3/14 Sasha AMPS 440 +3 269 +6 339 PMPS 262 +261 +4 181

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Sasha&Tara

Member Since 2012
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=66104

Goodmorning everyone!!!!!

Woke up again to him stepping on my head and acting normal. :-D

Wasnt able to get a ketone test in, but will try later...

Ate his Wellness Turkey this morning, but I had to spruce it up a bit, he's getting sick of the turkey.

Okay I'm running a little late, so I have to go, but I will be home at lunch to retest!!!


I'm posting his blood work, havent been able to figure out how to attach it to a SS yet. Forgive me if its messy, I will clean it up later on. But wanted you guys to see it, So this blood work was takenthe day I took him into the ER hospital because he wasnt eating the night before and looked awful. It was DKA, but I'm sure you can see more than I can as this might as well be another language to me. He was in the hospital for 5 days before he came home, and then he got ketones again 5 days later...

Sasha's Labwork
2/26/2012


hct^M 40 29-55 mmol/L
Na+^m 146.1 137-155.0 mmol/L
k+^m 3.93 3.50-5.10 mmol/L
CI-^M 115.5 107.0-120.0 mmol/L
pH^m 7.093 7.350-7.450 mmol/L
SO2% ^M 67.6 30.0-100.0
PCO2^M 27.4 35.0-45.0 mmHg
Glu^M 373 65-110 mg/dl
BUN^M 40 7-25 mg/dl
LAC^M 2.7 0.3-2.0 mmol/lL
Ca++^M 1.1 1.00-1.50 mmol/L
Mg++^M .59 0.35-.0.55 mmol/L
Creat^M 1.1 0.6-2.0 mg/dl
Hb^M 13 10.0-19.0 g/dl
A^C 116.5 mmHg
HC03-^C 8.5 mmol/L
BE-ecf^C -21.6 mmol/L
BU/Cr^C 35.4 mg/mg
Ca/Mg^C 1.9 mol/moL
nMG^C 0.57 mmol/L
O2CAP^C 18.1 ml/dl
Osm^C 315.8 mOsm/kg
BE-b^C -19.4 mmol/L
SBC^C 10 mmol/L
Gap^C 26.2 mmol/L
nCa^C .95 mmol/L
BP^M 760>26 mmHg


Zoasis Superchem,CBC,Total T4
2/27/2012


Total protein 7 5.2-8.8g/dl
Albumin 4 HIGH 2.5-3.9 g/dl
Globulin 3 2.3-5.3 g/dl
Albumin/Globulin Ratio 1.3 0.35-1.5 Ratio
AST (SGOT) 293 HIGH 10-100 U/L
ALT (SGPT) 432 HIGH 10-100 U/L
Alk Phosphatase 89 6-102 U/L
GGTP <5 1-10 U/L
Total Bilirubin 1 HIGH 0.1-0.4 mg/dl
Urea Nitrogen 30 14-36 mg/dl
Creatinine 1.2 0.6-2.4 mg/dl
BUN/Creatine Ratio 25 4-33 Ratio
Phosphorus 4.3 2.4-8.2 mg/dl
Glucose 191 HIGH 64-170 mg/dl
Calcium 8.3 8.2-10.8 mg/dl
Magnesium 2.2 1.5-2.5 mEq/L
Sodium 147 145-158 mEq/L
Na/K Ratio 35
Chloride 101 LOW 104-128 mEq/L
Cholesterol 222 HIGH 75-220 mg/dl
Triglcerides 119 25-160 mg/dl
Amylase 332 100-1200 U/L
Lipase 38 0-205 U/L
CPK 117 56-529 U/L
Comment: Hemolysis 1+ No signifigant interference

CBC
WBC 25.5 high 3.5-16.0 10/ml
RBC 6.6 5.92-9.93 10/ml
Hemoglobin 6.6 9.3-15.9 g/dl
Hematocrit 34.6 29-48 %
MCV 52 37-61 fL
MCH 17 11-21 pg
Blood Parasites None seen
RBC Comment RBC Morpholgy Normal
Platelet Count 445 200-500 10/mL
Platelet EST Adequate
Nuetrophils 78 HIGH 35-75%
Bands 1 0-3%
Lymphcytes 8 LOW 20-45%
Monocytes 4 1-4%
Eosinophils 9 2-12%
Basophils 0 0-1%
Absolute Neutrophils 19,890 HIGH 2500-8500 /uL
Absolute Bands 255 HIGH 0-150 /uL
Absolute Monocytes 1020 HIGH 0-600 /uL
Absolute Lymphocytes 2040 1200-8000/uL
Absolute Eosinophils 2295 HIGH 0-1000 /uL
Absolute Basophils 0 0-150 /uL

comment: Blood smear reviewed by technologist
Total T4
T4 <0.5 Low 00.8-4.0 ug/dL


Comprehensive Diagnostic
2/27/2012

ALB 3.6 2.2-4.4 g/dL
ALP 46 10-90 U/L
ALT 419* 20-100 U/L
AMY 301 300-1100 U/L
TBIL 1.9* 0.1-0.6 mg/fL
BUN 30 10-30 mg/dL
CA++ 7.2* 8.0-11.8 mg/dL
PHOS 1.7* 3.4-8.5 mg/dL
CRE 1.1 0.3-2.1 mg/dL
GLU 323* 70-150 mg
NA+ 141* 142-164 mmo/L
K+ 4 3.7-5.8 mmo/L
TP 6.8 5.4-8.2 g/dL
GLOB 3.2 1.5-5.7 g/dL
HEM 0
LIP 0
ICT 0


TOTAL SOLIDS: 7.1 gm/dl
PCV: 40%
 
Re: Sasha AMPS 440

Tara:

When Sasha was diagnosed, was he eating? Some of his liver values are off. It's not unusual for a cat with DKA to stop eating well which can cause a liver problem (i.e., hepatic lipidosis or "fatty liver"). It will be very helpful to have Sasha's labs repeated once he's feeling better so you have a clear baseline.

(Also, can you put the date in your subject line?)
 
Re: Sasha AMPS 440

OMG Sienne! I didnt even realize I didnt put in the date :o No, he wasnt eating the night before that was 2/25, I figured he just wasnt feeling well and all would be okay the next day...wow, I was wrong!!! so i took him to the hospital on 2/26. Then he wouldnt eat in the ER hospital either... 2 days later 2/28 they gave him a feeding tube. Ok let me put in the date and I'll check back in a couple of hours!!! Thanks!
 
Re: 3/14 Sasha AMPS 440

Much better this morning than I thought he might be...I was afraid he would bounce into unmentionable numbers so looking good!

Thanks for the bloodwork. We can help with the "tab" but I also have to work today. Glad he is feeling normal!! WOOOTTT!!

Have a great day.
 
Re: 3/14 Sasha AMPS 440

Hi guys .. :o mocha can't believe sasha is getting tired of turkey .. mocha loves turkey! I don't have any understanding of the lab values but it is always nice to hear our kitties are acting normal :-D have a great day!
 
Re: 3/14 Sasha AMPS 440

Thank you Marje- yeah I was afraid I was going to wake up to him off the charts!!!!! I cant believe I was relieved to see him in the 400's!!! But he is looking and acting like his crazy lil self so I am psyched!!!

Devon, tell Mocha to tell Sasha that Wellness Turkey is YUMMY and GOOD for him!!!! He is making me jump through hoops to get him to finish it... lol, and of course I bought those HUGE cans of it!!! lol... I'm going to have to switch the flavors up again!!!Thanks for the support :-D and hug Mocha for me!

I just wanted to add this real quick. This was the diagnosis when they sent Sasha home with on 3/1/2012. I just got this paperwork a couple of days ago...

Diagnosis:
1. Diabetic Keoacidosis (DKA), resolved
2. Pancreatitis
3. Diabetes mellitus

DKA, resolved
Metobolic acidosis-r/o DKA vs other
Hyperbilirubinemia, improved-r/o pothepatic (pancreatitis vs other) vs primary hepatic (inflammation vs infection vs Neoplasia vs other)
Elevated ALT, improved-r/o reactive vs primary hepatic inflammation vs infection vs neoplasia vs other
Left shift nuetrophilia-r/o inflammation vs infection vs other
Eosinophilia-r/o allergy vs parasites vs other
Protienuria- r/o spurious vs inflammation vs infection vs renal vs other
Hypophosphatemia/hypokalemia, resolved- r/o electrolyte shift vs other

Ok, Hope everyone's having a great day!!!I'll be back!
:-D
 
Re: 3/14 Sasha AMPS 440

It's amazing what a little perspective will do for you. A 440 AMPS all by itself looks ugly, but knowing he's bouncing from great numbers last night, plus all he's been through, makes it look almost like a relief. Add a good WCR, well, today earns a smile. :-D Clear that bounce now Sasha and let's see what you can do.
 
Re: 3/14 Sasha AMPS 440 +3 269 +6 339

Thanks Linda!!! I have yet to get a ketone test in today... I will be stalking him when I get home from work!!! I stopped home for 10 minutes on my lunch and found a note from my sister in law there . She refers to him as her "Godson" and was there with me when he was first diagnosed. She learned with me how to take his BG and give him shots. She had the day off today and stopped in to check on him. She took his BG at +3 and made sure he ate his Wellness after. :-D
 
Re: 3/14 Sasha AMPS 440 +3 269 +6 339

:lol: :lol: :lol:

celi & binks

funny-pictures-cat-wants-turkey.jpg
 
Re: 3/14 Sasha AMPS 440 +3 269 +6 339 PMPS 262

PMPS-262

Oh Yeah :cool:

Happy to see Sasha didn't end up in outer Mongolia after the steep dive last night.
And a nice recovery :-D

This is the lowest PS you have shot at the current Lantus dose - make sure and get your +1 and +2. . .

Is he still chowing down?
Any recent ketone reading?
 
Hey Sandy! :cool:
He's eating alot...actually he's eating as we speak. Went through almost an entire big can of wellness today and a whole can of Merricks food... He's now at 181 +4 hours on Lantus!!! But now since his numbers are lower (which is awesome), his trips to the litterbox are less frequent. Since I've been home I've been running up and down trying to get my laundry done- and I missed him in the litterbox :-x I"ve gotta go to sleep soon, I wish he'd just pee already!!!! I am going to be up really early in the AM... If I wake up tomorrow to a low number like 250, should I reduce his dose??? I never know what I'm going to wake up to these days, and I hate leaving him alone. nailbite_smile I'm not sure I'm going to be able to come home on lunch to check on him tomorrow...my boss has me booked up. ughhhhhh

Have a great night!!! :razz:
 
I think it's important that you get a few sleep tests in this cycle, especially a +11.
That +11 can go along way in helping you get a feel for the direction things are headed.

Dose? under normal circumstances I would say stick with the TR protocol guidelines and wait for a signal that a reduction is warranted.
However these are not normal circumstances - you raised his insulin dose, temporarily, to get him through a crisis, which is now abating

I need to consult with the oracle ;-) :cool:


Your +11 will be 5am eastern, correct?

I'll post back here before turning in.
 
DKA, resolved
Metabolic acidosis-r/o DKA vs other
Hyperbilirubinemia, improved-r/o posthepatic (pancreatitis vs other) vs primary hepatic (inflammation vs infection vs Neoplasia vs other)
Elevated ALT, improved-r/o reactive vs primary hepatic inflammation vs infection vs neoplasia vs other
Left shift neutrophilia-r/o inflammation vs infection vs other
Eosinophilia-r/o allergy vs parasites vs other
Proteinuria- r/o spurious vs inflammation vs infection vs renal vs other
Hypophosphetemia/hypokalemia, resolved- r/o electrolyte shift vs other
Click to expand...

When the dust settles, you may want to post on Health and ask if anyone has any vet recommendations in your area. That is the most dumbass discharge list of things I've read in a while. That might make sense in terms of what they were looking for when Sasha was admitted. The point of having him in the hospital is to figure all of that out and intervene accordingly. Metabolic acidosis is due to the DKA -- basically, Sasha's blood pH was off. From the labs, it's likely that there was something going on with Sasha's liver. If he hadn't eaten well in 3 days, so that's no surprise. (They should have intervened earlier at the hospital.) The phosphorus and potassium values (Hypophosphetemia/hypokalemia) are off due to DKA.

Did they do an ultrasound? Do you know if they sent out labs in order to get a spec fPLI to diagnose the pancreatitis. Typically, if they are trying to determine liver involvement, labs are sent to TAMU (the vet lab at Texas A & M).

Enough of my criticizing your vet. I'm really liking that blue number!!
 
Sandy :cool: Thanks you're the best! The "oracle"lol ... I love it! Yeah, I'm going to be waking up at 4:45 AM, so I'll be able to get a +11 in for sure!!! And hopefully be able to get a ketone test before I leave for work... he is looking great today though, I gotta tell you!!!!!!! Back to his old tricks and I'm lovin' it! Thanks again!!!
 
Sienne, You can criticize that vet all you want!!! lol... because it happened on a Sunday, my only alternative was to take him to this place. His regular vet was okay up until now, but now that things went haywire I'm REALLY starting to see how little Sasha's regular vet knows about diabetes. I am going to look for a new vet. All of the Lab work was done "in house". Sooooo, nothing went to Texas!!!! I am definitely taking him to a different vet next week for a visit. I will take your advice and post in Health...gotta find this little guy a vet who knows what theyre talking about!!! Have a great night! See you tomorrow!!!!
 
We will just have to see how this cycle plays out - Sasha is definitely changing - for the better :cool:
Maintaining the food/insulin/hydration balance is key.

your supply of HC stocked?

Sasha&Tara said:
Yeah, I'm going to be waking up at 4:45 AM, so I'll be able to get a +11 in for sure!!!
Click to expand...

I'll meet you back here after your +11 ~O)
 
Thanks everyone!!!!!Thing are changing quick...lol, stay tuned to this morning's condo....hugs to you all!!!!!!!!!!!
 
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