https://www.felinediabetes.com/FDMB/threads/9-16-naomi-amps-159-7-136.235415/#post-2637616 Good morning! Naomi is not doing well. Went to the vet yesterday. Labs results are not good. CREA has increased a lot. 2 weeks ago was 3.5 yesterday was 5.7 She might have a UTI again despite cornsilk and d-mannose. I increased her insulin to 1.5 units. At AM I give her a reduced dose apart from the days I am off work, like today. Still not eating on her own.
If you have her labs you might want to post and have @Marje and Gracie look at them Hate to hear she is not feeling well
I have added them to the labs tab in her ss. I don't know what I need to do to help her and this is sad
I'm so sorry Naomi isn't feeling well. Sending lots of healing vines to her, and strength to you. You're both in my thoughts.
By her numbers she definitely needs fluids my vet had told me that when the BUN gets high they will stop eating and so Bella get 100ml of fluids at home, maybe that would slow it down and help her feel better, did vet say anything about giving fluids I have 2 CKD cats
I'm at the vet right now giving her fluids and antibiotics. I don't think she agrees on fluids long term at home because she's diabetic. I've done this discussion with her before. We'll be here again tomorrow for fluids. I'll ask her to show me how to do it
Seems to me she’s needs them daily, not sure why she won’t because of diabetes, glad she is getting them today and tomorrow. Has she seen an internal specialist?
She keeps saying it's not good to poke diabetic cats many times. We will do it of course for the insulin and antibiotics but she doesn't want the pokes for subqs for some reason. I don't know what she has experienced in her clinic and says that. Also Naomi had these wounds on both sides of her body in July when I was giving her antibiotic injections at home for quite some time. She moved a couple of times when I was giving the injections. I don't know if this caused the wounds. So now my vet has one more reason to be reluctant. But at this stage we are now things will only get worse. I'll start fluids even if she doesn't agree. 3 months of Naomi not eating on her own is enough
Hi. I am so sorry that Naomi is not feeling well and I know this is also very stressful for you. I am happy to see she is at the vet—and I am assuming it is your regular vet vs an internal medicine specialist? Given all the disease states involved, getting Naomi to an internal medicine specialist would most likely be best at this point. Typically, internal medicine specialists can be found at emergency/specialty clinics or University hospital settings. Regular vets are essentially the equivalent of our primary care physicians vs the internal medicine specialists who are like our own specialists and must go through additional years of education and clinical training managing more complicated and challenging disease states like pancreatitis, diabetes, CKD or multiple issues at once. They are often best with new or acute situations, diagnostics needed beyond labs, diagnosis as well as establishing the best treatment plan/course. They are more comfortable with diagnostics and treatments many regular vets are not comfortable with—-such as the fluids with diabetes and CKD. I understand & appreciate their discomfort with a treatment with a challenging case but that is when I wish they would recommend that you take your cat to an internal medicine specialist vs not offering treatment that may be helpful &/or even necessary during an acute situation. Dehydration does effect Creatnine and BUN values so that is a factor that may be effecting those #s as well as any infection or inflammation. It may not be the only cause for increased in lab values, but it can be a contributing factor. This is why during and also once a cat is stabilized, any infections are treated, pancreatitis flares addressed, etc, repeat labs are very important along the way to assess what is improving or what is still an issue. Thoughts and prayers your way
Thanks for your reply! I've never heard of this term internal medicine specialist in Greece. I don't know if they exist or how I can have access to a medical school. What we have here is small veterinary practices or big clinics with many vets, where animals are hospitalized if necessary, they have all the equipment a big clinic should have. This is where I take Naomi.
My guess is the big clinic that you speak of with the large staff and ability to manage hospitalizations would be where your specialists are located. You can always ask & they will be able to tell you. It may be a situation where outpatient is handled by the regular vet and then if necessary or requested, the internal medicine specialist becomes involved. Some of our specialty clinics in the US require a vet referral in order for your pet to be seen.
All of the vets in this clinic have seen Naomi and they are all present when we go there, they all say their opinions but only one decides, I guess this is the specialist! Naomi is their most complicated patient at the moment with all these medical issues.
Poor Naomi. Yes....multiple organs, multiple disease states is challenging. It sounds like the “decision maker” may be the internal medicine specialist.
