08/04 J.D. PMPS 315, +2.5 244

Yesterday's Condo

Last Night:
330 PMPS
250 +4.25
283 +6

I was rather impressed with the 250 at +4.25 considering all the HC that J.D. ate at PMPS and again at +2.25.

I went out shopping for J.D. stuff at WalMart last night with my elderly neighbor and got off schedule with J.D.'s syringe feedings. I had to ;-) have a beer with her after I ran home to feed at +2.25, as she is leaving for Germany this week. I returned home at the +4.25.

J.D. was walking around this morning and his coat is soft and fluffy and appears clean, although I know he needs a bath.
He got 10ml of MaxCal at PM +11.75, and after his insulin and a sampling (some licking of) MC FF Medleys, we went for a walk.
He got 20ml of MaxCal and his meds, including his bupe at +0.75, and now he is just laying on the couch.

Oh, he did lick at some LC FF this morning when he first got up.

I think all he has is 30ml MaxCal and some Miralax left to be syringed and then he is done with his meds for the morning. I hope he understands that all of the shoving things down his throat is helping him.

My thoughts are with Mariko, and her Ginger, today.

Re: 08/04 J.D. +11 437, AMPS 572, +3 379

My squirrel friends have been hanging out on my deck, and I got one to step 3 inches into the house. I know, not a good idea :lol:

J.D.'s test results are in, and they are trying to fax them to the IM vet but his fax is busy. They said I can go pick them up, so I'm off to go get them.

Then, I need to hop in the shower and clean up, lest I look like a worn out crazy cat lady for the IM vet. We leave in an hour.

Re: 08/04 J.D. +11 437, AMPS 572, +3 379, +4 258

I have a print out of the CBC and a doctor hand written report.

His USG is 1.022 same as last time
Pro: trace?
ph: 6.0
I can't read the rest... but No infection, No something :roll:

His WBC, MCV, and MCHC are back within range, and his RBC and HGB have improved a little.

I have to try to feed him something... although I have no syringes made up, and the get on the road.

Re: 08/04 J.D. +4 258 - some test results - off to IM vet

Good initial reading on the labs!

Good luck at the IM vet today. Paws crossed for excellent labs.

Re: 08/04 J.D. +4 258 - some test results - off to IM vet

I was looking at his condo yesterday and on the schedules, I think if you are going to give SEB, you must separate the times more from the meds....so give the meds later OR give the meds first and give them a minimum of an hour (longer is better) to absorb and then give the SEB.

Your health food store is highway robbery! A one lb bag of powder at vitacost is $28.00. Of course, it would take forever to go through one lb. I can buy some here and mail it to you. It would be so much cheaper. Mike has a discount with fedex so we could overnight it. PM me if you are interested and I'll go get it today.

Forgot to answer your other question but I'm pretty sure I posted this the other day. You can try to stop the Pepcid and use the SEB syrup and see how it goes. You can always restart Pepcid.

Re: 08/04 J.D. +4 258 - some test results - off to IM vet

let us know how the vet visit goes, dyana.

i'm glad you took the time . . . since you "had" to have a beer with your neighbor. ;-) you need that little bit of normal life!

Re: 08/04 J.D. +9.25 158 Back from IM vet had ultrasound & x

I'm just copying and pasting this from what I sent to the Feline Assisted Feeding Group and the Feline Pancreatitis Support Group, because I'm a little worn out.

We got home at +8 and our appointment was from +5 to +7.5. The second I stepped in the door, I got company.

The IM vet shaved his belly and gave him an ultrasound and a couple chest xrays. His pancreas is a little enlarged and parts of? his lower intestine are thick. He (the vet) was talking possibly IBD (just another support group to join), but said the way to confirm it is with a biopsi and J.D. shouldn't be put under anesthesia at this time.

I asked him about the buprenex dose and the doctor thinks cats don't get pain from chronic pancreatitis like dogs and humans do.

He talked a little bit too negatively, for me. He said we can try an anti-inflamontory like lucharan or something like that, or pred something, but the pred something is a steroid and isn't recommended for diabetic cats. He said the lucharan? would be expensive and wouldn't show results for at least 4 weeks, if it works. He seemed knowledgeable, but...

The IM doctor said the pred drug could cause heart failure and mess with his diabetes and the lucheran or whatever it's called could cause his WBCs to lower, and explained that they are both immune depressants (I am soooo bad with medical stuff), but that if his gets an infection, he can still have antibiotics.

That Ultrasound and chest xrays were scary.

He also said J.D. is blind. I've thought that Baytril was affecting what little eyesight J.D. had left. Maybe, I'm just imagining it, and he's been totally blind for a while, but he does seem to see less, just lately. It could just be my fear of Baytril and possible blindness.

He's supposed to email his findings to me. And hopefully, he'll send a copy to J.D.'s regular vet. I would like to talk to her, too.




I syringed 50ml of IAMS Maximum Calorie to him this morning, and we left two hours later, so I quickly blended some canned chicken and pumpkin canned cat food and stashed two syringes in a plastic bag in my purse. I gave him one right before the ultrasound.


He ate a bit of medium carbohydrate Fancy Feast Medleys when we got home, and a little bit more about a half hour later, and just ate a bunch of it about 20 minutes ago.



His CBC blood work came back and his RBC and HGB have improved a little and all else that was out of range is now within range. Oh, and I asked the vet at least twice about what to wash his lips and chin and side of his mouth with after syringe feeding (because I don't want him to get sore or pimples, or loose the whiskers he needs to "see" with), and he said he didn't know. He said syringe feeding causes food aversion

Marje, I asked the vet all my questions, and I had about 15 of them.
I asked him about Slippery Elm Bark and he had never heard of it.

J.D. just got up from a nap and just now, and ate some more MC.
Okay, it's +10.5, but he's eating cat food from a cat food bowl.

Re: 08/04 J.D. +9.25 158 Back from IM vet had ultrasound & x

That is a lot of information to digest. I see some good news in there, that his b/w is better. I hope some more knowledgeable people come along soon and can give you some advice. Thinking of you and J.D. :YMHUG: :YMHUG:

Re: 08/04 J.D. +9.25 158 Back from IM vet had ultrasound & x

Dyana, I saw what Stacey wrote to you on the FPS board and I agree completely. I can't believe a specialist would suggest going directly to a chemo drug (leukeran) without further diagnostics. I don't like the yahoo IBD board at all. I feel that there are several people giving inaccurate advice, just my opinion. I wouldn't waste my time there. Many cats on the FPS list are dealing with IBD and Stacey and Maureen know as much about it and more. One of my friends of the list is using pred but her cat had a biopsy first because should you ever feel it could be small cell and you start pred, it is harder to get a diagnosis. Have you tried changing to a novel protein that J.D. has never had before? That can often take care of IBD and a grain free diet works for others. Going the med route is not something I would do without trying a strict diet trial as it often takes care of the issues. I'm glad the anemia is correcting itself. :YMHUG:

Re: 08/04 J.D. +9.25 158 Back from IM vet had ultrasound & x

Oh wow... I don't like your vet already..

CATS DON'T FEEL PAIN FROM PANCREATITIS LIKE HUMANS AND DOGS DO??

CATS ARE IMMUNE TO PAIN IN THEIR INTERNAL ORGANS?????? Oh, so not all of their internal organs, just the pancreas doesn't feel pain????

That would be a big time WRONG there, vet... If J.D. has pancreatitis, likely reason he is not eating well is because he feels pain.

:roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll:

Re: 08/04 J.D. +9.25 158 Back from IM vet had ultrasound & x

I have to agree with Tina that I'm not impressed with the vet. I know for certain cats can experience pain with pancreatitis as Gus had an acute episode and he was absolutely in pain.

Leukeran is a chemo drug and, if you recall, Mariko tried it with Lucy and it made her sick. Budesonide is a steroid but is very helpful with IBD specifically.

Well I am not surprised he hasn't heard of SEB. I'd say 99% of allopathic vets have not.

IM Vet and some questions

Is Budesonide okay for diabetic cats?

The doctor said he wouldn't recommend putting J.D. under for the biopsy. And as far as the two meds he suggested Prednisone or whatever it is and the Leukeran which is very expensive, he said more than once, "if they help".

His temperature at the acupuncture vet was 99 on Saturday. It was 100.4 last night, here at home. At the IM vet it was 98 and the vet tech did it the first time, and I questioned whether that was okay and the IM doctor took his temp. again and it was 98. Isn't that very low? Do I need to worry about that?
I googled and found:
In general, hypothermia can be due to:
- Poor perfusion
- Vasodilatory substances (as in the case of pancreatitis)
- Heart disease
- Kidney disease
- Dehydration (more severe)

Marje, thank you for the offer to overnight some SEB to me. I want to talk to a vet about it. I am hoping that J.D.'s regular vet will call me. I just don't know how I can give it to him 1 hour away from other meds. I'm sure it's possible. I just need to wrap my head around how to do it.

Re: 08/04 J.D. +9.25 158 Back from IM vet had ultrasound & x

tiffmaxee said:

Have you tried changing to a novel protein that J.D. has never had before? That can often take care of IBD and a grain free diet works for others. Going the med route is not something I would do without trying a strict diet trial as it often takes care of the issues. I'm glad the anemia is correcting itself. :YMHUG:

Click to expand...

How would a novel protein diet be started? Like go try to find kangaroo or quail or something? He is such a picky eater, especially right now.

Re: 08/04 J.D. IM Vet and some questions

dyana, all of this isn't my area of expertise, but i just want to send you some encouragement. you're so good with JD and he's so lucky to have you.

these are for you:

Re: 08/04 J.D. IM Vet and some questions

Hi Dyana,

Just stopping by to visit.... I started Zeus on Leukeran a couple of weeks before he passed. When we did the U/S the vet said that it could have been IBD or possibly lymphoma. They said we could do a biopsy but that most of the time they can't get in far enough with the needle to get a good sample, and we might treat the same way in the end anyway, so we chose to do the Leukeran. I had to get it compounded at a pharmacy, and it was expensive but the liquid was much cheaper than buying the pills. Zeus hated it.

I googled normal temps for a cat, it said 100.5 to 102.5. My Smokey had a low temp due to advanced kidney failure.

As for the novel protein diet, I have my cats on a hypoallergenic food, it's venison flavored and a vet diet. We tried rabbit to begin with but the cats didn't like it. My male cat Bubby has tummy issues. We just had an U/S, he's got thickening of the bowel, intestines and stomach. We are also doing a steroid (and I cross my fingers every day) and a drug for bacteria in the tummy. Knock on wood, so far so good.

Thinking of you, and J.D.

Hugs,
Kathie

Re: 08/04 J.D. IM Vet and some questions

Hi Dyana,
I'm like you: I don't know much about medical things and meds. So I just want to send you and J.D. some all-purpose vines. I hope that you get the help you need. That vet doesn't sound too promising!

Hugs and scritches,

Ella & Rusty

Re: 08/04 J.D. IM Vet and some questions

Dyana --

I think Linda's Bear Man had IBD. I sent her a note asking her to stop by.

Re: 08/04 J.D. IM Vet and some questions

Dyana

When Gus started having intestinal issues, we didn't know if it was IBD or lymphoma. We suspected lymphoma since he'd never had a single day's problem with his intestines. Due to his age, we also did not want to do a biopsy....not even a needle one for the reasons Kathie mentions. So we put him on prednisilone. If the IM vet said prednisone, then he is not up-to-date. Cats cannot use prednisone in that form and they have to convert it prednisilone so it's best to use prednisilone. However, it is no longer made by the pharmaceutical company. We had it compounded into a palatable liquid for Gus. Dr. B felt if he responded well to it and continued to respond well to it, then his problem was IBD; if not, it was most likely lymphoma. He responded well to it at first and then stopped.

Budesonide is a steroid as as prednisilone. It is less systematic than prednisilone and can be a very good choice for IBD. Will it affect his BG? Most likely it will. But JD is likely not to go into remission and if it addresses the IBD, you can adjust his insulin dose.

Re: 08/04 J.D. IM Vet and some questions

Skooter was switched from predisone to Budesonide when his diabetes was diagnosed. He gets a chicken flavored oral option...0.5mL a day and it seems to be doing the trick very nicely for him.

His IBD was diagnosed after they did exploratory surgery and did about 10 biopsies several years ago.

He also doesn't mind the medicine. I have to order it from a compound pharmacy. The clinic orders it and I pay them and then Wedgewood (I think that is the name) ships it direct to me. It is about $65 for a bottle and it usually lasts me about 2 to 3 months each time.

Thank you. All of you, for your flowers, Julie and your well wishes and stories and encouragement and help. :YMHUG:
I had a rough day, and that ultrasound the vet wanted to do was scary.

He did email the discharge papers to me.
And his temperature was 98.9, not just 98. I took it at home, poor kitty, three pokes up the butt in one day, and it was 98.9.

He has been eating some MC in a bite here and three or four bites there.

So, I may be a chicken tomorrow when I have to go to work, just to let you know and reduce his dose, if I feel unconfident in his eating.

I need to start a list of what to ask his regular vet, but I'm just exhausted and it's bedtime. Hopefully, I can think of them all tomorrow, as I hate to bug her, she is such a nice lady and so busy at the practice she's at.

Night Night, friends.

Dyana

Just wanted it chime in here...Sid (not diabetic) has IBD. We just added the cerenia on a daily basis with her. Feline vet specialist at my clinic was involved in the study for the company. Cerenia reduces inflammation and can have a bit of an appy stimulant. It can be given daily she said. 1/4 to 1/2 pill daily or every other day. Her own kitty ended up with IBD that became lymphoma. She sd she wished the drug was around back then as we would have started her cat on it when he had the IBD. Just a thought. She has noticed that at her cat hospital they haven't seen as much of the lymphoma in cats since they started prescribing the cerenia on a regular basis.

Lots of hugs for you and lots of scritches for J.D.

Vines from us too. :YMHUG: :YMHUG: I hope that you can work out your schedule. I too don't know enough about those drugs, but the IM vet does sound pretty off hand.

Re: 08/04 J.D. IM Vet and some questions

Sienne and Gabby said:

Dyana --

I think Linda's Bear Man had IBD. I sent her a note asking her to stop by.

Click to expand...

Dyana, you are dealing with a lot, and doing a great job. I don't know if I can add a great deal, but I will try to organize some further thoughts tomorrow. Bear Man tried a lot of things, including Budesonide and Leukeran, but he was primarily managed on steroids (Prednisolone and sometimes Dexamethasone). He used many other drugs for support as well, including Cerenia, Ondansetron, and Bupe.

I am unsure if a feeding trial of a novel protein can work for him because whatever you choose must be fed exclusively, and it may take weeks to start to see results. If J.D. currently needs many foods to entice him to eat, feeding a single food may not be possible.

As I once posted to Mariko, Leukeran was a wonder drug for Teddy for his lymphoma, but Bear was not able to tolerate it. After seeing that her Lucy did so badly on it, I wonder if a cat who is already debilitated and inappetent has poorer success with it than a cat who is stronger going into treatment, as Teddy was. I would be concerned about its impact on appetite, causing nausea, and also having potential to cause anemia, when J.D. already has issues with those.

I agree that Cerenia has mild anti inflammatory effects, and may also help with visceral pain. I believe that both IBD and pancreatitis are painful. If a cat responds well to treatment with a pain med, then one can conclude that the cat was in pain. You were asking the other day about sub Q Bupe, which I have used. They say that in cats, absorption by the trans mucosal route is superior to the sub Q route, so I would stick with that if you can.

As for his hypothermia, I wonder if he has some stool in his rectum. The thermometer can read low if it is in fecal matter. It must touch the wall of the rectum. Everything that happened at the vet today (cold steel table, shave, cold gel) would perpetuate hypothermia. It would be good to continue monitoring at home.

I would look forward to seeing the test results, u/s report, and doctor's report. I am sorry to hear he may be blind. Try to drop a cotton ball in front of him with your hand hidden behind his head to see if he notices it. How is his blood pressure doing lately?

If you are concerned about perfusion, the best test for that is CRT - capillary refill time. Blanch the skin above his upper canine tooth with your finger and then release and note how long it takes to return to a normal pink color. Normal is 2 seconds.

In what way were the ultrasound and X-ray's scary?

Good to hear the CBC values have improved.

Sorry that my thoughts are a bit scattered. I will try to check in again tomorrow with more thoughts if any more occur to me. I'm writing a huge exam on Wednesday, so I am a bit distracted tonight.

Oh Budesonide - Bear tried it. It helped a bit for a while, but then he needed something stronger. It is reputed to act locally in the gut and have fewer systemic effects, but I expect it will have an effect on his BG. Maybe it's worth trying to see if it helps before going for the bigger guns.

Bear also took metronidazole. It's reputed to have a soothing action on the gut. Not sure if they are still trying that for IBD. Maybe ask your vet?

Also regarding Leukeran ... I think they try it alone for IBD but for lymphoma it is used in combo with Prednisolone. IBD and lymphoma exist along a continuum. The two diseases have much in common, and the first can develop into the second. But that is why they have many treatments in common. The point is to suppress the immune system, which both steroids and chemotherapy drugs like Leukeran both do. Leukeran is a very big gun. It saved Teddy's life, but I don't know if J.D. could tolerate it right now. Something to discuss with your vet.

Take care. J. D. has a good Mom.

I agree that this vet does not sound too promising. Perhaps he treats a lot more dogs than cats and isn't really up on kitties.

Has JD ever had venison or duck? Max Cat makes both, and they are low carb and low phos. My kitties love them.

I'm glad to hear J.D. is eating some on his own, even if it isn't your first choice of food.

I'm sorry to hear he is blind, but it sounds like he has been managing pretty well. I am always amazed at how well Cinco figures things out when he can't see.

Sending lots of good appy vines for J.D. and soothing and restful vines for you. :YMHUG:

(((Dyana))) I'm sorry about the diagnosis and I'm sorry the vet was so unpleasant. I was going to write a ruder phrase but decided to restrain myself. Linda is brilliant. And this is when she's distracted?

Zener is on budesonide for IBD/lymphoma. We don't know which one and don't want to put him through a biopsy. Our vet said the budesonide targets the gut better. We first started on 1 ml per day and the insulin went from about 1.25u to 2.25u. Then we went to 0.8 ml BID and the insulin went up to 3.75u or 4u and then back down to 2.25 and now we are on the way back up. The budesonide definitely helped with appy. Zener was pretty lethargic before we started it.

Tillie is on prednisolone. We get it compounded and actually prefer that. We can make micro adjustments to the dose. She's on 0.25 ml per day. Her symptoms reappear whenever we've gone below that and we've tried 3 times now. So we know she is getting the minimum needed. She also likes it so takes it easily from the syringe.

Anne can describe this stuff better than me. Let us know if you have any questions.
Liz

Dyana,

Is J.D. on any Bupenor, the pain med, right now? How much are you giving to him, and how often is he getting?

I'm not a vet, but having an enlarged pancreas doesn't sound like it would feel too good to me. :roll:

Cats absorb the Buprenor much, much better when you apply it to their gums, not on their tongue or in their food. I've used it many, many times, on a few of mycats and this drug's pain relieving effects can be instantaneous for your cat.

My Jomo vomited a lot when she had pancreatitis, but did not have so much diarrhea. I fed her baby food squash to increase her fiber, but you might try a teeny, tiny amount of a cat-safe fiber added to J.D.'s food to see if that helps bulk up the poo some.

Are you against giving J.D. the pain medication called Buprenor, also called Burprernex? I've been told by Dr. Stephen Gardner, Director of Medicine at VCA Albany CA. that cats DO feel pain when they have pancreatitis and they find that cats heal much, much faster from it when they are given pain medicine. Buprenor is the best and safest pain medication for cats.

http://www.vcahospitals.com/albany/our- ... dner/23365

In addition, he said that cat's with pancreatitis often have other digestion issues going on, like the bile spilling out into the rest of the body and coating other internal organs. The digestive issues can be food allergies from feeding cats the same food day after day after day.

We had both done some research on it, and we agreed that using a small amount of collostrum in Jomo's food was definitely worth a try. Also, for Jomo, when she did have the diarrhea, I would put her on the prescription enzymes, and then take her off of them again once her poo was normal again. (It was nearly yellow and foul smelling) That was under Dr. Gardner's supervision as well, but it really worked wonders for Jomo.

With pancreatitis you've also got to make sure that your cat has enough fluids. All the pooping and vomiting can cause dehydration. A cat won't eat if it is dehydrated. It will feel sick to it's stomach.

Sending prayers for J.D. and wisdom for you to pick the best medications for him. I am hoping your regular vet will have some guidance for you as well. Maybe this vet doesn't have the expertise with cats. You are dealing with so much and are doing a wonderful job with J.D.