Tuesday, 29 July 2014

Feline Hope

Thank you so much to everyone who has commented and left their good wishes for my girlie. We are most grateful to the lovely Sparkle for thinking of us too and sending you over here to leave your lovely comments. We are also absolutely tickled with Sparkle modelling the bracelet. I'm sorry this is a very quick update but I thought it better to do a summary to let you know how things are going than wait till I get time to do a long version.

Magic seems to be stabilising and everyone's prayers seem to be doing the trick to my immense relief. We have had a really rocky time but seem finally to be getting there. When I did her first glucose curve on the 3units of insulin, which she has been on since discharge, she had two critical blood glucose dips. At 4hrs she went to 2.9mmols and at 8hrs she went to 1.8mmols both of which are dangerously low. I was horrified and did a control check on the monitor as I wondered it if had become faulty, but it wasn't. She looked otherwise well and without the blood glucose reading I was oblivious. I felt like I'd had ice water poured over me as this has obviously been happening while I have been at work in the preceding days too and I just never knew.

Logically the nadir, which is the name for the lowest reading, would occur around 6hrs and I had been testing at this point when I was not at work. Similarly her vet appointments where around the 6hr stage and didn't pick this up either. Trust my Magic to be like the recession and have a double dip! This all happened on the 19th Jul and it has taken me this long to even make a flippant comment about it as it scared me so much.

Luckily, her diabetes and critical care vet were both on shift on the day this happened and it was really reassuring that staff who knew her were available and could give very specific advice. We withheld the insulin for the evening dose, and the next day she was still lower than would be expected so she has been reduced to one unit of insulin twice daily. She seems to be maintaining really well so far on this dose and the latest curve done this weekend has shown a really nice consistent level. Crucially, none of this Saturday's results made me want to wet myself!

In herself she continues to be an absolute delight and I am still blown away by how good she is even when I am stabbing her ear or scruff. She occasionally protests or gives me a warning snarl or swipe if it is sore, but there is absolutely no malice or injury. She sits without being held and if she jumps to the top of the sofa or window ledge she will come back if coaxed. This morning I was in a rush as I had a 9am meeting. When I came out of the kitchen after drawing up the insulin I was all set to find her but saw the last inch of her tail disappear round the living room door as she was making her way to the sofa to wait on me to come and do the needful. I cannot imagine how awful this whole process would be if I had to kitty wrangle and see her being distressed. Obviously, I would do it as it needs done but being able to work in partnership with her is a blessing.

I'm not sure where we are headed next with her condition but probably just need to have faith. We see her lovely diabetes vet on Thursday and I'll write an update on where next from now. In the meantime, thank you so much and please accept my virtual hug to you all.

Tuesday, 15 July 2014

Feline Faith

Progress over the weekend has seen Magic eating a little more with no tube feeds only her drugs going in. Her insulin continues at 3units twice daily. Tube wound dressing every second day and bandage changes as often as she manages to unravel them.
 Presently, she only owns half a fur coat as she is missing her undercarriage, her neck and thigh fur as well as a half a dozen cubes at strategic points where she was being scanned. If you look closely you can see she also has some clipper rash too. The feel of skin on a cat is strange but boiling hot which you never notice on a furry cat! She seems very ashamed of her coat but each time I lift her she gets a belly kiss and lots of cuddles.
 Somewhere along the line there was an 'incident' with her left set of whiskers which I didn't even notice when I got her home. She's not bothered tho' which is not surprising with everything else she has going on.
Foodwise, I am not really sure where we are going with this but it might just be early days. After they both rejected the healthy diabetic diet(!) 'I' decided that they would both be changed onto Applaws as it is very high protein and is clearly of good quality. I know this as it looks like the ingredient it is meant to be and doesn't make me heave when I open the sachet like normal cat food does. Sadly, Magic only deigned to eat the broth surrounding the meal and her blood sugars were utterly hellish 20.1 and 24.9mmol. So, rather than let her remain in a grossly hyperglycaemic state I gave her some Sheba and even with the little she is eating her sugars are around the 8-12mmol level.

All being well, the tube will be removed and we can discuss her management plan. I would dearly love her to achieve remission if humanly, or felinely, possible. However, there is a fine balance in making sure she is safe, comfortable and happy. Currently, she is remarkably compliant I would hate to try to force her to do something she is unhappy with, to destroy her routine, let her become hypoglycaemic when no-one is around or to damage her trust in me as she comes to me to fix things. Tonight she sat watching as I prepared the syringes and drugs. When I asked her to follow me through she trotted in and sat waiting on the towel on the sofa that I use to denote the treatment area for carrying out her care.
I've been doing her blood sugars at least three times a day. This is for her to make sure I am not giving insulin when she is near to a hypoglycaemic state but also so that I can monitor what food is working for her, in what amount, how the insulin affects her and it will give me confidence that I am getting her care right. Getting blood out of her ears is becoming problematic no matter how much I warm or stroke them and I am having to prick her three or four times to get her to bleed. Aside from a wee squeal and a scowl she remains sitting with me and lets me got on with it. Last night I was having no joy with either a handheld lancet or the pricker device. Wondering if it was the depth setting that was the issue I increased it. Stupidly I forgot to wrap a tissue round my finger and when I pressed the trigger the lancet went straight through her ear and right into my finger. Her ear remained resolutely blood-free but my finger bled like stink. This was a low point but I can only imagine how much worse it would be trying to wrangle a resisting cat which is why I am keen to do this by consent.

Red is being a little star too. I try to give him as much attention as I do for Magic but her care has been quite intensive and he has probably not had his fair share.
Last night as I was using the sewing machine he took things into his own paws and brought me a mousie mousie to play fetch with him. He was so sweet that I couldn't do anything but agree to join in the game.
He is enjoying the cuisine and thinks Heston Blumenthal has moved in as the menu has improved to include chicken with pumpkin, wild rice or asparagus, sea bream, tuna, pacific prawns, cream and a wide selection of dry foods. He's been enjoying EIGHT meals a day and frequent treats.....or at least he was! When I was trying to tempt Magic to eat I was laying out wet and dry food for both of them in the spirit of fairness. However, as she wasn't eating he was hoovering up all the delicious foods she was rejecting. Normally he is a lean, mean cuddling machine weighing as much as a puff of air but he was beginning to turn into a little butterball.
Sadly Heston has left the building and it's back to good old Sheba.

Thursday, 10 July 2014

Feline Grace

I am humbled by how much grace, stoicism and understanding Magic is showing with her condition. She has just come to me to have her bandage reapplied. I noticed earlier it was beginning to loosen a little but was substantially intact so I decided to leave it for the time being. Just now she's obviously had another good go at it and also managed to get the ends sopping wet presumably from drinking more water.
So she came to find her favoured human and made it known things needed sorting then sat on the sofa where I normally perform her care. I didn't have a spare primapore dressing to hand but she let me go for it while waiting patiently for me. Once we were done I lifted her for our post-treatment cuddle and she couldn't snuggle in any closer and was frantically trying to groom my hair which felt like a thanks. I am actually moist eyed writing this at her bravery in accepting what I do for her, for how she is playing a part in her care and knowing to come and tell me something needs fixed.

I'm hideously biased about Magic as she has been there for me through some dreadful life events so it is a privilege to care for her in her hour of need.

Friday, 4 July 2014

Day and Night

I am immensely grateful to everyone who has left supportive messages and to Jane of Jane and Chris who offered to share her experience of caring for a diabetic kitty and very kindly stood by her offer by answering a question I had.
Poor little Magic is still having a really hard time. My earlier optimism that she was beginning to eat was misplaced as it was not sustained and she has eaten negligible amounts since. She has also vomited a few times. I am really disappointed as the tube feeding needs to continue and she is driven spare by the bandage and tube. An appetite stimulant was started 2 days ago and tonight an anti-emetic added. A review at the Vet Hospital on Tuesday showed that on ultrasound her liver is improving and it is less 'bright' and more defined. Her liver and renal bloods have shown signs of recovery with only an odd few remaining abnormal. Here glucose was low but thought to be the nadir rather than a hypo.
The morning tray with crushed drugs, feed, water for flushing and insulin
These last three mornings have been a dreadful flashpoint with her growling for the full 25 minutes, jerking each time I move to press the plunger, giving me the odd smacky paw and legging it with the 50ml syringe of feed attached to her neck. I have no idea why this is as I don't do anything different, the tube has not dislodged or blocked and I try everything to keep her feeling settled. Yesterday I had to split the feed because she became so resistant and stressed that I let her calm before resuming. Later I gave her a very stern talking to I told her that the situation was not good, and I was no happier than she was, but it was a means to an end till she was eating.!.!.! I also warned her that if she kept it up I'd be forced to do the cat burrito with her wrapped in a towel. That earned me a gimlet stare.......!

Strangely, the evenings are a much calmer affair. Tonight, for instance, she watched me prepare the feed, drugs and insulin then followed me through and when I spread the towel out and patted it she walked with great dignity and settled herself to be fed. It brought a tear to my eye and I felt such love for her accepting what is happening with such grace.
In the absence of any other reason for the morning shenanigans I need to consider that my pre-noon grumpy, narky, growly cat is actually just not a morning cat and I never noticed before.
The bandaging of her neck drives her bonkers and I never know what state I am going to find her in. Before I took her back to the vet hospital she was sitting with her paws tucked in under her chest and on a quick glance I saw the white collar and thought everything was chirpy. When I lifted her to trim her nails she suddenly unravelled. I then realised there was only the pinned end of the bandage and the padding round her neck as she'd unravelled and removed the rest, tucked it underneath her and sat with her arms folded looking as innocent as a cherub. I reckon I am pretty wise to cats but I was flabbergasted by her downright craftiness in outfoxing me. The next time I hear anyone refer to a cat as a 'dumb animal' I'm going to introduce them to her!

Tuesday, 1 July 2014

A little nibble

Quick update: Magic has just come when their night-time dinner was announced and actually ate a third of a sachet of Sheba. I could not be more delighted. Its still tiny steps/mouthfuls, but they all add up hopefully.