2/17 Quincy AMPS 98 - vet report

Since 98 is close to blue, I decided to stick with 0.10 for this morning. Quincy did a really good job clearing out the stress from yesterday's vet visit. Seems like all has been forgiven. I hope his blood and urine work comes back normal, for many reasons of course, but in part so we can avoid going back sooner than 3 months from now. I had noticed Quincy was urinating more - not so much more often but just greater volume. I'm hoping it's because I've been mixing water into his food to make it soupy and slow him down.

So, on to the vet report. Quincy weighed in at 12.6 pounds, just 0.2 pounds less than 3 months ago. While he probably could stand to lose a pound or so, I was glad to see him hold steady since his last visit given all the vomiting and BM problems he had, esp. in Nov and Dec. My vet was very pleased with Quincy's progress on the diabetes front. When I said he was down to 0.10, he said that was next to nothing. To which I replied, maybe so, but it got him down to 36 3 hours after his evening shot on Mon night. Especially given then, my vet encouraged me to do an OTJ trial. He thinks it's ok to stop the insulin now. I don't think the OTJ trial practice of testing AM and PM for 14 days occurred to him, but when I told him, he though it was a good idea. But as I've discussed over the last couple of days, I think I'm going to do one more dose shave, to whatever's less than 0.10 ("some" insulin or just a couple drops) to see if Quincy's AMPS numbers will hit green more often before going into a bonafide OTJ trial. I asked my vet if he had other cats on lantus that had experienced remission, and he said about 20% of them do. He said no one does the home testing that I do, though. I left Quincy's BG log with him. Maybe my experience with Quincy will influence him to suggest hometesting to his other clients. I suspect a lot of them aren't willing to do it, so he just keeps their animals at a higher BG level for their safety.

We spent more time discussing Quincy's lymphoma. Given his improvement over the past month (i.e., fewer GI problems - anti-jinx!) we tentatively decided to sit tight for now and stick with MWF leukeran dosing. We talked about budenoside again, including how powerful it is, that the more inflammation there is the more likely absorption is, and the possibility that if Quincy goes on it, it might derail his potential for diabetes remission. I explained that I didn't want to push Quincy onto such a strong drug if it could do more harm than good, but was fearful to do nothing more if it was warranted. We also discussed cyclosporine as a complement to the leukeran, and I asked him about B-12 injections too. He said he usually goes with B-12 injections when there are bowel issues, but we did see some of that recently. He also mentioned that the B-12 and B-complex injections sting, which could present a problem with Quincy, who really fights with the vet staff there for blood and urine draws. I didn't think they were a daily thing, though. We decided to test his cobalamin and folate levels along with doing the regular full panel blood work. So by next week I should know if B-12 deficiency is an issue for him. They also are doing urinanalysis and a urine culture - the whole nine yards.

Hopefully Quincy will get a clean bill of health (well, at least no new issues!), and the next three months will be good for him. I know if I can get him off insulin and keep his vomiting at a minimum, they will be VERY good for me. And Quincy overall seems very happy, such a good boy.

Yesterday

 

Aw, Quincy is a little trooper. It is good to hear that his weight has stayed stable. Hope everything comes back good Laura with his blood and urine. cat_pet_icon

 

i'm skimming through very quickly, but wanted to correct this. B-complex injections sting. B-12 injections don't.

 

It sounds like Quincy had a good vet visit. Let us know what the lab results have to say.

 

This is a great Quincy report, and I'm so happy to see it. I'm sending good test result vines. BTW, Bear has resumed B12 injections weekly for his IBD, and he has no discomfort from the shot.

 

Thanks - actually now that you mention it, I think he was talking in particular about B-complex shots when he mentioned the sting, and I just assumed it applied to B-12 as well. Glad it doesn't!

 

What a positive sounding vet visit; I sure hope you get some good results back from all the tests.
I was wondering how they are able to manage Quincy when they are wrestling to take draws, do you know?

It's also great to see others are pushing their vets on the values of home testing; hopefully some other FD kitties that see your vet will benefit from your efforts to influence your vet.

here's hoping for lots of :mrgreen: for Quincy.

 

I think they use a few people to hold him down. In the past, they've occasionally given him something to sedate him a little (not to knock him out but just to mellow him out). All I know is, I've had a few different people there remark on what a bear he is, and there is a big bright orange sticker that says "WILL BITE" on the cover of his file. His resistance to the testing is the main reason why my vet thought Quincy would not be a good candidate for intravenous chemo (because the chemo and all the bloodwork it requires would really diminish his quality of life). So I'm really glad the oral chemo has worked so far! And I'm grateful this is usually only every 3 months.

 

re: budesonide

cleo is on pred for the lymphoma. budesonide targets the GI tract specifically, so we see it used more for IBD --pred seems to be the go-to steroid for the different lymphoma protocols.

my harry (civie) has been on 1ml budesonide SID for just over one year now and his latest BG test this past week yielded a 56 (so i just wanted to reassure you that budesonide doesn't seem to cause that problem with diabetes). cleo's numbers (and insulin dose) have gone much higher (to 2u lantus from 0.75u lantus) because of the 2.5mg prednisolone she gets BID.

 

Re: re: budesonide

Quincy was on prednisone for a full year when he was diagnosed with diabetes. We weaned him off the prednisone, and he's been off it completely since last June. No drugs have taken its place (yet). I know I would try budenoside first before going back on the prednisone. We did catch the lymphoma very early, though, or at least that's what we think given how aggressive we were to do a biopsy surgery after a relatively short spat of vomiting and X-ray evidence of intestinal thickening. So I am hoping maybe we beat it into remission or something close to it in that first year with the leukeran/pred combo. I don't know if leukeran alone will be enough to keep the lymphoma at bay forever, but if Quincy doesn't have clinical symptoms, or just minimal one, I want to hold off on more drugs. They all have side effects of some sort, on BGs or otherwise.

ETA: He was diagnosed with IBD at the same time as the lymphoma - the lower intestine specimen revealed IBD, while a specimen from a lymph node near the stomach and small intestine was where the lymphoma was found. Nothing was found in the small intestine specimen. The stomach specimen had helicobacter but nothing else.