03/24 Binie, AMPS 496, wound healing complication

[Heike & BInie]

Last post: https://www.felinediabetes.com/FDMB/threads/03-21-binie-amps-475-fur-shot-again.287953/#post-3164025

Good morning,

I tried to get back on the right track by going back to 2,5 IE today. Thanks @Wendy&Neko for the support! . Unfortunately a complication arised: I found an old wound infected again under Binies front armpit.

It was a bite wound from six month ago which was treated in multiple ways (rinsing and leucase cones at the vet and finally antibiotics). It never appeared severe but it always came back after being seemingly healed. I can't count how many times I went to the vet with her. When the diabetes was diagnosed, this finally made sense.

So at the beginning of the diabetes treatment we treated a bladder infection and the wound together with a long antibiotics treatment. My vet examined it at the end of february and said it was o.k. Yesterday evening I saw her licking there and saw that there is a small open wound and a swelling. This also seems to effect her bg and it is not really coming down after the shot. I spoke to an online doctor today to find out if I should stress her with the emergency vet and we agreed, that it is only an emergency, if the ketones go up. I measured the ketones in the blood and with 0,1 they are quite good. I will go to our vet tomorrow and see what she can do. Binie is eating her food like the weeks before (she is not a good eater at the moment despite being overweight) and she seems not to feel too uncomfortable. I hope the vet can do something for her tomorrow and we manage without opening the wound up again in an operation. Thank god I have almost a week off now and have time to take care of all of this.

I hope everyone is having a relaxed sunday!

 

[thornmallow__]

Last post: https://www.felinediabetes.com/FDMB/threads/03-21-binie-amps-475-fur-shot-again.287953/#post-3164025

Good morning,

I tried to get back on the right track by going back to 2,5 IE today. Thanks @Wendy&Neko for the support! . Unfortunately a complication arised: I found an old wound infected again under Binies front armpit.

It was a bite wound from six month ago which was treated in multiple ways (rinsing and leucase cones at the vet and finally antibiotics). It never appeared severe but it always came back after being seemingly healed. I can't count how many times I went to the vet with her. When the diabetes was diagnosed, this finally made sense.

So at the beginning of the diabetes treatment we treated a bladder infection and the wound together with a long antibiotics treatment. My vet examined it at the end of february and said it was o.k. Yesterday evening I saw her licking there and saw that there is a small open wound and a swelling. This also seems to effect her bg and it is not really coming down after the shot. I spoke to an online doctor today to find out if I should stress her with the emergency vet and we agreed, that it is only an emergency, if the ketones go up. I measured the ketones in the blood and with 0,1 they are quite good. I will go to our vet tomorrow and see what she can do. Binie is eating her food like the weeks before (she is not a good eater at the moment despite being overweight) and she seems not to feel too uncomfortable. I hope the vet can do something for her tomorrow and we manage without opening the wound up again in an operation. Thank god I have almost a week off now and have time to take care of all of this.

I hope everyone is having a relaxed sunday!

OMG! Lucky you have the week off to handle this. Can you put Binie in a shirt or something, so the wound stays covered and she can't lick at it?

 

[Heike & BInie]

OMG! Lucky you have the week off to handle this. Can you put Binie in a shirt or something, so the wound stays covered and she can't lick at it?

Yes, I am really lucky I don't have no where to go tomorrow and I can take any appointment the vet suggests. Especially after the weekend the vets schedule is often extremely tight. And the last month I had to tell my co-works so often that I have to leave early or come later because of Binie - I am happy not to worry about that....

Binie is unfortunately not very cooperative and so far I never made her wear anything. Interestingly my vet, who only works with cats, thinks that preventing them to lick is counterproductive, because keeping the wound open would help to heal from the inside out. She only makes them wear bodys after operations, so they don't tear open the stitching. But to be honest, I am not 100 % sure, if that is always true. I will see what she will suggest for the treatment tomorrow. Maybe that is an option and than I will try...

Hope you enjoy your sunday!

 

[Marje and Gracie]

Last post: https://www.felinediabetes.com/FDMB/threads/03-21-binie-amps-475-fur-shot-again.287953/#post-3164025

Good morning,

I tried to get back on the right track by going back to 2,5 IE today. Thanks @Wendy&Neko for the support! . Unfortunately a complication arised: I found an old wound infected again under Binies front armpit.

It was a bite wound from six month ago which was treated in multiple ways (rinsing and leucase cones at the vet and finally antibiotics). It never appeared severe but it always came back after being seemingly healed. I can't count how many times I went to the vet with her. When the diabetes was diagnosed, this finally made sense.

So at the beginning of the diabetes treatment we treated a bladder infection and the wound together with a long antibiotics treatment. My vet examined it at the end of february and said it was o.k. Yesterday evening I saw her licking there and saw that there is a small open wound and a swelling. This also seems to effect her bg and it is not really coming down after the shot. I spoke to an online doctor today to find out if I should stress her with the emergency vet and we agreed, that it is only an emergency, if the ketones go up. I measured the ketones in the blood and with 0,1 they are quite good. I will go to our vet tomorrow and see what she can do. Binie is eating her food like the weeks before (she is not a good eater at the moment despite being overweight) and she seems not to feel too uncomfortable. I hope the vet can do something for her tomorrow and we manage without opening the wound up again in an operation. Thank god I have almost a week off now and have time to take care of all of this.

I hope everyone is having a relaxed sunday!

I hope you can get this sorted out quickly for her. Great that you caught it!

I saw your post on Ivy’s condo about Binie being hypothyroid after I131. You might want to post in the groups.io Feline Thyroid Management group because meds to treat hypothyroidism should be given twice a day due to the cat’s metabolism. My Tobey had I131 in Dec, 2022 and became hypothyroid, too. I learned a lot from the above group and the T4 given to hypothyroid cats, unlike hypothyroid humans, has to be dosed twice a day (divide the current dose you are giving in half and give twice a day). In addition, after Tobey’s tT4 was normal, the specialist said he was euthyroid but he wasn’t. Clinically, he was still acting very hypothyroid and his creatinine was up. With advice from the group above and talking to my regular vet, we had a full thyroid panel done on a Tobey which includes a tT4, fT4, tT3, fT3, and TSH and his fT3 was almost nonexistent and his TSH was really high. The way the thyroid works is if more is needed , TSH is secreted to tell the thyroid to produce T4. T4 is then converted to T3 which runs the body’s organs. In Tobey’s case, the TSH was telling his thyroid to release T4 but the T4 was not being converted to T3 and so it was like he had no thyroid hormones at all. At the recommendation of the vet which does the thyroid testing and is an expert and in conjunction with our vet, we started also supplementing with T3 and Tobey is like his old happy, active self. His creatinine has come back down to prehyperthyroid levels. When I discussed all of this with the vet that did his I131, she had all kinds of excuses for not doing full thyroid panels and addressing the T3 but I believe she has finally come around to see how important it is. At any rate, I thought I’d throw that out there. It’s worth checking if you can get a vet to do a full thyroid panel. The T3 med is very easy to give. I get it compounded into a powder and it is tasteless and odorless so Tobey eats it in his food along with his T4 pill.

 

[Heike & BInie]

I hope you can get this sorted out quickly for her. Great that you caught it!

I saw your post on Ivy’s condo about Binie being hypothyroid after I131. You might want to post in the groups.io Feline Thyroid Management group because meds to treat hypothyroidism should be given twice a day due to the cat’s metabolism. My Tobey had I131 in Dec, 2022 and became hypothyroid, too. I learned a lot from the above group and the T4 given to hypothyroid cats, unlike hypothyroid humans, has to be dosed twice a day (divide the current dose you are giving in half and give twice a day). In addition, after Tobey’s tT4 was normal, the specialist said he was euthyroid but he wasn’t. Clinically, he was still acting very hypothyroid and his creatinine was up. With advice from the group above and talking to my regular vet, we had a full thyroid panel done on a Tobey which includes a tT4, fT4, tT3, fT3, and TSH and his fT3 was almost nonexistent and his TSH was really high. The way the thyroid works is if more is needed , TSH is secreted to tell the thyroid to produce T4. T4 is then converted to T3 which runs the body’s organs. In Tobey’s case, the TSH was telling his thyroid to release T4 but the T4 was not being converted to T3 and so it was like he had no thyroid hormones at all. At the recommendation of the vet which does the thyroid testing and is an expert and in conjunction with our vet, we started also supplementing with T3 and Tobey is like his old happy, active self. His creatinine has come back down to prehyperthyroid levels. When I discussed all of this with the vet that did his I131, she had all kinds of excuses for not doing full thyroid panels and addressing the T3 but I believe she has finally come around to see how important it is. At any rate, I thought I’d throw that out there. It’s worth checking if you can get a vet to do a full thyroid panel. The T3 med is very easy to give. I get it compounded into a powder and it is tasteless and odorless so Tobey eats it in his food along with his T4 pill.

Thank you so much for this valuable information! To be honest I didn't dive into this so far because shortly after this diagnosis the fd diagnoses came up and my head was full with that. But this all makes very much sense. The TSH gets checked regularly but not the T3. I will ask for that the next time. And giving the meds in two fractions also makes totally sense for me. I will do that and register for the group you suggested.

Do you think the hypothyroidism could have triggered the diabetes? It made Binie gain 1,5 kg in short time and I feel that could also have contributed. So I am hopeful it maybe helps with the diabetes when the thyroid is properly adjusted. So... another subject I have to dive into now... Thank you so much for the helpful suggestions!

 

[Marje and Gracie]

Thank you so much for this valuable information! To be honest I didn't dive into this so far because shortly after this diagnosis the fd diagnoses came up and my head was full with that. But this all makes very much sense. The TSH gets checked regularly but not the T3. I will ask for that the next time. And giving the meds in two fractions also makes totally sense for me. I will do that and register for the group you suggested.

Do you think the hypothyroidism could have triggered the diabetes? It made Binie gain 1,5 kg in short time and I feel that could also have contributed. So I am hopeful it maybe helps with the diabetes when the thyroid is properly adjusted. So... another subject I have to dive into now... Thank you so much for the helpful suggestions!

You’re welcome. If the TSH is normal, that’s a great sign! And the T3 that needs to be tested is fT3.

We don’t know all the things that can cause FD. When I see cats that have never had dry food, have never had steroids, & still get FD, I have to wonder what caused it. Often, I think it is a low grade chronic pancreatitis. The only symptoms one might see to tell the vet is “kitty is off their food a bit” or “kitty is just not quite right”. In a few days, kitty is better but likely the kitty had a mild case of pancreatitis. It’s more common than we think. While I’ve never see anything that draws a causation between hyperT being the culprit in FD development, I have seen FD cats later develop hyperT.

 

[Wendy&Neko]

Infections/inflammation can impact the BG, so good that you increased to try to counteract it.

Will Binie let you put warm wet compress on the wound to try to help drain it?

 

[Heike & BInie]

Infections/inflammation can impact the BG, so good that you increased to try to counteract it.

Will Binie let you put warm wet compress on the wound to try to help drain it?

Unfortunately not.... It is even hard to have a look at the wound, because I have to divide the fur for it. I really hope the vet can rinse it tomorrow and place the leucase cones. The bg hardly went below 400 today. On the other hand she is eating, grooming herself and acting fine. I hope she does not need an operation and we can fix it somehow....