3/17 Cain Question about insulin dose times

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Jennifer&Cain(GA)

Jennifer&Cain(GA)

Member Since 2013
Hello!

Previous condo

I took Cain in to the second vet to see what she thought of Cain's new issues and while she said I did a good job bandaging the feeding tube, he did have Hepatic Encephalopthy. She also thought the splayed legs and whatnot was due to low potassium levels. His levels were fine at the beginning when my vet did the blood tests but by now it's probably pretty low. And the lack of seeing where he was in his brain chemistry due to the liver causing issues. She said he could still see. He was hobbling around my leg at the vet office while I was waiting on her. Cain's down to 13.12(?)lbs from 14.50lbs earlier in the week. I wasn't sure exactly on the last part of the weight. I asked her specifically if she thought he had a chance, and with hospitalization and fluids, she thought he had a good chance. Things can always go pear shaped but there's a good chance of him making it if he gets the fluids and other meds he needs. If I couldn't get what I needed from my regular vet (who is taking care of the after care) she could take him on but since I'm new I'd have to try to arrange something with them. But she figured my vet can take care of it.

So off I went to my regular vet. He's on an IV drip with potassium and cobalamin (I think maybe cyanocobalamin), a different antibiotic (ancillian or something like that), b12 (unless that's the cobalamin), cerenia, and baytol? I'm doing this from memory. I looked at the chart before I left the clinc after changing Cain's bandage. He's getting fluids definitely and getting fed. However they don't have as full time at night, so I might be shuffling him back and forth to get fluids during the day (they're trying to figure out something for me at night) and I'll keep him home at night to feed him with how frequent he needs it. I'm the one changing his bandage (I wanted to) but I started this stuff early this morning and so he doesn't have any insulin. I can give him some when I get home but I pretty much woke up, got dressed, stuffed him in the carrier, and I'm finally home after running some quick errands.

Marje, I have a copy of the labs. This blood draw was from last monday I believe so some of these values are probably different.

Shoot I forgot to ask if he needs to draw blood to do any tests.

I did ask the first vet I went to this morning about zofran (ondansetron) and I think they don't want to prescribe it due to sheer cost. She was saying generic is $400. She told me she didn't use it for her self when prescribed at one point due to cost. I do wonder how much the costco about 50mins away costs on it. She also didn't want to interfere with whatever my vet would prescribe. I didn't get to ask my vet yet but I was dropping Cain off so he can get some needed fluids and meds. And tell him what the other vet thought.
 
Re: 3/17 Cain Back in the vet hospital

(((Jennifer)))

I can't say that I'm surprised. I'm glad that the vet is optimistic. That's huge.

Let me suggest you take notes when talking to the vet. It's so easy to get overloaded given how emotionally difficult it is when your kitty is sick. Don't hesitate to ask the vet to spell things or to explain the reasoning behind what's being done. If the vet gets exasperated, tough. Let the vet know you want to understand what's being done so you can follow through and give the vet the feedback on how things are going.

I suspect the antibiotics are either amoxicillin or ampicillin and the other antibiotic you mentioned was Baytril.

B-12 is actually a collection of compounds that are, as a group, called cobalamin. Among the several B-12 compounds are methylcobalamin and cyanocobalamin. For Cain to be getting cobalamin means that he's getting all of the B-12s in one vitamin. However, in many cases, when B-12 is being referred to what's actually meant is cyanocobalamin (which eventually breaks down into methylcobalamin).

I also want to encourage you to be Cain's advocate with your vet. Push for what you know he needs. Make sure YOU understand because you know we'll be asking lots of questions.

You can create an additional page for Cain's SS and put the labs there. There should be a + sign in one of the corners of the SS. Clicking on it will add a page. If you look at Gabby's SS, you'll see how I did hers.
 
Re: 3/17 Cain Back in the vet hospital

I'm glad they checked him in and are moving things forward with his care...and that they say his prognosis is good! Our prayers continue!!!
 
Re: 3/17 Cain Back in the vet hospital

Hi Jennifer,
We are continuing to send prayers and vines and are thinking positively.

Here is a link to the prices of Zofran/Ondansetron on Canada Drugs Online, a reputable Canadian online pharmacy that I have used when it was still possible for them to ship insulin across the border (Canadian online pharmacies no longer ship insulin because of the refrigeration requirement). None of the prices is anywhere near $400! Perhaps you could insist that your vet give you a prescription so that you can at least get some. The bottle that Rhiannon is sending you should carry you through until you can get a prescription filled.
http://www.canadadrugsonline.com/DrugMoreInfo2255.aspx

Did the vet talk about doing fluids at home? Marje made a terrific video and can also walk you through the process:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=75933

Thinking about you. Hang in there!

:YMHUG: :YMHUG: :YMHUG:

Ella & Rusty

p.s. Do you have a smart phone? If so, you may be able to record memos on it so that you will have a spoken record of what transpires at the vets'. On the iPhone the voice memos app is on the Utilities tab. I'm sure that all "smart phones" have this capacity somewhere in their programs.
 
Re: 3/17 Cain Back in the vet hospital

Jennifer:

I am so glad that you asked about Cain's chances and got a positive response! It's so much easier to move forward if you know improvement is possible. It's good that he's getting the IV fluids and meds he needs.

I also have some Ondansetron I could send you if you need it. They are 8 mg tablets - I'm not sure what the correct dosage is for kitties, but I'm sure you can break them down. I have eight tablets left, so that should last a while. You can send me your address by PM if you want me to send them to you.

Sending lot of healing vines and hugs! You and Cain are still in my prayers. Hang in there!!! :YMHUG: :YMHUG: :YMHUG:
 
Re: 3/17 Cain Back in the vet hospital

Paws crossed for Cain, and hugs to you. You are doing the bestest a bean can do. :YMHUG:

We get the Ondansetron (Zofran) for Zener from Thriving Pets. They fax the order to our vet, and she sends back the prescription, it is quite easy for our vet to do this. Her practice is no longer carrying a lot of meds because of how expensive things are and patients can get them even cheaper online, so she is fully on board with doing this with mail order vet pharmacies.

This is the link to the med on thriving pets:
http://www.thrivingpets.com/index.php/o ... ofran.html

The 4mg tablets are 1USD each (and 80 cents each if you order 30 or more). Zener gets 1mg twice a day (about 30 minutes before AM and PM shot meal), so it costs us 50 cents per day (40 cents actually because we order more than 30 at a time) to use this med.

We are keeping paws, whiskers, tails and everything else crossed for Cain.
 
Re: 3/17 Cain Back in the vet hospital

(((Jennifer))) Sending all sorts of good wishes to you and Cain today. The news from the second vet sounds positive. Thanks for the update. :YMHUG:

I second the suggestion for recording the conversation with the vet. I've got the iTalk Recorder app on my phone and I ask the vet but usually start recording as soon as we start talking. And I also ask for spelling of new terms. On a side note, I've also recorded Neko's purr on the phone - it helps me if she's away at vetty for the day.
 
Re: 3/17 Cain Back in the vet hospital

I typed the lab in. I think I fell asleep twice while doing that. I should take a nap soon. I got about four or five hours I think. I-) I wanted to get him in first thing. Thanks all for the vines and hugs.

Sienne, funny thing is I wrote everything down that I could remember for the first visit (at the second vet today) then I for some reason didn't for my regular vet. ohmygod_smile I didn't even think to take a picture of the chart with the meds written out so I could write it up later. That's what I'm doing when I go back at 5pm.
Thank you for explaining the medications and you're right. If I know what it does, I can argue for it better. And explain it to y'all. :-D

Ella, when she said that about the cost I wonder when she looked last. Prices do come down over time. Though there is an antibiotic that I'd would love for it to come down in price more if I get prescribed it again for me personally. :) Thanks for the link! I do have a smartphone now. I have a Windows phone but I'm sure it's on there somewhere. Time to go digging.

Anne, I think I missed that link before. It sounds familiar. That doesn't sound so bad! I will ask if my vet will work with them.

Tricia, thanks :)

Wendy, yes she sounded positive enough that I decided to push forward. Plus he was stumbling around and meowing in the carrier so I know he was perking up some.
 
Re: 3/17 Cain Back in the vet hospital

Sending prayers for cain. I am glad that the second vet sounds positive for Caine. I think that was a great that you took him in at this point with all the issues you are facing.
 
Re: 3/17 Cain Back in the vet hospital

Piling on positive thoughts and healing vines for Cain. I hope he feels better soon.
 
Re: 3/17 Cain Back in the vet hospital

I'm glad your vet is optimistic. Keep thinking positively. :YMHUG: I hope you gets some sleep because that will help you.

When J.D. first got Ondansetron, I paid $33 for 10 pills at my local grocery store pharmacy.
I now use the Costco Pharmacy (you do not have to be a member to use their pharmacy) and just recently paid $29 (including tax) for 90 pills. That's a difference of $3.30 per pill at the grocery store to less than $0.33 cents per pill at Costco. And they are the 4mg tablets, so you split each pill into quarters and that makes it $0.08 cents per dose, if you can get them from Costco. The 90 pills that I bought at Costco will last J.D. for more than a year, for $29.
 
Re: 3/17 Cain Back in the vet hospital

Hi Jennifer,
I am so glad that the vet feels positively about Cain's recovery!
And I am happy that hear that he is perking up a bit. :-D

Sending continuing healing vines to Cain.
And more :YMHUG: :YMHUG: :YMHUG: to you!
 
Re: 3/17 Cain Back in the vet hospital

Aww you guys. :YMHUG: :YMHUG: :YMHUG: Hugs for all!

This time I took a picture of his chart. And I had a notepad handy with pen! He's been given Ampicillian, Cerenia, B12, Baytal. The IV had B complex, potassium (KCl), saline of course, and he had 350ml of it today. Cain will go back in tomorrow at 8 and stay there all day to get more fluids again. They have him on a heating pad and towel while he's getting the IV fluids. The vet staff noticed Cain's leaning his head against the wall of the cage he's in. Like he's been doing at home.

So far the vet is flushing out the toxins and helping restore lost vitamins and potassium. He didn't have any lactulose on hand which is what I read used to help Hepatic Encephalopathy. I'll ask about blood work should be done to make sure it's Encephalopathy. I'm going to read up on it some more. I asked about it. I do worry though since it's a sugar solution and while the Wiki on it says it can be used for human diabetics, I think it's dangerous for diabetic cats?

Cain got another Ampicillian shot, Famotidine shot, and a Dexamethysone shot. (I asked how that was spelled. I think I got it right.) Which is a steroid he said. Cain's definitely going to have deal with insulin for a bit huh? My vet felt Cain's bladder and managed to get him to go a bit since he hadn't urinate while he was there. The urine was a vibrant yellow, but no where near the dark yellow I saw this past weekend. Cain went again on his towel nest which looked just like the yellow I saw in the office. I should invest in pee pads I think. Though I always have to run laundry every day anyways here.

Cain unfortunately did not get as much food as I hoped for today. Between my shuffling him from vet to vet, there was four hours between feeding, and I accidentally took home the syringes I use for food, and well he wasn't fed until I got him back home. I am feeding him every two hours of 15ml of A/D, and since it's about day 4 now, he's on to 20 to 30ml of A/D every three hours next food time. Cain's been great about keeping the food down. I'm being careful about upping it though since he didn't get as much food today. I was told to give him some pedialite tonight as well, just a few ml when I feed him to help with electrolytes since he's home and not at the vet.

I do have a question though. Since he's at the vet during the day, I'm trying to figure out a good schedule to give his insulin. I'm going to give a shot in an hour (midnight), and I can go in at noon to change his bandage, check on how much he's been fed, pet him, and give him another dose of insulin, and what not. Should I have the staff check his BG like I would or should I pop in three hours after the shot to check? Though with what all is going on, I doubt he's going to drop much.

And really! I didn't realize ondansetron was so cheap. There are several on the pancreatitis list that is chiming in on the cost as well. I just need a prescription now. I am bringing in the printout that the pancreatitis group has in their links.

Thank you all for the hugs and help and vines!
 
Re: 3/17 Cain Back in the vet hospital

Jennifer

His kidney levels look good :-D as of the report you have posted, his potassium is find so I wonder if it has now dropped? His liver enzymes are over the top and that is reflective of his FHL.

I've for some denamarin I can send you. I'll PM you for your address. It really helps support the liver but you have to be able to get it down him. You can't cut the pills.

Is there not an ER in town where he can stay overnight?

Sending prayers and vines. I hope you can get the script for the ondansetron. I also buy it at thrivingpets,com.
 
I'm glad his pee is more yellow now.
I have used Lactulose for J.D. for constipation before and it didn't seem to alter his BGs. I think others have used it too. Try putting Lactulose in the Search box of FDMB and see what matches you get. It is a different kind of sugar, so may be okay for diabetics.
Sending you more hugs. I hope he is eating well, and that you get the Ondansetron.
I think the schedule of 12:00am/12:00pm sounds okay, if the vet hospital will test him or you can test him 3 hours later. It's what works best for your schedule. If you gave him some insulin at midnight last night, I just wouldn't give him any more any earlier than 12 hours after that.

Hugs.
 
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