Is Orbax antibiotic safe for diabetic cats?

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Judy & Fritz

Judy & Fritz

Member Since 2021
I didn’t have a lot of faith in the vet who diagnosed Fritz, and I got a second opinion on 8/3. He had no bacteria in his urine in that first urinalysis, all was well re UTI’s. The second opinion vet said that she thought he had a “slight” UTI, had to do an ultrasound to determine, and prescribed Orbax. I have given him three doses of it and his appetite is not nearly as good as it was. He is on Prozinc, .5 units twice a day. His BG numbers have all been in the 200’s. I just read the side effects of Orbax and they include loss of appetite. There is also a flag saying not to use in conjunction with a medication containing zinc! The third vet I spoke to on the phone is at the same veterinary hospital as the first one. I have Fritz scheduled for a glucose curve on 8/17 with her. She was surprised at the UTI diagnosis, was reading his chart and said that there was no sign of a UTI at his 7/23 visit there. Something held me back from giving Fritz his 9:30 CST dose tonight. Then I read the side effects, which include severe loss of appetite, nausea and diarrhea as well as many other horrible things. This is my first week of testing and giving insulin and of course, I’ve been hovering. There is such stress involved with this diagnosis that I am unsure whether to trust my gut instinct or not. Help! Lol.
 
Ultrasound to diagnose a UTI? Strange.
Maybe Orbax is ok to be given because ProZinc contains Zinc Oxide? Or is Zinc the suspension for ProZinc that keeps the insulin active?
I'm sure someone here knows, you should add a ? to your title to get faster answers for his PM dose.
I'll think on who might have experience with this and can be tagged for help.
 
Prozinc is made from protamine zinc, but I really don't know if that means that it can't be used with Orbax. However, if Fritz is getting sick from taking Orbax, for whatever reason, I would stop giving it to him. It sounds like Fritz doesn"t even have the suspected UTI, so maybe no antibiotic is needed right now. And if one is needed, have the vet prescribe something other than Orbax.
I hope Fritz feels better soon!
 
Thank you so much, @smorgasbord and @Daddy Jack's Mommy! I don’t believe he has a UTI. No problems whatsoever with urination. I will be watching him carefully. I thought the same thing, an ultrasound to diagnose a UTI seemed VERY strange. Not quite three hours have passed since I didn’t give Fritz his dose of Orbax and he just came into the room in his normal peppy way and demanded food! I feel like I can breathe again. Thank you!
 
Judy & Fritz said:
Thank you so much, @smorgasbord and @Daddy Jack's Mommy! I don’t believe he has a UTI. No problems whatsoever with urination. I will be watching him carefully. I thought the same thing, an ultrasound to diagnose a UTI seemed VERY strange. Not quite three hours have passed since I didn’t give Fritz his dose of Orbax and he just came into the room in his normal peppy way and demanded food! I feel like I can breathe again. Thank you!
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Great news indeed. That must be a huge relief.
 
Judy & Fritz said:
Such a relief! Btw, should I begin testing mid-cycle? He has only been on insulin and testing for two days, but his ears have already begun to form a blood drop more readily. Thanks!
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It would be wonderful if you could start getting some mid cycle tests! The sooner the better so that you'll know how the dose is working and whether you should increase, decrease or keep the dose the same (along with curves so you have some data). It's great that you're already finding it easier to get blood from Fritz! Good job!
 
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Daddy Jack's Mommy said:
It would be wonderful if you could start getting some mid cycle tests! The sooner, the better so that you'll know how the dose is working and whether you should increase, decrease or keep the dose the same (along with curves so you have some data). It's great that you're already finding it easier to get blood from Fritz! Good job!
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And I start mid-cycle 6 hours after his first insulin dose, correct? I take him to the vet for his first glucose curve on 8/17. Third new vet, and although we have spoken on the phone, I want to talk to her in person and have them do another urinalysis for my own peace of mind. After that, I will do the curves at home. His BG this morning was 285, higher than it was on Wednesday and Thursday morning tests, he did eat that big bowl of food at 1:00 a.m. I will retest at 2:00 p.m. Thank you!
 
Every cat is different (ECID), so you never know what point in the cycle will be his lowest (his nadir). Although +5, +6, +7 is more usual, it can be as low as +3 or 4 or as high as +8 or 9. So if you get some random BG tests in at varying times, it will give you a clearer picture of what's happening in the cycle. The nadir can also change (I think our sugar babies enjoy keeping us on our toes!), so random tests can give you a lot of info. Also, getting a bedtime test is a good habit to get into, as it will let you know what's happening and whether you should get more tests during the night. If his BG is a lot lower 2 hours after his PM dose, it means it's an active cycle and he may drop too low. Knowing this at bedtime allows you to set an alarm so you can wake up and test his BG. Without that bedtime test, you never know. And most cats go lower at night. Gathering data is the best way to keep our kitties safe!
 
I’ll start today doing random tests. I never thought about a bedtime test, 2+ after last insulin shot, but that makes perfect sense! And I would have no problem setting the alarm and doing another test. So 2-3 hours after 2+ test if it’s a lower number?
 
Maybe an hour or two, completely depending on how low the BG is. However, if it was extremely low, it would be best to test 15 minutes later, before going to bed, to be sure that Fritz wasn't dropping too fast. If it was dropping fast, then you would give a little medium carb food and keep an eye on his BG. And you could reach out on the message board for some support. This is worse case scenario, but it can happen when you never expect it. Do you have a hypo kit together in case you need it?
 
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Daddy Jack's Mommy said:
Maybe an hour or two, completely depending on how low the BG is. However, if it was extremely low, it would be best to test 15 minutes later, before going to bed, to be sure that Fritz wasn't dropping too fast. If it was dropping fast, then you would give a little medium carb food and keep an eye on his BG. And you could reach out on the message board for some support. This is worse case scenario, but it can happen when you never expect it. Do you have a hypo kit together in case you need it?
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I do have a hypo kit, with medium carbs, higher carb and even higher carb foods, wet and dry. Also Karo syrup, honey, oral syringe, an infant enema bulb syringe to give Karo rectally if need be, Aquaphor for lubricant, pet emergency clinic phone number and driving instructions.

i followed vet instructions 9 years ago and injected when my Maggie’s “head was in the bowl.” She didn’t finish eating, just a bite, I could NOT force her to eat, and she went on to seize, coma and die. Extremely sudden, so swift it was shocking. I kept rubbing honey on her gums, but nothing reversed it. She died before we got to the emergency clinic, My vet had actually told me NOT to test her at home, actively discouraged me from doing so. Her diabetes was prednisone-induced, years of allergy treatment. I didn’t know much, just trusted my vet. I didn’t even know a diabetic person! Maggie hid before dinner and I went and got her to feed her. I will ALWAYS feel as if she knew what was coming and I basically murdered my baby girl. So a hypo kit was the FIRST thing I got together this time.
 
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Daddy Jack's Mommy said:
Maybe an hour or two, completely depending on how low the BG is. However, if it was extremely low, it would be best to test 15 minutes later, before going to bed, to be sure that Fritz wasn't dropping too fast. If it was dropping fast, then you would give a little medium carb food and keep an eye on his BG. And you could reach out on the message board for some support. This is worse case scenario, but it can happen when you never expect it. Do you have a hypo kit together in case you need it?
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Okay, I did a +6 and it was 201, the lowest it has been on this meter. I always put Fritz in a separate room for 15 minutes to eat so the other cats won’t bother him, and when I opened the door this time, he hadn’t touched his food, although he had been begging to be fed. I put Dr. Elsey’s kibble on top and shut the door again. He still had not eaten, so I offered a different flavor and he chowed down, but only ate 3/4 of his food. Watching him…...
 
Judy & Fritz said:
There is also a flag saying not to use in conjunction with a medication containing zinc!
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The issue is that the Orbax can react with zinc in the GI tract affecting absorption. Not an issue with an insulin containing zinc.

Medications or supplements containing iron, zinc, magnesium or aluminum will bind orbifloxacin and prevent absorption into the body. Such medications should be separated from orbifloxacin by at least two hours.
https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951544
 
Thank you, Larry. That makes sense. I have to do that with slippery elm drops because they too can effect absorption.. However, I took him off of it. We are both new to this insulin protocol. I did not like the lack of appetite and possibility of vomiting and diarrhea. I read that you should not give probiotics with insulin, yet every time I give my cats antibiotics, I give them probiotics. Right now my focus is on testing and injecting and making sure he eats well. His urinary tract was perfect per the original vet. I truly believe requiring an ultrasound to diagnose what she called a very “slight” UTI was a bit much. The new vet doesn’t believe he has a UTI. Watching him carefully until his glucose curve on 8/17, will have another urinalysis done then. Urination is currently normal. Thx again for the help.
 
Judy & Fritz said:
I do have a hypo kit, with medium carbs, higher carb and even higher carb foods, wet and dry. Also Karo syrup, honey, oral syringe, an infant enema bulb syringe to give Karo rectally if need be, Aquaphor for lubricant, pet emergency clinic phone number and driving instructions.

i followed vet instructions 9 years ago and injected when my Maggie’s “head was in the bowl.” She didn’t finish eating, just a bite, I could NOT force her to eat, and she went on to seize, coma and die. Extremely sudden, so swift it was shocking. I kept rubbing honey on her gums, but nothing reversed it. She died before we got to the emergency clinic, My vet had actually told me NOT to test her at home, actively discouraged me from doing so. Her diabetes was prednisone-induced, years of allergy treatment. I didn’t know much, just trusted my vet. I didn’t even know a diabetic person! Maggie hid before dinner and I went and got her to feed her. I will ALWAYS feel as if she knew what was coming and I basically murdered my baby girl. So a hypo kit was the FIRST thing I got together this time.
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I'm so sorry that you had to go through that with Maggie. It's so clear that you loved her very much, and I'm sure that Maggie knew that. We can only do the best that we know how to do with the knowledge that we have. It wasn't your fault, and now you know how to protect your sweet little Fritz.
I'm glad that Larry could give you a clear answer about the Orbax and prozinc.
Judy & Fritz said:
so I offered a different flavor and he chowed down, but only ate 3/4 of his food. Watching him…...
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I hope he's eating well for you now. How's he doing?
 
Daddy Jack's Mommy said:
I'm so sorry that you had to go through that with Maggie. It's so clear that you loved her very much, and I'm sure that Maggie knew that. We can only do the best that we know how to do with the knowledge that we have. It wasn't your fault, and now you know how to protect your sweet little Fritz.
I'm glad that Larry could give you a clear answer about the Orbax and prozinc.
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Maggie was born on the day my only son, Andrew, 23, was killed riding a bike in Denver. He was my soulmate, just the most beautiful, amazing, wonderful person. Bizarre traffic accident, sideswiped by a dump truck. I adopted her in October of that year and when I saw her date of birth, I felt that I had been led to her. Because she was born the day he died, I felt as if she was a kind of connection to Andrew. So her death almost broke me. I still feel such guilt, to this day. But I know Maggie knew how loved she was, I adored her. We get through these things somehow, but they are unspeakably difficult.
 
Judy & Fritz said:
Maggie was born on the day my only son, Andrew, 23, was killed riding a bike in Denver. He was my soulmate, just the most beautiful, amazing, wonderful person. Bizarre traffic accident, sideswiped by a dump truck. I adopted her in October of that year and when I saw her date of birth, I felt that I had been led to her. Because she was born the day he died, I felt as if she was a kind of connection to Andrew. So her death almost broke me. I still feel such guilt, to this day. But I know Maggie knew how loved she was, I adored her. We get through these things somehow, but they are unspeakably difficult.
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Oh Judy, I am so sorry for the loss of your son. I also lost my only son, 9 years this October. I can understand why losing Maggie would have taken a piece of your heart. :bighug:
 
Daddy Jack's Mommy said:
Oh Judy, I am so sorry for the loss of your son. I also lost my only son, 9 years this October. I can understand why losing Maggie would have taken a piece of your heart. :bighug:
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Omg, you too? How old was your son? Carolyn, I am so, so sorry! It is unbelievable that we have both gone through this. I can remember seriously wondering what am I going to do with all this love? I had just adopted my first cat two weeks before, and found my answer. This past Monday was the 21st anniversary of Andrew’s death. And soon, he will have been gone longer than he was here, but that makes no difference. He is always in my heart and every day is one day closer to him. I wouldn’t change a thing. Being Andrew’s mom was worth every bit of the pain. That Garth Brooks song “The Dance” pretty much says it all. I know that each subsequent loss has gotten no easier, and I am sitting here in tears for the loss of your son, for Marley being sick, and for the fact that when we love, we are going to pay the price. :bighug:
 
Billy was 37 when he died in October 2012. Last week, someone asked me how many children I have. I still say two. (I also have a daughter.) He'll always be my son. Love does come with a price.
 
I have a daughter too! Lol. Last night I thought I may have shot into a food spike. An hour before PM test I found Fritz sitting by a food bowl I had overlooked. I didn’t see him eat, just sitting there looking innocent, but when I tested an hour later, his BG was 324. It has been in the 200’s all week. He ate well and got his normal dose of Prozinc. At +2, he was at 252. He slept, played a bit, acted pretty normal but not as perky as usual. I put up a question on the forum about whether to set my alarm but by midnight, no one had answered, so I fed him (ate like a little pig!) and set the alarm anyway. Didn’t do bedtime test ( had to double poke him when strip wouldn’t read, his little ears were red), just woke throughout the night to check on him. This morning, AMPS was 250, polished off his food, sound asleep, all is well. How is Marley?
 
You're such a loving cat mom. Fritz is lucky to have you. I think 252 was a pretty safe number, but once you get some mid cycle data you'll know more about what to expect from him. The +2 was lower than AMPS, but because you've just started testing him between cycles, that may not be unusual for Fritz. A lot of cats are lower at +2, but it's a worry if the number is much lower or just a low number on its own. Jack, who has consistently extremely high pre shot BGs right now (still in the 400 and 500s) goes down at +2. Thursday night, his PMPS was 581 and @+2.5 he was 369. Much lower but not low enough to worry about and not near a 50% drop so there was no worry for me. On the other hand, there's Marley. Thursday night, he was 392 @ pre shot. He was 189 @+2.5, which was 50% lower than his pre shot number. So I kept an eye on him. At 3.25 he was 123. I know Marley's numbers are wonky, and he's a very sick little boy right now. But those numbers had me concerned enough to keep periodically testing him until they were rising steady. One hour later, @+4.25, he was 133, and his numbers kept going up. By +6 he was 266. None of those numbers were unsafe. My concern was the over 50% drop so early in the cycle. Marley has taught me (and that wasn't the first time) that nadirs can come much earlier in the cycle. Nothing is written in stone. FYI - I don't have Marley's SS published. His insulin shots and times are not conventional.
As you get to know what's normal for Fritz, you'll get a feel for when to worry and when not to worry.
Marley is not doing well. He has a vet appointment at 2:30 today. He is the sweetest little love, and I think that we're losing him. He has severe stomatitis and has been battling mouth ulcers since May. He now has a large mass under his chin. He's in pain, and I'm not sure if we can help him. It's just so hard...
 
One of my other babies, Rena, had severe stomatitis (she was rescued from an active meth house raid, so she came with a myriad of health problems). Stomatitis is truly horrible to deal with. Has the mass been there for a bit, or is it new? I know your vet appointment is at 2:30, do you have anything on hand for pain before you go? I hate for any of them to suffer, I’d rather it be me. I know how much you love those babies of yours, and it really is so very hard. Surrounding you and Marley with love and healing, peace and strength. Holding you in prayer. Please let me know what the vet says, if you’re able. :bighug:
 
Marley's been on pain meds since May. This has been ongoing. :( The mass just showed up. You know, first hand, what a heartless disease this is. I'll touch base with you later and let you know how he's doing.
 
Judy & Fritz said:
Please let me know what the vet says, if you’re able.
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Marley is such a sick little boy. He's home with us now, but I don't think he'll be with us much longer. It looks like the ulcer is actually a tumor (that's the second doctor that said that) and not stomatitis related. I'll send you a PM later today.
~Carolyn
 
Daddy Jack's Mommy said:
Marley is such a sick little boy. He's home with us now, but I don't think he'll be with us much longer. It looks like the ulcer is actually a tumor (that's the second doctor that said that) and not stomatitis related. I'll send you a PM later today.
~Carolyn
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Oh no! I am so very sorry. I’m glad Marley is home with you. Will watch for your PM when you can manage one. I hate this for you and for little Marley. SO MUCH. Why can’t freaking cancer leave these innocent babies alone?
 
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