Discussion in 'Feline Health - (The Main Forum)' started by Amanda & Ham, Feb 7, 2017.
Amanda what is on the estimate? What is the vet suggesting?
Amanda, please contact Chris @Chris & China to see if DCIN can help with his veterinary care. What did they say that $543.59 was for? What do they think he needs?
I've sent a pm to Chris asking her to look into it.
Amanda, what did they do yesterday? and what tests are they proposing they need to do today? (it may be that you don't need all of them) We can try and help you with that.
A recheck fee, fluid administration pump, fluids: normosol liter, day board, capstar, cerenis, iv catheter, profile: senior 17 screen, electrolytes, hemogram complete, glicose: blood levels, fpl, x rays, feline a/d
Amanda, the tests they are suggesting seem reasonable, I can't comment on cost as I don't live in US, Chris is usually on the board a little later, I am keeping my paws crossed that DCIN might be able to help you.
In the meantime is it worth asking the vet which he feels is the most urgent test/treatment? Might it make sense to start with that if it's affordable?
Does Ham go outside? The Capstar is for fleas. Unless Ham has fleas, I don't see why that would be necessary. Otherwise the estimate seems reasonable. I would think getting Ham rehydrated and eating would be the urgency right. If they can get him on fluids for now it would buy some time to see if DCIN can help with the costs to get the testing done to figure out what is causing Ham to feel so poorly. Paws crossed here too!
I just took Ham back to the old vet... he may not be well educated on diabetes but I can make payments to him if I can't get any help. They are already starting him on fluids and they said not to worry we'll get in back up and moving.
I had made a smart comment at that other vet about how it might be cheaper to put Ham to sleep and they said that's an option if you can't afford his medical care. I was appalled at that response.
Good move going back to the old vet Amanda!! It sounds like even if they aren't totally up on the diabetes, they are more interested in his well being than your money. That comment from the new vet was horrible. We can help you out with the diabetes stuff but right now the focus has to be on getting Ham feeling better. Please keep us posted.
Good momma bean! He has us all worried!! Hang in there hammie!
Sending prayers and healing energy for Ham and lots of hugs for you Amanda
I can't tell you how relieved I am to hear this news
If you are otherwise happy with your old vet, as Linda says, you can get help with the diabetes here. FWIW my vet is great, but BFG was her only diabetic cat, and she painted a very bleak picture for George, as I drove home just after he had been diagnosed I really felt that his days were numbered, so it was with the folks here that I was able to get George regulated and OTJ.(in remission), he's like a new cat now.
Once you get your lantus supplies, you'll have a wealth of experience available at the click of web browser, and all the support you could possibly need.
Keep us posted on his progress. We are all rooting for him.
Thank you all of you... I really love this message board and all of the people on it. I will keep all of you posted.
As others have said, we can help you with the diabetes. This vet sounds like a much more reasonable and compassionate person. That's worth a lot.
Linda, indoor cats can have fleas. Some vets will routinely administer Capstar to a kitty remaining in-house for treatment if kitty hasn't recently been treated for fleas and/or if there's any hint of fleas. It's to protect all the other animals by keeping his clinic flea free.
Amanda, please update when you can. We're all rooting for you and Ham!
I an anxiously awaiting the news to find out what your baby's diagnosis ends up being. You're a great kitty mommy!
How awful! I am appalled, too, but sadly, not really surprised. Seems like it's all about the $$ to some vets, rather than genuine care and concern about the innocent creatures they have vowed to help and protect!
I am SOOOOO relieved that Ham is getting treatment! Good move, going back to his other vet, and God bless them for being so compassionate!
Please do keep us posted, we will worry about Ham! Sending prayers and healing vines-
May be worth thinking about but when I moved Sky to a different insulin and had to increase the dosage of it she was sick and stopped eating. This was a huge deal for her as she loves her food. She had anti nausea medication, tests, everything. Looked as if she wanted to eat but didn't.
I was lucky and could trace it back to the increase in her insulin. Stopped her insulin completely and she was eating again within 48 hours. Switched her back to her old insulin and she has been fine ever since.
It could be the insulin is making him feel poorly and not wanting to eat?
My vet was fully supportive of me stopping the insulin for a short time as I could show that it all linked in. I'm not suggesting you stop the insulin but could be worth trying to think back and see if anything changed in the week or so leading up to him stopping eating or even asking the vet to consider that the insulin may be disagreeing with him. If they do think it could be linked stopping insulin for a couple of days (if he can cope without it) could be a cheaper option than a barage of tests and more medicines.
Hope you get him sorted soon. They are a worry.
The vet is going to keep Ham over night. I asked them to call me with an update on his status before they went home for the evening. Which is 8... so hopefully I'll know more in a couple of hours
Thank you for the update!
I am sending a ship load of good vet vines, feel better vines, and eating vines, to Ham.
We have a farm vet in our county that people come from states away to see. His prices are inexpensive and he may not be up on the latest and greatest but he cares, and I think that's why people drive from so far away to see him. I wish The Best Of Luck to you and Ham.
Sorry it's a late update. Vet called Ham's glucose is down and they got him to eat about a table spoon of food before they left. He's still on ivy fluids and I should be able to pick him up tomorrow.
That's wonderful!!! He will be so happy to see momma bean. Hope he is right as rain soon.
Amanda, that's wonderful! I'm so glad he got the help he needed! I know it's got to be a huge relief to you! Prayers and vines for a speedy recovery from whatever is griping him.
Elated to hear the news! Such a relief for you, Ham (and us too!). It will be interesting to hear what the vet thinks caused the problem. It might be a good idea to ask the vet about having some anti-nausea medication and an appetite stimulant on hand at home while he continues to recover at home.
Once you get him home try some fortiflora on his food if he still doesn't want to eat. My cats love the taste, it settles their tummy, and gives them more energy.
Update: Ham is home!! Vet said he did have DKA and some ketones. But both are gone he wasn't eating on his own though bUT they did send me home with a syringe and some biomox (amoxicillin). I'm just glad he's home and up and moving drinking water... we'll try food in a little bit, I'm gonna let him settle for a bit.
Yay!!!! So glad he's home, and feeling better!
Wonderful news on Ham being home. Sorry to hear he had DKA. You will need to keep an eye on the ketones going forward by home testing his urine and getting him better regulated will certainly help. What did the vet suggest as far as insulin is concerned? That too plays a role in getting Ham fully recovered.
I'm so glad to hear Ham is home now and feeling better!!!
I told him I was picking up some lantus tonight and what dose he said still keep him on 3 units
Amanda, can you provide us with a little history of how the dose was prescribed initially and how (I am assuming 1u at a time) it was increased for Ham? I'm just concerned that part of the problem might actually be too high a dose as opposed to too low. Ham is a big boy and that can affect how much insulin is needed but not necessarily. I am simply wondering if the dose has been increased too quickly and you might have skipped over the best dose for him. The cat has a remarkable defense system that will work to keep BG up if it detects the BG dropping too fast or too much. This is just a possible theory but something that I think bears looking into.
So should I maybe just give him 2 units tonight and see what it is in the morning?
Will it be possible to do some monitoring tonight? A +2 or +3, possibly staying up later if need be?
Trying to get up to speed on the situation: was any insulin given at the vet, or has he been completely off since 2/7?
There are a lot of factors going on here (recent DKA, poor eating, lower-than-usual preshot, uncertain dosing history) and I don't I have enough know-how to answer the question of dose. Tagging @Chris & China on this, but I don't know if she's currently online. How long until shot time?
Honestly, if it were not for the DKA, I would be inclined to say skip again until tomorrow morning given that he's in not-bad numbers now after (I think) no insulin for a while, but the DKA makes that tricky...
Shot time is now... just finished syringe feeding him... I must say not one of my favorite things since there is now food everywhere. Yes I can do +2 and +3 tonight. I'd like to give him something even if it is only 1 unit
The last shot I gave him was Monday night. The vet gave him some yesterday and this morning
Get a pre-shot test first to see what his BG is now so we know how much he is dropping with later tests and let us know what that test is. I'm thinking 1 unit because right now we have to be sure he keeps food down. That would be one click on your pen. But don't shoot till we know what his BG is now.
OK, if you can monitor and (especially) if he indeed has been getting insulin the past couple days, then definitely shoot! Edit: Linda just posted above with good counsel-- get a BG number to help make the final decision on dose.
I am not going to be able to stay up much later tonight, but there should be others on for your +2 and +3, so just holler if you get numbers that concern you.
I'll be up and will check in for another couple of hours or a little more depending on need.
She should have some insulin syringes with half unit markings now.....DCIN found someone to donate the Lantus today since we couldn't ship with the storm that moved into the east coast.
If Ham has been on 3 or 4 units of Teujeo, (and you're able to test tonight) I think he could safely be started a little higher than 1U....especially since he's had ketones in the last 24 hours
Amanda.....did Erin show you how to use the syringes with the pens?
If not, you just pull the cap off and there's a little rubber stopper....insert the syringe and pull out a little more than what you want and then slowly expel the extra into the sink or something.....you don't want to push it back into the pen because that could contaminate the insulin
Do you know which insulin he was given and how much?
Didn't know she had the new Lantus already. Good to know. Waiting for pre-shot info. I agree a little higher would be ideal but was worried about the Toujeo. What are you thinking dose wise Chris?
He was given the toujeo that I took in and probably the 4 units this morning
It was 269
I don't think I'd want to give 4u at that pre-shot which is considerably lower than he was before he got sick but maybe 1.5u to 2u. @Chris & China, your thoughts?
Amanda, if you absolutely had to, could you test beyond the +3 tonight? By +3 it should be evident whether Ham is having an active cycle or not but if he is, it might be necessary to test him beyond that point to keep him safe or at least set an alarm to get up and test in the middle of the cycle. This is why I am waffling between 1 and 2u doses. Hopefully Chris will give us her opinion shortly and we can give you a consensus.
I'm thinking if she was giving 4U of Teujeo, she could probably start with 2U tonight if she's able to test tonight
We don't want to have to work him all the way back up again
Not Chris, but I think it would be ok to start Lantus at 2u bid if kitty is monitored tonight. I'd be concerned about shooting any less than 2u because of the recent ketones.
Supposedly Lantus and Toujeo can be given 1 : 1. However, we've never seen Toujeo used for a cat. For that reason, I think monitoring is key since we don't really know what to expect.
Just giving an opinion based on what I would do if I were in Amanda's shoes...
I think we have a consensus of 2u Amanda as long as you can monitor!
Ok sorry guy it took to long to get an answer due to the fact I have to give him his insulin early in the morning. I gave him 3 units as the vet said and at +3-270 and +6-309. It is 3am now and his next meal and shot is 6am. I will not be able to monitor his levels due to having to work.
I think you are ok now this cycle, he doesn't seem to be dropping, I'll watch for you for your amps at 6am, post up with his numbers when you get them
In the norning, how soon after his shot do you have to leave for work?
And when do you get back?
Amps 288. I leave foe work 6:15 and get home anywhere from 9-12 hours later
Is he eating this morning? Or are you still assist feeding?
Is your vet still recommending you stick with the 3u?
One other question, what are you feeding?
I was ready to assist feeding but when I turned around he's eating the high carb dry food I put down for my other cat so I'm just gonna let him eat it. Since he's eating on his own. Yes the vet said 3 units
Concern with giving full shot is that he will go low when you are not there to no monitorr, in particular this is of a concern since we have no data to speak of with lantus.
Since his appetite is back up that is great. Eating the high carb food, though not ideal for BG will probably bolster his numbers. If you can leave food out for him to graze on, or have an autofeeder supply him with regular snacks, that will also help to keep him safe.
Not shooting enough insulin is also risky due to recent dka.
Have you any neighbours that good check in on him later in the morning?
He's not terribly low this morning, seems he's stayed flat all cycle.
Is he looking better too?
Well that was short lived... assisting feeding it is. He's getting 9 lives
The only food I have I can leave out is high carb dry or a can
Oh sorry and no there's no one who can look in on him later
The problem is whether he will eat it if he needs it.
It's a very tough call amanda, if you were staying home I would stick with the 3u, knowing that you could monitor and take appropriate action.
But, I'm nervous about him dropping too low, and because his appy is off, he might not look for food.
Shooting a reduced dose this morning might be the 'safer' option, Perhaps the 2u that was suggested last night. But.. not ideal due to the Dka.
The way I see it that's what your options are.
Skipping altogether, probably not advisable given the Dka.
Whatever you do leave food out for him, dry and wet, just in case he needs it and looks for it.
The vet said hid DKA was gone
I left canned food down last night and no one touched it. I will give him 2 units and leave food out
Amanda, in going through your post, I may be mistaken, but I thought I saw that you shot at about 9:00pm EST last night. It has been 12 hours since his last shot, correct?
Thanks. I was just making sure the shot was not being given 3 hours early.
My mistake no you were correct his shot was 9 pm and 6 am this morning. There was nothing I could do it was either early or not til tonight.
Just to let you know, if you were shooting a regular dose (the same each time), an early shot acts like a dose increase and a late shot acts like a dose decrease. It has to do with the depot. I wouldn't be the best to explain it, and I know you have to run to work.
I would leave out whatever food he will eat. Sending eating vines to Ham.
Well I only gave him 2 units instead of 3 and I did leave food out for him... not good food but food.
Look into getting some lower carb dry if you plan on leaving it out to feed on. Evo or young again. I'd leave wet to graze on too.
That's great, the reason we keep going on about it is that a cat that has had recent dka is more at risk of developing it a second time if all the 'ingredients' for it are present.
2)not enough insulin
3)higher BG (though DKA can also occur at lower BG)
4)not enough food
So just need to be a bit careful with ham since he has only just had it.
Hope Ham stays safe till tonight.
Just an note on housekeeping, so that the ss reflects what has actually gone on.
1) since amps was at +9 (ie 9hours after last nights shot could you pop that in the box with the number you shot at amps ie amps@+9 288 (you will need to manually colour the cell yellow)
2) Can you pop the units that your vet gave Ham while he was in their care in the relevant boxes (along with the time they were shot) and any BG readings they got during the cycle or at amps/pmps.
3) make a note in the remarks section/ or in one of the cells that he was in vet care, when he was there and when he came home.
4) for the time being as it's important to track his food intake, it might be a good idea to keep a track of that on the ss, either in the remarks section or in the cells.
If you could do that and keep it up to date, it will be very helpful as it will allow those trying to help to see at a glance what is going on, and what has gone on. Thanks
I'm going to look into it... I felt so bad I got the free sample from young again on Monday and I tried giving it to him after he threw up his wet food Monday night and he seemed to really like but threw it up as well
His shots starting tonight are going to be an hour or so late since I have to change our schedule back to 2nd shift again.
Not sure what you mean by this, do you mean you will shoot an hour late tonight? Or that with your shift, you will be gone for more than 12 hours?
Shooting an hour late is not so much of an issue, it can act as a little bit of a dose decrease. So numbers might be a little higher for a cycle. But you do not need to compensate for it by shooting more insulin.
It is more problematic shooting early, as this can act as a dose increase, so could see kitty's numbers dropping lower than you would expect them too.
All in all it is best if, as much as possible you stick to a 12 hour shooting schedule.
Usually if we need to change shot times we try to do it by no more than 30 min in a day, as for most kitties this has been found not to impact the cycles too much. I used to keep a not of the times I shot, so I could keep track of the cycles, as I sometimes found myself getting confused.
I do stick to a 12 hour schedule. But my shift at work is changing to 2nd so yes he will be getting his shot an hour late everytime until we get to noon and midnight. And as I stated I didn't have a choice this morning.
I understand, so you are going to be shooting an hour late every day till you get to the required schedule. Sorry, just wanted to clarify, and yest it was a difficult choice this morning.
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