2/13 Latte AMPS~394, PMPS- 169

In the spirit of the Olympics, day 1- Latte has set a world record for AMPS!
She is appears to be setting herself up in a pink surf suit in preparation for tonights competition...The great Red bounce!

pmsp~280
+1.5~320 (pred delayed 'till know, expecting a better start number)
+3.5~395
+5.5~420
amps~394

Increased to 2 units last night.

No question on ketones this morning ~ negative

yesterday
viewtopic.php?f=9&t=6043

 

Re: 2/13 Latte AMPS~394

So that's what some kitties are up to this morning!
The BG Olympics!

I hope Latte can settle a bit now that the opening ceremonies are over and it's get down to business time.

Latte, let's see an Olympic type improvement in your numbers today!

 

Re: 2/13 Latte AMPS~394

Morning!! OK we dont need this bright color this early in the am!!
Carolyn, you said you use harpoons, I have 3/4 of a box of 1/2" syringes-do you need them? Be glad to send them to you-PM me if you want them.
We would be glad to see the gold medal on Latte's SS today--Have a good Caturday!

 

Re: 2/13 Latte AMPS~394

Hey m'dear - saw your question about pain meds in your condo yesterday, and did a little digging... so here's a little food for thought ... oh, and, remember to ask if there are any drug interactions w/ all her other meds.
(been working waaay too long and gonna get some sleep now... @-)
Latte, pleeeeez soak up some more of that insulin and slide back into the blue..... pleeezzz
Is it time for "R"? Is "R" affordable? Does your vet know what "R" is and how to use it safely?
OK... some info on pain meds.... I'll catch up with you girls later....

Knowing Latte's sensitivities, I'd stay away from tramadol. If her pain is from arthritis or neuropathy, gabapentin would be an option to ask about. I don't know if would help w/ pancreatitis pain.

If in doubt, I personally would ask about using buprenorphine (Buprenex) - its considered one of the safer meds for cats, and effective for mild-moderate chronic pain, with few side effects and minimal sedation; it is used for pancreatitis pain; but I don't know how effective it is for arthritis... is Latte takiing Cosequin?
(BTW I've used bupe for all my cats over the years and never had one become inappetant)

The drops are tasteless and well tolerated by cats. According to the VASG, at the high end of dosing, a single dose can last up to 12 hrs.
http://www.vasg.org/chronic_pain_management.htm
"A ceiling effect on analgesia exists with partial agonists, making them less useful for severe pain. Buprenorphine is interesting in that increasing the dose prolongs the duration of analgesia, while the degree of pain relief remains essentially unchanged. Doses of 30 ug/kg (0.030 mg/kg) will provide ~ 8-10 hours of analgesia, and 40 ug/kg (0.040 mg/kg) may produce as much as 12 hours of pain control. The onset of action is fairly slow (~ 30 minutes when given IV, 60 minutes IM, transmucosal or transdermal)."

*Important point* Buprenex is dispensed as an oral liquid for transmucosal absorption - the drops must be placed inside the cheek pouch, NOT on the tongue. It loses its effectiveness if swallowed. This is due to the "first-pass effect" which removes from 85% - 95% of the drug when absorbed from the GI tract. In contrast, transmucosal buprenex has the same bioavailability as IM administration.
http://www.vasg.org/newer_options_for_c ... ment_2.htm

The VASG also has info on other meds; I posted a brief summary on tramadol, gabapentin, and a few others; and Dr Lisa cautions about Tramadol here:
http://www.felinediabetes.com/FDMB/view ... 647#p13647

Apparently, gabapentin and tramadol have not been studied for their adverse effects in cats, but a gabapentin study is underway at UC Davis under a 2008 Winn Foundation grant:
http://www.winnfelinehealth.org/Pages/W ... _final.pdf

Several of the CRF list members have had good results w/ gabapentin. Laura has used it for Seth (21 y/o, crf, hyperT, high BP, arthritis) for over a year. She also felt it improved his appetite.

http://groups.yahoo.com/group/feline-cr ... sage/46858 Her experience:
"Our vet has given my 21 year old Seth gabapentin (neurontin) mixed in Val syrup, and it is amazing how that works. Gabapentin is a human drug for epilepsy, that has shown remarkable success in treating neuropathic pain. It's currently being studied in the US for treatment of the pain of shingles.

Our vet compounds this for us, and it 50mg/ml gabapentin, crushed and mixed into 10cc Val syrup. The doseage is 0.2 ml by mouth, once a day. Maybe your vet will be willing to try this? It really has been wonderful for Seth - he even ventures upstairs from time to time. Hasn't done that in over a year, until lately.

Seth was diagnosed with CRF 2 years ago, and also has high blood pressure, hyperthyroidism and arthritis. He's doing great on the gabapentin, with no side effects or interactions with his other meds."

Nancy on the CRF list posted some notes on pain meds from a lecture at the Penn Vet Confc last March; here's a few excerpts for quick refc - questions to check out w/ vet:
http://pets.groups.yahoo.com/group/feli ... sage/39271
http://pets.groups.yahoo.com/group/feli ... sage/39278

GABAPENTIN: 5-10mg/kgq12h. Anticonvulsant; Neuropathic pain analgesic. May be useful in dogs and cats as adjunctive therapy for refractory or complex partial seizures or the treatment of pain. "Appears to be efffective in chronic pain in cats where an increase in sensitivity has occurred (allodynia), or where the pain appears to be excessive in comparison to the lesion present (hyperalgesia)." Caution in patients with diminished renal function (consider reducing dosage). Sedation and weight gain most likely side effects. Signs to monitor your cat for include ataxia, lethargy, bradycardia, depression and dilated pupils; In dogs, don't use with xylitol (causes rise of insulin and hypoglycemia as a result); has a short half life & fast clearance, so pills given 3x/day. Decrease dose slowly to avoid rebound pain; don't stop cold turkey.

(My vet has recommended gabapentin for my cats (arthritis)... I would be less inclined to try Tramadol...)

TRAMADOL: 1-2mg/kg once to twice daily; Has not been evaluated for toxicity in cats and not used extensively; Neurological side effects more readily seen in the cat compared to the dog, dosing should be started at the low end. Metabolism is slow in the cat; may see "Opioid" like side effects." May be useful in conjuction w/ NSAIDS. Can be partially reversed by naloxone. Very limited information is available on adverse effects in cats. Cautions for animals subject to seizures or drugs that lower the seizure threshold (phenothiazine, like acepromazine); cautions in geriatric, debilitated patients, cats w/ impaired renal or hepatic function. Dysphoria, mydriasis have been noted. Potential for CNS (central nervous system) effects--sedation, agitation (paradoxical) anxiety, tremor, dizziness or GI upset (anorexia, vomiting, constipation, diarrhea). Overdose "opioid effects" produce respiratory depression, lethargy, coma, seizure, cardiac arrest, death.

BUPRENORPHINE: 0.02mg/kgsublingual -under tongue-q8h. "Feedback from owners indicates that after 2-3 days at this dose, anorexia develops. Smaller doses may be more appropriate for "long term" administration especially in combination with other drugs." Opiate partial agonist . Good analgesic for mild to moderate pain in small animals. May cause respiratory depression, decrease in blood pressure and cardiac rate. Can be reversed with naloxone. Check drug interactions. (I used in several of my cats, but not for any length of time.)
###


Carolyn, I hope her numbers come down this weekend... really glad there's no ketones lurking...
Big hugs -
Deb, angel Evie, and the boys

 

Re: 2/13 Latte AMPS~394

Uh...what Deb said .... :lol:

She took the words right out of my mouth!!! :lol:

 

Re: 2/13 Latte AMPS~394

Seriously though, I was going to stop by and give you your link from yesterday's condo:
viewtopic.php?f=9&t=6043

I feel like a silly little court jester now....wow Deb...that was amazing...
And all I have to say is good morning and I hope you are doing ok. Shadow sends another kiss to Latte today...hmmmm....what exactly went on at that party the other night...he is acting all dreamy and weird....and it isn't even Spring!
I don't know nuttin about nuttin but I am sending hugs to you...(I think I will print up that post from Deb...wow) that was awesome!!

hope you have a good day today...((Carolyn and Latte))

 

Re: 2/13 Latte AMPS~394

Oh no, Latte! The Olympics is for the pros! Get back on the beginner's slope for a nice gentle ride down!!!

Hope the dosecrease works it's magic for you (((Carolyn))). And that Deb's incredible research brings you some answers.
Great job Deb!

Vines to you & Latte! :YMHUG:

 

Re: 2/13 Latte AMPS~394

Valentine's Day New Moon Party tomorrow night...spread the word!! Shadow needs an excuse to see Latte again...and Raja wants to hang out by Logan's side again too....winter blues must be chased away with another party!! Everykitty get on the phone and spread the word... :mrgreen:

 

Re: 2/13 Latte AMPS~394

Stu is up for a Valentines's Day party. He suggests that Latte try for a medal on the flats rather than on the mountain: perhaps ice skating or curling. Come down soon, Latte!

Ella & Stu

 

Re: 2/13 Latte AMPS~394, +2.25-306

Hello Pat-
Thank you for reminding me of yesterdays condo. I originally posted from my phone this morning and cant put in links! Meant to come back and do it.

Latte is TOTALLY up for a valentines day party. By tomorrow, she will be in the spirit- sportin' her fancy red outfit! Pink pre-party today, red/black tie dinner this evening, and a red heart day tomorrow! ;-) As long as she has her beloved Shadow next to her, she will be okay! :YMHUG:

She is so excited to see all of her old and new friends from earlier this week!
Thanks for hosting Pat!!!

 

Re: 2/13 Latte AMPS~394, +2.25-306

Sorry, Latte's AMPS may not put her in gold medal contention. I've seen higher numbers!! (And I don't want to see Latte gearing up for competition.)

A few thoughts on Deb's post. Arthritis is an inflammatory condition vs. neuropathic. I honestly don't know if approaches to managing either form of pain are equally effective for both conditions. It would probably be worth discussing with one of your vets or someone at the veterinary pharmacy at the U of MN whether bupe or gabapentin would be effective for arthritis. I've used bupe on several occasions with Gabby (post-dental and after an abdominal surgery) and with one of my civvies both in the oral and injectable form. It's worked great but it's use was for an entirely different purpose.

 

Re: 2/13 Latte AMPS~394, +2.25-306

Hi Carolyn. Just wanted to stop by and tell you that I loved the video you put together of Latte. You two are such fighters!

Also, I'm sorry I haven't said anything before, but it's been a rough couple of months for me. Anyway, you offered quite a while ago to send me some phos binders and I just want to let you know that I really appreciated your offer and the info you provided. My nice vetty bean gave me a cup of binders and I've purchased a bag now, so I think we have all of our "equipment".

 

Re: 2/13 Latte AMPS~394, +2.25-306

I was reading your post on Health about pain medications. I just wanted to mention that Bear tolerated Bupe well, but that on the recommended dose for his weight, he slept for 12 hours. he didn't get up to eat or use the litter box. I give him a half dose or less now, and he is much less sedated. If you do decide to try Bupe, I would start with a very low dose and work up.

 

Re: 2/13 Latte AMPS~394, PMPS-169

I would like to thank those of you who tolerated my negative nancy and super sarcastic tone this morning. I was secretly workin' Mr. Murphy's Law. Of course I could not even let my dearest LL'ers know this or it would not have worked. ;-)

Run down:
amps-394
+2- 306
+4-238
+6-198
+7-185
+10.5-167
pmps-169

Of course we are in for a massive bounce at any moment. Probably meet up with Mr. Pred in an hour or two. :YMSIGH:

She is fine. Pretty much been sleeping since +6. Got up for a few minutes when I came home after running errands. Had a nice poop, and back to her throne. Does not look like she is planning on going anywhere soon.

 

+1-176
+3-181

I wonder how long I should be holding my breath over here.

On the downside she is not eating well. 9/10 times she does not eat more than a few spoons of baby food after shot until around +4 or later. But she didnt really want the baby food tonight. Nor did she eat anything after bfast this a.m. she did show a little interest in some fancy feast after her +3 test and took a few licks. She is laying in a pile of catnip right now. Will try more food again soon.

 

WoW! What a marked improvement in PMPS! Go Latte! Brought a deep sigh of relief and a big smile! :mrgreen:

Even if she bounces from here, that's a step in the right direction. Hopefully her liver will remember quickly what those lovely shades of blue and green look like and that it really was happy there once upon a time! Blue is your friend....blue is your friend.... ;-)

Hope the bounce isn't as bad as you expect, and that you 2 have a lovely evening.

 

Remember too, she's been surfing high for a long time now. It's been awhile since she's seen these numbers and the drop isn't as familiar a feeling right now.

And maybe not having a huge hunger, and not only wanting the kibble will let her surf a bit longer and keep these numbers lower than you expect from an impending bounce. But not a good feeling if she's acting 'off' and not just 'content' with food intake... :-Q

Sending settled tummy and feeling good vibes....that would perk her appy a bit.

 

Thanks, Sienne! You explained it waaay better than I did, in my rambling post yesterday morning! :smile: It really is difficult because, as you said, these pain meds are only effective for certain types of pain. The VASG site provides a very technical overview of the physiology of pain and how the various classes of drugs work on the different kinds of pain (eg., inflammatory vs. neuropathic) ...which I understand while reading it and immediately forget once I stop reading it!

Gabapentin (Neurontin) has been found to be effective and is used for chronic neuropathic pain, pain associated with malignancy, as well as arthritis pain in cats. But I couldn't find any reference to whether it would be effective for pain associated with pancreatitis... it may not be. It is partially metabolized by the liver and excreted by the kidneys, so reduced dose recommended for renal and hepatic patients; oral antacids may decrease the bioavailability of gabapentin, so should be given at least two hours apart.
http://www.wedgewoodpetrx.com/learning- ... y-use.html
http://www.veterinarypartner.com/Conten ... C=0&A=2764

Carolyn - Evidently, when used in combination w/ hydrocodone or morphine, it increases the effectiveness of gabapentin. Its a long shot, but you could ask the vet or pharmacist if combining gabapentin with a different opiate (ie., Buprenex) might have a similar effect. If so, you could try using the bupe to reduce the gaba dose, and reduce the risk to Latte's kidneys. Would want go over her entire list of meds for any possible interactions.

OTOH, bupe is used for chronic pancreatitis-related pain (among others), but I couldn't find any reference to whether it would be effective for arthritis pain. I am not certain, but I think I remember reading somewhere that it may be used for neuropathic pain. Didn't want to mention it since I don't have a citation for it. :smile: Bupe is relatively safe, but the trade-off in using opiates long term is tolerance; this can be partly mitigated by rotating related meds and using adjuncts, eg, cosequin for arthritis.

The VeterinaryPartner site has a good, brief description of how buprenorphine and other opiates work on the mu, kappa, delta and sigma brain receptors (sounds like Greek row in a frat/sorority neighborhood!): :?
http://www.veterinarypartner.com/Conten ... ourceID=52

Top 10 potential drug interactions:
http://www.vin.com/proceedings/Proceedi ... &O=Generic

Adverse effects on the kidneys and liver are related to how these drugs are metabolized in these organs. Here's a brief explanation of drug clearance:
http://www.merckvetmanual.com/mvm/index ... 190110.htm

An updated, more comprehensive (and understandable!) compendium on pain management was published in 2007. The AAHA/AAFP Pain Management Guidelines is a great reference:
PDF (14 pp):
http://www.catvets.com/uploads/PDF/Pain ... _FINAL.pdf
website:
http://www.catvets.com/professionals/gu ... ns/?Id=174

For quick reference - index to pain meds for cats:
http://www.veterinarypartner.com/Conten ... &C=299&S=2

Although, I was *very* disappointed in their reference page for Tramadol:
http://www.veterinarypartner.com/Conten ... C=0&A=1815
It sounds like a sales pitch for Tramadol. (other than the cautions for liver and kidneys - Tramadol is removed from the body by the liver (70%) as well as via kidney excretion (30%))

Deb, angel Evie, and the boys

 

ohhhh gosh we don't want Latte to get jealous!!! we saved some of the silliest mice just for our favorite girl!!
hugs and kisses :lol:
Hans and Sonny