4/1 Paisley PMPS/355 +5/465 Help on vet report

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Lylene & Barry

Member Since 2009
3/30 Paisley's Previous Condo http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=67540&p=735390#p735390

Paisley saw the vet on an emergency basis yesterday (Saturday). Ouch on the base price just to have the vet come in to the clinic. We have no emergency clinics or weekend hours here. This is not her regular vet. This is the clinic we use for everyone except Paisley and Barry. Sault Animal Hospital - http://saultanimalhospital.com/index.php, if anyone is interested. The vet recently purchased the clinic so I'm not real familiar with him. Paisley's regular vet clinic was closed this past week. Maybe for the best.

I could use some help with medication names as his writing isn't extremely clear.

Temp. - 103.8F
Dental - Abnormal - needs dental cleaning ASAP
Digestive - Abnormal - not eating; vomiting
Rest of physical exam - normal
Weight - 11#
BG - 259 ( at +9.5)
Lantus - 1.5u BIB
History of UTI

Suspect infection - dental and/or UTI (he told me bladder)

Treatment-
Injection of penicillin, B12, Azi? (cortisone) Dose of steroid was 0.5mL, which is 1/4 normal dose. We did discuss the pros and cons of using it.
Injection of Ceren? 0.75mL
Amoxicillin 2mL BID for 10 days (sweet)
subQ fluids PRN

We discussed the UTI issue. He isn't certain her UTI had actually cleared as the other vet clinic had said. It has something to do with a diabetic's immune system not working quite normal and, therefore, not always producing what the vet is looking for. Urine should have been cultured, which it wasn't. That's if I understood him correctly. Does this sound familiar to anyone?

He really is concerned about the dental being done as soon as she gets over this. I asked him to be more specific and he said a couple weeks. Her other vet said she needed a dental but wasn't so concerned. Maybe a difference in personality. Dr. Jeff is military. Very to the point. He had no problems with me hometesting, unlike her regular vet.

We also discussed Barry's need for a dental and the HCM. I think I'm going to take Barry and all his records to Dr. Jeff for a second opinion. He does cardiac ultrasound, which may shed a little more info on the HCM. Barry is OTJ since 10/09.

The shots really helped her for about 14 hours. She ate well for 10 hours. Now she is back to not eating. She slept for several hours and just got up a few minutes ago. It's shot time so I have to get on that and syringe feed her if she refuses everything I offer. Thanks for all of your help.

Lylene, Paisley & Barry
 
Re: 4/1 Paisley AMPS/308 +5/204 +9/216 PMPS/355 Update

Ended up having to syringe feed her.

Still looking for some help with the names of two of the medications she received. They're in the original 4/1 post under treatment.
 
Re: 4/1 Paisley AMPS/308 +5/204 +9/216 PMPS/355 Update

wow...i'm no help on the AZI...
but would the Ceren? be Cerenia?

Wish i could be more helpful :sad:

sending poor little Paisley strong healing vines...
and vines for Barry as well.
(now going to research HCM)

celi

you might want to add "med ??" to your subject line to get more eyes, Lylene...
 
Re: 4/1 Paisley AMPS/308 +5/204 +9/216 PMPS/355 Update

injection of ceren - is likely cerenia. that's a good one for quelling nausea. punkin's had it both via injection and through tablets. he had it for more than just one dose - i wonder if you can get more until she gets past whatever is making her nauseated.

dental - i'd say get on it. we've seen over and over that cats with dental issues can't seem to get regulated until their dental work is done. and until a cat is under anesthesia it's hard to see what's going on in their mouths - so if he can see it needs doing, that probably says she really needs it.

bladder infection - i don't know about the specifics, but in general, the urine should be cultured to see if there is bacteria and if so, what bacteria is there. that way the antibiotic is only given if needed and is the correct one for whatever is growing.
 
Re: 4/1 Paisley AMPS/308 +5/204 +9/216 PMPS/355 Update

Cerenia is for nausea.

Could it be Azithromycin, which is an ABx?
 
Re: 4/1 Paisley AMPS/308 +5/204 +9/216 PMPS/355 Update

yes, i agree with celi - edit your subject line and ask for "help on vet report?"
 
Re: 4/1 Paisley AMPS/308 +5/204 +9/216 PMPS/355 Update

now that I know what HCM is...
sending STRONG vines to Barry.

((((lylene))))
 
Re: 4/1 Paisley AMPS/308 +5/204 +9/216 PMPS/355 Update

I had the same thought as Venita -- could the AZI be azithromycin which is an antibiotic? Also, amoxicillin is a relative of penicillin. Did he actually give both?

If you Google "names of steroid drugs" you can find some extensive lists. I didn't see anything that came close to "azi."

I tend to agree with the others -- the Ceren is probably Cerenia which is used for nausea and vomiting.

Re. a bladder infection or UTI: The best way to determine if there's an infection is a cystocentesis (a needle is inserted into the bladder to get a urine sample) which allows the vet to get a sterile sample and then a culture and sensitivity is done. The C & S allows the vet to determine what the type of bacteria is and what antibiotics can be used to treat the infection.

If you saw a good response to the Cerenia, you might want to discuss this with the vet. You may need to give it for a few days or use a similar drug if Paisley is nauseated.
 
Re: 4/1 Paisley AMPS/308 +5/204 +9/216 PMPS/355 Update

This vet sounds very thorough. What did he think of the blood in both vomit and stool though?

Cerenia is available in pills. I would get more. Its more effective to prevent vomiting than overall nausea but can be very helpful. Antibiotics themselves will tank her appetite most likely. Cerenia is one that you need a break with. I can't remember the specifics. Five days on, two days off or something like this. It builds up in their system.

Was the pred a one time dose or ongoing?

Big hugs to you both.
 
Cerenia is the one medication. he said it was for nausea and should help her appetite. It was a one time injection. She hasn't vomited since early Saturday morning. The other injection was a combination of penicillin, B12 and steroid. The medication that starts with an A has to be the steroid. It was a one time thing. I'll find out tomorrow.

As for the UTI that she was diagnosed with in February, they spun the urine that was obtained from a special urine collection cage. Then they looked at it under the microscope. I did ask about cystocentesis but they try the special cage, then try to squeeze it out. If that fails then they go in with a needle. With the second sample obtained, they didn't see anything under the microscope, therefore no infection. They gave a Convenia shot at diagnosis. No C&S was done.

I'm seriously considering switching vets.

Thanks for all the input.
 
The steroid could be Azium? It is a brand name for dexamethasone. This can be given by injection or orally.

Amoxicillin is a great antibiotic, but often causes diarrhea. Do you have any Fortiflora on hand? It is not unusual to do an injection of penicillin (to get things under control quickly) and then follow up with oral amoxicillin.

I don't know Paisley's situation very well, but often a culture isn't done if the UA comes back normal unless you specifically ask for it. It sounds like the not eating is a big problem, you may need more Cerenia or some ondansetron (Zofran) to get Paisley through this time. :YMHUG:
 
Just checked her temperature and got 103.6F. It was 103.8F at the vet. Should it have gone down by now? This is something I've not had to deal with and feel a bit out of my league. Wondering if I should give him a call.
 
Melissa,

I asked about a C&S but was told the infection was gone so no need for C&S.

When my cats or dog get sick it's been things like CRF, heart, allergies. In general, they tend to be healthy.
 
Dang! I just wrote a very long response, and as I was about to wrap it up my computer shut off (a little unnerving nailbite_smile ).

Mainly I was wondering about the second time they took urine...was that for a recheck to see if the infection was gone?
If so, How long after the covenia shot was out of the system was that urinalysis done? You usually need to wait about 5 days after the antibiotic is finished before you retest, or it can skew the results. It is also possible because a culture/sensitivity was not done the wrong a/b was given, which did not clear the infection completely.

Regarding the FD and UTI's. Most cats will start dumping sugar into their urine when they have a bg around 200. That of course becomes a great breeding ground for bacteria. I do not see anything past 2/20 on your ss, so I am not sure if that might apply in Paisley's case. It gets tricky to knock out a UTI when a cat is sitting in high numbers. Yet it is hard to get the numbers down when they have an infection. Round and round it goes.

I would ask the vet for some more cerenia if the nausea is continuing. One dose will only last about 24hrs. Ask for it in shot form vs oral. I personally feel it is more effective that way. Also, you want to make sure Paisley keeps it down.

Did the vet today offer any thoughts on the vomiting and blood?

I think if he still has a high temp, it would warrant calling the vet.

I hope you guys get some restful sleep tonight. Hang in there!

ETA: good basic info on UTI's http://www.marvistavet.com/html/urinary_tract_infection.html
 
Contacted the vet. He was concerned about the temp and her not eating. I told him I had suggestions of subQ fluids unheated and wiping her paws with water or standing her in water. He approved those. I told him I'd be contacting the office in the morning about something for appetite. He said that he wants to see her tomorrow if she hasn't improved.

WOW! I'm impressed. He never even mentioned the vet she has been seeing. Guess Paisley and Barry have a new vet. And I don't have to have to deal with the desk staff at the other clinic who aren't exactly polite. They don't think I'm acting in the best interest of my diabetic cats, especially because I get information off the internet. I don't follow the vet's recommendations like returning in a week to have her BG tested (we home test, duh) or feeding the prescription diet (Purina DM) or increasing her Lantus by 1.0u based on her BG there (she jumps into the 400s for a few hours when stressed). A whole unit at once, even after I had told him and the tech what happened to Barry. Oh, and Convenia IS for UTIs. Really??? I read on the internet that it isn't approved for that. Damned internet. Wait, it was the FDA and Pfizer websites. ohmygod_smile I can understand their frustration to some extent but that is between me and the vet. They need to cut out the attitude and act professional. Yes, I did talk to the vet about it.

Ok, I feel better now.

So Paislely got something over 50mL subQ (LRS). She did very well. She stood in water with 3 paws in and one on the edge of the pan. She also licked some liquid left over from cooking a hamburger. It's the first she's eaten anything on her own in 24 hours.

She's kept down some syringed chicken Wellness mixed with a bit of water. Total of 20mL. Will give more soon. She hates it and growls but I'm bigger and badder than she is so I win. :o

On we go.
 
i like the sounds of your new vet. i figure i don't need perfect personality if the skills are there.

btw, my reading about convenia says that it was developed for skin infections and that it isn't particularly good on other things. it's main plus is "conven-ient" because 1 shot lasts 2 weeks. i don't know how it's a plus if it doesn't work on the bacterial infection the cat has. ohmygod_smile

sounds like you're doing everything right. i'm glad some with experience stopped by to offer info.
 
I think it sounds like you found a great vet. I am glad you don't have to go back to the other office. I hope she starts improving quickly. Definitely get more cerenia. Sending hugs.
 
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