1/9 Blue AMBG 66/1/10 PMBG 55

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Patty and Blue said:
He's still eating but not like he was. Mornings he doesn't eat much. I just gave him some of his favorite food and he ate great. In fact, he'd probably eat more if I gave it to him.
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I'm assuming this was the 10% Meowmix? The feed you gave him of it yesterday doesn't seem to have had any adverse effect on his BG levels.

How is his weight?


Mogs
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I haven't weighed him but he's bony. His tummy is still large. I'm upset.
The only medicine I'm giving him now is the Gaba. I'll try to weigh him
today.
I'm leaving to renew my license in a few minutes. He's still in the corner.
 
I think you need to feed him whatever he wants to eat. His bg is low enough to try and see if he will gain some weight.
 
I'd try feeding more of the food he likes, Patty.

Did you get anywhere on the recommendation/Rx for pain meds? Also, when is Blue due for his next round of blood tests?

:bighug:


Mogs
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I will start feeding what he likes several times a day, small meals.

He looks at me like he knows me now. I just noticed today. He does seem weak, although
that could be the Gabapentin and weight loss.

As for pain meds, no email back from the oncologist. I have called my vet and she isn't in today
but I left a message for Dr. Bruno my original vet and owner of hospital. This process is maddening.
 
:banghead:

I hope Dr. Bruno gets back to you quickly. If not, chase. Being a veterinary professional, I wonder whether he might get more joy out of BluePearl if he were to contact them about meds, etc., on your behalf?

Patty and Blue said:
He looks at me like he knows me now. I just noticed today.
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I'm glad to hear this. :bighug: ((((Blue))))

He does seem weak, although that could be the Gabapentin and weight loss.
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When's the last time Blue had a full blood chemistry panel done (including electrolytes - sodium, potassium, phosphorus, calcium, etc.)?

How many days has Blue been back on the gabapentin for, Patty, and how many times a day are you giving it? (I'm trying to better get my head around where he is treatment-wise.)


Mogs
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He had the CBC done before his last chemo. Blood chemistry before he started chemo.
I've been giving the Gabapentin off and on for a few days, no more than twice a day.

I just spoke with Dr. Bruno and he wants me to give him Prednisone so that's what were
going to do. I pick it up tomorrow, as it's almost 5:00 here and closing time. He said he
has never heard of it interfering with chemo. The only problem might be his diabetes
might flare. He said Blue would feel better on it and it could help with pain and also
appetite. I have to do something because I just am watching him get sick.
 
Patty and Blue said:
I just spoke with Dr. Bruno and he wants me to give him Prednisone so that's what were
going to do.
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I'm glad Dr. B got back to you. What matters is doing something to help Blue. If necessary you can work insulin treatment around other things he needs. IIRC, Elise mentioned something a little while back about pred being used as an adjunct to the chemo treatment.

Patty and Blue said:
it could help with pain
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I'd suggest asking for a repeat Rx for more gabapentin to be on the safe side, so that you'll have something readily to hand at home should Blue need it (plus it's an anti-seizure med so might be worth discussing that with Dr. B in light of Blue's odd clinical signs).

I found this article about electrolyte disturbances. I wonder if it might be an idea to ask Dr. B whether doing another round of blood work - including a chemistry panel to check all electrolytes - might be helpful, in case some imbalance or other might be contributing to Blue's odd behaviours, weakness, etc? (Note: I am just generally digging around and brainstorming here, nothing more. I have no idea whether or not this might have any merit.)


Mogs
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Thanks Mogs. I appreciate everything you're doing to help my Bluebird. :bighug:

I did ask Dr. Bruno for a refill for the Gabapentin.
I'll pick it up tomorrow along with the prednisone.

Blue is drinking tons of water again and peeing huge amounts. I'll ask Dr. Johnson about doing some blood work tomorrow. I just want him to feel better and it scares me the way he is acting. I read somewhere about water for cats that has electrolytes in it. Maybe they have it at the vet if he needs it.

Bug doing better? Did you getting any sleep?
 
Patty and Blue said:
He had the CBC done before his last chemo. Blood chemistry before he started chemo.
I've been giving the Gabapentin off and on for a few days, no more than twice a day.

I just spoke with Dr. Bruno and he wants me to give him Prednisone so that's what were
going to do. I pick it up tomorrow, as it's almost 5:00 here and closing time. He said he
has never heard of it interfering with chemo. The only problem might be his diabetes
might flare. He said Blue would feel better on it and it could help with pain and also
appetite. I have to do something because I just am watching him get sick.
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That’s what I thought. I didn’t want to contradict the oncologist but the protocols for lymphoma call for chemo and prednisolone. When I had to stop chemo with Tiffany prednisolone kept her going forward many months. I know the bg might go up but if so we start him back on some insulin. To me the benefits outweigh that.
 
Glad you're getting the gabapentin refill, Patty. I'm a great believer in having potentially helpful meds available at home 'just in case', because then there's no delay involved due to waiting to get another Rx issued and filled if they're needed.

Patty and Blue said:
I'll ask Dr. Johnson about doing some blood work tomorrow. I just want him to feel better and it scares me the way he is acting.
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I suggest making that blindingly clear to Dr. J. As I've said before, you know Blue better than anyone. Also be sure to tell the vet about the increased thirst and urination. (Can't see how it could be from the diabetes because Blue's numbers are in the normal range.)

With my Ma Hen hat squarely on my head, if Dr. J says that s/he doesn't think it would help to do the blood work, perhaps ask whether it would do any harm to just check where Blue's at, not least of all for your own peace of mind?

:bighug:


Mogs
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Thanks guys. I'll speak with either Dr. Bruno or Dr. Johnson tomorrow. He's so much better tonight.
He's been in that corner for a few days. He looks at me and meows now. I feel so much better.

I remember Elise you being shocked about the prednisone. I was too but asked at Bluepearl after his
first treatment. Dr. Bruno was adamant that Blue needed to be on it. At least I have someone helping
me treat him. I didn't know what to do. The Bluepearl vet has still not responded to my question about
pain medicine. She's terrible. I really liked the Dr. that diagnosed Blue. He called and talked with me at
length when he examined Blue and did the MRI. Very nice vet specialist.
I have never talked to the oncologist. :(

Has anyone heard anymore from Jeanne? I have been checking on her but hate to bother her if she's
still unwell. I thought maybe one of you had heard from her?
 
In addition to all the CKD stuff, Tanya's Site has a wealth of information on a whole raft of cat health issues and treatments. (I actually bought Helen's book so that I'd never have to worry about losing access to the information in the event of an internet outage or the TS server being offline!) It's a good place to rummage around:

Index of Symptoms - Cat Health Issues (Tanya's Site)

Bearing in mind that the site leans toward the kidney side of things, there may be some intrinsic skewing in some of the stuff in the index but I just had a look at a few symptoms that sound like Blue's clinical signs and found the following 'symptom/possible cause(s)' groupings (NB: not exhaustive lists):

Increased Drinking
* Dehydration
* Kidney infection
* Hypercalcaemia (high calcium levels)
* Gastric hyperacidity

Increased Urination
* Kidney infection
* Hypercalcaemia (high calcium levels)
* Fluid therapy

Increased Urination at Night
* Low potassium levels
* Potassium Imbalances
* Side effect of calcitriol

"Spaced Out" | Staring Into Space
* High potassium levels
* Hypertension
* Calcium imbalances
* Uraemia (high toxin levels)
* Metabolic acidosis
* Side effect of metoclopramide (rare)

Weakness
* Low potassium levels
* Potassium Imbalances
* High phosphorus levels
* Anaemia
* Lack of food

Might be something somewhere in that lot to investigate. There's overlap in some places.


Mogs
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Oh my, that's a great list and who knew his symptoms would be listed. I will definitely
talk with my vet tomorrow to see if they'll run some blood work. He's much better
but I'd like to be treating whatever the problem is. Thanks for checking the site
and pulling that information. It makes me feel better already. Now why couldn't
the oncologist let me know this and do some blood work. My what a lousy vet.
Would all of the above be included in a blood chemistry panel?
 
Patty and Blue said:
It kind of sounds like an electrolyte problem when I checked your link above. Fluids would help that wouldn't it?
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I guess it depends on the nature of the imbalance, Patty, and it might just be a dietary tweak needed, or a med/supplement given by mouth: if a level is too high then something may be needed to reduce it (classic example might be the use of binders to lower serum phosphorus levels in CKD kitties), but if too low then a supplement might be needed (e.g. potassium supplement to treat hypokalaemia).


Mogs
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Wow so many things it could be. I will try to get him in tomorrow to be checked. I’ve been thinking
all along it was from the chemo. I guess indirectly it might have caused the problem. Thanks for all the information.
I’ll keep you both posted.

I’m calling it a night. My eyes are so tired I’m having trouble reading. Talk tomorrow. Goodnight and thx. :bighug:
 
Patty and Blue said:
Would all of the above be included in a blood chemistry panel?
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Over here panels are like 'set menus', so you go for the one that's closest to requirements and then, provided there's enough blood in the sample drawn, you bolt on other tests (e.g. running a standard chem panel but bolting on pancreatitis and B12/folate tests when a GI issue is suspected). I got caught out a couple of times with electrolyte tests for Lúnasa because the standard panel our vet normally uses doesn't include potassium for some reason so I have to remember to specifically request it now.

Looking at that list and thinking of Blue's clinical signs, I'd suggest asking the vet about a CBC plus chem panel including: phosphorus & other kidney markers, calcium and potassium (these are mentioned several times in more than one group), and I think sodium and chloride are other common electrolytes tested for. Your vet should be able to take Blue's clinical signs into account and advise you further. If you haven't passed the info on to your vet, maybe give them a copy of the list of clinical signs and concerns you sent to BluePearl earlier this week.


Mogs
.
 
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