4/7, Susie, 294 AMPS and lab work

Summer and Susie (GA)

Summer and Susie (GA)

Member Since 2020
https://felinediabetes.com/FDMB/threads/4-6-susie-258-amps.245790/

Susie continues to baffle me by going up in numbers after a wonderful 4/4. I got her lab work and have recorded it on my spreadsheet. Also went back and recorded Decembers lab results. ALTs have gone up and white blood cell count is above normal. Her ABS NEUTS are sky high which is totally out of the blue. She had 12,006 and the normal range is 2500-8500. ANYONE HAVE ANY EXPERIENCE WITH HIGH ABS NEUTS?.

Vet says there is some kind of inflammation or infection going on (although he didn't mention her ABS Neuts at all). This was based on the white blood count. He wants her to have back to back Covenia injections 10 to 14 days apart then do a mini chemistry. She had oCovenia on March 1st and seemed to handle it well but a lot of folks on this site do not recommend it. I DON'T KNOW WHAT TO DO? She needs intervention soon for whatever is going on (infection/inflammation?) I need advice. Anyone know of a better injected antibiotic?

As for her numbers, they continue to go up after a wonderful day on 4/4. I don't know what is going on but I'm tossing her lantus pen (opened on 3/2) just in case it is no longer viable. I'll start the new pen and increase her dosage to 2.25 if this is acceptable to the "powers that be".
 
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Has she ever had a thyroid panel to rule out hyper-t? Did the vet feel a nodule on her thyroid? If not then ignore that. Convenia has a purpose but makes no sense unless you know there’s an infection it works for. It also is long lasting which is why many don’t like it because if there is a bad reaction there’s nothing to do for it. Was anything said about the elevated liver values? The eosinophils are elevated and that can be due to allergies.

I doubt the pen is bad. I used mine to the last drop. I think she needs more juice and would increase.

Why do you want the antibiotic injected? Is she hard to medicate?
 
The high neutrophils is generally due to inflammation or infection, yes. You could try a broad spectrum antibiotic like Veraflox if you can't identify where the infection is at. We have done that successfully. You can have confidence ruling out an infection with this antibiotic (or another in the same class like Baytril, but Veraflox has the fewest side effects and is more well tolerated I find). The high ALT can also be due to inflammation or infection, and for that (infection) you would need the Veraflox. It's a great way to address a potential infection (low-hanging fruit) hypothesis before going to more expensive hypotheses and tests.

If you have inflammation or infection going on, that will affect her BG numbers. You can check out Pearl's SS and see what many times when she comes out of the green into blue, she is in the middle of a Pancreatitis attack. Allergies could also potentially affect the BG, if Susie has those.
 
tiffmaxee said:
Has she ever had a thyroid panel to rule out hyper-t? Did the vet feel a nodule on her thyroid? If not then ignore that. Convenia has a purpose but makes no sense unless you know there’s an infection it works for. It also is long lasting which is why many don’t like it because if there is a bad reaction there’s nothing to do for it. Was anything said about the elevated liver values? The eosinophils are elevated and that can be due to allergies.

I doubt the pen is bad. I used mine to the last drop. I think she needs more juice and would increase.

Why do you want the antibiotic injected? Is she hard to medicate?
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The vet is concerned that she is headed toward hyperthyroidism. He did not say anything about feeling a nodule. He has no idea where or what the infection/inflammation is. Just said she needed the Convenia. I don't know how it is to medicate Susie as I have never had to do it. I prefer an injection because of her swallowing issues. He mentioned her ALTs went up even more. This was my biggest issue until I saw her ABS Neuts. He said the next steps regarding her ALTs would be invasive - including a liver biopsy which I would hate to do. He keeps thinking if I can get her blood glucose down then maybe her ALT would come down too. Do you know anything about elevated ABS Neuts?

You are probably right about the pen. I just don't understand why she would have such a good day on 4/4 and then shoot up the next couple of days later. Any idea? Is this some kind of a bounce? Thanks, Elise.
 
Margaret (and Pearl) said:
The high neutrophils is generally due to inflammation or infection, yes. You could try a broad spectrum antibiotic like Veraflox if you can't identify where the infection is at. We have done that successfully. You can have confidence ruling out an infection with this antibiotic (or another in the same class like Baytril, but Veraflox has the fewest side effects and is more well tolerated I find). The high ALT can also be due to inflammation or infection, and for that (infection) you would need the Veraflox. It's a great way to address a potential infection (low-hanging fruit) hypothesis before going to more expensive hypotheses and tests.

If you have inflammation or infection going on, that will affect her BG numbers. You can check out Pearl's SS and see what many times when she comes out of the green into blue, she is in the middle of a Pancreatitis attack. Allergies could also potentially affect the BG, if Susie has those.
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Thank you, Margaret. I might ask my vet about the Veraflox. I assume it is a pill? Is it small? I have never had to get a pill down Susie's throat but I worry about doing that because she has swallowing problems which are also undetermined.
 
Summer and Susie said:
The vet is concerned that she is headed toward hyperthyroidism. He did not say anything about feeling a nodule. He has no idea where or what the infection/inflammation is. Just said she needed the Convenia. I don't know how it is to medicate Susie as I have never had to do it. I prefer an injection because of her swallowing issues. He mentioned her ALTs went up even more. This was my biggest issue until I saw her ABS Neuts. He said the next steps regarding her ALTs would be invasive - including a liver biopsy which I would hate to do. He keeps thinking if I can get her blood glucose down then maybe her ALT would come down too. Do you know anything about elevated ABS Neuts?

You are probably right about the pen. I just don't understand why she would have such a good day on 4/4 and then shoot up the next couple of days later. Any idea? Is this some kind of a bounce? Thanks, Elise.
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You don't want a liver biopsy, they'd have to cut her open. Fine needle aspiration can be done, but it's ultrasound guided and you have to actually see some suspicious spots to sample.... or your just random sampling. I'll pray for Susie.
 
Summer and Susie said:
Okay, folks, another question. Because Susie has an unknown infection, which could be influencing her BG, is it wise to take her up to 2.25 units before she has the Convenia?

@tiffmaxee, @Margaret (and Pearl), @Suzanne & Darcy
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Personally (this is just a personal opinion) I'd wait to see if there is any response to the antibiotic before making too many changes in dose. You could wait a few days after the Convenia and then increase if she's still high.
 
Suzanne & Darcy said:
You don't want a liver biopsy, they'd have to cut her open. Fine needle aspiration can be done, but it's ultrasound guided and you have to actually see some suspicious spots to sample.... or your just random sampling. I'll pray for Susie.
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I don't want anything invasive. They already did that when they mistakenly thought she had stones and went in only to find it was scar tissue.
 
Suzanne & Darcy said:
Personally (this is just a personal opinion) I'd wait to see if there is any response to the antibiotic before making too many changes in dose. You could wait a few days after the Convenia and then increase if she's still high.
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That is my feeling too, Suzanne. I hate that her glucose is so high but don't want to play too much with that until the infection is cleared - if it ever is. I have been dealing with high ALTs since December. They just continue to go up. Now I have these "sky high" ABS Neuts. What the heck is going on with this poor cat? I am afraid for her.

By the way, I appreciate your prayers. I am not overly religious but I do believe in God and the power of prayer. Not that it always works but that is life.
 
Margaret (and Pearl) said:
Nope, it's a marshmallow liquid! Smells yummy. Oddly enough lots of cats like marshmallows. LOL!
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Good to know. I just looked up Convenia and it is a "broad spectrum" but many sites said it is for skin infections. Susie had a shot of it in early March for red spots on her belly and it did clear them up. I guess, at some point, I need to start trusting my vet. The injection is easier for Susie and me and she has had it before and suffered no consequences so I guess I will schedule it.
 
Summer and Susie said:
That is my feeling too, Suzanne. I hate that her glucose is so high but don't want to play too much with that until the infection is cleared - if it ever is. I have been dealing with high ALTs since December. They just continue to go up. Now I have these "sky high" ABS Neuts. What the heck is going on with this poor cat? I am afraid for her.

By the way, I appreciate your prayers. I am not overly religious but I do believe in God and the power of prayer. Not that it always works but that is life.
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Liver damage. Yep, best get her on antibiotics ASAP. Yep, Convenia is for skin infections. I do remember it helped with her red spots... but since you reminded me that she had a Convenia injection in March... that means it must not have been effective in reducing her liver enzymes or her elevated white count (neutrophils). They've gotten higher, correct? So you are re-trying an antibiotic that didn't help Susie's condition (even though she suffered no ill effects). Sorry. Don't be mad.
 
For my 2 cents worth....Veraflox might be worth a try. It's a liquid, and I just put it in food. From what I have read, it was "specially formulated" to be palatable to cats. Both my peanuts eat it very well, and they, especially Fred, my diabetic, are verrrry picky.

About a month ago, we put Fred on Veraflox just to make sure we weren't dealing with an occult infection somewhere, as his numbers were/are all over the place. It's an excellent broad-spectrum ABX. While he is still a bouncing ball, it was after the Veraflox that things slowly started to turn a little corner. I do believe it helped in some way.

Good luck!!
 
Purrberry said:
For my 2 cents worth....Veraflox might be worth a try. It's a liquid, and I just put it in food. From what I have read, it was "specially formulated" to be palatable to cats. Both my peanuts eat it very well, and they, especially Fred, my diabetic, are verrrry picky.

About a month ago, we put Fred on Veraflox just to make sure we weren't dealing with an occult infection somewhere, as his numbers were/are all over the place. It's an excellent broad-spectrum ABX. While he is still a bouncing ball, it was after the Veraflox that things slowly started to turn a little corner. I do believe it helped in some way.

Good luck!!
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Mixing in food is good! And they like it!
 
Suzanne & Darcy said:
Liver damage. Yep, best get her on antibiotics ASAP. Yep, Convenia is for skin infections. I do remember it helped with her red spots... but since you reminded me that she had a Convenia injection in March... that means it must not have been effective in reducing her liver enzymes or her elevated white count (neutrophils). They've gotten higher, correct? So you are re-trying an antibiotic that didn't help Susie's condition (even though she suffered no ill effects). Sorry. Don't be mad.
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I am not mad, Suzanne. I just don't know what to do. I did make an appointment with an Internist who is not too far away but I can't get in before 4/22. I don't know what to do until then. I guess I will go ahead with the Convenia tomorrow if I can get her in for the shot. She needs something now.
 
Summer and Susie said:
I am not mad, Suzanne. I just don't know what to do. I did make an appointment with an Internist who is not too far away but I can't get in before 4/22. I don't know what to do until then. I guess I will go ahead with the Convenia tomorrow if I can get her in for the shot. She needs something now.
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Yes. That's a long time. Too long. You will find a way to help her, I am sure. Ask about the Veraflox. See what the vet says.
 
Purrberry said:
For my 2 cents worth....Veraflox might be worth a try. It's a liquid, and I just put it in food. From what I have read, it was "specially formulated" to be palatable to cats. Both my peanuts eat it very well, and they, especially Fred, my diabetic, are verrrry picky.

About a month ago, we put Fred on Veraflox just to make sure we weren't dealing with an occult infection somewhere, as his numbers were/are all over the place. It's an excellent broad-spectrum ABX. While he is still a bouncing ball, it was after the Veraflox that things slowly started to turn a little corner. I do believe it helped in some way.

Good luck!!
Click to expand...

Purrberry said:
For my 2 cents worth....Veraflox might be worth a try. It's a liquid, and I just put it in food. From what I have read, it was "specially formulated" to be palatable to cats. Both my peanuts eat it very well, and they, especially Fred, my diabetic, are verrrry picky.

About a month ago, we put Fred on Veraflox just to make sure we weren't dealing with an occult infection somewhere, as his numbers were/are all over the place. It's an excellent broad-spectrum ABX. While he is still a bouncing ball, it was after the Veraflox that things slowly started to turn a little corner. I do believe it helped in some way.

Good luck!!
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Thanks, Kathleen. I really appreciate the information on Veraflox. You are the second person to recommend it today. I will call my vet first thing in the morning to see if he has it. I like that it is a liquid so I don't have to get pills down her throat with her swallowing issues. Again, thanks for taking the time to comment on my concern. I have an appointment with an Internist but can't get in before 4/22. I know Susie needs an ABX now so will call my vet in the morning.
 
Summer and Susie said:
Thanks, Kathleen. I really appreciate the information on Veraflox. You are the second person to recommend it today. I will call my vet first thing in the morning to see if he has it. I like that it is a liquid so I don't have to get pills down her throat with her swallowing issues. Again, thanks for taking the time to comment on my concern. I have an appointment with an Internist but can't get in before 4/22. I know Susie needs an ABX now so will call my vet in the morning.
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Vet can order it if it is not a normal stock item. In the meantime, you can go on Baytril or Zeniquin while you wait for it to come in (same drug class) but these are pills (liquids not tasty). If your cat is large, a course of antibiotics will be 2 boxes of Veraflox, each bottle has about 14 doses if the dose is 1ml each day.
 
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