2/19 Fortune AMPS 463 +2 550 +5 380 +12 98 PMPS 201

[RachelG]

Yesterday

Fortune is snuggled in my arms today, probably still tired from the hospital.

His BG is sky high so I'm worried that he is crashing and that it will affect his kidney.

I got his medical records. The new IM that took over documented that I said our GP ghosted us. Ugh. She also wrote that we are both on speaker listening. Is that unusual? Yeesh.

I reached out this morning when I realized there was not a plan beyond a recheck next week (to evaluate his b/w and if he needs subQ) and longer term pending his biopsy results. But what about his anemia? Are we just hoping he won't crash?

I am so nervous with his BG this high.

 

[JaxBenji]

speaker listening

what does this mean lol? Sorry about the extra notes...you all are such loving beans

FWIW Fortune's BG is bouncing from those greens yesterday but I don't know what that impacts. Just here for moral support

And thank you for sending love to Jax while nursing Fortune

 

[RachelG]

what does this mean lol?

LOL We put them on speaker phone so we can both listen and ask questions. IDK why it's relevant to the medical record though. They document "Mr. asked...Mrs said" like how is which one of us saying the question relevant? Yeesh.

And always plenty of love to go around!

 

[RachelG]

FWIW Fortune's BG is bouncing from those greens yesterday but I don't know what that impacts. /QUOTE]

Oh the bouncing makes sense! That does give me comfort. I feel awful he is still so high, and kinda panicky tbqh, but understanding that it will hopefully come down helps. It's hard to go against dr's order (if I had he would have gotten 3 IU last night!) and see him still not feeling well.

 

[Wendy&Neko]

Fortune's body is not yet used to greens (that will come), plus the dose has not been stable (not your fault), so the depot is in flux. I would suggest no more pokes today, and a lot of time spend lovin' on him instead. Try to make sure he gets lots of fluids today, water down his food if he'll eat it that way. Neko survived her hours in high numbers just fine. They do eventually come down from the bounces.

 

[carfurby (GA)]

 

[JaxBenji]

LOL We put them on speaker phone so we can both listen and ask questions. IDK why it's relevant to the medical record though. They document "Mr. asked...Mrs said" like how is which one of us saying the question relevant? Yeesh.

And always plenty of love to go around!

Ohhhhh I get it now lol but also am puzzled with you why is in the medical record...they should just write caregivers for everything!

 

[RachelG]

I updated my spreadsheet with his lab work, and I find the alkaline phos levels worriesome. He is on ursodiol for his liver and now I’m second guessing if they were administering it - his levels jumped up!

Would greatly appreciate if someone with some knowledge could take a peek

Fortune's body is not yet used to greens (that will come), plus the dose has not been stable (not your fault), so the depot is in flux. I would suggest no more pokes today, and a lot of time spend lovin' on him instead. Try to make sure he gets lots of fluids today, water down his food if he'll eat it that way. Neko survived her hours in high numbers just fine. They do eventually come down from the bounces.

We have been loving on him like crazy! Two weeks ago we thought we were going to lose him, and I am so so grateful to have him snoring in my lap rn.

This makes sense. I just am so grateful I found this group, and only wish it was when he was first dx’d last year!

Ohhhhh I get it now lol but also am puzzled with you why is in the medical record...they should just write caregivers for everything!

Yeah I’m not too pleased with how she documented things. There’s a few things misrepresented. But I have so few spoons that I’m trying to focus on the most important things, like snuggles with Fortune! He is getting some chx tonight and gave DH puppy eyes for a treat earlier. He is very much his mischievous self tonight!

 

[Suzanne & Darcy]

Yesterday

Fortune is snuggled in my arms today, probably still tired from the hospital.

His BG is sky high so I'm worried that he is crashing and that it will affect his kidney.

I got his medical records. The new IM that took over documented that I said our GP ghosted us. Ugh. She also wrote that we are both on speaker listening. Is that unusual? Yeesh.

I reached out this morning when I realized there was not a plan beyond a recheck next week (to evaluate his b/w and if he needs subQ) and longer term pending his biopsy results. But what about his anemia? Are we just hoping he won't crash?

I am so nervous with his BG this high.

Definitely recheck that hematocrit if they are re-doing blood work next week. You need to know if you need to start ESAs (like Epogen or Arenesp).

 

[Suzanne & Darcy]

LOL We put them on speaker phone so we can both listen and ask questions. IDK why it's relevant to the medical record though. They document "Mr. asked...Mrs said" like how is which one of us saying the question relevant? Yeesh.

And always plenty of love to go around!

I don't know. They are like a bunch of lawyers ... documenting everything and who said what. I guess make sure if you put people on a speaker phone to say... we have you one speaker phone so that we can both hear what you are saying and we can both ask questions, is that okay?

 

[Suzanne & Darcy]

I updated my spreadsheet with his lab work, and I find the alkaline phos levels worriesome. He is on ursodiol for his liver and now I’m second guessing if they were administering it - his levels jumped up!

Would greatly appreciate if someone with some knowledge could take a peek



We have been loving on him like crazy! Two weeks ago we thought we were going to lose him, and I am so so grateful to have him snoring in my lap rn.

This makes sense. I just am so grateful I found this group, and only wish it was when he was first dx’d last year!


Where's the bloodwork. In the spreadsheet?
Yeah I’m not too pleased with how she documented things. There’s a few things misrepresented. But I have so few spoons that I’m trying to focus on the most important things, like snuggles with Fortune! He is getting some chx tonight and gave DH puppy eyes for a treat earlier. He is very much his mischievous self tonight!

 

[Suzanne & Darcy]

ALP can often be elevated in a diabetic cat. Don't you have a record of every med they gave him while he was at the ER?

 

[Suzanne & Darcy]

I see his creatinine has been a little higher than it was and a little lower. He was up to 4 at one time. Dehydration can cause elevate creatinine.

 

[RachelG]

I don't know. They are like a bunch of lawyers ... documenting everything and who said what. I guess make sure if you put people on a speaker phone to say... we have you one speaker phone so that we can both hear what you are saying and we can both ask questions, is that okay?

Both my husband and I try to be on every call so we are informed and can ask (different) questions. It is just strange to me that she documents what each of us says, vs O stated...which is typically what I see on medical records.

Additionally, she conveyed that the idea to keep Fortune on Wednesday into Thursday was MY idea, when in fact it was the criticalist who was overseeing Fortune's case who strongly recommended it. It was only when this IM called us Wednesday am (first time speaking to her) saying that Fortune is "eating like a pig" and "doing well, he can go home," that we asked questions about how long he had been off of fluids, will that potentially make his creatinine shoot up, etc. and that we wanted to make Fortune was stable when he came home, which is what the other dr had told us. She wrote that Fortune may crash *anyway* because of everything going on rolleyes but that it was "fine" to keep him.

My pocketbook and heart would have liked him home a day early, but it seemed like the correct thing based on the other doctor was to keep him. And overall I don't trust her - she bumped Fortune up to 3IU with no spot check the day he went home. If we had dosed him 3 IU last night that feels like it would have been a bit disastrous!

ALP can often be elevated in a diabetic cat. Don't you have a record of every med they gave him while he was at the ER?

He has a history of cholangeohepatitis, which is why he on ursodiol. I'm now concerned that they weren't giving it to him. I have his full digital record, but not the full list of meds.

I see his creatinine has been a little higher than it was and a little lower. He was up to 4 at one time.

Yes, his creatinine was 4 and he was admitted for that and anemia on Saturday night. It has come down to 2.9 (one dip to 2.6) and that is also what will be check next week.

 

[Suzanne & Darcy]

Now, all that junk is out of the way... it sounds so wonderful... the day that you have spend with Fortune today. This has lightened my mood... which was not too great when I read the paper from the vet that my vet consulted with.... and then Darcy had 0.6 ketones, which made me happy.... then I read your wonderful update on Fortune I just feel really, really happy (smiling at my computer screen now and getting teary-eyed.)

 

[Wendy&Neko]

I see you couldn't resist getting another poke in today. Good to see he's on his way down. Now, restrain yourself!

 

[RachelG]

I see you couldn't resist getting another poke in today. Good to see he's on his way down. Now, restrain yourself!

Hehe yes! Happily - to be fair that was done before I saw your message, I updated the forum much later. Fortune got the news and has been a lovey dove since he knows there's no pokes!

 

[Marje and Gracie]

Would greatly appreciate if someone with some knowledge could take a peek

ALP can elevate if kitty is not eating because ALP indicates liver disease like hepatic lipidosis as well as other liver diseases or issues. However, if hepatic lipidosis is a concern, the ALP is “usually” quite elevated. Often, the vets will do a bile acid assay, if the bilirubin is normal, which is fairly simple and gives a better idea of liver function. I’m assuming he didn’t eat for several days.

Gracie took ursodiol for quite a long time as she had an up and down ALT. Her bile acids assay was normal. I never saw any effect on her ALP with the ursodiol.

Are you also giving milk thistle? I like Herbsmith at Chewys. My little one, who is four, has never had a normal ALT although the highest it’s ever been is 135 which is not a big deal with ALT. I give her milk thistle although the vets think this is her normal as she has never been sick.

I’m glad he’s home and feeling better.

 

[Butters & Lyla]

I'm glad to hear you have a snuggly, snoring kitty in your lap!!

 

[RachelG]

Thank you! No, he is actually a great eater (keinahora). That had been the first thing the doctor would tell me in the daily update. At least 230g/day, and at home we try to feed at least 6oz 2x/day. I have no idea why it shot up, and the doctor on his case the Wed-Thurs didn’t say anything, I only discovered it when going through his records. So strange.

Even as recently as last week his level was in the 30s.

 

[RachelG]

Fortune is just keeping us on our toes! His PMPS is 98, so we are stalling without food and retesting. Is that the right move? @Wendy&Neko @tiffmaxee

 

[Wendy&Neko]

Absolutely right thing to do. See where he is in 20-30 minutes.

 

[Wendy&Neko]

Hmm, I see 201 on the SS, wonder if the 98 was a faulty strip.

 

[RachelG]

Hmm, I see 201 on the SS, wonder if the 98 was a faulty strip.

Oh weird, I didn't even think of that! We had to use a second strip because there was too much neosporin on the first.

Next time I'll test again. Although it would be great if he is hitting the greens, it's crazy that he was just in the 500s!

 

[Wendy&Neko]

We had to use a second strip because there was too much neosporin on the first.

We have found recent research that Neosporin is not good for cats. It contains polymixin which is not good for cats. Emla cream (needs prescription from vet) is an alternative. Other ideas in here.

 

[RachelG]

Omigosh I had no idea! I read on this site that was the thing to do when I first started (neosporin with pain relief).

I appreciate you letting me know. I'll ask our vet for Emla cream, but in the meantime I'll try to order the Ledum 30C homeopathic remedy.

UGH poor Fortune.

 

[Wendy&Neko]

Yes, it was a surprise to all of us when when one of our long time members said her vet told her not to use Neosporin. I found Ledum at a vitamin shop. Holding with cool wet cloths can help too in the interim.

 

[RachelG]

Already found it quickly on Amazon! Will be placing an order, and finding some washcloths in the meantime for tomorrow

 

[Katherine&Ruby]

So glad to hear that Fortune is being a cuddle bunny again, and flashed you some green, even if for the briefest of moments. Sounds like your boy is on the mend. Really happy for your little family, Rachel.

 

[RachelG]

Thank you, Katherine! We are so so grateful to have him here!!

 

[tiffmaxee]

I am so glad to see you and Fortune had a nice day at home. Reading the way the vets documented your conversations gave me a good laugh. It’s not like you can go after them for malpractice. It made me angry that the ghosting was included. Ridiculous and so unnecessary. I hope the night was full of purrs and cuddles.