08/15 J.D. +12 487 - Labs - ate a little food from cat bowl!

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Dyana

Very Active Member
Yesterday's Condo

What do I do about my mess up with his insulin, last night? I ended up shooting at +15.75. That was at 9:45pm and he usually gets his shot at 6 and 6. I can just give him insulin when he needs it (goes above 200, which he probably is now), or I could do 9:00 today, and 8:30 on Sat, and 8:00 on Sun, and 7:30 on Mon, and 7:00 on Tue. I guess I'll do that. He just got his shot at +11.25. He got two syringes of food at 6:00am when he got his bupe and another three syringes with his meds at 8:30 when I woke up from this dream. It was lucid and I remembered the details well, so I wrote it out.

I had a dream:

I was in my old beloved pick up truck, and Ginger and J.D. and I had just pulled up to a farm like area.
The windows were down, and Ginger, who was in the passenger seat, and was sitting on the edge of the window and kind of tangled in the seat best and something else. I was afraid she would jump and hang herself. I started to get out, and the back seat door behind me was also open, and I though J.D. would jump from the seat and out onto the ground, but instead he choose to hope up onto the edge of the window in the door, and hope down from there. I was concerned because he is sick and frail, but he made it. I went to help Ginger.
I did not see where J.D. went. I looked around the hilly area and did not see him.
Eventually, I saw him up on a dirt horse trail in the hills probably trying to head home because he didn't know where he was. I kept calling and calling and calling.
I kept asking people where the trail was, and saying we have to find the trail.
I and someone else (I don't know who) found a trail and started down it, but it soon turned into knee deep swampy water, from one edge of the trail to the other (widthwise). I knew he wouldn't be on this trail. I thought there must me another trail, maybe higher up the hill that was drier. I kept asking people and no one seemed to be able to help me. We were in a horse pasture, with lots of little horses (mares and foals), and there on the edge of the pasture was what looked like another trail. I remember picking up a little foal that was kind of in the way to where we would need to step and handed it to my companion, who was ewing and ahing the baby. I said we have to go, we had to find J.D.
We went down that trail for just a teeny bit, and there was some strange (what later turned out to be an obstacle) in front of us. It was made of hard shiney plastic and it looked kind of like an amusement park ride, and I got in the first compartment and it went straight up in the air and then it descended, down, fast, and it seemed to take a longer time than it should have to come down.
I got off that, and found the trail and we walked a while down the dirt path, and I kept calling J.D. and calling him and calling him. I knew he had a good head start, but I knew I walked faster than he did. The trail opened up to a tiny town and I couldn't see where the trail went. We went into a bar and there were lots of people and I was asking them where the trails were, and right there was someone I recognized from the trail society. He was the head of it. I asked him where the trails were and asked my companion to describe the place we had started from, hoping he could think of what trails connected from that place. He did not tell me where the trail was, but he did say to me "I can let you take out one cat", and mumbled something about we don't normally allow extrications. We left the bar and found another trail that also soon turned to being filled with swampy water with steep edges on each side. I didn't know what to do. I was desparate and crying.
Then I looked ahead just a bit up the trail, and there was a bridge and when I looked under it there was hundreds of what looked like cat paper cut outs underneath. I don't know why I kept calling J.D., but from the first few rows, I saw movement, and I thought it was J.D., and he was coming to me. I thought he couldn't get through or wouldn't want to get through all that water and was going to help him, but he kind of walked along the steep side to me and I picked him up and it was him and he was a different color (still tuxedo) but like purple and then he changed back to black and white.
We went back down the trail and through the bar and I thought the people would be all cheering, but I think all they really wanted was for me to buy them all a drink, which I didn't. I saw the head of the trail society/police/ranger/or whatever he was, as we left and wanted to give him a high five as I was so happy, and he was just so policeman-like and not friendly.
But, I had J.D. and I was just so elated, and relieved. And then I woke up.

I am waiting anxiously for the vet to call with the results of the blood work. Please send vines.
 
Re: 08/15 J.D. AMPS 281 -Had a dream- anxiously waiting for

Sending good BW result vines. Wow on the dream. I hope you got some rest with all that concern. I had to laugh at "We went back down the trail and through the bar and I thought the people would be all cheering, but I think all they really wanted was for me to buy them all a drink, which I didn't. I saw the head of the trail society/police/ranger/or whatever he was, as we left and wanted to give him a high five as I was so happy, and he was just so policeman-like and not friendly." Those kind of dreams are always so scary. Have a great day Dyana. ((((HUGS))))
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Thank you. :YMHUG: back to you, Melissa.

The vet just called. She said his BUN was up a little and his glucose was 234 which she said is just perfect. I waited anxiously for the rest. She said his RBC was much improved and his WBC was slightly elevated but said she wasn't that concerned about that right now. She said his potassium and sodium were off and suggested I go to the grocery store and by him some steak seasoning called New Salt or something like that. I said shouldn't I get him a prescription medication, and she said that the problem is that they don't carry it and it could take until Monday to get it if they order it. I asked if maybe the ER vet would have it, and she said she would call around and see if she can get some and call me back. I would be willing to drive far to get it, if that's what's needed.
She said that potassium can be lost from the insulin and it can be lost from kidney disease. Anyway, that's why he was walking so low to the ground.
She said that the Lactated Ringers (which I have) has potassium in it along with a bunch of other stuff. I thought it was just water.

He does need more fluids. She gave him 150ml of fluids yesterday at 11:00am and his fur was sticking up again by evening last night. She said I could give 100ml per day. I told her about how he seemed to need them again last night, and that I would give them about 10:00am (in a half hour), and maybe I should give him 50ml AM and 50ml PM, and she said that would be fine. I said I don't know how I'm going to do the fluids once I go back to work, but that isn't until next Tuesday, so I have lots of time to figure that out.

I'll go pick up the BW paperwork, a little later.

Anyone know anything about potassium and sodium and how to balance it in cats?
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Yes. I want to cry some more. I am getting teary eyed now. Time to get the fluids ready.

List of things I need:
New Salt, or hopefully prescription from vet for potassium and sodium
Buprenex
more needles for fluids
another bag of fluids with administration line, since I'll go through this one by next Friday
to eat and sleep some more
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Hi Dyana,
Wow, that was an intricate dream! It was so vivid. Amazing that you could remember it in such detail. I'm glad it had a happy conclusion!

Also glad that J.D.'s labs came back and that they are unremarkable. There is a low-sugar Gatorade that has lots of potassium, electrolytes, and salts in it. I don't know if it would be safe for cats to drink, but perhaps someone here does. In the meantime the lactated ringers will help this weekend.

Lots of vines and continued good thoughts for J.D.

Hugs, scritches,

Ella & Rusty
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Did your vet ask you to get the new salt for potassium? I just bought potassium gluconate at the drug store and ground it up to powder and put it in Tiffany's food or baby food. I bought some NOW potassium gluconate that is already powder for Max when his potassium was down a little but my vet said he didn't need it. I think he does but I'm chicken to add any unless I check his blood as too much is not good either. The Tumil K that the vets use is exactly the same thing and the NOW is much cheaper. It is concentrated so you only need 1/8 a teaspoon. I bought mine from Amazon. In my opinion giving the fluids twice a day at 50ml vs once a day at 100ml won't make any difference. Add as much water as possible to the food for extra fluids. When they urinate a lot from either kidney disease or diabetes they lose the potassium in the urine. It will be easier for you to give daily fluids once a day when back too work because you can do it at night, right? Overall not too bad a report. I forget was a urinalysis sent out for culture? :YMHUG:
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

No urinalysis was done. I asked her about it and she said to let him be for a few days. He has had enough trips to the vet this week (four in six days).

I forgot. The Occult Blood was Negative.

I am warming up his fluids and they should be ready.
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

((((((((((dyana and JD))))))))))

i can't add any more to the advice you've been given, but wanted to stop by to let you know you and JD remain in my thoughts and prayers.
sending a boat load of positive thoughts and healing vines.

try to get a little rest, dyana. i'm worried about you, too...
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

(((Dyana)))
Sending many many vines to J.D.
I haven't been able to log on much lately, but I've been thinking about you and J.D.
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Great news with J.D.'s BW.

I still feel like I'm pretty new to the fluids thing since we just started doing them with Trix in March, but one thing I had asked my own vet about was doing 50mls twice a day instead of 100mls once a day. This is just her opinion and something for you to ponder, but she said she thinks the 100mls once a day is better - the benefit is pretty much the same, and it's a QOL thing only having to stick her with the harpoon once a day instead of twice a day. But every vet and every kitty is different.

Sending more hugs and prayers!!
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

The 'potassium salt' the doctor is talking about can be found in the spice section of most grocery stores - maybe not the 'New Salt' brand but there are others. I use this to support DH's hkpp issues. It's not sodium salt, it IS potassium salt. That used to be really confusing as I never took chemistry in school so didn't realize there are several different kinds of 'salt'...I thought it was all just the same as 'table salt'. It's usually stocked down toward the bottom of most stores. 'Now' products makes a Potassium gluconate powder that will do the same thing...it's already been mentioned above.

Potassium combines with glucose to cause the muscles to work correctly. Many times when their glucose numbers are 'off', potassium and sodium is also 'off'. Lactated Ringers resolved Dakota's low potassium issues within a couple of days...

HUGS, lots of thoughts and prayers continue!!!
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

((Dyana)), thinking about you and J.D.
Continuing to send vines and hugs.
I hope you're able to get lots of lovely rest with your kitties today. ♥
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Many hugs for you and vines for J.D. I think I would go with the once a day fluids too. 100 ml is only 0.4 cups of fluid.
Liz
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Okay. I'll go with the once a day fluids starting tomorrow. He got 50ml this morning and will get another 50ml tonight.

He had a soft poo. I hope the 5ml of baby food squash I am adding twice a day will help with that.

I am off to pick up the blood work. They have my prescription for Tumil K waiting for me to pick up at the ER vet, so that's a drive. I really need to go to the grocery store sometime today.
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Dyana,
Prayers & healing vines on the way for JD. Michael is sending prayers too. He lays on his back with his front paws folded in prayer and of course his hind legs wide open. When I see him like this, I ask him, Are you saying your little prayers? and he blinks.
Glad JD's had good results.
Paula & kitty Michael
 
Re: 08/15 J.D. AMPS 281 -Had a dream- BW Results In

Piling on gardens of vines for sweet J.D. I'm glad the BW didn't find anything too alarming. Try to get some rest sans the crazy dreams, ok? :YMHUG:
 
Re: 08/15 J.D. AMPS 281, +5.75 154, +8.5 330 Labs Added

Here's J.D.'s Blood Work: I hope you can read it, if not, it's on a tab in his spreadsheet.
IDEXX Laboraties - Total Health Plus (Chem 27) - 08/14/14

TOTAL HEALTH PLUS Chemistry
Reference Range Flag
ALK PHOSPHATASE (ALKP) 36 12 - 59 U/L
ALT (SGPT) 52 27 - 158 U/L
AST (SGOT) 25 16 - 67 U/L
CK 92 64 - 440 U/L
GGT 1 0 - 6 U/L
AMYLASE (AMYL) 1605 623 - 2239 U/L
LIPA 55 11 - 242 U/L
ALBUMIN (ALB) 3.4 2.6 - 3.9 g/dL
TOTAL PROTEIN (TP) 7.3 6.3 - 8.8 g/dL
GLOBULIN (GLOB) 3.9 3.0 - 5.9 g/dL
TOTAL BILIRUBIN (TBIL) 0.1 0.0 - 0.3 mg/dL
DIRECT BILIRUBIN (DBIL) 0.0 0.0 - 0.2 mg/dL
BUN (BUN/UREA) 51 16 - 37 mg/dL H
CREATININE (CREA) 2.3 0.9 - 2.5 mg/dL
CHOLESTEROL (CHOL) 251 91 - 305 mg/dL
GLUCOSE (GLU) 232 72 - 175 mg/dL H
CALCIUM (Ca) 9.2 8.6 - 10.6 mg/dL
PHOSPHORUS (PHOS) 4.1 2.9 - 6.3 mg/dL
TCO2 (BICARBONATE) 13 12 - 22 mEq/L
CHLORIDE 115 114 - 126 mEq/L
POTASSIUM 3.5 3.7 - 5.2 mEq/L L
SODIUM 144 147 - 157 mEq/L L
A/G RATIO 0.9 0.5 - 1.2
B/C RATIO 22.2
INDIRECT BILIRUBIN (IBIL) 0.1 0.0 - 0.2
NA/K RATIO 41 29 - 42
HEMOLYSIS INDEX ABN
Unable to report serum indexes on this sample.
LIPEMIA INDEX ABN
Unable to report serum indexes on this sample.
ANION GAP 20 12 - 25 mEq/L

TOTAL HEALTH PLUS
Test Result Reference Range Flag
T4 0.8 - 4.7 ug/dL
Interpretive ranges:
<0.8 Subnormal
0.8 - 4.7 Normal
2.3 - 4.7 Grey zone in old or symptomatic cats
>4.7 Consistant with hyperthyroidism

TOTAL HEALTH PLUS Hematology
Test Result Reference Range Flag
WBC 19.9 3.9 - 19.0 K/uL H
RBC 6.26 7.12 - 11.46 M/uL L
HGB 9.7 10.3 - 16.2 g/dL L
HCT 32.3 28.2 - 52.7 %
MCV 52 39 - 56 fL
MCH 15.5 12.5 - 16.5 pg
MCHC 30.0 28.5 - 37.8 g/dL
% NEUTROPHIL 79.5 - %
% LYMPHOCYTE 11.5 - %
% MONOCYTE 6.3 - %
% EOSINOPHIL 2.7 - %
% BASOPHIL 0.0 - %
AUTO PLATELET 499 155 - 641 K/uL
ANISOCYTOSIS
REMARKS SLIDE REVIEWED MICROSCOPICALLY.

NEUTROPHIL 15821 2620 - 15170 /uL H
LYMPHOCYTE 2289 850 - 5850 /uL
MONOCYTE 1254 40 - 530 /uL H
EOSINOPHIL 537 90 - 2180 /uL
BASOPHIL 0 0 - 100 /uL
RETICULOCYTE 13 3 - 50 K/uL
% RETICULOCYTE 0.2 - %


FECAL OCCULT BLOOD
Test Result Reference Range Flag
OCCULT BLOOD NEGATIVE
Comments: This is a screening test for the presence of occult blood in feces. Certain foods and drugs may cause false positive results. This result should be interpreted in conjunction with history and other diagnostic procedures.


Does anything stand out to you exceptionally? Like the MONOCYTE and NEUTROPHIL?

J.D. was 330 at +8.5, so I'm going to test him next at +10 in about 15 minutes and maybe shoot early. I am so off schedule, I had to write the time of day on his spreadsheet, and write out what time I need to do this and that, next.

J.D. is sleeping a lot. When I syringe feed him, he sits up with his legs crossed like my avatar. When he is in between feedings he sleeps. I hope that is okay.

I got Renakare a generic version of potassium gluconate in gel form. That's what my vet ordered from the other vet, so that's what we got. J.D. seemed to like the taste of it.

I need to be syringe fed or taken out to dinner and forced to eat. I didn't eat yesterday except for some ice cream late at night which I didn't taste, and today a lollipop from the bank and just ate a slice of frozen pizza. Still need to sleep, too.
 
Re: 08/15 J.D. +5.75=154 +8.5=330 +10=380 Okay to shoot? - L

I think I'll shoot at +10.5.

J.D. is still walking low to the ground, not all the time, but I just saw him do it. Tanya's CRF Site says the Potassium Gluconate can take a couple days to show improvement: http://www.felinecrf.org/potassium.htm
It also says to test the Potassium in 24 to 48 hours. I put a call into my vet to discuss when to test him again, but she never called me back. I made an appointment for Monday anyway. I hope she calls me tomorrow.

He's peeing a lot, today and yesterday. And he has peed in his bed twice now, so I don't know if that's a sign of bad things.
Please keep the vines coming on strong, I think he needs a miracle sometimes.
 
Re: 08/15 J.D. +5.75=154 +8.5=330 +10=380 Okay to shoot? - L

I don't have any advice on the b/w. I just wanted to say I'm keeping you and J.D. in my prayers. Make sure you take care of yourself too or you won't be able to help J.D. I hope you can get some sleep tonight. :YMHUG: :YMHUG:
 
Re: 08/15 J.D. +5.75=154 +8.5=330 +10=380 Okay to shoot? - L

I decided to do a Fur Shot tonight. I have been worried about being 3 hours off schedule and have until Tuesday morning to go from a 9/9 shot time to a 6/6 shot time. I shot early this morning, so shooting early tonight is not really advised. I just syringed his food and gave him his pills. I will give him his fluids which may help to bring his BGs down, and will use R if needed. I can shoot as early as 5:00am tomorrow and adjust forwards from there. This way I can get a good night's sleep too.

He acts so much better when he is eating (his syringe feedings).

Okay, please keep the vines coming, because we sure do need them.
Hugs to all of you.
 
Re: 08/15 J.D. +5.75=154 +8.5=330 +10=380 - Labs

{{{Dyana}}}

I'm glad the BW was reasonably good, all things considered, and the vet had some steps you can take to help J.D. Now you need to start taking care of YOU. J.D. and Ginger need you, so don't let yourself get rundown.

Sending lots of good appy and healing vines for J.D. and restful, healing vines for you. Scritches to Ginger so she doesn't feel left out! :YMHUG:
 
Re: 08/15 J.D. +5.75=154 +8.5=330 +10=380 - Labs

Thanks Tricia.

I am sitting on my hands. He was 487 at +12. I gave him his fluids and I gave him a drop of R.

Ginger is a really special wonderful girl, and I'm sure she would appreciate any extra scritches she can get.

J.D. does act more normal after he eats.

I was about to blend up some more MaxCal, but his tummy has not been as tight since I stopped giving it, so I have a can of Wellness Core Kitten Food ready to be blended next.

I need to give him his buprenex at 10:30pm, and I will give him some more food then, and then if I sleep the night away (that would be so nice), then if I wake up at 4:30am to give him his Potassium Gluconate (as it is supposed to be given every 12 hours, but I gave it to him as soon as I got home and that was 2:45pm, and I just can not fathom a 2:45am wake up and if I can get him to 6/6 that would be ideal) then I can stay up until 5:00am and give him some insulin then.

Hope he does fine.

He just got up from the bathroom where he was snoozing a little. He is walking better. He walked to his water bowl where he hung his head for a second and then walked on to his bed in the living room, and is now standing next to me at the computer. His fur is really soft (and has been for days/weeks) and his body feels at the moment nicely plump but not the tight belly he had before.

Okay, that's enough of talking and hopeful thinking. Keep the vines coming, please.

Off for the night, I hope.
 
Re: 08/15 J.D. +5.75=154 +8.5=330 +10=380 - Labs

Dyana

Sending many healing vines.

I'll BBL to look more closely at his bloodwork but diabetic cats quite routinely have lower potassium....lower than normal. Gracie does. Hers is usually 3.9. I asked the IM specialist this week and he said it is because the insulin causes more potassium to be taken from the blood into the cell. That's not a bad thing. What is a bad thing is when the potassium is low due to CKD because that typically means the cellular level of potassium is lower than what you see in the blood.

I'm not certain about the sodium but I will research it for you. JD's Na/K ratio is normal so that's good!!!

I
 
Re: 08/15 J.D. +12 487 - Labs - ate a little food from cat b

Thank you, Marje :YMHUG:
 
Re: 08/15 J.D. +12 487 - Labs - ate a little food from cat b

((((((Dyana)))))))

Sending tons of healing vines to JD.

Good call on the 'fur shot'. You can get back to schedule next cycle, with no worries about JD potentially bottoming out due to back to back early shots.
You also eliminated the pressure of trying to figure out how to get back on schedule by Tuesday AM.
You have R to guide this cycle if needed.
Take any opportunity to keep things simple right now. You have so much going on - your mind is in overdrive and working overtime.
Eat something even of you don't feel like it and get some rest - your mind and body need both.

Like others have said here tonight, take care of yourself. JD and Ginger both need you.
 
Re: 08/15 J.D. +12 487 - Labs - ate a little food from cat b

I am sending many healing vines to J.D. His bloodwork looks pretty good!

Others have addressed the hyponatremia (low sodium) and hypokalemia (low potassium). I wonder if the hyponatremia might be due to dilution from all his recent sub Q fluids. His total protein, however, is in a good range, so he doesn't look over hydrated. Marje may turn up more info on the sodium.

He has a high white blood cell count (leukocytosis). His white blood cell total of 19,900 (or 19.9 K) per uL is the sum of the numbers of all the white blood cell types: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Because his neutrophils are high (neutrophilia) and his monocytes are high (monocytosis), this causes his leukocytosis.

Neutrophilia can be caused by infection or inflammation, among other things. You could get a bit more info about his neutrophilia if they examined a blood smear and reported his numbers of segs (segmented or mature neutrophils) and bands (immature neutrophils), but I don't see this reported.

The monocytosis can be caused by chronic inflammation or infection. Given that J.D. had recently been treated for infection, my guess would be that the mild neutrophilia and marked monocytosis are due to chronic inflammation or infection somewhere in the body, which is something you already know has been occurring.

I think he is peeing a lot because he has the extra fluids in his body. I think he already has the miracle he needs - and it is you. You are doing so much to keep him feeling well. I hope you can sleep better knowing his blood work is pretty darn good. Please take care of yourself, and I am keeping the vines coming your way.

p.s. There was a mention of anisocytosis. This means that his red blood cells are of varying sizes. This could be not significant, especially as his MCV and MCHC (two red blood cell indices) are in the normal range, but it could just indicate his body's attempt at regenerating red blood cells. His body may pump out immature red blood cells (of different sizes) to try to deal with his anemia. Regeneration is a good thing.
 
Re: 08/15 J.D. +12 487 - Labs - ate a little food from cat b

Sending tons and tons more healing and appetite vines for JD! And hugs to you and Ginger :YMHUG: :YMHUG:

Dyana, I hear that MaxCal doesn't taste very good - if I were you, I would go for the pizza and a salad, that tastes better and all 4 food groups are represented! ;-)
 
Re: 08/15 J.D. +12 487 - Labs - ate a little food from cat b

Low sodium can be caused by quite a few things including hyperglycemia. It can also be lower due to GI issues and could be concurrent with low potassium.

There wasnt much on what to do for it.

Sending many more prayers.
 
Re: 08/15 J.D. +12 487 - Labs - ate a little food from cat b

I can't help at all with the bw.

But I can send much light and prayers and vines for J.D., for you. What an amazing mamabean you are.

Marilyn and Polly
 
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