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

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Violet and Garland

Member Since 2011
Yesterday

Garland is sick. The scare we had a couple months ago we were only battling high ketones. She was still behaving fine and eating normally. We upped her insulin and gave SQ fluids for a few days until the ketones said negative.

This time, ketones are not as high as that last scare, but she is not eating, lying around - not a lot of energy, and has thrown up a couple times. I am almost positive this happened because of lack of enough insulin. I bought some new needles a few days ago that are shorter than the ones I'm used to, I know for sure I gave one fur shot, I was nervous about another one the day before that. Plus, there is a chance the lantus pen had gone bad.

I had been seeing higher numbers for about 3 days. I was about to raise her dose. Mon-Wed everything was fine. She was spunky and eating normally.

Yesterday: she ate breakfast, I was running errands throughout the day. But by late afternoon I had noticed I hadn't opened as many cans as usual. Garland had been sleeping in the playroom most of the day. I figured maybe she felt bad because of her missed shot, or her recent high numbers. When I gave her her PM shot, I decided to do a ketone meter test. I do a urine one a couple times a week because I can't afford to use that many meter strips. Those things are expensive. So I do a meter check about 1-2 times a month. The meter read 5.7. So now I knew we were in trouble. Her urine ketone check 2 days before had been negative.

But I know how to battle this ketones. I plan (with yalls guidance ) to raise her insulin dose and give fluids. I gave 100cc last night, and will continue to give 100cc a day. That's how much I was giving last time.

My biggest fear is the not eating. I remember all to well what happened last time she stopped eating. I hope hope hope I can fix this before we have to get another e-tube. I'm not even sure my DH would let me put her back in the ER because of the costs.

As soon as my little ones get done with breakfast I am making a trip to the store. I tried to get a BG this morning, but these new lancers are different than the ones I usually get, and after pricking her ear a dozen times with no luck, I'm gonna go buy the other ones. I also want to get some pepcid. She threw up yesterday, and I caught her dry heaving around 3am. Is there anything else I should get?

Also , I only have 1 ketone meter strip left. Does anyone have a tip on where to buy them cheaper?

I can't believe this is happening again. I'm so upset. 3 times in 5 months. I feel like I'm battling a war that can't be won. Her numbers had been soo good over Thanksgivibg. We even had brought her dose down because she had so many low greens. And now to have this happen at Christmas is heartbreaking. I'm so worried about her.

This morning she's still not eating (so it's been about 24 hours) and is not doing much of anything. I can tell she feels awful. So keep us in your prayers....
 
Re: 12/9 Garland AMPS -coming soon --- Sick again :( Not eat

For the pecid - you want the basic pepcid, not the AC. And you want 10mg tablets. You'll give her 1/4 of a tablet (2.5mg), which you can do twice a day.

Many prayers for you guys!! You are truly amazing.

Amy
 
Re: 12/9 Garland AMPS -coming soon --- Sick again :( Not eat

Hi Violet,

Aren't you in DFW? If so, I have a box of fluids & drip sets you can have, if that will help. Send me a PM if you would like them.
You want Pepcid AC, original strength (Famotidine 10 mg tablets). The dosage you were quoted is correct - 1/4 tab.
The best place to get blood ketone strips is on e-bay. "Barn Cats R Us" just got a nice order off e-bay - you might PM her and find out which seller.
 
Re: 12/9 Garland AMPS -coming soon --- Sick again :( Not eat

TrixieCat said:
For the pecid - you want the basic pepcid, not the AC.

Not to butt in, but are you sure on this. I am not positive in this situation, but it usually is the Pepcid AC that we give the cats.
 
Re: 12/9 Garland AMPS -coming soon --- Sick again :( Not eat

I've always been told NOT the Pepcid AC for cats....but yes, I could be wrong. Someone please do correct me if I am.

I do know you want the 10mg tablets, and the dose is 1/4 tablet, 2.5mg.
 
Re: 12/9 Garland AMPS -coming soon --- Sick again :( Not eat

TrixieCat said:
I've always been told NOT the Pepcid AC for cats....but yes, I could be wrong. Someone please do correct me if I am.

I do know you want the 10mg tablets, and the dose is 1/4 tablet, 2.5mg.

The Pepcid AC is correct. (You may have been thinking not Pepcid Complete).

Get Pepcid AC 10 mg tablets.
 
Re: 12/9 Garland AMPS -coming soon --- Sick again :( Not eat

Linda and Bear Man said:
TrixieCat said:
I've always been told NOT the Pepcid AC for cats....but yes, I could be wrong. Someone please do correct me if I am.

I do know you want the 10mg tablets, and the dose is 1/4 tablet, 2.5mg.

The Pepcid AC is correct. (You may have been thinking not Pepcid Complete).

Get Pepcid AC 10 mg tablets.

You are absolutely correct, Linda...I was thinking "not Pepcid Complete". Was just about to type that. My memory... ohmygod_smile . Thank you guys for catching me on that.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

AC- okay

I plan on to start syringe feeding today . I think I still gave a couple cans of recovery left. If not what should i use? I have a couple syringes too. But last time I attempted syringe feeding it was a disaster. Made tube feeding look like a walk in the park yikes
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

There are four Pepcid products:

Pepcid Complete

Active Ingredients (in each chewable tablet)

Famotidine 10 mg--acid reducer
Calcium carbonate 800 mg--Antacid
Magnesium hydroxide 165 mg--Anacid

Pepcid AC, original strength

Famotidine 10 mg--Acid reducer

Maximum Strength PEPCID® AC® - Tablets

Famotidine 20 mg--Acid reducer

Maximum Strength PEPCID® AC® EZ CHEWS®

Famotidine 20 mg--Acid reducer

******************************************************************************************

Violet, you want the Pepcid AC, original strength.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Pepcid won't dent this Violet. Can you have your doctor call in scripts for both Cerenia AND Ondansetron. Let me know if I can help with this. It really is urgent to get this if you are going to try and do this from home. Food is critical and she has to keep it down. The cerenia will hold off the vomiting hopefully. The ondansetron will deal with the nausea and yuckiness and hopefully help her return to eating on her own. Focus on keeping food down and assist feeding until the crisis is over. Fluids, insulin. You have the R still right? Is it still good?
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Amy -- "basic" Pepsid (famotidine) IS Pepsid AC. (You don't want Pepsid Complete or extra strength. See their website.)

Violet -- I suspect this is a pancreatitis flare. Make an appt with your vet. You will want to get some pain meds (bupe), ondansatron if Garland is vomiting, and/or Pepsid if this is only nausea. (I'll defer to Karrie on these meds.) and I'd really encourage you to take a look at this post and consider starting some of the supplements. Your vet may want to consider a course of steroids to help with the inflammation. If your vet wants to run labs, you want a spec fPLI. It has to be sent out to IDEXX but it is the definitive test.

If this is, in fact pancreatitis, some cats are more prone than others to flares. What's key is catching this early -- which it sounds like you've done. If Garland is prone to flares, you'll want to talk to your vet about making sure you have supplies to manage this at home so you don't have to wait until you can get an appointment (which could take as much as a couple of days) to start treating.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

We posted at the same time Sienne. Depending on pepcid in my opinion will harm Garland in that she wouldn't be getting what she needs. In addition to Cerenia and Ondansetron yes, but not alone.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Sending tons of healing vines and positive thoughts for Miss Garland. I wish her to make a full and speedy recovery.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Karrie -- I've not had to use Pepsid in combination with an anti-emetic (fortunately). As long as the food stays down, that's the goal. If both an H2 blocker and an anti-emetic will do the trick, it's OK by me!
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Sending Healing Prayers & Green Healing vines to Garland--So sorry this is happening to you at this time..
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

All the posts I have read here on FDMB say to get Pepcid AC, original strength (10 mg) and that the dose is 1/4 of a tablet. Apparently it tastes awful and you should not grind it up to put in food.

Violet, I am so sorry that your girl is not feeling well. The not-eating, from what I have read, could be a pancreatitis flare. Has she had pancreatitis in the past? Sienne posted this link to the Old Board in someone's condo recently. You may already know it, but I'll include the reference here: http://www.felinediabetes.com/phorum5/read.php?8,876722,876722

Sending many healing thoughts and vines to dear Garland,

Ella & Rusty

p.s. I see as I was about to post this that Sienne has already given you this information (and more), and so has Karrie. But we wanted you to have the healing thoughts and vines!!! Feel better, Garland!
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

I never wished my laptop was working more than right now :cry:

Okay: here's what I've got

1) picking up a refill at my pharmacy in an hour for 5 odansetron pills. Last time I cut them into 4ths, but I dont remember how often I gave it

2) I have 3 16mg cerinia pills left from before.

3) I can get pepcid at the store

What is the final decision for meds y'all want me to start giving her?
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

You should talk to your vet. I think this is pancreatitis but there is no way to be certain. If Garland isn't feeling well and given her history, please make a vet appt. If this is pancreatitis, you need pain meds and that requires a prescription. You need labs to know what's going on. You should have someone with veterinary expertise get eyes on your cat. (If this was one of your kids, you would be calling the pediatrician. It's the same idea!)
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Why do you think it's pancreatitis? Isn't this just the same thing that happened before?
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

I'm off to the store

Thank you all so much for your prayers and advice!!!! Love you all!!!! ((((hugs))))
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Violet:

Why do you think it's pancreatitis? Isn't this just the same thing that happened before?
None of us can reliably tell you what it is or isn't. We don't have eyes on Garland and none of us is a vet. Again -- if this was one of your children, would you start prescription meds without talking to your pediatrician? All I can tell you is that if this was Gabby, I'd be calling my vet. I do not want to make suggestions that could be completely wrong and have you delay getting Garland the appropriate treatment. This is especially the case given you had ketones last night.

And, please get a ketone test as soon as you can.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

At the store- is generic pepcid okay? It looks to have the same ingredients and half the price?
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Sienne- I've called and left a message early this morning at the ER vet. Waiting for a return call
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

I spoke to Violet this morning. She tells me she has 3 or 4 blood ketone strips left. DCIN has just ordered a box of 10 blood ketone strips ($41.75) to be sent to Violet, but delivery will take into early next week. (I cancelled the order because Eva sent strips for 2nd day delivery. Better to save DCIN's money for a vet trip, when it comes to this.)

This is one of those cases where finances are a serious impediment to veterinary treatment. And because of family commitments (two children 3YO and under), as far as I know Violet hasn't yet arranged "local" veterinary care for Garland.

I offered Violet DCIN's financial assistance if she has to pack her 2 young children and Garland into the car and take the cat to the emergency vet an hour away. I have offered DCIN payment for the placement of an E-tube, if needed. Most of you know that DCIN, through donors like you, is currently helping Desi with Tawny's DKAs--$6500 so far. I will keep in touch with Violet to see what DCIN is able to do to help. Violet has told me that her husband would be highly reluctant to add to the $2K they still owe Care Credit for Garland's last DKA hospitalization.

I appreciate the suggestions folks might have about home treatment--OTC or script meds, the foods that Violet might be able to get Garland to eat, offers of locally delivered fluids.

I hope this village can get Garland back to health.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Violet - I agree with seeing a vet, I was thinking because it worked before it would be okay now. The disclaimer is like Sienne said.

I have to go look up cerenia dosing. Do you have it written down for last time? ondansetron is 1/4 of a pill twice a day. Pepcid AC - you can use generic but I pay the extra buck or two for the brand name. 1/4 of a 10mg pill once or twice a day.

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

Also - why are you still seeing the emergency vet? Can they recommend an awesome non emergency vet for you?
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Violet, I'm so sorry you and Garland are going through this again. We're sending you some Nova Max ketone strips, too, 2nd day delivery.

I sent you a PM. Thinking of you and Garland today.

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

Eva & Butters & 5 Others said:
We're sending you some Nova Max ketone strips, too, 2nd day delivery.

Thank you Eva. Because of your help, I have cancelled DCIN's order for Garland's ketone strips.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

If anyone is in the DFW area, perhaps you could recommend a local vet for Garland. I'd also suggest that this be posted on Health to see if anyone has any recommendations.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

I have a local vet. But thisis more of a trust thing. The vet who diagnosed her wasn't very accepting of what I wanted. Inhad to demand Lantus and he basically called me stupid for saying I wanted to home test. He recommended at her diagnosis I should put her down. Needless to say, I haven't taken her back there.

This ER vet, Dr Hill, is so sweet and understanding. He is familiar with Garland and FDMB and supports us in home testing and takes suggestions seriously. I can handke the drive if I must take her in. It's more I can't afford another huge ER stay. The last one was $5000

I heard back from his nurse while I was gone. He is off today, won't be back until morning.

I have all the meds. Should I give her anything before I try to syringe feed? She threw up again while I was hone. Although I'm not sure what, bc she hasn't eaten since yesterday morning.

New ketone check is 4.0, yesterday was 5.7 thank you so much for sending strips. The generosity here always leaves me speechless. Thank you!!!!
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Ps- I'm still posting from my cell, sorry for spelling mistakes. It won't let me scroll to edit after I post so I can't fix them lol
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

I would give the cerenia today - she has to keep food down.

Here is the info I have in an email of mine for dosing: Cerenia is 1-2mg/kg so 8mg (half of a 16mg pill) is OK for a 4kg cat. Smaller 3kg cats might want 6mg (quarter of a 24 mg pill). Dosed once a day with something like a day skipped every 3-5 days (especially if using the higher 2mg/kg dose). It has a long half life so can build up in the system. Basiically, cats get the same mg/kg as dogs do for nausea (not the higher level dogs get for motion sickness).
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

So only give cerinia? The box says 1/2pill every 24 hours. Garland is about 9.8 pounds
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

So she's 4.4kg - 1/2 of an 8mg pill is 4mg which is 1mg per kilo so thats good.

I would give the ondansetron also but the cerenia will help her keep food down - stop vomiting. And focus on assist feeding food. Maybe save the ondansetron for tonight and not start off too fast.

I understand your financial constraints. I don't want others to think I'm pushing you not to see a vet. I just know these drugs are critical for keeping food down - which I wouldn't wait on is all.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Violet:

I'm concerned about the vomiting. This could be pancreatitis or it could be that Garland ingested something she shouldn't have. (Gabby was vomiting repeatedly when she ate dental floss.) There are a lot of recommendations flying and we don't have any idea what's wrong. Is it possible to talk to one of the vets at the ER and find out if they feel this is an emergency or if there's something you can do at home until you see the vet that's been following Garland? Do you have any friends who have cats who like their vet (vs. the one you described)?
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

just to throw another point of view in here, I've always been told that something like vomiting needs a vet visit first, and preferably an x-ray. You don't know if the vomiting is caused by illness. It could be constipation, or that she ate a toy or a Christmas decoration. With Garland's history you assume it is illness, but what if it's not?

A local vet wouldn't cost that much. Here it's around $40 for the exam and around $100 per x-ray (I know I live in a cheap area!). The vets consider unexplained vomiting an emergency. Last time I called mine for an appointment for Jazzy, at first they were going to give me an appointment the next day, until I mentioned vomiting, then they found room for her the same day.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Sending feel all better soon vines to Garland.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Y'all I would love to take Garland up to the vet for bloodwork and x-rays. I really would. I totally agree that's what should be done right now. But the reality of the situation is I don't have the money. Our CC are maxed out, and i think my balance in our checking is around $100 (for food and diapers) until DH gets paid on the 15th. Im so lost. I wish I had pet insurance or something.

Finally got the kids fed and in bed for naps. Now I'm gonna attempt Garland. How many cc's do people do in one feed?
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

If you do it, it would be 4mg. 20-30cc a feeding. Again... I'm not going against the advice of the experts here. They are being responsible providing the advice that they are. We would do the same on the assist feeding forum - not just blindly medicating and feeding. A vet would normally see an inappetant vomiting cat and then advise on what to do.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Totally understandable not being able to pay for a vet bill. Leo had a bout of not eating and vomiting awhile back. I took him in to the vet, the vet thought it was pancreatitis but wasn't sure. Leo's treatment was the very same as what you're doing for Garland, cerenia, sub-q, and bupe. She also advised to let Leo eat whatever he wanted, even if that meant letting him eat his 'junk food' which is kitty kibble. I hope this helps and I hope Garland starts feeling better soon.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

I gave 1/4 tablet cerinia (4mg) and syringe fed 24cc A/D. I have her closed off so I can monitor her. Fingers crossed she keeps it down

Tracy- thank you for Leo's story. :) gives me hope :)
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

Violet. I know how caring and helpful Dr. Hill is, and that you have built up a great amount of trust in him.

Please think about calling the hospital and asking if they would call Dr. Hill and ask him to call you back. I think this is an imperative. I know that it is going to be nearly impossible to take Garland in on a $1K/day emergency basis (it is the weekend coming), but if Dr. Hill says to take her in, he will likely call ahead and arrange appropriate diagnostics and care.
 
Re: 12/9 Garland AMPS 289 --- Sick again :( Not eating

She didn't keep it down. She just threw up. Sigh... And she seems thirsty. She keeps hovering around her water bowl.

To top it off, while i was cleaning up cat vomit, my 3 year old flushed something down the toilet and it clogged/overflowed, putting gross toilet water all over the bathroom floor. And I have no idea how to unclog a toilet. Can this day get any worse ? :cry:

Venita- what should I ask them when I call? Should I just talk to the doctor on duty if they say they cant call dr hill on his day off?
 
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