8/13 Stu AMPS 393, +5.5 150, PMPS 182, +4.5 265

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Ella & Rusty & Stu(GA)

Ella & Rusty & Stu(GA)

Member Since 2010
yesterday: viewtopic.php?p=220928#p220928

Happy Friday the 13th, Everyone! (My late Auntie Elsie, who was born on a Friday the 13th in 1901, always considered it her lucky day)

Maybe it will be Stu's lucky day. He had a good night. Ate everything in the automat, played vigorously with his mice, and this morning has an AMPS of 393!! (down to 254 at +3). I sure don't know what is happening to his bg. I'm shooting 1 unit, but maybe I should go up a bit (but since at one point yesterday he dropped to 59 from high numbers, maybe I should keep it at 1 unit). I am totally confused about everything. We started on the hyperthyroid medication Methimazole this morning: 5mg pill and he is supposed to have 1 pill every 12 hours. I don't know if this dose is considered low, medium, or high, but Cassandra says that it is important to start low and work up if necessary in order to prevent a renal crash. I'll ask the vet, but I think he will just say that it is the dose he recommends. In any event, Stu will be re-evaluated on Aug. 25th, when we do the next blood work, and then we will see if the Methimazole is doing anything.
One neat thing: Stu is fascinated by his new water fountain. He is playing with the water (and also drinking from the fountain as well as from his water bowls).
Off now to walk to the post office and try to get my mind to process how indeed I can deal with three conflicting diseases at once: diabetes, kidney disease, hyperthyroidism.
Later,
Ella & Stu
 
Re: 8/13 Stu AMPS 393, +3 254

there's so much on your plate but you seem to be handlng it so well and sound positive. I admire that about you.
It's nice to hear Stu is playing and likes his fountain.
 
Re: 8/13 Stu AMPS 393, +3 254

Nice +3 for Stu. That's good that he likes his new water fountain...wondering if the kittties can stop over tomorrow to visit with him.
So far it would be Raja and Shadow and Mannie I think and any other kitties who can make it. Would that be okay?
Raja has been reading and stressing, tying to figure out what they can bring...well, she would like to tell you herself!

Dear Miss Ella: :mrgreen:
I would like to make a special dinner for Stu for tomorrow if that is okay with you.
I know that he should watch his sodium and phosphorus so I am wondering if this would
be okay for Stu:
unsalted beef consommé
chicken liver pate
Roast L.I. duckling
raw chicken/pumpkin mousse
with plenty of cold Glacier water in wine glasses
(he needs to drink plenty of fluids, right?)
He is always cooking such wonderful fudz for us all and we wanted to bring
him some stuff for a change. Do you think this is okay? I haven't started yet so if there's anything
I should take off the menu that is fine. I want to be sure it is okay with you.
Thank you.
Sincerely,
Raja girl
 
Re: 8/13 Stu AMPS 393, +3 254

Hi Ella! Fun on the fountain! I have one of those, and a kitty that just loves to play with the water - she's always in it pawing at the water as it cascades down. Just too funny!

There is just so much on your plate - amazing how ell you are doing with it all. I wish I could advise, just don't have the expertise. It seem logical to hold the dose, unless really high numbers dictate otherwise, get the new hyperT meds on board, and see where you are at. Sounds like that is the plan. I would ask about the meds though - low dose, or? and hope your vet will answer with a yes or a no besides not the recommended dose. I have no clue - good luck with it all! Enjoy the walk - it is what I do when I need to figure things out.

Hope you guys have a great day! Mannie is so excited to see Stu tomorrow with Raja and Shadow...
 
Re: 8/13 Stu AMPS 393, +3 254

Ella & Stu said:
I am totally confused about everything. We started on the hyperthyroid medication Methimazole this morning: 5mg pill and he is supposed to have 1 pill every 12 hours. I don't know if this dose is considered low, medium, or high, but Cassandra says that it is important to start low and work up if necessary in order to prevent a renal crash. I'll ask the vet, but I think he will just say that it is the dose he recommends. In any event, Stu will be re-evaluated on Aug. 25th, when we do the next blood work, and then we will see if the Methimazole is doing anything.
Click to expand...

I don't think that starting at 5 mg BID would be considered starting low. A low dose would probably be more along the lines of 2.5 mg once daily for two weeks, then recheck, and increase to 2.5 mf BID if needed. I hope that Cassandra stops by with her opinion.

http://www.felinecrf.org/related_diseases.htm#HyperT1

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6658&O=Generic
 
Re: 8/13 Stu AMPS 393, +3 254

That's a pretty high starting dose, especially for a renal kitty. I've seen them start as low as 1.25mg SID to err on the side of caution. The last thing you want is the T4 levels dropping too fast as it can cause a renal crash.

Not sure if you saw this before, but I really recommend joining the Yahoo Feline Hyper-T group here. There is just so much good information there.

Some other reading for you (I like the VIN WSAVA conference info lots):

http://www.vin.com/proceedings/Proceedi ... &O=Generic
http://www.vin.com/proceedings/Proceedi ... &O=Generic

And your vet may want to see this VIN WSAVA info on starting a renal kitty at 1.25mg SID:

http://www.vin.com/proceedings/Proceedi ... &O=Generic

A snippet from that proceeding:

Pre-Existing Azotemia in a Newly Diagnosed Hyperthyroid Cat

First, in such a case, the diagnosis of hyperthyroidism can be somewhat complicated by a decline in thyroid hormones (euthyroid sickness) within the reference range. Second, given the further decline in GFR to be expected after resolution of the hyperthyroid state, it is important to start an azotemic hyperthyroid cat with a reversible anti-thyroid therapy (trial therapy). Methimazole or carbimazole are used (orally or transdermal), at a low starting dose (i.e., 1.25 mg orally once a day). This allows assessing the impact of anti-thyroid therapy on renal function. These patients should be monitored every 2 weeks. Dosage adjustments should be made prudently. The presence of overt signs of thyrotoxicosis (heart murmur, emaciation, proteinuria) underlines the importance of treating the hyperthyroidism. Management of CKD is also warranted. If the patient stabilises and renal function remains stable after reestablishment of a euthyroid state, a more definitive treatment, such as 131I, can still be considered. If renal function declines significantly after methimazole or carbimazole treatment is instituted, and more importantly if this is accompanied by a clinical deterioration of the cat, it seems wise to maintain the cat on a reversible anti-thyroid therapy, which can be adjusted individually as needed.
 
Re: 8/13 Stu AMPS 393, +3 254

Ella, I'm so glad Cassandra and Linda have chimed in on the Methamazole dose. I thought that was high too. When I had a Hyper T/CRF cat, her dose was only 2.5 bid at first and then we lowered it as her kidney values got worse.

I am really glad Stu likes the fountain. Blackie has never liked running water, so I put our cat fountains away. And I'm glad to hear that he is eating so well and is feeling good. I know you must be stressed out, but you are doing great!
 
Re: 8/13 Stu AMPS 393, +3 254

Ella...how far away is that Post Office? :o
Just stopping in to say hello again. So great to see Linda and Cassandra...HI :razz: Good information for you...thinking of you Ella! :YMHUG:
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150

Wow, Casssandra and Linda and Ele! I'm on it!!!

Ella

p.s. to everybody else. Thanks for checking in on ur. No, had other things to do besides the post office. I'm off now to take this info. to Stu's vet.
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150

I can't offer advice jsut hugs. Hang in there, you can handle this. You are strong and love Stu soooo much.

Stu, I'm coming tomorrow too. But you are blue today, so, you wanna surf? Mannie is there already and I'm going to go get ther others. Rainbow board, all our friends can come. -- Tess
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150

Hey Ella & Stu just checking in also to say--We hope Stu responds great to new meds, feels really good, and gets better in no time--

STU man I heard you are having dinner with Raja & it looks like a great menu--Hope you can come surfing with me again soon & Shadow & Mannie--Luv Ya--Miss you lots--Moonie
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150

Wow, that's quite a drop for Stu today! Hope he can stay down there and enjoy some blues for a while.

Hang in there Ella!
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150, dose?

Hi again, Everyone,
Sorry to be so late in getting back. I had a lot to do this afternoon (I'm on the committee for our chapter of the Adirondack Mt Club's annual picnic on Sunday, so had shopping, etc. to do). I dropped off a copy at the vet's of the paper on Hyperthyroidism and renal disease that Cassandra sent me. The vet was at his other clinic (50 miles from here), but I explained to his receptionist that 5 mg of Methimazole bid was seemingly a high dose for a cat with the potential for renal failure and that I was going to cut the pills into quarters and give 1.25 mg sid. She said that he would be sure to read it and that he was always open to new research. I wound up missing a +9 and a +10, so decided just to wait until PMPS to see where Stu's bg is (save an ear!). His nadir today was 150, but I think I'll hold the 1-unit dose, at least for the next cycle. Does anyone have any clue as to why Stu's PMPS +4 or +5 is so high these days? Shouldn't the insulin have kicked in by then, the way it does in the morning cycle? And then the AMPS has been very high, too. Everything is just so weird!

Mr. Cat is thrilled that his friends are going to cook that delicious meal for him tomorrow. The menu looks scrumptious! Raja, you have done it again! Thank you all so much for watching out for my big little guy (no longer quite as big, since he has lost about 2 lbs since April).

More reading to do this evening. I will also try to visit some condos.

Ella & Stu
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150, dose?

wow, I learned a lot in this condo today.

I think his PM +4 are high because they are mini-bounces from the nicer stuff that is happening during the day.

You can either hold the dose and see if the bouncing stops, or you can increase the dose *if* you'll be able to stay home and feed those lower morning cycles to keep him from going too low. That would hopefully bring the higher preshots down, but would also bring the nadirs down so extra monitoring and food manipulation would be needed. Not many people want to do that.
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150, PMPS 182

Cassandra and Sasha said:
WCF and Meowzi said:
USG suggests kidney insufficiency. But I'll defer to Cassandra, since I'm not sure how much of an influence an overactive thyroid is on kidney values. She tried to explain it to me once but my eyes just glazed over :lol:
Click to expand...

Okay....you must be kidding on that one. Your eyes glazed over? :lol: :lol: :lol:
Click to expand...
No, I'm not kidding, they did too glaze over! :lol:

It was this post. Remember it? You lost me at hypothalamus-pituitary-thyroid ... and then you added that little schematic diagram! :dizcat

Anyway, re-posting link in case Ella has any desire to read about the hypothalamus-pituitary-thyroid axis and the hypothalamus-pituitary-adrenal axis ;-)

eta: PS - Ella - the bloodwork coming up: send-out or doing in-house?
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150, PMPS 182

omg - i should have gone to med/vet school. i can't believe the volumes I am learning just by reading these posts, and the links, and trying to understand it all. It is just awesome. We are so fortunate to have so many knowledgeable people here. Simply outstanding.

Gosh Ella - not too bad of a day for Stu. I'm with Ann and others - can't offer advice, just hugs. a ton of hugs. Mannie is so stoked to be coming tomorrow and cooking with Raja for Stu. You will be overwhelmed with kitties... busy cooking kitties.
 
Re: 8/13 Stu AMPS 393, +3 254, +5.5 150, PMPS 182

Hi guys. Wow aren't you glad that we have such wonderful people here on the Board. The amount of knowledge available here never ceases to amaze me. I hope your vet will be receptive to the info you were able to give him.

Tori says she's hoping to come visit you tomorrow. She hates to see a good friend not feeling well and hopes a visit will cheer you up Stu.
 
Hi again, I've read the links but I must admit that my head is spinning, too! I've got to get the scientific vocabulary down so that I don't have to keep looking up the abbreviations and the unfamiliar terminology. Thanks to Cassandra and WCF for the link to that complex discussion on the old board. And thank you, Libby, for the tip about the bg levels. (I'm going to stick with 1 unit for the time being.) (It is such a relief to talk about diabetes-related problems!!!!!)
Now I shall apply my brain to a different science: the culinary science exhibited in the menu for the dinner that is being planned for Stu tomorrow.
Good night everyone, and may all the kitties stay off of that newly decorated pink floor (at least until the paint dries)!!

Ella & Stu
 
Hi Ella & Stu....just dropping in to see how Mr. Stu is doing today, doesn't look to bad. Wish I could give you some input, but I'm totally clueless at this point. I'll have to do some more reading when I have the time to actually pay attention to what I am reading. Anyway, hope Stu is doing well and I hope he enjoys his get together with the other kitties.
 
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