1/9 Blue AMBG 66/1/10 PMBG 55

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Hi Patty,

I'm really pleased to hear that the Bluebird's come out from his under-table retreat and is perkier this morning. ((((Blue))))

Patty and Blue said:
First test this morning for BG was 54 which frightened me so I retest and it was 66.
What would I do if he were that low?
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For a cat not on insulin the 54 should be OK - sometimes remission kitties may see numbers in the 40s at times - but 'twas no harm to retest for peace of mind. If BG were to continue trending downwards then it might be a good idea to run the info past Blue's vets as a precaution.

Still trying to find a 'sweet' dose for the Noodler; her BP dipped just below the normal range again today. She gets very subdued and quiet, and she seems tired when her numbers get that low. It's worrying to contemplate that, without the meter, I'd have no idea her BP was in danger of going too low on the meds. The timescales might be different - days vs. hours - but managing her BP does remind me in some ways of using Lantus to control blood sugar. Because it takes up to a week for the amount of amlodipine in Lúnasa's system to reach steady state after any adjustment - not unlike waiting for a Lantus depot to stabilise - it's tricky trying to identify a good dose.

I'm tired and addled, comme d'habitude. How are you today? Are you managing to sleep OK?

:bighug:


Mogs
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PS: Spreadsheet police here! :D I'd suggest making a note of that 54 reading in Blue's spreadsheet. That way, as you take subsequent readings, you'll be better able to determine whether it's an outlier or the start of a trend. I note that Blue's PMBGs are trending a little lower.

(I know, I'm such a nag! :rolleyes: :p ;) )


Mogs
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I'm upset again. He's staying under the table but not sleeping. I just gave him some more Gaba in case he's in pain.
I'm not sure what's going on but it scares me.

Poor Noodle Bug. It's frightening when the blood pressure gets low. Thanks goodness you can track it at home and
change her dose.

I put the low reading in the note section. I'm thinking it was just a fluke, but noted just the same.
 
Patty and Blue said:
I'm upset again. He's staying under the table but not sleeping. I just gave him some more Gaba in case he's in pain.
I'm not sure what's going on but it scares me.
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I really, really feel for you, Patty. I'd be scared too. :bighug:

The only thing I can think to suggest to you is to send an email to the oncologist (cc'd to your own vets) with a summary of the odd behaviours after both chemo treatments (dates, odd things observed, how long it took for behaviour to return to normal after the first episode, how long Blue has been behaving differently since the second dose, in which ways he seemed better after receiving gabapentin, etc.). I'd also suggest following up the first email with phone calls and 'chasing' emails if you don't get a prompt and satisfactory response. (It's what I'd try to do myself.)

Things you've commented on in your threads that stick out in my mind (not quite in order of occurrence):

- Aggression toward one of your other cats (completely out of character).
- Protracted periods of staring into space.
- Not moving for a long time, almost as though he might be 'asleep sitting upright'.
- Marked increase in grooming activity.
- Wanting to be near you more than usual.
- Unusual, very loud vocalisations.
- Starting to sit/hide in an unusual spot/reluctance to move away from that spot for the last couple of days.

I think you should tell them how worried you are, that you think they need to know about what's happening, and that you need to speak with them ASAP about these behaviours and what might be done to help. No-one knows Blue as well as you do. Your observations are important. I really think they should be taking your concerns seriously, especially as the chemo treatment seems to have been the trigger on both occasions (albeit that there were 11 days and 7 days respectively between the 1st and 2nd chemo treatments and the emergence of the odd behaviours/clinical signs).

I wish there was something I could do to help.

((((Patty and Blue))))

:bighug:


Mogs
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Thank you Mogs. Great list and I'll use it since you already put it together. At least he gets up to eat so that makes me feel like he's not going to die. I know that sounds awful but that's where my thoughts have gone today. It's been a sad day.
 
He's been in the corner all day. He has come out to eat and go to the litter box but that's about all. I'm so worried.
I keep checking on him. I took his temperature and it was 101.3 and his BG is 68 tonight. I sure hope he perks up
soon. I did give him gaba earlier. I'm not sure if I'll give him more or not....
 
Worrying about the two of you. How is your Bluebird doing today, Patty? How are you?

((((Patty and Blue))))

I just noticed in your spreadsheet remarks that Blue tried to nick your sandwich the other day. Naughty boy. :) Is his appetite as good as ever?

:bighug:


Mogs
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He's still in the corner but he is still eating. He's not eating uncontrolled like he was but I'm making sure he has
additional by giving him the tuna in water. I gave him a dose of Gabapentin this morning so he seems to be
sleeping some now. He's just still acting weird, and doesn't ever come to me.

How are you and your buglet?
 
Thanks Mogs. I can't tell you how relieved I was! He's back in his corner but now he's sleeping.
He looks comfortable. Just very tired. He has the strangest reaction to that chemo. I hope he
doesn't have to take it again and they switch him to an alternative.

Are you okay? Noodle? :cat:
 
I can picture your relief very vividly, Patty. :bighug: It's good that he's having a comfortable snooze for himself now. ((((Blue))))

BTW, one of the things I missed for the list was that at times Blue hasn't been sleeping as much as he usually would. I think that's something that should be included too.

I'm hanging in there. Very tired, but that's nothing new. :rolleyes: Trying to get the Noodle to eat enough again. That BP dip knocked her appetite again. :( :banghead: I've been trying to reintroduce the renal support kibble again with limited success thus far. I know the other food's too high in protein but she seems better in herself on it than the renal stuff. What to do...


Mogs
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I understand your dilemma Mogs. Having had cats with CRF it's always hard to juggle what they should eat with what they will eat.
You have to also take into account others issues with your Noodle.

You are correct. He hasn't slept in days. Every time I looked his eyes were wide open. He sat like a statue for a couple of days.
It was so strange.

Hope you can sleep some. Me, I'm going to watch some football. I think I can finally concentrate on something besides Bluebird.
Although I check on him every 5 minutes. :)
 
Hi Patty,

It's still in the normal range and he's not on insulin. That said, there is definitely a gradual downward trend in Blue's BG levels - both AM and PM. While the numbers are definitely in the normal feline BG reference range, it might be an idea to flag the downward trend in your list for the oncologist. (Note: I have no idea whatsoever whether there is any significance in the downward trend, just noting that it's there. You should know the way I work by now: I make notes of everything and anything I observe, just in case it might be valuable.)

Patty and Blue said:
Me, I'm going to watch some football.
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Masochist. :p

Patty and Blue said:
. I think I can finally concentrate on something besides Bluebird. Although I check on him every 5 minutes. :)
Click to expand...
'Course you do! He's your furbaby and you love him. :) (I'm the very same.)

((((Patty and Blue))))

:bighug:


Mogs
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Hi Patty,
Just came by to check up on Blue and how he is getting on with the cancer treatments. I'm so sorry to read that he is reacting badly to the chemo treatments. You're both in my thoughts. Sending Blue and you lots of prayers and positive energy. I hope that you are able to get some traction with the oncologist tomorrow and a good path forward for Blue.:bighug::bighug:
 
Thanks guys. Blue is back in his corner but he seems to be more relaxed. He's eaten well and continues to drink water and go to the litter box. He can still jump on the counter and counter to counter. :rolleyes:

I'm probably going to try sending an email listing everything that has happened. Even if I leave messages they don't call me back. It's so frustrating.

Thanks for being here for me. :bighug:
 
I didn't realize Blue has been OTJ for weeks now. Congratulations on that, Patty!:bighug: It seems not long ago that he was doing those crazy steep dives with his numbers every day. Seeing his numbers continue to hold is wonderful.
 
Yes, isn't that great? I'm still not used too it. He'd go one extreme to the next. I'm happy to get more sleep now.
It is all consuming to test, feed and run for syrup and high carb food, but worth it in the long run.

It's looks like Butters is doing better as well. I'm happy for you. Hoping you achieve remission.
Thanks for checking on us. :bighug:
 
Hi Patty,

Checking in to see how yourself and Blue are doing today. Any joy from the vets at all?

((((Patty and Blue))))


Mogs
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HI Mogs,
Blue is about the same. He's still not eating that well so I gave him some of his favorite Meow Mix 10%
and he of course loved it. I hope it doesn't make his BG go up too much.

I called Bluepearl and got a direct email for the vet treating Blue. It's like pulling teeth. I send the list
you wrote and voiced my concerns. I haven't heard back yet.

I've been busy trying to schedule covid vaccine for my mom and myself. I think everyone is doing the
same because the website cashed.

Also, working on get stem cell scheduled for my knee. It's been a busy day but not much accomplished.

How are you and bug doing? Did you get any rest? Are you able to schedule a covid vaccine yet?
 
Hi Patty,

Did the Meow Mix make Blue feel any better? I'm glad he enjoyed it. ((((Blue))))

I'm glad you got the direct email address for the vet. Don't be shy about using it. I hope that you hear back from them today. If not, I'd suggest sending a follow-up email in the morning.

I'm also glad to hear that yourself and your mom will be able to get covid vaccinations (website permitting). If (and with our current shower it's a very large if) our government keeps to it's touted schedule I won't be eligible for a first dose of the vaccine until some time in April. At time of posting, I have no plans to bet the farm on getting a jab within that timescale, but they might surprise me.

Any joy with the stem cell appointment?

The bug's not eating again and she's as cranky as bejeezus tonight. I didn't get to sleep till nearly 6am this morning. :(


Mogs
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I just got this reply:

Hi Ms Gilmore
I'm sorry for any miscommunication. I have not gotten any messages through my voice mail and they may have been sent to the wrong doctor.. I believe you spoke to one of my colleagues Dr. Tuncay last week.

Please note none of these issues are side effects of chemo. Your paperwork should list possible side effects. It could be dementia but that's pretty rare in cats. Rarely, steroids like prednisolone can cause behavior changes but very, very rare in cats. Could be abdominal discomfort, but would not account for all of these signs. We could try additional pain medications.

Mostly, I'm worried the cancer could be affecting Blue's brain. This is uncommon but can happen with this cancer. Unfortunately there is no easy way to diagnose this for sure- usually requires an MRI/CSF tap which I would NOT recommend due Blue.

My best
JW
 
Oh, Patty... :bighug:

That's not the sort of information that should be conveyed via email.

I wish I knew more about this stuff so that I might try to do something to help you.

I guess start with the pain meds and see how they help?

How are you?

:bighug:


Mogs
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I was mad when I received the email but better now. I emailed her back to ask
what pain med she would recommend. I will get it at my vet if possible. I only
have the Gaba so he might need something stronger.

She's a terrible vet...:arghh:

You need some sleep girlfriend. Tell little buglet to cooperate and eat.

I'll schedule stem cell tomorrow. I have blood clotting disorder so had to arrange with my
doctor to get off blood thinners for a couple of days. I think they might schedule for later
this week. I hope!!!

No luck scheduling the covid vaccines. All the sites kept crashing.
 
Patty and Blue said:
She's a terrible vet...:arghh:
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You'll get no argument from this corner. She was obviously away from vet school the day they did bedside manner and communication skills.

The Noodler finally ate some Hill's k/d for me. Yes, I do need kip.

Hope you do better with the vaccines tomorrow. Fingers and paws crossed that you'll get the stem cell appointment too.

Keeping you both in my prayers.

((((Patty and Blue))))

:bighug:


Mogs
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I am seeing red at that vet’s response to you. I’m steaming. Are you sure you don’t want to see if the vet school is taking chemo patients? I’m so sorry you are being treated like this.:bighug:
 
Yes, my reaction as well. I might look into UGA tomorrow to see what they can do to help.
I've been there with a friend whose cat was ill. The vet had just run tests and they
said they needed to redo them. I think she's still paying if off.
Bluepearl is planning an MRI on the 21st and blood work isn't that big a deal if they need to run it. Would
probably be around the same if I can get him into UGA. What's another thousand. :eek:
I'm so disappointed. I expected someone to actually care. I don't think that's asking too much. I've never even met
her or talked with her and just now got my first reply.
 
I think part of the problem is you don’t get to talk face to face. She might not be good with emails. So she is suggesting an MRI? I thought she wrote not recommended. I understand when a vet needs to do their own ultrasound as the disc isn’t good enough. It only shows what the person doing it sees and things can be missed. I had to have a second one done for that reason. For me it was a good thing because it saved Max from exploratory surgery! Was your friend not happy with UGA? I know the outcome was not good.
 
No, UGA was great but they ran all the tests over because they said their machines are more advanced.
She had just paid the vet the same day for the same tests but UGA wouldn't use them.

They scheduled an MRI of his abdomen to see if tumors were shrinking and were then going to give a
different chemo if they weren't.

UGA has some clinical trails available for Lymphoma in cats. I might talk to my regular vet.

It is hard when you can't look someone eye to eye. She's a yankee...that's what we say in the south
when people have attitude. :D
 
Patty and Blue said:
I'm so disappointed. I expected someone to actually care. I don't think that's asking too much.
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I would be too, and I'm disappointed for you. It is perfectly reasonable to expect the person(s) providing medical care to your beloved companion to care about their patient - and their patient's human! It should be a given, not an ask.


Patty and Blue said:
She's a yankee...that's what we say in the south
when people have attitude.
Click to expand...
:D

Over here we're a tad less restrained with the pejoratives. :oops:

Night night.

((((Patty and Blue))))


Mogs
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Also, is the appetite stimulant prescribed by the oncologist mirtazapine? Have you given Blue any mirtazapine since it was prescribed for him? (I noted yesterday that you were considering giving him a dose of appy stimulant.)


Mogs
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I only gave it for a few days until I thought he was no longer constipated. I haven't given
any of the app stimulant. He's still eating but not like he was. Mornings he doesn't eat
much. I just gave him some of his favorite food and he ate great. In fact, he'd probably
eat more if I gave it to him.
What are you seeing?
 
I was just looking back over Blue's older threads and saw that he'd been prescribed the metoclopramide and I just wondered whether any of his meds might have anything to do with the odd behaviour.

Metoclopramide's typically OK to use for a few days. It crosses the blood-brain barrier, and there's a risk of neurological side effects if it's used for long periods. More info on metoclopramide here.

Also, mirtazapine can sometimes make cats behave weirdly. It's FDMB nickname is 'meowzapine' because some cats become noticeably more vocal when it's active in the system. More info on mirtazapine here.

Using the two meds together can apparently increase risk of side effects. According to marvistavet.com:

The chance of neurologic side effects is increased when metoclopramide is used in conjunction with mirtazapine, an appetite stimulant.​

I thought it best to check with you which meds Blue is currently taking.


Mogs
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