Warren - 5/29/2000 - 7/1/2016 rest in peace my furry friend

Discussion in 'Feline Health - (The Main Forum)' started by robr, May 22, 2015.

  1. robr

    robr Member

    Joined:
    Mar 22, 2014
    I desperately need help. I will refer you to a couple of threads and then summarize where am at:

    Intro forum:
    http://www.felinediabetes.com/FDMB/threads/meet-warren-again.136271/#post-1424641

    Lantus forum:
    http://www.felinediabetes.com/FDMB/threads/5-4-warren-amps-518.137335/

    Warren was diagnosed with diabetes a bit over a year ago. He was on Vetsulin for a couple of months and went into remission for almost a year. When he started having problems again, I had a full lab workup done, urinalysis, blood, physical, etc and my vet said the only health issue Warren has is his diabetes. In Warren's 15 years, he has NEVER had issues with behavior.... problems using the litter box, etc.

    I put him back on Vetsulin but it did not last more than 8 or 9 hours. After perhaps a month of Vetsulin, I switched him to Lantus (a month ago). In that month I have not been able to regulate him. 1 unit pushes his blood sugar too low (40s) and the Lantus can last as long as 16 hours. 0.75 (approx, no way to measure exactly) doesn't seem to be enough. You can examine the spreadsheet, I have probably 150 data points over the month and a couple of curves.

    He has been peeing on the kitchen rug, so I placed a litter box about 5' away in the bathroom. When he is locked in the bathroom, he uses it 100% of the time. When I let him out, he uses the rug too often. My wife has sentenced him to living in the bathroom and wants me to have him put to sleep. She will not tolerate any more peeing outside the litter box. The ultimatum is coming and I feel like I'm just about out of things to try.

    I believe the peeing problem is related to his diabetes being unregulated. His levels looked reasonably stable the past 48 hours (200s-300s - not great numbers but first time I've seen him out of 400s and 500s for this long of a stretch), I was hoping we were finally starting to stabilize, then he peed on the floor and I checked and he had bounced (556. First time he'd been over 400 in 48 hours).

    My wife feels his peeing is behavioral since he has an option of a litter box 5' away from where he is going.

    Warren does not seem stressed in any way. He's happy, purring, playful, sitting in laps, he's his normal self.

    I need a plan I can communicate to my wife and be able to tell her 'if x,y,z doesn't work, I will have him put to sleep'. I don't know if he'd do better with Lenevir, that's one option, but from what I've read it seems when Lantus doesn't work, it's because it's not bringing down the glucose levels, which is not what I'm experiencing. I'm not in a position to throw a lot more $$ at shots in the dark, again my wife feels I have spent enough $$ already on an "old cat" (an awesome old cat) but I can probably get away with a few hundred. I just lost my Mom in March and really hate the idea of saying goodbye to another close friend when there may be a straightforward solution. Any help is greatly appreciated.

    Thanks everybody.
     
  2. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Have you really cleaned the area he's peeing on? Cats can smell the tiniest scents and if he can smell the pee, he will continue to mark that same place.

    I've heard of something called Anti-Icky Poo that's supposed to work really well on urine stains/smells
     
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  3. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    Has he been checked for a UTI?
    peeing on litter can be painful as can a uti or even a bladder infection so cats will often pee on something soft .... even when the litter box is right there.
    I believe it has to be a Cystocentesis. ( they draw urine out of the bladder with a needle for a sterile sample)
    I will go find someone else to explain more about this test as I have never had to do one.


    His ss could be explained by an infection.
    I'd also say another possibility is he's dropping to the green floor in the pm cycle ( or somewhere) which makes him bounce to black.
    You could use a little random testing to try to catch it. Look how fast on 5/11 he went from 196 ( almost yellow ) to a green earning a reduction.
    It's possible he's doing that at night.
     
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  4. Meya14

    Meya14 Well-Known Member

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    Jan 2, 2015
    If it's a carpet he's peeing on, the easiest way to clean is to pour a mix of half water and half vinegar with a dash of laundry soap slowly on spots, and suck it up with a shopvac. My cat (the non diabetic 15 year old one) was doing the carpet thing every day for a while. We took her to the vet, who thought it might be behavioral. We blocked her off from the favorite spots and got "Cat attract" litter additive per the vet recommendation. Haven't had an issue since. The vet said some older cats lose their sense of smell and it can cause them to be confused about where to go, the cat attract solved it.

    Of course, have your cat checked out for UTI and stones which are common with diabetic cats. These could cause the accidents.

    Also, if you have your litterboxes on a different level of the house then where the cats usually are, this can be hard for an older cat (arthritis) and they choose to go on carpets instead of doing a flight of stairs. This is harder for an unregulated diabetic cat cause they have to pee a lot.
     
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  5. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Hi Rob!

    My first reaction is that it's probably a urinary tract infection. Punkin probably had 8 or more before he became diabetic, and that was always the sign. He'd pee on the floor right next to the box. He'd pee on the middle of our bed. :eek: He'd pull something onto the floor - paper or plastic bag or something, then pee on it. He never had any other symptom - just peeing outside of the box. if I didn't pick up on his cues soon enough, the bladder infection would get to the point where he'd have blood in his urine and then i'd see that.

    They stop using the box because they associate the box with hurting.

    The reason the cystocentesis is important is using a needle to withdraw urine directly from the bladder gets a "clean" sample to evaluate. I'd get him checked first thing.

    Adding water to his food will help rehydrate him and dilute his urine so it doesn't hurt him as much if it is infected. Once punkin became diabetic and I started adding water to his food he never had another bladder infection.

    Diabetic cats are notorious susceptible to bladder infections and dental infections (decay and gingivitis). High blood sugar also means sugar in their other body fluids like urine and saliva. It allows bacteria to grow. Infections/inflammation also can increase blood sugar. It looks like he probably needs a dose increase back to 1.0u, but if it is an infection as the antibiotic kicks in, his blood sugar will likely come down again. Your tests will tell you when that happens and if he needs a dose decrease.

    I definitely wouldn't have him put to sleep for this. He likely just needs a course of antibiotics. Give a probiotic like Fortiflora, which is available from the vet or Amazon if he does get antibiotics so he doesn't develop diarrhea from the ABs.

    This is just a normal bump - hang in there and keep loving your sweet Warren. And I'm so sorry about your mom's passing. That's so difficult. :bighug:

    julie
     
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  6. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    For inappropriate elimination, always go to the vet and rule out any medical problems.

    Here is a list I compiled previously. Some of the items may not apply.
    ***********************************************************************
    You might try an integrated approach using multiple options from the list below on a consistent basis:

    * start with crating, using a medium large crate (30" long is big enough for cat and a litter box) until progress. He probably won't go where he'd have to lie in it ... but if he does, something is wrong and it may be medical.

    * tarps and newspapers may be easier on clean up if you don't crate him

    * feeding on a schedule and then placing him in the litter box (maybe in a crate) within 15-20 minutes after eating, until he goes, then praising and letting him out.

    * Feliway/Comfort Zone - friendly facial pheromones which reduce stress and may reduce marking behavior. Cheapest prices are usually on the net (ex http://www.LambertVetSupply.com ) I've used it and it helps.

    * Cat Attract litter - supposed to help attract cat to litter box

    * rule out arthritis or constipation - pain causes box avoidance

    * watch if the other cats ever attack him in the box and if so, you may need to keep him separated from them. I've got one the others attack, completely unprovoked.

    * litter box should be 1.5 times length of cat, litter cleaned frequently, but avoid really strong smelling cleaners as cats may avoid them due to the scent.

    * you've got to get residual odors out from areas which were 'nailed'. If you don't get those spots thoroughly cleaned, any residual odor may trigger using the spot again. Enzyme based products such as Nature's Miracle, are the most likely to have success. Carpet may need to be rolled back and treated on the back side, plus treating the pad separately (or replacing the pad). It can require repeated applications.

    * regular play sessions of about 15 minutes to reduce stress and promote bond with you

    * reward desirable behaviors - if you see him use the box, praise and treat him

    * put unpleasant textures in places he has peed to encourage avoidance

    * read some of this author's books: http://www.catbehaviorassociates.com/ she's pretty good - ex "Starting from Scratch"
     
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  7. itzj

    itzj Member

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    Sep 29, 2014
    I don't think you should set any list of xyz and then he's put to sleep. It is just pee and he deserves better than that. And I say this coming from a house where our diabetic is being a total twerp with pee. And despite being the tough wife in my house, I say stand your ground. :) Warren is worth more than a kitchen rug.
     
  8. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    I agree. We have 6 cats in the house and every single one of them has moments/days/weeks where they pee or poop where they shouldn't. Sure it makes us mad when it happens, but we clean it up and carry on. There's no way we'd get rid of the cats over it - although they might seem to understand most of what we say to them, I doubt any of them does it on purpose to make us mad so I can only assume they don't really understand it's something all that horribly bad even though they're all litter box trained. The odd occasion where one of them has done it consistently for a few days, there's almost always been a reason for it - either an infection or one of the other cats has scared them (usually on purpose) while they're in the litter box so they don't want to use it, or it'll happen if we're away overnight - I can only assume that upsets them. Oh and Rosa went through a bad stage of not using the litter box a lot of the time when she was first diagnosed diabetic too (she'd actually been using the floor rather than the box on and off for a week or so but we had no idea why at the time). She was very weak when she was first diagnosed and didn't really start to improve until a few weeks later - is it possible he's finding it difficult to get in and out of the box? He might be prepared to struggle with it in the bathroom as he can't get away from the wet floor as easily as he maybe can in the kitchen. If it's weakness from neuropathy then it should improve, but that isn't going to be instant.
     
  9. robr

    robr Member

    Joined:
    Mar 22, 2014
    I'm waiting for the vet to call me back this morning. They just checked for a UTI a month ago but maybe we check again. I've been using an enzyme cleaner on the carpet. Yesterday he went on the couch as well which is new for him. I really feel like it's diabetes related but I could be wrong. I don't know what else I can do to try to regulate his diabetes to test that theory though other than switch insulin. After a month, it doesn't seem like lantus is going to work.
     
  10. robr

    robr Member

    Joined:
    Mar 22, 2014
    The vet is going to do another uti on Monday and want to look at the spreadsheet data. Of course the collective knowledge of this group is greater than that of my vet so not sure what advice I'll get about his insulin that I wouldn't already have gotten here.
     
  11. Meya14

    Meya14 Well-Known Member

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    Jan 2, 2015
    With careful and consistent dosage adjustments, you should get there, but it takes some time. It was months before Max's sugars were anywhere near normal, but I saw improvements in his eating/drinking/excessive urination a lot sooner. I assume based on your SS that you are on an altered schedule, not 12hr. I'm also assuming you are doing this because of the late nadir you are getting with Lantus? If this is the case, there are some shorter acting insulins that might give you better regulation such as PZI.
     
  12. robr

    robr Member

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    Mar 22, 2014
    I'm on a 12hr, if you check comments I put an * next to the actual shot times. Pretty much the only times I haven't done 12 hour were when I bumped him to 1 unit and his glucose was too low at the 12 hour mark, but the every 12 had been pretty consistent especially of late.

    Pzi may be next but I'm waiting for someone with more knowledge than I to tell me based on their experience lantus isn't going to work, it's time to switch or do another curve in order to determine that.
     
  13. Meya14

    Meya14 Well-Known Member

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    Jan 2, 2015
    Well, 0.75U doesn't appear to be enough, so in order to get him regulated, you would have to raise the dose. This might cause him to go low again, and earn a reduction. So at this point you would be bouncing between these doses without good regulation. The other thing that you could try is changing his feeding schedule so that the most food is given just prior to the start of his nadir +9ish. You could also feed a medium carb food to keep the nadir sugars a little higher.

    If there is an infection, this alone can make him unable to be regulated, so the BS might improve after treatment. I'd wait until the urinalysis until you change too much with the insulins.
     
  14. Louellen

    Louellen Member

    Joined:
    Apr 3, 2015
    I think all that you can do right now is to check for a UTI (which can be a cause and crop up any time), wait for those results, then address the insulin issue if no UTI causing it.

    But, I'm also wondering if perhaps, you've changed litter types? The more perfumed litter may be great for us but, some cats hate it! Did you change litter types? That may be a cause.
    Also, as everyone else has mentioned, if you've already tried a "de-scenter" product...is your kitchen rug that expensive? Maybe, getting rid of the rug might do the trick? My brother and wife are at their wit's end with 2 cats who are NOT diabetic and do the same thing no matter what they've tried. They even had to rip up their wall to wall carpeting! It may be a behavioural problem vs a medical one???

    Oh, and by the way, I had a female dog who used to lose control of her bladder and pee (started more suddenly) and would pee on her bed and the floor, carpets etc.. The vet said that when this type of thing happens and there's no real reason medically....they suspect either a behavioural issue or, sometimes, it's hormone changes over time from the spaying. She was put on estrogen (of course, not what a male cat would need) and within a week...no more "oooopsss moments" after that.
     
  15. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    Very good point Louellen. At least 2 of ours hate scented litter of any kind so we have to go with making sure all the boxes are scooped at least once a day and using an unscented litter (plus we found a lot of the scented types play havoc with Michael's allergies too so even if the cats had loved them, we didn't have much option but to switch back).
     
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  16. Louellen

    Louellen Member

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    Apr 3, 2015
    Thanks Manxcat. I had a similar problem and had to switch back to the unscented too.

    I was also thinking about any changes that may have happened within the household/routine? Sometimes, a change that the cat doesn't like, will be the cause of a behavioural problem with litter box issues.

    What has me thinking about this is that since the box has been 5' away from the spot he was urinating on...IF it was diabetes related (i.e.: cat couldn't get to box quickly enough), that 5' wouldn't be making the much of a difference. He'd be heading to it to go. That's what's making me think that it's not the diabetes issue that's causing this action.

    I once knew a couple who had a baby who used to sit on the floor in a diaper and play. The baby's urine attracted the cat to the spot and the attention being on baby, meant the cat "acted out" too and would go wherever baby sat in wet diapers.

    There's so many reasons. I'd explore all of that first and would NOT let the cat be put to sleep just because of a urination issue. Yes, it's annoying but, there HAS to be a solvable issue causing it.
     
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  17. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    That makes me think of something else I was told once too - can you try moving the litter box to the spot he's been using? If there's something in the rug attracting him to that spot particularly, putting the litter box right over it might just get him using the box instead.

    And yes, I agree on the change of routine. My two were used to being the only cats in the house until I moved here. They both had issues learning to use a litter box that another cat had used first - we had to give them their own box in a place none of the other cats ever went to begin with. They got used to it in the end as they made friends with the other kitties in the house, but it did take time.
     
  18. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    It may also really help if you can get his BG under better control

    Looking at your spreadsheet, it would really help if you could start getting at least one test in every PM cycle (at least a "before bed" test) Most cats go lower at night, so it's important to know what's going on during that cycle

    I'd also suggest just deleting the +13 and +14 columns ...it makes it confusing and people will just keep asking about it, so since you are now shooting every 12 hours, why not just get rid of them? If you right click on the top cell in those columns, it'll give you the option to "Delete column"

    If you can get a few nighttime tests and we can see that he's not dropping overnight (and then bouncing during the day) then in a couple of days, if he's still running so high, it's time for an increase back to 1U

    Cats insulin needs change, so just because 1U got him into the 40's before, doesn't mean it'll do it again now
     
  19. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    I just want to throw this out into the ring. As KT got older and more frail, he would occasionally pee on a couple of different rugs in the house. We even had litter boxes sitting 2 feet apart in their bathroom, he'd pee between them. He would sometimes pee on my bed....then I realized that those things likely felt like the soft litter under his feet. The 'between the litter boxes' - with sides on either side, he likely thought he was IN one of them. I then realized his eyesight was getting very bad, he likely couldn't see the difference. His muscles were also getting weak, when he woke up sometimes, I'm not sure he could hold the pee all the way to the box. I did change to Levemir hoping it was the lack of regulation on Lantus - he quit doing it nearly as often but we lost him to other conditions before we knew for sure.

    Just food for thought....
     
  20. Nancy & Cootie (GA)

    Nancy & Cootie (GA) Member

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    Oct 16, 2014
    My two cents and I'll try not to write a book . . . has Warren's blood pressure been checked lately? If not, you may want to have it checked and his eyes checked on Monday along with the UTI testing. In hindsight, my vet was not proactive enough about checking Cootie's blood pressure and I wasn't informed enough at the time to insist on it.

    During the sixteen months that I had Cootie--she had been my parents' cat before my dad passed away & my mom went into Alzheimer's care--she had a lot of inappropriate urination problems (in a brand new house on brand new carpet, no less). Each episode was related to a medical problem, of which she had many, even tho it seemed easier initially to chalk it up to behavioral or litterbox issues. When Cootie's diabetes was uncontrolled, she too, would pee on an area rug even though a litter box was a few feet away (happened in two rooms--bathroom and laundry room). With Cootie's last episode of peeing outside the box she also peed on the couch right by where my husband was sitting. This time her blood pressure medication wasn't helping enough--she was losing her eyesight through retinal detachment and needed a second BP med to help restore some of her eyesight. Cootie passed away last month and I miss her terribly.

    Warren's only been on the Lantus for a month, please give him a chance at regulation! This board has so many experienced Lantus users that may be able to help with the dosing, please don't give up on Warren! I don't have any advice on the Lantus dosing as Cootie used ProZinc and just kind of worked her way down to remission as her thyroid problems were dealt with.
     
  21. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Rob,

    I am so sorry to hear that you are in this predicament. It's stressful enough trying to get your little one regulated without the additional pressure from the missus (although I can sympathise with her -- inappropriate urination issues can be distressing) but I hope that you will be able to persuade her to be patient while you get little Warren into better numbers.

    FWIW, there was another FDMB member here late last year whose cat had very similar problems (Juliet ( @KittyMom777 and Silver). Silver avoided the litter box a lot despite it being in very close proximity all the time and Juliet was at her wit's end about it. She used Cat Attract (and I think Litter Attract, too). Silver's back legs were a bit weak (diabetic neuropathy). She gave him B12 for this (Zobaline, IIRC). Both helped the situation. Does Warren show any sign of weakness in his limbs? It might be an idea to ask your vets to check his B12/folate and also his potassium levels (I've read here that the latter may also cause limb weakness). Also, it might be an idea to (ironically) check that Warren's properly hydrated. One of our members had long-term problems with her cat's inappropriate urination issues. They resolved when she switched her to a wet diet with a little added water. It seems to have been caused by chronic dehydration. I've had similar historical issues with my civvie. Since switching her to wet food + water she doesn't have 'accidents' any more, either.

    In addition to the suggestions already on this thread, it might be worth asking your vet if an ultrasound of Warren's bladder might help to rule out bladder stones if a simpler cause can't be found.

    In the interim, if you're desperate you could try putting a cheap, rubber-backed doormat and puppy pads over the area where Warren is peeing; not ideal because it won't break the habit of going to that place to relieve himself but it would make clean-up easier. Try really dousing the soiled area with Febreze, too (check the rug for colour fastness).

    Regulation is a gradual process. It takes time for our little ones' bodies to re-learn how to function at healthy BG numbers. It might be a good idea to log times when you know Warren peed inappropriately to see if there's any correlation with his BG levels at the time. It might give you better evidence to support your case with your good lady that Warren needs a little time for the insulin to help his sugar levels to get back to healthier levels and, all going well, his toileting behaviour back to normal. I really do understand how stressful inappropriate urination problems can be (been there) but I hope that some of the suggestions on this thread will help you to find a way to help Warren get back to normal and keep your good lady onside in the meantime.

    :bighug:
     
  22. Melanie and Smokey

    Melanie and Smokey Well-Known Member

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    Feb 24, 2010
    How are you feeding? If you currently feed just two meals - am and pm - can you add a meal towards his mid-cycle? That could stop that drop to the 40s and make the 1 unit work better and allow for the higher dose to bring down the whole cycle better.

    I would have the vet check for arthritis when you get him checked for a UTI. Make sure the litter boxes have a low enough entrance and are kept clean.

    When you say he has been peeing on a rug, do you mean installed carpet or a throw rug? If it is a throw rug, keep it off of the floor for now. Keeping all "targets" picked up helps them not have accidents. Inappropriate peeing can be frustrating, but certainly not something he should be put down for until all reasons have been explored. It could be stress from the bad vibes he's getting from everyone for being sick and not behaving.

    Use Febreze around cats sparingly. There has been some reports that it may cause cancer in pets.
     
  23. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    @Melanie and Smokey - Thank you so much for that advice. I hadn't heard any warnings about it. Thankfully, I've only used it for deodorizing the very occasional 'accident' sites. If I were a regular user of it, I'd be freaking out right now. I certainly won't be using it again. Modern life can be such a health minefield... :nailbiting:
     
  24. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Even if they don't think there is an infection make sure a culture is run. So many times I've read of cats having infections that only showed up with a culture and sensitivity, especially if it has gone to the kidneys. Creatinine was normal?
     
  25. Tisha's_Person

    Tisha's_Person Member

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    Aug 3, 2014
    Okay, litter box avoidance is actually something we know LOTS about in our house. In addition to the medical issues addressed above, let me share what worked for us. Tisha kept peeing everywhere until we got a breeze litterbox. The "litter" is no absorbent and drains to a pad below that is super easy to change. We also bought puppy pus and put them around her litter boxes. If she doesn't like the box, she will use the pad, which is also easy to clean up and is soft. The combination of clumping litter in a normal box, breeze litter box and puppy pads has basically eliminated peeing other places.
     
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  26. MollynSkooter

    MollynSkooter Well-Known Member

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    Jun 4, 2014
  27. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Rob,

    How are things going with Warren and yourself today?
    .
     
  28. robr

    robr Member

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    Mar 22, 2014
    I'm waiting for a call to find out if he has a UTI, but they already started him on clavimox. The other issue is they had me collect a sample to test, then when I brought it in I was told that often collected urine will show negative because it's diluted. But they suspect he's had a UTI now even before the last test which was over a month ago (again with collected urine) . Fingers crossed that's what's going on. Thank you for all the other ideas as well. I'll update as I learn more.
     
  29. robr

    robr Member

    Joined:
    Mar 22, 2014
    I never heard from the vet today, but in the past 24 hours his numbers look better than they have since his relapse.

    I am a little worried as at +12 he was at 50 and I shot him anyway as historically the lantus doesn't hit nadir for 8 or 9 hours and he should be rising well before then. But +3 and he's still only at 52. I may need to stay up with him into the wee hours to make sure the nadir isn't hitting earlier with the clavimox in his system. I think all the trending data I've collected over the past month may be out the window
     
  30. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    Jul 9, 2012
    Yes. Do keep an eye on him tonight... set that alarm several times....
    Most of us older hands won't shoot a 50. That's really when you know how your cat responds....
    You may need to break out the gravy.... or honey.... if he drops more....

    of course, all you need is a 49 to earn that dose reduction......
     
  31. robr

    robr Member

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    Mar 22, 2014
    He's having a bit of dry food now. He won't touch the honey on his own but I got a few drops in. This is the lowest he's ever been on a 0.75 dose by far.
     
  32. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    Jul 9, 2012
    looks like he bounced to the moon this morning....
    but that time he spent in the green was healing time for that pancreas.

    next time maybe try to reach for the low carb wet food.... to encourage a surf and not increase the bounce with dry food.
    He may have bounced that high regardless of the dry food.....
     
  33. robr

    robr Member

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    Mar 22, 2014
    Thank you so much for keeping an eye on his data, I believe he would have bounced this high anyway based on past events when he gets into the 50s. I think the dry food I gave him is pretty low carb (as far as dry goes) but I've been meaning to look it up. I also tried to give him a small handful of Temptations treats in a bowl but he started gagging on them and drooling almost immediately.... I thought maybe they went down wrong so tried again after he was squared away and he had the same response. It was very odd, I've never seen anything like that before. He was OK eating them one at a time though.

    I'm exhausted this morning but better safe than sorry.
     
  34. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    He is nauseous I think. I really think there is an additional health issue and agree that an ultrasound is a good idea.
     
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  35. robr

    robr Member

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    Mar 22, 2014
    Vet just called, there is a lot of bacteria in his urine. She said keep him on the clavimox for a week, if he's doing well, continue it for an additional two weeks, if not, she will change antibiotics. Thank you all again for the help. Now that we seem to have some solid reasons behind the peeing and inability to regulate his insulin my wife is backing off. I should change the title of this thread, I find it stressful when I see it :)
     
  36. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Didn't he run a culture and sensitivity? He should because then you will find the right antibiotic for his particular infection. If it's the wrong one it is wasted time. Makes no sense.
     
  37. robr

    robr Member

    Joined:
    Mar 22, 2014
    I didn't know to ask that, I just know they sent it out to a 3rd party lab. I'll call back and ask.
     
  38. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Then they should have gotten a culture and sensitivity. It just struck me as odd that he said to try clavamox and if it didn't work he would try a second one. Will they email you all the labs by any chance? If you don't want to ask I understand.
     
  39. robr

    robr Member

    Joined:
    Mar 22, 2014
    No, I don't have a problem asking. I just called, the doctor had gone home but the person that answered said generally they only do the culture and sensitivity on a sterile sample. They had asked me to bring in a sample rather than bring in the cat. I pointed out this is the second time they asked me to bring in a sample to test and that I'm pretty sure since they had the cat the first visit back in March, if they had taken the sample then rather than have me bring it in, the second visit/lab test wouldn't have been necessary. They're talking about a third visit now. I told them this is getting expensive and if they want a sterile sample I don't want to pay a third time. They're calling me back tomorrow when the doctor is in. It may be time to find another vet, I've been going here for 20 years and this place was great until our vet died and his estate sold the business. Now they seem to have 4 or 5 doctors that rotate between locations and I never know whom I'm going to get.
     
    Last edited: May 28, 2015
  40. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    If you have already started antibiotics you can't do a culture right now. Once there are antibiotics in the system, even if it is not the right one it messes up the culture results. A culture needs to be done before AB are started or about 7-10 days after they are finished to get accurate results. I had the same problem with my Tuxie and his UTI. Luckily the second round of zenequin knocked it out of his system.

    Good luck with the treatment and I am so glad you have found a reason for the peeing problem.
     
  41. robr

    robr Member

    Joined:
    Mar 22, 2014
    Ugh. Ok glad I have this info for my talk with the vet tomorrow, the person I spoke with apparently didn't realize that it was too late, but she's not a vet.
     
  42. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Usually you want a week off antibiotics before getting a culture as well.
     
  43. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    going all the way back up to Julie (pumpkin) post....
    they need to do a cystocentesis....
    they use a needle to take the sample out of the bladder.... that's a sterile sample.
     
  44. robr

    robr Member

    Joined:
    Mar 22, 2014
    Yep, I was just following their instructions. They told me bringing in a sample would be fine as long as it was fresh and I got it into the fridge asap.
     
  45. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    my vet does it that way too. They are more worried about the needle stick introducing something into the bladder.
    I hope they get you an answer.
     
  46. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    If you get a free catch you are likely to get bacteria from the outside and it isn't sterile.
     
  47. robr

    robr Member

    Joined:
    Mar 22, 2014
    That would seem that you'd be more likely to get a false positive. The vet told me that the issue is that free catch urine can be too diluted and often you end up with a false negative (Warren's first UTI test was negative).
     
  48. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Urine that's still in the bladder SHOULD be sterile...as it "makes it's way out" of the body, it can pick up bacteria in the urethra as well as off the skin as it's collected.

    The fact that urine should be sterile is why the cytocentesis is so important....if they get it directly from the bladder through a needle and there's bacteria, then you know for sure you're dealing with a UTI
     
  49. robr

    robr Member

    Joined:
    Mar 22, 2014
    Had a talk with the vet on Friday. She says was surprised they charged me for an office visit when I only spent 10 minutes with her to review warren's spreadsheet and hand her his urine sample. Told me that it's not normal for them to do a cysto for the first UTI test but it should have been done for the 2nd. Warren has been on clavimox for 6 days now, yesterday he'd been in the bathroom all day, I let him out at 7:30pm for a little bit as I start the whole routine with him around 8. Within 10 minutes he had peed on the kitchen floor again (5' away from the litter box in the bathroom). So either the clavimox isn't working or it's something else. I think we're likely to have to do the culture and sensitivity, hopefully they'll be willing to cut me a break on the pricing.

    On the other hand, his blood sugar levels are looking better than they were before the clavimox (other than the 2 days he was bouncing)
     
  50. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Have you ever tried Cat Attract litter Rob?? I've seen that stuff work miracles so it might be worth a try
     
  51. robr

    robr Member

    Joined:
    Mar 22, 2014
    I haven't yet as I'm almost certain this is not behavioral, but it's on my just in case backup plan. It seems to be priced pretty competitively though.
     
  52. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    It's a little high, but usually when it works, people are able to gradually switch out the Cat Attract and start adding in their old litter.

    His numbers today look much better too....sure hope he doesn't bounce from going so low, but it sure wouldn't surprise me
     
  53. Meya14

    Meya14 Well-Known Member

    Joined:
    Jan 2, 2015
    I second the "cat attract". Our older female cat was peeing daily for months on a few spots on the throw rugs. No physical issues, so vet said it might be behavior. Blocked off her "favorite areas" and added the cat attract, and it was magical. She hasn't had an accident since. Older cats lose their sense of smell and get confused I think.

    Worth every penny! Amazon has it for cheaper than local places.
     
  54. robr

    robr Member

    Joined:
    Mar 22, 2014
    I meant to write a positive update earlier today but I didn't get around to it. Unfortunately now I can't. Warren is just wrapping up his second week of clavimox, he also has a Feliway collar now and cat attract litter. His diabetes still isn't regulated but overall the trends have definitely been improving. I've been letting him out of the bathroom during the day for the past few days and he was doing well. I left him out overnight last night and also no issue. However today he peed in the kitchen again (once again 5 feet away from the litter box with the cat attract). I think I will have to go the cytocentesis route to see if he has an infection that the clavimox hasn't addressed.
     
  55. Mogmom and Goofus

    Mogmom and Goofus Well-Known Member

    Joined:
    Dec 9, 2014
    Poor Warren, I hope you can get something figured out soon.
     
  56. Melanie and Smokey

    Melanie and Smokey Well-Known Member

    Joined:
    Feb 24, 2010
    Can you move the litterbox over to where he is peeing and see if he goes in it or just picks another spot beside it to pee? If he goes in it, you can get him accustomed to using it there where he wants to pee, the very slowly start to move it back to where you want it. A poorly placed litter box is better than him going on the floor (I have 2 boxes in my dining room 'cause that is where they wanted to pee).

    There is also a Dr Elseys for Seniors. Its like a pulverized crystal. It is more costly that the attract even, but seemed to lure my senior peer into the box more.
     
  57. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    You have to take your victories where you can get them sometimes.....not peeing on the floor for several days was better than doing it several times a day!

    Hopefully you'll figure out what's going on soon and he'll be back to doing his business where he should. I agree that it might be worth having the litter box in the way for a little while so it's right where he's peeing and then scooting it back a little at a time
     
  58. robr

    robr Member

    Joined:
    Mar 22, 2014
    Tomorrow will be 7 days Warren has been off clavimox, so the plan is to have a cysto done tomorrow with a culture and sensitivity. He's been living in the bathroom the past week other than when he's willing to sit on my lap in the evening while I watch some TV.

    His blood sugar has improved but not regulated.

    I feel bad for the guy, he is so excited when one of us comes to use the bathroom. At least he has a window to sit in. Hopefully we learn something useful from the results.
     
  59. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    His numbers definitely look more consistent on the spreadsheet - I don't see any black in the last 2 weeks, which is always good! :)

    I really hope you're able to get some useful information from the culture and sensitivity tests - hopefully then he can get out of the bathroom a bit more.

    The one thing I do see is that it looks as though he's bouncing on some cycles and with only pre-shot tests to work from, it's difficult to know if he might be dropping low sometimes which might be causing the bouncing (I'm looking at 6/10, 6/12 and 6/14 where he was fairly low at one of his preshot tests for the day and wondering how low he might have gone mid-cycle). Is there any way you can get some mid-cycle tests to get an idea of where he's getting to at his lowest point?
     
  60. robr

    robr Member

    Joined:
    Mar 22, 2014
    It's true, no black is GREAT news. He sometimes bounces when I give him one unit. It's a challenge because .75 (Approx) doesn't seem to be enough, but 1.0 can push him too low. There was only a single instance where less than 1 unit pushed him low and perhaps I made a dosage error (which is easy enough to do as the difference in the syringe between 0.75 and 1.0 is less than 1mm). As you rightly point out though, some of those readings could have been even lower as his nadir is usually around the 9 hour mark and the measurements are taken at around 12 hours.

    As the protocols outlined here weren't working after many weeks, I developed my own protocol and it seems to be working better. It looks something like this.
    If his AMPS/PMPS is:
    >275 - 1 unit
    100-275 - 0.75
    50-100 - 0.5
    <50 - wait

    Actually I just made that up. When comparing it to the spreadsheet, I'm more aggressive. I should nail that down to a set of consistent rules, but that's the general idea. The nadir takes so long for Warren (7-9 hours), I'm not worried about shooting him when he's low.

    I'm also looking at replacing the glucose meter as even when he hit 42 the other day (and may have been lower earlier), he was 100% perfectly normal. I wouldn't expect that.

    We're headed out on vacation in a couple of weeks, and whomever we find to care for him while we're gone won't be doing any testing, so I'll pre-measure out a bunch of 0.75 doses for the week we're away.
     
  61. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    We don't recommend pre-filling syringes.....what you might want to do instead is fill a syringe to where you want the dose to be with some kind of colored liquid so your petsitter has something to compare to

    It's also way too soon to decide on a vacation dose...these kitties can really surprise us in a short period of time!

    I see you're making up your own dosing scale too. Lantus really doesn't work well on a sliding scale. It needs to be a consistent dose, and if you'll get at least 1 test in mid-cycle during the day (if you can) and ALWAYS a "before bed" test at night, it'll really help us to help advise you on when to increase the dose.

    If you absolutely can't get mid-cycle tests during the week, it's even more important for you to get more tests on weekends so we really see what the dose is doing for Warren

    The protocols we use here are already very aggressive but if they're followed, they're also very safe and more importantly, they work well. I know it SEEMS that when his numbers are higher, you should give a higher dose, but if you don't understand why they're higher, that can be very dangerous...and it's also just not how Lantus works

    If Warren were my kitty, I'd give him .75 every 12 hours, and get at least the 4 tests in we like to see (the 2 pre-shot tests, and the mid-cycle and before bed test) and hold that dose for at least 6 cycles and then let's see where he's at.

    The people here really have a lot of experience "reading" spreadsheets, so please let us help you to help Warren
     
    manxcat419 likes this.
  62. robr

    robr Member

    Joined:
    Mar 22, 2014
    Thanks Chris, it's been a challenge. I've gotten a lot of inconsistent dosing advice from people looking at the chart from these forums and there have been a few occasions where dose changes were recommended so I followed that recommendation. But then found I needed to change back. Earlier in the chart you'll see there was a pretty consistent period of 0.75 with much more frequent readings taken. But I also have a problem with measuring 0.75, there is no way to accurately do it which is a bit of a frustration for me since it makes it impossible to give a consistent dose. I can get mid-day readings (I work from home), but I just didn't want to keep prodding his ears any more than necessary and nobody that was helping me was asking for those readings even though I was offering to take them.

    And I certainly wouldn't trust someone else to measure my cat's dose when even I have difficulty at measuring. I'd hate an inexperienced person to come to my house, shoot my cat in the AM, accidentally give him a few units and nobody would be around to check on him for 12 hours. I guess I could check with the vet when I'm there tomorrow and see if any vet-tech's want to make a few extra $$. Boarding is cost prohibitive, so pre-measure for a sitter or possibly a vet-tech are my options. Or no insulin for a week, but IMO that's not a real option. What is the issue with pre-filling? WebMD doesn't seem to have an issue with it for humans. http://www.webmd.com/diabetes/tc/storing-insulin-and-prefilling-syringes-topic-overview
     
  63. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You can mark a syringe sample with tape, too.
     
  64. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Lantus has a proven protocol that we use here called "Tight Regulation Protocol". If you have Warren on low carb food (the Fancy Feasts) and can get at least those 4 tests in every day, if you follow the protocol, you'll start to see results, but every cat is different so we can't say at what point Warren will really start to show a lot of progress. We can only tell you that the protocol works!

    It's important that you post daily (if you can) and let those people with experience help to advise you. I see some days where he went low, and then bounced, so you have to learn when that's happening and when you just have to ignore those high numbers and when he really needs a dose increase.

    Doses can really change quickly, especially when you finally hit that "breakthrough" dose and they can start coming back down the dose ladder very quickly...that's why it's way too soon to think about what he might need a few weeks from now.

    The manufactures of Lantus say it's not recommended to pre-fill syringes
     
  65. Melanie and Smokey

    Melanie and Smokey Well-Known Member

    Joined:
    Feb 24, 2010
  66. Liliana Treeman

    Liliana Treeman Member

    Joined:
    May 10, 2015
    Warren I have same problem and will try stuff like cat attract litter .
    My Foxie was fantastic for 15 years so i now its not her fault
    My Husband love her as much as I do so my situation is much easier,but I'm exhausted .
    We do not restrict her movements
    I think that may add to your cat stress
    I hope things improve for us all
    It's not easy for sure
     
  67. robr

    robr Member

    Joined:
    Mar 22, 2014
    Thanks for the references above. Waiting for his cysto results. Hopefully Monday. I've gone back to a .75 dose 100% of the time again. Ill try to get in those 4 reading a day after my hand heals (surgery today).
     
  68. Liliana Treeman

    Liliana Treeman Member

    Joined:
    May 10, 2015
    Ro
     
    robr likes this.
  69. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Glad you got the cystocentesis done. Hopefully that will help get the right antibiotic for warren.

    There are a couple of points that I haven't seen anyone address yet.

    I think it's helpful to understand how Lantus works. It's a depot insulin, so when you inject, some goes to work immediately and some builds up in the body and slow releases. The size of the depot is related to the size of the dose. When you increase a dose, it can take a few cycles for the depot to build up. When you decrease a dose, the larger depot can take as long as 6 cycles to reduce to match the new smaller dose. During that time, the old size depot can continue to "give" and lower blood sugar.

    That's why changing a dose too often, like with a sliding scale, can work against you. To see what the current dose can do, you want the dose and depot to be settled in. Think of it as needing a calm lake to evaluate the dose, and changing the dose too often is like rocking the boat.

    Here's a good description of how it works. http://www.diabetesclinic.ca/en/diab/2treat/lantus_vs_levemir.htm

    Lantus dosing is based upon how LOW a dose will cause the cat to go. It can be hard to change after you learned on vetsulin, which isnt a depot insulin, but lantus dosing isn't usually adjusted based upon the preshot test, unless it's too low to shoot. With lantus, it's really important to get some midcycle tests in so you know how low he's going. Sometimes high numbers are caused by bouncing from low numbers.

    If you could add on 1 more test per day, it would tell a lot about what's going on with him. Doesn't have to be at a particular time, just sometime between the shots. If you imagine the spreadsheet as a jigsaw puzzle, getting a sprinkling of tests throughout the spreadsheet will help reveal more than a stripe down the middle. What you have with preshot tests are sort of like having the edge pieces of the puzzle without anything in the middle.

    You commented about the meter and him getting to 40's...Lantus is gentle and he may very well have been in the 40's without hypo symptoms. That's not at all uncommon in the Lantus ISG. You don't want him thete, but i wouldn't assume your meter was wrong.

    If he gets another antibiotic you might want to get a probiotic to prevent diarrhea. Most cats like Fortiflora. You just sprinkle it on their food. It's available only from vets or online.

    Anyway, I've written you a book, but hopefully some of it will help you help Warren. Keep asking questions! There is a wealth of experience on here and people will keep helping you.

    Hang in there!
     
  70. robr

    robr Member

    Joined:
    Mar 22, 2014
    I appreciate people that write books, im generally verbose myself :). thatnks for all the info. warrens #s have gone up the past few days, could be a bounce but usually they last around 24-48 hours. will just keep with .75 for now again and await results of the cysto and plan on more readings when i have 2 hands again
     
  71. robr

    robr Member

    Joined:
    Mar 22, 2014
    So Warren has not had a good past 2 days for some reason with his glucose levels. He didn't see 500s for about a month then the past 2 days ... 500s. It doesn't look like a bounce. Though I don't have nadir readings from the prior days, I don't think his preshot readings were low enough. If you look at his bounce history, all his pre-shot readings are EXTREMELY low. The lowest reading I have just prior is 199. I've also just been giving him 0.75 dose now for the past 11 days.

    We let him out of the bathroom about 10 days ago, no peeing in the kitchen until today, but I think that's because his glucose levels are so high.

    His cysto was negative BTW. $200 for telling me he doesn't have an infection. Do they still need to do a culture and sensitivity if the results are negative? Just wondering if I paid for a test that they didn't have to do.

    We are off on vacation starting mid next week, so we'll have a period of no readings while the cat sitter takes over.
     
  72. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Just what did they do for the $200? That much should cover obtaining the urine sample, doing a dipstick test, looking a the urine setemeint under a microscope and sending the urine to a lab for a culture and sensitivity test.
     
  73. Tiger(GA) and Ruth

    Tiger(GA) and Ruth Well-Known Member

    Joined:
    Apr 15, 2014
    I was wondering exactly the same thing as Larry! :eek::eek: I just had a the same thing done for my Tiger yesterday, including C & S, my bill was $140! I would want to see a bill breakdown if I were you!
     
  74. robr

    robr Member

    Joined:
    Mar 22, 2014
    It was $200 for the cysto, office visit, etc. I guess my question was, do they first do a test to determine if there is bacteria, and if bacteria is found, THEN do the culture and sensitivity? They told me the C&S was a much more expensive test than the previous testing I had done (which was test for bacteria from a sample I brought, but no C&S). Ie, did I pay for testing that isn't done once it is determined there was no need after seeing no bacteria present.

    Anyway, I'm not that worried about it at this point, but just curious.

    In other news....... My wife is losing it because Warren peed in the kitchen again. She believes (and I can't entirely disagree) than the Lantus simply isn't working out. It's been 2+ months and he isn't even close to showing signs of regulation. I switched to Lantus because the vetsulin (which used to work before he went into remission) was no longer working after his relapse, but it turned out he had a UTI working against him which we didn't know at the time. While we're on vacation, she wants him locked in the bathroom 24/7 as our cat sitter should not have to deal with cleaning up pee. She wants me to switch him back to the vetsulin immediately and see how that goes so we have enough data before our vacation to decide which insulin to use.
     
  75. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    That seems reasonable with a C&S. Frequently bacteria is not found is not found in the sample and thus is a UTI is really suspected then a C&S is in order. It also depends upn what else the vet's analysis of the urine showed? Do you have a copy of the results?
     
  76. robr

    robr Member

    Joined:
    Mar 22, 2014
    Any thoughts before I transition him back to vetsulin? Or the best way to go about that transition? Given there is a depot for Lantus, I imagine I'd want to start with a low dose at first.
     
  77. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    I don't know that I would switch back to Vetsulin. It looks to me like Warren may be dropping low and then bouncing. If you look at 6/25, he started off at 199 at AMPS but by PMPS he was up in the 500s. With no mid-cycle data, we can't be sure of course but that looks to me like he might have dropped into green and then bounced. As bounces can last up to 6 cycles, it's quite possible that he's still bouncing now. If there's any way you can get some mid-cycle tests in, that would really help to figure out what's going on with him. It wouldn't surprise me too much if he'd earned a reduction somewhere between 6/16 and 6/21 as he had some fairly low pre-shots in there...if those were rising numbers, then it's quite possible he might have been under 50 at mid-cycle. And as too much insulin can look like not enough, maybe what he really needs right now is a slightly smaller dose of Lantus to flatten those cycles out. As his accidents only seem to happen when he's in the 500s, flattening the cycles might well help in getting him to use the litter box instead of the floor.
     
    Critter Mom likes this.
  78. robr

    robr Member

    Joined:
    Mar 22, 2014
    I get my stitches out Monday but will try to get some more #s and stay with the Lantus. Just getting exhausted from fighting my wife. She's lost all patience with trying to work Warren through this and I can't take much more of the stress.
     
  79. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Would she be prepared to talk to any of us on here? Whether by joining the site herself or by using your login? That way maybe we could talk her through the different types of insulin and why, for most cats, Lantus is a better choice than Vetsulin.

    I completely understand why you haven't been able to get mid-cycle tests with stitches. Hopefully you'll be feeling better soon and will be able to get a few more numbers for us all to look at so we can try and help you more. :)
     
  80. Brashworks

    Brashworks Member

    Joined:
    Jun 21, 2015
    Hi Rob I wish I had great advice for you about Warren but I don't. I feel for you in your situation with your wife. Of course, I have no idea about your relationship but I can understand how stressful it must be to basically be asked to choose between them.

    Not sure how long you have been married, or what your relationship is like (and none of my business!) but in many relationships, what seems like the obvious issue actually has something else behind it. I'm wondering if she might feel a bit threatened by all the attention you are focusing on Warren. Stranger things have happened. Did she just tolerate Warren before he got sick, or did she have any affection for him? Who does the cleaning up when he eliminates where he shouldn't? I'm sure the stress in the household only makes it worse for Warren, perhaps creating a vicious circle, or at least contributing to it.

    I'm sure your wife must love you and have some regard for your feelings for Warren, and surely she must understand on some level that if she pressures you to have him put to sleep against your wishes it may have long-term consequences to your relationship; likewise, I'm sure she's feeling like you are picking Warren over her. Resentment will build in either scenario. Perhaps you can soften her position - not sure what your fights are like, or what is said, but perhaps you could disarm her. If you haven't already, tell her how much you love her, how much you need her support in this and what it means to you, that it's not forever, and how much you appreciate her on your side. That of course she is more important in the grand scheme of things, but for right now, you need to do this and ask, would she help you? Might work to lessen the tension. Just a thought!
     
  81. robr

    robr Member

    Joined:
    Mar 22, 2014
    Thanks for the advice. Warren was also her baby until we had children (they are now 9 and 10). Once we had kids, Warren no longer held that place in her heart. We have four cats, she loves three of them, but not so much Warren. Meanwhile, Warren is my baby. We used to be a foster home for the local shelter and have had Warren since he was 2 weeks old. He lives in my lap, the other cats don't give a rats ass about me.... I love them, but I'd trade them all in to keep Warren :). She wants the house to remain how it always was before Warren's recent issues. Clean, everything in it's place and she wants the litter box we've put in the bathroom downstairs gone. We also don't have tons of extra $$, so the $$ I've spent on Warren (probably close to $1000 at this point) she sees as taking money away from the kids and family. Logically she is correct. Emotionally, I don't care because diabetes is 100% treatable. There is no reason I shouldn't be able to get him regulated and restore things back to normal. But the 'chaos' has been ongoing now for 3 months (1 month of vetsulin and 2 months of lantus) and she doesn't want to keep going indefinitely. I've tried to explain to her what's going on, what bounces are, but in her mind she thinks I'm making excuses for him. If I didn't think there was hope things could return to 'normal', then I'd give up, but I don't see any reason at all why things can't be that way. I just don't know how long it's going to take. Which I think frustrates her more than anything. This definitely isn't a who's getting the attention thing. It's a cat litter and pee in the bathroom/washer/dryer area and kitchen thing as well as a $$$ thing.
     
  82. Brashworks

    Brashworks Member

    Joined:
    Jun 21, 2015
    Thanks for the clarification. I just don't know what to say. :nailbiting: I don't know how to un-love a cat and I don't know how another person could ask me to choose between them and my pets. Actually, I do… he was kicked to the curb and my pets are still with me :D. Not feasible in your situation and I feel for you!!!
     
    Critter Mom likes this.
  83. Liliana Treeman

    Liliana Treeman Member

    Joined:
    May 10, 2015
    I'm sorry too
    My husband is very supportive
    Your poor cat is sick and like my Foxie
    It's not his fault .
    It's too months now and for the first 3 days she went to the litter box
    Ask your wife what if she become sick
    And pee in her bed.
    I don't want to sound inconsiderate but imagine Warren locked up in the bathroom
    While you are gone.
    I try litter atract and Foxie likes it
    Good luck
     
  84. Nancey

    Nancey Member

    Joined:
    Apr 23, 2012
    @robr if you have not taken Liliana's advice I strongly suggest it. The cat attract cat litter from Dr Elsey really works to get the cat back in the box. I had a cat that had a really bad UTI and that litter was the saving grace as he was peeing everywhere until I tried it. Now you could still have a issue with the rug going forward as that is one thing I cannot get past with this one kitty. I cannot put a rug in my hall bathroom of any kind as he will to this day pee on it. Not sure why but he does. We took him in out of the street when his owner kicked him to the curb in the middle of winter because they had a kid and he wanted to sleep in the baby's bed. So we do not know if he was confined to a bathroom for a while or what, but I have tried pretty much any material they make bathroom rugs out of and he will pee on them, but only in the hall bathroom as stated. I have the same rugs in my master bath and he has never gone there. Could be Warren now has an association with the kitchen rug. I know it sounds strange but it is at least worth trying, remove the rug and see what happens.
     
  85. robr

    robr Member

    Joined:
    Mar 22, 2014
    We have another bounce. Looks like we need a dosage reduction down to 0.5
     
  86. robr

    robr Member

    Joined:
    Mar 22, 2014
    Moving him back to .75. He seems to be in the 200-300s most of the time at 0.5. This is so frustrating. He also has diarrhea all the time. Poor guy :(
     
  87. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Is the diarrhea a new symptom? What does the vet say?
    Giving a teaspoon of plain pumpkin may help give it some form.
     
  88. Liliana Treeman

    Liliana Treeman Member

    Joined:
    May 10, 2015
    I'm sorry for your poor kitty,my Foxie is not doing well either.
    I'm beginning to think that I'm just pretending that she is better and the reality is that her life is horrible.
    Always thirsty and hungry and dirty,she is peeing on the floor again.
    If she could talk I bet she will tell me she has had enough .
     
  89. Liliana Treeman

    Liliana Treeman Member

    Joined:
    May 10, 2015
    I'm thinking of unthinkable
     
  90. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    @Liliana Treeman ...before you think on it too much, please start posting daily, get our spreadsheet going and let us help you! There's so much to the sugardance and unless you have someone who's been doing it awhile to guide you, you may not be making the best decisions to help your dear Foxie!

    If you'll post daily over in the Lantus forum (I think you're using Lantus, right?) and keep us up to date on how she's doing, we can probably help you improve the quality of her life quite a bit.

    Are you home testing? Have you tried creating our spreadsheet? If you have problems with it, let us know! We can help!
     
  91. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    I'm new to all of this and I can't believe he's jumping from 83 to 500 in 4-5 hours. Is this a case of the 'wrong insulin' for this cat? Wow.
     
  92. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    That sounds like a bounce, @pevsfreedom ....there are 3 ways that cats can start a bounce
    1. their blood glucose goes too low (under 50) so their liver releases stored sugars and hormones to bring it back up FAST...Bounce!!
    2. The BG drops too quickly.....Like from 400-150 in 2-3 hours...those fast drops like that can trigger a bounce too
    3. Just dropping into a number their body hasn't been living at for awhile.....Their body gets used to living at 300, so when the insulin brings them down to 100, (which still a great number), the liver is eonce again releasing those stored sugars and hormones to bring it back up to where Mr. Liver THINKS it should be.....the more time your cat spends in the "good" numbers, the less Mr Liver is going to freak out and he'll eventually get used to the idea that those lower numbers are safe and he doesn't need to over-react

    Make sense?
     
    Brashworks likes this.
  93. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    The Mr. Liver explanation really cleared everything up! :)
     
    Chris & China likes this.
  94. robr

    robr Member

    Joined:
    Mar 22, 2014
    The diarrhea is not new, but the vet said once we get him regulated, it should go away. What's new is he's started pooping just outside his litter box (while he's locked in the bathroom). Prior to this, he's used the litterbox 100% as long as he was locked in the bathroom. Yesterday he also threw up in the window, it was black. He sits in and got it all over himself, the curtains, etc. Maybe there is more going on than just diabetes but none of the tests found anything.

    I don't know what to do about his insulin. It looked like 0.5 wasn't working well enough, I was going to go back to 0.75, then started second guessing everything. What if he was bouncing and I didn't catch it (I've been taking more frequent readings as requested by some folk here). But I'm starting to feel like this is a losing battle. I feel like it's my fault I can't regulate him and I must be doing something wrong. But a life living in the bathroom 80% of the time is no life at all for my friend. My vet is out of ideas, I just don't understand because I thought with diabetes, it's something that should always be able to be regulated. I don't think there is much else I can do that I'm not already doing other than switching meds and starting over with a different insulin. But I think maybe that's just me grasping at straws and trying to avoid the worst case. Sitting here crying but I'm exhausted and out of ideas, money and hope.
     
  95. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    Black vomit? Did you Google that? I did, and this is what I got.
     
  96. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Black vomit, especially with a coffee ground appearance, can be a sign of a GI bleed, such as from an ulcer.

    Pooping outside the litter box can be a sign of arthritis - it hurts to go, the pain is associated with the litter box, so it is avoided. A trial of glucosamine could be helpful, or Adequan.


    Also, it is possible to have a fecal blockage plus diarrhea. The liquid stool is able to pass, the obstructed area hurts. That may cause litter box avoidance, too.
     
  97. robr

    robr Member

    Joined:
    Mar 22, 2014
    Thanks. The black vomit thing doesn't look good at all. I think I'm done. I don't have the luxury of time, family cooperation or $ to continue. I can't even get the diabetes under control. I really appreciate all the help from this forum and especially you BJM. I've learned a ton, and my other 3 cats will hopefully benefit from never having to deal with diabetes from those lessons.
     
  98. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    Rob, if you make the decision you are thinking about, my heart breaks for you. You have been doing everything you can. :bighug::bighug::bighug::bighug::bighug:

    And don't EVER feel like you have failed Warren! You have done more than most cat parents would even think about.
     
  99. robr

    robr Member

    Joined:
    Mar 22, 2014
    I'm going to run everything by the vet on Tuesday when she's back in the office and make sure there's nothing I'm missing and there's no reasonable course of action. Thanks shiloh.
     
  100. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    I did some reading, and if it is an ulcer, it can be controlled, and that could explain some other issues. I will be praying for you and Warren.
     

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