Help me work out what a good end looks like for my cat like

[Curlewwoohoo]

My cat is 16yo and diabetic. I inject him twice a day with insulin.

Every 6m the vet wants to check his blood glucose levels to see if he's on the right amount of insulin. It usually isn't right, which means plotting a blood sugar curve, by pricking his ear and getting a reading every 2hrs to draw a curve, which I've learnt to do at home. Or taking him to the vets to get a glucose sensor put on which lasts 5-14 days and which I can read with my phone. And making adjustments to his insulin.

He's had various issues over the years, including UTI's which cause insulin resistance, which he is being treated for right now.

Despite all this he seems happy. He's a healthy weight (always been a bit big), healthy coat, likes cuddles, potters about.

If his blood sugar isn't well controlled the risks are, too high makes him feel rough and can damage organs. Too low could cause him shakes and ultimately coma and death.

Obviously this is only going to go one way. My issue is this. I don't want him to gave a diabetic crisis and die. This doesn't sound like a good way to go. But I also don't want to be responsible for taking him to be put down when he's happy and we are keeping him well.

Lots of likes in the title! Am not a teenager 😂

When is his next review? I think personally I would choose to have him PTS at that point or if he develops another UTI. It’s kinder to let him not have to undergo further tests and experiences at the vet that are unpleasant… at his age. Even if he is happy and healthy at the point of being PTS you know his body actually isn’t healthy and is just a step away from a quick and stressful decline requiring multiple vet visits and stress for him.

Where is the cat tax, honestly, OP, you know the rules <sniff>

At 16yo he's had an amazing life duration ime.

Does your vet have advice? I find vets are brilliant at balancing quantity of life with quality of life. They completely accept that death is a fact of life. I'd ask them how they would know, if it were their cat.

Main thing is that You need to be prepared for a sudden crisis when his quality of life is looking bleak and the odds of successful recovery low (which I guess is why you started thread). If you treat every good day as an unexpected blessing, then the bad moment, whenever it comes, won't be too difficult. If every good day is a blessing, then You'll know what to do for his best interests when the impossible day arrives.

ps: you sound like a saint. I have never been as good a Cat Mom as OP.

We have had 2 diabetic cats, they both started to deteriorate in a fairly obvious way - eventually the insulin wasn’t enough and they became very unstable. That was the time to let them go.

If you are happy managing the insulin then just keep going. Ours got to an estimated 18 (stray) and almost 19.

Payment!!!
Live 'action'...

I think that you clearly know your cat, and will know the right moment to call it a day. I have had many pets of various sorts over the years and in every case, at the end it has been clear that they have had enough and the time is right.

@AlltheFs can you tell me a bit more about what that looked like? What am I looking out for? At the moment we're struggling with mountain peak blood glucose, about 27 to below 3. So treating with antibiotics in hopes its a uti. I couldn't get a urine sample to confirm.

Providing he seems happy I'd leave him for now if you're confident in injecting your cat and pricking his eat to get blood. Just keep an eye on him. If he stops wanting to eat, gets diarrhea or generally does not seem himself it might be time then. Cats often pick up in the Spring/Summer. Maybe he has one last Summer left in him. I'd ask the vet can you tell me when he won't have any more good days, when it's time to let him go please? That was when my vet told me it was time to let my 18 1/2 year old boy go after he had a seizure. He said 'his good days are all behind him now'.

Our male started to lose weight dramatically, he just started to look really poor all of a sudden. Dull coat, sunken eyes. He had early multiple organ failure as it turned out.

The female became really lethargic, didn’t want to do anything at all, she just didn’t look right. The vets had plenty of things they suggested to try but we felt it was her time.

This was some years apart by the way. We have just had a lot of cats!

Thank you! I really hope we have something definite to go on like this. And avoid diabetic coma or having to put him down because we can't control his sugars, even though he seems well.

If he's happy then continue. You know what he's like so you'll know when it's time. Some people can be very quick to suggest PTS as soon as a cat has something like this but it's manageable.
Our last cat developed diabetes and I used to do glucose curves at home. She also had IBD and when that flared up we had to change the insulin (she was quite a complex case!). We did have some honey which we used twice when she had a hypo, works v quickly.
She was happy doing her usual elderly lady cat things then the last couple of months she lost more weight but still seemed happy. I had "that conversation" with the vet, she improved for a while then one night we knew we had to let her go the next day.

Thank you @Vinorosso74 !@Vinorosso74 ! My cats diabetes doesn't behave either, we're on the third type of insulin now which is one that's not registered for pets. Every 6m the vets seem enthusiastic to Fiddle with things to try to flatten his curve out to hills rather than mountains but it doesn't seem to work for him, it feels like eventually they give up until the next 6m review!