? Jester's latest labs - vet wants me to give up

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shelaghc

Member Since 2017
@Marje and Gracie - could you look over Jester's latest labs? They're from this past Saturday.

Jester's vet can't figure out why he's still losing weight - down to just over 7 pounds now - and wants me to give up and "let him grow old gracefully."

This isn't growing old. This is wasting away without a diagnosis.

His eyes are bright, he eats all the time, uses the litter box, gives me happy purrs, and runs after bugs.
 

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How are jesters teeth?

How many calories is he eating approximately?
Teeth are fine.
I don't know what the calorie content is, but he's mostly been eating around 3 to 3.5 cans of Friskies per day. Generally he'll only eat medium carb foods.
Yesterday because he's so damn skinny I got a furshot - second one in two weeks.
For the first time I can remember, I managed to get about a can or more of pate into him. But I can't count on that.
 
Teeth are fine.
I don't know what the calorie content is, but he's mostly been eating around 3 to 3.5 cans of Friskies per day. Generally he'll only eat medium carb foods.
Yesterday because he's so damn skinny I got a furshot - second one in two weeks.
For the first time I can remember, I managed to get about a can or more of pate into him. But I can't count on that.
Can you mix pate and shreds half and half?
 
Have they done an ultrasound or xrays?
The vet keeps telling me how much ultrasounds cost - at least $500 - and x-rays are in the $hundreds and I don't have that.

I already owe him nearly $300 for past tests - and that's with him giving me discounts.
Had he had a stool sample tested for parasites?
No - but I have three cats and none of them are exhibiting the same symptoms.
 
I belong to a group on Facebook that had a vet as one of the administrators. Perhaps she could offer other possible things to look at.

The group is called Cats with multiple medical conditions.
I'm already a member and have posted there.
Chris Ronkoski suggested I post here and tag @Marje and Gracie for her insights.
 
Shelagh, my cats are all strictly indoor kitties but one of them, Vinnie, is a dedicated mouser and has gotten tapeworms from them, in the past. Please don't give up on Jester, I can't even imagine the vet telling you that! Marje isn't on here much anymore, but I can contact her on FB and ask her to stop by for a look at the labs.

Sending prayers and vines for Jester, hugs for you. :bighug::bighug::bighug:
 
@Squalliesmom and @Chris & China tracked me down. Sorry....I’m in TX dealing with my mom’s estate and I haven’t been on as much this spring.

I’m still seeing that his hematocrit is much lower than it should be and is bordering on anemia. He’s not quite there yet. I would wonder about feline hemolytic anemia but the only symptom he seems to have is weight loss. Are his stools black in color?

His BUN and total protein might be high due to dehydration.

Has he had any steroids because steroids can cause neutrophils to be high and lymphocytes low. If he hasn’t, then the neutrophils indicate something is going on that the body is fighting.

What you need is a vet that is willing to find out what’s going on. Is there any potential to take him to a board certified internal medicine specialist?

Those are the things I’m seeing that really stand out. His ALT has jumped up but ALT has a short half life and it is very, very mildly elevated. That should be watched to see if the trend continues up. My Gracie had issues with this (her ALT was in the 300s but then would drop back down to high 90s) and she’s had weight loss. It ended up she had IBD and lymphoma and you would need, to start, an ultrasound for that.

I didn’t see a total T4 in this latest test. It was normal in April but it can change fast. It would not account for the low hematocrit though.

I hope this helps. I will do my best to try and check back tonight....we are just really busy here right now but I will really try to be sure I do it before I go to bed.

And, IMHO, I would not put to sleep a cat that is active, eating, and happy. I’d find a vet willing to find out what’s wrong.
 
I’m in TX dealing with my mom’s estate
I'm so sorry. I lost my Mom several years ago and know what that's like. Thank you so much for stopping by under such trying circumstances.

Are his stools black in color?
With three cats, it's hard to tell. But I don't recall seeing anything like that.

Has he had any steroids because steroids can cause neutrophils to be high and lymphocytes low. If he hasn’t, then the neutrophils indicat
No steroids. Vet refuses because he says it would be medical malpractice to prescribe them without proper testing which I can't afford .

What you need is a vet that is willing to find out what’s going on. Is there any potential to take him to a board certified internal medicine specialist?
I don't know. The only places I'm aware of in my area are the emergency vets and they won't take anyone else's test results.
And, of course, they charge far more than a standard vet.

And, IMHO, I would not put to sleep a cat that is active, eating, and happy. I’d find a vet willing to find out what’s wrong.
Believe it or not, he's not suggesting I just put him to sleep.
He wants me to just wait while Jester slowly wastes away until the time it becomes appropriate.
He honestly said to let him grow old gracefully.
But there's nothing graceful about this.

We're going to another vet tomorrow evening. The hardest part for me is the money.

Thank you again for taking so much care to look over Jester's labs.
 
I'm so sorry. I lost my Mom several years ago and know what that's like. Thank you so much for stopping by under such trying circumstances.
With three cats, it's hard to tell. But I don't recall seeing anything like that.
No steroids. Vet refuses because he says it would be medical malpractice to prescribe them without proper testing which I can't afford .
I don't know. The only places I'm aware of in my area are the emergency vets and they won't take anyone else's test results.
And, of course, they charge far more than a standard vet.
Believe it or not, he's not suggesting I just put him to sleep.
He wants me to just wait while Jester slowly wastes away until the time it becomes appropriate.
He honestly said to let him grow old gracefully.
But there's nothing graceful about this.
We're going to another vet tomorrow evening. The hardest part for me is the money.
Thank you again for taking so much care to look over Jester's labs.

You’re welcome. I’m glad to hear your vet doesn’t want to put him to sleep....I misread the meaning behind “vet wants me to give up” ;)

Do you weigh Jester every week? Do you track how many calories he eats and how it has changed since he was diagnosed? I. Sure others have asked but did you change his food when he was dx and perhaps he’s getting less calories?

Here is the thing about the thyroid: there’s a condition called euthyroid sick syndrome where the tT4 looks normal due to other concurrent diseases, but in reality, the cat may be hyperthyroid and exhibit PU/PD, eating a lot, weight loss. My vet is great about drawing blood for me to send to Dr. Dodds at Hemopet to run a full feline thyroid panel (feline thyroid panel 4).

IMHO, if the thyroid is truly normal, I don’t understand the vet’s reluctance on an ultrasound. It’s a great diagnostic tool and at least could potentially rule out things.
 
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Do you weigh Jester every week? Do you track how many calories he eats and how it has changed since he was diagnosed? I. Sure others have asked but did you change his food when he was dx and perhaps he’s getting less calories?
No on the weighing. I've only recently been able to get a baby scale. Up until just a few months ago, I was hopelessly unemployed and nearly out of money. Most of Jester's supplies have come from very kind people here and friends and family. Even now, I'm still recovering from years of poverty. (My car now has to be replaced and my cell phone has been crashing.)
I did try to change his food after diagnosis, but Jester has resisted getting off carbs. I've been fortunate that he's accepted medium carb food lately instead of the high-carb he used to eat. I've tried so many tricks to get him off it and have just had to give it up. Last fall, after getting him onto very low carb foods and Jester actually going into remission, he stopped eating inexplicably. The vet (a different one at the time) wasn't willing to do a lot because of my financial situation.
It took ten days, with me syringe feeding him most of that time, before he started eating normally again. And the only foods he ate with reliability was the high carb stuff again.
With all the weight loss, I'm extremely reluctant to experiment and have him start that all over again.
Call it PTSD, but it scared me to death and I just can't handle that anymore.

As to the caloric content, no. I was for a long time keeping track of how much Jester was eating on his spreadsheet, including types of food and how much of each can down to fractions. But with the new job, not much sleep because of all the ins and outs of caring for Jester, along with standard life stressors, I've been so tired that I haven't been able to keep up with it anymore. The best I can generally do is mentally take note of how many cans of food he eats in a day.
Generally speaking, it's all similar - Friskies shreds, Friskies filets, Friskies Tasty Treasures Turkey Flavor with Cheese and Turkey flavor with Bacon.
And it's all medium carb between 13 and 17.
Here is the thing about the thyroid: there’s a condition called euthyroid sick syndrome where the tT4 looks normal due to other concurrent diseases, but in reality, the cat may be hyperthyroid and exhibit PU/PD, eating a lot, weight loss. My vet is great about drawing blood for me to send to Dr. Dodds at Hemopet to run a full feline thyroid panel (feline thyroid panel 4).
This is the first I've heard of anything like this. TBH, I throw so much from the boards at this vet he probably gets sick of it. He's older and pretty knowledgeable overall. But he's no great expert on feline diabetes. And I doubt he's used to pet moms who, frankly, question diagnoses and how he medically treats his critter patients.
He's probably learned more about the various conditions because of Jester than in his entire career.
I'm planning to make a list for the second opinion vet to ask him/her about on Wednesday evening.

I do hope they're willing to at least save me a little money by using the info from the most recent blood tests.

I really don't know how I'm going to pay for anything more, but I can't just let Jester die this way.
 
I would not give up on Jester and think it's terrible that the vet suggested that.

Prayers and good thoughts headed your way for both you and Jester.
 
Does your city have a low cost vet or animal shelter? They usually offer vet services at a low cost for people that can't afford normal vet bills. If so try taking him there to have tests run.
 
Can you mix pate and shreds half and half?
Just saw this one - nope. Jester won't eat it that way. I wish I could.

Although yesterday - miracle of miracles - he ate about a full can of pate with a *lot* of encouragement from me. (I'd never ask a catsitter to go to the lengths I do for this miracle.)
This morning I was only able to get about a quarter of a can of pate into him using the same methods.
 
Does your city have a low cost vet or animal shelter? They usually offer vet services at a low cost for people that can't afford normal vet bills. If so try taking him there to have tests run.
I haven't found one yet that has ultrasound equipment.
And the best one for low cost services overall won't look at Jester because he's diabetic. They don't treat diabetic cats.
 
No on the weighing. I've only recently been able to get a baby scale. Up until just a few months ago, I was hopelessly unemployed and nearly out of money. Most of Jester's supplies have come from very kind people here and friends and family. Even now, I'm still recovering from years of poverty. (My car now has to be replaced and my cell phone has been crashing.)
I did try to change his food after diagnosis, but Jester has resisted getting off carbs. I've been fortunate that he's accepted medium carb food lately instead of the high-carb he used to eat. I've tried so many tricks to get him off it and have just had to give it up. Last fall, after getting him onto very low carb foods and Jester actually going into remission, he stopped eating inexplicably. The vet (a different one at the time) wasn't willing to do a lot because of my financial situation.
It took ten days, with me syringe feeding him most of that time, before he started eating normally again. And the only foods he ate with reliability was the high carb stuff again.
With all the weight loss, I'm extremely reluctant to experiment and have him start that all over again.
Call it PTSD, but it scared me to death and I just can't handle that anymore.

As to the caloric content, no. I was for a long time keeping track of how much Jester was eating on his spreadsheet, including types of food and how much of each can down to fractions. But with the new job, not much sleep because of all the ins and outs of caring for Jester, along with standard life stressors, I've been so tired that I haven't been able to keep up with it anymore. The best I can generally do is mentally take note of how many cans of food he eats in a day.
Generally speaking, it's all similar - Friskies shreds, Friskies filets, Friskies Tasty Treasures Turkey Flavor with Cheese and Turkey flavor with Bacon.
And it's all medium carb between 13 and 17.

This is the first I've heard of anything like this. TBH, I throw so much from the boards at this vet he probably gets sick of it. He's older and pretty knowledgeable overall. But he's no great expert on feline diabetes. And I doubt he's used to pet moms who, frankly, question diagnoses and how he medically treats his critter patients.
He's probably learned more about the various conditions because of Jester than in his entire career.
I'm planning to make a list for the second opinion vet to ask him/her about on Wednesday evening.

I do hope they're willing to at least save me a little money by using the info from the most recent blood tests.

I really don't know how I'm going to pay for anything more, but I can't just let Jester die this way.
Just as a note...I am not suggesting you change what you are feeding him. I just wondered if you were feeding him a higher calorie food before and he’s dropped weight because, even at 3.5 cans, the calories aren’t enough. Calories do not equal carbs or vice versus so it’s important to not mix that up.

My thought was just that you check the calories/ounce of what you used to feed and the calories/ounce of what you now feed. As an example, some foods have 20 calories/ounce and some 35. You can see the difference in overall calories that you are feeding him even if you’ve fed 3.5 cans all along.

Once you determine how many calories he was eating before the weight loss and what he’s eating now, you can see if there is any difference. It’s just one thing to eliminate esp if he’s feeling well and it doesn’t cost any money. If he’s eating less calories, feed him more of what he likes to get to the correct calorie range.

Paws crossed.
 
We're at the vet's office now waiting in the examination room for the doctor.

Jester is far more chill than me. He's lying quietly on the table next to me. No purrs though.

If the scale is correct, Jester is one pound heavier today than Saturday .
He did eat over a can of food before we came, but that doesn't seem to make sense.

On an interesting note, I gave them the link to Jester's SS and they printed the whole thing for this year for his chart.
 
We're at the vet's office now waiting in the examination room for the doctor.

Jester is far more chill than me. He's lying quietly on the table next to me. No purrs though.

If the scale is correct, Jester is one pound heavier today than Saturday .
He did eat over a can of food before we came, but that doesn't seem to make sense.

On an interesting note, I gave them the link to Jester's SS and they printed the whole thing for this year for his chart.
They put my chart in CC'S file too
 
We're at the vet's office now waiting in the examination room for the doctor.

Jester is far more chill than me. He's lying quietly on the table next to me. No purrs though.

If the scale is correct, Jester is one pound heavier today than Saturday .
He did eat over a can of food before we came, but that doesn't seem to make sense.

On an interesting note, I gave them the link to Jester's SS and they printed the whole thing for this year for his chart.
I’ll be interested in what you find out. A UTI won’t cause weight loss or lower HCT. If he’s gained a pound in just a few days, there are two questions to ask:

—is it a difference in scale used? Vets don’t calibrate their scales as often as they should. That’s why, since you have a scale, you should weigh him each week. Pick the same day at about the same time. It might help to pick a day you don’t work. I weigh my cats at 10 a.m. on Wednesdays with the scale always on the same kitchen counter. There can be a small difference...even up to 0.5 lb based on whether they ancestors pooped or peed.
—if he has actually gained a pound and it’s not from not having peed or pooped yet, then I wonder about the kitty retaining fluids.
 
If he’s gained a pound in just a few days, there are two questions to ask:
—is it a difference in scale used? Vets don’t calibrate their scales as often as they should.
I actually asked them if it could be a difference in the scales and they didn't seem to be concerned about it.

So we now have a plan. They took a urine sample and will let me know when they get the results. (They were vacuuming while we were there....)
If it's a UTI I'll get Clavamox and we'll go from there.

If not, she's of the opinion otherwise that the weight loss might be more related to Jester's BG being so unregulated.
I'm supposed to limit Jester to no more than three different foods per day and hold his dosages to 1.5U unless his BG goes way out of whack on one end of the spectrum or the other. Too low and no insulin. Duh. ;-) Too high - and she means too high like upper 300s for several days - and I contact her for consultation.
No more pates for the time being.
She also wants a curve the weekend after this.
She also thinks the Denamarin isn't really making a difference. But I'm supposed to finish out the box so we don't make too many changes all at once.

She wasn't completely convinced about my OneTouch and recommended the AlphaTrak, but I nixed that because of the cost of the strips.
Good thing, she didn't argue the point and said she'd look up the variances between the animal and human meters.

Total was about $150 - not including the cost of Clavamox if it's needed.....
 
I actually asked them if it could be a difference in the scales and they didn't seem to be concerned about it.

So we now have a plan. They took a urine sample and will let me know when they get the results. (They were vacuuming while we were there....)
If it's a UTI I'll get Clavamox and we'll go from there.

If not, she's of the opinion otherwise that the weight loss might be more related to Jester's BG being so unregulated.
I'm supposed to limit Jester to no more than three different foods per day and hold his dosages to 1.5U unless his BG goes way out of whack on one end of the spectrum or the other. Too low and no insulin. Duh. ;-) Too high - and she means too high like upper 300s for several days - and I contact her for consultation.
No more pates for the time being.
She also wants a curve the weekend after this.
She also thinks the Denamarin isn't really making a difference. But I'm supposed to finish out the box so we don't make too many changes all at once.

She wasn't completely convinced about my OneTouch and recommended the AlphaTrak, but I nixed that because of the cost of the strips.
Good thing, she didn't argue the point and said she'd look up the variances between the animal and human meters.

Total was about $150 - not including the cost of Clavamox if it's needed.....
Well....I never say never but his numbers don’t look to me like they would cause weight loss. I’ve seen cats whose BG is much worse (cat less regulated) but the weight was stable because they were getting insulin and the right amount of calories. They just needed more insulin but what they were getting was helping their bodies to a certain degree.

It’s up to you on whether you follow her dose recommendations and I’ve not used PZ so I never often dosing advice on it.

I used the One Touch for a couple years and loved it. It was very close to my vet’s AT. I switched only because the sample size was so large.

Pls let us know when you hear about the UTI.
 
We were there from 6:30 to 9:30 - they had emergency walk-ins.
I had no dinner before leaving for the vet's because I was too nervous and never had a thought we'd be there that long.

Just finished dinner and I'm exhausted besides. Jester's his old self - demanding more food so I gave him some.

It’s up to you on whether you follow her dose recommendations and I’ve not used PZ so I never often dosing advice on it.
I'm willing to give it a try for a while. To some extent it's common sense and it's the most direction *any* vet has given me since Jester was diagnosed over a year ago.

At least she didn't try to talk me out of testing him - especially when I reminded her that this morning his BG was in the mid-300s and this evening he was down to 115 and if I had blithely given him the same dosage at night as the morning without testing, he would likely have gone into insulin shock. (He got none - duh.)

Now it's time for my five hour sleep before getting up to give Jester his Denamarin pill, then a one hour nap until I can test and feed him and the rest of the kids.

Thanks so much for all your help.
btw, the vet was very impressed with your understanding of the labs (I printed it out and showed it to her).
 
We were there from 6:30 to 9:30 - they had emergency walk-ins.
I had no dinner before leaving for the vet's because I was too nervous and never had a thought we'd be there that long.

Just finished dinner and I'm exhausted besides. Jester's his old self - demanding more food so I gave him some.


I'm willing to give it a try for a while. To some extent it's common sense and it's the most direction *any* vet has given me since Jester was diagnosed over a year ago.

At least she didn't try to talk me out of testing him - especially when I reminded her that this morning his BG was in the mid-300s and this evening he was down to 115 and if I had blithely given him the same dosage at night as the morning without testing, he would likely have gone into insulin shock. (He got none - duh.)

Now it's time for my five hour sleep before getting up to give Jester his Denamarin pill, then a one hour nap until I can test and feed him and the rest of the kids.

Thanks so much for all your help.
btw, the vet was very impressed with your understanding of the labs (I printed it out and showed it to her).
I’m very glad you’ve found someone you like and trust. I’m glad to help any time I can. The best way to get me for the foreseeable future is to PM me. I get notices of PMs, but not my tags, to my email and I can then pop onto your condo.
 
I’m very glad you’ve found someone you like and trust. I’m glad to help any time I can. The best way to get me for the foreseeable future is to PM me. I get notices of PMs, but not my tags, to my email and I can then pop onto your condo.
Thanks so much for being available for me and all your advice. I'll start weighing Jester regularly this Saturday.

Trust takes time.
I like her and am willing to give her recommendations a try. I'll be more impressed if she's right about the UTI.
I'll start to trust her when Jester starts to gain weight again.

This morning he's already eaten over 1.5 cans of Friskies with only 1.5U and an AMPS of 309.

The one thing I didn't agree with at all was that she believes BGs in the 300s are fine. I told her that I disagree and prefer mid to low 100s.

We'll see what happens .
 
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Just wondering.... Did you check your scale with the vets when you got home? At least doing that will let you see if there is a difference & how much. I know you were exhausted when you finally got home! I hope he continues to eat & not loose any more! Be good to your momma Jester! :bighug::bighug:
 
Thanks so much for being available for me and all your advice. I'll start weighing Jester regularly this Saturday.

Trust takes time.
I like her and am willing to give her recommendations a try. I'll be more impressed if she's right about the UTI.
I'll start to trust her when Jester starts to gain weight again.

This morning he's already eaten over 1.5 cans of Friskies with only 1.5U and an AMPS of 309.

The one thing I didn't agree with at all was that she believes BGs in the 300s are fine. I told her that I disagree and prefer mid to low 100s.

We'll see what happens .
Many vets will say the 300s are fine because they think the cat is not in danger of a hypo if it’s in thr 300s. We all k ow differently because they can clear bounces fast and drop low. I asked my vet, who is absolutely amazing, why vets are ok with the 300s and she said because they can’t be available to us 24/7 like we can within FDMB and they think the kitty is safe from hypos.

Paws crossed the weight stabilizes and he gains a bit!

And you’re welcome....we are pooped out by evening so I’ve just been checking in with you when we stop to veg.
 
I'm intrigued and curious right now. Jester ate a total of four cans of cat food yesterday.

Despite that and a BG that started out at AMPS 309, he had a mid-cycle +6 of 141 (I ssnuck home from work), +10.5 after work of 253, and a pre-bed BG of 150.
AMPS today was 280.

btw, his weight on my scale yesterday was still just over 7 pounds. So they do need to calibrate that thing at the vet's office.

I'm going to hold off weighing him this Saturday since I did it yesterday and see how he is next Saturday instead.
 
Human scales of the home bathroom variety are notoriously inaccurate at light weights. But as long as you weigh him on the same scale in the same way in the same position, you will at least be able to tell if he's losing, maintaining, or gaining.
 
@Marje and Gracie - could you look over Jester's latest labs? They're from this past Saturday.

Jester's vet can't figure out why he's still losing weight - down to just over 7 pounds now - and wants me to give up and "let him grow old gracefully."

This isn't growing old. This is wasting away without a diagnosis.

His eyes are bright, he eats all the time, uses the litter box, gives me happy purrs, and runs after bugs.


Dry form FIP? Impossible to test for really as it's just an active form of a commonly carried virus. Not necessarily the right age group though...
 
I'm intrigued and curious right now. Jester ate a total of four cans of cat food yesterday.

Despite that and a BG that started out at AMPS 309, he had a mid-cycle +6 of 141 (I ssnuck home from work), +10.5 after work of 253, and a pre-bed BG of 150.
AMPS today was 280.

btw, his weight on my scale yesterday was still just over 7 pounds. So they do need to calibrate that thing at the vet's office.

I'm going to hold off weighing him this Saturday since I did it yesterday and see how he is next Saturday instead.
There’s always a slight difference between the vet’s scale and mine. Since I weigh them every week with the same scale and there’s are no other animals on it, I trust mine.
 
Here's a tip. You can add some powdered egg white to his food. It will add a few more calories and add some protein so muscle mass hopefully isn't lost. Make sure the only ingredient is egg white.
 
The new vet thinks Jester's getting too many calories, that it's keeping him from being regulated and that I need to work him down to less food.
The last week or so he was up to more than three 5.5 ounce cans of Friskies. Sometimes as much as four cans.
 
The new vet thinks Jester's getting too many calories, that it's keeping him from being regulated and that I need to work him down to less food.
The last week or so he was up to more than three 5.5 ounce cans of Friskies. Sometimes as much as four cans.
I don't know what to say about this. I'm not an expert but it doesn't make sense to me.

Have you tried feeding him something that doesn't have the carrageenan and fillers?
 
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