5/9 Sammy AMPS=477 Situation Deteriorating

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Maureen & Sammy

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http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=13995

Recap Yesterday (Saturday): AMPS=390 +4~208 +6.5~296 PMPS=364

Recall that Tuesday, Wednesday & Thursday he was running below 150. Then the PM cycle Thursday spiked high again. I took him to the vet early Friday morning because he hadn't gone since Tuesday. The vet said it wasn't constipation but pain in pushing and put him on Tramadol. His first 1/4ml dose of Tramadol was Friday night. The instruction were twice a day and move to 1/2ml if necessary and get back to the doctor Tuesday. I was to continue MiraLax. Watch for wonkiness, dilated pupils and dysphoria. Luckily Cheerio, a civvie, graced us with his presence so it was it was easy to see dilation. Sammy is keeping to himself in the dining room and has growled if I picked him up. Since the oral syringes are in 1/2ml doses last night and since nothing had happened poo-wise I stopped trying to do 1/4ml and gave him what might be called a fat 1/4: the third little bar before 1/2ml which is the fifth bar. I also stopped sticking him. At six this morning there was what I might call regulation-size poo (or would if I didn't know he hadn't gone since Tuesday) in the Sammy-only LB and he was back on the chaise in the living room. However, I fell back to sleep and was 30 minutes late with the insulin. I gave him more of the Tramadol. I was afraid there for a while that he wasn't going to eat anything. He finally ate a shrimp and a bit of tuna fish (with the MiraLax in it). He just walked into the kitchen for water, looking very suspiciously at me, and went back to the dining room.I beginning to question the ethics of this situation. They're talking about him being on Tramadol the rest of his life. Can somebody look at his ss and see if we should stay at 2U?
 
I would increase Sammy's insulin dose to 2.25 while this is still going on. Something is making his numbers high.

With regards to the vet, it sounds like time to get a second opinion, quickly. I'll tell you my scary story - when I first adopted Lucy, she didn't have her first poo for several days (it might have even been a week). She stopped eating. She had a history of doing that in her foster home when she had a bad hairball that would plug things up, so I was giving hairball remedy and lots of water. Finally took her to the vet, who should have done an x-ray but didn't and I didn't know to insist on it. They gave her more hairball remedy and said to come back Thursday if she wasn't better. Wednesday night I found her in the closet - I thought she was dead. She had gone into DKA. I don't know which thing caused the other things to happen, my guess is that she had an acute pancreatitis attack and that caused the other stuff, but I don't know. All I know is that I went from having a cat that was kind of ok but not feeling great and not pooping/eating, to a cat that was nearly dead, in less than a day. I'm not saying that Sammy is heading for DKA, but if he's growling and not eating, then something is hurting. If your vet isn't helping, then ask another one.
 
Have you tested for ketones?
Libby always knows the right thing to do and the right thing to say always....so glad she is here!
(((Maureen & Sammy)))
 
No my strips were too old and I threw them out the other day. I haven't been out of the house to replace them. I'll get dressed and do that.
 
Maureen--I have told you about the wonderful vets in Westbury--These people feel that Sammy is not getting the proper care from your vet, they are most likely Right!!!--Please contact the center for specialized veterinary care, westbury, & I will give you the doctors to ask for--Just for second opinion!!!
Maybe it is time to go up a notch in Sammy's care!! You need vets with lantus experience!! I'm here till 12 ish, then back tonite for Moonie about 6!! At least he poo'd--!!! Hope this situation turns around.
Libby is almost always right!!! I would definitely listen to her!!
Possibility that Sammy doesnt feel good, but the Tramadol is helping as he pooped.
Check for ketones as was suggested--We are not saying he has them, just check them! OK! Hoping Sammy gets better today!
 
Maureen

Libby has brought up excellent advise, if at all possible, seeking a second professional opinion and look at Sammy is very important.
 
I don't mean to scare you, well I sort of do... I can tell from the tone of your posts that you are more worried than the vet is and that you know something is wrong. If they can't answer your questions to your satisfaction, then I would go somewhere else. Things can change so fast when they stop eating.

I volunteer for Siamese Rescue, and one of the adopters I worked with emailed last week. She had gone to her vet because her kitty's jaw was "clicking" and she didn't know what it was. The vet took a look in the cat's mouth and said he needed 10-12 extractions for a chronic mouth condition. Now stomatitis IS common in Siamese, but this diagnosis seemed to come out of nowhere and she didn't believe it and was scared. She went to a different clinic for a second opinion. The second vet agreed that the diagnosis was likely, but the difference is that he SHOWED her the cat's mouth and showed her why he was thinking that, and then explained how they would proceed to further diagnose before pulling all those teeth. Same diagnosis, but the explanation and actually pointing to things in the cat's mouth made all the difference. Maybe ask your vet to SHOW you on the x-ray why he thinks what he does, or go somewhere else that will.
 
Hi Maureen, Sending you support and I hope that you will follow Libby's advice and get a second opinion. Roni has confidence in the vets she suggested in Westbury, so maybe you ought to try to set up an appointment early next week. In the meantime, we are thinking positive thoughts for Sammy.

Ella & Stu
 
OK, I got the Keto-Diastix I just need an obliging cat. I also got some new control solution and is +2 of 463. He won't let me do a +3 and that's never happened before
 
Well, the doctor Roni recommended pushed on but between the two of us we found her. The soonest I can see her is Wednesday morning at 10 and I have to get a referral and Sammy's records sent over.
 
you sent me a PM with a schedule question. If you're only off by 30 minutes (because you shot a little late this morning), then yes, you can make that up tonight.
 
Honestly, if Sammy isn't eating, Wednesday is too long. This situation has been going on for quite some time. From Roni's note, it sounded like there's more than one vet that may be worth seeing. A cat that is eating only minimally for what will amount to 4 days could mean a very serious problem. Hepatic lipidosis, which can result from inappetance, can kill due to the damage it does to the liver. Caught early, it's reversible. If Sammy is still not eating, this may mean an ER visit.
 
yes, I was off by exactly 30 minutes and that in turn was off by more or less 40 minutes because we had to go to +12.5 Wednesday PM because his +12 was 117 and I wasn't sure what to do before I got the SHOOOOOOOOT command at +135. I'd like to shoot at +11 can I do that?
 
Sammy has been eating. He's just not eating now. And I got scared this morning because I shot him late. And he wasn't eating like he always does. He has eaten since just without any gusto and only a couple of shrimp and a bit of tuna fish
 
I hope you can get Sammy into the new vet and they figure out whats going on. I have not looked at your ss, but read about the constipation and pain meds. The first time I ever brought latte to the vet it was for constipation. The vet put her on a pain med for the same reasons yours suggested (hard to get out/painful). Latte went into renal failure from the medication (different one you are using). What I wish I had done was further explored WHY the possible reasons for the constipation. I could have tried to change her to wet food for more fluids, or encouraged more water, or maybe she had IBD at that point and we could have addressed it. It also could have been because of arthritis pain, which our latest experience proves to be a partial cause of her current lack of bowel movements.

Im sure he is uncomfortable from the constipation. If he is not eating, he obviously will not produce much stool. Is Sammy drinking enough water with the miralax? high numbers can make cats crabby (at least latte), and possibly the tramadol is having an effect that causes him to be a little grouchy as well.

Can you try some babyfood today? A lot of cats will eat that when nothing else is interesting. Most people use beechnut chicken, beef, turkey. We use gerbers.
 
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