Any hospital recommended in Kansas City area?

Had some blood work drawn after our DKA episode 2wks ago. Someone on the PZI board said he's anemic at least based on those labs, what can I use/do to get it up? The vet seemed un-phased by it saying his labs looked fine. Thanks!


ETA:Looking for a hospital with US machinery & knowledgable vet to dx/treat this. Willing to travel to Kansas City area if anyone has any recommendations. Thanks!

 

Re: Anyone know how to fix anemia?

Please provide a link to the lab results.

 

Re: Anyone know how to fix anemia?

Larry, here's a link to the post with the pictures of the labs.
http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=111140#p1173362

 

Re: Anyone know how to fix anemia?

An HCT of 25% is not that bad. The kidney values a re good so it does not look like that is the cause.
Anemia can be cause by two things:
A- Not making enough red blood cells. Kidney problems can lower the rate of production
B- The red blood cells are dying too quickly. That can be caused by a disease killing the cells or internal bleeding

What I did not see was a reticulocyte count. Reticulocytes are immature red blood cells and the count will help identify if it caused by A or B.
What do the stools look like,? Black tary ones indicate bleeding into the GI tract.

 

Re: Anyone know how to fix anemia?

Discuss with your vet the use of an appropriate vitamin and mineral supplement. Basically, you need all the vitamins (especially B vitamins) and minerals (iron especially) that go into making hemoglobin.

If your cat has any digestive issues, discuss with your vet how those may be handled. Some diabetics may have pancreas damage that reduces production of enzymes necessary for digestion and over the counter enzyme supplementation may be needed. Probiotics such as Intelliflora or Forti Flora help in some cases, too. Supplemental Vit B12 (cyanocobalamin) may be best if injected.

There are a number of conditions which may cause anemia and they group in some major ways: blood loss, nutritional deficiencies, or production impairments (cancer, chronic disease).

Merck Veterinary Manual on Anemia

 

Re: Anyone know how to fix anemia?

Good to know thanks!! Could it possibly be a temporary effect of the DKA?
She did say when I took him in for that his intestines felt "ropey" which usually came from inflammation. But she didn't dig any deeper to find a cause. His stools are normal. I actually was just looking at an enzyme supplement I'm going to order. A holistic vet recommends it on my Facebook page, it's from Dr Mercolas website. I thought since he gets Friskies/FF with the by products it couldn't hurt. Anyone tried this before:

http://shop.mercola.com/catalog/digesti ... s,90,0.htm

I'll check out that link thank you! I'm also taking him to see an internal med vet this week, I will ask about that additional test. Hopefully these are good IM vets at our college b/c it's $120 consult!

 

Re: Anyone know how to fix anemia?

Yes, I tried it with Spitzer. Unfortunately, he threw a saddle thrombus before I was able to see much benefit and I let him go.

Please do check with your vet, so she is in the loop and to make sure it won't interfere with anything.

 

Re: Anyone know how to fix anemia?

Ohhhhh ok I think I figured it out!!! I keep looking at other conditions & ran acrossed pancreatitis. He matches the symptoms exactly!! Dehydration, weight loss, lethargic, vomiting ect & now he seems to look insulin resistant for right now at least. It totally fits & then add in the "ropey" intestines & it says it can also cause anemia. I mean the shoe fits! By the looks of it it also could have led to the DKA episode as well. Now I just need to get him tested to confirm. I really need to find a new vet though as I'm not happy with this one.

So if this is the case anyone dealt with this have any experience with treatment for it? I know it said low to mid carb diet, again he does well on some higher carbs to so I wondered about him needing a tad more than <10%.

 

Re: Anyone know how to fix anemia?

Chronic pancreatitis can result in enzyme deficiency. Discuss a trial of enzymes with your vet.

Cyanocobalamin injections may help with recovery and prevention.

Primer On Pancreatitis

 

Re: Anyone know how to fix anemia?

Candy,
The link that BJM gave you on the Primer on Pancreatitis is full of great info.

You would want your vet to confirm the diagnosis by running the Spec fPL test if possible, and ask if fluids and pain meds would be a good option for Itty

 

Re: Anyone know how to fix anemia?

Thank you! I read through all that & it's great info! I'll be calling tomorrow about the testing to confirm. I also ordered the enzymes & will consult the internal med vet on those before use. Thank you again!

1 more question, with insulin resistance is there anything I can do to get his sugar down right now? The I'm shots he seemed to react to a lil better I wonder if I should do those instead? Or is it insulin resistant no matter how they get it?

 

Re: Anyone know how to fix anemia?

You may need to switch to a depot insulin for longer effectiveness over 12 hours, plus carryover. Although it looks more expensive up front, on a per unit cost, Lantus is actually about half as expensive as ProZinc.

Meanwhile, follow our ProZinc suggestions on dose increases with careful monitoring.

 

Re: Anyone know how to fix anemia?

Bailey also suffers from pancreatitis,I had heard that aloe vera juice was helpful in human treatment,I researched and this is what I found out.
The aloe juice MUST be made from the inner leaf gel,not the outer rind,it must be pure and free from synthetic preservatives,and must not contain potassium sorbate,sodium benzoate or ascorbic acid,as these can be toxic to cats.in other words pure inner leaf gel with nothing added.
I have been giving Bailey 1 teaspoon of the juice twice daily on his food,it could be a coincidence but since starting him on the juice his bg numbers are more consistent,and his tummy that has been swollen due to the pancreatitis has gone down.
Hope this information helps.

 

Re: Anyone know how to fix anemia?

Ascorbic acid is a form of Vitamin C. Little Big Cat on antioxidants

Per the article, ascorbic acid is often manufactured synthetically.

 

Re: Anyone know how to fix anemia?

Bailey where do you get your aloe juice, do you order it? Thanks for sharing!

I'll check that out BJM, thanks a lot for your help! I've been on the phone all morning (although still haven't heard back from my vet). I've spoken to several vets & an IM vet at the school, they all suggest US to dx it and/or check other things. Downside is it's $300 for it plus $107 for consult, then I have treatment expense on top of that. Ugh! Wouldn't be that big of a deal except I just spent that much 2wks ago & it didn't fix anything :/

So if he's resistant will increasing even do anything? I assumed it wouldn't make a difference.

 

You do continue increasing following the protocol as the increased glucose can cause other problems.

By following the protocol, you safely increase, attempting to match the glucose levels with the insulin. If it is pancreatitis, treating that may help.

As far as the vets recommending further tests. You can do them if you want to be as accurate and certain as possible of the diagnosis. Or, you can discuss empirical therapy with the vet(s), where you treat "as if" that is the diagnosis. The problem with empirical therapy is that if you're wrong, the treatment may not help and could harm.

That said, B vitamins are water soluble and not likely to cause harm at a therapeutic dose.
Subcutaneous fluids may put a water load on the heart and kidneys; amount must be regulated.
Buprenorpine for pain may make the cat groggy and in some cats, a bit aggitated.
Digestive enzymes, which may be a result of pancreatic damage from chronic pancreatitis, are available over the counter (ex Mercola makes a product).
Allegedly, fat content in the diet for cats doesn't matter; some cats may do better with less fat (just add plain poultry to the canned food.)

 

I use digestive enzymes for KT altho' the ones I'm using are from my local health food store instead of the Mercola. I DO use the Mercola probiotics also. We now suspect chronic pancreatitis, nothing he eats will 'stick to his bones'. Before we started the digestive enzymes, he was eating but everything went straight thru without absorbing anything. We had to fuss with the dose until we got it right - if given too much, it gives him a tummy ache. They also must be mixed EXTREMELY well as any in the mouth can cause burns. I tried backing off them for a bit - we lost every bit of our forward weight gaining momentum very quickly. He's now back to skin/bones, we're starting all over again. The digestive enzymes I use are Pancreatic 8x, I typically use about 1/16th tsp per 5oz can of food.

I so hope you figure this out! BIG HUGE HUG!

 

To: BaileyUK

Hope no one minds my asking re Aloe Vera juice as I'm so very interested in the topic. Please, do you have any links to the research sites you've perused? I believe that value of this juice is much underestimated both in humans with digestive issues & felines with pancreatitis. I'm a bit at a loss when searching, so any information will be much appreciated.
Best wishes,
Sophie

 

Aloe Vera per National Institutes of Health (US)

 

Sophie feel free to ask, we're all here to learn!

I ordered the Mercola enzyme last night. Was looking at the probiotic to but I'm so leery of things with the diabetic, but if works ok to mix for you I may order it as well. He's very skinny in the back hip area but he looks more pot belly in the mid section. But he has put on some weight since getting fluids. Now I have 4 cats so can I mix it all the food or will I have to separate him to feed? I'm assuming they would all benefit from it diabetic or not.

I don't mind doing the tests as I just want to know how to fix it. My issue is the vet school seems to pick wasteful ways to get to the answer. They kept telling me to hospitalize for IV fluids (8-10% dehydrated) at $1400 a pop, then once hydrated they'd do more testing. My vet gave him SubQ for $18 which corrected it. If I'm gonna spend $1400 it better fix him not something as simple as hydrating when it wasn't life threatening at that point & there was an optional way to give it. However they're the only ones around here with the equipment. But we're scheduled to see the IM for consult & US tomorrow afternoon.

I'll check out some B vitamins & ask about the others tomorrow. BJM do you happen to know about CatSip cat milk, whether it's ok or not? It says it's treated with enzyme & lactase to break down the milk sugar so the cat doesn't have to. I give it as an occasional treat to one of my civvies & Bitty's never touched it. Until now he wants it for some reason but I pulled it up b/c I wasn't sure.

I checked him yesterday for ketones -. Checked today & it's between small/trace. I fed him the SD MD today, coincidence? I told the vet when she called but she just shows no interest in figuring this out. She just keeps repeating it's the food & he needs more fiber ohmygod_smile But that we could test for pancreatitis if I really wanted to. Um YES he's not right & he needs help getting well!!!! Grrrr

 

Ever so politely point out that obligate carnivores do NOT need fiber! And that prescription food manufacturers have a vested interest in saying that.

Plain psyllium powder, without added carbohydrate, can be used in cats with constipation or megacolon; it even helps soak upexcess liquid in diarrhea. The dose is 1/8 to 1/4 teaspoon twice a day, mixed in food with extra water.

A teaspoon of CatSip may be used as a small treat, or to encourage eating drizzled over the canned food. Breaking down the lactose doesn't remove the carbohydrate, just changes the form, so you'd need to monitor for glucose spikes.

 

Great thank you! I'll limit what he gets & maybe save it for only when he's lower. The 2.5U & FF gave him a good curve last night! I need to get on my iPad & update SS but he ran in the 100's all night until this morning he was 350 amps. Now hopefully his insulin needs don't just keep rising like they have been! And hopefully we can get some answers today at our appt in a few hours. Also waiting for him to urinate so I can test ketones today, I'm afraid they're looming with the slight smell on his breath but his numbers have been very high the last few days.

He doesn't have diarrhea luckily so I'll skip that. And I think the enzymes will help to with any digestion issues. What is with these vets being so undereducated?! I have thyroid/adrenal issues myself & find the same problem with endos. It's like they have no clue about this stuff. How do you specialize in something (especially something as intricate as the endocrine system) & not at least know the basics?! It's insane :-x

 

You can learn to give the subq fluids yourself at home, it's pretty easy and I've done it for a couple of my cats. Here's a great video by member Marje and Gracie who was giving her Gus subq fluids daily.

 

Re

Info for Candy and Sophie,
Sorry for the late reply to your request on info re aloe vera juice,I was told by my health store they had good feedback from people suffering from pancreatitis.I did a google search on aloe vera juice treatment for feline pancreatitis and this brought up lots of links.The most important issue if you are thinking of giving the juice to your cats is that it MUST be the inner leaf gel (the outer rind is toxic for cats) and it must be free from synthetic preservatives and NOT contain potassium sorbate or sodium benzoate.the juice I give Bailey is Pukka organic juice,there are a lot of less expensive brands on sale but they are not pure and contain additives,make sure you buy pure inner leaf gel with nothing added.
I can only take as I find and it seems to have made an almost immediate improvement in Baileys condition.please get back to me if You have any more questions.
Best wishes to you and your kitties Diane