Solensia, platelets crashed, skilled opinions requested

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Valher

Valher

Member Since 2018
Hello all - it's been a while since I've posted. Boo is 18 now, glucose is well regulates (Prozinc 1.5) but he is having neuropathy which caused an injury in April and exacerbated his arthritis pain. On April 26th he started Solensia injections, 1x/mo. The bloodtests on Monday show his platelets have crashed since February, potassium is low, but all the vet said was that he has kidney disease between stage 1 & 2? She didn't request any further testing, didn't discuss potassium supplements, and didn't mention taking him off Solensia, which has renal failure as a risk. Boo also has developed super dirty ears, requiring daily cleaning, tested as yeast so I have drops for that but am concerned they contribute to the unsteadiness, which the vet didn't address. I'm super concerned that I'm working with a vet who is inexperienced in with diabetic concerns and complications in an elderly cat.

I know we have some very knowledgable people here, so if anyone can point them my direction, it would be greatly appreciated.

Blood tests here: https://drive.google.com/file/d/153-BTK2ATgOTIBNa2QipMyUjzEq6cdUK/view?usp=drivesdk

Many thanks! Valeska & Boo
 
I’m trying to look but it is not accessible. You need to change the permissions to anyone with the link so we can see them.
 
I don’t think Solensia is contraindicated for cats with kidney disease (and there seems to be specific data that cats with stage 1/2 CKD tolerate Solensia), so that may be why your vet didn’t mention stopping it.
 
I would not be concerned about a machine count of low platelets since ct platelets tend to clump together resulting in a low platelet count. You report includes the statement "PLT Aggregates Detected". Aggregates means clumping.
From the report it appears the testing was done on a in-house IDEXX machine. When an IDEXX reference lab runs the test and report low platelets (at least in cats) they put a blood smear on a microscope slide and examine the slide by a human with a microscope. Usually they report clumping is present and estimate of platelets is adequate. This is what a recent IDEXX report said for one of my cats "
"Scanning of the blood film revealed adequate platelet numbers. Due to
clumping, the automated platelet number cannot be accurately determined.
Slide reviewed microscopically."
 
Thank you, Larry. I was going to ask about this. A lot of the time you will see notations on your lab results that “platelet clumping was detected” which means that you are not getting an accurate platelet count with the automated equipment. A manual count of blood platelets should then be done if there is a concern.
 
I have looked at the bloodwork and I would not be overly concerned about Boo’s blood values are very borderline (Creatinine) and yes, the SDMA may indicate that CKD is present but with that Creatinine and BUN, I would not freak out. I would just keep an eye on things. I also would have had a urinalysis done on Boo to check for USG and protein. If they didn’t do it, I would just do it at his next recheck unless he shows signs of having a UTI.
 
Regarding the ears: how are they now? It is true that ear problems can contribute to problems with balance. What kind of neuropathy are you talking about? Do you have a spreadsheet? I was trying to see his spreadsheet for clues as to how he is doing with his BG but there’s nothing on there for three years.
 
Larry and Kitties said:
I would not be concerned about a machine count of low platelets since ct platelets tend to clump together resulting in a low platelet count. You report includes the statement "PLT Aggregates Detected". Aggregates means clumping.
From the report it appears the testing was done on a in-house IDEXX machine. When an IDEXX reference lab runs the test and report low platelets (at least in cats) they put a blood smear on a microscope slide and examine the slide by a human with a microscope. Usually they report clumping is present and estimate of platelets is adequate. This is what a recent IDEXX report said for one of my cats "
"Scanning of the blood film revealed adequate platelet numbers. Due to
clumping, the automated platelet number cannot be accurately determined.
Slide reviewed microscopically."
Click to expand...
Thank You!! The platelets is what I was most freaked out about. I'm going to ask for another blood test with a hand count of the platelets. It's frustrating that the vet didn't even mention it.
 
Suzanne & Darcy said:
I have looked at the bloodwork and I would not be overly concerned about Boo’s blood values are very borderline (Creatinine) and yes, the SDMA may indicate that CKD is present but with that Creatinine and BUN, I would not freak out. I would just keep an eye on things. I also would have had a urinalysis done on Boo to check for USG and protein. If they didn’t do it, I would just do it at his next recheck unless he shows signs of having a UTI.
Click to expand...
Thank You! I have an appointment next week to check the ears and will request a urine test. Regarding the ears, they are starting to be a bit cleaner every day. He's been walking on his hauks (sp?) a little bit, but walks more steady after he's eaten. His BG is good, so I think changing food made him weaker in general. We finally found something he'll eat - wavura - but I have to add water and blend it so it's more like a shake. Kinda gross, but it's what we do, right?

I don't test every day anymore and give the same shot morning & night. I test if he seems off (drinking or eating more, walking funnier, etc) and do a curve about once a month. This plan works best with him and our family schedule, and we've actually been slowly reducing the insulin. I saw the vet last Monday and did a curve on Tuesday. Here is the info I sent the vet and she agreed with the reduction to 1.5:

"You mentioned that his BG level was 179 yesterday, but he hadn't gotten his am shot yet so a ran a curve today to see if the insulin injection (1.75) should be lowered. He is free fed with canned Fancy Feast. His curve results were:

10:30 am: 169, given 1.5 units insulin
12:30 pm: 178
2:30 pm: 139
5:14 pm: 114
7:00 pm: 142"

Thank you and Larry again for your help, it's eased my mind a great deal.

valeska & boo
 
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