Mr Tinkles vet visit, URI (again!)

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Laurie and Mr Tinkles

Laurie and Mr Tinkles

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The last few days, Tinkles' chronic URI symptoms have been getting progressively worse, and I made a vet appointment for this morning to discuss options. He has been on two rounds of Amoxicillin and AB eye ointment, I put L-lysine in his food twice a day religiously, and yet once again he has an infection...his third time since his FD diagnosis in April. His BG has not gotten back to good levels since we had the (near) hypo about 3 weeks ago, and I really feel like that has fed the URI....and the URI has fed the BG...it's a vicious circle. I'm very frustrated with it. :evil:

I am getting low on ProZinc, and I have been doing a lot of internal debating about whether or not to continue with it. I really DO think it is a very good insulin, but Tinkles just swings too wildly on it, and the chronic URI symptoms become an infection as a result of poor BG control. I worry that I'm not giving him the best chance he can get of going into remission, and time is ticking away. For all of those reasons, I've decided to give Lantus a try. During the summer, my schedule is not as crazy, so shooting on a 12/12 schedule is possible for me, and I'll just have to find a way to make it work in the fall! So, I asked for the prescription and ordered the Lantus.

We saw a different vet today, she is the "cat specialist" in the practice, and she was great, very thorough. She put him on Azithromycin, she said that they have been getting good results with it, and eye ointment again. I hope the third time will be the charm! (My pessimistic side is not buying it, but we'll see...)

I'm really tired of the roller coaster at this point. It's only been 2.5 months, but it feels like years....
 
You know we just switched. All I can tell you is that only you can make that decision for Mr. Tinkles. You will know in your gut if you should make the change.

That being said - after only a few days on Lantus, Oscar's ketones are at 0 for the first time since we were at that high dose of ProZinc a few months ago. Its too early to tell if we get less wild swings and less inverse curves because we are still on the intro dosing stage.

You know you will have our support no matter what you choose! cat_pet_icon
 
Awww, what a pain!!!

I had a chronic UTIer for a while & that is really exhausting and frustrating to deal with. What worked for us was to use a urinary acidifier - I kept reagent pH paper at home http://www.911healthshop.com/phstrip5580b.html that I used to test his pee just like with the Ketostix, and I found as long as the pH was around 6 - 6.5 he was fine, but if it got higher than that he would have problems. We were able to manage it with an acidifying diet, or at one point regular food with an acidifying supplement from the vet. It's not what I generally see people mention on the board, but it worked wonders and is the approach that I swear by. If you can keep the pH in the right zone, the bacteria can't grow, as I understand it. You have to be careful with that approach not to get the pee too acidic, which can cause even worse problems, but with the pH paper it's easy to monitor. Once I got that working, he never needed antibiotics (which had never helped anyhow). Of course there are different urinary problems and that solution might not work for other types of issues, but it worked great for my guy.

Sorry things aren't going great, that can be so frustrating. Hopefully Lantus will do the trick, though we will miss you!!! I hope you will keep visiting here & posting to help out others!!!! As you know, we need all those with PZI experience we can get here!!!! I don't recall if you know Ele & Blackie - they switched to Lantus a few months ago and Blackie was in a similar boat with UTI problems that seemed to be compounding things. She may be able to help you learn the Lantus ropes and help with UTI issues as well.

Hope things improve soon!!! :YMHUG:
 
Thanks for the support everyone! I'm happy that Oscar is ketone-free, Kelly! I hope the Lantus will work better for him, I know it's frustrating to see no improvement.

Joanna, I appreciate the info about urinary acidifier, I will remember that if I ever have to deal with a UTI....but Tinkles has an upper respiratory infection (URI) and I don't think that will help for his issue. ;-) Now, don't be embarrassed, I've done the same thing! It IS good info nonetheless, and I will store it away for the future!

Funny how things work....I woke up this morning to a very nice low yellow PS#. Tinkles is definitely feeling better, his eyes are much improved and the nasal discharge is getting clearer. I fed him, shot a slightly reduced dose, and got a few things done around the house. His +3 was also a low yellow, so I didn't expect too much drop, but I had some errands I needed to run, so I tested him right before I left...and got a +4.5 99! I gave him a big snack (with some FF to cushion him) and had to go. Naturally, I worried the whole time I was gone, came back to a +9 125! I hope he didn't go too low, we don't need a bounce now. :roll:

So, now that I made up my mind, have the lantus, and was all set to switch....I can't do it! ARRRGGGHHH! I have to see if he is back on track, finally, and give the ProZinc at least a little more time. I have been so torn, I really don't want to switch if the ProZinc will work for him, he was on a good course for a while. It just didn't seem to be working for him since the hypo. It appears that the URI was there and affecting his numbers for far longer than I thought, he just didn't show the symptoms as early as he has in the past, I guess?

So, I'm not going anywhere, at least not yet! Even if I do (eventually), I will still be here, PZI is my home! :mrgreen:
 
Oh Gosh, our little tribe gets smaller and smaller. Well of course Laura you do what's best for Tinkles but you will be very missed here on pz-island...get it? lantus land.
I'm thinking tom has a UTI and want to get ahold of those acid testing strips.
Good Luck,
Lori
 
Laurie and Mr Tinkles said:
Joanna, I appreciate the info about urinary acidifier, I will remember that if I ever have to deal with a UTI....but Tinkles has an upper respiratory infection (URI) and I don't think that will help for his issue. ;-) Now, don't be embarrassed, I've done the same thing! It IS good info nonetheless, and I will store it away for the future!
Click to expand...

OMG I got such a great laugh over this one. :roll: Thank you for your gracious acceptance of my 100% irrelevant advice! ohmygod_smile

Sadly I have experience too with URIs, one of my civies has chronic problems and is on a long-term therapy with Azithromycin, it has worked very well for her, well, except the problem always comes right back (on any antibiotic), but that's just her.

Sweet #s today!!! Looks like s.o. likes his ProZinc after all! cat_pet_icon

PZ-Island, oooooh, I lOVE that!!!!! :mrgreen:
 
Lori, I love the pz island! :cool: I'm not going anywhere though, I'm going to give the ProZinc more time. I am not out of it yet, I probably have enough for a month or so. If Tinkles does stay in good numbers, I won't switch.

Joanna, I knew you would get a laugh out of that! It IS good advice, Lori can use it now, and you never know who else may benefit from it! :mrgreen:

The vet did put Tinkles on long term Azithromycin therapy, 5 days straight, then every 3 days for up to 6 weeks. She gave me a script for it, and I filled it at a human pharmacy. It isn't inexpensive though, and the medicine only holds for 10 days, so then I have to get a refill. Is that how you did it? Any tips for cutting costs? Have you ever tried L-lysine? I use that with Tinkles, and it does seem to help somewhat. I give that to him every day. I think we are always going to have to deal with this, it just never goes away completely. Before he was diabetic, he never had an infection from it, he just would sneeze a few times now and then.

Yes, he had good numbers yesterday..yay!....but he did bounce a little. Not too bad, only to 370ish.
 
Yeah, Noora gets it every 3 days probably for life. I didn't even know a human pharm would do it, when I've asked about the smaller doses the only thing they have is the nasty cherry-flavored liq that expires really fast anyhow, so.... nope!!! I think I used that when she was getting it several days straight, but no way for the every 3 day thing.

I get mine from a vet compounding pharmacy, they put the right dose in little capsules (thankfully she tolerates being pilled pretty well, in fact I used to let her scarf some baby food after each one, and now she yells for the meds whenever I get the bottle out, and goes right to her pilling spot!!! doesn't seem to have fully caught on yet that I can't afford to keep her in baby food.... ;-) shhhhh, better not say it too loud or she may realize it's not coming!!!).

I think I pay about $75 for 30 capsules, which is insane, but at least it lasts 3 months. I should ask for more capsules per script, I think their price is based on getting a custom order, rather than really being per capsule, but I'm not sure. I get them from Golden Gate Pharm (SF Bay area, but they ship I assume anywhere in the US).

I've tried the Lysine before and was never 100% sure if it helped - I'd continue with it, but the cheap versions I've found she seems to barf up, the only one she liked of course was when I got it from a vet pharm who made a liquid with chicken flavor, but charged something like $70 for a 1 or 2 month supply, so that's not going to happen. I should probably experiment with crushing tablets myself and mixing them with baby food, I don't think I've tried that yet. Right now I have a gel thing marketed for cats & dogs that I found on Amazon, forget the brand name, but the price was good (but she barfs it). The same brand has some chewy treats, my vet gave me a sample but she wouldn't touch them. :(

How do you give the lysine? Does he like it? Have you noticed any effect with his BGs from the supplement? Bix has minor chronic sniffles, I should probably try it for him too - the gel I have has sugar in it though, so I'm not trying that...
 
The cherry flavored liquid is what I got, it was $27 for 6 days worth. :shock: And yes, it expires very quickly, 10 days. So I'm in search of a better alternative! I'll have to look for a compounding pharmacy here, if not I'll check into that one, thanks!! I'm not a fan of pilling, but I could probably get it down him in a pill pocket. If worst comes to worst, I could probably mix it with water or something and syringe it into him!

The vet gave us Duralactin paste the second time around on the Amoxicillin. He LOVES the taste, but it was pretty pricey, $15 for 6 days. It has l-lysine in it, and it did seem to help him. Then I went and looked online, found it for about 1/2 the price, but still....pretty expensive for something you need to give all the time. Finally, I found capsules at the local health food store. They are 500mg, I started out giving him half of the capsule mixed in his food twice a day, but it didn't seem to work that well, so I increased him to 500mg BID. The vet said that's fine, he weighs almost 12 lbs. He doesn't seem to taste it at all. I just pour it on top, and stir it in just a little. The bottle cost me about $7, 100 capsules...very reasonable. It says it has no added sugar, so I think it's ok...Twinlab is the brand. It doesn't seem to affect his BG.
 
Oh, thanks! I called a pharmacy here yesterday and got a price of $80 for 6 weeks worth compounded in a liquid. That's better than the human version, but your pharmacy is much more reasonable. I'll have to do some more calling today.
 
Hi Laurie, I'm glad you're staying for awhile. I'm just getting to know everyone.

I've used the L-Lysine from the health food store for some time now. I crush it and stir it into the food. They don't seem to notice it. It takes a couple of days before the sniffles and sneezing stops. Than I stop giving it.

But I also vaguely remember a discussion over in Health about not using is every day for a lifetime. Can't remember why.

Lori, I love PZIsland. :mrgreen:
 
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