12/21 Deb's Spot amps ~ 145 - Ralph update, long

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Deb & Spot

Deb & Spot

Member Since 2009
yesterday's condo: viewtopic.php?f=9&t=32559
I took a quick glance at LL this morning and it looks like a lot of other kitties are running a bit higher today.
recap:
amps - 144
+9 - 144
pmps - 107 (@ +13.25) shot given late due to Ralph being at the vet.
amps - 142 (@ +11.5) trying to get back on schedule. Need to adjust schedule earlier due to Plans on Friday

I'm thinking that the higher (the 140's) bg's are still from the illegial drooler snack the other day. He recoved well, but I believe it is still in his system since he is very carb sensitive.
No evening test last night....bean was dead tired and beaten up mentally and forgot to do a +4 and when I remembered, it was after he had his snack and to late. However, I did occasionally wake up for a few seconds during the evening and if my memory is right, Spot was sleeping on my tummy all night long. Nice and furry purry for test and had absolutely no problem eating his breakfast.

Ralphie update: another $300 poorer (and I'm not complaining) and nothing showing up as to why he is acting the way he is. They did a T-4 test and took some xrays. Ralph was not a happy camper at all! They took him to the back to do the tests, and you could hear him yelling at them all the way in the front. Happy was not in his vocabulary at all! When they brought him out to me, he was growling and hissing and bit my finger. They sent me home with some pain pills for him to take, just in case there is some discomfort somewhere. For the life of me, I can't remember the name, but it starts with a M. All the way home he was growling at me, all the way up to the time he walked through the door. Once home, he seemed to settle down. It was past their dinner time, and he was more than happy for me to pick him up and put him on the counter so he could eat. He seemed more alert last night, he even jumped up on the bed for his nini snack. This morning he seems to be restless, walking around the house, pacing. He didn't eat all of his food (had his meds in it too), but I just called mom and she said she offered the rest to him and he finished. He lost .5 lb. since last week, so I'm having her offer him food throughout the day.

Test Results:
T-4 - 2.0
USG - 1.026
BUN - 52 (above normal)
Creatinine - 1.9
phospherus - 4.0
Calcium - 10.4
MCV - 51 (Above normal)
MCH - 18.06 (above normal)
Glucose - 249 (above normal)

Question: what is MCV & MCH?
Xrays of his spine, hips, and pelvis showed nothing. Vet did say that it looks like he may have had a fracture (two) on his pelvis, but that it looked like it was an old injury. She also said that she couldn't be sure of this due to Mr. Ralph having some poop in his colon and it was kind of obstructing her view. Said I could bring him in another time, they can give him an enema, sedate him, and re-xray if I wanted. I don't think that will be necessary right now.
I have also been keeping a record of Ralph's bg's. He has been running higher than he usually does - he's usually 50 or 60 and is running between 107 - 140 range. Vet said that's low, then added, well, for the cats we see here. I asked about maybe giving him some insulin and she said normally she wouldn't advocate it for a cat w/numbers like his, but since I am so good at keeping records and testing, that she would feel comfortable if I wanted to give him a drop. Not going to try this until I'm home this weekend tho. So, with everything, it looks like his kidneys may beginning is have some problems, but that is it. Vet doesn't think Ralph's behavior is from that though. So, I know that he doesn't have hip/leg displasia or arthritis, his thyroid is ok, kidneys not bad, but not good either. Dental will be scheduled in January (need to save some $$ or get that credit card paid down before doing this). Thinking about getting a neurological exam done on him also....oh, one thing she said is when he stands in the corners, just staring off to space, he could be having seizures, so I'll need to keep an eye on that.

A very big thanks to everyone who visited our condo yesterday and gave me some input for Ralph. It was very much appreciated. I want to apologize also for not being able to visit many condos. I do glance through LL to see how your kid-kitties are doing and chime in when I can. It's been one heck of a week already, both at work and at home and I don't see any lights ahead, just yet, lol. Hope everyone has a wonderful Tuesday...four more days to Christmas!!!!
 
Hi Deb,
At least you know the results of the tests they did. Now you just have to figure out how to interpret them (!) (no help from me, but I know that others will be able to). Anyway, I hope that Ralphie will get back to his usual self soon. Isn't it awful when they "take them into the back room"? Our vet here has a good "back room", but at our old vet in Brooklyn Stu always put up a fuss. Hope you all will have a good day today with less stress.

Hugs,
Ella & Rusty
 
Good morning guys ... nice blue start to the day for spot .. I know it's high for spot, but still a nice blue! I don't really know what to say about ralph so I'll just say that I'm thinking of you guys and hoping that this all gets figured out soon ... your a great bean ...
 
I know next to nothing but hope you find out what's up with Ralph.

# Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs. The MCV is elevated when your RBCs are larger than normal (macrocytic), for example in anemia caused by vitamin B12 deficiency. When the MCV is decreased, your RBCs are smaller than normal (microcytic) as is seen in iron deficiency anemia or thalassemias.
# Mean corpuscular hemoglobin (MCH) is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell. Macrocytic RBCs are large so tend to have a higher MCH, while microcytic red cells would have a lower value.
# Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average concentration of hemoglobin inside a red cell. Decreased MCHC values (hypochromia) are seen in conditions where the hemoglobin is abnormally diluted inside the red cells, such as in iron deficiency anemia and in thalassemia. Increased MCHC values (hyperchromia) are seen in conditions where the hemoglobin is abnormally concentrated inside the red cells, such as in burn patients and hereditary spherocytosis, a relatively rare congenital disorder

MCV Mean Corpuscular Volume Increased with B12 and Folate deficiency; decreased with iron deficiency and thalassemia
MCH Mean Corpuscular Hemoglobin Mirrors MCV results

http://www.assistfeed.com/BloodTestValues.htm
[MCHC] 28-40
Mean Cell Hemoglobin Concentration. The average concentration of hemoglobin in a given volume of blood. The MCHC is a calculated value derived from the measurement of hemoglobin and the hematocrit. (The hemoglobin value is the amount of hemoglobin in a volume of blood while the hematocrit is the ratio of the volume of red cells to the volume of whole blood.)

[MCV] 35.5-55.0
Mean Cell Volume The average volume of a red blood cell. This is a calculated value derived from the hematocrit and the red cell count. The hematocrit is the ratio of the volume of red cells to the volume of whole blood while the red cell count is the number of red blood cells in a volume of blood. You may also see this referred to as: Mean Corpuscular Volume
 
Deb & Spot said:
They sent me home with some pain pills for him to take, just in case there is some discomfort somewhere. For the life of me, I can't remember the name, but it starts with a M.
Click to expand...

I hope the medication was not Metacam (Meloxicam). It is not to be used in cats any more. If that's what you have, I would discontinue it and return it to the vet for a refund.

http://www.avma.org/onlnews/javma/nov10/101101e.asp

I'm sorry Ralph had such a hard time of it at the vet. It does look like he has some early renal disease. I think that your vet did a urinalysis, but did not do a urine culture, as the urine did not look suspicious? A UTI could possibly cause higher BG's and higher renal values. It might be something to consider checking if things don't improve.

Higher BG's , restlessness, and weight loss do seem to indicate that he is uncomfortable somewhere. It sounds like the dental may be a good next step. (((Ralph))).
 
Here's more info, Deb.

MCV: The MCV result is high. This is a value that measures the size and volume each red blood cell. Alone, this value is not of significance, but it helps to describe other conditions that may be affecting the red blood cells. A high MCV is defined as “macrocytic”, and means the red blood cells are large in size. This most commonly seen with regenerative anemias because younger, newer red blood cells are larger. More rarely, this can be seen with Feline Leukemia Virus (FeLV) infections in cats, a bone marrow disorder or with Cobalamin (B12) or Folate deficiencies.

MCH: The MCH result is out of normal range. This value indicates the hemoglobin concentration for an average red blood cell. A low MCH indicates a low hemoglobin concentration and a high MCH has no significance. This value is of no significance if the other red blood cell parameters are normal.

BUN (w/ normal creatinine and normal USG): The Blood Urea Nitrogen (BUN) is elevated. This is a by-product of protein metabolism that is cleared by the kidneys. Elevations can either indicate kidney disease, or be from dehydration, a very recent high protein meal or severe muscle trauma. Since the creatinine and urine specific gravity are both normal, kidney disease is unlikely. More rarely, gastrointestinal hemorrhage, tetracycline or corticosteroid use could also cause this finding.

Can your vet get a B12 (cobalamin) and folate level? This should be on a blood panel.
 
Wow, you guys are awesome! Thanks so much for your feedback and your information. Thanks, Gail and Sienne for the really good indepth information and to you, too Linda, for the information on the Metacam. I'll have to wait until my mom gets home to see if that is what it is...sounds like it could be. Only gave him 1/4 tablet so far, so I printed out that information and will take it to the vet. I will also ask about getting B-12 and Folate levels, plus a culture next week.
So, by what I'm reading, Ralph could have a bit of B-12 or folate deficiency. That alone wouldn't cause his personality to change, would it? Ralph has never taken any meds, except the miralax or the buspar. He was getting the Miralax, 1/8 tsp. daily up until last week when I started the fish oil, and he was only on the buspar for about 2-3 months around a year ago, so tetracycline or coticosteroil usage out. Going to do some research on the gastrointestinal hemmorage in a few so at least I know what that is.
Again, Ladies, thank you thank you thank you, and thanks to everyone for your support. You really really don't know how much it means to me. I love my Ralphie....he is the niftiest little (term used lightly) guy and I am so worried about him.
 
Sienne and Gabby said:
BUN (w/ normal creatinine and normal USG): The Blood Urea Nitrogen (BUN) is elevated. This is a by-product of protein metabolism that is cleared by the kidneys. Elevations can either indicate kidney disease, or be from dehydration, a very recent high protein meal or severe muscle trauma. Since the creatinine and urine specific gravity are both normal, kidney disease is unlikely. More rarely, gastrointestinal hemorrhage, tetracycline or corticosteroid use could also cause this finding.

Can your vet get a B12 (cobalamin) and folate level? This should be on a blood panel.
Click to expand...

The USG of 1.026 is a bit dilute, and with the slightly elevated BUN, just bears keeping an eye on and trending. (I'm no CRD expert, so I'm just going by what bits of reading I have done).

I think that if there were GI hemorrhage occurring, you might have seen some signs of anemia in the bloodwork. How is the pooping now? I don't think there is any problem giving both fish oil and miralax, if he is a bit constipated (going by what the vet was saying about the X-ray).
 
DEB!!! I am so upset for you & Ralph!! I have had this with Copper, where he doesnt eat & has lost weight..He is definitely constipated & I give them Both
B12 methylcobalamin & fish oil every day--Have also been giving them Olive Oil 8 drops each since they were young for hairball passage--
Boy my cats is oily!!---
But Copper has had that not eating well & lying around grouchy thing--I fed him steak, chicken, turkey & spruced up the cat food to get him to eat--which he did--Man, he always eats some steak...But Arthritis makes them very grouchy & since it got cold, it makes sense--Could be...
Sending Healing Green Vines to dear Ralph & hope he gets better Real Soon--You know we Lubs you Deb, Spottie & Ralph!!
 
Last week, when we went to the vet and she saw his BUN levels, she gave him some squids and did mention that he just may be a bit dehydraded.
Just did some reading on the GI hemorrhage, and had to click off the sight when I saw the words "cancer"...got kind of sick to my stomach, iykwim. After some calming time, and reading Linda's response, I'm thinking that may not be it either. His blood work looks pretty good to me, yes, some elevation on a few things, but nothing that screams out. I'm leaning towards something neurological..of course, I may be wrong, but if the dental doesn't do it's trick, then I'm going to see when I can get him scheduled. They don't do it at the vet's office, not sure where since we haven't gotten to that point yet.
Thanks again!

Roni, good idea to throw the tasty stuff into the food mix. I'm going to go shopping after work and grab some steaks for him (and Ali, Spot, Molly, mom and I) and see how he eats that. I'm concerned about the way he is eating....like he takes a mouthful, lifts up his head, chin raised, and swallows. This is unusual also. I'm going to have to buy some olive oil also...and more B-12, have some left from when Spot had his neuropothy, glad I held onto it!
Thanks for your concern! We lubs you too!!!
 
Deb & Spot said:
Thanks, Gail and Sienne for the really good indepth information and to you, too Linda, for the information on the Metacam. I'll have to wait until my mom gets home to see if that is what it is...sounds like it could be. Only gave him 1/4 tablet so far, so I printed out that information and will take it to the vet.
Click to expand...
It had better not be metacam. If it is, I would be having a major fit. Esp if your vet thinks his kidneys may be starting to have some problems.

When you check the name of the med, check the dose too. According to petplace.com, the lowest dose metacam pill is 7.5 mg. 1/4 of that is 1.875 mg. I don't know how much Ralphie weighs, but the VASG site's dose range for a 10-lb cat is LESS THAN 0.5 mg.

I agree with Linda, USG of 1.026 bears watching. It can fluctuate, but at this level, it should be monitored. And I would not be giving metacam to any cat with this level of USG. More to the point, I would not give metacam to any cat, period, unless it is a quality of life issue and all other options have been explored.
 
Spot am+6 ~ 81

Boy, I was way off base with the medicatin...it is actually tramadol, not Metacam....my bad!
Mom fed both boys and they consumed all food!

Dian...we lubs you more :-D
 
Deb & Spot said:
I'm concerned about the way he is eating....like he takes a mouthful, lifts up his head, chin raised, and swallows. This is unusual also. I'm going to have to buy some olive oil also...and more B-12, have some left from when Spot had his neuropothy, glad I held onto it!
Click to expand...

I wonder if he's eating like that because his teeth hurt.

Just to clarify, the methylcobalamin B12 that you give for neuropathy is not the same type of B12 that you would give if he ends up being diagnosed with a B12 or folate deficiency. In that case, you may end up giving injections of cyanocobalamin B12. Just throwing that in in case you aren't already confused enough!

Giving him some tasty stuff to stimulate his appetite sounds like a great idea. Another thing that helps Emily is to have a heat pad in her bed. I use a bean bag that I warm in the microwave. Of course, you have to be very cautious that it is not too hot, and that it is covered with several layers of bedding.
 
all my guys love the heating pad or heating blanket. or get one of those warming pads that was talked about a while ago. name escapes me
 
Thanks for the clarification on the B-12, Linda. I thought about the teeth also, so that is why I brought it up to the vet. I also thought that maybe there was some kind of growth in his throat, but if that was the case, I think his breathing would be effected, and that is not the case.
As far as the heating bed/pad goes, I guess I know what to get Ralphie for Christmas!!
 
Does he let you pick him up okay when he is at home with you?

I know cats can be susceptible to pancreatitis which is extremely painful.

Maverick has hind end arthritis but this came on over time - slower going up the stairs (bunny hopping down). He made a click when he walked too.

Wishing you get everything figured out. Sending hugs for you and Ralph.
 
I bought the petsafe heated bed for Maverick (dr. foster and smith and petsmart have them). But I bought a size that is too small for Maverick (small dog bed). Wish I had gone with the larger one where he could lie on his back. I wish it was just a blanket/dog bed vs a bed with edges.
 
Deb: I would not rule out hyperthyroidism just based on a T4 by itself. First, occasionally a cat can be hyperthyroid but it takes a little bit of time to show this in the bloodwork. One of our cats kept showing symptoms of hyperT (drinking/peeing, losing weight, eating alot, restless, meowing at night, and eventually a kind of hoarse meow) but his bloodwork was normal...even doing a fT4 AND tT4. After a few months, his numbers started creeping up above normal and he was eventually diagnosed with hyperT. Now when I want a thyroid test done on one of my cats, I have my vet draw the blood and I send it to Dr. Jean Dodds at Hemopet (www.hemopet.com) and she runs a full thyroid panel (fT3, tT3, fT4, tT4) and she also looks at the age of the cat (as there are geriatric levels) and medical history. Her costs are extremely reasonable ($61) and she's fast....and the expert on thyroids. It doesn't sound like Ralph is showing all the symptoms of hyperT so it's possible I'm off base. But...if he does start having more of the symptoms, I would consider a better thyroid panel.

Also thyroid function can affect what you see in renal levels esp creat. If the thyroid is running "hot" or a little high, then creat would appear to be more normal as plenty of blood is being effused through the kidneys; if the thyroid level is low, then you might see the creat increase due to lack of effusion of blood through the kidneys. I'm with Linda in that his USG, while normal, is kinda low. One of my renal insufficient civvies has a USG of 1.025 and it is dilute due to receiving squids. Ralph's USG is about the same as hers and he doesn't get squids, right? Since BUN can be affected by many things, as mentioned by Sienne, I wouldn't get overly excited if just that one number was elevated.

Anyway, just some thoughts to keep in mind. I'm not suggesting that you run out and have another thyroid panel done; just watch him to see if he develops some of those symptoms and if he does, consider a more comprehensive panel.

I hope you get some rest; glad Spotty is ok. Also...for pain, I think buprenex has less side effects than tramodol but I think there has been some distribution problems in vet clinics and I see more vets giving tramodol lately.
 
((( Deb ))) You've gotten some great information from your friends here - better detail than what I've gotten from doctors on my OWN tests.

I hope the dental really helps him out.
 
amps ~ 145
+6 ~ 81
+9 ~ 86
pmps ~ 100
+4 ~ 97

Eagerly awaiting for me to get his snack together and head off to , which will be happening very soon!

Karre, Ralph has no problems with us picking him up. Doesn't fight us or meow or anything like that. He has had bouts of restlessness and then sleeping. Putting his medication in his food is not working. He knows it's in there and is refusing to eat it. I put food down w/o meds and he ate it up. Not much more to report on him.
Marjorie, thank for the additional information. I will keep an eye out for symptoms.

Thanks to everyone who posted in my condo today. I will be making copies of the condo so I can keep things fresh in my mind.
 
sending healing vines for Ralph...you have gotten great info....i'm glad Spot is giving you nice numbers too...sorry i can't be of help w lab reports....but know i'm thinking of you all!
 
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