09/05 J.D. PMPS 479 Full Lab Results & Zantac Question

Status
Not open for further replies.
Dyana

Dyana

Very Active Member
Yesterday's Condo

Last Night:
538 PMPS (TOR)
500 +2 (100ml fluids)
323 +4.25
466 +11

I am impatiently waiting for our regular vet to call me to let me know if the CBC part of his blood work is back. It has to be. The test was Tuesday morning. It's Friday. I called this morning and the receptionist said she was having a computer problem and couldn't tell and would have the doctor call me back. :(

J.D. had one grape sized dense like play dough poo this morning and two grape sized dense poos outside on a walk about an hour ago. His tummy doesn't seem to be as hard. Big, but not as hard feeling. I started the morning with the last two syringes of 1/2 can of MaxCal mixed with 1/2 can of Friskies, and since then he has had 5 syringes made up of 1/2 can of MaxCal and 1/2 can of Friskies and 1/2 can of Natures Logic Chicken Dinner Fare.

I also called the Specialty Hospital this morning to see if I am going to get a report and she said that a report from the IM doc and the Nutritionist doc was sent to my regular vet on the 3rd and 4th and that the Cardio doc will be doing the same.
I would think I would get a copy... Anyway, maybe that's the hold up, is my regular vet is very busy and has to read the reports. UG!

I'm glad to see the +7 blue :) with no R used.

Back to housework.
 
Re: 09/05 J.D. PMPS 479 - Lab Results - Opinions on meds/sup

Here is J.D.'s complete blood work (finally) from Tuesday:
IDEXX Laboraties - Total Health Plus (Chem 27) - 09/02/14
TOTAL HEALTH PLUS Chemistry
Reference Range Flag
ALP 50 12 - 59 U/L
ALT 88 27 - 158 U/L
AST 35 16 - 67 U/L
CREATINE KINASE 72 64 - 440 U/L
GGT 1 0 - 6 U/L
AMYLASE 1447 623 - 2239 U/L
LIPASE 29 11 - 242 U/L
ALBUMIN 3.2 2.6 - 3.9 g/dL
TOTAL PROTEIN 7.0 6.3 - 8.8 g/dL
GLOBULIN 3.8 3.0 - 5.9 g/dL
TOTAL BILIRUBIN 0.1 0.0 - 0.3 mg/dL
BILIRUBIN - CONJUGATED 0.0 0.0 - 0.2 mg/dL
BUN 43 16 - 37 mg/dL H
CREATININE 1.7 0.9 - 2.5 mg/dL
CHOLESTEROL 22 91 - 305 mg/dL
GLUCOSE 416 72 - 175 mg/dL H
CALCIUM 10.3 8.6 - 10.6 mg/dL
PHOSPHORUS 3.0 2.9 - 6.3 mg/dL
TCO2 (BICARBONATE) 22 12 - 22 mEq/L
CHLORIDE 117 114 - 126 mEq/L
POTASSIUM 4.1 3.7 - 5.2 mEq/L
SODIUM 152 147 - 157 mEq/L
ALB/GLOB RATIO 0.8 0.5 - 1.2
BUN/CREATININE RATIO 25.3
BILIRUBIN - UNCONJUGATED 0.1 0.0 - 0.2
NA/K RATIO 37 29 - 42
HEMOLYSIS INDEX N
Index of N,+,++ exhibits no significant effect on chemistry values.
LIPEMIA INDEX N
Index of N,+,++ exhibits no significant effect on chemistry values.
ANION GAP 17 12 - 25 mEq/L
TOTAL HEALTH PLUS
Test Result Reference Range Flag
T4 1.4 0.8 - 4.7 ug/dL
Interpretive ranges:
<0.8 Subnormal
0.8 - 4.7 Normal
2.3 - 4.7 Grey zone in old or symptomatic cats
>4.7 Consistant with hyperthyroidism
TOTAL HEALTH PLUS Hematology
Test Result Reference Range Flag
WBC 17.2 3.9 - 19.0 K/uL
RBC 5.81 7.12 - 11.46 M/uL L
HGB 9.2 10.3 - 16.2 g/dL L
HCT 30.3 28.2 - 52.7 %
MCV 52 39 - 56 fL
MCH 15.8 12.5 - 16.5 pg
MCHC 30.4 28.5 - 37.8 g/dL
% NEUTROPHIL 76.1 - %
% LYMPHOCYTE 18.1 - %
% MONOCYTE 2.1 - %
% EOSINOPHIL 3.7 - %
% BASOPHIL 0.0 - %
AUTO PLATELET 500 155 - 641 K/uL
ANISOCYTOSIS SLIGHT
REMARKS SLIDE REVIEWED MICROSCOPICALLY.
SOME CELLS ARE DEGENERATED. DIFFERENTIAL MAY BE AFFECTED.
NEUTROPHIL 13089 2620 - 15170 /uL
LYMPHOCYTE 3113 850 - 5850 /uL
MONOCYTE 361 40 - 530 /uL
EOSINOPHIL 636 90 - 2180 /uL
BASOPHIL 0 0 - 100 /uL
RETICULOCYTE 6 3 - 50 K/uL
% RETICULOCYTE 0.1 - %
Spec fPL 15.5 (Fasting) 0.1 - 3.5 ug/L H (Added Test)
Comments: > or = 5.4 ug/L
Serum Spec fPL concentration is consistent with pancreatitis. The cat most likely has pancreatitis. Consider investigating for risk factors and concurrent diseases (e.g. IBD, Cholangitis, Hepatic Lipidosis, Diabetes Mellitus). Periodic monitoring of Spec fPL may help assess response to therapy.
FOLATE & VITAMIN B12 (COBALAMIN)
COBALAMIN (B12) > 2000 275 - 1425 ng/L H (Added Test)
FOLATE 19.9 8.9 - 19.9 ug/L
MAGNESIUM (Added Test)
Test Result Reference Range Flag
MAGNESIUM 1.8 1.8 - 2.4 mg/dL



For comparison, here is his blood work from August 14th:
IDEXX Laboraties - Total Health Plus (Chem 27) - 08/14/14
TOTAL HEALTH PLUS Chemistry
Reference Range Flag
ALK PHOSPHATASE (ALKP) 36 12 - 59 U/L
ALT (SGPT) 52 27 - 158 U/L
AST (SGOT) 25 16 - 67 U/L
CK 92 64 - 440 U/L
GGT 1 0 - 6 U/L
AMYLASE (AMYL) 1605 623 - 2239 U/L
LIPA 55 11 - 242 U/L
ALBUMIN (ALB) 3.4 2.6 - 3.9 g/dL
TOTAL PROTEIN (TP) 7.3 6.3 - 8.8 g/dL
GLOBULIN (GLOB) 3.9 3.0 - 5.9 g/dL
TOTAL BILIRUBIN (TBIL) 0.1 0.0 - 0.3 mg/dL
DIRECT BILIRUBIN (DBIL) 0.0 0.0 - 0.2 mg/dL
BUN (BUN/UREA) 51 16 - 37 mg/dL H
CREATININE (CREA) 2.3 0.9 - 2.5 mg/dL
CHOLESTEROL (CHOL) 251 91 - 305 mg/dL
GLUCOSE (GLU) 232 72 - 175 mg/dL H
CALCIUM (Ca) 9.2 8.6 - 10.6 mg/dL
PHOSPHORUS (PHOS) 4.1 2.9 - 6.3 mg/dL
TCO2 (BICARBONATE) 13 12 - 22 mEq/L
CHLORIDE 115 114 - 126 mEq/L
POTASSIUM 3.5 3.7 - 5.2 mEq/L L
SODIUM 144 147 - 157 mEq/L L
A/G RATIO 0.9 0.5 - 1.2
B/C RATIO 22.2
INDIRECT BILIRUBIN (IBIL) 0.1 0.0 - 0.2
NA/K RATIO 41 29 - 42
HEMOLYSIS INDEX ABN
Unable to report serum indexes on this sample.
LIPEMIA INDEX ABN
Unable to report serum indexes on this sample.
ANION GAP 20 12 - 25 mEq/L
TOTAL HEALTH PLUS
Test Result Reference Range Flag
T4 0.8 - 4.7 ug/dL
Interpretive ranges:
<0.8 Subnormal
0.8 - 4.7 Normal
2.3 - 4.7 Grey zone in old or symptomatic cats
>4.7 Consistant with hyperthyroidism
TOTAL HEALTH PLUS Hematology
Test Result Reference Range Flag
WBC 19.9 3.9 - 19.0 K/uL H
RBC 6.26 7.12 - 11.46 M/uL L
HGB 9.7 10.3 - 16.2 g/dL L
HCT 32.3 28.2 - 52.7 %
MCV 52 39 - 56 fL
MCH 15.5 12.5 - 16.5 pg
MCHC 30.0 28.5 - 37.8 g/dL
% NEUTROPHIL 79.5 - %
% LYMPHOCYTE 11.5 - %
% MONOCYTE 6.3 - %
% EOSINOPHIL 2.7 - %
% BASOPHIL 0.0 - %
AUTO PLATELET 499 155 - 641 K/uL
ANISOCYTOSIS
REMARKS SLIDE REVIEWED MICROSCOPICALLY.
NEUTROPHIL 15821 2620 - 15170 /uL H
LYMPHOCYTE 2289 850 - 5850 /uL
MONOCYTE 1254 40 - 530 /uL H
EOSINOPHIL 537 90 - 2180 /uL
BASOPHIL 0 0 - 100 /uL
RETICULOCYTE 13 3 - 50 K/uL
% RETICULOCYTE 0.2 - %
FECAL OCCULT BLOOD (Added Test)
Test Result Reference Range Flag
OCCULT BLOOD NEGATIVE
Comments: This is a screening test for the presence of occult blood in feces. Certain foods and drugs may cause false positive results. This result should be interpreted in conjunction with history and other diagnostic procedures.


In Summary, his POTASSIUM, SODIUM, WBC, NEUTROPHIL, AND MONOCYTE are back to within Range. His Creatinine and BUN and Phosphorus decreased by quite a bit. His RBC and HGB is a little lower and we are still battling that issue. Why we have it, is not known.



What opinions do you have regarding making the following changes to his meds/suppliments?

Current medications and supplements:
Baytril 22.7 SID PM Try stopping
Cerenia 16mg SID AM
Ondansetron 1mg BID
Cyproheptadine 1mg BID
Flagyl 50mg BID Try Stopping
Jarrow Formula B-Right 1/10th cap SID PM
Methlcobalamin 250mcg BID Halve
baby food sSquash 5ml BID Try Benefiber instead
Miralalax 1/4 tsp BID
Probiotics 1/3 cap BID Try stopping
Denamarin 1 SID AM
Azodyl 1 SID PM
RenaKare 1/2 tsp BID
Pepcid 2.5mg as needed Try Zantac instead
Simethicone 0.15ml as needed
Fluids 100ml EOD Start
Buprenorphine is not listed here. He gets 0.05 TID on my days off and 0.08 BID on work days.

The IM Vet suggested trying stopping the Baytril as it could be affecting his appetite, and his past elevated WBC was slight and we can not find any infection, and elevated WBC can be from inflammation, too, besides infection. I am just concerned about DKA with high blood glucose and possible infection and the not eating (but he is getting enough calories via syringe).

I talked to our regular vet regarding the stopping of the probiotics because of the possible gas issue and the suggestion to try stopping the Baytril and asked if we can try stopping the Flagyl too as J.D. is constipated and Flagyl has always been my go to (as needed only) for stopping any loose stools. She said to try to stop the Flagyl and we'll revisit it (talk about it) in 2 weeks.

Our regular vet said to halve his B12, so instead of 250mcg of methylcobalamin BID and 1/10th capsule of Jarrow B-Right SID, I'll just give him 250mcg SID with the Jarrow B-Right. I guess, I'll halve his .25ml of weekly injected cyanocobalamin (not listed) to .12ml or go to bi-weekly?
Regular Vet said to try to stop the Flagyl to see if it helps with his constipation.

The Nutritionist vet said to try 1/16th tsp of Benefiber instead of the squash to soften his stools.

The Nutritionist vet said to try stopping the probiotics to see if it helps with his gassy tummy.

The IM vet said to try Zantac (prescribed ranitidine 9mg (15 mg/ml) PO q12h) instead of the Pepcid as it may help with prokinetic effect (I had to Google that one).

Both the IM vet and the Cardiologist said that fluids would be okay for J.D. and the IM vet said 100ml every other day would be okay to start with.


Do you think these are too many changes at once? Should we just do a couple at a time, or just go for it?
J.D. will be happy to stop the ABs.
 
Re: 09/05 J.D. PMPS 479 - Lab Results - Opinions on meds/sup

I don't have any advice on the meds/supp. I just wanted to check on J.D. and let you know I'm thinking of you and J.D. :YMHUG: :YMHUG:
 
Zantac Question

The pharmacy gave me a syrup, a peppermint flavored syrup, that's super sweet. I just called them and they said that's the way it comes. They said it has sorbitol and sucra something in it. They said I can try a compounding pharmacy. Does anyone else give Zantac a different way?
 
I'm pretty sure Zantac comes in pills, too, but I don't know if you can split them into a dosage that is appropriate for J.D.
 
You might want to PM Anne/Liz, as Zener gets Zantac. Neko's acupuncture vetty also suggested it as an alternative to Pepcid.

I hope you can try stopping some of the meds. That's a formidable list that JD gets. :shock:
 
Funny that you asked if we thought it was too many changes at once. It seems to be it is. If you want to find what might be causing any issues for him, it's best to change things one at a time and give a few days after each change.
 
I'm not as experienced as Marje, but I agree with her about not changing too many things at once. You want to know which changes are helping, and you wouldn't be able to if you did several at the same time. I'd pick the one you most want to get rid of and do that first - the one that you hope will help the most.

Here is what Tanya's site says about Zantac (including dosage):

Ranitidine Dosages
One reason why people may decide not to use ranitidine is that it usually has to be given twice a day, whereas famotidine is usually only given once every other day, or occasionally once a day.
The usual dose is 0.25 to 1.00 mg per pound (0.5 - 2.00 mg per kg) every 8-12 hours, though most people find twice a day is fine.
You therefore would give a 10lb (4.5kg) cat 2.5 - 10 mg twice a day.
The standard size pill is 75mg, so for a 10 lb (4.5kg) cat who is getting the higher dose, it is usually easiest simply to give an eighth of a tablet twice a day (i.e. 9.375 mg, or a little under 10 mg).
Some people give up to twice this amount, but as with famotidine, I suggest starting low and increasing the dose if necessary since ranitidine is also excreted by the kidneys. Be guided by your vet.
Ranitidine tastes quite bitter and can make cats foam at the mouth, so you may find it easier to give it in a gelatine capsule (gelcap). Many people prefer to give the second dose of the day at bedtime because this seems to help cats who vomit at night or first thing in the morning. It usually takes effect pretty quickly, within a couple of days.

The main problem with ranitidine is dividing the tablets up into cat-sized dosages. If you find it hard to cut the pill into eight, you could try dissolving it in water and giving an eighth of the resulting mixture via syringe.

Ranitidine Oral Suspension
There is also a liquid (syrup) form of ranitidine, but this is peppermint flavoured, so not many cats would like it, plus you need a prescription for it. However, I understand you can obtain it in a beef flavoured compounded suspension from Thriving Pets. If you enter the word "tanya" (without the ") in the promotional code box, you will receive a 10% discount on orders over US$55. Shipping is free for orders over US$55 after the discount.
Click to expand...

Hope that helps. Sending tons of healing vines for J.D.
 
Nothing to add to what Tricia posted from Tanya's site on the meds, we used that same information for Zener's Zantac. Our vet also suggested the change from pepcid to zantac for the GI motility benefit. So true about the challenge of cutting those little pills into eights! ohmygod_smile We use a simple pill cutter to cut the pill into quarters, then half each of those to get to the eights for Zener's dose. You lose a few to crumbling. Some of the Zantac 75 pills come in a five-side shape, and these are a bugger to cut. We get the Target generic brand and it comes as a round pill, much easier.

Anne
 
Sorry to bump up yesterday's post, but I didn't see a new one for today.

Dyana said:
The pharmacy gave me a syrup, a peppermint flavored syrup, that's super sweet. I just called them and they said that's the way it comes. They said it has sorbitol and sucra something in it. They said I can try a compounding pharmacy. Does anyone else give Zantac a different way?
Click to expand...

I don't know how peppermint flavoring and peppermint oil differ, but you might want to research it a bit more before giving it to J.D. Peppermint is listed on the ASPCA site as harmful for cats and dogs - http://www.aspca.org/about-us/faq/peppermint-oil. Marje mentioned it in a recent post, as well. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=124716e

Hope all is well!
Shelly
 
Happy Saturday to you kids....you are such a good Mama Dyana! That is quite a list of meds
for your boy. He is such a good kitty. Sending you all hugs....

Edited to add: I have no idea about the answers to the questions you posed but I just wanted to
give you some good vibes. I know you will get the most thorough answers....and that J.D. will be
the better for your searching! :mrgreen:
 
Sorry for the late start today. :roll:
I need to run to a neighbors, and then test shot and feed and then run to the grocery store, and then I can make a condo for today. I did just get off the phone with the IM.

I'll write later, when I can. J.D. is normal for him.
 
I just fed him even though it's +11.5, but with him, ya gotta go with the flow. He's eating FF Cod, Sole & Shrimp, and doing that teeth clacking thing he does when he likes something.

Off to neighbor's house.
 
Status
Not open for further replies.
Back
Top