10/13 Butters AMPS 202 PMBG 193. Finally an update.

Butters & Lyla

Butters & Lyla

Member Since 2020
Yesterday overnight Butters cleaned one of the plates I left out for her.:) She decided she could handle eating shredded chicken on her own. This morning, she refused all of the foods. I syringe fed her 1/2 oz a/d with pumpkin and water after I gave her a half-dose of insulin (and bupe, ondansetron and zyrtec).
She has been keeping everything down. Still looks to be in pain. Still twitching/trembling. Still no BM.
I'm taking her to the other ER shortly, Animal Health Partners. I called and they said bring her through the ER, so I'm getting ready and will go shortly. It is going to be a long drive in rush hour traffic.

Have a great day, all:bighug:. Hope all kitties surf safely.
 
JL and Chip said:
Hey Lyla, if you make the new vet a copy of the paperwork from your other vets as well as the ER, you might also want to include a note about the twitching you’ve noticed. That might or might not have been documented by the ER, but could be a clue for the new vet. You could also video it if possible—sometimes seeing an episode is more enlightening to a vet than the client trying to describe it.
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Great idea, thanks. I took a video of her twitching and trembling, which I'll bring and hopefully it is small enough to email to them since I'm not allowed in with Butters. I read through the record from the ER visit and they appear to have noted it...just never addressed it.

Tomlin said:
Best today :bighug::bighug::bighug:!!

Happy you have all the records....keep getting them emailed to you along the way after each and every appointment.
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Thanks! I will make sure they do. It's crazy that I have to beg...but I'm not above begging.
 
We've been thinking about you all night...all morning too! I'm glad you're off to the ER and I sure hope everything goes well! I especially hope they can help her with the pain, get an ultrasound ASAP and figure out what's going on in there...

We'll be watching closely for updates. So sorry about having a long drive in rush-hour traffic...ugh..hate that too...but I know you'd do anything for Butters...at least it's not snowing, yet...so no blizzards to have to slog through...

Sending plenty of prayers and strong healing vines for our girl Butters! :bighug::bighug::bighug::bighug::bighug:
 
Lyla, I'm praying for you and Butters.
I hope they can give you some kind if idea about the twitching.
My heart is just breaking to hear she is in pain
I know you will keep us all updated when you can
Drive safely ♥♥:bighug::bighug::bighug:
 
I just got home. The ER vet went through Butters' history on the phone and reviewed her medical records. She said she thinks Butters needs to stay for at least two days while they do further investigation and attempt to get her eating and drinking on her own again.

She is booked in late tomorrow for an abdominal ultrasound, which will be done by the internal medicine specialist vet, who will examine Butters.
They are going to try to get her to eat. If she doesn't, they will place an NG tube in her while she is in the ER. If they determine she needs to get sent home with a tube, it would be an e-tube.
They are going to have her blood work rerun.
Urinalysis, but also a urine culture to be able to better rule out no infection. Will be obtaining the urine sample through cystocentesis.
They want to check her blood pressure.
And of course IV fluids and continuous monitoring of vitals and BG.

This vet also didn't seem concerned about the twitching/tremoring. I made sure they got the video and I do plan to keep asking for someone to look at it and investigate what it could be about.

I think that's it for now.
 
This new ER sounds very thorough. I hope they get to the bottom of this soon. :bighug::bighug::bighug: I hope you can try and get some rest yourself. Things could be intense when you get Butters back home again.
 
:bighug::bighug::bighug::bighug::bighug::bighug::bighug:

Questions to ask.
Can they bump up the ultrasound appointment if there is a cancellation?
What meds do they intend to give her and can they bump up the pain meds and the zofran? The first ER clinic messed up and you certainly don't want this new cliinc to go backwards.

And as Wendy said, rest.
 
They did sound pretty good to me. I am a bit alarmed by their insulin administration practices, but otherwise good.

Good points. The ER/Clinic has a long waiting list for ultrasounds because of the long weekend. The best they could do is say if they see any change in her or a test result comes back that is particular cause for concern, they may end up triaging her differently and would push her up. But the internal medicine specialist is there only during the day and I want to make sure she is the one to do it.

This clinic doesn't use ondanestron!? That's what they told me. :confused: They are going to use cerenia and mirtazapine and will up her bupre a little. That's all the meds they are planning for now. I told vet the whole story with the first clinic and how I was sent home with inadequate meds to make sure Butters was comfortable, and she was surprisingly empathetic and agreed she had been underdosed.

I try not to complain about needing rest, but I think I actually need some. It's weird to not have her here and I hope she isn't in pain. But I'm overwhelmingly tired. I will get some rest.
 
Olive & Paula said:
:bighug::bighug::bighug::bighug:

Did they give you any idea of the problem? This place sounds more promising. Yes rest, do something special for yourself. It will be a few long days for you. They will update you or you can call correct?
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They weren't sure without doing any tests yet but she said she is basically not ruling anything out at the moment and does think there could be something else going on besides pancreatitis, but she didn't want to harbour a guess.

The ER vet said I can call anytime, and then she'd call me back as soon as she could. But otherwise she will call me if there is any change in Butters' condition or any plans. Test results are all sent to me. And she will definitely call me with an update before her shift ends.
 
Hoping you can get some definitive answers and a solid plan for Butters. This vet sounds much better than the last, hopefully that continues. I'm glad they will increase her pain meds, at least maybe she'll be more comfortable. Happy she ate her food last night :)

I've been thinking of you both all day, this is the first I've had time to read your post. Sending positive thoughts for Butters. You definately need to get some rest, you've earned it for sure. Hoping for good news updates :bighug:
 
Lyla sounds like she is in better hands, and I'm so glad they will be upping the pain meds.
I know you are crazy worried, but please try and sleep, Butters will need you
rested when she comes home.
I am praying for your precious girl.
Why oh why do our kitties have to get sick ♥♥:bighug::bighug::bighug::bighug:
 
Aw, Lyla, I’m sorry she’s not feeling better. This new ER sounds super thorough - I’m so glad you found them!
Praying for you and Butters. Hope you get some answers soon! :bighug::bighug::bighug::bighug:
 
Olive & Paula said:
What do they do insulin administration that concerns you? Is it really crazy or something?
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I thought it sounded odd but probably nothing I need to worry about. they will administer Lantus 2x / day, but they insist on administering Caninsulin/Vetsulin in between Lantus doses if at any point they check the cat's BG and it is too high. "High" is defined as 360+. I don't think Butters will go over 360, though, so I don't think I need to worry.
 
Finally an update. The ER vet called. The internal medicine specialist did Butters' ultrasound today and will call me tomorrow. It showed a lot of gas and a very inflamed pancreas. That's all according to the ER doc. Nothing indicating any other disease like IBD. Her labs came back showing stage 1-2 CKD. They've been giving her Plasmalyte through an IV and trying to get her to eat, which she won't. NG tube tomorrow if she doesn't eat anything overnight.

And her BG has been coming down a bit all day (currently 193 when vet called) so they didn't give her any insulin tonight.

Oh and her meds....so they have her on buprenorphine and gabapentin for pain and she is still in pain. They can tell. She is still being a meatloaf and not sleeping and restless. The vet looked at the video of her twitching and believes she is twitching from pain because she wants to sleep but can't. I'm undecided as to whether I agree or not. Anyhow, they are switching her to methadone for the pain, which sounds very scary to me. This poor cat hasn't been able to have a good sleep since Friday.
 
Hi.

I’m sorry Butters is in such pain but hopefully the methadone will help.

Feline pancreatitis can cause hypocalcemia which can cause facial twitching. When you speak with them again, ask if they have run an ionized calcium. I’m sure they ran calcium bur ionized calcium is more accurate. ER clinics ionized calcium will not be as accurate as the ionized calcium sent out to MSU BUT for emergency purposes it’s precise enough.

Prayers out to you and Butters.
 
Olive & Paula said:
So a severe case of p'titis then?
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That's what the ER vet said. The internal medicine specialist will call to discuss with me tomorrow.

Diane Tyler's Mom said:
Oh Lyla my heart is breaking for Butters.
Methadone should help with the pain.
Please keep us updated even if it's 1 AM or after
I'll most likely be up ♥♥:bighug::bighug::bighug:
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Thank you so much :bighug: They said next update will be sometime between 6am-8am EDT provided that nothing bad happens overnight.

Lisa & Oberon said:
Oh, poor baby. I hope they're able to get her some better pain control and get some food into her. Sounds like they're doing all the right things for her.
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I believe they are. It sounds like they recognize that she is in pain and are working to get it under control, which will hopefully get her to eat something.
 
Tomlin said:
Hi.

I’m sorry Butters is in such pain but hopefully the methadone will help.

Feline pancreatitis can cause hypocalcemia which can cause facial twitching. When you speak with them again, ask if they have run an ionized calcium. I’m sure they ran calcium bur ionized calcium is more accurate. ER clinics ionized calcium will not be as accurate as the ionized calcium sent out to MSU BUT for emergency purposes it’s precise enough.

Prayers out to you and Butters.
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Thank you:bighug::bighug:
I'll ask them. Thanks for that. They didn't mention this to me. They also don't send files out until she is discharged. But when the office opens tomorrow I'm going to call and beg them to send me everything. I seem to be amassing a number of lab results in her spreadsheet from this week. Poor girl.
 
Butters & Lyla said:
Thank you:bighug::bighug:
I'll ask them. Thanks for that. They didn't mention this to me. They also don't send files out until she is discharged. But when the office opens tomorrow I'm going to call and beg them to send me everything. I seem to be amassing a number of lab results in her spreadsheet from this week. Poor girl.
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Thats pretty standard :).....not getting the records until discharge, however you can definitely see if they will forward the labs. I hope tomorrow is a better day and you both get some sleep!
 
Thanks for the update. I hope poor Butters gets some relief from the pain soon and gets some sleep.
Try and get some sleep as well as you must be exhausted.
Sending healing, eating and pain free vines to Butters
 
This does feel very serious. I am worried about her. For right now all I can do is hope that she starts to show signs of improvement overnight, and that I get a positive update in the morning. :bighug:
 
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