tag:blogger.com,1999:blog-73262749049710105522024-03-06T00:31:19.246-05:00Cat Living with Hypertrophic CardiomyopathyOur cat Myrna Loy, born March 22, 2009, died of HCM 8/19/15. We will continue the blog and FB page. With five cats, we often have a variety of medical issues. Please share your information. Please check the Archives, Categories, Search, and Tabs for more information.Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.comBlogger547125tag:blogger.com,1999:blog-7326274904971010552.post-60821761045775298492024-02-26T14:50:00.003-05:002024-02-26T14:50:30.761-05:00Update Katharine Necropsy-Discussed with Pathology; Doing Tox Screen<div class="xdj266r x11i5rnm xat24cr x1mh8g0r x1vvkbs x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">I talked to the pathologist who did Katharine’s necropsy. There’s no one specific thing that happened that led to her death. Except her pancreas wasn’t doing well. Two weeks before everything seemed OK and stable. There are a lot of things we cannot see with ultrasound, x-rays or bloodwork. You can only see them once there’s a necropsy, and you see them under the microscope. The same thing with her heart. She had lesions in her heart, the myocardial fibers disarray that they <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>described in the necropsy means that she had lesions. This disrupts the heart’s signaling that helps it beat properly. The heart got worse with the stress from whatever was going on with her liver and pancreas that led to her death. And what happened to the heart probably created the clots that they found in the vessels of her lungs. So she died of liver and pancreas failing that upset the heart that led to clots in the lungs that meant she couldn’t properly breathe. It was a cascading effect. But what caused it initially maybe the pancreas. Which means that no matter what you do to protect them, if the pancreas gets upset, it will lead to a cat’s death. We saw this with Baby. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">There is no reason that they found in the brain for the neurological issues that she had. I can only describe it as if she had Parkinson’s disease. She had this odd twitching that was going on in her face for the last couple of months and her front right leg would shake or vibrate, depending on how she was sitting or sleeping.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">They are doing a tox screen. That will take two weeks. </div></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-17697150045393495302024-02-24T19:21:00.001-05:002024-02-24T19:21:25.815-05:00Katharine's Vet Gives Me the Cause of Her Death<div class="xdj266r x11i5rnm xat24cr x1mh8g0r x1vvkbs x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">The necropsy doesn't offer a definitive cause of death. I posted the necropsy in the previous post. <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHVVGPHX3GBHaCjmMtH8w4lF6qy5by14fGcX-EpEAcDMeVYsko-NMM6X-xJ7mYBUcCreYPHvq5LNZVQDQYrTjhSTAUXkiLHvsl9OjikpAkNO2eKUBifVYaVx4Cf5iNG8onxGVBYQfbXnZoaAee9BbeYQ7UIkloW4ESl6dycX7lhJhyphenhyphen8jQLSABH7HXEoMk/s2115/KH%20chews%20my%20hair%20Dec%202022IMG_7343.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="2115" data-original-width="1905" height="129" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHVVGPHX3GBHaCjmMtH8w4lF6qy5by14fGcX-EpEAcDMeVYsko-NMM6X-xJ7mYBUcCreYPHvq5LNZVQDQYrTjhSTAUXkiLHvsl9OjikpAkNO2eKUBifVYaVx4Cf5iNG8onxGVBYQfbXnZoaAee9BbeYQ7UIkloW4ESl6dycX7lhJhyphenhyphen8jQLSABH7HXEoMk/w116-h129/KH%20chews%20my%20hair%20Dec%202022IMG_7343.jpeg" width="116" /></a></div><br /></div><div dir="auto" style="font-family: inherit;">And there are things not addressed. I'll have to call them Monday. But her vet read the report and said she died of (which is not listed as a cause in the report but she surmised the cause by the descriptions in the report:)</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">(DIC) "Disseminated intravascular coagulation (DIC) is a hematological syndrome characterized by the activation of intravascular coagulation resulting in <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>excessive fibrin formation and simultaneous consumption of coagulation factors and platelets resulting in severe hemorrhaging." </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">She had too many clots (fibrin) in her blood vessels and organs, and especially in her lungs leading to blood loss and oxygen loss because nothing could circulate; this causes damage to all organs. This led to further organ failure including heart, lungs, liver, pancreas, kidneys. And even the thyroid showed inflammation responses to the process. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">We knew she had mild CKD and her blood values had been high normal and stable TWO WEEKS before her seizure. Her cardiology report TWO WEEKS prior said that her heart disease HCM was moderate and stable from last September's checkup. Her liver and pancreas had made her sick in December, and we believe she had been getting sick since November. We had been hand feeding her all through December and January and she had seemed stable the week before she had her seizure. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">Her vet believes the last seizure was caused by the underdiagnosed liver and pancreas disease (even though blood work TWO WEEKS before showed mildly elevated results and her ultrasound showed mild issues with both organs.) Apparently, severity of liver and pancreas disease cannot be accurately detected until they blow up, which is what happened after her seizure.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">So, seizure caused the dominoes to fall; or the game of Jenga was being played internally and something became elevated/declined to function properly and caused her seizure which then increased the decline of her organs.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">Her vet says that she was dying Saturday night/Sunday morning and that the reason she couldn't breathe wasn't because of the small amount of fluid in her lungs at death but because of the clots and lack of oxygen in her body that made breathing impossible. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">I'm glad she was home when she died, that I had her bundled up in bed with me and my arm wrapped around her. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space-collapse: preserve;"><div dir="auto" style="font-family: inherit;">This is Katharine a few months ago, doing what she loved to do-climb up onto me, cuddle up against my head, then CHOMP DOWN on my hair.</div></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-68592133161756430842024-02-23T21:18:00.000-05:002024-02-23T21:18:07.139-05:00Katharine Died February 4, 2024<p> I hadn't realized that I had not posted her death. She died of respiratory failure. She had fluid in her lungs and however that worked, her heart stopped. We were going to give her oxygen and take her to the ER but she died before we could leave the house. </p><p><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjB12NYydbmlxvoWWWvGADCYzaxruBRPvabYdQZdMfT3Z-iGIRy1HJAQFknCvtup-f2EjBpdc7i8UhS1SqO3HdKlEojHOPpbQ72xH0QDubYdArh5jmwK4uRHbSpJruxvDAjr4qYDJLEJhPeFhVEubjFnnyIxWZYcl77-LU3FgNz4anExOV0B8IhrkjKKbo/s4032/KH%20box%20June%2020232.jpeg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img alt="Katharine Hepburn" border="0" data-original-height="4032" data-original-width="3024" height="138" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjB12NYydbmlxvoWWWvGADCYzaxruBRPvabYdQZdMfT3Z-iGIRy1HJAQFknCvtup-f2EjBpdc7i8UhS1SqO3HdKlEojHOPpbQ72xH0QDubYdArh5jmwK4uRHbSpJruxvDAjr4qYDJLEJhPeFhVEubjFnnyIxWZYcl77-LU3FgNz4anExOV0B8IhrkjKKbo/w103-h138/KH%20box%20June%2020232.jpeg" width="103" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Katharine Hepburn</td></tr></tbody></table>She had gone to the ER after her seizure January 27; then to the vet hospital January 28. She was there until Wednesday Jan. 31 when she came home. She was weak, couldn't-and never did-cry or make a sound. She could barely walk. The hospital said they didn't know why and that was that. We nursed her, fed her, and she could use the litter box but wouldn't eat on her own. She finally drank water Friday. But Saturday she was breathing heavily. The ER withdrew fluid from her pleural cavity-pleural effusion-but could not account for cause. She went back that evening at 9 pm but they said there was more fluid but not enough to risk removing because it was too close to the heart. Her breathing worsened over night. I should have taken her back about 2 a.m. when her breathing rate was 48 and she had this vague expression and did not easily respond to touch or speech. I had her bundled up in a blanket next to the radiator because the ER said her body temperature was dropping. She woke me at 5:30 trying to move and I picked her up and put her into bed with me. She did not try to move. She seemed to be unaware of me. She was still breathing heavily. She woke me at 6:30 with sharp, shallow sounds but still unconscious. I should have taken her then to the ER. I hesitated. I don't know why. Then it slowed about 7:15. That's when I got my husband and we were helping her when she stopped breathing. I will never again let that happen. Yes, she was likely dying but not being able to breathe must have been uncomfortable. </p><p>We took her body for a necropsy later in the day. We received the report today, February 23, 2024. The report is inconclusive. Many things were wrong but nothing to account for the pleural effusion. No heart attack. No brain tumor. No accounting for weakness or neurological issues she had been having. No real reason for liver failure. Or why her heart stopped. She had 30ml of fluid in the pleural cavity-two tablespoons. That would have made breathing hard. But not enough to stop breathing-or so vets believe. </p><p>We are going to request a tox screen as the pathologist suggested. And I'll speak to them next week about any other tests. </p><p><br /></p><p>NECROPSY</p><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Gross Description</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">A 4.1kg spayed female cat was necropsied on 2/5/2024. Autolysis was mild. The animal had moderate amounts of subcutaneous and visceral fat, and had an overall body condition score of 6/9. Scant red-tinged fluid stained the fur around the left nares. The abdomen </span><span style="color: #0000ee;">and left forelimb were shaved, and there was a small puncture wound over the left cephalic vein consistent with venipuncture. There was also a shaved region over the left side of thorax with needle puncture along with mild associated subcutaneous dark red </span><span style="color: #0000ee;">hemorrhage. There were approximately 30ml of transparent, red tinged fluid ni pleural cavity. The lungs were diffusely mottled shades of dark red. The heart weighed 17g and the left and right ventricular free wals respectively measured 8mm and 3mm in thickness. There was a slightly enhanced reticular pattern. The left thyroid gland was dark purple, and enlarged measuring 2cm x 1cm x Icm; there were 3mm in diameter fluid filled cysts at the cranial and caudal ends. There were 3 blue, 1cm in diameter, spherical </span><span style="color: #0000ee;">capsules in the stomach contents. No other significant lesions were observed.</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Comments</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Overall, the described changes are mild and likely incidental, or are related to clinical treatment or diagnostic procedures. The enlargement of the left thyroid gland may suggest thyroid hyperplasia or a benign tumor. No lesions to suggest any other specific underlying disease process were observed. </span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Microscopic Description</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Representative routinely stained sections of brain, heart, lung, spleen, liver, kidney, tongue, esophagus, stomach, intestines, pancreas, urinary bladder, adrenal gland, thyroid gland, haired skin, lymph node and bone marrow were examined. Autolysis was mild.</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">In the left ventriculum of the heart, the cardiomyocytes were often arranged in abnormally intersecting patterns and there was variation in myofiber size. Multifocally, the myocardium was replaced by moderate amounts of fibrosis. In the lung sections, the small pulmonary vessels were occluded by fibrin thrombi.</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">In the liver sections, there were mild multifocal centrilobular areas of hepatocellular necrosis, characterized by loss of cellular details with retention of the architecture or loss of hepatocytes and replacement by hemorrhage. There was moderate Ito cell hyperplasia. In the pancreas, there was mild focal infiltrates of degenerate neutrophils in the pancreatic </span><span style="color: #0000ee;">parenchyma. The peripancreatic adipose tissue was extensively replaced by amorphous basophilic to amphophilic material mixed with degenerated neutrophils, consistent with saponification.</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Multifocally in the kidney section, there were mild infiltrates of lymphocytes and plasma cells in the interstitium. Rare thickened Bowman's capsules were observed. The thyroid gland were moderately hyperplastic and there was a large cyst which contained high amounts of homogeneous eosinophilic fluid in the center of the thyroid. No other significant lesions</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">were observed.</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Morphologic Diagnosis(es)</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Heart: Moderate multifocal myocardial fibrosis and myocardial disarray</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Liver: Mild acute multifocal centrilobular hepatocellular necrosis</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Pancreas: Mild acute neutrophilic pancreatitis with severe peripancreatic fat necrosis</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Lung: Mild pulmonary thromboembolism</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Thyroid gland: Moderate hyperplasia with cyst</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><br /><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">Comments</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">The findings in the heart are most consistent with hypertrophic cardiomyopathy (HCM), which is the most common type of cardiac disease in cats and is a common cause of sudden death. The changes in the liver may be secondary to the cardiac condition but given the centrilobular pattern, a toxic insult cannot be completely ruled out. </span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">The fibrin thrombi in the lung can be secondary to the heart condition or pancreatitis which can lead to disseminated intravascular coagulation (DIC). This cat also had thyroid gland hyperplasia, but this is likely non-functional and considered as an incidental finding. The findings in the kidneys are mild and likely an incidental finding as well. No further</span></div><div class="separator" style="clear: both; text-align: left;"><span style="color: #0000ee;">testing is currently pending.</span></div><div class="separator" style="clear: both; text-align: left;"><br /></div></div><p><br /><br /></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-67067905307235383512024-01-29T00:25:00.004-05:002024-01-29T00:27:35.451-05:00Katharine's Health History Since November and Possible Causes<div class="separator" style="clear: both; text-align: left;">Presents with:</div><p></p><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Inability to eat enough on her own.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Physical weakness, inability to climb without stumbling.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Sometimes shaky after taking Mirtazapine-drug interaction? Low glucose/pot; hyper/hypo? </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Exhibits leg and facial twitching.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Mirtazapine no longer has the anxious/eating affect; does not cause her to want to eat; not acting long term for three days.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Mirtazapine didn’t work well with Benazepril or Gaba or Cerenia to help her eat. Was made weak <span> </span><span> </span>on benazepril; improved after ceasing.</div><div class="separator" style="clear: both; text-align: left;"><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Became weak on gabapentin. Improved after ceasing.</div></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">Contraindications that may cause issues for Katharine:</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Gabapentin is contraindicated to Mirtazapine. Made her weak, not eat?</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Gaba is contra to phenobarbital. Made her weak? (Side effect for humans-weak, disorientated, etc.)</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Mirt is an antidepressant. Made her weak?</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Mirt-processed in liver/renal. Can cause ALT elevations, hepatic injury. She has had increased levels this past year.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Mirtazapine and Cerenia do not work well together for her. Cannot be given the same day.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Antihistamines contra to phenobarbital.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Steroids interact with phenobarbital.</div><div class="separator" style="clear: both; text-align: left;"><ul style="text-align: left;"><li>Chronic use of Mirtazapine drives up phenobarbital levels-we saw this in her blood count in December. We saw a decline when we ceased Mirtazapine in January after a month of not taking it. </li></ul></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">History October-December 2023:</div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><b>September</b></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Weight September at home-10.2 ½ </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>9/13/23 cardio exam showed heart disease increased to 1.76. Put on Benezapril and Plavix. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>But that made her weak immediately. She stopped eating as much. </div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><b>October</b></div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Not eating became worse in October. Weight down 10/4/23 to 9.12 at vet.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>By 10/9/23 noticed that Mirtazapine is not making her eat as much, does not have the same effect. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Feeding more AD by hand 10/16/23 at 6-9 ml twice a day. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Cardio said to cut Benz to once a day 10/16/23. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>10/19/23 Mirt began not working well at all. Effect lasted about two hours. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>She was appearing weaker, unable to stand straight and walk, and seemed tired and uncomfortable. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>10/20/23 cardio said to give her Atenolol BID and stop Benz. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Began feeding AD three times a day at 9 ml. each time. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Tried Cerenia and Mirt together not working well. Better when we alternate days. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>She has trouble climbing and stumbles on stairs, and struggles with cat tree. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Begins to exhibit shakiness and twitching in body and head. Front legs begin to slide around when she sits and stands. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>10/22/23. Eating very little on her own at this point. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Finally by 10/26/23 she responds well to Mirt and eats well on own. Hand feed evenings only. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>10/27/23 weight is 9.12. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>10/30-31 eats on own, hand feed 9ml AD evening only.</div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><b>November</b></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>By 11/3/23 Mirt is working as normal-she eats all day long, and appears to eat all week well enough. Continue hand feeding AD evening.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>11/11/23 weight still 9.12. Continues through the month. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>She is stable enough physically but not strong. </div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><b>December</b></div><div class="separator" style="clear: both; text-align: left;"><b><br /></b></div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>12/3/23 wonder if lack of strength is reaction to arthritis and if should start gabapentin as previously discussed. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Began gaba 12/3/23 at .1ml of 50mg/ml strength. She appears to walk stronger and to stand straighter with it after receiving it in the morning. She begins to spend each day playing with catnip toys and rolling around. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>But slowly over time, this decreases. By 12/13/23 she is appearing weak, tired, run down again. Not eating as much. Stops playing with toys, not as vocal or alert. Mirtazapine isn't working with gaba.</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Stopped gaba 12/15/23. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>12/16/23 weight down to 9.9. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>12/17/23 too weak to climb cat tree. Can’t climb shorter towers. Is very weak. Won’t eat. Not vocal. Shaky. Twitching more. Checked heart rate-150; BR seemed normal. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>12/19 Added corn syrup to AD to combat weakness and twitching-thought low on glucose. Increased potassium a bit more (Renal K gel.) Adding glucose seemed to backfire (sign of pancreatitis?) She was even weaker and would not eat anything. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Reviewed Dr. Miller’s October scan report and read about pancreatitis. Discovered it could be her liver and/or pancreatitis that is flaring up. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>12/20/23 began ½ Cerenia each day. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Asked for Hills ID from Cat Clinic and began hand feeding her that 9ml three times a day. Also fed her tunajuice 9ml three times a day. Tried to get her to eat tunafish. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Added taurine pills. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>By 12/21/23 began to nibble on tunafish on her own. Continued hand feeding ID and tunajuice. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>*Noticed her face and eyes twitching as if she can’t close them and the lids are blinking rapidly. Her front legs twitch under her for a few minutes. </div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>12/23/23-12/27/23 each day wakes up perky, walking fast down the hall, eating food overnight, very vocal, able to climb pet stairs, regular stairs, and cat condo. Then after her morning meds, quiets down; after hand feeding quiets more; after eating breakfast-which she is eating more of on her own, she quiets even more. Appears weaker and more tired by the evening. Continue to hand feed ID and tunafish juice and tuna that she eats on her own. She began eating dry food and dry treats during this week, also. Has more twitching in the evening. Breathing rate appears higher in the evening-CHF or heart or response to weakness and not eating or to being hand fed?</div><div class="separator" style="clear: both; text-align: left;">•<span style="white-space: pre;"> </span>Is receiving Forta Flora. Did not eat the Visibiome probiotic or Biome food.</div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">Weight 12/22/23 at home 9.5</div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Saw Dr. Miller 12/28 ultrasound gastro scan; pheno too high at 37; decreased pheno to ½ tab.</div><div class="separator" style="clear: both;">-Is mirtazapine driving up pheno level? Studies shows it can.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Continued hand feeding ID four times a day, letting her eat what she would. </div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Continued to be weak.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><b>January</b></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/1 Still hand feeding ID; she’s not eating well enough on her own. </div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Continues to do well in the a.m. when she wakes, and to decline in energy as the day progresses.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/3-used ear drops and eye drops-ears full of black wax. Used ten days until 1/14.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/4 began 75mg magnesium and 25mg potassium extra daily in a.m.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/5 her weight at home is 9.3 ½.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/5 began baytril. Perked her up a bit.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/7 began cypro ¼ and she began to eat some on her own. Ate Fancy Feast and tuna.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/8-1/10 She continues to be hand fed but begins to eat more on her own. More perky and alert also. Eats Fancy Feast and tuna.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/10 weight at home is 9.5 </div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/11 Sees cardio, heart is fine, not related to issues of inappetence. She does not eat when she gets home. Declines to eat on her own. We increase feeding PO of ID. </div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/11-14 We hand feed ID and offer tuna but not Fancy Feast. </div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/15 She perks up and begins to eat some Fancy Feast on her own and we feed ID.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>1/16 Not eating well on her own, only a few bites of dry food and tuna. We continue to hand feed.</div><div class="separator" style="clear: both;"><ul style="text-align: left;"><li>1/17 sees vet for tests: PLI, cbc/chem, bile acids, pheno. Pheno level down to 14 now that she's off mirtazapine-need to increase pheno again. RBC low, liver values high, kidney values creeping up, etc. </li><li> She seems to do well with Hills ID and tuna; then begins to eat more food on her own of Fancy Feast and dry gastro fiber food; then goes into a decline. </li><li>Week of January 23 she was eating well on her own, stronger, playing with toys, able to climb and walk well. Seemed stable and that our schedule and process was working.</li><li>Then she seizured Saturday January 27. Took her to the ER.</li></ul><div><br /></div></div><div class="separator" style="clear: both;"><b>Possible causes of issues:</b></div><div class="separator" style="clear: both;"><b><br /></b></div><div class="separator" style="clear: both;">Her calcium is high. <a href="https://vcahospitals.com/know-your-pet/hypercalcemia" target="_blank">Hypercalcemia</a> can cause tremors and twitching. Inappetence. Increased thirst and urination. Overall weakness. (Kidney stones, blockages.)</div><div class="separator" style="clear: both;"><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">*These symptoms are also pancreatitis, heart disease, medications, high pheno, low pot, dehydration, lower calories/nutrition. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">-Caused by CKD, cancer, other issues, taking too much calc, <a href="https://www.merckvetmanual.com/cat-owners/hormonal-disorders-of-cats/disorders-of-the-parathyroid-glands-and-of-calcium-metabolism-in-cats" target="_blank">parathyroid</a>-leads to too much <a href="https://my.clevelandclinic.org/health/articles/22355-parathyroid-hormone">PTH.</a> Addison’s disease-hypoaldost and low glucorticoids produced-lethargy, not eating (how to test?), caused by dehydration. <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/primary-aldosteronism#:~:text=What%20You%20Need%20to%20Know,potassium%20levels%20in%20your%20body." target="_blank">(Aldosteronism</a>)</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">It’s a loss of calcium in the bones, goes to blood stream, excreted by kidneys, lands in organs through blood. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Test: Pth, PTHrp; aldosterone level, glucorticoids?</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Steroids and furosemide help body not absorb calc. Helps kidneys excrete calc into urine. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">*Test urine for calcium? Would be high if more is excreted into urine?</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Fiber-gastro response food helps to fight calcium buildup, and renal CD diet. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><a href="https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293" target="_blank">Addisons</a>: auto immune disorder, with low corticoids, with inappetence, weight loss, lethargy, dehydration; also shock, low blood pressure. Poses like IBD and CKD. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">-does she have abnormally small adrenal glands?</div><div class="separator" style="clear: both;">-needs mineralcorticoids and steroids.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Cushings: hyperadrenocorticism, with increased thirst and urination, poses as CKD, muscle wasting, enlarged liver BUT increased appetite. Similar signs to diabetes.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Hyperaldosteronism: adrenal disorder. Caused by tumor in adrenal gland. Also idiopathic. Causes CKD. Or is misdiagnosed as CKD. With muscle weakness, lethargy, HIGH BLOOD PRESSURE (as with CKD, heart disease), loss of appetite.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">-test with test to MSU.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">High <a href="https://medlineplus.gov/lab-tests/anion-gap-blood-test/#:~:text=The%20anion%20gap%20measures%20the,blood%20isn't%20acidic%20enough." target="_blank">anioin gap</a>-is metabolic acidosis. This test is an indicator of your pet’s acid:base balance, its blood pH and its bicarbonate buffer blood reserves. It is critical that the acidity (pH) of your dog or cat’s body be kept within a very tight range by the continual presence of carbonate (=bicarbonate=HCO3-) in its blood and your pet’s kidney’s ability to discharge excess chloride into its urine while conserving bicarbonate.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">-caused by CKD, diabetes, When your pet’s blood sugar levels are not under control, the end result is <a href="https://my.clevelandclinic.org/health/diseases/24492-metabolic-acidosis" target="_blank">metabolic acidosis </a>– in this case lactic acidosis and ketoacidosis – as those products build up in your pet’s blood stream. A similar effect occurs in starvation, a cause of ketoacidosis as well. Also, lack of blood flow and oxygen to the body-heart disease, etc. Also-kidney, urine stones, blockages, A deficiency in aldosterone, as occurs in Addison’s disease can also cause a mild increased in your pet’s anion gap.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Ketoacidosis is a metabolic state caused by uncontrolled production of ketone bodies that cause a metabolic acidosis. While ketosis refers to any elevation of blood ketones, ketoacidosis is a specific pathologic condition that results in changes in blood pH and requires medical attention. The most common cause of ketoacidosis is diabetic ketoacidosis but can also be caused by alcohol, medications, toxins, and rarely, starvation.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">High <a href="https://medlineplus.gov/lab-tests/alkaline-phosphatase/#:~:text=An%20alkaline%20phosphatase%20(ALP)%20test,%2C%20kidneys%2C%20and%20digestive%20system." target="_blank">ALP- </a>The main use of ALP is as a sensitive indicator of cholestasis in the dog (it will increase before bilirubin), however it is non-specific because corticosteroids (exogenous or endogenous “stress”) induces production of this enzyme, with subsequent increases in serum or plasma activity. In the cat however, ALP is a specific indicator of liver disease, whereas in large animals, the enzyme is less useful as it is insensitive, cholestatic disorders are infrequent, and reference intervals are quite broad.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">The major isoforms that can be measured in animals are liver-ALP (L-ALP), corticosteroid-ALP (C-ALP; only in dogs), bone-ALP (B-ALP) and intestinal-ALP (I-ALP), but there are others including leukocyte-ALP and placental-ALP.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Although alkaline phosphatase is considered a “liver enzyme,” it is produced by other cells, too.</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Alkaline phosphatase levels can be affected by many things, including certain medications and a variety of illnesses.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Certain medications, such as steroids, can cause this level to increase. Additionally, a variety of medical conditions can affect the ALKP level.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Most of the conditions that affect this enzyme cause the blood level to become elevated. The following are a few conditions that cause an elevated ALKP level:</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Pancreatitis (inflammation of the pancreas)</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Gall bladder disease</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Hepatitis (inflammation of the liver)</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Liver failure</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Cancer affecting the liver or bones</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Hyperadrenocorticism (Cushing’s disease)</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Diabetes</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Toxic injury to the liver</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">High albumin- Albumin is a major protein in a cat’s body that originates in the liver. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Diseases indicated by low levels of albumin are as follows:</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Chronic liver disease</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Inflammatory Bowel Disease</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Pancreatitis</div><div class="separator" style="clear: both;">•<span style="white-space: pre;"> </span>Pyothorax (an infection in a cat’s chest cavity)</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Unlike low levels of <a href="https://medlineplus.gov/lab-tests/albumin-blood-test/" target="_blank">albumin, </a>high albumin in cats has been found to be much less of a cause for concern. This is because, while low levels of albumin indicate loss, high levels indicate overproduction.</div><div class="separator" style="clear: both;">The most common high albumin cause is dehydration in your cat or a diet that is abnormally high in protein. While both dehydration and improper nutrition are a cause for concern, both can be easily fixed, and neither indicates underlying disease on their own.</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">High calcium can drive down PTH-high calc tells body PTH isn’t needed unless there’s a disease of the parathyroid. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">- High calc binds to phos, lowering phos.</div><div class="separator" style="clear: both;">-Magnesium acts as a phos binder if given more than body needs-good if need to drive down phos. </div><div class="separator" style="clear: both;">*She has low phos-anemia? </div><div class="separator" style="clear: both;">-low phos means low bicarb, danger to kidneys/indicates CKD</div><div class="separator" style="clear: both;">- high glucose levels might also be interfering with this phosphorous levels. Poorly controlled blood sugar levels or diabetes, might not allow the body to absorb phosphorous. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">-low phos indicates diabetes and hepatic acidosis; can be due to not eating well, too much calc or magnesium.</div><div><br /></div></div></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><br /></div></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-2031265940430043982024-01-28T13:09:00.000-05:002024-01-28T13:09:25.851-05:00Katharine Has Multiple Organ Issues <p> Katharine is currently in the ER as I write. (1/28/24). She has developed <b>CKD, liver disease, pancreatitis, and IBD, and of course heart disease</b>. IBD/pancreatitis has been chronic for the last few years and worsened this fall. Liver disease is more recent although one value has been high for the past year. CKD was first thought to be a result of heart disease but has suddenly worsened with the onset of severe liver/IBD/Pancreatitis. In the ER she has low temperature, low heart rate, low glucose, and high liver and kidney values. She may need to be transferred to the vet hospital if she cannot be stabilized to come home. She had a major seizure yesterday afternoon-not grand mal as everyone thinks is normal. Her seizures have never been more than her spacing out and falling over, unable to walk. When she had break out spaciness in 2021, additional phenobarbital always corrected them. Then she had a larger one and didn't respond to more phenobarbital, so an ER visit with oxygen and fluids was required. We increased her phenobarbital afterwards and she has been seizure free for two and a half years. Yesterday, she seemed fine. She ate, walked, was vocal, etc. But as she drank from the water bowl, she began to space out for a few minutes (from video footage.) I was in the other room when I heard a noise. When I found her, she was on the floor struggling to get up and water was everywhere. I gave her extra phenobarbital twice and she did not respond and began open mouth, fast breathing which she had never done before. I took her to the ER and they put her on oxygen, ran tests. All we know so far, is what I described. </p><p>I was thinking back to Myrna Loy, our first cat with HCM, and for whom this blog and Facebook page were created. As much as I struggled to take care of her for 6 years and 9 months, I now look back and see that it was EASY compared to the cat issues I have dealt with in the last few years-Baby and Bette and now Katharine-because she responded to everything I tried. The only thing that never worked was rutin for the accumulation of lymphatic fluid called <a href="https://vcahospitals.com/know-your-pet/chylothorax-in-cats" target="_blank">chylothorax</a>. She was so sick those last few months, and I was concentrating on fighting those issues that I did not try many rutin options. But still, she had CKD but it was mild until the very end but never in failure even as she died-two days before her values were good. </p><p>But Baby and Bette and now Katharine-it's been a juggling nightmare with competing issues. For Katharine we respond to what we see in test results and exams and at home: is she eating, not eating? We need to hand feed her how much? What can she eat that the liver and pancreas will tolerate? She needs some fat for her body and medicines and vitamins; but she needs little fat for the liver and pancreas. Which appetite stimulant works and which one upsets the pancreas and liver? Does she have IBD and needs an antibiotic? She needs to watch her sugar for the pancreas (it's not as if she eats sweets) and watch her sodium for her heart and watch her calcium because it is creeping up, and take a potassium supplementation in a pill and Renal K powder and Renal K gel so that it is normal instead of below normal because her kidneys and heart need a good strong level. She drinks a lot-so her urine appears dilute; but her specific gravity is low and her SDMA is high indicating declining kidney function. Myrna's urine was dilute from taking high levels of diuretics and we worked hard to keep her hydrated with water by mouth and in food, and with meds and making sure she drank enough. But her SDMA was normal until the end, and her specific gravity was normal until the end. Katharine has tremors and shakiness-neurological, pharmaceutical, disease related? </p><p>And of course she seemed normal on Saturday before the seizure. She had eaten, been vocal, was moving around. I thought she had spent the week improving and was more stable. She had been eating more and we had been hand feeding less. She was mobile more. Had been engaged in toys more. And was climbing cat trees again. But the seizure hit her hard. And they think it hit because the liver-which processes phenobarbital-is acting up and may not have processed the phenobarbital well. (They did begin an additional seizure medication <a href="https://pubmed.ncbi.nlm.nih.gov/36872425/" target="_blank">topiramate</a>. But it is contraindicated with liver and CKD and causes anemia so may not be well tolerated in the long term.) But other things are going on that are causing low body temperature and low glucose and higher kidney and liver values. </p><p>But what exactly? And what would be the point of an MRI, CT, or biopsy-requiring anesthesia which she cannot tolerate due to heart disease, and may not tolerate due to her current health issues-to discover other causes if she is dying of a disease or cancer that cannot be cured or fought because she cannot undergo anesthesia for treatments, treatments which may not prolong her life, and face having anesthesia causing heart failure, which then leads to her death of heart failure. If she did not have heart disease, I would go forward with an MRI and biopsy if needed. I would fight. And I will fight. But our options are few. We had a plan. We had a schedule. It was working. She was stable. And then she wasn't. That is what is hard for me to fathom. We work with what we know but then the body actually has something lying beneath the surface that throws a wrench into our process and into her health. </p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-14990479666279010232023-11-07T17:15:00.004-05:002023-11-07T17:15:44.134-05:00Updates Katharine and Roxanne and Elizabeth-Gastro, Meds, Weakness, Inappetence and More!<p><span style="font-family: georgia;">So much has been going on this past month. In early October, blood work was done on Katharine and Roxanne; then Katharine and Elizabeth had their annual updates where more blood work was taken and more issues arose.</span></p><p><span style="font-family: georgia;"><b>Roxanne</b> is still testing high for potassium or <b><a href="https://todaysveterinarypractice.com/internal-medicine/evaluation-and-management-of-the-hyperkalemic-patient/" target="_blank">HYPERkalemia </a>a</b>t 5.3 (with 4.9 being high normal.) What does that mean? We need to consider testing for possible <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/hypoaldosteronism#:~:text=Renin%20deficiency%20is%20the%20most,diabetes%20and%20potentially%20diabetic%20nephropathy." target="_blank"><b>hypoaldosteronism</b></a> which is rare. It may also indicate <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/underactive-adrenal-glands--addisons-disease#:~:text=Key%20points%20about%20adrenal%20insufficiency,the%20hormones%20cortisol%20and%20aldosterone." target="_blank"><b>Addison's disease or diabetes.</b></a> And is connected to possible renal failure or decline. For now, monitor. We might consider giving her a diuretic if she continues to test for hyperkalemia. <span style="background-color: white; color: #4d5156; font-size: 16px;">Symptoms may cause </span><span style="background-color: white;"><span style="color: #040c28; font-size: 16px;">muscle weakness, nausea, heart palpitations, irregular heartbeat, and abnormal blood pressure</span><span style="color: #4d5156; font-size: 16px;">.</span></span></span></p><p><span style="font-family: georgia;">If a cat has <a href="https://www.aaha.org/aaha-guidelines/2023-aaha-selected-endocrinopathies-of-dogs-and-cats-guidelines/less-common-feline-endocrinopathies/feline-hyperaldosteronism/" target="_blank">HYPERaldosteronism</a> which produces <b><a href="https://vcahospitals.com/know-your-pet/hypokalemia-or-low-potassium-levels-in-cats" target="_blank">HYPOkalemia,</a></b> that could indicate cancer. And low potassium disrupts the body's function, leads to racing heart, weakness, etc.</span></p><p><span style="font-family: georgia;">She also tested POSITIVE AGAIN FOR <b><a href="https://www.webmd.com/pets/cats/cat-fiv-feline-immunodeficiency-virus" target="_blank">FIV virus antibodies. </a></b>The vet is checking to see if there is a test to test for the actual vaccine so that we can determine if she received the vax as a kitten or if she was exposed to the disease since 2017 (somehow despite no other cat in the house having FIV.) We will monitor her for active disease and try to make sure she does not fight or bite or get bitten by any of our other cats.</span></p><p><span style="font-family: georgia;"><br /></span></p><p><span style="font-family: georgia;"><b>Katharine </b>developed <b>weakness and inappetence </b>after taking an ACE inhibitor <a href="https://www.drugs.com/search.php?searchterm=benazepril" target="_blank"><b>Benazepril </b></a>for two weeks-she began in mid September. <a href="https://www.drugs.com/mirtazapine.html" target="_blank"><b>Mirtazapine </b></a>did not work to spur her appetite. She began losing weight. While her weight was fine around 9.12 or 9.14, when it fell in early October after one week to 9.7 after we thought she was eating well enough, we had to begin feeding her by hand using the trusty 3ml plastic syringe method. (We give her 9ml of <b><a href="https://www.hillspet.com/cat-food/pd-ad-canine-feline-canned" target="_blank">Hill's AD </a></b>in the morning before breakfast, 9ml if she is not eating dinner, and 9ml at bedtime.) We concluded that somehow the Benazepril was prohibiting the absorption or interaction of the Mirtazapine, although there is no known contra-indication. </span></p><p><span style="font-family: georgia;">When Katharine had her annual exam October 19, <b><a href="https://averycreekpethospital.com/blog/how-to-tell-if-my-cat-is-in-pain/#:~:text=The%20normal%20heart%20rate%20in,and%20multiply%20it%20by%204." target="_blank">her heart was racing at 260 </a></b>(normal should be 140 and no lower than 135 and no higher than 200.) Given her heart rate was high, the cardiologist said to give her <b><a href="https://www.drugs.com/atenolol.html" target="_blank">Atenolol</a> </b>twice a day; given that she was weak, to pull the Benazepril and to check her heart rate in a week. She recommended that we buy and try a mobile <a href="https://kardia.com/" target="_blank"><b>EKG Kardia </b></a>to monitor the heart rate at home. When we tried it, we got a laughingly low rate of 77-which would indicate she was near death. Given that she was up and about, eating, walking, alert, we knew it was wrong. We took her to the vet the next day and compared the in house heart rate reading to the Kardia device and both ran about 177. This means the Atenolol at BID (twice a day) is working. But she does need an ACE inhibitor if it can be tolerated. We will try Enalpril sometime in the future and monitor. Follow the link to purchase the device if interested. <b><a href="https://www.youtube.com/watch?v=ofbtEy2RtrE&t=9s" target="_blank">Follow this YouTube video for more information on how it works.</a> </b>It took until almost the end of October for Katharine to stop appearing weak; and it wasn't until this week 11/5/23 that Mirtazapine began working normally to spur her to eat.</span></p><p><span style="font-family: georgia;">We also noticed her breathing rate had increased. But it was difficult to get a true reading. So, in late September, her cardiologist said that it was ok for her to take </span><a href="https://www.drugs.com/search.php?searchterm=Furosemide" style="font-family: georgia;" target="_blank"><b>furosemide </b></a><span style="font-family: georgia;">once a day every day of 1/4 of a 12.5mg tablet (3mg approx.) Since the tablets were small and crumbled when cut, we changed over to the 20mg tablet, cut that into quarters, and shave off a bit more to reach the same 3-4mg dose. </span></p><p><span style="font-family: georgia;">Because she wasn't feeling well at her annual exam, Katharine hasn't yet had her annual rabies shot so we will soon return for that.</span></p><p>She had her <b><a href="https://www.vet.cornell.edu/animal-health-diagnostic-center/testing/protocols/metabolic-function" target="_blank">PLI/Cobalmine/Folate</a> panel </b>tested for <b>pancreatitis and gastro issues </b>and she has a high folate. These blood tests are to test for metabolic function. Specifically, folate is B12 and indicates malabsortive issues in cats (or humans.) If the cat cannot absorb nutrients, health issues develop. AND the inability points to issues in the gastro metabolic system which could be disease, irritation, infection, etc. This goes along with the gastro scan she had in early October that showed she had a "smouldering" pancreas, an issue developing. She is already on steroids. The vet suggested we had a different probiotic <a href="https://visbiomevet.com/" target="_blank">Visbiome </a> She also received a shot of B12. We can take her monthly to receive them and/or supplement her diet with B12. The vet wants us to give her <a href="https://www.amazon.com/dp/B07MWKYP86?ref=ppx_yo2ov_dt_b_product_details&th=1" target="_blank">cobalamine tablets which is B12. </a>I ordered some from Amazon and am waiting on them to arrive. </p><p><b>Elizabeth </b>had her annual exam in October and her rabies shot. She is good. She also needs some probiotic and will take Visbiome three times a week and not daily. Her PLI/cobalamine/folate test was also good except the folate was high. She has the same sort of gastro issues as Katharine but does not present with symptoms (although she was sick in June.) </p><p><br /></p><p>I think that is up to date on the cats. Jimmy has had a few urine out of the box accidents but we keep at it encouraging him to use the litter box and doing treats and behavioral work. </p><p><span style="font-family: georgia;"><br /></span></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-37801881726371878302023-10-06T14:22:00.002-04:002023-10-06T14:22:44.686-04:00Updates Roxanne and Katharine-CHF, Furosemide, Gastro Scans and More!<p><span style="white-space-collapse: preserve;">Updates:</span><br /><span style="white-space-collapse: preserve;">Roxanne is still testing for FIV. Vet did Western Blot Test yesterday-Thursday 10/5. Did a urine test because urine wasn't available at her checkup last week. We rechecked for potassium because it was abnormally high at her checkup. And she got her first gastro ultrasound just because she's nine, never had one, senior years will begin to show changes, high potassium could be a sign of adrenal gland issues (although that would appear in other blood work and has not.)</span><br /><br /><span style="white-space-collapse: preserve;">Ultrasound showed normal adrenal glands so we will hold off doing any further blood work (there's an $800 gland panel) and we won't test aldosterone levels (high pot might mean HYPOaldosteronism and Addisons Disease) unless potassium remains high for the next couple of months or she gets sick and has other issues. Baby had HYPERaldosteronism with low potassium (can be signs of Cushings) and developed high blood pressure which was primarily caused by CKD (which showed up in urine Specific Gravity and SDMA, BUN, and creatinine tests.) [Baby's hyperaldosterone remained stable from 2018-2020 and was not a cause of her death in 2021.] We will check iron levels in the future if RBC and such hematocrit values change because iron can be a reason for blood values being off.</span><br /><br /><span style="white-space-collapse: preserve;">Ultrasound showed prominent pancreas but no inflammation; normal adrenal glands; but cysts on the liver-this can be normal in cats and becomes a problem if there are too many or they become enlarged. We will monitor for vomiting, diarrhea, poor appetite (symptoms of so many issues), RBC (red blood cell count), liver values. She also has mild kidney changes normal for her age. Again-we will monitor kidney values, BUN, creatinine, potassium, phos, SDMA, and urine. </span><br /><br /><span style="white-space-collapse: preserve;">Katharine-I have been concerned that she has had numerous possible CHF episodes since July, and four these past two weeks. Her xrays yesterday showed some hazing around the heart related to HCM but none in the lungs to indicate CHF. But her cardiologist said that it was fine to put her on 3mg furosemide once a day since she has possibly had CHF episodes because her breathing rate declined within an hour of being given furosemide. Given my experience with HCM, I know when I see fast breathing rate at 40 bpm or more that is sustained and unchanging and must be immediately treated. </span><br /><br /><span style="white-space-collapse: preserve;">Her ultrasound showed "smouldering pancreas" with cysts but no issues or concerns. She is already on a steroid for IBD but cannot increase the amount for the pancreas due to HCM. She otherwise has a normal gastro system and organs. She has some slight scarring on kidneys due to normal aging process but her SDMA and BUN, creatinine, potassium, and phosphorous are all normal. But we will continue to monitor those for signs of CKD, especially important to monitor since she has HCM. I must make sure she gets enough potassium to support her kidneys while on diuretics now as a daily dose and not just an emergency dose. </span><br /><br /><span style="white-space-collapse: preserve;">So, we await blood tests for Roxanne. </span><br /><br /><span style="white-space-collapse: preserve;">Katharine and Elizabeth go to the vet for annual checkups in two weeks (poor Katharine-she's been at the vet and cardio four times these last four weeks and one more to go.)</span></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-41524988189723893862023-09-19T23:13:00.002-04:002023-09-19T23:13:32.901-04:00Katharine's HCM Advances, Adds New Drugs<p> Katharine saw the cardiologist 9/13/23 and her heart has increased in left atrial from 1.50 September 2022 to 1.76 a year later. If it continues to progress, she'll be at 2 or over 2 by April, and more potential issues might develop. For comparison, Myrna in her first year had a left atrial of 1.83, then 1.69 after a few weeks using COQ10 (see later paragraphs.) It would decrease again to 1.52 the next year and remain low until the disease took over in 2013 (almost four years into the disease) and the left atrial increased to 2.12. At this point, she began to develop a series of serious issues. In 2013 she had a heart attack; in 2014-15 she had increased serious CHF issues. And then she died in 2015 (I can't find what size was her left atrium in order to compare to Katharine but it was 2.20-2.30.)</p><p>She had two cases of possible CHF this summer after major storms-late July and late August. I had given her small doses of diuretics which worked almost immediately although she needed two more doses in August. With the heart size increasing, more CHF might occur if I do not stay on top of it and fight it immediately with furosemide (lasix.) She may need a daily dose to ward off CHF. I will continue to monitor and discuss it later with the cardiologist if more CHF occurs.</p><p>The cardiologist put her on <a href="https://my.clevelandclinic.org/health/drugs/20743-clopidogrel-tablets#:~:text=Clopidogrel%20(Plavix%C2%AE)%20is%20an,certain%20types%20of%20heart%20surgery." target="_blank">Plavix-</a>1/4 once a day; and an <a href="https://www.cvcaresidenttestprep.com/drug-handouts/enalapril-benazepril/" target="_blank">ACE inhibitor Benazepril-</a>1/4 BID. She is also on <a href="https://www.webmd.com/drugs/2/drug-11035/atenolol-oral/details#:~:text=Atenolol%20is%20used%20with%20or,survival%20after%20a%20heart%20attack." target="_blank">Atenolol </a>1/4 once a day.</p><p>Myrna was on Enalapril for an ACE inhibitor. I don't know why Katharine is not. The cardiologist said something about it has a different approach given Katharine's early issues. ACE inhibitors stop the ACE process-the angiotesin converting enzyme-which shuts down the bodies' veins, constricts veins in the case of a heart attack or accident that causes the body to lose blood. When you inhibit the ACE process, you allow veins to be wide opened and fully functioning. This helps lower blood pressure, and increases the flow of oxygen to the blood and therefore to the heart. The ACE process also increases SALT so by stopping the ACE process using an inhibitor, the body's ability to retain salt is reduced, thereby lowering fluid due to less salt, and therefore reducing blood pressure.</p><p>I also bought from <a href="https://www.chewy.com/rx-vitamins-coq10-30-softgels-heart/dp/192746?utm_medium=email&utm_source=transactional&utm_campaign=OrderConfirmation" target="_blank">CHEWY, a bottle of Rx Vitamins 30# COQ10, </a>a supplement that we used with Myrna that improved her heart condition for a few years. Each capsule has 30mg. With Myrna, I'm not sure pet formula COQ10 existed because I bought Nature Made and squirted each capsule into her food. She received 200mg per day. Then later, I put it into the goop mixture I devised of this and other supplements and vitamins to improve her kidney function when the amount of diuretics increased and the load on her kidneys was too much, and her kidney values declined. This pet specific COQ10 is small enough that she can swallow it. I will give it to her daily. It's a lesser amount that what Myrna was taking but then Myrna's heart was far worse at 8 months old than Katharine at 14 years old. </p><p>So, if Katharine's heart is nearing 2.0 this next year, and Myrna had severe issues at 2.12, we must work hard to try to improve Katharine's heart function, keep her overall health stable, and monitor closely for CHF; and be aware that there is a chance we might lose her in the next two years. Given her age at 14 and a half, she has lived a long life and we have had her a very long time. I'm grateful that her other health issues-seizures, IBD-are under control and hopefully remain so. That leaves me time to concentrate on taking care of her heart. But I refuse to make any concessions, to give in the inevitable, and to treat her condition as a given. And I refuse to give up. I cannot plan for how I want her life to end or when. But I will help her fight; I will help her body stay strong in order to fight. </p><p>Please read more at the blog's tabs: Myrna's Story, Meds, About HCM; and do a word and category search for further information.</p><p><br /></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-92000790887422814292023-09-19T21:54:00.003-04:002023-09-19T21:54:45.602-04:00Apps for Feline HCM<p><span style="white-space-collapse: preserve;">Someone mentioned they use an app to track their cat's progress and breathing. Here are some apps that help with tracking breathing. You can also use the clock/counter/timer on your smart phone, your stove or microwave, a kitchen timer, etc. if watching a watch (very small hands) or your house clock is difficult or not available. </span><br /><br /><span style="white-space-collapse: preserve;">I have NOT used these. These are NOT paid sources. These are NOT things I recommend as products, just things I Googled. You and others might have even more apps to recommend. Please do so here in comments. Thanks. </span><br /><br /><a class="x1fey0fg xmper1u x1edh9d7" href="https://apps.apple.com/us/app/count-my-breaths/id1513102381"><span style="white-space-collapse: preserve;">https://apps.apple.com/us/app/count-my-breaths/id1513102381</span></a><br /><br /><a class="x1fey0fg xmper1u x1edh9d7" href="https://apps.apple.com/us/app/my-pets-heart2heart/id1564965551"><span style="white-space-collapse: preserve;">https://apps.apple.com/us/app/my-pets-heart2heart/id1564965551</span></a><br /><br /><a class="x1fey0fg xmper1u x1edh9d7" href="https://www.cavaliermatters.org/unique-hereditary-diseases-index/mvd-heart-disease/mvd-respiratory-app-cardalis/#:~:text=The%20Cardalis%20app%20is%20very,information%20is%20recorded%20and%20charted"><span style="white-space-collapse: preserve;">https://www.cavaliermatters.org/unique-hereditary-diseases-index/mvd-heart-disease/mvd-respiratory-app-cardalis/#:~:text=The%20Cardalis%20app%20is%20very,information%20is%20recorded%20and%20charted</span></a><br /><br /><a class="x1fey0fg xmper1u x1edh9d7" href="https://apps.apple.com/us/app/srr-counter-for-dogs-cats/id1086456790"><span style="white-space-collapse: preserve;">https://apps.apple.com/us/app/srr-counter-for-dogs-cats/id1086456790</span></a></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-14051776854949707612023-09-09T17:15:00.001-04:002023-09-09T17:15:25.891-04:00Cat Medications and Supplements-Where to Buy<p>Cat Meds: <br />Cat meds do not need to come from the vet but it does depend on if it is exclusively sold by the vet; or if the vet exclusively has the smaller dose made for pets while the human pharmacy may only have the larger doses for humans. You might need to get some meds from your vet or cardiologist to get started when your cat is first sick (be it HCM or other issues), and then take the time to comparison shop for a more affordable price. When a sick cat needs six or more meds as with HCM, you'll want meds that you can get for a month's worth that are only $10 or less (for example) or whatever is affordable and available. <br /><br />Most meds a cat needs are human meds and likely can be purchased at the local human pharmacy and for less money than from the vet. Even if the tabs come in only large sizes, check to see if they can be cut down to the dose you need (using a good pill cutter) so that you can buy the cheaper human size and not the more expensive vet size (if applicable.) Ask the pharmacist about the possible various dose sizes and thencomparison shop. There are various variables to consider. <br /><br />Target, Kroger have had $4.00 meds in the past when we needed so many for Myrna Loy. We now get the various meds from Kroger, and a local compounding pharmacy, and an online pharmacy Wedgewood; and we have used the online pharmacy Road Runner in the past.<br /><br />Check for hours a pharmacy is opened. You'll want something that is convenient for you to access. You don't want the store to be opened until 10 p.m. but the pharmacy closed by 6 p.m.<br /><br />Supplements: can often be purchased at pet stores, Amazon, 1800pets, Chewy, etc.-like Laxatone, Lysine, Renal K, cat vitamin paste, immune liquids, taurine, etc. <br /><br />Vitamins like COQ10, vitamin E, iron, magnesium, potassium for humans, etc. can be purchased at Kroger or Target (comparison shop: Target, Kroger brands, vs Nature Made, Sundown and other brands-look price per pill count, pill size per mg; and specials on price: 2 bottles for one for example) or elsewhere for human supplements and then cut them up or pierce and mix into food (depending on the flavor of the gel cap.) [These supplements are only some a cat might need. See the blog Med tab for what we used for Myrna. Your cat might not need them or might need others. These are suggestions referencing what we used.]<br /><br /><br /><br /></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-53066844836637044772023-07-08T18:05:00.003-04:002023-07-09T10:00:00.253-04:00Short Story About a Cat Named Myrna Loy<div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both;"><b><br /></b></div><div class="separator" style="clear: both; text-align: justify;"><b>This is a short story I wrote around 2012 when Myrna was still alive. It was never submitted to be published. It's a very simple story about a process we really used with her. </b></div><div class="separator" style="clear: both; text-align: justify;"><b><br /></b></div><div class="separator" style="clear: both;"><b><br /></b></div><div class="separator" style="clear: both;"><b><br /></b></div><div class="separator" style="clear: both;"><b>A Cat Trains the Owner </b></div><div class="separator" style="clear: both; text-align: justify;"><b><br /></b></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="font-weight: bold; white-space: pre;"> </span>Once again, Jen found it difficult to wake up on time after being up twice last night to help Myrna go to the bathroom. It was like this every night and had been like this for over a year. You’d think by now she’d be used to having her sleep disturbed, followed by the ritual of 5 to 15 minutes of waiting for the girl to go, before finally climbing back to bed and then taking another 15 minutes before she was back to sleep. </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>Most nights, the girl got her up just once but lately, it had been twice. If she went by 11 p.m. she would be up again around 2 a.m. and then again around 5 a.m. If she got her to go by midnight or 1 a.m. then the girl would go by 4 or 5 a.m. It was rare the girl went by herself but she always woke up Jen to say she had gone. </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>It was a process that began when Myrna wasn’t using her litter box. They had worked with her using various behavioral techniques and timing when she needed to go. If three hours had passed and Myrna was up and about, they would ask her if she needed the litter box. They would take her, give treats to encourage her to go, and sometimes it worked. Quickly, the girl learned that treat time equaled litter box time and would cry when she needed to go, would also go downstairs to the basement as soon as she heard the treat bag. Sometimes it worked and sometimes it didn’t. But over time, Myrna made the connection, and the trick began to work. She began using the litter box more often. </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>But the trick wasn’t meant to be used while Jen was sleeping. All she could do was pray the cat would use the box and not have an accident. But Myrna decided she would only use the litter box if Jen got up in the middle of the night to give Myrna a treat. So, one night, about 3 a.m., Myrna climbed on top of Jen, stood on her chest, leaned in and cried very loudly and incessantly until Jen woke up. </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>“What’s wrong?” Jen asked. Myrna bounced off Jen and jumped to the floor. Jen thought nothing of it and rolled over. Seconds later, Myrna was back, standing and crying again. </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>“What? You have a toy?” asked Jen and Myrna bounced off again. Jen went back to sleep but seconds later Myrna was on her again. </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>“MEOW, MEOW, MEOW!!!!!” cried Myrna at which point Jen had to get out of bed. She turned on the bedside light and followed Myrna. Myrna went to the litter box, climbed in, and went. Then she hopped out, looked up at Jen and cried, and walked in circles doing the twitchy butt thing she did when she wanted attention. Jen got the hint. She petted her and praised her. </span></div><div class="separator" style="clear: both; text-align: justify;"></div><div class="separator" style="clear: both; text-align: justify;"></div><div class="separator" style="clear: both; text-align: justify;"><br /></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>“Good girl, Myrna! You used your litter box!” Jen got out a piece of paper and wrote down the time and then went back to bed and turned off the light. Only she hadn’t completed the process by ending the praise with a treat so Myrna climbed up onto her again. </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>“MEOW! MEOW! MEOW!” </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>“What???!! What do you need now?” cried Jen. And Myrna cried and walked in circles on the bed.</span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span> </span> Then Jen remembered the usual process: Myrna goes, Myrna is praised and petted, and then treated. But the treats weren’t up here so Jen dutifully went downstairs to the kitchen to get the treats. She gave one to Myrna and praised and petted. And then Myrna sat and looked for another, so Jen gave another, then another, then finally one more before saying,</span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>“That’s it Myrna. Back to bed” at which point both Jen and Myrna went back to bed. </span></div><div class="separator" style="clear: both; text-align: justify;"><br /></div><div class="separator" style="clear: both; text-align: justify;"><span style="white-space: normal;"><span style="white-space: pre;"> </span>So, ever since then, this has been the nightly ritual. If Jen could train Myrna to go without a treat or without Jen’s involvement, that would be great. But this helps Myrna, this comforts Myrna, and Myrna hasn’t had an accident day or night in a year. So, what if Jen hasn’t slept more than three months in a year? As for Jen’s husband, Myrna doesn’t bother to wake him. He would never wake up. He sleeps through everything.</span></div><div style="text-align: justify;"><br /></div></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-48177018737822369322023-06-09T14:54:00.002-04:002023-06-09T14:54:10.268-04:00Bette Davis Necropsy Report-Cancer in the Brain<p>Bette's necropsy report came in two weeks ago and I have only been able to post about it now. A necropsy report-if you've never seen one-drills down into the cellular level of tissues. Samples are taken from all major organs and tissues and any areas noted as a concern or involved in the demise of the animal. They also look at all organs and give a physical description. </p><p><br /></p><p>Basically, Bette died of brain cancer. The Nerve Sheath Tumor was gone from her spine. BUT it had spread through the nervous system into her brain. The SYMPTOMS of TRIGEMINAL NERVE damage that we thought we saw: open mouth breathing, excessive drooling, tongue out, difficulty swallowing, combined with her right eye not blinking or closing, and the eye ulcer (from not closing the eye all the way) that hit her two weeks before she died, were signs of brain cancer. </p><p><br /></p><p>Likely it was spreading before radiation treatment. Possibly could have been seen if another MRI had been done as she began radiation treatment. Definitely would have been seen if we had been able to convince anyone to do one in the last week or so when she was struggling to breathe and no one would listen (the vet school ER for example.) I would have wanted to do palliative care and to be more aware of her demise and spend the time accordingly (not that I wasn't with her that last week) instead of trying so many things to fix whatever ailed her, only to be ignored by almost anyone I approached. (Her regular vet was wonderful as was her dentist-see previous posts.)</p><p><br /></p><p>Her increased breathing issues were also related to decreasing brain function. </p><p><br /></p><p>She also had ASPIRATION PNEUMONIA. When she went immediately into respiratory distress at 6 p.m. that Thursday night 5/18/23 was because she aspirated food into her lungs. Likely, she regurgitated and inhaled it. Aspiration pneumonia quickly happens when something is inhaled into the lungs and quickly causes respiratory distress and death. </p><p><br /></p><p>She had declining cranial responses-the eyes weren't closing, she couldn't move her limbs-over night Thursday and when we put her to sleep Friday, all from brain cancer.</p><p><br /></p><p>She also had mild HCM-not detected in January-but seen in pathology report in the left vent and in the cells. It was not drastic and is likely radiation/cancer change related. However that works. She wasn't presenting "clinically" meaning there were no outward or vital signs indicating heart disease. </p><p><br /></p><p>She also had lymphoma in her cells-cancer-that cats do not recover from.</p><p><br /></p><p>She had a small tumor/nodule on her thyroid that would have become an issue if the rest of the cancers hadn't happened.</p><p><br /></p><p>NO MASS in the body; NOTHING wrong with the esophagus or larynx causing breathing issues. The ER doctor that Thursday 5/18 thought something was pressing down on the esophagus causing the breathing issues because the xray showed gas in the opening and at the end but the airway suppressed in the center. The vet school radiologist for the pathology report looked at the xray and said it was normal. The way she was laying for the xray made it look as if it were pushed down; and the pathology did not find a mass in that area. </p><p><br /></p><p>There are terms in the necropsy such as:</p><p>*heart myofiber disarray and fibrosis</p><p>*Lipofuscin granules </p><p>*hepatic parenchyma small nodular aggregates listiocytes</p><p>*pancreas nodule of hyperplastic exocrine pancreatic epithelial cells</p><p>*proliferations of thryoid epithelial cells</p><p>*fibrin hemorrhate viable and degenerate neutrophils</p><p>*infiltrates of a momomorphic medium round cell population</p><p>etc.</p><p><br /></p><p>I did complain this week to the owner of the ER about the rudeness of the clerk on that Thursday when she said "The doctor already told you we can't fix this. Whatever's wrong with her we can't fix this." as we are standing there with Bette in severe respiratory distress. I calmly discussed my concerns, as well as shared the necropsy. She apologized and seemed concerned about the interaction and said she'd address it. I can only hope changes are made because they have been a wonderful ER that we have almost exclusively used since 2009 despite being 40+ minutes away. (The cardio is in the same building and can run over to see a sick cat as needed.)</p><p><br /></p><p>I also calmly complained to the vet school about the over reliance in my view, of the ER staff on VITALS to determine if a patient is fine, while IGNORING how the patient presents with difficulty breathing. I said that the resident in the ER had said that Bette on 5/16 was fine, while they ignored that she looked awful, wasn't breathing well, and made horrible noises. I wanted her admitted so that the hospital staff could see her the next day but was refused. Possibly they could have done an MRI or made further determination that she was failing so that again, we could have done palliative care. I told the manager that she crashed two days later in respiratory distress and died that Friday. So CLEARLY she was NOT FINE on Tuesday. I'm not sure a practice manager can change how vet school students are taught and how the residents handle cases. AND it was just a voice message that I left after getting the manager's number. But I told him that she was a rad/onc patient and the pathology report was on file there. </p><p><br /></p><p>We fight the signs of illness as we see them. That's what I encourage you to do-always. Monitor your pets especially those with a chronic condition such as HCM. They need meds, regular schedules; they need monitoring for breathing; they need help eating; they need all symptoms addressed even if in the end they will die of HCM or cancer. And fight-complain-when vets are not helping or solving or searching; or clerks are rude. Fight your panic that prevents you from thinking of what to do. Get organized for pet care-we did even more of this for Bette's care than we already do for the cats. </p><p><br /></p><p>What did I learn from Bette's ordeal: </p><p>*to get the MRI earlier than later as soon as it seems necessary; to get it again weeks later if the pet seems worse (as she lost the use of her rear left leg in April maybe? When she first had trouble breathing in May?) </p><p>*to keep oxygen on hand always</p><p>*to check the cats' faces for ability to blink-if you get half way to their face and they blink that's a good sign; if you get up to them before they blink, that's not a good sign.</p><p>*That I was able to force myself to think as I panicked about her breathing issues and to act quickly, to overcome the panic and to act. I hadn't been in this situation since Myrna died in 2015. It all came back and is now registered in my brain.</p><p>*That I did more for Bette than for Baby when she was sick in the ER struggling for a week in 2021 before we had to put her to sleep. We put her to sleep too soon and I'll never know what I could have done. But I panicked. (Baby was breathing on her own unlike Bette who could never have come back home.)</p><p><br /></p><p>So, there was nothing that we could do to cure Bette while we were doing everything we could think of doing to help her. She was slipping away the moment she got sick in January because that was the first sign. </p><p><br /></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-63260889256345715362023-06-09T14:47:00.006-04:002023-06-09T14:47:56.862-04:00Cats Virus Causes Them to Not Eat<blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px; text-align: left;"><div class="separator" style="clear: both; text-align: justify;">UPDATES: So Jimmy wasn't eating last week; Elizabeth began not eating last 6/3 Saturday; and Katharine was a picky eater more than usual last week, also. </div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;"><br /></div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;">We discovered that all of the meds we normally would use-Cerenia, Mirtazapine, stomach meds, nausea meds-were contraindicated with his Prozac. Either the Prozac made them not work, or the other meds had a possibility of running up a heart rate/blood pressure, or can make a cat weak-depending on interaction. Jimmy saw the vet for sub q fluids Friday and Saturday and a B12 shot Saturday and began to slowly eat on his own Saturday afternoon. He spent Saturday-Sunday slowly eating a couple bites every two hours; then eating more and more often Monday and Tuesday, until he was eating a full meal on his own by Wednesday. He was slow and "out of it" and would disappear for hours until ready to eat Saturday-Tuesday; by Wednesday was hanging out upstairs again. </div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;"><br /></div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;">His CBC/chem panel blood work showed signs of inflammation and pain: neutrophils and monocytes were increased to HIGH, and the lymphocytes and eosinophils had decreased to LOW. Possible causes: anemic-he had lower red blood cells but normal reticulocytes so not likely; Bone Marrow disease-with low RBC, high others, possible but requires bone marrow testing so NO for now; kidney disease-his SDMA is increasing from 10 to 11 last time, to 12 this time. Combined with the increasing RBC it's possible. Urine test was clear, no protein, no glucose, SPG-specific gravity-was normal at 1.030. So no obvious signs but something to monitor especially as he is 14. As a cat ages, kidney disease can be a problem. His ALT, ALP, etc. were all normal-no liver issues, no dehydration, etc. Other causes with the blood results: gastro issues, pancreas issues. He had an ultrasound Thursday that showed some small intestinal thickening of the walls which indicates possible virus or possible IBD coming on. If he continues to improve-and given that Elizabeth and to some extent, Katharine, were also not eating-the vet thinks it is some sort of virus. We are to monitor, give extra lysine (herpes virus) they already take, and if further "intervention" such as sub q fluids or more B12 or other tests are warranted, we'll go from there. (Other tests-MRI? Other blood work? A steroid-although not Prednasolone because of his pre-diabetic history and Prozac.)</div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;"><br /></div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;">Elizabeth-suddenly wouldn't eat Saturday as much as usual. But given we were busy with Jimmy, we let her do her thing. Then Sunday she wouldn't eat at all. We began hand feeding her Hills AD by syringe every two hours Sunday and into Monday. Elizabeth can take Mirtazapine. She had some Sunday which took hours to kick in and let her eat very little Sunday night. She had it again Monday to no effect. We have been giving her Cerenia (anti-nausea/vomiting med) since Sunday. It might have helped but did not encourage eating. I called the vet Monday and they saw her on Tuesday. They gave sub q fluids, a B12 shot, checked CBC/chem panel, did a urine-all came out normal. Nothing like Jimmy's blood work to indicate any pain or inflammation. </div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;"><br /></div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;">We continued to hand feed her as needed until she finally began eating a couple bites every two hours Tuesday night and Wednesday. She also had an ultrasound Thursday that showed she also has a small intestine wall thickening that indicates IBD. Again, the vet said that if she's eating on her own enough, to continue to monitor her recovery. Use Forta Flora in her food-and Jimmy's-but any further "intervention"-meds, tests-will be discussed if this happens again.</div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;"><br /></div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;">Katharine-she responds well to Mirtazapine and eats well on it for a few days before needing more. She has not yet seen the vet. BUT again, the vet thinks a virus of some sort hit them. It affected Elizabeth slowly over time when she was showing signs of being a picky eater; hit Jimmy hardest because of the dental procedure and anesthesia which makes the body slower and more apt for things that are working their way through the body, to suddenly emerge. This can happen with HCM-in the form of CHF after surgery/anesthesia-for example. AND it's because they all have chronic health issues of various sorts.</div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;"><br /></div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;">Roxanne? Not sick. Secluded in the a.m. so that she eats and isn't bothered by the others; is also younger and so far healthy with no chronic issues.</div></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: justify;"><br /></div></div></blockquote><p></p><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both;"><br /></div></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-30254883330616261792023-05-28T14:46:00.000-04:002023-05-28T14:46:29.880-04:00Feline Thrombosis/FATE-Feline Arterial Thromboembolism-the Affect of Blood Clots in Cats<p><br /></p><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">When Bette first went lame, many readers thought it could be thrombosis. So, what is thrombosis? Thrombosis is when a clot forms in (typically) the heart and travels and cuts off blood supply to the affected region. It can be to the heart-heart attack, stomach-vomiting (typically a symptom), or front or rear legs (the rear legs are saddle thrombosis or FATE-feline arterial thromboembolism.) Clots can be formed due to injuries or disease but for cats, it's mostly due to heart <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>disease.</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">We know it was not thrombosis because we eventually learned with an MRI that it was Nerve Sheath Tumor. The tumor damaged the nerves to the rear part of her body, especially the left leg. But it did not affect blood flow in the legs. (A tumor could of course, depending on location on the body.)</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">A clot that travels in a blood vein will damage the arteries to the legs and arterial blood pressure will not register. Hopefully, the normal blood veins in the leg will continue to work and supply blood to the legs and the leg will be healthy. This may not always be the case. Cats can be paralyzed by loss of blood flow to the legs. In January, Bette's leg weakness went away while on prednisolone. Thrombosis isn't cured with prednisolone. And she maintained normal arterial blood pressure.</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">A cardiac ultrasound by her cardiologist in January showed no signs of heart disease, or clots having formed in the heart. With thrombosis due to HCM, an ultrasound would show changes to the heart and clots. When the problem of weak legs returned in March, that is when she had an MRI that showed the tumor.</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">When a clot forms in the legs, this can happen over days even if the onset seems sudden. The PAWS of the affected leg will be pale, not pink (or pale gray), and the paws will feel cool or cold to the touch. This is why you should always check cat's paws for color and feel of temperature so that YOU know when the paw is normal and may not be normal. If you suspect the paws are getting cold, see the vet and cardio as soon as possible.</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">When the clot settles in the artery of the leg, the cat will be in pain-typically over time-a few hours, a day; may go weak, may not want to move around; may begin to breathe heavily due to the clot having formed in the heart and passed along the body; may begin to breathe heavily due to increasing pain as the clot forms in the legs until the artery is cut off; the cat eventually will likely scream out in pain, and panic, and try to move around, as if to get away from it. The cat will not be able to stand or move the affected leg or legs. The cat will need immediate attention at the ER, the cardiologist office, or from the regular vet (you should discuss with your regular vet if they have experience with thrombosis and what treatments they can offer in the way of emergency care so that you know if they can treat the cat or if the cat needs the ER.)</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">We went through this with Myrna Loy. She had a heart attack in 2013, and FATE in 2015. With her heart attack, it was difficult to assess what was happening. She had begun to breathe heavily that morning and I gave her extra diuretic. She then hid and I spent a couple of hours trying to get her out from under the bed. I monitored her but saw that her breathing was getting worse. I finally had to chase her out with the vacuum. She ran, then laid down in the hall. I gave more diuretic but that didn't change her breathing. I called the cardiologist and she suggested that Myrna was having a heart attack. I rushed her to the ER which the cardio shares, and she was treated and the ultrasound showed a heart attack. Luckily, she was on Enalapril so the blood veins were kept open in her body so that the heart rate wasn't driven up, damaging the heart even more. She received oxygen, diuretic, other ER drugs, and stayed overnight until stable; was put on a twice weekly dose of aspirin in addition to the Plavix she was already on. </div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">When she had FATE in 2015, she woke up and began to have a difficult day. She seemed uncomfortable; she wasn't eating well; her breathing eventually increased. I remember her paws were cool to the touch, but it was May and the AC was on and she had been on the floor. I ignored a major first sign. I was with her upstairs all night as she didn't want to move, didn't want to be touched, didn't want to eat, and seemed more and more in discomfort. As her breathing increased, I increased the diuretic. Her breathing rate fluctuated. She had just settled down on the bed for awhile, resting, breathing comfortably when she suddenly raised up, seemed to look surprised, and then leapt up from the bed and cried out in pain. She jumped down onto the floor and her rear legs were not moving. I picked her up, placed her back on the floor to make sure, and saw she couldn't use them. I immediately took her to the ER. By the time we arrived, it had resolved itself. She was treated, kept overnight, and saw the cardio the next day. She luckily had lost only the use of the artery. The other blood veins in the legs had taken over and supplied the legs with blood so that she never lost the use of her legs. </div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">There is more information at the blog about what we went through and there is this information from a conference I attended in 2011. You can do word/category searches at the blog to learn more about thrombosis and thromboembolism.</div><p><a href="http://myrnaloycardiomyopathy.blogspot.com/2011/07/notes-from-july-2011-st-louis-avma_4170.html" target="_blank">2011 Vet Conference Thrombosis</a></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-42420757492131615132023-05-20T17:10:00.001-04:002023-09-15T12:33:38.037-04:00How to Feed a Sick Cat-the Art of Getting a Cat to Eat or Feeding It by Hand<div style="font-family: inherit;"><div class="" dir="auto" style="font-family: inherit;"><div class="x1iorvi4 x1pi30zi x1l90r2v x1swvt13" data-ad-comet-preview="message" data-ad-preview="message" id=":rg4:" style="font-family: inherit; padding: 4px 16px 16px;"><div class="x78zum5 xdt5ytf xz62fqu x16ldp7u" style="display: flex; flex-direction: column; font-family: inherit; margin-bottom: -5px; margin-top: -5px;"><div class="xu06os2 x1ok221b" style="font-family: inherit; margin-bottom: 5px; margin-top: 5px;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x1lliihq x1s928wv xhkezso x1gmr53x x1cpjm7i x1fgarty x1943h6x x4zkp8e x3x7a5m x6prxxf xvq8zen xo1l8bm xzsf02u x1yc453h" dir="auto" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); display: block; font-family: inherit; font-size: 0.9375rem; line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><div class="xdj266r x11i5rnm xat24cr x1mh8g0r x1vvkbs x126k92a" style="font-family: inherit; margin: 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">When Bette would not eat on her own earlier in the week, I was trying to syringe feed her. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">When you have a cat that cannot eat on its own, won’t eat enough because the cat is sick, has a disease, there are a variety of foods, medicines to try, and feeding methods. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">One of the best foods to feed a cat is Hill’s AD. It blends very well with very little water-a couple drops-therefore allowing a lot of calories and nutrients to get into the cat. Take a fork to blend in the can and <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>then you should be able to easily syringe it up. This is of course a little easier to do when you’ve taken some of it out of the can and placed into bowl like I did in the photo. Use a 3ml plastic syringe which is enough for each try. We feed 9ml or more as tolerated at a time. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">We also tried various liquid cat foods or "soups" by Friskees, and Fancy Feast "Broths" to add to AD and to syringe feed to add flavor, nutrients, and to encourage her appetite, and liquids that we hoped would be easier for her to swallow (since she could not easily swallow.) You can also use "cat milk" typically for kittens-add some to AD, or syringe feed 3ml for hydration.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Other meat based items that you can use: jars of baby food-chicken, beef, sweet potatoes (great source of potassium and fiber for gastric issues). Tuna juice. And you can make up your own broth. You do not want to buy commercial broth because it has too much salt and onions both of which you want to avoid. But you can make your own and add a little bit of sugar as long as the cat is not diabetic, and a little bit of salt as long as the cat isn’t HCM. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">I was going to use these broths for Bette. I boiled chicken with chicken livers because I thought she might need some iron. Chicken livers are a great source of iron, but it’s impossible to syringe. And since she wasn’t at that point eating on her own, I didn’t think she would eat it. But assuming that some of the iron rich liver leaked iron into the broth, I boiled them together. I did add to both the beef and the chicken broth a little bit of salt because she does not have heart disease. And I added just a little bit of sugar because she’s not diabetic. And since she wasn’t eating, and since sodium and glucose are necessary electrolytes, I wanted to make sure that she got something of those into her. Yes, it’s just a guess as to how much to put in. And it’s a guess as to how much she actually would have needed. I used 1/16 of a teaspoon if that in both of sugar and salt. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">How much should you feed your cat by syringe? I would say to start with 9 mL every 2 to 3 hours. Yes it depends on how much you can you get in at a time so if your cat rejects being hand fed after one or two syringes, decrease the amount of time in between each feeding and then try to increase the number of syringes you can actually get into your cat. We wrap a small hand towel or a paper towel around the neck of a cat. The cat is usually sitting, but Bette was mostly laying down, sitting up. You wrap one free arm around the cat and hold its head while using the syringe and your fingers in the other hand, to pry the cats mouth and gently feed the cat. You’ll want to go very, very slowly. Especially if the cat is very sick and weak. You don’t want to get food or liquid into the lungs. That will lead to pneumonia-not to frighten you, but that’s not going to happen if you go slowly. And yes, it’s frightening if your cat rejects it because you’re thinking your cats going to waste away. (I was very worried about Betty. I was worried about her even Thursday night when she was in the ER and I asked them how will they feed her. I just had it in my head that she had not been eating well for the last few days even as she presented with so many other things that were life-threatening, and not eating wasn’t one of them.) Your cat won’t waste away as long as it is getting enough food and enough nutrients every day and as long as you can keep it hydrated and as long as you can keep a staple weight. If your cat is 12 pounds and it’s been sick and you’re struggling to feed it and it gets down to 11 pounds after a month it’s OK. Sure, you want to discuss with your vet the overall body condition because it’s not just about how much it weighs, but is it healthy. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">I probably forgot to mention something as to how to feed. It is a trial and error. Food gets everywhere. Have baby wipes handy. Don’t yell at the cat. Don’t yell at your spouse. Don’t yell at yourself. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">There are meds that can help your cat eat on its own if the cat is capable and healthy enough to respond to the medication. There is Cerenia a good anti-nausea medication. There is onedansetron which is a good anti-vomiting medication. There is Cyproheptadine an allergy medication which stimulates appetite. And there is mirtazapine, which is a pill and Mirataz ear gel, appetite stimulatants. I think those are the top meds that doctors give to prevent issues or help stimulate appetite, so that the cat can eat more on its own.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">I do suggest that you keep a notebook. Start with cats weight and write it down, and write down when you feed it and how much you feed and how much water you give. The best way to monitor how much a cat is eating is to measure it always. Measure how much wet food you put into a bowl-cup, tablespoon, teaspoon. Measure it accurately. Because cats are funny. You will feed a cat an ounce of cat food and you will swear that it ate most of it. But because it pushes it off the plate or around the plate, when you collect all of it and you measure it, you might find that 1 ounce is not mostly gone, but is mostly still on the plate. If you know how much you fed the cat and you know how much the cat ate, then you can measure the amount of calories that the cat is taking in. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">A cat should have on average 260-280 calories per day. A 5oz can has a range of 120-180; 3oz can 70-125. Dry food varies but a cup is usually 250-300 calories. But you might give less than a quarter cup at a time and the cat might eat less than a quarter of that at a time of 25 calories. So, always measure before and after and keep a note of amounts.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="font-family: inherit; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Good luck.</div></div></span></div></div></div></div><div class="x1n2onr6" id=":rg5:" style="font-family: inherit; position: relative;"><div class="x1n2onr6" style="font-family: inherit; position: relative;"><div style="font-family: inherit;"><div class="x1n2onr6" style="font-family: inherit; position: relative;"><div class="x1n2onr6" style="font-family: inherit; padding-top: 491.758px; position: relative;"><div class="x6ikm8r x10wlt62 x10l6tqk" style="font-family: inherit; inset: calc(0% + 0px) calc(50% + 1.01px) calc(40% + 1.01px) calc(0% + 0px); overflow: hidden; position: absolute;"><a aria-label="May be an image of oatmeal cookies and text" class="x1i10hfl x1qjc9v5 xjbqb8w xjqpnuy xa49m3k xqeqjp1 x2hbi6w x13fuv20 xu3j5b3 x1q0q8m5 x26u7qi x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xdl72j9 x2lah0s xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r x2lwn1j xeuugli xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1ja2u2z x1t137rt x1o1ewxj x3x9cwd x1e5q0jg x13rtm0m x1q0g3np x87ps6o x1lku1pv x1rg5ohu x1a2a7pz x1ey2m1c xds687c x10l6tqk x17qophe x13vifvy x1pdlv7q" href="https://www.facebook.com/photo/?fbid=218088420974908&set=pcb.218089677641449&__cft__[0]=AZWcycl7BhqFE1Ehh3Hm01kL7NWtvRRk2Poyf4gtQtI3_hsCOu0WLiHzutdftaNvcXXB6Bq0PH4uz7-1KLD_AHDMG3BKBmvVS8A1Bs7c9Xd0aNhf9TbOM5OQUOed8SwoHyoYzjyZEuqmjL1K4WkrZ560qeDC7kFVAGqzxF-UDJNYnzu5X0WF1Qi1lBC5kOp9Rxw&__tn__=*bH-R" role="link" style="-webkit-tap-highlight-color: transparent; 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position: absolute; top: 0px; width: 268.68px;"><img alt="" class="x1ey2m1c xds687c x5yr21d x10l6tqk x17qophe x13vifvy xh8yej3" referrerpolicy="origin-when-cross-origin" src="https://scontent.find1-1.fna.fbcdn.net/v/t39.30808-6/348552478_1415389352608504_2708484770398610593_n.jpg?stp=cp6_dst-jpg_p960x960&_nc_cat=110&ccb=1-7&_nc_sid=730e14&_nc_ohc=OvSguPqpGJ0AX98d5nC&_nc_ht=scontent.find1-1.fna&oh=00_AfCWTcsIOxPGHe_e3apyQapDLPsbQGDGy3MtfTvxyb22SQ&oe=646D3F89" style="border: 0px; height: 195.703px; inset: 0px; position: absolute; width: 268.68px;" /></div></div><div class="xua58t2 xzg4506 x1ey2m1c x9f619 xds687c x47corl x10l6tqk x17qophe x13vifvy" style="border-bottom: 1px solid var(--media-inner-border); border-top: 1px solid var(--media-inner-border); box-sizing: border-box; font-family: inherit; inset: 0px; pointer-events: none; position: absolute;"></div></div><div class="x1o1ewxj x3x9cwd x1e5q0jg x13rtm0m x1ey2m1c xds687c xg01cxk x47corl x10l6tqk x17qophe x13vifvy x1ebt8du x19991ni x1dhq9h" data-visualcompletion="ignore" style="border-radius: inherit; font-family: inherit; inset: 0px; opacity: 0; pointer-events: none; position: absolute; transition-duration: var(--fds-duration-extra-extra-short-out); transition-property: opacity; transition-timing-function: var(--fds-animation-fade-out);"></div></a></div><div class="x6ikm8r x10wlt62 x10l6tqk" style="font-family: inherit; inset: calc(60% + 1.01px) calc(33.3333% + 1.01px) calc(0% + 0px); overflow: hidden; position: absolute;"><a aria-label="May be an image of seedlings" class="x1i10hfl x1qjc9v5 xjbqb8w xjqpnuy xa49m3k xqeqjp1 x2hbi6w x13fuv20 xu3j5b3 x1q0q8m5 x26u7qi x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xdl72j9 x2lah0s xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r x2lwn1j xeuugli xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1ja2u2z x1t137rt x1o1ewxj x3x9cwd x1e5q0jg x13rtm0m x1q0g3np x87ps6o x1lku1pv x1rg5ohu x1a2a7pz x1ey2m1c xds687c x10l6tqk x17qophe x13vifvy x1pdlv7q" href="https://www.facebook.com/photo/?fbid=218088434308240&set=pcb.218089677641449&__cft__[0]=AZWcycl7BhqFE1Ehh3Hm01kL7NWtvRRk2Poyf4gtQtI3_hsCOu0WLiHzutdftaNvcXXB6Bq0PH4uz7-1KLD_AHDMG3BKBmvVS8A1Bs7c9Xd0aNhf9TbOM5OQUOed8SwoHyoYzjyZEuqmjL1K4WkrZ560qeDC7kFVAGqzxF-UDJNYnzu5X0WF1Qi1lBC5kOp9Rxw&__tn__=*bH-R" role="link" style="-webkit-tap-highlight-color: transparent; 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font-family: inherit; inset: 0px; opacity: 0; pointer-events: none; position: absolute; transition-duration: var(--fds-duration-extra-extra-short-out); transition-property: opacity; transition-timing-function: var(--fds-animation-fade-out);"></div></a></div><div class="x6ikm8r x10wlt62 x10l6tqk" style="font-family: inherit; inset: calc(60% + 1.01px) calc(0% + 0px) calc(0% + 0px) calc(66.6667% + 1.01px); overflow: hidden; position: absolute;"><a aria-label="May be an image of food, 2 remaining items" class="x1i10hfl x1qjc9v5 xjbqb8w xjqpnuy xa49m3k xqeqjp1 x2hbi6w x13fuv20 xu3j5b3 x1q0q8m5 x26u7qi x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xdl72j9 x2lah0s xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r x2lwn1j xeuugli xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1ja2u2z x1t137rt x1o1ewxj x3x9cwd x1e5q0jg x13rtm0m x1q0g3np x87ps6o x1lku1pv x1rg5ohu x1a2a7pz x1ey2m1c xds687c x10l6tqk x17qophe x13vifvy x1pdlv7q" href="https://www.facebook.com/photo/?fbid=218088484308235&set=pcb.218089677641449&__cft__[0]=AZWcycl7BhqFE1Ehh3Hm01kL7NWtvRRk2Poyf4gtQtI3_hsCOu0WLiHzutdftaNvcXXB6Bq0PH4uz7-1KLD_AHDMG3BKBmvVS8A1Bs7c9Xd0aNhf9TbOM5OQUOed8SwoHyoYzjyZEuqmjL1K4WkrZ560qeDC7kFVAGqzxF-UDJNYnzu5X0WF1Qi1lBC5kOp9Rxw&__tn__=*bH-R" role="link" style="-webkit-tap-highlight-color: transparent; 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border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline-flex; flex-basis: auto; flex-direction: row; flex-shrink: 0; font-family: inherit; justify-content: center; list-style: none; margin: 0px; min-height: 0px; min-width: 0px; outline: none; padding: 0px; position: relative; text-align: inherit; touch-action: manipulation; user-select: none; z-index: 0;" tabindex="0"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x1lliihq x1s928wv xhkezso x1gmr53x x1cpjm7i x1fgarty x1943h6x x4zkp8e x3x7a5m x6prxxf xvq8zen x1s688f x1fey0fg x2b8uid" dir="auto" style="-webkit-font-smoothing: antialiased; color: var(--blue-link); display: block; font-family: inherit; font-size: 0.9375rem; font-weight: 600; line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; text-align: center; word-break: break-word;">See insights and ads</span></div></div><div class="x78zum5 x13a6bvl" style="display: flex; font-family: inherit; justify-content: flex-end;"><span class="x4k7w5x x1h91t0o x1h9r5lt x1jfb8zj xv2umb2 x1beo9mf xaigb6o x12ejxvf x3igimt xarpa2k xedcshv x1lytzrv x1t2pt76 x7ja8zs x1qrby5j" style="align-items: inherit; align-self: inherit; display: inherit; flex-direction: inherit; flex: inherit; font-family: inherit; height: inherit; max-height: inherit; max-width: inherit; min-height: inherit; min-width: inherit; place-content: inherit; width: inherit;"><a aria-label="Boost post" class="x1i10hfl xjbqb8w x6umtig x1b1mbwd xaqea5y xav7gou x1ypdohk xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1o1ewxj x3x9cwd x1e5q0jg x13rtm0m x87ps6o x1lku1pv x1a2a7pz x9f619 x3nfvp2 xdt5ytf xl56j7k x1n2onr6 xh8yej3" href="https://www.facebook.com/ad_center/create/boostpost/?entry_point=www_profile_plus_timeline&page_id=638164266262256&target_id=218089677641449&__cft__[0]=AZWcycl7BhqFE1Ehh3Hm01kL7NWtvRRk2Poyf4gtQtI3_hsCOu0WLiHzutdftaNvcXXB6Bq0PH4uz7-1KLD_AHDMG3BKBmvVS8A1Bs7c9Xd0aNhf9TbOM5OQUOed8SwoHyoYzjyZEuqmjL1K4WkrZ560qeDC7kFVAGqzxF-UDJNYnzu5X0WF1Qi1lBC5kOp9Rxw&__tn__=*W-R" role="link" style="-webkit-tap-highlight-color: transparent; border-color: initial; border-radius: inherit; 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padding-left: 12px; padding-right: 12px; position: relative; z-index: 0;"><div class="x6s0dn4 x78zum5 xl56j7k x1608yet xljgi0e x1e0frkt" style="align-items: center; display: flex; font-family: inherit; justify-content: center; margin-left: calc(-1*var(--button-inner-icon-spacing-medium)); margin-right: calc(-1*var(--button-inner-icon-spacing-medium)); width: calc(100% + 6px);"><div class="x9f619 x1n2onr6 x1ja2u2z x193iq5w xeuugli x6s0dn4 x78zum5 x2lah0s x1fbi1t2 xl8fo4v" style="align-items: center; box-sizing: border-box; display: flex; flex-shrink: 0; font-family: inherit; margin-left: var(--button-inner-icon-spacing-medium); margin-right: var(--button-inner-icon-spacing-medium); max-width: 100%; min-width: 0px; position: relative; z-index: 0;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x1lliihq x1s928wv xhkezso x1gmr53x x1cpjm7i x1fgarty x1943h6x x4zkp8e x3x7a5m x1lkfr7t x1lbecb7 x1s688f xtk6v10" dir="auto" style="-webkit-font-smoothing: antialiased; color: var(--primary-button-text); display: block; font-family: inherit; font-size: 1.0625rem; font-weight: 600; line-height: 1.1765; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span class="x1lliihq x6ikm8r x10wlt62 x1n2onr6 xlyipyv xuxw1ft" style="display: block; font-family: inherit; overflow: hidden; position: relative; text-overflow: ellipsis; white-space: nowrap;">Boost post</span></span></div></div><div class="x1o1ewxj x3x9cwd x1e5q0jg x13rtm0m x1ey2m1c xds687c xg01cxk x47corl x10l6tqk x17qophe x13vifvy x1ebt8du x19991ni x1dhq9h x1wpzbip" data-visualcompletion="ignore" style="border-radius: inherit; font-family: inherit; inset: 0px; opacity: 0; pointer-events: none; position: absolute; transition-duration: var(--fds-duration-extra-extra-short-out); transition-property: opacity; transition-timing-function: var(--fds-animation-fade-out);"></div></div></a></span></div></div><div style="font-family: inherit;"><div class="x168nmei x13lgxp2 x30kzoy x9jhf4c x6ikm8r x10wlt62" data-visualcompletion="ignore-dynamic" style="border-radius: 0px 0px 8px 8px; 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color: var(--secondary-text); display: block; font-family: inherit; font-size: 0.9375rem; font-weight: 600; line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;">Share</span></div></div><div class="x1o1ewxj x3x9cwd x1e5q0jg x13rtm0m x1ey2m1c xds687c xg01cxk x47corl x10l6tqk x17qophe x13vifvy x1ebt8du x19991ni x1dhq9h x1wpzbip" data-visualcompletion="ignore" style="background-color: var(--hover-overlay); border-radius: 4px; font-family: inherit; inset: 0px; opacity: 0; pointer-events: none; position: absolute; transition-duration: var(--fds-duration-extra-extra-short-out); transition-property: opacity; transition-timing-function: var(--fds-animation-fade-out);"></div></div></div></div></div></div></div><div class="xzueoph" style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 12px; margin-bottom: 6px;"></div></div></div></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-18679803283778008262023-05-20T17:07:00.000-04:002023-05-20T17:07:02.691-04:00Difficult Week For Bette Davis<div class="xdj266r x11i5rnm xat24cr x1mh8g0r x1vvkbs x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Bette Davis died May 19, 2023 of radiation effects after one month to the day (4/19/23) of treatment for Nerve Sheath Tumor. We are getting a necropsy to know the exact cause but something was compressing her esophagus and larynx, and she could not swallow, then could not breathe. Below are notes from the Facebook page.</div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;"><br /></div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">May 16:</div><div dir="auto" style="font-family: inherit;">Another late night trip to the ER. Bette suddenly is not doing well today unlike yesterday. Yesterday the dentist said she was doing great, she was improving. Yesterday she ate a bowl of food on her <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>own. Yesterday she seem to be on the mend. Today she can’t swallow, she coughs, she chokes, she spits up most of her food. She won’t eat on her own. We have a hard time, we have to go very, very slowly feeding her. We have to make sure she takes her meds first and keeps them down, then wait and feed her. I took her to the ER, to the local one that we use and they were going to do x-rays and sub Q fluids, but they can’t do endoscopy to check to see if her throat is closing up. I called the vet school ER and they said they do endoscopy. I run her up to the vet school an hour drive only to be told they don’t do endoscopy. That’s an internal medicine appointment that I have to schedule and that’s a few weeks out. They claim she can breathe and was oxygenating. Therefore they can’t admit her and then have endoscopy see her as a hospital patient. I’ve decided I’m not going to go back to the vet school ER because they misdiagnosed her last week when they said, everything’s fine, we don’t know why she’s drooling, tongue hanging, out open mouth breathing. That turned out to be the trigeminal nerve damage that her personal vet thought it was when she saw her on Wednesday the day after the ER visit. So tomorrow I have to call a couple local specialized hospital animal clinics. They don’t have ERs and I have to see if they do endoscopy. I have to see if anyone can see her. She can’t eat, and we’re not getting enough into her.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">May 18:</div><div dir="auto" style="font-family: inherit;">Not good news. Bette is currently in the local ER again and this time X-ray shows there’s a compression on her esophagus which is why today she’s been in increasing respiratory distress. </div><div dir="auto" style="font-family: inherit;">Earlier today I had her in at her vet. And the plan that we came up with was to have her get a shot of steroids because she’s not able to keep her medication down. And she got a shot of Cerenia. And we were not supposed to feed her. Just give her some water by mouth. But keep an eye on her. And we were going to take her back tomorrow to do the same thing again and discuss with the surgeon about doing a feeding tube through the esophagus. Then we were going to do sub q shots over the weekend and then on Monday back to the vet and see what the plan is to go forward and see how she’s doing. Her vet thought that if we just left the throat alone, then maybe it would heal assuming that it’s due to the Trigeminal nerve damage. But then, about 6 o’clock, she went into distress. She was panicking trying to get out of her box, trying to get out of the room. Just panicking. We got the oxygen. I contacted her vet. We started using the oxygen. And then I was texting with her vet, and the vet eventually said to get her to the ER, that she was in respiratory distress. We all assumed her larynx was collapsing. But it’s fine. It’s the esophagus that is partially closed. It’s always closed until used. But she’s gotten gas into it-the gagging, coughing are symptoms and causes-on both sides of the closed part. But something is closing the middle part which causes her to drool and gag back up anything we put down. And it has something to do with pressure on larynx. I can’t recall what’s causing breathing issues. </div><div dir="auto" style="font-family: inherit;">What is it? She needs an MRI to know. What do we want to do? Find out what it is. Because she wasn’t dying. Not from normal decline. But we need to know. And that’s if she can be stable enough to move her. We’re out of oxygen. We had two brand new cans that were nearly empty. We used all three to get her here. I’ll complain tomorrow. What did we expect? That she’d be worn out from radiation treatment. That when it was over, she’d rest and start therapy next month. That we’d get her through to the end of the year before maybe starting over. We didn’t expect nerve damage, excessive drooling from it, mouth, breathing issues, and a new tumor or something causing this complication. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">May 19:</div><div dir="auto" style="font-family: inherit;">The only update is that the vet called around 1 o’clock in the morning to say that that she had woken herself up because she finally urinated-she hasn’t urinated since 1 AM Tuesday. She urinated and defecated, and then panicked and her breathing ramped up and she was struggling to breathe. So they had to increase the oxygen, increase the medication to relax her, etc. The vet at that time wasn’t sure if she would make it through the night. She is currently stable, but stable with oxygen and sedation. They’re not sure she can be transported for further evaluation. The neurologist is going to look at her labs and her x-rays to evaluate and let us know what is the next step. Of course if she can’t be transported without oxygen, and she can’t be intubated because she doesn’t have a proper airway, I’m not sure what that means so until we get there I’m not going to guess. </div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;">Here’s what I wish: I wish people had listened to me days ago, a week ago when I first had her at the vet school ER on that Saturday almost 2 weeks ago. They said she was stable. There’s no reason to take her. They thought she was fine. She wasn’t fine, but she wasn’t as bad as she was yesterday. When I took her to the ER on Tuesday and the vet school again dismissed her and said she’s stable, she’s fine we can’t find any reason for why she’s breathing the way she is and nothing is wrong. If they had just listened to me and kept her overnight then maybe internal med would have seen her Wednesday and they would’ve imaged her Wednesday or Thursday and maybe they would’ve found this obstruction and maybe by now she would’ve had surgery instead of crashing. And if her neurologist at the other place where she originally had her MRI when I called two weeks ago to get an appointment to see what was wrong, if they had only listen to me that something was wrong and she needed to be evaluated then we would’ve caught it early enough while she was stable enough and breathing well enough on her own before she was incapable of breathing. If only everyone had listen to me and done what I asked a week ago, days ago, two weeks ago we might still have her and yes she would’ve undergone surgery probably to remove the obstruction and maybe they would’ve said well it’s cancer or you know she needs more radiation-which I would not have done because she’s done with radiation-and maybe she would’ve only had a few more weeks or a few more months but at least she would be home, stable to breathe, comfortable at home. She’d still have a life instead of struggling. And that’s not being selfish. It’s being realistic. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">I would not have chosen to put Betty down, just because she got lame. I would not have chosen to put her down just because she got a tumor. I would not have put her down because she needed radiation. But the kicker is if she had not gone through radiation would she still have had this obstruction? </div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;">Without the radiation there is a chance that should would go lame in both legs and lose ability to eliminate on her own. Yet many cats wear diapers and need help and live. And use wheelchairs. Would that have caused other issues and would the nerve have metastasized? There’s so many possibilities that the only choice was to have radiation to try to treat the tumor. </div><div dir="auto" style="font-family: inherit;">And the outcome is basically the same sort of. It’s possible that one scenario would’ve been she would’ve just gone lame. She would have spent the last month post when she would have received radiation treatment not having received radiation treatment and she would be have been fine. Would she have otherwise been fine for the rest of the summer? Would we have put off these complications or avoided these complications? She would be perfectly fine at least for a while until the tumor got worse and infiltrated her body or metastasized. She would have had a good summer or a difficult summer. Maybe she would have lived risk free until fall? It’s hard to say. I know the CT and the MRI did not pick up whatever this obstruction is so it must be post radiation or during radiation unless it’s something else entirely like something has collapsed because of radiation. Or Something is lodged in the larynx because of radiation. Until she has surgery or a necropsy, we won’t know. I hope this doesn’t happen to another cat of ours. But I do know that we will seek whatever treatment we think a cat needs to prolong a cats life. To treat the problem. Because when this all began, she was perfectly fine. And she is perfectly fine. Her health isn’t failing. She wasn’t dying. Except that she can’t breathe. And when you can’t breathe, a whole host of chemical, physical, biological processes kick in and starts to shut down your body. If she can’t survive off oxygen, then she can’t survive. And that’s where we might be. But I do this again yes. Why? Because she was perfectly fine until she wasn’t. </div></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-70182831681745754782023-05-20T17:00:00.003-04:002023-09-15T09:21:56.747-04:00Bette Davis Died After Struggling Post Radiation Treatments<div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">May 19:</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">Bette’s life is now done. We chose to put her to sleep. I don’t know what happened but she’s so quickly declined. She wasn’t lucid. She was in and out of it. She wasn’t really aware of her surroundings. Because she would physically panic If off oxygen, they arranged for us to go back to the room and see her in the oxygen cage and talk to her and say goodbye. Then they brought her out so that we could hold her and pet her and she started to struggle a little bit but she <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>was so out of it also because of the pain meds, but in a different way that when they gave her the first medication that usually puts them to sleep, and usually stings, and a cat who is conscious enough reacts, she did not react. And then she was quickly gone with the next medication. We are now dropping her off for a necropsy, so that we get an idea as to what happened.</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">UPDATE: See a later post about her necropsy which showed she had cancer in the brain.</div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div><div dir="auto" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><br /></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-10001132179679001682023-05-15T12:26:00.000-04:002023-05-15T12:26:02.458-04:00Feline Trigeminal Nerve Damaged When Aggressively Intubated<p><br /></p><p style="text-align: center;">Bette Sees Dentist Who Rules Jaw Issues are Likely Trigeminal Nerve Damage </p><p style="text-align: center;">From Aggressive Jaw Opening When Intubated</p><p style="text-align: center;"><br /></p><p>I know it looks scary that her tongue is hanging out. But the photo from last Wednesday when I took her to the ER and her tongue was really hanging out and her mouth was really wide open and she was breathing hard is scarier. </p><p>But we saw her dentist today and he observed and checked her and he said that she is actually doing much better than what I described that she was doing a week ago and then last Saturday and last Wednesday at the ER. She’s no longer holding her mouth all the way open, she’s no longer sticking her tongue all the way out, not moving it. She’s able to close her jaw even if it is somewhat still open. She can move her tongue which he said is a good sign even if it still hangs out a wee little bit. He believes that someone once, or more than once got aggressive, not in a mean way, but in a “they aren’t paying attention” way when they opened up her mouth, opened her jaw wide for intubation. That damaged or inflamed her<a href="https://wagwalking.com/cat/condition/trigeminal-neuritis" target="_blank"> trigeminal</a> nerve. It’s a nerve that connects throughout the face, the jaw, the eyes as in the outside of the eyes not the optic nerves. That is why he suspects her right eye is not responding, that’s why she was drooling, had open mouth, her tongue sticking out while she was swallowing hard a few days ago. He believes that she’s on the mend. He said to give it another 7 to 10 days. If after 10 days it hasn’t completely improved then maybe something else needs to be done but right now he thinks she’s on the mend. She may not be perfectly healed, because once the damage is done, depending on how severe it is, it may not heal all the way. He said he doesn’t think there’s a reason to get an urgent MRI either. And don’t intubate her for the next two weeks. Just let her rest. So we will not go ahead with the last two radiation treatments. We do have to see them and go over whatever. But we’re going to skip the last two treatments so that she’s not intubated and I called her neurologist, and I said we will no longer need an urgent MRI but we would like to get one sooner than the one that we have five weeks from now if possible. So we are back to at least she’s no longer drooling. That is a major improvement over this this past week and she’s able to not drool and spit out her food or medications. Now we just need to eventually get her to eat on her own, and hopefully that will happen when she’s more comfortable, licking or chewing and swallowing more solid food. So better news, good news, etc.</p><p>He also gave her a shot of the antibiotic Convenia. He suspects that there’s an infection and given that she supposedly had a UTI and then her radiologist said she didn’t he suspects, she probably did, and Zenequin can be too strong. It gets the job done but it’s too strong and so he said Convenia is nice and slow and quiet will work its way through a system and fight off anything.</p><p><br /></p><p><br /></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-0aIq4xlSpL-33QrZ1rXgCdvc83DLPtocZwRzKP7NMEQ1VnlRA3_0m2vYzqVhY0s5NMPgX0o8SiONFFm-LwAO9gVh0jlxvh2lP--SVjbKThtKn-6413JttwjQX-pAe903lCnFME5wk5mvkkrOZsfSCTEjYBWwB3AWLfe_UH5XOFjXU3YuflpuMsQZ/s2048/BD%20tongue%205:15:23.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2048" data-original-width="1478" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-0aIq4xlSpL-33QrZ1rXgCdvc83DLPtocZwRzKP7NMEQ1VnlRA3_0m2vYzqVhY0s5NMPgX0o8SiONFFm-LwAO9gVh0jlxvh2lP--SVjbKThtKn-6413JttwjQX-pAe903lCnFME5wk5mvkkrOZsfSCTEjYBWwB3AWLfe_UH5XOFjXU3YuflpuMsQZ/s320/BD%20tongue%205:15:23.jpg" width="231" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Bette at home, head on counter.</td></tr></tbody></table><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgckHR9hHHcNkdF2ewLb5nERuhPlElU-os9IM4kNDB1YNrCMgBy1BgvPREx72P7l7A1i5gMHxHKgEWRajKV1UpgDXcDND9_FjK59j3SvRnthvkGAsw4ZYewUFEUomGNkj9CIx7PrTvdljp_8tmmWaI6FBZCqqCJSkN4n46bhpcvckYy4tROQrnhd5Jw/s4032/BD%20May9%20stress%20breathing%2020232.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgckHR9hHHcNkdF2ewLb5nERuhPlElU-os9IM4kNDB1YNrCMgBy1BgvPREx72P7l7A1i5gMHxHKgEWRajKV1UpgDXcDND9_FjK59j3SvRnthvkGAsw4ZYewUFEUomGNkj9CIx7PrTvdljp_8tmmWaI6FBZCqqCJSkN4n46bhpcvckYy4tROQrnhd5Jw/s320/BD%20May9%20stress%20breathing%2020232.jpeg" width="240" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Bette May 9 before ER-mouth hung open, tongue out, fast breathing.<br /><br /></td></tr></tbody></table><br /><p><br /></p><p> </p><p><br /></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-88167405486955266142023-05-14T20:03:00.001-04:002023-05-14T20:03:19.946-04:00Bette Has Had Many Issues Since Beginning Radiation<p>Bette began the process of radiation treatment without any issues. The first few days she was home, used the litter box, ate well, then slept but was also up later in the day, moving about, being taken from room to room. But quickly small issues emerged-litter box use and ability to eliminate, lameness, exhaustion, fast breathing, inappetence, drooling, open mouth, weak front legs, weak side of face. No one knows the cause. We are going to the dentist on Monday 5/15/23 because he's an expert and will be able to evaluate and offer suggestions as to cause and treatment. We are to hear from her neurologist about setting up an MRI recheck on Monday and hopefully we can get her in sooner than the June appointment we already had set. The following are notes from the notebook I have kept about her treatment. I tried to clean them up so that they make sense, replaced person and place names. The grammar or sentence structure is not always correct. </p><p><br /></p><p>4/19 Began radiation treatments Wednesday-Friday. Never sick, tired, ate well at home. Restless at night. Used litter box without issue. Good 4/19-21. Looked and acted normally. But quickly lost use of left leg, no weight on it.</p><p>4/22 Signs of difficulty eliminating. Increased Miralax and Cisipride and Forta Flora. Smaller bowel movements. Began difficulty getting into the box as leg got weaker. Began urinating periodically on pads and not in box. Still looked normal. Eating ok.</p><p>4/24 High amount of blood in urine. Not using box, urinating over box onto pad or on pad. Dark red. vet school checked urine and no bacteria. Red blood cells they thought from stress. Increased Buprenex, Methigel, water by mouth. Ate ok but not as much.</p><p>4/25 Vet school prescribed Gabapentin at bedtime-50mg/1ml; we gave .75ml. That settled her down at night to sleep. </p><p>4/26-4/28 Better, using box, restful, slept well at night. Could move up and down basement stairs on her own. </p><p>4/29 Urine out of box, restless at night. Gave more Buprenex, water by mouth, Methigel. </p><p>Weight was 11.11. </p><p>4/30-5/1 normal, weaker legs, unable to move as much, box use getting difficult. Eats well enough. </p><p>In May-begins squinting eyes, slight drooling and wetness around mouth. This increases daily.</p><p>5/1-Monday-normal day, fine post treatment. Good evening. Ate well.</p><p>5/2 Evening-can’t get into litter box, puts legs in but butt is out and urinates onto pads. Can still slide her body and drag left leg and use front legs to move around. Is drooling.</p><p><br /></p><p>5/3 Came home from vet school dirty and wet around mouth, chest, legs because the drooling has increased greatly. The gunk on her is food she tried to eat after treatment. </p><p>5/4 Thursday vet school radiologist sees ulcer in right eye. Gave antibiotic gel cream for eye bacitracin neomycin polymyxin. She is now very lame, harder to move around but she can move herself. Continued drooling out of mouth all day into next. Could still eat. Began urinating laying on pad and it got all over her. Got urine sample from pad into vet. Eye gel glues eyes closed, makes a mess on face. </p><p>5/5 Friday BD urine on pad laying down, on herself 5:30 a.m. Her vet said Thursday's urine sample has high amount of bacteria although not sterile sample. Dr gave Zenequin. Seems tired and not able to get into box easily. Drooling is worse, very wet. Eats only some. Eyes closing more, gel on face. Afternoon and evening-used the box by getting into it and only got a little wet with urine. </p><p>5/6 Saturday -Was fine in the a.m. and ate but by the afternoon was clearly run down. Wouldn’t eat all day. Gave water PO often and she rejected it. Difficult getting food into her with syringe. Eyes squinting, second eyelids out on both eyes, drooling, open mouth, weak, tired. She hadn’t had a BM or urinated since Friday 5:30 a.m. Was afraid she was crashing or had blockage or fistula. Seemed cool, less pink. But BR was normal at home. Took her to vet school ER. Tested-despite clinical signs nothing tested positive. BR/HR/temp/BP normal. ER doesn’t know why she’s drooling. Or why feeling/looking miserable. She hates having her mouth touched. Bladder at ER was small but she wasn’t dehydrated in skin test nor in blood work so did not give fluids. Urine tested positive for bacteria so continue Zenequin. Left leg has good blood pressure but less muscle mass. Gave Onedansetron for nausea, suspect drooling nausea related. She ate very well for them-although a drooling mess. They cleaned her face and she looked perfect.</p><p>5/7 Sunday-finally urinated on a pad 2:30 pm as she lay and had to be cleaned. She perked up afterwards and ate and drank for five minutes. Then slept. Then by 6 pm. seemed run down again. Never urinated all day or night. Looks miserable. Ate little. Gave water PO. Drooling increasing, even more wet on body. Eyes squinting closed more. </p><p>5/8 Monday Dr. Radiologist said tumor may not be shrinking, litter box issues related. Discussed Saturday ER. Needs followup MRI. Left leg has no feeling-blood and good pressure (ER) but wasting muscle tone. Mouth is held open slightly, drooling is excessive, tongue is out. Eyes squint more. Vet school radiologist doesn’t know why. Sort of dismissed it as mouth soreness. *They’ve never had a mouth injury during intubation. Bette looks miserable. *On Monday Dr. Radiologist said ER urine sample was not bacteria but would not say why the ER said bacteria other than ER doctor misread it. Said to end Zenequin. Said to end Buprenex, give Gaba 1ml BID and not just at bedtime. Decided to do 1ml Gaba post treatment, ½ ml dinner, ½ ml bedtime. Evening heard jaw click noise, open mouth more, tongue out, not comfortable. NO urine or BM since Sunday.</p><p>Finally urinated 3:30 a.m. Tues. on pad.</p><p>5/9 Tuesday-Drooling is worse. She’s wet, hard to hold down meds, jaw makes noise, heavy breathing, open mouth. BR was 80 in the morning when we arrived at vet school. It did not fluctuate while we waited for treatment. Dr. Radiologist said it was normal BR when in treatment. She later said she did not react when mouth and face touched-but then said that was done under anesthesia (so not a good indicator.) She was drooling post treatment and was dirty from struggling to eat and keep it down. Mouth was opened, tongue out. BR was excessive. They still released her. And it got worse in the car going home. Decided to go to local AEC. They put her on oxygen and that calmed her immediately. Blood work shows some iffy-most to do with breathing fast; and some white blood cell counts are low. Lungs clear, eyes irritated. Gave Optimax eye drops. Don’t know why mouth is opened, drooling, fast breathing. May be signs of pain or injury or anxiety. Took xrays of body and nothing is wrong internally-no fistulas, no blockages. </p><p>5/10 Wednesday Gave Valium in a.m. before treatment instead of post treatment to help with anxiety if drooling is related. Radiologist concerned that radiation causing breathing issues but denies mouth soreness still. Finally urinated 2:30 pm on pad at home. We then saw Dr. Vet to review issues. She checked mouth, teeth and said it’s pain reflex but cause is unknown. Might be TMJ or nerve damage. Related to intubation likely. Said to give Buprenex post treatment to help with jaw pain and to use it as break through pain control as needed. Checked eyes-irritated, no ulcer. Said to use Topamycin for eyes post treatment, lube pre treatment. Bette BM 10 p.m.; urine by midnight pads and on her. Her mouth is opened, slack, drooling excessive, tongue out still. Gave buprenex at home. Can’t keep down Gaba with drooling and bitterness of med. AEC bloodwork-showed low WBC count, off RBC counts; and off CO2 counts due to fast breathing. And low potassium. Give Renal K. Kidneys normal. Decided to stop Onedansetron except as needed since drooling isn’t nausea related but likely pain. Giving more water by mouth. Eyes squinting closed. </p><p>5/11 Thursday radiology treatment; said they will compound Gaba into pills (ordered from NJ pharmacy) because drooling is excessive and with bitter Gaba she can’t keep it down. She came home DIRTY from spitting up her food at vet school post treatment. Giving Renal k potassium and buprenex post treatment. She cannot CHEW today, can’t eat her dry food or treats. Drooling is worse ever. Decide to give only Buprenex because she can keep that down; Gaba at bedtime. Must be gentle with mouth, hold it partially closed to help her swallow. Careful not to choke on meds or aspirate liquids. Giving water by mouth. Slept rest of day. No urine/BM. Eyes-especially right-keeps closing. Mouth still open/drooling.</p><p>5/12 Friday BM 3:45 a.m.; front legs seem weak-especially RIGHT front leg. And vet school called and said they s<b>uspect drooling </b>now is from TMJ or trigeminal nerve damage. Could be inflammation or a tumor or damage. They say this has never happened before. </p><p>Urine in crate by 1 pm. Once home. Giving tuna juice, water by mouth, buprenex. Decide to syringe feed AD. Renal K, etc. Right eye is not opening up as much, right side of mouth NOT sore but left is. We suspect her right side of face nerve damage. Eye does not respond to touch. Pupils look the same. Hard to lift herself and move with weak front legs. </p><p>5/13 Saturday less drooling, less opened mouth, tongue only out a little. Must be careful when syringe feeding-hold mouth closed, go slowly, and with meds. She is eating some on her own. Clean her, protect catheter paw. Right side of face not responding as left to touch or pain. Suspect weak front right leg, doesn’t seem to resist as front left. Hard for her to move around. Right eye not blinking when touched. </p><p>Urine and bm in box 9:45 a.m. A little wet. Eating on own in late day/evening and syringe feeding. </p><p>5/14 Sunday Weight down to 10.13 from 11.11 a month ago, and 11.3 a week ago. Not eating on her own. Careful with syringe feeding. Mouth not as opened. Does open it and breathes fast but can mostly close it, especially when sleeping, or tongue is out a little bit. Urine/bm 9 a.m. in box and only a little wet. Slept well over night. </p><p><br /></p><p><br /></p><p><br /></p><p><br /></p><p><br /></p><p></p><p><br /></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-81065190314853160862023-05-10T18:21:00.000-04:002023-05-10T18:21:12.305-04:00Pet Oxygen Masks<p><br /></p><p><br /></p><p>If you wanted various sizes of <a href="https://www.amazon.com/Novaco%C2%AE-Medical-Oxygen-Tubing-Silicone/dp/B0B4TC9NK5/ref=sr_1_4?crid=30356OG7SY81R&keywords=pet%20oxygen&qid=1683755479&s=pet-supplies&sprefix=pet%20oxygen%2Cpets%2C165&sr=1-4&fbclid=IwAR0LvpOZ67nf4jrNixsOkfJwEWn8vGnxR11Hv0ZRvC9o8kTXncR_a9MzMys" target="_blank">masks for oxygen for pets,</a> Amazon sells many.</p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-4157113336734391602023-05-10T18:18:00.001-04:002023-05-10T18:18:34.899-04:00Pet Oxygen Tent/Chambers<p><br /></p><p><span style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">If you wanted an <a href="https://www.amazon.com/Pawprint-Oxygen-Buster-Cage-Large/dp/B082P4F15V/ref=sr_1_3?crid=30356OG7SY81R&keywords=pet%20oxygen&qid=1683755394&s=pet-supplies&sprefix=pet%20oxygen%2Cpets%2C165&sr=1-3&fbclid=IwAR1wTvNJiklKZBnBMjDMtZROrSw1uOKThXUJUzIKR-U4eMuzgVHZ270asa8" target="_blank">oxygen tent</a>-and learned how to use them-here is just one on Amazon; $319 for a small.</span></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-48341080567885604982023-05-10T18:16:00.000-04:002023-05-10T18:16:03.461-04:00Pawprint Oxygen Cannister Kit for Pets<p><span style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;">I don't think this was available-certainly wasn't recommended-when Myrna was alive or it would have been in our house. It's easy to use, safe to use; doesn't require a chamber. About $210 for a kit.</span></p><p><span style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; white-space: pre-wrap;"><a href="https://pawprintoxygen.com/product/oxygen-kit-for-cats/" target="_blank">Pawprint Oxygen</a> kits for dogs or cats. </span></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-35034375490628628172023-05-07T16:55:00.002-04:002023-05-07T16:55:35.893-04:00Bette Has Evening Trip to ER after Radiation Weakens Her System<p><b>Saturday May 6:</b></p><p>So-despite doing better, today Bette decided she was not. She seemed fine this morning and ate. But hasn’t eaten, nor had water-except for the 9ml we gave every three hours-hasn’t eliminated, and both eyes are closing, she hates being touched, hated her mouth touched, was drooling. This happened over the course of the day. By 4 pm I thought something was wrong. I reread the information from her radiologist about how certain symptoms can appear and be normal; how others are life threatening. By 7pm I thought she was worse and since the drive to the vet school is an hour-they have emergency also, have her records, nothing needs to be explained except about what happened today-I took her then instead of waiting even later and risk coming up here with her at midnight. (We are not strangers to midnight visits to our regular ER.) </p><p>They believe she is exhausted from treatment, and is dehydrated; she is not crashing-radiation can cause fistula-a hole-in the colon or bladder leading to death and those signs would appear quickly after occurrence, she would vomit and be lethargic and be unresponsive. Her eyes are closing and they will check both. They will do another urine test. They may change the antibiotic. They will do an ultrasound to make sure her bladder and colon are fine. She doesn’t have a fever. Breathing and heart rate are normal. </p><p>She arrived very weak but once in the examination area, tried to bolt very fast on three legs anytime they let go of her.</p><p>She presented clinically with issues but NOT when tested. She had normal temp/breathing rate/heart rate/pulse; was not congested nor wheezy as I thought; and was not dehydrated-not in the blood work, not in the skin test. Her right eye no longer has an ulcer but both are irritated. Her kidney/liver/electrolytes were normal. The ultrasound showed no fistulas or blockages. She does have a UTI with a high level of bacteria, no crystals, normal pH. </p><p>They thought the drooling and not wanting to be touched in the mouth was from nausea. Similar to humans with indigestion and burping, the mouth can get irritated and uncomfortable. They gave her a new med <a href="https://medlineplus.gov/druginfo/meds/a601209.html" target="_blank">Ondansetron.</a> <a href="https://www.zoetisus.com/products/petcare/cerenia" target="_blank">Cerenia </a>is to stop vomiting and helps with nausea, also. But when a cat presents with strong nausea that causes drooling and mouth aversion, this med is necessary. </p><p>They will do a urine culture to see if we need to change the antibiotic. </p><p>They did not give fluids since she was fine. </p><p>They cleaned her eyes and face (the eye gel gets messy.) We are to continue use of the eye gel but we don't need to use as much and only twice a day (so far.) </p><p>But why had she not eliminated? They don't know why. She had a small bladder and they withdrew some for the test. </p><p>She ate very well for them after not eating all day at home and BEFORE she received the Ondansetron. She left looking more chipper for no reason other than having ate finally. She was perfectly fine once home. She received the new med and her bedtime Gabapentin and ate some more. BUT she still did not eliminate. </p><p><b>Sunday May 7:</b></p><p>We got up this morning and was fine. We seculded her in the dining room on her own so that I knew if she was the one using the litter box. She ate, etc. She was tired but alert. She slept a lot. I could not express her bladder (I'll need to learn how.)</p><p>Then at 2:30 she got into the litter box, and finally urinated-in the box, over the box, on the pad; then moved out of the box, laid down and finished urinating on a pad. She was soaking wet with urine on her backside, legs, and tail. I used a pad to wrap her up so that I could carry her to the laundry room without dropping urine all over. The pad also soaked up a lot of it from her. I gave her a bath in our blessedly very deep laundry room sink from which she could not jump. It also has a hose. I sprayed her down while holding her up in one arm because the bandaged port line in the front left leg cannot get wet. I shampooed and rinsed. Then I wrapped her up in a large towel to dry her, took her outside and sat on the deck in the sun for about 15 minutes, turning her over every so often to dry her. Then I brought her back inside, and she laid on the blankets while we finished cleaning up the pads. </p><p>She also eventually began this afternoon to drink water out of the bowl on her own again after not drinking all of Saturday. </p><p>I'm not sure what happened yesterday. Is it possible she did not get enough of her prednisolone? Maybe I didn't see an air gap that can occur which decreases the amount in the syringe. (Wedgwood sends orange syringes to go with their orange bottles.)</p><p>We continue to take this one day at a time. </p><p><br /></p><p><br /></p><p><br /></p><p><br /></p><p><br /></p><p></p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-10852488372888223402023-05-06T00:21:00.000-04:002023-05-06T00:21:06.163-04:00Bette Has Issues This Week with Radiation Treatment<p>Bette: developed an ulcer on the eye due to being under anesthesia each day. That can happen because the eyes don't close and can dry out. They are supposedly using drops to keep the eyes wet during treatments but I guess it can still happen. They gave us a eye gel to use for a couple weeks. They do a full physical check each day before treatment and that's how they discovered the ulcer. <br /><br />She's had trouble using the litter box this week, stepping in but not getting her butt into the box, then urinating out of the box. I thought it was due to treatment, the tumor weakening her rear legs, etc. I captured a sample and took it into the regular vet on Thursday. The results showed high level of bacteria, some blood (not seen visually this time unlike two weeks ago) no crystals, high WBC. So, she's now on Zenequin for ten days. BUT today after treatment (before Zenequin) she blessedly used the box twice by getting into the box, butt and all. She did get a touch of urine on her rear leg so we will continue to have to clean her. </p>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0tag:blogger.com,1999:blog-7326274904971010552.post-23407402024599763592023-05-03T17:33:00.000-04:002023-05-03T17:33:03.446-04:00Bette Radiation Treatment Update Last Two Weeks<div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;"><b><br /></b></div><div dir="auto" style="font-family: inherit;"><b><br /></b></div><div dir="auto" style="font-family: inherit;"><b><br /></b></div><div dir="auto" style="font-family: inherit;"><b><br /></b></div><div dir="auto" style="font-family: inherit;"><b>May 2-3 </b></div><div dir="auto" style="font-family: inherit;"><b><br /></b></div><div dir="auto" style="font-family: inherit;">Bette is doing well. She is having trouble urinating in the litter box but we have pads around the box so she has gone on those. But it seems she still has no blood in the urine or a UTI but we will continue 9ml water PO (by mouth), Buprenex .25 or so, and Methigel 2x a day. She has not yet gained use of her lame rear left leg but is able to quickly get around and up and down furniture. She is eating well, maintaining weight after losing 9oz in late March-April. We continue to put her in different rooms so that she is not shut up in just one (she usually spends the day post treatment in the enclosed dining room although the French doors allow her to see us; and her siblings hang out with her after she has rested.)</div><div dir="auto" style="font-family: inherit;"><b><br /></b></div><div dir="auto" style="font-family: inherit;"><b>May 1</b></div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;">My husband drove Bette to the vet school for treatment today and will drive her up on Friday as well.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="background-color: white; color: #050505; font-family: system-ui, -apple-system, "system-ui", ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">I gave him notes on the drive-time it takes, when it's boring (long, flat section), the dead animals he should try to ignore (there are so many!), where the police hide in their HUGE blue SUVs, the scenery (long, flat, boring), exactly when he'll be tired, exactly where and when there will be traffic. I even told him which gas station to stop at, the blond cows at the yellow house, and the geese and goslings in the marsh along a road. I told him which left turn to take to get to the vet school, to stay in the left lane and not the right when going down that street, and how to hand her off to the attendants. All of which he rolled his eyes and scoffed at until I told him rather forcibly to PAY ATTENTION! And then when he got home he said that I was right about almost all of it, but did I mention this one spot? Yes, I had but he must have still been scoffing.</div><div dir="auto" style="font-family: inherit;"><b><br /></b></div><div dir="auto" style="font-family: inherit;"><div class="xdj266r x11i5rnm xat24cr x1mh8g0r x1vvkbs x126k92a" style="margin: 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;"><b>April 27</b></div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;">A good day for Bette. She is over the obvious blood in urine but we continue to treat it as if still there. She didn’t sleep well Tuesday night so we increased the Gabapentin from .50ml to .75ml (the script calls for 1ml) and she slept well and used the litter box without crying or being disturbed. And she was able to get around (too much med and it makes cats wobbly.) She did well at today’s treatment. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="margin: 0.5em 0px 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;">The drive is now becoming automatic. And the wait from 8:30 to 11 or so <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>(today we left at 12) is flying by. I read the news, my book or magazine, and suddenly she’s done. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="margin: 0.5em 0px 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;">But I still need a break. My husband will take her Monday and Friday next week.</div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;"><b>April 26</b></div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;">So far this morning, Bette is doing much better. Her urine does not appear to be showing any signs of blood. And she used her litter box. We will continue to do the water by mouth every 2 to 3 hours, the extra Buprenex, and the Methigel. And, if it happens again, then I will contact her regular vet who will give her Zenequin . But I think right now everything is going in the right direction and that her bladder is going to hopefully calm down.</div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;"><b>April 25</b></div><div dir="auto" style="font-family: inherit;"><b><br /></b></div><div dir="auto" style="font-family: inherit;">Bette possibly has bloody urine. I saved the pad to take today to treatment. She went at bedtime 10:30 pm in the box but over it onto the pad. It was light red orange. She had an accident in the crate on the way home and it was very dark orange and her urine has been stinking since Friday. So I didn’t know if yesterday it was the radiation treatment but last night it was rather dark looking. But since she only went one time, I didn’t think it was necessary to take her to the <a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a>ER. She received her bedtime pain med which may have helped. We’ll know more later.</div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;"><div class="xdj266r x11i5rnm xat24cr x1mh8g0r x1vvkbs x126k92a" style="margin: 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;">So-The vet school checked and thought she had no bacteria in the urine and suggested not giving antibiotics. They didn’t give sub q fluids to wash out the bladder and any irritants or bacteria that might be there but did give the regular amount of fluid she receives each day with her treatment. They did not offer me guidelines to address the issue. I’ve never had a vet dismiss this problem. They thought it was just stress since she does have a history of idiopathic cystitis. <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>So I called her vet office once home and left a message with them asking her to call me Wednesday when she’s in. And that wonderful woman called me on her day off!! She said if this continues, she’ll prescribe Zenequin antibiotic because there could be bacteria and the pad wasn’t showing it. If it clears up, then Zenequin worked. Meanwhile, give more Buprenex (pain relief/inflammation reducing), water by mouth (we do 9ml a few times), and Methigel to improve the ph level of the urine. The radiologist did finally prescribe Gabapentin for night time. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="margin: 0.5em 0px 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;">I would have taken her to the ER last night had she continued to urinate and was in pain when urinating. We have had to do that years ago with Baby, Bette, Elizabeth; and Myrna-with HCM-was frequently in the ER after 8 pm.</div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;"><b>April 24</b></div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;"><div class="xdj266r x11i5rnm xat24cr x1mh8g0r x1vvkbs x126k92a" style="margin: 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;">Bette-good Sunday day. Slept well overnight. Good Monday so far. My husband and I changed my schedule since getting up at 4 am was exhausting for me. It’s amazing how one more hour and a half of sleep can feel great! Up at 5:30; shower and dressed; downstairs to make my breakfast and tea-now to go-and her meds; give her meds, crate her, finish gathering whatever; go to car. By 7:25-five minutes late but still ok-in the car. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="margin: 0.5em 0px 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;">He will medicate and feed other four cats, clean <span style="font-family: inherit;"><a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>boxes, do waters. When I’m home I’ll empty dishwasher/put in dishes, sweep; feed and medicate Bette (as soon as we are home). Then do my list of things to do. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="margin: 0.5em 0px 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;">He has hours of vacation he can use that allows him to take off an hour or so in the morning to care for the cats. He will be up earlier to take care of the cats for the days when he has an 8 am call. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="margin: 0.5em 0px 0px; overflow-wrap: break-word;"><div dir="auto" style="font-family: inherit;">Granted, I’m not a wash and go person. If I were, I suppose I could roll out of bed, shower and dress, etc at 6:30. But that’s never been me. Not that I put on makeup for over an hour but it’s not five minutes either.</div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;"><b>April 23</b></div><div dir="auto" style="font-family: inherit;"><br /></div><div dir="auto" style="font-family: inherit;">Bette had a good Saturday of moving around or being moved and resting. Last night she slept very well. Not sure why compared to a restless Friday night. She used the litter box. We didn’t give her extra Valium. She slept on the bed and then the floor. So-I slept well for the first time in days, including a restless Friday night. The weekend break has been good for both of us. After she urinated in the cat house Friday night, and the urine got on the floor, and after cleaning <a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a>the floor three times, I covered the floor with pads, even under blankets. You can see her sleeping under the rocker and see how small is the room.</div></div></div></div></div></div></div></div>Joannehttp://www.blogger.com/profile/04365829116476582805noreply@blogger.com0