7/19 Copernicus (dose review?) AMPS= 456 +6=468 PMPS=536

Krista & Copernicus

Krista & Copernicus

Member Since 2026
PP

I am not liking today's numbers increasing and in the black. When he gets this hi I can't always get him out of it without IV fluids. Why so hi?? I'm doing subq fluids. This seems to have started before the increase to 17 and different than new dose wonkiness. Including Friday labs.
 

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NDW is one possibility as he did just start this dose. I'm rooting for the "high before the low" which means coming down from a bounce from those yellows.
 
Wendy&Neko said:
NDW is one possibility as he did just start this dose. I'm rooting for the "high before the low" which means coming down from a bounce from those yellows.
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Does anyone ever increase by more than 1 unit at this point? This is why vet school pushing for TouJeo. I thought Lantus was supposed to be smoother and less ups and downs?
 
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For a larger dose cat, think of the increases as 10-15% of the total dose. You could easily move to 1.5 unit increase now and 2 if he hits 20 units.

Lantus is flatter, once you get the into better numbers.
 
Krista & Copernicus said:
PP

I am not liking today's numbers increasing and in the black. When he gets this hi I can't always get him out of it without IV fluids. Why so hi?? I'm doing subq fluids. This seems to have started before the increase to 17 and different than new dose wonkiness. Including Friday labs.
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Thanks for starting a new condo.

I know you are asking about dosing and Wendy has answered but since you posted his labs, I’m really curious. If they say he has a magnesium issue, why didn’t they check his levels? Also, his kidney values, other than phosphorus, are really not bad at all. And he is not anemic. CKD cats are considered anemic once the HCT drops below 30%. His hemoglobin is low but his MCHC and MCV are normal. Usually with iron deficient anemia, they would be low although the MCHC is on the borderline and between that and the HGB, it might be why they want to treat him for iron deficiency.

I read that Wedgwood Pharmacy can provide injectable methylcobalamin but I don’t know if it has any magnesium in it or if it always has to be given IM. If you find a way to give him methylcobalamin, you also have to give him a multiB to keep the HCT from dropping lower. This is the multiB I’ve always used for my CKD cats and I don’t see any magnesium in it. They only need 1/10 capsule a day.
 
Krista & Copernicus said:
I am not liking today's numbers increasing and in the black. When he gets this hi I can't always get him out of it without IV fluids. Why so hi?? I'm doing subq fluids. This seems to have started before the increase to 17 and different than new dose wonkiness. Including Friday labs.
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Glad to see your post.

I agree with Wendy and Marje. Also, if it wasn’t done, I’d want to do a sterile urine collection and run a urine culture & sensitivity (C&S). Diabetic cats are notorious for getting UTIs and high BG makes the bladder a very bacteria-friendly breeding ground.
 
Marje and Gracie said:
Thanks for starting a new condo.

I know you are asking about dosing and Wendy has answered but since you posted his labs, I’m really curious. If they say he has a magnesium issue, why didn’t they check his levels? Also, his kidney values, other than phosphorus, are really not bad at all. And he is not anemic. CKD cats are considered anemic once the HCT drops below 30%. His hemoglobin is low but his MCHC and MCV are normal. Usually with iron deficient anemia, they would be low although the MCHC is on the borderline and between that and the HGB, it might be why they want to treat him for iron deficiency.

I read that Wedgwood Pharmacy can provide injectable methylcobalamin but I don’t know if it has any magnesium in it or if it always has to be given IM. If you find a way to give him methylcobalamin, you also have to give him a multiB to keep the HCT from dropping lower. This is the multiB I’ve always used for my CKD cats and I don’t see any magnesium in it. They only need 1/10 capsule a day.
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Attaching urine results. Vet school said culture looked good so far, but that was like a week ago and I haven't heard back from them even after I emailed and left a voicemail. The admin let me know I wasn't their only patient and they are allowed up to 3 days to return messages.

7/12: Mg=3.4 (range 2.0-2.6)
7/11: Mg=3.9
7/10: Mg=4.1

The vet school was supposed to repeat his labs but I never heard back. Magnesium is included in vet school CBC. So I took him to primary care on Friday, and they ran a CBC. I didn't find out until after the results that magnesium is NOT included on the primary care panel. I was frustrated. His magnesium is quite high and his symptoms match when I google it. Weakness, lethargy, etc. Now that he has this acromegaly label I have noticed a lot of the vets just say his symptoms are all from that. As if that's an acceptable treatment plan.
 

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Krista & Copernicus said:
Attaching urine results. Vet school said culture looked good so far, but that was like a week ago and I haven't heard back from them even after I emailed and left a voicemail. The admin let me know I wasn't their only patient and they are allowed up to 3 days to return messages.

7/12: Mg=3.4 (range 2.0-2.6)
7/11: Mg=3.9
7/10: Mg=4.1

The vet school was supposed to repeat his labs but I never heard back. Magnesium is included in vet school CBC. So I took him to primary care on Friday, and they ran a CBC. I didn't find out until after the results that magnesium is NOT included on the primary care panel. I was frustrated. His magnesium is quite high and his symptoms match when I google it. Weakness, lethargy, etc. Now that he has this acromegaly label I have noticed a lot of the vets just say his symptoms are all from that. As if that's an acceptable treatment plan.
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He’s still concentrating his urine fairly well especially considering he gets fluids.
 
Marje and Gracie said:
Thanks for starting a new condo.

I know you are asking about dosing and Wendy has answered but since you posted his labs, I’m really curious. If they say he has a magnesium issue, why didn’t they check his levels? Also, his kidney values, other than phosphorus, are really not bad at all. And he is not anemic. CKD cats are considered anemic once the HCT drops below 30%. His hemoglobin is low but his MCHC and MCV are normal. Usually with iron deficient anemia, they would be low although the MCHC is on the borderline and between that and the HGB, it might be why they want to treat him for iron deficiency.

I read that Wedgwood Pharmacy can provide injectable methylcobalamin but I don’t know if it has any magnesium in it or if it always has to be given IM. If you find a way to give him methylcobalamin, you also have to give him a multiB to keep the HCT from dropping lower. This is the multiB I’ve always used for my CKD cats and I don’t see any magnesium in it. They only need 1/10 capsule a day.
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Unfortunately that b vitamin does have magnesium stearate in it. Thats why I need support for compounded or transdermal or injectable meds.
 
Krista & Copernicus said:
Unfortunately that b vitamin does have magnesium stearate in it. Thats why I need support for compounded or transdermal or injectable meds.
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I’m sorry. I missed that 🤦🏻‍♀️🤦🏻‍♀️ And I was even looking for it.

Krista & Copernicus said:
The urinalysis was before any fluids I should have mentioned.
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Fluids can affect the USG if you’ve been giving them regularly even if you didn’t give them right before the test.
 
Marje and Gracie said:
I’m sorry. I missed that 🤦🏻‍♀️🤦🏻‍♀️ And I was even looking for it.


Fluids can affect the USG if you’ve been giving them regularly even if you didn’t give them right before the test.
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I haven't been given them regularly, but he was on IV fluids for 48 hours a week prior. How does it affect the USG? In what way? I have a urinalysis from before IV fluids I will post tomorrow. Also, no one has checked a fPI for pancreatitis.
 
Krista & Copernicus said:
I haven't been given them regularly, but he was on IV fluids for 48 hours a week prior. How does it affect the USG? In what way? I have a urinalysis from before IV fluids I will post tomorrow. Also, no one has checked a fPI for pancreatitis.
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If a cat has CKD, their kidneys can no longer concentrate urine as it did before. Typically, a USG of 1.012 or less is definitely indicative of CKD. The more they drink or receive fluids, the less the kidneys can concentrate the fluids. It’s just part of the disease. A normal USG would be above 1.030. Because some cats drink a lot of water or might get fluids for another condition besides CKD, it’s possible the USG could be lower as the day progresses so the best time to do a test for urine specific gravity is the first urine of the morning. If the USG is 1.030 or higher, the kitty is able to concentrate urine.
 
“Normosol R” is just another type of fluids.

You mentioned probable IBD. How are his stools? (color, consistency, frequency, etc).

Glad to see he’s out of the blacks for now.
 
JL and Chip said:
“Normosol R” is just another type of fluids.

You mentioned probable IBD. How are his stools? (color, consistency, frequency, etc).

Glad to see he’s out of the blacks for now.
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stools are normal. He had some soft stools after oral b12 so maybe it was the citric acid. I think IBD was suggested because the reflux and thickening but now I think the reflux was early CKD and pancreatitis all along. I also still suspect inflammation in esophagus bc hard swallowing. He poops every day sometimes every other. The lethargy...you can see it in this photo.🥺
 

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