3/21 Cosmo AMPS 488

I'd start with a full senior or geri blood panel if he hasn't had one lately. Hyperthyroidism, GI disease or any chronic inflammatory disease, kidney disease or heart disease or needing a dental are some of the common conditions making it hard to regulate. Cushings is less common than either acromegaly or IAA (insulin auto antibodies), both of which Neko had.

Bummer on the sniffles. Does he have any allergies? I noticed pollen on the car yesterday.
 
Wendy&Neko said:
I'd start with a full senior or geri blood panel if he hasn't had one lately
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He had a Sr. Panel done in December that is on a tab in our SS doc. It has been a while since his thyroid was checked.

He had an extra ultrasound around that time and here are some of the opinions:
Opinion & Recommendation
Moderate diffuse small intestinal wall thickening, with prominent small intestinal muscularis layer. Inflammatory bowel disease should be strongly considered. GI biopsies may be warranted.
Mild focal cranial abdominal lymphadenopathy. Reactive lymphadenopathy secondary to gastroenteritis or inflammatory bowel disease should be considered.
No sonographic evidence of pancreatitis, however, this does not necessarily exclude pancreatitis.
Enlarged and diffusely hyperechoic liver, likely secondary to diabetes mellitus. Hepatic lipidosis would be another consideration.
Bilateral mild renal pelvic dilation. This may be secondary to polyuria caused by diabetes mellitus.

We know he has allergies - to foods and maybe even seasonal. Not properly tested. He used to have a very bald belly and legs where he nibbled off the hair. At times, he has had skin irritation, but is much better on his current diet. He has often seemed to snore or wheeze for many years. Maybe a chronic sinus inflammation? This seemed like a man cold and felt warmer to the touch.
 
Actually, he did have a T4 on his panel in December. I’ll see if I can post it.

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I can't read what you posted, though it looks like it's in the middle of the range. You can always put the T4 on the labs page. That data is recent enough I don't think you need to redo it. I forgot to ask, how are his teeth? Needing a dental are probably the number one reason a cat is hard to regulate.

If he had a bald belly but the fur has regrown, that does sound more like an allergy. But I know from experience that it's possible to have both food allergies and small cell lymphoma in a cat. :( Unfortunately it looks like a surgical biopsy would be needed for a proper diagnosis. But sounds like he's eating fine, maintaining his weight and no other GI issues (other then megacolon), so those are good signs. Speaking of which, the megacolon, arthritis, and snoring/wheezing would have me check for acromegaly first. And I'd throw in the IAA test cause it's a cheap add on to the same lab.
 
Wendy&Neko said:
I forgot to ask, how are his teeth?
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He had a dental done a few years ago. Maybe 2 years ago. The vet did say he needs his teeth done, but does not seem eager, especially because he isn’t regulated.

Would you test for acro and IAA even though his dose is less than 5 units? I suppose if we were on TR, we would be upping his dose much more quickly.

Yep! Eating fine, maintaining (maybe gaining :facepalm:) weight, happy, purry, no neuropathy any more, 5 Ps all good. Clinical signs great. Not lethargic, or irritable, etc. Just unregulated and some pretty high numbers from time to time. The only thing I notice between greens and reds, is that Cosmo seems a little more relaxed and softer belly/body. Maybe this is the best we can ask for?

:cat:
 
thebigfuzz said:
The vet did say he needs his teeth done, but does not seem eager, especially because he isn’t regulated.
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That's the catch 22, often cat don't get regulated without a dental. The specialty dental vet West Coast Dental Vets are great, they are used to complicated cases. I really liked going there with Neko. You do need a referral.

thebigfuzz said:
Would you test for acro and IAA even though his dose is less than 5 units?
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That's your call, we've seen acros and IAA kitties on 3-4 units. The study showing how common acro it is saw some on as low as 1 unit. There aren't large scale studies on IAA. We don't usually suggest testing until doses get higher, cause there can be other things that make it hard to get regulated up to 6 units. I think I'd recommend the dental route first. And yes, some cats just love to bounce. :rolleyes:
 
Glad Cosmo is feeling a bit better and that he still got a spa trip today; hopefully he stayed away from the swivel chair ;) Hope you had a good day and hope Cosmo slides down :bighug:
 
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