8/3 Julia AMPS 101 - Response to vet visit post

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Yesterday

AMPS 101 0.75 4%, 13% and her antibiotic
+1 / 97 4% and 13%
+2.25 / 53 13% and a smidgeon of 20%
+2.5 / 52 13% and a tiny bit of puke from Jules which was only water
+2.75 / 56 4% and 13%
+3 / 64
And then we all fell asleep since we were so exhausted.

Thank you all for your thoughts and advice yesterday and today. This morning you can see I came to my senses and went back to the 0.75. I know that is not how Lantus is dosed but you will have to excuse my brief moment of panic. Oddly enough, the higher 400 scared me more than her 50’s she gives me which don’t even phase me. Therefore, we are back at 0.75 and we had a great morning. I know our situation, we are always home with her, and I know how to guide her with food so I think we will be fine with my little moment of insanity. Even Mom is okay with low numbers. Moreover, it certainly makes sense that the 400 could be from bath and puking. As I mentioned, the second Mom opened the carrier door to pet her and let her out she completely calmed down. That explains when we tested her when Mom was holding her, why her number was that much lower.

I really wish they had done the C&S and should we have to go back to the vet I will make the request before they take her to clean her up. She is acting fine this morning minus a tiny puke that was just water and inhaled more food right after it. I will certainly watch her appetite and we record everything she eats so we are on top of things in that regard. I do not like that she might be unnecessarily on the antibiotic but am not sure what to do. I do not want her to be antibiotic resistant but I do want her to have it if she needs it. Cystitis as Sienne mentioned is certainly a possibility especially since she seems to have peed normally since her episodes early yesterday.

The part that has me most upset is I now realize what the vet gave her for pain is Meloxicam. This damn vet gave her a shot of it last year but that was before the diabetes and stuff. I guess this is her “go to” pain medicine. It has me feeling nauseous that she has now had two doses of this drug when I do not want to have ever had it. I did not know about it yesterday but just did some research now. How long do I need to watch Julia to make sure this drug is having no adverse effects on her kidneys? Should we have then do a kidney function test in a certain amount of time to make sure she’s okay? I’d much rather do that and know for sure.

As far as buying another meter goes, we have to check Dad’s blood sugar, too, and I am always wandering around trying to figure out where I left a meter since Dad and Julia share them. Ironically, after I typed last night that I was going to get another Micro, I lost the one we had. I just found it in the most random place so, another meter in the house will certainly not break our budget and we do use them all anyhow. I think that is why Dad even told me to get another meter.

I think I somewhat agreed to the fructosamine simply to appease the weird situation. However, no appointment was made and there is a lot of time between now and when she wants it done in 4-6 weeks so, I am not even thinking about it at this point. I am focused on the fact that we had a good numbers day today.

The lower numbers make much more sense to me as being accurate. I can see her behavior always walking around tail up and she has started walking us to the door again when we go out which she used to do but had stopped. She was playing with ribbon on a balloon this morning. I think we will be fine. And I am going to get the Ketodiastix if i can find them when I go out this weekend. Right now I need to mow a lawn I've been ignoring too long before the neighbors think the house is abandoned.

Julia weighs 10lbs, something oz (can't remember) and they said she lost 6 oz since June's diagnosis visit. Is that from her not processing things right due to diabetes or could something else be going on? Maybe she needs to eat more. Right now she eats around 3 cans a day of FF spread throughout the day. The vet didn't hear me or didn't answer when I asked what she should normally weigh (as a Mackerel Tabby).

I will make sure that when we go to the vet again we do NOT see this particular vet. I know others that I prefer. In fact, the more I think about it the angrier I am getting that I may have hurt Julia’s kidneys with this drug I did not know about. This vet is not up to date on MOST things it seems. She actually asked me how I do that and when I asked her what she meant, she said dose 0.75 because she has no smaller dose adjustments than 0.50. I told her what syringes we used. Gosh, I hope I did not hurt Julia’s kidney function with this drug. It is making me feel sick thinking about it. :cry:
 
I've only use Meloxicam in a dog with severe arthritis, but I know cats react to things in a totally different way, so was looking online too. Seems like there's a lot of mixed results out there! (Which just makes it that much more confusing!!)

Found a story from Australia where (if I'm reading it right) said it could actually help some cats with renal issues? Of course this article seems to be limited to only the oral Meloxicam, not the injection.

Sure hope Julia has no problems in the future! It's scary enough dealing with the diabetes and wondering if every single thing we try is going to help or hurt them!

Of course you're forgiven for your temporary bout with Insanity :lol:

Here's that one story if you are interested in reading it
http://www.petmd.com/blogs/fullyvetted/ ... f2k1VRpjIk
 
I think most of us have asked our vets to write in bold red capital letters on the front of our vet records folder
NO METACAM and NO COVENIA
Hopefully with just the one dose, Julia will be fine. I would look for a different vet, though.
And as long as you're home testing, you can save the money for the fructosamine test. You don't need it.
 
There is mixed information on the use of nonsteroidal, anti-inflammatory drugs (NSAIDs) with cats. There is an article posted in the stickies on the Health board about the use of NSAIDs. There are some situations where they are the best drug. However, it's my belief that just like with humans, you should be given informed consent. The vet should tell you that there is a danger of acute renal failure with meloxicam. We did have a member here who's cat did have renal issues as a result and Carolyn/Latte became very active in the movement to have the FDA issue a black box warning for the use of this drug with cats.

I also did the same thing as Dyana. I have it plastered all over both of my cats charts at the vets' office -- no metacam and no convenia.
 
Thank you all for the information and support.

Is the renal failure a problem I would notice right away? I don't even know what to look for since her peeing habits are so odd already. She only had the medicine twice and it was the oral dose. The vet told me nothing about this or I never would have okayed it! I am so angry right now at that vet :evil:. Do you think it would be a good idea to have them run a kidney panel on her now or at some point? When she had the full blood work in June they said some values were off but could be explained by the diabetes. I need to find out exactly what was off. I got the results the day after my surgery so I wasn't all there. But, if there is anything I can proactively do to stay on top of any renal problems I will do so.

As far as a different vet, I still like that practice as some of the other vets are fantastic. It's just this particular one that did the Meloxicam both times...yesterday and within the past year but I can't remember when. Others have wanted to use Covenia but had no problem giving us something else. That note is absolutely going on her folder. And we will not be using this particular doctor anymore. There are plenty of others to choose from there.

The fructosamine is not happening either so no worries there. I still feel sick at the thought that I okayed something that could hurt her. :cry:
 
One thought...

If there is a practice manager, you might want to arrange a time to talk with that person or someone who has a lead role in the practice. I'd let them know your concerns about Metacam and even offer to send the FDA warning if they were not aware. I'd ask them to run a full kidney panel at no charge to you as a proactive measure and to insure the vet did no harm to Julia.
 
Mom is planning on going up there Monday to talk to someone and to ensure the note about those two medicines go on her chart. In addition, she is going to ask for the full renal panel for sure. Thank you!
 
Just catching up with the last few days Elizabeth. I hope Julia is feeling better.

I don't know how fast you would see any effects on the kidneys from using meloxicam. But I'm glad your mom is going to talk to the vets.
 
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