2/19 Ruby AMPS 94/+3 57/+5 73/+7 69/PMPS 85/+2 83/+4 88

[Katherine&Ruby]

Yesterday's continued lively condo.

Best part, I did actually get a diagnosis this time. I know what I'm dealing with. I know that I'm treating for the condition she has. There are no questions about whether I'm doing the right thing.

Thank you for your thoughts, Wendy. I think I am a bit like you. The uncertainty would drive me a little cuckoo. Last night I posted on the Raw Feeding for IBD group on FB and, after sharing the ultrasound report which states "small intestines have a diffuse and thickened wall 3.2mm with a prominent submucosal and muscularis layer" a mod suggested that the thickness indicates SCL rather than IBD. So I really do have to consider a biopsy, even if I have to put it on Care Credit. I have spent the morning trying to find an appointment with an Internal Medicine specialist. I received a name for a highly highly recommended vet at Animal Medical Center on the East Side of Manhattan, but his first appointment is a month from now.

Meanwhile, I found diarrhea in the litterbox this morning. Added more S. boulardii to her food. She is eating, so that is a relief, and her BG numbers have been pretty good since the dose increase. Trying to focus on the positives.

 

[tiffmaxee]

I don’t want to scare you but my lymphoma kitty had thickening without any masses and it was intermediate cell. I would want to know for sure what you are dealing with as treatment will make her feel much better. I need to read your previous post.

 

[JaxBenji]

Just here to hand out hugs

Hang in there mama bean

Nice cycle for Ruby

 

[RachelG]

Oh I'm sorry, this sounds like a lot! I want to let you know that even thought the big C sounds scary, SCL is very treatable! Fortune was doing really well on his treatment. The only complication he had was diabetes from pred, and you already know how to manage that!

Even with everything going on with him, the SCL is in remission at the moment (keinahora).

That is great she is eating!

 

[Katherine&Ruby]

Oh I'm sorry, this sounds like a lot! I want to let you know that even thought the big C sounds scary, SCL is very treatable! Fortune was doing really well on his treatment. The only complication he had was diabetes from pred, and you already know how to manage that!

Even with everything going on with him, the SCL is in remission at the moment (keinahora).

That is great she is eating!

It DOES sound really scary, Rachel. I have been crying all morning. Thank you for sharing how treatable it is. It makes me feel a bit better for my poor kitty.

 

[RachelG]

Big hugs.

Ruby knows you're doing the best you can for her. Knowing what you're dealing with allows you to give her the best care and treatment possible.

I hope that internist is fabulous!

 

[Katherine&Ruby]

Big hugs.

Ruby knows you're doing the best you can for her. Knowing what you're dealing with allows you to give her the best care and treatment possible.

I hope that internist is fabulous!

I decided that I couldn't wait a month for the fabulous internist, so in the meantime I've made an appointment next Thursday with one of the IMs who treated Ruby's DKA in September at Blue Pearl where the ultrasound was originally performed. I stopped communicating with her after she pushed prescription food on me, discouraged home BG testing, and was generally very difficult to communicate with directly, but I'm willing to let bygones be bygones to focus on her CKD and GI issues.

 

[tiffmaxee]

I wrote a long response that got lost. I agree with what Wendy wrote. My lymphoma kitty had thickening but no masses. She was diagnosed with intermediate cell lymphoma by endoscopy.

You can start with Blue Pearl and if not happy switch to the other one if you dint like what you hear. All I can say on that is that a good oncologist is essential. The earlier you find out what you are dealing with the better. As. Marje and Wendy said treatment is not the same for IBD and scl for all cats.

 

[Katherine&Ruby]

I wrote a long response that got lost. I agree with what Wendy wrote. My lymphoma kitty had thickening but no masses. She was diagnosed with intermediate cell lymphoma by endoscopy.

You can start with Blue Pearl and if not happy switch to the other one if you dint like what you hear. All I can say on that is that a good oncologist is essential. The earlier you find out what you are dealing with the better. As. Marje and Wendy said treatment is not the same for IBD and scl for all cats.

Grateful to you, Elise. The diarrhea really scared me today as I haven't seen her do that since she was very sick in September. Am convinced I need to get to the bottom of this. Meanwhile, Ruby's sister Olive's blood work came back and everything is totally and utterly normal. She was put on three days of Onsior for her limpy leg but she is as healthy as can be otherwise. Fascinating how two cats who grew up next to each other, eating the same things and living in the same environment can have such different health profiles.

 

[tiffmaxee]

Is the diarrhea frequent? Pudding consistency or looser? My lymphoma kitty had pudding once a day. She was started regurgitating her food shortly after eating but not every day. I thought it was scarf and barf.

 

[Katherine&Ruby]

Is the diarrhea frequent? Pudding consistency or looser? My lymphoma kitty had pudding once a day. She was started regurgitating her food shortly after eating but not every day. I thought it was scarf and barf.

I’m not sure you could consider it diarrhea. It was not liquid, more like pudding. This is the second time in the last four days. She has not been vomiting as far as I know. I was worried I was giving her too much S. boulardii so skipped that for a day but nothing changed.

 

[tiffmaxee]

That’s what happened with Tiffany. It was only once a day and she was acting fine. I thought it was the food change since she had very early CKD at age 10 and was switched to Hills KD. This was 11 years ago so things were different then. I always wondered if she had scl that morphed or IBD from the beginning.

 

[Katherine&Ruby]

@tiffmaxee Another point I keep forgetting to mention is Blue Pearl did a B12 and folate test and found that her B12 was >1000 but her folate was low at 8.28, indicating something is going on with her small intestine.

 

[Katherine&Ruby]

Just here to hand out hugs

I need them today! Thanks, Susanne.

 

[Wendy&Neko]

Beautiful cycle so far today. How often are you giving Pepcid? Not the best thing for kitties with GI issues.

 

[Katherine&Ruby]

Beautiful cycle so far today. How often are you giving Pepcid? Not the best thing for kitties with GI issues.

I did indeed read that post and I don't intend to use it long term. I gave a ¼ tab to her on Tuesday and then again this morning when she was avoiding her food but she's been eating fine since. I just got off the phone with her vet and he's giving me a prescription for Metronidazole that I hope will make her a bit more comfortable and her stool less runny. We are holding off on the budesonide until we see the internist next Thursday.

 

[Wendy&Neko]

The Metronidazole short term should help. Just note, if you don't know already, it tastes horrible.

 

[Katherine&Ruby]

The Metronidazole short term should help. Just note, if you don't know already, it tastes horrible.

Should I ask for the liquid instead?

 

[carfurby (GA)]

 

[Wendy&Neko]

I put metronidazole pills (tiny) in a pill pocket with ease. There is no way of getting away from the foul taste in a liquid. I even tried some compounded chicken flavour, but I was told in no uncertain terms that the flavouring did not work!

 

[Katherine&Ruby]

PMPS = 85. We've had a really nice green numbers day. Since this morning she has been eating well but she's been in a meatloaf for most of the day. Hope the antibiotic helps her tummy.

 

[Butters & Lyla]

That's a nice PMPS but I'm sorry you've got so much to figure out for Ruby. My heart goes out to you. I hope the antibiotic helps her.

I saw Marje responded to your question about transitioning to a raw diet. I was going to point you to the FFL website but she did that. It was easy with Butters because she had been on a raw diet prior to her DM diagnosis. She started vomiting her food and refusing to eat it the day I started her on insulin. Probably a coincidence. So I gave her canned but got her back onto raw pretty quick but I used the FFL site as a guide.

 

[Marje and Gracie]

From yesterday:

Ok, so if I understand you correctly, I should not have started the +9 feeding until Ruby was at a drop dose AND having blue preshot values. Please confirm.

Yes, will be getting the full blood panel next time with the fixings. The panel done in January was actually done to recheck the high-ish SDMA number from December. I have been working hard in earnest to feed Ruby low phosphorus foods since her last test result, and so I hope that when I take her back to the vet in March that the phos. will be even lower. I have been giving Ruby the appetite stim only after the Cerenia does not work. I know the mirtazapine is a very powerful drug. I've tried giving SEB to Ruby and she won't go near any food with it unfortunately. Perhaps I should get gel caps and put some SEB in them. I am quite distressed though that she won't eat on her own. Does the inappetence come in temporary waves or will I have to be correcting her nausea all the time?

OK, I'm going to dive into the process of transitioning and will see what happens! I would love to start with the prepared foods but most of them contain ground bones, no?

I probably wouldn’t have started a +9 feeding.

The SEB can be made into a syrup and syringed. You can also use George’s Aloe Vera with it but be sure you read the info because you can’t just use any aloe vera. IMHO, cerenia doesn’t work as well as zofran but they work together very nicely to address nausea. I don’t know whether you’ll have to address nausea all the time. I gave Gracie both just to make sure it wasn’t an issue plus the cerenia is an anti-inflammatory.

i’m not sure which prepared raw foods have bones. It’s been too long since I’ve used them.

I hope you get the info you need for Ruby from the IM. Wendy and Elise are excellent sources. I didn’t have a good experience with the endoscopy and biopsy so that colors my feelings about it which is not fair to you and Ruby.

 

[Katherine&Ruby]

I saw Marje responded to your question about transitioning to a raw diet.

Yes, thanks, Lyla. I bought some Primal today just so I would have something premade where I could see if Ruby and Olive take to raw before embarking on making my own. It's thawing in the fridge right now so will start them with a smidgen tomorrow in their food.

The SEB can be made into a syrup and syringed. You can also use George’s Aloe Vera with it but be sure you read the info because you can’t just use any aloe vera.

I've ordered George's juice and I already have the syringes and SEB so I hope I can get Ruby to take it. She's very compliant with pilling, although if she reacts to assisted drinking like she does to me giving her subQ fluids, I might have some trouble.

IMHO, cerenia doesn’t work as well as zofran but they work together very nicely to address nausea. I don’t know whether you’ll have to address nausea all the time. I gave Gracie both just to make sure it wasn’t an issue plus the cerenia is an anti-inflammatory.

The Zofran is coming by tomorrow hopefully, and some cyproheptadine next week. Interesting to know that cerenia is an anti-inflammatory. The Pepcid might have helped Ruby today as she was eating well but I'd feel much better if the SEB and aloe juice performed the same function.

I hope you get the info you need for Ruby from the IM. Wendy and Elise are excellent sources. I didn’t have a good experience with the endoscopy and biopsy so that colors my feelings about it which is not fair to you and Ruby.

Don't worry, Marje. You're definitely not the only person to advise me against it and I'm so grateful that I can get a multitude of perspectives before arriving at my own conclusions about what to do. At this point I've learned so much from everyone here and all of the research that I've been doing that I'm much better equipped to handle the situation than I was in September when faced quite suddenly with Ruby's DKA crisis with no knowledge of feline health at all.