Pig 8/31 amps +8 189; +9 163

Discussion in 'Lantus / Levemir / Biosimilars' started by LuvinThisPig, Aug 31, 2018.

  1. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Yesterday's

    Today was interesting. We went to a new vet, a feline specialist out of Tulsa. I am very impressed with her. She advocated many things that are pretty forward and was incredibly knowledgeable about many of Pig's issues. Her labs are a bit pricey, but her in house procedures were under priced. All in all a very good experience.

    First, we are still awaiting the results of his geriatric panel (CHEM CBC T-4). I had wanted to run the ADH and ACTH values but we could not find a lab that ran the ADH testing and she would have had to have a special kit to run the ACTH. So, we will need to go back sometime in the near future to run these labs, especially if the water intake continues to be excessive as a lack of ADH causes what is known as diabetes insipidus (@Bronx's dad). ADH is the antidiuretic hormone and controls water regulation in the body (at least that is how I understand it). Meaning, if ADH is off then kitty presents with the polydipsia and polyuria even without a lack of insulin. (@manxcat419 am I correct here?)

    However, at this point we are looking at really good results. His abdominal ultrasound showed a healthy and normal sized liver, no inflammation (which is improvement from WSU because their reports showed a slightly inflamed liver...???). Perfectly normal kidneys (no inflammation meaning that his urine theoretically should have stopped backing up into his system). A bit of thickening in the small intestine, which we already knew from WSU and it is mild at best. I am a bit concerned because the spot in his bladder that was supposed to be a blood clot from a cystocentesis stick is still there. If it is, indeed, a blood clot it should have dissolved by now. Its been 4 months. So, that will need monitoring for sure to check for growth. (@LizzieInTexas) We will also be monitoring the slight thickening as well.

    Next, his echo... well there is not much to report there except he had a perfectly normal and incredibly healthy heart! Yay! No muscular thickening or signs of HCM or anything. We are very blessed here.

    We did run another urine sediment sample as well to make sure there is not current infection.

    But, pending chem panel results, its looking like I just spent $700 to learn what @Wendy&Neko has been saying to me all along... That the glucose inconsistencies are simply dose related. As in, we need to dial in on a good dose. Yet, I NEEDED to do this to eliminate all other possible causes. At least this way I KNOW exactly what we are dealing with.

    Not to mention, I as well as this new vet, are very suspicious that a lot is also stress induced by the Ace. It makes him wonky sometimes. So, pending chem panel results, we will be seriously reevaluating meds.

    But, for now, we breath a sigh of relief.
     
  2. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Oh...

    @Wendy&Neko my whole work schedule is flipping for about 2 weeks until I complete onboarding and training with my new company. I am going to start pushing his shot times back (an hour later each shot) until we reach 4:00. This will not make him drop low since I am pushing it out. What I am most concerned about is switching it back once I move to my normal shift. I will need to make the change fast. Like, over the weekend. How should I do that? Just simply skip a dose or move by an hour each shot? That is pushing it pretty hard.... But, I trust your dosing judgement kitty wizard! :p
     
  3. Carol in Chicago

    Carol in Chicago Member

    Joined:
    Apr 5, 2017
    Great report - tons of good information and follow-up from prior tests / data. OMG. I have spent $700 and all I got was poop!

    So glad you are impressed with the new vet. I'm sure she was impressed with you also. :)

    I hope the labs come back good. Hope you don't have to wait too long with the Holiday.
     
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  4. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    I had to chuckle with this one... The last round was almost that on poo issues, yet with constipation it can add up quickly! Extraction is expensive!

    I think it takes a special breed of people to spend $700 on poop! :p. But, I find those are the best kinds of people!
     
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    About to go offline for a week on holiday.

    First, having a baseline echo is a good thing, well worth it.

    As for moving shot times, how many hours do you need to move it over how many days? Others can answer this if I am not around.
     
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  6. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    Interesting. Very interesting. Gizmo has blood in his urine again so I don't know what is going on with it. I have not done another u/s (yet?). Everything I have read leads back to cancer, however, bladder cancer in cats is "very rare" and "aggressive" - I do NOT think that is what we (both of us) are dealing with. It has been 4 months for us now too. Prognosis for bladder cancer is quick degeneration and life span of ~6 months. For the most part I just forget about it. Nothing to be done and why worry.

    Was it the same size? I would love to be able to get both (Gizmo & Pig) u/s images to a specialist and have them compare them. I suspect it is from the cystocentesis. I also suspect that we would never get the vet's to admit this because it would mean they were liable.

    Here is a very interesting write up on urinalysis interpretation I found..

    https://www.purinaproplanvets.com/media/1315/pur-urinalysis-clinical-handbook.pdf
     
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  7. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    adding... I will be curious to see what his CBC shows and if there are any indications of anemia.
     
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  8. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Poor Pig. I won't tell him that you are calling geriatric!:eek:

    Overall, sounds like a positive report, and your new vet sounds very up-to-date. Leo has thickened intestine walls too, mostly we assume from the Acro.

    Congrats on the new job! That is great! Sympathy for the 4am thing though. Aren't people sleeping then?

    Have fun on your holiday Wendy - I hope somewhere tropical.
     
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  9. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    I entirely concur. I do wonder, as I had someone else mention it to me, if perhaps it could be something along the lines of a keloid scar...? I have never nor could I find any research that could definitively place a keloid inside the body, but that does not mean that it cannot happen. Just consider, if someone were to stick in the same place more than once or if even an old stick was not quite healed and there was a new stick in the same place. It makes sense that scar tissue could build up over time and on top of older scar tissue, especially if the bladder walls were a bit stretched or distended.

    I don't think bladder cancer, either. Pig's showed no calcification at all. So... what is the thing? I think you are right about getting those US images to a specialist. I will look into this. I am planning to repeat the U/S in a few months to see if it is growing or if his intestinal walls are thickening further. The new vet made sure to get a close, accurate measurement on the thing.

    I am in the process of reading over this article you sent. I don't see how someone can say that it CAN'T be related to a cysto stick. The needle is decent sized.

    I will certainly post the results when we get them. Also, this is a good way to see if those GLMs are adding phos into the diet.
     
  10. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Haha! The geriatric panel because it is more comprehensive... There isn't anything geriatric about this cat. Trust me, his punching bag buddy Tail can tell you that! :p
    I hear a lot of people reporting this with Acro along with kidney and heart issues. Its just a guess, I suppose, how that rampant GH will affect the body. ECID
    Thanks! Yikes on 4:00 am also... Ugh. I will have to be out of bed by 2:00am. Either way, its a great opportunity and after training I will go back to a normal shift.
     
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  11. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Well that is good to hear you will only be on this really early 4am shift start for only a shot period. Sometimes, I'm awake until 2am! And sometimes I have seen you post at 1:30am too. A big change for you. A good one.
     
  12. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Yes, that is correct. The diagnosis in that case, if uncomplicated, would be diabetes insipidus. However, with Pig, it's clearly tied to his other issues so if that is part of the problem, it may well be that it needs to be included in another diagnosis as the primary underlying cause.
     
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  13. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    Ditto. I will probably do a repeat u/s around end of November. If you make any headway on someone willing to look at both let me know and I will see what I can do to get a copy of Gizmo's u/s or, at the least, a snap of the bladder spot from the u/s.
     
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