02/06 Fortune AMPS 472 +4 371 +9 370 PMPS 320 - first night home!

[RachelG]

Fortune came home last night!

He ate well (3 cans!), and slept in our bed with us. I cannot express how grateful I am to have our boy with us. Even Marty, his younger brother, didn't hiss at Fortune even though he definitely smells different after his hospital stay.

This morning Fortune ate well and seemed very alert and bright! He dragged a ton of litter onto the bed with him, but I'm not even a little annoyed by it. Around +4 he had some diarrhea, and has been exhibiting nauseated symptoms - sitting and staring at the water, taking gulps, etc.

We called the hospital where he was (pretty sure they hate us lol), asking for his lab work and imaging reports. I called back to ask for anti-nausea and anti-diarrheal meds, and they told me a nurse would call back.

I also called our GP - apparently he is out today and the earliest available is Wednesday at 3pm, after the oncologist on Tuesday. I asked if the vet who is in today can prescribe the meds, and they will get back to me too.

In the meantime, we are monitoring his breathing and constantly checking his gums because we are so scared.

I went over his progress notes from the hospital where the indicate the checks they do (litter box, flushing line, vitals, etc.) and several times the tech wrote that they couldn't complete the task "because of patient's temperament," or "patient tried to bite," "patient was hissing," etc. It breaks my heart - Fortune is very clear with his body language about what he needs, and they clearly weren't cluing in. I told them to talk sweetly to him whenever they need to touch him, and that he prefers having his face and chin pet over his body, but I guess no one took that down. At home, we have been able to do his BG testing, administer meds, check his gums, etc. He may be vocal or cranky about it, but I rub his face and tell him he is a good boy and how much I love him and he complies.

I am so concerned about getting him seen by the right folks and I feel like I'm failing him. So I'm just giving him all the pets and kisses he will tolerate and loving on him like crazy.

 

[Christie & Maverick]

What an ordeal for Fortune, I'm glad he is him home with you. I had a kitty some years ago with kidney disease, and she was treated with EPO for a short period of time. Truthfully the fact that Fortune was feisty is a good sign, when my girl's anemia dropped so badly, I tried the EPO but she deteriorated quickly. I think too blood transfusion helped Fortune, which I never got a chance to try.

 

[tiffmaxee]

I can’t believe he wasn’t sent home with meds. Whenever my cats were in the ER I was sent home with everything I might need. Make a list of what he had at the ER and email it to your vet’s office maybe. I wonder if the ER sent a report to them? You could Email yours as well.

 

[tiffmaxee]

My kidney cat on epo was on it for 6 months as I recall. I gave her 3 shots a week.

 

[RachelG]

Truthfully the fact that Fortune was feisty is a good sign, when my girl's anemia dropped so badly, I tried the EPO but she deteriorated quickly. I think too blood transfusion helped Fortune, which I never got a chance to try.

Yes, I agree - on Wednesday he was alert but non-responsive. It was horrific and terrible. He didn't make a peep or acknowledge them putting 3 IV catheters in him, so I'll take his "spicy" to quiet and depleted any day of the week! It's just hard because it tells me he isn't happy.

I'm so sorry you lost your girl to this. It's awful.

I can’t believe he wasn’t sent home with meds. Whenever my cats were in the ER I was sent home with everything I might need. Make a list of what he had at the ER and email it to your vet’s office maybe. I wonder if the ER sent a report to them? You could Email yours as well.

They did give us SOME meds - an appetite stimulant and some new meds to address the GI tract bleeding. When I asked about ondansetron, they told me cerenia is adequate.

Thankfully my GP's practice got back to me and we are going to head over to get the anti nausea and anti diarrhea meds. I just want him to be comfy and happy for as long as possible.

My kidney cat on epo was on it for 6 months as I recall. I gave her 3 shots a week.

That is awesome! It makes me so nervous to hope for that much time. They gave him darbepoetin, which is similar? But we are supposed to wait for the Tuesday appointment to have his PCV checked to get another shot, they won't give it to us at home which is why we are so scared. They gave no indication how frequently he should get it or how soon it wears off or how long he has. Just a cryptic "any day you have is a win."

I feel like it's a different language because I don't understand what they are saying!

 

[tiffmaxee]

That is awesome! It makes me so nervous to hope for that much time. They gave him darbepoetin, which is similar? But we are supposed to wait for the Tuesday appointment to have his PCV checked to get another shot, they won't give it to us at home which is why we are so scared. They gave no indication how frequently he should get it or how soon it wears off or how long he has. Just a cryptic "any day you have is a win."

I feel like it's a different language because I don't understand what they are saying![/QUOTE]

It is the same. It takes time to bring up the HCT and you want it at the lower end of normal, not the high end. I was given an RX and bought from an on line pharmacy. I see that you can now get it from lots of places. You first spend to see the cause of the anemia. If it’s from kidney disease I can turn you on to people that can help you that I know on a groupsio forum. My cancer kitty had stage 4 CKD because of a screw up by an oncologist. Even my good vet said she would develop antibodies to epo She didn’t be abuse of the help I got. I did not lose her to the anemia. So one step at a time.

I am so glad your vet is giving you what is needed to keep Fortune comfortable.

 

[RachelG]

It is the same. It takes time to bring up the HCT and you want it at the lower end of normal, not the high end. I was given an RX and bought from an on line pharmacy. I see that you can now get it from lots of places. You first spend to see the cause of the anemia. If it’s from kidney disease I can turn you on to people that can help you that I know on a groupsio forum. My cancer kitty had stage 4 CKD because of a screw up by an oncologist. Even my good vet said she would develop antibodies to epo She didn’t be abuse of the help I got. I did not lose her to the anemia. So one step at a time.

I don't know why we weren't given an RX - just hoping so hard he makes it to Tuesday and it can be addressed. We can get it anywhere, just need that vet approval. It gives me hope that you didn't lose your girl to anemia - I feel like I cannot take a deep breath because of the fear that he will become severly anemic again!

His HCT was at 27 when he was discharged, up from 24 in the morning after his second transfusion. We are blind until his next appt, which will be four days from his shot.

They aren't sure if it's from kidney disease since his values are only mildly elevated and stable (compared to previous labs), and he was stage 2...They also think the cancer has infiltrated his right kidney and there is a large mass on it. I am hoping so hard the oncologist has ideas on how to address things so we can have him around as long as we can, without unnecessarily giving him stress or discomfort. I just wish I could take him somewhere else sooner, since I do not like this hospital.

Right now he is snoozing between the heating vent and a radiator - his favorite place in the winter!

 

[tiffmaxee]

I’m not convinced the kidney disease is the cause either. It shouldn’t be with his kidney values. I was surprised they gave him epo. I don’t know if it helps with anemia caused by something other than CKD. In this case I think it would be the lymphoma. It’s good you will see an oncologist. I pray it’s a better one than I had.

 

[RachelG]

I don’t know if it helps with anemia caused by something other than CKD. In this case I think it would be the lymphoma. It’s good you will see an oncologist. I pray it’s a better one than I had.

They gave it for non-regenerative anemia, which is a common complication of severe CKD, but can be caused from other things. It replicates the process of a hormone that stimulates the bone marrow to create more red blood cells, which it is not doing on it's own in non-regenerative anemia.

Some "light googling" tells me that darbepoetin is a "longer acting" form of it, which supposedly has a three-fold longer half-life than epo. The study was conducted in India, but it was the only thing I have found so far that mention how long it lasts!

 

[tiffmaxee]

Aranesp is the best one. Perhaps that is what was given. It isn’t given as often and takes a bit longer to kick in. I need to Google that.

Just did. They gave the better one. Aranesp must be a brand name.

 

[carfurby (GA)]

Sending prayers.

 

[RachelG]

So Fortune's medications are getting to be a bit unwieldy with different times of day and conditions (before vs after food, 1 hour before eating, etc). Does anyone have a tracker sheet they use? Or maybe a white board? I use a pill planner for my meds, but the chemo and liquid meds can't go in one.

Aranesp is the best one. Perhaps that is what was given. It isn’t given as often and takes a bit longer to kick in. I need to Google that.

Just did. They gave the better one. Aranesp must be a brand name.

Yes! We spoke to the IM again, and she finally explained that "if he makes it, he will need it Friday." Unbelievable how she speaks to us. How did you check their PCV or HCT numbers? Would you bring them in to the vet? At what frequency?

She told us that he doesn't fit the "typical patient profile" for it, because his kidney numbers are normal. She shared that the other IM doc that we saw Sunday 1/31 (who did no blood work or testing) advised against it, but this doctor didn't see harm in trying, despite it not being "benign." The good news is our GP vet's office is happy to prescribe it, and we can get it from any local pharmacy.

His eye seems to be bothering him again, he is having trouble chewing (though he is still very hungry, thank G-d), and his back teeth look painful, so we have decided that, pending any change overnight, we will take him to Red Bank to be seen. We called and the next available internist appt is March 4, but the person we spoke to told us that if we come through the ER an internist will oversee his case and will consult with oncology so he can get care sooner. I really hope he can keep holding on until we get a better doctor on his case.

It's supposed to snow tomorrow + the SuperBowl, so I'm hoping it will be relatively empty if we go early.

His BG is still high, but stable and not super high. His PH on discharge was mildly acidic still (7.335), but as the IM loves to say to us, Fortune has a lot going on.

FWIW, mother has lymphoma, and had to get transfusions when she was severely anemic. She recovered, and is stable now. She also has "a lot going on," but she isn't on hospice care! My Fortune is still excited for food, giving head butts, and seems happy except for the discomfort from his left eye and when chewing.

Here's Fortune in his favorite bed, with his younger brother Marty. Marty usually sleeps in the whale bed next to Fortune in the shark, but decided to sit close to him. He also groomed Fortune today. My heart! Their beds are right between the heating vent and the radiator.

 

[Butters & Lyla]

Awwe they are so precious. It’s great that Fortune is eating well and interacting.
I tracked meds right in my spreadsheet for a while.

 

[tiffmaxee]

Love the picture. I got my lymphoma cat started on chemo by going through the ER too. Prayers.

 

[Wendy&Neko]

Good luck with the Red Bank adventure tomorrow.

Love the pic of the beds and it's so sweet Marty is playing nurse. Did you get any eye meds from the vet? My current SCL kitty got eye ulcers periodically from the pred, so we are tapered down to almost nothing now. My vet gave me eye drops that make quick work of any eye issues.