? 04/17 Eddie Update: Hospitalization and QUESTION

Good Day everyone,

Here is yesterday's very challenging day following Eddie's CT scan event and possible pancreatitis:

https://felinediabetes.com/FDMB/thr...titis-need-advice-please.262095/#post-2938723

Just spoke to vet at clinic. The shorthand version of our phone call:

No ketones. Rapid pancreatitis test negative. Possible UTI infection (bacteria in urine via cystocentesis), which will be confirmed later this afternoon (slide under microscope).

WBC-normal, neutrophils-normal. Hopefully, treatment=broad spectrum antibiotics.

How do you spell relief?

Will post final update. It's also odd: Eddie's BG at what would have been AMPS + 3 = 12.3

I'm almost ready for a power nap, stat.

 

Oh I'm so thankful that he was negative for ketones and for pancreatitis at least the rapid test. Poor guy! Poor you. Hopefully you're getting in that power nap! Healing prayers already sent up!

 

I'm happy to hear this is a UTI. I hope it clears quickly.

 

Hoping this is “only” a UTI. Were the kidney and liver values normal as well? Any fever? Poor boy has had a rough few days (as have you). Thinking of you.

 

I hope Eddie recovers soon.

 

Sending prayers.

 

Spoke with vet: she was able to isolate and confirm bacteria from the urine on a slide. The sample will still be sent to IDEXX. Blood, kidney and liver values all good and in normal range. Only anomaly, slightly higher sodium...BG 12.00.
The plan is to rehydrate and stabilize so he will spend tonight in the hospital and the some tests will be done again tomorrow. Tonight they will see about giving him insulin...
What a week this has been.

 

Thank you!

 

This has been a rough week for you both! It's great news that it is uti and all other values are normal! Get some rest continued prayers for you and Eddie!

 

Hope your little guy is on the road to recovery. Get some good sleep!
Tom

 

Paws crossed Eddie comes home soon. Did they say if he's been eating?

 

I just spoke with the hospital. Eddie has eaten!!! They said he's a little drowsy (Gabapentin) but he ate. I feel like celebrating!!!

They did a BG test on him prior to his eating and it was 198, which is phenomenal given he's had about 3u over the past 36 hours. They are going to test again since he's eating a reassess. They did not want to give him 9u in his recovery mode.

Honestly, I feel like weeping with relief. Thank you, again, everyone, for your support. It really helped to be able to report what was happening and to have such compassionate and kind responses. It means a lot.

 

I will tonight, thank you!!

 

Thank you!!

 

I have just been reading about what happened to Eddie over the last several days. You two have been through so much. I am terrified by what happened to Eddie. Thank the Lord he is alive. I hope you will get more answers soon.

 

Thank you!! It has been terrifying. Such a perfect word. I'm about to post an update with today's date...

 

@Wendy&Neko
@FrostD
@Bandit's Mom

Hello Everyone, Eddie is coming home tonight!! I'm going to pick him up. I have a question about insulin dose. For the past few days whenever he got insulin it was 1u. I spoke with the vet a few moments ago and she was saying that Eddie @ AMPS was 248 and @ +8 306 (so, he's eating now and still on fluids). She was thinking we should go to 4.5u and I said no, I didn't think I would be comfortable increasing that much after these few days at 1u or zero units.

I said I'd be ok with 2u and I'm wondering is 2u ok or should I just go to 1.5u given the current situation. I don't want to put him in a hypo episode.

Their only concern has to do with low body temperature. For awhile Eddie's temperature was lower than they liked and so they put him in a warming enclosure to raise his temperature. He's been out of it for about 5-6 hours and seems ok but I'm told if he seems lethargic to bring him back and readmit. They think, though, the low temperature might be a function of the sedative they gave him to allow for placing the fluids, etc. (Acepromazine maleate, one of the side effects is a change in heart and respiratory rate and thermoregulatory ability allowing for either hypo- or hyper-thermia. The vet thinks that medication might have still been on board.

Anyway, he's coming home!! Please let me know your thoughts on insulin. 2.0u or 1.5u.

Thank you!!!

 

Glad he's coming home!

Do you have a heating pad by chance? Or heated blanket? Might be nice for him to have the option.

Hmm. I don't think I'd be as conservative as you're thinking, but I also wouldn't do 9U. Ironically, 4.5U sounds like a nice compromise. The trouble there is I don't know what that means in terms of getting him back up to a good dose, that's potentially weeks of setbacks. Unless Wendy says you can call them failed reductions or fast track.

If he were my cat, I'd actually do 7U. But I know you're tired, and worried. See what Wendy says.

Remember that he's still at risk of DKA while infection resolves, and he's not getting enough insulin. Depot has sort of drained by now with the skips and reductions.

 

Oh, really? Hmmm. I am worried to do higher than 4.5. Hopefully Wendy will see this by the time I get home with him. I do have a heating pad...and I've cranked up the gas fireplace by his bed...
@Wendy&Neko

 

So you didn’t ask me and I don’t usually give dosing advice…. But given that Eddie doesn’t have a history of DKA and things aren’t exactly normal right now, I’d say better to err on the side of caution and go with a conservative dose. For now. You can always fast track back up the dosing scale. But you can’t get the insulin back out once it’s in.

That’s just my two cents. Is this return to the old universe or a new universe for Eddie? Probably the former, but one never knows until the data is collected. If the UTI or whatever else is going on is resolving, his dosing needs might be lower. Fluids can also lower BG. Probably not down to 1.5u forever, but who knows what he needs right now. I’ve held a hypoing cat as it died despite aggressive efforts to being BG back up via syrup in the rectum (not my cat, and situation “shouldn’t” have happened because the dose should have been safe) but sometimes things change. So yeah, I’m pretty conservative…

Now I’ll wait for everyone to roll their eyes and disagree with me, lol. Just wanted to put it out there so you know that you’re not crazy in your hesitancy…

 

Hi JL, In this case I’m an err-on-the-side-of-caution advocate. I worry after all he’s gone through to keep it conservative. I’m at the vet waiting to pick him up and there is a woman here by my car just sobbing. Heartbreaking. I wish I could do something.
im wondering what Wendy think. Thanks for your thoughts.

 

Nah, nobody will do that for being conservative based on experience!

My reasoning is he's been at 8-9U quite awhile, well before the UTI. In my experience, I believe the IAA antibodies drop the BG while infections are present in some cats (again unfounded, just my theory with what I've seen with Mr Kitty) then they go back up.

I don't think there's a heck of a lot of depot left, so it's not like shooting 7U on top of a full 9U depot. The late 3U shot plus 9U depot kept him mid blue for one cycle, and he's been climbing since. So the dose needs to be somewhere in between there I'd say.

 

Gosh, everyone, you can see I'm not the sharpest knife in the drawer tonight. I posted the question here, which is the April 17th thread and not today's post. Oh, well. He's home!!