6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10; 572 +3.5

[RG & Mali (GA)]

yesterday's condo

Morning all Not a good night or morning for Mali girl. 4 Hi's in a row starting at PMPS last nite. I've increase her dose to 1.5u this morning. She squalled most of the nite and she puked clear/white small amounts of liquid this morning b4 shot and bupe. She also has been constipated and did not poop yesterday, but did this morning including some hard and some puddin' type OLB and down side and also peed on hardwoods.....she has NEVER done that.

Vet called last nite with her lab report from Wednesday and said her kidney values were higher indicating dehydration. I will p/u fluids this morning and start that immediately. Her neutrophils (major white b/c value) is still down so starting Leukeran may not happen. Vet thinks lymphoma is probably the culprit. At last lab she said it was either that or IBD but w/o exploratory, it's just an educated guess.

Sorry I've opened TGIF with such a downer, but as the well worn and trite phrase by now goes "it is what it is".
Healing vines to all in need in LL....have a great Friday :!:

 

[Deb & Wink]

Re: 6/21 Mali AMPS Hi

Morning Robert,

Sorry to hear Mali was throwing you nothing but HI's again. The dehydration may have something to do with that so here is hoping the fluids will help out a bit.

She squalled most of the nite and she puked clear/white small amounts of liquid this morning b4 shot and bupe. She also has been constipated and did not poop yesterday, but did this morning including some hard and some puddin' type OLB and down side and also peed on hardwoods.....she has NEVER done that.

Poor Mali girl! Hope she gets to feeling better today.

We are all sending our best wishes and prayers for Mali.

Feel better sweetie and get all the hugs and attention you can get from your bean. OK? With love, your cousin Wink

 

[Frosty]

Re: 6/21 Mali AMPS Hi

Hi Robert. Sorry that Mali is beginning the weekend not feeling too well. I hope the increased fluids helps her get re-hydrated and brings her numbers down. We have her in our Prayers.

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet getting fluids

Thanks for stopping by,Deb..you and cousin Wink are always welcome :YMHUG:
I decided to take Mali to the vet this morning and leave her to have them give fluids and watch her while I had to take care of some business. I just didn't feel comfortable leaving her b/c she didn't eat, and just sat and stared at her water bowl out on the catio for like an hour without moving...she would drink a little but I think she just got very dehydrated so I made the call to take her in. They will call when she has some time to get her fluids and level out some.

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi

Hi Robert. Sorry that Mali is beginning the weekend not feeling too well. I hope the increased fluids helps her get re-hydrated and brings her numbers down. We have her in our Prayers.

Thanks, John....hope PF is recovered from his ordeal yesterday

 

[Anne & Zener GA]

Re: 6/21 Mali AMPS Hi

Tons of vines for Mali. Have you seen Marje's video on giving fluids? Gus is the star.
Liz

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi

Tons of vines for Mali. Have you seen Marje's video on giving fluids? Gus is the star.
Liz

Hi Liz,
No I have not seen it but would like to..where do I find it?
I gave fluids to Mali when she was first dx'd with pancreatitis and think I did ok, but would still like to see how Marje does it.

 

[Ann & Tess GA]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Send tons of healing vines to Mali! I hope she is feeling better soon! Here's the link to Marje's video.

Mali! You at the vetty???? KTSS will be there to get all the vetty smell off when you get home! We has excellent aroma therapy! -- Tess

 

[BorisV]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Sending big Tashie kisses and well wishes to Mali! Come home Mali, we were just starting to be pals! Miss you :smile:

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Send tons of healing vines to Mali! I hope she is feeling better soon! Here's the link to Marje's video.

Mali! You at the vetty???? KTSS will be there to get all the vetty smell off when you get home! We has excellent aroma therapy! -- Tess

Excellent video by Marje! I think that was about the time i lost my internet so I missed it. She goes into MUCH more detail on subq fluids than I got from the vet tech when I gave them a month or so ago.

Thank you for the vines, Tess... I will be home soon for that aroma therapy-Mali

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Sending big Tashie kisses and well wishes to Mali! Come home Mali, we were just starting to be pals! Miss you :smile:

Thank you Tashie...be home soon-Mali

 

[Sienne and Gabby (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

I hope Mali starts to feel better. The fluids may really help!

Did you ask the vet about an appetite stimulant (Mirtazepine or cyproheptadine) if Mali isn't eating well?

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

I hope Mali starts to feel better. The fluids may really help!

Did you ask the vet about an appetite stimulant (Mirtazepine or cyproheptadine) if Mali isn't eating well?

Hi Sienne,
No I haven't ask about that yet. She has been eating very well until this morning when she didn't touch her breffis and started the staring at her water bowl deal. Normally she has a very good appy and when it slows down a little, I pour a little Fortiflora over her FF and she scarfs it down. I will ask about it when I pick her up after while. Thanks for checking in!

 

[mtncat58]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Oh Mali, so sorry hope you get o the mend soon. Sending lots of healing vines your way.

 

[Marje and Gracie]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Robert

This sort of sounds to me like Mali is having another episode of pancreatitis. Doesn't it to you? I would not be surprised if she doesn't have mild, chronic pancreatitis that flares up to more than just mild from time to time. That could be why you got those highs last night and this morning.

I would talk to the vet, also, about some buprenorphine for pain. Bupe is a good pain med for cats with compromised kidney values because it is not processed through the kidneys; I believe my vet said it's the only one that isn't processed through the kidneys. I'd be very interested in seeing her bloodwork results when you get them. Let me know if you have any questions on giving fluids. After every day for +3 years, I think we could do it in our sleep. Gussie, too :lol: :lol: :lol: For about 1.5 years, we were doing two cats daily.

While it's more convenient to just do it EOD, especially if you have a cat that isn't like Gus, it's actually much better for their little bodies to do less every day. The most important point is to be sure all fluids are totally absorbed before you do it again.

I thought you "ran off with someone else" when I didn't hear from you.

:lol: :lol: :lol: :lol: NEVER! ;-)

Sending Miss Mali many healing vines!

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10

Robert

This sort of sounds to me like Mali is having another episode of pancreatitis. Doesn't it to you? I would not be surprised if she doesn't have mild, chronic pancreatitis that flares up to more than just mild from time to time. That could be why you got those highs last night and this morning.

I would talk to the vet, also, about some buprenorphine for pain. Bupe is a good pain med for cats with compromised kidney values because it is not processed through the kidneys; I believe my vet said it's the only one that isn't processed through the kidneys. I'd be very interested in seeing her bloodwork results when you get them. Let me know if you have any questions on giving fluids. After every day for +3 years, I think we could do it in our sleep. Gussie, too :lol: :lol: :lol: For about 1.5 years, we were doing two cats daily.

While it's more convenient to just do it EOD, especially if you have a cat that isn't like Gus, it's actually much better for their little bodies to do less every day. The most important point is to be sure all fluids are totally absorbed before you do it again.

I thought you "ran off with someone else" when I didn't hear from you.

:lol: :lol: :lol: :lol: NEVER! ;-)

Sending Miss Mali many healing vines!

It does seem a lot like before along with the deteriorating lab (I've posted). I picked up Mali and she's really not much if any better after the fluids. She had thrown up some bile while she was there because she hasn't eaten anything today. When the tech brought her out she started heaving and she put her down and she promptly thru up more bile and her Cerenia so they took her back and gave it to her in an injection.

Marje, I already put her back on bupe a couple of days ago .25ml bid so I hope that is helping with the pain. She just stands over her water bowl and puts her throat and chin in it..doesn't look like she's drinking much. I checked her as soon as I got home with her and she is still Hi after all day, after dosecrease and nothing to eat!
Liz referred me to the fluid instructional video that you and Mike made and it is excellent! We had given Mali fluids when she was first dx'd w/pancreatitis and we didn't do a lot of the things you pointed out, but I guess we got it in her ok :-|
Wow, you do have a bunch of experience in fluid therapy!
I guess I'll go ahead with the increased dose at PM. I hate that she has an empty stomach...hopefully she will eat, but if not I guess we will have to get the syringe working again.
Take a look at the lab and special note to the increase BUN and Creatinine and let me know what you surmise from it.

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Oh Mali, so sorry hope you get o the mend soon. Sending lots of healing vines your way.

Mali sends thanks to you and Lucky for your healing vines her way. :YMHUG:

 

[Cleo & Jane (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Hi Robert, Cleo and I are also sending healing vines to Mali. Hope she perks up some for you tonight. It is hardest on the beans, when our kitties down't feel good~

 

[Dyana]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10

Sending strong vines of feel better and eating more to Mali tonight.
There's a good video on assist feeding via syringe I can find for you too, if you need it.

I hope the new dose helps her. Try to get a mid-cycle test tonight, if you can.

Please give a couple of loving pets to Mali from me.

 

[Marje and Gracie]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10

Her BUN is higher than Gus's and he is in Stage 4 CKD. She needs fluids every day. Your vet will need to tell you how much she can safely have with her heart murmur. Our Teddi Bear had a murmur, her values were not as elevated as this, she weighed 6 lbs, and we gave her 75mls every day until I got her creat and BUN back down close to normal. Then I went to EOD.

I am not surprised Mali is feeling bad. Her phosphorus is wwaaaayyyy too high. Did the vet not say anything about this? The reference range of up to 8.2 includes kittens and their P level is always higher as they are forming bone. But for a cat with CKD like this, you really want that P down around 4/4.5. It is likely one of the culprits making her so sick....high P can make a kitty feel terrible and it can cause CKD to progress faster than if it is under control. The other thing that worries me is that her phosphorus x her calcium is greater than 70. This puts her at risk for hyperparathyroidism and tissue calcification.

I would have her on 1/4 of a 10mg Pepcid AC bid (forgive me if you said you are doing this and I missed it....it's not on her profile). Hanging out by her water dish like that and the bile is acid tummy and high P will cause that. I'd also get the ondansetron (1 mg bid; the tabs are 4 mg do she needs 1/4 bid...Costco is the cheapest place to get it). Once she has the ondansetron on board, if she still isn't eating, I'd get the cyproheptadine.

But she needs a phosphorus binder OR she needs the renal prescription diets. I'm not a big fan of them but for a P that high, they would probably be the fastest way to get the phosphorus down if she will eat them. If not, you need aluminum hydroxide phosphorus binder. Vets often give epakitin but that is old school....if you can find the aluminum hydroxide locally either from your vet or a compounding pharmacy, then you could just get enough to get started and then order it from AlOh at ThrivingPets .

I think your vet is bring too complacent. I don't want to scare you but the vet needs to work very proactively with you to get her BUN, creatinine, and especially her phosphorus way down.

I'll check back later in case you have questions. I've thrown alot at you.

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids

Hi Robert, Cleo and I are also sending healing vines to Mali. Hope she perks up some for you tonight. It is hardest on the beans, when our kitties down't feel good~

Hi Jane, yes it is hard on the beans, but i guess that's why we are here to absorb some of that pain. Thanks for the vines for Mali

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10

Sending strong vines of feel better and eating more to Mali tonight.
There's a good video on assist feeding via syringe I can find for you too, if you need it.

I hope the new dose helps her. Try to get a mid-cycle test tonight, if you can.

Please give a couple of loving pets to Mali from me.

Thanks Dyana, she is not eating and staggering a bit but still with us. Will get a test in a bit to see if she has moved from Hi yet.
I would like to see that video if you find it. Have a great evening.

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10

Her BUN is higher than Gus's and he is in Stage 4 CKD. She needs fluids every day. Your vet will need to tell you how much she can safely have with her heart murmur. Our Teddi Bear had a murmur, her values were not as elevated as this, she weighed 6 lbs, and we gave her 75mls every day until I got her creat and BUN back down close to normal. Then I went to EOD.

I am not surprised Mali is feeling bad. Her phosphorus is wasaayyyyy too high. Did the vet not say anything about this? The reference range of up to 8.2 includes kittens and their P level is always higher as they are forming bond. But for a cat with CKD like this, you really want that P down around 4/4.5. It is likely one of the culprits making her so sick....high P can make a kitty feel terrible and it can cause CKD to progress faster than if it is under control. The other thing that worries me is that her phosphorus x her calcium is greater than 70. This puts her at risk for hyperparathyroidism and tissue calcification.

I would have her on 1/4 of a 10mg Pepcid AC bid (forgive me if you said you are doing this and I missed it....it's not on her profile). Hanging out by her water dish like that and the bile is acid tummy and high P will cause that. I'd also get the ondansetron (1 mg bid; the tabs are 4 mg do she needs 1/4 bid...Costco is the cheapest place to get it). Once she has the ondansetron on board, if she still isn't eating, I'd get the cyproheptadine.

But she needs a phosphorus binder OR she needs the renal prescription diets. I'm not a big fan of them but for a P that high, they would probably be the fastest way to get the phosphorus down if she will eat them. If not, you need aluminum hydroxide phosphorus binder. Vets often give epakitin but that is old school....if you can find the aluminum hydroxide locally either from your vet or a compounding pharmacy, then you could just get enough to get started and then order it from AlOh at ThrivingPets .

I think your vet is bring too complacent. I don't want to scare you but the vet needs to work very proactively with you to get her BUN, creatinine, and especially her phosphorus way down.

I'll check back later in case you have questions. I've thrown alot at you.

Wow, that is a lot to digest, but thanks for all the things to think about. The vet refered us to a specialty vet this evening because I think they are out of answers so we gave them a call and they said to bring Mali on over and we did. Not the greatest vet experience. After taking a few notes on Mali and me giving them her lab report, insulin, syringe,etc. they take her back and a little later they come back to tell us they want to keep her for the weekend and it will be approx. 3000.00 American dollars....after I picked myself up off the floor and peeled the DW of the guy, I told him naahhh, I don't think so and he understood and brought her back out after getting BG (600+) and giving IV fluids. So only $162 later, we thanked them and took Mali home.

She ebbs and flows, but staggers a bit when she starts to walk but at least she has her fluids up for today.
I will address all the issues that you brought up with our vet in the morning and see if there is any motivation to pursue your points..I hope there is.
She is so sad looking now, I'm going to have to psyche myself out to stick her and check her BG, but I will and see if the Hi has come off any.
Thanks for ALL your knowledge and input, Marje...talk later.

 

[Marje and Gracie]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10

Staggering can also be a symptom of high P levels. Your poor baby. The thing is....she probably would benefit from a stay in the hospital on IV fluids but that cost is absurd. Is there any other 24 hour clinic/ER nearby?

 

[Dyana]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10

Here's the video on assist feeding: http://www.youtube.com/watch?v=U6o17wH6ujk It is considered one of the best and is shared to folks on this board quite a lot.
I hope Mali is feeling better.

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10 572 +3.5

Staggering can also be a symptom of high P levels. Your poor baby. The thing is....she probably would benefit from a stay in the hospital on IV fluids but that cost is absurd. Is there any other 24 hour clinic/ER nearby?

Yes, there are two but they are both night time ER and not open during the day and it's 5:30am here now. Sorry about bailing on you last night, I could not hold my eyes open any longer. For what it's worth, I did get a b4b time reading at 572 +3.5..whoopie, first BG below Hi in the last half dozen or so.
You did throw a lot at me last night and I want to go in all directions, but what is the one thing that you think is most important to pursue today?
Vet says start subq fluids tomorrow at 100ml every 48hrs. And no, she is not presently getting Pepcid AC. What is the other name for ondansetron?
As reported earlier, Mali has been very tough to pill, thats why we have gotten everything in liquid or compounded into liquid that we can. In her state now, it may be easier, don't know.

 

[RG & Mali (GA)]

Re: 6/21 Mali AMPS Hi; At Vet for Fluids;Hi +10

Here's the video on assist feeding: http://www.youtube.com/watch?v=U6o17wH6ujk It is considered one of the best and is shared to folks on this board quite a lot.
I hope Mali is feeling better.

Mornin' Dyana, thanks very much for the video. I had seen it sometime back, but did not remember where it was..thanks for sending. This morning is 24hrs since she has eaten so I guess today is the day for assist feeding. I picked up one of the ring type syringes at the vet yesterday but do you know where you can get the ringless ones? I remember clogging problems sometime in the past with the ring type.

Miss Mali did not have the greatest night. She paced a lot with the signature guttural squawl off and on and spends a lot of time over the water bown both inside and on the catio. Guess I'll get the AMPS in a little while and see what I can do to get Mali on the mend.
Thanks for stopping by, Dyana.

 

[Dyana]

The other name for Ondansetron is Zofran.

She does need to eat. Have you tried deli meat, or unspiced chicken or baby food with just meat and broth, yet?
You can call around to vets or maybe pharmacies to try to find ringless syringes. Mine are 10mL.
If you can get some IAMS Maximum Calorie, that would be great for the assist feeding. It's like 6% carbs and 330 calories per can. You would want to get about 1 can into her a day, I think. Sick kitties need more calories.

 

[RG & Mali (GA)]

The other name for Ondansetron is Zofran.

She does need to eat. Have you tried deli meat, or unspiced chicken or baby food with just meat and broth, yet?
You can call around to vets or maybe pharmacies to try to find ringless syringes. Mine are 10mL.
If you can get some IAMS Maximum Calorie, that would be great for the assist feeding. It's like 6% carbs and 330 calories per can. You would want to get about 1 can into her a day, I think. Sick kitties need more calories.

yep, that's it..Zofran..shudda remembered that from old chemo days of the past...no have not tried the deli meat, chicken or bfood..just her FF so that's another option.Got 3 or 4 cans of the Iams max calorie left from earlier times so if I can find the ringless syringes, I should be in business. I know Marje doesn't usually check in at this time so I'll do the best I can on the questions I had for her.
Thanks, Dyana, you are a great help :!: