? Black may be approaching end - opinions on labs?

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zerovector said:
As for the Denamarin, it's a smooth enough pill I just can't figure out how to get it down his throat. The Ursodiol is a jagged triangle that's even worse.
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Have you tried number 5 sized empty gel caps? They are relatively easy to pill with a squirt of water
 
zerovector said:
I have some coming tomorrow. He dispatched an entire can of Weruva pate - he absolutely loves this food I just wish I knew what the phos/carb content was.
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Well their website gives good info on nutritional content HERE but i dont want to comment on wether getting food in him is most important etc… because other members have more experienced advice. I hope the gel caps work!! Good luck and well wishes to you both
 
Lando demando said:
Well their website gives good info on nutritional content HERE but i dont want to comment on wether getting food in him is most important etc… because other members have more experienced advice. I hope the gel caps work!! Good luck and well wishes to you both
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Looks like 9% carbs, I could tell because his BG is acting up. Not that it was ever even super controlled on zero carb.
 
Some cats are more carb sensitive. I wouldn't worry about carbs, can always offset that with dose.

As for phos, I wouldn't worry too much about that either. You can always use a binder if needed.

For what it's worth, his SS does not look end of life. Nor does he sound it. We never really know what we have left, but nothing so far is screaming to me that he's end of life.

Let me go back and dig for labs, did they test for EPI? GI panel?

Edit: phos was 4.6 so not technically binder-level yet. You'd just have to watch which binder you sue (calcium vs no calcium depending on labs).

EPI and GI panels are send-out tests and I didnt see those in previous posts.
 
FrostD said:
Some cats are more carb sensitive. I wouldn't worry about carbs, can always offset that with dose.

As for phos, I wouldn't worry too much about that either. You can always use a binder if needed.

For what it's worth, his SS does not look end of life. Nor does he sound it. We never really know what we have left, but nothing so far is screaming to me that he's end of life.

Let me go back and dig for labs, did they test for EPI? GI panel?

Edit: phos was 4.6 so not technically binder-level yet. You'd just have to watch which binder you sue (calcium vs no calcium depending on labs).

EPI and GI panels are send-out tests and I didnt see those in previous posts.
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They didn't do those tests - they ran the first set of labs, then did an xray and decided he should be euthanized based on the labs/ascites.
 
zerovector said:
So I have the Ursodiol in suspension now, 25mg strength - the pharmacist indicated that that equals 1ml of liquid. does that sound about right?
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I've not used it, but dose should be 5-7mg per lb, once a day. So at 6.5lbs you should at least be at 30mg (32.5mg to be precise).

25mg strength doesn't exactly mean much - does it say 25mg per mL? Or can you post picture of the label? They can compound it all sorts of odd ways
 
zerovector said:
They didn't do those tests - they ran the first set of labs, then did an xray and decided he should be euthanized based on the labs/ascites.
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That's a shame, it's just an extra vial or two of blood when they're already drawing it. I got the same thing when Mr Kitty had pleural effusion, they didn't even want to give him a chance. He's still here, but we were able to resolve the fluid issue.

Can't believe they didn't even want to draw some fluid and send off for cytology...could have at least pointed in some direction vs still at square one.
 
FrostD said:
That's a shame, it's just an extra vial or two of blood when they're already drawing it. I got the same thing when Mr Kitty had pleural effusion, they didn't even want to give him a chance. He's still here, but we were able to resolve the fluid issue.

Can't believe they didn't even want to draw some fluid and send off for cytology...could have at least pointed in some direction vs still at square one.
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2 different vets too...so really it's up to me to treat this and I'm not a vet, i'm an IT guy :(
 
zerovector said:
2 different vets too...so really it's up to me to treat this and I'm not a vet, i'm an IT guy :(
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Based on labs I suppose it does lean more liver disease, so it's absolutely worth trying the Denamarin and ursodiol.

But it could also be cancer, kidneys, or heart (or something else, not sure, not a vet either). Kidneys are less likely since they look pretty good, and labs don't look like cancer but it doesn't always show up in lab work. You said they didn't hear a murmur, so odds are heart is ok but not guaranteed.

Did they have an estimate of how much fluid was in there? Is it impacting other organs? Does it seem to be increasing over time? Also wondering why they didn't drain any fluid (there's pros and cons), but as you said they kind of wrote him off.
 
FrostD said:
I've not used it, but dose should be 5-7mg per lb, once a day. So at 6.5lbs you should at least be at 30mg (32.5mg to be precise).

25mg strength doesn't exactly mean much - does it say 25mg per mL? Or can you post picture of the label? They can compound it all sorts of odd ways
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FrostD said:
Based on labs I suppose it does lean more liver disease, so it's absolutely worth trying the Denamarin and ursodiol.

But it could also be cancer, kidneys, or heart (or something else, not sure, not a vet either). Kidneys are less likely since they look pretty good, and labs don't look like cancer but it doesn't always show up in lab work. You said they didn't hear a murmur, so odds are heart is ok but not guaranteed.

Did they have an estimate of how much fluid was in there? Is it impacting other organs? Does it seem to be increasing over time? Also wondering why they didn't drain any fluid (there's pros and cons), but as you said they kind of wrote him off.
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he said "a lot" per the x-ray, but it didn't come up during the physical examination - usually serious ascites is readily apparent (I've had family deal with this)

yeah they just wrote him off for any surgical interference due to age, so he should just be euthanized. Per the quality of life scale, he's definitely not there. Eating (enthusiastically) drinking, using the box.
 
Ok yes it's 25mg/mL, so if you want to give 25mg you give 1mL.

Based on what I've read on Dr Google, that's a bit under dosed. @Suzanne & Darcy ?

You'll want to keep an eye on his weight. If it changes too much, you'll need to adjust dose based on weight.

To figure out what volume that is, take the desired dose and divide by 25. So if you wanted to give 32.5mg, you would take 32.5/25=1.3mL. As a sanity double check, you know a higher dose would mean higher volume, lower dose is lower volume, so result makes sense.

[Full unit conversion if you want to see it: 32.5mg * (1mL/25mg), the mg cancel so you're left with mL]
 
zerovector said:
he said "a lot" per the x-ray, but it didn't come up during the physical examination - usually serious ascites is readily apparent (I've had family deal with this)

yeah they just wrote him off for any surgical interference due to age, so he should just be euthanized. Per the quality of life scale, he's definitely not there. Eating (enthusiastically) drinking, using the box.
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It's not technically surgical in the usual sense. They shave the area, stick a big ol' needle in there and let it drain/pull it out.

One vet wanted to twilight Mr Kitty for it, but my usual vet did not do any sort of anesthesia (and he's quite a ferocious cat at the vet).

I am not 100% sure on the difference for abdominal fluid vs pleural effusion, but for pleural effusion - they cannot remove too much fluid at once as it can crash blood pressure. They also obviously have to be careful around lungs, etc.

In my opinion it's worth asking about. It might make him more comfortable, and it may give you an idea how well the meds are working. Mr Kitty was producing fluid at about 125mL per week, and our plan was to give the meds a month and do weekly drains for him - beyond that studies showed the meds likely weren't enough to correct the problem, and also who wants to be stabbed with a needle to drain fluid every week forever and ever? That amount of fluid obviously seriously impacts breathing ability. The first two drains were 100+mL so we increased med dose. The third was like 75mL, the fourth maybe 25mL?

I certainly don't intend this as medical advice, just sharing our experience/situation.
 
zerovector said:
Looks like 9% carbs, I could tell because his BG is acting up. Not that it was ever even super controlled on zero carb.
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In case you are interested one of our members listed weruva pates
BFF play weruva pate . I wrote down the protein carbs & phosphorus #s in a notebook.
BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 129%
BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5%
Phosphorus 129%
BFF play chicken cherish
Protein 31%
Carbs 5%
Phosphorus 135%
BFF chicken & turkey tiptoe
Protein 31%
Carbs 5%
Phosphorus 136%
BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5%
Phosphorus 149%
BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 154%
BFF play chicken & duck destiny
Protein 32%
Carbs 5%
Phosphorus 165%
BFF play chicken & beef best buds
Protein 33%
Carbs 5%
Phosphorus 171%


Here is also a list of all the weruva pates
https://weruva.com/nutrition-landing/pates-ni/

You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts.
 
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zerovector said:
I didn't even know that was a thing, I'll look into it
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Number 5 gelcaps are really tiny and won’t fit a Denamarin. I’m not sure of the size of the Urso, but you were going to get it made into a liquid anyway. I have every size gelcap here at home from size 2 to 5. I can stuff medications in there in order to give multiple small pills at a single time. I buy mine from Amazon.
 
zerovector said:
I will see about finding a vet who even wants to do it - I could barely get him seen in the first place
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And there can be some value to having the fluid sent off for pathological analysis. Sometimes they can tell what’s going on from the type of fluid/cells. I, very recently, have had to have my cat’s chest tapped twice for pleural effusion. She’s not a cat who is bad at the vet (although occasionally she will growl but that’s about it) but for the comfort of the cat, my vet will give a little torbutrol for sedation so that she’s not good to feel that needle. When they were finished she was just so chipper (she felt so much better after she could breathe easily). In the car on the way home she jumped out of her carrier and into the back seat to socialize with my kids. This was done two weeks in a row. The first time they drew off 200 mL of fluid and the second week they drew off 100 mL. She’s 15 so not quite as old as Black, but no Spring Chicken.
 
Suzanne & Darcy said:
And there can be some value to having the fluid sent off for pathological analysis. Sometimes they can tell what’s going on from the type of fluid/cells. I, very recently, have had to have my cat’s chest tapped twice for pleural effusion. She’s not a cat who is bad at the vet (although occasionally she will growl but that’s about it) but for the comfort of the cat, my vet will give a little torbutrol for sedation so that she’s not good to feel that needle. When they were finished she was just so chipper (she felt so much better after she could breathe easily). In the car on the way home she jumped out of her carrier and into the back seat to socialize with my kids. This was done two weeks in a row. The first time they drew off 200 mL of fluid and the second week they drew off 100 mL. She’s 15 so not quite as old as Black, but no Spring Chicken.
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I just remembered that I never canceled his next appointment, which is Friday - however this is with the same office who was EAGER to euthanize him
 
zerovector said:
I just remembered that I never canceled his next appointment, which is Friday - however this is with the same office who was EAGER to euthanize him
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:stop::stop::stop: Yes. It would be hard to take him there and even let them put their hands on him…. knowing how they really just wanted to euthanize him. Are there any different vets at that practice, or just one? I wonder if anyone is better? Was this the first or second vet you saw?
 
The 2nd vet is a first come first serve with one attending vet, who doesn't seem to have the time to fully investigate things. It seemed like he was doing me a favor by giving me some hail mary scrips (for the the Ursodiol). I have another one in mind but I wouldn't get an appointment for a week at least.
 
zerovector said:
Thank you! He more or less, is exactly the same. He's not any worse and he hasn't lost anymore weight but he's not gaining weight, either. He's taken a particular liking to Weruva Pates, and ate 3 cans yesterday.
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So glad he’s hanging in there and enjoying the food!
 
I would do the same dose twice a day for a few days - making sure to mix it in a very soupy portion of food.
If after 2-3 days you see no improvement, you could up one of the daily doses to 1/4, keep the other one at 1/8, and watch again.
It works by pulling water into the stool, so you have to make sure Black gets extra water. It also can take a while to work, and you don't want to up the dose too fast because when it finally kicks in it won't be pretty (don't ask how I know).
 
Virginie said:
I would do the same dose twice a day for a few days - making sure to mix it in a very soupy portion of food.
If after 2-3 days you see no improvement, you could up one of the daily doses to 1/4, keep the other one at 1/8, and watch again.
It works by pulling water into the stool, so you have to make sure Black gets extra water. It also can take a while to work, and you don't want to up the dose too fast because when it finally kicks in it won't be pretty (don't ask how I know).
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I agree with @Virginie ! I did exactly that with 18 lb lando. I also used a baby syringe to administer with the mirilax dissolved in water
 
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