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I'll say the best number he ever has had was the day after the covenia hot, but the later in day was back to bad. I really dont care for that covenia shot. I'd rather give him the pill 2x a day. Vet is worried about too much antibiotics.
 
I don’t like convenes becsuse it stays in their system at least a month so if they have a bad reaction nothing you can do. My vet who I usually agree with likes it and says he’s never had a problem.
 
Yeah, she knows that I don't care for it. He had it 2 times last year, and honestly I'm not sure it "works" on him. But we had the clavomox earlier and she wanted to try a different one this time.
 
If your cat is indeed has allergies, it may not even be his food. I have an itchy boy too. He would scratch himself bloody. The vet told me she could send out blood work and get him on a shot regiment like people do to eliminate the allergies. I didn't end up doing it because he stopped itching himself bloody.
 
If your cat is indeed has allergies, it may not even be his food. I have an itchy boy too. He would scratch himself bloody. The vet told me she could send out blood work and get him on a shot regiment like people do to eliminate the allergies. I didn't end up doing it because he stopped itching himself bloody.
We're not sure, but symptoms were much improved when he was on the rabbit. He was still getting those others things though. Vet said could be in my house too or pollen or whatever. I wanted to get testing done, but she said really not worth it. I dunno.
 
Well, got back from vet. wanted to check my meter vs there equipment. AlphaTrak2 showed 423, their equipment/testing showed 485. Now she's wondering if maybe he has cushings disease because of the concurrent skin issues. So I suppose I have some reading to do. Ugh.
 
I had a Cushing's kitty and have come across a number of other Cushing's kitties over the last 3+ years. My personal feelings is that is may be under-diagnosed since it was considered rare. Years ago acromegaly was considered rare in kitties and now it is estimated that as many as 25% of kitties may actually be acro.

My Tuxie (GA) was impossible to regulate. He had thin skin...it never got to the tearing part...and extremely poor hair re-growth. He was shaved for an ultrasound a few months after diagnosis and never regrew the hair back after 3 years. He had an extremely "swollen" belly..almost looked like he was pregnant :)...due to the enlarged organs...pancreas, liver, kidneys. There are two types of Cushing's...PDH involves a tumour on the pituitary gland (most common) and ADH ( involves a tumour on one or both of the adrenal glands) PDH has had some success with trilostane(vetoryl) although using this drug involves getting regular bloodwork to make sure the dose is correct.


The simplest least invasive test for Cushing's is the UCCR (urine cortisol-creatinine ratio) which involves collecting a urine sample at home ( so there is no stress involved) Your vet would send this sample to an outside lab such as IDEXX or any lab that performs the test. If the test comes back positive or borderline then other tests are needed to determine what type of Cushing's it is. An ultrasound done by a board certified technician can also be helpful in making the diagnosis.


Other tests that may be useful to check for high dose conditions are a full thyroid panel, which can be done at IDEXX. As well testing for insulin autoimmune antibodies or acromegaly can be done through MSU (Michigan State University) There are many members on here who have dealt with IAA and acro kitties that can give you lots of guidance if Rufus were to test positive for those. :bighug::bighug::bighug:
 
I had a Cushing's kitty and have come across a number of other Cushing's kitties over the last 3+ years. My personal feelings is that is may be under-diagnosed since it was considered rare. Years ago acromegaly was considered rare in kitties and now it is estimated that as many as 25% of kitties may actually be acro.

My Tuxie (GA) was impossible to regulate. He had thin skin...it never got to the tearing part...and extremely poor hair re-growth. He was shaved for an ultrasound a few months after diagnosis and never regrew the hair back after 3 years. He had an extremely "swollen" belly..almost looked like he was pregnant :)...due to the enlarged organs...pancreas, liver, kidneys. There are two types of Cushing's...PDH involves a tumour on the pituitary gland (most common) and ADH ( involves a tumour on one or both of the adrenal glands) PDH has had some success with trilostane(vetoryl) although using this drug involves getting regular bloodwork to make sure the dose is correct.


The simplest least invasive test for Cushing's is the UCCR (urine cortisol-creatinine ratio) which involves collecting a urine sample at home ( so there is no stress involved) Your vet would send this sample to an outside lab such as IDEXX or any lab that performs the test. If the test comes back positive or borderline then other tests are needed to determine what type of Cushing's it is. An ultrasound done by a board certified technician can also be helpful in making the diagnosis.


Other tests that may be useful to check for high dose conditions are a full thyroid panel, which can be done at IDEXX. As well testing for insulin autoimmune antibodies or acromegaly can be done through MSU (Michigan State University) There are many members on here who have dealt with IAA and acro kitties that can give you lots of guidance if Rufus were to test positive for those. :bighug::bighug::bighug:
Thanks for the info! He's been licking himself for about 3 or 4 years. Almost back legs and tummy were the worst. We finally switched him to a novel preotein and he was doing better. Then his ears were severly infected. He was on ear drops (steroids) for almost a month, with no success. Then Osurnia (steroid) that seemed to solve it. He was on pred for 2 months (low dose 5mg) but he did not lick at all when on that! Then Thanksgiving diagnosed diabetic and no more steroids. Now all for legs are bad, the back worse. Belly is thin, as is neck starting to. Vet thinks this along with his number not budging at all might be cushings.

I guess my question right now is, if he has had the licking /scracting issue for 3 or 4 years, wouldn't he have had more issues if this went undiagnosed this long? OR did the steroid use just make it worse?
 
Another couple things to note...When he was on the pred, the hair grew back, though not completley. He doesn't really have a pot belly. He doesn't have thin skin (I dont think?).

Also, if a cat had cushings and was on a steroid, would they stop licking/scratching?
 
I guess my question right now is, if he has had the licking /scracting issue for 3 or 4 years, wouldn't he have had more issues if this went undiagnosed this long? OR did the steroid use just make it worse?


If the excess licking has been going on for 3 or 4 years then it is probably not Cushing's related. It sounds more like an allergy or intolerance to some type of food. Trying some novel proteins, such as rabbit or venison with no other protein source may help to determine whether there is a food allergy/intolerance. Steroids are commonly used for food allergy symptoms, but steroid use can also lead to FD.


ETA My Tuxie never had "licking problems" with his Cushing's.


ETA Cushing's kitty's glucose levels would go through the roof if given steroids. Cushing's causes a very high level of cortisol to be produced, which is a natural "steroid" hormone in the body. With Cushing's the normal "on/off" switch for cortisol does not work and the body is constantly being bombarded with cortisol.
 
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If the excess licking has been going on for 3 or 4 years then it is probably not Cushing's related. It sounds more like an allergy or intolerance to some type of food. Trying some novel proteins, such as rabbit or venison with no other protein source may help to determine whether there is a food allergy/intolerance. Steroids are commonly used for food allergy symptoms, but steroid use can also lead to FD.


ETA My Tuxie never had "licking problems" with his Cushing's.
Thanks. A lot of times if he's not sleeping, he's licking. Oh beleive me I'm trying my hardest to get him to eat rabbit or duck, but he's just being picky. I know the nausea is part of it. He was eating rabbit last year, and now just wants his gross fancy feast. I am 99% sure he has as allergy and intolerance to turkey. I took the fancy feast with turkey listed in the ingredients out of rotation, and its been better. But the rest of the cans have meat byproducts listed. Im sure there are amounts of turkey in there.
 
Thanks. A lot of times if he's not sleeping, he's licking. Oh beleive me I'm trying my hardest to get him to eat rabbit or duck, but he's just being picky. I know the nausea is part of it. He was eating rabbit last year, and now just wants his gross fancy feast. I am 99% sure he has as allergy and intolerance to turkey. I took the fancy feast with turkey listed in the ingredients out of rotation, and its been better. But the rest of the cans have meat byproducts listed. Im sure there are amounts of turkey in there.


If there is nausea involved that makes food changes even harder. Mogs gave you information on pancreatitis in an earlier thread (very common with FD kitties) so ruling that out first would be a good idea. You can either get a snap test done at the vet, which is a yes or no test, or a fPLI test done...needs to be sent to IDEXX or another outside lab that performs the test...which would give you an actual number reading.
 
If there is nausea involved that makes food changes even harder. Mogs gave you information on pancreatitis in an earlier thread (very common with FD kitties) so ruling that out first would be a good idea. You can either get a snap test done at the vet, which is a yes or no test, or a fPLI test done...needs to be sent to IDEXX or another outside lab that performs the test...which would give you an actual number reading.
He does have pancreatitis :(
 
Here's his back leg...
 

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He does have pancreatitis :(


Is he being treated with anti-nausea meds such as Cerenia or Ondansetron and pain control meds such as buprenorphine?


ETA My Tuxie had chronic pancreatitis and anti-nausea meds and pain control meds were a mainstay during his flares.


Your photo would seem to indicate either a skin condition or an food allergy/intolerance. Have they ever done a skin scraping to check for skin conditions?
 
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Mogs
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thanks!
Is he being treated with anti-nausea meds such as Cerenia or Ondansetron and pain control meds such as buprenorphine?


ETA My Tuxie had chronic pancreatitis and anti-nausea meds and pain control meds were a mainstay during his flares.


Your photo would seem to indicate either a skin condition or an food allergy/intolerance. Have they ever done a skin scraping to check for skin conditions?
Vet told me she thought he had pancreatitus back in October. When he had his blood work done and was diaganosed diabetic in Novemeber, we also did the pancreatitis test (not sure which on). Came back positive. Never given any meds for it. He was on pepcid and that seemed to help. We did try cerenia pills on my suggestion. Didn't do anything for him. We started Ondansetron on Saturday. Huge dose. Seems to working, but still won't eat the wysong rabbit. Dental specialist gave me liquid gabapentin for pain. Not sure i notice any difference with him on it (except more tired).
 
Ok dumb question. How do you know when he was having a flare? I can't seem to differentiate when he's in pain or not, or maybe in constant pain??
 
thanks!

Vet told me she thought he had pancreatitus back in October. When he had his blood work done and was diaganosed diabetic in Novemeber, we also did the pancreatitis test (not sure which on). Came back positive. Never given any meds for it. He was on pepcid and that seemed to help. We did try cerenia pills on my suggestion. Didn't do anything for him. We started Ondansetron on Saturday. Huge dose. Seems to working, but still won't eat the wysong rabbit. Dental specialist gave me liquid gabapentin for pain. Not sure i notice any difference with him on it (except more tired).


One thing that seemed to help for me at least with mild nausea was slippery elm bark (SEB) which you can buy at a health food store. Make sure it is the pure SEB with no additives. You can get this in capsule form and open the capsule, make a watery slurry from it and syringe it about 1/2 hour before feeding. With my kitty I found it worked much better than the pepcid AC

ETA With Tuxie, who was a total food pig, if he wouldn't eat his food, I knew he was having a pancreatic flare. With kitties who are grazers it is harder to tell, but if they appear hungry but just won't eat, or are licking their lips at the food dish and not eating then a flare could be suspected.
 
Ok dumb question. How do you know when he was having a flare?
Things to watch for (not an exhaustive list):

- More lethargic/less sociable/withdrawn/increase in hiding behaviour.
- Much more defined clinical signs of nausea.
- Reluctance to eat/inappetence.
- If flare is severe, then much more marked signs of pain (primarily abdominal but it can also radiate to the back - and some vets may mistake the latter for arthritic pain).
- Softer, whiffier stools; sometimes more orangey-brown in colour if a mild flare but more of a gooey/marshmallowy texture - possibly very tan, greenish, or even greyish in colour - if flare is worse.
- Marked upward trend in BG levels (even during milder flares).

I can't seem to differentiate when he's in pain or not, or maybe in constant pain??
Clues may include:

- sitting in a sort of tense 'meatloaf' position, especially after eating.
- hiding (e.g. lurking under tables, behind sofas or curtains).
- seeking out cool places to lie down, e.g. stone/tiled floors (soothing to abdomen).

If in doubt, it's wise during a flare to treat for possible occult pain as reduction in any pain present may lead to the flare subsiding more quickly (advice given to me by feline internal medicine specialist).

As with so many things, it's a case of Know Thy Own Cat. If you keep a little daily journal of clinical signs it may help you to better spot patterns of behaviour. (I found it to be a godsend for Saoirse.) The daily journal is also invaluable to refer back to because it can help you to better identify things which do and don't help matters, plus it is beyond helpful when you need to backtrack to something that was working better or which helped resolve prior flares effectively.

Couple of day-to-day things to try:

- raise food and water bowls several inches from the ground to a more comfortable eating height (helps with nausea if kitty doesn't have to lower its head to eat and drink).
- massage neck and shoulders to release endorphins if Rufus' body/posture looks a bit tense after eating.
- give Rufus a catnip toy to lick after his meals (catnip is thought to act as a mild analgesic).
- keep a close eye on stool consistency and frequency (constipation can trigger flares).
- feeding smaller meals spaced out over the cycle can be easier on the pancreas (ETA: must meet feeding needs of insulin in use!)
- adding 1-2 tsps water to each mini meal can help maintain adequate hydration levels.



Mogs
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Things to watch for (not an exhaustive list):

- Much more defined clinical signs of nausea.
- Reluctance to eat/inappetence.
- If very severe, then much more marked signs of pain (primarily abdominal but it can also radiate to the back - and some vets may mistake the latter for arthritic pain).
- More lethargic/less sociable/withdrawn/increase in hiding behaviour.
- Softer, whiffier stools; sometimes more orangey-brown in colour if a mild flare but more of a gooey/marshmallowy texture flare is worse.
- Marked upward trend in BG levels (even during milder flares).


Clues may include:

- sitting in a sort of tense 'meatloaf' position, especially after eating.
- hiding (e.g. lurking under tables, behind sofas or curtains).
- seeking out cool places to lie down (soothing to abdomen).

If in doubt, it's wise during a flare to treat for possible occult pain as reduction in any pain present may lead to the flare subsiding more quickly (advice given to me by feline internal medicine specialist).

As with so many things, it's a case of Know Thy Own Cat. If you keep a little daily journal of clinical signs it may help you to better spot patterns of behaviour. (I found it invaluable for Saoirse.) The daily journal is also invaluable to refer back to because it can help you to better identify things which do and don't help matters, plus it is beyond helpful when you need to backtrack to something that was working better or which helped resolve prior flares effectively.

Couple of day-to-day things to try:

- raise food and water bowls several inches from the ground to a more comfortable eating height (helps with nausea if kitty doesn't have to lower its head to eat and drink).
- massage neck and shoulders to release endorphins if Rufus' body/posture looks a bit tense after eating.
- give Rufus a catnip toy to lick after his meals (catnip is thought to act as a mild analgesic).
- keep a close eye on stool consistency and frequency (constipation can trigger flares).
- feeding smaller meals spaced out over the cycle can be easier on the pancreas.
- adding 1-2 tsps water to each mini meal can help maintain adequate hydration levels.



Mogs
.
Thank you thank you thank you! So much awesome info!! Looks like he's probably not in too much pain. I am giving him a probiotic so I think that firms up his stool, but hard to differentiate between this and food intolerance. I do know that if he doesn't have pepcid or ondansetron he has a hard time wanting to eat. So maybe he has a low grade constant state of pancreatitis. But then again, hard to distinguish between symptoms of intolerance and pancreatitus.
 
I do know that if he doesn't have pepcid or ondansetron he has a hard time wanting to eat. So maybe he has a low grade constant state of pancreatitis. But then again, hard to distinguish between symptoms of intolerance and pancreatitus.

Often alongside the IBD and pancreatitis there may be liver issues (a condition known as triaditis).

IBDkitties.net is well worth a read. NB: check out their take on longer term use of antacids (e.g. famotidine, aka Pepcid AC); might be worth taking into account for Rufus.

Here's a link to info on preparing slippery elm bark (SEB) from Tanya's Site:

http://www.felinecrf.org/holistic_treatments.htm


Mogs
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Often alongside the IBD and pancreatitis there may be liver issues (a condition known as triaditis).

IBDkitties.net is well worth a read. NB: check out their take on longer term use of antacids (e.g. famotidine, aka Pepcid AC); might be worth taking into account for Rufus.

Here's a link to info on preparing slippery elm bark (SEB) from Tanya's Site:

http://www.felinecrf.org/holistic_treatments.htm


Mogs
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Oh wow. I had no idea the pepcid was bad. Glad he's off of it now. Do you know if slippery elm be use in conjuction with a probiotic?
 
Oh wow. I had no idea the pepcid was bad. Glad he's off of it now. Do you know if slippery elm be use in conjuction with a probiotic?
I would imagine so. Maybe ask the question in a new thread on the FH board?

There is a bit of a question mark over whether SEB may reduce absorption of medications so my vet advised me to give meds and SEB at different times.


Mogs
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There is a bit of a question mark over whether SEB may reduce absorption of medications so my vet advised me to give meds and SEB at different times.


SEB acts as a coating on the digestive tract, which can prevent absorption of meds. When I used it I would always give it an hour after meds to allow the meds to be absorbed properly.

ETA when I used an anti-nausea med I usually used the injectable cerenia so it did not affect the absorption of the cerenia. The bupe I also gave as an injectable, which worked well for me.
 
Looks like he's probably not in too much pain.
Word of warning: cats are notoriously good at hiding pain and discomfort. Taking time each day to observe Rufus is the best way to learn to 'hear' what his body is telling you. No-one knows him the way you do, and you are therefore in the best position to figure out Rufus's unique 'tells'.


Mogs
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Word of warning: cats are notoriously good at hiding pain and discomfort. Taking time each day to observe Rufus is the best way to learn to 'hear' what his body is telling you. No-one knows him the way you do, and you are therefore in the best position to learn Rufus's unique 'tells'.


Mogs
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Oh I know. Back when this started in Ausgust / September he would go downstairs and lay under the pool table. Even in the shower. He has never done those things. He doesn't even like going downstairs because of his arthritis. I know those are his "big" tells. But the lip smacking and general lethargy I wasn't and aren't sure of pain or tired or because his BG is still so high. And I've been unemployed for WAY too long and I'm with him WAY too much. He's probably hoping I get a job soon so I can stop babying him :)
 
Oh I know. Back when this started in Ausgust / September he would go downstairs and lay under the pool table. Even in the shower. He has never done those things. He doesn't even like going downstairs because of his arthritis. I know those are his "big" tells. But the lip smacking and general lethargy I wasn't and aren't sure of pain or tired or because his BG is still so high. And I've been unemployed for WAY too long and I'm with him WAY too much. He's probably hoping I get a job soon so I can stop babying him :)


Lip smacking is a sure fire sign of discomfort...whether nausea or dental issues. I spent most of the last 3 years of my Tuxie's life with him close to 24/7, which besides giving me such a close bond, also allowed me to "know" when something was off. Knowing YOUR kitty is so very important. :bighug::bighug:
 
I do think it's a dental issue. Well, actually I think its a combo of both. His numbers need to get better for them to do xrays and cleaning though...
 
downstairs and lay under the pool table. Even in the shower. He has never done those things. He doesn't even like going downstairs because of his arthritis. I know those are his "big" tells. But the lip smacking and general lethargy I wasn't and aren't sure of pain or tired or because his BG is still so high.
Those are exactly the sort of things to look for. Also, if you notice a new behaviour be sure to note it in your journal. It might be a one-off but, if it keeps cropping up then you may be able to spot a new pattern based on your notes.

Lethargy is the #1 symptom to watch for with pancreatitis. If you look in the FDMB FAQs at the Pancreatitis Primer it contains stats for the number of cats in a study with a given symptom and 100% of the cats in the study presented with lethargy.

Based on my observations of Saoirse it is possible with time and sufficient observation to gauge degree of lethargy qualitatively to a certain extent.


Mogs
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Lip smacking is a sure fire sign of discomfort...whether nausea or dental issues. I spent most of the last 3 years of my Tuxie's life with him close to 24/7, which besides giving me such a close bond, also allowed me to "know" when something was off. Knowing YOUR kitty is so very important. :bighug::bighug:
I read on here (I think) that one positive about a diabetic cat is that you will now have a much closer relationship with each other. So a small ray of sunshine in an otherwise horrible disease :)
 
Those are exactly the sort of things to look for. Also, if you notice a new behaviour be sure to note it in your journal. It might be a one-off but, if it keeps cropping up then you may be able to spot a new pattern based on your notes.

Lethargy is the #1 symptom to watch for with pancreatitis. If you look in the FDMB FAQs at the Pancreatitis Primer it contains stats for the number of cats in a study with a given symptom and 100% of the cats in the study presented with lethargy.

Based on my observations of Saoirse it is possible with time and sufficient observation to gauge degree of lethargy qualitatively to a certain extent.


Mogs
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Hard to tell the lethargy from the tired. I keep saying to the vet he seems lethargic. She keeps saying, well he's a cat and he's older so the sleep a lot. But you're right, he's my kitty and I know him better then anyone. That's also hard when you know something and the vet is dismissive. It's hard because you want to respect them and they know more info then you, but at the same time I don't always agree with what their plan is.
 
PS:

Always mention the 'one-off' oddities to your vets during check-ups, especially if it's something that you truly feel 'really ain't quite right'; sometimes a small thing can be an early warning of something heading down the line so it's always wise to enquire about and research any unusual clinical sign or behaviour. Unfortunately, how effective the early alert proves to be is very much down to the experience and expertise - or lack thereof - of the vet consulted.


Mogs
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I do think it's a dental issue. Well, actually I think its a combo of both. His numbers need to get better for them to do xrays and cleaning though...


My guy had some serious dental issues. I had them done even though his numbers were very high and he was no where near regulated....cleaning and 4 extractions. A serious dental infection can certainly cause glucose levels to be raised up. There is no reason to forego a dental procedure because a kitty is FD. Unless the kitty has heart issues a dental can be done as long as the vet is experienced with FD kitties.


From my experience with two FD kitties ( brother and sister) the bond is so so much stronger with an FD kittty. My Tuxie ended up being a gem for shots/testing/pilling while his sister was not as good with the routine. However with both kitties I have found that the love and trust and bond is very much stronger than with a "normal" kitty. I have loved all my kitties, but my Tuxie is/was my heart kitty. :cat:
 
I have 2 cats, and I hate to say it Rufus is my dude. Just has always had a bond and he's so affectionate and caring.

Regarding dental, regular vet referred me to dental specialist because they have more equipment and staff in case there are issues. Dental specialist won't do anything until fructosamine comes back "fair" or better. Both don't think he has issues at least by visually inspecting his teeth. He has lost 2 teeth in the past few months. If you watch him eat, he chews on on side, drops food, wont attempt to eat dry food for weeks, and does this weird tongue thing now. But both still don't think its a dental issue. Both think its the pancreatitus causing him pain to chew. I don't know. Its going to be spendy too. Oh and he had a grade 1 murmur, but I think it went away?
 
Dental specialist won't do anything until fructosamine comes back "fair" or better.


Unfortunately fructosamine testing is only of any use at the start of treatment. It shows an average reading of glucose readings over 2-3 weeks. Once a kitty is on insulin it does not show the ups and downs during each cycle...only the average reading. If a kitty has been very high 1/2 half the time and very low the other 1/2 the time the fructosamine may show a "good" reading, which does not reflect the day to day changes. Home testing is by far the more accurate gauge of how well the insulin and dose is working for your kitty.

ETA Also visual inspection of teeth only goes so far. When my girlie had her dental the visual showed "maybe" a problem with 2 teeth. She ended up needing 8 teeth removed. A vet with a good dental x-ray unit is the best bet.
 
I asked the vet tech about the fruc test and being high and low, but his came back at 480 something I think. And no BG test has ever been below 384? I think. I might give the specialist a call tomorrow and see what actual numbers she wants to see it be at. I have to wonder if his numbers arent budging because of dental issue. then again, he was on antibiotics and the numbers didn't budge, and you'd think they would if he had issues.
 
he was on antibiotics and the numbers didn't budge, and you'd think they would if he had issues.


Not all antibiotics are as effective with dental issues. For my two I used antirobe ((clindamycin hydrochloride) before each dental and it helped to alleviate most of the visual infections. I personally ( for my own teeth) had a few teeth 4+ months ago that were badly infected and even the clindamycin did not get rid of the active infection. Only by having the teeth actually extracted was I able to "cure" the infection. Sometimes infections are far below the gum line and extractions are needed.
 
Well hopefully I can get him in soon. I really don't want to jeopardize his health, but were going on what 10 weeks and his number are almost a constant. He seems so much better, but no change in numbers. Maybe time to look for a different dental specialist. I did point out to the vet today that his best recorded number was the one the next morning after is covenia injection.
 
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