? 3/17 diabetic in remission, Chloe questions

[MaryB]

Hi everyone!
Chloe is 1 month off Lantus now and doing well with her sugars.
Chloe had her vet visit on 3/8 where everything checked out well except the potassium level was 3.1 and she was prescribed potassium gluconate every 24 hr. They said recheck in 3 months, which I thought was odd, but ok.
Later that week I felt like Chloe was acting “off”… her leg was still weak and she seemed anxious (maybe just from being at the loud vet with dogs vs our normally super quiet house?) and I felt she was lethargic. I took her back on 3/14 and they repeated labs. Her T4 level was 4.3 on 3/8 the vet said that was fine… level felimazole dose same. On 3/14 the T4 was 2.3 and the vet also said leave the dose the same. I don’t really understand that? their optimal range was 0.8-4.7… this seems very wide and not possible to know if controlled.
Also her potassium had increased to 3.9 after 3 days of supplements (I couldn’t get the pills till Thursday) and they suggested to stop it and recheck in ~1 week.
Now the last couple days she has been very lethargic, her back legs and just above tail very sore/tender, her breathing is sometimes fast. Another place I read suggested potassium 4-4.4 but my vet said 3.5-5.7?
Is this potassium related?
What about the T4 .. any thoughts?
I’m very confused and overwhelmed and heartbroken seeing her be in pain. Any help is appreciated

https://www.felinediabetes.com/FDMB/threads/3-17-chloe-update.260793/#post-2926590

 

[Larry and Kitties]

I took her back on 3/14 and they repeated labs. Her T4 level was 4.3 on 3/8 the vet said that was fine… level felimazole dose same. On 3/14 the T4 was 2.3 and the vet also said leave the dose the same. I don’t really understand that? their optimal range was 0.8-4.7… this seems very wide and not possible to know if controlled.

My civi Boots is on methimazole. Started on oral them went to transdermal since the oral resulted in inappetence and lethargy. Last year his level was 4.5 and the vet said dose was OK. However, this Feb it increased to 5.6 and I increased dose. Doing bloodwork next month. I consider 4.2 to be fine but a 2/3 is too low. Anything happen to that would have resulted in the decrease (4.3>2.3) from 3/8 to 3/14? Some cats have problems like my Boots has with oral hypothyroidism drugs

Chloe had her vet visit on 3/8 where everything checked out well except the potassium level was 3.1 and she was prescribed potassium gluconate every 24 hr. They said recheck in 3 months, which I thought was odd, but ok.

Also her potassium had increased to 3.9 after 3 days of supplements (I couldn’t get the pills till Thursday) and they suggested to stop it and recheck in ~1 week.

Now the last couple days she has been very lethargic, her back legs and just above tail very sore/tender, her breathing is sometimes fast. Another place I read suggested potassium 4-4.4 but my vet said 3.5-5.7?
Is this potassium related?

The acceptance range for potassium on Boot's labs is 3.7-5.2. .

I would stop the felimazole since that may be causing the problem. The potassium of 3.9 is OK. What form of potassium gluconate are you giving? Maybe the form is causing problems.

 

[MaryB]

My civi Boots is on methimazole. Started on oral them went to transdermal since the oral resulted in inappetence and lethargy. Last year his level was 4.5 and the vet said dose was OK. However, this Feb it increased to 5.6 and I increased dose. Doing bloodwork next month. I consider 4.2 to be fine but a 2/3 is too low. Anything happen to that would have resulted in the decrease (4.3>2.3) from 3/8 to 3/14? Some cats have problems like my Boots has with oral hypothyroidism drugs



The acceptance range for potassium on Boot's labs is 3.7-5.2. .

I would stop the felimazole since that may be causing the problem. The potassium of 3.9 is OK. What form of potassium gluconate are you giving? Maybe the form is causing problems.

hello,
Thanks for your information!
She’s been on the oral for about 3 years.
They stopped the potassium (potassium gluconate pills) Monday and it was rechecked yesterday at outside lab so waiting for those results.
Nothing occurred to make the change. I did learn she has arthritis by an X-ray yesterday.
I’m taking her to a walk in vet at her clinic today her vet isn’t available. I’m going to ask for adequen. Her other vet gave omega III but she’s in pain and needs something to help her quicker than omega. I hope they will give it and it works I’m really heartbroken seeing her this way.
She is lethargic so perhaps the potassium has dropped again and she needs the supplement. I’m really confused and overwhelmed.
Thank you for answering

 

[Larry and Kitties]

You can try gabapentin for pain. My civi Moxie was on 50mg twice daily for years. I got 100mg capsules from human pharmacy and divided that into two capsules. It tastes terrible and my cats would not touch their food if it was added to food. I give 100 mg to two of my cats and 150mg to one divided into 50 and 100mg before vet visits. Very affordable if you go pharmacy shopping.She was also on Adequan injections for years.

 

[MaryB]

You can try gabapentin for pain. My civi Moxie was on 50mg twice daily for years. I got 100mg capsules from human pharmacy and divided that into two capsules. It tastes terrible and my cats would not touch their food if it was added to food. I give 100 mg to two of my cats and 150mg to one divided into 50 and 100mg before vet visits. Very affordable if you go pharmacy shopping.She was also on Adequan injections for years.

Thank you, I want to try the adequen but not sure the dose? Or if the vet will even agree. I am just so saddened she is hurting… I feel helpless. Could also be the potassium still too. Waiting on the lab results. I just want to help her feel better. It’s scaring me to see her hurting.

 

[MaryB]

Just received Chloe’s potassium level from yesterday and it was 4.3 so it isn’t that causing the lethargy, could this all be from arthritis? Her t4 was 3.1 yesterday… so basically over the last 10 days t4 has been 4.3, 2.3, now 3.1… what is even right? Is she taking enough? Too much? I’m lost

 

[tiffmaxee]

Arthritis is painful. I know because I have it in both hips. It won’t make her lethargic but it very well could make her not want to move a lot.

 

[MaryB]

Arthritis is painful. I know because I have it in both hips. It won’t make her lethargic but it very well could make her not want to move a lot.

Thank you for explaining how debilitating it can be; I don’t have it myself (yet) fortunately so I’m not familiar. I am happy to report Chloe received her first Adequen infection this afternoon around 4:30pm … she will go back for her 2nd on Wednesday but after that they should be able to teach me to do myself. I’m not sure how often they are given. I’m praying she gets some relief soon.

 

[tiffmaxee]

That is great.

 

[MaryB]

That is great.

I feel better knowing she got it, even though I know it’s not immediate. I hope it will be soon.
The vet gave her a NSAID… osinor? I didn’t really want it, but she said to take it just in case for pain . I haven’t given it… it’s a 3 day supply. I was afraid of anything like that even though her kidneys are good… she is elderly.

 

[tiffmaxee]

I would not give a NSAID as they are not good for the kidneys. I think you give weekly adequan and then it gets spaced out. See if it works. If it doesn’t help enough I would try a different pain medication. I know others feel differently. If all else fails and my cat was in a lot of pain I would look at QOL and possibly try a NSAID but not at first. If you give both you won’t know if adequan alone can help. Just my two cents fwiw.

 

[MaryB]

Thank you @tiffmaxee … I thought that was accurate on the kidneys.
She goes for 2 next week then I’m not sure how they space out. I’ll see if I can search for someone here who has taken them. Maybe they’ll know the dose schedule.
I want to try the other therapies first in addition to adequen (acupuncture, laser). She has an appointment April 5.

 

[Sienne and Gabby (GA)]

I agree with Elise -- I would avoid an NSAID. Onsior is only supposed to be used for 3 days and not for longer term pain management. Larry's suggestion about using gabapentin may be another option.

 

[MaryB]

I agree with Elise -- I would avoid an NSAID. Onsior is only supposed to be used for 3 days and not for longer term pain management. Larry's suggestion about using gabapentin may be another option.

thank you! I had an off feeling about it… so I didn’t use it.
I’m going to give the adequen a chance to work and also try acupuncture and or laser.