06/28 Tashie Urinalysis June 11

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BorisV

BorisV

Member Since 2013
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=98621&p=1055211#p1055211

Re: 06/27 TASHIE AMPS=420

The second is a link Jill sent me with a great discussion regarding Ketones. There seems to be a difference of opinion on which is the most accurate way to detect them and which shows first. I talso seems the two tests pick up on different acids. It's a very interesting discussion.
Click to expand...

TRIED to read through all of that - it's just over my head - WAY too many comments and I got lost after reading the first few. I'm just incapable of understanding it right now - if someone could give me the CLIFFS NOTES version? Sorry, I'm just blanking out.

Please understand that other than when she was spayed as a kitten (15 years ago) she has NEVER been away from me - never boarded, nothing. Boris is having a hard time with this also so I am making sure he gets lots of attention - he is VERY sensitive and he is missing his sister.

Called the hospital this morning:
They have her on IV fluids
She is NOT eating (no surprise) so they are syringing her
The upped the Lantus to 1U and are also giving her the "R" insulin to bring her down - she IS being monitored

I'll update as I know.

Thanks for all the prayers
 
Re: 06/28 Tashie

I hope Tashie starts to feel better. Have you brought over a smelly t-shirt of your? That may help her feel more comfortable.

You may want to ask the vet about Tashie's electrolytes. If they are low, it's an indication that this is DKA and not just high ketones.
 
Re: 06/28 Tashie

Sienne, what is DKA? Thought that IS high ketones? How do they test for electrolytes? She had THREE tests yesterday - two of them we don't get results for 5 days, they other should be back sometime today. Don't even remember what that one was. I'm really not quite as "thick" as I am sounding - this has just hit me HARD and my brain is just not working!
 
Re: 06/28 Tashie

Then, in all likelihood, this is DKA. The good news is that Tashie is at the vet, they are monitoring, and she's getting what she needs.

There are a few things that contribute to the development of ketones/DKA: infection, not enough insulin, and not enough food. Please discuss the infection/inflammation issue with your vet. The usual culprits are a UTI or a dental issue. The former may be evident through an elevated white blood count or via a urinalysis. The latter may only be evident by looking into Tashie's mouth and seeing whether there is tartar or gingivitis. (This isn't easy with a cat that's awake!)
 
Re: 06/28 Tashie

Sienne, she DOES have some dental issues - but they were going to deal with that "later" ....... maybe I need to talk to them about that today - but would it be "safe" for her to have anesthesia right now? So worried! Thanks for your help, I know I'm brain dead but I appreciate your time and knowledge!
 
Re: 06/28 Tashie

(((((Bern))))) Sending tons of vines to Tashie. Skritches to Boris, it's hard on him too. I hope she recovers quickly so she can get home to her Mamabean.
Liz
 
Re: 06/28 Tashie

phew!! so glad to see your post this am/afternoon!! I was worried for you both all night!

poor sweet girl.......I am glad she is at the vet's getting great care....they will fix her up, feeling better.....and home she will come!

and then you can start to worry about those low numbers again! they do keep up on our toes eh?

keep us updated....we all do send you our greatest healing waves from afar.....

so very very very hard when our animals are sick and helpless and CAN'T TELL US WHAT IS WRONG OR HOW THEY FEEL....

but you are her best and greatest gift....you will get her well

~kelly
 
Re: 06/28 Tashie

I just want to add my prayers for sweet Tashie. I know she'll be home and feeling better very, very soon!!
 
Re: 06/28 Tashie

Sending healing vines for sweet Tashie. Hugs and scritches to you and Boris. She WILL get through this! :YMHUG: :YMHUG: :YMHUG: :YMHUG: cat_pet_icon cat_pet_icon :YMSIGH:
 
Re: 06/28 Tashie

Sending healing vines for Tashie. I really hope she is feeling better and comes home very soon. Lots and lots of prayers for you both!
 
Re: 06/28 Tashie

Bern sent me an update on Tashie.

On her bloodwork with my comments on each added below (I hope others will also chip in on what they know):
Na+/K- ratio is low
--indicative of DKA as it shows an electrolyte imbalance; I wonder what the actual values are?
AST/ALT are elevated (120/280)
--possibly developing fatty liver? I don't know for sure but I'd ask the question along with at what point do they consider a feeding tube if they can't get enough calories in her via syringe?
BUN is elevated but her creatinine is normal
--good sign kidneys are working now; not sure why she is showing dehydration (elevated BUN)
lymphocytes are low; neutrophils are high; WBCs normal
--low lymphocytes can be indicative of chronic bacterial infection; high neutrophils can indicate bacterial infection or also some sort of inflammation
urine specific gravity is normal but on the low side
--could be due to IV fluids; I'd try to find a recent urine test result when Tashie wasn't getting fluids. Fluids, IV or subq, will cause a decrease in USG.

No results yet on blood pH or specfPL.

Vets are giving Tashie 1u lantus bid and also giving 0.5uR as needed to bring numbers down.

Bern...
just a few other thoughts; have you considered moving her to a 24 hour facility? I know you are concerned about her numbers at night especially if they are giving R and I would be, too. Even if they are there monitoring during the four hours of R activity, numbers can still come down more when the basal insulin kicks in. You said they said not to worry as she has glucose in her IV. I asked Jill and Sienne about this since they've both had cats in DKA. Jill thought it was a routine thing they do when they suspect DKA. Sienne said they are probably giving glucose/dextrose for energy/calories. Neither she nor I would be comfortable that it would keep Tashie from going low.

It would be interesting to see the BG readings, insulin doses given and time given (for L and R) but I know you are really swamped and stressed .....very worried about your baby.

I hope some of this helps you. If you are able to get a copy of the blood/urine results and post them here, that would be great. We have a lot of really good eyes and experience on looking at labs.

Sending Tashie mega healing vines.
 
Re: 06/28 Tashie

(((((Bernadette & Boris))))) I had no idea, I'm sorry :cry:

I'm praying for Tashie--she'll pull through this.

Give her a hug from me when you see her
 
Re: 06/28 Tashie ***Posting Question***

Never mind - I just saw where to do what I need to do - give me a few and I'll scan & post test results with SPECIFIC dates noted
 
This is the Urinalysis report from June 11 - the DAY after I took her to the 24 hour ER. The night before she had "trace" ketones and was given Sub Q's. This urine was taken the following day using a syringe
 
Re: 06/28 Tashie Blood Work & Urinalysis YESTERDAY

This is BOTH blood & urine just taken YESTERDAY
 
While the urinalysis values are normal range, your vet didn't run a culture. That's the only way to know if there's an infection.

I agree with Jill's point about it being standard that glucose is given so that more insulin can also be given. Call me a worry wort, though, because I would want your kitty to be monitored 24/7. Too much can happen overnight if there's no one there to check on Tashie. When Gabby was first diagnosed, she was in full out DKA, had pancreatitis and hepatic lipidosis. My vet recommended that she be hospitalized at a 24 hour critical care vet hospital. It was like being on a human ICU. If you think about this in terms of human care, if you were in the hospital, the nurses and doctors wouldn't go home after 8:00 PM. Your care would be around the clock.

I doubt that this is the time for a dental. However, Tashie may benefit from an antibiotic if there are dental issues. At least an antibiotic can offset any infection or inflammation that may be occurring until Tashie is back to normal.
 
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