Xuxu 1/30/13,confusing Dx.

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DebH

Member Since 2012
So we are 5 days along and still don't know what is wrong with Xuxu. He was DKA, and it's taken 3 days on R to get his ketones back down to trace. We started him back on Lantus last night, just 1U. He's still dropping to 60 on that. But this is the first day he seems to feel comfortable, breathing easy and not restless. He's getting a feeding tube tonight since his gag reflex seems strong causing problems swallowing. Maybe that will make him more comfortable.

Test shows he's not hyperthyroid, not Cushings, but is cushinoid. So still back to some type of inflammation that we can't pin down. they also mention stress...STRESS!@#@!# what the hell do they think he's under. The radiologist is going over the scans again to make sure there wasn't something in the adrenals that was borderline at the time. In consultations with Antech, they keep bringing up IBS, but there are absolutely no signs. He's digesting fine and has solid stools except when I have to give him karo for crashing. They suggest putting him on Atopica (Cyclosporine). That doesn't seem a good idea since we can't guarantee keeping his BG below 500. The other option is steroids, recommended only if he's considered terminal in a day or two. I was ready to do that last night, but he seems so much more comfortable today. I'm not really fooling myself, I don't think this is going to end well. Blood cancer is still out there too.
 
DEb, I am really sorry to hear that Xuxu is still not getting better. There does seem to be something going on that is not yet identified. It is a perplexing situation and I am sure you re frustrated and scared for him. The feeding tube will, at least, help you get enough calories into him so that he doesn't risk fatty liver, and, hopefully, DKA again.

Sending healing prayers for him.

Are you working with a Board certified internal medicine specialist? We have a place near Chicago called the Vet Specialty Center where they have many specialist all board certified in their area. They have state of the art testing equipment as well. Perhaps a place like that could get some answers for you.

Wouldn't blood cancer show up in blood tests?
 
I'm using blood cancer as a generic term. It will take a bone marrow biopsy to detect lymphosarcoma or bone marrow cancer. If we've eliminated all else, I'm not sure it will be worth it. At this stage, I don't think he could withstand chemotherapy. I did that to a cat with mammary cancer before and swore I'd never do it again. She could have had a last 4 pleasant weeks instead of the 8 weeks in hell I put her through.
 
He's actually doing much better tonight, even purring and ketones are down to O. It's this up and down that keeps me holding on. His BG hasn't gone above 516 in 2 days, which has NEVER happened before. We'll see tonight if it goes back to 750. so maybe the Panacur is shocking his system enough to work right. He was at the vet all day, I only gave .75 Lantus tonight, 1U this morning and he did go up and down a bit on that, they had to give dextrose 3 times when he would get down to 60, then up a bit, then back down when the dextrose wore off, but he never really crashed. My vet thought I was poking him too much with hourly readings sometimes, but now she sees how fast he can change. And poking his ear has never bothered him.
 
Hey Deb

Sorry things are still chaotic.

Here is a table I constructed for Insulin dosing options; some of these are very non-traditional. There are some other pages to that spreadsheet which may provide food for thought, plus a TID spreadsheet.

Maybe you could print them out, or share the link with the docs, to see if they thing any of the ideas would be helpful.

To all others: this spreadsheet I've linked is mostly IDEAS. I don't include it in my signature link because of that. She is in need of ideas, and thus, I am sharing it.
 
I think that is a very good link. Most of us know of those dosing strategies, although I am not sure I ever heard of anyone giving it 4 times a day (QID). I think if you put a note on the TID and QID that the dose is generally LOWERED for each of those shots, and that these are for difficult to regulate on BID situation, you could link it in your signature.

I think Deb considered TID, but her schedule doesn't allow it? I just wonder though, if .25u of lev had him crashing and swinging back to 750, changing the dosing schedule might not work either. I can only think that something like a .15u dose TID would maybe work. It would have to be less more often.

Deb, I am glad to hear that he did OK yesterday. Still keeping good thoughts for him.
 
Sheila & Beau & Jeddie (GA) said:
I think that is a very good link. Most of us know of those dosing strategies, although I am not sure I ever heard of anyone giving it 4 times a day (QID). I think if you put a note on the TID and QID that the dose is generally LOWERED for each of those shots, and that these are for difficult to regulate on BID situation, you could link it in your signature.
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Click to expand...

Thanks Sheila

I put some additional notes on to clarify it. Did you look at the additional pages? I suspect the "running bond" pattern (like overlapping bricks), might generate some comment, to put it mildly.
 
No, you're right I only saw the first page. Maybe THAT could be linked by itself?

At any rate, while most kitties follow the 12/12 protocol with long acting insulin fairly well to excellently, it is always good to have some "creative", but tried and tested alternatives for those that don't.
 
Just checking in and noticed your post. nothing to add seems like except you're doing everything possible.
You and Xuxu are on mind mind today sending lots of gealing vibes and hugs.
 
Thank you Marci and Buddy. Xuxu is a quandary, although he not aware of it. He just wants his Iams kibble back.
 
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