Hi, all. Thanks for the support last week. Here's the scoop on Pippin:
Pippin went into the kitty ICU Friday afternoon, after being at the vet Thursday, having bloodwork drawn and getting som SQ fluids. Friday AM, the vet called to tell us his renal function was compromised (elevated BUN/Creatinine). We did an abdominal ultrasound and found the following:
- Kidneys very big
- pancreatitis (shocker, right?)
Since Pippin's kidneys were big at the end of October when he was diagnosed and they look bigger now, we were considering pyelonephritis vs. renal lymphoma. We began treatment for pyelonephritis (IV fluids & antibioitics) along with sending urine culture and doing a renal aspirate to check for lymphoma. Friday night, my husband and I visited Pippin and he looked awful. He got very excited to see us, then he got nauseated (they said he'd been getting nauseated w/ handling), and his BG was > 580. Doh! They adjusted his lantus dose, gave an anti-emetic (Cerenia), and continued the IV fluids & antibiotics. He got a tiny dose of mirtazipine.
Saturday AM, his creatinine was normal, and his BUN was elevated but improving. His blood sugars were improving. Over the next day, his blood sugars became problematic again, but never quite as high as that > 580. He also started eating much better. Sunday evening, Pippin developed a gallop heart sound. He had a murmur, so we anticipated that might happen. Cutting back the fluids caused the gallop to resolve. So, we know Pippin has heart disease of some sort, though I'm hopeful that since he never became symptomatic, and it took > 2 days of fluids at a pretty high rate to cause a gallop, we're at the "mild" stage. The plan is to do an ultrasound to look at his heart after the New Year, since it's nothing urgent right now. Pippin also got diarrhea Sunday. We believe this is due to the clavamox, but he does have to stay on it.
Monday morning, Pippin's kidney values were back to normal!!
They weaned him off IV fluids, and we picked him up. The renal aspirate came back and showed NO LYMPHOMA! Hurray!
So, now, Pippin is home, eating fairly well atm, though he's really preferring his fishy flavors. And yes, I know, fish isn't ideal - and let me state clearly that this is not a long-term dietary plan. The internal medicine vet is aware of what he's eating, and she says that for this week, let's just work on his appetite and let him eat what he wants. He is also eating a small amount of W/D dry food. Again, we're encouraging appetite and watching right now, and working on adjusting the diet after a few days. I am also firmly restricted from doing BGs until the end of the week to let Pippin accommodate to his new Lantus dose (4 units 2x/day, which I know is a whopping dose) & being home. Haha. The vet knows that I will obsess about numbers. We are watching him particularly carefully around 6-8 h after his Lantus dose and offering food around that time, to prevent hypoglycemia. I know the ideal is to monitor blood sugars, and everything in my own training as a nurse tells me CHECK THEM. At this point, though, I just have to trust the internal medicine specialist.
We are rechecking his kidney values Thursday (so hopefully they'll result by Friday, before the weekend) and touching base with internal medicine Friday. The bloodwork Thurs should also have a glucose level in there, since we'll be doing a basic chemistry panel. We're very hopeful that his unregulated blood sugars were secondary to inflammation/infection and as he continues on his 6-8 weeks of antibiotics, they'll start to improve.
For right now, though: Pippin doesn't have lymphoma. His kidney values are normal after fluids & antbiotics. We have a heart condition to investigate, though it's on the back burner for a couple weeks, as we'd like to give him a break from stress (and maybe my husband and me a little break from it too). Pippin is eating. He's active. He's meandering around the house with his tail held high (you can tell he doesn't feel well when it's not!). He came and slept on me last night.
Best. Christmas present. Ever.
Pippin went into the kitty ICU Friday afternoon, after being at the vet Thursday, having bloodwork drawn and getting som SQ fluids. Friday AM, the vet called to tell us his renal function was compromised (elevated BUN/Creatinine). We did an abdominal ultrasound and found the following:
- Kidneys very big
- pancreatitis (shocker, right?)
Since Pippin's kidneys were big at the end of October when he was diagnosed and they look bigger now, we were considering pyelonephritis vs. renal lymphoma. We began treatment for pyelonephritis (IV fluids & antibioitics) along with sending urine culture and doing a renal aspirate to check for lymphoma. Friday night, my husband and I visited Pippin and he looked awful. He got very excited to see us, then he got nauseated (they said he'd been getting nauseated w/ handling), and his BG was > 580. Doh! They adjusted his lantus dose, gave an anti-emetic (Cerenia), and continued the IV fluids & antibiotics. He got a tiny dose of mirtazipine.
Saturday AM, his creatinine was normal, and his BUN was elevated but improving. His blood sugars were improving. Over the next day, his blood sugars became problematic again, but never quite as high as that > 580. He also started eating much better. Sunday evening, Pippin developed a gallop heart sound. He had a murmur, so we anticipated that might happen. Cutting back the fluids caused the gallop to resolve. So, we know Pippin has heart disease of some sort, though I'm hopeful that since he never became symptomatic, and it took > 2 days of fluids at a pretty high rate to cause a gallop, we're at the "mild" stage. The plan is to do an ultrasound to look at his heart after the New Year, since it's nothing urgent right now. Pippin also got diarrhea Sunday. We believe this is due to the clavamox, but he does have to stay on it.
Monday morning, Pippin's kidney values were back to normal!!
They weaned him off IV fluids, and we picked him up. The renal aspirate came back and showed NO LYMPHOMA! Hurray! So, now, Pippin is home, eating fairly well atm, though he's really preferring his fishy flavors. And yes, I know, fish isn't ideal - and let me state clearly that this is not a long-term dietary plan. The internal medicine vet is aware of what he's eating, and she says that for this week, let's just work on his appetite and let him eat what he wants. He is also eating a small amount of W/D dry food. Again, we're encouraging appetite and watching right now, and working on adjusting the diet after a few days. I am also firmly restricted from doing BGs until the end of the week to let Pippin accommodate to his new Lantus dose (4 units 2x/day, which I know is a whopping dose) & being home. Haha. The vet knows that I will obsess about numbers. We are watching him particularly carefully around 6-8 h after his Lantus dose and offering food around that time, to prevent hypoglycemia. I know the ideal is to monitor blood sugars, and everything in my own training as a nurse tells me CHECK THEM. At this point, though, I just have to trust the internal medicine specialist.
We are rechecking his kidney values Thursday (so hopefully they'll result by Friday, before the weekend) and touching base with internal medicine Friday. The bloodwork Thurs should also have a glucose level in there, since we'll be doing a basic chemistry panel. We're very hopeful that his unregulated blood sugars were secondary to inflammation/infection and as he continues on his 6-8 weeks of antibiotics, they'll start to improve.
For right now, though: Pippin doesn't have lymphoma. His kidney values are normal after fluids & antbiotics. We have a heart condition to investigate, though it's on the back burner for a couple weeks, as we'd like to give him a break from stress (and maybe my husband and me a little break from it too). Pippin is eating. He's active. He's meandering around the house with his tail held high (you can tell he doesn't feel well when it's not!). He came and slept on me last night.
Best. Christmas present. Ever.
It's just that they asked me to chill on the testing until the end of the week, so that we don't obsess about high numbers. Not that I would ever obsess. Ha.
