Update on Raja plus looking for advice

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Heather and Raja (GA)

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Took her in today and the good news is she weighs 9.06 lbs which is great. I know she had recently gained weight so she has lost some but she's still better than she was in August when she got sick. Also the vet said that yes I can use the sub q fluids and she actually said it was good that I did though I didn't ask how long they are good for after they are opened.

Now on to the bad news. They aren't sure what's wrong with her, they said maybe infection, maybe pancrititis, maybe hepataic lipidosis.

I don't think it's hepatic lipidosis because again she is acting like she was back in August when I took her to the emergency vet and her regular vet and her liver values were high at the er vet but a week later at the regular vet they were fine

She wanted to take X-rays because she said Raja might have swallowed something she shouldn't have. I told them no, first I know Raja she's 17 yrs old and she's picky about food plus in her 17yrs she's never been one to eat anything but food and again this is the same symptoms she had back in August.

She wanted to run a frutosimine test on her but I said no to that too. My thought is right now her BG is elevated, that I know for sure but it very well could be from being sick and I am checking her so in a few days when she starts to feel better if her BG still stays elevated I'll think about starting her on lantus again. To me at this stage a frutosimine test would be a waste of money

The other thing she wanted was to give her steriods and yet again I said no. She's just guessing at this point, she isn't 100% or even 50% sure if she does have pancrititis and because there is a chance the steriod could raise her BG enough that she needs insulin again I want to be cautious, I don't want to just pump her full of meds hoping one will work and knowing one could make her sicker.

They gave me more sub q fluids to give her plus an antibiotic and recommended force feeding her until she is eating on her own. She also gave her a B12 shot and told me to continue giving her Reglan and cyproheptadine to help her with throwing up and make her hungry

Also she was struggling to poop yesterday and today. Finally she pooped a little but it was pebble sized and marble sized, she also has diarrhea along with it but just enough to stick to her rear end and make a mess all over the house when she sits. She said she isn't constipated, she thinks it's just from the diarrhea and then later today after the vet visit I noticed her scooting on her butt on the floor 3 different times. About 10 years ago she had impacted anal glands and needed surgery to clean it all out, so I'm wondering if maybe that's it. Would the anal glands be something they would know off the bat was wrong or is that something they don't normally look for?

The vet we saw today is not her regular vet, this is someone I've never seen before and they've already set us up for a recheck on Monday.

Basically I want to know if yall think I was right turning down the X-ray, the frutosimine test, and the steriod shot and if I should bring up the possibility of impacted anal glands on Monday.
 
I would want to know what they are looking for with the xray, before spending the money. AND if after doing an xray they will want to do an ultrasound. If that is the case, I would go right to the ultrasound and skip the xray.

If you are home testing, then there is no need for a fructosamine test - as you know, it just gives you the average BG over a period of 2-3 weeks. If you are testing, then you already have that information.

What is the reason for giving steroids? I would want to know why they want to give this and what they hope to accomplish with it. Yes, steroids can cause diabetes, so you want to be careful when using them.

If the vet checks her hind area, the vet will easily be able to see and feel if anal glands are an issue. And it is very possible that this is a problem and the vet can express them. They can show you how to do it at home as well. Depending on if this is the problem, they may be infected and an antibiotic needed.

When Maui had this problem, I had to use a warm water compress to the area to help alleviate the swelling.
 
Thanks for the reply.

I went in thinking I was doing the right thing by Raja asking the doctor and making an informed decision with her as to what treatment to do with Raja and then when I talked to my boyfriend he basically told me I was wrong and I should have listened to the vet, so I was questioning my decisions.

When I go in on Monday I'll ask the original vet (not the one I saw today) what they are looking for on the xray and I'll ask her about the anal glands

She's red and raw around her butt, even some of the fur is gone. I've been wiping her with sensitive skin baby wipes and I'm crossing my fingers we are done with the diarrhea. I cleaned her before I left at 330 and now at 830 I went to check on her and her rear end is dry. I'm going to try the warm compresses, that will help even with sore skin.

She ate 3 syringe fulls of beef baby food I spaced the first two an hour apart and just now gave her the 3rd one. I will try another syringe full in about an hour and see how she does.
 
if she is red and raw around her butt - don't use the baby wipes! They actually sting a raw butt. I know what you are thinking, but they are baby wipes. There is something in them that cause it to sting a raw area.

You are better off using a damp cloth, wet paper towel, make up pads - with water and wiping the area. If you have petroleum jelly, you can put that on gently to help soothe the area.

If you must use a soap product, baby shampoo, or a very mild dish soap or shampoo will work, put a little on a wet cloth and wash the area and then rinse it as you don't want to leave soap residue.

It sounds like something is wrong back there as it shouldn't be red and raw - it does need a vet to check it out.

ARe you able to get her to eat cat food? Syringe it into her maybe?
 
Heather,

I am so sorry to hear you are going through this with Raja. Regarding the pancreatitis, they can do a fPl test for that, its not real accurate but it can tell them a little. Lilly had pancreatitis, her test with the fPL was 3.1 and the scale I think of the test ranges 3-10 of 3 being not having to 10 being really having It. I think if I remember correctly. But she still had it and was really sick with it to the point she would not eat.
Also they can do an ultrasound of the pancreas but it really takes someone who knows what they are doing otherwise results can be iffy.
Also you do not always have to listen to what the vet tells you, please make your own informed decisions.

Terri
 
She has stopped with the diarrhea so I'm not having to wipe her rear but it's still red and raw, I will be talking to the vet about that. I figured the ones for sensitive skin would be ok but if I need to wipe her again I'll use a warm wash cloth instead

Thanks Terri, I'm going to ask about that tomorrow. I didn't know there was a test for that, I wonder why they didn't offer that to me back in August when they thought she was pancrititis.

She is eating the baby food and she's actually eating some food on her own, I'm having to syringe feed her the baby food. I've been trying to space one syringe full at each feeding every couple of hours because I figure that would help with her tummy troubles rather than just trying to feed her 3 syringes full at one time.
 
Ok Rajas bg was 242 then 2 hours later and without eating anything her bg is 346

So we are back in the game. I will start her back on insulin either Monday or Tuesday when I can get the insulin from my dad. I do have the open pen I used back in august. Its been sitting in a drawer in my bedroom since I got it, any ideas on if it's ok to use? It hasn't been kept refrigerated and it's been open for 3 months

I will talk to the vet tomorrow about her diabetesD
 
Heather,
I'm sorry to hear that her BG has continued to go up, and of course about all the problems she's had recently. I really hope this is just a bump in the road for both of you.

I looked at the Lantus sticky on storage of the inuslin and here is what it says:
Think Tank Discussion: How Long Does Lantus/Levemir Last Once Opened?

Opened Lantus and Levemir vials, cartridges, and pens can last longer than many FDMB members seem to think. Some caregivers of diabetic cats have used Lantus/Levemir down to the last drop. Lantus users from the German Katzen Forum have reported using opened Lantus for up to six months and Levemir up to four months if kept refrigerated and handled properly. Lantus is NOT as fragile as we once thought.

From two of the leading researchers in the field of lantus use with feline diabetics, Jacquie S. Rand BVS, DVS and Rhett D.Marshall BVS (University of Queensland, Brisbane, Australia):

"Glargine should be refrigerated because it has a shelf life of 4 weeks once opened and kept at room temperature. We have found that opened vials kept refrigerated can be used for more than 6 months. If using an insulin pen, the manufacturer recommends that once a vial of insulin is used, the pen be kept at room temperature because temperature changes associated with refrigeration alter the volume administered by the pen."
http://www.uq.edu.au/ccah/index.html?page=43599&pid=0

We use U100 syringes to draw Lantus from cartridges and pens. We do NOT use needle tips which can be attached to the pens to administer insulin. Therefore, refrigeration will not alter the volume administered by the pen apparatus. Refrigeration combined with the use of syringes to draw insulin (versus using the needle tip made for the pen) from the opened pen has been found to extend it's life well beyond the 28 days suggested by the manufacturer.

Unopened Lantus is good until the expiration date stamped on the box if refrigerated and handled properly.
Click to expand...

If that's right, then I don't think the opened one you have is still good, but hoping a lantus user can confim or refute that.
Carl
 
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