3/10 Rupert PMPS 486,+2, 457,+5.5, 403

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Re: 3/10 Rupert AMPS 502

do you think there's any possibility of getting him into the vet before tuesday night? just wondering if these high numbers are reflecting an infection - could be the herpes and it sounds like you think he has many of the characteristics of it, could be something else.

i had to drive my daughter back to college last night and thought about you a ton on the drive. these high numbers are not good and i understand completely why you are so worried. i'm wondering, though, if a vet visit wouldn't turn up something else.

regarding the teeth - doesn't have to be a tooth that has to be removed for the teeth to cause high numbers as well. could just be gingivitis. if you look at jenn's mikey's ss here - he had a dental on february 1st. look at the dose column since then:https://docs.google.com/spreadsheet...sLdGx4YXJRQXVWdFdWdzVFTUU3ejcwOXc&output=html

he did have teeth removed, but even not needing that, cats can have dramatic changes with just having their teeth cleaned and any infection cleared up.

if i were you, i'd try to get the vet visit asap - look at teeth, eye drip, perhaps do blood work and look for any infection.

also, i know i asked some time ago about his eating schedule but am not sure how that got left. one thing that helps with diving/bouncing kitties is to feed them mini-meals. take the total amount of food given and divide it by 2. in the morning, give half divided up fairly evenly in the first 3-4 hrs. repeat in the evening.

so for example, i give punkin 1.5 cans of fancy feast 2x/day. he weighs about 13lbs. i give him 1/2 can at 7am with his shot. i take one more can and divide it into thirds and he gets 1/3 each at 8am, 9am and 10am. the rest of the day i give him boiled chicken for treats after his pokes. the volume of the boiled chicken is fairly small - like a 1" cube or less per poke. i repeat the same thing in the evening beginning at 7pm.
 
Re: 3/10 Rupert AMPS 502, +3, 522

I do split his feed, he's not a huge eater as it is, he gets fed right after his shot, then +1, and+2 and usually at +6,

he seems fine this morning, fairly alert/active/vocal. ate some steak bits at test time this morning, followed by about a tablespoon of EVO/Friskie mix. has just eaten some more of the same, with his lysine and his enzymes.

I have to go clean the barn now. will cal vet when she opens.
 
Re: 3/10 Rupert AMPS 502, +3, 522

vet appt at 12 noon.

what should I ask for re the herpes? is it possible to put him on the meds as a diagnostic method? I gather it's difficult to diagnose ordinarily. What sort of med is it, some form of anti-viral? She's a very nice lady, older, did at least know that Lantus was the way to go, but seems to not be totally into all the nuances. I need the right info so I don't sound like an idiot talking to her. this place is exclusively a Cat Clinic so you'd think she'd be well versed. I'm prepared to push as much as I need to, so any suggestions appreciated. If she finds his teeth are bad (gingivitis or decay wise)... should I push for an appt next week? She's going to give me the old 'need to get his numbers down' speech probably. is there a good counter for that? I am prepared to take him back to the other vet who was a dental specialist if necessary. a
 
Re: 3/10 Rupert AMPS 502, +3, 522, questions for vet?

vet visit usually sends Ruperts BG levels thru the roof, so be interesting to see where he goes from here. He looks okay at the moment, weight good, not too dehyrdated.. hopefully he doesn't panic too much on the way to the vet. She's probably going to freak at the high numbers.
 
Re: 3/10 Rupert AMPS 502, +3, 522, questions for vet?

I am posting from work on my phone so I have to be brief.

I would give her his history about the eye like you shared w/ us last night.
Ask if it would be worth trying some eye drops (sorry can't remember names off hand). They will probably be antiviral. If a secondary infection is suspected she should prescribe an antibiotic.

Good luck. Hope it goes well and you get some answers
 
Re: 3/10 Rupert AMPS 502, +3, 522, questions for vet?

i don't know about the herpes - i guess i would say that i've seen pictures that look similar to rupert's eyes and someone who has a cat with herpes in the eye suggested to me that might be what rupert has. ordinarily i think herpes can be diagnosed from a scraping of cells looked at under a microscope - in people, at least. i don't know about cats.

if she balks on the dental - i would say that even though his numbers aren't regulated, i feel strongly that i would like to proceed.

one critical thing that caused problems for punkin that might make you want to go to the dental vet anyway - you want the dental done by someone who has a dental x-ray machine and who will make sure the roots are all out if any teeth have to be extracted. punkin's vet was old school, extracted the teeth but didn't have an x-ray machine and we had a couple of months of infection and a lot of AB's to get through it.

so very glad you were able to get him in! i'm not sure what else to tell you - but the bottom line is that we suspect some kind of infection is raising his BG. without resolving that, you're not going to be able to get him into better BG.

there is a place for just nodding your head if you're getting dosing information and then go about doing what you think you should when you get home. it gets awkward to be taking dosing advice from the internet kookie people, if ya know what i mean!?
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514

back from vet. teeth seem okay. mild gingivitis, she refuses to do cleaning at the moment. he doesn't seem to be too bad in there anyway. not sure about the rest, she thought the herpes idea was possibly valid, he's now prescribed a/b, starting Monday morning (wants a pee sample dropped off Monday morning so she can send with courier to vancouver for tests - not that she suspects UTI but figures we may as well test and culture and rule out all possbilities) so we can't start a/b until AFTER the pee is collected (6am monday morning!). She suggested he might need different insulin, at which point I said 'oh, maybe Levemir?' and she said 'oh no, caninsulin would be better'. I kind of tuned out at that point. Anyway, the plan is to put him on the a/b (respiratory/sinus infection specific) for one week, monitor, if he improves then this might suggest infection there, if no progress, will add 'eye ointment' to see if that helps, also will ad 'gum infection' specific a/b following that. Of course his eyes weren't running at the vets. she said they looked a tad inflamed but nothing major. checked his lungs, totally clear.

grasping at straws.. she's not seeing anything screaming out from him to suggest that he has something else going on. Palpated him all over, kidneys felt normal, no pancreatic pain, said he looked not bad and that she wanted him to lose more weight? (he's at 6.75 kg, which is down a smidge, but she want's him at 6, that's at least another pound off.. hm). She kept saying 'his weight is probably why his numbers are so high'. doesn't explain the bouncing does it. Anyway...
will do +11 and await instructions. I know you are probably going to say stay the same and wait for the a/b to kick in.

sorry this is long. I'll try to be less wordy in future.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, vet report

A culture on an unsterile urine sample may not give you good info. Why didn't she draw urine with a needle while you were there?

Is Rupert on Lysine? A friend of mine read a journal article that the lysine dose for an active flare should be two 500mg bolus doses of lysine (1000mg a day). All 500mg at once, not sprinkled on food throughout the day.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, vet report

I agree with Karrie's point. The vet should have done a sterile urine draw (cytocentesis). Sending a nonsterile sample to a lab for culture is a waste of your money.

Seeing "mild gingivitis" on inspection in an awake cat may be indicative of more than mild gingivitis on inspection when the cat is anesthetized. Trying to see what's going on in a cat's mouth when the cat is alert is not the best way to get an accurate read on what's going on. (With Gabby's first dental, 2 vets thought she had mild to moderate gingivitis. Her gingivitis was moderate and she also had FORL with several teeth and required extractions and they only knew that with x-rays and inspection when she was anesthetized for the dental.)

Could you also ask your vet to provide you with references that indicate why doing a dental now is contraindicated? Have you given any thought to finding a different vet or finding a veterinary dentist with whom you could consult?
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, vet report

CANINSULIN?!?
AHHHHHHHH! NO! ohmygod_smile

I've recently started my furkids on Lysine in their food. Lymphoma/chemo kitty Daffy was sneezing and also periodically gets runny eyes, and that has stopped. Baby Piglet (very slight runny eye) is much better. CRF kitty Holleigh-berri has *always* had runny eyes and brown stains, and the improvement comes and goes, but she's not getting reliably high and regular doses. That may well make all the difference, from what I have read about it. A long time ago I bought a product called "Angel's Eyes" to eliminate the runny brown eyes, but never used it http://www.angelseyesonline.com/faq.htm. I was never completely comfortable with its description of how and why it allegedly worked.

MJ
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, vet report

Hi Pip,
I'm so glad you got Rupert in to the vet. I agree with Sienne about the dental...I can't tell you how many times we have seen people take the cat for a dental when the vet said there was just "a little gingivitis" and the cat ends up needing several extractions...it happens all the time. I also agree on the urine testing....to diagnose a UTI, the vet needs to do a cystocentisis. The problem with using a sample you collect externally is that it can easily be contaminated by external bacteria. If the C&S shows bacteria, you will not know if there is truly an infection, or the sample was contaminated.

About the herpes....when he was diagnosed with FD, Mr Tinkles had a URI, which turned out to be chronic...weepy, goopy eye and sneezing. The vet told me it was likely a result of herpes virus. It took 2 courses of Amoxicillin, 2 more long courses of Azithromycin (6 wks each), eye ointment, lysine and an insulin switch from Prozinc to Lantus....6 months total in time....to finally clear up the infection. I never really got a good handle on his numbers until the infection was finally responding to treatment. I could see the infection waxing in his numbers before the symptoms reappeared. Fortunately he rarely has flares anymore....but as soon as I think he might be flaring, I start the lysine. One thing to watch out for....don't let her give you an eye ointment with steroids in it. Not only is it not going to help the numbers, it can actually cause more of a problem with herpes. Which AB did she give you?

Karrie's suggestion on lysine is exactly what I did...500mg BID. I mixed each dose in his food. I started out with 250mg BID, it didn't seem to do much...increased to 500mg BID after checking with the vet. Some people give it all the time, I only use it when Mr T is flaring.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, vet report

ergh - i vote for a new vet. there are better ones out there. can't believe she would suggest switching rupert to caninsulin.

you mentioned a veterinary dentist earlier, right? i'd take him back there and see about the dental.

i agree with the info about the cystocentesis - even my old school vet did that on punkin.

at least you have some direction on which way to go. i'd pursue both the herpes and the dental areas.

how is he looking/behaving today?

eta: weight loss in cats has to be really slow and gradual. karrie has experience with fatty liver that can develop if a cat doesn't eat or loses weight too quickly. hopefully she'll see this and offer you some advice on how to help him lose weight safely. otherwise send her a pm and ask. slow is key.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, vet report

she's given us Azithromycin... suspension. yummy caramel flavour(as if the cat cares) .. first ingredient.. sucrose?????? should we use this or not? how much will this alter his BG readings skewing any good effects the a/b's might be having?

yes, he's on lysine, 250 mg mornings, but I"ll start morning and night

urine sample was pretty sterile (we took one in today but she wants a fresh one for monday so I"ll get it again) , direct from cat into a level 8 sterile containment jar (courtesy of the military).

I'm thinking of calling the other vet on Monday to ask her if she'll take a dental xray of Rupert... it might show something in his teeth, it might even show if something evil going on in his sinuses.

this vet just seemed to focus on his weight and say things like "I know you have your preferred food but.... " blah blah. She wanted him on Hills M/D which is super high in carbs and he won't eat it anyway. She knows I won't use it so I guess she thinks I'm feeding him some other garbage.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, sucrose in a/b

no - you can't give him that. what is she thinking!?! kudos to you for noticing it. i'd give her a call back.

good grief.

do you have other options for vets? she's sure not helping you at this point.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, sucrose in a/b

but wait. are you saying she's starting you on an antibiotic today and then is going to check his urine for an infection on monday? you won't have accurate results if he's starting on the AB today.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, sucrose in a/b

Julie --

I think Pip said that she was instructed to hold on the AB until after she gets the urine sample on Monday.

And no, I wouldn't give sucrose to a diabetic cat. Rupert's numbers will be even higher. It's amazing that for all of their training, vets don't read labels! (If your vet tells you it's only a small amount of sugar and it won't make a difference, ask if the vet had a diabetic child, if s/he'd like you to give said child a couple of teaspoons of ice cream several times a day. Usually that shuts the vet up because the obvious answer is "no.")
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, sucrose in a/b

Pip

I'm sorry I didn't see this earlier. Herpes is extremely difficult to diagnose if it is not in an active stage. Even when I took Tobey in the first time it happened and his eye was basically swollen shut with an ulcer, the veterinary opthamalogist said it presented as herpes but they have to do scrapings, etc to see and neither of us wanted to put him through that. Because he responded so beautifully to the herpes-specific treatment and because it only happens when he's stressed, then 2+2=4 and herpes is the diagnosis. The first doc I took him to was my regular vet, thinking that he and Grace had been wrestling and she scratched his eye but there was no scratch. My regular vet thought it might be herpes and sent us home with terramycin ointment. That is NOT enough for herpes and oral antibiotics do not treat herpes eye episodes. The treatment is aggressive and includes idoxuridine anti-viral drops (qid), tobramycin anti-bacterial drops (tid), 500 mg l-lysine bid mixed in food, terramycin anti-bacterial ointment (sid), and also artificial tears qid.....my doctor uses idrop vet because it has no preservatives in it. It's not cheap but it's great (and not idrop vet PLUS). Tobey and Gracie both get the idrop vet bid every single day since they both have some meibomial gland inflammation....it keeps their eyes lubricated.

Does Pip need all that now? Probably not....all of that is for an active breakout where you see an ulcer or beginnings of one, squinting, tearing, goop, etc. Would some of it help him? Probably.

IMHO...it's worth it to schedule a dental with a dental specialist so you can get those xrays and look for the FORLs. They are sneaky and a vet cannot usually see them on visual inspection unless they have really progressed to where the gum is pulled away from the tooth. And I think if you can, it's also worth a trip to an opthamalogist to just be sure as sure as you can be on the eyes. Again, without a scraping type biopsy, they can't say 100% if it's herpes but they can put 2+2 together.

And I absolutely agree on the urine sample.....gotta have the cysto..otherwise, you are wasting your money and I wouldn't start a cat on an antibiotic for a suspected UTI. As far as an A/B helping a "sinus infection".....I'm not sure...I'll acquiesce to those who have posted here and have that knowledge.

And yes...there can be sugar in a/bs and also...you gotta watch the eye drops/ointments. Some of them have steroids.....like neopoly dex and BNPH.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, vet report

Awwww, Pip. It will be ok.

I cannot comment on the dental issues, as I do not have any experience with that.

What others are telling you about how to get a urinalysis is correct. I think Laurie explained it pretty well. If it were me, I would probably call the vet first thing Monday a.m. (maybe even leave a message tonight), and tell her you chatted it over with Rupert. Even though he does not want to come back and get stuck with a needle, he prefers to have it done right so he does not have to take more medicine unnecessarily. Tell her the cat is always right@ ;-) I would not waste my time, money, or sleep to bring a sample over on Monday a.m

Did she tell you what she thought about his hydration? Do you know how to check for that?

I really do wish she would have offered an antiviral eye drop to start with immediately (would not have affected any urinalysis). Cats, like people, can become resistant toward a/b's. So it is really best to use them only when you know for sure. Besides, if an antiviral is what was needed, the a/b will do no good and the infection will continue. Herpes is a viral infection. A secondary infection can occur that is bacterial, but.... (*sorry, just my personal rant* ;-) ). Laurie is correct on ever getting drops with steroids. Steroids can raise blood sugar. Also, from what I understand, drops are easier than the ointment. I wont even try the ointment with my current weasel!

This is tough, I know. I made so many mistakes in the beginning with Latte. I can't tell you how many improper urinalysis' she had before someone told me. Or, starting an a/b before checking infections. After a few years of giving her medicines via injection I thought I was a pro and almost gave her first insulin shot as an OD (10u)! ohmygod_smile We try to go in as prepared as possible, but all of us (at one time or another) have walked out of these visits wishing we had asked this, or had the vet do that. And just like the vets, we cannot know everything. We have to learn (sometimes by mistake). We do the best we can.
 
Re: 3/10 Rupert AMPS 502, +3,522,+6.5,514,+11, sucrose in a/

have discovered the dental vet (who also has 'regular' vet clinic) is open on saturdays! yay. this makes a big difference. of course she's closed as of 1pm today so too late to talk to her. I've sent an email and will phone her on Monday. I think we'll probably hold off on submitting the urine sample on Monday, and I'll hold off on the a/b. Phoned and left message for today's vet to call me first thing monday, asking about the sucrose. Jeesh, the whole idea of the a/b was as a semi diagnostic to see if it would at least help and thereby suggest some infection is going on somewhere, if it's full of sucrose how the heck is it supposed to help lower the numbers sigh. good grief. She's fired, I'm gonna take him to Sue as soon as she can get us in. Meanwhile.. what do I give him tonight? he's been red and black forever it seems. dosing time in half an hour
 
Re: 3/10 Rupert AMPS 502, +3,522,+6.5,514,+11, sucrose in a/

Oh- I now see your post about the a/b's.

It may be time to shop around for another vet.
 
Re: 3/10 Rupert AMPS 502, +3,522,+6.5,514,+11, 486 dose??

the urine sample was collected directly into a level 8 sterile container straight from the cat. yes, he peed in the bottle. just FYI. not that I"m going to bother sending it in on monday anyway.
 
Re: 3/10 Rupert AMPS 502, +3, 522, + 6.5-514, vet report

Azithromycin is very appropriate, if it's an infection, IMHO. My vet told me that they have had a lot of success using it for sinus/URI infections, particularly with herpes virus involved. Since Mr T was on it for 6 weeks, I got it compounded into a chicken flavored liquid after the initial 5 days, with no sugar...he loved it, and it was much less expensive that way. The sugar is not desirable obviously....if you can, I would ask the vet for a script and get it compounded. (Call around, prices vary widely, at least here in the US!) However, the medication is the important thing, the sugar will likely boost him a bit, but it in no way nullifies the benefit of the meds.

As far as I know, the pills are too high of a dose for a cat, so if you don't use the liquid, you will need to get it compounded.

I agree that some of the things the vet is saying are not correct, but the AB is very appropriate for an infection that is herpes related.
 
Re: 3/10 Rupert PMPS 486 question about clindamycin(left ov

from initial visit a couple of months ago, I have a bottle of Clindamycin, given to Rupert by locum vet that was there at the clinic the first time we went in.. to alleviate possible gum infection. it's for all sorts of dental 'issues'. It has been stored in the fridge since opened .... He did seem to improve a lot when on this. of course it's supposedly 'expired', vet says it's dead after 12 days (??). do you think I should use this as an interim?? of course this wouldn't address the possible herpes issue.
 
Re: 3/10 Rupert PMPS 486 question about clindamycin(left ov

Hey Pip, I'm so sorry Rupert is going through all this (and you, too!). But you've learned some valuable information tonight and at least you know now how to proceed. These "internet kooks" on FDMB really know their stuff! There is so much collective experience here. I hope you can find a vet you can work with.

If in doubt about dose, give what you have been giving at AMPS. There are a lot of variables in the mix right now and if you will shortly begin medications, they will probably have to be taken into account with regard to dosing. At least if you start from your present dose, you will have a baseline.

Thinking of you and Rupert and hoping that a plan of action can be put together soon.

Ella & Rusty

p.s. just saw your question about clindamycin. If it is expired, I don't think I would use it.
 
Re: 3/10 Rupert PMPS 486 have clindamycin(left over) use??

have you already shot, pip? if not, yes, we're thinking increase by .25u and just make sure you get a test at +2 so we see where it's going.

i'm SO sorry you're having so much trouble with this. we're all cheering for rupert and you. you're doing great.

if you've already shot, then do the increase in the morning unless there is a significant change.
 
Re: 3/10 Rupert PMPS 486 have clindamycin(left over) use??

I shot what I would call a f1.5 again. just half an hour ago. will shoot true 1.75 tomorrow if met with the same numbers.
 
Re: 3/10 Rupert PMPS 486

Even if it is an infection, raising the dose is fine. The only thing to be aware of is that if you start an AB (and I wouldn't use an expired AB) and an infection is present, numbers can come down quickly once the AB kicks in.
 
Re: 3/10 Rupert PMPS 486

I'm sorry: I didn't realize there was a back-channel discussion going on with regard to a new dose. Good luck with the dosecrease tomorrow morning.

Ella
 
Re: 3/10 Rupert PMPS 486

I would bookmark this thread to read back through. You've been given a lot of great info. I'm glad you are considering another vet. This current one is not doing what is needed.

Regarding weight loss, Maverick's story is in my signature. He almost died on me because a vet suggested he lose weight and switch to a lower calorie food. I spent six thousand dollars on emergency feeding tubes and repairing the damage due to botched placement (PEG tube, not etube) and another surgery. It was pure hell. One thing is that once you have a cat recover from Feline Hepatic Lipidosis (Liver failure due to weight loss) you tell everyone about it so they avoid ever dealing with it. Read Maverick's story. Safe weight loss in a cat is one that is closely monitored with a baby scale or a shipping scale (cheap on amazon) that weighs to the ounce and no more than 1-2% a week, with periods of maintenance to give the liver a break.

Forums saved Maverick's life, not the vet. They armed me with info to be his advocate and get the courage to talk to and fire our bully vet and keep looking until we found a new one. Forums like FDMB are experts on diabetes. A vet may see a handful of diabetic cats (the ones that aren't euthanized) - this forum helps thousands. They live and breath diabetes. You are in good hands.

You are doing great looking out for Rupert and getting him the care he needs. Hang in there.
 
Re: 3/10 Rupert PMPS 486

hello :cool:

I'm adding my voice to the "time for a new vet" chorus. . .

Pip & Rupert said:
teeth seem okay. mild gingivitis,
Click to expand...
BK had his 1st dental, with a dental specialist, on 12/08/2008, I think there were 8 extractions done -- several resorptive lesions.
No complications. And the results - have a scroll down his ss, from there to about mid February 2009 - on our way to regulation we were!
Down to 3u - from 13.5! Life was good.

Then pink started to creep back into the picture and by April we were seeing red. By early May we were back to 5u.
I was seriously bummed, to say the least. Figured it was his IAA . Oh well. The dream of regulation was nice while it lasted.

Then one day I happened to be just at the right place to catch one of those BIG kitty yawns - son of gun - there was a ring of red right up around one of his remaining back teeth.

It had only been 5 months since the dental - it never occurred to me that gingivitis would be an issue so soon. Silly me thought after the major dental we were good for a year. Back to the dental specialist he went on May 29, 2009.

He had a cleaning - and the rest is history. :mrgreen:

Pip & Rupert said:
She suggested he might need different insulin
Click to expand...
Oh yeah, wish I had a dollar for every time a vet told me that. . .
 
Re: 3/10 Rupert PMPS 486,+2, 457

thanx for the info everyone. Rupert definitely going in on Monday, if possible. to dental vet. or at least I will talk to her on the phone and formulate a plan.

looks like Rupert is getting a dose increase tomorrow. will check at + 5 just before I go to bed. thanx for everything, everyone.
 
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