Janie update - Monday morning

She was 367 at 8: 30 a.m., up from 292 at 6 a.m.

Saw a vet at our regular clinic this morning - I love them all - and she went over Jane's labs with me. Good news is we can get the diabetes under control, get the hyper-t under control, and she'll feel much better. Bad news is her BUN is off the charts, her kidneys are small and she's in CRF. More bad news: Fixing the thyroid problem will likely make her kidneys worse, so we will see.

Recheck in three weeks, sooner if a problem. Will likely start subq fluids then, but we'll wait and see.

Got an rx for Lantus, but won't shoot till tonight, to get her on a working schedule.

And waiting for my sleep-deprived brain to clear so I can write a scathing letter to the ER clinic/its board of directors/some appropriate state vet oversight agency. If it hadn't been for this board, she would be gone today because of them.

 

Hi Kris

Did they do more bloodwork today? What was her BUN/creat? It is very important, in terms of looking ahead at a prognosis, to know how far the fluids over the weekend was able to drop her BUN/creat. (That's why I keep harping on it ;-) ) Did they do a blood pressure?

If you didn't get bloodwork today, I wouldn't wait that long to redo bloodwork. You don't have to see the doctor, just bring her in and have them draw blood to send out. She's on a hefty dose of methimazole (tapazole), too, and you want to make sure that she tolerates it. I wouldn't wait more than 10 days, personally. What was her previous dose? 2.5mg BID is a big dose for a tiny cat (she's only 5 lbs, right?) unless you've worked your way up to it.

The Lantus peeps on this board may be able to help you learn this new insulin, they are a supportive bunch.

You mentioned Janie was treated there before? Do you know any of the specialists there? Again, just thinking of what would have the most effect, I'd call any of the specialists you know well and talk to them about how you loved the place when you brought Jane there for her cancer care/surgery/ultrasound/whatever it was, but you just had the worst experience this past weekend, etc. and it makes you worry about bringing her there in the future. This brings you out of the category of "unknown complainer" to the category of a good, established client who is known to be a courteous normal person and is outraged at XYZ. Know what I mean? Whatever you do, make sure to include the praise of your previous visits so they know you can tell the difference between great care and haphazard care when offered at the same place. And mention the blood pressure too.

 

Hmm. She didn't repeat the bloodwork today because she said she didn't expect to see much difference. But I tend to agree with you. I'll let her rest today and bring her tomorrow for a draw.

She's been on transdermal tapazole for a couple years now at that same dose - or at least that's what the vet calculated today. .1 ml once a day topically - now, 2.5mg twice a day orally. Expecting better absorption orally than with the ear stuff.

I asked about the bp -- and maybe cause we're in Smalbany, but she said it's almost unheard of - hard to get because you can't keep them still, hard to get accuracy because of the stress of the visit and so on. Vet noticed she's walking on more of her back legs, not her pads, and it could be neuropathy (temp or perm) from diabetes, could have had a tiny stroke (but we have no bp readings) or could be related to the thyroid zinging.

I asked for Lantus because it seemed to work well for her when she was first dx - but i'll be frequenting the lantus board now too for the voices of experience. i'm going to let her go high today rather than shoot now and not be able to maintain the schedule - will do at 7:30 for 12-hour spacing. Thoughts, Jess?

ETA -- her weight is up 13 oz from Friday night's onset - give or take for scale variations.

 

You had a scary night, that was quite a thread. There isn't much I can add, but I would like to mention that I've had 5 hypert kitties in my life, none did well on transdermal ear cream. One that was unregulated for some time, lived with my inlaws until she was 16, she had high blood pressure that led to more complications because she was undertreated before my place.

Switching to oral Tap is a great idea. 2.5mg BID is the normal starting dose for oral meds.

Getting blood pressure seems easy enough, my vet has done it on many of my cats plus a cardio did it for Mr. Darcy.

 

Just adding that I'm sending hugs - that was scary indeed last night - glad you got those numbers up.

Have no advice because I haven't dealt with the things you and Janie are dealing with but just wanted to say how happy I am that she's perking up - and will keep sending many healing thoughts and vibes and prayers your way.

Hugs to you.

Emmy & Dude (& Mittsi too)

 

So just to clarify, Janie has not had any blood work but for the first round on the 30th?
And I wonder why they give fluids, if they don't think it makes a difference? (growl)

Good, keep us posted on results.

Ok, dose makes more sense then.

Sigh. Major sigh. I guess this means everyone gets their surgeries done without BP readings as well. Um, there's no chance that anyone did a good ocular exam in Jane, is there? And does this explanation mean there isn't a BP machine?

There are issues of getting them to stay still, and elevations from vet stress, but these are well known. A BP can bump up due to stress, but only so much. So a cat's BP starts looking abnormally high at above 160mmHg (systolic), so if we get a 180 on a PO'd cat, ok, maybe it's because they're in a snit. But if we get a 230? No, I wouldn't say that has anything to do with snits or tempers. KWIM?

My own experience with Lantus at-home and in-hospital is that it can take a while (several doses) to bring down the high numbers, so I wonder if there is benefit in waiting till 7:30pm to get the ball rolling. I don't know enough to advise you myself, esp in light of the recent hypo, but you can ask Lantus peeps for advice as I'm sure you're not the only one who has been in this spot. I'll say in advance that IMO you should avoid R, if anyone advises its use today, because you have a kitty whose metabolism is running wild due to hyper-T and you just can't cover all the bases (safety wise) for its home use at the moment.

 

I just read about last night's hypo. Poor Kris and Janie! I'm so glad she bounced back alright. Give the Diva a kiss from both my DH and me. (He doesn't pay attention to any of the other FDMB kitties. But he always asks how lovely Janie's doing. What a heart breaker she is!)

 

((Kris)) I haven't been on too much but I heard precious Janie was having problems and want to send my love to you and her.

Also, I offer you my assistance with anything you might need or want to do should you decide to file a complaint with the board. I haven't read the post on what happened there, so I won't comment on the merits, but I am happy to offer my help. I have gotten pretty familiar with the standard practice acts so I can usually help pick out the violations.

I send you lots of hugs and love and of course, dear Janie too.