2/19 Ruby AMPS 94/+3 57/+5 73/+7 69/PMPS 85/+2 83/+4 88

Discussion in 'Lantus / Levemir / Biosimilars' started by Katherine&Ruby, Feb 19, 2021.

  1. Katherine&Ruby

    Katherine&Ruby Well-Known Member

    Joined:
    Oct 8, 2020
    Yesterday's continued lively condo.

    Thank you for your thoughts, Wendy. I think I am a bit like you. The uncertainty would drive me a little cuckoo. Last night I posted on the Raw Feeding for IBD group on FB and, after sharing the ultrasound report which states "small intestines have a diffuse and thickened wall 3.2mm with a prominent submucosal and muscularis layer" a mod suggested that the thickness indicates SCL rather than IBD. So I really do have to consider a biopsy, even if I have to put it on Care Credit. I have spent the morning trying to find an appointment with an Internal Medicine specialist. I received a name for a highly highly recommended vet at Animal Medical Center on the East Side of Manhattan, but his first appointment is a month from now. :banghead:

    Meanwhile, I found diarrhea in the litterbox this morning. Added more S. boulardii to her food. She is eating, so that is a relief, and her BG numbers have been pretty good since the dose increase. Trying to focus on the positives. :blackeye:
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I don’t want to scare you but my lymphoma kitty had thickening without any masses and it was intermediate cell. I would want to know for sure what you are dealing with as treatment will make her feel much better. I need to read your previous post.
     
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  3. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    Just here to hand out hugs :bighug::bighug::bighug:

    Hang in there mama bean :bighug:

    Nice cycle for Ruby :cat:
     
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  4. RachelG

    RachelG Member

    Joined:
    Jan 8, 2021
    Oh I'm sorry, this sounds like a lot! I want to let you know that even thought the big C sounds scary, SCL is very treatable! Fortune was doing really well on his treatment. The only complication he had was diabetes from pred, and you already know how to manage that!

    Even with everything going on with him, the SCL is in remission at the moment (keinahora).

    That is great she is eating! :bighug::bighug:
     
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  5. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    It DOES sound really scary, Rachel. I have been crying all morning. Thank you for sharing how treatable it is. It makes me feel a bit better for my poor kitty.
     
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  6. RachelG

    RachelG Member

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    Jan 8, 2021
    Big hugs. :bighug::bighug:

    Ruby knows you're doing the best you can for her. Knowing what you're dealing with allows you to give her the best care and treatment possible.

    I hope that internist is fabulous! :bighug:
     
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  7. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    I decided that I couldn't wait a month for the fabulous internist, so in the meantime I've made an appointment next Thursday with one of the IMs who treated Ruby's DKA in September at Blue Pearl where the ultrasound was originally performed. I stopped communicating with her after she pushed prescription food on me, discouraged home BG testing, and was generally very difficult to communicate with directly, but I'm willing to let bygones be bygones to focus on her CKD and GI issues.
     
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  8. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I wrote a long response that got lost. :banghead: I agree with what Wendy wrote. My lymphoma kitty had thickening but no masses. She was diagnosed with intermediate cell lymphoma by endoscopy.

    You can start with Blue Pearl and if not happy switch to the other one if you dint like what you hear. All I can say on that is that a good oncologist is essential. The earlier you find out what you are dealing with the better. As. Marje and Wendy said treatment is not the same for IBD and scl for all cats.
     
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  9. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    Grateful to you, Elise. :bighug: The diarrhea really scared me today as I haven't seen her do that since she was very sick in September. Am convinced I need to get to the bottom of this. Meanwhile, Ruby's sister Olive's blood work came back and everything is totally and utterly normal. She was put on three days of Onsior for her limpy leg but she is as healthy as can be otherwise. Fascinating how two cats who grew up next to each other, eating the same things and living in the same environment can have such different health profiles.
     
  10. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Is the diarrhea frequent? Pudding consistency or looser? My lymphoma kitty had pudding once a day. She was started regurgitating her food shortly after eating but not every day. I thought it was scarf and barf.
     
  11. Katherine&Ruby

    Katherine&Ruby Well-Known Member

    Joined:
    Oct 8, 2020
    I’m not sure you could consider it diarrhea. It was not liquid, more like pudding. This is the second time in the last four days. She has not been vomiting as far as I know. I was worried I was giving her too much S. boulardii so skipped that for a day but nothing changed.
     
  12. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    That’s what happened with Tiffany. It was only once a day and she was acting fine. I thought it was the food change since she had very early CKD at age 10 and was switched to Hills KD. This was 11 years ago so things were different then. I always wondered if she had scl that morphed or IBD from the beginning.
     
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  13. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    @tiffmaxee Another point I keep forgetting to mention is Blue Pearl did a B12 and folate test and found that her B12 was >1000 but her folate was low at 8.28, indicating something is going on with her small intestine.
     
  14. Katherine&Ruby

    Katherine&Ruby Well-Known Member

    Joined:
    Oct 8, 2020
    I need them today! Thanks, Susanne. :bighug:
     
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  15. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Beautiful cycle so far today. :D How often are you giving Pepcid? Not the best thing for kitties with GI issues.
     
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  16. Katherine&Ruby

    Katherine&Ruby Well-Known Member

    Joined:
    Oct 8, 2020
    I did indeed read that post and I don't intend to use it long term. I gave a ¼ tab to her on Tuesday and then again this morning when she was avoiding her food but she's been eating fine since. I just got off the phone with her vet and he's giving me a prescription for Metronidazole that I hope will make her a bit more comfortable and her stool less runny. We are holding off on the budesonide until we see the internist next Thursday.
     
  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    The Metronidazole short term should help. Just note, if you don't know already, it tastes horrible.
     
  18. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    Should I ask for the liquid instead?
     
  19. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
  20. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I put metronidazole pills (tiny) in a pill pocket with ease. There is no way of getting away from the foul taste in a liquid. I even tried some compounded chicken flavour, but I was told in no uncertain terms that the flavouring did not work! :arghh:
     
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  21. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    PMPS = 85. We've had a really nice green numbers day. Since this morning she has been eating well but she's been in a meatloaf for most of the day. :( Hope the antibiotic helps her tummy.
     
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  22. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    That's a nice PMPS but I'm sorry you've got so much to figure out for Ruby:bighug::bighug::bighug:. My heart goes out to you. I hope the antibiotic helps her.

    I saw Marje responded to your question about transitioning to a raw diet. I was going to point you to the FFL website but she did that. It was easy with Butters because she had been on a raw diet prior to her DM diagnosis. She started vomiting her food and refusing to eat it the day I started her on insulin. Probably a coincidence. So I gave her canned but got her back onto raw pretty quick but I used the FFL site as a guide.
     
  23. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    From yesterday:

    I probably wouldn’t have started a +9 feeding. :)

    The SEB can be made into a syrup and syringed. You can also use George’s Aloe Vera with it but be sure you read the info because you can’t just use any aloe vera. IMHO, cerenia doesn’t work as well as zofran but they work together very nicely to address nausea. I don’t know whether you’ll have to address nausea all the time. I gave Gracie both just to make sure it wasn’t an issue plus the cerenia is an anti-inflammatory.

    i’m not sure which prepared raw foods have bones. It’s been too long since I’ve used them.

    I hope you get the info you need for Ruby from the IM. Wendy and Elise are excellent sources. I didn’t have a good experience with the endoscopy and biopsy so that colors my feelings about it which is not fair to you and Ruby.
     
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  24. Katherine&Ruby

    Katherine&Ruby Well-Known Member

    Joined:
    Oct 8, 2020
    Yes, thanks, Lyla. I bought some Primal today just so I would have something premade where I could see if Ruby and Olive take to raw before embarking on making my own. It's thawing in the fridge right now so will start them with a smidgen tomorrow in their food.

    I've ordered George's juice and I already have the syringes and SEB so I hope I can get Ruby to take it. She's very compliant with pilling, although if she reacts to assisted drinking like she does to me giving her subQ fluids, I might have some trouble.

    The Zofran is coming by tomorrow hopefully, and some cyproheptadine next week. Interesting to know that cerenia is an anti-inflammatory. The Pepcid might have helped Ruby today as she was eating well but I'd feel much better if the SEB and aloe juice performed the same function.

    Don't worry, Marje. You're definitely not the only person to advise me against it and I'm so grateful that I can get a multitude of perspectives before arriving at my own conclusions about what to do. At this point I've learned so much from everyone here and all of the research that I've been doing that I'm much better equipped to handle the situation than I was in September when faced quite suddenly with Ruby's DKA crisis with no knowledge of feline health at all.
     

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