8/14 Bob AMPS=427 Blood Panel Results

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Lkldcatlady

Lkldcatlady

Member Since 2013
yesterday's condo

Good morning LL! Where the hell did this 427 come from?? I"m gonna cry. :cry:

I will never be able to concentrate this weekend. I'm feeling the stress and I've had a headache for a week to prove it. And I don't want any patience pants! No matter what color they are!!!! :evil: (sorry Deb!) The only thing I did differently last night was to feed a little wet food. He mainly drank the water, may have eaten a piece of chicken or two.

Ok, down to business. I need to figure out the following:

1. what Bob's dose should be while I'm gone
2. what his "no shoot" number should be (if there should be one)

As I said before, a vet tech will be over at 7 and 7 to test Bob's blood and give his shot. I may have her give him some fluids while she is there to be safe. I couldn't do it - the needle was 18 gauge and it was HUGE. I tried to push it in, but it wouldn't even go in!!! Horrible! :o A friend of mine will be staying at my apartment and getting a couple of mid-cycle numbers for me and trying to convince Bob to eat and drink as much as possible. Oh, btw, I will post blood panel results later if I get them today.

I tried to look at his numbers and decide for myself what his dose should be. I'm assuming that because he's been on 1.25 for 6 cycles, that his depot is now filled to the 1.25 level? Am I understanding that correctly? I guess I would leave him at 1.25 maybe? or maybe decrease to 1.00 to be extra safe since it looks like he might eat a little wet food. Although, I tried to give it to him this morning and he walked away from it. I guess Bob doesn't know about all the hungry kitties in the world, otherwise he would appreciate the expensive-ass food I buy him.

I would really appreciate any advice I can get. I must finish my 3 page "taking care of Bob" manual and get it to the printer to be laminated and bound. :lol:

I'm going to get some advil, so I'm sure I will be in a better mood later. I hope all kittehs and beans have a great day with some great numbers!
 
Re: 8/14 Bob AMPS=427 Dose advise for trip????

Lkldcatlady said:
...1. what Bob's dose should be while I'm gone
2. what his "no shoot" number should be (if there should be one)

As I said before, a vet tech will be over at 7 and 7 to test Bob's blood and give his shot. I may have her give him some fluids while she is there to be safe. ...A friend of mine will be staying at my apartment and getting a couple of mid-cycle numbers for me and trying to convince Bob to eat and drink as much as possible...I'm going to get some advil, so I'm sure I will be in a better mood later....
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Hi Dara :-D Two good questions--I'm sure you'll get an answer on those soon from an advisor! Sorry but I don't feel experienced enough to answer them. Looks like Bob will be in good hands while you are gone; I don't know where you're going (how long will you be gone?) but have a safe trip! I hear ya on the Advil--I take it every morning like a vitamin...and sometimes later in the day...uh!
 
Re: 8/14 Bob AMPS=427 Dose advise for trip????

Dara

Let me catch up a bit and I'll brb but i want to read your last couple of condos and his SS.

Ask the vet tech to bring 20 or 21g syringes if he will sit still. Those 18g are harpoons and even if she can can do it well, I'd still not want my cat stuck with them. If he were to need fluids long term, they can build up scar tissue. It takes me about 7 mins to get 150 mls of fluid in Gus with a 21g needle.
 
Re: 8/14 Bob AMPS=427 Dose advise for trip????

I'm a tad traumatized. Bob's fructosamine was 589. When he was on dry food, it was 100 points less. WTH!!!! I'll be posting his lab results - just waiting for the vet's office to send it over. He's also dehydrated. He was never dehydrated before. I don't understand what is going on.
 
Re: 8/14 Bob AMPS=427 Dose advise for trip????

Dara

I wouldn't get wrapped up in the fruc test number. It's possible that when he was on dry and you had him on a higher dose of insulin but weren't testing as much, that he was actually dropping down into lower numbers. I'm not sure if the first fruc test was done in relation to when he started insulin, was switched to Lantus, etc.

It will be interesting to see his blood work and I really hope they did a free and total T4 because hyperT cats can have a higher fruc level. However, hyoerT cats are usually ravenous and losing weight. Bob is not ravenous....

I hope you have a chance to post bloodwork because it will give us an opportunity to pose some questions for the vets. I would be sure that Bob is getting the appropriate amount of calories each day even if you...or the vet tech...has to syringe feed him.

The vet prescribed the fluids? How much and how often and based on what? You say Bob is dehydrated but we don't have the bloodwork yet. Did the vet lift his scruff to see how fast it went back into place or check his gums to see if they were tacky? If so, what exactly did the vet say or did you observe that his skin didn't snap right back into place?

Are the weights done on the vet scale and did they use the same scale? Because vet offices don't recalibrate their scales very often and there are small and large animals often put on them (unless they have a small digital scale for cats), I spent the money to buy a Topline digital scale for cats and I weight my cats at home. I have noticed sometimes the techs at my vet office forget to hit the "tare" button in between clients which they need to do especially if there was a blanket or carrier, etc on the scale prior to Bob being on the scale. I know you can observe he seems lighter but it's best to monitor his weight yourself.

Bob has had a lot of changes going on since he was dx. Two different insulins, three different foods (dry, canned, YA), alot of dose changes in a short time. I'm not saying that any of these things are attributable to whatever is going on with him but I think with all diabetics, consistency is a good thing.

Instead of changing things so quickly when something appears to not be working, once we see the results of the labs, I'd try to focus on picking one course for Bob right now. The first thing I would do is decide what you are going to feed him.....canned or YA and then determine his daily caloric need and be sure he gets it. I'd be sure he gets water if you are going to feed the YA. And, once you get back, I'd focus on getting him on a dose that gets him into good numbers and sticking with it. That means you will need patience pants and big girl pants :lol: :lol: :lol:

On the dose, while it takes about six cycles for the depot to fill on an increase, it doesn't do that on a reduction. But I really don't know how to characterize this dose for him.....is it a reduction from 1.5u or is it an increase from 1u? I tend to think it is a reduction since you shot 1.5u for four cycles, 1u for two, and 1.5u for one before settling on the 1.25u.

I know you won't like this answer but I'd give this dose today and see what happens. You leave on the 16th so we still have time to see what he does today and decide later tonight or tomorrow morning on a dose. Will he be getting fluids every day while you are gone? It's usually best to give fluids between nadir and +11 as fluids can drop the BG. How much? ECID but I've seen it drop some cats quite a bit.

How often can your friend test? Can she get a +2 each cycle and can she post here? My concern would be her being able to get Bob to eat if numbers go low. I know that is an understatement for you ;-)

What would you feel comfortable as a no shot number considering your friends abilities and getting Bob to eat?

Once you post the labs, I will take a look and see if anything stands out to me; there will be others who might also have very good insight. I am working today and will try to get back to you during the day but may not be able to until tonight.

In the meantime, sending healing vines for Bob and :YMHUG: for you. :YMPEACE:
 
Re: 8/14 Bob AMPS=427 Dose advise for trip????

4-23-2013

08-13-2013

Hi guys - I didn't have time to enter onto the spreadsheet so I just created links. Haven't talked to the doctor yet, but this is what the tech pointed out:

1. Fructosemine is high - according to charts, it means "poor control". When I had this done at the specialists office, he was at 475.
2. His BG was 374. I took his BG with my meter 5 minutes before they drew his blood. It was 207. How could there be such a huge variance?
3. His Biliruben (sp?) is high. Vet said probably related to the fact he's not eating much.
4. He is dehydrated. Not sure what number shows that, but I already knew that.

I have a call into the vet, but she didn't seem too concerned about any of the results. He just needs to get hydrated.

I noticed his triglycerides and they seem EXCESSIVELY high if I'm looking at it correctly. What the heck is that about??

I am really torn here. I know we've changed alot. Tried the canned food for a week - that didn't work out well so I switched back to dry, but it's the YA, which I do see Bob picking at here and there for the last two weeks. He's always drank alot of water, so I'm not sure why all of a sudden he's dehydrated. When you pull up his scruff, it slowly goes back into place (but not crazy slow). They checked his teeth and gums, but no comment. The vet mentioned on the 3rd that he was a "little dehydrated".

So, I think I'm having a similar problem to Bern and Tashie, although Tashie is 6 years older than Bob. I'm not going to syringe feed my cat and I certainly can't have anyone else do it. Bob's laid back, but not that laid back. I've never seen him so miserable than in the last few weeks. I'm still thinking about things, but I think I'm taking him back to his old food and just deal with the larger amounts of insulin. At this point, I don't care about his kidneys a few years from now. Right now, I care that he is miserable and I seem to be making him more miserable with all these changes. He doesn't like the wet food and obviously, he's not liking he YA too much, or the fact that it's no carb is effecting him somehow.

I'm not sure how much my friend will be around to check on Bob's blood, but I'll have her do it twice a day as close to +4 as possible.

Sorry guys, I know I'm wonky about all this stuff, but I just can't stand to see Bob feel as bad as he has been. There's nothing else showing a problem, so it has to be what I've been feeding him. I just want him to be happy and feel good. And when he doesn't feel that way, I don't want to force food and water on him and be giving him fluids at home and poking his ears day and night. I know the TR protocol works and is the best treatment, but with a cat like Bob who refuses to eat right, I just don't know what else to do. :cry:
 
I hate posting from my phone.... It just ate my reply.... Grrrr.

I don't have any great recommendations for you.

I can tell you that when Izzy is dehydrated she doesn't feel good and she will go off her food.

Some things that make giving subq fluids easier for us are to warmy the bag to at least 99 degrees. I float the bag in a sink full of hot water until my infrared thermometer reads 99 degrees when it is out of the water and sitting on a towel. I also use Termumo 21 ultra thin wall needles.
 
Just a quick post. ...at work.

This latest fruc test shows him in the range of fair glucose control (500-614 mg/dL). I would suggest you check the specialists bloodwork and see if they use the same lab and same reference range. It can be slightly different from lab to lab.

Interestingly, his April be indicates dehydration; the current one does not. But I am all for treat the cat not the numbers as long as you are cautious when it comes to administering fluids.
 
Janet and Izzy said:
I hate posting from my phone.... It just ate my reply.... Grrrr.

I don't have any great recommendations for you.

I can tell you that when Izzy is dehydrated she doesn't feel good and she will go off her food.

Some things that make giving subq fluids easier for us are to warmy the bag to at least 99 degrees. I float the bag in a sink full of hot water until my infrared thermometer reads 99 degrees when it is out of the water and sitting on a towel. I also use Termumo 21 ultra thin wall needles.
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Hey Janet - I'm going to let the vet tech who is watching Bob do it! I'm too nervous.


Marje and Gracie said:
Just a quick post. ...at work.

This latest fruc test shows him in the range of fair glucose control (500-614 mg/dL). I would suggest you check the specialists bloodwork and see if they use the same lab and same reference range. It can be slightly different from lab to lab.

Interestingly, his April be indicates dehydration; the current one does not. But I am all for treat the cat not the numbers as long as you are cautious when it comes to administering fluids.
Click to expand...

Marje - are you looking at the right one? The vet finally called and she said the Albumin is high and also the CBC Hemoglobin and Hematocirt are high and those all point to dehydration.

The vet said to give him 150 ml each day. What do you think abou tthat?? She also mentioned an appetite stimulant - do you think I should go ahead and get that?
 
Hey Janet - she said give 1/4 of a pill once every 3 days as needed. That doesn't sound like too much, although I don't know the milligrams of the pill. Do they actually help Izzy?
 
150 sounds generous? When Bob first came home from his dka ER stay, he got 100ml, two times a day, but only for a couple of days. Then it was 100ml per day. I guess it depends on his level of dehydration.

I saw someone mention that fluids can lower BG levels? Should that be taken into account when Dara is away as far as dose goes?

And what about shot location on days he gets fluids?
 
Thanks Carl - I didn't even think of that! She said 150 ml once a day every day. At first she said 250ml every other day then changed it when the blood results showed he was dehydrated. I already thought about asking the tech to do just 150ml every other day. I do need to find out about shot location. I assumed I would just do it lower on his back. I usually go up and down on his back. Never tried any other areas - I can't get enough skin....any thoughts on the appetite stimulant?
 
Sometimes when Bob was getting 100ml, I split it into two 50ml treatments per day. Some days he didn't want to sit still. One day he just up and walked off! I'm chasing him, and fluids just kept gushing out of the bag all over the floor. :lol: If your Bob needs 150, maybe it'd be an option to do 2 x 75's per day?

The other stuff, I'm not much help with. Bob got his shots in the same place every day. And I never have had to use an appetite stimulant. I think Bob would eat just about anything I put in his bowl. :smile:
 
Dara, I don't have any dose advice. I just wanted to stop by and see how you and Bob are doing and say I'm thinking of you and sending prayers your way. Good luck with whatever you decide on his food and his dose.
 
Dara, I'm sorry you're having so much difficulty with Bob! I truly think he'll be fine while you are gone though. I hope he comes down for you a bit tonight! :YMHUG:
 
Here are my thoughts on appetite stimulants. I'm a believer in appetite stimulants having their uses. Yes, there are side effects from any medication. There are more serious side effects from a cat not eating, or eating very little.

Every time Wink would get a UTI and diarrhea, the shelter would put him on antibiotics which killed his appetite. So, out would come the appetite stimulant and he would eat little bit of food to keep him going. He still wouldn't eat much, so I had to encourage him to eat, holding the dish for him, keeping him company. Even on the appetite stimulant, his appetite was suppressed from the antibiotic.

Wink was also losing weight too quickly, 3-4% a week, so the appetite stimulant helped him to eat more and keep his weight up.
 
Hi Dara,
I'm sorry it's been so difficult and stressful for you.
I know how stressful when our kitties seem unhappy and not feeling well.
Big hugs to you and Bob.

I don't have any advice for you, but I'm sure you'll get some good suggestions from others.
I hope you'll find a solution that makes both you and Bob happy.

My friend's cat was really really stubborn about keeping his kibbles.
We tried many times to switch his food to wet over the years, but he'd only ate so little of it.
So my friend kept giving him kibbles, but also kept offering a small amount of wet too, whether the cat eats or not, it's out there.
And out of blue, recently his cat started liking wet, and we were :o :o :o but happy.
This cat is 14 years old, I thought he would never change but he did.
So, even if you decide to change his food back to his old food for now, it doesn't mean you have to give up completely on wet. :-D
 
Dara

Sorry to get back so late but it was a long work day for me.

I just want to remind you of a post in one of your previous condos that Jill made:

i'd like to take a minute to underscore sienne's words of caution on using an appetite stimulant unless kitty is very, very sick and nothing else works. vets are often reluctant to prescribe appetite stimulants with good reason. they're very hard on the body. indiscriminate use of an appy stimulant has the potential of leaving kitty with more problems than you bargained for.
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Mirtazapine can have side effects such as tremors (like Bern saw with Tashie) or agitation. I would have your friend and the vet tech keep an eye out for side effects.

Sorry I had to look at this in a rush this morning? I was just checking the BUN as it will often be elevated if kitty is dehydrated. But elevation of the HCT and HGB can also indicate dehydration. It is possible the AST is low due to him not eating but I'd watch this number. The things I'd check with my vet include the elevated triglycerides and the huge drop in his thyroid levels since last April.

I think you can bring the triglycerides down by giving a fish oil such as Nordic Naturals for Pets.

Here is the video we made on How to Give Subcutaneous Fluids to Your Cat at Home. Please let me know if you have questions.

I think for now, I'd suggest holding the dose. Be sure you have your no shot number for the vet tech. If your friend tests and he's below 100, I'd tell her to let the vet tech know and consider dropping the dose back to 1u bid until you are home.

Have a great trip!
 
Hi Dara,

I've got no food or dose advice, just wishing you a safe trip & Bob a comfortable, easy time while you're gone. Hope his appetite picks up soon, I think re-hydration will help that.

As for fluids, I've given them to a number of cats, most ended up liking them, especially if they are warmed as was mentioned above. It always helps to give comfort during & treats after!
 
Hi Dara,

No advice from me either, but wanted to stop by and let you know I was thinking of you and Bob. It is so stressful having to leave them. I think it is a good idea that you have a vet tech coming in, and someone staying at the house! Smart thinking :-D I know you are leaving in a few days, and I pray that Bob starts to eat better, and acts like he feels better before you go. That would be a wonderful going away gift he could give you!

Jane
 
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