Update on Jake :)

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michelle & jake

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Hi all....

It's been a rough week with Jake. Last week Friday (almost a week & a half ago) he curled up on my bed, clearly not feeling well. He really wasn't eating, he was pretty crabby, & I thought the end was near. Saturday he was a bit better, ate some....so I figured I'd just see how it went. The first few days he was walking a bit wobbly....still not eating much except for the little bit he would eat off a spoon....would only stay in our downstairs rec room....it was all not good.....I shed a LOT of tears. I knew he needed to go to the vet ----for one reason or another :(

Yesterday morning I woke up, & he was in the kitchen with our other cat, begging for food. He seemed perfectly fine, as if the whole previous week hadn't happened. After chatting with some on this board, I decided to still take him for blood work. Well, it turns out his liver is not well. His bilirubin level was up.....& his ALT & ALP (hope I got that right?) were wayyyyyy high, esp his ALT.

So.....she was not optimistic. Again, I was in tears. She said I could either put him down then & there......which was not an option because to me he seemed fine, in no pain at all.......hospitalize him.....which at 14 I'm not going to put him through, nor can we afford it......or take home fluids for him. I chose option 3.....although I'm not so good with a needle. Luckily my vet friend (who is his normal vet but she was off yesterday) lives near me, & came over & did it for me. But he needs them twice a day for the next week, until his next appt Monday. I can't ask her to keep coming over. I tried this morning, but only got half the fluids in. I will try again later & if I have to call her, so be it.

He's been diabetic for 7 years......I recently found out his meter was not working properly so that is probably a huge part of his set back. BUT.....this cat is GORGING on whatever I give him to eat. I mean....he is CHOWING....and begging for more. I have to be careful, because sometimes he'll eat too much too fast & puke it up (seems like all the tabbies in our family do that) but so far he's keeping everything down. She also gave me pills to give him in the morning....& another med twice a day. I talked to her this morning & she said it's great that he's eating so well. To me, he seems back to normal.....but we won't know until she rechecks next week. Although he seems to be doing better I am not optimistic. Jake has always gotten the short end of the stick....not just the diabetes but other issues as well (urinary blockage, abscess on his chin....the list goes on). I'm doing everything I can & I won't give up.....but I also can't stop crying.

We used to post here all the time, & unfortunately life got busy & I just kind of stopped....although I never stopped home testing!! Diet & home testing are the most important things I learned here, & for that I thank you all!!!! We could probably use a few prayers over here........

Michelle & Jake
 
Re: Liver problems :(

((michelle))

what are the new meds he got? for his liver?

if not, ask your vet friend about denosyl or denamarin. they are supplements for the liver and not uncommon around these parts. Mousie had denosyl for the first month after her diabetes diagnosis and then her liver values were back to normal.
 
Re: Liver problems :(

Let's see.....the pills....once a day in the morning....are Denosyl 100 mg

& the liquid stuff is Metronidazole also 100 mg

I can handle pills.....I can handle oral meds....but the IV is tough. You'd think someone who's been giving shots for 7 years would be ok with it, but the truth is I HATE needles....I'm doing the best I can though & I'm grateful for my friend who is here to help if I need it.

He's still doing really well.....still eating lots....& keeping it all down (knock on wood!!!!)

I will be on edge until next Monday when he is rechecked. I pray that the levels were high because he hadn't been eating. And I still don't know what made him feel so crappy in the first place!


Michelle
 
Re: Liver problems :(

good! glad to hear he's already on it. i'd be interested to see if anyone thinks a week on denosyl will make enough of a difference or if the recheck should be done further out than that?

i hated fluids myself. my first attempt at it was a complete disaster. my fiance and the living room floor got more of them than my cat did.

but ultimately i got the hang of it eventually. i found that sitting a plate of tuna in front of one cat kept her so distracted she had no idea what i was doing to her :)

you might edit your subject line in the first post and include something like "sub-q help needed?" to see if anyone's got some helpful advice for you in regards to the fluids
 
Re: Liver problems - giving IV fluids :(

Thanks, Cindy!! I'm sure, like everything else, I will get used to it. I never ever thought I could give insulin shots, but now it's like second nature. I never ever thought I could test his blood, but now I don't even think about it. Hopefully I will get the hang of it. It does bother me that I only got half in this morning....& yes my hubby got a bit on him.....but hopefully it will go better tonight & if not, my friend will come. I don't know what I would do without her.

I think the vet is thinking....& someone else here mentioned it too.....that possibly his liver levels could be high because of his lack of food the week before. Hopefully now that his eating is normal again....& then some....that the levels will go down? I don't know much.....she didn't seem too optimistic yesterday....but when I told her this morning that he's been chowing she was ecstatic. I'm sure we will have to go again the week after, even if levels do come down, to keep an eye on him.

I just started a new job last week too.....THAT is stressful!! I don't even like it....but I've been looking for a year so I had to take it. It's through a temp service & even though I know they're looking for a perm person....I keep telling myself "it's only temporary....it's a paycheck....to help pay for Jake!" LOL

And today I had a root canal.....I tell ya when it rains it pours!!

I'm so thankful for everyone here, the friendship & the advice. I feel so badly that I left. Well, I didn't leave.....I just never quite got around to posting again, & eventually I forgot. A fair weather poster, that's me!!

Michelle
 
Re: Liver problems ---giving IV fluids :(

I think you said the fluids are room temp because they aren't in the fridge, but even so, they're still cold. I would recommend that you warm them in a bowl of warm water or using a heating pad for a little bit, don't make the fluids hot, just warm, more comfortable.

Bevel side up with the needle, that will make the fluids flow faster and squeeze the bag while administering. If DH is helping have him squeeze. I usually hold it in one hand and squeeze, but much easier when DH is doing it.

Try to do this on a counter or hard floor, somewhere where he can't get his claws in to get away from you.

As always, give a treat and this does get easier too :)
 
Re: Liver problems ---giving IV fluids :(

This may not be at all the same thing, but years ago I had a cat (civvie) who developed bad liver problems. With time on an antibiotic (the vet said the most common cause of the sort of liver problem he had was an infection) and Denosyl, he was just fine again. I don't recall exactly how long it took, but I think it was a month or two from "really bad" to "no evidence of a problem." So liver problems don't necessarily mean the end. That cat lived another 2 years and died from something else (at age 17 1/2).
 
Re: Liver problems ---giving IV fluids :(

I just can't believe how much he's eating....he's even back to stealing from Elwood's bowl! I'm just praying it continues to stay down....

Warm bowl of water...got it. Actually my 11 yr old will have to help me tonight, because my husband works 2nd shift. The hard part is just getting the needle in (bevel side up...I did remember that this morning).....& remembering to hold it in. Wish me luck...hopefully my second try will go smoother than the first!
 
Re: Liver problems ---giving IV fluids :(

Yay I did it....well sort of...probably I should have gotten a wee bit more in, since I didn't get as much in as I should have this morning....but I did what I could. We lost the needle twice so I ended up sticking him 3 times. It is so hard for me to tell when the needle is in, & I'm so afraid of hurting him that I end up not getting it in far enough. He got kinda pissed! This poor cat has been poked so many times......sigh....but the vet said whatever I can get in is better than nothing. There's a reason I didn't go into medicine....stupid needles...lol...
 
Re: Liver problems ---giving IV fluids :(

Now Jake has diarrhea....should I be worried? Or is it from the fluids? Or the meds? Or the special diet (Hills A/D, I think it's called)? I have to go to work right now so I won't be giving him the fluids till I get home around lunch time....should I call my vet??? I did send an email to my friend the vet....but wanted to know if you knew..
 
Re: Liver problems ---giving IV fluids :(

I would tell your vet. Diahrea may make him more dehydrated. I've never had a cat get diahrea from fluids, but I'm no expert.

A/D is what Tucker gets twice a day with his meds, he loves it and it does not bother his IBD, but the change in food could cause your kitty to have stomach trouble. However, A/D is great for cats that have not eaten in a while, filled with all the good stuff.
 
Re: Liver problems ---giving IV fluids :(

Thanks....my friend emailed me & said if the diarrhea doens't stop, that he could take an anti-diarrhea med. He's still getting his regular food, but he's also getting the AD. Still eating lots though.....& more importantly keeping it down.....so that's good at least.
 
Re: Liver problems ---giving IV fluids :(

fwiw, the metronidazole i believe is an anti-diarheal med so hopefully that stops soon
 
Re: Liver problems ---giving IV fluids :(

Ugh!! Failed miserably tonight!! I had the needle in.....got some fluids in....but then it came out & I tried 3 times to get it back in....he was getting pissed & I was getting flustered so I knew we weren't going to get anywhere. I'm going to take him in to the clinic tomorrow when I get home from work so they can do it....I feel horrible....he's not getting nearly what they suggested he get....sigh....
 
Re: Liver problems ---giving IV fluids :(

Michelle, don't beat yourself up - you are doing the best you can! I have given fluids to several of my cats, and sometimes I have no problems at all, other times I just can't get it. One of my cats is pretty skinny, and when he is dehydrated, he is like shoe leather to push a needle through. I just figure I get in what I can and compensate when it goes well. I know I get stressed out when I have to give him fluids, and I'm sure that makes it worse. If you can relax, I'm sure it will go better. BTW - Chase was also on denomarin for his liver values and he had really good, fairly rapid results. Fingers crossed!
 
Re: Liver problems ---giving IV fluids :(

So Jake had his follow up today....after TWO blood draws (he was NOT happy) they found his liver levels are much better. Not normal.....which means another week of fluids & meds....but a LOT better. Another check next week. I didn't get the numbers.....he puked in his carrier on the way out as they were checking me out, so I was pretty anxious & forgot to ask. But the vet was amazed at how much better he looks & she said it was good that he was feisty during his blood draw, lol.

Thank you so much to everyone here for the encouragement....I really thought he had used up all of his 9 lives. We will never know what made him feel so crappy that week....but I am so thankful he is getting better!
 
Re: Liver problems ---giving IV fluids :(

I'm sorry I'm so late to your thread but I wanted to give you some encouragement. My kitty Simba - altho not diabetic - became VERY ill in February. We'll never really know why altho we believe it might be due to some bad canned food. But his liver function tests - like your kitty's - were sky high. Simba actually turned yellow because his bilirubin was so elevated. One vet suggested we put Simba out of his misery. He had basically quit eating. Thanks to Lynee and Max here and another wonderful vet - we continued with subq fluids, the Metronidazole, Ranitidine for nausea/vomitting, Prednisone, Denemarin, and an appetite stimulant. An ultrasound showed inflammation of his bile ducts, and it's thought he had triaditis. Ursodial was also added to help thin the bile. Within a week - Simba was no longer yellow and eating all on his own. We have weaned him off most of his treatment except for the Ursodial, Denemarin, and the prednisone dose has been decreased now. His liver tests are all within normal range and he acts like himself once again. He's 15 years old and everyday I look at him and i'm so happy I kept at all the treatments even tho I often wondered if I was just torturing him.

I'm so glad your Jake is doing better and I hope he continues to improve and is soon running and playing again.

I'm
 
Re: Liver problems ---giving IV fluids :(

Thank you!! I'm relieved he's doing better too!! Although I thought giving fluids would be easier the second week. Not so. Yesterday he seemed petrified....he was actually hugging me :( I didn't force it as I thought he was traumatized enough yesterday. I should have had them give him fluids yesterday while he was there, but I was already late for work. If I'd known the first blood test was going to get screwed up & they'd have to do a second....I would have had them do it during that time!! I tried today too....but no luck. I will try again tonight. How is it that insulin shots can be no big deal to me, but I have such trouble with this darn needle???

Michelle
 
Re: Liver problems ---giving fluids :(

Michelle
I don't know if this will help you at all. I stil have 2 other cats that get subq's every other day.

Definitely I warm the fluid using a heating pad. I hang the bag then on a hanger on a cabinet. The higher you can hang it the faster the fluid can run in. Then I have my kitty lay in one of his/her bed's on the counter top. I quickly push the needle in and then cuddle with them. One - I actually had to hold down initially but even she has learned to relax. With the bag hanging like this - I only need one hand to open up the valve to have the fluid run in. If you get the needle in all the way - oftentimes you can let go of the needle/tubing and cuddle your kitty with both hands.

For me - I had to just not think about putting that needle into my cat. It's big and much scarier looking than the insulin needle but I knew it would make my cat feel better.

I don't know if any of this helps you. Just thinking of things that helped me get started.
 
Re: Liver problems ---giving fluids :(

Thanks Patti. It IS a big needle & he's so skinny I feel like if I push it too far it's going to hurt him. He tries to run off & as skinny as he is, it takes all my strength to hold him. I don't want to call my vet friend again...& since today was a total failure I'm going to call & see if I take him in tomorrow so they can do it. I hate to do that, because he really hates the vet & all those dogs....he gets so stressed....but he needs the fluids so I have to do it!

Michelle
 
Re: Liver problems ---giving fluids :(

My liquids suggestions:

1) Warm the bag to 101F [I use a heating pad]. Use a digital thermometer like the not so cheap ThermaPen or an IR thermometer perhaps from Radio Shack or elsewhere.

2) Get over to Wal-mart or wherever and get some big plastic "S" hooks from the hardware dept.

3) Hang the bag over a place where your kitty already has a bed. H has a bed on the couch that is one of his "safe" places - where he is uber comfy. He likes sleeping there is is comfortable there. All I have to do is say "time to test" or "time get liquids" and walk with him to that place and he jumps up into that bed. I put the needle in and watch some TV with him for 4 minutes and we are done. I have nail in the wall and a couple carabiners hanging from that nail then the "S" hook that the bag hangs from. You are not expected to have carabiners lying around but I'm sure you can fashion something.

4) Use a smaller needle like a 21g x 1" Terumo needle. I get mine from http://www.shopmedvet.com. Terumo's 20g and below have a ultra thin wall that help the liquids flow faster.

5) Use a macro-drip IV admin set that is 20drops/ml or below like these for $1 each.
 
Re: Liver problems ---giving fluids :(

Thanks once again for all the advice! It's funny because when it's time for an insulin shot, or a blood test, he hops right into my lap. When it's time for fluids, I swear he says "^%$# you, lady" & walks the other way, lol.

I did take him yesterday to get the fluids...he had thrown up the night before & I wanted to make sure he got what he needed. Do you know.....she got them in him in about 5 minutes?? It takes me at least 20!! She gave me some great tips....he held completely still for her & she got them in no problem. Of course, she's a tech & she does it all day. But......she grabbed the scruff of his neck....as much as she could....this really seemed to help him settle down. She said it's comforting to them (not to me, though...I winced when she did it. I'm such a baby!!). Then she still held the scruff while inserting the needle, she said if you hold the scruff up like that it will drip faster. I just couldn't believe how quickly she was done. She also pinched the spot where the needle was, like she was holding onto it through his skin. I'm sure they all have their own way of doing it.....but I couldn't believe how nicely he sat for her!! He's a squirmy wormy when I do it. I guess they can smell fear, lol

Man I hope he's better next week.....this whole thing has been traumatic for us both!! But I appreciate all the little tips & tricks I've learned here!!
 
Re: Liver problems ---giving fluids :(

Keep us up to date Michelle. It does get easier like everything else. And of course it's always more difficult when it is YOUR kitty. Hoping to hear tho that Jake continues to improve tho!!!!
 
Re: Liver problems --- almost 100% better!!!!

Just got back from the vet & Jake is MUCH better!! No more jaundice.....no more dehydration....bilirubin is .8 (she said still a WEE high....normal is in the .1 - .6 range)......he looks better than even before he got sick!! He gained another 1/2 lb so that's good too!! Thank you all so much for all of your support & advice!!! I thought he was a goner......& I think the vet did too!! She is amazed at how well he's bounced back. I'm going to continue the SAMe & will recheck in 2 weeks. She did a fructosamine as well, but will not get the results until tomorrow.

I honestly think this all happened because of my stupid meter. It was giving me false results.....& now I don't know what to do......if I should get a new one & continue to test?? She wants him to be on .1 unit of insulin a day....period. I do need to get new insulin....ours is pretty old. I hadn't given it much thought since he *seemed* to be doing well with it.....but in light of the situation I'd best get a new vial!!!

Again, thank you!!
 
Re: Liver problems --- almost 100% better!!!!

I would HIGHLY recommend you continue to test at home. A fructosamine can be very deceiving as that is only an average of your kitty's BG over a period of time. The best way I know how to explain it is to give you an example:

We adopted Boris who was on 2 units bid of insulin. His fructosamine's were "perfect" we were told. But when I started testing him - his BG's ran from 47 - 250. Now an average of that is somewhere in the 100's - so yes if you look at that - he "was perfect". But do you rEALLY want his BG to drop down to 47. NO! Long story short - we were very lucky and were able to wean Boris off of insulin.

All I'm trying to say to you is that testing is really your best treatment when also giving insulin. If you don't trust the meter you have right now - then get a new meter - but please please continue to hometest! Also it is not necessary to buy the expensive "animal" BG monitor. Many people like the Walmart Relion meter.

And continuing the SAMe is also an excellant idea too.

I'm sooo glad to hear tho that Jake is much better. He's sooo lucky to have such a loving and attentive mom! :)
 
Jake had a recheck this past Tuesday & he is doing FANTABULOUS!!!!! His bilirubin was .4 & his ALT (I think I got that right....whichever one was wayyyyyyyy high when he first went in) was 107.....still chowing like a horse & is just doing so well. She did suggest keeping him on the SAMe for now.....she said the 107 is a *touch* high...should be less than 100.....but she's amazed at how well he's doing. Purring like crazy.....social...I definitely have my old Jake back. I did buy a new vial of insulin but haven't used it yet, I want to get a new meter first. His numbers have been pretty good on the old insulin, which is pretty old, so I'm a bit leery of using a brand new vial...he only takes 1 unit so I have to be careful. The vet said his fructosamine was really good & his glucose when he was in.....just 3 hours after his shot....was 127!!!

Thank you AGAIN, all of you.....I was so panicky & not optimistic at all that he would make it....even the vet said it didn't look good...so for him to completely turn around.....I'm very grateful!! Jake has definitely used up his 9 lives!!!

Michelle
 
That's great news, Michelle! It is amazing how well a cat's liver can regenerate. Denosyl / denamarin is super wonderful stuff for supporting the regen. You've done a great job with the fluids and all. Give yourself a big hug (but save the biggest hugs for Jake). :lol:

laur
 
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