Update on Gizzy

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Harley and Pattie

Harley and Pattie

Member Since 2010
Just got this from Lori

I am hating my Dr. grrrr....
she basically is saying "well the exam is normal so...."
i said, no, i want full bloodwork and renal panel. she said she may do xrays too then.

pattie
 
so are they doing a renal panel???
From the FDA:
http://www.fda.gov/AnimalVeterinary/SafetyHealth/ProductSafetyInformation/ucm055434.htm

Veterinary Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are used to control pain and inflammation. Inflammation - the body’s response to irritation or injury - is characterized by redness, warmth, swelling, and pain. NSAIDs work by blocking the production of prostaglandins, the body chemicals that cause inflammation.

In companion animal medicine, approved veterinary NSAIDs are used to control the pain and inflammation associated with osteoarthritis in dogs and horses. Some veterinary NSAIDs are also approved for the control of postoperative pain in dogs and cats. There are potential risks associated with the use of NSAIDs. Veterinarians and pet owners should be aware of the following facts:

All dogs and cats should undergo a thorough history and physical examination before beginning NSAID therapy.
Appropriate blood/urine tests should be performed to establish baseline data prior to, and periodically during, administration of any NSAID.
Common side effects include vomiting, diarrhea, not eating/eating less, and lethargy. If your pet experiences any of these potential side effects, STOP administering the medication and contact your veterinarian immediately.
Veterinary NSAIDS may be associated with gastrointestinal ulcers/perforations, liver, and kidney toxicity.
Serious side effects associated with the use of NSAIDs can occur with or without warning and, in some cases, result in death.
Use with other anti-inflammatory drugs, such as other NSAIDs and corticosteroids, should be avoided.
Patients at greatest risk for kidney problems are those that are dehydrated, are on diuretic treatment, or have pre-existing kidney, heart, and/or liver problems.
NSAIDs can cause stomach or intestinal bleeding.

Risks associated with NSAIDs are detailed on the package inserts and Client Information Sheets that accompany all veterinary NSAIDS dispensed to clients. A Client Information Sheet should always be given to the client with each NSAID prescription. Pet owners should read this information carefully. Owners and veterinarians should carefully consider the potential benefits and risks of using an NSAID and other treatment options before deciding to use an NSAID. Use the lowest effective dose for the shortest duration consistent with individual response.
Click to expand...

If an adverse reaction occurs, STOP the medication and contact the vet. Since kidney issues can be a great concern (as listed by manufacturer and FDA) when a cat uses an NSAID it would only MAKE LOGICAL SENSE to test kidney functioning.

The above information is posted in support of Lori sticking to her guns about getting a renal panel done, and to educate anyone who may read this.

Lori...keep fighting for what Gizzy needs. You are doing great. I will keep checking in on you. If you need anything, please let me know.
 
They are doing full woodwork and urinalysis. Its taking forever and Im climbing the walls...!!
 
When you get the results, write them down and post.
Make sure you have a copy in your hand when you leave.

I have high hopes the outcome will be ok!!!
 
The test for pancreatitis, spec fPLI, usually needs to be sent out. When you said there were "side effects" and you stopped the meds, you never mentioned (or I missed) what was going on.
 
She suggested an ultrasound as next step. my reg vet does the pancreatitis test in house so i may go to them for that tomorrow. i just dont know anymore.
 
some adverse reactions to medications will clear once the med is stopped. So, if these symptoms were related and blood work is fine, then I would suspect he will improve.

It may be worth repeating labs in a few days to a week if he still shows symptoms.

What were Gizzy's symptoms exactly? runny poo, vomiting?
 
Lethargic, vomiting, looser stool.
BUT what I don't know if the medication is just a coincidence to what is going on now. This lip smacking is so frequent - he's obviously nauseous and I can tell he's in pain. So if it's not pancreatitis then maybe it's dental.... but I'm not yet convinced that its not pancreatitis. Our other cat died of pancreastitis 3 weeks ago and the behavior seems similar. i just feel so sorry for him i just don't know how much more I want to put him thru.
 
There are a lot of things that can cause those symptoms. I would not rule out the onsior, however. In fact, I would be pretty leary about using it again.

If you have not left the vet yet, I would talk with them about using some anti nausea medications....pepcid and ondansetron.
What did the vet say about his hydration level? Would it be a good idea to get some fluids in case he keeps vomiting and having diarrhea?

Does Gizzy have hard stool, followed by diarrhea?

I think the vet is correct that an u/s may be a good way to go , if you can swing it.
 
she did not think fluids were necessary - does not seem dehydrated and he is eating. ( that was another symptom - decreased appetite... still eating just about half the amount). I am asking now about pepcid. I just think this is such a coincidence that this all started when we moved 3 weeks ago... I just can't put my finger on it! soooo frustrating
 
Lori --

Could there be anything in your new place that Gizzy is getting into that is not good for a cat? If it were clearly toxic, lab values would be off. It's certainly possible that stress set of a bout of pancreatitis.

If your vet is testing for pancreatitis by looking at amylase and lipase levels, these are not reliable tests for a cat. I'd really ask to get a spec fPLI sent out to IDEXX.
 
Hi Lori and Gizzy!

I'm sorry Gizzy is still not well. I would suspect possible pancreatitis too.

I'll keep you guys in my thoughts and prayers. Call or email if you need anything.

Dr. Skadron is really wonderful, if you think your not getting what you need from the vets you have been seeing.
 
Glad he is well hydrated.
Keep encouraging him to eat all he will. You can supplement with a little meat only babyfood (I used gerbers chicken or turkey).

I would get the pancreatitis test done, and an ultra sound (could be a GI issue). If you think a dental is needed, you may need to look into that sooner than later.

I would recommend the UofM for the ultrasound. I think they are the best around, when it comes to reading them. They could also do all the other tests you are needing in one swoop.

I'll look for the labs later today

ETA: At the University, you will have a "team" of vets attempting to cover any and all issue's Gizzy is having, in order to come up with an appropriate tx plan. They also have a social worker there, who is absolutely wonderful to help you talk things through and make decisions. This service is free to those using the clinic. You could ask them about the pet loss support group as well. I could never attend, because they day it was held.
 
OK - sorry for the delay....had to have our Easter "lunch" at 4pm when I got home from ER. Thank goodness my family is understanding!!

I 'm uploading Gizzy's complete dr. report complete with blood work and urinalysis #'s . Let me know if there is anything else I should have the drs check.

I just keep coming back to the "coincidence" of all of this. The lip smacking started when we moved 3 weeks ago (4 weeks after we lost our other cat). Do you think it could all be stress induced with all the changes?

The thing that's bothering me the most is his loss of appetite. He's eating about 1/2 of what he did before. Maybe once the meds are out of his system - that will come back?? That's what I'm hoping anyway. I gave one tablet of Onsior on Friday night - so it's been 48 hours. I also sense that he's in pain. Those two things really bother me.

I'm boiling a chicken breast so he can have some treats tonight! Poor guy has had a rough day.

Thank you all for taking time on Easter to help me out!! Can't tell you what it means to me!! ;-)
 
Did you scan the original, save it to your computer and try to post?

In the past, I've uploaded to snapfish, shutterfly, or whatever online photo albums are available. Then I shared it as a photo on here. You would right click the 'photo', hit copy photo location, then click the IMG box above your post and past the link between

Chicken?! Sounds great! My foster got some freshly boiled chicken tonight, too!
She didnt have a rough day, tho. She is just spoiled. :lol:
 
labs look normal - glucose is high but with all the stress. Could losing his mate, moving into a new house, all the workmen, and painting cause these symptoms. Might be the stress of it all and he needs some time to get adjusted. Try a calming collar...worked great for laura.

pattie
 
I definitely think Gizzy has some separation anxiety for sure. He meowed for food tonight right on schedule (+4)....but only ate a few bites because I walked out of the room. As soon as I came back into the kitchen, he started eating again. I also boiled some chicken and he ate that with a vengeance! I'll keep giving him that....plus I will try 1/4 tablet of Pepcid AC to see if that helps with the lip smacking.
 
Hi Lori

I agree with Sienne about the pancreatitis test. It can't be run inhouse. This is the test you want:

Spec fPL

If your vet does not use Idexx, I believe Texas A&M also runs the test...in fact, they developed it. The U/S is also good.

The thing about pancreatitis is it can have a wide range of symptoms depending on how severely the kitty has it. Some cats are nauseous and vomit and are totally anorexic. But in all but the really mildest cases, it is painful
and so buprenex or buprenorphine should be given (or another similar pain drug but I think this one is the best....tramodol is very bitter and can make cats hyper). Also, a cat does not have to be dehydrated to benefit from
fluids if they have pancreatitis.
 
Can't help with all the med stuff but sending vines for Gizzy to feel better and eat better and hugs for you (((Lori)))
 
He was pretty good last night. His #'s were are 122 at +5.5. I should have checked him again, but I fell asleep. He was at 394 this morning at +12.5 (because I overslept). This mama peep had a long day yesterday! :)

He's eating - just less. I boiled some chicken for him last night and that's all he wants now - I think I've created a monster!!

I'm planning to take him in for a pancreatitis test today. My vet does the test in house - they have the machine that specifically does the fplt test. They just got it, so I'm wondering how that differs from sending it out to Idexx??
 
Can you ask the vet what the full name of the test is that they do in-house to test for pancreatits? PLT is for platelets. Also, ask what is the range of normal/ negative for the test the vet does.... the ranges for the 2 tests are entirely different and not alike at all.

ETA:
the test for pancreatitis needs to be taken at the time of the problem.... it's like taking your temperature if you think there is a fever. You can't wait till the next day and know what your temperature was the previous day and today, the fever could be gone, so you'll never know how you were the other day.
Yesterday could have been 103.5 degrees, but today you are down to 98.6 degrees, so what's the use of checking for fever today.
 
The full name is Feline Pancreatic Lipase Test. They did it on my other cat when he was diagnosed. It glows neon if it's positive.

What should the normal ranges be on the test that is effective?
 
It sounds like the vet is doing the SNAP fPL in house test. This test will give a reading of normal or abnormal, not a number. It is possible, if the test is abnormal, that the vet might follow up with the Spec fPl test which is sent out and which comes back with a numeric value. Or the vet may just go ahead and treat. The test which is sent out requires fasting. Did the vet tell you if fasting is required for the test today?

http://www.idexx.com/view/xhtml/en_us/smallanimal/inhouse/snap/fpl.jsf

http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/snap/fpl/snap-fpl-test-white-paper.pdf

ETA: On your urinalysis paperwork that you posted - did the vet say anything about the bacteria (mild cocci) in the urine, and if that was a significant finding?
 
She said that bacteria iscommon and nothing to worry about.
no, no fasting with this test.
Wouldnt lipase or amaylse levels be SOMEWHAT elevated if he had pancreatitis though?
 
the result should be a number. under 3.5 is negative.
they say there is a grey area from there to 5.3, then 5.4 and up is definitely pancreatitis.
Shadoe's results were always in the teens, but Oliver was always in the iffy range.
 
On the test which is sent out, the result will be a number. On the in house test, the result will be normal or abnormal.

They used to test amylase and lipase for pancreatitiis, but it is no longer felt that these tests are diagnostic. The newer tests test for a pancreas specific lipase.

There should not be bacteria in urine obtained by cystocentesis, as far as I know. Urine is sterile. Contamination is possible in a free catch sample, but shouldn't be present in a sterile sample.
 
My new vet just emailed me and said she would recommend doing an ultrasound first - she thinks its a GI issue.... She does not believe in the fpl test as it is so vague.
 
I agree that an ultra sound could offer valuable information at this point.

I never did the pancreatitis test with Latte due to funds, and the fact that her overall tx plan involved the same things you would use for a p-attack. That said, I think it is up to you as to which route you think is best. I do however think if you want the p-test, the best way to go is to get it done properly the first time around. It will be more accurate and cost less $ in the long run (not to mention a possible extra vet visit for Gizzy).
 
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