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Put a feeding tube in or not, that is the question

tiggy2
November 5th, 2009, 08:35 AM
HI

I'm new to the site but have read a fair number of post and fine the advice here very good so here I go.

I have a 15 year old female with early stage CRF. She has been steadily losing weight for months and the final suggestion by my vet is to put a feeding tube in.

She does eat, Wellness brand wet food (took about 2 months to get her on that), but obviously not enough to maintain or put on weight. SHe's down to 9.7 pounds from over 12 pounds. My Doc. wants to get her onto the low protein diet, but of course she won't eat that, hence the suggestion of the feeding tube to get her to switch to the low protein diet.

Her thyroid is OK had that checked before we found out it was CRF.

So feeding tube or no. It goes in tomorrow:))

Sorry for the delay.

mikischo
November 5th, 2009, 09:00 AM
Welcome to pets.ca. Although most veterinarians push their low protein prescription diets for CRF, many other people do not recommend them. Wellness brand wet food (the one your cat is currently on) is one of the foods recommended by others, especially the chicken, turkey, and chicken and beef varieties because they are not too high in phosphorus. Growler's cat, Duffy, was diagnosed with CRF in 2007 and she has an excellent thread that you may want to look at. Here it is:

http://www.pets.ca/forum/showthread.php?t=45017&page=1

It is a very long thread. She has a shorter version but I can't find the link at the moment. I will look for it later. Growler comes on here every day and when she sees your post, she will have some more information for you. If you don't have a copy of your cat's most recent bloodwork, it would be helpful if you ask your vet for a copy and post the numbers here.

Here is another excellent website that contains a lot of good information on CRF:

http://www.felinecrf.org/

tiggy2
November 5th, 2009, 09:10 AM
Growler's cat, Duffy, was diagnosed with CRF in 2007 and she has an excellent thread that you may want to look at. Here it is:


Thank you for the speedy reply

I've read Growler's posts and been on the other CRF sites, hence I got my cat on the wellness brand..thanks for that. My other cats are doing better on it:))

We checked the blood work, can't remember the numbers but I do remember they indicated Tus was in the early stages of CRF, Phosphorus levels were normal, but there was protein in her urine.

I don't understand why she continues to lose weight even though I feed her every 4 hours or so. She'll eat close to a tbls per feeding, sometimes more.

Mind you my other guys are loving it, so much so that they are getting a tad fat:((

mikischo
November 5th, 2009, 10:24 AM
You said that she eats just under a tablespoon every 4 hours or so. Is that about 3 to 3.5 oz or so per day? How does that compare to the amount she was eating before she started losing weight and how large is her frame? Was 12 lbs. a good body weight for her frame size? I am just wondering if the weight loss is just due to eating less than previously or if there is something else at play here.

There are other people on this board who have had their cats put on feeding tubes for various reasons. I believe sugarcatmom is one of them and she also comes on here daily and will also give you some good information. It is possible a feeding tube would be helpful to help her to eat more if you feel that what she is getting is not sufficient, but I also do not recommend using the prescription low-protein diets. I lost my own cat this year at the age of 18. He also had heart complications. He was diagnosed with early stage CRF in 2007 and in late January of this year, I decided to follow the vets recommendation to put him on a prescription low-protein diet even though his CRF was relatively stable. By mid-March (after being on the low-protein diet for six weeks) his CRF had suddenly worsened rapidly. I'm not saying that this might not have happened anyway, but the switch to this type of diet was obviously not helpful and I sometimes wonder if it might even have been a contributing factor.

There are also medications available to help with the proteinuria. Has your vet discussed this with you? An ACE inhibitor such as Fortekor (benazepril) is sometimes used in conjunction with amlodipine to treat proteinuria.

tiggy2
November 5th, 2009, 11:15 AM
How does that compare to the amount she was eating before she started losing weight and how large is her frame?

She used to eat dry food, so to measure that was impossible as I have 4 others who ate it as well. She was a little over weight, small cat in general. She should weight I figure around 10 pounds, but she has lost muscle mass. So aside from the constant weight loss, (1/2 pound a month), it's the muscle mass that concerns me.

Is that about 3 to 3.5 oz or so per day?

It's probably around 3 oz's of food, I've never measured it that way, but not enough to gain or maintain the weight.

but I also do not recommend using the prescription low-protein diets.

I am in agreement, so why do the vet's push it so much? For one thing it has tons of by-products in it.

There are also medications available to help with the proteinuria. Has your vet discussed this with you? An ACE inhibitor such as Fortekor (benazepril) is sometimes used in conjunction with amlodipine to treat proteinuria.

I don't think they (vet) knew about this, but I will mention it. So much information to try and put together and not a lot of confidence in presenting it.

I would like to try alternative ideas to a feeding tube, because she is eating, but the vet did not have any. The suggestion of a stimulant was tossed out due to it's side effects of hard on the kidney's.

So I'm at a loss as to what to do:(

sugarcatmom
November 5th, 2009, 11:46 AM
Hi tiggy2,

Is your kitty on any supplements or medication? Have you tried appetite stimulants? If you could get a copy of her latest lab results, that would also be helpful.

While putting in a feeding tube can be a life-saver in many situations, it should be more of a last resort thing, when other less invasive options have failed. And I also agree with mikischo that you don't want to go the low-protein route. That won't help at all in the weight gain department.

To get her eating more, you might have to try offering her a few different brands and flavours of wet food. Some other good ones to try besides Wellness are Innova Evo 95% venison or beef, Nature's Variety Instinct, and Precise has some good low phosphorus flavours as well. Does she like raw or lightly cooked chicken breast? That would be an excellent source of quality protein.

You can also top-dress her canned food with stuff like powdered freeze-dried meat treats (Halo Liv-a-Littles or Real Food Toppers, for example). Even pulverizing some of her favourite kibble and sprinkling it on top might help. Parmesan cheese or cat nip can also work.

Without knowing what you've already tried and what her blood work results are, I'd say that it's too early to go with a feeding tube, especially if it's just to force a completely inappropriate low-protein diet into her. How long is the vet thinking of keeping it in her? What happens when it comes out? It just doesn't make sense to me.

sugarcatmom
November 5th, 2009, 11:56 AM
Sorry, took me a while to respond and you've already answered some of my questions.


It's probably around 3 oz's of food, I've never measured it that way, but not enough to gain or maintain the weight.

Definitely needs to eat more. Try some of the tips I mentioned, but what you're aiming for is about 20-30 calories per lb per day. 3 oz of Wellness is only about 100-120 calories, and she needs at least 200 calories a day to maintain 10 lbs.

I am in agreement, so why do the vet's push it so much? For one thing it has tons of by-products in it.

They don't know any better. Vets get woefully limited education on feline nutrition, and what they do get is provided by the very pet food companies (ie Hill's) whose products they then sell out of their clinic. Big conflict of interest.

The suggestion of a stimulant was tossed out due to it's side effects of hard on the kidney's.


But starving and weight loss are even harder on the kidneys. As is a surgical procedure involving anesthetic. So if some of my tips to get her eating more don't work, I would seriously revisit the possibility of an appetite stimulant. You don't have to use it all the time. There is a good one called mirtazapine that is very effective.

tiggy2
November 5th, 2009, 12:04 PM
Thank you for getting back to me. I've just cancelled the feeding tube as I'm not 100% comfortable with it either and now that I have touched base with you guys I might be able to come up with some other solutions.

Tus does eat, just not a lot per feeding. She likes the Wellness brand and if she snubs that I sprinkle Sasha's blend on it and lap lap we go:)

I don't know what kind of supplements to give her. As for the appetite stimulant, it was tossed out because the vet felt it was too hard on Tus's kidney's. Are there other's that are not hard on the kidney's.

I will be asking for copies of the test results today and I hope you guys will stick with me to at least guide me in a direction..through the path of overload of information:))

Thanks again

mikischo
November 5th, 2009, 06:12 PM
She was a little over weight, small cat in general. She should weight I figure around 10 pounds, but she has lost muscle mass. So aside from the constant weight loss, (1/2 pound a month), it's the muscle mass that concerns me.

Proteinuria can also be a contributing factor to weight loss and possibly muscle wasting as well. When you get the test results, please also post some results of the urinalysis, in particular the urine specific gravity (USG) and the protein number.

I've just cancelled the feeding tube as I'm not 100% comfortable with it either and now that I have touched base with you guys I might be able to come up with some other solutions.

Great.:thumbs up

I don't know what kind of supplements to give her. As for the appetite stimulant, it was tossed out because the vet felt it was too hard on Tus's kidney's. Are there other's that are not hard on the kidney's

For stimulating the appetite, one of the safest things you might want to try for starters are the B vitamins, in particular Vitamin B12 (cyanocobalamin). B12 is known to help stimulate the appetite. All the B vitamins are very safe as they are water soluble and any excess will be excreted in the urine.

Also, if you haven't already done this, raising Tus's food and water dishes off the floor can be helpful. Sometimes cats with CRF can experience some nausea and it can help if they don't have to lower their heads so far when eating or drinking.

I will be asking for copies of the test results today and I hope you guys will stick with me to at least guide me in a direction..through the path of overload of information:))

Growler doesn't usually come on-line till very late and will likely be on late tonight. She is the most knowledgeable in explaining and interpreting the test results. If you get a chance to post the results today that would be great. For starters the most important numbers from the blood test are the urea, creatinine and phosphorus, including the reference ranges as well because they can vary slightly from one lab to another. Also the USG and protein numbers from the urinalysis.

tiggy2
November 5th, 2009, 09:22 PM
Ok got the blood test results, they are in mmol/L if that makes sense to you guys.

This was done Aug/25

Urea = 10.8 Ref. Range 6.4-11.8
Creat. = 162 Ref Range 67-157
Alk. Phos = 48 U/L Ref Range 14-49

This was done Oct/02
The Urinalysis came back with
PH = 6
Prot. = trace
USG =1.019

This was done Oct/02
Lab result of
ALT = 94 (Low 20 High 100)
BUN = 30 (Low 10 High 30)
CRE = 1.8 (Low .3 High 2.1)

The Aug blood work was a more in depth work up as opposed to the one in Oct.
Hope this makes more sense to you guys as it's rather over my head at this point:)

For stimulating the appetite, one of the safest things you might want to try for starters are the B vitamins, in particular Vitamin B12 (cyanocobalamin). B12 is known to help stimulate the appetite. All the B vitamins are very safe as they are water soluble and any excess will be excreted in the urine.

Can I try people vitamin B12, or do I need an animal one?

I have lifted the food up and I also give her Pepid AC 3 times a day (10mg cut into quarters)

I've put an email into the vet about your suggestions on Mirtazapine and the ACE Inhibitor's, I just hope she responds favourably, as I will need a prescription for them to try.

Anyway hope this info helps. Off to bed as Tus gets me up very early to feed her, she get hungary early:)

mikischo
November 6th, 2009, 12:14 AM
Can I try people vitamin B12, or do I need an animal one?

People vitamins are fine and might be worth a try to help with appetite.

I have lifted the food up and I also give her Pepid AC 3 times a day (10mg cut into quarters)?

The Pepcid AC should definitely be helping if there are any issues with nausea.

The Alk Phos value that you posted is actually the alkaline phosphate value and is a measure of liver function. There should also be a value for Phosphorus somewhere in the test results.

It looks like the first test was done in International Units and the second one in U.S. units? In Canada International Units are normally used.

Given a diagnosis of early stage CRF and the issues Tus has been having with weight loss and lack of appetite, I am quite surprised that the urea and creatinine numbers are not higher, although the USG is definitely low.:confused:

growler~GateKeeper
November 6th, 2009, 01:23 AM
Hi Tiggy2, welcome to the CRF club :grouphug:

First lets talk about how Tus is feeling, what's her energy level like? does she sleep constantly are you having to wake her to feed, is she playing/active, interested in the world beyond the windows? Are her spirits high or is she cranky all the time?

Any unusual symptoms? Does she feel cold? Does she grind her teeth? Is she at the water bowl for long periods?

What's her poop like? How often is she peeing?

Good decsion not to go the feeding tube route at this point, as mentioned above lets try special toppings on the food & a bit of variety first. Will she eat cooked chicken breast? Duffy loves Purebites Chicken (http://www.purebites.com/ProductsCatEng/productschicken_cat.html) it definately helps encourage eating. I've also baked plain chicken breast pieces with even better results. Also adding in a different food once in a while helps peak interest in meal time.

Ok got the blood test results, they are in mmol/L if that makes sense to you guys.

This was done Aug/25

Urea = 10.8 Ref. Range 6.4-11.8
Creat. = 162 Ref Range 67-157
Alk. Phos = 48 U/L Ref Range 14-49

This was done Oct/02
The Urinalysis came back with
PH = 6
Prot. = trace
USG =1.019

This was done Oct/02
Lab result of
ALT = 94 (Low 20 High 100)
BUN = 30 (Low 10 High 30)
CRE = 1.8 (Low .3 High 2.1)

The Aug blood work was a more in depth work up as opposed to the one in Oct.
Hope this makes more sense to you guys as it's rather over my head at this point:)

Are all other numbers in normal range?

The Oct blood work in actually in US values in comparison to the Aug which is in SI units, so to make it easier to read I've converted it here:

................Aug................Oct
BUN/Urea...10.8...............10.71
Creatinine..162................159.12

The kidney numbers are fairly stable, dropping just slightly :thumbs up and honestly not that high. The other 2 you posted Alk Phos & ALT are liver enzymes which indicate the health of the liver but can increase due to the kidneys because most everything is filtered through them, just something to keep an eye on at this point.

Tus only has a trace amount of protein in the urine at this point I wouldn't think that was the main cause of the weight loss, more likely it is nausea especially since Tus is already on Pepcid.

What is more concerning at this point than the proteinuria is the USG, that's quite a low number for a cat not currently on fluid therapy. Have you noticed a marked increase in Tus' drinking & peeing? Has the vet mentioned Tus being dehydrated? If you were to run your finger along Tus' gums are they dry & sticky feeling or wet & slick with saliva?

For stimulating the appetite, one of the safest things you might want to try for starters are the B vitamins, in particular Vitamin B12 (cyanocobalamin). B12 is known to help stimulate the appetite. All the B vitamins are very safe as they are water soluble and any excess will be excreted in the urine.

Can I try people vitamin B12, or do I need an animal one?

Vit B12 is the one generally recommended but should always be under the direction of the vet as excess vitamins can be harmful, some multi-vitamins can be too high in vit a & d for a crf cat. Human varieties may not have appropriate values for cats needs most especially Taurine, plus they are weight based on an adult human. If you want to start a Vit supplement I recommend Nu Cat Senior (http://www.vetriscience.com/nu-cat-senior.php) your vet can order it in for you or if you have a smaller pet specialty or rawfood store they may carry it or you can order online.

I have lifted the food up and I also give her Pepid AC 3 times a day (10mg cut into quarters)

Did the vet recommend 3 quarters per day? Was she vomiting often? How is that working for Tus, have you seen a marked improvement with little to no vomiting/lip licking/nausea?

I've put an email into the vet about your suggestions on Mirtazapine and the ACE Inhibitor's, I just hope she responds favourably, as I will need a prescription for them to try.

Anyway hope this info helps. Off to bed as Tus gets me up very early to feed her, she get hungary early:)

Does she eat more in the morning feeding than the others? Do you give her a bigger portion size then? What time is the last feeding of the night?

tiggy2
November 6th, 2009, 08:45 AM
Wow you guys certainly zoom in on the topic, more so then the vet??:)

Anyway I'll just answer all the questions here with a starting story.

We moved from Ontario to NB last Sept/08, moved into new house Dec/08, I noticed Tus losing weight around Feb/09 and her breath was just terrible. She was not eating well and she would eat on one side of her mouth, so my first thought was teeth. Took her to first vet, we did blood work and they cleaned her teeth and took one tooth out. Charged an exorbitant amount of money for that $700.00 and I never took her back there again. At this point we are eating dry food and a different type then when we were in ON.

The weight continued to drop, found another vet, did the blood work. The Oct. ones and as you guys noted not a big indicator for CRF, but with the weigh loss and nothing else showing up we were leaning towards CRF.

At this point I was switching all of them to wet food and going through the "not wanting to eat this crap" hassle so I figured maybe that was why the weight loss.

I went back again in Aug. that's when they did the blood work in the office and then the urine test and arrived at the CRF. I was sent home with protein reduced food, (which of course she did not eat and I stopped giving:)) Benazepril for blood pressure and suggested to get pepid ac, as CRF cats are known to have stomache upset.

As for behaviour, the only real change is in the morning she is very agitated, I have to get up feed her and then she will settle down. I noticed she was licking her lips a lot and trying to vomit ( she vomited the first time about a month ago in 15 years). So she gets fed at around 5am then every 4 hours until 11pm. Most of the time she is looking for treats and if she is looking I give her food. If she snubs it, I put Sasha's blend on top and that does the trick. She likes the wellness Turkey and Salmon and there's one that has sardines in it, stinks real bad and I can't always get, it but that one goes down well. The BC (Before Grain) wet foods are a hit but can be expensive as they only come in small cans. The cooked meats are snubbed but I continued to try new things.

Her gums around her teeth seem pale and when she eats her food, which is wet, plus I add water to it, it's like she has to chew it, like it's too dry?? She is dehydrated. I talked to the vet about Sub-q fluids and she is hesitant due to the Sub-q's causing hyper tension in cats and screwing up the electrolytes in the body?

There is no phosphorus reading on the blood work, I guess they forgot that one?

As for drinking more, not that I noticed and as for peeing more not that I noticed and with a muti cat house hold I can't tell by looking in the kitty litter. I don't think she is going any more than usual. No one is the house hold has loose bowels, sometimes the stool can be dry and small.

If there is a way to track it let me know. In some ways she seems more in tune with her surrounding and I don't know if it's because she wants something and therefore is around more?

I guess that's the scoop, so where to go from here? I'm waiting to hear back from the vet on the info I sent her on the appetite stimulant and the ACE Inhibitors. Until then I'll have to continue with the feeding every 4 hours. Any suggestions on the dehydration?

Thanks again guys I can't thank you enough for helping me out with this. Takes a hugh weight off my shoulders. As you can tell I'm very new to the forums as I don't even know how to inset the quotes from others:laughing:

Sorry if I did not answer the questions properly or to the correct person. I'll get it eventually. I'll even get some Pic's of the old gal so you can see who you're helping out:pawprint:

tiggy2
November 6th, 2009, 08:57 AM
PS
One little thing I thought I'd mention.

The hair on the back of the right rear leg is gone, from the join to the ankle. So one leg is partially bald. It's been like that since Feb or March. She also has feline ache, and therefore scratches her chin and mouth frequently. The ache I clean when I notice it.

Don't know if it has any relevance, but knowledge is power!!

Thanx

tiggy2
November 6th, 2009, 09:22 AM
An exciting update

My vet just called and we're going to put try Tus on the Mirtazapine for the Appetite and she's going to put her out and have a look in her mouth and stomach to see if anything is wrong as well put her on IV fluids for the day. We'll go from there.

So at least she's willing to look at other options and work with me:goodvibes:

growler~GateKeeper
November 6th, 2009, 11:32 PM
Benazepril for blood pressure and suggested to get pepid ac, as CRF cats are known to have stomache upset.

Did they actually check her blood pressure & what was the number do you know? Or did they put her on the bp meds because of the CRF?

As for behaviour, the only real change is in the morning she is very agitated, I have to get up feed her and then she will settle down.

When they get hungry & aren't fed promptly sometimes the stomach acid will cause nausea since there is nothing in their stomach for it to work on, and that makes them cranky, especially if she knows the nausea is coming soon. My grrl usually gets me up around 5-530am for breakfast too :)

Her gums around her teeth seem pale and when she eats her food, which is wet, plus I add water to it, it's like she has to chew it, like it's too dry?? She is dehydrated. I talked to the vet about Sub-q fluids and she is hesitant due to the Sub-q's causing hyper tension in cats and screwing up the electrolytes in the body?

There is no phosphorus reading on the blood work, I guess they forgot that one?

Re Phosphorus on the test, depends on which test they ran, most of the standard tests do check for phos, calcium, potassium etc.

Did the bloodtest have RBC, WBC, Hgb, PCV, HCT, MCV on it?

A couple of the symptoms you've mentioned (pale gums, lack of appetite, vomiting, lip licking, that specific "chewing" action with the watered wet food, blood pressure meds) are making me think anaemia. To check for this the Packed Cell Volume or Haematocrit needs to be tested. Ask your vet about checking the red blood cell levels for anaemia before she is anaesthetized. While she is looking at her teeth she can also check for mouth ulcers which are also common in CRF cats, can cause lack of appetite & the teeth-grinding-like chewing.

As for drinking more, not that I noticed and as for peeing more not that I noticed and with a muti cat house hold I can't tell by looking in the kitty litter. I don't think she is going any more than usual. No one is the house hold has loose bowels, sometimes the stool can be dry and small.

Most likely she is peeing more considering she is not concentrating her urine as she should be, plus drinking more to compensate for the water loss, this is reflected in the dehydration & the small dry poops. Often the CRF cat's body will pull water from everywhere (including poop) in order to reuse it throughout the body (which is why they normally concentrate urine), this attests to their desert heritage & low frequency of water drinking.

Any suggestions on the dehydration?

Depending on Tus' disposition you can have the vet show you how to properly syringe-feed water, this stresses many cats out far more than the benefit of the additional water so that may be a deciding factor there. There is also the option of a water fountain - some prefer running water, or adding a small amount of flavouring to the water - boiling a plain no salt added chicken breast & using some of the now-chicken-flavoured-water from that to add into the bowl.

The hair loss on the back leg could just be ill-health related, unless she is reacting to fleas, laundry soap from the blankets, etc. Have you noticed her washing alot there? Is she pulling the hair out?

Re the acne - what type of bowls do you use for food & water? Plastic? Stainless steel? Plastic bowls have been known to harbour bacteria even after repeated washings which may cause feline acne in some cats as they contact the sides of the dish.

Through the years I've also noticed my dogs & cats (who don't use plastic bowls, except for the current water fountain) have gotten short duration acne in their "teen years" 12-15yrs that clears up fairly quickly not to return.

tiggy2
November 7th, 2009, 08:27 AM
Hi Growler

Thank you for getting in touch with me. Your advice helps keep me on track and not get lost in the tons of information out there:angel: Allows me to zero in on specific areas

Did they actually check her blood pressure & what was the number do you know? Or did they put her on the bp meds because of the CRF?

No checking of blood pressure, just put her on it with the assumption of high blood pressure. Any issues with putting her on it without checking blood pressure. Vet said it was very difficult to check cat's BP

When they get hungry & aren't fed promptly sometimes the stomach acid will cause nausea since there is nothing in their stomach for it to work on, and that makes them cranky, especially if she knows the nausea is coming soon. My grrl usually gets me up around 5-530am for breakfast too :)

I try and feed her as late as possible, but between 5 and 6 up we must get. Of course the rest of the guys are just loving this early morning feeding. They are getting into the habit now:)

Re Phosphorus on the test, depends on which test they ran, most of the standard tests do check for phos, calcium, potassium etc.

They forgot the Phosphorus test on this one, we're going to see if they still have a sample of her blood and can check it and of course do a check this time around.

Did the bloodtest have RBC, WBC, Hgb, PCV, HCT, MCV on it?

None of those things were on it. It was a "Senior Wellness " test

A couple of the symptoms you've mentioned (pale gums, lack of appetite, vomiting, lip licking, that specific "chewing" action with the watered wet food, blood pressure meds) are making me think anaemia. To check for this the Packed Cell Volume or Haematocrit needs to be tested. Ask your vet about checking the red blood cell levels for anaemia before she is anaesthetized. While she is looking at her teeth she can also check for mouth ulcers which are also common in CRF cats, can cause lack of appetite & the teeth-grinding-like chewing.

I will ask her to check for anaemia as well. Thanks for the heads up on that one.


Most likely she is peeing more considering she is not concentrating her urine as she should be, plus drinking more to compensate for the water loss, this is reflected in the dehydration & the small dry poops. Often the CRF cat's body will pull water from everywhere (including poop) in order to reuse it throughout the body (which is why they normally concentrate urine), this attests to their desert heritage & low frequency of water drinking.

I'll try and keep an eye on her and catch her going into the litter box, might be able to see if she is at least peeing large amounts.

Depending on Tus' disposition you can have the vet show you how to properly syringe-feed water, this stresses many cats out far more than the benefit of the additional water so that may be a deciding factor there. There is also the option of a water fountain - some prefer running water, or adding a small amount of flavouring to the water - boiling a plain no salt added chicken breast & using some of the now-chicken-flavoured-water from that to add into the bowl.

I have 2 water fountains, 1 in the kitchen and 1 close to the bedroom for the arthritic cat, she doesn't have to walk as far at nite. But putting a chicken flavour to the water might work. Would the chicken additive also add bacteria? Would I have to clean it out every day? Force feeding is not top on my list. This was one of the reason the vet wanted to put a feeding tube in was to get more liquids into her:(

I've also onto putting low sodium tuna water into the cat food and making it very soupy. But did I read somewhere that tuna is not good for cats? If I can do this option. I would blend the tuna up and use it as an additive to the cat food and make her food even soupier.


The hair loss on the back leg could just be ill-health related, unless she is reacting to fleas, laundry soap from the blankets, etc. Have you noticed her washing alot there? Is she pulling the hair out?

She maybe doing it to herself. If I catch her licking that area I get her to go to another area.

Re the acne - what type of bowls do you use for food & water? Plastic? Stainless steel? Plastic bowls have been known to harbour bacteria even after repeated washings which may cause feline acne in some cats as they contact the sides of the dish.

She used to use plastic, but I've changed to glass bowls as I read about the plastic and ache. She's had this for most of her life and sometimes it will get so bad that her chin get all swollen from large under the skin growths. I use an antiseptic wash for a couple of days and it goes away. It also goes around her mouth and of course she scratches it making it worse. It comes and goes, maybe she has PMS:laughing:

Through the years I've also noticed my dogs & cats (who don't use plastic bowls, except for the current water fountain) have gotten short duration acne in their "teen years" 12-15yrs that clears up fairly quickly not to return.

Hopefully she will grow out of it:)


I have a question since you obviously have a multi animal house hold. How do I keep my other kitties from getting any fatter with me feeding Tus every 4 hours? I could put Tus in a separate room but I'm afraid they'd pick on her more. She's lowest on the totem pole.

Also how to you put in the quotes from your posts, so I don't have to bold them:)

growler~GateKeeper
November 8th, 2009, 12:50 AM
No checking of blood pressure, just put her on it with the assumption of high blood pressure. Any issues with putting her on it without checking blood pressure. Vet said it was very difficult to check cat's BP

The problem I have with that is it is a potentially unneccessary medication. There are a few different bp meds that are commonly used in cats but the blood pressure should be monitored during use otherwise how does the vet know if they have the correct dose or when they need to increase the dose? Depending on certain bloodwork numbers some of the meds should be avoided for potential conflicts, ie some meds may cause increase in potassium levels which should be avoided if a cat already has high potassium, some meds may exacerbate anaemia, etc.

Some vets won't check a cats bp because they feel the cat's bp is not going to read accurately in clinic due to stress but that likely would only affect it by about 20 pts. With the proper equipment it's not difficult to check, they shave a small area on the back leg place the cuff & check the reading, ideally it should be between 120-149. My CRF cat had her bp checked during 2 stressful exams from vet's she hadn't seen before in unfamiliar clinics one being the Emergency vet and both times her bp was 120, perfectly normal.

They forgot the Phosphorus test on this one, we're going to see if they still have a sample of her blood and can check it and of course do a check this time around.

None of those things were on it. It was a "Senior Wellness " test

Phosphorus especially & calcium are very essential parts of the CRF diagnosis and treatment course.

The Senior Wellness panel should have at least 25 entries under Blood Chemistry (phos, calcium, ALT, Alk Phos, BUN, Crea, Glucose, Albumin, globulin, sodium, CPK etc) plus a Complete Blood Count (WBC, RBC, Hgb, PCV, HCT, MCV, plasma count etc) tested and the Urinalysis.

Perhaps they have the same name for a different series of tests. The full test might be called a Feline Senior Complete Panel.

I'll try and keep an eye on her and catch her going into the litter box, might be able to see if she is at least peeing large amounts.

It's not always large amounts but may be more frequent trips.

I have 2 water fountains, 1 in the kitchen and 1 close to the bedroom for the arthritic cat, she doesn't have to walk as far at nite. But putting a chicken flavour to the water might work. Would the chicken additive also add bacteria? Would I have to clean it out every day? Force feeding is not top on my list. This was one of the reason the vet wanted to put a feeding tube in was to get more liquids into her:(

I've also onto putting low sodium tuna water into the cat food and making it very soupy. But did I read somewhere that tuna is not good for cats? If I can do this option. I would blend the tuna up and use it as an additive to the cat food and make her food even soupier.

The "chicken water" won't add bacteria - it's cooked & you probably don't need very much. You could always try a small amount a tablespoon or two in a regular bowl of water see if they like it before adding it to all the bowls.

Tuna is very addicitive for cats sometimes to the point where they refuse to eat anything else. It also is high in sodium and depletes the body's store of vitamin e causing an imbalance. Try plain slightly warm water.

I have a question since you obviously have a multi animal house hold. How do I keep my other kitties from getting any fatter with me feeding Tus every 4 hours? I could put Tus in a separate room but I'm afraid they'd pick on her more. She's lowest on the totem pole.

I used to have a multi pet household, right now I just have my CRF grrl Duffy. When I did, the 2 cats were always either fed at opposite ends of the room or in different rooms. My last dog was fed also in a separate room & the 2 dogs before him were fed in the same room but opposite ends.

You could feed Tus her regular meals in a separate room, and the others a small treat instead of full meals like Tus.

Also how to you put in the quotes from your posts, so I don't have to bold them:)

When you read to the bottom of my post there is a button on the right hand corner that says Quote when you click that it will put my entire response in your reply box.

To separate into different quote parts - in your reply box you can either highlight what you want & click the pale yellow button to the left of the # (on the same line of buttons where the Bold is) that will separately quote only what you've highlighted. Or in your reply box with a full post quoted you can copy the code that starts the quote looks like this [QUO to the end of the numbers be sure to include the end bracket ], then paste that infront of the line you want and at the end of the line type [/QUOTE] you can then separate one post into several quotes and type a response in between, this way you can also remove extra wording.

tiggy2
November 8th, 2009, 11:26 AM
Her CL is high could just mean she is dehydrated and her CO2 is high which also could just be dehydration and could be causing the acidic issues.

I think I have all I need to do this time around. Of course we're checking her mouth and I'll be putting her on IV fluids for the day. At least that will help. This vet is not to keen on Sub-Q fluids, supposedly there are new studies out that say that Sub-Q fluids can cause Hypertension in cats. It's better to have them ingest the fluids, if only it was that easy:))

Thanks again for all your assistance. I'll keep you in the loop about tomorrow.:fingerscr

If I missed anything let me know as I know you'll pick this up later and I'll get your response before I go in tomorrow:))

tiggy2
November 8th, 2009, 11:28 AM
OK

My post got all messed up and I had the whole thing done:wall:

and I did it the right way too, I was sooo proud. Now I'll have to go back and redo it.

So what you see above is the last bit:sorry:

tiggy2
November 8th, 2009, 11:48 AM
The problem I have with that is it is a potentially unneccessary medication. There are a few different bp meds that are commonly used in cats but the blood pressure should be monitored during use otherwise how does the vet know if they have the correct dose or when they need to increase the dose?

I'll be asking to have her BP done tomorrow and as it is she has a bald spot on her back leg already:) I presume it would not matter that she is anaesthetized for it?

vets won't check a cats bp because they feel the cat's bp is not going to read accurately in clinic due to stress but that likely would only affect it by about 20 pts.

This is what my vet said, and that it stressed the cat out and that it's hard to keep the cat still.


Senior Wellness panel should have at least 25 entries under Blood Chemistry (phos, calcium, ALT, Alk Phos, BUN, Crea, Glucose, Albumin, globulin, sodium, CPK etc) plus a Complete Blood Count (WBC, RBC, Hgb, PCV, HCT, MCV, plasma count etc) tested and the Urinalysis.


Mine has 15 ( Sodium, Pot., NA:K Ratio, Chloride, Calcium, Urea., Creat., Glucose, Alk. Phos., ALT (GPT), T. Pro., Albumin, Globulin, A;G Ratio and T4 baseline.) The Urine test was just, Ph, Prot., and USG.

Supposedly they have a blood test specific for CRF so I guess we'll be going for that.

"chicken water" won't add bacteria - it's cooked & you probably don't need very much. You could always try a small amount a tablespoon or two in a regular bowl of water see if they like it before adding it to all the bowls.

A good idea, I'll put some in a bowl for her and put it by her sleeping spot.


Tuna is very addicitive for cats sometimes to the point where they refuse to eat anything else.

Thought it was too good to be true:)

I only use it as an additive. I also found she like chicken and broth baby food. Also use it as an additive, for those fussy days, I put a small amount on top of the wet cat food

could feed Tus her regular meals in a separate room, and the others a small treat instead of full meals like Tus.

I'll try this and/or feed the fat cats less.

in your reply box with a full post quoted you can copy the code that starts the quote looks like this [QUO to the end of the numbers be sure to include the end bracket ], then paste that infront of the line you want and at the end of the line type you can then separate one post into several quotes and type a response in between, this way you can also remove extra wording.[/QUOTE][/QUOTE]

Thank you for this, now I don't feel like a :loser:. Of course I had to do it twice, I'll consider it practice:)

So tomorrow is the big day for Tus, I think I have all my notes.. I need to have her HCT and HGB checked to see if she is anemic. She also has high ALT which could indicate liver damage or issues with her bile duct. Her potassium is very low, so I'll need some supplements for that, (any suggestion).

The rest of the post is below, now you have it all:D

I'm just gonna post this without checking it, that's how I lost the last one, so I apologies for any mistakes.

growler~GateKeeper
November 8th, 2009, 10:28 PM
I'll be asking to have her BP done tomorrow and as it is she has a bald spot on her back leg already:) I presume it would not matter that she is anaesthetized for it?

They should do it before anaesthia cuz once she's under her heart rate & bp will be slightly slower & more even thus creating a false reading. It takes less than 5 mins for a check.


I also found she like chicken and broth baby food. Also use it as an additive, for those fussy days, I put a small amount on top of the wet cat food

Just be sure there are no onions in the baby food.

I need to have her HCT and HGB checked to see if she is anemic. She also has high ALT which could indicate liver damage or issues with her bile duct. Her potassium is very low, so I'll need some supplements for that, (any suggestion).

ALT is still in normal range so I wouldn't worry too much about that right now, unless she is showing signs of liver issues. The values do fluctuate all the time so it might have just been on the high side of normal when they tested her and lower at some other point during the day.

She has low potassium? Is it still in normal range or below that? The vet will have supplement options for you, potassium should never be supplemented without vets approval as it can be very dangerous if not neccessary.

Her CL is high could just mean she is dehydrated and her CO2 is high which also could just be dehydration and could be causing the acidic issues.

Yes high CL can indicate dehydration and the conflict with low potassium levels may result in metabolic acidosis (excess stomach acid, nausea etc) though there are other factors in that equation.

:goodvibes: Tus for tomorrow

tiggy2
November 9th, 2009, 08:31 PM
Hi Growler

I'll just post a brief update as I don't have all the info until all the test results come back tomorrow. We have to send out some of our tests.

SO far Tus is not anemic :thumbs up. Her kidney readings have not changed very much and the protein in her urine has decreased. A good sign in some ways but it does not explain the not eating and the upset stomach and extra acid. Her throat is irritated, could be because she has been throwing up this weekend, something she has not done before:( Not in 15 years

We are waiting on the other test results but are afraid it could be stomach cancer as the kidney's do not seem to be a major issue and if her liver is good then I am at a loss as to what is causing the upset stomach and extra acid.

So another sleepless nite, but at least she's home:) I'm feeding her some baby food now and then I'll blend up the cat food to make it easier on her throat.

I'll get copies of the test results tomorrow and post them and then I'll have to dive into more research if nothing shows up.

Thanks for hanging with me and keep the paws crossed for some good news:fingerscr.

Chat tomorrow

sugarcatmom
November 9th, 2009, 10:15 PM
To help sooth her throat and stomach, mix 1/4 tsp of slippery elm bark powder in with the baby food (along with an extra couple tsps of water).

All fingers/toes/paws here are crossed that you're not dealing with something as serious as stomach cancer. :fingerscr

growler~GateKeeper
November 10th, 2009, 12:06 AM
Good there is no anaemia :goodvibes: :fingerscr that is it not stomach cancer or pancreatitis :goodvibes:

tiggy2
November 11th, 2009, 12:52 PM
Ok I have all the test results but we, vet and I are still at a loss as to what's wrong with Tus. The vets's main concern is with her USG which is 1.020, which is too diluted. Her cholesterol and Alk Phos. are on the high side as well and I'm thinking maybe cushing's disease?

Anyway I'll post the results with the reference next to it, see if anything pops with you.
Reference
Sodium 154 149-156
Potassium 4.2 3.3-5.2
Na:K Ratio 37
Chloride 121 112-122
Calcium 2.59 2.28-2.85
Phosph. 1.38 0.94-1.95
Urea 11.6 6.4-11.8
Creat. 145 67-157
Cholesterol 6.31 1.80-5.83
T. Bili 1 0-4
Alk. Phos. 54 14-49
CK 181 58-489
AST (GOT) 27 11-44
ALT (GPT) 60 34-90
Gamma-GT 0 0-6
T. Pro. 69 65-84
Albumin 32 25-37
Globulin 37 35-54
A:G Ratio .86 0.50-0.90
Lipase 100 16-139

WBR 9.0 4.7-17.0
RBC 8.58 6.4-11.5
HGB 124 89-156
HCT .368 .28-.44
MCV 42.9 35-52
MCH 14.5 12-17
RDW 22.9%
Retics .41% = 35.18 x 10E9/L


WBC Diff. (%) (x10E9/L)
Segs 64% 5.76
Eos 17% 1.53
Lymph 13% 1.17
Mono 6% 0.54

NRBC / 100 WBC


PLASMA
Protein 72 g/l

RBC Morphology
Heinz NONE

So there you have it

Some I understand, some I don't.

So any ideas or suggestions on what to look for or where to look would be appreciated, as I don't think the kidneys are the main issue, they are a factor but there is something else going on that needs to be addressed.

Right now we have her on Pepid AC, I have a script for Zantex liquid, if the pepid is not working. I think I'll try and track down some of the slippery elm bark. Also have her on Amitriptyline - 5mg in the evening to help with her appetite and hopefully her gnawing on her back legs, and I still give her the benazepril, but I might give it to her every other day, still debating that one.

Anyway back to the drawing board, as the vet still thinks it's a cancer that has not manifested itself. Maybe so, but this illness has been going on for almost a year now, seems kinda long for a cancer and no serious decline:confused:

Also looking into poisons plants a long shot, but you never know:)

Chris21711
November 11th, 2009, 12:58 PM
tiggy - Growler is normally the one who reads the test results. She normally is on later in the day, although Wednesday is her day off, maybe she will pop in a bit earlier today.

tiggy2
November 11th, 2009, 03:50 PM
Hi Chris21711

Do you know anything about cushing's disease or anyone else have knowledge on it. If someone had some knowledge about it I might be able to rule it in or out as an illness.

Thanks for the response.

I guess Growler has gotten very good at reading tests results:)

sugarcatmom
November 11th, 2009, 04:39 PM
Do you know anything about cushing's disease or anyone else have knowledge on it. If someone had some knowledge about it I might be able to rule it in or out as an illness.


Cushing's is extremely rare in cats, and usually manifests as uncontrollable diabetes. What makes you suspect Cushing's? One thing I don't see on your lab results above is a blood glucose value. Do you know if they tested for it?

tiggy2
November 11th, 2009, 06:51 PM
Hi

The only glucose I have is just the Glucose at 6.1 which is a little high as 6.7 is the top of the scale.

As for cushing's. I read that having high ALK Phos. and high Cl values could indicate cushing's as well as the USG of around 1.020. That's the only guess I have and believe me it's a guess. I'm grasping at anything to find out what's wrong with Tus as I don't want her suffering if it's something terminal or if it's something that can be fixed.

So any suggestions on what it could be I'm all ears..or eyes in this case:))

growler~GateKeeper
November 12th, 2009, 12:55 AM
Urea & Creatinine are both back into normal range with the urea just on the high edge which could have indicated a kidney infection or just the dehydration. The liver enzymes with the exception of Alk Phos are normal, Chloride on the high edge, the high cholesterol and the symptoms presenting I would suspect Cushing's (http://www.cat-world.com.au/hyperadrenocorticism-cushings-syndrome), Liver disease (http://www.cat-world.com.au/liver-disease-in-cats), Pancreatitis (http://www.manhattancats.com/Articles/pancreatitis_test.html) or cancer (http://www.manhattancats.com/Articles/Feline_Cancer.html). Alk phos and cholesterol can be indicators of liver or bile duct obstructions, all of the symptoms presented occur with Pancreatitis but high lipase and amylase are almost always occur, Tus' lipase is normal & the amylase is not listed.

Were there any notes at the bottom of the test from the Lab Dr?

If it was my cat I would have an abdominal ultrasound done to try to rule out some of the possibilities as this will give a clearer picture of what is happening in the abdomen and will show any inflammation, enlargement or tumors. :2cents:

:goodvibes: :grouphug:

tiggy2
November 12th, 2009, 10:22 AM
Urea & Creatinine are both back into normal range with the urea just on the high edge which could have indicated a kidney infection or just the dehydration.

Her Urea and Creat were always in the normal high range which is why the kidney issue was always a puzzle, especially since the other problems kept coming up.

liver enzymes with the exception of Alk Phos are normal, Chloride on the high edge, the high cholesterol and the symptoms presenting I would suspect Cushing's (http://www.cat-world.com.au/hyperadrenocorticism-cushings-syndrome), Liver disease (http://www.cat-world.com.au/liver-disease-in-cats), Pancreatitis (http://www.manhattancats.com/Articles/pancreatitis_test.html) or cancer (http://www.manhattancats.com/Articles/Feline_Cancer.html). Alk phos and cholesterol can be indicators of liver or bile duct obstructions, all of the symptoms presented occur with Pancreatitis but high lipase and amylase are almost always occur, Tus' lipase is normal & the amylase is not listed.

This is always been the puzzle. There would be 1 or 2 things that would point in a direction of some disease like the CRF but then the other pieces of a disease would not fit. or some other flag would go up that would not fit. What I find the most frustrating is that she could have X illness that could be resolved with Y medication but we can't find out what X is:wall:


there any notes at the bottom of the test from the Lab Dr?

There was no other notes on this report. On the Aug report was her T4 in normal range so hyperthyroidism could not be diagnosed. No liver enzyme increases to flag one for hyperthyroidism. The mild increase in creatinine could be early signs of CRF. At this point I thought it might be her thyroid causing weight loss.


it was my cat I would have an abdominal ultrasound done to try to rule out some of the possibilities as this will give a clearer picture of what is happening in the abdomen and will show any inflammation, enlargement or tumors.

This was the suggestion of my vet. They just got a new ultasound machine in, so it would be a good time to have her done.

I just have to wait a little while for the dust to settle on the last visit. Since she came home smelling like the vet, "my boy" decided he did not like the foreign smell and sprayed the bed room where she slept, and since Tus was full of fluids and doped up she pee'ed on the bed. It's taken me 2 days, 4 loads of laundry and about a litre of Nature's Miracle to get the smell out of the bed room. Not a happy mom with my boy, Tig.:mad: But hey I have a very clean bedroom:)

Oh one question. Any thought on the USG of 1.020? The vet seems to be very worried about this. I don't quite understand why??

and please give all the :2cents: you can, it's your advice that's gotten me this far.

Thanks

sugarcatmom
November 12th, 2009, 12:32 PM
A glucose of 6.1 is perfectly normal. I wouldn't worry unless it goes over about 8-ish, and even then it could be stress-induced hyperglycemia.

One of the key Cushing's symptoms is thin, fragile skin that tears easily, so I'm just really doubtful that is what you're dealing with here.

On the Aug report was her T4 in normal range so hyperthyroidism could not be diagnosed.

Not necessarily. Do you know what the value was, and do you have any previous T4 values for her? The normal range for T4 also includes young cats, which naturally have higher T4 values than older cats, thus skewing what the range should be for seniors. As cats age, their T4 would typically start going down, not increasing, so anytime there is an increase, even if that number still falls within "normal", it should be investigated further. Having a Free T4 done at the same time as the T4 would give more precise results.


Oh one question. Any thought on the USG of 1.020? The vet seems to be very worried about this. I don't quite understand why??


It basically means her urine is very dilute. Normal is between about 1.035 to 1.060. So the question becomes, what is going on that Tus is unable to concentrate her urine? I agree that maybe an ultrasound would be a good idea, but you would want someone knowledgable interpretting the results.

growler~GateKeeper
November 12th, 2009, 11:58 PM
Her Urea and Creat were always in the normal high range which is why the kidney issue was always a puzzle, especially since the other problems kept coming up.

Pretty much what is happening at this point is Tus has pre renal atozemia.

Azotemia is the medical term for an increase in the BUN or creatinine. Uremia is defined as azotemia plus clinical signs of renal failure such as anemia, polyuria-polydipsia, vomiting, or weight loss. Azotemia is divided further into prerenal, renal, or postrenal causes. Prerenal azotemia is due to causes other than actual kidney malfunction that decrease the blood flow to the kidney. These include dehydration, Addison's disease, or heart disease, *can also be from issues with the tubes leading into the kidneys*. Renal azotemia occurs due to damage to the kidney itself, and can include chronic or acute renal disease/failure that results in more than 75% of the kidney not functioning. Postrenal azotemia occurs when there is a build-up of pressure in the urinary system. Causes may include blockage of the urethra due to feline lower urinary tract disease (FLUTD) or bladder stones, which prevent urine from being removed from the body.

It doesn't mean there isn't also something else happening at the same time.

There was no other notes on this report. On the Aug report was her T4 in normal range so hyperthyroidism could not be diagnosed. No liver enzyme increases to flag one for hyperthyroidism. The mild increase in creatinine could be early signs of CRF. At this point I thought it might be her thyroid causing weight loss.

Interesting, my lab reports always have some little note from the lab's Dr at the bottom. :shrug:

Increased liver enzymes are not always present with HyperT, but one symptom of HyperT that 99.9% of affected cats have is obviously increased hunger.

Any thought on the USG of 1.020? The vet seems to be very worried about this. I don't quite understand why??

Feline urine in the range of 1.013 - 1.034 is considered moderately concentrated, when in this range and combined with dehydration it may be considered inappropriately dilute, with more investigation necessary.
Inappropriately dilute urine <1.035 in combination with dehydration can indication renal insufficiency oither possible causes are liver disease, pyelonephritis (ascending urinary tract infection that has reached the kidneys) or major electrolyte imbalances - of which Tus' are fine.

http://www.iris-kidney.com/education/en/education05.shtml

tiggy2
November 16th, 2009, 06:18 PM
An update on Tus

We're going in tomorrow morning for an Ultra sound. I did the shaving here so she does not have to spend as much time there and of course 1 less traumatic event for the poor gal.

I'm starting to feel bad with all the bet visits, this is the most times she has ever been to the vet in 15 years, she's never been sick. Lucky I guess:)

Actually I noticed when I was shaving her, I had her on her back and holding her belly, so urine dribbled out. Do cats, like people, have bladder control issues, or could it be something else?

Anyway I'll keep you up to date and if there is anything else I can ask the doc. about, as always let me know.

Thanks again for the support.

Paws and claws crossed, but I got a bad feeling:((

Love4himies
November 16th, 2009, 07:15 PM
Good luck tomorrow, tiggy :goodvibes: :goodvibes: :pray: :fingerscr. I hope if you find anything, it is easily taken care of. :grouphug:

tiggy2
November 16th, 2009, 09:36 PM
Thank you Love4

I'm hoping as well, that would be nice:)

growler~GateKeeper
November 17th, 2009, 12:23 AM
Actually I noticed when I was shaving her, I had her on her back and holding her belly, so urine dribbled out. Do cats, like people, have bladder control issues, or could it be something else?

Yes sometimes they do have bladder control issues, possibly Tus had a full bladder & being upsidedown put enough force on the bladder to cause a small leakage, it could also have just been a reaction to the stress of being shaved :shrug:

:goodvibes: for the U.S. tomorrow

tiggy2
November 17th, 2009, 12:45 PM
Hi

We're back from the vet. Tus did well with the Ultra Sound:), just growled a bit.

Anyway her liver is good, her kidneys are as expected for a cat her age, but her pancreas is enlarged. The vet said, if you can see the pancreas it usually means problems?? So...it leaves me to believe she has pancreatitis.

I have some antibiotics for her in case she has bladder issues from the dribbling pee. I did not want to stick another needle in her belly to make sure, so but her on the antibiotics. Vet also suggested a high fibre/low fat diet.

So that's were we stand now. Any suggestion from you guys? Gee's I can't believe how tired I am. Just wish I could know for sure what's going on and deal with it:sad:

Also tired of all the different research I've had to do, and now my boy has started to chew his belly up and Rosie is " not well" either:(OK that's my complaining for the day, thanks for listening:)

rjesak
November 17th, 2009, 01:32 PM
I so get it Tiggy!!! One of cats has completely different problems but I'm just so tired of worrying about him :sad: and trying to digest all the different information I'm getting:confused:. I just wanna be able to love on him and have that be enough! :laughing: Hang in there. :grouphug:

sugarcatmom
November 17th, 2009, 02:24 PM
Anyway her liver is good, her kidneys are as expected for a cat her age, but her pancreas is enlarged. The vet said, if you can see the pancreas it usually means problems?? So...it leaves me to believe she has pancreatitis.

Can you get the vet to send a sample of her blood out for a fPLI test? That tends to be a fairly accurate diagnostic for pancreatitis in cats. If she really does have it, pain killers are the most important part of treatment. There is some debate about whether or not a low fat diet helps (for some it might ease symptoms, in other cases it makes no difference). Lots of p'titis cats do well on some of the canned Merrick flavours, which have a moderate amount of fat.

tiggy2
November 17th, 2009, 10:02 PM
Can you get the vet to send a sample of her blood out for a fPLI test? tends to be a fairly accurate diagnostic for pancreatitis in cats.

I will send her an email and see if the lab still has some of Tus's blood from the last test's we did and hopefully they can use that to do the test.


she really does have it, pain killers are the most important part of treatment.

Would the stomach upset cause that much pain or is it some other type of pain? How can I tell if she's in pain aside from the acid indigestion she seems OK, maybe a little more distant lately.

some debate about whether or not a low fat diet helps (for some it might ease symptoms, in other cases it makes no difference). Lots of p'titis cats do well on some of the canned Merrick flavours, which have a moderate amount of fat.

Ya I thought I read that somewhere about the fat diets, but if she'll eat them, what harm can it do? Might be good for my fat cats..yes??

Anyway just fed them all again, as I seem to spend a fair amount of time feeding the cats. I presume it still holds true for Tus on the frequent feedings? I try and get food in to her as late as possible to try and get her through the nite. Don't know if this helps or not.

I'll let you know on the test.

Any other med's or supplements to help her out?

tiggy2
November 17th, 2009, 10:08 PM
I so get it Tiggy!!! One of cats has completely different problems but I'm just so tired of worrying about him :sad: and trying to digest all the different information I'm getting:confused:. I just wanna be able to love on him and have that be enough! :laughing: Hang in there. :grouphug:

I try.

and thank you for the kind words. It gets hard with multi cats and they are all getting just a little older.

I have 2 that are 8 years old ( known affectionally as the "kids") 2 that are 15 (the old dolls) and 1 that is 11, her 11 year old buddy died 2 years ago of unknown illness:((

sugarcatmom
November 17th, 2009, 10:31 PM
Would the stomach upset cause that much pain or is it some other type of pain? How can I tell if she's in pain aside from the acid indigestion she seems OK, maybe a little more distant lately.

The pain of pancreatitis comes from the inflamed pancreas itself. Since cats are so good at hiding their pain, and because pancreatitis is known to be extremely painful, pain meds should be given regardless of whether a cat is actually showing any overt signs.


Any other med's or supplements to help her out?

There's a great link here (http://www.felinediabetes.com/phorum5/read.php?8,876722,876722) with a brief overview of pancreatitis and some treatment options (although it's slanted towards diabetics, the info is still worthwhile).

Here's a link discussing the diagnostics used to recognize pancreatitis:
http://www.cvm.tamu.edu/gilab/research/Pancreatitis.shtml

growler~GateKeeper
November 18th, 2009, 02:58 AM
Anyway her liver is good, her kidneys are as expected for a cat her age, but her pancreas is enlarged. The vet said, if you can see the pancreas it usually means problems?? So...it leaves me to believe she has pancreatitis.

A vet internist (one who speciailizes in the inside stuff) or a vet with a lot of experience with ultrasounds can see the pancreas even when there are no issues, but that generally holds true.

I second the suggestion to have the fTLI or the fPLI test run to give better diagnostics.

Some info here on Pancreatitis (http://www.manhattancats.com/Articles/pancreatitis_test.html) and fairly technical here pancreatitis in pdf (http://www.hcvma.org/notes/SpeakerNotesDebZoran.pdf)

Would the stomach upset cause that much pain or is it some other type of pain? How can I tell if she's in pain aside from the acid indigestion she seems OK, maybe a little more distant lately.

I would suggest if you can write down what brand/flavour Tus eats each day & what her symptoms are that day - is she vomiting more or less, does she act more sick, feeling better, running around, sleeping more etc See if you can spot a trigger that makes her feel worse, that way you can eliminate some of the foods that cause worse symptoms.

:goodvibes:

tiggy2
November 19th, 2009, 09:49 AM
update on Tus

I managed to obtain some pain med's., Ketoprofen 5mg (expensive drug, gee's almost $5.00 a pill), anyway I gave her 5mg suppertime yesterday and she seemed better last nite, but this morning she's in pain again. I'm supposed to give her 1 a day, but I gave her 1/2 a pill this morning cause she looks so miserable.

I'm also wondering if the increase in Amitriptyline is making her more dopy? She walks like she either in pain or really "stoned" or maybe a bit of both. I've increased the Amitriptyline from 5 mg a day to 5 mg twice a day in order to get her eating more. She's just skin and bones.

Also the vet is finding out if the lab has some of Tus's blood left from her last blood work. To get the fPLI test done it has to be sent to Ontario, I'm in NB and her blood is in PEI..some fun hey, so god only knows how long that's going to take:sad:

I do have one question? What is the prognoses with pancreatitis in a 15 year old cat? She seems to be going down hill quickly and if this is the case what can I do to make it at least better for her etc etc?

I have another cat with issues but I'll start another threat as it's my "boy" and he's now licking his belly bald:needhug: So have a look for "Licking his belly bald..now what?" and any advice for him would be appreciated

Thanks

Love4himies
November 19th, 2009, 10:19 AM
I noticed you are using Amytriptylne on your cat. What is the purpose of the vet giving that to your cat?

I had Sweet Pea on it and was told by my vet that this should only be used on healthy cats as it can have some pretty severe side effects, especially on the liver. I ended up taking her off of it because it made her aggressive.

Here is a link:

http://www.vetinfo.com/side-effects-amitriptyline-cats.html

tiggy2
November 19th, 2009, 10:52 AM
I noticed you are using Amytriptylne on your cat. What is the purpose of the vet giving that to your cat?

I had Sweet Pea on it and was told by my vet that this should only be used on healthy cats as it can have some pretty severe side effects, especially on the liver. I ended up taking her off of it because it made her aggressive.

Here is a link:

http://www.vetinfo.com/side-effects-amitriptyline-cats.html

Thanks for the info on the side effects, makes sense why she's so dopy and drinking more.

The reason we put her on this is to get her to eat more and to lick at herself less. She has her back legs licked and gnawed bare.

If you know of any other appetite stimulants, let me know as the poor think is nothing but skin and bones.

sugarcatmom
November 19th, 2009, 12:09 PM
If you know of any other appetite stimulants, let me know as the poor think is nothing but skin and bones.

Mirtazapine. Works great, you only need to give it once every 3 days, and it suppresses nausea as well.

tiggy2
November 19th, 2009, 01:18 PM
Mirtazapine. Works great, you only need to give it once every 3 days, and it suppresses nausea as well.

Thanks for the tip, I've printed out the info on it and I'll pass it on to my vet and switch her over. The amytriptylne is really making her dopy, especially with the pain med's.

It might work with my "boy", Tig who has licked all his fur off his belly. Waste not:))

Any suggestions on pain med's as the ketoprofen is for short term only.

sugarcatmom
November 19th, 2009, 02:14 PM
Any suggestions on pain med's as the ketoprofen is for short term only.

Buprenex or a Fentanyl pain patch are safer for feline use than the NSAIDS are, so I would see if your vet has either of those available. Buprenex is either used as an injectable or sublingually but needs more frequent dosing (potentially every 8 hrs, depending on the level of pain). The pain patch is good for about 5 days once it's put on.

Here's some more info on pain management in cats: http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6621&O=Generic

tiggy2
November 21st, 2009, 11:13 AM
I have a question?

I'm presume this pancreatitis is fatal? Tus is not eating at all now and is sleeping a lot more. I can't believe how quickly she is going down hill. Is this normal?

I'm going to the store now and get some baby food to see if I can get her to eat that because I can't give her the pain med's unless she has food in her stomache:(

Any other suggestions on how to make her more comfortable as I can't stand to see her suffer, especially if there is no hope of recovery.

She maybe sleeping but I'm not:((

sugarcatmom
November 21st, 2009, 01:43 PM
Pancreatitis can sometimes be fatal, but not always. Supportive care is really the only treatment. I urge you to get a different pain med from your vet, I don't think the Ketoprofen is strong enough, and it has too many risky side effects. With something like Buprenex or Fentanyl, you don't need to wait for her to eat to administer it.

What about subQ fluids? That might also help her feel better. Vitamin B12 injections are worth considering and have no adverse effects.

Hang in there!! Cats can have an amazing ability to rebound from some pretty serious illnesses. :grouphug:

tiggy2
November 21st, 2009, 02:25 PM
Pancreatitis can sometimes be fatal, but not always. Supportive care is really the only treatment. I urge you to get a different pain med from your vet, I don't think the Ketoprofen is strong enough, and it has too many risky side effects. With something like Buprenex or Fentanyl, you don't need to wait for her to eat to administer it.

What about subQ fluids? That might also help her feel better. Vitamin B12 injections are worth considering and have no adverse effects.

Hang in there!! Cats can have an amazing ability to rebound from some pretty serious illnesses. :grouphug:

I'll have to wait until Monday as my vet is closed on Sunday's. I managed to get some baby food in to her, so now I'll pill her with the last pill I have. Tomorrow will not be fun either.

I'll ask about the shots and the subQ fluids, although she's drinking more now then ever, she sits by the water fountain or sleeps on her box by the window.

I don't know who will break first her or I. I'll let you know what happens

tiggy2
November 21st, 2009, 11:49 PM
Hi again guys

Just wondering if I could give Tus prednisone tomorrow since I don't have any pain med's to give her and the one's I gave today will wear off by tomorrow am.

Would it help with her pain at all? Or is there any human pain med's I can give her to get her by until Monday.

I managed to get her to eat and I think it was helpful especially with the pain med's in her.

growler~GateKeeper
November 22nd, 2009, 02:49 AM
Prednisone is not going to be enough to manage pain, and you should never give human meds to cats some can be very very dangerous to them.

Does your vet have an answering service or is there an emergency vet in your area that would be open tomorrow that you can speak to regarding a refill on the meds?

tiggy2
November 23rd, 2009, 10:42 AM
Hi again

I have a request into the vet for Tus to obtain some pain med's. She has not eaten since last nite, and that was only a small amount.

I've been reading about pancreatitis and some are saying to keep food away or to put a feeding tube in to give the pancreas a break. Obviously I can't not feed her as she is loosing weight as it is, but back to the feeding tube, especially since she won't eat again and now I have to find low fat foods.

So I ask again "to put a feeding tube in or not"?

Any suggestions on the low fat foods?

I just want the poor thing to get a little better, she's so miserable:(

sugarcatmom
November 23rd, 2009, 05:35 PM
I've been reading about pancreatitis and some are saying to keep food away or to put a feeding tube in to give the pancreas a break.

Withholding food is one of the treatment plans when dealing with acute pancreatitis in dogs, but it's not an option for cats. They must eat. Putting in a feeding tube does ensure that the cat is getting nutrients (doesn't give the pancreas a break though, there is still food that needs to be digested), but before going that route I'd make sure other options have been exhausted. Were you ever able to get any mirtazapine from the vet? This along with appropriate pain meds might help significantly.


now I have to find low fat foods.

Any suggestions on the low fat foods?

You don't have to feed her only low-fat foods, especially at this point where it's more important that she eat SOMETHING. Anything. What else have you tried? Will she eat plain yogurt, boiled chicken breast, cheese, low-sodium canned salmon? What about cat treats like Temptations or Greenies? Different flavours of baby food like beef or lamb? Whatever it takes to get her eating.

There is no scientific proof that a low-fat diet prevents pancreatitis in cats. This concept was transferred over from dogs and humans, but the thing is, cats aren't dogs or humans. They are designed to digest meat that is moderately high in fat (40-50%) and protein. Feeding something too low in fat will have other health consequences. Having said that, there are a couple foods that some p'titis cats anecdotally seem to do better on. Merrick Cowboy Cookout and Grammy's Pot Pie both have 42% of calories from fat. Pro Plan Turkey & Giblets is 39% and Fancy Feast Elegant Medleys Shredded Lean Turkey or White Meat Chicken are 34 and 35% respectively.

So basically, before considering a feeding tube, the things that need to be addressed are pain, hydration and nausea, and it's possible that Tus' appetite will come back in line. Mirtazapine will help with nausea and appetite. Subq fluids will ensure she's not suffering from dehydration, which can cause nausea. 1/4 10mg tablet of Pepcid AC (not Complete) can help deal with excess stomach acid if given 20-30 min before a meal. And then the all-important suitable (ie not NSAIDs) pain medication.

Let us know what the vet says.

tiggy2
November 23rd, 2009, 10:02 PM
Hi guys

Well I finally got in to see the vet 9 hours later, I made an appointment and brought Tus in. So she's in the vet's over nite for IV fluids again, and the possibility of the fTLI or the fPLI test done. She is going to talk to the lab and see what exactly these test will indicate as I don't want to fork out another $200.00 to find out that she has an enlarged pancreas. The vet thinks it might be cancer and if this is so than I need to take a different approach all together, but I need to know if it is cancer or is it pancreatitis.

She is also going to post her information on a Vet forum to see if anyone else can see something that she might have missed and post the ultrasound as well.

Basically we are trying to find a confirmed diagnoses so I can at least either treat her or just give her some comfort and dignity. Remember a week and 1/2 ago it was kidney failure:(( Now her pancreas.

So that's where I stand now. I hate to leave her there but if I can't get her to eat she needs some nutrients to keep her going and pain med's to make her comfortable.

With regards to the food, the baby food, (chicken/chicken both type) with low sodium tuna on top worked for a few bites, but when she refused the tuna and any treats I knew I was in trouble.

As for the pepid AC, I never thought to just give it to her 1/2 hour before her meal, I more or less gave it to her after the meals. I'll remember that one. Her breath smells acidic, especially if she has not eaten for awhile.

I'll let you know what's up with her tomorrow.

and of course my boy is still licking his belly raw:((( I've now started him on Tus's Amitriptyline to see if that helps as it did not work for Tus.

sugarcatmom
November 23rd, 2009, 10:54 PM
Glad she's at the vets for tonight. I hope the fluids help and she starts to feel better. :fingerscr

tiggy2
November 24th, 2009, 07:53 PM
Well she's back from the vet:)

And drink, man she practically living by the water fountain. I thought with the IV fluids she would not want water?

Anyway we've sent blood off to get the test done for pancreatitis, should have that result in a couple of days.

My vet is also posting her history on a vet forum to see if anyone can come up with something a little more concrete. They are tossing about irritable bowel as well:(

We have a topical prednisone, which I put on her ear 2 times a day for now and the pepid ac and the rest of the antibiotics. We'll see how that goes. The #1 priority is to get her to eat and I'm hoping the prednisone will help with that.

So far she's had about a table spoon of food on her own. If that keeps up then I won't have to force feed her. We'll see how tomorrow goes, when I can feed her every 2 hours or so.

How much food should I be getting into her? I know she needs like 6oz, but I doubt I can get that much. Another words if I can't get her to eat on her own should I force feed her? I hate to do that.

Right now I'm feeding her the Wellness brand with tuna (a few flakes of low sodium) on top. She mostly eats around the tuna, as she's not to keen on chewing her food.

Any idea's as to what's up with that. When she eats it's like she's chewing her food or having a hard time getting the food down. She'll lick the food and then try and chew it like it's too dry? I water it extra for her as well.

Any suggestions on high energy or "good" food that I can give her to get her calories up? Baby food even, she seems to like the texture of that.

I guess it's another wait and see time and more time feeding:)

Thanks for all your:fingerscr

So far she's hanging in there

sugarcatmom
November 24th, 2009, 08:17 PM
We have a topical prednisone, which I put on her ear 2 times a day for now and the pepid ac and the rest of the antibiotics. We'll see how that goes. The #1 priority is to get her to eat and I'm hoping the prednisone will help with that.

Prednisone may help with appetite, but that effect might not be strong enough in her situation. Why not mirtazapine?


How much food should I be getting into her?

How much does she weigh?

When she eats it's like she's chewing her food or having a hard time getting the food down. She'll lick the food and then try and chew it like it's too dry? I water it extra for her as well.

Did the vet take a good look at her mouth recently?

Any suggestions on high energy or "good" food that I can give her to get her calories up? Baby food even, she seems to like the texture of that.

Hill's A/D is often used for animals with anorexia, and it's about the only Hill's product I would ever consider using. Has a very smooth texture and seems to be appealing to many cats. It's easy to mix with a bit of water and feed via syringe if you have to.

The canned food with the highest amount of calories is Eukanuba Maximum Calorie (http://rxpetfood.com/eukanubamaximumcaloriecaninefelinecan.aspx), at 57 per oz. You can only get this one and the A/D at the vet.

Have you tried feeding her Wellness Kitten? That and the Wellness Chicken are pretty high at 40 cal/oz.

Here is more info on assisted feeding:
http://www.assistfeed.com/FelineAnorexia.htm
http://www.felinecrf.org/persuading_cat_to_eat.htm

tiggy2
November 24th, 2009, 08:47 PM
Prednisone may help with appetite, but that effect might not be strong enough in her situation. Why not mirtazapine?

If the prednisone is not enough in a couple of days I'll get the mirtazapine. Right now it's hard to get her to eat pills with a treat and pilling her makes her gag. But I will request it on Thursday if appetite does not improve.

much does she weigh?

Yesterday she weighted 9 pounds 2 oz's the week before she was 9.8 pounds so she lost 6 oz in a week:(


Has the vet take a good look at her mouth recently?

A couple of weeks ago I had her in and we put her out to check her mouth and throat and there was nothing wrong there and she had her teeth done in Feb., the start of all this. I noticed her lack of eating and bad breath and attributed it to bad teeth.[/QUOTE]

Have you tried feeding her Wellness Kitten? That and the Wellness Chicken are pretty high at 40 cal/oz.

No, but I'll get a can. Should I be worried about the fat content due to her pancreas issues?


Here is more info on assisted feeding:
http://www.assistfeed.com/FelineAnorexia.htm
http://www.felinecrf.org/persuading_cat_to_eat.htm

Thanks I'll check them out and get some tip, especially the "how much to feed" that really helps.

sugarcatmom
November 24th, 2009, 09:46 PM
Yesterday she weighted 9 pounds 2 oz's the week before she was 9.8 pounds so she lost 6 oz in a week:(

Generally, 20-30 calories per pound per day is the rough guideline, but for an inappetant cat, just getting even 50-60% of that in would be a good start. If you can convince Tus to eat about 3/4 of a can of A/D per day, I think that would really help.

Should I be worried about the fat content due to her pancreas issues?

Right now, it's more important that she eat.

You've probably mentioned this, but what antibiotics is she on? These could be a big factor in her inappetance and I'd really be inclined to stop them unless there was a specific reason for her to be taking them.

tiggy2
November 25th, 2009, 06:13 PM
Generally, 20-30 calories per pound per day is the rough guideline, but for an inappetant cat, just getting even 50-60% of that in would be a good start. If you can convince Tus to eat about 3/4 of a can of A/D per day, I think that would really help.

I'll have to check to see if the vet has that cat food. But in the mean time I'm hand feeding her and using the small 5oz can as a guide line. Whatever I can get her to eat. I can't obtain a lot of the different types of cat food here in NB. Like the wellness kitten. I can get the wellness regular and that's what I've been using so far. Found a "tuna" for cats and she's eating that right now. But of course that will change tomorrow.

So far only 1 "assisted" feeding:)) The rest hand fed:)) My hand stinks of cat food. I need to get some latex gloves.


Right now, it's more important that she eat.

what antibiotics is she on? These could be a big factor in her inappetance and I'd really be inclined to stop them unless there was a specific reason for her to be taking them.

It's amoxil. and right now she won't take them with treats and to pill her makes her gag, so I've put them on hold until I can get the food intake up. I've finally got some Slippery Elm Bark in today. It says 1/4 tsp. Is that per day or per feeding?

So I guess it's stinking fish hands for awhile..the things we do for our pets:)):cat:

sugarcatmom
November 25th, 2009, 08:23 PM
So far only 1 "assisted" feeding:)) The rest hand fed:))

Yippee! That's great that she's getting some nutrition. Way to persevere!

I've finally got some Slippery Elm Bark in today. It says 1/4 tsp. Is that per day or per feeding?

I'd start with about 1/8 tsp twice a day and see how she does. You can go up to 1/4 tsp 4x day if needed and if she tolerates it. If she won't eat it mixed with food, you can make a syrup and syringe a small amount into her mouth. That might also be soothing to her throat if she has some sort of issue with swallowing. The syrup recipe is at the bottom of this page: http://www.littlebigcat.com/index.php?action=library&act=show&item=slipperyelm

So I guess it's stinking fish hands for awhile..

Ya gotta do what ya gotta do..... :thumbs up

tiggy2
November 27th, 2009, 09:13 AM
Riddle me this:confused:

Tus is now back to not eating again, so it's "assisted" feeding, not a pleasant experience for either of us.

It seems when she has the IV fluids she's good for a day or two and then she declines after that. and becomes more dehydrated again.

So why does she become dehydrated when she is drinking probably more and of course the food she eats is wet and I add water to it?

I've put a request into the Vet to try SubQ fluids to see if that makes a difference and to give her appetite stimulant as well, cause when she eats and is hydrated she's like her old self again and now she's getting miserable again.:cry:

I don't want her to have to go into the vet's for the day for IV fluids again.

So any ideas as to why she becomes dehydrated?

Love4himies
November 27th, 2009, 11:08 AM
To me, if a cat who is getting fluids is also getting dehydrated it is because the kidneys are not concentrating the fluids. :shrug: Perhaps SCM will be on soon and answer your questions.

sugarcatmom
November 27th, 2009, 02:28 PM
So why does she become dehydrated when she is drinking probably more and of course the food she eats is wet and I add water to it?

Here's a lecture by Dr. Lee on the subject of PU/PD in pets:

http://www.pets.ca/forum/showthread.php?t=52691

And another link:

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2556

sugarcatmom
November 27th, 2009, 02:41 PM
Forgot to mention that prednisone will also cause an increase in water consumption, but this was going on before Tus was put on steroids, correct?

growler~GateKeeper
November 28th, 2009, 12:38 AM
The cats kidneys process & filter water from the body, then recycle most of it back into the body, what is left is concentrated with the toxins for excretion so the urine in a normal healthy cat actually has little water content.

A cat that is chronically dehydrated will drink more to try to replace what they are losing through electrolyte imbalance & excess urination, the volume of urine output doesn't allow the body to catch up even though the cat is drinking high volumes.

Dehydration is not only the loss of water from the body but also the loss of electrolytes - body salts such as potassium & sodium they also get flushed out with the waste.

A cat with compromised kidneys is more likely to be dehydrated and is unable to concentrate the urine sufficiently so they need to drink & uriniate more to flush out the same amount of toxins that would normally be excreted with less urine.

Tus feels better directly after having fluids because it relieves the immediate symptoms of dehydration, flushes toxins faster, and generally makes her feel better. The IV & SubQ fluids is a delicate balance of not only sterile water but several electrolytes as well, so when Tus has fluid therapy not only is the water balance restored but so is the electrolyte balance.

A dehydrated cat will also refuse to eat in part because of the "stomach ache feeling" that happens when low on fluids but also in part because they just feel cr@ppy.

tiggy2
November 29th, 2009, 09:45 AM
I have an appointment set up for monday to take Tus in for SubQ fluids and to have them show me how it's done. I'm hoping this will make the difference as I can't keep forcing her to eat 3-4 times a day. It's a battle every time.

Also I noticed when I feed her that she grinds her teeth. Sounds like she is chewing something, but of course there is nothing to chew so it has to be her teeth. Any idea on what that could be? It sounds awful and sounds like it could be painful?

Anyway, lets keep :fingerscr that this works as this is the last straw as I won't force a cat to eat every day, it's too painful on both of us. There has to be a reason why she does not want to eat and I don't feel comfortable forcing someone to eat when they don't want to all the time. I don't mind once in awhile but all the time??



I'm also going to get some Vit. B in her as well, hope that will help.

Of course there is the feeding tube???

I'm also hoping the test results will be back by Monday as I'm still waiting to see if it's pancreatitis. <sigh>

sugarcatmom
November 29th, 2009, 12:52 PM
Good luck tomorrow. Here's an excellent primer on giving subQ fluids if you haven't already seen it: http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html
Growler and I can also help you if you have any questions. One thing the vets never seem to mention is that it really helps if you warm the fluids first.

Also, it's time to get some mirtazapine. And if the fPLI shows pancreatitis, some better pain meds. If those don't work, perhaps a feeding tube would be the way to go.

tiggy2
November 29th, 2009, 03:06 PM
Good luck tomorrow. Here's an excellent primer on giving subQ fluids if you haven't already seen it: http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html
Growler and I can also help you if you have any questions. One thing the vets never seem to mention is that it really helps if you warm the fluids first.

Also, it's time to get some mirtazapine. And if the fPLI shows pancreatitis, some better pain meds. If those don't work, perhaps a feeding tube would be the way to go.

I agree on the mirtazapine and if that does not work than it's a feeding tube, but only if it will make a difference. I don't want to prolong her life if it's painful or no hope beyond another month or two. I expect she has been sick for the better part of a year and nothing seems to be making her better or more comfortable:cry:

So Monday will be another information day with I hope the test results.

I can't see myself putting Tus through force feedings and Subq fluids with no positive results, to me it's like torturing the poor girl and then life becomes not a lot of fun:( Does that make sense?

growler~GateKeeper
November 30th, 2009, 12:07 AM
Also I noticed when I feed her that she grinds her teeth. Sounds like she is chewing something, but of course there is nothing to chew so it has to be her teeth. Any idea on what that could be? It sounds awful and sounds like it could be painful?

Teeth grinding is a symptom of either the dehydration or the stomach acid, since Tus had her teeth checked not long ago we can rule that out. It does sound awful but it's not painful, Duffy used to do it before we got started on regular fluid therapy & worked in a few little things to help with stomach acid, Duffy never had a big problem with s.a. so raising the food & water dishes btwn 3-5 inches off the ground, more frequent feeding, adding a late night feeding helped to calm that down.

Fluid therapy is not as scary as it may look & as scm mentions definately warm the fluids first :goodvibes:

tiggy2
November 30th, 2009, 09:24 AM
Teeth grinding is a symptom of either the dehydration or the stomach acid, since Tus had her teeth checked not long ago we can rule that out. It does sound awful but it's not painful, Duffy used to do it before we got started on regular fluid therapy & worked in a few little things to help with stomach acid, Duffy never had a big problem with s.a. so raising the food & water dishes btwn 3-5 inches off the ground, more frequent feeding, adding a late night feeding helped to calm that down.

Fluid therapy is not as scary as it may look & as scm mentions definately warm the fluids first :goodvibes:

Thanks for addressing the teeth chewing, god it awful. It sounds like she is chewing something plastic:yuck:

Do you think the SubQ will help her eat. I'm concerned that she won't last much longer without food. The most I can get into her is about 20-30 ML a Day, and that's not enough to keep a bird alive not alone a cat:sick:

I don't want to wait too long before I have to go with a feeding tube and the force feeding is exactly that force feeding:(

nljnky
November 30th, 2009, 11:19 AM
Mirtazapine had my cat eating the first day I gave it to her.
Please try it.

tiggy2
November 30th, 2009, 05:03 PM
Mirtazapine had my cat eating the first day I gave it to her.
Please try it.

Can't get it here it seems. So it's onto another drug that is similar to the drug I just gave her that did not work, just made her dopy. So I'm not holding out much hope for that.

tiggy2
November 30th, 2009, 05:07 PM
Update.

Tus is now down to 8 pounds 15 oz's from 9.2 last week. Got the subQ fluids in her this afternoon no issues there, but this force feeding is not working.

She now shakes and grows and spits it out along with the teeth grinding. So I'm at my wits end. If she doesn't eat soon she'll die from starvation.:cry:

Anyone have any other suggestions on the "assisted feeding", cause right now it's torture on both of us.

Love4himies
November 30th, 2009, 05:23 PM
So why aren't you putting a feeding tube in?

Whoops wrong thread

tiggy2
November 30th, 2009, 06:14 PM
So why aren't you putting a feeding tube in?

Methimazole is also known as Tapazole and should be available in Canada

I was hoping the SubQ fluids would work with the appetite stimulant. I was also waiting for the test results, but they were sent to the States and of course they are having their holiday.

If there is no hope of recovery then a feeding tube is just prolonging her torture.

But I'm leaning towards the feeding tube cause forcing her to eat is not the answer.

Should I wait another day or not?

Love4himies
November 30th, 2009, 06:29 PM
If that was my cat the feeding tube would have been put in within a week of my cat not responding to forced feeding.

Cats do not do well when they are not eating so you could be doing more damage not having a feeding tube than having one.

I believe your kitty is also on amoxil? If so, this could be part of the problem of your cat not eating.

tiggy2
November 30th, 2009, 07:26 PM
If that was my cat the feeding tube would have been put in within a week of my cat not responding to forced feeding.

Cats do not do well when they are not eating so you could be doing more damage not having a feeding tube than having one.

I believe your kitty is also on amoxil? If so, this could be part of the problem of your cat not eating.

I stopeed the amoxil as I couldn't get food into her and if there was the possibility of upset stomach then I stopped it.

I just picked up the appetite stimulants and you have to give it with food..well that's not going to work.

So..I've emailed my vet and I'll call the clinic tomorrow to have a feeding tube put in, hopefully tomorrow.

Poor thing

I'll also have to check a little further on the mirtazpine/tapazole as I noticed someone from BC had it so you can get it in Canada.:wall:

Love4himies
November 30th, 2009, 07:44 PM
I stopeed the amoxil as I couldn't get food into her and if there was the possibility of upset stomach then I stopped it.

I just picked up the appetite stimulants and you have to give it with food..well that's not going to work.

So..I've emailed my vet and I'll call the clinic tomorrow to have a feeding tube put in, hopefully tomorrow.

Poor thing

I'll also have to check a little further on the mirtazpine/tapazole as I noticed someone from BC had it so you can get it in Canada.:wall:

Ignore that line, it was a mistake and meant for another cat forum. I deleted in on my post.

tiggy2
November 30th, 2009, 08:31 PM
Ignore that line, it was a mistake and meant for another cat forum. I deleted in on my post.

Ignore what line? The why not get a feeding tube?

I presume you are now suggesting a feeding tube?

sugarcatmom
November 30th, 2009, 08:47 PM
Can't get it here it seems.

You absolutely CAN get it here. Ask your vet for a prescription and take it to the nearest pharmacy. It's a human anti-depressant, also known as Remeron. Honestly, your vet has been wasting enough time with this.

sugarcatmom
November 30th, 2009, 08:51 PM
Here's more info for you vet regarding dosage, etc., since they clearly don't know anything about it: http://www.VeterinaryPartner.com/Content.plx?P=A&C=301&A=2552&S=2

tiggy2
November 30th, 2009, 09:28 PM
Here's more info for you vet regarding dosage, etc., since they clearly don't know anything about it: http://www.VeterinaryPartner.com/Content.plx?P=A&C=301&A=2552&S=2

I've sent her the info on it.
The drug she gave me is cyproheptadine which is another antihistimine. I presume since the last one did not work this one would not work either. And of course as I said you have to give it with food:(( well she won't eat, kinda defeats the purpose.

We'll see what tomorrow will bring.
I'm getting real tired of this and so is Tus:cry:

lindapalm
November 30th, 2009, 10:08 PM
I use Cyproheptadine Hydrochloride appetite stimulant on one of my cats, up to twice a day. I don't have to give it with food. Within a half hour she is meowing to be fed, never have had to give it to her twice. Don't use it a lot, but works great when I have to. Had to get her to stop eating after shes had it.

sugarcatmom
November 30th, 2009, 10:16 PM
The drug she gave me is cyproheptadine which is another antihistimine. I presume since the last one did not work this one would not work either. And of course as I said you have to give it with food:(( well she won't eat, kinda defeats the purpose.


Like lindapalm says, you don't give cyproheptadine with food. What was the other antihistamine that you were given? As far as I know, cyproheptadine is the only one used as an appetite stimulant for cats. I'm seriously losing confidence in your vet.

growler~GateKeeper
December 1st, 2009, 12:21 AM
Thanks for addressing the teeth chewing, god it awful. It sounds like she is chewing something plastic:yuck:

Do you think the SubQ will help her eat. I'm concerned that she won't last much longer without food. The most I can get into her is about 20-30 ML a Day, and that's not enough to keep a bird alive not alone a cat:sick:

I don't want to wait too long before I have to go with a feeding tube and the force feeding is exactly that force feeding:(

Subq's will help her to feel better which may make her more inclined to eat but it will not counter-act the stomach acid or the nausea enough to be a stand alone treatment for stomach acid.

Is Tus still on pepcid for stomach acid?

Since she is still grinding her teeth & nausea the pepcid is not working for her either by dose or application.

Speak to your vet about another histamine H2 antagonist, also available over the counter, called Zantac 75. The active ingredient in Zantac is ranitidine 75mg, and it works in a similar way to Pepcid AC. You will need to ask about appropriate dosages, it is also available in injection form from the vet.

Or ask about Metoclopramide (Reglan) it is available by prescription only. It works in a different way to acid blockers by regulating stomach contractions, and therefore may help with nausea caused by a lack of motility in the stomach. Since Reglan can cross the blood/brain barrier, it also acts on the brain to control feelings of nausea, therefore should NOT be given to cats prone to seizures. Reglan can be given with Pepcid AC as long as the doses are given at least 2 hours apart.


While you are waiting for the vet to move on an appetite stimulant you can try tempting Tus with something along the lines of Pure Bites freeze dried treats (http://purebites.com/ProductsCatEng/productschicken_cat.html) or Halo-Liv-A-Little treats (http://shop.halopets.com/Natural-Treats)


Ignore what line?

Love4himmies meant ignore the tapazole she mis-typed it.

tiggy2
December 1st, 2009, 09:18 AM
Like lindapalm says, you don't give cyproheptadine with food.

The pharmacist told me to give it with food, not the vet on this one, so maybe you don't have to have food with cats, just people?


What was the other antihistamine that you were given?

Amitriptyline was the other one. It worked well with my boy who was licking all the fur off his belly. Gave it to him for 2 days, he basically slept those 2 days. Gave time for his belly to heal.


far as I know, cyproheptadine is the only one used as an appetite stimulant for cats. I'm seriously losing confidence in your vet.

I just looked up the spec's of the drug and came across the fact that it helps with anxiety, hence it worked with Tigger, my boy. Maybe we gave it to TUs to calm her as she was agitated in the morning. I really thought I was looking for appetite stimulant, hence the feeding tube thread.

Well Tus is going for the feeding tube this afternoon, I insisted. I think you're right when we weighted Tus yesterday and she had lost a pound in a week, I think the vet should have said to put the tube in then, but I guess we're both waiting on test results. But kinda stupid to die waiting for test results.

Love4himies
December 1st, 2009, 10:15 AM
I think I mentioned before that Amitriptyline should only be given to healthy cats, none that have any health issues. It is normally used to help ease stress levels in cats. However, it just made Sweet Pea more aggressive. :frustrated:. My vet would only prescibe it if blood work was good prior to the prescription and follow up blood work at LEAST every six weeks to check liver and kidney functions. He was most concerned about liver with this med. If I were you, I would discuss with the vet to slowly discontinue the use of this med. It shouldn't be stopped cold turkey.

http://www.marvistavet.com/html/body_amitriptyline.html

http://www.drsfostersmith.com/rx_info_sheets/rx_amitriptyline.pdf

I like, Sugarcatmom, am wondering about your vet. :frustrated:. Is there another one in your area?

tiggy2
December 1st, 2009, 10:34 AM
I think I mentioned before that Amitriptyline should only be given to healthy cats, none that have any health issues. It is normally used to help ease stress levels in cats. However, it just made Sweet Pea more aggressive. :frustrated:. My vet would only prescibe it if blood work was good prior to the prescription and follow up blood work at LEAST every six weeks to check liver and kidney functions. He was most concerned about liver with this med. If I were you, I would discuss with the vet to slowly discontinue the use of this med. It shouldn't be stopped cold turkey.

http://www.marvistavet.com/html/body_amitriptyline.html

http://www.drsfostersmith.com/rx_info_sheets/rx_amitriptyline.pdf

I like, Sugarcatmom, am wondering about your vet. :frustrated:. Is there another one in your area?

Tus has not been taking the Amitriptyline now for awhile. She took it for a couple of days, maybe a week, but made her too dopey and I stopped it.

As for another vet, this is the second one as the first one was charging way too much money. $700 for teeth cleaning and 1 tooth extraction, I can't afford that kind of care:(

Chancing to another vet. How am I supposed to know if the next one is any better? I don't want to go through all these test again to end up the same place.

Any suggestions on how to find a "good" cat vet.

I might find another one for the other cats and see how they do with relatively healthy cats:)

tiggy2
December 1st, 2009, 12:05 PM
She's now in the vet's getting the feeding tube put in, lets hope she survive's the procedure.

I managed to keep her home until they really needed her, less stress.

Should have her home supper time tonight:fingerscr

and then on to plumping her up for Xmas..like christmas turkey:))

sugarcatmom
December 1st, 2009, 12:16 PM
Amitriptyline was the other one.

Oh okay. That is actually an anti-depressant, not an antihistamine, and isn't really an appetite stimulant for cats. Cyproheptadine is entirely different. Were you ever able to give any to Tus?

She's now in the vet's getting the feeding tube put in, lets hope she survive's the procedure.
...
and then on to plumping her up for Xmas..like christmas turkey:))

Crossing my fingers that she does okay. Is she getting a PEG tube or an E-tube, do you know? The PEG tube goes directly into the stomach through her side, and the E-tube is into the eosophagus through the neck. Surgery for the PEG tube tends to be a little more involved.

Here is some info on feeding tubes if you haven't seen it already: http://www.catinfo.org/feedingtubes.htm

I also have a lot of experience with them, so if you need any help let me know.

Love4himies
December 1st, 2009, 12:35 PM
You can't really tell how good a vet is until you visit. You also have be knowledgeable yourself, I always say "knowlege is power". I was so ignorant when I had Snowball and I feel had I done my research and not listened to the vet I was taking him to, I could have prolonged his life. And this vet was NOT cheap, so money doesn't indicate quality.

You are entitled to copies of all your kitty's lab work that you could take to a new vet so they don't have to run new tests.

Glad to hear you stopped the amitriptyline. Unless it is beneficial, there is no reason to take any med.

Sending some :goodvibes::goodvibes::goodvibes: and :pray: for Tus. I think once the calories and nutrition starts getting into her she will feel so much better. :grouphug:

Love4himies
December 1st, 2009, 06:48 PM
Any updates?

tiggy2
December 1st, 2009, 07:32 PM
We're back and exhausted :(

The tube is in and her neck is all wrapped up, looks very uncomfortable. SHe's drooling very stinky sticky drool. She's very dopey still as the vet put her out cold.

I'm instructed just to give her about 10cc's of food tonight and then try and get at least 1 can of food into her a day. Right now I have the Hill's recovery diet in hopes that that will kick start her system.

Also have the subQ fluids which I plan on giving her for the next couple of days to try and get her hydrated.

I still have the antibiotic which I can crush up and give her as well, and I now can use the liquid Zatex to help with her upset stomach.

Do you think I should use the slippery elm bark as well?

As for pain med's we're sticking with the prenosone(sp) until we get the test results and know better what we are dealing with.

Any advice on what to give her to help kick start her system?

As well the bandage seem so big, she can hardly move her neck. Also I'm not supposed to take the wrapping off, but I'd like to to make sure the stitches are healing well and that the bandage is not chafing.

I guess all in good time...one day at a time.

Thanks for sticking with me, it really really helps.

Never thought I'd use these forums but now I see why they are so important and that people really do care:angel:

sugarcatmom
December 1st, 2009, 09:44 PM
I'm instructed just to give her about 10cc's of food tonight and then try and get at least 1 can of food into her a day.

Good plan. Did the vet give you some detailed instructions on how to feed Tus and care for the tube? It's important to go quite slow at first, like maybe 3mls per minute or less. Gradually work up the amount of food by 5-10mls per session. You also don't want the food to be cold from the fridge. And it's very important to rinse the tube with about 10mls of warm water after each feeding to prevent the tube from clogging.


Do you think I should use the slippery elm bark as well?

I wouldn't at this point. See how she does first and if vomiting or diarrhea become an issue, maybe then it would be useful. You'll have to be very careful that the slippery elm doesn't clog the tube if you do decide to use it.

Also I'm not supposed to take the wrapping off, but I'd like to to make sure the stitches are healing well and that the bandage is not chafing.

She may need a bandage change at the vet in the future, but for now just leave it be. It looks worse than it is and most cats adapt to it very quickly.

Good luck with the feedings. I found it worked best if I put the cat on my lap while doing it (facing away from me), but you'll figure out a system that works best for you and Tus.

tiggy2
December 2nd, 2009, 08:13 AM
Good plan. Did the vet give you some detailed instructions on how to feed Tus and care for the tube?

Yes we had some instructions, but as always yours are more detailed:))

As well the tube is not working <sigh> It's clogged already and we haven't even started yet. We put in water last nite and tried to get some food in the tube and it would not go in. So here we are with some food in the tube and it won't go any further. SO we worked it with water until we got that amount down the tube.

I tried again this morning. Unfortunately with watered down slippery elm bak (thought it might help her stomach) well did not matter as that wouldn't even go down the tube. Then tried to flush that out and managed to pop the syringe out and spray both of us with water.

JC will anything go right with this poor cat. I think she's been tortured enough. She's just miserable.

Anyway called the vet and now have to go back AGAIN at noon to day and try and get that fixed. They should start paying me for all the trips I go there.

As for the slippery elm bark I've mixed some into her food, about 1/2 tsp per can so I'll leave it at that. I'm just trying not to upset her stomach.

I wouldn't at this point. See how she does first and if vomiting or diarrhea become an issue, maybe then it would be useful. You'll have to be very careful that the slippery elm doesn't clog the tube if you do decide to use it.


Good luck with the feedings. I found it worked best if I put the cat on my lap while doing it (facing away from me), but you'll figure out a system that works best for you and Tus.

I plan on watching a movie with Tus on my lap, then both of us will be relaxed and I can give her small amounts over a long period of time:))

It's important to go quite slow at first, like maybe 3mls per minute or less. Gradually work up the amount of food by 5-10mls per session. You also don't want the food to be cold from the fridge. And it's very important to rinse the tube with about 10mls of warm water after each feeding to prevent the tube from clogging.

Thanks for this detail, I'll hang onto this so I don't forget the amounts. It's always the amounts that is so hard to pin down.


You may need a bandage change at the vet in the future, but for now just leave it be. It looks worse than it is and most cats adapt to it very quickly.

Ok I'll try not to feel any more guilty than I do now and went I see the vet again I'll ask about the bandage change. Of course still waiting on the test results from the US of A.:frustrated:

tiggy2
December 2nd, 2009, 02:39 PM
update

The test results came back and it's not pancreatitis.

The fPL was 2.4 ug/L Control Range is 0.1 - 3.5

The TLI Fasting 88.7 ug/L Control Range 12 - 82

They figure the TLI is up due to the possibility of the kidney's not working properly.

So back to the drawing board.

Aside from that they have to reposition the tube as it's kinked somewhere, where they can not see via x-ray. Expect it's kinked behind her back teeth. So under she goes again, more dopey cat with nauseous belly, no food or water for yet another day. I expect with all the F'ing around she'll die anyway. She'll be so far gone I won't be able to get her back.

If this doesn't work than I'll make that decision myself, enough is enough.

tiggy2
December 2nd, 2009, 09:08 PM
update on the poor old thing, she might be hanging in there better thean me:)

I have her back again. She's really dopy, can barely walk, but made it to the litter box. I just helped her stand so she would not fall in her own pee.

This tube is working 100% better, she doesn't seems to be drooling as much and the tube sticks out on top of her neck instead of the side of the neck.

We only gave her 10ml of food and 10 mls of water, did not want to push it.

Tomorrow I'll do the watch the movie and give her her food.

Sorry for the ranting on the last post. I get so frustrated and angry at the lack of compassion and knowledge of some vets, it makes trying to make decisions very stressful. Needless to say my stress level is off the charts.

Great way to loose weight as I barely eat myself:))

So again:sorry: for the temper tantrum, at least they did not charge me as they made the mistake and admitted it.

Funny think is they had problems with the tube from the get go, you think some bells would have gone off.

Question on pain med's. Since it's not pancreatitis does she need pain med's? I'm still using the prenosone as that's all she'll give me:(

Thanks

Love4himies
December 3rd, 2009, 08:04 AM
Wow, I am really having serious doubts about your vet now.


Not too difficult to determine if the kidneys are working, urinalysis combined with blood work, if necessary an ultrasound. :frustrated:

I really hope the feeding will get Tus back on the road to recovery. :pray: :goodvibes:

tiggy2
December 3rd, 2009, 09:23 AM
Wow, I am really having serious doubts about your vet now.


Not too difficult to determine if the kidneys are working, urinalysis combined with blood work, if necessary an ultrasound. :frustrated:

I really hope the feeding will get Tus back on the road to recovery. :pray: :goodvibes:


I just got a call from her this morning apologizing for the difficulty yesterday. I say Thank God it was her day off and someone else did the tube:)

That said. The final verdict on Tus is she might have had an inflamed pancreas but not now, could be a condition that will crop up again. They, meaning others, think the elevated results indicate it's her kidney's, again and/or possible bowel or GI issues. With the bowel or GI issues biopsies would have to take place and I'm not willing to go that far. I think we're done enough.

So the plan/ my plan is to keep the tube in, if the weight comes back on and she recovers from this then great we carry on with healthy diet. If she does not get better with the tube in then the tube comes out and we let her go with some dignity intact.

Also she wants to monitor her blood pressure as that seems to be an issue and is concerned with the subQ fluids as it can increase blood pressure. Of course I will keep as much fluids in her via tube as possible, but will probably give SubQ as well as I think dehydration has caused problems in the past.

As for Pain med's I'll use up the few dose's of pred. and then I guess that's it as Pred. is hard on the kidney's.

Any suggestions on how to get her smelling better, she stinks and the other cats are afraid of her. I've put some baby powder on the bandage wrap as that stinks of awful chemicals. Are there dry shampoo's for cats that I can use as I don't want to bath her, enough trauma for a life time I'm sure:))

And god her breath, and drool ich. I'm hoping that will get better as food gets into her belly. I now can use the liquid Zantex for the acid indigestion, that might help too.

As for this vet, not much else she can do now.

I'll just get advice from you guys on diet and healthy foods etc.:angel:

But the rest of my cats I think I'll look around for another vet:))

Love4himies
December 3rd, 2009, 10:15 AM
I really don't know anything about pancreatitis, but do know a bit about bowel issues.

Does Tus have diarrhea or constipation? Any mucous or blood on her feces?

As for pred, I know it is a dreaded drug for humans. It makes them feel horribly moody, and ill along with weight gain. Some would rather have their colons taken out than to be on pred for the rest of their lives to control their disease. Others don't do too bad on it. Now I can't speak for cats, and as far as I am concerned, neither can vets as cats can't speak to them.

rjesak
December 3rd, 2009, 10:28 AM
Oscar definitely gained weight while he was on pred (in this case he was underweight so we considered that a plus). He also went a bit mean. We've had big problems with aggression toward his younger brother ever since he went on - even though he's off the pred, he learned this bullying behavior and we're still trying to work it out of him. It also (most likely) is responsible for the calcium oxalate stones he just had to have removed from his bladder.

I don't think we had a choice in Oscar's case (we were fighting asthma so options were limited) but he's a completely different cat since he started on pred and, even though he's off now, a lot of those changes took root.

I'm not sure about alternatives for pain - my vet uses Metacam which has it's own issues, but I wouldn't use pred if you didn't have to!

tiggy2
December 3rd, 2009, 03:17 PM
I really don't know anything about pancreatitis, but do know a bit about bowel issues.Does Tus have diarrhea or constipation? Any mucous or blood on her feces?


As far as I know Tus has never has any bowel movement problems. I have 4 other cats and I know I have one that will have diarrhea every now and again, but has not had that problem since I switched to wet cat food.

So I can say that all 5 cats have had as far as I know normal feces, no blood or mucus. Of course a lot less now with the wet food as well. YEA wet food.


As for pred, I know it is a dreaded drug for humans. It makes them feel horribly moody, and ill along with weight gain. Some would rather have their colons taken out than to be on pred for the rest of their lives to control their disease. Others don't do too bad on it. Now I can't speak for cats, and as far as I am concerned, neither can vets as cats can't speak to them.

Vet's are unsure why it works in cats, that's what I keep hearing them say.

But Tus is moaning now, could be pain or breathing funny now that the tube is down her throat??

tiggy2
December 3rd, 2009, 03:22 PM
Oscar definitely gained weight while he was on pred (in this case he was underweight so we considered that a plus). He also went a bit mean. We've had big problems with aggression toward his younger brother ever since he went on - even though he's off the pred, he learned this bullying behavior and we're still trying to work it out of him. It also (most likely) is responsible for the calcium oxalate stones he just had to have removed from his bladder.

I don't think we had a choice in Oscar's case (we were fighting asthma so options were limited) but he's a completely different cat since he started on pred and, even though he's off now, a lot of those changes took root.

I'm not sure about alternatives for pain - my vet uses Metacam which has it's own issues, but I wouldn't use pred if you didn't have to!

I had my boy (Tigger) on pred. for about 2 days and it did the opposite. He was distant, won't sleep with me, just really not my cat, so I took him off that and now use antihistamines for the coughing and sneezing which I presume is due to allergies. That works great as long as I can get him to eat the pill pocket without tasting the pills. Once he tastes the pills it becomes a game of how to get him to eat it without knowing. The antihistamines taste terrible, especially Benedryl ( which I find is the better one).

Don't know if that would help with your guy?

rjesak
December 3rd, 2009, 04:11 PM
We did eventually get him off the pred and onto Accolate instead. Between that and two inhalers, he's been breathing easily for a few weeks now - even when I burned the bacon for the stuffing at Thanksgiving and filled the house with smoke! :laughing:

I've never heard of Pred being used for pain but I hope it works for your poor baby. It sounds like she's going through the wringer. :grouphug:

tiggy2
December 3rd, 2009, 09:47 PM
Ya I find this vet does not want to give me pain medication, just prenosone, which as you say is not a pain medication.

I'll see how's she's doing tomorrow, she's still really dopey from all the drugs and I'm going to have to get her moving or she'll get bound up now that she has food in her stomach.

Any advice on that. Should I be concerned about bowl movements now that she has food in her. We managed to get 90ml of food into her, the most she's had in about a week. Did not want to push it beyond that the first day, might put her body into shock:)

Also gave her SubQ fluids, plus all the fluids we flushed through the tube. She is pee'ing about the only time she has gotten up.

I'm also concerned about her lack of any energy, I'm presuming it's to do with the 2 surgeries. Any advice on that? Should I get her up and moving or just let her sleep? Should I push for pain med's as well? Cause I also get the excuse that you can't give pain med's on top of Pred.

Of course I'm skeptical of this vet, I wonder why:frustrated:

aslan
December 3rd, 2009, 09:50 PM
prednisone is plain and simple a steroid.. the vet may be prescribing it for the asthma alone, not as a pain med. Being asthmatic i've never been told not to take anything for pain while using it. I would demand pain meds if you feel the kitty is in pain, or ask another vets opinion. you could always pm Dr. Lee and see what he says.

hazelrunpack
December 3rd, 2009, 09:54 PM
Pred can act as a pain med if the pain is due to inflammation. Once the inflammation is reduced, the pain often subsides.

I know nothing about cats, though, so can't advise about pred plus pain meds. I really just wanted to pop in and send some :goodvibes: I check your thread every time I'm on and I wish you both the best. :grouphug:

tiggy2
December 3rd, 2009, 10:24 PM
Pred can act as a pain med if the pain is due to inflammation. Once the inflammation is reduced, the pain often subsides.

I know nothing about cats, though, so can't advise about pred plus pain meds. I really just wanted to pop in and send some :goodvibes: I check your thread every time I'm on and I wish you both the best. :grouphug:

Thank you very much for popping in. I appreciate all the:goodvibes: I can get.

This poor animal, be it kitty, dog, rabbit, or anything else has been through hell and back. I just hope she keeps on trucking. I keep asking her to hang in there one more day and so far she's accepting the torture. I can only hope that it is all worth it. I guess I'll know that in a couple of days.

I'll keep you up to date on her progress and try and get some pictures of her, especially some before shots.

hazelrunpack
December 3rd, 2009, 10:31 PM
I'd love to see some pics or your beautiful girl! I'm sure lots of other members would, too.

You've got all the :goodvibes: that :fingerscrs, :pray:s and 32 crossed :pawprint:s can generate, winging your way in the meantime!

tiggy2
December 4th, 2009, 09:22 AM
Wondering if anyone could tell me what to expect from my cat's behaviour in the first couple of days while on this feeding tube?

Is it painful? Should I be looking into pain med's? This moaning she's doing, comes from her chest, could it be breathing issues?

She doesn't move very much. From the bed to the littler and back again and that's about it.

She looks miserable:( no purring, unless that moaning is her attempt, I don't think so:)

And of course still drools and her breath is terrible? Should I be bringing this to the "vet" or is this normal for a tube cat in the first couple of days?

I like to have some knowledge, especially with this vet or she'll just pass me off as a worrier and not do anything about it.

Love4himies
December 4th, 2009, 11:29 AM
Poor girl.

Yes, pred is a steriod and will reduce inflammation. It does this by affecting the immune system and stopping it from allowing the tissues to become inflammed.

It should not, however, be used as a general pain reliever for long term as the side affects can be dangerous (unless it is actually being used as Aslan stated for a specific illness).

Meow had her cat on a feeding tube not too long ago, perhaps you can pm her.

http://www.pets.ca/forum/showthread.php?t=59566

sugarcatmom
December 4th, 2009, 11:59 AM
Wondering if anyone could tell me what to expect from my cat's behaviour in the first couple of days while on this feeding tube?

The whole ordeal that she's been through and the surgery to place the tube can be quite exhausting, so it's normal that she'd be rather subdued. Is she holding down the food okay? Has she pooped yet?


Is it painful? Should I be looking into pain med's? This moaning she's doing, comes from her chest, could it be breathing issues?

The tube itself shouldn't be painful, but whatever it is that has put her in this state might be. I have no idea what the moaning is all about. Would be worth mentioning to the vet.

And of course still drools and her breath is terrible? Should I be bringing this to the "vet" or is this normal for a tube cat in the first couple of days?

Drooling and stinky breath is not a normal side effect of the tube (but she was doing that before the tube placement though, wasn't she?). She could be nauseous or in pain, it's hard to say. One way to determine if it's a pain response is to give her proper pain meds (ie buprenex or Fentanyl) and see if things improve. If it were me, I'd gradually stop the steroids. Is she on antibiotics? If so, which one?

tiggy2
December 4th, 2009, 01:09 PM
The whole ordeal that she's been through and the surgery to place the tube can be quite exhausting, so it's normal that she'd be rather subdued. Is she holding down the food okay? Has she pooped yet?

She is holding down the food great. I just gave her 60ml over 2 hours and she did not even wake up, along with 40 mls of water.

No poop yet. I do have a stool softener if that would help, lactulose syrup.

The tube itself shouldn't be painful, but whatever it is that has put her in this state might be. I have no idea what the moaning is all about. Would be worth mentioning to the vet.

I plan on dropping in on the vet's office this afternoon, can't avoid me that way:)


Drooling and stinky breath is not a normal side effect of the tube (but she was doing that before the tube placement though, wasn't she?). She could be nauseous or in pain, it's hard to say. One way to determine if it's a pain response is to give her proper pain meds (ie buprenex or Fentanyl) and see if things improve. If it were me, I'd gradually stop the steroids. Is she on antibiotics? If so, which one?

The only time she drooled was when the tube was put in. The bad breath has been there for awhile, and I presumed it was due to acid indigestion. Now it just smells rancid. The drooling is not as bad as it was with the first tube and I just saw her finally able to drink some water on her own:)

I would like to get her on some kind of pain med's and off the pred., so I guess I'm going to have to push that a little more.

The antibiotic she is on is amoxil 50mg 2ce a day. Just started that and I just crush it up and put it with the water.


I just hate to see her look so miserable:(

Love4himies
December 4th, 2009, 01:16 PM
SCM is right, the pred should be a very gradual decrease. Never stop them cold turkey.

tiggy2
December 5th, 2009, 11:51 AM
Update

I managed to get some pain med's. We now have tramadol, liquid, which I give around 0.2-0.5 ml's. I gave her 0.5ml yesterday straight up and got a lot of frothing, I mixed it in the water and gave it that way after she had some food.

She still drools and it still smells bad. Hoping the antibiotics will fix that.

Is it normal for stuff to come back up the tube? It's the same smell that she drools out? I figure that is not a good sign. She now hides under the couch.

Doesn't seem to be coming around. How long does it take before you see some kind of improvement. Am I just torturing the poor thing more? She looks miserable. How long do I keep doing this?

I guess I'm second guessing my decision to keep her going.:cry:

sugarcatmom
December 5th, 2009, 01:33 PM
Oh tiggy2, I'm so sorry that Tus is having such a rough go of this. It's heartbreaking to see our furry friends so sick. I really can't tell you how long to keep going, it's such an individual thing that only you and Tus and the vet can try to figure out. I can tell you about my own similar experiences.

My kitty, Aztec, developed diabetes almost 7 yrs ago, but it was probably a month or 2 until it dawned on me that something was up. Took him to the vet for blood work, and before I got the results back, he crashed (vomiting, wouldn't eat, hiding in the closet). Off to emergency we go, and it turns out he's developed diabetic ketoacidosis (DKA), a life-threatening complication of untreated diabetes. He was knocking on death's door and needed intensive 24hr vet care for a week, plus a feeding tube, before he was able to come home. He was pretty miserable, hiding in the closet, exhausted and scared for several weeks. It was 3 months of tube-feeding every 6 hrs before he ate on his own, and most of my friends/family thought I was insane to put this much effort into saving him. But he pulled through! And now, at over 16 yrs of age, he is the happiest little love bug and the joy of my life.

His brother, Egypt, didn't make it to his 12th birthday. One day, he just stopped eating. When an appetite stimulant didn't have any effect after 24 hrs, he also went to emergency. An ultrasound showed a dangerously blocked gall-bladder and he was scheduled to have it removed that night. There had been no other evidence that anything was wrong. When they removed his gall-bladder, they also biopsied his liver/pancreas/intestines and put in a feeding tube. Biopsy results showed moderate IBD, which was a shock to me because he'd never had any symptoms (no diarrhea, no vomiting, good appetite). I was hopeful: IBD wasn't supposed to be fatal. But for him it was. His decline was steady and rapid, despite being on a cocktail of various drugs and supplements and forced feedings. 6 weeks after he first stopped eating, he gave me a look and a pleading meow that will haunt me forever. I couldn't get him to the vet fast enough, for the last time. I don't know what it was specifically that he couldn't overcome, whether maybe he had developed intestinal lymphoma (a potential off-shoot of IBD) or what else had been brewing inside his little body, but we'd come to the end of the road. I have no regrets over what happened, and instead look upon the whole thing as an amazing learning experience, with Egypt as my teacher. He taught me so much about love and life and death and for that, I will be forever grateful.

My heart goes out to you. Try to spend some time with Tus that aren't about her being sick, but just the 2 of you, sharing a peaceful moment, no thoughts of the future or the past. Focus on the sensations of that singular point in time, the warmth of her fur, the rise and fall of her chest as she breaths. Feel your love for her, and nothing else. :grouphug:

tiggy2
December 5th, 2009, 05:38 PM
I will try and spend some non sick time with her:)

she's now hiding under the couch and growls at me, so my husband has taken up the feeding process for now. Rather have HER happy then ME. I can watch from the side:)

I'll let you know what's up in a couple of days

tiggy2
December 9th, 2009, 05:43 PM
Well it's Wed., and we did another trip to the vet's last nite. I really thought that would be it, but both the Vet and my other half were all for giving Tus a couple more days.

She has put on weight, almost 6oz in a week. Her coat looks better, according to the vet, she has had bowel movements, small ones, but good ones, and has not vomited anything up. The good things

The bad are she is soo weak, she can barely walk. Most of the muscle mass in the back legs are, non-exsistant, but what can you expect when you don't move for 5 days.

She did however come out from under the couch today and sit in her spot in the window:))):) We also made the bandage around her neck smaller, so it's less constricting.

I would like to get one of those sweaters that I have seen other cats have that have feeding tubes in. It would keep the tube in place without having the bulk of a bandage. The wrap we have now still pulls the tube and it looks like it could rip her skin. Remember she has 2 holes due to the mistake of the placing of the 1st tube. I change the bandage and put polysporin on it to help keep it clean.

Does anyone know where I can get or make a turtle neck sweater so I can keep the tube in place without having a big bandage? I don't think she would mind the warmth since winter is upon us.

Also does anyone know of a way to get her to walk more or get her legs strengthened, like rehab? I'm afraid if we don't get some strength back she'll be a long time coming back if at all. I'm hoping the snow will leave us in a couple of days and then I'd get her outside, she loves the outdoors:)

Still no interest in much, like she's depressed. The vet said to give her time as she has had a lot going on in the last month especially the last 2 weeks. How much time?

Anyway thought you'd like to know, she's still with us. The roller coaster of emotions has been absolutely exhausting. This is my first animal that I have been the soul care taker and after 15 years of friendship it doesn't get any easier. I hope it won't be this bad with the other 4.

And of course we still have no idea what is wrong with her. The vet is hoping to get a scope soon and then we might be able to get a biopsy on her bowels or pancreas or anything else that it will reach without causing too much damage.

Love4himies
December 9th, 2009, 05:47 PM
Awwww, tiggy, you will know when it is time. Gaining weight is such a good sign so I think your vet is right, give her some more time. It will take a while for recovery.

My ex-boss had to feed her cat for almost 3 months and that was years ago and the kitty is still alive today.

sugarcatmom
December 9th, 2009, 09:19 PM
She has put on weight, almost 6oz in a week. Her coat looks better, according to the vet, she has had bowel movements, small ones, but good ones, and has not vomited anything up. The good things

These are great signs!

The bad are she is soo weak, she can barely walk.

That's par for the course. She's been through a lot and it's going to take a good chunk of time for her to come around.

I would like to get one of those sweaters that I have seen other cats have that have feeding tubes in.

There is something called Surgi-Sox (http://www.dogleggs.com/files/surgisox/torso.cfm) that might work, although what I used was a type of human surgical stocking with holes cut in for the cat's front legs. You could also look for some baby clothes that might fit her.

Also does anyone know of a way to get her to walk more or get her legs strengthened, like rehab? I'm afraid if we don't get some strength back she'll be a long time coming back if at all.

Give her time. I wouldn't stress her too much right now by forcing her to move around. If she'll let you message her legs a bit or brush them to keep the circulation going, that might help. You could also get a heated pet bed insert like this one: http://www.kvsupply.com/browse/Home/Pet/Dog/Beds-Bedding/Heating-Cooling/Large-Pet-Warmer/D/30100/P/1:1:100:200:10000:10200:10204/I/82973

tiggy2
December 11th, 2009, 08:59 PM
Newest update

Well she's still with us. Thursday was a hard day. She vomited all her food and it took her 40 minutes of straining to have a poop the size of a nickel. It was heart breaking to see. Especially since she had thrown up all her food the nite before.

I've put her back on the vet's recovery food and increased the pumpkin from 2 tsp's per 5oz can to 4 tsp's in hope that will solve the poop end. The recovery food seems to be the one she can tolerate, so I'll keep her on that until I can get her back onto the Wellness brand again:)

She still won't sleep with us, nor have we heard a purr from her:(. She now like's to hang out in my shower and I've put a glass of water next to her because she seems to want to drink more. Still only getting 4 oz's of food a day, tried more and that's when we got into trouble.

Do you think 4oz's is enough for now?

I haven't gotten to the store to check out baby clothes for a neck wrap, hope to do that this weekend. As for the pet warming blanket, I have heating pads that I put under blankets or pet beds, on low. The arthritic cat loves it:))

My boy started to lick his belly again, I guess he's starting to feel my tension again <sigh>

So we take it day by day, she looks so terrible, but she does look at the window a little more, maybe that a sign?:fingerscr

I'm still trying to get some pictures loaded, just the ones I have are way too big, just have to figure out how to shrink them up.

Any idea's for getting the bowel's going? I'm using pumpkin and the suggestion of freezing it in tsp lumps was great idea:)) Thanks to whoever came up with that one. and of course SubQ fluids and the fluids I put into her tube.

Anyway thanks for listening and keep your paws crossed that she'll turn the better corner soon.

tiggy2
December 14th, 2009, 04:28 PM
Just wanted to let everyone know that I had to put Tus to sleep last nite. It was obvious she was not getting better but weaker, as she continued to vomit and then we found blood in her stool. The final straw for me was finding her face down in her own vomit in the kitty litter box.

I put an email in to the vet and she was kind enough to answer the call and put her down for me last nite.

I will still try to get a picture or 2 but I'm having issuing transferring them from one computer to another.

I also just got a phone call from my brother to inform me that my father is dying and it's only a matter of days. So it maybe awhile before I get the pictures to you.

Thank you all for your support and advice with Tus it meant a lot to me.

I'm sure I'll be back with other cat issues, as my boy is starting to lick his belly raw again:(((

Love to all and Happy Holidays:cat:

sugarcatmom
December 14th, 2009, 05:09 PM
Oh tiggy2, I'm so sorry, about both Tus and your dad. What a painful time for you. Please take care of yourself, and I look forward to some pics when you're ready and able. :grouphug:

:candle:

Love4himies
December 14th, 2009, 06:21 PM
I am so sorry about Tus and your dad, tiggy :cry: :grouphug:

growler~GateKeeper
December 15th, 2009, 02:43 AM
tiggy2 :grouphug: I'm very sorry about Tus & your Dad :sad:

:rip: sweet :angel2: Tus :candle: She is playing at the Rainbow Bridge (http://www.indigo.org/rainbowbridge_ver2.html) with those who've gone before :candle: :grouphug:

rjesak
December 15th, 2009, 08:10 AM
I'm so sorry. What a hard time this is for you! :grouphug: My sympathy is with you.

tiggy2
December 16th, 2009, 10:27 PM
Thank you everyone.

I heard an interesting comment today about grieving. We have all kinds of outlets for the grief of people but none for the grieving of our pets. To me the lose of Tus is like the lose of my first born child and I'm grateful that at least here there are others who can understand and grieve with me.

As for my Dad, I am on my way home now to see him one last time, but with him it was a long expected illness and there will be lots of others to grieve for him.

I'll get the picture to you guys when I get back home. I finally transferred them to my new computer and was looking at them last nite, lots of good memories:)

hazelrunpack
December 16th, 2009, 10:32 PM
I just saw the news, tiggy2. :grouphug: Such a difficult time for you. You both fought so hard.

:candle: Tus

Have a safe trip. A gentle passing and Godspeed for your Dad :pray: