03/30 Willow AMPS 88/+2.5 79/+3.5 86/+4.5 83/+8 88/ PMPS 90 /+2.5 83/+4 76/+9 81- Vet Update

nslade001

nslade001

Member Since 2018
yesterday

Hi everyone, first thanks so much for all the prayers and wishes. I know I write novels, but it's also largely me keeping notes for myself :) So thanks for taking the time to read through everything.

Brief summary of yesterday: Willow *almost* earned a reduction, and really didn't want to eat; we managed to coax/feed her into eating pretty much her normal amount through the day and night though, with the help of Fortiflora. She seems to be having difficulty eating, and I see one molar with a *large* hunk of plaque/tartar on it, who knows what else is going on in there. Last night her PMPS BG never really rose, even when we held off an hour, so I decreased that insulin shot by 50% because I wasn't comfortable with a full (dose and her appetite being so iffy (didn't skip it because she was definitely hungry, and ate her pmps meal well prior to shot). Oh! Also gave 75cc SQ fluids in the evening because we're not adding as much water to food, and urine output is down.

This morning her bg was still low for her (it never really rose much after +9pm, which is really odd for her). So we decided to treat her yesterday as a earned reduction and reduced her dose to 0.75 U. Her appetite today is a bit better, only needs coaxing/feeding with the last bits of food. She is still quiet and uncomfortable (teeth? constipation?)

We do have a vet appointment for this afternoon, and I'm probably going to book dentistry for Monday if I can. If that doesn't solve whatever is going on with her outside of FD, I don't know what else to do.

Dentistry question: Fasting Protocol for FD patients? Also, I assume skip shot in am (Willow's bg has dropped at the vet before). Advice?

Wishing you and your kitties a great day of safe surfing :)

Thanks again, I so appreciate all you do. With love, Nikki

AMPS 4.9 (88)
0.75 U Lantus
+2.5 4.4 (79)
+3.5 4.8 (86)
+4.5 4.6 (83)
+8 4.9 (88)
PMPS 5.0 (90)
+2.5 4.6 (83)
+4 4.2 (76)
+9 4.5 (81)
 
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Ti-Mousse had dental (6 extractions) 10 days ago. Normally no insulin and no food since midnight and first appointment in the morning. For Ti-Mousse, I gave half dose insulin and vet said light breakfast as he was scheduled at 2h30 in the afternoon only! I would have had to wait a few weeks to get a first appointment, so I went with the afternoon and it went perfect! Even if my vet is used to treating diabetes using Lantus instead of Caninsulin, I was a bit concerned about her instructions with food... and Wendy told me that there are new Fasting Protocols now for FD! Good luck with Willow :bighug:
 
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Vet update: Still don't know what's going on. Gums look fine re no inflammation/swelling, she's sort of reluctant to put Willow under anaesthetic for dentistry if it doesn't look like she needs to. Willow's abdomen seems tender to the touch, so she thinks it's likely something pancreatic causing her to be off her food (although we emphasized she seems to be having trouble eating/chewing). Sent home with Ondansetron, Famotidine and transdermal codeine (since I don't want to give the bupe because of constipation, or knock her out so she's too sleepy to eat with the gaba). I just got enough to do till Monday, and can call for refills if they seem to be helping her. I have a pharmacy at home. It seems like we're just randomly throwing meds at her, but she needs *something* because she's obviously not right. Gave her ondansetron to start, will give codeine and famotidine around suppertime. Ugh. My poor girl :( She did great, though.
 
Did your vet happen to do any blood work? There is a way to test for pancreatitis. The test is called a Snap fPLI (this is like a pregnant test -- it's one in office and you get a +or - reading) or a Spec fPLI in which case the blood is sent out to IDEXX labs for the test to be run and you get a value.

Here's Marje's Primer on Pancreatitis.

Ummmm..... I'm not sure why you want to give codeine. It's also an opiate and has a very similar side effect profile to buprenorphine, including constipation.
 
Here's a thought. You think he is having trouble eating, yet teeth appear to be fine. What about something under the gum line, like bad root or tooth that might be cracked under the gum that can't be seen just by looking?
 
Sienne and Gabby (GA) said:
Did your vet happen to do any blood work? There is a way to test for pancreatitis. The test is called a Snap fPLI (this is like a pregnant test -- it's one in office and you get a +or - reading) or a Spec fPLI in which case the blood is sent out to IDEXX labs for the test to be run and you get a value.

Here's Marje's Primer on Pancreatitis.

Ummmm..... I'm not sure why you want to give codeine. It's also an opiate and has a very similar side effect profile to buprenorphine, including constipation.
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No, she never mentioned bloodwork; Willow's most recent was Mar 12 and is on the SS labs, but we didn't do any specific for pancreatits.
Re the codeine, she said it's the least constipating of the opiates, so shouldn't cause any issues. And I thought I read somewhere that transdermal were less constipating than oral/injected? Sigh. Not true?
I'm really not sure if it's pancreatic, she just doesn't seem *that bad* to me; I honestly was thinking teeth. Thanks for the link, apparently I have to re read it.
 
Olive & Paula said:
Here's a thought. You think he is having trouble eating, yet teeth appear to be fine. What about something under the gum line, like bad root or tooth that might be cracked under the gum that can't be seen just by looking?
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Yes, that's what I thought, and I even got her to recheck her teeth. She really seemed insistent that she felt it was "because her pancreas doesn't work properly" or might be "slightly inflamed" that she's inappetent. So I just asked for 3 days of meds to carry through till Monday, and said if things didn't improve by then we'd have to reconsider.

I did give willow an injection of ondansetron when we returned, then we napped and just now fed her....she *horked* her meal all in big gulps, no hesitation, and quickly till it was gone. And never hid after eating. So now I'm second guessing myself.

*Maybe* I'll just leave it at the ondansetron injections for now, so I'll know *what* is working, unless she starts looking uncomfortable in any way/hiding/picking at food/etc etc any other of her myriad of issues. Right now she's up on our bed, grooming.
 
nslade001 said:
*Maybe* I'll just leave it at the ondansetron injections for now, so I'll know *what* is working, unless she starts looking uncomfortable in any way/hiding/picking at food/etc etc any other of her myriad of issues. Right now she's up on our bed, grooming.
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Worth a try. Have you tried Cerenia? The shot is 24 hours AND it has anti-inflamitory properties also which can help some kitties with pancreatitis. Just a thought. Some kitties do better on Ondan, some on Cerenia and some need both.

Definitely sounds like she is feeling better which is all that counts :):bighug:

Re: dental.. maybe see if you can get to a dental specialist and just start with xrays). Most Blue Pearl hospitals will have one (dental specialists) and they are better equipped to deal with a kitty thst has multiple issues. They may be a bit more expensive but you slso get more specialized care including anesthesiologist (if necessary). I never felt like they were overly priced anytime I took Gizmo to the IM (and I never regretted it).
 
A dental specialist is a good idea for older kitties with issues. They will often have an anesthesia specialist available and do extra monitoring and are used to handling multiple conditions. As it was, I still think he learned from Neko. :p Neko’s dental vet said she could eat until 6AM the morning of, but only 1/3 of brekkie for a noon time operation.

Sending healing vines for your girl, glad she ate.
 
Sounds like The ondansetron helped? Max became inappetent every time he had pancreatitis and rarely vomited. Ondansetron always worked.
 
LizzieInTexas said:
Worth a try. Have you tried Cerenia? The shot is 24 hours AND it has anti-inflamitory properties also which can help some kitties with pancreatitis. Just a thought. Some kitties do better on Ondan, some on Cerenia and some need both.

Definitely sounds like she is feeling better which is all that counts :):bighug:

Re: dental.. maybe see if you can get to a dental specialist and just start with xrays). Most Blue Pearl hospitals will have one (dental specialists) and they are better equipped to deal with a kitty thst has multiple issues. They may be a bit more expensive but you slso get more specialized care including anesthesiologist (if necessary). I never felt like they were overly priced anytime I took Gizmo to the IM (and I never regretted it).
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Hi, the cerenia is what I originally used with her in a flareup in November, started with injections and moved to the tablets. I still have some tablets left, so my plan was to see if I could get her eating well with the injectable ondansetron, then pill in meatballs the cerenia :) to see how the two work together with her. Plan to start that tonight.
I'd like to see a dental specialist, but there are none nearby that I know of; maybe in future. I know I'll have to look at dentistry if she doesn't improve treating this as a pancreatic flare.
We don't have the options you do with vets lol. And Willow doesn't have her rabies vacc, or I'd consider crossing the bridge to ogdensburg ny (which apparently many people around here do).
 
tiffmaxee said:
Sounds like The ondansetron helped? Max became inappetent every time he had pancreatitis and rarely vomited. Ondansetron always worked.
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It seems so...she ate her +6 meal like a piglet, her +9 meal very well, and her PMPS meal very well! Slipped 6mg cerenia into her PMPS meal as well. Seems fine pain-wise, at first sign we'll try the transdermal codeine. Sleeping now :) With love, Nikki
 
Krystina & Nelli said:
Nikki, you might want to read what the American Veterinary Dental College, AVDC reports on anesthesia and dental.

*If Nelli ever has any dental work, including simply an exam and cleaning... :bighug:
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Oh wow, sorry I wasn't clear! There's to be dentistry at all right now! I meant she's simply reluctant to put Willow under anaesthetic at all :) due to her age and crf. She never suggested (and I wouldn't agree to!) dentistry without anaesthesia:) With love, nikki
 
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