6/27 Eddie AMPS 263, PMPS 261, +6/361 A/B question

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Jen&Eddie

Jen&Eddie

Member Since 2013
Yesterday's Condo

YESTERDAY: AMPS/350, +2.5/324, +6/276, +11/279, PMPS/297 (DOSECREASE), +2/316, +5/298, +6/291
TODAY: AMPS/263, +3/277, +8/281, +10/268 (VET), PMPS/261, +2/337, +4/313, +6/361

Hi LL. Thank goodness it's Friday! I'm wiped out, and looking forward to chillaxing this weekend.

Eddie's numbers for today remain flat. The insulin hasn't budged him from above renal threshold for a few days now. Symptom wise, he seems fine, except for perhaps a little reduced energy.

Vetty visit went pretty well. We met with a vet tech who we haven't worked with before, and she was a sweetheart. I got the impression that Eddie might be well known around the office. While he was getting his blood drawn and being weighed, Eddie found another tech who has cat-sat for us in the past, so he invited her in to meet with us. :-D Her mom is diabetic, and she cared for a diabetic cat during her vet internship. We didn't actually get to meet with the vet today. I suspect that the person who took down our appointment maybe didn't schedule a vet visit. They had us down for a glucose blood and urine test. :roll:

They did do a blood glucose test which was 268 on a human meter, so pretty much in line with the rest of Eddie's numbers today without any increase due to vet stress, which is kind of interesting. Unfortunately, Eddie had an empty bladder, so they couldn't do a cystocentesis this afternoon. They checked a couple times during the time we were there just in case his bladder filled a little, but no such luck. They do want us to try to do a free catch and bring it in tomorrow morning. I know that's definitely not the preferred method. If nothing else, they do want to rule out crystals. Eddie is super cooperative for me when donating a urine sample, so I think I can get a free catch. Is it pointless though to check for bacteria due to possible contamination? They didn't see any other definitive signs of an infection, but the vet felt that a brewing infection is entirely possible with the upswing in his numbers, and prescribed a course of Simplicef Generic/Cefpodoxir for 10 days.

So, should we start the A/B tonight even though we don't have a confirmed infection, or does it make sense to hold off until we drop off the free catch sample tomorrow morning in the hopes that it can shed some light as to whether there is a UTI?

Vetty also provided with a prescription for Lantus pens. Yay! She was reluctant initially since she had never heard of anyone doing that before, and didn't want us (correctly) to be using the dial a dose feature. Our tech today, however, having a diabetic mother, totally understood what our thought process was with the pens, and basically using them as mini-vials, so we have our prescription! We got in late for the appointment, and I got home with Eddie just in time for T/F/S so he got a dose of the existing vial tonight. They also agreed that it would be odd for the insulin to be ka-put after less than three months. We will run to the pharmacy to get the pens tonight. I signed Eddie up for a Lantus savings card...we shall see if they accept it. Even at full price, it's ultimately cheaper to do the pens than to have to purchase a whole new vial assuming that the current one is no longer working.

Also on my shopping list is the Duck and Pea pill pockets. We've never had to pill Eddie before, but I'm cautiously optimistic that he will cooperate with that, like he does with everything else. I actually had some pill pockets on hand that ADW sent us with our order of syringes, but they are not the diabetic friendly ones.

Vines and hugs to all those beans and kitties who need them, particularly Elise, Max, and Elise's mom, and green vines to all the kitties on OTJ trials and to Pixie who successfully completed his trial today! :mrgreen: :mrgreen: :mrgreen:
 
Re: 6/27 Eddie AMPS 263, PMPS 261 Vet update

That's great the Eddie is such a good kitty at the vet. I'm sorry you didn't actually get to see the vet, but it's great the vet tech gave you a prescription for the pens. I don't know about starting the AB or about testing free catch urine. Hopefully someone with more knowledge will be along soon.
 
Re: 6/27 Eddie AMPS 263, PMPS 261 Vet update

I've been told that free catch of urine can introduce bacteria into the urine, so that is not the way to go. You can identify crystals if that is what you are looking for. But as long as Eddie is still peeing good size amounts and not going in and out of LB trying to pee, I'd guess that's not the issue. Do you add lots of water to Eddie's food? I have a cystitis kitty who sometimes has crystals and I have to make sure he's getting lots of water to flush out any crystals.

For answers on the ABs question, you might want to select the ? icon and put something on your first subject line.

Good luck getting a pen with the Lantus savings card.
 
Re: 6/27 Eddie AMPS 263, PMPS 261 A/B question

Thanks Wendy,

I'm trying to find out whether there is enough of a chance that the free catch will be of diagnostic/lab value to make it worthwhile to wait to begin the A/B until after I get a sample - there's a good chance that I can get Eddie to cooperate for me yet tonight to get a free catch, and I could administer his first A/B tonight...do you refrigerate urine? @-) I remember something in Brian/Tyler's condo about getting a urine sample before beginning the A/B so as to get an accurate result as to the presence of bacteria, but I'm not finding the condo at the moment.

I don't know much about crystals, but his LB habits are normal in quantity and frequency, so I seriously doubt that's the issue either. We do add water to each of his six daily meals to make them about applesauce consistency. Since converting to 100% wet food, none of the kitties ever drink out of the water fountain anymore.

We hit the pharmacy tonight to pick up Eddie's pens. I opted to get the whole box rather than trying to get one at a time. To the pharmacist's credit, she tried to process the discount card multiple times and all three of the pharmacists were trying to brainstorm ways to process it, but without a Provider ID # (NPI), the manufacturer will not accept the discount card, and vets don't have a NPI. Talk about sticker shock. :shock: :o I'm going to have process that the help of an adult beverage or two tonight. So far, it looks like Eddie's not going to interfere with adult beverage time tonight. When I got to the pharmacy - CVS - which is a big chain, all three people working in the pharmacy were very curious to learn about Eddie and his prescription for Lantus pens. None of them had ever seen that before. They all also wanted the name and contact info for my vet, given our vet's willingness to do something outside the "norm" for a diabetic pet. That was kind of cool.

We'll try out a new pen with tomorrow AM's dose. On the off chance that it is the insulin that's toast, I'll be around to monitor closely.
 
Re: 6/27 Eddie AMPS 263, PMPS 261 A/B question

Hi Jen. That's too bad they didn't schedule a vet appointment for you. A free catch will likely not give you an answer as to whether there is an infection and I would hate to start an antibiotic if unnecessary. It's too easy to get surrounding bacteria as you can't wipe him before he goes. Any change you could bring Eddie back tomorrow? I once had to leave Tiffany for half a day for her bladder to fill up. She was inclined to pee as I picked her up to get her into the carrier. It got to the point that I wised up and I would wait to put on my pants until after she was safely in her carrier so I only had to wash me, LOL!!
 
Re: 6/27 Eddie AMPS 263, PMPS 261 A/B question

Hi Elise,

Gah. I'm torn now. I kind of feel like my options are sort of limited. I feel like I should start the A/B if he does have an infection present even without obvious symptoms, and I don't want to let it continue to stew. Since they couldn't get a urine sample this afternoon, the option I have right now is to bring in the free catch. They don't really want to keep him there since he doesn't have obvious symptoms of UTI, and I don't really want to leave him there for the same reason, so we're kind of guessing based on his high numbers the past several days. It pretty much has to be an infection or the insulin. If I wait to bring him in to try again tomorrow (assuming he has a full bladder) and then have to wait a couple days for the culture, that's just several more days with a potential infection stewing. I dunno. :?
 
Re: 6/27 Eddie AMPS 263, PMPS 261 A/B question

It's a tough one. Even if you bring in a free catch they will need a culture and sensitivity to make sure the antibiotic they give him is the right one. I guess if you go ahead the worst is he gets a round of AB for nothing. Go with your gut. It's usually right.
 
Re: 6/27 Eddie AMPS 263, PMPS 261 A/B question

Thanks Elise -

At the risk of starting him on the A/B unnecessarily, I went ahead and gave him his first dose. I did get a free catch before his dose, so if does by chance provide any useable diagnostic info, it's pre-A/B. Eddie's such a champ. He was napping in a box, and I picked him up and hugged him, brought him to a litter box and set him down, and he promptly squatted to potty, which I was able to catch without touching him or the litter or the litter box to do at least what I can do to avoid contamination. It's what we can do for the time being. He was also a good boy and nommed up his pill pocket with pill enclosed even though I heard a crunch and he bit into the pill. Those duck and pea pockets smell horrific, but Eddie thinks they're pretty darn yummy.

After watching him not budge from high numbers for several days and despite doubling his dose in two weeks, I gotta do something, ya know? :? Including spending another $400 on insulin on the off chance his current vial is shot. ohmygod_smile Ugh. Something's gotta give I hope. :?
 
Re: 6/27 Eddie AMPS 263, PMPS 261 A/B question

Yes, you refrigerate urine. And label it well! :lol:

$400 for 5 pens! Ouch. I don't know how much a round trip flight is to Thunder Bay, but we pay around $100 in Canada. Paws crossed either the ABs or the new juice do something for you.
 
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