Risky update 9/19

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kse

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Risky woke up this morning to a great pink preshot, but had trace ketones present. After a second positive test for trace ketones, Martha took Risky to the ER vet. The vet tested for ketones and said they were a 1+ on their meter. Risky also had a fever and was tested for a UTI. Sure enough, the Urine came back positive for a UTI. The vet gave sub q fluids and a convenia shot and sent Risky home. Martha and I had discussed the convenia shot, but they gave it without telling her. When she left, I told her I was not comfortable with the Convenia for the UTI (off label and not recommended or normally effective for UTIs) and that she really needed an alternative antibiotic to knock the UTI out. We discussed the combination of not eating well, infection, and low insulin and the path to DKA. So, Martha seeked out another vet and took Risky.

Before she could get Risky to the second vet she noticed he was becoming extremely lethargic and his breathing was labored. The vet was very good by all measures. At first glance at Risky she said she could smell the ketones on his breath. His fever had also increased. They put ice packs around him, put him under oxygen, and put him on IV fluids. The vet never confirmed DKA to Martha, but did say he was ketonic.

The vet said they may use R insulin tonight with Risky, but had not made a determination.

He will stay overnight at the Emergency Vet, with the option tomorrow to move back to the clinic or stay at the ER. Martha was very impressed with the clinic, and by all accounts it sounded like she got a good vet. The vet asked all the right questions--past UTIs, had he been checked for Ptitis etc....So, they are doing bloodwork to check for Ptitis etc.

Hopefully, Martha got Risky to the vet early and this will not be an extended duration. So, please keep Martha and Risky in your thoughts and prayers. I am hoping for an update tonight.
 
Kim,
When you saw Risky the other night, how did he look? Any clues that this was coming? I'm praying this didn't all happen within the past 36 or 48 hours due to little to no insulin. Crap.
Please update us as you hear anything.
Carl
 
Update---Risky's fever has increased--they are now giving something to break it. The good news, from my experience with the dreaded Ketones and DKA--his bloodwork and electrolytes came back good. Just a few values were minutely high or low. I know from my DKA experience, that is good news. One of the biggest problems with DKA is the negative impact it has on the eletrolyte balance. They did give 1 unit of R and said he is resting comfortably. The vet thinks this was caught early. They are giving him baytril, antibiotic, to help clear the UTI.

I guess it is unfair for me to sum up his condition from my Friday visit. I had never seen Risky before, so I can't judge if he was lethargic or normal. I didn't even see ketones and DKA coming in my own Kitty--so, I can assure you the indicators are modest until the condition reaches a certain level.

Risky was negative for Ptitits.

I am sure the high units of insulin were warding off the ketones, but I would also assume the UTI had been present for some period of time. The vet also indicated that she thought the UTI had been active for some time.

I will continue to update you.
 
Kim
Can you explain the negatives about Convenia or whatever they shot him with? I know I have seen threads posted in health about it recently, but confess I didn't really pay attention. Is it bad news for all cats, or for sugarcats in particular?

Carl
 
I will attach Dr.Lisa's response to Convenia:

http://catinfo.org/?link=convenia

Convenia is a long lasting antibiotic that stays in the body for up to 2 months. Unlike short acting, oral antibiotics, there is no way to stop the drug. If a negative reaction occurs with an oral antibiotic--you can stop giving the drug. There is no antidote or way to stop the Convenia if side effects occur.

Also, it is a broad spectrum AB that is labeled and mainly used for skin infections. It is not labeled or very effective for UTIs.

Dr. Lisa provides a good overview of the drug.

It is in BIG BOLD letters on my chart.....NO CONVENIA or METACAM!
 
Covenia is a long lasting AB, they say 2 weeks but it is actually much longer. Some, not just sugar kitties, can have a reaction to it that causes enemia and death, there is no antidote. I have heard that some kitties with a mild reaction can recover.

What amazes me is how many Vets give the shot without the concent of the owner. Harley got a Covenia shot without my knowledge by my soon to be ex DIL, since then everyone has advised me to report her but since the divorce wasn't final I didn't want to cause my son more trouble so I didn't. When I boarded Harley at Vet #2 they actually had a sign hanging in the exam room touting the benefits of Covenia without naming it and advising to ask for it. Geez.
 
Kitty has also been given the drug without my consent. BUT, no more and I assure you my vet understood me!
 
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