1/16 Shadoe +11 395 amps 320 pmps 396

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Yesterday’s Condo

Shadoe's feeling great this morning, provided you set aside her being stressed with our pill adventure at +11, described in y'day's condo. I blame the 395 on me. I think I should have tested her BEFORE the pilling :lol:

Today Shadoe is starting in familiar pinks but lower pinks, so I am hoping that she will get into nice yellows later in the day.

Shadoe did wake me in the usual fashion: walk all over me, think 10lb dumb bell here, then settle on me till I got up. I gave her a bit of the tuna and tuna water from yesterday, to tide her over till amps. After her amps and shot, she ate a bit of liver&chicken food, then settled into a chair for nap#1 for today.

I am quite anxious to hear her test results, and I should receive most later today. I'll post them along with the results from last blood collection.

Question: Since yesterday's BG numbers were obtained under exceptional circumstances, are they excluded from dose considerations?

After all, if she had not received the SubQ fluids at the vet, there is really no way I can see that Shadoe would have gotten that green under her own steam. Once the fluids' affects wore off, Shadoe returned to her comfy colors.

How I see it, if we don't know what issues Shadoe is having and the results are not back, even though this is cycle7 this morn, yesterday's crazy nice numbers don't really count much in the picture, so any increase Shadoe would be due should be delayed.
But, since there may be issues that would call for a more aggressive approach, we need to wait till all the results are in, right?
And just wondering, what exactly is meant by a more aggressive approach? What changes in the process?

Note to self: look up definition of succinct and try it.
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

Sorry I can't give you any advice about the dose, just stopping in to read the news, ~O)

It won't hurt to continue the dose you're on until you have the additional data though. Definitely get those pill pockets...will save tons of stress on both of you.

Did you ever read the joke (really long) about how to pill a cat? If you haven't, you must! And it describes my adventures with Morris to a T, which is why I gave up pilling years ago. If it can't be rubbed on the skin or shot into him, he doesn't get it. Well, he was on a feeding tube once and that works too....but you don't want to go there unless you have to! :lol:

Have a good day, Gayle and try not to stress too much! :roll: Maybe take a nap? I-)
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

succinct? lol waz dat mean? lol
yes yes please post vet results here when u get them!
Glad to hear Shadoe is doing good this morning. Did u see the link in yesterdays condo about pilling?
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

Brenda,
Shadoe is a sly one so I sure hope the pill pockets work. If I did not know better, she would hide the pill under her tongue and give me her big doe eyed look that says What? It's really gone; honest!

Ronnie, yes, I have that link open and was reading it. The dry makes sense to be sure. I will need to use those pockets or some other method.
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

What adventures you hare having! As for pilling your Shadoe.... :roll: well...wishing you lots of luck

They should have a program that's called "Are you smarter than your Cat" cause they really seem to do a
lot of thinking on how to outsmart us when we are only trying to help them, ya know? I have never tried to
administer pills to either of mine...the liquid is enough of a challenge. :?
Thinking of you and waiting to read the news from the report...
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

OK I have read that link about pilling, and pulled out a couple syringes I have that the vet gave me awhile back - they are 1 big chunky 6ml and a thinner 3ml to use if I needed to give some syrup or something if Shadoe got too low in the numbers.

I also have an interesting flushing syringe from my dentist when I had some oral surgery and the tip on the syringe is fine and curved, to be used for irrigating the area. I never used it just used normal rinsing, but I did keep it.

I was thinking if the pill pockets don't work, I'll just crush the 1/4 tablet and mix it with some tuna juice then squirt into the side of her mouth. That should work I think.

Silly me :lol: thinking Shadoe will play along with anything that I have planned. :YMSIGH:
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

Hi Gayle
Good that Shadoe happier today. That's always the biggest bonus in my book.
Max had vet visit yesterday too so his normal testing was off and PMPS was high for him.
I almost did not do a +3 but I couldn't stop myslef and he had dropped 200 points, yikes.

Good luck with the pills. I used the pockets for Max and he just chewed around the pill
and left me a little white blob on the floor.
I used to put it in a dab of Laxatone so it would slide down, and then you need to chase
with water (which I did not know before coming to this site) Of course the Laxatone use
was before I knew he was Diabetic so I don't know about using it now.
What about a dab of vaseline? Is that allowed? Someone might know better than me.
Post the vet results. We are anxious to hear.

Have a great Saturday!!
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

Good morning.
I am not a lot of help with pilling. You can also use a piece of cheese to hide the pill in. I would check first about breaking up the pill because some pills broken can taste pretty bad.

Will be waiting to see test results.
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

I know there are some lactose issues with many cats, but we put pet pills into a small amount of Laughing Cow cheese. I suppose cream cheese would do. The idea is it is tasty and soft so it is hard to remove it if the pill is wholly contained in a small enough bit of cheese. I used to use butter but that's a lot messier.
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

Please don't crush the pill until others provide some input or call your vet and find out if this is OK. Not all pills should be crushed or mixed with a fluid. Can you scruff Shadoe and get the pill far back in the throat? There are pilling devices for cats so you don't lose a finger when you do this. Give some chicken broth, baby food, or tuna water, or even food afterward. Following a pill with a treat will help, too.

I'd saw your +2. You might want to hold this dose for a bit since it looks like Shadoe's numbers are coming down. At the very least, see the way the cycle plays out and see what others have to say.
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

Good Saturday Morning Gayle!

Wow, what a week you have had. Looks like you had a very productive vet visit yesterday.

Re: dosing - my instinct would say wait until all the results are in especially after yesterday's numbers, but that advice is based upon instinct and your condo and not on years of FD experience.

Re: pilling...if the pill pockets don't work (they didn't for one of my kitties) I was able to get a pill shooter from my vet. It was less than $10 and I use it on my kids who are poor pillers. I didn't read the link about pilling cats...maybe this advice was in there? In fact, Beabhen (GA) was on three pills in the am and I could fit all three pills in the pill shooter and get them down her in one shot! The whole pill event would take less than 15 secs with this device.

Sending lots of positive vibes for Shadoe and hoping the pepcid works and test results return soon!!!!
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

Hey thanks! Those are great ideas!
I wonder if I gave her a spoon of yogurt and put the crushed 1/4 tablet into it, if yogurt would be bad for her. I do know for a fact that she loved to have a spoon of my yogurts way back when, so I know yogurt would work.

I also think I am going to have to crush the 1/4 tab - I mean come on! That is such a tiny tablet I had trouble cutting it i half and the half the halfs it is so hard and likely not a quick dissolver, and it's sure not the size that is the problem. Whether in a pocket, a piece or cheese or a spoon of yogurt, I think crushed will work better, if OKd by the vet.
Sienne,
I never tried the scruffing method, and I have not tried the syringes yet either.

The logic to me is that the pepcid tab is already cut into 4 pieces, so that is like a coarse crush.
But, I am going to see the vet today to get the bloodwork results, so I'll ask then.

Amy!
Yikes, I want a pilling thingie. I doubt my vet has this thing but I'll ask for sure!


It will be a good learning exercise for us; I am so glad it's just for 3 or 4 days!

As for the dose change, I will be more than happy to wait ti mid week, like usual. I would be even more happy to remain at this dose and finally start heading in the other direction with the dose: DOWN!
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

If you want the pilling thingie and your vet doesn't have it...let me know and I'll get one from my vet and send it to you. I think my vet calls it a pill shooter. It's been years since I bought it so I don't remember.
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

One more thing I just thought of...you could do pepcid as an injection. I don't know the cost of a vial or dosing, but something to ask the vet about too if all other methods fail. You already know how to give an injection :-D
 
Re: 1/16 Shadoe +11 395 amps 320 dose question

Oh yeah we are all good at the injection part of this process!
I feel certain I could do the injections of stuff or fluids, depending on the injection sites.
I'll ask the vet about the pill shooter, but I don't know if I should buy one if it is for only 4 days of pepcid twice a day.
I do know that I WANT one cuz I want everything haha_smiley
 
Re: 1/16 Shadoe +11 395 amps 320 +2 227 +4 164 results OK

Just a quick note here - the vet called with results and nothing jumping out at her.
I am going to pick up a copy of the results, and will post the numbers then.

She did some research online at some boards, not sure where, but I like that she is responding to what I say. She also spoke with the pathologist about the IAA test and they don't have it because it does not seem of much importance because the results would show antibodies cuz she is not a cow or a pig.
I know - those are my words, but they are the gist that I got.

Her glucose was 10.6 /191 which she said was quite good considering it was taken at the vet's when Shadoe was not at her calmest, but the fructosamine was high. Then she said it is what would be expected in an unregulated animal so no surprise there. She said that since I have changed her dose quite a bit, it may account for the higher value. I told her that we have changed her dose a bit slower than we could have because of my wanting to be around to test after changes.

The only big suggestion she had was to see if Shadoe can stick to just one or two foods, with not lots of change and see if the food was constant, the type, etc, we could eliminate the food as an issue. She mentioned MD and DM as a couple, as well as EVO. I said she was not too partial to those but maybe I could get her to stick to a couple of the ff and some EVO.

She said she did not see any indications of much other than possibly a low grade pancreatitis? What's that mean? Acute, not chronic? She would be more concerned if Shadoe was not eating and was vomiting, but she is eating a bit. I think she has forgotten that I took her in specifically because she was not eating and was vomiting. :YMSIGH:

About the IAA, she said if I could get info on some places that do the test, she could contact them about it and maybe get more info and possbly arrange for the test to be done here? I could not say much to any of it because it's all foreign to me.

Anyways, she had to get off the phone as there was an emergency on the other line, but I told her I was coming over to get copies of the results and we could talk more then, she said ok and we hung up.

And now I am off to the vets.
 
Re: 1/16 Shadoe +11 395 amps 320 +2 227 +4 164 results OK

Pepcid can be crushed, but if you are using the brand name Pepcid and not just generic Famotidine, it is horribly bitter.

Gayle and Shadoe said:
She did some research online at some boards, not sure where, but I like that she is responding to what I say. She also spoke with the pathologist about the IAA test and they don't have it because it does not seem of much importance because the results would show antibodies cuz she is not a cow or a pig.
I know - those are my words, but they are the gist that I got.
Click to expand...

I do think that the few here that have dealt with IAA would tell you that it is incredibly important to know. One cat, Black Kitty (who is now off insulin), was up to 13.5u at one point. Sharyn's Fiona was at 29u. Both were also using R insulin on top of that. You wouldn't want to be shooting that without knowing why you had to.

The only big suggestion she had was to see if Shadoe can stick to just one or two foods, with not lots of change and see if the food was constant, the type, etc, we could eliminate the food as an issue. She mentioned MD and DM as a couple, as well as EVO. I said she was not too partial to those but maybe I could get her to stick to a couple of the ff and some EVO.
Click to expand...

DM and MD have very poor ingredients. The EVO 95% line has some great options like chicken/turkey, venison, beef, and duck. Regular EVO canned is very high in phosphorous, and is detailed in Dr. Lisa's Commercaial Canned Food section.

She said she did not see any indications of much other than possibly a low grade pancreatitis? What's that mean? Acute, not chronic? She would be more concerned if Shadoe was not eating and was vomiting, but she is eating a bit. I think she has forgotten that I took her in specifically because she was not eating and was vomiting. :YMSIGH:
Click to expand...

Was the fPLI or Spec fPL run? That is the only accurate way to diagnose pancreatitis. Some vets try and use lipase and amylase levels, but there is no correlation with those in cats as per the most recent research. Here are a few good informational sources for feline pancreatitis:

WSAVA/VIN Proceedings
Jojo's Pancreatitis Post (page loads slowly)
Idexx Pancreatitis Roundtable Discussion

About the IAA, she said if I could get info on some places that do the test, she could contact them about it and maybe get more info and possbly arrange for the test to be done here? I could not say much to any of it because it's all foreign to me.
Click to expand...

Michigan State University runs the IAA test: http://animalhealth.msu.edu/Bin/Catalog ... st&Id=1494


I hope some of this helps! Sending feel good vines to Shadoe.
 
Re: 1/16 Shadoe +11 395 amps 320 +2 227 +4 164 results OK

Gayle
Glad nothing serious jumped out at the vet but I know you want answers to the "why"
The diagnosis of no diagnosis sometimes does not always make us happy.
Not that I know tons or how many varieties you are feeding Shadoe but it is not
a bad idea to try and stick to a constant food.
At the beginning with my new vet, she wanted me to feed Max m/d, which I refused to do
based on the carb content. She said, feed what you want but keep it constant because
we will not know if it is food or insulin.
At that time I was mostly feeding friskies and special kitty. I even tried Wellness but that did
not go over well.
Now weare soley FF. All 3 eat it. Even the die hard dry food sisters come to eat now.
 
Re: 1/16 Shadoe +11 395 amps 320 +2 227 +4 164 results OK

Brenda, I was laughing so hard the cats think I am nuts. I swear the first 4 happened to me. The only difference was that we are talking about just a tiny piece, only 1/4 of a little pill.

Goodness, she did hurl up a bit of food this morn and she is licking her nose again, so I guess the 1/4 that I thought I got down her throat is likely sitting in a dark corner someplace. She is still not really eating much, so I crushed another 1/4 and mixed it into 1tsp of blueberry yogurt. I know for a fact that she LOVES my yogurt and is about the only food she will steal if it is left unattended, so that crushed 1/4 pepcid went down like butter! She never knew it was there and was sad when the big eyes did not get her more yogurt.

OK I am going to put together a ss of sorts with her test results.
The quick n dirty out of range:
total protein = 90 range = 60-85
albumin = 45 range 28-43
CK = 790 range 15-295 (don't know what this one is)
Cholesterol = 7.5 range 2.0-7.0
Glucose = 10.9 range 3.9 - 8.0
Fructosamine = 511 range 140 - 320
Hemoglobin = 159 range 80 - 150
Hematocrit = 0.46 range 0.24 - 0.45
Lymphocytes = 6.4 / 0.8 range 1.5 - 7.0

Spec fPL (Feline PLI) = 13.7 range 0 - 3.5 (not sure how she does not see this as a problem?)
Notes on the U/A sheet:
>5.3 ug/L: Serum Spec fPL concentration is consistent with pancreatitis. consider investigating for risk factors and concurrent diseases (e.g. IBD, hepatitis, diabetes mellitus). Periodic monitoring for Spec fPL may hep assess response to therapy.

the T4 looks OK at 26.3 with range of 11.0 - 46.0

As I said, I'll put together a sheet with all the results because seeing only the out of range without the rest is not a complete picture.
 
Re: 1/16 Shadoe +11 395 amps 320 +2 227 +4 164 results OK

Gayle and Shadoe said:
OK I am going to put together a ss of sorts with her test results.
The quick n dirty out of range:
total protein = 90 range = 60-85
albumin = 45 range 28-43
CK = 790 range 15-295 (don't know what this one is)
Cholesterol = 7.5 range 2.0-7.0
Glucose = 10.9 range 3.9 - 8.0
Fructosamine = 511 range 140 - 320
Hemoglobin = 159 range 80 - 150
Hematocrit = 0.46 range 0.24 - 0.45
Lymphocytes = 6.4 / 0.8 range 1.5 - 7.0

Spec fPL (Feline PLI) = 13.7 range 0 - 3.5 (not sure how she does not see this as a problem?)
Notes on the U/A sheet:
>5.3 ug/L: Serum Spec fPL concentration is consistent with pancreatitis. consider investigating for risk factors and concurrent diseases (e.g. IBD, hepatitis, diabetes mellitus). Periodic monitoring for Spec fPL may hep assess response to therapy.

the T4 looks OK at 26.3 with range of 11.0 - 46.0

As I said, I'll put together a sheet with all the results because seeing only the out of range without the rest is not a complete picture.
Click to expand...

Keep in mind I am not a medical professional, so my comments are based only on my experience with lab work in my own animals.

It looks like Shadoe is dehydrated. That would account for the elevated total protein, albumin, HCT, and hemoglobin. CK/CPK is a muscle enzyme that can be elevated in cases of a stressful blood draw. That elevation is relatively mild and could be consistent with that. You can see on Sasha's labs what a very elevated CPK is like from actual muscle damage during her bout with Toxoplasmosis. Cholesterol is a mild elevation and not concerning - is often elevated in diabetic cats. The lymphocytes (white blood cell) can be low and the neutrophils (another white blood cell) high during a blood draw. Were the neutrophils elevated?

The Spec fPL clearly shows pancreatitis. Pancreatitis causes dehydration. Is Shadoe getting any SubQ fluids? They are a main part of treatment, as discussed in the links I provided above. Chronic pancreatitis is very common in diabetic cats. Treatment often includes SubQ fluids, pain medication, Pepcid or another acid reducer, and an antiemetic (anti-nausea) such as Cerenia or Reglan or Zofran. There are other things you can add too, and Jojo's pancreatitis post I linked to above covers just about all treatment options.
 
Re: 1/16 Shadoe +11 395 amps 320 +2 227 +4 164 results OK

Thanks Cassandra,
The blood was drawn for the tests when I took her in to the vet on Friday, and yes, Shadoe was given SubQ fluids on that time, with the result being her first green value.
Can I give these fluids myself? If yes, should I insist on giving myself? How do I know if she would need to receive fluids? I don't see why not if it's just an injection.
Should I request pain meds and are they administered on a regular time schedule?

|Neutrophils: in range ( 2.5-12.5 )when dx and yesterday but higher now
Oct4/09 = 76.1./4.5
Jan15/10 = 84.4 / 10.6

So to recap:
I want to administer SubQ fluids myself as needed
I want rx for pain meds - preferably Buprenex
I want rx for antiemetic (anti-nausea) such as Cerenia or Reglan or Zofran (which is best?)
I have the pepcid already

The vet is going to call me later, but if she gets too busy and does not, I'll go into the vet hospital tomorrow and ask to discuss the above with whatever vet is on duty, yes?

I am not great at google ss's so I am putting all the results/numbers into an Excel ss :?

Is there anything else I am missing?

And Shadoe's numbers are so nice today :YMSIGH:
 
Re: 1/16 Shadoe +11 395 amps 320 +2 227 +4 164 results OK

Shadoe's numbers are really nice today...what do u mean by that SIGH smiley? lol

Im so glad u got eyes from Cassandra!
She's a rock star-uh-huh! \M/
 
Re: 1/16 Shadoe +11 395 amps 320 +2 227 +4 164 results OK

Gayle and Shadoe said:
Can I give these fluids myself? If yes, should I insist on giving myself? How do I know if she would need to receive fluids? I don't see why not if it's just an injection.
Click to expand...

I would try and give them at home and keep them on hand for subsequent flares of the CP (chronic pancreatitis). They are quite simple to do. As long as Shadoe has no known heart problems, then giving fluids is highly beneficial during a flare. CP causes lots of toxins to build up in the system, and the fluids help push those out, as well as lessen the inflammation.

There are many of us here that have given fluids before and can help you. Tons and tons of posts about it on Health too. This Fluid Therapy website is aimed at cats with renal failure, but clearly explains many aspects of giving fluids and has lots of great information.


Should I request pain meds and are they administered on a regular time schedule?
Click to expand...

Yes, as Dr. Lisa often says, patients should not have to beg for pain medication. Pancreatitis is a very painful condition. From the WSAVA/VIN link I posted above:

Analgesia is of critical importance in the comfort of the patient, but also in the progression of the disease/inflammation through the negative physiological effects of pain. Pain causes disease and prevents healing.

Buprenex is a wonderful choice and can be given PRN (as needed) or more frequently. Sometimes transdermal fentanyl patches can be used for continuous relief.


|Neutrophils: in range ( 2.5-12.5 )when dx and yesterday but higher now
Oct4/09 = 76.1./4.5
Jan15/10 = 84.4 / 10.6
Click to expand...

This may just be from the blood draw - higher neutrophils and lower lymphocytes. I would discuss with your vet.


So to recap:
I want to administer SubQ fluids myself as needed
I want rx for pain meds - preferably Buprenex
I want rx for antiemetic (anti-nausea) such as Cerenia or Reglan or Zofran (which is best?)
I have the pepcid already
Click to expand...

As far as antiemetics go, I prefer Cerenia/Maropitant and Zofran/Ondansetron. Cerenia is a vet drug and the vet is much more likely to stock it. Zofran is a human drug and the medication will likely have to be called into a pharmacy. I am not fond of Reglan personally, although some vets still use it often, but some cats do have bad reactions to it and Sasha was one of them (so my thoughts are a bit jaded from that).

Dolasetron/Anzemet is related to Zofran/Ondansetron and can also be used.

Pepcid/Famotidine is also available in injectable form from human pharmacies, and may be a good thing to keep in Shadoe's treatment box now that you have a positive pancreatitis Dx. You can get a large vial from the pharmacy for very little, and it has a nice long shelf life.



The vet is going to call me later, but if she gets too busy and does not, I'll go into the vet hospital tomorrow and ask to discuss the above with whatever vet is on duty, yes?
Click to expand...

That's a good idea. The sooner full treatment is started on a flare the more quickly it will probably pass.

There are many people here that have dealt with CP - you are in good company. :smile:
 
Sending healing vines to Shadoe this evening!

I know you will keep updated on Shadoe and the plan! I know Cassandra addressed this, but I did fluids at home for a year for our Beabhen! You can totally do this.

Wow, Cassandra. Amazing eyes!
 
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