05/31 Tray's PMPS 166 Spoke to vet

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Iorwen & Tray

Iorwen & Tray

Member Since 2010
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=44405&view=unread#unread

Tray goes in for his ultrasound today, he knows something is up and kept running from me this morning and trying to hide :lol: How do they know? He ate this morning, as the vet said it would be okay since they won't sedate him. Hope all goes well and we get a good report.

His BG #s have been awful. I'm sure it's mostly due to stress and his not feeling well but should I increase the dose? The vet said I might want to hold off on that until we know if he's fighting an infection but I don't want him running high for so long either.
 
Re: 05/31 Tray's BG 353 Ultrasound day, Dose question

The vet said I might want to hold off on that until we know if he's fighting an infection but I don't want him running high for so long either.
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Morning Iorwen and good luck with the ultrasound. Yes, they really do know something is up on Vetty day, smart kitties! I'm no expert, and I'm sure someone will be up soon, but I agree with your Vet. Maggie's numbers were high before her dental, and I was advised to hold off until her infected tooth was removed. I know yours is a different situation though, and Tray is much higher, so I don't know, but those are my thoughts. Lots of get well vines for Tray and hugs for you. I know you'll keep us posted.
 
Re: 05/31 Tray's BG 353 Ultrasound day, Dose question

I tend to look at it a different way. If a cat has an infection, BG numbers will go up. High BG numbers is a set up for other problems. For example, if your cat stops eating due to feeling lousy and the insulin dose isn't meeting his needs, it increases the risk for DKA. We usually encourage increasing the dose but being attentive to when antibiotics start having an effect and bringing down numbers.

Also, I'm assuming you were giving a PM shot. It's not noted on your SS.
 
Re: 05/31 Tray's BG 353 Ultrasound day, Dose question

thank goodness there's no anesthesia to worry about - Tray will do fine with the ultrasound. thinking about you both!
 
Re: 05/31 Tray's BG 353 Ultrasound day, Dose question

Good morning Iorwen & Tray! Good luck today! We'll be thinking about you. Hope all goes well!
 
Re: 05/31 Tray's BG 353 Ultrasound day, Dose question

Mornng Iorwen, sending clear ultrasound vibes to Tray & pray all will be well!! Hugs from us & lubs!!
 
Re: 05/31 Tray's BG 353 Ultrasound day, Dose question

Hi guys, I don't have any dosing advice, just wanted to let you know that we are thinking of you and tray today and hope that the US goes nice and easy for everyone ..
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Well this is annoying, Tray's ultrasound was cancelled as the specialist couldn't come in and isn't sure when I can rebook. At least Tray seems to be doing better but still, I'm a bit upset and wonder if it's worth rebooking if it's not done this week.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Like you, and the others, I want everything to run smoothly, especially for our sugarbabies. Sending tons of prayers to you and Tray for a quick rescheduling, and am sending you healing vines for him to make a full and speedy recovery.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Wow, that is totally annoying! If Tray is feeling well, I would be tempted, as you are, to postpone rescheduling the u/s. The one thing that is still going on is that his BG's are out of whack, which would sound infection driven. Are they planning to do a follow up urine culture after a couple of weeks? I wonder if it might be better to use the money towards that. If he shows any signs if illness again, then go ahead and reschedule the u/s. That's what I might be thinking of doing at this point.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Linda and Bear Man said:
Wow, that is totally annoying! If Tray is feeling well, I would be tempted, as you are, to postpone rescheduling the u/s. The one thing that is still going on is that his BG's are out of whack, which would sound infection driven. Are they planning to do a follow up urine culture after a couple of weeks? I wonder if it might be better to use the money towards that. If he shows any signs if illness again, then go ahead and reschedule the u/s. That's what I might be thinking of doing at this point.
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That is an excellent suggestion, not to mention more cost friendly for my wallet. Thank you, I will definately bring that up when my vet checks in. She's in surgery for most of the day but I put in a request to speak to her about this.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

How upsetting! Stressful !!Poor Tray, how could vets be so inefficient??
Wonder how they would feel if it was their cat ?--Hope Tray continues to get better--Hugs from us & Heling vines For Tray boy!!
 
Re: 05/31 Tray's BG 353 Really Annoyed!

omg, and what a bummer! I think I ten to agree with Linda. Maybe hold off on the U/S, urine recheck in a couple. Well I am sorry.... I hope the rest of your day is better.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Depending on where you're located, if there is a good 24 hour veterinary facility that does specialty work like veterinary radiology, there's likely to be someone there who does US, if you want to do some research on this yourself. At least here, a lot of the vet practices will have a roving person who comes in on scheduled days to do ultrasound. There are a couple of 24 hr ER/specialty centers that do US, as well.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Sienne and Gabby said:
Depending on where you're located, if there is a good 24 hour veterinary facility that does specialty work like veterinary radiology, there's likely to be someone there who does US, if you want to do some research on this yourself. At least here, a lot of the vet practices will have a roving person who comes in on scheduled days to do ultrasound. There are a couple of 24 hr ER/specialty centers that do US, as well.
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There is one but they charge an outrageous amount of money which is why I made an appointment for a specialist to come to our vet, it was quite a bit cheaper that way, albeit still pricey.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Iorwen - call the vet school near you. UofT - do they have one? How much were you going to be charged. At the University of Montreal vet school the cardiologist charged $300 for her ultrasound. It would have cost us well over $1500 for what we got done at the vet school compared to what we would have paid at the specialty hospital. You might want to look into this in case you do ever need it.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Karrie and Maverick said:
Iorwen - call the vet school near you. UofT - do they have one? How much were you going to be charged. At the University of Montreal vet school the cardiologist charged $300 for her ultrasound. It would have cost us well over $1500 for what we got done at the vet school compared to what we would have paid at the specialty hospital. You might want to look into this in case you do ever need it.
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I don't think UFT has one, it might be a college that does it. Senaca. I'll have to look into it. They were going to charge me $600, $300 sounds much better although things are usually much cheaper in Montreal than in Toronto.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Thats what I would have been charged by the specialty hospital. But my vet for my dog said they could hire an ultrasound person for $300 but they wouldn't have been a cardiac specialist. It really gets me mad how vets charge so much. But this isn't a vet bashing site so I won't explain why I feel this way ;) You guys all know about how much I love vets :mrgreen: :mrgreen: :mrgreen:
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Karrie and Maverick said:
Thats what I would have been charged by the specialty hospital. But my vet for my dog said they could hire an ultrasound person for $300 but they wouldn't have been a cardiac specialist. It really gets me mad how vets charge so much. But this isn't a vet bashing site so I won't explain why I feel this way ;) You guys all know about how much I love vets :mrgreen: :mrgreen: :mrgreen:
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Right there with you :lol:
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Just spoke to my vet and her best guess is Tray has a kidney infection so her advice was to do another round of antibiotics next week when the old one leaves his system and then when that is done to run a urine analysis and or am ultrasound then. Any thoughts? Also she would like to give another convenia shot, should I ask for oral antibiotics instead?
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

I would still do a sterile urine draw and a culture and sensitivity. I wouldn't wait on this. A kidney infection - you don't cut short antibiotics for this. Its treated with 6 weeks of antibiotics in dogs at least - the kidney group was recommending 8 weeks.

Edit - I also have no experience with the antibiotic shot that Tray was given.
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

Karrie and Maverick said:
I would still do a sterile urine draw and a culture and sensitivity. I wouldn't wait on this. A kidney infection - you don't cut short antibiotics for this. Its treated with 6 weeks of antibiotics in dogs at least - the kidney group was recommending 8 weeks.

Edit - I also have no experience with the antibiotic shot that Tray was given.
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I'm not sure what you mean by cutting short his antibiotics. He's on an antibiotic that lasts 12-14 days. I would be going in on day 11 to get another round of antibiotics.
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

That would be an overlap of about 3 days...? Would you be required to start them that same day, or wait until the 14 days are up to start the new round?

Sorry for the questions. I've never dealt with Convenia before.
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

I meant if you are treating a possible kidney infection don't stop the antibiotics. Others with experience here will comment but any break in antibiotics isn't a good thing - its continuous for six weeks minimum in dogs. Lets see what others say for cats.
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

Karrie and Maverick said:
I meant if you are treating a possible kidney infection don't stop the antibiotics. Others with experience here will comment but any break in antibiotics isn't a good thing - its continuous for six weeks minimum in dogs. Lets see what others say for cats.
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okay, well Tray will definately be on them for 4 weeks and then he was going to have his urine analysed but I have actually made an appointment to finally visit with Tray's elusive regular vet to pick his brain while he examines my other cat, Percival. He's got the most experience especially with diabetic kitties so I will bring up the 6 weeks thing with him.
 
Re: 05/31 Tray's BG 353 Really Annoyed!

Iorwen & Tray said:
Just spoke to my vet and her best guess is Tray has a kidney infection so her advice was to do another round of antibiotics next week when the old one leaves his system and then when that is done to run a urine analysis and or am ultrasound then. Any thoughts? Also she would like to give another convenia shot, should I ask for oral antibiotics instead?
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I am not qualified to recommend a specific antibiotic. I had the impression that Convenia stays in the system for quite a while, so I can't comment of when (if ever) it might be safe to repeat a Convenia shot. I agree with Karrie that treatment for pyelonephritis (kidney infection) should be continued longer (6 weeks) than treatment for a simple bladder infection.

I think that the best protocol for treatment of suspected UTI's is to do a culture and sensitivity on a sterile sample collected via cystocentesis, select the antibiotic based on the result of the C & S, repeat the C & S about 1 week into the treatment to evaluate the effectiveness of the antibiotic, test again after 6 weeks, and then to retest again about 2 weeks after the cessation of antibiotic treatment. Note that pyelonephritis may culture negative (as may some infections of the bladder).

While your vet mentioned a urinalysis, I would take care to ask for the cysto and C & S, not a urinalysis, and not by a free catch specimen. I'm not a vet, but I would be tempted to ask for the C & S prior to starting another antibiotic or prior to repeating the current antibiotic. I would hold off on the ultrasound unless treatment with antibiotics is not successful, his symptoms worsen, he relapses. An ultrasound can detect pyelonephritis, but won't be helpful in terms of suggesting an appropriate antibiotic.

http://www.harpsie.com/kidney_infections.htm

Bear Man and Emily both took Baytril for pyelonephritis. It's a big gun, and has potential side effects (e.g. blindness), so that is something to discuss with your vet.
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

I believe that you do need to have a break in the ABs in order to not get a false negative reading on a culture and sensitivity. There are definitely some urinary track conditions that do not culture positive. I would also take a look at Dr. Lisa's site regarding her discussion on UTIs. I don't recall whether she discussed pylonephritis but she clearly has an opinion about the use of antibiotics.
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

Hi Iorwen,

Hope Tray is feeling better soon! I haven't had any experience with convenia shot so I can't help there. I know you asked the question on giving oral instead. Did you get any input? I always wondered myself. If there is an infection I hope its under check soon. Have a nice night guys.

jan and sara
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

Sienne and Gabby said:
I believe that you do need to have a break in the ABs in order to not get a false negative reading on a culture and sensitivity. There are definitely some urinary track conditions that do not culture positive.
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I am not sure that I would stop and restart antibiotics, if pyelonephritis is suspected. One concern could be promotion of antibiotic resistance. Another would be allowing the infection to proliferate during the time off a/b's. I guess the factors which argue towards infection here were the sudden onset of illness, fever, some bacteria seen in urine (if I recall correctly), elevated BG's, urination outside the litter box (IIRC), and good clinical response to antibiotic treatment. I am not sure how one would rule out bladder vs. kidney infection, however. You do want to see a negative urine culture in this case, to confirm that the antibiotic is working. You can't rule out a false negative (as Sienne mentioned). The reason for rechecking one (or two) weeks into tx is to make sure that you don't get a positive culture, which could happen if the antibiotic is not correctly tailored to the specific bacteria present.
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

Iorwen, I don't have any advice but wanted to let you know that I'm thinking of you and hoping this whole things gets cleared up soon. It looks like you are getting some great advice from everyone. Prayers and hugs!
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

Linda --

I wasn't suggesting that the AB be stopped. I think your point is well taken; if it's not the right AB, then there's some likelihood that bacteria will be cultured. There have been any number of times when someone's cat had a UTI, was on ABs, and a C & S was re-run a week after the ABs were discontinued. Then, 2 weeks later, the UTI is "back." It was probably never gone due to a false negative reading due to the residual effect of the AB.
 
Re: 05/31 Tray's BG 353 New Question if you don't mind

I am dealing with a dog with some kidney damage to a kidney infection. Hers is a long story but involved a couple missteps.

1. If she doesn't do a C&S now - how would you know if the shot is even effective if there is a UTI/Bladder infection/Kidney infection?
2. If Tray does have a kidney infection - stopping and restarting abx can backfire. And why are they thinking kidney infection and not UTI?

But if the temperature is down, does that mean the abx shot is treating bacteria that was causing the infection?
 
Got to talk to Tray's usual vet who went over all the test results and my concerns and questions. He suggests I bring him in next week, when his convenia is leaving his sytem, and he'll do a culture and sensitivity test. He believes we should start him on a round of antibiotics to treat bladder and kidney infections. His ab of choice is clavamox, he says he finds it has the least amount of side effects. I can choose liquid or pill form, although he recommends the liquid. Then we would repeat the test again and if we see a relapse in symptoms and or fever we would rebook the ultrasound.

Tray seemed good this evening, ate just a bit, so did my civvie. I think the heat is bothering them and I'll have to turn on the a/c for them. But Tray's PMPS was better, 166, a blue! Which put a smile on my face. This vet said I should go ahead and raise the dose by .25 starting tomorrow if his BG is still high.
 
Hi Iorwen, I'm so sorry Tray is having such a hard time with everything, but so glad he seems better this evening. What a nice PMPS tonight for him. Sending some healing vines and positive thoughts for you and Tray. Hugs.
 
I'm glad you got to speak w/the vet today.

Hope you are get a handle on this soon and get it resolved.

Feel better Tray.

And very nice PMPS this evening!
 
Glad you got a chance to talk to the regular vet. I know you have confidence in him. Sorry if I'm making things complicated I tend to do that best.

Awesome PMPS for Tray!!!!
 
So sorry to hear that Tray is not feeling well and the challenge it is to figure
out what's wrong with him. I think that's always the hardest part.
If you decide to head east to our medical facilities (DMV Emergency Hospital) has very
good staff you have a place to stay and chill with my 4 furbabies, DH and DD's too. :-D
((hugs))
 
Iorwen - if you get a chance, check out Kasha's condos from a year ago - she had a u/s around a year ago and they diagnosed pyelonephritis - she was on Baytril for 6 weeks and it worked like a charm. She'd had 2 rounds of Convenia and it never completely got rid of the infection (which is probably how it moved up to her kidney). Just my experience.
 
Hi Iorwen. I am so glad that you were able to speak to your vet today, and talk things through. You've gotten so really good info here today from several people - that should help alot. There are some good discussion here on the board in regards to convenia should you wish to research it further. You can launch a search and it should find them for you. I know Mannie and I were one of those, back in September I think. Personally I won't use it again. I hope that you can get a handle on it all through all the help given.

Very nice pmps for Tray!!! I hope he is feeling better.
 
If you opt for the liquid AB, please make sure (and double and triple check) that it doesn't contain any form of sugar. Often, the liquid preparations are in a sugar syrup (e.g., sucrose, dextrose) base.
 
Hi Iorwen and Tray,
It sounds as if you had a good conversation with Tray's regular vet and have decided on a course of action. And you got some great input here today, too. I do hope that all will go smoothly now and that Tray will start to feel much better. It's good that his PMPS came down. Too bad he had to be put through such stress today.
We continue to think positive thoughts and Rusty is sending his pal some healing vines. Feel better, Tray!

Ella & Rusty
 
I didn't have a chance to read through everything but please keep in mind, and I know Linda has experience with this, that sometimes the kitty can have pyelonephritis and have urine that shows no bacteria. The diagnosis is made through the US. My Gussie has this....and he goes on six weeks of uninterrupated baytril.....works like a charm.
 
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