1/31 Ming PMPS = 133, +3 = 218

[Crista & Ming]

http://www.felinediabetes.com/FDMB/threads/1-30-ming-pmps-256-test-results.225007/

Guuuuuueeeeess what? Ming has hyperthyroidism (edit: the specialists said he’s borderline hyperthyroid but will most likely become hyperthyroid)



^^ those are wacky, crazed smiles that come from caring for a cat that wants to have all the illnesses lol

We’re also going to address the protein in his urine with fortekor or this other drug that is less dangerous for the kidneys (telmisartan). The vet that relayed the results to me wants to talk to Ming’s main vet about everything before we start meds.

We left a message for North West Nuclear Medicine to check his labs and also their experience with treating diabetic patients. If he’s fit for radiation therapy, I’d probably put the Libre on him and give some type of vacation dose.

I’ve uploaded his labs. I’m at work right now and it’s busy and I’m kinda tired and upset about Ming’s tests.

The tech said his blood really looked like a milkshake so maybe, when the opportunity comes again, I’ll try a fasted sample.

tagging @Wendy&Neko
@Sandy and Black Kitty @Marje and Gracie

Marje, if you could look at Ming’s labs and let me know what you think. Thank you!

 

[Crista & Ming]

Here are his labs:

 

[Sue and Luci]

Oh Crista...I'm sorry to hear about his labs...and yet another thing on both your plates.

Try not to be upset - we all know he's in the best possible place for a kitty with a couple of medical quirks...he's a lucky boy to have such a dedicated mama bean looking after him. I could think of situations where such a gorgeous boy might not fare so well with these issues. Consider yourself blessed that you've found out - and now onward to treatment and hopefully a well managed issue.

Sending hugs

 

[Crista & Ming]

Thank you @Sue and Luci. You’re right. My coworker said something similar. She said Ming is exactly where he’s supposed to be. I do believe if he was in another person’s hands, he might be dead by now.

NWNM just called. They said he’s borderline and to do a free t4 recheck in a month. So that’s booked.

They also said, sometimes they can’t give insulin right at the 12 hour mark or the cat doesn’t eat so they don’t give insulin. I’m fine with that as it’s only about 3-4 days. We could probably come up with a plan for those situations if he needs to be treated there.

 

[Tina Marie (GA) and Jan]

Also sending hugs Crista. I empathize, and really like what Sue said. She's right, and I bet several of us could take that same advice. Bloodwork results we don't like easily bring us down, but we are here to love and help our dear kitties. I look forward to hearing thoughts from those you have tagged. Ming really is a lucky (and beautiful) boy to have you. And this might not be worth much, but he's got some good results in there too

 

[Sue and Luci]

Yes, I was thinking of some people who just don't have the wherewithal, tolerance, finances, etc. to keep a cat with medical problems...it's just heartbreaking but as you know not everyone is as fortunate as we are that we have the means or perhaps the desire to take care of these precious babies we've been entrusted with. I see those people looking for homes for their kitties - due to various life challenges that they're facing that puts them in an unfortunate position of simply not being able to provide the care that these precious babies need!

We're all here to support you...and we know that you'll do the very best for Ming! He is indeed a very lucky boy to have found such a wonderful mama bean!!! Can't say that enough! Hang in there...you'll do great with whatever care he needs!

 

[Wendy&Neko]

Marje has a family emergency to deal with, so may not be on board for a while. I will try. First, there is a group.io group that specialized in FelineThyroidManagement. A good group with a knowledgeable moderator. You might want to join there. I know they will recommend a complete thyroid panel, but you can read more there. I do know that there are people here managing kitties with hyperT and diabetes, or even a couple hypoT. It can make regulation more tricky, but I know you can do it. Getting his thyroid regulated can help drop the insulin dose. Talking to NWNM is good. Glad they thought it was no rush.

Sorry to hear about the UPCR. Neko once had a higher number when she peed on the exam table before they could get the sample. What they did test was higher. Anyway, telmisartan I have heard is a better choice, but it wasn't available at the time Neko was dx'ed with proteinuria. I believe @Sienne and Gabby (GA) has some experience with it.

I was reading somewhere that fatty blood can be because of diabetes, pancreatitis, corticosteroid use, and a few other things. Anyway those are the three boxes Ming checked.

Managing multiple conditions is harder, but I know it's doable for you. Ming has the right person.

 

[carfurby (GA)]

I'm so sorry, but Ming is lucky to have you to take care of him. I know you'll do everything you can for him. Sending prayers.

 

[Sonia & Leo]

Crista Thank goodness Ming has you and "Team Ming" fighting for him, if only all kitties could be half as lucky.

 

[tiffmaxee]

I’m not anyone you tagged but the sample was ++++ lipemia which could have an effect on the results so I would have them run again and you shouldn’t be charged. My vet also runs tests a second time before coming to a diagnosis. Also I don’t see the thyroid panel. You need a complete panel. Did the vet feel any nodules on the thyroid? The groupsiothyroid group is really good so I would join. Was Ming dehydrated when tested?

 

[AmandaE]

Sorry to hear you’ve had more piled on your plate but I do agree with everyone... you’re so great with Ming and he’s just so lucky to have someone like you who cares for him so completely... you’ve done a great job so far and you will manage this hurdle too. I think it’s ok to let yourself feel a little down about it though... it’s a lot.

thinking of you and Ming

 

[Crista & Ming]

Thank you everyone: @Tina Marie and Jan , @carfurby @Sonia & Leo @AmandaE for the kind words and encouragement! I feel better after reading all the nice messages and also giving myself some time throughout the busy day to process my emotions/thoughts.

Yes, I was thinking of some people who just don't have the wherewithal, tolerance, finances, etc. to keep a cat with medical problems...it's just heartbreaking but as you know not everyone is as fortunate as we are that we have the means or perhaps the desire to take care of these precious babies we've been entrusted with. I see those people looking for homes for their kitties - due to various life challenges that they're facing that puts them in an unfortunate position of simply not being able to provide the care that these precious babies need!

We're all here to support you...and we know that you'll do the very best for Ming! He is indeed a very lucky boy to have found such a wonderful mama bean!!! Can't say that enough! Hang in there...you'll do great with whatever care he needs!

Yes, I am so privileged to be able to treat Ming without thinking too much about cost and time. And to have such wonderful resources at work and especially here on FDMB. I can't thank you all enough!!

I’m not anyone you tagged but the sample was ++++ lipemia which could have an effect on the results so I would have them run again and you shouldn’t be charged. My vet also runs tests a second time before coming to a diagnosis. Also I don’t see the thyroid panel. You need a complete panel. Did the vet feel any nodules on the thyroid? The groupsiothyroid group is really good so I would join. Was Ming dehydrated when tested?

His blood is always lipemic Should we run the same panel with hopefully a less lipemic sample? I am doing a t4 in a month too.

The vet ordered a cTSH which she said is a new thing and it's what the nuclear medicine specialists have been recommending to do. She also felt nodules during his physical exam.

His last general panel also indicated dehydration. Is that something I should address?

Marje has a family emergency to deal with, so may not be on board for a while. I will try. First, there is a group.io group that specialized in FelineThyroidManagement. A good group with a knowledgeable moderator. You might want to join there. I know they will recommend a complete thyroid panel, but you can read more there. I do know that there are people here managing kitties with hyperT and diabetes, or even a couple hypoT. It can make regulation more tricky, but I know you can do it. Getting his thyroid regulated can help drop the insulin dose. Talking to NWNM is good. Glad they thought it was no rush.

Sorry to hear about the UPCR. Neko once had a higher number when she peed on the exam table before they could get the sample. What they did test was higher. Anyway, telmisartan I have heard is a better choice, but it wasn't available at the time Neko was dx'ed with proteinuria. I believe @Sienne and Gabby (GA) has some experience with it.

I was reading somewhere that fatty blood can be because of diabetes, pancreatitis, corticosteroid use, and a few other things. Anyway those are the three boxes Ming checked.

Managing multiple conditions is harder, but I know it's doable for you. Ming has the right person.

Thanks Wendy for letting me know about Marje. I hope everything is okay

Yay! I love groups! I'll go join there soon and do some reading!

Yes, I'd feel better about using a safer med. The vet mentioned they've been using that more recently with feline patients. This is an entirely different vet that reported the results to me. Main vet is in tomorrow. But the vet today admitted she's never treated proteinuria on a cat that doesn't have kidney disease. I just took a blood pressure and got 145 on the doppler. I'm going to try again later and see if I get similar results. He was a little freaked out by the doppler lol

Now I'm a little paranoid he's got something going on - a mini panc flare, maybe. My family reported to me that Ming stayed in my room all day today but he's eating - just not as much as usual.

Thank you, Wendy, as always. You are such an invaluable resource and overall amazing person to us here on FDMB

 

[tiffmaxee]

Thank you everyone: @Tina Marie and Jan , @carfurby @Sonia & Leo @AmandaE for the kind words and encouragement! I feel better after reading all the nice messages and also giving myself some time throughout the busy day to process my emotions/thoughts.


Yes, I am so privileged to be able to treat Ming without thinking too much about cost and time. And to have such wonderful resources at work and especially here on FDMB. I can't thank you all enough
His blood is always lipemic Should we run the same panel with hopefully a less lipemic sample? I am doing a t4 in a month too.

The vet ordered a cTSH which she said is a new thing and it's what the nuclear medicine specialists have been recommending to do. She also felt nodules during his physical exam.

His last general panel also indicated dehydration. Is that something I should address?


Well, this sample was pretty lipemic. It makes some levels higher and others lower than they really are but won’t change the hyper-t part. Somewhere I have a chart saved. If I find it I’ll post it for you. Since your vet felt the nodules it’s likely accurate. Sorry you will have this to deal with too. Most cats do well with the ear gel treatment so that’s good. Your vet is knowledgeable about it so that’s good as well

 

[Wendy&Neko]

Neko’s proteinuria showed up almost a year before her kidney numbers went out. It can be a precursor. And you do want to treat because it can accelerate kidney disease if not controlled. Proteinuria is more common on acros, so different case than Ming.

145 is a decent bp. Neko was freaked out be Doppler too the first time.

 

[Si am cat mom]

 

[Crista & Ming]

@Wendy&Neko I agree. It's time for me to re-read Tanya's ckd website again.

This might be a tad morbid/negative: I always assumed Ming would become a kidney cat (just from seeing so many kitties pass from kidney disease). During Ming's first appt with my main vet now, she said, "Ming won't die from diabetes. Probably from something entirely different." LOL!! She's pretty straight forward about things and I agree with her. (btw I don't think Ming is going to die right now!! He is a very healthy, fat boy right now lol)

I just did another BP. Still freaked out. I initially used a smaller cuff size for the first reading. I got ~170 on the small cuff. Switched to a size up and got 140 for BP. What's real??? I don't know. I'll do one more test in the morning or maybe when he's half asleep hehe

 

[Sienne and Gabby (GA)]

What was the vet suggesting telmisartan for? It's a blood pressure medication and seems to get good press for proteinuria. The link I attached is a couple of years old so there may be newer information.

I would want the labs redrawn and I agree, if you can do a fasting set of labs it might help. The lipemia really can throw the values off.

This is a link to a blog by Mark Peterson. He's a feline endocrinologist who's well recognized for his treatment of hyperthyroidism. His practice is in NYC and I want to say that @Ella & Rusty & Stu(GA) may have looked into getting Stu (?) treatment there.

 

[Crista & Ming]

What was the vet suggesting telmisartan for? It's a blood pressure medication and seems to get good press for proteinuria. The link I attached is a couple of years old so there may be newer information.

I would want the labs redrawn and I agree, if you can do a fasting set of labs it might help. The lipemia really can throw the values off.

This is a link to a blog by Mark Peterson. He's a feline endocrinologist who's well recognized for his treatment of hyperthyroidism. His practice is in NYC and I want to say that @Ella & Rusty & Stu(GA) may have looked into getting Stu (?) treatment there.

Thanks Sienne!

The telmisartan is for proteïnuria. He’s got +4 proteins in his urine.

If I redid his blood panel, what values might changed? I’m trying to think practically here as @tiffmaxee mentioned the hyperthyroid results won’t change with another test and his proteinuria issue is tested with pee.

 

[Ella & Rusty & Stu(GA)]

What was the vet suggesting telmisartan for? It's a blood pressure medication and seems to get good press for proteinuria. The link I attached is a couple of years old so there may be newer information.

I would want the labs redrawn and I agree, if you can do a fasting set of labs it might help. The lipemia really can throw the values off.

This is a link to a blog by Mark Peterson. He's a feline endocrinologist who's well recognized for his treatment of hyperthyroidism. His practice is in NYC and I want to say that @Ella & Rusty & Stu(GA) may have looked into getting Stu (?) treatment there.

Yes, we did all the research on HyperT and decided on the I-131 radiation treatment for Stu. Dr. Mark Peterson is a wonderful, caring man in addition to being a pioneer in the treatment of HyperT. His practice is in Bedford Hills NY (Westchester County, close to NYC; he also has a clinic in the city). Unfortunately Stu turned out not to be a candidate for I-131: his mulltiple diseases, including kidney disease and cancer, had progressed too far. But if I ever had another HyperT cat, I would get him/her to Dr. Peterson ASAP.

Wishing all the best for Ming.



p.s. It looks like Dr. Peterson's clinic is now only in NY city: here's a link to the website:
https://animalendocrine.com/