? Lab Results

Can someone please take a look at Pepper's lab results and SS and give your opinion. She's been sleeping a lot. Is this do to her BG's being high or do you think it could also be pancreatitis? Vet wants to get her BG regulated before we jump another hurdle with her pancreas number, to see if it comes down. (She said it could possibly be from her Diabetes being out of whack). Also, if it is her pancreas, is there something else I can be feeding her that would help with this and put some weight on her. She has been on Friskies pate her whole life 1/4 can 5-6 times a day. She is picky eating in the afternoons and did not eat her last meal, last night and vomited white foam this morning.

Thanks in advance!!

 

Here is a primer that Marje and Gracie wrote http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.79693/

The white foam sounds like an acidic tummy. You can give Pepcid for that or even just some freeze dried treats helps absorb the acid (that is what I do).

 

@Marje and Gracie

Can you take a look?

I'm glad you raised the dose. Hopefully the numbers will come down. If you don't see enough results in a few days I suggest you go to 2 units. It's not healthy for her to be this high for a long time.

Sounds like an upset belly. Pepcid could help. Add extra water to the food. If she stops eating for 12 hours don't wait to address it.... She may need cerenia, fluids, and bupe if it's pancratitis.

 

ok. Thank you. Will boiled chicken breast work for a treat?

 

Definitely that's a good snack

 

The labs look good. The test for pancreatitis was not there though. What did your vet suggest? I’d want to try nausea medication to see if it helps. When Max had pancreatitis I found ondansetron or cerenia helped. He would often eat Gerbers baby food 2nds. As long as your cat doesn’t have a problem with cornstarch it should be fine to try. If the chicken works that’s good too.

 

I agree with everything Elise said. Her labs look great although her urine is a bit dilute as her urine specific gravity should be above 1.040. However, the unregulated diabetes could be causing her to drink more water which would drop her USG.

IMHO, your vet is headed in the wrong direction. She needs to test for pancreatitis now if Pepper is “off” and especially if she is not eating and has an acid tummy. Just for general info, pancreatitis sometimes presents with very obvious symptoms like nausea, vomiting, pain, inappetence, etc., a lot of the time, there’s nothing you can put your finger on but she seems “not quite right”. Your vet should run a snapfPL or specfPL (I prefer the latter) but you’ll need to fast for six hours. While that can be a challenge for a diabetic cat, what I’d do is fast overnight, have the test done first thing in the morning, and then shoot an hour late. I suspect that the sleeping more is due to the high BG.

You can also help the white foamy vomit from an acid tummy by having food in her tummy. A lot of times, over night, kitties will develop acid in their tummies so if you give her a snack, it might help. I had an autofeeder set up for 4 a.m. and it gave Gracie several freeze dried chicken treats and that stopped the acid vomiting. I don’t use anti acids and I believe they are way overused but an occasional one here and there is fine. Boiled chicken breast also works great for a treat.

I also think you should be raising the dose every six cycles by 0.5u until you start seeing yellow nadirs. If there is a way to get an “out the door” test in the morning and an “in the door” test when you get home, that would help put her pattern together. I’d also recommend a +2 at night as well as a before bed test as it looks like you’ve been doing.

Hope she feels better soon.

 

@Marje and Gracie

Thank you for your response, now that raised more questions.

Dr. said the Precision/PSL is the pancreatic enzyme that's elevated. (Pancreatic Sensitive Lipase test). Is that incorrect?

Pepper was drinking copious amounts of water when her labs were done. (The day she was diagnosed with Diabetes). So, that should explain the specific gravity.

I test at 6am, feed, and shoot around 620. I leave at 630am.

In the evening I get home from work at 545pm, I test at 6pm, feed and shoot about 10 mins later.

My husband feeds her at 10am and 2pm, then again at 10pm before we go to bed. If he's up at 2am, he will feed her then. (So she is eating 5-6 times a day).

Husband will not do a BG while I'm at work, unless its an emergency situation.

I will start doing the +2 in the pm and am/pm on the weekends.

Every 6 cycles? Is this 6 days?

Thank you

 

Why is she getting lower numbers in the am after insulin tests and not in the pm after insulin tests?

Also, she has been on lactulose, as needed her whole life and she received a dose yesterday, I'm wondering if this could have raised her BG last night. The vet says "no" its a synthetic sugar and is not absorbed in the body, but I don't know what else would be contributing to her having a high BG on her before bed test last night.

 

6 cycles is 3 days......each cycle is 12 hours

 

Thank you @Chris & China

 

There is some history about the Precision PSL you should be aware of. IDEXX Labs in conjunction with Texas A&M University, developed the specfPL and snapfPL to diagnose pancreatitis. It isn’t 100% but it’s fairly accurate. The number can be elevated, which might indicate pancreatitis, if there is any concurrent issue with the liver, gallbladder, etc.

In trying to respond to that, Antech Labs developed the Precision PSL. It does not have the accuracy of the specfPL or snapfPL and even their statement on it indicates it is just an indicator that pancreatitis “might” be considered. Again, as in the more accurate tests, if there is something else going on with a proximal organ, it might elevate the Precision PSL.

What I was questioning was your vet thinking it was the diabetes causing the increased Precision PSL and that it would come down with the diabetes being regulated. It likely will not and Pepper could have pancreatitis. My Gracie was well regulated but her Precision PSL and her specfPL were always elevated because she had elevated liver enzymes. Ultrasounds indicated the pancreas and the liver were totally normal. As we look back now, it appears the IBD/lymphoma was causing the increase in the liver enzymes and both tests for pancreatitis.

What that means for Pepper is that I would not just assume there is not something else going on just because she’s unregulated and the vet thinks that is the reason for the increased Precision PSL. If she’s not feeling right, eating right, acting right and if she’s vomiting, there is something going on besides unregulated diabetes.

 

Thank you. I guess we will play it by ear and keep on doing what I am doing.