08/16 J.D. PMPS 511, +3.25 294 - RenaKare Gel is such a pain

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Dyana

Dyana

Very Active Member
Yesterday's Condo

Last Night:
487 +11.75 intentional Fur Shot (TOR)
509 +13.5
466 +20

I have not finished updating my spreadsheet with the times he got fed and meds, yet. They are scribbled on the back of an envelope.

He does seem brighter at times and sleepy and doesn't want this syringe feeding (but he still gets them) at times.
We have gone outside for 3 short walks today.

Possitives:
He is walking better
He had a perfect poo.
He ate a few cat treats and licked at little bit of MC at +1.5 and licked at a little MC at +5
Purring louder (he woke me up at +1.5 by trying to jump up on the couch with me where I was snoozing, and he was purring loudly and that's when he happily ate the cat treats. Maybe he was just so proud of the perfect poo :) ).

Negatives:
Weight on 08/13 10lbs 8oz and on 08/16 10lbs 2oz
Peeing like crazy sometimes..
Still sleeping a lot

Linda and Bear Man said:
I am sending many healing vines to J.D. His bloodwork looks pretty good!

Others have addressed the hyponatremia (low sodium) and hypokalemia (low potassium). I wonder if the hyponatremia might be due to dilution from all his recent sub Q fluids. His total protein, however, is in a good range, so he doesn't look over hydrated. Marje may turn up more info on the sodium.

He has a high white blood cell count (leukocytosis). His white blood cell total of 19,900 (or 19.9 K) per uL is the sum of the numbers of all the white blood cell types: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Because his neutrophils are high (neutrophilia) and his monocytes are high (monocytosis), this causes his leukocytosis.

Neutrophilia can be caused by infection or inflammation, among other things. You could get a bit more info about his neutrophilia if they examined a blood smear and reported his numbers of segs (segmented or mature neutrophils) and bands (immature neutrophils), but I don't see this reported this time.

The monocytosis can be caused by chronic inflammation or infection. Given that J.D. had recently been treated for infection, my guess would be that the mild neutrophilia and marked monocytosis are due to chronic inflammation or infection somewhere in the body, which is something you already know has been occurring.

I think he is peeing a lot because he has the extra fluids in his body. I think he already has the miracle he needs - and it is you. You are doing so much to keep him feeling well. I hope you can sleep better knowing his blood work is pretty darn good. Please take care of yourself, and I am keeping the vines coming your way.

p.s. There was a mention of anisocytosis. This means that his red blood cells are of varying sizes. This could be not significant, especially as his MCV and MCHC (two red blood cell indices) are in the normal range, but it could just indicate his body's attempt at regenerating red blood cells. His body may pump out immature red blood cells (of different sizes) to try to deal with his anemia. Regeneration is a good thing.
Click to expand...

Thank you, Linda.
I'm not sure, but in reviewing all his past blood work reports I think they changed the term NEUT SEG to % NEUTROPHIL and his was 79.5, but they don't show a reference range other than a % sign. In the past the reference range was 35 - 75 % but they stopped adding that on the report. I guess his is H then.

So often I get a report back and they have changed the order of tests and the names of the test. I just try to match the reference range sometimes to make sure I am entering the right test in the right spot on my spreadsheet.

He had high NEUTROPHIL and LYMPHOCYTE on 07/21, then normal range on 08/02, and now back to high again.

Do you know what the RE: 281 HEMOLYSIS INDEX ABN Unable to report serum indexes on this sample and RE: 282 LIPEMIA INDEX ABN Unable to report serum indexes on this sample mean, and is it important?

His ANISOCYTOSIS was SLIGHT on 07/21 and on 08/02. I did not see it listed on this past report, so I left it blank on this lab report on 08/14 my spreadsheet. I never had it on a report until 07/21 and 08/02, and now it's not on the report again. Maybe there aren't any this time or previously when it wasn't reported?

Does anyone know if he should be tested again soon for Potassium?


This is my horoscope for today:

CANCER
Dearest Cancer, you must have a lot on your plate! Today may be a little stressful, but there will be ways to find relief. Your mental stability is the most important thing, so if you feel like you are overwhelmed and stressed; take time for yourself to readjust your mindset. That will help make your busy day less painful to get through.

My mind does still seem tired. I slept in until about 10:00am :roll: and feel like I could use more. It took me forever to write this condo. :oops:
 
Re: 08/16 J.D. AMPS at +21 571, +1.5 374, +4 121, +5.25 139

Okay, I have another question. I mark with a felt tip on the fluids bag where I want the fluids to go to. The fluids bag is hanging about 2 feet above my head. I sit down on the floor and I flush the line (and I don't think I flush that much), but when I look back up at the fluids bag the line I drew now only looks like 25ml from the last line (because of the different angle?). Should I somehow reach up from my sitting position and mark the line on the bag that way?
 
Re: 08/16 J.D. AMPS at +21 571, +1.5 374, +4 121, +5.25 139

I think I'm going to go to work for a few hours as my "me time" today. Although I could use another nap, and J.D. could probably use some Bupe soon, I can get over time if I go to work today, and none if I go to work tomorrow, and I will have a ton to catch up on next week when I go back on Tuesday, and I just can't see myself putting in extra time next week because of it.

J.D. just got him bupe, is fed well, so I am off.
 
Re: 08/16 J.D. AMPS at +21 571, +1.5 374, +4 121, +5.25 139

Dyana:

I'm glad you're taking some "me" time, although going to tbp doesn't seem very relaxing to me!

I have had the same question about fluids. I know our expert, Marje, is off the grid for a while, but hopefully someone else with lots of experience will answer that question. I'll be watching for it.

Meanwhile, I'm still praying for you and J.D., and sending lots of healing and appy vines for him.
 
Re: 08/16 J.D. AMPS at +21 571, +1.5 374, +4 121, +5.25 139

Dyana said:
I'm not sure, but in reviewing all his past blood work reports I think they changed the term NEUT SEG to % NEUTROPHIL and his was 79.5, but they don't show a reference range other than a % sign. In the past the reference range was 35 - 75 % but they stopped adding that on the report. I guess his is H then.

He had high NEUTROPHIL and LYMPHOCYTE on 07/21, then normal range on 08/02, and now back to high again.

Do you know what the RE: 281 HEMOLYSIS INDEX ABN Unable to report serum indexes on this sample and RE: 282 LIPEMIA INDEX ABN Unable to report serum indexes on this sample mean, and is it important?

His ANISOCYTOSIS was SLIGHT on 07/21 and on 08/02. I did not see it listed on this past report, so I left it blank on this lab report on 08/14 my spreadsheet. I never had it on a report until 07/21 and 08/02, and now it's not on the report again. Maybe there aren't any this time or previously when it wasn't reported?

Does anyone know if he should be tested again soon for Potassium?
Click to expand...

Mature neutrophils are normally segmented, and are called "segs". Sometimes there is such a high demand for new neutrophils that the body pumps out immature neutrophils, called bands. The proportion of bands to segs can sometimes be important. If it was not noted in the report, I assume that they did not find a significant number of bands, which is good.

White blood cell numbers are reported in several ways. The percentages are called the "differential". For instance, if they count 100 white blood cells on a blood smear, and 79 of them are neutrophils, then that is reported as 79% neutrophils. Then they multiply that number by the total number of white blood cells to get the "absolute" number. So for J.D., 79.5% (or .795) neutrophils times 19.9 K (19,900) WBC = 15821 neutrophils per uL of blood. i.e. 79.5 percent of 19,900 is 15821. And so on for the other four types of white blood cells. The reference ranges can be published for the absolute numbers. They are just different ways of expressing the same thing.

Neutrophils, monocytes, and lymphocytes all play a big role in fighting infection. It's not unexpected to see that they are (or were) elevated as we know he has been fighting infection. WBC levels can be affected by other things as well, such as stress. I would leave it to the vet to comment on where she would expect his WBC to be at this stage of his treatment.

Hemolysis and lipemia are two types of artifacts that may occur in blood testing. Artifacts are not due to the patient, but are related to the sampling. Hemolysis is caused by bursting of red blood cells in the syringe or blood tube. It can be caused by rough handling of the sample, or by many other factors. Lipemia is caused by recent ingestion of food causing very small particles of fat to make the sample cloudy. When patients are asked to fast, it is usually in an attempt to try and avoid lipemia. You don't want to see these artifacts, although sometimes they are unavoidable, as they can interfere with results of some parts of the CBC or chemistry. If they can't report them, I think this is a good thing.

Anisocytosis is variation in the size of red blood cells. A small amount is not unusual. Sometimes there is such a high demand for red blood cells that the body sends out immature ones, which are larger than normal ones. It can be a sign of regeneration (the body is trying very hard to build new red blood cells). As J.D. is anemic, this is not unexpected. If the technician notes it on a smear, then the finding should be written into the report, but on its own, it is not that informative as a finding.

As he is being treated for his hypokalemia (low potassium), you might want to recheck it the next time he is in, or perhaps in a couple of months, or if you feel like his clinical signs are not improving and you want to see if you are making progress. Someone else may have other suggestions on this.
 
Re: 08/16 J.D. AMPS at +21 571, +1.5 374, +4 121, +5.25 139

Dyana,
When I gave Bob fluids, the bag was usually about three feet above my eye level and I experienced the same issue where it seemed like the line "moved". I did just what you asked about. Once I sat on the floor, I reached up and drew the line where it needed to be.
On the potassium... Bob had chronic low potassium, and what his vet did is add potassium to his fluids. It took quite a while for that method to work, but eventually he got back to low-normal ranges. If fact, the potassium issue was the primary reason he got fluids (rather than it being due to dehydration) once he was over his ketone and dehydration problems. He got fluids every day for about a month at the start of his diabetes, 100 ml per day usually. Maybe ask the vet if it could help with JD?

Big hugs,
Carl
 
Re: 08/16 J.D. PMPS 511 - RenaKare Gel is such a pain

Thanks again for answering my questions. :YMHUG:

I got home just in time for PMPS. If I hurry, I am going to try to go for a swim before they close. I munched on a couple of granola bars at work.

Has anyone every used RenaKare Gel. It is SOOOOOOOO hard to get it from the tube into the syringe. I don't think it can be warmed to make it easier as it says to keep it at certain temperatures and the high one is 86 degrees.
It takes me forever to measure this and tonight, it was more of a guess. I am going to complain about it when we go see the vet on Monday.

J.D. went to the cat food bowl and kind of stood there for almost a minute. Didn't eat, but it's a bit of progress, I think.

Okay, off to try to get a swim in.
 
Re: 08/16 J.D. PMPS 511 - RenaKare Gel is such a pain

I'm glad J.D. is walking better and had a perfect poo. You're doing a great job taking care of him. Sending prayers for J.D. and hugs to you. :YMHUG: :YMHUG:
 
Re: 08/16 J.D. PMPS 511 - RenaKare Gel is such a pain

I will cross post on the Main Health Forum.

I finally felt hungry when I was driving to work. I passed a fast food joint that was advertising corn dogs 50 cents. That got my tummy hurting. I LOVE corn dogs. The 4-H fair is going on this weekend. I was thinking maybe I should go there for my "me time" ;-) I wonder if that's how J.D. feels, not hungry. No, that can't be, because he's been syringe fed.

We just got back from a walk as night time is approaching.

He is at his water bowl, drinking slowly. I often find him with water on his chin, and have thought he was drooling, but I think it might be the way he hangs out hoovering over his water bowl.

I do feel better about him.
 
Re: 08/16 J.D. PMPS 511 - RenaKare Gel is such a pain

More hugs Dyana. RenaKare must be about the same thing as RenalK. It IS a pain and Doc hated it...doesn't sound like JD minded it so that's great!! If I let it sit more than a few seconds in the syringe, it stuck the syringe and I'd miss my opportunity I'd fought for... :roll:

HUGS!
 
Re: 08/16 J.D. PMPS 511 - RenaKare Gel is such a pain

Squeaky and KT said:
More hugs Dyana. RenaKare must be about the same thing as RenalK. It IS a pain and Doc hated it...doesn't sound like JD minded it so that's great!! If I let it sit more than a few seconds in the syringe, it stuck the syringe and I'd miss my opportunity I'd fought for... :roll:

HUGS!
Click to expand...
And, it's Vanilla Custard flavor :roll: Why not fish or chicken or beef or bacon?

Here's my post on Health: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=123647
I squeeze as hard as I can to get the stuff out and I try to suck with the syringe at the same time, but it's so hard to get out of the tube for some reason and I get a bunch of air in the syringe, and just getting that 1/2 teaspoon takes a lot out of me.
 
Re: 08/16 J.D. PMPS 511, +3.25 294 - RenaKare Gel is such a

Mommy has a full belly, of McDonald's Value Meal :)

J.D. just got his Bupe and will get his fluids in a few minutes, and then it's bed time!

ni~ni LLand. Thanks for everything you do, and for all the well wishes and help :YMHUG: I really appreciate you.
 
Re: 08/16 J.D. PMPS 511 - RenaKare Gel is such a pain

Dyana said:
...
I squeeze as hard as I can to get the stuff out and I try to suck with the syringe at the same time, but it's so hard to get out of the tube for some reason and I get a bunch of air in the syringe, and just getting that 1/2 teaspoon takes a lot out of me.
Click to expand...

Pull the plunger out of the syringe and squeeze into the now open end - reinsert plunger and squeeze out air. All set...MUCH easier but we sure wasted a lot of med before we learned that trick. If it sticks, put vaseline on plunger and work it inside barrel until it slides easy.

Vanilla custard? Yuck!

nite nite...me too...
 
Re: 08/16 J.D. PMPS 511, +3.25 294 - RenaKare Gel is such a

I wish I could help you with the RenaKare gel but everyone I know has used Tumil K.

Sending more vines and hope you rest.
 
Re: 08/16 J.D. PMPS 511 - RenaKare Gel is such a pain

Squeaky and KT said:
Dyana said:
...
I squeeze as hard as I can to get the stuff out and I try to suck with the syringe at the same time, but it's so hard to get out of the tube for some reason and I get a bunch of air in the syringe, and just getting that 1/2 teaspoon takes a lot out of me.
Click to expand...

Pull the plunger out of the syringe and squeeze into the now open end - reinsert plunger and squeeze out air. All set...MUCH easier but we sure wasted a lot of med before we learned that trick. If it sticks, put vaseline on plunger and work it inside barrel until it slides easy.

Vanilla custard? Yuck!

nite nite...me too...
Click to expand...

I would have never thought of that, but what a great idea, Lyresa!
 
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