? Yum has been a bit lethargic the last 3 days

Discussion in 'Lantus (Glargine) / Levemir (Detemir)' started by MJW, Feb 17, 2018.

  1. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    Do you think she could be lethargic because her BG is finally approaching normal levels she hasn't felt for a while?
    Or do I need to worry about cabergoline side effects?

    Her breathing rate is elevated now while she is resting---between 40 and 50 breaths per minute.
    I think that is new for today.
    It motivated me to measure her heart rate, which is low normal 137 to 148.
    Why is she breathing faster than she should be? It was noisy a while ago, which is why I measured it.
    I don't hear anything odd now.
    She is 3 oz heavier today than yesterday. I don't think she has poo'd.
    If she had pain, I think her heart rate would also be elevated, right?
    I hope I am just being crazy.
    I had her BP checked Thursday, just because we hadn't checked it in 6 months. The systolic was around 150, a good number.
    She wasn't anemic in her blood work a few weeks ago. She gets B12 shots once a week.
     
  2. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    So, lower and unusual BG could cause tiredness. I don't know about the other possible causes, unfortunately. But I did see that in Quintus when he started coming down. My personal explanation was that as glucose was finally getting into his cells, his metabolism was finally able to do a whole bunch of stuff it wasn't able to do before => tiring.

    I have no idea about the breathing. Is this something that sometimes happens? Elevated breathing is something I'd give the vet a ring about, but I'm maybe overreacting because it's not an issue I'm familiar with.

    :bighug::bighug::bighug:

    Aside from that it's so nice to see all this yellow, not long ago it was only black and red!
     
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  3. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    I agree with Stephanie, as she approaches lower and healing numbers, the body is working like it is supposed. A bit of a reset going on.

    Have no experience on the breathing issues.
     
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  4. Stacy & Asia

    Stacy & Asia Well-Known Member

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    I would record a video of the breathing episodes to show your vet, that’s what I did with Asia. Have you had the Bnp test done on Yum? It’s an indicator of heart disease, more like a yes no than anything diagnostic, but if it’s positive, you could proceed to get an echo or something more definitive for diagnostics.

    To me there’s a huge difference between tired and lethargic. What makes you say she is lethargic? Asia was very sleepy when she started seeing normal numbers, but I still wouldn’t have called her lethargic, she was interested in eating, used the litter box, enjoyed attention, would purr, she just slept more than usual. When I think lethargic, I think hiding or sleeping in unusual places, not much interest in anything, head down, things like that, which I would say are not symptoms of lower bgs they aren’t used to.

    I hope you figure out what is going on and Yum is feeling better soon. :bighug:
     
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  5. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    She saw a cardiologist and had an echocardiogram last August. I think we did the BNP test. She has a stage 3 murmur due to normal physiologic changes with aging. Of course that was last August.
    Yum has been affectionate and more clingy. She does droop her head a bit and her eyes squint a bit when she rests. Her eyes weeped some earlier. She's not hiding. She was very interested in breakfast, snack 1, and lunch today. I didn't offer snack 2, and she has not eaten dinner. I enticed her to dinner with canned salmon, which she ate, but her main dinner only drew a lick or two.
    Her breathing is still rapid and she is making snoring sounds, apart from purring.
    Acromegaly can cause extra tissue to grow in the throat.
    She might have picked up an infection when I had her at the vet Thursday for a BP check.
    If she is the same in the morning I will probably take her to the emergency vet.
    I don't want to make a mistake.
    Just because I am crazy doesn't mean there's nothing wrong with her.
     
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  6. Stacy & Asia

    Stacy & Asia Well-Known Member

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    You're not crazy, I would be concerned with it too, especially if this is not typical for her. I hope she relaxes a bit and you can take her in the morning. Any chance you could get ahold of your regular vet after hours/weekend and send a video and see what they think?
     
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  7. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Bubba was very lethargic when he first started staying in green numbers. But, the breathing thing, I don't know, as I don't have experience with that and cabergoline. I like Stacy's idea to video the breathing if it reoccurs. It might be worth a call to the vet office.
     
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  8. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Cabergoline side effects seem to be mostly GI related. I haven't seen any with heart or breathing issues. Breathing over 30 at rest should be discussed with the vet. Eye squinting or weeping can be acro things. As is the snoring.

    Looks like Yum is due for another increase. Looking much better though.
     
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  9. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    So true! (except you're not crazy)

    Video of breathing and send to vet seems like a really good idea. I've found videos invaluable to get first opinions without risking dragging the cat to the vet for nothing. You can also post it here, who knows?
     
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  10. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    I can measure breath rate, so I don't think I need a video. It was still high at 40 breaths per minute at AMPS, but the last time I obsessively measured it, it had fallen to mid 30's. The breath noises (stridor? seemed to be on exhale) have subsided too. Maybe she had pain. Maybe her BG bumped up last night because she had pain.
    She is eating but not ravenously.
    I read cabergoline can affect heart valves in humans. Maybe she has a headache or a stomach ache. She finally poo'd, but not a lot.
    Cats hide their pain. They "talk" and make demands and complain a lot, but they don't describe their aches and pains.
    She's not feeling great; she's not going outside even though it's warmer. But I think she is medically stable.
    Thanks for all the feedback here. And thanks for the input about cats being tired as their BG drops to normal.
     
  11. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Was she asleep when you got the high breathing rate? I'm just asking because sometimes when my cats are dreaming they will start to breath rapidly for a few minutes, then when they pass out of the dreaming phase, they quiet back down again.
     
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  12. MJW

    MJW Well-Known Member

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    She has been dreaming a lot. I made sure to measure it when she was awake but resting.
     
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  13. MJW

    MJW Well-Known Member

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    Cabergoline can cause dyspnea (rapid breathing) in 1% to 10% of humans. I think I will try cutting her dose back to every other day.
    I emailed my vet. She will be a better judge of how worried I should be.
     
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  14. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Was the breathing “discordant” ie chest and abdomen not in sync?
     
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  15. Wendy&Neko

    Wendy&Neko Well-Known Member

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    The breathing noises sound like typical acro stridor, due to thickening of the pharynx, lethargy is also a common acro symptom.

    Is Yum on anything for pain? Regular buprenorphine was a game changer for Neko. Growth pains, headaches are part of human acromegaly so likely for our furry ones too. Some people have success with gabapentin, but it did nothing for Neko but make her sleepy. A couple peeps have tried CBD oil, but I have no experience with it and there are no studies on it's use in cats, though CSU is doing one for dogs.
     
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  16. MJW

    MJW Well-Known Member

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    Oh. That sounds terrible. I don't think it was discordant, but I'm not sure I would recognize it.

    My vet wanted me to go to the ER today, to have her checked for fluids in or around the lungs.
    Since her respiratory rate has improved all day, and she since she seems happier and more comfortable, I decided against it.
    I did listen for crackling in her lungs with my stethoscope, but I didn't hear any. Not sure I would recognize it of course.
     
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  17. MJW

    MJW Well-Known Member

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    She did seem to be in pain yesterday. Today she is improving. I'm giving her adequan for arthritis, but nothing just for pain. I will have to discuss pain meds with my vet. Very depressing.
    I will give her cabergoline only every other day for a few days, to test if any symptoms correlate with dose frequency.
    On a happier note, she was at an AT2 135 at AMPS+9!
     
  18. Stacy & Asia

    Stacy & Asia Well-Known Member

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    I started giving Asia bupe for arthritis and pancreatitis, it made a world of difference. It is sad that they need these things, but it’s nice that we can help them feel comfortable again.

    Yum is starting to look really good on paper, it must be such a huge relief from all the reds and blacks! :bighug:
     
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  19. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Woot for low blues!:cool:

    The thing with having an acro cat is recognizing and managing any symptoms. Such as pain relief. I am glad she seems better today. Her appy would probably be off too if she had CHF. Any coughing, and I would bundle her up to ER. Paws crossed.:bighug:
     
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  20. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Glad she’s better. Do try and get a video if she does the breathing thing again, i can look at it and tell you if it’s discordant.
     
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  21. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    Maybe her chest and abdomen are moving in opposite directions when she breathes. I guess that is discordant breathing, which can be related to heart valve problems.
    Her respiratory rate has stayed below 40 today, but it doesn't go lower than 30 even when she is completely relaxed.
    Sometimes she makes a sound in her throat when she exhales. It's not purring. I wonder if she is moaning from pain.
    I hope there is nothing wrong, other than her adjusting to low BG values, but I will take her to the vet this afternoon.
    We go there almost every week...
     
  22. Wendy&Neko

    Wendy&Neko Well-Known Member

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    It's stridor. Unfortunately, normal for acros.

    Good luck at the vet. Nice to see the return of the green today. I found the IAA meant Neko delayed her bounce.
     
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  23. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    Vet took an X-ray. No fluid in Yum's lungs or chest. She was scared so her respiratory rate and heart rate were naturally elevated. Her gums were pink and her blood was well oxygenated: 93%.
    Her respiratory rate was higher again at home today after her cabergoline dose. It was lower all day yesterday, when we skipped the cabergoline.
    I called the pharmacy this afternoon and they said the base they use in their compounding is a sugar syrup. If cats can't taste sugar, why are they using sugar? I wonder how many carbs she is getting in that .5ml dose??? Maybe that is why her BG goes high after her cabergoline dose? Maybe she went low last night because we skipped the cabergoline?

    Always so many questions and so many unknowns.

    She is definitely not feeling great, but I don't know why. Maybe it will pass.

    I should be celebrating her greens but I am too afraid of the acromegaly.
     
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  24. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Good news on the no fluid.

    Sugar syrup? :banghead: Works for dogs. Next time I would ask for no sugar.
     
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  25. Bronx's dad

    Bronx's dad Well-Known Member

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    Nov 30, 2016
    That stinks to hear they are putting sugar in the cabergoline. When I got the fish flavor cabergoline, I did ask about carbs and they said none, but it was not assuring.
     
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  26. MJW

    MJW Well-Known Member

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    Well, Karo syrup (a sugar syrup) has about 57 calories per tablespoon.
    That comes to about 2 calories per 0.5ml.
    So if I mix 0.5ml of the medicine with 1.5 oz of radcat chicken, I'm feeding her about 4% carbs, about 6% carbs if I mix it with 1 oz of radcat.
    I guess it's not a disaster. She always gobbles it up.
     

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