1/29 Pants AMBG 119

[kira913]

Pants is still not eating well, his demeanor seems to have improved somewhat -- he was finally purring again -- but I could only get him to eat a small portion of a can of Fancy Feast. I can't afford to stay home with him all day to monitor, so I skipped insulin last night and this morning. He was 119 and dropping when I checked this morning, but I did not check again since I was focused on getting him to eat. He usually does manage a few more bites if I keep prompting him every 5-10 min

Picking up Gabapentin from the vet this afternoon to ease his dental pain so he hopefully starts eating a little better again if that doesn't work, vet said he could get us some Zorbium to make it through the weekend. At least he's not refusing the fancy feast like before, and it usually keeps him low 100s

Vet is taking away the Leflunomide dosage, potentially switching to ProZinc just to rule out any reaction to the insulin. May go back on Atopica or do another round of doxycycline to try and improve his bloodwork so that he can get the hole in his gum addressed surgically, pending go ahead from the internist. I have half a mind to just start the Atopica again myself, since my vet and I are already leaning that way and it seemed like it helped. I don't really want to lose ground on his bloodwork...

 

[Allie & Gen]

Previous post for context (please try to include a link when you make a new post): ? - 1/28 Pants AMNS 85, +.5 57, +1 77, +2.5 57, +3 109

Poor Pants. I was just reading your older posts, and it sounds like he's really been going through it. I don't have experience with many of his conditions, but my cat has had problems with inappetance lately too. In addition to anti-nausea meds and gabapentin, I've been giving him mirataz, an appetite stimulant, which many folks here have used. It's been very effective. Given the complexity of Pants' ailments, I don't know if that might be contraindicated, but I didn't see it mentioned in my quick readthrough (sorry if I missed it), so I thought it was worth bringing up!

There are some general tips for appetite stimulation here, though I imagine with the complexity of his situation, they may be of diminished usefulness: Suggestions on How to Stimulate Kitty's Appetite

I hope the pain meds help Pants feel better, hungrier, and more purrful. Wishing you both the best! He has the sweetest face, and I love his pajamas.

 

[Allie & Gen]

Oh, also we generally say "AMBG" or "PMBG" when we don't give a shot - "AMNS" might confuse some folks. That said, it's just a convention and not really important!

 

[kira913]

Oh, also we generally say "AMBG" or "PMBG" when we don't give a shot - "AMNS" might confuse some folks. That said, it's just a convention and not really important!

Thank you, I will keep in mind to add link, and I really appreciate the acronym clarification! Didn't want anyone to think I was giving him insulin in this state

We have really been going through it. Fortunately he's had a really good attitude and rolled with the punches up until now... Internist was shocked he was behaving so normal considering his bloodwork. Now, though, I can tell he's really feeling the pain my stress is through the roof, and I hate being at work away from him in his current state. It was a relief to hear his purring this morning, even if he didn't eat much. I was praying for that, at least

I feel kind of trapped between a rock and a hard place. Vet says he's not in good enough condition for dental surgery, but my gut is telling me that we need to act now or he's going to just keep declining. I don't think he's going to eat properly until he gets dental surgery, and if he doesn't eat, his bloodwork will only go down. When I pick up his gabapentin tonight I'm going to pressure them to at least reach out to a specific orthodontist I took another cat to so we can at least understand what values we're to targeting -- let them make the decision of what they're willing to handle

 

[Allie & Gen]

I feel kind of trapped between a rock and a hard place. Vet says he's not in good enough condition for dental surgery, but my gut is telling me that we need to act now or he's going to just keep declining. I don't think he's going to eat properly until he gets dental surgery, and if he doesn't eat, his bloodwork will only go down. When I pick up his gabapentin tonight I'm going to pressure them to at least reach out to a specific orthodontist I took another cat to so we can at least understand what values we're to targeting -- let them make the decision of what they're willing to handle

I am all too familiar with this quandary, if at a slightly less complex level. My cat was at a dental specialist for a scheduled surgery when they aborted due to his high BG - which is how I found out he'd come out of remission. We're finally, hopefully getting the surgery done in a few days, but it took some time for me to learn (and convince my vet) that waiting for his diabetes to be better-regulated before dealing with his teeth was a bad plan, because as long as the issue persists, he's likely to be unregulatable.

(Some recent developments have suggested that Gen may have a slightly more complex case himself, in which case it might not be as cut and dry as "which comes first - regulated BG or resolving dental issues" - but regardless.)

As I don't know much about most of what Pants is dealing with, I don't know how other factors weigh in when it comes to being in good condition for dental surgery. But when it comes to diabetes specifically, apparently there have been a number of cats here who have had theirs improve significantly once an oral health problem was dealt with ... though I think from what I'm reading that Pants is probably diabetic from steroid use, and I'm not sure how that factors in either.

Sorry I can't be of more help, but I think your instincts make sense and that it's worth further discussion with medical professionals at the very least!

In the meantime, hugs. And if it's not contraindicated/not already-trodden ground, I really would encourage you to ask your vet about mirataz!

 

[kira913]

As I don't know much about most of what Pants is dealing with, I don't know how other factors weigh in when it comes to being in good condition for dental surgery. But when it comes to diabetes specifically, apparently there have been a number of cats here who have had theirs improve significantly once an oral health problem was dealt with ... though I think from what I'm reading that Pants is probably diabetic from steroid use, and I'm not sure how that factors in either.

Sorry I can't be of more help, but I think your instincts make sense and that it's worth further discussion with medical professionals at the very least!

In the meantime, hugs. And if it's not contraindicated/not already-trodden ground, I really would encourage you to ask your vet about mirataz!

Just feeling a little less alone in it all helps tremendously, to be honest I really, really appreciate the insight with your own experiences, it helps me feel a little more like I'm on the right path. I had a cat with stomatitis in 2023, and after full mouth extraction his quality of life skyrocketed.

Our vet thinks the hole in his gum may already prevent them from being able to do a gingival flap on that side if that's the case, I think I'd rather risk surgery than risk things worsening. Pants already has a terrible track record of dental issues (extractions every 6-12 months since shelter intake), so I'm honestly leaning towards an FME if an orthodontist thinks it may be a good preventative measure.

He's is definitely diabetic from the long term steroids, but I've also heard anecdotal evidence of diabetic symptoms during FIP treatment that resolve after completion -- so I'm erring on the side of far less insulin than traditional SLGS. Vet also feels that he's better off a little too high than too low. That said... I keep wondering if raising instead of lowering the steroids (and trying to balance out BG with insulin) would get us over the hump to a good place for surgery. But I don't know if that would only worsen things instead

With how recent the FIP treatment is, it seems like there's just not enough literature to be certain what to do for Pants our internist seems to just be firing shots in the dark. They mentioned a possible new med that my vet and I've never heard of before, and I just r silly

My hope is that even if things don't turn out well, maybe we can contribute to some research. I don't know. Hopefully everyone enjoys all his crazy blood work in his sheet, LOL