Started Prozinc August 1 after 6 years with Lantus

You might want to reconsider the Convenia. This is a link to information from a vet, Lisa Pierson, DVM, regarding the risks of giving a cat Convenia. Many vets will give a long acting antibiotic injection rather than bother their clients with having to give pills. The problem is that once the drug is given, there's no way to interrupt its action. Convenia is maximally active for 1 - 2 weeks but lasts for up to 2 months. Its primary action, based on the drug company's information is for skin infections. It does not have an indication for dental issues. Just a personal note, my vet will not prescribe Convenia.

GI issues are not uncommon with Clavamox and Clindamyacin. You can give probiotics to offset the issue but you need to separate the dosing by a few hours.
 
Suzanne & Darcy said:
I agree with what Marje said here. With my most recent heart kitty, I was just looking through her cardiology reports since Sienne had mentioned the ejection fraction. Ginger’s was not great at 39.8%. Anyway, I came across a list of questions that I had submitted to the cardiologist regarding comparing the first ultrasound data to the data recorded by the cardiologist at Ginger’s first visit. The bottom line was that there really was not a lot that we could compare because the vet who had done the original echocardiogram didn’t have the advanced equipment that the cardiologist had (so while the first echocardiogram was good enough to show things like thickening of the left ventricle, etc., there was a whole lot of missing information about her heart function. In addition, Ginger was being over medicated, and the cardiologist had us discontinue two different medications.

I would definitely keep the Tuesday appointment and see how it goes, but I would also try to get on the schedule with one of those cardiologists.
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My vet is telling me the US is an echo. She’s been a vet over 35 years and she trusts this old guy. He’s diagnosed a few of my pets before. He’s a grumpy old man but seems to know his stuff. I’m pissed because she didn’t prioritize me to call the cardio. The old guy was available First thing Tuesday so I took it. The cost is about the same. If he finds something I still have to go to the cardio!
I’m a mess😥😥😥
 
Sienne and Gabby (GA) said:
You might want to reconsider the Convenia. This is a link to information from a vet, Lisa Pierson, DVM, regarding the risks of giving a cat Convenia. Many vets will give a long acting antibiotic injection rather than bother their clients with having to give pills. The problem is that once the drug is given, there's no way to interrupt its action. Convenia is maximally active for 1 - 2 weeks but lasts for up to 2 months. Its primary action, based on the drug company's information is for skin infections. It does not have an indication for dental issues. Just a personal note, my vet will not prescribe Convenia.

GI issues are not uncommon with Clavamox and Clindamyacin. You can give probiotics to offset the issue but you need to separate the dosing by a few hours.
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I didn’t even want to mention Covenia because of the reaction I get.

Bella saw a highly qualified dental specialist and an IM. She’s had Covenia in the past and it really helped her mouth. All the probiotics in the world didn’t help when she had diarrhea for 28 days due to clindamyacin. I won’t do that again.
I was shocked when both specialists said you can give Covenia weekly to cats.

She’s done well with that drug but her mouth issues are progressing which is why I had planned the extractions. She’s too frail now snd until we get answers on the heart, the dentist won’t do it.
 
I don't disagree with getting feedback from the cardiologist before doing a dental or any other procedure. Not everyone is familiar with the issues around Convenia. You've clearly done your homework. I've never heard of giving Convenia weekly, either.

(Part of the reason that I post a heads up is because we never know who is reading which threads. There are lots of people who will take what a doctor says and not ask questions. I want to be sure our members are asking questions!)
 
DianefromDallaa said:
My vet is telling me the US is an echo. She’s been a vet over 35 years and she trusts this ol
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Yes. Cardiac ultrasound is same thing as an echocardiogram. I hope I didn’t imply it wasn’t the same. Two names; same thing.

The purpose of my post was only to say that not all ultrasounds of the heart are equal. There is different equipment as well as different operator experience, knowledge, and training. For example, when the cardiologist did the ultrasound of Ginger’s heart, they didn’t even have to shave her fur. That’s a small and perhaps silly thing to note, but there were huge differences between the detailed reports I got from the cardiologist and the other vet. That’s doesn’t mean the other vet wasn’t a good vet. And I am definitely not denigrating the IM vet that is going to do the echo on Tuesday and I am really glad you will be having it done at that time— and can hopefully get some answers.
 
I’d also like to add a couple things. First, you do really need a cardiologist at some time. Not meaning to heap on you at all but I also had a very experienced IM doing an echo on my younger cat and he said she had HCM. Our closest cardiologist (Tobey’s) is two hours away and that’s why I took her locally but I immediately made an appt for the cardiologist and he said she did NOT have HCM. They had her positioned incorrectly. Her heart, for some reason, is a little bit askew from where it typically would be but the IM was not experienced enough looking at the heart to know that.

Also...you said they used Aranasp when her HCT came down. I looked at her labs and the lowest I saw it was 30%. Aranasp should not be used until the HCT or PCV is below 20. You can read more about it HERE but you’ll need to scroll way down to the section “Possible Treatment Plan for CKD Cats”. There is no harm in giving her the B vitamins I discussed and which are also discussed on the linked page.
Suzanne & Darcy said:
You fixed it. Spreadsheet in the signature works!
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I did that ;):)
 
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Suzanne & Darcy said:
Yes. Cardiac ultrasound is same thing as an echocardiogram. I hope I didn’t imply it wasn’t the same. Two names; same thing.

The purpose of my post was only to say that not all ultrasounds of the heart are equal. There is different equipment as well as different operator experience, knowledge, and training. For example, when the cardiologist did the ultrasound of Ginger’s heart, they didn’t even have to shave her fur. That’s a small and perhaps silly thing to note, but there were huge differences between the detailed reports I got from the cardiologist and the other vet. That’s doesn’t mean the other vet wasn’t a good vet. And I am definitely not denigrating the IM vet that is going to do the echo on Tuesday and I am really glad you will be having it done at that time— and can hopefully get some answers.
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I didn’t take it that way at all. I’m concerned because he’s a traveling doctor so his equipment is portable not sophisticated.
 
Marje and Gracie said:
I’d also like to add a couple things. First, you do really need a cardiologist at some time. Not meaning to heap on you at all but I also had a very experienced IM doing an echo on my younger cat and he said she had HCM. Our closest cardiologist (Tobey’s) is two hours away and that’s why I took her locally but I immediately made an appt for the cardiologist and he said she did NOT have HCM. They had her positioned incorrectly. Her heart, for some reason, is a little bit askew from where it typically would be but the IM was not experienced enough looking at the heart to know that.

Also...you said they used Aranasp when her HCT came down. I looked at her labs and the lowest I saw it was 30%. Aranasp should not be used until the HCT or PCV is below 20. You can read more about it HERE but you’ll need to scroll way down to the section “Possible Treatment Plan for CKD Cats”. There is no harm in giving her the B vitamins I discussed and which are also discussed on the linked page.

I did that ;):)
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My vet administered a tiny dose when her PCV dropped below 30, not 20. Her RBC dropped and the vet thought this was a good option. She’s too frail did feel better.
 
DianefromDallaa said:
My vet administered a tiny dose when her PCV dropped below 30, not 20. Her RBC dropped and the vet thought this was a good option. She’s too frail did feel better.
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I understand but I know my vet wouldn’t have done it. There could be other reasons why she is frail. She could have an iron deficiency that is not related to her CKD. I don’t know. But I do know you have to be careful using Aranasp and it is not recommended to give it to a cat with an HCT of 30. It’s based on the HCT and not the RBCs.
 
What kind of Fancy Feast are you feeding her at breakfast and dinner? She drops very fast in the first hour. First, is she eating a good amount at breakfast? I think you should feed her something with a few more carbs in it for the meal fed at shot times— something closer to ten percent. This could help slow her initial drop. Those steep drops can really cause bouncing. If it works, it also could cause her nadir to move a little later in the cycle.
 
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