Reintroduction new issues labs posted

Discussion in 'Feline Health - (The Main Forum)' started by Darin and Charlie, Dec 6, 2018.

  1. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    Hello we are Darin and Charlie , old account from 2014/15 was Darin & Charlie could not get into that account, i would rather use that one if someone could help. I was the person who helped Paula get Michael to another member from FDMB upon Paula being admitted to the hospital.

    Starting in the last week of Oct'18 charlie would have these projectile vomits about every wk.
    In beginning he the nex day he seemed fine. then on the 3 or so vomit he looked super ill, brought him to the vet for Fluids and cerenia, that next day was completely back to normal. The next vomit was 5 or so days later brought to vet for another round of fluids/cerenia, next day did not see the same results as previous treatment, took back to vet more fluids on the day before thanksgiving(made another apointment for 11/23 2pm) seemed somewhat better, on thanks appy started to decline, just enough food eaten to give lantus 3 drops is current dose bid, current weight 11.88 has lost 3/4lbs over last month, has been pretty much holding steady blood sugars 80-100 for the last yr, his appy and physical appearance had steadily been declining.

    About an hour before appointment he was unable to hol,d his own weight standing up and started vomiting, rushed him to his vet, they started fluids and tests, was told his bs was over 700.
    At uids and fast acting insulin to get his numbers down. On saturday morning i went to visit him, was told bs was now under 200 and was eating, at our visit he looked, and acted the best i had seen him in a month. he was scheduled to stay there on fluids till monday, also during this time he received an antibiotic, blood labs indicated infection. On sunday the hospital did a blood lab that his reg Dr had ordered to have done before he came home.
    On Monday 11/26 took charlie home, he was very much himself. called vet to see what next step would be. set an appointment for tuesday 11/27. At the 11/27 vet visit took his blood to compare to what the hospital levels were. The results were pretty much the same, scheduled next appt for Thurs 11/29 for another lab, unless charlie started to decline.

    On wednesday his am shot, started to eat his food so i gave his shot, had to leave for an hour. came home and he had only ate 3/4 of his shot meal, so i called and rescheduled my vet visit for 1:30 that after noon, did labs kidney values had increased, deceided to admit him for iv fluids and upon back home to start sub q fluid at 100mls/day , so during reg vet hours he was there getting iv fluids then at 5pm took to animal hospital for iv fluids, did this till he was eating again which took till 12/1 am.

    After picking up charlie and getting him home i was pretty up set with the pet hospital, i picked up charlie at noon, the told me he ate good and gave insulin at 11am, so at 1pm i do a +2 test he was at 77 pretty much normal for him, i was pretty happy seeing that in the last week or so i had to skip many insulin shots due to poor appy. was not interested in food so i called back to see how much and of what he ate, maybe he was full. called and vet tech said maybe 3/4 cup of mix dry with wet purina DM. after the call i thought why are they feeding aiabetic dry, and if fed dry his bs should be much higher, so i called back to see what his bs was at shot time told me 189, it did not make sense for him to drop that much in 2hrs. so now its 20-25 min later retest now he is at 60, pretty heated at this point about the dry, take him back in case of needed sugar, they take him back to test bs while the Dr talks to me about how they do insulin there. With their method some animal is going to go hypo. They started feeding him at 10am, tested at 11 bs 189 gave insulin, well there was my answer, made note to self never have them give insulin while in their care.
    Its possible that charlie is in remission, his last dose was 11/1 am, since i have been watching his bs spike some from his meals and then start to drop and end up pretty close to the numbers he was at pre-spike 6am current bs 105 after a night of eating various foods including a vet kidney food at 32% carbs

    our current home therapy, vet upped his sub q to 100mls/bid from 100mls/day, she stated he could saftly have up to 300mls daily if needed. also taking Zenquin 25mg, 1/4 pill daily for 8 days.
    i have bought various wet foods that meet the kidney and diabetic needs, mostly weruva brand.
    i have niacinamide for fast phosphorous remover, aluminum hydroxide phos binder and also Kidney Support Gold, they all should start arriving today.

    I have joined the ckd group on Facebook and have received great advice but long time between my questions and answers.
    I followed the advise from the pro's here to get charlie to where he is today, i was hoping for the same help/advise now with the ckd, TIA
    Can give or get any other info you may need.
    i will post all his labs from the 1st on 11/23 - 12/5, need to get from vet
    Thanks so very much
    Darin and Charlie
     
  2. Darin and Charlie

    Darin and Charlie New Member

    Joined:
    Dec 24, 2017
    Last current labs, will have an updated 1 tomorrow to see how the increase sub q fluids are doing to his levels.
    1st lab from 12/5, 2nd lab from 11/30 [​IMG] [​IMG]
     
  3. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    i just tried to make a post and a "your post is spam" warning popped up
     
  4. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    also the did an in house +/- test for pancreatitis, said positive, not sure how to treat the combo, my vets only course of action as of now is keep doing home fluids, i have an appointment tomorrow for a lab recheck after increasing the sub q fluids.
    i have supplements on the way for the phosphorus, but how do i tackle the other 2 high values.
    i did just wake to him vomiting, makes me worry that he is getting worse, or is it what comes with kcd/panc.
    i could use real life what to expect and how to respond.
    pretty much been a wreck the last 1.5, had to take day off work yesterday from being physically and emotionally drained.
    Thanks
    Darin & Charlie
     
  5. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Hi Darin....I remember you from back in the day!

    That's a LOT of fluids…..I'm no expert on fluids, but most cats here get 100-150ml every other day. Too much fluid can put him into heart failure.

    That is a HUGE jump in BUN, Creatine and Phos for only a few days. @Marje and Gracie is the one I go to for labs but I'm not sure if she's here. She does check in now and then though. You might want to send her a PM.

    It does look like he's in CKD though....and that usually brings some nausea/inappetence.

    You might want to try adding ondansetron for nausea/vomiting. It works on different receptors than Cerenia and they can both be taken together if one or the other isn't working.

    You should ask them to run the Spec fPL….the SNAP is pretty unreliable...it can say "yes or no" but it's not 100% right and it doesn't give any idea how bad it is. The Spec test gives more information.

    The treatment is pretty much what you're doing though....fluids, nausea medication and pain medication. Pancreatitis is very painful so that needs to be addressed.

    Here's Marje's Primer on Pancreatitis that has lots of great information

    Sorry to hear Charlie is feeling so poorly. Hope you can get him feeling better soon!
     
  6. Darin and Charlie

    Darin and Charlie New Member

    Joined:
    Dec 24, 2017
    thanks for your reply Chris, we started at 100mls/day on 12/3 at 8pm, had only 2 doses of fluids prior to the most current test, with the increase in the values my vet thought he needed more fluids, by here calculations, he could safely have up to 300mls/day. She said his heart sounded great. She has me do a breath rate couple times after giving the fluids, he has been with in range.

    as far as the cerenia / ondansetron would this be daily dosing for his condition?
    i have another vet visit 12/7 at 2pm cst for another lab to see how he is responding.
     
  7. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    It can be dosed daily if necessary. We've had quite a few cats on both for long term use
     
  8. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    i think i will plan on that, the cerenia dose i gave 5hrs ago must just be starting to have an effect. He just ate 2 tbsp of baby food.
     
  9. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    Do you ever hear about Michael? Last entry on his Facebook page was July 30th, 2017
     
  10. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    not for a long time, that last entry was probably the last i had heard seen anything
     
    Chris & China likes this.
  11. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    charlies sugars usually spike after vomiting he did vomit 2 time tonight. 12/6 2pm bs 110
    12/6 8pm vomit
    8:30pm bs 180
    1015pm bs 159
    11pm vomit
    12/7 12:45am bs 203
    1:15am bs 234
    last time he vomited he spiked to 166 but server hours later he was back to 120.
    just incase we have to get back on the juice what are the rules as to giving fluids and insulin, ive read that the fluids increase the power of the insulin. his dose was 3 drops last dose was 12/1 morning.
    not sure how to proceed if starting up with the insulin again, i give sub q more to the right side of the shoulder then where i give insulin.
    i only have a 3hr window am/pm where insulin/fluids can be given
     
  12. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    How much do you think 3 drops was?

    I'm thinking you might want to start at .25 unless that's a lot more than the 3 drop dose.

    You want to try to give fluids at least 2 hours before or after insulin and since they're usually done in the scruff, do the insulin somewhere else like the abdomen, side or flank.
    [​IMG]
     
  13. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    Probably like a skinny .25, if I have to start the insulin, fluids 2hrs after insulin should work for me, thanks
     
  14. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    Hi Darin. I thought I recognized the names in your username. Thank you so much again for helping Paula :bighug:
    I too, hope Michael is doing well.
    I have heard that sometimes fluids can lower the BG after they are given. Have you noticed this at all with Charlie? If you are not going to be able to monitor outside of your 3hr window, you may want to switch it around and do the insulin first, and then do a BG test before deciding on doing the fluids 2 hours later. Just my thoughts.
     
  15. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    He had a pretty bad night last night I'm switching vets, just felt like my regular vet was just dropping the ball and stuff, such as the day that I picked up fluids there were no directions with it, like how much to give how often and just some other stuff and I feel in the dark with them, we have been hospitalized twice we didn't start talking about Sub-Q until 2 days after the 2nd hospitalization now he's with the new vet we're going to be hospitalized him and till all his levels go back to normal normal, and then restart with the home fluids and I have some other kidney support stuff that should be here by Monday.
     
  16. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Hi Darin. I remember you as as well. I’ve given daily fluids for more advanced CKD but usually 100 ml. I’ve given 150 ml a few times but just for a day or two.. Those kidney numbers are high. Was a urinalysis done? Did your vet say he was dehydrated or is he just hoping extra fluids will bring the numbers down? Any chance of an infection? Pancreatitis symptoms varies from cat to cat and even episode to episode in the same cat. Ondansetron can be given three times a day as itwears off kind of quickly. It used to take about 30-45 minutes to start working for Max. Cerenia is given every 24 hours. Dose either daily until the appetite is normal. The first time I gave Max fluids his bg dropped quickly but subsequent fluids didn’t cause a drop. It’s an ECID kind of thing. I hope Charlie feels better soon.
     
  17. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Sorry to hear this. Sounds like IV fluids are needed. The phosphorus is too high and will also make him feel nauseous. You will need either a low phosphorus food or a phosphorus binder added to his food.
     
    Last edited: Dec 8, 2018 at 7:33 PM
  18. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Hi Darin

    I was just dropping in and got the tag. I also remember you and thank you again for all you did to help Paula and Michael. :bighug::bighug:

    Did you get any more labs since he got IV fluids? His renal values are, frankly, pretty high. I have seen higher but his are up there. Sometimes a few days on IV fluids will bring down the creatinine and BUN so I wonder if you’ve had any updated labs. Subq fluids at home won’t usually bring down those elevated values.

    The other issues I see are the phosphorus way too high. The calcium x phosphorus should not be over 70 or you risk tissue calcification so the niacinmide and the P binders will hopefully help but you should also get him on as low a P diet as you can. You can read more about the issues with high P levels here.
    His potassium is way too low so he needs some help there as well.

    One thing to remember is that dehydration can affect labs so let’s hope you are seeing some better results with fluids.

    Please keep us posted.
     
  19. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    Hi Tiffmaxxe, old regular vet did an in house pancreatic test came back positive, but did not send off for spec fPl.
    On 11/23 was given an antibiotic injection, labs indicated infection, next lab showed that injection did what it was supposed to do, on 12\5 my vet prescribed sequin 25mg 1/4 tab daily for I don't know what (felt she was blindly throwing darts)
    The old regular vet never talked to me about how to treat the pancreatitis, did not send me home with any meds to control/help symptoms, nor any meds to help with any ckd symptoms. No original talk about binders, only her is some samples of prescription vet food.
     
  20. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    Lab posted is before being hospitalized. 1209180108.jpg can someone tag Marje and Gracie, thanks

    I have to figure out how to control the vomiting at all cost. Every time he vomits his bs spikes. On thurs afternoon his b's was 105, (in remission as of now, no insulin since last Saturday 12/1), that night around 8pm he vomits give cerenia,
    8:30 test bs 180
    9:30 bs 167
    10:15 bs 159
    11pm vomits
    Pretty sure I test his bs but can't find in notes
    12/7
    12:45am bs 203
    2:30 am bs 234, I went to work
    11:30am home from work, bs 438
    12 went to new vet appointment, knowing he would need iv fluids and to get his bs lowered.
    Every time he vomits he gets that much more dehydrated and needs iv fluids.
    He is currently hospitalized until Monday/Tuesday.
    12/8
    6pm hospital vet calls with update, he is active and eating pretty good, bs is holding around 120.
    Labs levels (I will post labs after work and visiting Charlie) are coming down compared to the before labs.

    I can not afford anymore hospitalization, if he continues to vomit, I can't get enough fluids to help him.
    Items I will have available

    Niacinamide, fast acting phosphorus remover
    Mirtazapine appt stim
    Cerenia nausea control
    Ondansetron nausea/vomit need to get from vet
    Sub q fluids
    Foods
    Weruva paw lickin chicken phos 196

    Arrives on 12/12
    Weruva steak frites phos 118

    My main concern at all costs is the vomiting.
    If there is anything else I need to have in my toolbox let me know.
    I would like to have as much as I can on him when he returns home.

    Thank you and very much appreciated.

    Darin & Charlie
     
    Last edited: Dec 9, 2018 at 3:09 AM
  21. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    You probably can get cerenua cheaper on line but will need an RX. So but some to have when he comes home and get an RX so you can get mire as needed. Max rarely vomited and I used ondansetron for nausea. I bought it mostly from Costco or on line. Most vets don’t have it as it’s a human drug. Your vet will charge too much for it if he does have it.
    I’m not fond of mirtazapune. I used it for Tiffany and it made her very vocal and agitated. I understand tge transdernal firm if it murtaz has fewer side effects. Give as small a dose as you need if you try it. I used cyproheptadine for Max as needed but rarely needed it if nausea was successfully controlled.

    I’m not familiar with the binder you are using. I used aluminum hydroxide powder that was pretty tasteless. I just added more water to tge food as it was tacky.
    Sounds like he is improving. :bighug:
     
    Last edited: Dec 9, 2018 at 4:38 PM
  22. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    He has excellent response to the mirtz, the supplements I have should hold me over till I can make an online order.
    Posted is the PDF on niacinamide.

    It's my understanding that the higher phosphorus lvls is responsible for the vomiting.

    Thanks for your reply
    Darin & Charlie
     

    Attached Files:

  23. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    Not a question about Charlie, but my mama cat I got spayed last Monday did pre surgery bw, vet said liver values were high, but was not concerned since mama cat looked so good, is there times when bw shows a high value that would not be concerning. Can't remember how high, do have labs at home
     
  24. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Thanks for posting that link. It’s a new one to me. Nice to see an alternative. I’ll read it later.
     
  25. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
  26. Darin and Charlie

    Darin and Charlie New Member

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    Dec 24, 2017
    Strange stuff going on with Charlie at the emergency vet

    The emergency vet just called to update me about Charlie.
    Yesterday when he was admitted his b's was high 500's they used humolog to bring in down to safe range.
    This morning they called to update me 630amand said there was a spike in his bs the night before, so they gave him his .25u, she did not give me the original number or what it spiked to, or the times of the test , but told me his sugar now was 127 or 137 can't remember.
    When I went to visit him around 12:45 the vet tech said they gave insulin last night at midnight.
    The part of the update she just gave me was they I can't remember exactly was she said but at one point his bs was 109 they fed him k/d pate 38.9%. The did blood work and it had dropped to 62 at 2, in 2 hrs I think, (she was talking so fast and would just keep talking when I would try to ask a question) said no insulin of any kind since last night at midnight.
    Non of this makes any sense.
    If I skipped any info that you might need I can give you more, but I'm physically, emotionally, and mentally drained dealing with all this.
    Thanks
     
  27. majandra

    majandra Member

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    Oct 11, 2018
    I can't offer any advice, just support
    :bighug:
    Hang in there
     
  28. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    The fast acting insulin may have been too much. Just guessing. I think perhaps what his body is fighting has him bouncing around. I wonder if he ate enough food? Hard to say not being there. Did he seem ok to you while you were there? :bighug:
     
  29. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    I agree with Elise.....without knowing more, they may have over-done it with the Humulin .

    Does your phone have the option to record a call? Or put it on speaker and have it record your conversation? Makes it a lot easier when they're throwing lots of information at you when you can go back over it
     
  30. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    How’s Charlie doing?
     

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