Heike & BInie
Very Active Member
Last post: https://www.felinediabetes.com/FDMB/threads/08-22-binie-amps-444-3-265.293361/#post-3201842
Good afternoon,
sorry, that this is going to be a longer text.
First of all thank you very much to @tiffmaxee, @Wendy&Neko and @Sienne and Gabby (GA) for the insights regarding steroids. I did some research and I also understood, that it can make a bacterial infection worse. But as I understood the vet, she didn't think about it as a treatment option for the infection itself but as a life-safer in case of a sepsis. It seems that this multi-resistant germ they found in january can lead easy to a septic-shock and because I wrote her about Binies unusual behaviour the day before she was scared that she was sliding into something like that. I found some research (for humans) that steroids might (not sure) help in a situation like that. But we didn't give it and I am glad about it because of the reasons you pointed out. If we come into another situation where my vet might think it is appropriate, I know how to challenge her idea now. Thank you!
The antibiogram came back from the lab: Unfortunaltely it is true what the vet suspected: The multiresistant germ enterococcus is still there besides Proteus mirabilis and Escherichia coli. Two rounds of Efex in january and may didn't help. The antibiogram now gives three other options, unfortunately there is one option Binie can't take because she reacts with vomiting immediately. So I am starting with Pradofloaxin tonight and hope that she can take it well and it helps. I also started to do a research about the other option in case the first one fails. It is florfenicol as a vet medicine or chloramphenicol in human medicine. The vet product has to be injected three to four times a day so the vet suggested we try to find the oral medication for humans. Unfortunately it is not approved for humans in Germany and the vet trys to find out how to get it and I am researching as well. If we can not get it at the international market and if the first antibiotic fails, I may end up giving the injections. So the situation is not really great. I asked if we should do ultrasound or an x-ray but she said that it doesn't make really sense because whatever we finde there, first priority is to fight the infection.
The good thing is, that Binie was somehow better today. Seems like the fluids and the pain meds helped. She was lying quite relaxed in her cat bed all day and ate well. Just now she started some hiding again and I just injected some novalgin the vet gave me. Hope it helps. Ketones went down to 0.3 mmol/dl in the the morning at amps.
My questions:
1. I know we are in a situation where the ketones can get up easily and they already did and came down after the fluids yesterday. Therefore I increased her insulin from 1.0 to 1.25 and feeded more carbs in the morning (20% besides her lc food). Today she was high (above 350) all day. I wonder if my strategy with higher carbs is right?
2. Does a second opinion in this situation makes sense? Somehow I feel the situation is clear, there is an infection, we know the germs and which antibiotics to take. We have to cross our fingers they work. Would a second opinion make sense? I wanted to consult an internal medicine specialist online but the earliest appointments are in september. I don't like to drag Binie around for a life consultation, if it doesn't make sense. I know all the vets in my surrounding and I am not convinced they can help. The next clinic is 80 km drive and I know that would be so stressful for Binie.
3. Is there anything more I can do?
Finishing this long text Binie is still in her hiding place. I really hope I can handle what is happening at the weekend. I am on my own here and the vet office is closed. There is an emergency vet in the next town which is open during the day but I don't know if they can do anything for us in this situation. I feel like I have a plan but I am also scared.
Hope everyone is having a good start in the weekend!
Good afternoon,
sorry, that this is going to be a longer text.
First of all thank you very much to @tiffmaxee, @Wendy&Neko and @Sienne and Gabby (GA) for the insights regarding steroids. I did some research and I also understood, that it can make a bacterial infection worse. But as I understood the vet, she didn't think about it as a treatment option for the infection itself but as a life-safer in case of a sepsis. It seems that this multi-resistant germ they found in january can lead easy to a septic-shock and because I wrote her about Binies unusual behaviour the day before she was scared that she was sliding into something like that. I found some research (for humans) that steroids might (not sure) help in a situation like that. But we didn't give it and I am glad about it because of the reasons you pointed out. If we come into another situation where my vet might think it is appropriate, I know how to challenge her idea now. Thank you!
The antibiogram came back from the lab: Unfortunaltely it is true what the vet suspected: The multiresistant germ enterococcus is still there besides Proteus mirabilis and Escherichia coli. Two rounds of Efex in january and may didn't help. The antibiogram now gives three other options, unfortunately there is one option Binie can't take because she reacts with vomiting immediately. So I am starting with Pradofloaxin tonight and hope that she can take it well and it helps. I also started to do a research about the other option in case the first one fails. It is florfenicol as a vet medicine or chloramphenicol in human medicine. The vet product has to be injected three to four times a day so the vet suggested we try to find the oral medication for humans. Unfortunately it is not approved for humans in Germany and the vet trys to find out how to get it and I am researching as well. If we can not get it at the international market and if the first antibiotic fails, I may end up giving the injections. So the situation is not really great. I asked if we should do ultrasound or an x-ray but she said that it doesn't make really sense because whatever we finde there, first priority is to fight the infection.
The good thing is, that Binie was somehow better today. Seems like the fluids and the pain meds helped. She was lying quite relaxed in her cat bed all day and ate well. Just now she started some hiding again and I just injected some novalgin the vet gave me. Hope it helps. Ketones went down to 0.3 mmol/dl in the the morning at amps.
My questions:
1. I know we are in a situation where the ketones can get up easily and they already did and came down after the fluids yesterday. Therefore I increased her insulin from 1.0 to 1.25 and feeded more carbs in the morning (20% besides her lc food). Today she was high (above 350) all day. I wonder if my strategy with higher carbs is right?
2. Does a second opinion in this situation makes sense? Somehow I feel the situation is clear, there is an infection, we know the germs and which antibiotics to take. We have to cross our fingers they work. Would a second opinion make sense? I wanted to consult an internal medicine specialist online but the earliest appointments are in september. I don't like to drag Binie around for a life consultation, if it doesn't make sense. I know all the vets in my surrounding and I am not convinced they can help. The next clinic is 80 km drive and I know that would be so stressful for Binie.
3. Is there anything more I can do?
Finishing this long text Binie is still in her hiding place. I really hope I can handle what is happening at the weekend. I am on my own here and the vet office is closed. There is an emergency vet in the next town which is open during the day but I don't know if they can do anything for us in this situation. I feel like I have a plan but I am also scared.
Hope everyone is having a good start in the weekend!
