3/15 Logan AMPS 335/PMPS 354

Status
Not open for further replies.
Kelly & Logan

Kelly & Logan

Very Active Member
Yesterday:
viewtopic.php?f=9&t=9176

Logan is still not eating well. His internist emailed me on Friday evening but I didn't get it until this morning. This is her email:

Kelly,

I had the chance to speak with Dr. Dilillo yesterday. She expressed to me that Logan does not seem to be improving. You are feeling very frustrated with his response to his insulin and also his desire to eat. I looked at his glucose results yesterday and saw that he was still quite elevated despite Saturday’s curve which appeared to be in the lower 300s. During the conversation, we discussed the idea of getting Logan on additional medications to control his inflammatory bowel disease and I think that it may be time. I would love to discuss this further. I am out of the office today and will return on Tuesday. You are welcome to call me on Tuesday or I will try to reach you during the day and we can further discuss these issues. I always depend on you to convey to me how Logan is doing and feeling. If he is not feeling well, we will need to discuss readjusting his medications which will likely include increasing his dose and adding in an additional medication. We can discuss and establish a plan next week. If you feel that he is doing worse and can’t wait until next week, he can always be evaluated by the emergency service.

Robin Hopwood, DVM, PhD, DACVIM


It doesn't sound like she's too happy with me. And increasing his pred dose is not an option! And exactly what would the emergency service do?! They suck! I have conveyed how Logan is doing and have expressed my concerns about his insulin resistance and lack of appetite several times. Since she's not available until tomorrow, perhaps my anger will subside somewhat so I can have a conversation with her w/o screaming at her. If she really wanted to discuss this, she would've called me on Friday and not emailed me.
 
Re: 3/15 Logan AMPS 335

"additional medications"....does that mean additional pred or something else?
Well Kelly, you do have today to think about it as you said.

What would you think if they prescribed some other meds for Logan? Do you have idea as to what else they would suggest or do you think it just more of the same....

His AMPS are on the low 300 side, but still, they are not coming down enough. I know nothing of medications and I guess all I can do is send HUGS to you and Logan...I am thinking of you both and I am feeling your pain and anger...take some deep breaths and you will feel better about talking with her tomorrow...
(my two have always had good appetites and since the dental, both seem to be "off" the FF that I am offering. I can totally reltae to one a small part of what you are going through with Logan...I know how upsetting it is when they walk away form the food they are supposed to eat right now...very frustrating. how many cans of stuff can you place before them...it gets ridiculous when they turn away....and that is only one part of what you are dealing with! I feel so bad that you are going through all this...)

You have come so far and done so much and now....well, you have to deal with whatever it is now. You can breathe and compose yourself and think about it calmly now. What would YOU like them to do? You know what you do NOT want...so build from that...all the things that you know now...
I always find that if I write things down it becomes clearer to me....
((((Kelly)))) thinking of you....
 
Re: 3/15 Logan AMPS 335

Pat, it sounds like she wants to add yet another medication (or maybe more than one) and also increase the pred. I do want to try other medications. There are options that have less of an effect on the BGs. The pred is making him (at least we hope it's just the pred) very resistant. His AMPS start out ok, but he generally climbs all day and is close to 400 at PMPS. I want him off of the pred. It's not controlling his IBD and it's wreaking havoc with his BGs. He's been on the pred since mid-Jan!!! At higher doses, he was throwing large ketones. Yet, she has a cow when I increase his insulin sooner than every 7 days. I will not let him sit in the upper 300s for 7 days w/o increasing. Granted, the increases don't seem to have much of an effect, but at least I'm doing something. We're working towards a dose that will have an effect.

I think we need to replace the pred and not add to it. If she's not willing to do that, then I'll find someone who is. I plan on talking with Dr D (reg vet) to see if she found out about us transferring. There is another internist there that I really want to talk with. I feel like Dr Hopwood isn't willing to work with me a whole lot. She takes it personally and as a vet, you can't do that. You have to do what's best for your patient. I have tried it her way for over two months and it's not working. Time to change.

Thanks for the hugs and kind thoughts, Pat. As always, we appreciate them!
 
Re: 3/15 Logan AMPS 335

Hi Kelly and my sweet boy Logan.
Sending words of comfort for getting through this really tough phase with Logan.
I also am not familar with the meds although I hear enough abou them.
What is the pred used for?

Does anyone have a good vet anywhere?? OMG what is with this profession.
I hope you get a chance to get some new eyes on Logan.
I think it's worth a shot, (I've been to 4 so far) but hopefully one will be right
on point.

Big Hugs for you and Logan - Max was asking if Logan is allowed to go to
Shadow's and Raja's party. You know he will take good care of him and
he is not even jealous when the girls fight to sit next to him. :-D
 
Re: 3/15 Logan AMPS 335

I'm certainly not a big fan of prednisone as it is likely what triggered Quincy's diabetes. But in his case, it's the gold standard as part of a treatment for lymphoma. Others know better than me, but it seems like there are more options for IBD, including budenoside. I can understand your being concerned of the prednisone trade-off in Logan's case. It really does seem like the cure is as bad as the disease for him. What I don't understand is why/if your vet would focus on treating Logan's IBD with something that could contribute to a potentially more dangerous condition (DKA). Seems like it's time for your vet to consider the whole cat here.

I find it encouraging that your vet is talking with others and emails you about Logan. Hopefully you'll be able to have a good conversation with her tomorrow. Maybe you could ask your vet to share what would make her give up on prednisone - e.g., what criteria or timeline (or both) does she have in mind before deciding to pursue an alternative form of treatment? Maybe focusing on goals or ways to measure success and then talking about ways (e.g., meds) to achieve those goals might be a constructive, different spin to take.

Whatever you do, I hope you have a good dialogue tomorrow, and I hope Logan feels better this week.
 
Re: 3/15 Logan AMPS 335

(((Kelly))) I wish I had an answer for Logan, but all I can offer are my warmest thoughts and best wishes for him. I sure hope the internist has some options for him that will help, and not just add more of the same meds. You have been through so much with Logan and are a super mommy. Best of luck.
 
Re: 3/15 Logan PMPS 354

Not too bad of a pre-shot. Logan has gotten so traumatized by the pilling that he's running away from us even when we're not trying to pill him. We're not giving him the ABs tonight or tomorrow morning. He's had over 5 weeks of them. I'll talk to his internist tomorrow. I will do my best to be civil! I'm determined that he will come off of the pred, though. We have to try something else.

Thanks for the warm thoughts, everyone. Logan is looking forward to the party Wed. He'll be ready when Max gets here to escort him! He loves hanging out with Max. Maybe Max can convince him to try some lower numbers?
 
You sound a bit more relaxed Kelly....hope tomorrow goes well. And by that I mean that they will tell you about another type of med to try. I totally understand how you feel. (you have tried it her way for two months now..) I agree that if you aren't seeing wonderful results you should try Plan B.

Will be thinking of you....poor Logan and the pilling. They don't understand when you say you aren't going to do anything...they run away just in case. Sweet Logan. Well, tomorrow should be interesting....we are with you Kelly! ((Hugs))
 
Re: 3/15 Logan PMPS 354

Kelly & Logan said:
Not too bad of a pre-shot. Logan has gotten so traumatized by the pilling that he's running away from us even when we're not trying to pill him.
Click to expand...

That's what started to happen to me with Quincy too when he was on antibiotics. There's no way I could live with that for an extended period of time. Quality of life can be diminished with psychological trauma too, and it sounds like multiple pills for an extended period of time with little gain elsewhere is a big negative for Logan, and for you. Hopefully if you have to give him another type of medicine, you can either get it in very small tablets or in gelcaps. I wonder if you go to a compounding pharmacy, if getting flavored gelcaps would help without triggering vomiting?

And as for those pill pockets, I meant to tell you they worked with Quincy for a short time. But then he bit into one, cracked the yucky tablet, and refused to eat them ever again. Even almost 2 years later, sans medicine1! And we're talking about Quincy, the eating machine.

Good luck tomorrow!
 
Oh Kelly I pray that you are able to come up with another solution to treating Logan's IBD and not compromise his BG's.. You are in my thoughts and prayers with Logan. :YMHUG:
 
Status
Not open for further replies.
Back
Top