9/26 Jack amps 474 +4 394 +9 114

Last Condo

Jack is plunking along. Even with the extra food (almost a full big can a day) he is just maintaining his weight. I have a vet visit scheduled later today... Jack is fasting until then and I fear for my toes until his visit

Unfortunately, the vet is not familiar with Acro, and only somewhat with diabetes in general(had heard of lantus, but not lev and still recommended PZI).

This means some research on my part to try to educate her a bit(nicely of course) on treatment of symptoms. Sadly, a lot of the med articles I would like to bring are behind paywalls. I try to bring "professional articles" to her over "random forum posts" to help her and give a little leverage in what I am asking for.


On today's vet visit list:
discussing not using the box more frequently
weight loss
acro progession
discuss ultrasound


Things I plan to ask for:
bloodwork (probably a senior panel)
Pain meds ( gaba or Bupe)

Any other questions the group can think of that should be discussed?

Hope all the kitties and beans are doing well.

 

Jack - what's up with the fall colours this morning? Vetty visit isn't until later.

There are a few main areas of "acro progression" that I would discuss with vetty. First up is the heart - make sure the vet takes a good listen. Heart growth (cardiomyopathy) is a common condition with acros, that can lead to strokes, but with not much warning. If there is anything off sounding with the heart, I'd push for a echocardiogram (ultrasound of the heart). Kidneys are also an area of concern, but between the full senior panel, a urinalysis and possibly an ultrasound, you've got that covered for diagnostics.

Next up is the gut - seems a number of our acros have issues with bowels, whether it's growth, IBD, small cell lymphoma (slow growing) or other. The fact that he's losing weight in spite of eating sounds like he may not be absorbing all his nutrients properly. An ultrasound will be the best diagnostic. And last up, arthritis/pain in general. Get the vet to check him over for arthritis. Neko's vet could tell just by feel - heck, so could I. Didn't need X-rays for that. Getting him on some regular pain med is a good idea. It was a game changer for Neko's QOL. My vets choices in order was bupe, gabapentin, tramadol.

I'd also get the vet to take a good look at his mouth. Neko has some soft tissue growth that made it harder and harder for her to eat. Some of it could be dealt with via dentals, some not.

Depending on what you find out, things to consider are regular B12 supplementation and fluids. The B12 can help him feel better. I've heard some swear it slows the p'titis episodes and it can help with digestion. Or you could ask vetty to get the TAMU (Texas) GI panel done, that will check for B12 and folate and proceed based on those results. The GI panel is also a good one to check for SIBO. On the gut topic, is Jack getting any probiotics? Might help food absorption. As for fluids, that's only a good idea if his heart is good and his kidneys are not.

Let me know if there are articles you see but can't access. I might have them, or be able to get them frome Sienne.

Sending tons of good vetty vines.

 

Thanks for the info Wendy. There are a few things on your list that were not on mine so adding them in. Yes, heart and kidneys are high on my list of concerns. I know lasix can help with excess fluid around the heart, but can be contradictory with fluids if the kidneys are not in good shape.

The weight loss is a big concern, it reminds me of when he was still unregulated and leads me to believe he is not doing a good job digesting the food to get those much needed calories.

I'm pushing for a trial of some pain meds to see if it helps his QOL.

I'm not currently giving pro-biotics, but is something I will look into(is fortiflora still a good one?).

Luckily since switching back to his old food, he has not had a p'titis flareup in quite a while. So he's got that going for him, which is good.

 

Sending good vetty vines.

 

No on the fortiflora, it's just a single strain of flora. Here is a good page on probiotics for cats.

Neko played the kidneys vs. heart game. Fluids are good for kidneys/bad for heart. Lasix is good for heart, bad for kidneys. You learn about balance. At some point if Jack has any other condition going on, you may want a consult with an internal medicine vet. Mine was great at balancing conditions, and actually knew about acromegaly!

 

Loads of Betty vines and prayers for Capt. Jack. Wendy covered it all so nothing more to add

 

I'm sure Wendy has absolutely everything. I can access some articles behind paywalls through two universities, and am willing to look (it's part of my work). Feel free to DM me

 

Sending you vetty vines Jack

 

Jack fasted after breakfast today due to vetty visit... We came home from the vet and he just popped a 114, so much for vet stress . I should have known since he had to come out on the porch with me during the hurricane and laid down and took a nap. We are having a full senior panel done to start. If kidney's look normal she said it might be good to have the SDMA test done since it is more sensitive to declining kidney function.

I got some info on local ultrasound costs since they do not have equipment in house. A few options there cost wise depending on who interprets the results. She didn't seem overly concerned with the GI tract just yet, but did mention possibly doing the GI panel from TAMU...(Wendy you were one step ahead of her, she got a chuckle when I mentioned it right before her)

Heart sounded good, she checked for a good 2 minutes and could not hear anything unusual, breathing sounded good and no discernible lumps in the GI area. The mouth and throat did not show any excess soft tissue, but she said anything past the tongue they need to be sedated to see since cats don't stick their tongues out on command. Some very minor plaque on the teeth and he is getting cataracts, not tbut oo bad yet. She was concerned about the weight like I am and how thin he is overall and agreed something is going on that needs attention.

I also finally got her to agree to trial some pain meds. She is not a fan of bupe for his condition and said in the US, bupe gets expensive very quickly and can only be dispensed in the little pre-filled syringes. She wanted to start on a compounded Gabapentin and I considered that a fair compromise.

Overall no obvious signs of what is ailing him other then the symptoms. The current plan is continuing to give extra fuds for Jack(he will be a happy cat) and wait for the B/W results that should be in Thursday. The bloodwork will dictate the next steps, whether it be a GI panel, ultrasound or treatment based on the lab results. I found a local compounding shop just down the road that does vet compounding so I should be able to get him on some pain meds soon to see if that helps him out.

Jack appreciates all the vetty vines today, but he is much happier being home now

 

Glad you got to pull the TAMU card. Too bad the vet doesn't use Idexx Labs, they include SDMA for free. Did you get a urinalysis done? Proteinuria, common enough in acros, is also a hint of pending kidney issues.

Too bad your vet is wrong about bupe. I live in Canada and know better. Several. US members here have gotten it compounded online and much cheaper than those little preloaded syringes which are outrageous price. @Rhiannon Up here, I paid around $100 at the local compounder with a vial with three months supply in it. The bupe expired after three months.

 

She really seems to have a vendetta against it for some reason. At least she is mostly open and flexible so we compromised on starting with Gaba. If that doesn't work then I can get more insistent on having some bupe compounded and brush off the "oh the cost" argument from her.

I think at this point, we are outside her area of knowledge with Acro which was pretty shallow to start with. I had some literature I brought in that highlighted dealing with Acro symptoms and I'd like to think she learned a bit today. I know I did as well discussing some GI and other potential reasons for the weight loss. Always something new to learn as the kitties age and develop health issues, whether diabetes related or not.

They are an Antech shop, bummer that we would have to send out again to Idexx for the SDMA. But, better to get another lab done and potentially catch it early then have it show up in the Antech lab results and know it had already progressed and was overdue for treating.

 

My vet didn't know about acro either, but she did know about treating arthritis pain.

Be aware that gaba may make Jack sleepy. I have heard that over time they get over that. I gave up after three weeks and not much improvement on pain. But it's ECID on what works. Paws crossed it works for Jack.