07/13 Spitzer ill; Ideas??? UPDATE: doing better

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BJM

BJM

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Spitzer has been vomiting off and on for several weeks now, which makes insulin dosing nerve wracking, to say the least.
Repeat lab values 7/9 suggest infection and prior test ruled out pancreatitis.
hi: WBC 18.75 K/uL (normal reference 2.87 - 17.02)
hi: LYM 8.66 (normal 0.92 - 6.88)
2.1 (< or = 3.5 ug/L, unlikely to be pancreatitis)

AMBG 50 - he obviously didn't eat much last night, so his tummy is must have been upset (he's been on 2 units for a while)
+1.5 49 - after eating some Fancy Feast and about a tablespoon of Wellness Core kibble; had to leave for work, so obviously didn't give insulin. Also gave metaclopramide Rx from vet in hopes he'll keep breakfast down.

I'll go home around lunch - maybe take afternoon off - to check on him. If he hasn't vomited, his glucose should have popped up around 350 or so and I'll be able to give him some insulin.

I had cataract surgery yesterday, which didn't go as well as the 1st one & I was uncomfortable enough last night to take half a tramadol, so if he was in distress or hypoed last night, I didn't wake up for it.

I called the vet and left a message. I think he may need another round of antibiotics. I'm not sure what else to do at this point.

Anyone have any thoughts?

I'd reduce his insulin, but then if he eats normally, it goes way high (up to HI on glucometer).
 
Re: 07/13 Spitzer ill; Ideas???

I do not think another course of AB would hurt since WBC slightly elevated. Is LB use OK? constipated or blockage of some kind maybe? that's all that pops into my head at the moment. sorry spitz isn't feeling well
 
Re: 07/13 Spitzer ill; Ideas???

Litterbox use is OK as far as I know ... but 11 cats, 12 boxes, short of seeing him in the box, I don't really know.

He was lovey this morning ... probably because he was starved from going so low.

Vet wants to try Cerenia (ondansetron) for the nausea and vomiting, so I'm going out to get it and give it to him.
 
Re: 07/13 Spitzer ill; Ideas???

Have you tried Pepcid? And did they check kidney values? Maggie had borderline kidney failure and often threw up.

If your vet is really stumped, can he get you in at OSU?
 
Re: 07/13 Spitzer ill; Ideas???

Yesterday (Wednesday), I picked up the vet Rx - mirtazapine (1/4 tablet every 3 days, got 2 doses) & amoxicillan (drops).

I fell asleep watching TV, so started the meds a bit after midnight.

This morning, he had a good appetite, and his glucose was where I expected it to be (360-ish), since yesterday he missed the am dose, and I gave a reduced pm dose. I'm hoping we can get back on schedule - if he just keeps his meals down!

The first round of tests about 2 weeks ago did not show any elevations of BUN, nor creatinine, so his renal system looks OK for now. The labs seem much more indicative of either an infectious or a gall bladder/liver problem.
 
When he came home from the shelter, he had caught every respiratory illness that went through the intake holding area where he'd been for 4 months as part of a humane case. As a consequence, he was chronically snuffling (herpes) and still dealing with pneumonia, so he sounded a bit like he was under water ... like the swimmer, Mark Spitz (Olympic medalist in numerous swimming events).

After that 4 months, I couldn't stand seeing them stuck in the same small crate any more and I wrote a letter to the Chief Humane officer stating that I'd be willing to adopt him and his mother, Precious, "as is" if they did not meet the adoption floor criteria (& I knew d*mn well they didn't - he for the congenitally malformed lower jaw and she for being "feisty"). He relayed that to the owner, who had been postponing and getting continuances in the case, because he didn't want them euthanized. The owner relinquished them to me for adoption. Spitzer came home for a week, then spent 2 weeks at the vet on 2 different antibiotics, concurrently, by IV, due to the pneuomonia. It took 6 months for his lungs to clear and it to be safe to get him neutered. After another 5 months, he had dental surgery ($$$$) to reduce the lower canines growing into his upper palate and ulcerating holes there ... and gained a pound in the month after that was done.
 
I think you may get some relief from giving pepcid; my Shadoe has lots of pancreatitis issues, and is gassy and so, most days, I give her 1/4tab 10mg Pepcid BID. It often settles what is upsetting her and it's my first try.
If she is still acting upset I'll go with fluids and bupe, but the majority of cases, that little bit of pepcid is enough to calm her or even partially calm her insides.
I have never understood how giving cerenia in tab form for vomiting is going to work if the cat will just hurl it back up.
Can you get injectable cerenia? I don't know if it's available or not. I would try the pepcid first and see if it helps.
 
The mirtazapine seems to be doing the trick.
All accessible food plates were down to crumbs when I got up this morning. The 10 free-roaming cats had been leaving quite a bit overnight.
 
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