3/26 Minnie hospital update AMPS 316, +2 272, +4 222, +6 206, +8 180, +10? 96, +12 130 Potass. 2.2

Look how well trained I am, including numbers the vet told me in the title even though there's nothing we can do! They are checking BG every 2 hours.

Question - Any recommendation on flavors for liquid oral meds? Minnie will be on Bezafibrate for the hyperlipidemia and there are TONS to choose from.

Copied from from last post, yesterday.
She may be coming home tonight. They said she's showing some "spunk" but no interest in food this morning - I had to ask (tell) them to give ondansetron and offer food other than the low fat prescription stuff. Going to start the bezofibrate for hyperlipidemia and not wait 2 weeks to see if low fat diet helps. Potassium still a bit low 3.2 (normal range 3.4-5.3) and will check ketones this afternoon. Discharge criteria is based on potassium and ketone levels. She's still on IV fluids and injection insulin, next R dose in about 30min from now (noon my time). They'll have an update at 4-5pm 'whether we can discharge her'.

Her BG readings overnight (theirs)
PMPS +4 348, +6 433, +10 400. AMPS 316
potassium last night 2.1, this morning 3.2

She's being looked after by an ER specialist who fortunately she spoke to the internist [because "this seems to be a high level case, you seem to want a high level of care" - this did not endear me to her, no need for that!] - but GOOD because internist emphasized the need to continue insulin (unluckily internist only works Mon-Weds at least available to them for consult). Also good because (I can't believe this) they missed the need for ondansetron.

She asked if I wanted to think about Minnie getting a (permanent) feeding tube to avoid future hospital stays so I can get food down her next time this situation arises. I listened and asked a bunch of questions and said no, not needed right now. Her appetite is FINE except when she gets ill from the increased ketones.

 

All fingers, toes and paws crossed here that Minnie passes her numbers check today.

Neko liked chicken flavoured liquid bupe, she preferred the one described as "chicken soup" flavour to the one called "roasted chicken". I think it was Paula who got bacon+marshmallow meds? Does Minnie have a favourite food? Or special treat flavour?

 

Thank you! I emphasized a LOT that they should not worry about her BG numbers for discharge. She is so close with the potassium that I'm hopeful. Pretty frustrated that they did not try harder to get her to eat but hopefully I've steered them the right way. I TOLD them last night she didn't like DM but they just won't listen. And reminded them that the internist said low fat food was going to have mediocre results at best so they should not worry about giving her low fat food while she's in there, just get her eating. It is weird feeling that you have to educate doctors on things that seem so basic.

Thanks for the tip. I'll start with the chicken one - we'll have plenty of opportunity to try them all I suppose! She likes the Tiki chicken food.

Minnie does not have a favourite food - it's either healthy Minnie likes "everything" or sick Minnie likes "nothing". And she has no interest in any of the low carb treat I saw recommended here EVERYTHING. Purebites, Bonita flakes, Stella & Chewy, Origen. though brother Sammie loves them all. She used to like kibble - I got a free sample of YoungAgain, before I saw there is zero tolerance for kibble with TR (is that still applicable to her by the way?)

(sorry long essays, seems to be part of my coping mechanism! also killing time for the next 4 hours)

 

Isn't the YA pork based? And yes on the no kibble for TR. It's a matter of how long it lasts in the system compared to wet/raw food, and the answer is considerably longer. There has been no TR research with dry food, and since TR is already somewhat aggressive, we don't want to remove any of the safety mechanisms. If you think it'd help, you could crush a piece and sprinkle it on top of her food as an enticement, just not the main food.

 

((((Liz)))) Sending huge healing vines and light to dear Minnie. Hope her potassium goes up and ketones come down and she eats.

I have so much sympathy for vets. I know there is a mental health crisis in the veterinary community right now that is very dire and sad. But some of them seriously need a course in people skills, for the sake of themselves as much as their clients. "You seem to want a high level of care" is a totally unnecessary comment. Who doesn't want the best for their pets? Why would a medical professional provide anything less than that? They should be so lucky to have someone as knowledgeable as you guiding them in your cat's care.

 

Yes. Anyone who has their cat at the ER wants the highest level of care... although, having said that.... I have seen people at the ER vet who have had to go away because they didn't have the cash/credit to pay up front the estimated charges. Yes to what Katherine said about the mental health crisis in veterinary medicine. Apparently vets commit suicide at a very high rate. I was just talking to a vet school student who is a friend of mine about this yesterday asking her about this. It's a very high stress job and they get a lot of ugliness and rude/horrible people being nasty to them all the time. A lot of reasons. And they come out of vet school hundreds of thousands of dollars in debt, literally. And she said new vets make only about 60-70 K so they pay more on their loans than a mortgage. Some of them know they will never pay that debt off. And lots of other factors we talked about.

 

@Wendy&Neko I am so impressed by your knowledge and memory with every single one of your posts! I actually look for your responses on the entire list of threads just to read what you say, for all the kitties.

Just checked ingredient list of YA, yes pork is #1 ingredient then chicken fat. She's never had it. The kibble they used to love as a treat was the w/d which is now contraband on top of the fridge, waiting to be donated. They also used to like the Trader Joe's treats. Basically they seem to like crunchy things and the freeze dried stuff was of zero interest to her. I was thinking of using the kibble as occasional treats if needed, or like this situation where she's not eating.

Bezafibrate is ordered. Those flavor choices are insane but I stuck with plain old chicken.

 

LOL I just wrote a long response about vets and decided not to post it. I do appreciate the vets, especially our primary vet who is great - but alas they are not specialists. However I have also spent more on Minnie's health this year than I want to think about. This is hospital stay #5 in under 12 months. When the receptionist collecting payment said "You're free to go" I had to joke... that's the only thing you're not charging for!

 

My post was not an invitation to criticize veterinarians but to simply point out that some exercises in empathy could benefit the vet as much as the client in these intense situations. Kindness goes a long way.

 

I'm so sorry to read what you're going through with Minnie. I hope she is on her way home soon. Sending her a tonne of vines and prayers.

 

You’re free to go! That was a quick one, Liz. Is Minnie home now then?

 

(((Liz))) I am just catching up on all that has happened with Minnie.
What a time you have had. You must be exhausted.
Sending many strong Aussie vines to Minnie. You are an amazing mamabean!

 

Ah no...I was free to go after they took the full amount of the low estimate. Minnie was very much NOT free to stay.

I just talked to the dr and unfortunately she doesn't come home tonight...this is like the opposite of winning at slots in Vegas. I can hear all the coins dropping though.

She is stable but not interested in food. Serum ketones down to moderate, potassium unfortunately back down to 2.1 so they have increased IV potassium and added Magnesium and brought it up to 2.2. We discussed Mirtazapine - they only have tablets which are 1/4 tab every 3 days. Going with that (instead of me taking our transdermal) since she said tablets seem to have high impact at first dose which tails off over the 3 days. Hopeful she just needs to get that appetite kick started. Plus bonus, it's time for her cerenia and ondansetron. Holy trinity of "make Minnie eat".

Of significance to this group...her BG got into blues this afternoon ON THE VET READINGS which seemed higher than my Freestyle. No R since 6am. Obviously this is without food but still...makes me hopeful we are getting closer to the right levemir dose (oh by the way, am I the only one stunned that this is $25 OTC at Walmart vs $120 on Rx at Costco?? Thank goodness I made a trip to Walmart for some more sharps containers and thought to ask about R)

I am hopeful that once she is home from this little escapade we may (anti-jinx) turn the corner, adding the cholesterol meds. Then I will be tearing my hair out with the drama of pj parties. That cat!!

Thank you! I am still in my pjs and it's gone 6pm...oops. I think stubbornness is one of my core competences.

 

Bummer Minnie is still camping at the vet another night. Eat girl, eat!!

Nope, that's why we suggest going to Walmart.

 

Prayers for Minnie , she's such a beautiful kitty. I hope she starts to eat ♥

 

I didn't have time to check here before going in - I went in for all the other cheap supplies so I asked the pharmacist there for insulin price. My jaw hit the counter.

 

I get mine at Wally World too! I’m sorry Minnie is still at the vet but I wouldn’t want to have her come home until her electrolyte imbalances are corrected.
I have used Renal K powder at home as a potassium supplement... you need to go that route?

 

Minnie is like the Six Million Dollar Cat minus the “bionic implants.” I’m thinking of that old television show ... which probably nobody here even knows.

Seriously though we all need to chant Eat Minnie Eat or something!

sending eating vibes (oops it’s vines isn’t it ?)

 

Neko got potassium gluconate powder to up her potassium.

 

HA I have called her the 6 million dollar cat!! And also I used Eat Minnie Eat as the password for the Freestyle Libre website after the week+ hospital stay where they threatened a feeding tube!

I have about 1/3 tube of potassium gluconate gel from a previous hospital stay and she'll likely be on that a couple of weeks after coming home. My kitchen now has as much in it for cats as humans.

Got a last update from hospital tonight, Dr is encouraged. Full notes copied from my s/s here

1145pm update Dr Frasier: K slightly better, increased supplemental K a little over Kmax & monitoring heart rate hourly. Gave oral K pill. She "sneaked a little food" after syringe feeding. Skipped Levemir dose due to low BG but will give R as needed - it's rising after the food. Clinically doing better. Recheck ketones in morning. "Encouraged". Possibly home tomorrow depending on K, eating & ketones.

 

Its good to hear Minnie is doing better, we keep her constantly in our minds and pray she gets better as soon as possible

 

QUOTE="Wendy&Neko, post: 2767749, member: 5773"]Neko got potassium gluconate powder to up her potassium.[/QUOTE]
Yes! That’s what is in the Renal-K powder, potassium gluconate. Available at Chewy.com for $21.22. It has poultry liver and some fish to make it palatable (but Minnie can be picky). It comes in a gel form too that has some extra stuff in there like folate and cyanocobalamin (B-12).

we are probably getting ahead of you/Minnie. Oh wait.... I just read you have the gel already. Now you are ahead of me!
I’ll be watching for Minnie updates today!

 

Hey!!! good evening report last night!!!

 

Good to hear the positive update.

 

Hi Liz! Any new reports on Minnie today?

 

Hi! Thanks for checking in. I will do a post for today. She's still in while they work on balancing potassium and ketones.