appear.
But if you are testing the BG levels you will always be in control and a hypo should not happen.

If you are looking for a meter, you can buy a meter that is also a ketone meter which is good to have for shy cats who don’t like to pee in company. You will find the meter in the link I sent for Aussie CGs. That might be a good option for you. The ketone strips are expensive but you don’t use that many of them and they are a lot cheaper than having to hospitalise a cat with ketones! The blood glucose test strips that go with the glucose/ketone meter are cheaper.

 

Here is a link to stimulating kitties appetite. May not help a lot until you can get rid of the nausea.

http://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

 

Thank you so much for all your help!
It’s so good to be able to talk to others who understand and have more insight into what’s going on.

Our local vet and specialist have both been great but sometimes it still feels like there could be more or better ways of doing things so I really appreciate getting more information.

We finally managed to eat a bit of the broth sachet and even a few mouthfuls of her dry food at 3:30 today, so far staying down.
She’s keen to go outside but I’m pushing for that litter tray usage haha

 

What dry food are you feeding? All dry food in Australia is high carb. ( I do understand that when they are not eating any food is better than none!)
I’m glad she managed to eat some food and keep it down.
Did you give the insulin?

 

How are things going today @Jezzie

 

Hey @Bron and Sheba (GA)
Sorry life got busy with hubby home!
She’s on the Royal Canin diabetic dry food.

Yesterday we had a full day of no vomiting!! I was feeding her every 3hrs and I think that really helped.
Mixture of the fancy feast seafood broths and “chicken soup” - shredded chicken poached in water and served all together.
Last night I did more chicken but added a bit of rice to bulk, not so happy with that haha so back to straight chicken.
She was super happy in temperament yesterday and given she was eating so well we didn’t give any cerenia. This morning she’s a bit more withdrawn so I suppose we’ll see how we go.

Still no insulin
I know she may have increased her glucose quite a bit after eating solidly all day yesterday. Her past history of swinging dramatically is what makes me hesitant. Also the only day last week that she went dramatically backwards was when we begun insulin again after she’d eaten a solid meal. I’d rather be cautious and let her go a little high than drop too low.

I’m off to get a blood glucose meter this morning so once I’ve got a reading and if we keep the food stable then we’ll start again

Btw that Aussie file is awesome! Lots of helpful info!

 

Re glucose meters there doesn’t seem to be many different ones available in store local to me so I think we’ll be going for the AccuChek Performa.

Still cheaper than a vet visit for a once off reading haha!
Here’s hoping we manage ok with getting a sample eek
Going to read up on all the resources before attempting

 

Ok random question... Is the Accuchek Guide an option? My mother in law has a spare meter that I can borrow but that wasn’t on the list so just wanted to check

 

Hi Jezzie My name is Jeanne to tag someone for a direct answer type @ Bron and Sheba. I would do it for you but my tags arent working lately.
GOOD LUCK!

 

Hi Jezzie and Selene,
I hadn’t come across the AccuCheck Guide before but I just looked it up and it looks fine. If you can borrow one, that would be great. You just need to check that you can get the correct test strips ok.
The AccuChek Performa is a good one too.

Have you managed to check again for ketones yet?
It’s really important we know if there are any ketones present.

Great no vomiting all day yesterday! Progress. Feeding smaller amounts often is certainly better.
Rice is carbohydrates so best to steer clear of that if she will eat something else. Clever Selene refusing the rice.

When you get the chance, could you fill in your signature please?
To find it, go to your top right of this page and under your user name is signature. Click on it and tell us yours and Selene’s name, date of diagnosis, type of meter, type of food fed, any health issues, type of insulin and then save. Thanks. That will appear at the bottom of all your posts and will tell us at a glance a lot about Selene.
Bron

 

@Bron and Sheba (GA) no luck on ketone test yet, just got a blood glucose of 15.9 so we’ll give her insulin tonight with dinner
Eating has been on and off today but happy in mood.
Will continue to monitor for a toilet break for ketone test.

Edit to add: last ketone test was 3rd April so 3 days ago and negative for ketones, glucose was 2.5

 

I see you have your signature done. thanks! And good to know that 3 days ago there were no ketones.
Glad you are up and running with the home testing. Make sure you test before every shot to see it is safe to give the insulin and I would recommend testing at least once during the cycle to see how low the dose is taking Selene.
Until you gather some data, I would not shoot if you get a preshot below 8.3 initially but ....stall, don’t feed and post and ask for help (make sure you change the subject line to effect you need help) and test again 20 minutes later. This is because we don’t know yet how Selene reacts to the insulin dose and we need to stop and think before shooting.

We have a terrific spreadsheet which you can use to log in all your BG data. It is extremely helpful for us in helping you with dosing and You will be able to see how Selene is going.
Here is the link. If you have any trouble setting it up, we can help you easily so please ask.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

You will see that most people use the US numbers when talking about BG numbers.
To change our numbers to the US numbers you multiply by 18. Info about that is in the Australian info for CG I sent you.
When you install the SS you will see there is a world and a US version of the SS. You need to use the WORLD version. It will automatically transfer the numbers to the US version for everyone to see. You will continue to see the world version on your computer. Does that make sense?

I am concerned that the last test Selene had was 2.5 mol/L (45). That is too low.
Any time you get a number under 2.8 you need to give high carb food or honey to bring the number up higher.
Normal cat BG numbers are 2.8 to 6.6 (50-120).
Do you remember at what time during the cycle the 2.5 happened?
You will need to reduce the dose to 0.75 units if the 1 unit took her to 2.5 (45)
ETA......I’m just realising that maybe you were talking about the level of glucose on the ketostix result when you said 2.5. Not a blood glucose test. Am I right in thinking that?

 

@Bron and Sheba (GA) yep the 2.5 was urine not blood and it was 8:20pm and she hadn’t had any insulin for 36hrs so wasn’t the insulin causing the drop, just lack of eating.

The guide our vet set was between 5-10 so a little higher than 2.8-6.6 you mentioned.

Unfortunately we’ve just had another vomit - every time I think it’s settling we start up again sigh

She’ll be due for dinner and insulin at 8pm so assuming another blood glucose before then?

The 1unit is already much lower than what we were last year - her regular dose was 3 units twice daily!!
Some days I swear she’s heading for remission because we just get lower and lower.
Hopefully we can get some really clear cycles now I’ve got the monitor at home.

Also side note re cerenia - is there a limit to the number of days straight they can have it? I noticed the guide didn’t mention so by then our packet states no more than 5 days.

 

Just seeing this and it’s almost 8pm....yes test again at 8pm to see it is safe to give the dose

 

Vets usually set a higher BG numbers because most people don’t test the BGs at home and it is safer for them to leave the BG number higher but if you are looking at remission or regulation you can safely use the numbers I mentioned if you are testing consistently.
Do you have a hypo kit set up at home I case of low numbers?

Thanks for clarifying the 2.5 was the urine testing.

Oh I’m sorry she just had another vomit ....has she managed to keep anything down since then.?
I’ve not had to use cerenia for long so I’m not sure if you can use it past 5 days.....I’m sure I have seen others here use it for longer, but I’d ask your vet. There is another anti nausea medication called ondansetron....or zofran in Australia.....and it works on a different pathway. I would ask the vet if he would write a script for that and you get that at the chemist as it is a human drug...quite safe for cats and often works well when cerenia doesn’t.

 

Yes I remember you mentioning zofran so will be asking them next visit.
She didn’t eat any dinner after the vomit (and diarrhea, which is new) but her BG was 17.2 so we went ahead with insulin (1 unit).

If she doesn’t eat brekky we’ll start cerenia again but I’ll be giving the specialist vet a call tomorrow to touch base as the ultrasound (being done locally) isn’t until 15th.

ETA we don’t have a hypo kit per se but do always have honey on hand. I did read about the food suggests so we’ll look into those. Given how fussy she is honey is probably still our best bet in a hypo

 

Try and get her to eat something during the cycle if you can...some chicken maybe....and get a test in around +5 or 6 to see how low the BG is going.

You can always rub honey on her gums if she won’t eat it and she drops low.
Honey only lasts about 1 1/2 hours so don’t think you have solved the problem by just giving the honey once and leaving her..you will need to keep testing.
I hope the vomiting and now the diarrhoea is not going to persist. Poor Selene.

 

We’re all so exhausted
This is day 8 now

 

(((((Jezzie)))))

 

@Bron and Sheba (GA) G’morning
I hope you don’t mind me asking on this thread still
She ate a bit of chicken around 6:30am (came asking for food)
Now not interested at 8:30am but have just taken BG, 7.3
Shoot, don’t shoot?

 

Jezzie I’m just seeing this and I have to race out for a dr apt
Did you stall and retest.?
I’ll tag @Nan & Amber (GA) and @Wendy&Neko for you

 

No worries @Bron
I myself had to race out to take my daughter to kinder.
I’ve rung our specialist vet and updated them and they’ll call me back with advice (our usually vet isn’t in today)
When I get home I’ll retest and see which direction it’s heading

 

Nope, the 5 days is old guidance. The newer guidance is that you can give it daily.

Any progress on getting a spreadsheet up and running? I'm reluctant to give any suggestions on dosing without it.

 

Sorry Wendy not yet
My notes are scrawled between post its on my fridge and in my phone ‍♀️
I’ve got a lot to juggle atm and the spreadsheet is on my list but I haven’t gotten to it yet.
There’s only been the 3 BG readings so not much to see in terms of pattern.

Thank you for the info on cerenia, that’s good to know. I’m happy to give daily if that’s what she needs to be able to eat although it hasn’t made a dramatic difference this last week

 

The usual suggestion for new members, is that you get a number 200 (11.1) you post for help. Which you did, so good. You can either wait, without feeding, until her numbers go higher or skip. Keep in mind that if you stall for say 30 minutes, then the next shot is also 30 minutes later.

 

Jezzie I’m going to tag @Chris & China (GA) to see if she can help you with the spreadsheet. You will need to send her a private message with some details when she answers the tag.
How did you go with the morning shot?
I’m glad Wendy was able to help.

 

I'd be happy to set it up for you. It only takes me about a minute once I have some details from you!

 

Thanks @Chris & China (GA)

 

Sorry I didn’t reply sooner
After that day we had a phone consult with our specialist who insisted we move the ultrasound earlier (to today)
Currently at the hospital and it’s not good news; inflammatory bowel disease or lymphoma.
Either way only 6-12 months left of we’re lucky

 

Hi Jess, I just replied to your PM.
I’m so sorry to hear this news.
As I mentioned in the PM there are kitties here that have been treated for inflammatory bowel disease and lymphoma.
Vets in Australia don’t seem to be very proactive with it, but I know treatments are available here.
I would either change your subject line or start a new thread with “information on inflammatory bowel disease and lymphoma” as the heading.
@Wendy&Neko

How is Selene going?

 

Was just reading all of this, I am so sorry Jess, I pray you can find a treatment for Selene, my heart goes out to you, gentle hugs

 

Adding my prayers.

 

Well, that's just untrue! The cat currently snoring on my husbands lap has been in remission from small cell lymphoma for two years now. With a daily steroid and chemo every couple of weeks, the majority of cats can go into remission. As for IBD, we've seen lots of kitties here with IBD. Novel proteins and a good probiotic can help. And they definitely go a lot longer than 6 months. It's just another condition that has to be managed.

Your next step is first, see if you can get a consult with an internal medicine vet. If that's who you are seeing, find another one. Sounds like yours is a little out of date, OK, maybe a lot. The next step will be a biopsy or endoscopy to get a sample of the bowels to see which of the two conditions you are dealing with. The treatments for the two are different.

 

Tagging @JeffJ for the possible lymphoma.

IBD (Irritable Bowel Disease) is very treatable. There is even a facebook group for IBD kitties.

 

The chemo is just a pill/capsule ((chlorambucil) and is not that expensive is you get it from a compounding pharmacy. Just do not get the name brand Leukeran since that is outrageously expensive. My Mario was on Leukeran (when it was cheap) and lived two good years.

 

That may be true in the US, but not other countries. I have only given Leukeran for my three SCL kitties, and it's still cheap in Canada. Not sure what the price is in Australia.

 

You can buy Leukeran in Australia from the Animal Pharmacy in Sydney for $47.90 for 25 tablets.
It requires a prescription from your vet which can be emailed through to the pharmacy and they will send you the prescription to any state in Australia. I have used them and they are much cheaper than getting the medication from the vet and from other places.
If it is only given every couple of weeks, that’s not too bad a price.
All animals meds are more expensive in Australia than the US.
Here is the link
https://www.theanimalpharmacy.com.au/prescriptions/leukeran-2mg.html

 

Leo was on Leukeran for over 2 years after Small Cell Lymphoma diagnosis. Also he was on prednisolone. if you don't have the funds for testing, some people just give pred to help with the symptoms.

We feel the Leukeran and the pred both extended Leo's life. And the relative cost is pretty low. Side effects from Leukeran are nausea and reduction of hunger, since it is basically chemo therapy for cancer.

 

Hi Jeff, good to see you.
Ondansetron (zodran) would help with the nausea I would think as it’s used in humans having chemo.

 

Hi Bron - hope all is well on the other side of the pond. All well in Austin, TX.

Ondansetron worked somewhat for Leo's nausea. As the SCL progressed, it didn't work as well and he ate less following a chemo dose. When his appetite was off, we found mirtazipine helpful. However, you need to be careful. You don't want to make a nauseated cat hungry. So if you go with Leukeran, then pair it with Ondan like Bron said.

 

Hey everyone
Thank you so much for your replies and I’m sorry I disappeared. It was very full on to get the news right before Easter and then we’ve just been trying to work our way through our new normal.

So a few updates and a few replies to the comments...

* We are seeing an internal medicine specialist, she’s been with us since day 1 of Selene’s diabetic diagnosis. A few tentative feelers of mine on google and your own comments are showing that yes they can live a lot longer. I think she was just trying to prepare us for worst case scenario. She was absolutely all for us treating. We’re not a lost cause and weren’t sent home with a “well that’s it, enjoy the time left” so please don’t think her doctor isn’t putting her care as a priority.

* Selene commenced prednisone the very next day along with a higher dose of cerenia. We also changed her diet to exclusively hills z/d wet food (we did have a few days of transition where she had plain chicken as well). She also has access to z/d dry food during the day. Feeds have continued at every 3hrs. In the past 11 days we’ve had only 3 very small vomits; 1 food, 1 froth, 1 grass.
Her temperament has changed dramatically. She has extremely clingy days towards me (like today) but also very happy to be out and about around the family and no longer hiding as much. She’s also actively looking to go outside and explore and generally be active.
We are hoping these are all positive signs that she is feeling better and it may be IBD and not lymphoma since the prednisone seems to be helping. Her diabetes has been stable with her blood glucose readings regularly between 14-18 and a single unit of Lantus twice daily keeps her steady.

* Regarding diagnosis we are not in a financial position to do additional tests like a biopsy. The treatment plan at this stage is to treat with steroids and review. The chemo at this stage is not an option as I’m pregnant and have been advised it is not safe for me to handle.

So that’s it folks! I’ll be researching further and asking questions on the board I’m sure but for now we seem to be on an ok path.
Thanks everyone for your support.

 

I’m so glad you posted Jess, I have been wondering how things were going!
I’m so pleased you have been able to get Selene onto a treatment and she seems generally happier and that her prognosis is much better. You must be very relieved!

I am concerned about the diet she is on though. The z/d is very high carb...35% carbs for the canned food and higher for the dry. Diabetic cats need 10% or less carbs otherwise the pancreas is continuing to be stressed with the high carbs.
And it only has 28%protein in it. Selene is still a young cat and she needs more protein than that to maintain her muscle.
Have you thought about trying a raw diet with a new protein she hadn’t had before? Or even a novel protein in a canned food?
If you did swap to a lower carb diet the BGs would drop so you would need to be aware of that.

Having the BG between 14-18 is still too high. You need to either increase the dose by 0.25 units and see how that goes or reduce the number of carbs on her diet and that will reduce the BG.
I know you are having a baby soon and needing to get Selene sorted out and I don’t want to add to your worries, but please look at a better food for her. The z/d is not a natural cat food....have a look at the ingredients........the first one is rice and the second one is hydrolized chicken liver, then no other meat at all.......the third ingredient is powdered cellulose which is ground up wood..........cats are carnivores and need meat and low carb. I’m sure there is a better option for her. I’m sure the vet won’t agree though, as they get their food training from the food companies that make the prescription foods and know very little about other options....I know this from experience.

Please keep up updated as to how she is going as we care about all our cats.
Bron

 

Hey Bron, no kidding on the vets not agreeing re food *face palm* they are quite insistent that we continue on z/d or one of the other prescription diets (since Selene started refusing z/d the last few days).
Honestly the food is quite frustrating, I'm trying to research into it further and there are sooo many opinions between the various boards (IBDKitties, Vets, here) and its kind of doing my head in. We'll get there, just trying to not overload myself or change too much at once with Selene either.

I know that BG is still too high and I've been keen to get it to drop but the vets wanted to take it slow with dose adjustments - read that as no adjustment.
In the end I started adjusting it myself this week. After a missed dose on Monday morning (thanks preschooler for letting the cat escape before her meds grrr) we had a large spike but managed to get it back down to 16 on Tuesday. Its been fluctuating ever since then, sitting closer to 20 despite her barely eating and drinking like a fiend. Hence I started the dose adjustment by 0.25. Yet here I am today with her finally eating something (chicken) and we've spiked to 29 argh! When I called the vet they said no dose change ... like WTH. I've had no luck getting urine for a ketone test, trying yet again today. When I rang the emergency team this morning they weren't even concerned - I've just been on a massive tirade with hubby at home about how she's going to end up in fricken ketoacidosis before they do anything.

Anyway I've made a separate post about the dosing (and updated her spreadsheet) ... just realised I hadn't replied to your comment like I thought I had oops

EDIT to add no ketones phew