11/23 ChrisFarley life inspite of lymphoma update

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Hi Melanie,
So glad to see your update and to hear how well Chris did this past week. His photos are great. Keep on truckin', Chris. Lots of keep-feeling-good vines are on the way.

:bighug::bighug::bighug:

Ella & Rusty
 
Here is what Tanya's site says about Ondansetron dosing:

Ondansetron comes in 4mg pills, and a commonly used dose on Tanya's Support Group is 1 mg each day, so one pill contains four doses.



This seems to work well for many CKD cats; however, Pet Place mentions that the usual dose for cats is 0.11mg per pound bodyweight every 8-12 hours, i.e. 1.1mg for a 10 lb (4.5kg) cat given 2-3 times a day. Plumb's Veterinary Drug Handbook mentions an empiric dose of 0.5mg per kg bodyweight twice daily, so a 10 lb (4.5kg) cat would be given 2.25mg twice a day.

Oral, subcutaneous and intravenous pharmacokinetics of ondansetron in healthy cats (2014) Quimby JM, Lake RC, Hansen RJ, Lunghofer PJ & Gustafson DL Journal of Veterinary Pharmacology and Therapeutics 37(4) pp348–353 found that subcutaneous administration was more effective then oral dosing. It also states "twice daily administration at 0.5 mg/kg is likely inadequate to maintain serum concentrations within the therapeutic range; higher or more frequent doses may be needed." However, it further states that "the postulated therapeutic range - extrapolated from a previously published pharmacodynamic study - may not be accurate particularly if applied to repeated administration for chronic disease states." The study says that "A placebocontrolled clinical trial will be necessary to confirm which dose would be clinically effective for palliation of chronic nausea and vomiting in cats."

Obviously there are quite sizable differences between these doses. The above study found"Poor bioavailability should be taken into account when determining a route of administration for a patient as individual oral bioavailability ranged from 11 to 50% in the cats used in this study." For acute vomiting, such as in a cat with pancreatitis, higher and/or more frequent dosing may indeed be necessary. For chronic nausea in CKD cats, however, many people find the lower dose is fine, though they may need to give ondansetron twice or even three times daily. I would start with the lower dose of 1 mg each day, and if you find this is not enough, speak to your vet about increasing the dose or frequency.
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Doxi is a very powerful chemo drug, which works wonders, but it is very hard on the kidneys. They had to stop using it on my Sasha after a few treatments as her kidney values got worse. Just something to keep an eye on. It doesn't happen in every cat.

I'm so glad Chris is doing things he had stopped doing - that's always a good sign.

Let me know if you want that Ondansetron.
 
Melanie and Smokey said:
Chris proved himself the king of not taking pills. I gave him the Cerenia last night around 9. After his SubQ fluids I was setting him in the bed and he calmly spit his Cerenia pill out - an hour and a half after I gave it to him. Goofball.
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that totally cracked me up. *bows to the master*

glad to hear he's having many good days! the metronidazole worked wonders with punkin after he'd had c-diff.
 
Nice pics of Chris and his BFF. So glad he is doing well. Keep up the good work Chris. We are rooting for you!!!!
 
Melanie and Smokey said:
Thanks Ruth. Glad someone brings it up. The vet just put a damn pot-it on the script for the meds to call before giving it with the tramadol the e-vet put him on. Tramadol was on the insert listing for not contra-indicated drugs. When I called the vets office and said I was calling to find out about giving the Mirtz with the Tram, after being on hold for a while the receptionist came back and said the vet needed to look it upo_O A tech called back later and just said that I shouldn't give them together (already figured that out!) and I should wait until 24hrs after stopping the Tramadol. Never bothered to mention the complications (life threatening!) or the signs to watch for.

I did ask about the continuous use of the Cerenia too. Just got told they have lots of patients that use it long term and are fine. My normal vet always has us take the break and prescribes it at a lower dose. I am going to skip it tonight and tomorrow if he seems like he is still not vomiting. I will ask about the ondansetron again on Friday. The oncologist may be avoiding it at this point since he is having constipation issues. He is not vomiting now, but I think there is still nausea there and that is why he won't eat sometimes despite wanting to.

Chris is doing really good right now except he is still constipated, wants to eat but doesn't eat or doesn't eat much, and doesn't seem to want to be out in the sunlight long. He used to bask in the sun, now when he gets too much sun on him he goes back to his sleeping place in the closet.

Thanks everyone for their continued prayers, well wishes, and vines. It means the world.
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Hi--I am sending prayers as well… I have a 16 year old with nausea (CRF) been on SQ 5 years etc… I do give him a injection of cerenia now and then but my holistic vet sends me doses (as needed-1 dose lasts almost a month) of Nux Vomica prescription strength…might help? I crush it in the little tiny envelope and dump it in his mouth (surprise attack :)
 
What a handsome boy he is! I know my cats are weird when one comes home from the vet. So nice to see he is doing well! Sending vines.
 
I see there were some parties and some new trials started while we've been off snuggling. Keep up the great work!!! Hugs and prayers to all those needing them.


Chris has had pretty good response to his chemo :) Better than expected.

Last week he was feeling pretty good. Did lots of snuggling and acting low key, but pretty much himself. He seemed to be pretty fidgety, like he couldn't get comfortable, so we started the bupe back up whenever he vomited thinking it was the pancreatitis. Come the weekend he seemed to decline rather rapidly. He started to drool a lot, the nausea kicked in, and he had a hard time wanting to eat. No bowel movements. I decided we needed to take him to BluePearl on Monday morning. Oncology wasn't in so he saw a critical care dr. By the time we got there he had perked up quite a bit. When the critical care dr came in with him he was strutting around the room flirting with the vet, purring, talking, rubbing on everything, climbing on us demanding attention, over us to look out the window and talk to the people in the hall too. He looked and acted totally fine, like his usual loveable goober self!

He still wouldn't eat though :oops:

So the critical care doc did xrays and an US - to look for constipation, look at his heart because she could detect a murmur and doxorubicin can cause heart damage, and to look to see if the masses had progressed blocking stuff up.

We had no pancreatitis anymore, no constipation, no thickening of the lining in the stomach, intestines, or colon anymore, NO MASSES!!! We did have heart enlargement, but she didn't think it was to a critical level or causing heart failure or anything, just something that may limit the use of doxo going forward.

And guess what she said.... "I'd like to start him on Ondansetron since he is feeling nausea despite the Cerenia." :) She said everything everyone here said about the two together would do more than the Cerenia alone. We put Pepcid and the Mirtz back into his med pile too. The Mirtz made him a little bit crazy Monday night. I don't think we will give it the same time as the Ondansetron again:eek:

He wants to eat within 15-20 minutes of the Ondansetron so that is helping. He is still acting a bit down at home and not pooping, but is definitely better than the weekend. Hopefully his appy will continue to pick up, and his energy will pick up too.

We go back on Friday to see the oncologist. Hopefully she will have continued good news and maybe some more ideas to get him feeling perkier at home. We have been blessed with many more days that we expected with him, we didn't even imagine that the masses would resolve to this level. :cat:
 
I'm wiping away tears (of joy!) I've been wondering how Chris was doing! Looks like Christmas came early :bighug::bighug::bighug::bighug::bighug:

Continuing to send my absolute strongest prayers and healing vines for the big guy!
 
I've been a bit scared to look in here but it's all wonderful news :):):) so happy for you guys, and what a gorgeous nekkid belly he has!
 
Ruth is a mind reader or a member of the Yahoo lymphoma group 'cause her post is after I had my meltdown over there yesterday. Thank you for the prayers.

Chris remains symptomatic despite it looking better in imaging and blood work. He started to eat good again at the beginning of the week, but that dwindled to a couple pieces of dry food nibbled by the end of the week. He still is not pooping. His drooling and nausea continue, though they are helped tremendously by the Ondanestron.

Yesterday was a horrible oncology trip. They first called to cancel "if we wanted to" even though his blood work was ok for chemo because he wasn't feeling good. I said we had to figure out some course of action with him, we couldn't just leave him feeling crappy, if chemo is no longer an option we need to know that, so the tech said to come down and they'd look at him we'd discuss it even if they didn't give chemo. When we got there, someone who was completely unfamiliar with his case came out to grab him and take him back for chemo. We were like "ummm, that isn't what the plan was for today when we just talked to someone" She went in back and came back out and said the dr approved the chemo 'cause his numbers were good enough and they were doing doxorubicin. That confused us since the critical care doc on Monday said that it was what caused his heart murmur and it may not be able to be used again, plus they don't usually use it when the cat is feeling crappy. The tech went in back again and came back out to say "She says she's away of the heart issue, but has a lot bigger concerns than that right now." - Really, then how 'bout you get you ass out here and discuss it with us instead of sending a snide comment out with a tech?????? I hate to think it, but the elspar, which seemed like what is given when they are not feeling well would have been only good for a week and landed us on Christmas for his next treatment...doxo is the only treatment that would give us a skip of next week...so he got doxo. They were busy that day getting everyone treated and set up for working around the Christmas day, but they were just dismissive and rude. Like Chris was an inconvenience to treat. He wasn't eating and they administered a med that could take up to 4 days to start showing its effects. Maybe there's a good reason. But damned if anyone was willing to take the time to explain anything to us.

When the appointment was done. She flat out refused to refill to Ondanestron. "Go back to the vet who prescribed it to get it." We were like, umm, it was the vet here that prescribed it when the onco doc wasn't available. Its stopped the vomiting and nausea, what do we do with him not eating? We went down there when he was so sick specifically to have him seen there so that everything would be within the BP system and not scattered around different clinics. She doesn't use it, she isn't going to refill it. They kept making stuff up to not refill it. Said the other doc called it into our vet and they were the ones who prescribed it.. no, BluePearl called it into our pharmacy... So now we have to try to find that critical care doc and get her to call in a refill next week if Chris makes it that long.

Since the appointment Chris has been really lame in the back leg that they administered the chemo. We didn't realize at first it was his chemo leg, we just thought he was getting really weak. So we add that to his problems :( Not sure if it is something that will get better or not. If it is from the chemo med leaking inside, I doubt it will get better.

Today we were just spending lots of time snuggling him and watching him. About the time we decided he just was going to keep feeling yucky, he got down off the bed and went to sniff his food dish, pee, and take a little poop :) He didn't eat, but at least he showed interest in the food. As long as Chris is comfortable, we plan to keep assist feeding him to see if he can build some strength and an appetite on his own, see what Monday brings.

ETA: And we have a new diabetic at one of the shelters. Someone else has taken him home and working on diet change. Anyone want a skinny long black haired attention-hound? I ran into the shelter today to try to help her get the hang of testing him but she'd already taken him back home when I got there. They got 2 tests 611 on the meter and 211 from the vein o_O I gave her one of my lancing devices, I think they are so much easier to use and told her to call me and I'd come over to help her get the hang of it. I think they are all hoping I will volunteer to take him. Little overwhelmed and exhausted for a sugar dance right now.
 
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((((Melanie)))) it just shouldn't have to be so hard to take care of your baby. I'm so sorry. I'm keeping you and Chris Farley close to my heart and sending him many vines for comfort and appetite.
 
(((Melanie))) so sorry you are having all this additional stress from the vets, seems as if sometimes they loose sight of the fact that the animal's well-being is first priority. Sending appy vines for sweet Chris, and calming vines and hugs for you, i hope things improve soon. :bighug::bighug::bighug:
 
I'm so sorry things were so stressful at the vet. I hope Chris starts feeling better and eating. Hopefully you can get the ondasetron if you need more. Sending prayers and hugs. :bighug::bighug::bighug:
 
Sounds like the clinic is not making things any easier for you. Hope you get that prescription asap before everyone mentally "checks out" for the holidays. :(
If only severe illness would just go "on hold" and not get any worse so we could all enjoy our families and babies for Christmas. Good luck to you and Chris.
 
(((((Melanie & Chris Farley)))) No, I'm not psychic, just never got around to removing myself from the Feline Lymphoma mailing list. :oops::oops: ...sorry you had a lousey day at the oncologist, as if you didn't have enough stress! Continuing to send my strongest prayers and vines for Chris, and gentle hugs and scritches.
 
so sorry for all you are going thru…. it really should not be so difficult to get something to comfort your pet.
I found this--

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Since one can't access saline,zofran and tormadol whenever they like what are some OTC for zofran and tormadol?
Zofran.jpeg

Benadryl & naproxen: OTC meds to try to lessen nausea (in place of zofran) can include things like Dramamine (meclizine, dimenhydrinate), like Benadryl or Zyrtec (dyphenhydramine, loratadine, cetirizine), or like Zantac (famotidine, ranitidine). Toradol is an NSAID like OTC ibuprofen or naproxen. Not sure what you meant about saline. Salt + water = saline so ...Read more
I am not sure of how a feline reacts to some of these but I have used benadryl safely.
 
Melanie:bighug::bighug: sorry for all the stress. Sending feel better vines for Chris. You are doing an amazing job! That Tech or whatever he/she is needs to be reported!
 
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