? 7/16 Cosmo - AMPS HI. Liver question. Advise needed.

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http://www.felinediabetes.com/FDMB/threads/7-14-cosmo-dose-question.232289/

The good: Cosmo is eating, drinking, peeing, pooping and purring.

Diabetes, Megacolon and recent bowel obstruction.

The tough: BGs are super high. He seems to be having and adverse reaction to the medication (cisapride likely?). He has been having twitches/spasms yesterday that were pretty bad. I thought he was going to have a seizure, but didn't. We decided that since he was having nice, soft, regular #2's that we would stop the cisapride and lactulose. At least for now. When he started cisapride, one day his pupils were different sizes. I read that it can cause CNS (central nervous system) issues as a side effect in some cats.

The twitches/spasms seem a bit better today. We gave sub q 100ccs and amino bplex if he needs some vitamins /minerals.

Way back when he was first diagnosed with diabetes, his blood panel had elevated liver enzymes. Could all this be a liver issue? He has been prone to bounces - which I think is Mr. Liver getting scared and dumping glycogen into the blood stream. He doesn't seem to be metabolizing his Meds well either.

We are going to call the vet today for a consult. Any ideas from the group?

 

Liver values being out are very common for newly diagnosed diabetics. Cats aren’t able to process all their food when hyperglycaemic, a bit like starving themselves, hence the liver values go up. They will recover when his BG numbers come down. However, that means you need to get him out of these red and black numbers ASAP.

 

Yes, we want his BG down too!

We were at 1.5 for a time when he wasn't eating well, now we are back up to 2.0 (with a possible fur shot this am). We stopped lactulose as of this am and his last dose of cisapride was yesterday am. How soon can/should we make our way to 2.5 again with changing variables?

What I am wondering, is if his little liver is working at all with his adverse reaction to cisapride or metabolizing Meds.

We are struggling to solve the riddle, balance and do the right things

 

What if his liver isn't working and just keeps dumping glycogen?

 

Which liver enzymes are elevated and what are the ranges for your lab?

 

Hard to say if the high numbers you are seeing are from bounces (dumping glycogen), or not enough insulin. A few before bed tests at night will tell you if it’s the former. Also, don’t worry about bounces, they are perfectly normal and a sign that the liver IS working. Cats bounce until they don’t. From newbies to one cat I have seen who was diabetic for 9 years, and passed at 20 from something else, still bouncing to black.

As for increasing, a furshot depletes the depot. You have to restart again holding the dose until the depot is full. Seven days per SLGS.