New member. Injections and insurance questions.

[Alicia2022]

Hi everyone,

My 15yo Maine Coon Bella has been recently diagnosed based on her BG 560 and eating/drinking/peeing a lot.
Her weight is 7.7 lbs, used to be 14. I never heard about feline diabetes and just thought she’s losing weight because she’s getting old.
Prozinc 0.5 units twice daily, started yesterday. U-40 syringes, 0.3 ml, ½’’needle.

She’s skinny with tons of fur and I’m having big troubles trying to give her insulin shots. No matter what recommended spot I try, there is nowhere to inject into, basically. Fur, paper-thin skin, that’s it. All videos on YouTube show shorthairs with some fat. Plus, everyone says it shouldn’t hurt (although based on my own experience with subcutaneous injections they do hurt). Well, my cat definitely feels the needle, I’m afraid that I hit a nerve or a bone, do not inject, she escapes, I throw the syringe away, super frustrating.

I’ve read about testing and diet but for now it’s just too overwhelming to handle at once, so I need to figure out the shots first. So, my questions:

1) Any advice on injecting a super skinny cat?
2) Isn’t that dosage (0.5 units) too low? For how long should I stick to the prescribed dose? I’m planning to call our vet tomorrow to set up an appointment for testing. I thought it was a good idea to run the first few tests at the clinic (once a week?) I read here on the forum that everyone tests at home, multiple times per day even, so I’m really confused.
3) I need to decide whether to keep my cat’s insurance (ASPCA) or not. Diabetes is already listed on her file, and starting mid-July they want to raise her premium to $150/month, that would be $1800/year. Insurance minus deductible pays up to $4750 per year (accident and illness only, no preventative). I think that simply setting aside $3000 for Bella’s medical expenses would make more sense than keeping the insurance, am I missing something here?
I would greatly appreciate your help and advice!

 

[Larry and Kitties]

The "standard" starting does is 1 unit twice daily. but the low weight may require a lower starting dose. Without knowing BGs It is not possible to tell if dose can be increased. I would get a human meter like one of Walmart's Premiere meters since the strips are very affordable.
Regarding injecting, Just try to ping the skin and try to inject w/o going through both sides of the skin. That is not easy with ½" length needles.
Regarding insurance, if the diabetes treatment is not covered as an existing condition I would drop it..

 

[Sienne and Gabby (GA)]

The starting dose is 1.0u providing your cat is NOT on a low carb canned food diet. (Low carb is less than 10% carbs.) If you've transitioned your cat to a low carb diet, the starting dose would be 0.5u.

This is a link to information on Prozinc dosing methods.

 

[Noah & me (GA)]

We also had the once big and fluffy cat who just continued to lose weight over the years so I feel that pain.
I was taught to inject in the scruff but found it was much easier injecting below what's called the flank in the attached pic. We had him lay on his side and I pinched or "tented" the site and injected from a shallow angle. I don't want to scare you away but it's testing that looks a lot worse and takes some practice and patience.
Our first sugar cat would leap onto the kitchen table when the time came. He knew it might hurt but he trusted me and along with practice that's all it takes.

 

[Diane Tyler's Mom GA]

started yesterday. U-40 syringes, 0.3 ml, ½’’needle.

These are shorter needles U-40 with half unit markings
I copied what one of the reviews said , they are half unit markings even though I don't see it on the box ,you can always call to be sure
https://shoppettest.com/advocate-pe...MInfTou_Xv-AIVkfLjBx0yOA4DEAQYASABEgKfMPD_BwE

Here is the review

My dog was diagnosed less than a month ago and I was given 29g 1/2 syringes. She is a small toy poodle with Cushing's disease and her skin is very thin and delicate. I'm new to injections so I know I was causing her more discomfort than necessary. These make SUCH a difference. She no longer squirms and the ordeal is over much faster. The 1/2 unit markings are great as well.




Here is the link for prozinc dosing methods
https://felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

 

[Alicia2022]

Thank you all so much for all the helpful information and suggestions!
I've tried injecting around the flank area and that was much better. Although I'm not sure about the possible fur shots, so I may trim Bella's fur a bit. I'll likely order the syringes with shorter needles as well.
I've scheduled a testing appointment with our vet later this week and will look into home testing and devices to figure this out. Does pet insurance normally cover glucose monitors?
I also did some readings here on the forum regarding Prozinc vs Lantus and I guess we have to stick to Prozinc for now, at least until we figure out testing process and our schedules.

Regarding the dosage and the low carb diet. This is a tricky one. (BTW, should I create a new topic to ask about food?)
Our cat was given to us many years ago by a breeder who couldn't figure out the reason for Bella's digestive problems (constant diarrhea). The breeder couldn't feed her together with other cats and didn't want to breed her because of our cat’s suspected metabolic deficiency. So, she's been on RC Gastrointestinal dry food since we got her, and this was the only food that worked for her. Two years ago, we started introducing wet food as well because it’s easier on her teeth (not so many left!) and also makes easier to give her joint supplements. Now, her main dish is RC Renal support E, and from time to time also RC Aging. Both have around 20% carbs. She has a small amount of her dry gastrointestinal food always available for grazing.
After learning about her diabetes but before finding this forum, I decided to try and switch her from dry gastrointestinal food to the canned one (our vet advised that but didn’t go into any details regarding carbs, brands, etc.) Well, after finishing the first can she vomited, had loose stool, and refused to eat today before the injection. Luckily, we’re able to feed her the renal wet food after that. So…as much as I want to try other brands like FF (and they are so much cheaper!), I’m also super hesitant to change Bella’s current diet.

 

[Diane Tyler's Mom GA]

I've scheduled a testing appointment with our vet later this week and will look into home testing and devices to figure this out. Does pet insurance normally cover glucose monitors?

I googled it and it said
They would not cover any treatment for diabetes because it would be considered a pre-existing condition, and most insurance companies will not cover pre-existing conditions.
Most of us use human glucose meters that's what our numbers are based on

If you live in the US you can go to Walmart or order online from them
The Relion Classic Premier Meter. 9 dollars
17.88 for 100 test strips make sure you get the test strips that go with that meter
26 or 28 gauge lancets to poke the ear with
Some cotton rounds
Home testing is the only way to keep Bella safe

 

[Diane Tyler's Mom GA]

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
Take a look at the lancets ,you will see one side points up, that's the side you want to poke with
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up
A video one of our members posted
VIDEO: How to test your cat's blood sugar

 

[Diane Tyler's Mom GA]

Regarding the dosage and the low carb diet. This is a tricky one. (BTW, should I create a new topic to ask about food?)
Our cat was given to us many years ago by a breeder who couldn't figure out the reason for Bella's digestive problems (constant diarrhea). The breeder couldn't feed her together with other cats and didn't want to breed her because of our cat’s suspected metabolic deficiency. So, she's been on RC Gastrointestinal dry food since we got her, and this was the only food that worked for her. Two years ago, we started introducing wet food as well because it’s easier on her teeth (not so many left!) and also makes easier to give her joint supplements. Now, her main dish is RC Renal support E, and from time to time also RC Aging. Both have around 20% carbs. She has a small amount of her dry gastrointestinal food always available for grazing.
After learning about her diabetes but before finding this forum, I decided to try and switch her from dry gastrointestinal food to the canned one (our vet advised that but didn’t go into any details regarding carbs, brands, etc.) Well, after finishing the first can she vomited, had loose stool, and refused to eat today before the injection. Luckily, we’re able to feed her the renal wet food after that. So…as much as I want to try other brands like FF (and they are so much cheaper!), I’m also super hesitant to change Bella’s current diet.

I can tag some members about your food question
@FrostD

@Suzanne & Darcy

@Wendy&Neko

@Bron and Sheba (GA)

@Sienne and Gabby (GA)

 

[FrostD]

Has she had a GI panel done recently? Thyroid? Had you tried to determine food allergies?

So we do typically want them on a low carb diet, but at this point I personally would rather treat the diabetes first then worry about food since you don't know the cause. We can work around 20% food...it's not ideal, but I think the lesser of a few evils here (and I'm happy it's wet instead of dry). DKA is a serious risk when unregulated and with potential food issues, so I'd rather stick with food you know she'll eat and tolerate.

 

[Alicia2022]

Has she had a GI panel done recently? Thyroid? Had you tried to determine food allergies?

I had to google what a GI panel is, so obviously, no, we haven't done it recently. We did all the possible tests shortly after we got her, nothing could explain her problems, and then we just found that perfect GI dry food and lived happily ever after.
Bella's thyroxine and cholesterol are normal, just checked it in June.
Looking at Bella's tests, she has low PLT (73), high BUN/UREA (54), but the vet said her kidney function is pretty okay for her age. This clinic doesn't test for SDMA (our previous did, and they suggested we add the renal wet food to Bella's diet).

 

[FrostD]

Can you post the labs please?

 

[Alicia2022]

Can you post the labs please?

Thank you

 

[Diane Tyler's Mom GA]

@FrostD Here are the labs you asked her for

 

[FrostD]

Oh suzaaaannnee @Suzanne & Darcy lab interpretation please

 

[Diane Tyler's Mom GA]

@Suzanne & Darcy in case you didn't see the tag

 

[Diane Tyler's Mom GA]

@Suzanne & Darcy can you take a look at the labs

 

[FrostD]

I just read elsewhere Suzanne is on vacation so hopefully she gets a chance to check in, she will eventually I'm sure.

I'm primarily concerned about that hematology (WBC, monos, etc) and then the kidneys. Suzanne knows much better than I which of those are intertwined

 

[Alicia2022]

I'm primarily concerned about that hematology (WBC, monos, etc)

Bella (our cat) had a sore at her chin at the time of those labs. Our vet suggested this could be a manifestation of an infection in her jaw (quite possible because her teeth always looked too old for her age and now are almost gone). We're prescribed clindamycin oral treatment and the sore went away after a few days. In general, her entire head is sort of problematic. She most likely has nasopharyngeal polyps and is 99% deaf.
She also has arthritis, another source of inflammation. We asked our vet if there is any treatment she could recommend, and she just said that there are no good pain medications for cats and we may give Bella joint supplements if we want to. I read about Adequan on this forum, is this something we should consider?

 

[FrostD]

Bella (our cat) had a sore at her chin at the time of those labs. Our vet suggested this could be a manifestation of an infection in her jaw (quite possible because her teeth always looked too old for her age and now are almost gone). We're prescribed clindamycin oral treatment and the sore went away after a few days. In general, her entire head is sort of problematic. She most likely has nasopharyngeal polyps and is 99% deaf.
She also has arthritis, another source of inflammation. We asked our vet if there is any treatment she could recommend, and she just said that there are no good pain medications for cats and we may give Bella joint supplements if we want to. I read about Adequan on this forum, is this something we should consider?

Suzanne would also know about the potential jaw issues, and arthritis. But yes lots.of people here use Adequan and are very happy with it. I believe others use gabapentin or buprenorphine for arthritis pain relief, but off the top of my head I can't remember if one is better than the other (seems to be cat-dependent, gaba seems to make a lot of cats loopy).

Poor kitty!

 

[Diane Tyler's Mom GA]

I've read that many members have good results with adequan.
If you go to where it says search type in adequan , many posts will pop up about adequan in bold letters look at each post. You can do them at home also

 

[Diane Tyler's Mom GA]

Thank you
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@Suzanne & Darcy
When you get a chance can you please look at her labs Post #13 , #18 and #19
Are you still on vacation if not I hope you had a great time. I think I am driving you crazy with all the tags
@Alicia2022 is a new member a lot of information on her post

@Suzanne & Darcy

 

[tiffmaxee]

I can see that there’s inflammation and with the eosinophils being high wonder about an infection or allergies. That could also be from arthritis.

 

[Alicia2022]

That could also be from arthritis.

This was what our vet told us. Arthritis and/or the chin/jaw.

 

[Suzanne & Darcy]

@Suzanne & Darcy
When you get a chance can you please look at her labs Post #13 , #18 and #19
Are you still on vacation if not I hope you had a great time. I think I am driving you crazy with all the tags
@Alicia2022 is a new member a lot of information on her post

@Suzanne & Darcy

Gosh, why am I not getting any of these tags!!!

 

[Suzanne & Darcy]

@Suzanne & Darcy
When you get a chance can you please look at her labs Post #13 , #18 and #19
Are you still on vacation if not I hope you had a great time. I think I am driving you crazy with all the tags
@Alicia2022 is a new member a lot of information on her post

@Suzanne & Darcy

Okay, those aren't as bad as I thought. Elevated Amylase levels are of little significance in a cat. There is some inflammation present, which could simply be from the likely infection that she has. The high eosinophils may also indicate an allergic component. Simply put, her white count and other markers for an infection are present. Has she been put on antibiotics? I would urge that you not delay in getting a good broad spectrum antibiotic for Bella before you go on your trip. Don't let the vet give you a Convenia injection! Please. Get some oral antibiotics. If the vet gives you Clavamox, which is a very good drug, be prepared though that it may cause too much diarrhea which in her case would be further weakening. If the cause of the infection is unknown, I would go for something like Zenequin or... well there are quite a few other options that you can ask the vet about. Then after the course of antibiotics the infection markers in the blood would need to be retested to make sure they have gone down. Believe me, I found out the hard way (with a DKA and a week long ER stay) that infection plus high BG numbers was a recipe for diabetic ketoacidosis. Of course, the infection came on suddenly and I had no idea he was ill until it was too late.

 

[Suzanne & Darcy]

Also, those kidney values can DEFINITELY be helped by fluids! Take my word for it, they REALLY can! Your creatinine is not bad (although may be low due to weight loss). Sub-q fluids can get that BUN down, I assure you! Your kitty will feel better. Combine that with some antibiotics and who knows how much better she can get. Tell me, how is she eating?

Now, do you have a urinalysis? One should have been done. Urine Specific Gravity is something I would like to see as it is a more accurate predictor of kidney function. Here's another possible scenario. Urinary Tract Infection or possible kidney infection. These can skew all the kidney values.... again... needs antibiotics. Don't give up! We can help Bella to feel much better. And you are in the right place to get help with the ProZinc and BG, too. You've only just started that.

 

[Suzanne & Darcy]

This was what our vet told us. Arthritis and/or the chin/jaw.

Yes, it could be. The markers in her blood could be inflammation can be anything like arthritis, even teeth, infection, and even cancer. Don't panic. If her elevated white count will most likely respond to the right antibiotic. Please see my other lengthy posts above about the bloodwork. Sorry to inundate you today. When do you leave town?

 

[Suzanne & Darcy]

@Suzanne & Darcy
When you get a chance can you please look at her labs Post #13 , #18 and #19
Are you still on vacation if not I hope you had a great time. I think I am driving you crazy with all the tags
@Alicia2022 is a new member a lot of information on her post

@Suzanne & Darcy

No worries, Diane. I am not getting my tags lately or maybe they're just buried and I'm not getting to them? Has happened several times just today though :-(

 

[Suzanne & Darcy]

Please forgive me if you answered this somewhere, but it is important to check blood pressure in a cat with CKD. High blood pressure can cause blindness and seizures. It is not a foregone conclusion that a CKD cat will have high blood pressure, but it does increase the chances... so does advanced age as a matter of fact. Dr. Lisa Pierson of catinfo.org fame literally told me that she was "sick of seeing kitties go blind because their vets don't check their blood pressure." It's just not something that most vets will check unless you ask them to do so. My vet charges ten dollars for it. Three readings are usually taken and the average of the three is used. Again, please forgive me if you already answered this.

 

[Suzanne & Darcy]

she just said that there are no good pain medications for cats

This is so NOT true. The best pain medication for cats is Buprenorphine. It is the safe in cats and can be very effective. Vets use it all the time in their clinics in injectable form (Buprenex.) The liquid can be a little tricky for some people with "challenging" cats because it needs to be absorbed by the mucus membranes to be effective (gums) so it needs to be administered into the buccal (cheek) pocket. It's a very tiny amount of liquid. It can be compounded into a trans-dermal med by a compounding pharmacy (Wedgewood Pharmacy ... are you in the US?). Some people do use gabapentin and get varying results. Yes, response to gabapentin (which is actually an anti-seizure med) are quite variable. It's given to fractious cats when they go to the vet to calm them (again, it won't work in some cats). Now Buprenorphine is an opiate so yes, the vet needs to do the work to prescribe this for you (what I mean is that there's paperwork involved for them) so a lot of vets that I see these days (fortunately not my own vet) on this Board are refusing to bother to give it to their clients. :-( As for arthritis, yes there are options like Adequan and soon (hopefully) Solensia injections (my vet is really waiting for that one - we just talked about it recently... coming soon in the US we hope.) There are lots of natural supplements you can try just to see if any of them can help.

 

[Suzanne & Darcy]

Bella (our cat) had a sore at her chin at the time of those labs. Our vet suggested this could be a manifestation of an infection in her jaw (quite possible because her teeth always looked too old for her age and now are almost gone). We're prescribed clindamycin oral treatment and the sore went away after a few days. In general, her entire head is sort of problematic. She most likely has nasopharyngeal polyps and is 99% deaf.
She also has arthritis, another source of inflammation. We asked our vet if there is any treatment she could recommend, and she just said that there are no good pain medications for cats and we may give Bella joint supplements if we want to. I read about Adequan on this forum, is this something we should consider?

I am going to tag @Katherine&Ruby who has used Adequan successfully in her cat, Ruby. The last I heard, she had very good results. She's not on the Board every day though since she works a lot and also travels for work. Anyway, if you do a search under Adequan and see posts by Katherine, then read those, because Ruby was helped a lot by Adequan.

 

[Suzanne & Darcy]

I just read elsewhere Suzanne is on vacation so hopefully she gets a chance to check in, she will eventually I'm sure.

I'm primarily concerned about that hematology (WBC, monos, etc) and then the kidneys. Suzanne knows much better than I which of those are intertwined

Was on vacation last week... where was no wifi! Of course, was I on this Board anyway... yes! But I did get away and out in the woods and mountains, etc. And to think I told my husband it was good for him to get away where there was no wifi so he couldn't do any work! Anyway, I'm back for real now and on a computer and not my phone.

 

[Suzanne & Darcy]

Also (and maybe Diane has already linked you to some) but can you use a smaller gauge needle. Mine were VERY tiny 31 gauge needles. Darcy never seemed to feel it at all. Some people with long furred cats will have a small spot shaved at first to give them a place to inject where they can be more certain of what they are doing.

 

[Alicia2022]

Suzanne, thank you so much.
Antibiotic: we gave Bella oral clindamycin for 5 days. She tolerated it well. She used to have terrible side effects from other antibiotics before because of her sensitive stomach. Clindamycin helped and her chin sore disappeared. At the time the labs were done, her chin looked quite terrible. Our vet mentioned that Bella's teeth and jaws are problematic, but she (the vet) would rather not do any extractions but prescribe a flash antibiotics treatments a few times a year instead. I think this is reasonable.

We didn't have urinalysis or blood pressure taken. I'll ask the vet about this on Thursday. As well as about Adequan. Can Adequan be done concurrently with insulin injections?

Subq fluids: how often they should be given? Is this something we can postpone for 2-3 weeks?
I’m going on a trip and our vet will be on vacation.

Smaller gauge needles: received them today. Shaved a few spots on Bella as well. Injections are going just fine now. But all my testing attempts failed.

Buprenex: I don’t think Bella needs it now, right? She was given one injection of Buprenex in February when she had something going on either in her throat or her jaw and refused to eat. We never figured out what it was because the vet we went to with that issue was terrible.

As I mentioned elsewhere, we live in a rural area and don’t have a car (I can drive on country roads, my husband has almost zero driving experience). There are not so many vets to choose from. Our current vet was actually recommended by a local sugar cat mom (I don’t know her personally but I know this from Fb).

Eating: Bella eats constantly. When she is not eating, she is guarding her empty bowl. This was never like this before.
Her main food is RC wet Renal E. She also gets RC GI wet (and a bit of dry – she used to be on 100% dry food until recently). She also gets lots of water with her food because this is how she likes to eat (like a soup).
We just bought FF pates. Chicken / Beef/ Turkey liver. She is ecstatic about them! But we have to see how this new food affect her stomach. Are they okay food for CKD cats? I don’t understand how cheap food can be better than RC vet diet.

 

[Suzanne & Darcy]

Subq fluids: how often they should be given? Is this something we can postpone for 2-3 weeks?

As long as Bella is eating and drinking well, then I'd say you can postpone it for the duration of your trip. For the time being, if she's not already drinking a lot due to high BG numbers... which she probably already is... you can add some water to her food to make it a little bit soupy - as much as she will tolerate. Overall hydration is the key. As for how much fluid to give, it really depends upon the kidney values and the weight of the cat.

Smaller gauge needles: received them today. Shaved a few spots on Bella as well. Injections are going just fine now.

This is fantastic. I'm so happy for you and for Bella And, I saw this morning about the first successful test!

Buprenex: I don’t think Bella needs it now, right?

She probably doesn't need any oral Buprenorphine unless she's really hurting. You mentioned the arthritis and that the vet said there aren't safe pain meds for cats... that's why I mentioned Buprenorphine.

Eating: Bella eats constantly. When she is not eating, she is guarding her empty bowl. This was never like this before.

It's the high BG, usually they're always starving when their numbers are high.

Her main food is RC wet Renal E. She also gets RC GI wet (and a bit of dry – she used to be on 100% dry food until recently). She also gets lots of water with her food because this is how she likes to eat (like a soup).
We just bought FF pates. Chicken / Beef/ Turkey liver. She is ecstatic about them! But we have to see how this new food affect her stomach. Are they okay food for CKD cats? I don’t understand how cheap food can be better than RC vet diet.

I'm glad she likes the soup. I, too, was also forced to feed my diabetic cat the RC Renal foods (E was a hit with him most times). The reason people won't like you feeding that is because it's higher in carbs than what we would normally recommend for a diabetic cat. Personally, I would rather adjust the insulin accordingly and not stop feeding the RC Renal food if that is what she is eating now. FF pates are low carb, but they're too high in phosphorus for a CKD cat. There are some lower phosphorus options that are also low carb and I can help you with that if you want to -- after you return home. I would use the FF pates sparingly. The RC renal food is very low in phosphorus, and has other added nutrients that make it good for CKD cats. This may be why her phosphorus level is good right now (close to 4 is optimal.) I usually wait until I have no other options before feeding the renal diets to any of my cats (even non-diabetic cats,) but, as I said, she's been eating it an likes it and I don't think I would rock the boat now while you are going to be gone for several weeks.

 

[Alicia2022]

As long as Bella is eating and drinking well, then I'd say you can postpone it for the duration of your trip.

What do you think of drinking fountains for cats? Bella loves to drink from the faucet but it's not easy for her to climb on the counter (we build some improvised steps for her to get there). I'm not sure about safety of such a fountain (water+electricity=???).

She probably doesn't need any oral Buprenorphine unless she's really hurting.

Sometimes when she's sitting upright, one of her front legs really trembles as if she can't hold it in place. When I touch it, she's calm. I'm wondering if she's in pain. I have meloxicam, this is a NSAID recommended by a good vet abroad, but here in the US it's considered toxic for cats so I don't know if it's worth the risk.

And, I saw this morning about the first successful test!

I guess that was a one-time success. Just tried testing again, hit her poor paw two times, and there is just not enough blood.

here are some lower phosphorus options that are also low carb and I can help you with that if you want to -- after you return home.

Great.
Thank you, Suzanne !

 

[Suzanne & Darcy]

What do you think of drinking fountains for cats? Bella loves to drink from the faucet but it's not easy for her to climb on the counter (we build some improvised steps for her to get there). I'm not sure about safety of such a fountain (water+electricity=???).

Sometimes when she's sitting upright, one of her front legs really trembles as if she can't hold it in place. When I touch it, she's calm. I'm wondering if she's in pain. I have meloxicam, this is a NSAID recommended by a good vet abroad, but here in the US it's considered toxic for cats so I don't know if it's worth the risk.

I guess that was a one-time success. Just tried testing again, hit her poor paw two times, and there is just not enough blood.

Great.
Thank you, Suzanne !

What do you think of drinking fountains for cats? Bella loves to drink from the faucet but it's not easy for her to climb on the counter (we build some improvised steps for her to get there). I'm not sure about safety of such a fountain (water+electricity=???).

Sometimes when she's sitting upright, one of her front legs really trembles as if she can't hold it in place. When I touch it, she's calm. I'm wondering if she's in pain. I have meloxicam, this is a NSAID recommended by a good vet abroad, but here in the US it's considered toxic for cats so I don't know if it's worth the risk.

I guess that was a one-time success. Just tried testing again, hit her poor paw two times, and there is just not enough blood.

Great.
Thank you, Suzanne !

I know a lot of people just love the drinking fountains and the cats love them. A lot of cats will drink more from running water. I used to have a drinking fountain but I have a lot of cats and it got slimy even though we changed the water every day and it had a filter (I mean the internal parts -- the pump) and I had to take the thing apart at least once a week and clean it with vinegar and put it back together. IT was a nuisance. I gave up. I think for only one or two cats it would be a good thing. I wonder if they sell them with a UV light nowadays that would keep the thing cleaner?

Now, I am not a fan of Metacam for cats. My vet will not even prescribe it to cats at all. There is a "Black Box" warning on Metacam for cats due to kidney failure. Having said that, I do know of cats overseas who get "low dose" Metacam. Some vets over there even use it for kidney disease. So my guess is that the kidney damage is dose dependent. My vet says they have arguments about it all the time at vet conferences. Why use Metacam, though, when their are other options for pain relief (like Buprenorphine.) That's my attitude about it. Why risk it. Older cats are already prone to CKD. One of my cats does that front leg trembling thing sometimes too when she's sitting up like that. She doesn't seem to be in pain either. We haven't figured out what it is because otherwise she still gets around fine and jumps up on the bathroom counters and laundry room counters, etc. .... kitchen counters are not allowed

 

[eva eva]

I just read elsewhere Suzanne is on vacation so hopefully she gets a chance to check in, she will eventually I'm sure.

I'm primarily concerned about that hematology (WBC, monos, etc) and then the kidneys. Suzanne knows much better than I which of those are intertwined

looking at her WBC and Neuts. the neuts are baby white blood cells. so her system is attempting to make WBC faster. she seems to be fighting an infection UTI, teeth, ear?

 

[eva eva]

I know a lot of people just love the drinking fountains and the cats love them. A lot of cats will drink more from running water. I used to have a drinking fountain but I have a lot of cats and it got slimy even though we changed the water every day and it had a filter (I mean the internal parts -- the pump) and I had to take the thing apart at least once a week and clean it with vinegar and put it back together. IT was a nuisance. I gave up. I think for only one or two cats it would be a good thing. I wonder if they sell them with a UV light nowadays that would keep the thing cleaner?

Now, I am not a fan of Metacam for cats. My vet will not even prescribe it to cats at all. There is a "Black Box" warning on Metacam for cats due to kidney failure. Having said that, I do know of cats overseas who get "low dose" Metacam. Some vets over there even use it for kidney disease. So my guess is that the kidney damage is dose dependent. My vet says they have arguments about it all the time at vet conferences. Why use Metacam, though, when their are other options for pain relief (like Buprenorphine.) That's my attitude about it. Why risk it. Older cats are already prone to CKD. One of my cats does that front leg trembling thing sometimes too when she's sitting up like that. She doesn't seem to be in pain either. We haven't figured out what it is because otherwise she still gets around fine and jumps up on the bathroom counters and laundry room counters, etc. .... kitchen counters are not allowed

I have read that most cats don't like their water near where they eat. I experimented with the idea as I have a diabetic cat and a renal cat. I have 3 additional bowls in the house. Change the water daily. They all seem to be drinking more. noticed by water level going down rapidly (4 cats)

 

[Suzanne & Darcy]

I have read that most cats don't like their water near where they eat. I experimented with the idea as I have a diabetic cat and a renal cat. I have 3 additional bowls in the house. Change the water daily. They all seem to be drinking more. noticed by water level going down rapidly (4 cats)

I know my water bowls have a significant drop in level when the cats have dry food (which is a rare thing.)

 

[Larry and Kitties]

looking at her WBC and Neuts. the neuts are baby white blood cells. so her system is attempting to make WBC faster. she seems to be fighting an infection UTI, teeth, ear?

No, Neuts (neutrophils) are one type of white blood cells

"The function of white blood cells (also called leukocytes) is to defend the body against infection. There are 2 main types of white blood cells: phagocytes and lymphocytes."

"Phagocytes (from the Greek word meaning “to eat”) are cells in the bloodstream and tissues that surround and consume foreign particles, cell waste material, and bacteria. Their main function is to defend against invading microorganisms.

"There are 2 types of phagocytes: granulocytes and monocytes. Granulocytes protect against bacteria, parasites, and fungi. Some types of granulocytes are involved in allergic reactions. Neutrophils are the most numerous of the white blood cells and are the first line of defense against bacterial invasion. Other granulocytes, known as eosinophils and basophils, are involved in both protection against some parasites and allergic reactions. Monocytes travel from the blood to tissues, where they become cells called macrophages, which consume foreign particles and cellular debris.

"Lymphocytes are white blood cells that recognize and defend against specific infectious organisms. They also reject foreign tissue and cancer cells. Lymphocyte production in mammals begins in the bone marrow. Lymphocytes then become T cells, B cells, or natural killer cells."

above from: https://www.msdvetmanual.com/cat-owners/blood-disorders-of-cats/white-blood-cells-of-cats

High neutrophils typically mean an infections.
High eosinophils (a type of white blood cell) typically mean an allergic reaction
https://pets.thenest.com/elevated-eosinophils-cats-8191.html

 

[eva eva]

No, Neuts (neutrophils) are one type of white blood cells

"The function of white blood cells (also called leukocytes) is to defend the body against infection. There are 2 main types of white blood cells: phagocytes and lymphocytes."

"Phagocytes (from the Greek word meaning “to eat”) are cells in the bloodstream and tissues that surround and consume foreign particles, cell waste material, and bacteria. Their main function is to defend against invading microorganisms.

"There are 2 types of phagocytes: granulocytes and monocytes. Granulocytes protect against bacteria, parasites, and fungi. Some types of granulocytes are involved in allergic reactions. Neutrophils are the most numerous of the white blood cells and are the first line of defense against bacterial invasion. Other granulocytes, known as eosinophils and basophils, are involved in both protection against some parasites and allergic reactions. Monocytes travel from the blood to tissues, where they become cells called macrophages, which consume foreign particles and cellular debris.

"Lymphocytes are white blood cells that recognize and defend against specific infectious organisms. They also reject foreign tissue and cancer cells. Lymphocyte production in mammals begins in the bone marrow. Lymphocytes then become T cells, B cells, or natural killer cells."

above from: https://www.msdvetmanual.com/cat-owners/blood-disorders-of-cats/white-blood-cells-of-cats

High neutrophils typically mean an infections.
High eosinophils (a type of white blood cell) typically mean an allergic reaction
https://pets.thenest.com/elevated-eosinophils-cats-8191.html

you are correct. and as I said. neutrophils are a baby WBC. when you see an increase in Neutrophils it is the body reflecting its attempt to make more WBC to fight infection. so you see the rise. Unfortunately, also, as baby WBC they lack maturity to fight.