1/20 Clare AMPS 294 PMPS 320 Update and Vet results

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Georgette and Clare

Member Since 2014
Good evening, Lantus Land neighbors!

We're sending out many hugs and scritches and wishes for a healing, peaceful night to our neighbor kitties and beans who need them.

Today's News:

AMPS 294
+2 321
+4.5 287
+6 307

PMPS 320
+2 257
+4 182

It's good to be back on the board! Clare had a big day today so we thought we'd like to update you on how she's doing.

To refresh our story, since before the holidays we've been giving Clare a phosphorous binder for her CKD and also antibiotics to treat a somewhat mysterious infection, probably in her kidneys. We started with liquid Clavamox as an AB with a bad result: things started out okay but then while we were away over Christmas, Clare's stomach became upset and she stopped eating. Our wonderful caregiver and veterinary staff got her on fluids and Cerenia, which helped, but it was plain she wasn't tolerating the Clavamox.

When we got back things didn't change much, so we decided to switch her to Primor, a sulfa-type AB instead, and she's been on that for almost 3 weeks now.

Clare's been very brave and has been taking a capsule (with Primor, Cerenia, and Cypro), food additives (aluminum hydroxide and Fortiflora), injections (fluids, insulin and B12), and syringes (with water after the pill, and another with Miralax) each day. Her usual attitude toward all this is "Okay, that's done, now where's my chicken?" :cool:

Starting on about January 10th we noticed that her BGs were changing to a new pattern. Her cycles have smoothed out quite a bit from the dramatic dives and bounces she's had. Also, she's going into active cycles on lower and lower doses of insulin.

So tonight she's going lower on a "whisper" dose - which is the smallest dose we can do.

We went back to the vet today for a follow-up urinalysis to see what effect the AB has had. Good news! No bacteria or blood present, and "only a few white cells, nothing abnormal" said the vet. Clare's concentrating her urine well, too. Her weight is up and her temp and heart rate are good.

The bad news is that there are still cell "casts" present in her urine, which indicate some kind of breakdown in her kidneys or urinary tract.

So our vet is doing some further research and will probably recommend some specialized tests tomorrow.

Clare has had a good appy since we changed to the Primor. The fluid therapy especially seems to be good for her, although it's probably the thing she's most impatient with.

I'm in new territory with BGs in the yellows and blues so much of the time. I'm not sure when it's safe to go to bed! :nailbiting: I'd appreciate any neighborly advice on that or any ideas you might have about kidney issues, tests or etc. that might help Clare now.

As always, it's a comfort to have you with us during this journey. :bighug:

Have a good night, everyone!

Georgette and Clare
 
Hi Georgette:

Wow, Clare has been through a lot lately (and therefore, so have you!). It sounds like you've got a pretty good handle on things now.

Regarding her dosing, I'm not sure I'm clear on why you removed the + from her dose. From the last four cycles at least, it doesn't look like she's getting enough insulin. I don't see anything lower than 50 on her spreadsheet since 1/12, when she was on .25. At that time she earned a reduction to .1, which I would guess is what you are calling W+. You're using a human meter, so a 68 is really not too low - I'd have fed MC rather than give karo at that and tested in an hour. See how that shot her up, but then it wore off and she came down again? You reduced after that, and now she's got some pinks, yellows and high blues. I would think she needs that + back, but you could wait two more cycles, so that it's 6 since her last green number. As for when to go to bed - your guess is as good as anyone's! It looks like her nadir keeps moving around (I have one of those). I'd say you're safe if she's in the mid 100s at +6. Maybe you can set an alarm to get a +6 or + 7 the next time she's in blue when you go to bed - just to see if she goes lower.

I'm really not an advice giver - these are just my thoughts. I hope one of the more experienced people will come along and give you some really good advice. You might have to wait until tomorrow morning now.
 
I agree with Tricia although I'm not an advice giver on dosing either. I'm glad things are so much better now !!
 
I'm so glad Clare is feeling better! She sounds like she's in a somewhat similar situation as Trix. Last weekened Trix got really sick, seemingly with p-titis. As a precaution, vetty started her on an AB (zenniquin), and it has worked wonders. She is also on a second AB (amoxicillin) because she had batcteria in her urine. On top of that, she has outrageously bad kidney values...yet she seems to feel really good. It appears that the ABs are taking care of some sort of mystery infection for Trix, too!

Good luck with the increase, and sending prayers that the "casts" are nothing to worry about!!
 
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