1/9 Blue AMBG 66/1/10 PMBG 55

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Patty and Blue GA & Brat, Jan 9, 2021.

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  1. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    https://www.felinediabetes.com/FDMB/threads/1-7-blue-70-ambg.241135/

    Morning,

    Blue seems more alert this morning. I left him sleeping on his fleece under the table
    but this morning he was out and about. I'll keep my eyes on him.

    First test this morning for BG was 54 which frightened me so I retest and it was 66.
    What would I do if he were that low?

    Mogs, you okay and the bug?
     
  2. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Patty,

    I'm really pleased to hear that the Bluebird's come out from his under-table retreat and is perkier this morning. ((((Blue))))

    For a cat not on insulin the 54 should be OK - sometimes remission kitties may see numbers in the 40s at times - but 'twas no harm to retest for peace of mind. If BG were to continue trending downwards then it might be a good idea to run the info past Blue's vets as a precaution.

    Still trying to find a 'sweet' dose for the Noodler; her BP dipped just below the normal range again today. She gets very subdued and quiet, and she seems tired when her numbers get that low. It's worrying to contemplate that, without the meter, I'd have no idea her BP was in danger of going too low on the meds. The timescales might be different - days vs. hours - but managing her BP does remind me in some ways of using Lantus to control blood sugar. Because it takes up to a week for the amount of amlodipine in Lúnasa's system to reach steady state after any adjustment - not unlike waiting for a Lantus depot to stabilise - it's tricky trying to identify a good dose.

    I'm tired and addled, comme d'habitude. How are you today? Are you managing to sleep OK?

    :bighug:


    Mogs
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    Last edited: Jan 9, 2021
  3. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    PS: Spreadsheet police here! :D I'd suggest making a note of that 54 reading in Blue's spreadsheet. That way, as you take subsequent readings, you'll be better able to determine whether it's an outlier or the start of a trend. I note that Blue's PMBGs are trending a little lower.

    (I know, I'm such a nag! :rolleyes: :p ;) )


    Mogs
    .
     
  4. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I'm upset again. He's staying under the table but not sleeping. I just gave him some more Gaba in case he's in pain.
    I'm not sure what's going on but it scares me.

    Poor Noodle Bug. It's frightening when the blood pressure gets low. Thanks goodness you can track it at home and
    change her dose.

    I put the low reading in the note section. I'm thinking it was just a fluke, but noted just the same.
     
  5. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I really, really feel for you, Patty. I'd be scared too. :bighug:

    The only thing I can think to suggest to you is to send an email to the oncologist (cc'd to your own vets) with a summary of the odd behaviours after both chemo treatments (dates, odd things observed, how long it took for behaviour to return to normal after the first episode, how long Blue has been behaving differently since the second dose, in which ways he seemed better after receiving gabapentin, etc.). I'd also suggest following up the first email with phone calls and 'chasing' emails if you don't get a prompt and satisfactory response. (It's what I'd try to do myself.)

    Things you've commented on in your threads that stick out in my mind (not quite in order of occurrence):

    - Aggression toward one of your other cats (completely out of character).
    - Protracted periods of staring into space.
    - Not moving for a long time, almost as though he might be 'asleep sitting upright'.
    - Marked increase in grooming activity.
    - Wanting to be near you more than usual.
    - Unusual, very loud vocalisations.
    - Starting to sit/hide in an unusual spot/reluctance to move away from that spot for the last couple of days.

    I think you should tell them how worried you are, that you think they need to know about what's happening, and that you need to speak with them ASAP about these behaviours and what might be done to help. No-one knows Blue as well as you do. Your observations are important. I really think they should be taking your concerns seriously, especially as the chemo treatment seems to have been the trigger on both occasions (albeit that there were 11 days and 7 days respectively between the 1st and 2nd chemo treatments and the emergence of the odd behaviours/clinical signs).

    I wish there was something I could do to help.

    ((((Patty and Blue))))

    :bighug:


    Mogs
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  6. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Thank you Mogs. Great list and I'll use it since you already put it together. At least he gets up to eat so that makes me feel like he's not going to die. I know that sounds awful but that's where my thoughts have gone today. It's been a sad day.
     
  7. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Oh, Patty... :(

    :bighug::bighug::bighug:

    .
     
  8. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    He's been in the corner all day. He has come out to eat and go to the litter box but that's about all. I'm so worried.
    I keep checking on him. I took his temperature and it was 101.3 and his BG is 68 tonight. I sure hope he perks up
    soon. I did give him gaba earlier. I'm not sure if I'll give him more or not....
     
  9. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Does the gaba seem to do him any good - even in small ways?

    Temperature info:

    https://cat-world.com/cat-temperature/

    With you 110% in that shared hope.

    ((((Patty and Blue))))

    :bighug:


    Mogs
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  10. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I haven't noticed a difference when he gets the gaba. I am back and forth tonight about giving him another dose.
    I really don't know how to help him.
     
  11. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Worrying about the two of you. How is your Bluebird doing today, Patty? How are you?

    ((((Patty and Blue))))

    I just noticed in your spreadsheet remarks that Blue tried to nick your sandwich the other day. Naughty boy. :) Is his appetite as good as ever?

    :bighug:


    Mogs
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  12. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    He's still in the corner but he is still eating. He's not eating uncontrolled like he was but I'm making sure he has
    additional by giving him the tuna in water. I gave him a dose of Gabapentin this morning so he seems to be
    sleeping some now. He's just still acting weird, and doesn't ever come to me.

    How are you and your buglet?
     
  13. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Great news. As soon as I wrote the above and closed my computer, he jumped up into my lap. I'm happy!!!
     
  14. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Oh Patty! My heart did a little somersault for you upon reading this! :cat:

    ((((Patty and her Bluebird))))

    :bighug:


    Mogs
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  15. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Thanks Mogs. I can't tell you how relieved I was! He's back in his corner but now he's sleeping.
    He looks comfortable. Just very tired. He has the strangest reaction to that chemo. I hope he
    doesn't have to take it again and they switch him to an alternative.

    Are you okay? Noodle? :cat:
     
  16. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I can picture your relief very vividly, Patty. :bighug: It's good that he's having a comfortable snooze for himself now. ((((Blue))))

    BTW, one of the things I missed for the list was that at times Blue hasn't been sleeping as much as he usually would. I think that's something that should be included too.

    I'm hanging in there. Very tired, but that's nothing new. :rolleyes: Trying to get the Noodle to eat enough again. That BP dip knocked her appetite again. :( :banghead: I've been trying to reintroduce the renal support kibble again with limited success thus far. I know the other food's too high in protein but she seems better in herself on it than the renal stuff. What to do...


    Mogs
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  17. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I understand your dilemma Mogs. Having had cats with CRF it's always hard to juggle what they should eat with what they will eat.
    You have to also take into account others issues with your Noodle.

    You are correct. He hasn't slept in days. Every time I looked his eyes were wide open. He sat like a statue for a couple of days.
    It was so strange.

    Hope you can sleep some. Me, I'm going to watch some football. I think I can finally concentrate on something besides Bluebird.
    Although I check on him every 5 minutes. :)
     
  18. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Blue's BG tonight is 55 so I retested and it is 58. I'm feeding him some LC food, but is it okay for him to be that low?
     
  19. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I just remembered you said it was ok for Blue to have a lower BG since he's not getting insulin. I'm so used to
    grabbing the honey that I freaked! He's good, sorry. :rolleyes:
     
    Critter Mom likes this.
  20. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Patty,

    It's still in the normal range and he's not on insulin. That said, there is definitely a gradual downward trend in Blue's BG levels - both AM and PM. While the numbers are definitely in the normal feline BG reference range, it might be an idea to flag the downward trend in your list for the oncologist. (Note: I have no idea whatsoever whether there is any significance in the downward trend, just noting that it's there. You should know the way I work by now: I make notes of everything and anything I observe, just in case it might be valuable.)

    Masochist. :p

    'Course you do! He's your furbaby and you love him. :) (I'm the very same.)

    ((((Patty and Blue))))

    :bighug:


    Mogs
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  21. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I hope you get to talk with the oncologist tomorrow. You know the squeaky wheel right? Be pushy. Tell them you are scared. Good luck. :bighug:
     
  22. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    ^ This. ^


    Mogs
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  23. Butters & Lyla

    Butters & Lyla Well-Known Member

    Joined:
    May 30, 2020
    Hi Patty,
    Just came by to check up on Blue and how he is getting on with the cancer treatments. I'm so sorry to read that he is reacting badly to the chemo treatments. You're both in my thoughts. Sending Blue and you lots of prayers and positive energy. I hope that you are able to get some traction with the oncologist tomorrow and a good path forward for Blue.:bighug::bighug:
     
  24. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Thanks guys. Blue is back in his corner but he seems to be more relaxed. He's eaten well and continues to drink water and go to the litter box. He can still jump on the counter and counter to counter. :rolleyes:

    I'm probably going to try sending an email listing everything that has happened. Even if I leave messages they don't call me back. It's so frustrating.

    Thanks for being here for me. :bighug:
     
    Critter Mom likes this.
  25. Butters & Lyla

    Butters & Lyla Well-Known Member

    Joined:
    May 30, 2020
    I didn't realize Blue has been OTJ for weeks now. Congratulations on that, Patty!:bighug: It seems not long ago that he was doing those crazy steep dives with his numbers every day. Seeing his numbers continue to hold is wonderful.
     
  26. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Yes, isn't that great? I'm still not used too it. He'd go one extreme to the next. I'm happy to get more sleep now.
    It is all consuming to test, feed and run for syrup and high carb food, but worth it in the long run.

    It's looks like Butters is doing better as well. I'm happy for you. Hoping you achieve remission.
    Thanks for checking on us. :bighug:
     
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  27. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Patty,

    Checking in to see how yourself and Blue are doing today. Any joy from the vets at all?

    ((((Patty and Blue))))


    Mogs
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  28. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    HI Mogs,
    Blue is about the same. He's still not eating that well so I gave him some of his favorite Meow Mix 10%
    and he of course loved it. I hope it doesn't make his BG go up too much.

    I called Bluepearl and got a direct email for the vet treating Blue. It's like pulling teeth. I send the list
    you wrote and voiced my concerns. I haven't heard back yet.

    I've been busy trying to schedule covid vaccine for my mom and myself. I think everyone is doing the
    same because the website cashed.

    Also, working on get stem cell scheduled for my knee. It's been a busy day but not much accomplished.

    How are you and bug doing? Did you get any rest? Are you able to schedule a covid vaccine yet?
     
  29. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Patty,

    Did the Meow Mix make Blue feel any better? I'm glad he enjoyed it. ((((Blue))))

    I'm glad you got the direct email address for the vet. Don't be shy about using it. I hope that you hear back from them today. If not, I'd suggest sending a follow-up email in the morning.

    I'm also glad to hear that yourself and your mom will be able to get covid vaccinations (website permitting). If (and with our current shower it's a very large if) our government keeps to it's touted schedule I won't be eligible for a first dose of the vaccine until some time in April. At time of posting, I have no plans to bet the farm on getting a jab within that timescale, but they might surprise me.

    Any joy with the stem cell appointment?

    The bug's not eating again and she's as cranky as bejeezus tonight. I didn't get to sleep till nearly 6am this morning. :(


    Mogs
    .
     
  30. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I just got this reply:

    Hi Ms Gilmore
    I'm sorry for any miscommunication. I have not gotten any messages through my voice mail and they may have been sent to the wrong doctor.. I believe you spoke to one of my colleagues Dr. Tuncay last week.

    Please note none of these issues are side effects of chemo. Your paperwork should list possible side effects. It could be dementia but that's pretty rare in cats. Rarely, steroids like prednisolone can cause behavior changes but very, very rare in cats. Could be abdominal discomfort, but would not account for all of these signs. We could try additional pain medications.

    Mostly, I'm worried the cancer could be affecting Blue's brain. This is uncommon but can happen with this cancer. Unfortunately there is no easy way to diagnose this for sure- usually requires an MRI/CSF tap which I would NOT recommend due Blue.

    My best
    JW
     
  31. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Oh, Patty... :bighug:

    That's not the sort of information that should be conveyed via email.

    I wish I knew more about this stuff so that I might try to do something to help you.

    I guess start with the pain meds and see how they help?

    How are you?

    :bighug:


    Mogs
    .
     
  32. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I was mad when I received the email but better now. I emailed her back to ask
    what pain med she would recommend. I will get it at my vet if possible. I only
    have the Gaba so he might need something stronger.

    She's a terrible vet...:arghh:

    You need some sleep girlfriend. Tell little buglet to cooperate and eat.

    I'll schedule stem cell tomorrow. I have blood clotting disorder so had to arrange with my
    doctor to get off blood thinners for a couple of days. I think they might schedule for later
    this week. I hope!!!

    No luck scheduling the covid vaccines. All the sites kept crashing.
     
  33. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    You'll get no argument from this corner. She was obviously away from vet school the day they did bedside manner and communication skills.

    The Noodler finally ate some Hill's k/d for me. Yes, I do need kip.

    Hope you do better with the vaccines tomorrow. Fingers and paws crossed that you'll get the stem cell appointment too.

    Keeping you both in my prayers.

    ((((Patty and Blue))))

    :bighug:


    Mogs
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  34. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
  35. Butters & Lyla

    Butters & Lyla Well-Known Member

    Joined:
    May 30, 2020
    Sending more prayers, Patty.:bighug: Hoping to hear that Blue starts doing better very very soon.
     
  36. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Thank you :bighug:
     
  37. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I am seeing red at that vet’s response to you. I’m steaming. Are you sure you don’t want to see if the vet school is taking chemo patients? I’m so sorry you are being treated like this.:bighug:
     
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  38. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Yes, my reaction as well. I might look into UGA tomorrow to see what they can do to help.
    I've been there with a friend whose cat was ill. The vet had just run tests and they
    said they needed to redo them. I think she's still paying if off.
    Bluepearl is planning an MRI on the 21st and blood work isn't that big a deal if they need to run it. Would
    probably be around the same if I can get him into UGA. What's another thousand. :eek:
    I'm so disappointed. I expected someone to actually care. I don't think that's asking too much. I've never even met
    her or talked with her and just now got my first reply.
     
  39. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I think part of the problem is you don’t get to talk face to face. She might not be good with emails. So she is suggesting an MRI? I thought she wrote not recommended. I understand when a vet needs to do their own ultrasound as the disc isn’t good enough. It only shows what the person doing it sees and things can be missed. I had to have a second one done for that reason. For me it was a good thing because it saved Max from exploratory surgery! Was your friend not happy with UGA? I know the outcome was not good.
     
  40. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    No, UGA was great but they ran all the tests over because they said their machines are more advanced.
    She had just paid the vet the same day for the same tests but UGA wouldn't use them.

    They scheduled an MRI of his abdomen to see if tumors were shrinking and were then going to give a
    different chemo if they weren't.

    UGA has some clinical trails available for Lymphoma in cats. I might talk to my regular vet.

    It is hard when you can't look someone eye to eye. She's a yankee...that's what we say in the south
    when people have attitude. :D
     
  41. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I would definitely talk to your vet. First I would inquire to see if the option exists. :bighug:
     
  42. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I would be too, and I'm disappointed for you. It is perfectly reasonable to expect the person(s) providing medical care to your beloved companion to care about their patient - and their patient's human! It should be a given, not an ask.


    :D

    Over here we're a tad less restrained with the pejoratives. :oops:

    Night night.

    ((((Patty and Blue))))


    Mogs
    .
     
    tiffmaxee likes this.
  43. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

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    Aug 11, 2020
    Night guys. Thanks for the input as always. :bighug:
     
    Critter Mom likes this.
  44. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Patty,

    Are you still giving Blue the metoclopramide (Reglan) for constipation?


    Mogs
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  45. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    If you are, then * please do not give him any more * till we've talked.


    Mogs
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  46. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

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    Aug 11, 2020
    No Mogs, I'm no longer giving it. Is there a problem with it?
     
  47. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Also, is the appetite stimulant prescribed by the oncologist mirtazapine? Have you given Blue any mirtazapine since it was prescribed for him? (I noted yesterday that you were considering giving him a dose of appy stimulant.)


    Mogs
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  48. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    It can lower the seizure threshold. For how long did you give it to him, Patty?


    Mogs
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  49. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I only gave it for a few days until I thought he was no longer constipated. I haven't given
    any of the app stimulant. He's still eating but not like he was. Mornings he doesn't eat
    much. I just gave him some of his favorite food and he ate great. In fact, he'd probably
    eat more if I gave it to him.
    What are you seeing?
     
  50. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I was just looking back over Blue's older threads and saw that he'd been prescribed the metoclopramide and I just wondered whether any of his meds might have anything to do with the odd behaviour.

    Metoclopramide's typically OK to use for a few days. It crosses the blood-brain barrier, and there's a risk of neurological side effects if it's used for long periods. More info on metoclopramide here.

    Also, mirtazapine can sometimes make cats behave weirdly. It's FDMB nickname is 'meowzapine' because some cats become noticeably more vocal when it's active in the system. More info on mirtazapine here.

    Using the two meds together can apparently increase risk of side effects. According to marvistavet.com:

    The chance of neurologic side effects is increased when metoclopramide is used in conjunction with mirtazapine, an appetite stimulant.

    I thought it best to check with you which meds Blue is currently taking.


    Mogs
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  51. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I'm assuming this was the 10% Meowmix? The feed you gave him of it yesterday doesn't seem to have had any adverse effect on his BG levels.

    How is his weight?


    Mogs
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  52. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I haven't weighed him but he's bony. His tummy is still large. I'm upset.
    The only medicine I'm giving him now is the Gaba. I'll try to weigh him
    today.
    I'm leaving to renew my license in a few minutes. He's still in the corner.
     
  53. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    OMG I signed up for my mom on a site for the vaccine and they sent me an email
    that they had some available. The slots were gone in 12 minutes. :arghh:
     
  54. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

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    Aug 11, 2020
    His weight is 7.6
     
  55. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    What’s a good weight for Blue?
     
  56. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

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    Aug 11, 2020
    He was over 8 lbs. before his last chemo but now it's dropping. He was already skinny but now he's bony and
    it scares me.
     
  57. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I think you need to feed him whatever he wants to eat. His bg is low enough to try and see if he will gain some weight.
     
  58. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I'd try feeding more of the food he likes, Patty.

    Did you get anywhere on the recommendation/Rx for pain meds? Also, when is Blue due for his next round of blood tests?

    :bighug:


    Mogs
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  59. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I will start feeding what he likes several times a day, small meals.

    He looks at me like he knows me now. I just noticed today. He does seem weak, although
    that could be the Gabapentin and weight loss.

    As for pain meds, no email back from the oncologist. I have called my vet and she isn't in today
    but I left a message for Dr. Bruno my original vet and owner of hospital. This process is maddening.
     
  60. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    :banghead:

    I hope Dr. Bruno gets back to you quickly. If not, chase. Being a veterinary professional, I wonder whether he might get more joy out of BluePearl if he were to contact them about meds, etc., on your behalf?

    I'm glad to hear this. :bighug: ((((Blue))))

    When's the last time Blue had a full blood chemistry panel done (including electrolytes - sodium, potassium, phosphorus, calcium, etc.)?

    How many days has Blue been back on the gabapentin for, Patty, and how many times a day are you giving it? (I'm trying to better get my head around where he is treatment-wise.)


    Mogs
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  61. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

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    Aug 11, 2020
    He had the CBC done before his last chemo. Blood chemistry before he started chemo.
    I've been giving the Gabapentin off and on for a few days, no more than twice a day.

    I just spoke with Dr. Bruno and he wants me to give him Prednisone so that's what were
    going to do. I pick it up tomorrow, as it's almost 5:00 here and closing time. He said he
    has never heard of it interfering with chemo. The only problem might be his diabetes
    might flare. He said Blue would feel better on it and it could help with pain and also
    appetite. I have to do something because I just am watching him get sick.
     
  62. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I'm glad Dr. B got back to you. What matters is doing something to help Blue. If necessary you can work insulin treatment around other things he needs. IIRC, Elise mentioned something a little while back about pred being used as an adjunct to the chemo treatment.

    I'd suggest asking for a repeat Rx for more gabapentin to be on the safe side, so that you'll have something readily to hand at home should Blue need it (plus it's an anti-seizure med so might be worth discussing that with Dr. B in light of Blue's odd clinical signs).

    I found this article about electrolyte disturbances. I wonder if it might be an idea to ask Dr. B whether doing another round of blood work - including a chemistry panel to check all electrolytes - might be helpful, in case some imbalance or other might be contributing to Blue's odd behaviours, weakness, etc? (Note: I am just generally digging around and brainstorming here, nothing more. I have no idea whether or not this might have any merit.)


    Mogs
    .
     
    Last edited: Jan 12, 2021
  63. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Thanks Mogs. I appreciate everything you're doing to help my Bluebird. :bighug:

    I did ask Dr. Bruno for a refill for the Gabapentin.
    I'll pick it up tomorrow along with the prednisone.

    Blue is drinking tons of water again and peeing huge amounts. I'll ask Dr. Johnson about doing some blood work tomorrow. I just want him to feel better and it scares me the way he is acting. I read somewhere about water for cats that has electrolytes in it. Maybe they have it at the vet if he needs it.

    Bug doing better? Did you getting any sleep?
     
  64. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    That’s what I thought. I didn’t want to contradict the oncologist but the protocols for lymphoma call for chemo and prednisolone. When I had to stop chemo with Tiffany prednisolone kept her going forward many months. I know the bg might go up but if so we start him back on some insulin. To me the benefits outweigh that.
     
  65. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Glad you're getting the gabapentin refill, Patty. I'm a great believer in having potentially helpful meds available at home 'just in case', because then there's no delay involved due to waiting to get another Rx issued and filled if they're needed.

    I suggest making that blindingly clear to Dr. J. As I've said before, you know Blue better than anyone. Also be sure to tell the vet about the increased thirst and urination. (Can't see how it could be from the diabetes because Blue's numbers are in the normal range.)

    With my Ma Hen hat squarely on my head, if Dr. J says that s/he doesn't think it would help to do the blood work, perhaps ask whether it would do any harm to just check where Blue's at, not least of all for your own peace of mind?

    :bighug:


    Mogs
    .
     
    Last edited: Jan 12, 2021
    Reason for edit: Typo.
  66. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I agree. Chemo can effect the kidneys in a cat. His last numbers were good though. I checked.
     
  67. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Thanks guys. I'll speak with either Dr. Bruno or Dr. Johnson tomorrow. He's so much better tonight.
    He's been in that corner for a few days. He looks at me and meows now. I feel so much better.

    I remember Elise you being shocked about the prednisone. I was too but asked at Bluepearl after his
    first treatment. Dr. Bruno was adamant that Blue needed to be on it. At least I have someone helping
    me treat him. I didn't know what to do. The Bluepearl vet has still not responded to my question about
    pain medicine. She's terrible. I really liked the Dr. that diagnosed Blue. He called and talked with me at
    length when he examined Blue and did the MRI. Very nice vet specialist.
    I have never talked to the oncologist. :(

    Has anyone heard anymore from Jeanne? I have been checking on her but hate to bother her if she's
    still unwell. I thought maybe one of you had heard from her?
     
  68. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    I'll start a new thread tomorrow. Sorry. This one is getting long.
     
    tiffmaxee likes this.
  69. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Patty, I don’t think Blue had an mri. I believe he had an ultrasound.
     
  70. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    LOL you are right...that was me. :rolleyes:
     
  71. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
  72. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    In addition to all the CKD stuff, Tanya's Site has a wealth of information on a whole raft of cat health issues and treatments. (I actually bought Helen's book so that I'd never have to worry about losing access to the information in the event of an internet outage or the TS server being offline!) It's a good place to rummage around:

    Index of Symptoms - Cat Health Issues (Tanya's Site)

    Bearing in mind that the site leans toward the kidney side of things, there may be some intrinsic skewing in some of the stuff in the index but I just had a look at a few symptoms that sound like Blue's clinical signs and found the following 'symptom/possible cause(s)' groupings (NB: not exhaustive lists):

    Increased Drinking
    * Dehydration
    * Kidney infection
    * Hypercalcaemia (high calcium levels)
    * Gastric hyperacidity

    Increased Urination
    * Kidney infection
    * Hypercalcaemia (high calcium levels)
    * Fluid therapy

    Increased Urination at Night
    * Low potassium levels
    * Potassium Imbalances
    * Side effect of calcitriol

    "Spaced Out" | Staring Into Space
    * High potassium levels
    * Hypertension
    * Calcium imbalances
    * Uraemia (high toxin levels)
    * Metabolic acidosis
    * Side effect of metoclopramide (rare)

    Weakness
    * Low potassium levels
    * Potassium Imbalances
    * High phosphorus levels
    * Anaemia
    * Lack of food

    Might be something somewhere in that lot to investigate. There's overlap in some places.


    Mogs
    .
     
  73. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Oh my, that's a great list and who knew his symptoms would be listed. I will definitely
    talk with my vet tomorrow to see if they'll run some blood work. He's much better
    but I'd like to be treating whatever the problem is. Thanks for checking the site
    and pulling that information. It makes me feel better already. Now why couldn't
    the oncologist let me know this and do some blood work. My what a lousy vet.
    Would all of the above be included in a blood chemistry panel?
     
  74. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    It kind of sounds like an electrolyte problem when I checked your link above.
    Fluids would help that wouldn't it?
     
  75. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Has he ever had his blood pressure checked?
     
  76. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    No, not that I know of.
     
  77. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I guess it depends on the nature of the imbalance, Patty, and it might just be a dietary tweak needed, or a med/supplement given by mouth: if a level is too high then something may be needed to reduce it (classic example might be the use of binders to lower serum phosphorus levels in CKD kitties), but if too low then a supplement might be needed (e.g. potassium supplement to treat hypokalaemia).


    Mogs
    .
     
  78. Patty and Blue GA & Brat

    Patty and Blue GA & Brat Well-Known Member

    Joined:
    Aug 11, 2020
    Wow so many things it could be. I will try to get him in tomorrow to be checked. I’ve been thinking
    all along it was from the chemo. I guess indirectly it might have caused the problem. Thanks for all the information.
    I’ll keep you both posted.

    I’m calling it a night. My eyes are so tired I’m having trouble reading. Talk tomorrow. Goodnight and thx. :bighug:
     
  79. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Over here panels are like 'set menus', so you go for the one that's closest to requirements and then, provided there's enough blood in the sample drawn, you bolt on other tests (e.g. running a standard chem panel but bolting on pancreatitis and B12/folate tests when a GI issue is suspected). I got caught out a couple of times with electrolyte tests for Lúnasa because the standard panel our vet normally uses doesn't include potassium for some reason so I have to remember to specifically request it now.

    Looking at that list and thinking of Blue's clinical signs, I'd suggest asking the vet about a CBC plus chem panel including: phosphorus & other kidney markers, calcium and potassium (these are mentioned several times in more than one group), and I think sodium and chloride are other common electrolytes tested for. Your vet should be able to take Blue's clinical signs into account and advise you further. If you haven't passed the info on to your vet, maybe give them a copy of the list of clinical signs and concerns you sent to BluePearl earlier this week.


    Mogs
    .
     
    Last edited: Jan 13, 2021
  80. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    All of the above is included in a CBC plus chem 25.
     
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