Max not doing well post MRI

Max & Lori

Max & Lori

Member Since 2021
Max’s spreadsheet is not up to date since yesterday when he went for his MRI and CT at NCSU for acromegaly. It did show changes in his pituitary gland confirming acromegaly. He had a wonderful day the day before the MRI. He was happy and playful. Then yesterday happened. I was doing what I was instructed to do. They told me to give him 1/2 of his insulin dose the morning of the MRI and a very tiny amount of food. His BG was 125 that morning and I called to make sure they still wanted me to give 1/2 of his dose or less. I was instructed not to give any insulin and they would monitor him there. The entire day went by and we had no updates so I called around 3:00 pm. They told me he was getting his CT scan. We heard nothing else until they brought him out around 5:00 pm when the resident told me they didn’t give him his insulin and his BG went over 700. They gave him “regular” insulin via his IV 4 units, then later 2 more units. It came down to 486 at discharge. I was told to feed him and give his 11 units when we got home which was 1 hour past his usual time. BG 336 when we got home. He ate well and I did gave insulin. He dropped to 165 at the lowest point that I checked last at PMPS +5 but he had several small bites of food after each test. He acted fine. This morning was a different story. His glucose was 256 but he would not eat anything at all. I called and they said to give him half of his dose so I did. It has remained between 240-280 all day. It is now AMPS+8. He still hasn’t eaten anything other than a couple of tablespoons of baby food I syringe fed. I haven’t seen him urinate since last night but he did have a bowel movement. I checked for ketones with a meter which showed 0.3 and I’m not really sure what normal should be on those. The ER says it’s probably the anesthesia causing his lack of appetite and lethargy so I should monitor for 24 hrs. I had given him Mirataz gel inside of his ear and some Zofran this morning at AMPS when he wouldn’t eat. I don’t know what else to do. He has just slept nearly all day and not interested in anything. @Wendy&Neko if you are around, what do you think?
 
Sorry to hear Max if feeling some side effects. :bighug::bighug: Anaesthesia can mess with the GI system, though this isn't something I have seen on any of my cats. It's not unusual. Zofran can be given at least 3 times a day, I would give it again. It doesn't last all day. What dose are you giving?

0.3 on ketones is fine, worry if it gets over 2.0.

Could you fill in the spreadsheet as best you can?
 
@Wendy&Neko it was a 4 mg zofran. I am back at the NCSU ER. I called back and they said to bring him back. He seems to be worsening. BG now 458. I will work on the spreadsheet when I get another minute. Thank you.
 
Good luck at the ER. Keep us posted. :bighug::bighug::bighug:

4mg Zofran is fine for a larger cat. Not unexpected to see higher numbers with skipped/partial doses messing with the depot.
 
Yes. I used the full 4 mg Zofran for Darcy who was 15 + lbs. Good luck at the ER. I will pray for Max. I was just thinking about you last night and seeing how we hadn't heard from you for a while ... but that was to be expected because you said you were not going to post for a while... but now to see this upsets me. You have all my thoughts, good wishes, vibes, prayers!
 
Thanks for your prayers. I’m really upset too. The doctor ended up keeping him there in the hospital for suspected flare of pancreatitis. He will be there until at least Monday. He did not have any ketones but was dehydrated. The ER doctor suspects the spike in BG to over 700 may have triggered the pancreatitis flare. She said I had done all of the right things and everything I could have done at home. He was scheduled for SRT on Thursday of next week but that will probably not be done. I keep thinking I will wake up one day and this was all a bad dream. Max is the most loving and sweetest kitty ….it’s heartbreaking that all of this is happening to him. I love him so much.:(
 
Max & Lori said:
Thanks for your prayers. I’m really upset too. The doctor ended up keeping him there in the hospital for suspected flare of pancreatitis. He will be there until at least Monday. He did not have any ketones but was dehydrated. The ER doctor suspects the spike in BG to over 700 may have triggered the pancreatitis flare. She said I had done all of the right things and everything I could have done at home. He was scheduled for SRT on Thursday of next week but that will probably not be done. I keep thinking I will wake up one day and this was all a bad dream. Max is the most loving and sweetest kitty ….it’s heartbreaking that all of this is happening to him. I love him so much.:(
Click to expand...
Oh, Lori. My heart goes out to you! I’m so sorry this is happening. I can feel how much you love him. :bighug:
 
I'm so sorry to hear what your boy and you are going through. That was a long and difficult day for Max. I hope he will bounce back and start eating again at the ER and for you when you get him home. I'm sorry about the diagnosis too. I know exactly how you feel. We love our kitties so much and it is so hard to see them suffering and not knowing how to help. Prayers for both of you.
 
Thank you for all the love and prayers. The doctor called and said that Max responded very well to the treatment plan and is eating, meowing and moving about. He has urinated and pooped now. Plan is to let me come and get him at around 4:30 (3hrs from now) keep him on anti nausea meds, and pain meds, make sure he eats and drinks well. Will speak to the other doctors about the SRT. I want to have it done but I want to make sure Max can tolerate another round of anesthesia, given what happened already. The doctor said the anesthesia can trigger pancreatitis as well but she says SRT is the treatment of choice for acromegaly and she recommended it. I’m really worried about it though and not to mention the thousands of dollars I’ve spent already. The ER visit was an unexpected $4000. I’m retired now so not bringing in what I used to. I just want Max to be safe though and will do whatever to help him. The main thing is I’m worried about whether he can tolerate it. His BG is still high as of now but he got his full dose this morning per the vets report. Oh and Max says he’s ready to go home. He pulled out his central line lol.
 
Max & Lori said:
Thank you for all the love and prayers. The doctor called and said that Max responded very well to the treatment plan and is eating, meowing and moving about. He has urinated and pooped now. Plan is to let me come and get him at around 4:30 (3hrs from now) keep him on anti nausea meds, and pain meds, make sure he eats and drinks well. Will speak to the other doctors about the SRT. I want to have it done but I want to make sure Max can tolerate another round of anesthesia, given what happened already. The doctor said the anesthesia can trigger pancreatitis as well but she says SRT is the treatment of choice for acromegaly and she recommended it. I’m really worried about it though and not to mention the thousands of dollars I’ve spent already. The ER visit was an unexpected $4000. I’m retired now so not bringing in what I used to. I just want Max to be safe though and will do whatever to help him. The main thing is I’m worried about whether he can tolerate it. His BG is still high as of now but he got his full dose this morning per the vets report. Oh and Max says he’s ready to go home. He pulled out his central line lol.
Click to expand...
Max, you need to behave so mom can come get you. I'm so happy to hear that he is doing better, Lori. It is a tough decision about the SRT. Did you travel far to NCSU? Is it something that can be delayed a little or do you have a long trip back and need to take care of it now. Praying that he will be back in good form before this procedure - whenever you decide to do it.
 
Max & Lori said:
Thank you for all the love and prayers. The doctor called and said that Max responded very well to the treatment plan and is eating, meowing and moving about. He has urinated and pooped now. Plan is to let me come and get him at around 4:30 (3hrs from now) keep him on anti nausea meds, and pain meds, make sure he eats and drinks well. Will speak to the other doctors about the SRT. I want to have it done but I want to make sure Max can tolerate another round of anesthesia, given what happened already. The doctor said the anesthesia can trigger pancreatitis as well but she says SRT is the treatment of choice for acromegaly and she recommended it. I’m really worried about it though and not to mention the thousands of dollars I’ve spent already. The ER visit was an unexpected $4000. I’m retired now so not bringing in what I used to. I just want Max to be safe though and will do whatever to help him. The main thing is I’m worried about whether he can tolerate it. His BG is still high as of now but he got his full dose this morning per the vets report. Oh and Max says he’s ready to go home. He pulled out his central line lol.
Click to expand...
Hooray for Max doing better and coming home!! I’m very happy to hear it! I so hope he can get the SRT! My boy never didn’t make it long enough to het the SRT done - although I had planned to take him to NC state.
 
Hi Summer, thanks. It is tough but all that I have heard are positive things. So it’s hard considering what just happened. It just seems like with Max if it can go wrong it will. I hate to be so negative and I’m not usually that way. It just seems like one thing after another lately with my sweet boy. I know others including yourself have felt that way I’m sure. I’m just really anxious about it now. I’m going to see what the radiation oncologists think. I do think he needs time to recover from this but I don’t think they would want to wait too long after the MRI to do the radiation because of the mapping of the tumor. We will see. I live about an hour from NCSU so it’s not too bad, even though I hate the traffic in Raleigh. I went there and back twice yesterday because I forgot his inhalers and they were going to charge me an extra $300 for each inhaler if it came from their pharmacy… so I went back to get ours. Everything about veterinary medicine is expensive it seems. Thank you for your concern Summer.
 
I am so happy Max turned the corner! :bighug::bighug: And that he'll be home soon. :joyful: We've seen a few cats here get pancreatitis from stress too, which is also what Max had yesterday.

Are they sending you home with fluids too, just in case? A Primer On Pancreatitis

Of all the cats here I've seen have SRT, I don't think I've seen any have a pancreatitis flair. One bit of info that might help, the anaesthesia for the SRT is much shorter than what they need to do for the scans the first day. So it should be easier on him. That first day at Fort Collins was a really long one with the mapping. The other days Neko wasn't there for long.
 
@Wendy&Neko that is good to know about the anesthesia. They are not sending any fluids home with me because they worry about his heart with the ventricular hypertrophy. He was getting them from his regular vet but NC State wanted to stop them. We used them before and it really helped with his pancreatitis. He gets dehydrated so easily because he’s not regulated so that’s going to be difficult.
 
That makes sense given his heart. They will hydrate him as part of the procedure at NCSU. All you can do until then is try to entice him to drink. Soupy food, unsalted tuna water, broth from boiled meat are some ideas.

Has Max ever had his B12 levels tested? Some p'titis kitties are low in B12, and he might need supplementation.
 
Yes that was included in that panel they did earlier when he was initially diagnosed with chronic pancreatitis. At that time the report said his was within normal limits but he had just been given a B-12 injection a week prior to that. I asked the vet and he said that didn’t matter but I don’t know that I believe that. In people a B-12 injection lasts a month but I don’t know about cats. I do give him a Zobaline tablet once a day though. He never got another B-12 shot other than the one prior to the GI panel.
 
Zobaline = methyl B12. The other B12 is cyanocobalamin B12. Different B12's. Typically cats get a shot once a month too. And yes, the shot a week before would influence the test.
 
I didn’t realize zobaline was different, good to know. I will ask to get his repeated at some point. I have a new vet that seems to be more willing to work with me. Eventually I’m going to get him switched to Levemir and she seemed to be fine with working along with FDMB so I’m glad of that. I’m just going to wait until he gets through all of this then switch at a more stable time.
 
You must log in or register to reply here.
Back
Top