What would you do?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Sean & Rufus, Jan 29, 2018.

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  1. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    So...I wrote a long post a couple weeks ago introducing Rufus and his issues. Just wanted to explain again what happened and ask what would you do...

    Rufus is a big dude. He was 24 pounds at his heaviest, vet thinks he should be about 18 pounds, he does have a long body. A couple years ago, Rufus started throwing up quite a bit, and vet thought it was eating too much too fast. We then switched foods and started to vomit less, but then he started licking himself. Never did testing for allergies because was told it was a waste of money.

    Fast forward this last April. Brought him in for a vaccine and the vet said he looks miserable. Loss of hair, red ears, etc. I said, yeah, I've been saying for years. We switched him to Royal Canine Selective rabbit. He was also eating a tiny bit of deli turkey each day (dumb, I know now seeing as this was probably contributing to his issues). He was scratching and licking less, but still doing it. Switched to a different protein twice in Late July/early August because of cost of food. He didn't care for the new ones. Switched back to Royal Canine.

    Late August I noticed that he was eating less and less dry food. He was always getting 1/4 can of rc rabbit at night and continued to eat that, until later next month.

    Brought him to vet. No real reason that he wasn't eating. He had bad ears (infections?) and his creatine was a little elevated and he was slightly dehydrated. Vet said sometimes cats don't like to eat when creatine is elevated. A week goes by and still not eating well. This guy loves to eat, so this is strange. I called vet and asked about this drug that I read about, prednisone, to increase appetitie, and stop the itching. She doesn't want to do, but I twist her arm. He's on it for a few day and no change, so I decide to get second opinion from a different vet.

    New vet (Late September) gives him sub q fluids, new meds for ears, and antibiotic. He was like a brand new cat for about 2 weeks, then starts again witht he not eating. Now he's not eating dry and the wet has to have water added to eat. On top of that, he only likes a food for a couple days, and then no longer will eat it. The ear drops aren't working so we switch to a ear dropped only approved for dogs. It seems to work better. So now his appetite is up and down. Vet thinks he has pancreatitis now from me switching foods on him, but I had to to get him to eat.

    In november I wanted to have his teeth checked because why is he not really eating dry food. She says lets try some buprenorphine and see what happens. 1st day no change, second night he was eating dry food (normally), and wet food that wasn't altered with water! 3rd day, he was having issues with the dry food (dropping it, chewing head tilted). Didn't attempt to eat dry for 1 month after this. He was only on this for 3 days.

    So she agrees to dental check (this whole time vet 1 and new vet don't think his issues are tooth related). She wants to do bloodwork first. We scgedule it 3 weeks out. Week and a half later (thanksgiving), Rufus is peeing like crazy. We do bloodwork early and BG was 400's. We stop the predinsone and start Lantus.

    So here we are end of January. Rufus is kinda sometimes eating dry food, but mostly it is pureed fancy feast. He still won't eat unaltered wet food. Only wants Fancy Feast. I'm pretty sure he is allergic/intolerant to it. His stomach is always gurgling, has gas, could be IBD now. Went to dental specialst a couple weeks ago, and she doesn't think its a dental issue, but we cant't check because his number are too high.

    So, we are now on 5 units am & pm. He seems "better" for the most part. But his numbers won't go down to where they need to be, and still has issues eating. Is it the pancreatitis or bad teeth? Who knows because I can't fix the other without fixing the other first!

    We did have a scare last weekend and went to emergeny vet. She said while 5 and 5 units isn't THAT high, she thinks I need to see a specialist for him to get better because the underlying issue is casuing the numbers not to drop. My regular vet thinks it would just be a waste of time and money, and that when we get to 7 and 7 we should switch to a different insulin.

    I did leave out some details, as I truly didn't want to write this much. Thank you for reading this I know it was long. Now, what would you do in this situation? I truly thought that no more steriods and low/zero carb food would do the trick, but it's not working.
     
  2. Sean & Rufus

    Sean & Rufus Well-Known Member

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    FYI increments in dosing were: 1 and 1, 2 and 1, 2 and 2, 3 and 2, 3 and 3, 4 and 4, 4.5 and 4.5, and now 5 and 5. All BG tests/checks were done once a week at vet up until 2 weeks ago. He had a curve done at 3 and 2 I beleive and all numbers were in the 400' and low 500's.
     
  3. Juliet

    Juliet Guest

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    Sep 8, 2017
    You do know dry is bad for cats right? Bad for civvies just as much as diabetics. I think you’ve had quite a bit of advice re dosing in other posts. You should link your previous day’s post to your current day’s post like I suggested. Then all your info is in one place for others to follow and see what advice has already been given. You should also just stick to one post a day and out all your questions in the one post.

    I did send you this link before but take another look. You will get more eyes and answers if you follow the process.

    http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/
     
  4. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Thanks Juliet. The dry food is the young again zero, so it's pretty low carb, possibly less then the fancy feast. the reason why I didn't link is because I know this is really long already, and I'm sure people don't want to read though all of it. I know what I was told about dosing, but wondering if I should see a specialist and if anyone thinks his underlying issues are causing (and if so, how much) his "high" dose. So, should I keep increasing in hopes we get to the right level and not worry about underlying issues, or fix underlying issues asap and hope insulin needs aren't as much.
     
  5. Juliet

    Juliet Guest

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    No dry food is good for cats. Low or high carb.
    http://www.felinediabetes.com/FDMB/...r-more-than-just-carbohydrate-content.175004/
     
  6. Juliet

    Juliet Guest

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    I don’t know what you were previously advised. Go back and read and see what advice you’ve already been given.
     
  7. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    I was never given advice on my current question, as I never have asked it. I was given advice as to test at home, and more often.
     
  8. Sean & Rufus

    Sean & Rufus Well-Known Member

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  9. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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  10. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    So just to reiterate...Main vet thinks that once he is regulated, the pancreatitis, food allergy/ibd and dental issues (not wanting to chew food) pain will go away and everything will resolve itself. Her idea is keep going up on dosage til we get there. Emergency vet says we should see an internist and fix the underlying issues as much as possible now, to help get him regulated as she thinks we wont get him regulated until we fix the issue. I'd love to see an interest but is it worth it? I'm unemployed and spent $1000 in the last month alone. I'll spend as much as it takes, but don't want to throw money out the window.
     
    Last edited: Jan 29, 2018
  11. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    From what I understand, pancreatitis can make them not want to eat well, and can elevate BG numbers. See attached additional info

    http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.79693/

    Only an observation, but I had a peek at your SS and there are no preshot numbers for the last week, nor much data in between. It would be impossible to say he's getting enough or not enough insulin, especially if he is dropping lower and you aren't seeing it. I couldn't imagine making decisions without knowing preshot numbers, and how low the current dose is taking them.

    Side note: only in the Lantus and Levemir subforum are folks asked to post only once a day, and link to previous posts...it's quite busy over there, but here in the main forum, you can ask as many questions in as many threads as you'd like :), and I've seen a few posts go on for days here!
     
  12. tiffmaxee

    tiffmaxee Well-Known Member

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    My Max had chronic pancreatitis for several years before becomes BG diabetic. I got him tightly regulated with insulin and canned food. That will not cure pancreatitis. It’s hard to determine the cause of it. For Max it was stress first from tge I’ll ess and loss of his best friend. Then trips to the vet always brought it on. Food was not his trigger. So when it reared his ugly head I treated with nausea medication, cerenia or most often ondansetron. Regulation will also not get rid of dental disease any more than it would for you. Actually dealing with the dental issues might help regulate him. I’m sorry but you need a new vet.
     
  13. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Dec 12, 2016
    Poor Rufus.:(

    Sometimes the rule is - the only good food is the food they will eat. If a cat isn't eating all other issues kind of drop off the table don't they?

    I don't agree on the pancreatitis - if it is chronic then Rufus is having tummy issues and is probably in pain. Have they tried any medications to help this? AB, appy stim, anti-nausea and a pain med?

    The dental pain will just go away? How? Do you see or was any cavities noticed? How are his teeth? If there is infection in the teeth that could be part of your issue with the high dosage.

    If he does have IBD - there is options for meds - prednisolone and budesonide, as I am sure you are aware of. As well as the allergies - which may be relived when the IBD is dealt with.

    JMHO:
    Jones has an IM vet - best doc ever! If you can get a good one. He dealt with the things like the pancreatitis and IBD. He left the FD to me as I was home day to day to deal with the ups or downs. I have not regretted going. When he ended up at the ER (which is where the IM works out of) - he was there to work through that as well. I use my regular vet for prescriptions refills.

    I know funding can be an issue, but I think you are right in a way, you need to look at the whole picture to see what is the driver and what is a result. Looking at your spreadsheet - I couldn't say if the dose you are using is good or bad. Just not enough testing to see a clear picture.

    ETA: I think you need some of theses :bighug::bighug::bighug::bighug:
     
    Last edited: Jan 29, 2018
  14. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    The vet told me to cool it on the tests for a couple days. His ears were pretty beat up. My plan is to do a couple tests tomorrow and Wednesday and then do a curve on Thursday.
     
  15. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    The vet and even the dental specialist don't think it's a dental issue, but I do. You should see the video of him eating. They think it's pancreatitis causing him pain to chew. Might be part of it, but I think it is a tooth issue. Problem is specialist won't look at him til numbers are down. But what if numbers wont go down because of issue. Catch 22. Ugh.
     
  16. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Well they don't see any dental issues from looking at him. He has lost 2 teeth. We talked about tooth resorbtion. She did prescribe gabapentin but I really don't notice any difference in him, when i did give it to him. We started ondansetron on Saturday. Really is working. I think the pancreatitis is from eating a good that he' allergic to. I have the novel prisons ready to go, but he's being picky. I'm hoping soon with this ondansetron that I can get him eating the rabbit and his tummy calms down. He really is doing much better, just his numbers aren't budging much and the nausea and eating funky.
     
  17. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    What were youngiven for the pancreatitis? When Max first got it he was eating less and less. He was CD at the time because he had blocked. He preferred dry mostly I think because he was nauseous but I didn’t know it because he never vomited. He was given an uultrasound by an incompetent traveling vet who recommended surgical biopsies. I went back to my original vet who had his radiologist do another ultrasound and ran the SpecfPL test for pancreatitis. No biopsies were needed. Since his main symptoms were inappetence and finicky about eating I was given ondansetron for nausea, a human drug, and buprenorphine for pain and an appetite stimulant. By trial and error I learned when he got tge right amount of ondansetron when nauseous , he didn’t need the appetite stimulant. I was told to feed him any canned food he would eat. He preferred pieces rather than pates. You might try that with your other cat as a CRF food diet leaves them dehydrated.

    If interested I can give you good articles to read. There’s a primer for pancreatitis on this forum as well.
     
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  18. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Hi Elise, I think we cross posted earlier, I did include the link for the primer on pancreatitis for Sean ;)
     
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  19. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Hi!
    I know this is probably overwhelming for you I promise the more you know it will get easier and there is so much info it can be hard to take in be patient with yourself.

    I just want to add a few things
    I agree dry food is not the best choice however many Cats are addicted or seniors and changing routines drastically can cause other issues including depression.
    My boys are seniors and I do leave dr Elsey’s dry out for them. I tried YA and they puked all over and got diarrhea.
    Dr Elsey’s chicken is under 5% carb and salmon under 10%
    The thing I really like is it is not protein from plants. It is animal protein.


    1 other thing you may want to discuss with your vet is budesonide instead of Pred if indeed you do need a steroid.
    It has helped my nearly 20 year old boy immensely. Initially he got steroid induced diabetes I tinkered with the dose n he has been in remission for a long time. He feels so much better without the internal inflammation.
    Side note .... when he does have a panc flare I give sq fluids and ondansetron as well as cerenia and the flare is minimized to a few days.
    Hugs !
     
  20. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    He wasn't given anything when she told me he was diagnosed with pancreatitis. Only to me to give him pepcid. He hasn't had an ultrasound. Was diagnosed with the yes no test, not sure the name. He's eating pretty well now, just only wants his fancy feast which I'm 99% sure is the problem.
     
  21. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Oct 11, 2015
    Freeze dried chicken is a hit here especially when tummy issues
    Mine like momentum brand
    I throw in the vita mix or break up very small
     
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  22. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    thanks jayla. Problem is I'm pretty sure allergy is to fish and turkey, and most likely chicken. That's why I got the ya lid food. I really believe if I can get him to eat that and wet rabbit food a lot of the tummy issues will resolve. I just can't get him to steadily eat the dry and eat the rabbit.
     
  23. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    I never did the official testing for Ibd or panc. Just symptoms.
    I refused to sedate him at his age.
    Luckily my vet is all about Rico feeling well I know many are too full of themselves.
     
  24. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Maybe freeze dried rabbit ??
     
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  25. Squalliesmom

    Squalliesmom Well-Known Member

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    Have you tried raw food? Sometimes it seems to sit easier on the tummy, and is fairly readily available in novel proteins. I used to buy the frozen raw, my cats loved it. Also small meals several times a day work better than just a couple of larger meals.

    I don't understand all the glaring cues that he has dental issues, but the dentist saying he has no problems??? I think you need a new vet, and maybe a new dentist, too!
     
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  26. tiffmaxee

    tiffmaxee Well-Known Member

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    There’s also freeze dried venison and pork. When I got my kittens one started with loose stool. I switched them to Primal freeze dried first and now I use grit frozen and Balsnced Blends. Primal cones in novel proteins.
     
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  27. Sean & Rufus

    Sean & Rufus Well-Known Member

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    yeah I'm not sure why they all think he has no dental issues. Seems obvious to me. Really need his numbers to get better so that they'll look at him.
     
  28. Sean & Rufus

    Sean & Rufus Well-Known Member

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    He has absolutely no interest in freeze dried treats. Only likes temptations. So no treats i guess. Vet tech gave me some raw chicken and no interest. I swear I'm being recorded to see how long I last before I lose it. never really an issue up until August.
     
  29. tiffmaxee

    tiffmaxee Well-Known Member

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    Maybe if you give him ondansetron for nausea andc cyproheptadine as an appetite stimulant he will eat foods better for him. Hang in there. He’s a puzzle and we just have to figure him out.
     
    Last edited: Jan 29, 2018
  30. Sylvie

    Sylvie Member

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    Sep 26, 2017
    know vet said that to you but, you still should at least test before shots.
    put neosporin on ear/s every night or so, what i do with my cat and you can't even tell i have been poking the same ear 3 or more times a day for 4mths!!
     
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  31. Squalliesmom

    Squalliesmom Well-Known Member

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    I don't understand what you mean by "look at him." I can understand the dentist not wanting to do any work on his mouth until his numbers are lower, but certainly it shouldn't be a problem for him to look at Rufus' teeth and give you an opinion, if not a diagnosis. My sugar cat is 19 years old with a heart murmur and the beginnings of kidney disease, and the dental specialist I took him to had no problem looking at him and evaluating him for initial treatment, based on what he could see. Any feline dentist should have no problem looking at him, even if his numbers are high.
     
  32. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I phrased it wrong, i meant look at him meaning xrays. We did go to see a specialist. She did look in his mouth, and noticed 3 teeth missing (2 in the last 3 months) including 1 in the front. She doesn't see anything wrong, or signs of anything wrong. She did say he could have some tooth resporbtion or that 1 tooth in front could not be healed over, but by quick look in there she doesn't think his teeth are the issue at all. I really wish she would have looked at my video of him eating, but she didn't. Now the issue is even when his numbers are better, it's going to cost at least $1200 just to clean and do xrays and see IF there are issues.
     
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  33. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Shop around a bit. I just did an uncomplicated cleaning w/x-rays for about half that. The cost can climb rapidly if there are extractions or other issues, and sometimes they give you a "high" estimate up-front to help ease the sticker shock just in case, but $1200 for just the cleaning is a lot. The non-negotiable here is of course the x-rays, so you may be limited as to which practices in your area can do that.

    Good luck, this is a frustrating situation!
     
  34. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    any chance there is a broth in his mouth?
     
  35. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Yeah, this is at the specialist. I think my current vet was a little less expensive but she referred me to the specialist because of the diabetes and them being more prepared if any complications came up. Yeah they did a side by side estimate low end 1200, high end 2000+
     
  36. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Not sure what that is?
     
  37. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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    Also ask around because in a lot of places February is veterinary dental health month - so lots of discounts and packages and extra "dental staff" at offices. :cat:
     
  38. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Sorry meant growth.... not a morning person:oops:
     
  39. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    That's OK! I was like what in the? Well, neither vet has seen any growth by looking in there. I asked about possible polyp, because he can breathe heavy at times when sleeping, but they didn't think so. Guess we'll have to wait and see when he has xrays.
     
  40. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Hopefully his fructosamine come back better in February so he could get in!
     
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  41. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    I have a friend who had a senior kitty that started having trouble eating and drinking ..the food and water was falling out of the mouth. He drank from the sink faucet almost like a human as it got worse.
    Turned out he had a growth in the back of his throat.
    If Rufus has anything similar I am not to sure X-rays will show it - I think a scope or ultra sound might be needed.

    just more to think about in all your spare time :joyful::joyful::joyful:

    I am sure your heart is spinning with so much info...we are crazy cat people :cat::cat::bighug:
     
  42. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Well he drinks fine, so hopefully that's a good sign! I'll talk to the vet about this. I think they are getting tired of me and my theories on what the issues are :)
     
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  43. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    This document from a very authoritative source gives information on pancreatitis symptoms, diagnosis and treatments:

    IDEXX feline pancreatitis treatment guidelines

    This web page has a very helpful guide to clinical signs of nausea (including pictures of 'tense meatloaf' position sometimes adopted when discomfort occurs after eating):

    http://catcentric.org/care-and-heal...pcid-using-diet-to-manage-nausea-in-your-cat/

    It really helps a lot to spend time observing one's kitty when trying to identify potential health problems.


    Mogs
    .
     
  44. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Great links Mogs! I'm 99% sure I know what the issues are, the hard part is getting him to eat the food he needs to eat. His legs are almost bare fro the licking and biting. I think the allergy has turned into IBD/food intolerance. I know turkey is a culprit. I just can't get him to eat the duck or rabbit right now. Just turns and walks away. I'm back up to 8mg of Ondansetron 2x daily. Seems to be helping. Also, gave him gabepentin this am but he is out of it.

    Im doing a curve at home today, but am going to the vet at 3pm for them to check my meter vs theres. I'm going to get a fructosamine done also, but I'm sure it hasn't improved. I think the dental issues ares till there, but cant go until numbers improve :(
     
  45. Critter Mom

    Critter Mom Well-Known Member

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    Here's another site that might be of help, Sean:

    http://www.ibdkitties.net/

    Whether pancreatitis or IBD it would be a good idea to ask your vet about a course of B12 for Rufus (it helps both).


    Mogs
    .
     
  46. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    He's on zobaline and had 6 treatments of b12 injections that ended a few weeks ago. Vet said that was enough. I'll ask her again today. I was reading one of the things you suggested about nausea and it said to put him on a bland diet for a week or 2. Baby food for 2 weeks. I might have to give that a try.
     
  47. Steph & Quintus & L & O

    Steph & Quintus & L & O Well-Known Member

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    Dec 9, 2017
    My apologies in advance as I have not read all the thread, but sharing my brief experience with pancreatitis and diabetes. Quintus had "off the charts" pancreatitis which led to diabetes. Pancreatitis (and assorted choleangitis, diagnosed by ultrasound, or we wouldn't have caught it) were treated with a pile of meds, including antibiotics. Insulin for the diabetes. Post-remission, we did the Spec fPL test again and his numbers were in a much reasonable range (still "too high" as the pancreatitis is chronic, but not off the charts anymore). And more important, clinically, Quintus clearly got MUCH better. What my vet explained to me is that by attacking the problems on all fronts we had managed to break the vicious cycle (hence also the speedy diabetes remission). We dealt with the gallbladder. He had something infectious going on (often a side-effect of pancreatitis) and we pumped antibiotics into him for 2 whole months (in amounts that got me a few dark looks here -- virtual ;-) ). I worked agressively on bringing his BG down. And at some point, all these things stopped making each other worse, and he got over the hump.

    If you have pain and infection it will make the BG rise. If the BG is high the infection will love it. If the pancreas is unhappy it might have a hard time producing insulin. If it's drowning in sugar because there isn't enough insulin, it makes it worse. You see how it goes.

    This, FWIW, is my general philosophy when a pile of things are going wrong at the same time: work on everything.

    How long was he on antibiotics? Did things go downhill after the effect of the antibiotics wore off?

    Also, from my point of view, don't beat yourself up about the food. If you can get less carbs, do, but first of all he needs to eat and not get sick from what he's eating. (Reminder: Quintus went off his insulin while still eating 50% kibble for kidney disease. Broken record I am, I know.)
     
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  48. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Baby food will be an option short term but only if the allergy isn’t from the protein source you try. Best to use a protein never eaten before. It’s not complete nutritionally. Lacks taurine and essential cat ingredients.

    Max also became diabetic after several years of chronic pancreatitis.
     
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  49. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Hi! He was on clavomax 2x daily for 2 weeks in mid-late December, and had a covenia shot on the 18th of January. I'm not too sure the first round did much. I was only getting him check 1 time a week, but his bg numbers when checked seemed to stay the same or rise. It's tough to see what exactly the issue is. Did your cat always through out this eat dry food? My guy has issues eating and wouldn't even attempt for 1 month. All they keep saying is it is painful to eat with pancreatitis and thats why he is avoiding it. I still think he has teeth issues. But if he was on antibiotics wouldnt his number be better then?
     
  50. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Hiss tummy "sounds" better on fancy feast beef. I looked at the beach nut. They have a beef with no carbs or sugars. I know for a fact of the culprits is of fish, turkey, or rabbit. Turkey is definely the worst, but chicken could also be on this list. When this all started he was on rabbit dry and wet, deli turkey, hydrolyzed treats, and cosequin (fish). I do have call of the wild wysong supplements and a jar or taurine.
     
  51. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I'll say the best number he ever has had was the day after the covenia hot, but the later in day was back to bad. I really dont care for that covenia shot. I'd rather give him the pill 2x a day. Vet is worried about too much antibiotics.
     
  52. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I don’t like convenes becsuse it stays in their system at least a month so if they have a bad reaction nothing you can do. My vet who I usually agree with likes it and says he’s never had a problem.
     
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  53. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Yeah, she knows that I don't care for it. He had it 2 times last year, and honestly I'm not sure it "works" on him. But we had the clavomox earlier and she wanted to try a different one this time.
     
  54. krazy4kritters

    krazy4kritters Member

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    Jan 18, 2018
    If your cat is indeed has allergies, it may not even be his food. I have an itchy boy too. He would scratch himself bloody. The vet told me she could send out blood work and get him on a shot regiment like people do to eliminate the allergies. I didn't end up doing it because he stopped itching himself bloody.
     
  55. Sean & Rufus

    Sean & Rufus Well-Known Member

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    We're not sure, but symptoms were much improved when he was on the rabbit. He was still getting those others things though. Vet said could be in my house too or pollen or whatever. I wanted to get testing done, but she said really not worth it. I dunno.
     
  56. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Well, got back from vet. wanted to check my meter vs there equipment. AlphaTrak2 showed 423, their equipment/testing showed 485. Now she's wondering if maybe he has cushings disease because of the concurrent skin issues. So I suppose I have some reading to do. Ugh.
     
  57. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Your starter for ten ...

    Cushing's Syndrome in Felines

    (Note: For 'enlargement of the abdomen', a better descriptor would be 'pot-bellied appearance'.)

    To the best of my knowledge, Cushing's is rare in cats.


    Mogs
     
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  58. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Yup, I was just reading that one, and another. Doesn't look like a very "curable" disease.
     
  59. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    I had a Cushing's kitty and have come across a number of other Cushing's kitties over the last 3+ years. My personal feelings is that is may be under-diagnosed since it was considered rare. Years ago acromegaly was considered rare in kitties and now it is estimated that as many as 25% of kitties may actually be acro.

    My Tuxie (GA) was impossible to regulate. He had thin skin...it never got to the tearing part...and extremely poor hair re-growth. He was shaved for an ultrasound a few months after diagnosis and never regrew the hair back after 3 years. He had an extremely "swollen" belly..almost looked like he was pregnant :)...due to the enlarged organs...pancreas, liver, kidneys. There are two types of Cushing's...PDH involves a tumour on the pituitary gland (most common) and ADH ( involves a tumour on one or both of the adrenal glands) PDH has had some success with trilostane(vetoryl) although using this drug involves getting regular bloodwork to make sure the dose is correct.


    The simplest least invasive test for Cushing's is the UCCR (urine cortisol-creatinine ratio) which involves collecting a urine sample at home ( so there is no stress involved) Your vet would send this sample to an outside lab such as IDEXX or any lab that performs the test. If the test comes back positive or borderline then other tests are needed to determine what type of Cushing's it is. An ultrasound done by a board certified technician can also be helpful in making the diagnosis.


    Other tests that may be useful to check for high dose conditions are a full thyroid panel, which can be done at IDEXX. As well testing for insulin autoimmune antibodies or acromegaly can be done through MSU (Michigan State University) There are many members on here who have dealt with IAA and acro kitties that can give you lots of guidance if Rufus were to test positive for those. :bighug::bighug::bighug:
     
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  60. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Thanks for the info! He's been licking himself for about 3 or 4 years. Almost back legs and tummy were the worst. We finally switched him to a novel preotein and he was doing better. Then his ears were severly infected. He was on ear drops (steroids) for almost a month, with no success. Then Osurnia (steroid) that seemed to solve it. He was on pred for 2 months (low dose 5mg) but he did not lick at all when on that! Then Thanksgiving diagnosed diabetic and no more steroids. Now all for legs are bad, the back worse. Belly is thin, as is neck starting to. Vet thinks this along with his number not budging at all might be cushings.

    I guess my question right now is, if he has had the licking /scracting issue for 3 or 4 years, wouldn't he have had more issues if this went undiagnosed this long? OR did the steroid use just make it worse?
     
  61. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Another couple things to note...When he was on the pred, the hair grew back, though not completley. He doesn't really have a pot belly. He doesn't have thin skin (I dont think?).

    Also, if a cat had cushings and was on a steroid, would they stop licking/scratching?
     
  62. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    If the excess licking has been going on for 3 or 4 years then it is probably not Cushing's related. It sounds more like an allergy or intolerance to some type of food. Trying some novel proteins, such as rabbit or venison with no other protein source may help to determine whether there is a food allergy/intolerance. Steroids are commonly used for food allergy symptoms, but steroid use can also lead to FD.


    ETA My Tuxie never had "licking problems" with his Cushing's.


    ETA Cushing's kitty's glucose levels would go through the roof if given steroids. Cushing's causes a very high level of cortisol to be produced, which is a natural "steroid" hormone in the body. With Cushing's the normal "on/off" switch for cortisol does not work and the body is constantly being bombarded with cortisol.
     
    Last edited: Feb 1, 2018
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  63. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Thanks. A lot of times if he's not sleeping, he's licking. Oh beleive me I'm trying my hardest to get him to eat rabbit or duck, but he's just being picky. I know the nausea is part of it. He was eating rabbit last year, and now just wants his gross fancy feast. I am 99% sure he has as allergy and intolerance to turkey. I took the fancy feast with turkey listed in the ingredients out of rotation, and its been better. But the rest of the cans have meat byproducts listed. Im sure there are amounts of turkey in there.
     
  64. Sean & Rufus

    Sean & Rufus Well-Known Member

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    How do you post photos on here?
     
  65. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    If there is nausea involved that makes food changes even harder. Mogs gave you information on pancreatitis in an earlier thread (very common with FD kitties) so ruling that out first would be a good idea. You can either get a snap test done at the vet, which is a yes or no test, or a fPLI test done...needs to be sent to IDEXX or another outside lab that performs the test...which would give you an actual number reading.
     
  66. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    He does have pancreatitis :(
     
  67. Critter Mom

    Critter Mom Well-Known Member

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    If you want to load something from your device, use the 'Upload a File' button below the typing box where you enter your posts.


    Mogs
    .
     
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  68. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Here's his back leg...
     

    Attached Files:

  69. Critter Mom

    Critter Mom Well-Known Member

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    :bighug::bighug::bighug:

    .
     
  70. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Is he being treated with anti-nausea meds such as Cerenia or Ondansetron and pain control meds such as buprenorphine?


    ETA My Tuxie had chronic pancreatitis and anti-nausea meds and pain control meds were a mainstay during his flares.


    Your photo would seem to indicate either a skin condition or an food allergy/intolerance. Have they ever done a skin scraping to check for skin conditions?
     
  71. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    thanks!
    Vet told me she thought he had pancreatitus back in October. When he had his blood work done and was diaganosed diabetic in Novemeber, we also did the pancreatitis test (not sure which on). Came back positive. Never given any meds for it. He was on pepcid and that seemed to help. We did try cerenia pills on my suggestion. Didn't do anything for him. We started Ondansetron on Saturday. Huge dose. Seems to working, but still won't eat the wysong rabbit. Dental specialist gave me liquid gabapentin for pain. Not sure i notice any difference with him on it (except more tired).
     
  72. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Ok dumb question. How do you know when he was having a flare? I can't seem to differentiate when he's in pain or not, or maybe in constant pain??
     
  73. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    One thing that seemed to help for me at least with mild nausea was slippery elm bark (SEB) which you can buy at a health food store. Make sure it is the pure SEB with no additives. You can get this in capsule form and open the capsule, make a watery slurry from it and syringe it about 1/2 hour before feeding. With my kitty I found it worked much better than the pepcid AC

    ETA With Tuxie, who was a total food pig, if he wouldn't eat his food, I knew he was having a pancreatic flare. With kitties who are grazers it is harder to tell, but if they appear hungry but just won't eat, or are licking their lips at the food dish and not eating then a flare could be suspected.
     
  74. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Things to watch for (not an exhaustive list):

    - More lethargic/less sociable/withdrawn/increase in hiding behaviour.
    - Much more defined clinical signs of nausea.
    - Reluctance to eat/inappetence.
    - If flare is severe, then much more marked signs of pain (primarily abdominal but it can also radiate to the back - and some vets may mistake the latter for arthritic pain).
    - Softer, whiffier stools; sometimes more orangey-brown in colour if a mild flare but more of a gooey/marshmallowy texture - possibly very tan, greenish, or even greyish in colour - if flare is worse.
    - Marked upward trend in BG levels (even during milder flares).

    Clues may include:

    - sitting in a sort of tense 'meatloaf' position, especially after eating.
    - hiding (e.g. lurking under tables, behind sofas or curtains).
    - seeking out cool places to lie down, e.g. stone/tiled floors (soothing to abdomen).

    If in doubt, it's wise during a flare to treat for possible occult pain as reduction in any pain present may lead to the flare subsiding more quickly (advice given to me by feline internal medicine specialist).

    As with so many things, it's a case of Know Thy Own Cat. If you keep a little daily journal of clinical signs it may help you to better spot patterns of behaviour. (I found it to be a godsend for Saoirse.) The daily journal is also invaluable to refer back to because it can help you to better identify things which do and don't help matters, plus it is beyond helpful when you need to backtrack to something that was working better or which helped resolve prior flares effectively.

    Couple of day-to-day things to try:

    - raise food and water bowls several inches from the ground to a more comfortable eating height (helps with nausea if kitty doesn't have to lower its head to eat and drink).
    - massage neck and shoulders to release endorphins if Rufus' body/posture looks a bit tense after eating.
    - give Rufus a catnip toy to lick after his meals (catnip is thought to act as a mild analgesic).
    - keep a close eye on stool consistency and frequency (constipation can trigger flares).
    - feeding smaller meals spaced out over the cycle can be easier on the pancreas (ETA: must meet feeding needs of insulin in use!)
    - adding 1-2 tsps water to each mini meal can help maintain adequate hydration levels.



    Mogs
    .
     
    Last edited: Feb 1, 2018
  75. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Thank you thank you thank you! So much awesome info!! Looks like he's probably not in too much pain. I am giving him a probiotic so I think that firms up his stool, but hard to differentiate between this and food intolerance. I do know that if he doesn't have pepcid or ondansetron he has a hard time wanting to eat. So maybe he has a low grade constant state of pancreatitis. But then again, hard to distinguish between symptoms of intolerance and pancreatitus.
     
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  76. Critter Mom

    Critter Mom Well-Known Member

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    Last edited: Feb 1, 2018
  77. Critter Mom

    Critter Mom Well-Known Member

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    Often alongside the IBD and pancreatitis there may be liver issues (a condition known as triaditis).

    IBDkitties.net is well worth a read. NB: check out their take on longer term use of antacids (e.g. famotidine, aka Pepcid AC); might be worth taking into account for Rufus.

    Here's a link to info on preparing slippery elm bark (SEB) from Tanya's Site:

    http://www.felinecrf.org/holistic_treatments.htm


    Mogs
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  78. Sean & Rufus

    Sean & Rufus Well-Known Member

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  79. Critter Mom

    Critter Mom Well-Known Member

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    ECID! :)


    Mogs
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  80. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Oh wow. I had no idea the pepcid was bad. Glad he's off of it now. Do you know if slippery elm be use in conjuction with a probiotic?
     
  81. Critter Mom

    Critter Mom Well-Known Member

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    I would imagine so. Maybe ask the question in a new thread on the FH board?

    There is a bit of a question mark over whether SEB may reduce absorption of medications so my vet advised me to give meds and SEB at different times.


    Mogs
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  82. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014

    SEB acts as a coating on the digestive tract, which can prevent absorption of meds. When I used it I would always give it an hour after meds to allow the meds to be absorbed properly.

    ETA when I used an anti-nausea med I usually used the injectable cerenia so it did not affect the absorption of the cerenia. The bupe I also gave as an injectable, which worked well for me.
     
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  83. Critter Mom

    Critter Mom Well-Known Member

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    Word of warning: cats are notoriously good at hiding pain and discomfort. Taking time each day to observe Rufus is the best way to learn to 'hear' what his body is telling you. No-one knows him the way you do, and you are therefore in the best position to figure out Rufus's unique 'tells'.


    Mogs
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    Last edited: Feb 1, 2018
  84. Critter Mom

    Critter Mom Well-Known Member

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    Ta for this and the other info, Mary Ann. :bighug:


    Mogs
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  85. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Oh I know. Back when this started in Ausgust / September he would go downstairs and lay under the pool table. Even in the shower. He has never done those things. He doesn't even like going downstairs because of his arthritis. I know those are his "big" tells. But the lip smacking and general lethargy I wasn't and aren't sure of pain or tired or because his BG is still so high. And I've been unemployed for WAY too long and I'm with him WAY too much. He's probably hoping I get a job soon so I can stop babying him :)
     
  86. Critter Mom

    Critter Mom Well-Known Member

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    You two can never be with each other too much! :cat:


    Mogs
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  87. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Lip smacking is a sure fire sign of discomfort...whether nausea or dental issues. I spent most of the last 3 years of my Tuxie's life with him close to 24/7, which besides giving me such a close bond, also allowed me to "know" when something was off. Knowing YOUR kitty is so very important. :bighug::bighug:
     
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  88. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I do think it's a dental issue. Well, actually I think its a combo of both. His numbers need to get better for them to do xrays and cleaning though...
     
  89. Critter Mom

    Critter Mom Well-Known Member

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    Those are exactly the sort of things to look for. Also, if you notice a new behaviour be sure to note it in your journal. It might be a one-off but, if it keeps cropping up then you may be able to spot a new pattern based on your notes.

    Lethargy is the #1 symptom to watch for with pancreatitis. If you look in the FDMB FAQs at the Pancreatitis Primer it contains stats for the number of cats in a study with a given symptom and 100% of the cats in the study presented with lethargy.

    Based on my observations of Saoirse it is possible with time and sufficient observation to gauge degree of lethargy qualitatively to a certain extent.


    Mogs
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  90. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I read on here (I think) that one positive about a diabetic cat is that you will now have a much closer relationship with each other. So a small ray of sunshine in an otherwise horrible disease :)
     
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  91. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Hard to tell the lethargy from the tired. I keep saying to the vet he seems lethargic. She keeps saying, well he's a cat and he's older so the sleep a lot. But you're right, he's my kitty and I know him better then anyone. That's also hard when you know something and the vet is dismissive. It's hard because you want to respect them and they know more info then you, but at the same time I don't always agree with what their plan is.
     
  92. Critter Mom

    Critter Mom Well-Known Member

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    PS:

    Always mention the 'one-off' oddities to your vets during check-ups, especially if it's something that you truly feel 'really ain't quite right'; sometimes a small thing can be an early warning of something heading down the line so it's always wise to enquire about and research any unusual clinical sign or behaviour. Unfortunately, how effective the early alert proves to be is very much down to the experience and expertise - or lack thereof - of the vet consulted.


    Mogs
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    Last edited: Feb 1, 2018
  93. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    My guy had some serious dental issues. I had them done even though his numbers were very high and he was no where near regulated....cleaning and 4 extractions. A serious dental infection can certainly cause glucose levels to be raised up. There is no reason to forego a dental procedure because a kitty is FD. Unless the kitty has heart issues a dental can be done as long as the vet is experienced with FD kitties.


    From my experience with two FD kitties ( brother and sister) the bond is so so much stronger with an FD kittty. My Tuxie ended up being a gem for shots/testing/pilling while his sister was not as good with the routine. However with both kitties I have found that the love and trust and bond is very much stronger than with a "normal" kitty. I have loved all my kitties, but my Tuxie is/was my heart kitty. :cat:
     
  94. Critter Mom

    Critter Mom Well-Known Member

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    Very tired has a 'knackered' quality to it, but a lethargic cat tends to look poleaxed (often with signs of low mood).


    Mogs
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  95. Critter Mom

    Critter Mom Well-Known Member

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    Is, Mary Ann. And always will be ...

    :bighug::bighug::bighug::bighug::bighug::bighug:


    Mogs
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  96. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I have 2 cats, and I hate to say it Rufus is my dude. Just has always had a bond and he's so affectionate and caring.

    Regarding dental, regular vet referred me to dental specialist because they have more equipment and staff in case there are issues. Dental specialist won't do anything until fructosamine comes back "fair" or better. Both don't think he has issues at least by visually inspecting his teeth. He has lost 2 teeth in the past few months. If you watch him eat, he chews on on side, drops food, wont attempt to eat dry food for weeks, and does this weird tongue thing now. But both still don't think its a dental issue. Both think its the pancreatitus causing him pain to chew. I don't know. Its going to be spendy too. Oh and he had a grade 1 murmur, but I think it went away?
     
  97. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Unfortunately fructosamine testing is only of any use at the start of treatment. It shows an average reading of glucose readings over 2-3 weeks. Once a kitty is on insulin it does not show the ups and downs during each cycle...only the average reading. If a kitty has been very high 1/2 half the time and very low the other 1/2 the time the fructosamine may show a "good" reading, which does not reflect the day to day changes. Home testing is by far the more accurate gauge of how well the insulin and dose is working for your kitty.

    ETA Also visual inspection of teeth only goes so far. When my girlie had her dental the visual showed "maybe" a problem with 2 teeth. She ended up needing 8 teeth removed. A vet with a good dental x-ray unit is the best bet.
     
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  98. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I asked the vet tech about the fruc test and being high and low, but his came back at 480 something I think. And no BG test has ever been below 384? I think. I might give the specialist a call tomorrow and see what actual numbers she wants to see it be at. I have to wonder if his numbers arent budging because of dental issue. then again, he was on antibiotics and the numbers didn't budge, and you'd think they would if he had issues.
     
  99. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014

    Not all antibiotics are as effective with dental issues. For my two I used antirobe ((clindamycin hydrochloride) before each dental and it helped to alleviate most of the visual infections. I personally ( for my own teeth) had a few teeth 4+ months ago that were badly infected and even the clindamycin did not get rid of the active infection. Only by having the teeth actually extracted was I able to "cure" the infection. Sometimes infections are far below the gum line and extractions are needed.
     
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  100. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Well hopefully I can get him in soon. I really don't want to jeopardize his health, but were going on what 10 weeks and his number are almost a constant. He seems so much better, but no change in numbers. Maybe time to look for a different dental specialist. I did point out to the vet today that his best recorded number was the one the next morning after is covenia injection.
     
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