Pig 7/06 amps 225; +3 246; +9 165 ?? More Big Questions ??

Discussion in 'Lantus / Levemir / Biosimilars' started by LuvinThisPig, Jul 7, 2018.

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  1. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Yesterday's

    Okay... So, I need opinions. I decided it was best to get both the boys into the vet because Pig's bladder was getting fairly large and Tail went off his food entirely. So, here is the outcome.

    First off, we did do BW and it has been sent to the lab so that we could get T-4 values along with a couple others that in-house would not show. So, we will have those results very soon! I am excited and a bit anxious, of course.

    For Tail, the vet seems to think that stress (he is one of those that will not eat for a day if a stranger comes to the house and now there is someone living here... But, he is not hiding and approaches our visitor like nothing is amiss) and a lack of fiber is what is causing his irritation. So, he was given a script to Metro and Cerenia. The thing in his ear is gone and it seems that it was, indeed, just a waxy build up thing. Also, his ears were really red when we got there and she asked me if they did that at home. Well, they do. So, they ran a BP test on him because I guess this is one of the signs, but his BP came back at a healthy 146. So, no issues for Tail other than this mysterious flare of colitis.

    For Pig, to be honest, we don't know. For starters, she ended up taking radiographs because she could feel nothing by palpitations. I have felt him at home and he did not feel even remotely close to being constipated, but his bladder told a different story. Typically, it will swell up because he is backed up and the weight is pressing on the urethra. Well, radiographs showed something very, very interesting and a bit scary. His colon was totally empty. I mean nothing. But, his bladder was flipping ginormous! It is taking up almost his entire abdominal cavity. And we have no idea why other than his limited nerve functioning. She thinks his flare of colitis is because of the pressure of the bladder on the colon. The issue is, how to resolve this bladder??

    She is going to do some research into prokinetic options, but sent me home with Reglan in the mean time. I am not to actually use it until she says so, but this was to avoid a second 2 hour trip. I am to continue on the prazosin to help him empty a bit. Both kitties came home with prescriptions to Metro, Tail with Cerenia, Pig with Reglan and Adequan. My problem is this... My vet does not really know I feed raw food.

    Normally this would not be a thing, but I get home and this recall is there and to be honest, it is a bit coincidental.. For both of them to have the same flare and no discernable reason... They both have eaten the RC venison, but I do not have the containers anymore to see if it from the same batch. Now, the Metro should take care of any bacterial infection, but the people on the IBD group are super against it and say not to use it.... But, the vet said I should. I feel like the Metro is a to the IBD group like the dry food is to this group. However, I have been here for quite a while and there are several people here that I trust my kitties health to. So, I welcome any suggestions. I have not started the Metro yet. I still need to figure out a dosing schedule. If it is, in fact, e coli irritation then the Metro will help, but it will wipe out the biome as well... But, what do I do if not the Metro?

    @Wendy&Neko @JeffJ @Bronx's dad … And everyone else I can't think of to tag because I am so flipping tired I can't see straight....
     
  2. LuvinThisPig

    LuvinThisPig Well-Known Member

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  3. LuvinThisPig

    LuvinThisPig Well-Known Member

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    He has also picked up a really weird breathing thing while waiting for food... Like a nasal pant, almost? Like only when excited for food...
     
  4. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    I'm toast (1:15am), will look at this when I get up.
     
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    There is a difference between a short term course of metronidazole and a long term use of it. Size of dose also matters. The links you pointed to are for long term use. If you do give it, make sure it's separated in time from Pig's probiotics.
     
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  6. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Wendy, this is one of those times that I wish I lived in Canada so that I could show up at your front door with a fresh baked pie full of all my love and gratitude... :bighug::bighug::bighug:

    I was freaking out because you know I just want to do what's best, but I trust my vet and she is not one to Willy nilly on medications.. She is actually pretty close handed on that. Well, I did read those articles and came to the same conclusion... But, you know, people were doing the guilt thing...

    Then I told my Mom.. "Why am I panicking when I literally have the fortune teller of cats in our corner??" You have NEVER steered us wrong and the advice you proffer comes from a cool head and reasoned logic. Not emotionally fueled by opinion. I trust you almost second to none. Thank you, Wendy, for just being you and as amazing as always!! :bighug::bighug::bighug::bighug:
     
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  7. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Rest well, Jeff!! Those boys need ya! :bighug::bighug::bighug:
     
  8. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    This might be the bigger issue for the whole household.:eek: I hate it when strangers show up at our house and then they move right in. I usually try to get their name at least.:D

    Urine backup - I hope Pig has peed. It is bad for the bladder to get bloated. Maybe you could use a catheter - like they do on human men and women - to drain the urine. I think Pig would need mild sedation for this if you want your hands back.:rolleyes:

    Both Pig and Tail - since there are common items to both of them, I would suspect the food or a common medicine. Also the stranger could cause distress. Chinus won't come out of the bedroom until a guest has been here for 2 days.

    Flagyl (Metronadizole) - is short term only to my knowledge. I have first hand experience. I lived in El Paso in the 1980s, and used to go to Juarez to get groceries or other stuff occasionally. Twice, I got "The Amoeba". That's what my doctor called it. Maybe Pig and Tail have "The Amoeba". Kinda sounds like the movie "The Thing".

    Amoebas are maybe fine if some people are used to them. For me, I get emptied out both ends...probably until I die. First hand experience really shows you how people can really die from simple stuff like that. They used to prescribe Flagyl. And it worked like magic. One of the times I lost almost 8 pounds. Just one day after Flagyl and "The Amoeba" were gone. And El Paso... nice people, great Mexican food, but crappy place to live - hot, real dusty, high elevation, and hardly any rain.:(
     
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  9. JL and Chip

    JL and Chip Well-Known Member

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    Dec 28, 2009
    Hi there. I've been following along the past few months, including your trip to Washington and your VLOG. It's been a fascinating journey!

    My Tubby was an acrocat. We did SRT at CSU but unfortunately he didn't fare as well post-SRT as Neko and Leo and some of the others. We lost him to kidney failure, but he also had chronic issues with constipation and, toward the end of his life, with what was apparently bladder neuropathy. Remember the term "bladder neuropathy."

    I also have a civvie "TomTom" who has a broken tail. He had 5 urinary blockages (nearly died the first time) and nerve damage which has cause significant issues with urination, incontinence, and now the complete inability to urinate or defecate on his own.

    I joke that we specialize in solids and liquids at our house. Somehow I think you can relate! :)

    Back to Tubby ... he was diagnosed with acro relatively early and we did SRT as soon as CSU deemed him a good candidate. Unfortunately I think we lost a year as there was conflicting info about the need to "visualize" the tumor. Anyway, a month after SRT, he had a scheduled dental. His insulin needs initially went up after SRT, then shortly after the dental they started to come down. Then all hell sort of broke loose. He went off his food. He was diagnosed with pancreatitis. He developed significant kidney disease. His constipation became a nightmare to manage. His BG was all over the roadmap and he started hitting numbers I'd never seen before (600-730 at times). Nothing made sense. We had several years of data prior to SRT showing completely normal fPLI and kidney values, including SDMA, and yet something had changed. Dramatically.

    We ran multiple thyroid panels but hypothyroidism isn't all that common in cats. Throw in acro and even the folks at MSU where we sent the blood weren't sure how to interpret the results.

    So that's a whole lotta backstory for getting to where I'm going on Pig's distended bladder. One of the things that I realized too late was that Tubby wasn't emptying his bladder. He was a huge cat and difficult to palpate... not that I had any particular reason to try at the time. But when he'd get really constipated, I'd occasionally try to feel how much was in there and whether I could nudge it along a little. One day when I was palpating his abdomen, I was shocked to feel a huge bladder, despite the fact that there was plenty of urine in the litterbox and I had, in fact, just seen him pee. What the heck?

    I'm used to manually expressing bladders because I've been doing it daily for over 7(?) years since Tom has nerve damage and can't pee without assistance. If he's constipated, it makes expressing more difficult as it seems the stool impinges on the bladder or urethra or whatever and the urine doesn't flow easily. Neither of us like those days.

    So, back to Tubby... I immediately expressed his bladder and was stunned at how much came out. I thought maybe he had a partial blockage that had resolved when i expressed him? It triggered my radar but I couldn't wrap my head around what I was experiencing. It happened again a few days later and then he landed in the hospital. I specifically remember telling the docs that there was something wonky going on with the bladder and to please make sure he was emptying it and/or not showing signs of blocking. I followed up several times and they reported that all was fine. I later found that they assumed he was fine because they saw urine in the litterbox. When another vet took over, we determined that, indeed, he was NOT emptying his bladder.

    Apparently bladder neuropathy is a known thing in human diabetics. We talk about neuropathy in hind legs in cats, but no one seems to be aware of the possibility of bladder impact. I sure wasn't. By the time we figured out that might be happening with Tubby, he was in final stage renal failure and we had bigger problems. I'll always wonder how long it had been going on, whether it contributed to his kidney failure, and whether stagnant urine in the bladder caused some sort of toxicity or an infection that went retrograde into the kidneys. We also surmised that we had the "constipation" under control -- the stools were proper size and consistency-- but that he was suffering from "obstipation," meaning that there just wasn't enough peristalsis to actually move the stools forward.

    I lost him before we could get it all sorted out. But, amongst many, many other things, necropsy showed a significantly distended and thin bladder with loss of elasticity, so I have to think it went on longer than I care to believe.

    I'm not saying that bladder neuropathy is what's going on with Pig, but I'm sharing our story so you can be mindful of the possibility. Drugs might help, or you might have to start expressing his bladder, or he might simply have chosen not to pee before the vet visit. Once does not constitute a pattern. But now you know to monitor the situation. I sure wish my lightbulb had come on sooner.

    As for TomTom, the civvie I mentioned... his bladder issues are related to a tail broken near the base, nerve damage, and urinary blockages (which I'm told wouldn't be corrected by a PU surgery). I'm not familiar with Manx-specific issues but the nerve component feels vaguely familiar. Tom went from being completely incontinent to not being able to urinate at all. He also lost the ability to defecate. His drug protocol entails bethanechol, phenoxybenzamine, and cosequin for his bladder (cosequin is supposed to help bladder tone), lactulose or miralax if he becomes constipated, cisapride to help motility, and daily warm water enemas.

    As for the metro, I've used it off and on for years and am completely comfortable with it in short courses. I've never had any problems. Given the issues our acros face, we need to pick our battles and I'd say resolving the GI issue trumps a "maybe but probably not" risk to the gut flora.

    ETA: water changes DID affect my Charlie, though I wouldn't expect a problem if Tail is healthy and "normal." You could always drink some of the water yourself... :)
     
    Last edited: Jul 8, 2018
  10. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Hi JL

    Thanks for the detailed history of Tubby and TomTom. This is really useful. And encouraging. Sometimes it seems like we are spending too much time and money on Leo. But then I find an inspirational kitteh history like Tubby, and Theresa and I talk about it, and the health treatments. We have also followed Pig's journey. That's what I like about this forum, all the people's focus on their furkids. A shared experience which benefits all of us.:bighug:
     
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  11. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Wow! This is phenomenal information! I actually just sent it along to my vet and hopefully we can find some answers. I will start to research bladder neuropathy, myself, to see what I can come up with. His numbers are a bit erratic at the moment and I am praying that is food change and colitis related and not bladder related. This bladder thing scares me to death. I have tried him on the Bethanochol before and it only seemed to make him worse. As in, he did not get up and urinate at all. However, he was in higher numbers at the time and he will usually just lay there when in upper BGs. I cannot say thank you enough for all of this information. It is invaluable.
     
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