5/24 Junior AMPS 278 w/UPDATE on eating

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This is the cut and paste from yesterday's condo. If you can't get into your SS, could you list out Junior's numbers from the past couple of days?
kay&junior said:
Good morning,
Last night was ok, google docs not letting me update...so here goes...
he ate lunch from his feeder, don't know if his brother helped.
PMPS - 314, and that was with no shot in AM, gave 2 units after eating.
he ate a 1/2 can by himself with lots of water, then I helped him finish the rest.
in the middle of supper, which took about 45 minutes, he went to pee, so I got 2 urine tests in, 1 from the dipstick under his butt, and the other from the wonderful Breeze litter system Box. results not good to me, e-mailing vet next, she doesn't open til 9.00am.
Ketones-Negative!
Specific Gravity- 1.025 to 1.030
Protein-Trace
PH- 6.0
Leukocytes- small to mod, ( + to ++ )
color was clear & yellow, not cloudy at all. no straining, he lloked funny at me when I stuck the dip stick under his butt, but it worked!
Bedtime 4+ was 260 and he had a 1/2 can salmon by himself.
I did not start the Mirtazapine last night as the directions were not fully understandable, so will need to clarify that, and will be looking on the web today for FortiFlora as suggested. Clindamycin he starts tonight.
This AMPS was 278, He ate 1/2 can by himself, waited a few minutes, had help with the second 1/2, and got a shot, 2 u Lantus.
I left his feeder set for noon, and have the next 4 days off, so he will be getting intensive care.

anything else I need to do, I got the suggestion on the baby food, will get that on the way home, living in a tourist valley, I shop before they get here.

should I increase tonight to 2.25u?

any and all help appreciated, will get lots of numbers over the weekend, especially the mid-cycle.
Leuckocytes in the urine is typically an indication that an infection may be present. It looks like the specific gravity and pH are fine.

Are you able to get a +11? If so, can you post that number?
 
Still can't access Google Docs...
5/20...amps-285
+6 147
pmps 201
+4 323
5/21...amps 340
pmps 239
5/22...amps 227
pmps 322
5/23...amps 255
+2 271
pmps 314
+4 260
do you want more?
 
I think that's fine.

See if you can load someone else's SS. That will tell you if it's your account or a general Google docs issue. If you can open someone else's SS and it's a matter that you can't edit Junior's SS, make sure you're logged in to your Google account. Your user name will appear above the blue "Share" button in the top right corner. Sometimes, Google throws you out and you need to log back in.
 
Got on Google Docs, updated, and some notes too.

Will get a +11 tomight when I get home, after getting Forti Flora, and stopping at PO BOX to get Clindamycin, yes, it comes in the mail from my vet, distances.

Sienne, thanks for all your help, I am going to make it through this with my little guy!!!

I have to go back and read your notes again and make my notes.

will keep computer at work on all day....
 
Hi guys .. I did not realize junior was having such a rough time right now! Good thoughts go out to the both of you .. It's so scary when our babies are not feeling well .. I hope today Junior makes a complete turn around ...
 
Thanks Peter.

Yes, just a little setback, his kidneys are acting up, or not.

lots of help here, and much appreciated!
 
Got my call back from vet, after hearing his results of urine test, she now says do not start Clindamycin, calling in Amoxicillin 75 mg BID for 21 days, then Clindamycin for 10 days.

and still start Mirtazapine, but not at night, daytime is better, he will be hungry in less than an hour I am told...

anybody have suggestions or ideas or comments about the med change?
 
Hi There,

I help out on an forum for assist feeding cats.

You have to be careful with the mirtzapine. Your cat is inappetant for a reason - it could be an illness, it could be stress, and also nausea. Nausea in cats isn't just vomiting. Are you seeing any of the following:
Showing interest in food but just licking or sniffing and walking away?
teeth grinding
lip licking or lip smacking.

You should be extremely careful about giving an appetite stimulant without addressing nausea. Ondansetron or dolasetron are the preferred medications in cats to treat nausea. Giving Mirtz without addressing nausea can lead to long term food aversion. I liken it to giving you one with the flu. You may not be vomiting but you know that yucky nausea feeling and someone assist feeding you your supper. So please do look into this. I can send you a technical article for you to show your vet on treating nausea and vomiting in cats. Metoclopromide/reglan is often prescribed but this is not effective in cats unless nausea is due to stomach motility issues. Pepcid does nothing for nausea either unless its due to excess stomach acid.

The other concern I have is vets often prescribe way too much. Mirtz is often called meowzapine on the assisted feeding board. Some cats can become highly agitated on it. What dose are you giving?

When you assist feed, you should assist feed a food that you don't need your cat to eat on their own. A high calorie food available at the vets is Iams MaxCal 330 calories a can and only 3-6% carbs - I can't recall. Wellness Chicken I believe is 200 calories a can also.

I hope this helps and doesn't confuse you.
 
Hi Karrie,

Sienne said I should contact you, thank you for contacting me!

When I put his food down, I split his FF can into 3 sections, first he gets 1/2 can, he does that fine, wait a minute and give another 1/4 can, and then again til it is gone, BUT, for several days now he is slow on the first 1/2 can, the next 2 1/4 cans, I am feeding him from my fingertips, which he willingly takes, and licks my fingers after, I also make sure my hands are extremely clean, except for the cat food on them. No teeth grining that I have noticed, and I watch him closely, sometimes DH says to closely.
The dose of Mirtazapine is 1/4 tab of 15 mg tab every 3 to 4 days, in the AM. I am told by the vet it willl make him hungry right away.

I don't have the directions yet for the Amoxicillin, but it is in powder form, and I was told to mix it with chicken broth to reconstitute, and 75 mg BID. 21 days, followed by Clindamycin...his poor belly. I can only get FortiFlora online around here, so will order it, but with the long weekend, not sure how soon I will get it. how can I keep him comfortable in the meantime?

thank you all, now it is up to me & junior!

no computer at home, library computer 40 minutes away, emergency vet phone number next to phone, and his vet is not going away and gave her pager # to me. but, I think we can do it.

thanks from Junior!
 
Forti Flora on order, online did it!

pick up Amoxiclllin tonight, with Chicken broth to reconstitute, can't get liquid vitamin in time...

get ready to start Mirtazapine in the AM.

TG I have the next 4 days to work this into a routine!

Thank you everyone, will update as soon as possible.
 
I'm glad you are assist feeding. Since Junior is at risk of Diabetic Keto Acidocis you will have to step up the assist feeding though. You have to make sure he gets enough calories - err on the side of too much versus too little. Can you syringe feed/finger feed some extra calories along with assist feeding? Pure meat babyfood - the starch free versions I think are 60 calories a jar (no onion, garlic or seasoning). The ones with starch I think are 100 calories a jar. The best thing would be to get some oral feeding syringes from the vet and some Iams Max Cal. Let him eat the FF that he does eat on his own and syringe feed extra calories of the MaxCal. Don't syringe feed the food he normally eats or that you want him eating when he is feeling better to avoid food aversion.

I really push for ondansetron or dolasetron any time a cat is on an appetite stimulant. It isn't worth the risk of food aversion.

Marjorie linked to an awesome syringe feeding video on your condo yesterday. I hope everything is okay and he's back to his normal self soon.
 
Also if you "HAVE" to give the mirtz - start with 1/8th of a pill. If Junior and you can manage enough calories between his eating some and you assist feeding the rest - I wouldn't use it at all.

Also on the assist feeding forum we've seen a lot of side effects with the mirtz. And it stays in their system for three days. If you "HAVE" to give an appetite stimulant cypro may be a better option with less side effects. 1/8th of a pill or even less of this if you have a small cat.

Others here can comment on their experiences.
 
Thanks Karrie,
he is a small cat , just under 11 lbs, I think he's small, his brother is 18 lbs. Anyways, I will let him eat FF himself, and get baby food also on the way home to syringe feed calories, I will NOT start the mirtazapine, yet, will wait and see how he does, another 24 hours?
 
Wait as long as you have to. But make sure he's getting in enough calories. There are some foods out there like Wellness Chicken which is 200 calories a can and low carb. So if you can assist feed enough calories, he won't need mirtz or cypro. Antibiotics can reduce appetite also - they can make a cat feel nauseated. Assist feeding is one of the best tools in your toolbox. I didn't know about it until Maverick almost died (his story is in my signature). Now I pay it forward and help educate as many people as possible on assist feeding. Mirtz/Cypro do have their place - I'm not totally against it. Such as with a very fractious cat that won't allow assist feeding or the owner doesn't have the time or ability. Assist feeding can be a bonding experience also.

That's a small cat in my world too - but I think that would be an average cat LOL. I have two 17/18lb cats and one 10lb cat. She feels light as air compared to the other two.
 
We completely understand as our kitty Zener is often inappetant. We've had some experience with the meds Karrie writes about. We used reglan successfully for a short period for stomach motility issues but after using for a few weeks, it caused an increase in dyskinesia (involuntary movements) that he has from cerebellar hypoplasia. Now we give him 1/3 tablet of OTC Zantac which helps stomach acidity and motility. We also regularly give him ondansetron to prevent nausea and cerenia when his tummy is cramping and painful. And we also use cypro from time to time when he won't eat and we need to get food him to shoot. We never use the cypro without also using the ondansetron. We tried mirtazapine once and had a vomiting episode followed by not eating and having to syringe feed for about 5 days. The mirtz made him very restless and "meowy". We consider his tummy and eating issues much more of a challenge than his BG! Karrie is very helpful and has gotten us through many inappetant episodes with Zener. The assisted feeding group she writes about also has great information.

ETA: the reglan caused the dyskinesia (head tremors) after just a few days so we stopped right away. We give 1/8 of over-the-counter Zantac twice a day (not 1/3). Liz
 
It's interesting she is giving Amoxi and then clindamycin. Did she say why? Is the clindamycin for his mouth? That would make sense....

Also....urine specific gravity is not usually given as a range. And 1.025 to 1.030 is a little on the dilute side. Does he have renal issues? While "normal" is 1.008 to 1.060, a USG under 1.040 is indicative of
something going on. It can be a precursor of kidney issues even before the bloodwork shows it. It can also indicate pyelonephritis, hyperthyroidism, liver issues,and some FD cats may have lower USG. IT might also
be seen lower than 1.040 on a cat on steroids.

I'd be sure you know what his blood values are and if they are normal, I'd keep an eye on both his USG and his blood values.
 
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