? the cat is fine but I personally need support

Okay so I have a question that's been like eating away at me. So when I took Cosmo to the vet the first time when he was hospitalized, the vet told me I had two options. We could either hospitalize and treat or I could bring him home and just enjoy the time I had left with him. My first question was how long does he have with good quality of life and the vet said two weeks. Two weeks came as a HUGE shock considering the day before his appointment he was chasing a hair tie around the apartment for a solid twenty minutes. He looked like a kitten. Anyway, I obviously chose to treat because I was not at all prepared to hear two weeks. So it's been a month since he's been home and overall things have been going well. Around January 18th he started throwing up, but only in the mornings which was weird so I googled like crazy and I came to the "scarf and barf" conclusion. I took the necessary steps to prevent it and he was good for a while. Now, since January 28th he's thrown up every morning, like his whole meal (he hasn't had his morning insulin in 5 days). I called the vet three days ago and he suggested 5mg of Pepcid AC at night to combat overnight acidity so I've done that the past two nights and it hasn't helped.

So where this story ties together is how will I know when it's cosmos time to go. Other than the vomiting (and I think he's starting to pee a little more than normal again), he's a happy cat. He doesn't hide from us, he still purrs but not excessively, his appetite is totally normal despite throwing up (and after he throws up he goes right back to the food), he still plays every once in a while. So my biggest fear is that I'll take him to the vet who's going to say quality of life is no good, it's time to put him down. I want to trust his opinion but I have a cat who still jumps off the table at the vets office to explore the room and go on the chairs and say hi to everyone for pets. That just doesn't seem like a cat who should be put down, like I'm afraid they're literally going to hold him down to put him down and that doesn't seem right. Am I wrong? Is he suffering and I don't even know it? I'm sorry for the lengthy post I just don't want to make a wrong decision either way.

 

Hey there, I'm so sorry to read about all the stress you are going through around your kitty. I have a few thoughts.

First off, YOU, not your vet is the one who gets to decide if the quality of life for your cat is not good. I am reading that Cosmo still, jumps, explores, greets people and still plays every once in a while. That doesn't sound like a suffering cat to me.
If I was worried that my vet would euthanize my cat without a very lengthy discussion and without giving me time to sort my feelings out, I would change vets in a heartbeat. You need an ally who can help you make the one of the biggest decisions you will ever have to contend with in your life.

I'm really glad you decided to post here, because I think you can gain some perspective from others and get some more advice regarding treating Cosmo's diabetes, kidney disease and pancreatitis flares. Many people on the board have kitties with all three of these conditions and are managing them successfully. I hope they will read your post and be able to give you more ideas, especially on the throwing up.
Sending hugs to you and Cosmo! Hang in there!

 

It sounds like his quality of life is still pretty good, from what you describe. You know what signs to watch out for (hiding, lack of appetite, no purring/playing, inability to use the litterbox properly, etc.), and you aren't seeing them yet.

There are some vets who are too quick to suggest euthanasia, and prognoses are just educated guesses, in the end. You know your cat better than they do, you see your cat every day, you have a pretty good sense of Cosmo's actual quality of life. If you have doubts, you can always take him to a different vet for a second opinion. Even if you like the care you are getting at your regular vet, it doesn't mean that you have to do everything they say if you don't agree.

If you are worried about Cosmo's vomiting (and vomiting every morning isn't a good situation) and think you should take him to the vet but are avoiding because of this fear, you can also just take him to a different vet to be evaluated. If the Pepcid isn't working, maybe there is something else going on. Does Cosmo get meals throughout the night, or is it just the one big meal in the morning that he is (maybe) anticipating a little too much? If you don't already have one, the solution may be as simple as a timed autofeeder to dispense meals while you sleep...

Good luck, I hope you can resolve this and feel better about the situation soon!

 

It sounds to me like your vet is a little too quick with the "time to go" stuff and I think it's time to find a new vet. Cosmo is not an OLD cat. He may be considered a senior but he is a young senior. Your observations of him playing like a kitten, jumping on the exam table and being interested in his surroundings, suggest to me that while he may have some medical issues that need tending to, he is still full of life and not suffering from any severe quality of life issues. The fact that he vomits only in the morning and then goes back to his food suggests he is hungry and not acting like a normal cat. I don't see anything in your description of what's going on that would suggest Cosmo is in any major distress.

There are any number of things that could be contributing to the vomiting and I'd suggest finding a vet who is interested in helping you figure out what is going on with Cosmo. Perhaps giving Pepcid twice a day would help. You've noted pancreatitis in your signature and may be changing diet or changing up meal times a bit might help with that. I assume the vet checked for pancreatitis when he saw Cosmo.

When Cosmo was hospitalized, what did they treat him for? Were ketones or DKA the problem? Are you home testing for ketones? If not, it would be a good idea to start. Are you home testing Cosmo's BG? Is it possible his BG is going low at night and causing some nausea? If you are not home testing Cosmo, I would highly recommend you start. It may give you a clue as to what is going on.

Could you please take the "911" off your post title. While I understand your angst and don't want to minimize it in any way, the 911 is really meant for immediate emergencies such as a kitty is seriously low numbers. To remove the 911, click on the "Thread Tools" button in the upper right part of the screen and choose "Edit title". You can replace the 911 with a "?" mark. Folks around here get their adrenalin going wild when we see 911s on messages. Thanks.

 

He gets fed a 1/2 a can twice a day, then I wait about a half hour to let that digest before giving him 1/4 cup of dry food (it's easier for me to give the insulin while he's eating). He never finishes that dry food in one sitting so that sits out for him to graze on until his next feeding. He only ever throws up after the morning feeding which is so weird to me because it's the same food, the same amount, provided in the same way. I did call the vet to let him know and he said to give an additional 1/4 cup of dry before bed to hold him over until the morning because he goes 13 hours between the evening-morning feeding as opposed to the 11 between morning-evening. But that hasn't helped, that's why we're trying the Pepcid

 

Have you tried only giving him a small portion of his breakfast first and waiting 15-30 minutes to give him the rest? Sometimes I have to do that with one of my civvies, or he will barf it all back up. I also sometimes just break it up into smaller portions and feed each portion about 10 minutes apart.

 

It doesn't sound as if Cosmo thinks it's his time. My Smokey was a barfer long before I even got him. No one ever treated or looked into it. For 16 yrs he barfed multiple times a day. After I found this site and read people's posts I started changing things up. In the end what worked for Smokey was being fed every 3 hrs around the clock and no daily dry food. I did give Young Again dry food (1/16th of a cup) occasionally as a treat. Gave him bone broth daily.

 

A couple of thoughts:
For many cats, a quarter of a Pepcid morning and night, about half an hour before feeding am and pm, seems to work better than half (5 mg) at once.

There are better insulins for cats than Novolin - just wondering if your vet would be willing to try something else to help him.

As Woodsywife mentioned, several small feedings a day works well for diabetics, esp barfers. There are autofeeders that you can set the time to open if you are not home.

 

Yes, he still throws up whatever first hits his belly. Then he can keep the rest down. It's honestly the weirdest thing I've ever seen.

 

Unfortunately, I work two jobs =( The only times I am able to feed that work with my schedule are 5AM and 4PM with the insulin shot 30-45 minutes after the feeding.

 

Okay, I did wonder about doing the Pepcid twice a day but my question is how do you give it to your kitty before eating? This is the first pill I've ever given a cat and I was told to crush it up and mix it in his food. Is there something that would work better that would allow me to give it to him before? What about a pill pocket (even though directions say not to chew)

 

Thanks for the reply, I changed the title! I just want to clarify, my vet isn't saying its time!! At the very beginning, he said without treatment he was afraid Cosmo's quality of life would deteriorate quickly and he would only have about 2 weeks left with how advanced the kidney disease and diabetes were. What I should have added in the original post is that since that first visit I have taken him back once and his levels were getting better and I don't have an appointment for another two months, I'm sorry I left that out. My fear is that at this 2 month check up, things will go sour without me noticing and his condition will worsen or not be getting better, where euthanasia will again become a topic of conversation. When I first took him to the vet, the only reason I did was because of the excessive drinking and peeing, everything else about him was as described above, there were no other symptoms. So for me to hear "two weeks" was a huge shock and I'm afraid it will happen again. My vet puts quality of life over everything and he is a good friend so I know for a fact he will do what is best for my kitty. My original question was more geared towards am I wrong in my assumptions that he's okay just from what I've been observing? Is there something I am missing? Is there another indicator of quality of life that I can look out for so a scary diagnosis isn't such as shock the next time around?

 

How about an automatic timed feeder?

 

Regarding Pepcid - I cut the pills in quarters. My cats (fortunately) all love pill pockets, so I used just enough of the pp to wrap the Pepcid. The pp are soft and malleable, so easy to break up. Dr. Lisa's (catinfo.org) works like a charm - toss a tiny bit of pp on the floor, then another, then the pill, then another pp. Other than pp, whatever Cosmo likes best - cheddar cheese or some people have used cream cheese or Laughing Cow cheese. Yes, its dairy, but the tiny bit used for pills doesn't usually bother a cat unless it is sensitive to dairy.

Quality of life is different for every cat-human combination, but there are a few standard things to watch for:
peeing and pooping, preening (eg cleaning face after eating), playing. Drat - I think there is another 'p' that has slipped my mind.

Hope the testing continues to go well. It is one of the 3 important things to managing diabetes, the other 2 being diet and insulin.

 

How advanced is Cosmo's kidney disease.....advanced enough to need subQ fluids on a regular basis at home? What exactly was the diagnosis when Cosmo was hospitalized? Was it DKA? Both kidney disease and diabetes if left untreated would lead to a slow unpleasant deterioration but they both would have to be pretty advanced and already causing considerable quality of life issues to warrant a 2 week prognosis.

You are not describing a cat with severe uncontrolled diabetes, DKA or serious kidney disease and quality of life issues now. The GI issues while concerning don't sound severe so if Cosmo is eating, peeing, purring, preening and interested in you and his surroundings, then it's highly likely he is just fine and there would be no reason for the vet to be questioning Cosmo's quality of life. If Cosmo did have DKA or even just ketones when hospitalized then it would be prudent to home test for ketones so if they should reoccur you can catch it early and get him treatment ASAP.

Your vet sees your cat for a few minutes during an office visit. You are with your cat for considerably more time and you know him and his "normal" behaviour better than anyone else. Most cats do not act "normal" at the vet. I think it's fairly safe to say that you will know if there is any great cause for concern or if his quality of life is diminishing.

 

I place my cat's pills in gel caps and use a pill gun. Pepcid tastes terrible and I would not try to administer it with a gel cap or pill pocket or similar. Cheese works for many

 

I wouldn't worry too much about him chewing the pill in a pill pocket. First, if you were told to crush it up and mix it in his food, that pretty much amounts to the same thing as him chewing it. Second, you may find, if you only use just the smallest amount of pill pocket you need, that he will swallow it without chewing; mine do, they LOVE pill pockets, lol!

 

Have you tried FortiFlora? It's like a probiotic in a powder form that helps cats digest, settles their stomach and keeps them regular. I use it on my civie (non-diabetic) and on Dusty who's been off the juice for 3 years, just sprinkle it on their food and they love it. It's a little pricy but if used a few weeks it does wonders. Best price I've found is 1800petmeds about $28 for a box with 30 packets. Chime in anyone if they think it's unsafe to use fortiflora on a diabetic, I've read it's ok...

 

I'm new here so I don't know your whole story. With treatment a diabetic cat can live for many years and die of natural causes. Is there a reason why it's thought your cat is not going to have long to live? I had a cat diagnosed 20 years ago, and it was difficult getting her regulated until I found a vet that was experienced with diabetes who knew off the bat what the dosage should be and which insulin to use. At that point my cat turned around, regained health and never needed to be tested and looked and acted like a regulated cat. She never needed pepcid or any of that. Back in those days I cooked chicken for her and made sure never to give her grains. She could not eat dry food.

Now today, I have a newly diagnosed 12 year old cat so I'm finding out how things are done now. The insulin is different. I have assumed it would be simple to just give a dose twice a day and the cat should feel normal. But this cat (Ricky) will only eat dry food. So this is a different situation.
Best wishes, Pam

 

I also use a timed feeder, feeding every three hours around the clock.

 

I have used Fortiflora for both Squallie and one of my civvies. I never had a problem using it for Squallie and it really helped my civvie (she has IBD). If you are a member of petcareRx.com's PetPlus program you can get it for about $24.

 

@shannonmarie7992

I used an automatic feeder. Thus is a very popular one. You can use it for wet food. Some people do buy ceramic dishes to put in the plastic trays.

https://www.amazon.com/PetSafe-5-Me...qid=1486184901&sr=8-2&keywords=petsafe feeder

 

Barbara & Uncle / First off, YOU, not your vet is the one who gets to decide if the quality of life for your cat is not good.
MrWorfMen'sMom / Most cats do not act "normal" at the vet. I think it's fairly safe to say that you will know if there is any great cause for concern or if his quality of life is diminishing.
Both these quotes are so true. There's nothing worse than feeling abandoned but because none of us are there with Cosmo and you, only you will know. Cosmo will try and tell you too and you've been together long enough to know what he's thinking. For us we always had to consider pain and dignity and that's the real tough one. You can medicate pain but only you can look at Cosmo and know when "This just isn't right". This might sound awfully morbid but we've been through this so often we make sure we don't end up at an emergency clinic on Sunday morning with a vet we don't know. Sorry, that's not medical advice. I hope, we all hope, that when that day comes it will be a peaceful day for you and Cosmo. He knows you love him, we all wish you the best.

 

Miles used to scarf and barf. To combat that, I used the same technique that worked for my daughter when she had GERD as an infant: half as much food, but twice as often. Also, I elevated his food dish and I smushed the food onto the plate so he'd have to work a little harder to eat it. The auto feeder was a life saver. Unfortunately, Stratus (one of the civvies) ripped off one of the plastic lids in his attempts to break into it, and now he can easily crack it open in almost no time. (!) Thank goodness it didn't happen when Miles was alive. We think Stratus does it to "provide" for Logan, the kitten we adopted after Miles crossed, because Stratus doesn't eat it, he just opens it for Logan and watches him eat. Stratus also can turn on the washing machine, but we have yet to figure out how to train him to do the laundry.

Anyway, it sounds like Cosmo is doing pretty well other than the vomiting. I am guessing you had blood work done to rule out hyperthyroidism? My cat Nikolai (1994-2014) acted like a kitten and had good energy and appetite right up till the day he crossed, but he had no kidney function on one side and about 5% on the other when it came to that day. Nikolai was very vocal in the last year of his life, and DH and I argued about whether it was "time" or not. I personally couldn't see euthanizing a cat who was eating and drinking, but he was having accidents all over, and he was not smelling very good as his kidney function deteriorated. Cosmo isn't anywhere near that point, so I would say get a second opinion when you are ready (and don't let anyone let you feel guilty about that!) and just enjoy being with him. You've got this!

 

Shannonmarie, I free feed dry PurinaDM food for my Ricky. He will only eat dry food. I give him insulin morning and evening but he nibbles all through the day. I would think you could feed canned when possible and leave out some dry food for when you aren't there.
Pam

 

All my cats quit vomiting when I ditched the dry food altogether. Some of that stuff just doesn't digest and comes back up the way it went down; whole. I belive the chemicals they spray on that stuff is very bad for cats. why not give the insulin with his wet food instead?

 

Young Again dry food has proved to be a godsend for my cat, who grazed on dry food at will for all his 20 years. Changing to zero kibble was an unacceptable change, so much cat distress! and even the Science Diet MD diabetic would increase his BG. I found about YA here. It's mail order only.