4/28 punkin pmps 94 and thank you!

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julie & punkin (ga)

julie & punkin (ga)

Member Since 2011
yesterday: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=42131

turns out my husband gave punkin karo syrup last night at +3 when he was 43, hence the bump up of numbers during the night. He was 107 at amps this morning, so i dropped his dose another .25. at this point i'd rather the dose reduction didn't hold from yesterday and today than have to test him every 15 minutes today.

he looks pretty good - again, i can tell first thing in the am the cerenia has worn off. he ate most of his breakfast, but not all, although he stayed at the bowl for a long time working on it. doesn't want to put his membership in the Clean Plate Club in jeopardy!

eta: decided i should put in the string of numbers from yesterday:
11.5 67
12.25 94 amps 7.25 (drop by .25)
+2 97
+3 71
+4.5 68
+6 54
+7 59
+10 78
pmps 151
+3 43 husband gave karo
+3.5 54
+5 119
+6 100
+7 99

today
amps 107 7.0 (another decrease by .25)
 
Re: 4/28 punkin amps 107

Julie, so nice to see punkins numbers where they are :smile:
You said last night that he seriously cleaned the area that had been hurting, that's good news.
Do you think the infection is almost gone?
I wish you luck with the dose decrease! :mrgreen:
 
Re: 4/28 punkin amps 107

i hope so, squirrel. he's got several more days of this antibiotic and i need to get more of the cerenia to keep him from getting nauseated from it.

i have a seriously happy singing finch or sparrow, not sure which, just a few feet from my head at the feeder. what an awesome way to start the day!

my quilting group is coming today - in 1/2 hour and i gotta go get ready! probably won't be on much til later. have a great day everyone.
 
Re: 4/28 punkin amps 107

Hi guys ... what a night! Good luck with the dose decrease .. have fun with your quilting group!
 
Re: 4/28 punkin amps 107

I think punkin is definitely getting over the infection! Who knows what great things could happen with his diabetes now?! (antijinx) :-D :-D

Have fun with your quilting group--sounds like so much fun! I'm off to paint my bathroom. It is looking very purple, even though it's supposed to be more taupe?! Oh well, I like it!

Catch ya later...oh, and thanks julie, for checking in on Tessie Lou!
 
Re: 4/28 punkin amps 107

I think that infection was the culprit all this time for his numbers. I think Punkin is headed for homeplate (antijinx) :lol:
 
Re: 4/28 punkin visit with new vet - lots of Q's

just got back from a 90 minute visit with a new vet at a cats-only clinic.

honestly, overwhelming. I hope some of you can give me input on some of the issues she raised. This vet is young, like in her 20's, but seemed fairly knowledgeable.

1. Can someone tell me more about the fructosamine test? She recommended it - i'm unsure of the value when he's getting checked every few hours around the clock. what does it tell you that you can't get from monitoring?

2. She was not happy with punkin's dose - said she wouldn't feel comfortable giving a cat 7 u of lantus and would decrease him. i didn't ask about insulin resistance or acro - she didn't mention either one. she also said this site had good information on it, but she would not change a dose based upon a single number, like going below 50. she was pretty emphatic that she would advise on dose if i took punkin there.

3. She wanted to do a blood test to check for Bartonella, Feline Leukemia and FIV -
a. Bartonella is somehow related to gingivitis - I need to research it but wondered if anyone has knowledge of it.
b. Feline Leukemia - when felix died 2 years ago they said he showed evidence of having been exposed to FIV
c. FIV - punkin was a street kitty, then in the humane society for 3 months . . . that's the perfect recipe for FIV exposure
The vet said that all of those could impact how his diabetes is treated. I don't know if he's been tested for #b, c before, i'm sure not a. Felix and punkin were here together for 10 years.

4. she said the gum is still pretty infected, she thought switching to Azithromycin would be easier on his stomach, and if he has Bartonella the Azith would kill it - but it takes 3 weeks. She said it's in the same family as clindamycin, but easier on the gut. He's hasn't vomited since we started the cerenia and clindamycin, but he has had the diarrhea - it's better but not gone with the fortiflora. none today, though.

5. she said he had some cataracts, not too much - i asked if from high glucose and she said probably. she also said he had a heart murmur, level 2, which i've never been told.

6. she wanted to do a urine draw to check for UTI - i told her that when he's had UTI's in the past there's no missing it. He pees on our bed or somewhere equally annoying to get my attention. she really was pretty insistent on this, saying that he could have it without symptoms. i told her that i give him about equal amounts of water with his food and he also drinks some water from his dish. i have a hard time believing this one because of our prior experiences with bladder infections.

So, I'd love some feedback on any of this that you have knowledge of. which parts sound reasonable?
 
Re: 4/28 punkin visit with new vet - lots of Q's

Julie, I can't wait to hear the answers to your questions.. Damn, she'd have a field day with Tommy's 10.5U BID wouldn't she?
I'm leaning that she isn't going to be the vet for you. Seems to be going against quite a bit about what you already know about Punkin and how he reacts to issues, but i could be wrong. Did you let her test for the UTI.
Hope you had a good day today with your quilting group.
Take care Julie,
Squirrel & Tommy ;-)
 
Re: 4/28 punkin visit with new vet - lots of Q's

It sounds to me like you've found a young vet who needs to make sure you think she's smart and knows what she's doing. Unfortunately, she's showing her ignorance by insisting on a fructosamine level because that's like an A1C in humans; it shows what his blood glucoses have been doing over a long period of time. The fact you told her you do multiple BG checks on him a day and she still insists it's necessary, well, maybe she has a car payment that needs paying. She should have asked you for his spreadsheet. Also, since the antibiotics Punkin's on are working, why would she want to change him now? You noticed him cleaning that side of his face so it's obvious it's not painful anymore, or less painful anyway. I'm not so sure about FIV. I would think anything he was exposed to ten years ago would have surfaced by now. All of these things combined now make me wonder about her diagnosis of a heart murmur. She's not shown she can be trusted in her judgment if you ask me. Also, the fact she says she knows of this board, but she doesnt agree with Punkin's current dose or trust your judgment in increasing/decreasing his dose, makes me very leary. The people here who give dosing advise have WAY more "schooling" in FD that she does, I don't care how many years she spent in vet school.

Just the way you've phrased your post makes me know you have serious doubts about the validity of her statements. Trust your gut. I think the search is still on for your next vet.
 
Re: 4/28 punkin visit with new vet - lots of Q's

Patty is correct. A fructosamine test is worthless if you are testing on a daily basis. My vet has never asked for one since I started home testing. It's about as useful as having the vet run a curve.

Dose: What is she basing her opinion on? We're basing our dosing on research that's been published in a leading vet journal along with a lot of cats both here and on the German counterpart of this forum that have gone OTJ. I'm happy to provide you with the journal article so you can share it with this vet. We have data. The vet has opinion.

Regarding infections: Wouldn't the shelter have run FIV and FeLeuk? In any cat colony situation I can't imagine they wouldn't screen to keep infected cats separated from the uninfected cats. It would also be something your own vet should have run. As far as the bartonella, Azrithromycin is the preferred treatment. However, is this vet suggesting diagnosis by crystal ball? There are tests that can provide a diagnosis. They are mentioned in the material I linked. 3 weeks on Azrithromycin is appropriate IF Bartonella is present. If it's easier on Punkin's gut, that's fine but I would be concerned about indiscriminately giving an AB without a confirmed diagnosis of Bartonella. You end up contributing to antibiotic resistant bacteria if you just give the AB without a reason. It may be fine for the dental infection.

I'd ask your regular vet about the cataracts and heart murmur. I'd want a second opinion on the latter -- preferably from a cardiologist.

UTI - you will get a false read because Punkin is on antibiotics. The vet should know this. Even if you have a confirmed UTI that you treat, you wait at least 2 - 3 weeks post-antibiotic treatment before getting a follow-up cytocentesis to make sure the UTI is gone.
 
Re: 4/28 punkin visit with new vet - lots of Q's

i knew you all would have insights - i was wishing someone was with me to offer a second set of ears and ask the right questions.

punkin's spreadsheet was in front of her. she was telling me that she would do a curve, every 4 hours for 12 hours (I'm thinking YOU'RE MISSING THE NADIR IF YOU GO amps-4-8-pmps ON PUNKIN)

she told me she had read the Rand Protocol - i don't think she knew about the Tilly one, but specifically what she said was that she had "read" it. The vet tech told me that they had several diabetic cats and had had cats go OTJ. I told the vet that every day i see cats go OTJ by following that protocol. she made it pretty clear she would be in charge of dosing if we worked with her - that alone was a minus to me.

for the bartonella - she did suggest running a titer to see if Punkin had it. I looked online and our region has about a 45% infection rate, so that's probably not unreasonable. she said you could either do a 3 week course of azithromycin (why do they make meds so dang hard to sound out!?!) or do the titer to see if punkin was infected. part of the reason we were talking about this is she said it's similar to clindamycin but easy on the stomach. the downside is it's liquid only, human prep - ie, cherry flavored is how it comes. i'd have to have the compounding pharmacy prep it in capsules if we go that way.

one of my red flags when she was so adamant about his dose was that she never mentioned the acro/iaa tests.

ok, i have one other vet that was highly recommended by a friend who has done feline rescue and now has 7 cats, although none diabetic. i guess i can try there.

thank you all! the collective wisdom. i'm going to change the subject line back to punkin's regular programming! :lol:

his pmps was 94. :mrgreen:

amps 107
+2.5 110
+3.5 97
+5 88
+6 74
pmps 94
 
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