New member, first post (it’s a long one!)

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Benny’s mom, Sep 13, 2020.

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  1. Benny’s mom

    Benny’s mom New Member

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    May 23, 2020
    HI! I’m Terri, and my sweet boy Benny was diagnosed with FD on 5/23. I’ve been lurking for a while, trying to read everything I can in order to gain as much understanding as possible about this disease and how best to manage it. I am blown away not only by the information, but by the commitment and compassion of the members of this board. I have never joined or posted in a forum before, but this feels like the right place and time to start!

    Benny is 10 years old, 15.5 lbs and is the sweetest natured kitty ever. His health issues began in July of 2017, when he was diagnosed with clostridium overgrowth and placed on Metronidazole long term. In Feb 2018, he was prescribed Denamarin for elevated liver enzymes. A month later he was referred to an IM vet due to persistently elevated liver enzymes, inappetence and lethargy. Ultrasound showed mildly thickened intestines (IBD) and liver irregularity. Pancreas was ok. Budesonide started. Liver enzymes bobbled around for a bit, then skyrocketed in Aug 2018. IM vet recommended biopsy to determine whether we were dealing with infection, inflammation or cancer. Turned out to be inflammation (cholangitis). Budesonide discontinued, Prednisolone and Ursodiol started (in addition to Metronidazole and Denamarin). By October of 2018 he was finally stabilized and remains on this regimen to this day. After a bout of pancreatitis in October of 2019, he is now officially a Triaditis kitty. In addition, he has had occasional episodes of FLUTD/struvite crystals, which we have dealt with by adding a urinary acidifier, cornsilk extract and d-mannose powder to his food as needed.

    So...I was not entirely surprised by the FD diagnosis due to his long term and relatively high dose of Pred (7.5mg per day at the time of FD Dx). Previous attempts at reduction always resulted in an elevation of his liver enzymes. So I just accepted the fact that that’s what his body needed to keep the inflammation down. But as his insulin needs increased (I know I’m getting ahead of myself here), I was determined to try and SLOWLY reduce the Pred, to see if we could get a better response to the insulin without an uptick in his liver enzymes. He’s now down to 5mg per day. I hope we can eventually reduce it further...

    I really like and have a good relationship with my vet, and had put my trust in him as he himself had a diabetic cat for 8 years. However, he does not recommend home testing, says he never tested his own cat (!!) and that none of his patients test theirs. He said to just monitor clinical signs and bring Benny back for a glucose curve after a week or two. A friend had a diabetic pup that passed last year. She had an extra AlphaTrak meter, lancets and test strips which she gave me. I didn’t think it would “hurt” to get a little more info, so I cautiously began testing, with spot checks here and there. When I look at Benny’s spreadsheet I cringe, so many lost opportunities to gather data early on. All I can say is, I was still trying to follow my vet’s advice (he did say I could do curves at home, and the occasional spot check if Benny seemed off), and honestly, I was reluctant to accept the idea that managing diabetes would require multiple daily tests so I had motivation to accept his advice...it would have been so much easier if he were right! Well now I know better...

    Benny started at 1U Lantus 2x per day, and is currently at 5.5U. The how and why (and mistakes made along the way) will be evident from his spreadsheet. Although his numbers still aren’t great, he was starting to do better...until a few days ago due to yet another panc flareup which we are treating with fluids, Pepcid, Cerenia and Buprenorphine. He’s eating, has not lost weight, pee clumps are still larger than normal but only two per day, and he’s not hovering over his water dish. He’s not walking on his hocks but doesn’t move around as much as he used to. The vet suggested that might be due to neuropathy, so I also started him on Zobaline. Diet is low carb wet (Ziwipeak, Merrick’s, FF), Savage raw and Ziwipeak air dried raw in bone broth. Benny and his sister Lola previously LOVED their Instinct Ultimate Protein kibble but at diagnosis I switched to Dr. Elsey’s, just 1/16 cup, supplementing wet PM meals until 8/17 when I eliminated it entirely in order to determine if that might have been a contributing factor in keeping him in higher numbers. It does appear that it might have had an impact (along with a simultaneous increase to his current 5.5 U) as that’s about the time we finally started seeing blue numbers! That said, I’m pretty sure he’s going to need a dose increase, was going to run a curve but wasn’t sure if it made sense to do so during a panc flareup...advice would be greatly appreciated!

    Well that was a novel! Thanks for reading, I welcome all input and look forward to being able to do better for my boy with the help and support of this amazing community!

    Terri and Benny
     
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  2. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Welcome. Glad you started posting.

    Tagging @Wendy&Neko for you. She has experience with high doses and IBD.
     
  3. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome closet FDMB'r ;)
    You HAVE found a safe place to land. We will do everything we can to make this a loving and caring place for you and Benny who is adorable btw ohhh that little face! I wanna smoosh him.
    As you already know we ARE a community dedicated to helping any and all that find us and we will help you and Benny too. So glad you have mastered your signature and spreadsheet. WELL DONE!

    I am taken aback at your vets approach to feline diabetes. Testing is the ONLY way to keep Benny safe. I cant count how many have found that out the hard way sigh Well hopefully we can convince your vet otherwise
    WELCOME TO OUR FAMILY:bighug:
    jeanne
     
  4. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

    Joined:
    Dec 21, 2019
    I just want to say welcome Terri and Benny!! :bighug::bighug::bighug:

    I think a lot of us relate and have been there listening to our vet and wasting precious months. All you can do it look forward. I’m happy you’re home testing, has him on low carb food and are also giving zobaline for the neuropathy. I can’t speak much for his other issues, but I can say that the neuropathy is reversible and as his diabetes gets regulated, his nerves will regenerate. Minnie is on a different b12 methyl brand from Vitacost that a lot of us here use as well. It’s more affordable and it comes in capsules which makes it easier for me to mix with her food.

    Minnie does have IBD as well and is on budesonide for that right now. She’s on a pretty high dose too because of 2 hospitalizations for pneumonia and cardiomyopathy. Hang in there, and omg he’s such a cutie I just want to squeeze him!!!!!

    Welcome again!!!
     
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  5. Benny’s mom

    Benny’s mom New Member

    Joined:
    May 23, 2020
    Thank you so much!!
     
  6. Benny’s mom

    Benny’s mom New Member

    Joined:
    May 23, 2020
    Oooh, thank you so much for the warm welcome!! He is pretty smooshable ;) So grateful to have found this community!
     
  7. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    hang on for more replies. ;):bighug:
     
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  8. Benny’s mom

    Benny’s mom New Member

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    May 23, 2020
    Thank you for the warm welcome, and info on Vitacost! I will check it out. Such a challenge managing multiple conditions, grateful that others have the experience and understand! It’s great that Minnie is doing well on budesonide...and thank you! He is a cutie, with a personality to match. What a wonderful community this is, so happy to be here!
     
  9. Benny’s mom

    Benny’s mom New Member

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    May 23, 2020
    Minnie is beautiful! Love our white and tabby babies...and I see you are also in L.A.! Hello neighbor!
     
  10. LittleBo

    LittleBo Member

    Joined:
    Aug 30, 2020
    Oooh another triaditis kitty! Mine started with that last July and we've only just got normal liver enzymes. Currently trying to reduce her steroid dose, she's gone from 5mg to 2.5mg a day, keeping everything crossed her liver copes as my vet would like to get her off before going in with insulin.

    Welcome, this place is great!!
     
  11. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welcome - it definitely is a challenge dealing with multiple conditions.
    OK, a couple things wrong with what you said. First, IBD cannot be diagnosed by ultrasound alone, you need either an endoscopy (depending where the inflammation is) or a surgical biopsy to figure out whether out whether it's IBD or small cell lymphoma. And prednisolone or budesonide reduces inflammation (a good thing), but you don't want the cat to be on it either before a biopsy as it can hide the problem.
    I might get the vet to check for arthritis, unfortunately often seen in our older cats. Pain, as well as inflammation from pancreatitis, can increase blood sugar numbers. Might not be the best time for a curve. Though I agree he probably needs an increase. A cat needs however much insulin they need. A cat on prednisolone will need more. There are also some secondary conditions that mean cats might need a higher dose, my girl had two of them (acromegaly and insulin auto antibodies) which was why she was on a higher dose. When I added budesonide into her mix, it did not impact her blood sugars. I am really glad you are home testing - it's even more important for the higher doses.

    I also had a FLUTD kitty - low carb, low phosphorus wet food with water added really helped. I was actually feeding raw. As did some Feliway diffusers, stress caused break outs. And he got Cosequin, glucosamine can help the bladder wall. Later on he was on prednisolone, so I tested his blood sugars (because I can :)) and it only bumped his numbers up about 30 points and he wasn't diabetic.
     
  12. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

    Joined:
    Dec 21, 2019
    Right?? I’m very partial to our white and tabby babies and also black kitties as Minnie’s brother is a black beauty :D

    yes, I’m in LA too and just breathing these days around here has been a challenge :nailbiting:
     
  13. Benny’s mom

    Benny’s mom New Member

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    May 23, 2020
    Oh, congrats on the normal liver enzymes, I know what a relief that is! And on the dose reduction, that’s great! Triaditis can be so challenging but sounds like things are moving in the right direction...and hopefully the diabetes will follow suit! I’ll be keeping fingers crossed for you guys too...on both fronts :)
     
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  14. Benny’s mom

    Benny’s mom New Member

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    May 23, 2020
    Thank you, Wendy! Re: the IBD diagnosis, yes, you are absolutely right! The IM vet saw only mildly thickened intestines on ultrasound, called it “presumed mild IBD”...and recommended treating with Budesonide. Truthfully, IBD was never the worst of it for Ben...no vomiting, and the Metro controlled the alternating bouts of constipation and diarrhea that started the whole darn thing...but sadly didn’t begin to address the liver inflammation which did turn out to be the worst of it. Liver biopsy was positive for neutrophilic cholangitis/cholangiohepatitis, which the Bude wasn’t helping, hence the switch to Pred.

    And thank you for the suggestion to have the vet check for arthritis, I had not considered that! And I know exactly what you mean about stress causing FLUTD breakouts, same here. We’ve used Feliway diffusers as well. Fortunately Benny likes his raw food (Lola not so much). Will look into the Cosequin as well. Interestingly, since his FD diagnosis he’s not had a single episode! He’s less stressed now that I’m home more (thank you, Covid?)...

    The vet did mention that the higher dose of pred that he is on would likely mean Benny would require a higher dose of insulin. But I’ve also read up a little on the secondary conditions you mentioned, and can’t rule anything out at this point...

    He was a bit better today so hopefully he’s on the upswing and I’ll be able to run a curve on him in the next day or two. I hate seeing him so high :/

    Thanks again for the warm welcome, so grateful to be here!
     
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  15. Benny’s mom

    Benny’s mom New Member

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    May 23, 2020
    Black kitties are so special! Are they litter mates? Benny has a sister, Lola, who is a long hair calico beauty :)

    And ain’t it the truth? Challenging indeed :nailbiting:
     
  16. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    I really don't get the vets approach on diabetes. You can't find a human diabetic who's willing to inject themselves with insulin and NOT do a test before.
    Then why the **** should we do it to our cats?!
    Let's face it, a human has language and can help themselves if they feel off for some reason, a cat is 100000% dependent on us as their owners to react if something happens. Why should we go in the blind?
    Would any human doctor recommend not to test an infant with diabetes? Like he** no!!!?!
    Its so stupid. Stunningly stupid :banghead::banghead::banghead:
    I'm angry about the lack of logic, I really am. Insulin is a dangerous drug, even for humans.

    Sorry, rant is over. :nailbiting::blackeye:
     
  17. Benny’s mom

    Benny’s mom New Member

    Joined:
    May 23, 2020
    I know, it seems so shockingly obvious to me now. I was just told to inject insulin twice a day and check urine output, water consumption, mood, etc. Wasn’t even warned about the dangers of hypoglycemia. I guess I should be thankful for the fact that Benny ended being a kitty who needed a higher dose, as I am sure there are those for whom even 1U of insulin might prove to be too much! We dodged a bullet...while blindfolded. It makes me very sad, as I truly like my vet. He has been great about so many other things. And I figured if he kept his own cat alive and on insulin for 8 years without home testing, I could trust him on this as well. It was a very hard realization for me that my beloved vet was in fact very, very wrong about something that had the potential to kill my cat. He has now accepted the fact that I am testing, without specifically advocating for it. But am hoping to persuade him about the utter necessity of it, for the benefit of all his patients!
     
  18. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    BRAVO!
     
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  19. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Also keep in mind that many caregivers don't want the "bother" of home testing. A lot don't even want to do shots. Although my vet didn't mention home testing (a locum vet did), she was thrilled when I said I wanted to treat. And very happy to see my data when I got it - I was the first client to home test. It's a balance for vets, without knowing who will go the extra mile like most of us here. You don't want to push clients into the "not treat" category either.
     
  20. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

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    Dec 21, 2019
    They absolutely are! I found them both in a shoe box at the beach when they were tiny babies. I brought them back from Brazil with me. Total foster fail :D
     
  21. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    Hope you didn't take my rant personally. And also I ment vets in general, not only yours.

    Wendy might be right! I was told this is a difficult disease, it would be hard as nothing else, and many gave up beforehand.

    I really don't get why vets have that attitude. Maybe they think it stresses the cats? Maybe they have no experience with diabetes?
    It would be fun to find a vet who had diabetes himself, and ask what se recommends.
     
  22. Benny’s mom

    Benny’s mom New Member

    Joined:
    May 23, 2020
    I get that. I know for us, just the diagnosis and thought of giving twice daily injections was initially overwhelming, and we’d been giving Benny meds twice daily for years! It’s a lot to take in. It’s great that your vet, even though she had not initially suggested it, was receptive to the idea of home testing...and amazing that you were her first client to do so!
     
  23. Benny’s mom

    Benny’s mom New Member

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    Oooh, Brazilian rescues! My daughter has two foster fails, and her fiancé a black kitty he found as a tiny kitten on the street in Argentina and brought back with him! Lucky babies, all!
     
  24. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    We were a lot of firsts. First to home test and have a spreadsheet to look at, first cat diagnosed with acromegaly and insulin auto antibodies, first to get stereotactic radiation therapy, first on Lantus, then first on Levemir....
     
  25. Benny’s mom

    Benny’s mom New Member

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    May 23, 2020
    Didn’t take it that way at all! It’s frustrating...but I agree that Wendy brings up a good point. I’m sure most vets don’t want to discourage their clients from treating their diabetic pets by making it sound too overwhelming or challenging. And we want to be able to rely on our vets, but ultimately we are the ones who have to advocate for our kitties, educate ourselves and hope our vet supports us...or find one who will. That WOULD be interesting though, to find a diabetic vet...wouldn’t it?!
     
  26. Benny’s mom

    Benny’s mom New Member

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    Wow, that’s amazing....and the fact that so many others here can benefit from your pioneering is a gift to us all! Neko was a beauty btw!
     
  27. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    It really would! As someone who's tried it on their own body. And if they also recommend not testing, would be quite interesting!

    I've even wished I was a diabetic myself. Its so hard not knowing how it feels!
     
  28. Benny’s mom

    Benny’s mom New Member

    Joined:
    May 23, 2020
    @Wendy&Neko
    Wendy, when you have a chance, can you take a peek at Benny’s SS? He had a big drop yesterday. The panc flareup seems to have subsided (they are coming more frequently but not lasting as long; we’re treating aggressively at the very first sign) but also it was his 5th dose on a new vial of Lantus...wondering if that might not have had something to do with it? I had planned on doing a curve but I think yesterday’s numbers indicate I should hold the dose anyway, is this correct? He’s back up in solid pinks again today :/
     
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  29. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Yes, with you following SLGS and him seeing that 92 yesterday, you do hold the dose for a while longer.
     
  30. Benny’s mom

    Benny’s mom New Member

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    May 23, 2020
    Ok, will do! Thank you :)
     
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