Critical Condition

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I'm sorry to hear about the loss of your dog and cat. That is so sad. I feel for you.

If you go to another vet, you can use bags of frozen peas in the carrier to help to keep Perkins cool, and try to schedule an appointment for 1st thing in the morning.

The probiotics help because the antibiotics kill all the bacteria, both the bad ones and the good ones. The probiotics help to put some of the good bacteria back in the gut. Hopefully your vet will agree and let you know how much and what kind to give and when.

Good luck getting your questions answered.
Thanks, God bless
 
I posted Perkins labs on the SS I don't know if people can see them but if you can any thoughts on them would be much appreciated
 
That potassium is critically low, and also the sodium is low. Are you still giving subQ fluids? If so, what kind (lactated ringers?). If your cat is drinking and eating wet food, it may be better to give fluids orally, and force feed if necessary. The subq fluids, even the one with potassium is still a lower concentration of potassium than the blood, so overall it will lower potassium. With low potassium like this, adding more insulin will lower it, and not having BS at a normal level will lower it as well. Its a catch 22. Maybe talk to your vet about increasing your supplement or adding a medication to increase potassium. In people there are some drugs we use, not sure about cats. Low potassium can cause heart arrhythmias and is rather serious.

If I am remembering that you switched to short acting insulin? unfortunately, with the ketones, you NEED a basal insulin. The short acting doesn't act long enough to cover between doses, and ketones will develop and blood sugar will be high at next shot time. Short acting (regular insulin) for ketones/critical care is usually done by IV constant drip. A basal insulin like lantus or levemir + short acting if needed is a MUCH better idea. Unless the electrolyte imbalance is corrected, this is going to be very hard to manage at home.

My opinion is that you probably need to find another vet who can treat this the right way, and not the current one who is taking your $ and sending you home with a poor treatment plan.
 
That potassium is critically low, and also the sodium is low. Are you still giving subQ fluids? If so, what kind (lactated ringers?). If your cat is drinking and eating wet food, it may be better to give fluids orally, and force feed if necessary. The subq fluids, even the one with potassium is still a lower concentration of potassium than the blood, so overall it will lower potassium. With low potassium like this, adding more insulin will lower it, and not having BS at a normal level will lower it as well. Its a catch 22. Maybe talk to your vet about increasing your supplement or adding a medication to increase potassium. In people there are some drugs we use, not sure about cats. Low potassium can cause heart arrhythmias and is rather serious.

If I am remembering that you switched to short acting insulin? unfortunately, with the ketones, you NEED a basal insulin. The short acting doesn't act long enough to cover between doses, and ketones will develop and blood sugar will be high at next shot time. Short acting (regular insulin) for ketones/critical care is usually done by IV constant drip. A basal insulin like lantus or levemir + short acting if needed is a MUCH better idea. Unless the electrolyte imbalance is corrected, this is going to be very hard to manage at home.

My opinion is that you probably need to find another vet who can treat this the right way, and not the current one who is taking your $ and sending you home with a poor treatment plan.
Hi, we are giving him potassium powder that the vet gave us. When I spoke to him on the phone he said I could discontinue the IV fluids because Perkins is now eating and drinking on his own. Perkins just started taking insulin the day we brought him in on Friday the 10th, he gave us a bottle of Levemir he said a lady gets it from her doctor. I know Perkins didn't get the best care were we took him and the horrible part is the prices are still outrageous. Yesterday we went to pick up some food there, and a lady was pulling out of the parking lot in a Rolls Royce. I said to my mom that is the kind of car you have to have in order to afford their prices. He did tell us Perkins needed to be at a 24 hour hospital, which is so easy for a rich vet to say. There is one were we live but years ago we took a resuce cat there and they jumped on us for 4000 up front. We had to borrow the money. I know the place we are going to now is a joke but they did give us the bottle of Levemir for free and if they will do it again next month we will bring him back for more blood work. But like I said right now he is doing better, eating a lot and drinking a lot and his sugar was only 177 right before it was time to give him the Levemir. We are going to try to get a second opinion over the phone from a vet, this place got all our money for the month so next month we really should go to a cheaper place just for a consult.
 
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That's good to hear that you have levemir, I think I was thinking of another cat who was on R insulin. The lev vials are about 280-400 a piece depending on where you get them, so that's something.

As far as home care, if your cat stops eating and drinking, or becomes weak take him in to the 24 hour vet as low potassium can lead to fatal weakness of muscles including the heart. I would definitely have them recheck the potassium level about 7 days after that last test to see if your supplement needs to be increased. That test should really be no more than about $30. If you are still not in the normal range, you need to ask about increasing the supplement. Also, try to feed a high calorie diet to get those ketones to go away (IAMS max cal, wellness pates, kitten food), you might need to increase insulin if you do this, that's a good thing. The ketones that he has means he needs the extra food and insulin because he's burned off some fat stores.

Otherwise, as far as the labs go, the only other things off are the eosinophils, WBC and platelets. It's common for platelets to increase in infection. Seeing his labs doesn't shout cancer in my brain. In cancer, cbc labs are usually very wonky (increased potassium, decreased platelets, decreased HgB, decreased RBC), all that looks pretty normal. Typical infections - UTI, respiratory (cats are prone to viral and fungal resp infections), bowel infections, pancreatitis flare, skin infections, parasites. The eosinophils actually help narrow that down - as these become elevated in bowel, parasite, or allergic issues. Flagyl is the antibiotic of choice for GI infections, but you'd probably want to get an x-ray to rule out blockage too.

Is your cat an indoor/outdoor cat? Do you live in the south or in a hot climate? Has your cat had fleas recently? Any issues with skin/fur?
 
That's good to hear that you have levemir, I think I was thinking of another cat who was on R insulin. The lev vials are about 280-400 a piece depending on where you get them, so that's something.

As far as home care, if your cat stops eating and drinking, or becomes weak take him in to the 24 hour vet as low potassium can lead to fatal weakness of muscles including the heart. I would definitely have them recheck the potassium level about 7 days after that last test to see if your supplement needs to be increased. That test should really be no more than about $30. If you are still not in the normal range, you need to ask about increasing the supplement. Also, try to feed a high calorie diet to get those ketones to go away (IAMS max cal, wellness pates, kitten food), you might need to increase insulin if you do this, that's a good thing. The ketones that he has means he needs the extra food and insulin because he's burned off some fat stores.

Otherwise, as far as the labs go, the only other things off are the eosinophils, WBC and platelets. It's common for platelets to increase in infection. Seeing his labs doesn't shout cancer in my brain. In cancer, cbc labs are usually very wonky (increased potassium, decreased platelets, decreased HgB, decreased RBC), all that looks pretty normal. Typical infections - UTI, respiratory (cats are prone to viral and fungal resp infections), bowel infections, pancreatitis flare, skin infections, parasites. The eosinophils actually help narrow that down - as these become elevated in bowel, parasite, or allergic issues. Flagyl is the antibiotic of choice for GI infections, but you'd probably want to get an x-ray to rule out blockage too.

Is your cat an indoor/outdoor cat? Do you live in the south or in a hot climate? Has your cat had fleas recently? Any issues with skin/fur?

Hi, I wish we still had the kind of money to afford the 24 hour vet but right now we don't. We are still paying back the money we borrowed to go there in 2013. We only have 600 left on our charge card and we still have to feed the 2 cats outside a neighbor left when they moved and another indoor one. Thank you so much for the info. The vet didn't tell me any of this. He is indoor but we do feed two out door cats who have fleas and last year Perkins was by the sliding glass door where the out cats were and he did pick up some fleas. It is very frustrating that the vet didn't ask us any of this. We are letting him eat all the dry DM he wants and before the insulin I give him a half can of fancy feast but I guess I should give him a full can but when I do he makes a lot of soft poops. I wish we could afford better care for Perkins but on the other hand when we took our rescue cat to the 24 hour vet they did do all they could..... he had the best medical care even a feeding tube but it was too little to late. His liver failure got worse and he went into pancreatitis. Long story short the vet sent him home die. She said she didn't want to run up our bill just to have him die alone in a cage. And dying he was. He turned a bright shade of yellow I could see in his ears, he was drooling heavily and could only walk a few steps. We brought him home on Sunday and by Friday he was completely yellow. We asked Jesus to heal him. That night I was on the computer of course looking up liver failure when I heard a loud cry coming from the room he was in. There he was at the door wanting to come out. I couldn't believe what I was seeing. We opened him up a can of wet food and for the first time in 2 weeks he ate on his own. I put him on the table and looked in his ears and the yellow was gone. Some may say it was the feeding tube and meds but even with the tube he was throwing up. When we brought him back for the follow up and to have the feeding tube removed, the vet said it was a miracle. I have to keep reminding myself of that when I start to worry about Perkins. I'm not a religious nut or anything like that. I'm just like anyone else........if I get cussed out in traffic I will return the favor, but I know Jesus does love animals. This great big God who created the universe, cared enough to heal a little dying cat. Praise Jesus.
 
Fleas can transmit cat tapeworm eggs, which is why I ask. A heavy load of tapeworm can make it difficult for a cat to get good nutrition and can also lead to inflammation, infection, and blockage of the intestinal tract. You would see very small worms crawling on his fur near his rear or in his feces. If he has worms, you need to treat both the fleas and the worms to get rid of them.

At this point, I would free-feed your kitty, and letting him eat the wet food will help him get extra fluids too. Also, when my kitty was sick, I actually added a little water to the dry food and it turned into a mushy "soup" that let him get extra fluids. If you can go to the store and get PLAIN pedialyte, this is better than water, as it has additional potassium and other electrolytes in it. Make sure they kind you get doesn't have "xylitol" in it, as this sweetener is toxic to cats.

As long as he's still eating and not lethargic or "floppy" you shouldn't need the 24hour vet. You do need to get the potassium rechecked. I'd call the vet and see how much they will charge. It really shouldn't be more than $30. This could save you a lot of $ in the long run. Also, if you could test his urine with ketone urine sticks, you'll get a better idea if he's improving or getting worse.

I'm not surprised that your other kitty got better at home. Sometimes, home is the easiest place for someone to feel comfortable enough to heal in. We recently when through this with our 97 year old grandmother. Went to the hospital and they told us her heart failure was in end-stage, and that she was actively dying. Had the option for inpatient hospice or hospice at home to die. Said they thought about a week. We took her home, and she's doing fine, and that was months ago.
 
Fleas can transmit cat tapeworm eggs, which is why I ask. A heavy load of tapeworm can make it difficult for a cat to get good nutrition and can also lead to inflammation, infection, and blockage of the intestinal tract. You would see very small worms crawling on his fur near his rear or in his feces. If he has worms, you need to treat both the fleas and the worms to get rid of them.

At this point, I would free-feed your kitty, and letting him eat the wet food will help him get extra fluids too. Also, when my kitty was sick, I actually added a little water to the dry food and it turned into a mushy "soup" that let him get extra fluids. If you can go to the store and get PLAIN pedialyte, this is better than water, as it has additional potassium and other electrolytes in it. Make sure they kind you get doesn't have "xylitol" in it, as this sweetener is toxic to cats.

As long as he's still eating and not lethargic or "floppy" you shouldn't need the 24hour vet. You do need to get the potassium rechecked. I'd call the vet and see how much they will charge. It really shouldn't be more than $30. This could save you a lot of $ in the long run. Also, if you could test his urine with ketone urine sticks, you'll get a better idea if he's improving or getting worse.

I'm not surprised that your other kitty got better at home. Sometimes, home is the easiest place for someone to feel comfortable enough to heal in. We recently when through this with our 97 year old grandmother. Went to the hospital and they told us her heart failure was in end-stage, and that she was actively dying. Had the option for inpatient hospice or hospice at home to die. Said they thought about a week. We took her home, and she's doing fine, and that was months ago.
So glad your Grandmother is doing better. Total understand about the hospice thing, same thing used to happen to my Grandmother when she went to the hospital, they never wanted to treat her because of her age but she fought back many times and we took her home. My Grandmother did pass away in 2012 but God was very gentle about it. He gave us time to get ready. My Grandmother was very sick in the hospital , my mom had a dream my Grandmother was trying to get out of the hospital bed, she was wearing a glowing white robe but we kept telling her to get back in bed. God was letting us know it was going to be time soon. Not much after that she passed away. It was always just the 3 of us. I will call the vet and ask how much for the potassium blood test but with their prices who knows. We are planning on taking him for full blood work next month when we have money again, but we will first ask if they will give us another bottle of Levemir we can't afford both blood and insulin. If they say no we are done with them. The insulin is the only reason we are putting up with this office. The vet is a older gentleman but he should have told me how dangerous low potassium is. When he said it was low I am the one who had to ask what can we do for it. That's when he mentioned the powder. He thought we wouldn't want it because of the price. I haven't seen any worms, when he was a baby he did have tape worms but was treated for them. He got them again years latter when we brought in the rescue cat but again he was treated. I flea combed all the fleas out last year because we didn't want to use the poison. It wasn't easy but I did get rid of them all. Now if I could just do it for the roaches lol. I did mean to get the ketone sticks but we have been so busy taking care of and checking on Perkins I forgot. I'll pick some up on Wednesday. I sure hope they show no ketones, if they do I will have to call the vet and try to pull answers out of them. I'm sure God didn't bring us this far for nothing, we are believing for a total healing. Like I said, so glad to hear your Grandmother is doing better, spend as much time as you can with her, I wish I could turn back time and spend more time with mine but I know she is with Jesus now and she is happy. Life is short even if you make it to 100 like my Grandmother did, what is important is Eternity, and I can't wait to get there. God bless you and your Grandmother.
 
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