Insulin Resistant Cat - Not sure what to do

[marbear56]

My cat Finn is about 10 years old - he is a snuggly ball of sunshine.

Over the last year Finn started to pee on everything - couches, outside the litterbox, beds, doorframes - etc. We did some heavy cleaning bought more boxes and had him evaluated and he came back as diabetic - (making all of the drinking and peeing make sense). We had a baby last year, and couldnt have pee everywhere - so we moved him into what was our nursery for our daughter, emptied it of furntiture except cat trees, cat beds, and litter boxes and installed screen door for ventilation and socialization while we tried to get the diabetes under control.

Now months later, Finn is on insulin (up to 7 units) and shows no signs of his blood sugar coming down. It's maxed out on the wearable devices, and hes been on glucose support food and water, with no treats, and 2 doses of insulin a day with no end in sight to the pee and distress.

Emotionally he's as lovey as ever and adores us and the baby when we visit- but physically he's lost weight, is super sick with high blood sugar, and ever thirsty.

I'm frustrated as we have tried 2 vets now, and the outlook doesnt seem realistic or good (they think it might be a pituitary issue which would mean BRAIN SURGERY??!!), but putting him down seems cruel as he's still a happy snuggly boy.

Then again -I know he IS deterorating, AND living everyday somewhat isolated from the family and mostly in pee (despite me cleaning constantly the pee is never ending with 3 litterboxes and pee pads all over the room).

What should we do? I dont want to put him down, but I dont see any way this will improve, and cant let him out in the house with pee and the baby, but also dont want to see him suffer and spend his last days trapped in pee.

I would almost opt to have him be outdoors, but my neighborhood DOES have predators (foxes,hawks, owls) and while he's a big cat, I feel like that would be a hugely stressful change.

To make matters harder - he's also a bonded pair with his littermate, who he cant spend time with. The two sit on either side of Finn's screened door - but when I let his brother in to be with him, its just stressful for them both to be in pee.

Thoughts? Comments? Hope?

 

[lucyrima]

For the record - did the vet(s) explain about pit. surgery, what happens, how? Lots (relatively) of people get it as the pit's just behind the nose/forehead and very small. Surgery (in people anyhow) is often done up through the nose and is usually fairly fast - it's not like "BRAIN" surgery where they cut off half the skull and take out big chunks of flesh, etc. Maybe look at it further.

 

[marbear56]

For the record - did the vet(s) explain about pit. surgery, what happens, how? Lots (relatively) of people get it as the pit's just behind the nose/forehead and very small. Surgery (in people anyhow) is often done up through the nose and is usually fairly fast - it's not like "BRAIN" surgery where they cut off half the skull and take out big chunks of flesh, etc. Maybe look at it further.

yes they did - they said the only vet they knew of to do the surgery was in NY (we are in MD) and the only case they had success with the patient died shortly after due to infection/complications.

Do you have more information on cat pituitary surgery?

 

[lucyrima]

No, unfortunately, only for people (worked for neurosurgeons in the past).

 

[fionasmom]

I have had two diabetic cats, neither in the state that Finn has reached though. The last did become incontinent in the house but learned to sit, for the most part, on a throw on the floor which was covered with a pee pad. She even learned to move from it when it was wet, although she was often damp herself. I did bathe her, but never diapered her although that is an option depending. I do understand the condition that Finn has reached, but I would not put him outside. He is thirsty and thin and does not feel well; he may not be able to survive. You did not mention neuropathy, but my last cat developed mild neuropathy which would have affected her walking, running, and escaping outside.

I had an outdoor TNRed feral a few years ago who probably became diabetic, but was wild and untrappable. Another reason I would not let a diabetic cat outdoors.

You have said that you have been to a couple of vets; sadly, they may be correct in their diagnosis. Do you have any chance of consulting with a teaching hospital, specialty referral center with an endocrinologist, or doing any of those things remotely? There must be veterinary endocrinologists in NYC and it might not mean actually going there.

 

[marbear56]

When free roaming in the house he did target specific spots which we covered - but its too much with the baby (just turned 1) now mobile to have cat pee everywhere. In his room he's gotten worse peeing both in and out of the litter box and on a chair - we've tried puppy pads both disposable and washable but its been an impossible task to keep up.

We bought diapers, but both my husband and I work during the day outside of the home - and i feel like it would be cruel/unsanitary to have him have a wet diaper on for hours.

We could try asking the vet for their contact information - but both vets have said that they are running out of options for him given the multiple brands/types of insulin arent working. We started off with the more expensive kind off the bat, with no luck, and increasing the dosage (started at 3, now at 7) just doesnt seem to make a dent.

Its heartbreaking because he's still young - and while he has lost weight and does seem somewhat shaky on his back legs, he acts completely lovey/normal (maybe even moreso because he's isolated so pet/attention time is huge), but I'm stuck with feeling like there's no good solution here.

I dont want to make terrible decisions, but I dont want him to live the rest of his life trapped in a small bedroom full of pee. He's anxious to begin with so outdoors seems too high a risk to try - but I just dont think there is a solution that would enable him to be out in the house safely while still having it be livable for us, our daughter and our other cats. (Note that his pee made the other cats miserable as well - he peed on prime couch spots, and stunk up multiple rooms - they have been much happier since he's been in his own bedroom, although I do think his littermate misses him)

 

[fionasmom]

You are right that diapers won't work if he is alone all day and peeing as much as he is. Only one possibility with that is to put a skin protectant on him that is cat safe in case he is able to get to it and lick it, and then put the diaper on. Biggest danger is diaper rash which will add a whole layer of stress to all of you. If he is peeing so copiously that the diaper will fall off, that is another consideration. I did leave a GSD who was entirely incontinent, although not diabetic, alone all day when I went to work. He wore a belly band with a liner and skin lubricant and it was successful; however, belly bands don't work on cats.

Given shakiness in his back legs, I would absolutely not consider letting him out.

I absolutely get your point about the pee covered house and the baby and other cat. There is no "best of both worlds" solution to this and I would continue to keep him in his room, which sounds as well set up as it could be, while you continue to evaluate where this might be headed.

While I don't think that this will solve your problems, there is a well known Feline Diabetes group.
Feline Diabetes Message Board - FDMB
They may have suggestions, even for management of a cat like Finn.

 

[SwissMiss]

This is probably something that has been addressed already but just on the outside chance - are you feeding Finn a high protein low carbohydrate food? Wet foods that fit that category are best, better than dry kibble. I had a cat that had inflammatory bowel disease and then developed diabetes after being given prednisolone. He was on 3 medicines after awhile for the IBD and glargine insulin shots twice a day for his diabetes. He was urinating a lot and often right in FRONT of the litter box on a puppy pad. His blood sugar levels were all over the place. It was 3 1/2 years of heart break. I hope you have a happier outcome with your sweet Finn. Maybe like another poster mentioned a teaching hospital or a veterinary endocrinologist. My heart goes out to you.

 

[marbear56]

This is probably something that has been addressed already but just on the outside chance - are you feeding Finn a high protein low carbohydrate food? Wet foods that fit that category are best, better than dry kibble. I had a cat that had inflammatory bowel disease and then developed diabetes after being given prednisolone. He was on 3 medicines after awhile for the IBD and glargine insulin shots twice a day for his diabetes. He was urinating a lot and often right in FRONT of the litter box on a puppy pad. His blood sugar levels were all over the place. It was 3 1/2 years of heart break. I hope you have a happier outcome with your sweet Finn. Maybe like another poster mentioned a teaching hospital or a veterinary endocrinologist. My heart goes out to you.

Thank you so much - yes food was our first fix, which has been easier to give and monitor with him in the room. We do high protein low carb. Initially we debated switching to meats as suggested by his vet but he didnt like it so its a combo of wet/dry now all special for insulin resistance

 

[marbear56]

You are right that diapers won't work if he is alone all day and peeing as much as he is. Only one possibility with that is to put a skin protectant on him that is cat safe in case he is able to get to it and lick it, and then put the diaper on. Biggest danger is diaper rash which will add a whole layer of stress to all of you. If he is peeing so copiously that the diaper will fall off, that is another consideration. I did leave a GSD who was entirely incontinent, although not diabetic, alone all day when I went to work. He wore a belly band with a liner and skin lubricant and it was successful; however, belly bands don't work on cats.

Given shakiness in his back legs, I would absolutely not consider letting him out.

I absolutely get your point about the pee covered house and the baby and other cat. There is no "best of both worlds" solution to this and I would continue to keep him in his room, which sounds as well set up as it could be, while you continue to evaluate where this might be headed.

While I don't think that this will solve your problems, there is a well known Feline Diabetes group.
Feline Diabetes Message Board - FDMB
They may have suggestions, even for management of a cat like Finn.

Thank you - we're trying to keep him there as long as we can so long as the quality of life remains high - my reason for posting is moreso because i think its starting to be a detriment - he's peeing more than i can keep up with and despite 2 hepa filters, the screen door and an open window - the scent of cat pee is overwhelming (especially since his diabetes isnt under control, so its very strong). We're using enzyme cleaner constantly, but its been hard to keep up.

I'll give them a look! Thank you so much

 

[Geul]

I'm sorry all of you are going through this. It is hard. We also have a cat with diabetes, but fortunately, her insulin medication works well for her (we buy Vetsulin online).
What about your cat's weight? Does he need to lose weight? I'm not a vet, but I read that obese diabetic cats should be fed a diet that promotes a 1-2% loss of body weight per week. This slow, regulated weight reduction improves insulin sensitivity. Did the vet recommend a special diet? While some types of dry food can be suitable for diabetic cats, many brands are high in carbohydrates and can cause blood sugar spikes.

 

[silent meowlook]

How is Finn doing? What kind of insulin is he on? Has an infection somewhere in his body been ruled out? Have you done a fruitosamine test to get the average blood sugar level over the last 2 weeks? It can be beneficial in case he is spiking and dropping and spiking. Have they double checked how you give the insulin? Is the continuous monitor the only way you are checking him or do you also have a glucometer? When was the last full blood panel done?