2/19 Fortune AMPS 463 +2 550 +5 380 +12 98 PMPS 201

Discussion in 'Lantus / Levemir / Biosimilars' started by RachelG, Feb 19, 2021.

  1. RachelG

    RachelG Member

    Joined:
    Jan 8, 2021
    Yesterday

    Fortune is snuggled in my arms today, probably still tired from the hospital.

    His BG is sky high so I'm worried that he is crashing and that it will affect his kidney.

    I got his medical records. The new IM that took over documented that I said our GP ghosted us. Ugh. She also wrote that we are both on speaker listening. Is that unusual? Yeesh.

    I reached out this morning when I realized there was not a plan beyond a recheck next week (to evaluate his b/w and if he needs subQ) and longer term pending his biopsy results. But what about his anemia? Are we just hoping he won't crash?

    I am so nervous with his BG this high.
     
  2. JaxBenji

    JaxBenji Well-Known Member

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    Jul 10, 2020
    what does this mean lol? Sorry about the extra notes...you all are such loving beans :bighug::bighug::bighug:

    FWIW Fortune's BG is bouncing from those greens yesterday but I don't know what that impacts. Just here for moral support :bighug::bighug::bighug:

    And thank you for sending love to Jax while nursing Fortune :bighug:
     
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  3. RachelG

    RachelG Member

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    Jan 8, 2021
    LOL We put them on speaker phone so we can both listen and ask questions. IDK why it's relevant to the medical record though. :rolleyes: They document "Mr. asked...Mrs said" like how is which one of us saying the question relevant? Yeesh.

    And always plenty of love to go around! :bighug:
     
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  4. RachelG

    RachelG Member

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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Fortune's body is not yet used to greens (that will come), plus the dose has not been stable (not your fault), so the depot is in flux. I would suggest no more pokes today, and a lot of time spend lovin' on him instead. Try to make sure he gets lots of fluids today, water down his food if he'll eat it that way. Neko survived her hours in high numbers just fine. They do eventually come down from the bounces.
     
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  6. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
  7. JaxBenji

    JaxBenji Well-Known Member

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    Jul 10, 2020
    Ohhhhh I get it now lol :joyful::joyful::joyful: but also am puzzled with you why is in the medical record...they should just write caregivers for everything!
     
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  8. RachelG

    RachelG Member

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    Jan 8, 2021
    I updated my spreadsheet with his lab work, and I find the alkaline phos levels worriesome. He is on ursodiol for his liver and now I’m second guessing if they were administering it - his levels jumped up!

    Would greatly appreciate if someone with some knowledge could take a peek :bighug:

    We have been loving on him like crazy! Two weeks ago we thought we were going to lose him, and I am so so grateful to have him snoring in my lap rn. :bighug:

    This makes sense. I just am so grateful I found this group, and only wish it was when he was first dx’d last year!

    Yeah I’m not too pleased with how she documented things. There’s a few things misrepresented. But I have so few spoons that I’m trying to focus on the most important things, like snuggles with Fortune! He is getting some chx tonight and gave DH puppy eyes for a treat earlier. He is very much his mischievous self tonight!
     
  9. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Definitely recheck that hematocrit if they are re-doing blood work next week. You need to know if you need to start ESAs (like Epogen or Arenesp).
     
  10. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I don't know. They are like a bunch of lawyers ... documenting everything and who said what. I guess make sure if you put people on a speaker phone to say... we have you one speaker phone so that we can both hear what you are saying and we can both ask questions, is that okay?
     
  11. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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  12. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    ALP can often be elevated in a diabetic cat. Don't you have a record of every med they gave him while he was at the ER?
     
  13. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    I see his creatinine has been a little higher than it was and a little lower. He was up to 4 at one time. Dehydration can cause elevate creatinine.
     
  14. RachelG

    RachelG Member

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    Jan 8, 2021
    Both my husband and I try to be on every call so we are informed and can ask (different) questions. It is just strange to me that she documents what each of us says, vs O stated...which is typically what I see on medical records.

    Additionally, she conveyed that the idea to keep Fortune on Wednesday into Thursday was MY idea, when in fact it was the criticalist who was overseeing Fortune's case who strongly recommended it. It was only when this IM called us Wednesday am (first time speaking to her) saying that Fortune is "eating like a pig" and "doing well, he can go home," that we asked questions about how long he had been off of fluids, will that potentially make his creatinine shoot up, etc. and that we wanted to make Fortune was stable when he came home, which is what the other dr had told us. She wrote that Fortune may crash *anyway* because of everything going on :)rolleyes:) but that it was "fine" to keep him.

    My pocketbook and heart would have liked him home a day early, but it seemed like the correct thing based on the other doctor was to keep him. And overall I don't trust her - she bumped Fortune up to 3IU with no spot check the day he went home. If we had dosed him 3 IU last night that feels like it would have been a bit disastrous!

    He has a history of cholangeohepatitis, which is why he on ursodiol. I'm now concerned that they weren't giving it to him. I have his full digital record, but not the full list of meds.

    Yes, his creatinine was 4 and he was admitted for that and anemia on Saturday night. It has come down to 2.9 (one dip to 2.6) and that is also what will be check next week.
     
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  15. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Now, all that junk is out of the way... it sounds so wonderful... the day that you have spend with Fortune today. This has lightened my mood... which was not too great when I read the paper from the vet that my vet consulted with.... and then Darcy had 0.6 ketones, which made me happy.... then I read your wonderful update on Fortune I just feel really, really happy (smiling at my computer screen now and getting teary-eyed.)
     
  16. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I see you couldn't resist getting another poke in today. :p Good to see he's on his way down. Now, restrain yourself!
     
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  17. RachelG

    RachelG Member

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    Jan 8, 2021
    Hehe yes! :D Happily - to be fair that was done before I saw your message, I updated the forum much later. Fortune got the news and has been a lovey dove since he knows there's no pokes! :joyful:
     
  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    ALP can elevate if kitty is not eating because ALP indicates liver disease like hepatic lipidosis as well as other liver diseases or issues. However, if hepatic lipidosis is a concern, the ALP is “usually” quite elevated. Often, the vets will do a bile acid assay, if the bilirubin is normal, which is fairly simple and gives a better idea of liver function. I’m assuming he didn’t eat for several days.

    Gracie took ursodiol for quite a long time as she had an up and down ALT. Her bile acids assay was normal. I never saw any effect on her ALP with the ursodiol.

    Are you also giving milk thistle? I like Herbsmith at Chewys. My little one, who is four, has never had a normal ALT although the highest it’s ever been is 135 which is not a big deal with ALT. I give her milk thistle although the vets think this is her normal as she has never been sick.

    I’m glad he’s home and feeling better.
     
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  19. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    I'm glad to hear you have a snuggly, snoring kitty in your lap!!:joyful:
     
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  20. RachelG

    RachelG Member

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    Jan 8, 2021
    Thank you! No, he is actually a great eater (keinahora). That had been the first thing the doctor would tell me in the daily update. At least 230g/day, and at home we try to feed at least 6oz 2x/day. I have no idea why it shot up, and the doctor on his case the Wed-Thurs didn’t say anything, I only discovered it when going through his records. So strange.

    Even as recently as last week his level was in the 30s.
     
  21. RachelG

    RachelG Member

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    Jan 8, 2021
    Fortune is just keeping us on our toes! His PMPS is 98, so we are stalling without food and retesting. Is that the right move? @Wendy&Neko @tiffmaxee :D
     
    Last edited: Feb 19, 2021
  22. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Absolutely right thing to do. See where he is in 20-30 minutes.
     
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  23. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Hmm, I see 201 on the SS, wonder if the 98 was a faulty strip.
     
  24. RachelG

    RachelG Member

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    Jan 8, 2021
    Oh weird, I didn't even think of that! We had to use a second strip because there was too much neosporin on the first. :banghead:

    Next time I'll test again. Although it would be great if he is hitting the greens, it's crazy that he was just in the 500s!
     
  25. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    We have found recent research that Neosporin is not good for cats. It contains polymixin which is not good for cats. Emla cream (needs prescription from vet) is an alternative. Other ideas in here.
     
  26. RachelG

    RachelG Member

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    Jan 8, 2021
    Omigosh I had no idea! I read on this site that was the thing to do when I first started (neosporin with pain relief). :(

    I appreciate you letting me know. I'll ask our vet for Emla cream, but in the meantime I'll try to order the Ledum 30C homeopathic remedy.

    UGH poor Fortune. :blackeye:
     
  27. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Yes, it was a surprise to all of us when when one of our long time members said her vet told her not to use Neosporin. I found Ledum at a vitamin shop. Holding with cool wet cloths can help too in the interim.
     
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  28. RachelG

    RachelG Member

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    Jan 8, 2021
    Already found it quickly on Amazon! Will be placing an order, and finding some washcloths in the meantime for tomorrow :)
     
  29. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    So glad to hear that Fortune is being a cuddle bunny again, and flashed you some green, even if for the briefest of moments. Sounds like your boy is on the mend. Really happy for your little family, Rachel. :bighug:
     
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  30. RachelG

    RachelG Member

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    Jan 8, 2021
    Thank you, Katherine! We are so so grateful to have him here!!
     
  31. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I am so glad to see you and Fortune had a nice day at home. Reading the way the vets documented your conversations gave me a good laugh. It’s not like you can go after them for malpractice. :banghead: It made me angry that the ghosting was included. Ridiculous and so unnecessary. I hope the night was full of purrs and cuddles.
     
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