01/31 Ethan

[Erin Ethan]

Hi everyone,

Just wanted to share an update on Ethan (link to last post)

We've been doing a lot of practicing with the prick test and he seems to be getting more relaxed about it...still fidgety with his ears and head but I can usually stabilize them long enough to get a poke in. Lots of praise and treats ensue.

One thing that is worrying me...Every time I manage to get a 'real' poke in now he seems to bleed a fair bit. At least 3 decent size drops drip from his ear onto the counter before it stops (and this is without a warm-up, although his ears tend to run hot). He doesn't react or jump at all when this happens, although the drips seem to confuse him.

The first time this happened I assumed I hit the marginal vein by accident, but its happened a couple times since when I'm fairly confident I haven't hit the vein. His ears both now have dried blood covering the sweet spot.

I am wondering what I could be doing wrong. I use 28-gauge lancets, by hand, aiming for the sweet spot, and I don't think I am poking through the ear. Should I use finer lancets? Is there anything I could do to clean the dried blood off without too much rubbing?

Aside from test training, we switched Ethan's vet to the one who is going to be doing his dental work. When we switched, I asked to get a copy of his records. In his blood panel from when he was diagnosed with FD, I noticed that he has elevated lymphocytes and white blood cells (I think?) His prior vet didn't mention anything about this...but I think this could indicate infection (maybe from his teeth?) I'm not sure the best way to add these results to the "Labs" tab in the SS?

 

[Diane Tyler's Mom GA]

Hi Erin since Ethan seems to bleed easily you could try switching to 30 or 32 gauge lancets the bigger the gauge number the smaller the hole will be .Try the 30 gauge lancets first. What do you mean by using finger lancets?
When I test Tyler I just hold the lancet in my hand and poke
I would just use some warm water with a cotton round to try and get the dry blood off his ear. Maybe another member might have a suggestion

About the labs I tapped on your spreadsheet then tapped on labs , I see what you mean. Take a look at Tyler's labs the set up should look like that so you can fill in your results
I'm going to tag Bhooma for you , I'm sure she can fix it for you
Once Bhooma fixes it for you and you enter your results I'll tag Suzanne for you to look at them

@Bandit's Mom
Hi Bhooma if you look at Erin's SS and tap on Labs she can't enter her results I notice it's not set up like mine . Can you help Erin with this
Thank you Bhooma

 

[Erin Ethan]

Thanks so much @Diane Tyler's Mom! I'll go get some 30-gauge lancets, and will try the cotton round with warm water for cleaning his ears up.

What do you mean by using finger lancets?

Sorry just meant smaller (finer) lancets!

Take a look at Tyler's labs the set up should look like that so you can fill in your results

Ahhhh I see! I used the world spreadsheet template- looks like the Labs tab is different on there (I am wondering if there is a reason for this-- possibly to accommodate different units or reference ranges?)

 

[Bandit's Mom]

Hi Erin, it's great that Ethan is getting more comfortable with tests! Like Diane suggested, you could use finer lancets (30-31G) now that his ears have "learned to bleed" and if you're using a lancing device, you could reduce the depth of poke.

I don't see much test data on your SS for the last 10 days though? Are you getting tests but not entering them in the SS? Also that 43 (2.4) on the night of 1/25 earned him a reduction, so please go down to 1.5U.

Let me know if you need help with entering Ethan's labs in your SS. If you take a look at the Labs tab in Bandit's SS, you will get an idea.

 

[Erin Ethan]

Thanks @Bandit's Mom! Most of the pokes I've done on him to practice have been 'fake' pokes - enough pressure so he feels it (and goes through the whole process of letting me hold his ear), but not enough to draw blood. The two times I did draw blood I recorded on the SS- both those times he bled a fair bit (without any milking).

I'll reduce him to 1.5u moving forward.

After seeing Bandit and Tyler's labs I was able to enter Ethan's labs on his SS. Some of the tests I had to match up as our labwork only has abbeviations. There were some additional tests we had not listed - I added those at the top of the blood / urine test sections.

The only thing the prior vet mentioned to me was his elevated blood glucose/glucose in the urine. However from the report I obtained his WBC and Abs Lymphocytes are above the reference range. I also caught another test - "RETA"- that is elevated above the reference range as well. From what little I can find, RETA seems to measure something to do with the bone marrow output (?)

I've highlighted any unusual findings in yellow.

Edit: adding some details I found about RETA--

• I believe RETA stands for "reticulocyte count" (source: Reticulocytes, Blood - Holland Hospital Laboratory Services (testcatalog.org))
• High reticulocyte count can be caused by blood loss due to injury, ulcers, surgery, or chronic conditions, such as heavy menstrual bleeding or gastrointestinal bleeding.
• High reticulocyte count can also be caused by hemolysis, which is the destruction of red blood cells by infections, autoimmune diseases, drugs, or toxins.

 

[Kyle & Simon (GA)]

Hi @Erin Ethan. My guess is that the slightly elevated RETA, WBC and Lymph values are related to Ethan’s teeth - if he needs a dental there may be a small amount of inflammation going on. Perhaps ask your new vet about this? These numbers are not terrible- cats with massive infections or autoimmune diseases can have counts that are orders of magnitudes higher. Hopefully the dental will take care of this Wishing you and Ethan good luck!

 

[Erin Ethan]

Thanks so much @Kyle & Simon (GA) for your insight & well-wishes! It's a relief to hear that a massive infection or autoimmune disease would typically cause these #s to be much more elevated.

I'll definitely ask the new vet to get her thoughts too - she is supposed to review his bloodwork in any case to make sure there are no issues to proceed with the dental.