9/3 Ruby AMPS 349/+3 249/+6 244/+9 202/PMPS 127/+2 92
- Thread starter Katherine&Ruby
- Start date
Diane Tyler's Mom GA
Member Since 2018
Afternoon Katherine, maybe Ruby heard me yesterday asking her to poop 
I'm so glad she went. I'm going to take away your trampoline Ruby
I hope she slides down today. Have a good day Katherine
I'm so glad she went. I'm going to take away your trampoline Ruby
I hope she slides down today. Have a good day Katherine
Katherine&Ruby
Member Since 2020
Ruby never likes to disappoint her Auntie Diane!Afternoon Katherine, maybe Ruby heard me yesterday asking her to poop
I'm so glad she went. I'm going to take away your trampoline Ruby
I hope she slides down today. Have a good day Katherine
I am hoping it’s bouncing that she’s doing and not inflammation, but of course Ruby ain’t telling’. She seems fine and is hungry almost all the time. The fluids she’s getting is cutting down on the water drinking she’s been doing.
Katherine&Ruby
Member Since 2020
@Wendy&Neko I finally got a response to my email to Ruby's oncologist. She said many things: that one day of hyperglycemia is not a problem (I know this) and I shouldn't increase her dose (I know this too), thinks I test too much 
, that she has seen very few cats on pred being constipated and "once cats start having constipation issues, they worsen with time." If Ruby is "not doing well" the next time she sees her on September 22, she has reserved an ultrasound appointment for her that day "to further investigation."
I have a strong feeling that the ultrasound will not happen with the symptoms that Ruby is exhibiting that I admit are manageable, but not to my liking. I don't like seeing her in high numbers and I don't like feeding her so much Lactulose. If I weren't trained as well in using insulin by the FDMB, where would the breaking point be?
, that she has seen very few cats on pred being constipated and "once cats start having constipation issues, they worsen with time." If Ruby is "not doing well" the next time she sees her on September 22, she has reserved an ultrasound appointment for her that day "to further investigation." I have a strong feeling that the ultrasound will not happen with the symptoms that Ruby is exhibiting that I admit are manageable, but not to my liking. I don't like seeing her in high numbers and I don't like feeding her so much Lactulose. If I weren't trained as well in using insulin by the FDMB, where would the breaking point be?
carfurby (GA)
Member Since 2012
I'm glad you got some poop. I hope Ruby keeps sliding down for you.
You did see 50 on this dose, so not a lot of room for an increase. But I will point out that an oncologist is not an endocrinology expert. Endo docs have internal medicine backgrounds.
Maybe because those cats need to be on chlorambucil to really treat the SCL? And pred only helps short term? At least an ultrasound will tell you if the thickening of the bowels is reduced any or whether something in treatment needs to be changed.
Katherine&Ruby
Member Since 2020
Thanks, Wendy. I know there’s absolutely no room for an increase and I am not looking to change her dose. I feel very nervous keeping her at this dose that takes her so low, but I am also afraid of reducing. I would like to get Ruby off the steroid if possible, and would prefer that she be treated with chlorambucil alone at this point to see if that would work. But I don’t think that will go over well. As I said, everything is manageable at this point, I only wonder if there’s a better solution.
FrostD
Member Since 2020
I've been creeping on Miss Ruby when I can...is there any harm in saying exactly this to the oncologist? Is there any harm in just trying the chlorambucil for however long is a fair trial period?
Honest questions, I've never had a pet go through chemo. But from what I've read the likely side effects, if any, are nearly always mild GI distress for a bit.
I know your oncologist is a leading expert BUT reading between the lines and going off your word choices when you post about it, I wonder if she's really the right fit for you and Ruby. Just throwing it out there from an objective standpoint.
Katherine&Ruby
Member Since 2020
Hey Melissa! Thanks for keeping tabs on my Ruby. I honestly do not have the emotional energy to search for another doctor. I don’t know that there would be many oncologists who could manage the complexity of Ruby’s issues perfectly. Ruby has seen so many in the past year.
The hesitation on the part of this doctor comes from a few things. She wants to see how well the pred works and didn’t want to muddy the picture by starting both at the same time. She also said that there is no evidence that giving chlorambucil won’t cause another kind of cancer as it helps to quell this one. Although steroids are not chemo they can kill cancer cells in cats.
While I fully appreciate her method, I am also impatient for Ruby to get over this. Another ultrasound would be the only thing that would tip the scale for this doctor, and only if it shows that Ruby’s intestinal thickness has worsened. If an ultrasound shows that she has in fact improved, then there’s no more argument.
FrostD
Member Since 2020
I certainly understand and can appreciate that! I know how far we can dive in trying to do what's best for our kitties, just wanted to give an outsider's view because it sounds like she isn't quite working with you or giving you what you need to feel more at ease with the treatment plan. That said, there likely is no perfect solution for everything, just to do the best you can
22nd isn't too far away, though I'm sure it feels like it. Hopefully the ultrasound shows she's stable, but improved would be even better!
Katherine&Ruby
Member Since 2020
This oncologist is double board certified in Internal Medicine, but yes, she is not an endocrinologist. And she did not want me to increase her dosage of insulin, and I don't want to either.