AZJenks
Member Since 2014
4/12
Jenks began last night pretty well. He ate a good bit of his dinner unassisted, and then a little more with FortiFlora. Lately, his PM cycles have been pretty mild, but tonight he decided to drop a little too low and throw out a 41, which was then further complicated by the fact that he didn't want to eat either of the two cans of food I put out or even the high carb gravy with karo. I ended up having to syringe feed the gravy, much to his chagrin. I must've been a little heavy-handed with the karo because you can see the resulting number, but I don't care because it was essential to get him into safe territory with plenty of buffer should he decide he didn't want breakfast food either.
AMPS rolls around and his numbers are stable. He didn't want to eat much at breakfast either, but I was able to entice enough with some parmesan cheese to go ahead with a shot.
We're about 10 days post vomiting/diarrhea/metronizadole and the appetite still hasn't returned. I'm doing everything I can: trying a variety of flavors, adding natural enhancements, slippery elm bark, even the occasional massage (for him, not me hah!).
Currently, his appetite is hit or miss. It's unusual for him to shun gravy and karo. But he still perks up and eagerly goes for dry treats. I'm not sure what accounts for the difference.
We're going to call the vet today and see if he'll consider giving us an appetite stimulant. Right now, our priority is getting him eating before we move on to whatever is next. I've read a number of discussions about cyproheptadine vs. mirtazapine, and the consensus seems to be cypro > transdermal mirt > pill mirt in terms of side effects and potential for serotonin syndrome. Am I correct in my understanding? Is one more effective than the other in stimulating hunger? This assumes, of course, that the vet is (1) amenable to prescribing one and (2) willing to offer a choice.
There was a lot of stuff happening in yesterday's condo that I didn't get to, but will try to respond to here later this afternoon.
In the spirit of continued discussion and information gathering & sharing, here are some more interesting sources on creatine kinase that I've run across in the last 24 hours while trying to educate myself on the subject:
http://www.the-vet.net/DVMWiz/Vetlibrary/Lab- creatine_kinase.htm
In my opinion, a much better-written and more comprehensive informational source than the one included in the IDEXX manual. Among other things, it has a useful section on diagnosis.
Of particular interest is this statement:
"Aspartate transaminase (AST)--if increased without evidence of liver disease supports the diagnosis of muscle disease"
In Jenks' bloodwork, AST and CK are high, but ALP and ALT are normal.
https://web.archive.org/web/2013050...t.cornell.edu:80/clinpath/modules/chem/ck.htm
Cornell Veterinary University page about CK, including some interesting stuff about its biochemistry.
https://www.felinecrf.org/diagnosis_blood_chemistry.htm#creatinine
Tanya's site notes:
"If levels are high, it may indicate some kind of muscle disease; alternatively, very high levels of CK are often seen when an animal has heart issues. If your cat's level is over 1800, your vet should investigate further."
In contrast:
http://www.vetinfo.com/cfeleuk.html
An older link, but with an interesting. albiet unsourced, discussion buried in the middle of a bunch of questions about feline leukemia of all things. Relevant portion bolded:
"High CPK (creatinine phosphokinase) levels in cats occur for several reasons. There are numerous reports of high CPK levels in the absence of any identifiable disease, too. That may be because of diseases that are hard to find or there may be some problem associated with CPK that we just don't know about. The identified causes of CPK rises in cats are muscle damage, anorexia (not eating), inflammatory bowel disease and pancreatitis (possibly due to intestinal muscle damage, possibly due to not eating associated with these diseases), cardiomyopathy (again due to muscle damage), thromboembolisms (also probably due to muscle damage it causes in rear legs) and a genetic disorder in a research colony of cats with dystrophin deficiency. The CPK value can get into the hundreds of thousands and is commonly in the thousands just from not eating, apparently. This makes it a little hard to figure out how significant a rise in level is. It is still worth looking for any cause of muscle damage, checking for heart murmurs, making sure your cat is eating OK and thinking about pancreatitis. The TLI (trypsin immunoreactivity like) serum levels may be high with pancreatitis and somewhere I think I have read about an increase in pancreatitis in cats with FeLV, so that is another thing you could check out. Monitoring weight over the next month or so would be a good idea, too. As with all testing, lab errors sometimes occur, too. It might not be a bad idea to recheck the CPK level just to see if it remains high."
Jenks began last night pretty well. He ate a good bit of his dinner unassisted, and then a little more with FortiFlora. Lately, his PM cycles have been pretty mild, but tonight he decided to drop a little too low and throw out a 41, which was then further complicated by the fact that he didn't want to eat either of the two cans of food I put out or even the high carb gravy with karo. I ended up having to syringe feed the gravy, much to his chagrin. I must've been a little heavy-handed with the karo because you can see the resulting number, but I don't care because it was essential to get him into safe territory with plenty of buffer should he decide he didn't want breakfast food either.
AMPS rolls around and his numbers are stable. He didn't want to eat much at breakfast either, but I was able to entice enough with some parmesan cheese to go ahead with a shot.
We're about 10 days post vomiting/diarrhea/metronizadole and the appetite still hasn't returned. I'm doing everything I can: trying a variety of flavors, adding natural enhancements, slippery elm bark, even the occasional massage (for him, not me hah!).
Currently, his appetite is hit or miss. It's unusual for him to shun gravy and karo. But he still perks up and eagerly goes for dry treats. I'm not sure what accounts for the difference.
We're going to call the vet today and see if he'll consider giving us an appetite stimulant. Right now, our priority is getting him eating before we move on to whatever is next. I've read a number of discussions about cyproheptadine vs. mirtazapine, and the consensus seems to be cypro > transdermal mirt > pill mirt in terms of side effects and potential for serotonin syndrome. Am I correct in my understanding? Is one more effective than the other in stimulating hunger? This assumes, of course, that the vet is (1) amenable to prescribing one and (2) willing to offer a choice.
There was a lot of stuff happening in yesterday's condo that I didn't get to, but will try to respond to here later this afternoon.
In the spirit of continued discussion and information gathering & sharing, here are some more interesting sources on creatine kinase that I've run across in the last 24 hours while trying to educate myself on the subject:
http://www.the-vet.net/DVMWiz/Vetlibrary/Lab- creatine_kinase.htm
In my opinion, a much better-written and more comprehensive informational source than the one included in the IDEXX manual. Among other things, it has a useful section on diagnosis.
Of particular interest is this statement:
"Aspartate transaminase (AST)--if increased without evidence of liver disease supports the diagnosis of muscle disease"
In Jenks' bloodwork, AST and CK are high, but ALP and ALT are normal.
https://web.archive.org/web/2013050...t.cornell.edu:80/clinpath/modules/chem/ck.htm
Cornell Veterinary University page about CK, including some interesting stuff about its biochemistry.
https://www.felinecrf.org/diagnosis_blood_chemistry.htm#creatinine
Tanya's site notes:
"If levels are high, it may indicate some kind of muscle disease; alternatively, very high levels of CK are often seen when an animal has heart issues. If your cat's level is over 1800, your vet should investigate further."
In contrast:
http://www.vetinfo.com/cfeleuk.html
An older link, but with an interesting. albiet unsourced, discussion buried in the middle of a bunch of questions about feline leukemia of all things. Relevant portion bolded:
"High CPK (creatinine phosphokinase) levels in cats occur for several reasons. There are numerous reports of high CPK levels in the absence of any identifiable disease, too. That may be because of diseases that are hard to find or there may be some problem associated with CPK that we just don't know about. The identified causes of CPK rises in cats are muscle damage, anorexia (not eating), inflammatory bowel disease and pancreatitis (possibly due to intestinal muscle damage, possibly due to not eating associated with these diseases), cardiomyopathy (again due to muscle damage), thromboembolisms (also probably due to muscle damage it causes in rear legs) and a genetic disorder in a research colony of cats with dystrophin deficiency. The CPK value can get into the hundreds of thousands and is commonly in the thousands just from not eating, apparently. This makes it a little hard to figure out how significant a rise in level is. It is still worth looking for any cause of muscle damage, checking for heart murmurs, making sure your cat is eating OK and thinking about pancreatitis. The TLI (trypsin immunoreactivity like) serum levels may be high with pancreatitis and somewhere I think I have read about an increase in pancreatitis in cats with FeLV, so that is another thing you could check out. Monitoring weight over the next month or so would be a good idea, too. As with all testing, lab errors sometimes occur, too. It might not be a bad idea to recheck the CPK level just to see if it remains high."
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