3/19 Cain PMPS 253 Dose increase

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Jennifer&Cain(GA)

Jennifer&Cain(GA)

Member Since 2013
Hello!

Yesterday's condo

Cain's not doing as well today as he was yesterday. He's back drooling again, not wanting to move much and he didn't meow as much as he did yesterday. He's still trying to make the litter box at least once this morning, but so far not since I took him back home. He's still having small bowel movements and he's urinating still. The kidneys are still good we think due to all the fluids he's been getting. The labs came back and some values are higher and some are lower. Whatever CPK is, it's value is way higher this time. It shot up into the thousands. The vet mentioned that the antibiotics are getting ahead of the infection. (I need to double check this if it was infection or inflammation.) He thinks we're treading water at this point.

Cain had the last of the saline/potassium IV bag today and they sent him home with me early cause there wasn't going to be any staff besides the receptionist to release him later today. He got all his usual morning shots again and another ampicillin shot before I took him home. The rest were 24 hour shots and it was too early to give them again. I'm going to be giving him extra fluids though his feeding tube. Some pedialite. Cain's going back in tomorrow morning to see how he is. I forgot to ask for him to get weighed.

I will have the lactulose in hand today (in the next hour or two) and I think that's three times daily. How closely should I watch his BG during this medication?

Rhiannon, I got your package. Thank you! I'm going to start him on it today.
 
Cain Needs **FLORADIX** Right Now

Hi Jennifer,

Although I said I would no longer comment on Cain's condo I am still very sad about all of this...I posted this in your last night's condo, but you have started a new condo here now, and you did not mentioned to the people here a few VERY important things that you stated earlier this morning but you had written in last night's condo. These people can't really help you unless they know the full story... The first thing you did not mention here is that Cain is very weak and no longer standing on his back legs, and the other thing is that Cain is now anemic.

The reason that I yelled in my last post to you was because I still do not believe you recognize the urgency of action that is required to help Cain live. If a child puts his hand over an open flame we do not politely say, "Please remove your hand." No, instead we slap the hand away and say, "Don't do that! You will burn yourself!"

This latest development with Cain having anemia and his incredible weakness is quiet frightening. You've got to act quickly on this. I had a cat last month that died within 7 hours of being diagnosed with anemia that had been given fluids. Once his severe anemia was diagnosed, he never should have had sub-qs until the anemia was treated and began to resolve.

Cain should have a GREATLY reduced amount of sub-qs, or none at all, until you have successfully treated him for the anemia. If his anemia is very bad, and it sounds like it is, continuing sub-qs without treating him successfully for the anemia can kill him very quickly.

The sub-qs dilute Cain's blood, and then the red blood cells cannot carry enough oxygen to Cain's lungs. What happens is that the cat begins to take huge gasps of air because they cannot get enough oxygen into their lungs, they suffocate to death.

Is your vet still giving Cain a vitamin B-12 shot every time he administers the sub-qs? Did he only give the one vitamin B-12 shot?

Another cause of anemia is a lack of vitamin B-12. You also mentioned that Cain can no longer stand on his back legs at all. That's also a sign of a lack of vitamin B-12. BTW, another cause of nauseousness is ANEMIA.

It is very obvious to me that Cain has pernicious anemia. Did you know that vitamin B-12 shots last but a mere moment in the body of a cat or a human? Our bodies immediately pee out any excess vitamin B-12. With the amount of fluids that Cain has been receiving to flush out the toxins, he is probably peeing a lot of the vitamin B-12 out of his system. I would have the vet reduce Cain's amount of sub-qs, and ask them if they believe he still needs them. You said his pee was a normal color again, right?

You really need to start adding vitamin B-12 to the food that you are feeding him.

Cain needs to be on daily doses of both of Zobaline and Floradix, like right now!! They both need to be mixed into his food to help him recover from his anemia and his leg weakness.

The Floradix is an over-the-counter iron supplement that one of my vets had me feed to my cat Daphne in her food when she became extremely anemic. It worked immediately-- OVERNIGHT Daphne's red blood cell count went up, and it continued to go up. I did not take her off of the Floradix until she was producing all of her own red blood cells again. Daphne had been to the point of near death. I still have Daphne today.

A 4 pound can take 1/8 tsp per day. It DOES NOT cause any constipation at all!!! Cain should get at least 1/8 tsp, 2x a day in his food because he weighs more than 8 pounds.

http://www.vitaminshoppe.com/p/flora-fl ... yngql5RHLo
https://www.lifelinknet.com/siteResourc ... baline.asp

You should do some research on the internet to see who carries the Floradix locally where you live. The Vitamin Shoppe carries it. Many times pharmacies will carry it. You just ask the pharmacist if they have it. MOST grocery stores with a large alternative health section will carry Floradix there. I cannot stress to you enough how important it is that you get this Floradix into Cain's body, ASAP. You do not need a prescription in any state to purchase it.

Many blessings to both you and Cain, Tina
 
Re: 3/19 Cain AMPS 312 New Labs

Oh shoot I forgot about the anemia. I thought I was awake by this point too. Shoot.

This is what I wrote. I was thinking more of if I can leave Cain by himself long enough to go get the lactulose ready now.

"I added the new labs. Not great news this morning. He's anemic and treading water at this point. The good news is that his kidneys are still working.

Cain tried to get to the litter box this morning but his back legs do not support him anymore. Not in the last three days. He was quieter in the carrier this morning and didn't move as much as yesterday when the morning round of shots was given. Drooling more this morning but he wasn't last night. Not sure if his food was causing that this morning."

Sorry, I'm trying to keep up. I forgot. I thought I mentioned his back legs not supporting him before? Either this group or the pancreatitis group. That's why he's getting potassium. I had to have mentioned it by monday. That's one of the several reasons why he went into two vets that day.

Cain's not getting sub-q's (at least the version I know of), he was on an IV line and the IV had 0.9% NACL, 2ml B complex, 20mg KCL (there is a + and a +o in the notes I took a picture of, not sure what that o is. It was next to the KCL). They finished it this morning. About 200ml I think or less. I can add the methycobalamin to his food cause I still have the capsules that I fed him. Last time I wrote down he did a b12 shot was monday.

Yelling at me doesn't get things done, btw, especially when I'm already this stressed. Yelling at me makes me annoyed/pissed off at the person yelling at me and I want to back off the whole situation.

Sorry, but that's how I am.

I'll start the methylcobalamin back in his food and I'll look up the floradix thing. I'll run it by the pancreatitis group too. The anemia was discovered by the labs which was sent over this morning I think. His blood was drawn at noon yesterday.

I'm off to pick up the lactulose. If someone can let me know how often I have to check his BG during it, I'd appreciate it. :)
 
Re: 3/19 Cain AMPS 312 New Labs

Quick addition as I'm typing up the stuff for the pancreatitis group:

He walked out his carrier some just now. I left him in half of a carrier shell with a towel since he didn't seem to want to move. He was actually using his hind legs for a few steps before he stopped. So yay some good news for today!
 
Re: 3/19 Cain AMPS 312 New Labs

Hi, Jennifer.

CPK is creatine phosphokinase which is an enzyme that is sensitive to muscle damage. These levels rise with muscle problems such as shaking/trembling or injury. Low potassium can also cause a rise in CPK.

With the low RBC count, I'd encourage you to talk to your vet about whether a transfusion is needed. Based on the lab values, I can't tell if Cain has pernicious anemia. With this form of anemia, the red blood cells are abnormally shaped. The vet would need to look at the blood under a microscope to determine this. While the value for anisocytosis (i.e., red blood cells are of unequal size) is moderate, this could be due to Cain's elevated white count.

I honestly don't know if Cain needs to be at a 24 hour facility where he can be more closely monitored.
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369

+2.78 320
+5.48 369

Okay I have the lactulose and gave him the first one. I'll check his BG in an hour (providing I'm not out hunting down that foradix). Why do errands take so darn long? It took me nearly two hours, or maybe it was more than two hours, to get more syringes, buy more cat food for Brownie, get Cain's lactulose, and get a quick haircut. Both pharmacies took some time. Rush hour I'm guessing.

Sienne, both vets are closed by now. I don't know if he needs to go to emergency care. Thanks for the explanation of the CPK. A quick Google search said something about muscle damage but I wasn't sure how it was with cats.
 
Re: 3/19 Cain AMPS 312 New Labs

Hi Jennifer,

What matters is that Cain now has anemia and he is weak..

Fluids, whether delivered in an IV straight to the vein, or, injected under the skin subcutaneously, **will** lower Cain's red blood cell count even further. With his continued drooling it sure sounds like Cain is still not re-hydrated and that is a shame. (Did they check inside his mouth for any type of tooth infection as a cause for drooling?)

Did you ask them why they gave you Cain's fluid bag this morning, considering that there are still fluids in the bag, and they know that you do not know how to give subcutaneous fluids? Are you not taking him back to the vet tomorrow because they told you he is "treading water"?

*IF* you post Cain's red blood cell count in this condo there are people on this board that can tell you right away how badly Cain is suffering with anemia.

Those two vets that have seen Cain so far are not at an emergency animal hospital. I think that Sienna was suggesting to you early this morning that you might want to consider taking Cain to an emergency animal hospital to get him checked out, at this point.
 
Re: 3/19 Cain AMPS 312 New Labs

Whaaat? They didn't give me his fluid bag. They finished up his IV bag at the vet office this morning. :? Did I write that badly? The vet said he's re-hydrated. There were no teeth issues, that was one of the things they checked when I brought him in on the 7th.

I said I put his labs that arrived this morning in my spreadsheet. Under the labs tab. All the CBC tests are posted along with the Superchem ones. That's why Sienne was talking about not sure which anemia from the values.

I'm not going to take him back? I'm not sure where you got that idea. Of course I'm taking him back in tomorrow morning.
 
Re: 3/19 Cain AMPS 312 New Labs

Hi Jennifer,

I'm so sorry I can't help you with all of the issues you and Cain are dealing with right now. I can't imagine how overwhelmed you must feel. I do want you to know that I am continuing to keep you and Cain in my thoughts and prayers.

Hang in there!
Shelly
 
Re: 3/19 Cain AMPS 312 New Labs

Oh (((Jennifer)))
I am so sorry to hear that Cain is anemic and is not doing as good as yesterday....
I am sending many many prayers and positive thoughts to Cain.
Also some stay strong and calming vines to you.

Many hugs to you. :YMHUG: :YMHUG: :YMHUG:
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 New Labs

Great, Ok.. I mis-read that earlier, that they sent him home with you today because he had finished that bag of fluids and no one was going to be there for the rest of the day.

Good thing you will take him back tomorrow and get the anemia problem checked out. The Floradix really does help a lot though with getting *useable* iron easily into his system quickly, especially if he is still getting the vitamin B-12 shots.
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 New Labs

+7 358

So far so good with the lactulose, BG wise anyways. I don't know how long it takes to affect it. If it does. I might just be lucky that Cain isn't too carb sensitive.

Tina, it happens. I mis-read stuff all the time. From his notes, I don't think he's getting b-12 shots. I'll be supplementing the methycobalamin in tonight.
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 +7 358

the lactulose isn't absorbed, so it isn't likely to be responsible for his blood sugar.

from http://www.diabetesincontrol.com/articles/86-practicum/11408-diabetes-disaster-averted-48:
Most patients think that lactulose is like lactose and that it is a sugar that will raise glucose readings. However Lactulose is a synthetic sugar that is broken down in the colon into products that pull water out from the body and into the colon. It works by drawing ammonia from the blood into the colon where it is removed from the body. Because it is broken down in the colon it is not absorbed in the intestines and therefore has little if any effect on glucose levels.

Jon Murray, MD
Ruskin, FL
Click to expand...

jennifer, did he get insulin the morning of 3/17? it has 0 in the dose column. i'm looking at his ss and wondering about increasing his insulin dose to get him down a bit, but i know we're juggling so many issues. i'll talk to some others about it.

glad to hear that he walked a little bit today. that's good news!
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 +7 358

Jennifer,

It's good new that Cain walked a little on his back legs today--HURRAY!

When Tawny had all her issues & was so sick in 2011, she also was anemic. She also had a potassium deficiency. She had multiple issues, so many I don't remember them all. She had ketones, pancreatitis, wouldn't eat, wouldn't stand up (too weak), etc. She was in a 24-hr care facility, I visited her often (it was 50 miles away), I fell asleep on the sofas/chairs in the waiting room often, but other than coming home w/me every night (which she didn't, no way could I make that trip that often), she got pretty much the same kinds of treatments that you are posting Cain is getting. She got fluids when needed to, didn't when she didn't. She had an e-tube, and if I remember right they pulled it when she started eating, she went off her food again w/in days, and she had another one put back in. Three times she went into the hospital. At one point I sat in the parking lot outside the clinic and called Venita (DCIN--Tawny was originally placed w/me as a foster thru DCIN, this is now her furever home & I am known as the "Failed Foster Mom") hysterically bawling my eyes out that Tawny was back in the hospital yet again and even the vets had started delicately hinting about her prognosis not being stellar.

Tawny pulled through and returned to health.

We all know you are doing more than everything you can to help Cain and give him the best possible chance and are getting him--and giving him--the best possible care. & that, my dear, is all you can do.

Desi
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 +7 358

I could have sworn I wrote a reply to Julie and I guess it didn't post or I closed Firefox before that happened.

Julie, that's great to hear about the lactulose. I read on wikipedia that diabetics could use it but I wasn't sure about cats. Cause what I'm finding out is that cats are weird. On the morning of the 17th, yes he didn't get an insulin shot. He was visiting two vets and by the time he was put on an IV it was just too late to give him his shot and still keep him on schedule. At least what I could figure.

Desi, thank you very much for that story. I'm really starting to wonder if Cain will pull through. Especially with all the problems he's having and new ones just keep developing. Sometimes when I'm really down today I think I'm just prolonging his life just cause I want him here. But I will see about the vet visit and see what can be done with the anemia. The potassium must be working some if he's starting to walk on his legs again. :YMHUG: :YMHUG: Dad's worried about Cains' quality of life. I think if we can convince Cain's liver that it can stop being annoying and start working properly again, we can get ahead of any more problems.

Though so far I can't seem to catch him to test ketones. Maybe if I find a really wet towel that he urinated on...
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 +7 358

(((Jennifer))) Continuing healing vines for Cain, strength vines for you. You are both in my prayers. Stay strong :YMHUG: . There are so many people sending you positive vines. I hope you and Cain feel them surround you.♥
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 +7 358

Thinking of you and sending healing energy to Cain and strength and hugs to you.
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 +7 358

There is very little information about pernicious anemia occurring in cats. Cains HCT is very very low and he is most
certainly anemic. But his MCV and MCHC are normal and a cat that has an iron deficiency would not normally show these values as normal. Typically...but I never say never. You have to be careful about iron supplementation if there is not a proven iron deficiency.

The depletion of B12 is a bigger possibility. Supplementation with B12 is probably a good idea. For CKD cats, methylB12 and multi B help to prevent anemia. But CKD cats typically have non regenerative anemia and Cain may be more likely to have regenerative anemia.

Sienne's idea of a transfusion is a very good one. I also think Cain needs to be in a 24 hour hospital that perhaps has a critical care specialist. I think his anemia, compounding everything else, is complicated and I'm not sure that any of us are well versed enough with all these multiple conditions and how the symptoms are attributable to each to recommend a course of treatment.

Sending Cain many many prayers.
 
Re: 3/19 Cain AMPS 312 +2.78 320 +5.48 369 +7 358

Jenn

It's probably a good idea to raise his dose to 0.75u. We're not liking those high numbers. Can you do that next shot please?
 
Re: 3/19 Cain PMPS 253

PMPS 253

I started the .75u tonight, Marje. The dose was really late due to the fact I had to clean Cain and clean the areas he's been in. He drags his hind legs on the floor still so he can't make it to the litter box very well. I've been having to pick him up and carry him over, usually while he's going poop tonight. It breaks my heart to see it. And I think the lactulose is working cause it's a laxative right? He's been pooping a lot. I keep having to clean him up and the towels he's on every couple of hours. I'm not sure if his poop has a faint pink tinge. It kinda looks like it sometimes but it could be the lighting. He also has been getting lots of methylcobalamin in his food tonight which turned the food a light pink tinge.

I put him on his side and he kinda feebly tried to turn over but stayed there, and I took advantage of the concrete floor there to clean his butt off with water and paper towels and a wash cloth. He didn't react too much. Just twitched his hind leg if I accidentally brushed up against something he didn't like. Granted with the way he's pooping tonight, he'll be dirty again in thirty minutes but for that brief bit, I could put him on the towels again and not feel like I need to change them immediately.

:sad:
 
Jennifer:

Sending lots and lots of prayers for Cain and for you. I'd bet the methylcobalamin is causing a pink tinge to the poo. It does turn the food that color, so it makes sense. Have you invested in pee pads yet? I haven't priced them lately, but I know Walmart sells them, as does Costco, if you're a member.

I hope you are remembering to take care of you through all this, too. Many hugs. :YMHUG: :YMHUG: :YMHUG:
 
Jennifer, I've been watching Cain's condos for updates but this is my first time to post. Sending Cain MEGA healing vines and comfort vines to you. You're doing an incredible job caring for him and aiding his recovery. Cain is so lucky to have you as his mamabeaan. Lucky for him too that you found this website where you can benefit from the advice of the very knowledgeable caregivers here.
Prayers for encouraging improvement soon.
 
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