Shaikha 6/21 trying higher dose

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wombat88

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After the weirdness yesterday, I decided to try increasing her dose a little to see if we can get a better curve and possibly longer duration. She's all over the place right now, so not sure what it will do. I plan to try to test a little more often today just to see. She does seem to be feeling better, so maybe we'll get better numbers today. I do think the ursodiol has helped, but I also am thinking the subQ fluids have made a big difference. She's definitely soaking them up. It will be interesting to see if we see an improvement in her kidney function since she's been getting them regularly. She didn't want to eat all her food this AM, but eventually got 95% of it in so I think she's still a little off there.

6/20 PMPS = 236, gave 0.8U (lower dose due to weird pattern last night)
6/21 numbers:
AMPS = 360, gave 1U (slight increase from 0.9U she had been getting)
+2 = 324
+5.5 = 235
+7.5 = 217
MDPS = 230, gave 1U (actually given at +9 since she had such a delayed rise)
+3 = 194
+6.5 = 136

NOTE: No PM dose tonight. The reading above was really late -- much later than usual because she was lasting longer between doses -- she also got a slightly later start this AM than usual. Am not sure how to dose her now. The higher dose appears to be holding her longer, but I know from the past that she is so unpredictable I am not sure she can really go a full 12 hours. Will see how she's doing in the AM, but need to make some decisions. Either I lower the dose and stay t.i.d. -- and hope I get some blues, or I stay with a higher dose and try to get her to b.i.d. I think the improvement is she's feeling better again, but don't know how long that will last. She's got a ton of antibiotics on board, plus fluids, and I think that is making the difference. How long it will last is the question.

Any ideas???? I really don't know where to go with this girl. :?
 
Hi Wendy,

The sub Qs have made a dramatic improvement in Kitty's kidney numbers. Her CRT has dropped from 2.3 to 1.7 in about 8 weeks.

Glad she is feeling better!

Kim
 
kse said:
The sub Qs have made a dramatic improvement in Kitty's kidney numbers. Her CRT has dropped from 2.3 to 1.7 in about 8 weeks.

Shaikha's kidney numbers themselves shouldn't be high enough for her to really not be able to hydrate herself sufficiently, but her pancreatitis and liver problems complicate matters, since both of those require extra hydration. The specialist I consulted with seemed to think Shaikha's numbers likely were the result of a possible infection that isn't being touched with the antibiotics used to date. We either haven't used the right one or possibly not for long enough. They have some critters out there that will burrow into the walls and just hang on for dear life, so it can take a much longer time to get rid of them than the normal length of a course of antibiotics. Of course, in those cases culture and sensitivity may also not show a thing, since the bacteria is in the walls and not in the urine. I'm thinking though that if she's needed extra fluid due to the inflammation in her pancreas, that also can't be good for her kidneys either, so that may be playing a role too. SubQ fluids generally do make a difference in kidney values. Shaikha's also on two antiobiotics right now to take care of the liver problem (and to try to clear a persistent UTI), so hopefully between all of this we'll take care of several things at once.
 
Good Luck on the dose increase
We have aeverything crossed over here for you both!!
Denise and Shakes
 
Take a look at her spreadsheet the past few days. I have NO idea what to do -- stay with t.i.d., try to go b.i.d., bleah! I can't make sense of her.
 
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