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

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

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  1. BJM

    BJM Well-Known Member

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    {{hugs}}, whatever you decide.
     
  2. pevsfreedom

    pevsfreedom Well-Known Member

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    The silver lining of course is that 15 years old is a good run for any animal. We had to put our 1.5 year old cat named Baby down due to FIP earlier this year, which came and relentlessly killed her within 2 weeks of symptoms. If you think it's time then I would say you're probably right. Hopefully the vet comes up with a magical cure, otherwise I think you're making the right choice since this all sounds pretty miserable for Warren. Someone said ulcer's, so maybe your vet can help identify if there's any last resorts here.
     
  3. Liliana Treeman

    Liliana Treeman Member

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    I'm just like you.
    People here are wonderful,but you know your cat we all do.
    My Foxie is miserable ,and I don't think this will change.
    I'm not ready yet,but I'm thinking about.
    My great cat is alwayes hungry,thirsty and I know this is not life that she wants.
    My best wishes for you,you love your cat.
     
  4. Liliana Treeman

    Liliana Treeman Member

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    I'm sorry about all this,and wish you to have a clear mind ,you love your cat you know your cat.and you know when is enough.I definitely. Know that my cat is miserable ,and I don't want her to suffer.
    I'm sure you feel the same and your decision will be the right one.You love your cat.
     
  5. robr

    robr Member

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    My wife is certain that what I thought was black vomit was instead diarrhea (she washed it off the curtains and smelled it first). I'm surprised she told me as I had pretty much made up my mind that it was time. But with that piece of info, and with his glucose levels in the 90s today, I have some new found hope and am going to keep trying to regulate him and see how things go.
     
  6. pevsfreedom

    pevsfreedom Well-Known Member

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    That is good to hear.
     
  7. robr

    robr Member

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    And today he bounced again after dosing at 0.75. So I went to Walmart, bought a big magnifying glass and needles that have half units markings. Want to try to get his doses more accurate rather than winging it. With it making such a big difference between 0.5 and 0.75, I think it's critical to try to get the dosing as accurate as possible.
     
  8. Liliana Treeman

    Liliana Treeman Member

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    Good luck ,
    I know how hard it is for You and
    Your beautiful cat
     
  9. robr

    robr Member

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    What do you guys think of the latest readings? It almost seems to me like he's bouncing even at 0.5 units. I've now been measuring with the new syringes marked with 0.5 increments and using a magnifying glass. I'm feeling pretty good these 0.5 doses have been measured pretty consistently. I'm starting to wonder if maybe he's gone into remission again. Could use some thoughts on whether I should continue at 0.5, drop him to 0.25 or take him off and see what happens. He did poop on the kitchen floor this morning, which started my wife off on the 'you need to do something and stop making excuses for him' tangent again. I was intending to order some probiotics to help with his diarrhea tomorrow.
     
  10. Critter Mom

    Critter Mom Well-Known Member

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    Hi Rob,

    Warren's numbers are definitely better than on the 0.75 IU dose.

    Is there any chance that you might be able to get some tests in at AMS+2 and PMS+2 (and +3s for both if possible) ? It would really help to see what's happening in the early part of the cycle. If the dose is a bit high then the Lantus may be dropping his levels a bit fast earlier in the cycle and that might be spiking his BG mid-cycle. When a dose is too high, sometimes you can get an inverted curve. Getting the tests above (and ideally a full curve) would help members here to give you better feedback on what dose adjustment might be needed.

    Is there any change in his behaviour in the early part of the cycles? Does he seem any perkier? Also, is there any correlation between the time in the cycle and when he has his peeing mishaps?

    Do you have Warren on a B12 supplement, btw? If not, it might help with the litter box issues.

    EDITED TO ADD:

    Does Warren's appetite perk up early in the cycle? Keep an eye out for cues like this because it can indicate when the Lantus is kicking in.
     
    Last edited: Jul 19, 2015
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  11. robr

    robr Member

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    Hi Aine, I will take some earlier readings, but historically (looking earlier in the chart), the nadir hits him around 7-9 hours. I can try to get a full curve again as well, I just don't want to do it when he's bouncing and sometimes it's hard to tell when that is. He is hungry ALL THE TIME. He gets his food immediately after his insulin and I have to lock him in the bathroom with it so he doesn't push the other 3 cats away from theirs. We were having throwing up issues because of him eating too much, too quickly until I separated him during feeding. He is definitely perkiest when his BG reading is really good (ie, 80-140ish), but I haven't really seen behavior change at various times of the day. He's old, he does a lot of sleeping but he definitely comes running at meal times.

    When he does use the kitchen as a bathroom, it's generally in the morning. 6am - 10am. It has seemed like there is not a problem unless his BG is high, so I've been locking him in the bathroom when I get high readings. Today I think was an exception.

    Any recommendations for an easy to take B12 supplement? I can order that when I order the probiotic.
     
  12. BJM

    BJM Well-Known Member

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    To help slow down the eating and reduce scarf 'n' barf, these might help
    - add a tablespoon of water to help he feel more full
    - spread the food thinly over a large plate so it takes longer to eat
    - divide the food into mini-meals so he doesn't get too hungry
    - freeze part of the meal so it may be eaten after it thaws
    - consider a timed feeder to spread out the food
     
  13. Critter Mom

    Critter Mom Well-Known Member

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    That's exactly the sort of behaviour that I was asking you to look out for. If you catch him behaving like that earlier in the cycle, it'd be a good idea to test then and maybe an hour later, too. It's great for helping to catch early drops and shifting nadirs.

    Thanks for the information on his peeing behaviour. I did wonder whether there might very well be a correlation between peeing incidents and higher BG values so it's good to get that confirmed. That might be something to share with your good lady. It may reassure her to know that when Warren's BG is in better numbers the peeing hiccups subside, the tacit implication being that as he becomes better regulated it will hopefully resolve the pee mishaps.

    The B12 supplement recommended by many here for diabetic kitties is Zobaline.
     
  14. Critter Mom

    Critter Mom Well-Known Member

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  15. robr

    robr Member

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    Ok thanks, I'll read up on B12 tomorrow. In the meantime I put up his +2, 4 and 6 numbers from tonight. Stayed up way past my bedtime, will try to get a full curve starting tomorrow AM.

    .... and he's in the 400s in the AM. argggh!!!
     
    Last edited: Jul 20, 2015
  16. Critter Mom

    Critter Mom Well-Known Member

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    Drat, drat, and thrice drat! :)
     
  17. Critter Mom

    Critter Mom Well-Known Member

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    Hi Rob,

    Just checked Warren's spreadsheet and saw that he was high mid-cycle today. Is there any way that you might be able to snag some PM+10 and PM+11 tests? It might give you an idea of whether he's going lower on the PM cycle and then bouncing during the day.
     
  18. robr

    robr Member

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    Thanks so much for keeping an eye on him CM, I can plan to do that but need to catch him when he's not coming off what looks like a bounce. That's why I didn't bother with a curve today. His PMPS was 448, so not a great day for him as far as BG, but he did find his way to the litter box tonight when he had a very nasty poop, with a high BG he seems to prefer the kitchen, so I'm proud of him for that :)
     
  19. Critter Mom

    Critter Mom Well-Known Member

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    Does look more like a bounce alright. The reason I was asking about the +10/11 tests was to find a way to help you get a better idea of whether he's going too low at night and then bouncing (and peeing :banghead:).

    Well done, Warren, for pooping in the box. (((Scritches)))

    What did the stool look/smell like?
     
  20. robr

    robr Member

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    It smelled so bad even Chuck Norris would have run the other way. It was generally poop shaped, just soft and a medium brown color.

    He's still bouncing today it looks like. My wife just came upstairs to my office and let me have it about not having him put to sleep. This is so difficult.
     
  21. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    Rob, I am going to really blunt here, and I'm sorry if it is unwelcome. Ask her when she gets old and incontinent, does she want you to have her put to sleep? You said she loved Warren until the kids came along, and now he is just a burden. What if when your kids grow up, they see her the same way as she gets older? Again, I'm sorry to put it that way, but I don't know any other way.
     
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  22. Critter Mom

    Critter Mom Well-Known Member

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    Have you had Warren tested for pancreatitis? If not, I strongly recommend asking your vet to run a Spec fPL test for pancreatitis. Really malodorous, medium brown/tan stools are a symptom. If he does have pancreatitis his B12 may be low because pancreatitis can cause absorption problems. Given the ongoing toileting problems, I'd also recommend asking your vet about checking B12, folate and potassium levels (could be a potential cause of hindquarter weakness which might be making Warren slightly incontinent).

    I am so sorry that you are under such dreadful pressure on the home front. If you get the right diagnostics and then appropriate treatments, it could make the world of difference to getting Warren's diabetes regulated and hopefully restoring domestic harmony.
     
  23. BJM

    BJM Well-Known Member

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    At over 120 posts, it might be time to start a new thread, and maybe in the Lantus/Levemir forum.

    Maybe get a large 48" long dog crate to confine him in. Line it with some chucks (pads for incontinent patients). Put in a litter box, a carrier without a door (provides a hiding nook and a shelf to get up on), and food and water. This would make clean up easier.
     
  24. robr

    robr Member

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    Thanks BJM, he has a thread there, it just doesn't get much traffic. In fact it was suggested in that forum that I create this post in the main forum as the Lantus forum isn't heavily trafficked. In any case, I haven't been paying attention to what forum I'm in at any given time. I get the email notifications of new responses and just click the link and here I am :).
     
  25. robr

    robr Member

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    Looks like he's still bouncing on 0.5. I'm dropping him down to 0.25...which is a challenge to get the syringe just right without over shooting to 0. And these Walmart syringes suck for getting out every last air bubbles. I'm using a magnifying glass now and the bubbles even when at the top like to stick to the side of the tube as liquid goes around them. There must be air in the needle even when all the way pushed in and held down forcefully as there's no air in the lantus pen.
     
  26. Critter Mom

    Critter Mom Well-Known Member

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    1. Push the plunger in and out a few times before drawing up insulin so that the movement feels smooth.

    2. Try drawing up about 2 units, holding the syringe needle up and flicking to move the air bubble under the needle then express the extra insulin.

    3. Try twisting the plunger slightly when you're expressing the excess insulin.

    Also get a spare syringe, fill with water and practice squeezing out a drop at a time. When you get the knack, you can then get just above the required dose, squeeze out a drop, check the syringe reading, then rinse and repeat until you hit the mark you're aiming for.
     
  27. Critter Mom

    Critter Mom Well-Known Member

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    Rob, I've just had a look at Warren's spreadsheet and I really think you need help with dosing from members really experienced with Lantus. I strongly recommend that you start a new thread on the Lantus and Levemir forum and ask them to review Warren's spreadsheet. I don't have enough experience to suggest anything to you but I'm not sure down is the way to go.

    I understand the awful pressure you're under to solve the 'accident's problem' and finding a good dose and having some support to help you hold your nerve through the bounces is, to my mind at least, the best and fastest way to get help for Warren and thus help things calm down on the home front.

    In the meantime, are you able to get pre-shot and +2 - or better +3 - tests on every cycle. It would help a lot to know where the active cycles are happening (especially at night). Having this extra information every day would go a long way to determining what's going on with Warren's BG over a 24-hour period.
     
  28. robr

    robr Member

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    I'll bump the Lantis thread as well.
     
  29. Critter Mom

    Critter Mom Well-Known Member

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    Might be worth starting a new thread in L&L with today's date and then putting a link to this thread and the previous Lantus thread in the opening post (that's the recommended posting protocol over there). Also, when you create the new thread, use the question mark icon next to the thread title. It'll help the experienced members there identifiy that you need help faster. Be sure to reiterate in the opening post the type of pressure you are under at home - that Warren really needs as much help as possible as soon as possible.
     
  30. robr

    robr Member

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    Returning back to this thread from the Lantus forum where we've been having some discussion just to do an emotional dump.

    Warren's litterbox habits have gone downhill severely this past week (all documented in the spreadsheet and marked in purple).
    Changes about the time this started were to add the probiotic to his diet and I slightly upped his dosage by a hair, I'm calling it from 0.5 to 0.6 (just got calipers last night with the intent of being able to micro measure). His numbers I think look much better now than they have perhaps ever, wish it translated to better litterbox habits.

    I finally agreed with my wife on Sunday to have him put to sleep Monday, but couldn't do it. I was up all night with him and I was a wreck. I'm a wreck now just writing this (with Warren in my lap). I was hoping a few days with the better numbers would turn around his litterbox habits, but I know that takes time. Today he peed on the kitchen rug and in my son's backpack in the living room. My wife is slamming doors around here she is so mad. I was just given an ultimatum to have a plan, and if there is one more accident he's done. She believes this is behavioral rather than medical, and I don't blame her at all for not wanting cat pee all over the house and our things. Cat Attract litter and Feliway collars have not helped. As you all know, he's had three UTI tests and gone through multiple weeks of antibiotics. I'm out of ideas. I need a miracle now, he and I are both out of time. It just sucks because he looks healthy, has great coat, he's playful, he cleans himself, his weight is good, he just won't use the litterbox consistently.
     
    Last edited: Aug 6, 2015
  31. Critter Mom

    Critter Mom Well-Known Member

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    ((((((((Rob))))))))

    Warren's numbers have improved so much!!! That is going to make such a difference to things.

    Is he getting a B12 supplement? If not, could you start an aggressive B12 supplementation programme with your vet straight away? Now he's in better numbers his nervous system will have a chance to recover from any damage due to higher BG levels. If Warren has subclinical diabetic neuropathy this could be at the root of his elimination problems. Now that you have made such an advance in regulating his numbers, if it is neuropathy in play then the B12 could resolve the problem. I've seen it resolve the problem in a number of cats since I joined FDMB. If this is the problem, then it may take a little while to help BUT with the better-regulated numbers Warren is likely to be drinking less and peeing less because his kidneys won't be working overtime to get rid of excess glucose.

    I really do have great sympathy for you all with the inappropriate elimination difficulties: there is no denying that it's unpleasant. That said ...

    ^^^ This ^^^ is really not going to help matters. Stress can bring on UTIs in cats, and anxiety can cause elimination problems, too. I appreciate tensions are running very high, but it is possible that displays of anger about the situation may actually be a major factor in perpetuating it.

    I would suggest:

    1. Talk to your vet about the B12.

    2. I know it's awkward but let the vet know that there are some 'life stresses' in the home environment (no need to be specific) and you're concerned Warren may be picking up on it. (NB - I can hear how anxious you are, too, and Warren may also pick up on that.)

    3. Ask the vet to double-check that Warren doesn't have a UTI or cystitis (stress can induce the latter).

    4. Maybe ask him about something to help Warren with anxiety. Obviously tell him about lack of success with the Feliway collar. I have read that fluoxetine (Prozac) may be prescribed to help cats who are struggling with inappropriate elimination problems.

    Note: I've never given any of my cats anti-anxiety medications so I don't know what the risks and contraindications might be. Please ask your vet to detail risks and side effects if he does consider prescribing something to help Warren. (I have read that diazepam isn't great for a cat's kidneys.)

    Some links:

    Detailed article on elimination problems and clinical / behavioural signs that may give more clues as to the nature of the problem.

    Advances in Understanding and Treatment of Feline Inappropriate Elimination - Vet-authored, very comprehensive article. Includes things to check when making a diagnosis (has recommended tests to order, and also includes diabetes as a potential cause of elimination problems - maybe show your other half this as evidence that elimination problems most definitely can be as a result of diabetes). This article goes into fluoxetine treatment, guidelines and side effects (most relevant for a diabetic being that it may suppress appetite a bit.)

    I hope some of the above helps. I've only scanned the article in that second link: it looks really good.

    I am really hoping your wife will be amenable to giving you a chance to let Warren recover further. It is so heartening to hear how well he is looking and acting now. I think you've turned a corner. I hope you will be able to persuade your other half to explore all treatment options. My heart goes out to you ... :bighug::bighug::bighug:

    (((Rob & Warren)))


    Mogs
    .
     
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  32. Critter Mom

    Critter Mom Well-Known Member

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    TAMU B12 Dosing Guidelines

    From the TAMU document:

    B12 is water soluble. Any excess is excreted via the kidneys.
    .
     
  33. Tucker&Me

    Tucker&Me Member

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    Jun 24, 2015
    Dear Rob: I haven't followed you & Warren lately, but certainly can tell you are torn & heartbroken.
    I am so sorry. I can feel your hurt from here.
    Since I haven't kept up, please forgive me if this option has already been discussed..
    Could you get some help in finding him a home with an understanding cat person? Even for awhile!
    Maybe it would break the "cycle" he's in ?? Maybe he's picking up on the wife's stress..and should get out of there.
    Maybe that's your miracle.
    I know you're torn..but I'm thinking, so is he.
    Just a thought. God bless you both.
     
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  34. Robin&BB

    Robin&BB Well-Known Member

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    My heart goes out to you ... :bighug::bighug::bighug:(((Rob & Warren))) Mogs
    .[/QUOTE] (Just now reading through all of this ...) My heart goes out to you, too! Have all fingers & toes crossed for you.:bighug: - Robin
     
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  35. Kate and Kloever

    Kate and Kloever Member

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    Thinking about and praying for you guys!!!! XO
     
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  36. robr

    robr Member

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    Thanks everybody for the replies.

    Critter Mom, I shared (an edited version) of you post with my wife, she doesn't want to hear anything I have to say on the subject any longer, it's just seen as excuses. Hopefully coming from someone else, it will make a difference. Assuming she's receptive to the idea, I'll talk to the vet about B-12.

    Is there a way to do home testing for bacteria? ie, urine test strips? I've shelled out a ton of $$$ at this point for 3 UTI tests, I don't think my wife will be on board for spending more $$ when in her mind Warren should be put to sleep immediately. I understand if they come up positive, it would not mean he has a UTI, the bacteria could be introduced from another source, but if it's negative it would indicate he does not have one. Something like this perhaps? http://www.cvs.com/shop/home-health...nary-tract-infection-test-strips-skuid-870916
     
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  37. Meya14

    Meya14 Well-Known Member

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    UTI strips can be purchased at most pharmacies for a few dollars and may be a good screening tool for him. I think you mentioned that you have tested (negative) and treated multiple time for UTI based on symptoms, and no improvement. I'd use the strips for now to screen, but I'm not sure UTI is your main issue based on this history.

    I know when Jane was having her arthritis issues she started peeing/pooping on the rugs in the house instead of the litter box. After a few times, it became a habit for her because of the smells so we had to block off all of her "favorite" places and give her time to get used to the litter box again. I never considered neuropathy, but this could make it hard for him to feel he needs to go until it's too late, and he may have trouble with muscle control. Constipation issues can also lead to inappropriate elimination and may be more of a problem if neuropathy is an issue. It's so hard to figure these things out sometimes, I wish cats could tell us. In addition to the B12, perhaps pain control may help and laxative if he appears constipated.

    When Jane was going through this, and with other cats I've had who had issues, I often wondered what I would do if it didn't resolve. Bathroom issues are some of the most frustrating issues to deal with, especially if it looks like there isn't hope. Hang in there.
     
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  38. Critter Mom

    Critter Mom Well-Known Member

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    I've no experience of the above so don't know if they'd be suitable for cats. Multistix 10SG strips check for blood in the urine. @Meya14, @BJM - do either of you know if there are any suitable reagent strips for home use in cats?

    Re the vet: things are so critical now that I would strongly, strongly recommend you ask him about the kitty Prozac AND the B12. If I had to choose between the two in your current situation and the window was short, I think I'd probably go for the Prozac first. Until you get Warren to settle back into proper toileting habits, your worry is going to be pretty much constant. Warren will be feeding off all the worry and tension (all cats do) and if anxiety is feeding into his elimination problems that cycle needs to be broken ASAP. Anti-anxiety medication might be the fastest way forward.

    I've just found this article about treating elimination problems with Prozac.

    From the article:

    [Emphasis mine]

    I do hope that some of this will help you all.

    (((Rob & Warren)))



    Mogs
    .

    PS ... as a precaution, ask your vet for a small dose of cyproheptadine as well as the Prozac. Prozac is an SSRI. These and similar drugs can induce serotonin syndrome. Cyproheptadine is used as an antidote. It is used as an appetite stimulant in cats (small dose, e.g. 1/8 of a 4g tablet BID for a 10lb cat) so it is generally safe. (NB - this last addition is me appeasing my inner Safety Nazi; not meant to alarm or discourage you. Your vet should be able to advise you further.)
     
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  39. Critter Mom

    Critter Mom Well-Known Member

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    Excellent point, Meya. (Wish I'd thought of it. ;) )

    Rob, if you are taking Warren to the vet (and I really hope you are ;) ) ask him to double-check Warren for any signs of joint pain. A basic physical exam should pick up any discomfort. (NB - if exam is positive, don't let vet prescribe Metacam for pain - it's major bad news for the kidneys.)
    .
     
  40. Tucker&Me

    Tucker&Me Member

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    Warren

    I completely agree with Critter Mom.
    That bolded text in the article gave my heart an excited jump for you!
    PLEASE TRY.

    And if writing your good lady a few lines will help..then WE'LL ALL DO IT. :woot:

    Thank you Àine! :bighug:
     
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  41. Critter Mom

    Critter Mom Well-Known Member

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    Mercola article on serotonin syndrome in pets - contains lots of useful safety precautions for successful treatment with anti-anxiety agents (for example, take care if Warren's being given any liver supplements containing SAMe).
    .
     
  42. Critter Mom

    Critter Mom Well-Known Member

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    Mine too!

    :nailbiting: :nailbiting: :nailbiting: :nailbiting:
     
  43. robr

    robr Member

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    Talked to my wife, called the vet, the doctor isn't in and will call me in the AM.
     
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  44. Critter Mom

    Critter Mom Well-Known Member

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    Fingers, paws, arms, legs, and eyes crossed in the Shire ...

    Please, please let us know as soon as you have any news.

    (((Rob & Warren))) :bighug::bighug:


    Mogs


    PS: Some forum members have had great success when they switch to the Tidy Cat Breeze litter system.
    .
     
  45. pevsfreedom

    pevsfreedom Well-Known Member

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    Luna pees on the carpet about once week. She's declawed though so I think it's a behavioral thing or perhaps the sand hurts her paws.
    I'm about to watch the video on that page with the mad scientist Hans... We have 2 boxes and they fill up insanely quick and keeping them clean is hard, and the second they're dirty Luna refuses to use them, though Mushu seems to think the dirtier the better, he's always hanging out inside scratching the sand.
     
  46. Meya14

    Meya14 Well-Known Member

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    Jan 2, 2015
    The human test strips should work for cats too. They usually test for nitrates that the bacteria produce, as well as blood, protein, and pH.

    As for substrate preferences, sometimes that's an issue. If your cat prefers to pee on carpets or towels, you can try placing an extra large puppy pad (or 2!) in a clean, empty litterbox and put only a handful of litter on top of this. We did this with Jane for a while too, as she'd find any throw rug in the house to use instead of the box.
     
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  47. robr

    robr Member

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    Mar 22, 2014
    UTI test strips show negative for nitrates but positive for leukocytes (it was the darkest color on the chart).
    I think that means he has some sort of infection but not necessarily a UTI.
    He went in an empty sterilized litter tray and I tested within 30 minutes, so I'm pretty confident there was no contamination by third party white blood cells jumping into the urine :)
     
  48. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    I strongly encourage trying the Prozac too...it really can work wonders.

    Without going back through all the info, I just want to add one thing I just remembered...is there any chance the rugs Warren is peeing on have rubber backing? For some reason, a lot of cats just can't resist them and when you get rid of the rubber, you go a long way to getting rid of the problem....Just another thing to try if you haven't

    Wishing only the best for you both
     
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  49. Critter Mom

    Critter Mom Well-Known Member

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    Now that's a very insightful observation. That rubber backing tends to have quite a distinctive odour slightly reminiscent of urine. Someone gave me a prezzie of a mouse mat once that stank to the high heavens. You'd swear it had been used to line the bottom of a litter tray. Needless to say it got turfed out.

    Your son's backpack - is that by any chance made of something rubberised, too?
    .
     
    Last edited: Aug 7, 2015
  50. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    For cats, the test strips indicate a false positive for leukocytes (white blood cells) 995 of the time. > just ignore the leukocyte results.
     
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  51. robr

    robr Member

    Joined:
    Mar 22, 2014
    Darn, I thought we had a smoking gun with the UTI test.

    He does seem to pee mostly on rubber backed rugs. The backpack isn't rubberized as far as I can tell, but it is kind of an odd material.
    He also likes to pee on shoes. He really really likes shoes.

    The vet just called but then had to rush off the phone for an emergency and is going to call me back. She was all for the prozac, but started babbling something about how they only have capsules and I'd have to break them open and divide it up into multiple doses and she was mid sentence about trying to figure out another approach but then had to go.
     
  52. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Rob,

    Great to get an update from you, and excellent news that you've got the vet onside with the proposed treatment for Warren.

    Prozac comes in different forms (including a liquid preparation). Here is a useful article with further information, precautions and side effects for treatment of pets with fluoxetine (Prozac). From the article:
    Also ...
    It's fairly straightforward to divide up capsule contents by sprinkling them onto a plate and using a razor blade or scalpel to split the powder into reasonably even doses.* (CKD cat caregivers do it with capsules of vitamin B complex, AlOH binder, and so forth.) Each time you start a new capsule you can use one dose and pop the remaining doses into little empty gel capsules, ready for later use. Presumably it could be sprinked onto a teaspoon of food for administration? (Maybe add a few teaspoons of the spring water from a tin of human tuna on top if it's necessary to disguise the taste.) As I said yesterday, I've not used Prozac in a veterinary context myself, but if I was giving it to my cat I'd want to start at the smallest dose possible as a safety precaution to see how well the cat could tolerate it, and to minimize the chance of a strong adverse reaction. (You should've seen Saoirse after her one and only dose of mirtazapine (another anti-depressant - much stronger than Prozac). Saoirse's normally an extremely pacific cat, but the mirt turned her pupils into dinner plates and her into a major Psycho Kitty (qu'est-ce que c'est? ;) ), hence my suggestion that your vet give you a token supply of cyproheptadine to have handy at home just in case the fluoxetine were to disagree with Warren.

    Really rooting for you two in the Shire! :)


    Mogs

    * (And before any smart alecs out there ask, no I am not a coke head. :p )
     
    Last edited: Aug 7, 2015
  53. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
  54. Mitzelplik's Mom

    Mitzelplik's Mom Member

    Joined:
    Jan 24, 2015
    @robr , just catching up on your situation. Fingers & paws crossed that Prozac may be Warren's magic bullet!
    best,
    Joan
     
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  55. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    It sure can't hurt to try to keep those rubber backed things out of his environment! Ditch the rugs, get some shoe trees or tubs to keep shoes in (instead of on the floor) and tell your son to keep his backpack off the floor

    Just trying to offer cheap suggestions that might help with Warren!

    I had a "rubber back rug" pee'r......when I replaced the rugs with ones that had no rubber, problem was solved
     
    Last edited: Aug 7, 2015
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  56. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    I feel like my Mushu needs prozac, he's been the most anxious cat I've ever had since we got him. Apparently he used to have an insane flee infection before he got to the shelter. He doesn't pee on the floor but he's kind of manic and sits in the box for hours scratching the walls, etc. Lots of strange stuff like that. Really interested how it'll affect Warren.
     
  57. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    Best $30 I ever spent!

    http://www.amazon.com/Seville-Class...TF8&qid=1438969569&sr=8-3&keywords=shoe stand
     
  58. robr

    robr Member

    Joined:
    Mar 22, 2014
    Just got back from the vet.
    Got Warren a b-12 shot. Vet doesn't think it will do anything but agreed it can't hurt. Seems like I want to give him one weekly though for 6 weeks. She said she usually only does that for cats with IBS. I think she'd be fine with it though.

    She's prescribing 2.5mg of transdermal Prozac which gets applied to his ear. I'm waiting for the mail order pharmacy she called it into to call me with pricing. She also hadn't heard of combining with cyproheptadine and said let's just see how he does. She did say I could expect it to take 2-3 weeks to work.

    She didn't want me to spend the $ on a 4th UTI test at this time.
     
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  59. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    They aren't combined and taken together....the prozac can sometimes cause another problem called serotonin syndrome (fairly rare, but something you should know just in case).....the cypro is the "treatment" for serotonin syndrome
     
    Critter Mom likes this.
  60. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Larry, do you know whether in animals there's any variation in response between branded Prozac and generic fluoxetine? (I ask because I can attest personally that there is a difference in response between the two for some humans.)
     
  61. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    Prozac made me sweat like a pig and unable to walk (horribleness). That was a short 2 day trial :confused: - decided medication wasn't for me after that.
     
  62. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Rob,

    Sounds like a really productive visit with the vet! :)

    It's great about the B12 and the Prozac Rx. It's a two-pronged attack. I am wishing so very hard for these to help you both.

    :bighug::cat:


    Mogs
    .
     
  63. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I was able to tolerate branded Prozac OK. Prozamel, one of the fluoxetine generics, made my nightmares more frequent and much worse. (*shudder*)

    .
     
    pevsfreedom likes this.
  64. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    Sorry about that, the mind is a weird thing and these medications are even weirder. I think I tried Prozac, lexapro, and paxil, all of which were absolutely horrible (and were generic versions) [I have kind of bad OCD/anxiety hence why I tried them].
     
    Critter Mom likes this.
  65. robr

    robr Member

    Joined:
    Mar 22, 2014
    The transdermal pen (30 day supply) was about $25 including shipping from Wedgewood Pharmacy in case anybody else might find this info useful in the future.
     
    Critter Mom likes this.
  66. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    I used target's generic fluoxetine for my Thunder with no problems.
     
    Critter Mom likes this.
  67. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
  68. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I've not come across those, Rob. How do they work?
    .
     
  69. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    LOL!!!
     
  70. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Ditto. It's like having a tyrant living in your head. :(

    :bighug::bighug::bighug:
     
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  71. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    An extremely oppressive and agitated tyrant!
     
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  72. MarcieK

    MarcieK New Member

    Joined:
    Jul 29, 2015
    Rob, give the new script a few weeks to see if it works. I had to go through 3 different medication before I found one that stop Pedro's inappropriate urinations. Valium is the drug of choice for my buddy and all spraying has stopped. I also give 0.20 ml of Rescue Remedy for pets once daily. I feel your pain as we have worked down the same path and had many of the same conversations with my husband regarding Pedro's fate. I went to Sam's and purchased their large incontinence pads and simply covered everything in my office. If Pedro sprayed urine on one I simply tossed it in the trash and replaced it with a new one. Keep us posted.
     
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  73. robr

    robr Member

    Joined:
    Mar 22, 2014
    I'll let you know when I get it in about 5 days. The woman described it as setting it to a dose, twisting something and the medicine in gel form comes out of the tip and that gets applied to the ear. She told me to read the very thorough instructions for more info when it arrives.

    Warren is sitting in my lap at my desk as I type this and says hello and thank you to everyone because he's still alive and breathing. At least that's what he'd be saying if he could talk.
     
  74. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    I know I reacted very badly to Prozac, rash all over my upper body and unable to sleep.
     
  75. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Warren! :D I'm sending a special Good Luck kitty just for you along with lots of wishes for your new medicine to make you feel better.

    [​IMG]
     
    Jeanne likes this.
  76. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    When my Pdoc upped my dose to 60mg per day I got a really bad rash on my back just below the base of my neck. I got really jittery on it, too.
     
  77. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    Sounds like me on every painkiller known to man. Every person/cat is different with this crazy pharmacrap.
     
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  78. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Rob,

    How are you and Warren doing today? Well, I hope. :)

    Here is a thread that I think you should read:

    Diabetic Neuropathy and B12 Methylcobalamin thread

    From reading the above, it might be an idea to consider methylcobalamin B12 supplementation on a regular basis as the consensus seems to be that it is a better form of B12 than cyanocobalamin. I don't know whether your vet can give methylcobalamin injections instead of cyanocobalamin? Bearing in mind that time is of the essence it might be worth enquiring because B12 injections are a more efficient way of boosting levels because they circumvent any GI B12 absorption difficulties Warren might have.



    Mogs
    .
     
    Last edited: Aug 8, 2015
  79. robr

    robr Member

    Joined:
    Mar 22, 2014
    Don't want to jinx anything, but today is day 5 with great numbers. Pmps last night was 66, amps was 67. Unheard of. No litter box accidents in 48 hours. Fingers are crossed.
     
  80. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

    Joined:
    May 9, 2015
    Go Warren! And Rob you are doing a great job!
     
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  81. Tucker&Me

    Tucker&Me Member

    Joined:
    Jun 24, 2015
    I really want to try to get at least one of these in my household. Not as expensive as one would expect!
     
  82. Tucker&Me

    Tucker&Me Member

    Joined:
    Jun 24, 2015
    Hurrah!! Prayers are being answered!! All your POSITIVE efforts are paying off!!!
    OMG. This is making my day Rob.
    Go Warren. You can do it.You can do it.You can do it.:)
     
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  83. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014

    That's really promising, Rob!

    I saw the PMPS last night and saw you'd administered the insulin. You've definitely qualified for the Cojones of Steel award. :eek: :nailbiting: ;)

    Now that you're down to "shoot low to stay low" territory, I think you really need to post daily in the LL support forum simply because there will be more traffic there to help you with monitoring and to give you support should Warren dip too low.

    FOR WARREN'S SAFETY: It is VITAL that you get at least a +2 BG test to see where the cycle is possibly taking Warren, especially at night.

    Also, I'm sure you've already got this forum sticky but just to be on the safe side heres the TR group's guide to Shooting and Handling Low Numbers (helps to really familiarise yourself with it in a quiet time, not in the middle of a low; much calmer! ;) ).

    Another thought. From your other thread I see your little girl is quite the fishing expert! :) I'm glad that Warren enjoyed his treat but ... don't vary his diet at the moment.

    Different foodstuffs can spike a cat's blood glucose levels. For example, that unexpected 'bounce' after Warren's yummy fishy supper may possibly have also been influenced by the fish. (You can determine which foods spike a cat's blood glucose levels by testing before and after a meal of the food being studied, but that's for the future. In the normal run of things such wobbles are chalked down to experience and the caregiver works to get past the hiccup - no pressure. However in your critical situation you don't have that luxury at the moment. I strongly recommend that you keep everything as static as possible: food, feeding schedule, other routines. Particularly I can't recommend strongly enough that you feed Warren exclusively on the food variety that he has been eating while he has been getting these really good numbers. You need to minimize the risk of anything upsetting this good - and oh so critical - period of tight regulation.

    Stay on that lawn and picnic like a mad thing, Warren! :)


    Mogs
    .

    EDITED TO ADD:

    A caveat. My earlier comments about sticking to the one food for Warren at the moment only applies when Warren is in safe numbers on a normal cycle with no risk of hypo. Obviously if Warren were to go a bit low, you will need to feed what he needs to steer his numbers properly (his regular low carb, medium carb gravy, honey/karo - whichever is needed to get his numbers back into a safe range - as indicated in the 'Shooting and Handling Low Numbers guide.)
    .
     
    Last edited: Aug 8, 2015
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  84. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Rob,

    When you set up new threads on the LL support group, I'd appreciate it if you could tag me somewhere in a post so I can follow how Warren's doing. I can't cope with searching the board for threads; it's too busy and it overwhelms me.
     
  85. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You can follow him, Mogs. Click on his user icon and select "follow" to set that. You'll get notified every time he posts.
     
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  86. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @BJM

    Done.

    Thanks for the great tip, BJ. :)
     
    Tucker&Me likes this.
  87. Pretty Foots

    Pretty Foots New Member

    Joined:
    Jul 29, 2015
    Please read my post on Pretty Foots he is 15 years old. If you love your cat then do speak up for him. How we treat our animals is an indication of how compassionate we will be with our human relatives. Your wife should love that you are compassionate and will be there for her in the same loving way.
     
  88. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Pretty Foots - That is a very wise and insightful observation.

    @robr - Pretty Foots is right: your family are truly blessed to have somebody as deeply compassionate and dedicated as you to love and care for them. :)
    .
     
  89. robr

    robr Member

    Joined:
    Mar 22, 2014
    Hi all, somehow I missed all the posts over the weekend, I usually get an email when somebody replies but must have missed them. Thank you again for all the additional info, there's a few new things here to digest. I will also add a +2 each night to Warren's PMPs. Once I do start a new thread in the Lantus forum I will update here. I'm not entirely sure I have anything to ask there right now though. Thanks for all who are following Warren's journey through these tough times and sticking around to help. Can't tell you how much it's appreciated to get some support here. It's mentally exhausting sometimes and before this forum, I felt like I was going it alone.
     
  90. Mitzelplik's Mom

    Mitzelplik's Mom Member

    Joined:
    Jan 24, 2015
    Very happy to see some positive news about Warren!!!

    I agree with @Critter Mom that it is super critical to monitor Warren when you're shooting on such a low number like 66 or 67 to make sure he stays out of hypo territory. Folks on the Lantus page can definitely help you there too. You are definitely not in this alone :).
     
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  91. pevsfreedom

    pevsfreedom Well-Known Member

    Joined:
    Jan 16, 2015
    This is great to hear he's doing better for now. I hope it continues. Is this with the Prozac?
     
  92. robr

    robr Member

    Joined:
    Mar 22, 2014
    No, I haven't received the Prozac yet. I had a discussion last night with my wife about whether or not we should use it given that he hasn't had any accidents in several days now. I want her to help make decisions so I'm not the only one invested in this. She is of the opinion that his litterbox habits have been unpredictable and it's likely stress related in one way or another and given the 2-3 weeks prozac will take, she thinks I should start him on it anyway.
     
  93. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    It sounds like things have calmed down a bit for you all, Rob. I'm really glad. It will help Warren, too.

    I had another thought. If you do see Warren using his litter box, once he has finished give him lots of gentle, warm, praise and one of his favourite diabetic-friendly treats. It may help to make toileting in the right place a very positive experience indeed. It may also help reassure him in general and reduce any anxiety he may have about using the litter box.

    Now that you're working with much lower numbers make sure you've always got lots of test strips at home. :)


    Mogs
    .
     
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  94. robr

    robr Member

    Joined:
    Mar 22, 2014
    Has anybody heard of probiotics causing bathroom accidents?

    Shortly after I started Warren on probiotics, his peeing outside the box started happening more frequently than ever. But it was also a period where he was struggling with his glucose numbers. Still, I took him off the probiotics at just about the time his numbers were getting good. After 9 days of good numbers and no accidents, I tried the probiotic again tonight and I caught him in the act of peeing on our shoes only 2 hours later. It could be coincidence of course. His brother Brak (whom my friend adopted from us about 6 years back) loves the probiotics and does well on them (Brak also has diabetes and pancreatitis in addition). Also I started Warren on prozac 3 days ago. No noticeable changes in his behavior yet that I can tell ... but his behavior has been perfect the past 9 days. He has definitely seemed like a younger cat. I saw him jumping in the air to catch a moth yesterday and he's more 'lappy' than he has been.
     
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  95. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    That's a new one for me Rob, but I guess anything is possible with these sugarcats of ours!

    It's great that he went 9 days without any accidents too!! I bet your wife is happy with that! (at least I'd hope she was!)

    Did you pick up all the rubber backed rugs? Just wondering if you had done that and maybe it helped with his peeing problem...may just need to buy a shoe tree or a big plastic tub or something and keep those shoes off the floor where he can get to them
     
  96. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Rob,

    Big improvement in Warren's regulation, I see! It's great to read about how much better he's feeling and that he has more energy and joie de vivre; after all, that's what this sugar dance is all about. :)

    I'm sorry to hear he had a mishap, but 9 days without one is great news. Did the shoes have any rubber components, perchance?

    If discontinuing the probiotic coincided with improved toileting and its reintroduction correlated with another 'accident', I'd be inclined to stop giving that probiotic to see if his toileting habits improve again. If the unwanted behaviour stops, I'd be very inclined not to give it again and maybe try another type of probiotic in the future.


    Mogs
    .
     
  97. robr

    robr Member

    Joined:
    Mar 22, 2014
    No more incidents since the 1 attempt at the probiotic again. He got his second B-12 shot today. My wife didn't agree that the rubber backed rugs were any sort of culprit, to me he seemed to favor them more, but my wife didn't think so. We did remove the large room sized kitchen rug so now it's just hardwood floor and one small (rubber backed) rug in the kitchen which is his favorite accident area. We just all try to remember to put our shoes in the shoe thingy that hangs on the back of the bathroom door that nobody ever uses :).

    All in all it's been pretty quiet around here of late which is a good thing. I just ordered some no carb treats for Warren. The litterbox is in my home office so when I see him use it, I'll give him a treat.
     
  98. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Don't forget the praise! Lots 'n' lots of fusses 'n' praise! :)

    Glad to hear that there haven't been any mishaps since withholding the probiotic. It will be interesting to see if the better toileting continues. If after a while you then try the probiotic again and Warren has a mishap again, then you'd get some bit of confirmation that something in the probiotic is a trigger. Interesting.

    Please give Warren some scritches from me. I have a real soft spot for him. He could be Saoirse's fraternal twin. :)

    I'm really glad for all of you that things are calmer now. Long may they stay that way. :) (Anti-jinx, anti-jinx!)



    Mogs
    .
     
  99. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    Warren's peeing in your shoes makes me grin....KT always peed in shoes regardless of whether he felt good, felt bad or just felt onery. All shoes in our house were always standing on their toes against something. Altho he's been gone a year today, our shoes still stand in the 'KT salute'.

    KTSalute.jpg

    Sure hope Warren keeps doing better!

    HUGS!
     
  100. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    :(

    :bighug: (Lyresa and Spirit KT) :bighug:
    .
     
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