Prayers Pls - Saoirse Intraocular Bleed - SUNDAY UPDATE: Nausea Reduced, Eating Again, Eyelids Puffy

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How wonderful to hear that you are both doing better and settling into a more normal routine. I hope the next few days can be calm and quiet and restful for you both, Mogs.
 
Jeanne Skadowski said:
Another way to spot high blood pressure in cats is when they have headaches. People who have cats that develop headaches report that their animals press their heads against walls or cushions to stop the pain. I have seen a couple of my cats do this, on occasion...and funny thing, that is exactly what I thought at the time, "They have a headache!
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Thank you, Jeanne for this information on clinical signs and also for finding some links for me to study. I like to learn as much as I can about clinical signs because it helps me to 'hear' Saoirse better.

WRT the headaches, when Saoirse was really distressed the night before last she was under the table with her head against one of the struts between the chair legs. After reading the above I think she may well have had head pain. My poor baby ...


Mogs
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@Squalliesmom , @Diana&Tom -

Ladies, you can be my dutch uncles any time - and very welcome ones at that! :bighug:

Saoirse had a bit to eat then hid in the litter box for a little while after we got back from the vets but shortly after she settled under the coffee table so I let her rest there. With her home again I was able to get several hours of sleep. As you've seen above we had another stressy night but I did get another few hours of sleep once I was sure Saoirse was stable. I still feel like a wrung-out dishrag.


Mogs
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Thank you everybody for continuing to keep us in your thoughts and prayers. I'm sorry that I can't manage to reply to you individually 'cause I'm so tired but I'm holding all of your caring and good wishes close to my heart. I feel absolutely drained mentally and physically but knowing that all of you are pulling for us is helping me to keep going. Thank you for lending me your strength. I wouldn't be managing as well as I am without you all.

:bighug::bighug::bighug::bighug::bighug::bighug:


Mogs
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Critter Mom said:
@Squalliesmom , @Diana&Tom -

Ladies, you can be my dutch uncles any time - and very welcome ones at that! :bighug:

Saoirse had a bit to eat then hid in the litter box for a little while after we got back but shortly after she settled under the coffee table so I let her rest there. With her home again I was able to get several hours of sleep. As you've seen above we had another stressy night but I did get another few hours of sleep once I was sure Saoirse was stable. I still feel like a wrung-out dishrag.


Mogs
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You know we're right ;-) You will be much better placed to help Saoirse if you yourself are well-rested. When you're tired your mind can play all sorts of tricks on you so you don't always know what you're seeing or doing. Get some sleep and you will feel better, and make sure you're eating too (I made a rather nice banana bread today and would pop some over to you if you were nearer )
 
I'm glad Saoirse is doing better and I hope she makes a full recovery soon! Please do get some rest if you can. Can monotonous tasks help to calm you? I find they can help me regain composure and if I'm run down they get me to a point where I am calm enough to sleep.

I know it is a bit late for this but do you have any ginger in the house? Ginger can help soothe upset tummies. IIRC it works best as a drink so ginger tea or ginger ale/beer would be ideal.
 
Poor Saoirse, yes, it does sound like she may have the equivalent of a headache, although my Bengal boy does the head pressing thing when he is feeling insecure, so I guess it may be a reaction to stress, as well.

I'm glad to hear you got a bit of sleep! Please do take care of yourself, for Saoirse's sake, if nothing else. You need to stay calm, rested, and alert for her! I know I'm preaching to the choir, but sometimes we don't do what we know we need to do, unless others give us a gentle push. ;)

Sending all prayers and healing vines! :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug:
 
I just saw this and am sending :bighug::bighug::bighug::bighug::bighug: because there's no such thing as too many :bighug:. Glad to hear that you both are feeling better. Will continue to keep you in my thoughts and prayers.
 
Update: Saoirse is Nauseated / Suspicion that Eye Has Been An Undetected Problem for Some Time
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Greetings from the infirmary. I've got everything Saoirse needs set up in the living room. We've had mood lighting all day so that it won't hurt Saoirse's eyes. The tropicamide has given her pupils like dinner plates. She's definitely having vision problems; she was very hesitant moving around this morning but she is moving around a bit better as the day has gone one. I've also set up a little bedouin tent on the sofa for her so she can hide away and still be able to comfort her.

I slept beside Saoirse and when I awoke she had her paw draped over me. :) We had some purrs in the morning. We've had pee and poop, too.

Saoirse's having difficulty eating today. She's hungry but very nauseated - ondansetron didn't help. I suspect it's down to the amlodipine (BP med) upsetting her stomach; I read online that digestive upset is a common side effect. I made made some organic chicken and pumpkin kitty soup for her but even that was making her a bit queasy. Thank the kitty gods for Cosma Chicken Snackies: they're like kitty saltines for Saoirse and she is managing to eat the Snackies fairly well. Not ideal, but it's food and I'm getting a good lot of fluids into her as well. I cooked up a batch of slippery elm bark syrup. She has managed to get one dose down, and she did a bit better nausea-wise with her next micro meal so I'm hoping that with a few more doses of the SEB it will counteract the side effects of the amlodipine. The experience with managing her bad pancreatitis flare is paying dividends.

Saoirse's BG was 13.8 at lunchtime so I gave her a conservative 0.25IU Lantus dose. Just as well now she's having difficulty getting food down. I'm going to order a blood ketone meter for her.

After my own experiences with med side effects I always check Saoirse's meds for their side effect profile and possible interactions with other drugs (something I feel that vets don't have the time to do enough of so I make it my business to find out myself - and I've caught never do enough o. With all that Saoirse has going on and the worry over the truly frightening reaction she had to the ½ tablet dose of amlodipine last night I don't want any more nasty surprises so I'm stripping her regimen back to the bare bones for now. It's proving to be a difficult juggling act.

I've decided I'm going to buy a Doppler unit to monitor Saoirse's blood pressure at home from now on. Also a paediatric stethoscope. @Larry and Kitties - thank you for the advice and the links. I've found this veterinary Doppler kit; it's the best price I could find this side of the pond. I'm going to ask our vet to give me a tutorial in its use.

Looking back over Saoirse's journal, there have been a couple of times since FD diagnosis that Saoirse's affected eye has been irritated. I don't know whether it's related or not. It's a worry. @Jeanne Skadowski - in answer to your question about Saoirse's back claws she was due to have them trimmed early next week. (I'm too scared I'll do it wrong and hurt her so I get the vets to trim them regularly.) We've also had a case of winter fleas in the house and Saoirse has been scratching lately. It is possible that she may have scratched her eye. I did leave a message for the vet on Friday morning about this, but I don't know whether he received it.

I'm absolutely shattered and every bit of me aches but I wasn't able to get more sleep yet because I need to help Saoirse to eat. I just managed to get a little more kitty soup and another dose of SEB into her. I've decided to wait till 2am to give Saoirse the next dose of amlodipine. I'm going to order in some grub and try to get a few hours' kip. I feel so sorry for my baby; it shrivels me up inside to see anything wrong with her. :(

STOP PRESS:

Saoirse now has steatorrhea (pale, fatty, fluffy stools). :( If you're reading this, please say a prayer she doesn't get a pancreatitis flare on top of everything else going on.


Mogs
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Bama said:
I know it is a bit late for this but do you have any ginger in the house?
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Thank you for the suggestion. I can get some ginger to try it. How do you prepare it for a kitty? Is it ever contraindicated or does it have any side effects? (Sorry for all the questions; too exhausted to research.)

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Gill & George said:
Hi Mogs,

I wish I'd seen this before you went to pick up Saoirse.
How is your baby doing now??
Is she still feeling nauseated, gagging, signs of pain??


A bleed in the anterior chamber in the eye can block the 'trabecular meshwork' (eyes drainage mechanism) this can cause a rise in intraoccular pressure, if it rises sharply and high enough it can be very painful and in humans certainly causes nausea, and might well explain her behavior yesterday. The bleed will eventually clear out, and until it does it's going to be near impossible to tell what caused it. The most common cause of an anterior chamber bleed in humans at any rate is trauma. Has she had any knocks been scrapping with other cats?

Do you know if your vet was able to check her intraocular pressure ( I imagine it would be difficult if not impossible to do without sedation)
If her intraocular pressure is raised they may be able to give her eye drops to help relieve the pain and eye pressure and limit inflammation. It's worth asking your vet about.

prayers and hugs :bighug::bighug::bighug:
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Hi Gill,

Thank you so much for this information, especially the note about the bleed eventually clearing; it has given me some badly needed hope to hang onto and I'm so grateful. :bighug: I tend to do better when I understand what's going on; it's the unknown I find much more stressful - and frightening.

I don't know about whether or not the vet measured the intraocular pressure on Friday. Saoirse was sedated for the eye exam but he didn't report anything about pressure when he gave me his initial findings that afternoon. I will ask him when he comes to the house to measure her blood pressure. Re the eye drops she is getting tropicamide for dilation and Isathal to soothe. (Sorry if you've already read about these in one of my updates.)


Mogs
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Apologies for this thread getting so long. With the PTSD it helps me to manage better having everything in just the one place so I can find things again. I hope everyone's OK with that.


Mogs
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Some more hugs for you and Saoirse, Mogs :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug:

I'm so sorry to hear Saoirse's now having problems eating. With the changes in her medication, I think a side effect of her blood pressure medication sounds likely. Remember as well that those drops they use to dilate the pupils do affect vision - I've had those used on me occasionally (as a long-term contact-lens wearer they like to check the back of the eyes for signs of insufficient oxygen permeation every few years). That blurred vision alone can cause headaches and nausea even when it's just for an hour or so - I think it's because it has a disorienting effect when you have to struggle to focus - so it could possibly be linked to that too. And bright light can definitely be painful, so I'd stick with the mood-lighting as much as you can for the next few days. With that said, it's important that her eye is treated, so it may be that that's something that you just have to help her through for a few days until they can review her treatment.

It is entirely possible that she's somehow scratched her eye - we've had more than one cat do that on occasion with their own claws (we do get their claws trimmed regularly - our cats seem to just be a bit stupid with them). But we've never had one be left with lasting ill-effects from it after receiving treatment so if she has done something like that, I think there is every chance that she will make a full recovery. :bighug: :bighug: :bighug:
 
Hi April,

Thank you from the bottom of my heart for helping me to stay awake to watch over Saoirse on Thursday night. :bighug: I was demented with fear over her, and even more fearful again of passing out and not being there for her.

As you say, Saoirse's eye has to be the priority here and I'm directing all treatment decisions and what little energy I have to that end. Thank you for telling me about the effects of the drops. It helps me so much to get information like this because Saoirse can't tell me. Do the drops also leave you with a bad taste in your mouth (wondering if they drain through the sinuses)?


Mogs
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Critter Mom said:
Saoirse now has steatorrhea (pale, fatty, fluffy stools
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Sending prayers it's not anything but her change of diet the past couple of days! I remember Menace sending me into fits of worry a couple of times in our early days with the same symptom when her appetite was hit or miss but it disappeared as soon as she was back on her grub. Hopefully this is just the effects of diet change and stress and will pass as she starts to heal and eats better. :bighug::bighug::bighug::bighug:
 
Hi Mogs

You are so very, very welcome. I'm always happy to help in any way I can. :bighug:

I haven't ever noticed the drops draining through my sinuses, but then I've only ever had a single dose of them at any one time - I wouldn't be surprised if repeated doses might have some sort of effect on the sinuses and mouth. I only really thought about it when you said that Saoirse seems nauseated - it's been a while now since I've had them, but once I read about how Saoirse is feeling, I remembered ending up with a kind of sea-sick feeling from them and I thought knowing that might help you to understand at least one of the possibilities for her being off her food. :bighug:
 
Hi Linda,

Thank you for sending prayers. We need them badly and we'll take all of them we can get. :bighug:

I'm fairly sure it's the amlodipine causing the digestive upset; Saoirse's stomach was gurgling like mad overnight when I was monitoring her breathing. She only started on the plain chicken a few hours before producing the pale tan, fatty stool. That said, the stress won't be doing her any favours either. My baby ... :(


Mogs
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Hay Mogs, checking in to see how you and Saoirse are doing from the sounds of it has continued to be roller coaster ride for the two of you. Just know that the people here are cheering you along and that we do love the both of you. If there was someway I could be of real assistance I would so I do the best I can and pray that it is enough. Just remember it always seems to be the darkest before the light do not give up.
 
Hi Julia,

Heartfelt thanks to you, too, for keeping vigil with us on Thursday night. That was very real assistance, indeed, and so very much appreciated - as are your continuing prayers; they are being heard and answered. :bighug:

Last night really did put the heart crossways in me, but at least today I've got some experience to fall back on with the nausea problem. I just pray it doesn't tip over into a flare. Saoirse's appetite is holding up well. If I can get the nausea under control with the slippery elm that'll be a big help.


Mogs
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Huggles I am sure you can do this, I dont know if it will work.. but sometimes a bit of carbonated water settles my stomach when It is upset. There is nothing but the water and the bubbles so I do not believe that there will be any problems.. but then I am just shooting in the dark. This group and you have done so much in helping Magellan and me it is the very least I could do and your more than welcome luv.
 
I don't have any experience treating any of these issues other than nausea and you're doing what I would do so I will just send massive hugs, prayers, and healing energy to you both.
 
Mogs, I've no idea if this is likely to be the case, but do you think there's any chance that amlodipine dose is too high for her? Normal BP for cats is meant to be 160 or less, but if she was only 175 with vet stress, I'm not sure how much it would actually need reducing - our vet definitely was not prepared to treat at 175 because they said we had to take off at least 20 points for stress. Low blood pressure can also cause nausea, dizziness and lethargy just as it can in humans. It's a really tough call to make because there's no sure-fire way of knowing which out of all the possibilities is causing the nausea for her - and even if you could get her BP re-tested today, it would still be a stress-affected reading. I'd love it if anyone else can chime in with an opinion - I'm trying to come up with possibilities, but I've no idea which is the most likely to be accurate...or even if it's something else entirely.
 
Now you know why I want the home Doppler unit, April. I don't like working blind.

It's awful because I can't give her stuff that I would use for the pancreatitis management because I'm worried about drug interactions. (I'm already wondering whether there was an interaction with her ondansetron dose this morning. There is a major interaction between amlodipine and dolasetron, a drug similar to ondansetron. I did ask the vet as a matter of course about giving the new meds with the existing regimen and he said they'd be OK but I always do my own interaction checking. I checked on drugs.com and they did not have any drug interaction between the amlodipine and ondansetron so I thought it would be OK.

Thank you for the info that low BP can cause nausea. I've experienced low BP myself (beta blockers - I'm very med sensitive); I had the dizziness and lethargy but not the nausea.

I'm thinking of calling the vet's OOH service.

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Critter Mom said:
I don't like working blind.
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I really don't like that either, Mogs. The one thing that, for me, makes diabetes easier to manage than a lot of other things is that I can check the numbers and I can take control of them.

Unfortunately, any time I ask my vet about interactions, the standard response seems to be that there aren't any - the only one they told me to be careful with was Carafate. Yet I know interactions exist between some of the others and I need to split up the timing of various meds...but like you I only know because I checked on it myself. Unfortunately, I don't know enough about either amlodipine or ondansetron to know if an interaction is likely. I'll take a quick look over on the Tanya's support group to see if it's something anyone has found out about for their cats and let you know.

I was surprised to see nausea listed too - maybe the dizziness causes nausea for some cats rather than them really being separate symptoms. But I figure all information helps at this point. :)

If you can get hold of the OOH service, maybe they can let you know whether to continue the amlodipine or reduce the dose a little - it's certainly not something you really want to have to make a decision on without their advice.
 
@manxcat419 - Forgot to mention above that I spoke to the on-call vet this morning about the dose and it was agreed to give 1/4 tablet instead of 1/2 tonight. After the land I got last night, I know the 1/2 tablet dose was too high.

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manxcat419 said:
I'll take a quick look over on the Tanya's support group to see if it's something anyone has found out about for their cats and let you know.
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I'd be so grateful if you would, April. I can't get my head around the new support group set-up at all. :(

manxcat419 said:
If you can get hold of the OOH service, maybe they can let you know whether to continue the amlodipine or reduce the dose a little - it's certainly not something you really want to have to make a decision on without their advice.
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Absolutely. I can manage the anti-nausea and appy stimulant stuff myself, but cardiovascular stuff is in a different league altogether. I'm going to give them a ring. Will report back after.

I'm glad you're here. :bighug:

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I ran a search in the support group (I agree, it really isn't very user-friendly and I don't post there unless I have a direct question because it's just too complicated to keep track of). It seems that a number of people give amlodipine and ondansetron together in the same gel-cap so I'm not seeing any reports of an interaction. A couple of people mentioned giving famotidine an hour apart from BP meds, but that's because the famotidine can stop the other meds being absorbed so well.

Critter Mom said:
I can manage the anti-nausea and appy stimulant stuff myself, but cardiovascular stuff is in a different league altogether.
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My feelings exactly - you've had plenty of practice with figuring out the anti-nausea stuff. But once it comes to BP and anything related, it really needs a professional opinion - at least until you can start checking Saoirse's BP at home.

Critter Mom said:
I spoke to the on-call vet this morning about the dose and it was agreed to give 1/4 tablet instead of 1/2 tonight.
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That may make all the difference for her - if it was just a little too much of a reduction in her BP, halving the dose might do the trick. :bighug:
 
Hi Mogs,
You and your baby have been on my mind all day while I was at work... I am glad to read she is feeling a touch better.
Pease try to at least catch a nap if not for yourself for your baby .... more hugs-healing and peace :bighug::bighug::bighug:
 
manxcat419 said:
It seems that a number of people give amlodipine and ondansetron together in the same gel-cap so I'm not seeing any reports of an interaction. A couple of people mentioned giving famotidine an hour apart from BP meds, but that's because the famotidine can stop the other meds being absorbed so well.
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Thank you for the above, April. That's massively useful to know that other people treat with all three meds. I've got famotidine here but I didn't know whether it would be a problem.

I've spoken with the on-call vet - same one as this morning. He suggests Saoirse may have picked up a bug that upset her tum rather than the med, but in my head the jury's out on that.

I briefed him on Saoirse's other clinical signs and he said it is OK to skip the amlodipine BP med tonight. I hope he's right. I just looked at Saoirse's right eye and the eyelids are very slack. I have given her all the eye meds OK today. It shrivels me up inside to see her so poorly.

I'm very scared again.

ETA:

I'm due to call the vet in the morning for further advice on the BP med. I don't know whether it will be possible but I think I should ask whether they could do an emergency house call to see if she actually needs the BP med at all. I'm also going to ask about the famotidine as it's the only weapon left in the arsenal to help her tummy.

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Critter Mom said:
Thank you for the above, April. That's massively useful to know that other people treat with all three meds. I've got famotidine here but I didn't know whether it would be a problem.
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You're very welcome, Mogs. I give Rosa famotidine and she's also on benazepril, but I just give them at opposite ends of the day - it gets more complicated when it's multiple doses in any 24 hour period. It sounds as though the famotidine would be fine if you need to give her some of that, but I think I'd go with the 1 hour or more gap that other people are using between that and the amlodipine just to be on the safe side - she's got enough to contend with already without drug interactions getting into the picture!

I love the way vets always think it must be something other than what's been prescribed! :rolleyes: I think it's too much of a coincidence for it to be anything other than the new meds.

I think if she got a full dose this morning and the vet thinks it would be OK to skip a dose tonight and resume with half doses tomorrow, that might not be a bad idea - and you'll be able to tell for sure as it clears her system if that was contributing to the problem. She's getting her eye meds and those are the ones that will heal the existing issue so as long as you can keep up with those - and you are - his advice sounds reasonable to me. :bighug: :bighug:
 
My vet considers any BP in the office above 180 to be high but I've seen other feeling vets use 190. I wonder if they should take her BP again now that the amlodipine has had a chance to kick in. It worries me that it could be dropping her too low at home. If she is extremely lethargic, that could potentially be due, in part, to her BP if she doesn't really need the med.

If she were mine and the vet said to skip a dose, I certainly would for an in office BP of 170. That just seems so borderline to me.

Have you tried mixing George's 100% pure aloe vera which has been fractionally distilled in with the slippery elm? That's how I treated Gracie to settle her tummy and it worked really well. The link is for Amazon.uk but perhaps there is a local apothecary which carries it. It must be pure aloe vera and fractionally distilled.
 
Thanks for sharing details of your treatments for Rosa.

Re the vets, the only place Saoirse could have picked up a bug was at the vets. I hope they will agree to the home visit for a BP check tomorrow. It would simplify things a lot.

I'm feeling sick again. And getting cold and shaky, too.
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You've got this, Mogs. You're doing everything right for her. :bighug: :bighug: :bighug: :bighug: I know it's difficult to see her miserable, but skip that amlodipine dose and see how she feels without it - that really might make all the difference for her. I still don't think it's a bug - I could be wrong, but it seems to have started too soon after the change in meds for a bug to be the likely answer. A home visit would make things much easier for both of you - and they'd get a much more accurate reading for Saoirse because she'd be more relaxed. And of course that would be the best way to find out if the dose is taking her BP too low when she's relaxed.

Oh, and some more hugs because there are never too many hugs for a situation like this. :bighug: :bighug: :bighug: :bighug: :bighug: :bighug: :bighug:
 
Marje and Gracie said:
It worries me that it could be dropping her too low at home. If she is extremely lethargic, that could potentially be due, in part, to her BP if she doesn't really need the med.
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You should have seen her last night just after I gave her the half tablet. I went to check her and her whole posture was wrong. When I couldn't rouse her immediately I was terrified. I felt like I was in a nightmare. The relief when I got her to react ...

I've never given Saoirse aloe vera. I heard great things about it from one of the members here but I've also seen negative reports about it as well. I was afraid if I gave it to Saoirse it might not be the right thing to do. Any time I have to give her something different it really scares me (not without reason at times - last night, for example).

Thank you for the link, Marje. Can you point me anywhere I can read more about aloe vera for cats? I know from taking it myself in the past it can do wonders for the digestive system.

:bighug:
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EDITED TO ADD:

And the mirtazapine episode wasn't great either. :(

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Critter Mom said:
You should have seen her last night just after I gave her the half tablet. I went to check her and her whole posture was wrong. When I couldn't rouse her immediately I was terrified. I felt like I was in a nightmare. The relief when I got her to react ...

I've never given Saoirse aloe vera. I heard great things about it from one of the members here but I've also seen negative reports about it as well. I was afraid if I gave it to Saoirse it might not be the right thing to do. Any time I have to give her something different it really scares me (not without reason at times - last night, for example).

Thank you for the link, Marje. Can you point me anywhere I can read more about aloe vera for cats? I know from taking it myself in the past it can do wonders for the digestive system.

:bighug:
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EDITED TO ADD:

And the mirtazapine episode wasn't great either. :(
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Look at Natural Remedies #4 for info but please do not try it if you are not comfortable with it. It never caused Gracie to have diarrhea and I always used plenty of water with the aloe Vera and SEB. I did a 1:1 on the aloe Vera:water. Again, don't try it if you are concerned. I totally understand that sometimes you don't need to put one more thing in the mix.
 
Thank you for the link, Marje. Adding things with pancreatitis in the mix has always been hard. One is just so petrified of doing anything that might make things worse. Like what's happening now. :(
 
Mogs, we're all here for you. I just did a quick check of all the potential side effects (common to rare) of the amlodipine. From your description of the symptoms Saoirse has and is displaying, I'd say there is an extremely high probability of the amlodipine being the culprit especially when you've got a med sensitive girl. Since the vet told you it's OK to withhold it tonight, I'd be inclined to do just that and see if she doesn't feel better tomorrow and then reconsider dose if the vet thinks she still needs it. More hugs for both of you being sent across the pond. :bighug::bighug::bighug::bighug::bighug::bighug:
 
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