opinions welcome

[Anyname]

Vet visit today.

Vet says LB might respond better to Lantus if fed only twice per day. His numbers are erratic on current grazing regime. He's lost weight since a month ago. I am now wondering wether I should try to feed according to his bg levels. I have tended to feed him every few hours to avoid a hypo episode. Vet says LB is highly unlikely to have hypo episode on Lantus. His belief is that Lantus is too gentle. LB has been as low as 38 and didn't show any signs of trouble.

I am concerned about the recent high numbers at AMPS - LB doesn't seem terribly well. The itchy/scratchy problem has become worse which may be the reason for the weight loss. So much licking and chewing his fur off. :YMSIGH:

We are trying antihystimine (sp?) and some pain relief. I decided not to proceed with blood test for allergies until I got some feed back from FDMB. Very expensive.

Vet wonders about pancreatitis but says LB didn't appear to be sore during physical examination. Is that much of a guide?

posted this on health board: http://www.bioportfolio.com/news/articl ... n=stemcell

 

[Cheryl and Winnie]

Vet visit today.


Vet wonders about pancreatitis but says LB didn't appear to be sore during physical examination. Is that much of a guide?

posted this on health board: http://www.bioportfolio.com/news/articl ... n=stemcell

lack of pain on palpation during a vet exam does not rule out p-titis. in fact most cats have no discernible pain during exam:

from texas a &m web site on p-titis:

http://www.cvm.tamu.edu/gilab/research/ ... itis.shtml

"Cats, even with severe pancreatitis, present with less specific clinical signs than do dogs. In a recent review of a large number of cats with pancreatitis the following clinical signs were reported: anorexia in 87%, lethargy in 81%, dehydration in 54%, weight loss in 47%, vomiting and hypothermia in 46%, icterus in 37%, fever in 25%, abdominal pain in 19%, diarrhea in 12%, and a palpable abdominal mass in 11%. Especially remarkable in this report is the low incidence of vomiting and abdominal pain in cats with pancreatitis."

emphasis in bold is mine
You might wish to pass this(and the link to the site) on to your vet, as it is a very respected ( at least here in the states) authority on pancreatitis. I'm not sure what the availability of testing is down under. But if even remotely suspected it would certainly be worth some bw.

Is your kitty having other signs/symptoms of p-titis besides wonky numbers?

Here is the link to your post on health :
viewtopic.php?f=28&t=26135

it would be great if all responses to that article could be over on health to keep things less confusing (it is a general FD topic.) Thanks ! :smile:

ETA-- I forgot that you forgot to put the date and your kitties name in your condo header for today. which is why I forgot to remind you when I posted. it must be one of those days . ;-) time for some

 

[Anyname]

yes, will take the discussion over to health but wanted to thank you very much for your response. It was most helpful. I am a tad lost re LB's sitch as he's not seemed very well lately and pancreatitis may be the problem.

I also wanted to ask about the pain medication Metacam which LB has been prescribed. I have asked about it on Health just now but you seem very knowledgable and may be able to give me advice on it. At present, both DH and myself feel there is something wrong with LB. Spent an hour with lovely vet today but reached no conclusions. LB also has itchy/scratchy issues so it's all very confusing. Since last night I noticed three times he's cried when I've tried to get him to lay down for his BG test. The cry was a pain cry. :sad:

 

[Cheryl and Winnie]

yes, will take the discussion over to health but wanted to thank you very much for your response. It was most helpful. I am a tad lost re LB's sitch as he's not seemed very well lately and pancreatitis may be the problem.

I also wanted to ask about the pain medication Metacam which LB has been prescribed. I have asked about it on Health just now but you seem very knowledgable and may be able to give me advice on it. At present, both DH and myself feel there is something wrong with LB. Spent an hour with lovely vet today but reached no conclusions. LB also has itchy/scratchy issues so it's all very confusing. Since last night I noticed three times he's cried when I've tried to get him to lay down for his BG test. The cry was a pain cry. :sad:

I have only had one of my cats given metacam once post surgery. I see you made it over to think tank to see the thread about it there. From that new information it appears your vet is having you use it off label. It comes with quite a bit of risk for kidney damage. I have found the best pain med for pancreatitis and dental pain and cancer pain to be buprenorphine. something is not right w/ your kitty. do YOu have an internal med specialist he can see if your reg vet is not able to figure it out or unwilling to test for p-titis?
I'm off to sleep now and will check back w/ you later.
treating p-titis is one thing I know a lot about and I'm happy to answer or share any other information about it that you like.

what tests have been done? any imaging?

ps I didn't address the food issues earlier. but your vets answer seems more suited to other insulins.
(of course ECID.) but it sounds more likely that whatever is causing the allergic type reaction and the pain are contributing to numbers issue, not the feeding sced. Winnie was a grazer. lantus worked fine w/ that for her.

 

[Sienne and Gabby (GA)]

A couple of thoughts...

It's possible that whatever is causing the itching is effecting numbers. If it's a food-related allergy, you may want to try LB on novel proteins (e.g., duck, venison).

The higher/erratic numbers may take a little more detective work on your part. My first thought is that LB is dropping into lower numbers during the evening cycle and bouncing up in the AM. For example, the 56 during the AM cycle on 9/27 was followed by a rise to 171 at PMPS and my guess is that numbers kept heading up to the pinks this morning.

While Lantus is gentle, it doesn't meant that hypo is impossible. How you feed can influence numbers. There isn't one best way to feed since when or how much you feed depends on your cat. It's largely trial and error. The reason we tend to encourage frequent, small meals is that it puts less stress on a healing pancreas.

I agree with what Cheryl posted about pancreatitis. I would presume there are resources for getting an fPLI or spec fPLI that will give you a more definitive answer about whether LB is experiencing a bout of pancreatitis than just a physical exam.