? 04-26 Panzer PMPS 237 VET VISIT THOUGHTS & QUESTIONS

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Chrispooky12

Chrispooky12

Member Since 2021
As we all know Panzer still has a UTI. I started him on doxycycline Sunday night & he was fine. Last night he was puking & his head & paws were jerking as he was laying on the bathroom floor in pain. Spook had an appointment at the vet today so they told me to bring Panzer as well. Panzer was given subcutaneous fluids & an injection of Cerenia & Butorphanol for pain. I hope that pain med is okay please tell me if it's not so I know in the future. Spook got a urinalysis & the only elevation was white blood cells seen. He also got a full panel bloodwork. His glucose was high but normal due to stress, it was 205. The concerning part on Spook is his creatinine was 2.6 BUN 41 & his GGT was 8. Spook also got a shot of Cerenia, subcutaneous fluids, a Cerenia shot & MIrataz for his ear because he's not wanting to eat. He goes back for bloodwork on May 24th.I have 2 boxes of Cerenia for Panzer & 1 box for Spook. It says to give Spook Mirataz once daily for 3 days, I think that's too much? Thoughts & advice needed please. The vet wants me to change them both to a low protein & low phosphorus food & get them a water fountain to encourage drinking?https://felinediabetes.com/FDMB/thr...s-207-200-4-urine-culture-234-6-244-8.261132/
 
Spook is pretty young to be having kidney disease. I’m wondering if something else is going on that is affecting those numbers. Do you have the CBC results. Did they give you the USG (this would be important). White cells in the urine could mean a UTI or kidney disease. What other labs can you share? What was the vet’s diagnosis?
 
High GGT is indicative of a problem with the liver. What’s Antech’s reference range for the GGT and what is Spook’s ALT, AST. GGT is oftentimes elevated when something is obstructing the flow of bile from the liver to the small intestine. You can’t really know about that without an ultrasound. Right now, that would be premature. These labs may improve. I would repeat labs in 30 days or so and see what’s happening. Of course, if he gets a full-blown UTI things would be different and he would need antibiotics.
 
I would not begin renal prescription foods at this point. I would try to find lower phosphorus foods though. What was Spook’s phosphorus level? I will send you a list.
 
I just tagged you on the posts from today where I linked food lists. These food lists are much more up to date than Dr. Lisa’s lists. I can’t get my laptop to work so I’m not able to attach them here - so I tagged you on that post
 
GLU 205 74-159 Normal
CREA 2.6 0.8- 2.4 Normal
BUN 41 16-36 Normal
BUN/CREA 16
PHOS 4.9 3.1-7.5 Normal
CA 9.5 7.8-11.3 Normal
TP 7.0 5.7-8.9 Normal
ALB 2.9 2.2-4.0 Normal
GLOB 4.0 2.8-5.1 Normal
ALB/GLOB O.7
ALT 88 12-130 Normal
ALKP 56 14-111 Normal
GGT 8 0-4 Normal
TBIL 0.3 0.0-0.9 Normal
CHOL 208 65-225 Normal
AMYL 699 500-1500 Normal
LIPA 372 100-1400 Normal
Na 160 150-165 Normal
K 3.9 3.5-5.8 Normal
Na/K 41
Cl 118 112-129 Normal
Osm Calc 331
RBC 9.78 6.54 Normal
HCT 50.2. 30.3-52.3 Normal
HGB 16.0. 9.8- 16.2 Normal
MCV 51.3. 35.9-53.1 Normal
MCH16.3 11.8-17.3 Normal
MCHC 31.9 28.1-35.8 Normal
RDW 24 15.0-27.0
RETIC O.3
RETIC 28.8 3.0-50.0 Normal
WBC 10.03 2.87- 17.02 Normal
NEU 42.8
LYM 47.1
MONO 3.4
EOS 6.1
BASO O.6
NEU 4.29 2.30-10.29 Normal
LYM 4.72 0.92-688
MONO 0.34 0.05-0.67 Normal
EOS 0.61 0.17-1.57 Normal
BASO 0.06. 0.01-0.26 Normal
PLT 366 151-600 Normal
MPV 12.5. 11.4-21.6 Normal
PCT 0.46. 0.17-0.86 Normal
 
Suzanne & Darcy said:
I would not begin renal prescription foods at this point. I would try to find lower phosphorus foods though. What was Spook’s phosphorus level? I will send you a list.
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Okay he said low protein & phosphorus is that renal food? All of his #s are now on this post down below.
 
Suzanne & Darcy said:
High GGT is indicative of a problem with the liver. What’s Antech’s reference range for the GGT and what is Spook’s ALT, AST. GGT is oftentimes elevated when something is obstructing the flow of bile from the liver to the small intestine. You can’t really know about that without an ultrasound. Right now, that would be premature. These labs may improve. I would repeat labs in 30 days or so and see what’s happening. Of course, if he gets a full-blown UTI things would be different and he would need antibiotics.
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There in house blood machines are IDEX so his #s are from there. Please no UTI....He goes back fora repeat blood work in a month.
 
Suzanne & Darcy said:
Butorphanol is fine. It should help him to feel much better. There’s no drug interaction precaution with Doxycycline. How is Panzer acting tonight?
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He's actually much better. I gave him the doxycycline @+4 PMPS feeding & he's doing good so far probably because of the Cerenia shot.
 
Suzanne & Darcy said:
Spook is pretty young to be having kidney disease. I’m wondering if something else is going on that is affecting those numbers. Do you have the CBC results. Did they give you the USG (this would be important). White cells in the urine could mean a UTI or kidney disease. What other labs can you share? What was the vet’s diagnosis?
Click to expand...
All labs are in my replies now
 
Suzanne & Darcy said:
Spook is pretty young to be having kidney disease. I’m wondering if something else is going on that is affecting those numbers. Do you have the CBC results. Did they give you the USG (this would be important). White cells in the urine could mean a UTI or kidney disease. What other labs can you share? What was the vet’s diagnosis?
Click to expand...
He said repeat blood work in a month, has diagnosed him as of yet.
 
Chrispooky12 said:
GLU 205 74-159 Normal
CREA 2.6 0.8- 2.4 Normal
BUN 41 16-36 Normal
BUN/CREA 16
PHOS 4.9 3.1-7.5 Normal
CA 9.5 7.8-11.3 Normal
TP 7.0 5.7-8.9 Normal
ALB 2.9 2.2-4.0 Normal
GLOB 4.0 2.8-5.1 Normal
ALB/GLOB O.7
ALT 88 12-130 Normal
ALKP 56 14-111 Normal
GGT 8 0-4 Normal
TBIL 0.3 0.0-0.9 Normal
CHOL 208 65-225 Normal
AMYL 699 500-1500 Normal
LIPA 372 100-1400 Normal
Na 160 150-165 Normal
K 3.9 3.5-5.8 Normal
Na/K 41
Cl 118 112-129 Normal
Osm Calc 331
RBC 9.78 6.54 Normal
HCT 50.2. 30.3-52.3 Normal
HGB 16.0. 9.8- 16.2 Normal
MCV 51.3. 35.9-53.1 Normal
MCH16.3 11.8-17.3 Normal
MCHC 31.9 28.1-35.8 Normal
RDW 24 15.0-27.0
RETIC O.3
RETIC 28.8 3.0-50.0 Normal
WBC 10.03 2.87- 17.02 Normal
NEU 42.8
LYM 47.1
MONO 3.4
EOS 6.1
BASO O.6
NEU 4.29 2.30-10.29 Normal
LYM 4.72 0.92-688
MONO 0.34 0.05-0.67 Normal
EOS 0.61 0.17-1.57 Normal
BASO 0.06. 0.01-0.26 Normal
PLT 366 151-600 Normal
MPV 12.5. 11.4-21.6 Normal
PCT 0.46. 0.17-0.86 Normal
Click to expand...
This was Spook?

Also I am reasonably sure the low protein thing is outdated...Suzanne I think would know more.
 
What is 1.5 inches on this mirataz for Spooks ear? When should I put it on I also have to start pill pocketing cerenia to him tomorrow. Should the 2 be spaced out?@FrostD @Suzanne & Darcy Spook while at the vet peed on himself after they took urine from his bladder & he puked. I left the puke for doc to look at, it had furball in it.
 
Chrispooky12 said:
What is 1.5 inches on this mirataz for Spooks ear? When should I put it on I also have to start pill pocketing cerenia to him tomorrow. Should the 2 be spaced out?@FrostD @Suzanne & Darcy Spook while at the vet peed on himself after they took urine from his bladder & he puked. I left the puke for doc to look at, it had furball in it.
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@FrostD not sure why it didn't tag you above.
 
Chrispooky12 said:
What is 1.5 inches on this mirataz for Spooks ear? When should I put it on I also have to start pill pocketing cerenia to him tomorrow. Should the 2 be spaced out?@FrostD @Suzanne & Darcy Spook while at the vet peed on himself after they took urine from his bladder & he puked. I left the puke for doc to look at, it had furball in it.
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Yes. He had the Cerenia shot today so you can do it now if you'd like, I'd actually start with maybe 1/2" because the full dose can make them a little crazy. If I remember correctly, the package insert has a little ruler printed on the paper.

Tomorrow when you give the Cerenia pill, wait about an hour or so for the Mirataz. Cerenia needs time to kick in first, dont want to make the poor guy hungry while he's still nauseous. I think I've seen some people say 2 hours but I only ever waited 1 hour.
 
FrostD said:
Yes. He had the Cerenia shot today so you can do it now if you'd like, I'd actually start with maybe 1/2" because the full dose can make them a little crazy. If I remember correctly, the package insert has a little ruler printed on the paper.

Tomorrow when you give the Cerenia pill, wait about an hour or so for the Mirataz. Cerenia needs time to kick in first, dont want to make the poor guy hungry while he's still nauseous. I think I've seen some people say 2 hours but I only ever waited 1 hour.
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Yep it does have a ruler. I will start it tomorrow they eat again in an hour & a half.
 
FrostD said:
Yes. He had the Cerenia shot today so you can do it now if you'd like, I'd actually start with maybe 1/2" because the full dose can make them a little crazy. If I remember correctly, the package insert has a little ruler printed on the paper.

Tomorrow when you give the Cerenia pill, wait about an hour or so for the Mirataz. Cerenia needs time to kick in first, dont want to make the poor guy hungry while he's still nauseous. I think I've seen some people say 2 hours but I only ever waited 1 hour.
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I tried to give Spook & empty pill pocket earlier & he spit it out in his bowl. Tomorrow should be interesting. I'm cleaning my house that I clean tomorrow on Friday, so I can spend the day with the boys getting all there medication times figured out.
 
Chrispooky12 said:
GLU 205 74-159 Normal
CREA 2.6 0.8- 2.4 Normal
BUN 41 16-36 Normal
BUN/CREA 16
PHOS 4.9 3.1-7.5 Normal
CA 9.5 7.8-11.3 Normal
TP 7.0 5.7-8.9 Normal
ALB 2.9 2.2-4.0 Normal
GLOB 4.0 2.8-5.1 Normal
ALB/GLOB O.7
ALT 88 12-130 Normal
ALKP 56 14-111 Normal
GGT 8 0-4 Normal
TBIL 0.3 0.0-0.9 Normal
CHOL 208 65-225 Normal
AMYL 699 500-1500 Normal
LIPA 372 100-1400 Normal
Na 160 150-165 Normal
K 3.9 3.5-5.8 Normal
Na/K 41
Cl 118 112-129 Normal
Osm Calc 331
RBC 9.78 6.54 Normal
HCT 50.2. 30.3-52.3 Normal
HGB 16.0. 9.8- 16.2 Normal
MCV 51.3. 35.9-53.1 Normal
MCH16.3 11.8-17.3 Normal
MCHC 31.9 28.1-35.8 Normal
RDW 24 15.0-27.0
RETIC O.3
RETIC 28.8 3.0-50.0 Normal
WBC 10.03 2.87- 17.02 Normal
NEU 42.8
LYM 47.1
MONO 3.4
EOS 6.1
BASO O.6
NEU 4.29 2.30-10.29 Normal
LYM 4.72 0.92-688
MONO 0.34 0.05-0.67 Normal
EOS 0.61 0.17-1.57 Normal
BASO 0.06. 0.01-0.26 Normal
PLT 366 151-600 Normal
MPV 12.5. 11.4-21.6 Normal
PCT 0.46. 0.17-0.86 Normal
Click to expand...
IS this Spook or Panzer? Spook, right?
 
Be careful with the Mirataz, Christina. I would start with about half of the length of the strip that is shown on the box. He also may not need it every day. One of my cats got about half of a strip every other day and she was fine with that.... any more and she got aggressive and started slapping all the other cats in the house. Also, I've had cats go cuckoo on too much Mirataz (they don't call if Meowtazapine) for nothing! So... start low and go slow!
 
Suzanne & Darcy said:
Be careful with the Mirataz, Christina. I would start with about half of the length of the strip that is shown on the box. He also may not need it every day. One of my cats got about half of a strip every other day and she was fine with that.... any more and she got aggressive and started slapping all the other cats in the house. Also, I've had cats go cuckoo on too much Mirataz (they don't call if Meowtazapine) for nothing! So... start low and go slow!
Click to expand...
He's already a big time talker. He ate all of the first 2 feeding today, but had to be coaxed for the next 2.
 
Chrispooky12 said:
GLU 205 74-159 Normal
CREA 2.6 0.8- 2.4 Normal
BUN 41 16-36 Normal
BUN/CREA 16
PHOS 4.9 3.1-7.5 Normal
CA 9.5 7.8-11.3 Normal
TP 7.0 5.7-8.9 Normal
ALB 2.9 2.2-4.0 Normal
GLOB 4.0 2.8-5.1 Normal
ALB/GLOB O.7
ALT 88 12-130 Normal
ALKP 56 14-111 Normal
GGT 8 0-4 Normal
TBIL 0.3 0.0-0.9 Normal
CHOL 208 65-225 Normal
AMYL 699 500-1500 Normal
LIPA 372 100-1400 Normal
Na 160 150-165 Normal
K 3.9 3.5-5.8 Normal
Na/K 41
Cl 118 112-129 Normal
Osm Calc 331
RBC 9.78 6.54 Normal
HCT 50.2. 30.3-52.3 Normal
HGB 16.0. 9.8- 16.2 Normal
MCV 51.3. 35.9-53.1 Normal
MCH16.3 11.8-17.3 Normal
MCHC 31.9 28.1-35.8 Normal
RDW 24 15.0-27.0
RETIC O.3
RETIC 28.8 3.0-50.0 Normal
WBC 10.03 2.87- 17.02 Normal
NEU 42.8
LYM 47.1
MONO 3.4
EOS 6.1
BASO O.6
NEU 4.29 2.30-10.29 Normal
LYM 4.72 0.92-688
MONO 0.34 0.05-0.67 Normal
EOS 0.61 0.17-1.57 Normal
BASO 0.06. 0.01-0.26 Normal
PLT 366 151-600 Normal
MPV 12.5. 11.4-21.6 Normal
PCT 0.46. 0.17-0.86 Normal
Click to expand...
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Okay. Don't yet get too upset over this bloodwork. There could be something going on affecting these numbers. Now, I do believe that Spooks BUN is causing the inappetance, but honestly, it's not really that bad... just a little out of range (BTW, both the CREA and the BUN are elevated outside of the reference range, but it says NORMAL next to them ... the GGT also, which is definitely elevated... so this was confusing.) A lot of the other things look good. Liver enzymes, neutrophils and WBC, and his HCT all good too. I am bothered by the white cells in his urine. It does happen that a cat can have a UTI without an elevated white count. That GGT can indicate something wrong with the liver/transfer of bile to the small intestine as I said last night... but it also could just be an anomaly ... just a fluke... and maybe next time the labs are run, it may be back to normal. I am really glad that they did fluids on both Panzer and Spook. How is Panzer in the litter box today? I thought about you last night... how you must be upset with both Panzer and Spook not doing well at the same time. And I thought about how expensive it must have been yesterday. I feel for you, Christina! I can relate. I've had some of my own cat problems here this week too and have a weird thing going on with one of my girl cats and we are running an exotic test on her to see what's going on. I had to take her to the vet last Friday for blood draw... then again this Friday for another blood draw... then another two weeks after that... and they will send all of it to a lab. Honestly, she hasn't been acting right since they injected her last Friday with this hormone ... and she had a Depo shot too since she was breaking out all over with scabs, lumps, etc. Argh! Poor Esther.
 
Suzanne & Darcy said:
Yep. You can adjust the Cerenia a little bit each day if you want to... to get it to a time that is convenient for you... kind of like we do with insulin if we need to adjust the timing of our shots...
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Ok yeah that's what I'm doing with Panzers insulin right now,he got it an hour & a half late last night because we were at the vet longer than usual.
 
Suzanne & Darcy said:
I really think they should have sent Spook's urine out for a culture because of the white cells (I probably said that yesterday). It's bothering me though.
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I think they did an in house culture. I picked a fancy vet that has IDEXX machines at there clinic. I didn't know when I first took Panzer there, I guess that's good, I will call them & ask them real quick. I got Panzers insuline gargling & syringes today. Also found some turkey baby food that I couldn't find in my town. I think I should maybe wait to start him on it because I know he still doesn't feel good & I have to work the next 2 days. I should probably try the Cerenia doxycycline combo the next 2 days as well & make sure it works out. The plan is for him to be on Cerenia until he's done with the doxycycline. What are your thoughts?
 
Chrispooky12 said:
I think they did an in house culture. I picked a fancy vet that has IDEXX machines at there clinic. I didn't know when I first took Panzer there, I guess that's good, I will call them & ask them real quick. I got Panzers insuline gargling & syringes today. Also found some turkey baby food that I couldn't find in my town. I think I should maybe wait to start him on it because I know he still doesn't feel good & I have to work the next 2 days. I should probably try the Cerenia doxycycline combo the next 2 days as well & make sure it works out. The plan is for him to be on Cerenia until he's done with the doxycycline. What are your thoughts?
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That's fine. I hope it helps. A urine culture would take some days to "grow" any bacteria. They have to put it in a special dish with a certain type of nutrient media that "feeds" the bacteria -- and they grow it over a period of several days or more. Remember how last time Panzer's urine culture said something about it taking longer to grow. If it's a "fastidious" bacteria, it's more difficult to grow in a lab and takes a special kind of "food" and a longer time to culture. So, I think they just looked under the microscope and saw white cells but couldn't have had time to "grow" any bacteria to be identified yet. My vet has the in house IDEXX equipment, too, but a lot of time we still send out bloodwork because the lab can run even more tests. But this was probably okay for yesterday because you needed to get some fast answers on what was troubling Spook.
 
I am sure they will say that they didn't see enough white cells to warrant a culture... but they were over 6 per high powered field, as I recall (6 HPF)?? Or maybe I am mixing you up with another person.

But what was his Urine Specific Gravity number? I didn't see any of the urinalysis data in the thread above... unless I scrolled past it somehow. Sorry
 
Suzanne & Darcy said:
I am sure they will say that they didn't see enough white cells to warrant a culture... but they were over 6 per high powered field, as I recall (6 HPF)?? Or maybe I am mixing you up with another person.

But what was his Urine Specific Gravity number? I didn't see any of the urinalysis data in the thread above... unless I scrolled past it somehow. Sorry
Click to expand...
Ok they didn't see a reason to send it out is what they said :banghead: he is going to email me the paper with the urinalysis #s. He said if I wanted to bring him back in I could. On the blood test results those ones that have Normal beside them,ignore that. I tried to set it up as a 2 column format showing his #s & than normal range for those tests & when I posted it, it changed & all lined up together.
 
Well, I wouldn't drag that poor baby back their either after yesterday (unless he doesn't get better). Will they let you catch some urine in a cup/jar and bring it in?
 
Suzanne & Darcy said:
Well, I wouldn't drag that poor baby back their either after yesterday (unless he doesn't get better). Will they let you catch some urine in a cup/jar and bring it in?
Click to expand...
I don't think they will because it would be a clean catch, but I will ask them tomorrow. I had to tilt his head back & make him take the pill pocket with the Cerenia in it. He ate all of his food no coaxing. I laid one in my hand trying to get him to check it out after he was all done eating, he wanted nothing to do with it. It's weird because he is not enticed by fortiflora or parmesan cheese either. Panzer is enticed by both & he loves pill pockets.
 
Suzanne & Darcy said:
-----------------
Okay. Don't yet get too upset over this bloodwork. There could be something going on affecting these numbers. Now, I do believe that Spooks BUN is causing the inappetance, but honestly, it's not really that bad... just a little out of range (BTW, both the CREA and the BUN are elevated outside of the reference range, but it says NORMAL next to them ... the GGT also, which is definitely elevated... so this was confusing.) A lot of the other things look good. Liver enzymes, neutrophils and WBC, and his HCT all good too. I am bothered by the white cells in his urine. It does happen that a cat can have a UTI without an elevated white count. That GGT can indicate something wrong with the liver/transfer of bile to the small intestine as I said last night... but it also could just be an anomaly ... just a fluke... and maybe next time the labs are run, it may be back to normal. I am really glad that they did fluids on both Panzer and Spook. How is Panzer in the litter box today? I thought about you last night... how you must be upset with both Panzer and Spook not doing well at the same time. And I thought about how expensive it must have been yesterday. I feel for you, Christina! I can relate. I've had some of my own cat problems here this week too and have a weird thing going on with one of my girl cats and we are running an exotic test on her to see what's going on. I had to take her to the vet last Friday for blood draw... then again this Friday for another blood draw... then another two weeks after that... and they will send all of it to a lab. Honestly, she hasn't been acting right since they injected her last Friday with this hormone ... and she had a Depo shot too since she was breaking out all over with scabs, lumps, etc. Argh! Poor Esther.
Click to expand...
I really hope it is just a fluke & when we go back on May 24th everything comes out ok. It is so hard having both of my boys not feeling good, I've had many crys over it. I hate that I have to work the next 2 days. The bill wasn't as high as I thought it would be with everything they did for both of them. It was a little over $600 I expected it to be way more! Panzer has been fine in the litter box except he's been getting litter on his back feet quite a bit & flipping his back legs like a rabbit, which I haven't seen him do that since about a month of being on Zobaline. Poor boy his neuropathy must be acting up. He didn't finish his Zobaline food for the past 2 mornings so I am going to pill pocket it tomorrow. Aww poor girl I hope you get some results soon for her & she feels & gets better. It is truly hard being a cat & or dog mom, they are like our children to us. I said I would never get another cat when I lost Spooky to cancer in 2007. Than Panzer came along in 2012 & I couldn't resist him, then Spook came in to the picture 5yrs later & I fell in love with him as well. He originally was my daughter's cat, she has his blood brother. He got sick that first time in 2018 & I told her he was my cat, because I had gotten him all better. She didn't like it at first but she got over it. She is really worried about him & also her boy because they are brothers. At the vet yesterday they kept asking me if Spook had gotten into anything( toxins plants antifreeze anything) & I said no not that I know of I don't have plants because Panzer ate one when he was not even 1yrs old yet. It didn't hurt him but I'm not a plant person. Me & my daughter checked in the kitchen cabinets & in the laundry room around the water heater furnace, water softener area & didn't find anything. He does get in the kitchen cabinets but there's nothing that is open that he could get into.
 
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