Dr Kellon. Bloodwork back after starting invokana and it’s not good


Suzy Berkowitz
 

Scout had been on invokana 8 days and the L-carnitine 5 days when we pulled blood.
Triglycerides pre invokana- 68 and now is 129. His insulin and ACTH taken April 10th while he was on 3x a day metformin were ACTH -27.3 Insulin 57.17. Now ACTH 37.5 Insulin 184.64. He is getting 75mg invokana. What do we do now? I screenshot these latest and previous bloods and emailed them to you. Thank you

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Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Eleanor Kellon, VMD
 

How is he doing? You need to increase his pergolide. If he weighs 400 lbs, the 75 mg is a little low.  Should be 110 mg. It's up to you and your vet whether to go back on metformin.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001


Suzy Berkowitz
 

I will increase his prascend from 4 tablets to 5 this evening. The invokana tablet is 300mg oval. Where would I cut it to get the correct 110mg dosage? His appetite seems better. 
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Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Eleanor Kellon, VMD
 

I'd settle for 100 but even that would be difficult to gauge with an oval. Do you have a compounding pharmacy in your area? If you do, you could ask them if they will compound it for you so that you can easily measure a 110 mg dose.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001


Suzy Berkowitz
 

How does that work? I bring them the tablets and then what do they do?
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Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Eleanor Kellon, VMD
 

I don't know if it's even permitted for you to supply the tablets but if it is they would crush them and mix with a carrier then give you instructions on how much of the mixture to use. Otherwise, do the best you can to cut the quarter in half to add to the quarter you are currently feeding. You mentioned he is eating better. How much is he eating?
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Eleanor in PA

www.drkellon.com 
EC Owner 2001


Suzy Berkowitz
 

He is eating his 1.5 cups of stabul 1 mixed with a 1/2 ounce of the flaxen flow and 1 ounce of the flix flax treats. He really likes the flaxen flow so I think that helps but maybe the 15 months on metformin bothered his mouth more than I thought and that’s feeling better.  He seems more interested in the balance cubes as well but since he shares them  I have no way of knowing if he’s eating more of them. He gets 1 equipocket L/S  for his pills.
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Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Suzy Berkowitz
 

I spoke with a local compounding pharmacist, he said he couldn’t accept my pills but I weighed the pill for him and he figured out how much 110mg would weigh, so I will start him on that dose this evening. Is there anything that can be done to get the triglycerides down? Thank you.
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Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Eleanor Kellon, VMD
 

The triglycerides are still only mildly elevated. The most important thing for getting them down is food - no soaking, free choice hay/cubes, as much beet pulp as he will eat and add Stabul 1 to the mix. Adding whey protein may help too, 25 grams twice a day. Most amino acids are glucogenic when metabolized.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001


Suzy Berkowitz
 

I have never used beet pulp before. Is there a list of safe ones somewhere? How long do I rinse/soak/rinse?thank you
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Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Maxine McArthur
 
Edited

Hi Suzy
There is an entire folder on beet pulp in the “Core Diet” section of the Files.
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Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Lavinia Fiscaletti
 

Any non-molasses beet pulp is fine.

You'll need to rinse/soak/rinse any variety to remove dirt/iron.

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Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR


Suzy Berkowitz
 


Suzy Berkowitz
 

Thank you Lavinia
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Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915