12/23 Jessica AMPS 252; Need advice on Lab Test

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ftsang & Jessica

ftsang & Jessica

Member Since 2013
Jessica Previous condo

Good Morning all,
Finally, I got all the Utrasound, Lab and blood test upload to my link.
There is a lot of medical terms that I don't familiar with. I need your advices in order to make a right decision.
Please click on the links 2013-12-14 Bluepearl Lab Test and 2013 Jessica Blook Test Result History.
She still very hugry but her BG seems more under control.
One thing I don't understand is that she needs much less insulin right after the Vet visit on 12/14/2013.
Now, I only gave her 4.25U much lower than 5.75 to 6U I used to give her.
She got no UTI now after the urine cultrue test but she still pee or poo on the litter boxes that I put on the couch.
I think I need to put her back to basement for a while in order to train her to use the litter boxes only in the bathroon and basement.
 
High Jessica

I'll tell you what I can understand about the ultrasound and lab reports, though please keep in mind I'm not a doc!

The liver is enlarged, or bigger than normal, with lots of apparent nodules. This suggests something could be growing in the liver. It could be benign (infection, inflammation) or malignant.
The bile ducts being dilated could mean there has been something backing up the bile, causing them to distend.

The enlarged lymph nodes - labeled as reactive lymph node hyperplasia - suggests inflammatory issues, not cancer.
Thickening of the small intestine walls can be due to inflammatory bowel disease or malignancy.

"Neoplastic process" means something is growing, benign or malignant.

Difficult to visualize the kidneys may mean chronic renal disease, which can be managed.

High fructosamine means you've not been able to get the glucose under control (which you knew because you are home testing.) Keep up with the protocol and start reading about acromegaly and other high dose conditions, because there are some tweaks to dose adjustment and scheduling which can help control the glucose.

The TLI test is described here. It is to check for pancreatic problems. Another option is to discuss with the doc using over the counter digestive enzymes for cats. Mercola makes one version.

Slight elevation of ALT may reflect that the liver is somewhat swollen.
Elevated eosinophils could be due to intestinal parasites or to allergic processes (inflammatory impact there, too)
Elevated Neutrophis could be infection, inflammation, or leukemia.

If you treat inflammation, it may be with steroids, which would up the insulin dose further. Budesonide taken orally is supposed to have less systemic impact and help with inflammatory bowel disease, if that is what it is.

Hope this helps.

BJ
 
hi!

I'm not an expert at reading the labs or the ultrasound, but I do see that the vet suggested having Jessica tested for acromegaly. I know we've talked about it in the past and you haven't wanted to. It might answer some of the questions you are troubled by. It could explain the dose fluctuating - the tumor (which is not cancer) can increase or decrease in the amount of hormone it puts out. When the hormone changes, the amount of insulin needed changes. It also could explain her widened facial features, enlarged organs and the stridor that the vet noted (breathing sounds.) The only thing involved in testing for acro is to send a blood sample to Michigan State University. Most of the time we encourage people to get the insulin auto antibodies test at the same time because it's just $15 for that test and a fair number of cats have both. in my eye, i don't see iaa but if you decided to test for acro i would do both. If you decide to do that testing, here is the link for the two tests you would do: MSU Insulin-Like Growth Factor-1, Insulin Autoantibodies

i doubt that the litter box issue is because she doesn't know to use the litter box. i don't know what the cause is, but if she were mine, i wouldn't punish her. is there any chance she's not getting enough attention? did you have any luck at all with using the litter attractant? Have you tried a new cat litter?

This must be so frustrating for you. Just know that we'll support you as best as we can. Hang in there!
 
Frankie

I agree with Julie that it must be frustrating for you all but I know you are all doing the best you can.

As BJ said, there are some things on there that concern me and one of them is her liver and her gall bladder. I've been through this recently with Gracie where her bile duct was dilated. We ran a bile acid assay test to determine if the dilation was due to an obstruction or just due to infection. Thankfully, her bile acid assay came back perfectly normal and she was treated with antibiotics. The next U/S, her bile duct was normal. She had no symptoms and did not have an enlarged abdomen or enlarged liver (her liver was normal on U/S) but we possibly caught everything early.

I do have to wonder if all of this is related to another condition such as acromegaly. I also agree with Julie that if I was going to run any additional tests, it would be the IAA and acro (IGF-1) tests to see what you are actually dealing with. IMHO. And if your doctor is thinking the same thing....it might make sense to do it.

Sending hugs and vines for her.
 
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