2/11 Morris AMPS 484; PMPS 331 - lab results posted!

[Gwen and Morris]

yesterday: viewtopic.php?f=9&t=5844

For dinner, he had some tuna water & a bit of canned salmon. Around 8pm, I gave him another can of MC mixed with water - he ate about 1/2 of that and there was still some of this left in his bowl this morning. Around 5am, dh opened a can of HC for Morris & he ate it all up! (dh had been up since about 3am....he is not feeling well either!) I opened a new can of MC for his breakfast & he was eating that still when I left the room. Even though he was eating when I was giving him his insulin, he turned around & snapped at me! I guess his grumpiness is still there!!! I rubbed his coat where I injected & didn't feel any moisture, so hopefully it did not turn into a fur shot!

I guess I will be spending the day PATIENTLY ( haha_smiley ) waiting to hear from the vet with Morris' lab results! I sure hope I am busy at work today to help keep my mind off things at home!

 

[Deb & Spot]

Re: 2/11 Morris AMPS 484 - eating a bit more!

I'm glad to see that Morris is eating and probably feeling a bit better, even if he is grumpy! I know you are really anxious to hear the lab results. Will be checking in later to see what's up.
Hope you keep busy and stay positive!

 

[Brenda and Morris]

Re: 2/11 Morris AMPS 484 - eating a bit more!

Great that he is eating more! Hope you get an answer from the lab tests...I didn't, so don't get your hopes up on that score. Stay busy! nailbite_smile

 

[Gwen and Morris]

Re: 2/11 Morris AMPS 484 - eating a bit more!

Been thinking.......now that he is eating more & because what he is eating is 'chunkier' than what he normally eats, I am not sure that his teeth are causing the problem! Right now, he is eating Shredded White Meat Chicken Fare w/ GrdGrns (Fancy Feast Elegant Melodys).....normally he eats pate food.

What do you guys thing??

 

[Gwen and Morris]

Re: 2/11 Morris AMPS 484 - eating a bit more!

nailbite_smile This waiting is KILLING me!!!! It is just 12noon here now & I know they don't normally get any lab results in until sometime around lunchtime (not sure of the exact time). I am attempting to keep myself busy & if I don't hear from them by about 1:30, I will call the office & check to see if they have heard anything as yet.

I forgot to mention in my post this morning.....when cleaning out the LB this morning, I was absolutley STUNNED by how LARGE 1 clump of pee was! I have never seen a clump so big before! There were also several other clumps of pee that were 'normal' size for Morris. There was also 1 medium sized soft yet formed stool (vetty bean says that soft but formed stool is a very good indication that he is well hydrated!).

Back to waiting patiently...... nailbite_smile nailbite_smile nailbite_smile

 

[Gwen and Morris]

Re: 2/11 Morris AMPS 484 - eating a bit more!

YAY! Vetty bean called me with results!!!! fpl is a little high, but this test is not that reliable she said.....I then said that I heard it can show a lot of false negatives....she agreed & said it can also show false positives. She is not willing to diagnose Morris with pancreatitis just yet, but she says that he appears to be having pain issues even though he is not showing it (& didn't even complain as she poked & prodded yesterday). She would like him to start on some pain meds that you just need to put a drop or two on his tongue.....I said 'Is that Bupenex?"...she said yes (seemed impressed I knew what she was talking about!). Unfortunately they don't stock it but will order it in....she hopes it will come tomorrow, but it might not be in until Monday. I asked if there would be any other clinics in town that would stock it & she doesn't think so....she thinks everyone orders it in. As he is not in extreme pain, she thinks it would be ok to wait to start this.....if he was showing more pain symptoms, she said she would start him on another pain med to take the edge off while we waited for the bupenex.

Since he is starting to eat more on his own, we are only going to address the pain issue for now (not knowing for sure if the pain is from pancreatitis or from his teeth). She is, however, concerned about his overall intake. She wants me to be carefully monitoring his food & water intake (like I'm not already!!!) and be sure that he is eating a minimum of 270 kcals per day. She also wants him to be getting a minimum of 60 mls per kg of water per day (approx 300mls per day). She knows I only feed canned & that I add water to his food, but she wants me to learn how to do SQ fluids at home so that he won't get dehydrated.

She also would like me to do a full curve on him in the near future. She said that with Lantus, getting readings every 2 hours is just fine, but she wants the curve to run a over a minimum of 16 hours. I told her I would plan a couch night for 1 night next week.

Hopefully, with all of this, we will see marked improvement in him soon! If, however, he is not getting better, then the next course of action would be to try & arrange an ultrasound - that would need to be referred out & would probably mean a trip over to Vancouver!

I am going to the clinic this afternoon (after work) to learn about SQ fluids.....while there, I will try to remember to ask for a copy of his labwork. Anything else I should check on while I'm there?!?!

 

[Brenda and Morris]

Re: 2/11 Morris AMPS 484 - vetty bean report is in!!!

Glad to see that you got the report and that the p'titis in inconclusive...bummer! That's great that they can give him something for pain but why the heck don't they keep those meds on hand???? I would like to ask that vet if she had a headache if she'd be willing to wait until MONDAY to get a pill for it???? That's four days away! grr_red I wondered whether my Morris had any pain but there was no clear indication of it...he's generally pretty grumpy anyway. grumpy_cat

One thing you should get from your vet if you can is some feeding syringes, just in case you have to syringe feed. They usually just give you a couple when you ask for them...one of the few things I've gotten no charge. :razz: If he suddently stops eating over the weekend, you want to have a method of getting "something" in him.

 

[Kathy and Kitty]

Re: 2/11 Morris AMPS 484 - vetty bean report is in!!!

Brenda, any chance there are emergency vet clinics near you? Surely, they would have bupe on hand!

Glad you've gotten some vet input. Sending eatting vines to Morris.

 

[WCF and Meowzi]

Re: 2/11 Morris AMPS 484 - vetty bean report is in!!!

that's a long time to wait, till monday. i think tramadol may be another pain med that some have used (cagney?) but i'm not 100% sure. bupe's the preferred pain med here.

but since you're going to the vet's tonight, if you want to, ask for a few days' supply of tramadol, to tide you through monday when bupe comes in. but PLEASE DO NOT GIVE the tramadol until you check in with jojo (since i'm not sure that's the one cagney used). just trying to save you another trip to the vet's tomorrow if bupe isn't in then.

 

[Gwen and Morris]

Re: 2/11 Morris AMPS 484 - vetty bean report is in!!!

Considering what food choices he has been eating, I am very pleased with PMPS of 331 tonight!

I did not see the vet this evening while I was at the clinic.....it was just our favorite tech teaching us how to do things. Therefore, I did not get any other type of pain med for him. I did, however, ask the tech why no one in town stocks it!!! She said everyone in town gets it from the same place & the delivery is usually fairly quick....hopefully I will get it by Sat at the latest!

I also got a copy of his lab results....to conserve space, I will just type out the values that are out of their normal range.....if anyone wants me to provide the other results, I am more than willing to do that!

Glucose - 17.3 (range 4.0-8.0)
Albumin - 34 (range 23-33)
Cholesterol - 8.09 (range 2.00-6.00)
Mean Corp HGB - 13.4 (range 13.5-17.3)
Spec fPL - 14.0 (range 0-3.5) **then it has comments saying >5.3 ug/: serum spec fPL concentration is consistent with pancreatits. Consider investigating for risk factors and concurrent diseases (e.g. IBD, hepatitis, diabetes mellitus). Periodic monitoring of Spec fPL may help assess response to therapy.
Tetraiodothyronine - 10.7 (range 16.0-45.0)
Urine was negative for ketones & glucose was positive 3+

My question now is, why is the vet not willing to say Morris has pancreatitis when the lab report is saying he does?!?!? I know she mentioned to me on the phone "it's a little high" (I think it is pretty darn high!) and she was talking about there can be 'false positives' (I have heard of false negatives on this site, but no mention of false positives). I would love to hear your feedback!!

 

[Erica & Moses]

I wish I could help you, but I don't have any advice here....

But I am pulling for you and Morris. If that means anything :mrgreen:

 

[Jess & Earl]

Re: 2/11 Morris AMPS 484 - vetty bean report is in!!!

that's a long time to wait, till monday. i think tramadol may be another pain med that some have used (cagney?) but i'm not 100% sure.

Just a note on the tramadol ... Some cats seem to get very goofy on it to the point where the family feels upset (dunno how the cats feel, they might be feeling pretty good!). I used it in Dillon after his dental and he did just fine; his pupils dilated but he did not vocalize, or pace or do anything abnormal. It is rather recently started being used in animals so many vets may not be comfortable with it, and if they have used it they are more likely to have used it in dogs (dogs tolerate it very well).

As an aside, it should not be used in conjunction with cyproheptadine (they cancel each other out). It's also possible that a cat on SAMe and tramadol would be more likely to have side effects (restless/won't settle/agitated). I personally think this is so unlikely that I wouldn't hesitate to use both in my cat, but ECID so watch for symptoms if you're using both together for the first time. Cypro would reverse any bad side effects.

 

[Sienne and Gabby (GA)]

The IDEXX range on Spec fPL indicates that >5.4 is consistent of a diagnosis of pancreatitis. Here's their brochure describing the test and there are references at the end.

Generally, bupe is deposited in the cheek pouch and not on the tongue. Did she suggest that you start giving Pepsid (famotidine)? If she wants you to make sure to give fluids and pain meds, if you include Pepsid, you are approaching this as if it were pancreatitis. I'd suggest that you ask what her differential diagnosis is in that she would want you to get an ultrasound, especially since Morris' results on the fPL is so high. The ultrasound will not be cheap. Unless there is something else that she wants to rule out, would it make sense to treat it as pancreatitis. (And do you really want to have to try to get into Vancouver for the next 2 weeks. I'm presuming it's mayhem there now.)

If you've not seen it, here's Jojo's post on pancreatitis.

 

[Gwen and Morris]

Thanks for the link to that brochure Sienne! Very interesting!

Did she suggest that you start giving Pepsid (famotidine)?

Nope

I'd suggest that you ask what her differential diagnosis is in that she would want you to get an ultrasound

She only mentioned the u/s as being the next step IF the fluids & bupe don't work on getting him to eat normally again. To be honest with you, I don't think that will be an option for us.....if he gets that bad, I think we would want to put him out of his misery. I am big softie, so I would make dh do it!

(And do you really want to have to try to get into Vancouver for the next 2 weeks. I'm presuming it's mayhem there now.)

EXACTLY!! LOL!! Can't wait for the games to start tomorrow though.....will sure be nice being able to watch everything on TV live rather than time delayed from somewhere else in the world!

 

[Sienne and Gabby (GA)]

The US is diagnostic and may help to confirm a diagnosis of pancreatitis. My hunch is that your vet may want to treat this as though it were pancreatitis. I would push, hard, about the Pepsid. Of course, you can get it at any pharmacy. Plain, old, regular Pepsid. Not the AC. You give 1/4 of a tablet.

I'd suggest sending a PM to Jojo either here or even better, on FB, since you have the labs. Alternatively, post the labs on Health. Jess or one of the other vet techs may have some thoughts.

I'm linking a roundtable discussion on pancreatitis that I 'borrowed' from Cassandra. If you look in the section on diagnostic testing, the vets discuss fPLI vs. ultrasound. They seem to be happy to go with the lab test vs. the ultrasound for very pragmatic reasons.

 

[Gwen and Morris]

I would push, hard, about the Pepsid. Of course, you can get it at any pharmacy. Plain, old, regular Pepsid. Not the AC. You give 1/4 of a tablet.

How often should I give it? If I can buy it at the pharmacy, then why even bother the vet....it's probably more expensive there! LOL!

I'd suggest sending a PM to Jojo either here or even better, on FB, since you have the labs. Alternatively, post the labs on Health. Jess or one of the other vet techs may have some thoughts.

I did send jojo a pm here....I am not on face book. I also posted over on health.....thanks for your suggestions!

I am exhausted tonight....it has been a very long week.....sick kitty, sick hubby & sick daughter!!!! I think I am going to take a mental health day tomorrow! I will take a look at that roundtable discussion link you sent tomorrow.

I-) Night All! I-)

 

[Sienne and Gabby (GA)]

Pepcid is twice a day.

 

[Jill & Alex (GA)]

Pepcid is twice a day.

i remember jojo said to give it about a half hour before eating...

 

[WCF and Meowzi]

Pepcid - please read!

Plain, old, regular Pepsid. Not the AC. You give 1/4 of a tablet.

Eeek. I think Sienne made a typo. Pepcid AC is the one you can give. The one you shouldn't give is Pepcid Complete. She's correct re: dose - 1/4 of a 10 mg tablet, i.e. one dose is 2.5 mg.

 

[Carolyn and Spot]

300cc is a lot of fluids, make certain cat has no cardio problems before giving that much, ok? I gave 100cc BID and I'm one of the higher ones. Also, watch your numbers, fluids will flush the body and the numbers will in turn come down.

Def use Pepcid AC, like Jill said, Jojo said 1/2hr before eating. 1/4tab. I put it in a pill pocket and it didn't seem to have any adverse effects. Get a good pill cutter, those little diamond shaped pills are hard to cut.

Buprenex rocks, tramadol put my cat in a near drunken stupor.. we had lotsa side effects.

fpli is not inconsistent with positive readings, only negative ones.. and that's only if sample was taken while cat was not mid-flare.

Not sure if you've read this but here's Jojo's very extensive writeup on pancreatitis. http://www.felinediabetes.com/phorum5/read.php?8,876722,876722

Soon you will be so good at identifying an oncoming flareup of pancreatitis that you will be able to help your cat recover quickly.. pancreatitis is easy and cheap to treat, so be sure to ask lots of questions on the Health board if you have them and people will help you with best places to buy things. For instance, I once heard you can buy a whole case of fluids at Costco for like $20 with a prescription. Our costco had no pharmacy so I couldn't check it out, but my vet charged me $20 for ONE BAG LOL

 

[Linda and Bear Man]

>>> She only mentioned the u/s as being the next step IF the fluids & bupe don't work on getting him to eat normally again. To be honest with you, I don't think that will be an option for us.....if he gets that bad, I think we would want to put him out of his misery. I am big softie, so I would make dh do it!



(((Gwen))) Please don't think about having to go down that road yet. Pancreatitis is pretty treatable. While some attacks can be severe, a lot of us here have cats that go in and out of flare-ups and are managed at home. Forgive me if I am not up to date on all of the treatments that you are giving, in addition to fluids and something for pain, as well as the Pepcid AC mentioned above (or injectable Famotidine if your prefer). There are also drugs for nausea like Ondansetron and Cerenia that can be given if he doesn't respond to the Pepcid.