questionsshould my quality of life affect the decision to…

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Just in case he's handy, I'm hoping that @nortonsark is around to give an educated opinion.

My own is this:

Animals do not speak or understand English (notwithstanding the occasional dog that knows multiple words). When they're suffering, there's no explaining to them that adding to their suffering is for the best. They just know that they're suffering, and that you're hurting them more. Each person has to make this decision on their own. I think you know what I'd choose.

I'm very sad for you to be faced with this decision.

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I'm going to set your personal quality of life aside and say that it sounds like your cat has almost no quality of life. As @shrdlu said, you're not going to convince your cat that a little more suffering could help. It would be miserable while you tried to get it to a better state of health. The cat will never let you take it's blood, I doubt it will ever just accept the new food and instead resort to eating the bare minimum it needs.

I don't think it's cruel to reach a monetary limit on the help you can give to an animal. I'm sure you care for it, it's probably an important member of the family. However, breaking the bank and neglecting your own health to keep an animal alive that is constantly suffering because you feel bad about secondary reasons is not the way to go.

I'd have a different opinion if there was something you could do to end this animals pain and return it (and yourself) to an enjoyable life together. That just doesn't seem to be the case.

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@nmchapma: The trouble is, he CAN be helped. Diabetes can be turned around. But I just don't seem to have the resolve or the time to do it. I have to work; I can't stay home watching him for hypoglycemia or testing his blood every two hours. (I have been able to get some blood, but he's squirmy and I'm squeamish.)

So it's not, this cat can't be helped. IT's this cat can't be helped by ME. I go on the feline diabetes message boards and people are doing this. Their cats are getting better. So there's a lot of guilt that if I was a stronger person, if I had more time and more money, I could definitely help him.

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@curli76: I guess I need a better definition of what "getting better" is. Improved but still in pain is still suffering. How much longer will the animal live? Is it going to be worse for you, your cat, and your family to go through this suffering for months or years longer before you decide to throw in the towel?

Or is this something you could do for a few months and the cat would be cured? IANAV so I don't know how serious it really is. If that's the case then get up and do it! If the problem is your motivation maybe you should think twice before getting another pet.

As far as money goes, a pet isn't worth years or a life in debt (IMHO). I believe in an animals right to live, I believe saving the animal is the right thing to do, but a cat is not a human. How much is too much is you decision.

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@curli76: I have diabetic neuropathy. Mine is relatively minor problem at this point, but it's frequently quite uncomfortable. I am able to understand the problem enough to find coping mechanisms. Your cat can't.

I'm with @shrdlu & @nmchapma on this. You're losing quality of life, and your poor furbaby's quality of life is degenerating rapidly. Neither diabetes nor neuropathy will get better.

I believe in accepting the burdens of sick pets as long as they're manageable, but you are the only person who can ultimately define what "manageable" means. Many folks may disagree, but I don't think it's unethical to free your pet from pain and anxiety in this situation. The only other options are to continue dealing with it as best you can or to try to re-home him, and I personally wouldn't try to re-home a sick kitty. For what it's worth, as much as it might hurt my heart, I think I'd help him to go sleep and then try not to feel guilty.

I'm so sorry you're having to decide this.

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One other comment: diabetes doesn't "get better." It just gets managed better, and it can be a real b*tch to get to that point. Long ago I had a diabetic poodle. I'm a total needle weinie, so doing blood sticks & injecting insulin were major stresses for me. (Thank heavens the dog hardly noticed either one.) But try as I might, I couldn't get her stabilized; many times I had to eye-dropper maple syrup down her throat, desperately hoping she didn't choke, to bring her out of a low-blood-glucose near-faint. She also had severe liver problems, and after a few weeks of diabetes care we decided to let her go.

Whatever you've read on the feline diabetes sites about other cats & other owners, remember that they aren't you. You cannot ethically measure you and your kitty against other owners and other kitties. You alone know your situation and what you can manage. There really is no "good" answer here, unfortunately, but there is a "better" answer, and your heart will find it for you soon.

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Two weeks ago, I had to put my diabetic cat to sleep. He was one of the lucky ones. He lived with diabetes for 10 years and had a very good quality of life. He was the exception. Most diabetic cats do not live long (maybe 3 or four years after diagnosis) and so many things can go wrong with their health.Your cat seems to be miserable. He may not be have the very "manageable" diabetes.

It's a hard decision, I know. If you decide to put him to sleep, don't beat yourself up about it. Sometimes it's something we have to do.

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Over the years I've had several pets where I faced this decision. Animals live in the moment, but you can tell when they've been so miserable they're ready to lay down and die. You know your cat. Can you tell if it is ready? You have more insight and logic, but your heart knows. The fact you're asking this question says your heart knows it is time to let go, but your head says you should keep trying. Don't.

Had a 14 yr old Cocker Spaniel with hip dysplasia and failing kidneys. When we had to bring her food to her because she couldn't get up or move; when we had to clean messes she made where she lay, the choice was simple.

Our stray cat was with us for 12 years. She got hung up on barb wire jumping from a tree. Tore her side open and became infected. Days of inpatient IV antibiotics and surgery would cost $1000. Without it she'd suffer and die anyway.

Our sweet, 13-yo Yorkie took a bad fall. Concussion. Started having grand mal seizures. All she could do is lay in our lap. It's sad.

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So many touching stories here. @curli76 don't second guess yourself. You love your cat and will do the right thing. Just remember cats really live in the moment. They have no regrets about the past, nor much concept of the future. All he knows is that he is hurting right now, and it is up to you to do the best thing for him. He trusts you to do that, and it is your responsibility. Sending loving thoughts and good karma your way.

Sending condolences to @barnabee, so very sorry for your loss. I know how hard it is.

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Your cat's quality of life is going to be largely derived from your quality of life, and that should be the determining factor in this decision. You are more important. Sucks, cuz pets are great, but I think you know what you need to do.

Just trying to be straight with you, not curt.

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had a diabetic dog who got daily insulin shots for 10+ years, went through bad periods where managing it was very tough, and wound up in a coma twice during that time due to my own inattention during holiday visits (when there are kids around who give things such as sweets to the dog under the table.)

i do realize dogs and cats react a bit differently, and in cats, it's harder to manage... but with that said - there were plenty of times i thought of having him put to sleep, when i would get overwhelmed by life and circumstance.

Had i done that, i know without a doubt i would have regretted it horribly, the moment my own life got back on track.

You're the only one who can answer for you. For me, while putting him down was always an option, it was never one for me. Before deciding to put him down, if you're certain you can't handle it - at least make the attempt to see if any local rescuers have experience with special needs cats, and if anyone would be willing to take him...

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@goatcrapp: I am going to take a step towards you for a moment because I agree that OP really needs to understand what he is doing. Yes, it's a hard decision and sometimes it really is for the best when the suffering is unmanagable and there is no cure or help. You will be choosing to kill an animal that, even though it is in pain, does not want to die (instincts not feelings). You are deciding, because the cat can't, if the suffering is so bad that it's better off DEAD. When you make this decisison don't use those nice words. Its Not saved, not "better off", not going to a better place or to meet the spirit in the sky.

If you are sure you know this inside and then you can say it's the best thing to do, not the easiest, then it probably is. These decisions are awful, I just don't want you to regret yours.

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@hot72chev: Thank you. My lap is empty...

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@barnabee: I am so sorry for your loss.

@curli76: As others have already said, you have to assess your own situation and that of your kitty and decide what's best for all. Cats are notoriously difficult to draw blood from or give shots to, and he certainly can't understand why you are doing this to him. (If you haven't tried it, I can suggest wrapping him snuggly in a towel or blanket to immobilize him before dealing with it. Worth a try!) It sounds as though you would both get more sleep if you could properly manage this process, Give it one more try and see if you can find a system that works. My border collie is in very ill health and too smart to fool with pill pockets. I've been amazed to discover that I can actually push pills down her throat with my fingers twice a day. After fighting eating problems for months, I also discovered that there were alternate foods that she WILL eat. Ask your vet for other food options.

Maybe one more try will help you feel better. Good luck.

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@belyndag: Actually, he takes the shots like a champ. Doesn't even notice them. The main issue is he spends, I would say, more than half of his waking hours howling, and not just ordinary meows, howling that says, "I hurt."

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I had a diabetic cat, she passed from old age. She did have diabetic neuropathy, which in cats can be treated very nicely
w/ 1. regulation and 2. methyl b-12 ( cheap )

The hard part is the learning curve in test feed shoot. It can take some longer than others. Once that is done, it is much much easier.

There is a group DCIN Diabetic Cats In Need. They will help those who need financial aide so they can keep their cats and they will help you learn, and if that all fails, they will help place your cat with someone who does have the time and skill to get your cat regulated. Their website : [DCIN](http://fdmb-cin.blogspot.com/}

I have worked with these people, donated to this group and can attest to the fact that they know what they are doing and are paying forward the kindness that was offered to them when a beloved pet needed help w/diabetes.

I strongly urge you to contact them before making any final decision.
I would be happy to further address some of the specific issues...

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pg 2
... you mention. I will try to write more about that later tonight -- I'm out for a bit.

No, I am not a crazy cat person. I just know from experience how frustrating it can be and that it can take awhile, but in the end, I would not have changed a thing.

Hang in there. There are ways to have a happy cat and happy person. It sounds like you are in need of some help.
Be back later.....

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@ceagee: Shoot me a private message, if you will. I just left a FB comment on the DCIN page--the comment "so cute" under the picture of Mary and Rhoda (the cats). That's where you'll find me.

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@curli76: HI.
I sent you a PM on Woot w/ my email to contact me off woot. Sorry I don't do FB !
I can get on, but I don't know how it works, I'll try again.
I will post the tome I wrote off line here. But I can send it to you elsewhere if you like b/c of the links.

oh boy. This is going to take up a few posts.

starting w/ the next one easier.

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Hi, got back and one thing really stuck in my head and I wanted to get back to you about that issue first..
The yowling.Cats do not yowl in the manner you describe when they are in pain. They hide when they are in pain.
They do yowl when their blood sugar drops too low. I would bet a Bandolier of Carrots that is the issue.This possibility needs to be addressed ASAP. Running higher numbers for awhile is not going to hurt your cat -- unless he/she is ketone prone( which you did not mention so I assume not). Too low is very dangerous and needs to be addressed ASAP.Since you said you were having some testing challenges ( more on that ), if you can't test , if it were me -- I would try testing first,if not luck, I would just feed him/her some higher carb wet food for now and see how that works. If I could not test and fed and feeding helped the yowling, I would cut the insulin dose in half for now to be safe. Just sayin' what I would do ;)

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As to what to feed in this situation, you want a higher % carb food. Every cat has their achilles heal in this food area. Fancy Feast seems to have some addictive agent in it. Get some gravy flavors -- try a couple different ones. The grilled and sliced varieties generally fall in higher carbohydrate category. Fishy flavors in that category are usually happily received. The most important thing is to get something in. Give kitty what kitty will eat if numbers are low or no testing and yowling is prevalent.
I do wish to stress that testing when your cat is yowling would be optimal , then you can see how much, if
at all, you need to adjust the insulin. I love the numbers. I am more fluent in numbers then in yowls.
If you have not yet made a hypo tool kit. No time like the present. Keep several different higher carb flavors and brands in your kit. Some grain free dry too. Or other crunch treats.

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BTW -- I commend you on learning to test and trying to test your cat. Not everyone would do that.
If you are having trouble, imo,it's time to reevaluate your technique. I'd be happy to share some tips.
I won't write out a lot about that here, unless you ping and/or pm me back --- link to pm me . Testing can be overwhelming. I know I was freaked out at first, and blood was hard to get. But with some tips and practice I became a pro. You can too ! Promise.

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"He won't eat his new food " What food are you giving him? There are so many you can try. You do NOT need to use a veterinary formula. You just need to look for low carb( as percentage fed) canned food.
There are lists available on the FDMB , where I believe you have been, that have those values calculated out for many foods. Janet and Binkey's ( famous ) Food Charts. The numbers on the labels are sadly meaningless. But the ingredients can give you clues.
First, feed the best food you can afford. You mentioned that finances were an issue. There are many good inexpensive foods you can use. Friskies, 9 lives , Walmart's Special Kitty all have flavors that are low carbohydrate. Avoid flavors w/ gluten, corn starch, soy and rice. -- ie carbs.
As mentioned, you can check the list online, print out and take with you.
You can also do your own calculations. If you want the formula, please ask.

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The important thing w/ various foods is not all cans have the same calories.
A cat should eat 15-25cal / pound of ideal weight. A more sedentary cat you would calculate on the lower side, a more active on the higher side. Also, if your cat is overweight, losing too much at a time can make for a very sick kitty. So if you calculate out and it is a lot less then what you have been feeding. Gradually reduce to make sure that doesn't happen.
I cannot stress enough that you do not need to break your bank over cat food. If you are not going to be home for awhile and are worried your cat is dropping too low. Freeze a puck of the small canned food or fill ice cube trays w/ cat food. Leave that out and as it thaws kitty can eat.

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As for diabetic neuropathy. Besides the yowling -- what makes you /your vet feel this is an issue ? Is your cat on his hocks ? having trouble jumping ? As mentioned earlier, regulation and vit methyl B 12 are key there. It is reversible Here is an article on neuropathy in cats . Let me know. Trying to conserve some space ! As mentioned. I have never ever heard of a cat yowling b/c of neuropathy. They lay low and hide if in pain. They meatloaf. Yowling to me sounds like low blood glucose. I can't stress enough how important it is for you to check this out.

Other financial concerns. I did give the link for DCIN that can often help w/ strips and insulin.
There are other groups as well.
Many use the Walmart brand meter -- Relion and their strips which are relatively inexpensive.
I used a one touch meter and bought strips on ebay.
I always had the most luck w/ BD syringes 31 shorts with 1/2 unit markings. That is key.

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And of course, the type of syringes used depend on the insulin.
But others I know used walmart relion brand - same size same markings -- and they work great.
Do not reuse syringes or needles not matter how tempting. It contaminates your insulin and that is too expensive to risk. Depending on what state you live in you might buy them at an online pharmacy for less.

Speaking of insulin, what kind are you using ?
There are ways of purchasing insulin for less. Also, if you are having trouble w/ your insulin you may wish to change the kind you are using. Most do best on lantus or levemir.
Buying them in the small cartridges vs the vial is the most economical in the long run b/c they last longer.
Also you can sometimes get coupons from the manufacturer. Sometimes a pharmacy will sell you a singular cartridge.Sometimes you can find someone on the FDMB to split a box of cartridges .
Or someone may post that they have some on the supply closet. Or aforementioned groups can help.

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A huge help to me : You can print a pharmacy discount card for your cat -- works for syringes too.And/or try this site for coupons on prescription meds, including insulin (http://www.yourrxdiscounts.com/) To note: your vet by law must allow you to buy prescriptions outside of their office.
Of course, if you are using a vet only insulin, you still might be able to get it cheaper at an online pet med pharmacy.

To answer your big question at the end. I think it is too soon. You are overwhelmed. It is natural. You need some support and some alternatives to help you find a way to make it work for you and your cat.
The yowling is not from neuropathy. If your cat is not low, I would ask your vet to check for other causes. Just b/c your cat is diabetic does not mean that is the reason for everything. It could be hyperthyroidism or many many other things that are treatable and no, won't bankrupt you.

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Your cat is still active and eating and grooming . If your cat was truly in pain, he/she would slink off and hide in pain and sickness not yowl in your face. Your kitty is yowling to tell you something else.
I hope what I wrote helps you figure it out.

Please do not hesitate to pm me or ding me on this thread, I would be happy to talk to you on the phone or help in any other way. I 've been down this road, I know it can be frustrating and hard. I also know that it gets much much easier and that your cat can live a normal lifespan as a happy cat

I am sorry you are having health issues of your own. You and your kitty can support each other through difficult times

Whew ! I hope something in here-- rx discount card --helps other wootizens too .

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@barnabee: so very sorry for your loss. I know how awful it feels to lose a beloved kitty.

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Sorry if this comes across as heartless, but let me answer the direct question, "is it my obligation to do everything I can to try to help him get better?"

No. You are not obligated to to spend every last dime, nor to sacrifice your own health, career, and well-being. You've taken the cat to the vet, you've tried. You've done more than a lot of owners would. Other people above have suggested a few different food options, at this point, I would try that and see if it helps. But if things don't improve soon... you know what you have to do. You don't have to ask our permission. No one should look down on you.

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@ceagee: Thanks for all of your responses. I'll check my personal message after I get to all your comments. I strongly, strongly doubt he is hypo. He was in the mid-300s at the vet's when we had him tested in the 4-6 hour "zone."

However, he is waking me up in the "zone" so maybe there is something to that.

I do have some hypo-ready Fancy Feasts, but truth be told, he's a weird cat and he hates just about every flavor--especially the gravy ones.

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@ceagee: Thanks, yes, I've been to Janet and Binky's. He hates wet food. Won't eat it. He'll lick it, which I guess is good in a hypo episode, but he won't eat it.

We tried the Purina dry diabetes formula; he hated it;. I wasn't really keen on its ingredients or its carb count compared to some of the other foods. I am now trying to get him to eat Wellness Core grain free.

As for the neuropathy: He has been walking funny. He stops and sits down halfway through the apartment. He can't jump more than a few inches; sometimes not at all. He's lost some sensation throughout his body; his managed to get his legs soaking wet from his water fountain and he didn't even notice. The vet seemed to think it was neuropathy.

He is taking Lantus, 3 units 2x a day.

We've also got the Zobaline B12 for cats. It does not seem to be doing anything; if anything, he's getting worse.

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@ceagee: We started with the Accucheck compact, which was a huge mistake. Not only were the strips very expensive, but the automatic dispenser often malfunctions and the noise scares him. We did just buy a Relion; I haven't tried it yet. Getting blood is difficult. Usually I can't get enough. The other night his ear was gushing blood.

As for money, the main thing I can't afford is vet costs. I don't have a car and I live a $40 cab ride away from our vet. A glucose test alone is $43. I have no idea what they'd charge for a curve.

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@curli76: The numbers at the vet aren't worth a lot. Cats are stressed at vets.It increases their BG. So yes, your cat could have those numbers at the vets and be low at home.
That's a really big reason why testing at home is so important. I never had a curve done at the vets. My vet never wanted to do one. IT wouldn't be accurate. You can do one at home over a weekend. You don't even have to do it all in one day, you can spread it out over a couple days getting different times on different days.

3u lantus BID is a pretty big dose. How did you /your vet arrive at that dose ?

As for the food. Yes, it is most important that your cat eat, even if that means adjusting insulin to food.
Have you read this on how to transition to wet food ?
Some good tips. I have a document w/ some other tips as well I can email or post elsewhere.

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What about friskies or merrick's ? Evo is another grain free both wet and dry. It's high calorie, so depends on your cat.
But seems to be well liked.

If you don't like your relion, I do have an extra one touch I would be happy to send you . They don't take miuch blood and are easy to use. Strips are pricey unless you buy on ebay.
Do you warm the ear first ? Are you using a lancing device or hand poking the ear ?
Would you be willing to let an experience caregiver come to your house and help you with your testing ?
If you are, you can pm me what city -- no specific address --- and I will try and find someone to match you up with.
Sometimes even having someone on the other end of the phone via speaker while you are doing it can help.

I am very interesting in finding out what numbers you get when you kitty is yowling.

I'll check my pm, but I sent my email. I think at this point a better way to find than to go back and forth then deals ;)
I'm crashing for a bit. try my email.

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I very much understand how difficult this can be. Our cat was not very tolerant-draw blood? OK, here, let me start--scrratch!- Never got him to tolerate it, or even the shots-he would hide.

You might want to look into trying Levemir instead of Lantus as well. Our cat (Fred) did much better on it. It's newer and not as common in cats (yet) but is long acting and slower. Fred was an extremely difficult patient but put up with his shots better after we lowered his dose further and changed meds to the gentler Levemir.

I wish we had known about the group ceagee is talking about. That would have been great.

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My diabetic cat was pretty easy, he'd eat almost anything (and the vet never recommended any special diet) and I gave him his shots when he was eating so he never even noticed. I think I may have tried once to test his blood sugar but that didn't fly so I never tried again. He seemed to maintain a fairly level blood sugar. He lived for several years with diabetes. He never yowled until near the end but I attributed that to his sister being put to sleep. He did initially have weakness in his rear legs which is a symptom of diabetes but that went away after he got on insulin.

I always used BD syringes as they had a nice fine point and they even sent me a free monitor (which went unused and I donated to the local humane society.)

I was going to suggest talking to your vet about assistance groups or an adoption group but @ceagee has covered this much better than I.

When his sister was failing, I did hire someone to help try and give her IV fluids -- maybe a cat sitter in your area?

cf cf
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And to answer your original question, your quality of life matters, too. Regardless of whether you can improve his health, find him a new home, or have to have him put to sleep, you will probably feel as though you didn't do enough even though you tried as much as you could. It feels bad no matter what and I am very sorry for what you are going through and for everyone else who is or has been in a similar situation. This is hard.

cf cf
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@ceagee: Can you re-message me your e-mail? Google is not acknowledging it. Or hey, I'll just message you mine.

For the record, my guy is a champ when it comes to taking his shots. A couple of freeze-dried shrimp, and he doesn't really notice. It's everything else that's a pain.

I talked to the vet (although honestly, I trust the feline diabetes community more) and really, @ceagee has been very helpful in persuading me to try again. I'll follow up with him. Thanks, all, for your advice. The kitty lives, for now.

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@cf: Yes and no on the sitter. I have a weird situation. I live in a tiny city right across the river from NYC. There is just about nothing here. Take a bus 10 minutes in any direction (or take a half-hour walk), and I'm back in civilization.

I happen to have a wonderful catsitter, but I'm a little bit further than he normally travels and getting him up to my place twice a day is just not feasible. (Neither one of us has a car.) I don't really know anyone in my town; it's really a commuter city and many people around me don't speak English very well.

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@curli76: I'm very glad to hear you've come to an answer that you feel good about. Perhaps if you have time you can give us an update in a week or two so we how it's going for you and Cat?

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So glad to see that so many wooters are supportive and not just critical. A few years back we had a very loving lap cat that developed such bad diabetes that the levels couldn't even be measured. The vet said her only chance was two shots a day given 12 hours apart, on time everyday. And even with that the only hope was control, never healing. We tried for a while, but soon realized that sticking to such a schedule was going to be impossible, and the thought of her slowly deteriorating in health and suffering all the while seemed the worse of the two options. We cried at the time, but have never regretted the choice.