Metronidazole

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Jane & Boo (GA)

Jane & Boo (GA)

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My vet suspects that Silverado has pancreatitis. This is a guess on his part... no test performed. He prescribed 50mg, Metronidazole to be given every 12 hours for 30 days. Has anyone used this?

Jane & Silverado
 
I've had it prescribed for IBD, I don't know why it would be used for pancreatitis, I think it is an intestinal antibiotic...? Tastes awful, I found it a challenge to administer. 30 days sounds pretty daunting. You might get more info on Health too... maybe I'm mixing it up with something else? Flagyl, right? There's a site I like that has a lot of good info on meds & illnesses:

http://www.marvistavet.com/html/the_pet ... brary.html
 
Am I understanding correctly that your vet prescribed a drug due to something he suspects but performed no tests to determine?
 
His educated guess is based on "slightly elevated" white blood cell count and "slightly elevated" liver enzymes.... combined with no other obvious infections (ie, nothing dental, no UTI)... plus my difficulty getting Silverado regulated. My recent research of Metronidazole says that it has anti-inflammatory properties and is indeed prescribed for pancreatitis. If there are better remedies, I'm all ears.

The one thing that puzzles me most about Doc's suspicions is that Silverado doesn't have diarrhea and his appetite is unstoppable. Would this alone indicate that my vet is wrong about the pancreatitis?

Thanks for the feedback.

Jane & Silverado
 
I don't know anything about pancreatitis, so I can't speak to anything relating to that. However, a high-protein diet can cause BUN to be elevated, so could that be why the liver enzymes are slightly high? You can read about it here: http://www.webmd.com/a-to-z-guides/blood-urea-nitrogen
and I have also read that on various threads here, but I can't think of any of them offhand.

WBCs can be elevated due to an excited or stressed animal at the time of the blood draw. My vet told me this when my drooler's WBC was a little high, and Jess (I believe that's who it was) confirmed that, as did this website: http://www.peteducation.com/article.cfm ... 73&aid=987 (scroll down to "White Blood Cells").

Just mentioning these as possibilities. I don't know if this is the case for Silverado, and I don't know what your vet means by "slightly elevated" either. Just thought it might be worth bringing up. :)
 
"and his appetite is unstoppable."

How much do you feed him? Could he need more food?
How many of you with normal diabetics have "piranha" cats? I have nothing to compare.
I realize your numbers are not there, but unstoppable appetite is a very common trait/development in acromegaly.
 
Looking at his SS, that's really intriguing how it seems like he just adjusts to any insulin dose and gets good duration, but is all but immune to getting much drop. Bix looked like that at some doses that were good but not great, but increasing incrementatlly like you are worked pretty fast. I wonder if anyone has insight into Silverado's #s? I sure don't. I don't know what insulin resistance or Acro look like in the #s - I would think you would see higher #s than you are, but maybe not.

Don't know anything about Pancreatitis either, so no help there, sorry. I would look up symptoms (I'm sure you already have!!!) and use that as a guide (Acro also). As I understand it, it is very difficult to test for conclusively, but I think there are a couple tests they can do (PLI or fPLI maybe?), but they are expensive. I had a vet once tell me Bix had mild pancreatitis based on some regular bloodwork, but when I showed the data to a couple other vets they rolled their eyes and said those tests are really inconclusive. I don't think they are the same data points your vet is looking at, but I'd take it with a grain of salt (mostly because I would dread having to give Metronidizole to a cat for a few days, let alone a month!!!)

Bix was never a piranha cat, only when I overshot and had him in low #s, then he would eat like there was no tomorrow. :oops:
 
To answer Nancy's question, Buzz was never really a piranha cat either. When she was unregulated, she would act much more eager for food, meowing and crying when we would go to the kitchen, no matter if she had just eaten an hour ago. Now that she is in more stable numbers, she doesn't do that. She knows when mealtimes are, and she's always there waiting, but there isn't that desperation that she used to show.
 
Thanks for all the feed back. So far the Metronidazole is being well tolerated by Silverado, but I don't see any benefit. I just bumped his dose up to 2.6U BID because he is still hanging in those mid to upper 200s.

As for his unstoppable appetite... he eats everything he can get. At feeding time there are 7 civies along with Silverado to feed. Silverado works his way around to everyones food dishes. Anything left uneaten by the others, gets cleaned up by him. Keeping food out at all times is difficult, but I do fill a couple of bowls around midnight each night and again during the night about 2 am-ish. While I'm at work, I have a 5 compartment feeder that rotates every 2 hours. I don't think his appetite is from a lack of food. He was eating like this when he was first diagnosed. When he became regulated and then went into a short-term remission, his appetite was back to normal. As soon as the remission ended, the voracious appetite came back... along with drinking lots of water and peeing alot. I test regularly for Ketones and they are non-existent.

I'll do some research on the Acro symptoms to see if that's what I'm dealing with. I guess for now, I'll just keep increasing the insulin every couple of days. It has to eventually be the right dose.... doesn't it?

Jane & Silverado
 
Sounds like the appetite is related to not being regulated yet.

I can't look at your spreadsheet now but what Joanne said about the numbers not really reacting to increases, has been our situation, and I think others high dose moms (like Carolyn and Spot maybe) have said the same.
Have a look at Cody's numbers and see if anything looks familiar. The tumor does fluctuate, so you can have better weeks and worse weeks without a lot of explanation.

I wouldn't worry too much about it unless you get to 5-6+ u bid. Seems like that's about when folks really START to think about it. Sounds like you aren't anywhere near there yet. :-D
 
Woah Nancy.... you are having quite the time of it. As numbers go, Silverado runs pretty flat, but we're still under 3 units. I'm still being hopeful that he'll soon start showing a curve as we get closer to 3 units. Also, his digestive system is handling his appetite well. We have no constipation or diarrhea issues, but his poo is the stinkiest imaginable. Another poster referred to her kitty's aromatic deposits as "atomic poo"... that's quite appropriate for describing Silverado's assault of the litter box. I hope to never have to give Silverado (or any cat for that matter) the big "E" to, as you say, "get things moving". I admire your dedication to Cody... he's so lucky to have you taking care of him. What's involved in getting tested for Acromegaly?

Jane & Silverado
 
Thanks! You're funny! (big E) It not really that bad- my boys were bottle fed babies and I've always thought maybe thats why they are totally passive when I do about anything to them. I really am the mamabean! And it helps being retired from a "paying job" I am just SO GRATEFUL to the FDMB for the miralax suggestion- Cody's megacolon seems to have gone from his major issue to almost a non-issue (so long as I keep him out of the dog food :shock: )

As for your numbers, I think a lot of folks have noticed PZIR is very gentle and possibly more dilute, and I'm suspicious that it takes a while to "settle", so keep the faith :-D , keep moving up, and give each dose a good chance to settle and I'll bet you get there. Why did you drop back when you got to 3.2 before?

What's involved in getting tested for Acromegaly?
Click to expand...

I think you may be getting ahead of yourself. but....
If you continue to see flat numbers and you get to 5-6u, come visit the High Dose Insulin support group. There is info about the various HD conditions and how to test for them. Basically its a blood test, that has to be sent to Mich St Univ (only place that does it) in cold shipping. Your vet will object and think your'e crazy, so for now just keep doing what your are doing. I wouldn't even consider it until you get higher doses.

When our vet said Cody had pancreatitis she did IV fluids for about 3 days, then had me give fluids at home, subcutaneously. I still do this everyday and I think its why his kidneys are still in great shape even though he's not regulated (x3yrs). I do it now for his megacolon and because he doesn't drink much on his own ( he kind of gags when he drinks- maybe acro related) That is ALL I know about pancreatitiis - sorry.
 
Nancy and Cody said:
As for your numbers, I think a lot of folks have noticed PZIR is very gentle and possibly more dilute, and I'm suspicious that it takes a while to "settle", so keep the faith :-D , keep moving up, and give each dose a good chance to settle and I'll bet you get there. Why did you drop back when you got to 3.2 before?
Click to expand...


I dropped him back to 1.6 because he had a dental that day and Doc said to only give him 1/2 dose. When the metronidazole was prescribed, I decided to work back up slowly from there just in case there was a dramatic response to it. That hasn't happened yet and I expect that by the weekend, I'll have Silverado back up to at least 3.0 units.

Yes, I agree with you. Acro is not yet suspect, but I like to know things in advance, just in case. Thanks for the info.

Jane & Silverado
 
http://petdiabetes.wikia.com/wiki/Pancreatitis

Note the fPLI test for Pancreatitis. I have specific instructions for sending to Universities if your vets will send to Texas A&M. Nancy is aware of these instructions too. :-)

If you think IBD then the a full GI panel would not hurt which also includes the fPLI. There is lots of reading on this board about pancreatitis. The first place I'd start is in the non-DM Health forum.
 
Welcome back Gator and thanks for the link.

I don't think Silverado has pancreatitis because two of the most common symptoms are lethargy and anorexia. Silverado has neither symptom. I'm also seeing no benefit from the ab that he's been getting for the past 2 weeks.

I'm leaning toward Acromegaly. He's a big boy with really big feet. He also has an enlarged heart, heart murmur, labored breathing, snores, eats like he's been starved for days, drinks and pees like a race horse, has a big belly, and is insulin resistant.

If I get to the 5-unit BID level and still keep getting these numbers, I will have him tested for Acromegaly. Needless say, I hope I'm wrong.... but too many things point in that direction right now.

Take care.
Jane & Silverado
 
He's a big boy with really big feet. He also has an enlarged heart, heart murmur, labored breathing, snores, eats like he's been starved for days, drinks and pees like a race horse, has a big belly, and is insulin resistant.
Click to expand...

Oh...............................

You might want to read this article, It's brand new and isn't on the HD board yet. Open it as a PDF. Your vet is going to think you are wasting your money, most know very little about it, because it was thought to be rare, I copied it to my computer and burned it on a disc for my vet. I also printed some of the other articles. It helps to warm them up to the idea.
http://www.sciencedirect.com/science?_o ... 58b97d9ea5

If you get closer I have more about the shipping.
 
Nancy and Cody said:
You might want to read this article, It's brand new and isn't on the HD board yet. Open it as a PDF. Your vet is going to think you are wasting your money, most know very little about it, because it was thought to be rare.......
Click to expand...


Thanks for the great reading material. If we get to 6-units BID, I will have him tested. Too many signs point to it, but I'm hopeful that it's only a coincidence. As for getting my vet to take my money for the test.... NO PROBLEM. They love seeing me come in and aren't at all bashful about taking my money. :mrgreen:

Gator, thanks for the shipping info.

Happy Spring!!!
Jane & Silverado
 
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