Need help with Beau’s dosing!!

Just heard back from Dr G. Beau’s WBC is “sky high”. It’s 48 and high is 19. He is concerned that he may have an abdominal mass causing the inflammatory response. I’m on hold now with the office to get him scheduled as soon as possible.

I am in panic mode!
 
But how does he know it’s not just an infection? It could be. I do understand about how upsetting this is though. I would be a mess, and now I am quite worried about Beau — but what makes him think it’s not some kind of infection. I have had cats with high white counts before and we never did pinpoint the source of the infection. We have antibiotics and the white cells came down. Sometimes it’s hit or miss with which antibiotic works. I am hoping and will be praying for Beau.
 
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We don’t know it’s not an infection of some kind. I think that, rather than throw antibiotics at him, he wants to wait and see what the ultrasound shows. I wanted to get in today, but the vet who does ultrasounds isn’t there on Saturdays. She has no appointments on Monday so the soonest could get is Tuesday at 10 am.

In the meantime, I’ll continue with the fluids, as well as the mirataz to see if I can boost his appetite. And try to keep my sanity until Tuesday morning. I am so worried about him. To be honest, I am pretty much a wreck. I just keep giving Beau lots of loves, even more than usual.

I’ll continue with the 1.25 u for now, although it doesn’t seem to be keeping him out of the yellow today.
 
I totally understand what you are feeling. I am going through something similar with my cat William (and I just lost my beloved Ginger on July 12). William won’t eat much at all. He’s lost 3 lbs. Bloodwork is unremarkable. He’s having an ultrasound on Monday the 12th. I have to worry until then.
I am glad Beau will have his ultrasound sooner than that. Don’t be afraid to tweak his dose if he needs it. There’s no reason not to try to keep him out of the yellow.

How long ago exactly did his appetite start waning? How many weeks?
 
Suzanne & Darcy said:
I totally understand what you are feeling. I am going through something similar with my cat William (and I just lost my beloved Ginger on July 12). William won’t eat much at all. He’s lost 3 lbs. Bloodwork is unremarkable. He’s having an ultrasound on Monday the 12th. I have to worry until then.
I am glad Beau will have his ultrasound sooner than that. Don’t be afraid to tweak his dose if he needs it. There’s no reason not to try to keep him out of the yellow.

How long ago exactly did his appetite start waning? How many weeks?
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Good morning!

I’m sorry you lost your Ginger. And so recently. We don’t get over that hurt quickly. And now William is having trouble. That’s a long time to wait for the ultrasound. We can’t help but worry. They are our babies. I feel lucky I am able to get Beau in on Tuesday. But the anticipation is going to kill me. I’m trying to stay positive, but I have this feeling of dread.

The change in his eating first became noticeable about 2 weeks ago. But it was most likely going on for several days before that. I didn’t really see it until he started walking away from his food bowl, which is so unlike him. He had also quit letting me know he was hungry later in the day and for his late night snack. I just attributed it to the fact that his BG was low.

I haven’t tested him yet this morning. Getting ready to do that now. I had already decided to bump him back up to 1.5 to keep him out of the yellow. I hope I can keep him out of the lime.
 
In the last few days, I’ve really been able to see that he’s not himself. That he doesn’t feel well. I also noticed yesterday that his belly seems larger and feels hard. He also protests a bit when I pick him up. Maybe it hurts him. But perhaps that’s my imagination, the idea put there because of the possibility of an abdominal mass.
 
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But he still feels well enough to go out and enjoy some morning sun on the deck … before it gets too warm.
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Good morning!

I was tempted to bump Beau up to 1.75 this morning. He was all yellow the last 3 cycles. But I resisted and decided to keep him at 1.5 another day to see what would happen. I’m happy I did because he dropped ever so slightly into blue at +3.

I was also hesitant to make any more changes prior to tomorrow’s stressful vet visit for his ultrasound. It’s going to be a long morning for us.
Need to leave the house at 6:30 to deliver kittens an hour+ away for surgeries. I’ll have Beau with me because then it’s back to Auburn, over an hour depending on traffic, for his 10 appt. We’ll have some time to wait, so I’ll let him out of the carrier to stretch his legs. He’ll be finished at 11 and we’ll meet with Dr G. I’ll get him back home by 11:30. I get to rest and do chores a couple of hours, then it’s back down the hill for another hour+, in traffic, to pick up kittens from surgery. I’m exhausted just thinking about it.
 
Thank you.
It was a very long day.
The ultrasound showed much more fluid buildup, which I knew because I could see and feel that his belly was getting bigger. When I met with Dr G, he said there was good news and the potential for bad news. The good news is that the ultrasound didn’t show any masses. It’s possible that there is an infection in the mesentery, the connecting tissue of the stomach, which could be causing an inflammatory response and fluid buildup. He got a Covenia shot since he’s been such a bear with taking the oral clavamox, just in case. The bad news is that it is very likely it’s a heart issue. He said we could have a possible “bad outcome.” Not what I wanted to hear. He aspirated some fluid from the abdominal cavity to do cytology. He also is doing a BnP test to check the heart’s condition. If the cytology on the fluid comes back good, then it’s probably his heart. He didn’t want to wait for the results before doing the heart test so doing both. So, I’m on pins and needles again until results are back tomorrow. I feel in my soul that it’s his heart. But I hope I’m wrong. I’ve had that feeling of dread that I can’t shake since his appointment on Friday. My retired nurse friend says that what Dr G is describing sounds like congestive heart failure.
I asked him if any of this has anything to do with the pancreas looking like it’s trying to do its job and the good BG and being able to lower insulin. He said no, it’s a coincidence. What’s going on has nothing to do with it.
 
It seems strange that he didn’t have either a pleural effusion or pulmonary edema instead of ascites, although ascites is possible. So do you think the Convenia is an appropriate antibiotic for an infection of the mesentery? A cephalosporin? It sounds like Dr. G is very thorough. Did the Pro BNP test come back?
 
Also, I know quite a lot about cardiomyopathy in cats and heart failure/CHF. I may have mentioned that I just lost my Ginger to heart disease on July 12. She was diagnosed in February 2022 and lived with excellent quality of life for over two years. I am surprised that he wasn’t put on Lasix to try to remove the fluid.
 
Suzanne & Darcy said:
Also, I know quite a lot about cardiomyopathy in cats and heart failure/CHF. I may have mentioned that I just lost my Ginger to heart disease on July 12. She was diagnosed in February 2022 and lived with excellent quality of life for over two years. I am surprised that he wasn’t put on Lasix to try to remove the fluid.
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I haven’t heard from him yet. I know this is a surgery day so it will probably be end of the day. I don’t think he’s really thinking it’s an infection in the mesentery. But gave the Covenia as a just in case. I really feel that he’s leaning towards a heart issue. He said normally they would aspirate some fluid for cytology and wait for results. Then, if negative, do the Pro BnP. But he didn’t want to wait.

We talked about removing the fluid. He said we needed to know the cause before doing so. That you need to be more careful if it’s because of his heart. I also asked him about the possibility of FIP being the cause of the fluid buildup. He felt that, in a cat Beau’s age, it was unlikely. When they aspirated fluid I’m sure the color was noted. That yellow is a dead giveaway for FIP.

Of course, getting him to eat is still an issue. He eats very small amounts and is even more picky about what he eats. He’s getting quite a variety of food … whatever I can get him to take a few bites of. Adding cooked chicken, which he has always loved, has seemed to help. But he still doesn’t eat more than a heaping teaspoon of it. I’m assuming that he just doesn’t feel well and that the fluid buildup, causing pressure makes him not want to eat. ‍♀️

I knew that you recently lost Ginger but didn’t realize it was that recently. I am so sorry. I definitely didn’t know it was due to heart disease. I know that CHF is manageable in humans, so it follows that it would be in cats also. It’s encouraging to know that you had more than 2 more years with your Ginger after diagnosis.

I am hoping that, if that’s what we are looking at, that I can get the same with Beau. My heart is just aching at the thought of losing him.
 
Suzanne & Darcy said:
It would be unusual at his age to have FIP, but not impossible. If he does, I know quite a few cats personally who have recovered with the GS-441524 treatment.
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I have successfully treated 2 for the Rescue I work with. One was adopted with two of my other fosters, including her sister, almost 2 years ago. She is healthy and thriving. The one I most recently treated finished his observation at the end of June. He is also doing great, better than great.
Our Rescue has successfully treated 8 cats and kittens, I think. GS is a miracle drug!

I know it’s unlikely Beau could have FIP, but possible. That was the first thing that crossed my mind because of the fluid.
 
Do you think I should keep Beau’s dose where it is at 1.5?

I’m on pins and needles. No sleep. Hopefully I’ll hear this morning.
 
Thank you.

I was thinking I’d keep him at 1.5 if he stayed in the blue, but those yellows are creeping in. I have been giving him some higher carb, 8 - 10%, as I’m looking for something he will eat. So I’m happy that he’s not higher than where he is.
 
You’ve got the right idea— keep him eating. I can’t understand why it’s taking so long for the test result. It was just the pro-BNP, right?
 
Suzanne & Darcy said:
You’ve got the right idea— keep him eating. I can’t understand why it’s taking so long for the test result. It was just the pro-BNP, right?
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He’s not eating a lot, but at least he’s eating something. What entices him changes daily, often morning to night. When I try something like tiki cat or Weruva, he usually just licks up the juice or broth and leaves the chunky, yummy bits. Definitely a preference for pate.

I know it’s taking a long time. Usually results are next day. It’s a cytology on the fluid, as well as the BnP.
 
I guess they were waiting to get the pathologist report and tell you both things at the same time?

I feel like he would be more comfortable if they would either remove the fluid or give him diuretics. You can give him Rutin to help remove the fluid, but it’s a pretty large amount and he’s not eating— and you said he’s been not happy getting pills lately? That’s why you got the Convenia.
 
I know you’ve been concerned about Beau. I’m sorry I didn’t get back to you sooner. It’s been a crazy day and I finally have time to sit and let you know what’s going on.

The tests were both in this morning. It’s Dr G’s day off, so he called me from home this afternoon. It was a lot to take in.

BnP is in the normal range at 70, so that’s good. That doesn’t 100% eliminate a heart issue, but it’s a positive.
The cytology was helpful, but not conclusive. No cancer cells, but lots of inflammatory cells. He definitely has a visceral inflammatory response to something. He said his prognosis is still guarded.
He wants to be systematic about the next steps. And he doesn’t want to waste time in case there is something hiding or brewing.
He’s going to start with a new CBC panel tomorrow to see if there are any changes. While it is unlikely, he could have geriatric FIP. But he isn’t “ticking all of the boxes” for markers. His proteins and globulins aren’t elevated. So he’s also going to do an FIP titer. Those results should be in on Monday. He’s still hesitant to drain the ascites yet. The mirtazapine doesn’t seem to be helping much with his appetite, so he’s going to give him a dose of Allur
Dr Wallace, the ultrasound specialist conferred with Dr G again today and said that there were some areas where she couldn’t get a clear look because the fluids were clouding them. So, if the titer comes back negative for FIP, she’ll do the abdominal centesis to drain the fluid and another ultrasound to make sure there’s nothing in those areas she couldn’t see. If he’s positive for FIP, they’ll drain and we’ll discuss treatment options, GS shots or the new Stokes drug.
If he’s negative and the ultrasound shows nothing, he’s concerned that there may be a cardiac situation not on the BnP. So next step would be to do an echocardiogram. The cardiac specialist won’t be in again until the beginning of September and he doesn’t want to wait that long, getting it done sooner than later. We’d end up having to go to another clinic where there is a specialist on site.

So, that’s where we are at this time. No clear answers yet. :(
 
Oh wow, that’s kind of overwhelming, isn’t it. Thanks for updating me. That is a lot for you to take in, but I see some hopeful things in that report, perhaps. It’s looking like it’s not a cardiac problem so that’s good— and no cancer cells is also a positive. I feel like there’s hope…. although this seems like a stressful road for you and Beau for a bit of time before you get some more definitive answers. Have you been able to get any sleep? It is so stressful and all consuming at times when they won’t eat and you are trying everything… and you have 10 different food cans open to try to tempt them and you are holding their dish for them to try to get them to eat. That reminds me, have you tried a raised dish for Beau? It may be uncomfortable for him to eat at a regular low dish because of the ascites.

That was really nice of Dr. G to call you on his day off. A lot of vets would not do that. This sounds like a large veterinary practice with quite a few veterinarians.

I hope the Elura will help Beau’s appetite. I will be thinking about you and Beau today. I won’t bug you since I know you won’t have any more answers until next week. Don’t hesitate to reach out to me with anything. Hugs.
 
Suzanne & Darcy said:
Oh wow, that’s kind of overwhelming, isn’t it. Thanks for updating me. That is a lot for you to take in, but I see some hopeful things in that report, perhaps. It’s looking like it’s not a cardiac problem so that’s good— and no cancer cells is also a positive. I feel like there’s hope…. although this seems like a stressful road for you and Beau for a bit of time before you get some more definitive answers. Have you been able to get any sleep? It is so stressful and all consuming at times when they won’t eat and you are trying everything… and you have 10 different food cans open to try to tempt them and you are holding their dish for them to try to get them to eat. That reminds me, have you tried a raised dish for Beau? It may be uncomfortable for him to eat at a regular low dish because of the ascites.

That was really nice of Dr. G to call you on his day off. A lot of vets would not do that. This sounds like a large veterinary practice with quite a few veterinarians.

I hope the Elura will help Beau’s appetite. I will be thinking about you and Beau today. I won’t bug you since I know you won’t have any more answers until next week. Don’t hesitate to reach out to me with anything. Hugs.
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Good morning!

It is all very overwhelming and a lot to take in. It has been a very stressful time for both Beau and me. Sleep is still elusive, sadly, and I don’t sleep well anyway. And it’s not over yet.

I do feel better knowing the BnP was normal and there were no cancer cells. I’m trying to remain hopeful. Back to the Vet at 9:30 for the new tests.

They aren’t a large practice. They only have 3 vets at this time since one retired a couple of months ago. And she was also wonderful.

Funny that you mention elevating his food bowl. Last night, he seemed a little more enthusiastic about eating and for some reason I picked up his bowl and held it at head level. He still didn’t eat a “normal” amount, but more than he has been and he seemed a little excited about eating. I realized that he might feel uncomfortable bending down to eat right now. Poor sweet boy. I did the same thing this morning and he did eat a little more. So, raised food dish it is.

I appreciate your help and positive thoughts. It will be an anxious weekend waiting on tests again. The CBC could be back this afternoon, but I know the titer takes awhile.
 
Well, now we wait for the results of the CBC and FIP titer. It will probably be Monday morning.

While we were with Dr G I asked about Beau’s breathing. I know what labored breathing and it wasn’t that, but it looked like he was breathing a bit harder. Dr G agreed and decided to do a chest X-ray to be safe. He said both the lungs and heart look good. He drained about 60 ml of fluid to give him some relief. Gave him a dose of Entyce to help with his appetite, as well as CBD to help him feel better. He also went ahead and made the appointment for the ultrasound and abdominal centesis on Monday so it’s there if we need it.

Whether it’s the new food I tried, elevating his bowl (although he also ate while on his belly instead of standing), the Entyce or less fluid, Beau ate decently tonight.

He has a very soft purr which I haven’t heard lately, but felt. Tonight, while I was loving on him, I heard that purr. He seems to be feeling a little better. That’s probably due to the CBD.

I am so drained and exhausted worrying about my sweet Beau. I hope we can find what is going on with him soon.
 
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I am glad he drained some of the fluid. Too bad he didn’t go ahead and remove 100 mL. Did he sedate Beau for that? I am glad he’s been eating a bit better. The x-ray being clear is wonderful news. Did he see anything else on the x-ray? Why does this have to be such a mystery? Has he hinted at what he thinks it really might be? He really gave CBD to Beau? Do you know what kind?
That must have brought happy tears to your eyes when Beau purred!
 
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Suzanne & Darcy said:
I am glad he drained some of the fluid. Too bad he didn’t go ahead and remove 100 mL. Did he sedate Beau for that? I am glad he’s been eating a bit better. The x-ray being clear is wonderful news. Did he see anything else on the x-ray? Why does this have to be such a mystery? Has he hinted at what he thinks it really might be? He really gave CBD to Beau? Do you know what kind?
That must have brought happy tears to your eyes when Beau purred!
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He didn’t sedate Beau when the fluid was drained. I don’t know why the 60 ml. Maybe that was based on how much they think may be there? I know that they need to be careful about how much is removed depending on the cause, which of course, we don’t know yet.

He said the xray looked clear. He didn’t see any problems. Didn’t see anything physically unusual with the heart, such as enlargement.

I think he’s still leaning towards a heart issue, something the BnP doesn’t test for. However, even though the markers on his labs aren’t really there for FIP and Beau doesn’t have any of the other symptoms besides ascites, like diarrhea and and a fever, he is doing the FIP titer just so we can rule it out.

I does seem like the CBD helped him to feel better last night. I gave him another dose a while ago, so we’ll see. Dr G says it just “takes the edge off.”

I was so happy when I heard that purr and it did bring tears to my eyes. If I could just get him to eat better consistently, I would be even happier.

I did increase his dose to 1.75 this morning. I don’t want those yellows to creep up much further. I am happy that his numbers aren’t jumping higher and we are still much lower than the 3 and 2.75 of 3 weeks ago.

I’m going to try to stay calm and level-headed over the weekend, waiting for Monday to come. It’s so hard for me to focus on anything else. I know you understand that all too well.

I’m going to try and attach a photo of the CBD bottle.

Thank you for watching over us.

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I didn’t think to ask about the CBD oil being safe for diabetic kitties. He knows Beau is diabetic so I would assume he wouldn’t give it to me to use if it wasn’t. He gets 1 ml, as needed, every 12 - 24 hours.

I checked the ingredients this morning …MCT oil, vegetable glycerine, CBD isolate

This is what I found on vegetable glycerine …

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Hi Sharon. I am thinking of you and Beau. How is he today? I see his numbers are up a bit. It must be paid or inflammation causing that (and I have had people whose cats have had Convenia injections whose numbers went up and also their behavior was really off.)
 
Thank you for checking on us. Beau is just holding steady. I can tell how uncomfortable he is. He gets up, moves to another spot and settles in again. He’s been on the deck all morning enjoying the nice weather.

His BG is creeping up. I’m sure it must be because of pain and/or discomfort and whatever is causing the inflammatory response. I increased to 1.75u yesterday. Should I just leave it there for now?

He ate practically nothing yesterday and again today, so far. I went out this morning and bought some meat baby food and some chicken to cook. I did notice that he seems to be drinking more water though. I’m hoping to catch him peeing to get a ketone test. I’ve never done it before. His urinalysis from 6 days ago showed negative for ketones. If I can’t catch him to get a test because he isn’t peeing as often or as much, I’m going to ask if they can do one in the office. I’ll even take my strips, just in case, and ask them to pull some urine when or if they do another ultrasound for the abdominal centesis.

I completely lost it last night when he wouldn’t eat. Just sobbed and sobbed, feeling like this is my fault and I should have caught it sooner. And feeling completely helpless. He was doing so well with lower BGs and insulin doses that I missed something. Didn’t do something sooner when he wasn’t eating as well. I went down all of the rabbit holes! It’s been a long weekend.

I hope we get some answers tomorrow. I don’t want the FIP titer to come back positive, but it least it’s something I know.
 
It’s a natural reaction to blame yourself, but I don’t think it’s really a true one — I mean, when Beau started slowing down with his eating it could have been many different things. And you didn’t wait a long time to take him to the vet. It’s not your fault. I also know what it’s like juggling foster cats and kittens and running them around for spay/neuter appointments, etc. You really didn’t wait a long time before getting him in to the vet. Cats are so good at compensating for illness that we often don’t realize something significant is going on until it’s later than we wished we would have gotten them to the vet. This has happened to me many times. I know you know that already. I feel for you breaking down with him not eating. I know how that feels and how helpless and defeated a feeling it is. I pray you will get some answers tomorrow; you just have to! Poor Beau needs some help so they must decide on a course of action.
 
I sure hope so. He, and I, can’t continue this way.

Everything you say is so true, I know. But it’s so hard not to feel that way.

For some kind of answer and course of action tomorrow.
 
I know that feeling, but don’t give up yet. It’s too soon to give up because you don’t have answers yet, but boy is it hard to see them failing and feel so helpless and wonder what to do and what the future holds. Tomorrow he goes to the vet. If it’s FIP, I think you can deal with that. I am glad Dr. G has been trying to accelerate things. Tomorrow we need answers.
 
Just hoping for some kind of answer tomorrow.

I don’t like seeing his numbers go up. I’m not sure if I should leave his dose where it is. I hesitate to increase since he isn’t eating. I’m leaning towards waiting on what kind of information I get tomorrow.
 
Yes. I would wait just for safety sake. I would not increase before he has been at this dose for six cycles. I have a cat to take to the vet tomorrow morning at 9:30 ( but that’s 6:30 a.m. your time) to have a growth/cyst? checked out— but after that — later on, I hope to hear about Beau. What time is his appointment?
 
Suzanne & Darcy said:
Yes. I would wait just for safety sake. I would not increase before he has been at this dose for six cycles. I have a cat to take to the vet tomorrow morning at 9:30 ( but that’s 6:30 a.m. your time) to have a growth/cyst? checked out— but after that — later on, I hope to hear about Beau. What time is his appointment?
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Thank you. I’m comfortable with waiting 6 cycles. It’s only been 3.

His appointment is at 11:30, so 2:30 your time. I’ll definitely let you know what happened.

I can’t get him to eat anything and he seems like he’s getting a little weak, although he’ll still get up and relocate himself. I’m going to see if I can get at least something into him with a syringe. I hate doing it, but I’m concerned.

Good luck with your appointment tomorrow.
 
Suzanne & Darcy said:
Yes. I would wait just for safety sake. I would not increase before he has been at this dose for six cycles. I have a cat to take to the vet tomorrow morning at 9:30 ( but that’s 6:30 a.m. your time) to have a growth/cyst? checked out— but after that — later on, I hope to hear about Beau. What time is his appointment?
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Beau had 600 ml fluid drained today!!

And Dr G just sent me an email that the FIP titer came back positive.
 
Wow. Just… wow! I have never even heard of a cat having that much fluid drained. Poor Beau. I hate to think how uncomfortable that is and how it would affect all of his internal organs. How soon can you start the treatment?
 
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