Tuesday, February 7, 2017

Roxanne Back to Usual Self

No word yet on bartonella test results. But Roxy did finally begin to pick up starting Friday night and into the weekend. And I would say that as of yesterday, she's back to acting like her usual self. Not sure what happened. But there was definitely a change about her last week.
Roxy when she wasn't feeling well and was sleeping a lot. She's curled up with my favorite childhood doll Grandma (from Sears early 1970s.) She's in the bassinet of toys.

Thursday, February 2, 2017

Roxanne Not Feeling Well, Lethargic-Not Sure


Took Roxy to the vet today. She has seemed run down this past week a bit more each day. Still eating but just not as energetic. We are retesting for Bartonella (she had it last summer) and for Feline leukemia (tested negative last summer but just in case) and did a full CBC/chem panel to see if anything shows up in blood work. Bartonella takes two weeks to test which is sad since if she's sick she could use the antibiotics sooner than later. But we will keep an eye on her and see how she does. I will give extra lysine (she gets the powder in her food.) Have cypro in case she needs help eating. She's breathing fine and there was no congestion but I will monitor for any signs of heart issues (none expected but you never know.)


Chalk it up to learning something new everyday. Because Roxy's still run down but the blood work was almost normal except that the creatinine kinase was over 800 (normally way less than 400 and in July for her it was just over 400), we are doing the BNP test. This only requires that IDEXX run her blood work; it does not require another trip to the vet. So, what's new? I've never recommended the test. There are blood tests to detect heart disease-genetic tests and the BNP. I've never recommended BNP because if the cat is showing signs of heart disease, has a heart murmur, or any known issues with the heart, getting the blood BNP is a waste of time since only an echo can tell the vet what's wrong with the heart. The BNP test measures brain natriuretic peptide levels in the blood. There will always be a nominal amount but if the heart is having difficulty or the human or pet has had a heart attack, the BNP will sharply rise. Again, if the pet is having a heart attack, why test the BNP? Have an echo, have the vet treat the issue at hand. And an echo will show a heart attack and damage far better than a blood test. And yet, we're testing her blood. Why? Because she saw the cardio in October; because she's showing no signs of heart disease-no change in breathing rate so far; because her heart was beating normally at the vet; because we already drew blood and can test BNP to rule out any other cause that could raise creatinine kinase. However, I did make an appointment for Friday for the cardio just in case (which I can cancel if BNP is normal.) The other way creatinine kinase can rise is due to a hard physical injury to the body or brain. Did she fall? Not that we are aware of but in this house anything's possible. Here's a link to creatinine kinase and below is the link to the BNP explanation. https://www.healthgrades.com/sympt…/elevated-creatine-kinase


Roxy still a bit run down but the BNP heart test came back normal. Reference range is 0-100 and she's at 24. The cardio said if she's not showing signs (cold feet, fast breathing, not moving, etc.) and the blood test is low, then she is assumed to be fine. So, we will monitor and wait for the bartonella test to come back next week.

Thursday, December 22, 2016

Jimmy Needs a Prozac Adjustment Again

Once again, after about a month with the increased Prozac (I'm assuming because Prozac can cause aggression), Jimmy is once again attacking his sisters. Never sure of the cause but something happens in his head and he gets angry and attacks. This isn't just swiping and hissing but a full on attack. Fur flies, cats cry, and when two are fighting, they all get involved. And it happens in a flash. So, I will dial down the Prozac-this time to .18-and see if he improves. Problem is, with the lower dose, he then begins to have accidents which we've seen since about September (the last one being 11/26 when he went against a window.) Maybe I'll try a week of a low dose and a week of a high dose and alternate. I could tell a change was coming, though. He has always had these maniac/depressive mood swings when on Prozac. He would spend a couple weeks very happy and then begin to slow down and not be active or involved, and would seem lethargic and disinterested in his environment. So, I would adjust the Prozac. Since September, the depressive mood swing has led to attacks against his sisters (because those are the cats he's near) and going out of the box.

Thursday, December 8, 2016

Echos Necessary Before All Surgeries to Detect Heart Health and Avoid Problems

When writing up a medical history list of Bette for the cardio visit, I came across her 2013 dental surgery record. It was written for her and Cooper's dental surgery record which they both had had the same day. I realized in reviewing it that I had not taken either Cooper or Bette to the cardio for a scan prior to surgery. I believe it was because at the time Myrna was so sick, and we were spending so much on her care, and now were faced with $1000 for two dental surgeries, that spending another $600 for cardio echos was going to be out of reach. And yet I wished that I had spent that money.
Cooper had had an echo summer of 2012 and was fine. He had dental surgery a year later in 2013 and afterwards, began to slowly exhibit symptoms of being ill but symptoms I attributed to his reoccurring hypercalcemia (high calcium rate) which we had battled the year before and which had not returned. Blood tests didn't show anything other than a minor increase in calcium. Months later, March of 2014, after another dental surgery, he did not bounce back and we took him to the vet two days later, only to discover he had CHF. We rushed him off to the cardio. He would be on heart meds March-July and die of CHF in July.
If I had taken him to the cardio in June 2013, we may have caught early signs of heart disease. And certainly, he had heart disease by March 2014 which an echo would have caught and we could have avoided dental surgery and the onset of that first CHF-even if the outcome would have been the same in the end.
From now on, every cat gets an echo before surgery.

Bette Davis Visits the Cardiologist Vet for a Checkup

Bette Davis yesterday, finally had a cardio check-up with the famous Dr. D that was Myrna's vet cardio. She was the last one Dr. D had not yet met. Bette passed with flying colors: no issues, and she was well behaved.
Going to the vet cardio's office brings back mixed feelings. First, apprehension over what will be found-the same feeling I had when I took Myrna. Then, memories of being there so many times over the six years with Myrna when she was seeing the cardio, coupled with that feeling of "I should be back in three months which was the routine with Myrna but that routine no longer exists." Then sadness because that building houses the ER where she died.
Assuming no one gets sick, I won't return to the cardio's for a few months. Late next summer, Katharine and Roxy will return for annual check-ups: Katharine has a heart murmur and Roxy has an anomaly that needs monitoring.
Despite the mixed memories and feelings, it is always great to see the staff and chat with Dr. D about her life and family; and talk to Julie, the much respected, talented vet tech who worked with Myrna and me for so many years. She recently and unexpectedly lost a pet dog to cancer. She brought him in for a scan; cancer was discovered in the stomach; and she put him down that day. But there was also joy-her son is now two and she showed me photos and a video.

Jimmy Stewart Update December 2016

Jimmy update: doing well this week on .19 Prozac (up from .17.) The Solequin calming treats may have helped so we'll get more. Urine is free of bacteria, glucose, and crystals which is good. Fructosamine test for blood sugar was in the normal range at 208-although it could be lower. Kidney values-normal but ticking up. Need to keep an eye on him; hydrate more (albumin shows dehydration); and maybe some light kidney support vitamins if I can sneak them into his food.

Saturday, November 26, 2016

Jimmy Accidents Out of Box

Tuesday, Jimmy went out of the box against the living room window. Yes-the window, window sill, under the window to the foam insulation, behind that to the screen and sill on the outside; down the wall, under the baseboards, through the cracks between floor boards, down the chest, under the legs, etc. It took an hour to clean with my husband doing the outside work and me cleaning up the mess inside. And we both cleaned and moved the chest (in place because you don't want to inadvertently spread urine.) Last week, he went against the wall at the top of the landing, a favorite place of Myrna's. That was easy. This was beyond difficult. After wiping up the urine, I used cleanser, then bleach on the wood, window, screens, floor, chest, etc. Where it might actually bleach out color, I used sparingly. But the wood interior sill wouldn't stop smelling so I kept soaking it in bleach. Finally, I used a wet paste of baking soda and have left it soaking for a few days. I'll eventually wipe it up and vac and sweep and let it dry and make sure the smell is gone.
He has had accidents a few times this summer but on pads around litter boxes for the most part, nothing this horrifying since his issues first began in 2010. When he first began urinating out of the box in 2010, we tried everything-new boxes, new litter, calming sprays, changing placement of boxes, adding boxes, monitoring his use of and the time it took for him to go; monitoring behavioral cues; using behavioral training techniques; finally adding Prozac to the mix. We've titrated up Prozac as needed as time went by, all with success. He began to be normal by 2013, and only had one or two accidents against litter pads in the last two years. Then this summer he went about four times, and has gone three times since fall including this week. That's about seven accidents in six months, more than in the last three years put together.
I took him to the vet yesterday for blood work of CBC/chem panel and fructosamine to test his sugar levels as he is pre-diabetic (discovered a couple years ago.) If there is too much sugar in the urine, the bladder fills quickly and the body wants to "dump" it as soon as possible, and the cat feels it must go immediately. (And if there are reasons why they choose a certain site, it's difficult to discern as to why they chose that spot other than it might be cool or comforting-if they have a UTI for example. But why a window?) The CBC/chem panel shows some dehydration and some ticking up of kidney values. Those can be related but typically seen only in extreme cases of dehydration and a decline in electrolytes. And there are none. And his SDMA kidney value test was normal. We will get the fructosamine results in a few days. Meanwhile, we are trying a calming treat solequin the vet suggested. We add it to his food. http://www.solliquin.com. The vet also suggested we increase the Prozac. We had in August but by late September, he began showing signs of anger management issues and fighting with his sisters (psychotropics can increase anger as well as increase feelings of happiness.) We decreased the dose. He was fine. But now he's had two accidents. We increased it again to .19 from .17. She suggested we get it over 2.0 and if he gets angry, increase dose to see if he becomes less angry. What is difficult is that we started from zero in 2010 and built a successful approach that included training, boxes, litter, paying close attention to cues, and meds. There is no other successful med other than Prozac, that if Prozac stops working, there is nothing more effective. In fact, most other meds are less effective for controlling anxiety and litter box use. It was working. But if it is no longer working, and we have done all there is, what more do we do to solve the problem? Pray of course. Increase Prozac if possible. Clean more thoroughly (the house is clean but I have not washed walls and baseboards in months and probably should since Roxanne has been running around the house and is no longer confined-not that she's had an accident but to make the place smell more neutral.)
I'll ask the vet about any concerns regarding his kidney values. May need to pay attention there. And he needs a urine test and he did not have a bladder on Friday.