? 1/9 Herman amps 399 +3 311 +5 292 vet visit later today

Amy & Herman

Amy & Herman

Member Since 2022
Not seeing any improvement in his numbers, will increase again in the morning unless some thing changes. His appetite is still good and his demeanour overall is ok with play sessions and grooming and cuddling….

some questions:
I am running low on gabapentin and hoping to switch to bupe anyway based on input on this forum, so we are off to the vet this afternoon…..they have the files from our stay in the ER over Christmas. One of the notes from ER was a recommendation to perform an ultrasound….hoping for any input as to whether that is a worthwhile/logical next step?Are there any other tests, treatments I should enquire about?

We are in the midst of a bit of a treacherous snow storm so there is a chance my appointment gets cancelled in which case I will go on Thursday. I have enough gabapentin to take me till then.
 
What part of his body were thinking of doing an ultrasound on? What symptoms were they investigating?

Note on buprenorphine - typically they'll give you prefilled syringes to try it. It is really expensive that way. Since it was a long term thing with Neko (really bad arthritis), the vet suggested me getting my own vial, which I got done chicken flavoured at the local compounding pharmacy. Way cheaper, and I could tweak the dose as needed. Bupe is prescribed in a range of dose based on weight, but it varies what a cat needs. Dose tweaking to be expected.
 
Wendy&Neko said:
What part of his body were thinking of doing an ultrasound on? What symptoms were they investigating?

Note on buprenorphine - typically they'll give you prefilled syringes to try it. It is really expensive that way. Since it was a long term thing with Neko (really bad arthritis), the vet suggested me getting my own vial, which I got done chicken flavoured at the local compounding pharmacy. Way cheaper, and I could tweak the dose as needed. Bupe is prescribed in a range of dose based on weight, but it varies what a cat needs. Dose tweaking to be expected.
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They recommended an abdominal ultrasound, if needed….
Given Herman’s numbers, I’m not convinced we’re getting any handle on the pancreatitis but again I don’t know. His appetite is good. Attach some of the paperwork I received. It’s hard for me to really understand what it’s saying. I was hoping my regular vet would provide some clarification, but she was up until yesterday since Christmas.
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Wendy&Neko said:
They see some inflammation of the small intestines/bowel in an xray. An ultrasound would provide more detail. Sounds like his appetite is OK. No vomitting or diarrhea?
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No diarrhea, good appetite. he threw up a couple days ago, it looked like a hairball (which he is prone to)…
Finally got to talk to regular bey on the phone and bring her up to speed…..his appointment will now be on Monday, in the meantime she has dispensed bupe to me that I can pick up tomorrow. I think she wants to run bloodwork and recheck for uti but no mention of ultrasound.
 
I'm so sorry to read Herman went through pancreatitis(sounds like an acute attack!) It is super scary and painful for both you and Herman I am sure! I am glad to read he is on the mend though, thx to your loving care. I'll wait to see how your next vet visit goes Monday, it was my experience that often the ER Vets are super cautious, hence the Ultrasound recommendation? My Tiger had an acute pancreatitis attack, like Herman did and I could not have done without bupe, cerenia(she was a vomiter!:eek:) and anti nausea. I am glad you have the prescription for bupe though, and I guess we wait to see about the ultrasound.
 
Play sessions, grooming, cuddling, good appetite, no diarrhea. All good. There doesn't seem to be anything very remarkable about those imaging results/comments. The only thing is the "slightly enlarged" inguinal lymph nodes, which is a finding that you may want to, at some point, have confirmed or ruled out. I don't know that I would do an abdominal ultrasound unless Herman is showing signs again of being ill, unless you just want to know as much as possible. I would ask the vet about it next week and discuss everything. I'm really happy to hear that he seems a LOT better than he was doing just a short time ago.
 
Tiger(GA) and Ruth said:
it was my experience that often the ER Vets are super cautious, hence the Ultrasound recommendation?
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I had the same experience with ER vets. When Darcy was in the ER (with DKA) they were telling me all sorts of alarming things like he had anisicoria (uneven pupil size) and most likely had a brain tumor… so I should immediately take him for a brain MRI to a specialty hospital. Then she reported that he had “facial swelling” and again told me I should take him to a specialty hospital. All the while, they were at least doing the right things for his DKA resulting hepatic lipidosis. So at least they got that right. It was a good thing, really, that this ER is only open on weekends and in the evenings. so after that first weekend, I had to pick Darcy up in the morning and take him to spend the day at my regular vet and then pick him up at the end of the day and take him back to the Emergency Vet. My regular vet was the voice of reason in all of this. I also got to see Darcy every single day, morning and evening, so I could see for myself how he was doing It was also encouraging for Darcy, we could tell. It kept him going. My regular vet said she never saw any anisicoria or facial swelling. She did think he may have had a negative reaction to the Unasyn (antibiotic that he was receiving through his IV.) Anyway, the vet had me really really upset when she started talking about brain tumors. I was very torn about whether or not I should take him up to either University of Georgia or the Blue Pearl Specialty Hospital. So all of that long story is to say that my experience has been similar to Ruth’s. Of course, I do believe that this vet was really just trying to be very cautious. She seemed to care very much.
 
Hi Amy :)
Sorry that Herman is not feeling well. It's great that he's still cuddly and grooming.
When Fistuk had a pancreatitis bout the hospital suggested ultrasound. They said it'll be the only way to figure out exactly where the inflammation in the body comes from and have a clear sight of the GI. If you're able to get an ultrasound I'd recommend it.
But as @Suzanne & Darcy said, vets have a tendency to scare people and you have to really stay grounded. I'd suggest that you ask for clear intention as to what they are doing to ultrasound for, what answers they're hoping to find. And when you get the ultrasound results you also make sure you understand them clearly so you don't have to be swayed by any "you must" vet command.
I hope it's safe for you to travel today. Sending love :bighug::bighug::bighug:
 
Thanks everyone for the great advice. Today Herman even had some (high) blues, so that’s encouraging (although it’s been a long time since Herman was on such a high dose, we are up to 2 units). started the bupe tonight, hope to see blue again soon :cat:
 
So Amy, you really do think that Herman is in pain? I thought he seemed kind of over the pancreatitis now and so maybe he didn’t need the pain meds anymore. You can definitely try it though to see if he seems happier and better on the Bupe.
 
And it seriously is good to see those blues on his spreadsheet today. Try to not focus on the number of units. Cats insulin needs can definitely fluctuate and he needs however much he needs at the time. I’m going to celebrate the blues. If you find he needs tweaking of his dose soon, then don’t hesitate to change it. I think the blues are a victory! They’re healthier for Herman!
 
Suzanne & Darcy said:
So Amy, you really do think that Herman is in pain? I thought he seemed kind of over the pancreatitis now and so maybe he didn’t need the pain meds anymore. You can definitely try it though to see if he seems happier and better on the Bupe.
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Honestly the only indication of pain to me would be his high numbers, other than that he seems ‘Normal” but not sure if that’s because he is on the pain meds….maybe I should go a day or two without and see if his behaviour changes. I just wasn’t sure if he needs the support to get truly over this pancreatitis flare…..
 
Amy & Herman said:
Honestly the only indication of pain to me would be his high numbers, other than that he seems ‘Normal” but not sure if that’s because he is on the pain meds….maybe I should go a day or two without and see if his behaviour changes. I just wasn’t sure if he needs the support to get truly over this pancreatitis flare…..
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Yep. It’s all good! Your thoughts are similar to what mine would be with regard to the pain meds. I might actually use it for a couple of days and then stop/taper it down to see if his numbers appear to be affected.
 
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