7/20 Lucy PMPS=241;+2=281 // Back from Vet

Discussion in 'Lantus / Levemir / Biosimilars' started by mariko, Jul 20, 2014.

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  1. mariko

    mariko Well-Known Member

    Joined:
    Jul 10, 2011
    Good morning,

    Yesterday's condo

    Yesterday
    AMPS=149 (0.5u); +2=223; +5=250; +9=301
    PMPS=286 (0.5u); +2=256; +4=182; +7=189

    Today
    AMPS=270 (0.5u); +3=252; +6.5=200
    PMPS=241 (0.5u); +2=281

    After yesterday morning's diarrhea, she didn't have a diarrhea until around 3am this morning.
    That's almost over 20 hours of no diarrhea.
    But then she had another one this morning.
    So I'm not really sure if her poo situation is improving or not.

    She ate a little more than half of her breakfast portion this morning.
    The only thing she eats now is the First Mate wet.
    She mostly eats Salmon, but occasionally accepts Turkey or Chicken.
    It's not ideal to be feeding Salmon all the time, but it's better than not eating at all.
    As long as I offer the right thing at the right moment, she eats by finger-feeding.
    I am thankful that I haven't had to try syringe-feeding again because it didn't go well the first time.

    Both Lucy and I are stressed about all the pilling and bum cleaning, but at the same time we are getting better at it.
    At least I am.
    Since I can't wrap her meds with food she likes for her to eat it willingly right now like I used to, my current pilling method is the old fashioned way - pry open her mouth, toss the pill in and syringe some water.
    I have been wrapping all the meds in a small amount of pill pocket, and it's working much better than just pilling capsules one by one.
    This way I can combine all the meds in one ball, and it prevents capsules sticking to the inside of her mouth.

    I have a vet appointment for a bloodwork this morning.
    I'll leave in an hour or so.
    I made this appointment when she first got sick 3 weeks ago per vet's instruction.
    At that time we didn't expect her to stay sick this long.
    I gave her Cerenia and Bupe this morning, and hopefully she won't get car sick.
    I will ask the vet what else we can try about the diarrhea.
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    Re: 7/20 AMPS=270 // Vet for B/W

    Sending good vetty vines for Lucy. I hope the b/w will tell you what is going on. Have you tried using unscented baby wipes to clean her bum?
     
  3. mariko

    mariko Well-Known Member

    Joined:
    Jul 10, 2011
    Re: 7/20 AMPS=270 // Vet for B/W

    Thank you, Carla.
    I have pet wipes, but her bum usually gets really dirty that wiping wouldn't be enough.
    Usually right after she poops her runny poo, she sits on it firmly and sometimes even rubs her bum in it a little.
    I think her poo is so runny now that she doesn't feeling it moving, so she probably thinks it's hanging from her butt or something.
    I don't know why she does it, but this behavior only started when her poo got so runny.
     
  4. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

    Joined:
    Feb 14, 2011
    Re: 7/20 AMPS=270 // Vet for B/W

    Sending tons of good vetty, BW, appy, solid poo, and feel better vines to sweet Lucy....
     
  5. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Re: 7/20 AMPS=270 // Vet for B/W

    I'm sending good vet visit vines, better appetite vines, and solid poo vines to top it off.
    I hope her blood work is better, too.
     
  6. Anne & Zener GA

    Anne & Zener GA Well-Known Member

    Joined:
    May 26, 2011
    Re: 7/20 AMPS=270;+3=252 // Back from Vet

    Many vines for Lucy, of all kinds. Hugs to you, Mariko.
    Liz
     
  7. mariko

    mariko Well-Known Member

    Joined:
    Jul 10, 2011
    Re: 7/20 AMPS=270;+3=252 // Back from Vet

    We are back.
    Where do I begin.

    ** I'll try to write the things the way I understood it the best I can, but some of the technical things might not be exactly what the vet said. **

    During the physical exam, the vet felt her abdomen was "fluidy".
    And Lucy has gained weight even though she hasn't been eating enough, which made her think more that she's got fluids accumulation.
    So we took an x-ray to confirm.
    An x-ray doesn't actually "show" fluids, but things that should show such as intestines looked sort of blurry, and the vet explained this happens when there are fluids.
    So all these things combined, she thinks Lucy's got fluids in her abdomen.
    The vet said this could mean 2 things.
    One, she's not absorbing protein, and fluids are leaking from her blood vessels and accumulating in her abdomen.
    Two, there is a mass somewhere and blocking the fluids from going back to the heart.
    The blood result will tell us which, because if it's one, her protein value will be significantly low.
    If her protein value is not low enough to cause fluids leakage, we will start looking for the mass.
    The vet doesn't think that sub-q fluids are an issue because her chest looks fine.
    I've been giving her fluids on days she had diarrhea, which is every day.
    But I think I'm going back to an every-other-day schedule just to be safe.

    For her continuing diarrhea and poor appetite, the vet wants to do an ultrasounds.
    She wants to see if her IBD has likely turned into lymphoma.
    She said between severe IBD and lymphoma, there is no clear line and it's a slippery slope.
    Even an ultrasounds cannot definitely confirm, but she said it's the best tool available that is not invasive, unless we want to cut her open, which I don't.
    She also said it'll be a little more difficult to tell in Lucy's case because she's been on steroids for a long time, which would somewhat mask the symptoms of lymphoma.
    But the vet said that if lymphoma, her lymph nodes' shape would look different, sort of swollen, which is not seen in case of IBD.
    The next scheduled ultrasounds day at the vet is August 1st, but the vet wants to do it sooner.
    So she is checking with the ultrasounds vet if there is a day she could come in to do an ultrasounds for Lucy.
    If this u/s vet is not available sooner, the vet is sending us to a specialist to do it there.

    We discussed about the treatment option too.
    Normally the best option would be Leukeran, but knowing how she reacted to it, the vet wants to try increasing the prednisolone dose significantly.
    I asked what she thought about trying Leukeran one more time with pulse dosing, and she said the side effect of Leukeran is dose related, so with a bigger one-time dose of pulse dosing, even spread far apart, the vet thinks it would make her sicker, considering how sick she felt after just one pill.
    She said if Lucy was hers, she wouldn't consider it, and I also don't want to go through that again.
    We also discussed about combining prednisolone and budesonide not because I think budesonide won't affect her BG, but just because it's something different.
    The vet said we could try that if we run low on options, but budesonide is weaker, so she didn't think that's would be the best option at the moment.
    She said the most concern about increasing the steroids significantly is her diabetes, but we can also increase the insulin.
    I said I'm OK with that, but I was worried about adrenal grands suppression.
    Then the vet said she's not really concerned about that because it seldom occurs in cats, and explained to me that adrenal grands goes into sort of "rest" mode with steroids, but do not completely lose the function.
    As long as we don't stop steroids cold turkey, her adrenal glands should be OK.
    Besides, I don't really expect to be able to reduce pred dose again once we go up, so the vet is probably right about not worrying about it.

    Whatever we decides to do, the vet wants to wait for the b/w results and get the ultrasounds done first.
    And after we know more about what we are dealing with, she wants to decide the best course of treatment.
    In the meantime, she wants me to continue the meds I'm currently giving her.

    I am just glad that the vet is trying to make her better, and there is something to try.
    I was so afraid to hear there was nothing that can be done.
     
  8. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Re: 7/20 AMPS=270;+3=252 // Back from Vet

    Sorry to hear Lucy's still not feeling well, but I'm glad the vet has some ideas of things to try

    It's great that he doesn't just want to throw meds at her but wants to get some more tests done first to make sure you have the best chance possible to help her.

    Sending lots of healing, appy and good poo vines your way, and will pray they can get her in quickly for the ultrasound so you can have some clearer answers to what's going on

    (((Hugs for you)))
     
  9. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Re: 7/20 AMPS=270;+3=252 // Back from Vet

    {{{Mariko}}}

    I'm sorry Lucy is still having these problems. It really sounds like you have a wonderful, thorough, sensible vet, and that is good for Lucy and for you!

    Sending lots of good bw vines, good appy vines, good poo vines, and lot of hugs for you! :YMHUG: :YMHUG: :YMHUG:
     
  10. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    Re: 7/20 AMPS=270;+3=252 // Back from Vet

    I hope the test results give you some clear answers. I'm glad the vet is willing to try different things to help Lucy and that you still have options. I hope Lucy is feeling better this evening. :YMHUG: :YMHUG:
     
  11. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Re: 7/20 Lucy AMPS=270;+3=252 // Back from Vet

    Vines for us both and our cats. I am keeping Lucy in my prayers every day.
     
  12. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    Re: 7/20 Lucy AMPS=270;+3=252 // Back from Vet

    Mariko, I hope and pray that the vet's suggestions will help Lucy to feel better and that the test results will be encouraging. Lots of vines on the way to Lucy tonight.

    :YMHUG: :YMHUG: :YMHUG:

    Ella & Rusty
     
  13. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Re: 7/20 Lucy AMPS=270;+3=252 // Back from Vet

    I'm so glad that you have a good caring vet. I'm sending more prayers and vines.
     
  14. Tina & Rocky

    Tina & Rocky Well-Known Member

    Joined:
    Dec 19, 2013
    Re: 7/20 Lucy AMPS=270;+3=252 // Back from Vet

    It sounds like your vet has a plan of action, which is great. All the vet needs to do now is decide what is ailing Lucy, and then you can begin treating. Hope she's feeling better soon.
     
  15. Tiger(GA) and Ruth

    Tiger(GA) and Ruth Well-Known Member

    Joined:
    Apr 15, 2014
    Re: 7/20 Lucy AMPS=270;+3=252 // Back from Vet

    Mariko, I am continuing to send healing, appetite and prayer vines for you and Lucy, so glad to hear you have a good vet with some options for you and Lucy; hope the BW comes back with good results. :YMHUG:
     
  16. mariko

    mariko Well-Known Member

    Joined:
    Jul 10, 2011
    Thank you for all your vines.

    Lucy's appetite is particularly low this evening.
    She only ate about 1/4 on her dinner portion, but I still have some time before going to bed, so I'll keep trying.
    I thought about giving her Cypro, but I had already given her Bupe earlier in the evening, so decided not to.
    I think Bupe and Cypro together makes her feel too groggy even if given a few hours apart.
    I'm going to skip the next 2 doses of Bupe, and give Cypro instead sometimes around 3am or 4am, hoping she'll want to eat more in the morning.
     
  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    (((Mariko)))

    Your vet sounds in top of it. Sending many prayers that you get some good answers soon so your vet can help her feel more comfy.
     
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