12/9 Garland PMPS 314 -- vet update-- bilirubin?

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Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

I just want to offer my support and hope you get Garland whatever is needed to get well. I know how finances can make it hard to do what is best. Hopefully this can all be worked out for Garland and you. Sending healing vines and prayers to Garland and you.
 
Re: 12/9 Garland AMPS 289 +7 322--- Sick again :( Not eating

The nurse tech called me back. Didn't say much other than maybe bring her in for some bloodwork to look at glucose levels, etc.. She didn't seem concerned with the vomiting, only that she wasn't eating.... The blood panel we ran last month was almost $300... I think I could just cry. She's not feeling well at all. I made a 6:30 appt, and said I'll talk with my DH when he gets home in 30 minutes.
 
Re: 12/9 Garland AMPS 289 +7 322--- Sick again :( Not eating

Keeping you and Garland in my prayers. If there is anything that I can offer to help, fluids or anything else please pm me..I will be glad to help.

Kim
 
Re: 12/9 Garland AMPS 289 +7 322--- Sick again :( Not eating

Okay: I will most likely take her in. I need opinions, and fast. I have to leave in 30

What is the minimal testing I should get done? Money is tight. I can't have them running every test they have. Should I just tell them to put in a feeding tube so I can get food in her? What do y'all think?

What questions should I ask?
 
Re: 12/9 Garland AMPS 289 +7 322--- EyesQuick! What do I ask

I would ask if the frequent vomiting could indicate a possible foreign body or GI blockage anywhere, or if the vet thinks it is nausea. Is an X-ray required.

If the vet takes bloodwork, hopefully they will not have to sedate Garland (I think this was done in the past?).

Ask about a potential infection. Perhaps ask about a urine culture.

Physical exam - temp, does the abdomen feel painful, is she dehydrated? Can you manage this at home with sub Q fluids.

Ask about ketones. Is this DKA.

You could ask about a fPLI (test for pancreatitis). Not sure if this is helpful, or if you can just treat the symptoms (nausea, inappetance, pain).

Ask about meds:
Cerenia
Ondansetron
Famotidine (pepcid)
Pain control (Buprenorphine) ....... Important if it is pancreatitis
Appetite stimulant (e.g. Mirtazapine)

Can this be managed at home? Do you need more fluids? Is the syringe feeding going to work? Do you need more Rx food?

Does she need a feeding tube?

Bloodwork: CBC and basic bloodwork panel, possible fPLI, anything else needed to check for DKA
 
Re: 12/9 Garland AMPS 289 +7 322--- EyesQuick! What do I ask

DCIN has called the ER in advance of Garland's arrival and authorized up to $600 in payments. That amount might rise once we hear the treatment plan. Please, if you can help, the chip-in here.
 
Re: 12/9 Garland AMPS 289 +7 322--- EyesQuick! What do I ask

Vet update-

Typing from my cell and my wrist is killing me after all this phone posting today. Ouch. So I'll summarize

First- thank you everyone so much from the bottom of my heart. I will be forever grateful for EVERYTHING!!!!

Vet- so, garlands incision site where the e tube entered her neck is infected. I had been asking them about the area, and how it wasn't healing, for months, and they kept blowing me off. A few days ago I noticed she had scratched pretty bad at it, and reopened the wound. Well, they shaved the area, andbit looks much worse than I thought. :shock: So they gave her an antibiotic shot to help with that. He actually feels this is whats causing her nausea, and inappetite.

They ran glucose and ketones- BG was 300, ketones were trace. He said they were actually just below trace. She's not dehydrated either.

He does not feel she needs hospitalization just yet. He said the antibiotic should kick in and she will start feeling better. He also said he plans to give me a SQ fluids schedule. He gave her a shot (?) of ondansetron to help with the nausea.

I'm still waiting for the rest of the results. These are the preliminary results. When he comes back, I'll update again :)

Thank you all!!!!
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update pm

Add

He just left again- says he doubts it's pancreatitis bc she shows no pain when her belly is pressed on

Wants me to give 1/4 pill odansetron every 8 hours

Wants me to cut her insulin dose in half until she starts eating again- this one I wasn't to sure about

Said I should notice improvement by noon tomorrow, if not to bring her back in
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update pm

Violet --

This is great news!!

How about asking the vet if he knows of a vet he likes and trusts that's in your area? You need a local vet so you don't have to make this trek and go to the expense of using an ER.
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update pm

Fingers and paws crossed that all will be OK now. Thanks for the update, Violet. The prayers and healing vines at Lantus Land are mighty powerful!

Many hugs to you and your girl,

Ella & Rusty
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update pm

Oh no!!! Final test came back

High bilirubin - it's the only test that came back abnormal. Now he looks a bit worried. Talking about hospitalization :cry:
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update pm

Just as I was leaving THS I ckd the board one last time and saw this. I am so sorry this has happened to you guys!

Don't you just HATE IT when vets don't listen to you?

I am sending snowflakes and vines and prayers and Good Karma Wishes for Garland. Hopefully it is all due to just the infection and the shot and meds are gonna kick this thing in the butt w/no other complications.

Violet, as you know Tawny has been really sick too. Someone on the board sent us a blood ketone meter and I went right out on eBay and got a great deal on strips (thank God for plastic). I would love to send you a box, I got a very good deal on quite a few boxes. I'll PM you and you can send my your addy & i'll put them in the mail tomorrow. You've been very supportive of me and Tawny lately and I would like to give a little something back. ~ Desi
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Hi Voilet- We're sending warm thoughts and healing vines.

The lecture I attended Wednesday night in NYC talked A LOT about high bilirubin. I'm glancing at the lecture print out and one thing it says I'll quote "it is not unusual to find elevations in bilirubin concentrations in cats with an imflammatory diseases such as... and abscesses." There's a lot more written here, so I'm summarizing but basically if her ALP is normal (and bile acids and GGT are ok if they ran those) then this is likely a secondary elevation to her infection. It says cats can have elevated bilirubin without any form of primary liver disease due to the unique way they metabolize hepatic bilirubin. Of course- I'm no expert but that all sounds positive to me!!!!
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Ask the vet if Garland seem's jaundiced and if any of the liver values are off? Also ask if there's any indication of hemolysis (red blood cells being destroyed).

Could this have been a result of an abnormal phosphorus level given where ketones were yesterday?
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

I'm taking her home. If no improvement by noon, she will have to be hospitalized

Liver values are fine, no jaundice. He said the bilirubin is only "high" by .10. So since it's small, he wants to see how she does w fluids and odansetron

He told me not to syringe feed bc it will just make her throw up

Desi-- (hugs) sending you a pm.Our poor babies :(
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Jacspets said:
Hi Voilet- We're sending warm thoughts and healing vines.

The lecture I attended Wednesday night in NYC talked A LOT about high bilirubin. I'm glancing at the lecture print out and one thing it says I'll quote "it is not unusual to find elevations in bilirubin concentrations in cats with an imflammatory diseases such as... and abscesses." There's a lot more written here, so I'm summarizing but basically if her ALP is normal (and bile acids and GGT are ok if they ran those) then this is likely a secondary elevation to her infection. It says cats can have elevated bilirubin without any form of primary liver disease due to the unique way they metabolize hepatic bilirubin. Of course- I'm no expert but that all sounds positive to me!!!!
Click to expand...


This makes me feel better!!! Thanks for this :) Hopefully it's just this abcess she has. It looks really bad :(
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

It is promising that they are finding and treating the infection quickly. Fingers crossed that the elevated bilirubin is a side effect od fighting the infection and the number gets better as the antibiotics kick in.
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Sending white light and vines and prayers that it is just the abcess.
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

I would post back when you get home.

I would keep trying to assist feed with her history of DKA and FHL and bilirubin showing up. Very small amounts starting a couple hours after ondansetron or cerenia. Remember to chase them with some water so she swallows them.

The dosing experts should help with the insulin.

What kind of antibiotics is she going to be given?
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Also, baby food may go down easy. It's not high in calories so mixing it in with something like Clinicare may be a strategy.
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Good Grief - What a time you have been having. . .

So glad you got to a vet and that he spotted that infection.
infection+not enough calories+not enouth insulin = ketones.

I hope Garland will keep some food down.
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Violet asked me to post, but it appears she already has told you everything I heard from the vet and from her. Except to clarify that the ABx shot she received was Covenia (which is indicated for skin infections). Thankfully, tonight's treatment was only slightly under $400.

Violet, you may want to look into supportive supplements for Garland's liver--SAMe and Milk Thistle.
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Violet asked me to post, but it appears she already has told you everything I heard from the vet and from her. Except to clarify that the ABx shot she received was Covenia (which is indicated for skin infections). Thankfully, tonight's treatment was only slightly under $400.
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Just got home. Omg! Put out some food for her, she took 2 licks!! Yay! Hopefully in the morning she will feel like eating

Venita- I wasnt sure if I missed anything :) thanks for all your help tonight!!!

Garland was due for her shot 1.5 hours ago. She gets 3.75u. Dr said to give half bc she's not eating . Is that right?

I'll be back to post/answer questions after her shot , I just need dose advice real quick
 
Re: 12/9 Garland AMPS 289 +7 322--- vet update-- bilirubin?

Being that she has not eaten and you don't know if she will, the vets advice sounds reasonalbe.
 
Re: 12/9 Garland PMPS 314 DOSE?-- vet update-- bilirubin?

Thanks :)

I shot a skinny 2u. Now I'm gonna take a hot shower. What a day... :YMSIGH:
 
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