2/26 Fortune AMPS 458 +6 501 +11 373 +12 282 +13 411

RachelG

RachelG

Member Since 2021
Yesterday's drama

Fortune is walking much better, and ate a little bit at PMPS +9, but still pretty lethargic. I'm hoping that it is a side effect of the chemo.

This bunny is going through so much. I hope we didn't derail his BG progress with our scaredy pants last night.

We are getting ready for the internist appointment. Fortune isn't terribly interested in eating (excited at the can opening but not able to take a bite) so I'm hoping I can hand feed him.

He isn't interested in the food with potassium - for someone who eats plastic garbage bags and trash his is being picky!
 
Know you were given potassium by the vet. I mixed a little NOW powder protein in my cats’food and they didn’t notice it. To make sure they got it all I put it in Getbers 2nds 100% protein baby food. You must want one that doesn’t contain garlic or onion. There are more choices now I think.

I’m glad the medication is helping him to walk. That was so scary.
 
tiffmaxee said:
Know you were given potassium by the vet. I mixed a little NOW powder protein in my cats’food and they didn’t notice it. To make sure they got it all I put it in Getbers 2nds 100% protein baby food. You must want one that doesn’t contain garlic or onion. There are more choices now I think.

I’m glad the medication is helping him to walk. That was so scary.
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Yes - the renal k+ powder! We will pick up some baby food.

He is totally unable to eat anything.

I finally googled mestinon and I’m hysterically crying. Sleep deprivation Rachel doesn’t Google medications, and we just trusted the doctor. We even asked about side effects.

I’m beside myself. I’m worried he is on his way out and I don’t want to drag him 45 minutes to the vet if this is his last day!

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Rachel, what is making you so scared about this drug ? It says it will leave his system in 24 hours. What is happening ?
 
Headed to the vet - we think he needs critical care. I hope this is his CKD and that he needs fluids and potassium.

He hasn’t eaten this morning (or received his insulin.)

He is responsive but “off.” He is barely looking at food - even his stinky high carb treats and deboned kfc. He seems to be in a lot of pain - not squinty eyes or flattened ears, but hunched a little and doesn’t want to be moved. He is walking better, but just very lethargic.

I don’t know if it’s the chemo, the CKD or the mestinon, but I read in what I tried to post that it is rarely given to cats and should be considered very carefully.

Fortune’s labs indicate that he has high phosphorus and low potassium which doesn’t indicate that he needs a nerve medication, but rather those supplements perhaps in a concentrated form to accelerate healing? Idk.

tbh I’m just scared. I don’t want him to pass away at a hospital, and I don’t want this to have been his last 24 hours.

I’m definitely panicking. Trying to calm down.
 
Many vines and prayers. I hope the vets have answers. Generally, high P and low K are certainly hallmarks of CKD but he’s got so much going on that I really have no idea if that’s what those levels are attributable too.

Many vines and prayers.
 
Marje and Gracie said:
Many vines and prayers. I hope the vets have answers. Generally, high P and low K are certainly hallmarks of CKD but he’s got so much going on that I really have no idea if that’s what those levels are attributable too.
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thank you! Yes, he does have CKD, his creatinine has been 3.6-4 and high BUN. His kidney showed “mild renal changes” on ultrasound, and the one that was removed showed scarring and “age related changes.” They think he may have had an acute kidney injury from the anesthesia.

I guess my question is if the muscle weakness, etc could be from the low potassium/ high phosphorous, and if it is reversible.

We are cuddling with him in the car while waiting for him to be seen (curbside pickup lol)
 
RachelG said:
thank you! Yes, he does have CKD, his creatinine has been 3.6-4 and high BUN. His kidney showed “mild renal changes” on ultrasound, and the one that was removed showed scarring and “age related changes.” They think he may have had an acute kidney injury from the anesthesia.

I guess my question is if the muscle weakness, etc could be from the low potassium/ high phosphorous, and if it is reversible.

We are cuddling with him in the car while waiting for him to be seen (curbside pickup lol)
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Yes muscle weakness can definitely be attributable to low potassium and high phosphorus. I did know he has CKD but I don’t know if his symptoms are totally attributable to that or also something else. I hope you get answers.
 
Quick update: Fortune is NOT critical. Apparently there was a miscommunication when I called and they interpreted our concern as Fortune needing critical care. I was so flabbergasted because he has not changed DRAMATICALLY from when they saw him yesterday!

Now they are trying to say it was because we were late (we were 15 min late to check in, and I had called ahead), and the internist cannot see him because of other appts so they wanted him to come through ER to be seen.

I swear I’m going to have a heart attack. It’s a freaking roller coaster!!!
 
OH, Rachel. I just finished reading all of yesterday's posts and the posts from this morning and I think I am going to have a heart attack, too. I saw your post on the SCL list and felt pretty good about it. Then I read here and was on the roller coaster right with you. And then when you said he needed critical care, I just about died sitting here at the computer... because you said he was walking better this morning... which had made me very happy. Yes, they'd better address the high phosphorus and low potassium right away. Prayers, hugs, hopes, wishes...
 
Thank you for all of the warm words and well wishes, we really feel supported here, and really appreciate every single person here. :bighug:

TL;DR

Fortune is stable, and improved from this morning, possibly from the subQ fluids from the vet visit. His neuropathy has improved with treatment over just 24 hours and prognosis is good that he will recover; it suspected to be a complication of his cancer because of the rapid onset and positive response to the treatment vs diabetes or low potassium vs autoimmune. Right now we expect to see improvement over the weekend, and when nausea/pain/lethargy are improved (hopefully they are due to chemo) we will increase dose. He gets very tired right now and has to rest often between activities.

Internist feels his CKD is "stable" and is "fine" with his diabetes treatment.

Fortune ate half his breakfast (1 3oz can) with the gabapentin and the potassium when we got home - yay! He was cuddly and much more himself this afternoon, and we are hoping he is getting what he needs to heal. We will know in the next few weeks, but for now we are grateful to keep lovin on him.

Longer version

We got home a few hours ago. Fortune was NOT critical - there was some awful miscommunication on the part of the vet staff. They told ME that Fortune was in critical condition pass on the symptoms I reported, and that he needed to come through the ER, not his regular appointment. However, his status has not changed except that he was a bit more lethargic and looked somewhat pained. Fortune didn't have enough time to eat before we had to leave for the vet - last night he needed almost 1.5 hours for the meds to kick in. He is clearly more nauseated - hopefully it's from the chemo and will resolve soon.

2.5 hours after our original appointment, the internist called us. Fortune "looks ok." We discussed repeating b/w to see where the potassium is, but he just had labs done yesterday and only had one serving of the potassium so we held off. We are increasing his ondansetron to 3x/day to see if it helps (how do folks work out the timing for 3x/day meds?).

I inquired about subq fluids, however she doesn't know if it will help him, because he didn't "feel dry" to her. She agreed to give him fluids today and if it helps to revisit.

I pushed on his prognosis - and was told that the HSA is driving prognosis not his CKD or diabetes. She can't "stop his kidney from failing," but the CKD is "stable" and she is "fine" with how we are managing the diabetes. She also deferred to neurology on his weakness when I asked about how he looks. Because of his rapid progression, she felt it presented as neurological. No mention of phos binders or low phos food, even though he has high phosporous levels. :rolleyes: I don't really trust that she is giving him the best care, but right now I am not going to move Fortune to a new doctor because he is getting great care by the other doctors.

The neuro visit went well - I better understand what is going on now. Fortune's peripheral neuropathy MAY be caused by diabetes, but it is unlikely because of how quickly he progressed and how well he responded to the mestinon. The neuro was "very impressed" by how he responded on two small doses over 24 hours - yay! She believes that it is secondary to his cancer, and it affecting his nerves. She did not give us a name for it, but I did ask where I can look to become smarter and better help Fortune and I hope to get some more information in the coming days from her and the medical notes.

His prognosis with the treatment is good, and she believes that because of his good response, he will regain the ability to walk, jump, and move more easily. Right now, he needs to rest between activities because he is weaker. She basically described spoon theory if you're familiar with chronic illness (I'm a spoonie). We are going to wait to increase his dose until he has less nausea and feels better, but hopefully over the weekend we will see continued improvement.

So after the sage of the past three days, I feel like we really truly need a vacation. We went through all of 2020 without going away (or even out to eat), and I could deal. But the total and compete exhaustion is getting to me. I hope we can have some stability now that we have some answers.
 
You've been through the wringer. :bighug::bighug::bighug: Sounds like a mostly positive vet visit. With that skip this AM, he'll be high enough you can probably get some good sleep tonight. Give Fortune a little kiss from me.
RachelG said:
how do folks work out the timing for 3x/day meds?
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Every eight hours? Once when you get up, mid day and before bed.

Can you remind me which chemo drug he had yesterday. Not sure about cats, but I know some of the drugs have a nadir a couple days in after given, at least in dogs. The oncologist should have a good idea when he's going to really need more nausea support.
 
Wendy&Neko said:
You've been through the wringer. :bighug::bighug::bighug: Sounds like a mostly positive vet visit. With that skip this AM, he'll be high enough you can probably get some good sleep tonight. Give Fortune a little kiss from me.
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That's the one positive, lol! We are in desperate need of sleep and rest. Definitely will pass it on to Fortune - he definitely feels the love! It was so amazing to see those numbers yesterday. I really hope we get there again, consistently, soon!

Wendy&Neko said:
Every eight hours? Once when you get up, mid day and before bed.
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I need to change my schedule :) I try to go to bed by 9:30/10, but I wake up late. We are trying to be morning people. So thanks Fortune! I am also concerned about "over medicating," but if it helps with his comfort at this point, I think it's fine...

Wendy&Neko said:
Can you remind me which chemo drug he had yesterday. Not sure about cats, but I know some of the drugs have a nadir a couple days in after given, at least in dogs. The oncologist should have a good idea when he's going to really need more nausea support.
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doxorubicin (Adriamycin)

We were told the first few days following administration is going to be the "roughest," and onn the discharge notes from yesterday it mentions nausea/vomiting, anorexia/poor appetite and lethargy... there are suggestions for what to feed (bland diet, baby food, chicken, baby food, warming soft foods, boiled chicken/hamburger mixed with regular food, "pet" gravy, low sodium broth, etc.).

"Lethargy/weakness/fever/behavioral changes may be due to the chemo given, the body's adjustment to the new chemo drug in the system, the cancer, infection among other possibilities. Lethargy usually only lasts for a few days. You pet may not act like themselves, may exhibit behaviors not noticed before, and may not feel well. In response to this, keep an eye on your pet for fever above 103.5"

Fortune was less lethargic immediately before and after (in the car) and when we first got home from the vet. It is likely also exacerbated by the neuropathy which wears him out.

TBH I hadn't even read the notes til you mentioned the name of the drug. I'm not myself right now...I'm going to do a bit of a shop tomorrow and try some things.
 
OH - and it can cause kidney toxicity, so please keep Fortune in your thoughts. We are evaluating over the next few days if the side effects are worth continuing to treat, and how to minimize the effect.
 
I'm sure the oncologist will call for blood work before the next scheduled chemo. If you have a local vet, you could have done it there before hand, for likely a cheaper price.
 
Yes - we are having bloodwork done the week after chemo, so 2 out of every 3 weeks he will have a vet visit, but hopefully it's less stressful than the past month combined.

We don't have a local vet anymore, but maybe I can shop around. I really like that idea! To get bloodwork sent to my oncology team shouldn't be a big to-do, and it will be much easier for Fortune than having to travel 45 min each way.
 
Soooo...I just caught up on yesterday's drama with Fortune's dropsie. Your bunny responded very nicely to my threat.
But that aside, I'm so sorry you had yet another scare with him today. :bighug::bighug::bighug:
Sending many prayers.
 
Rachel try to get some rest. Even interrupted rest. If I lived close to you I would be brining food over to your place (itwhat we do down here in Georgia! And I am not really FROM Georgia but am a transplant... but it’s a nice thing to do. I would offer to help with your kitty too, but if you’re like me then ‘aint nobody going to watch over my cat but me ... except well maybe my husband and even then... you don’t know... because he’s a man and there’s a reason why God gave the ability to bear children to women rather than men (come on, you ladies who have had little ones and left them in the care of your husbands know what I am talking about!).

I am encouraged by some of your news. I would worry about drawing blood from him every day. I agree with you about the phosphorus and potassium thing and the weakness and the kidneys. You can take matters into your own hands and add your own phosphorus binders or at least Epakitin or you could try niacinamide. Also, all kidney cats benefit from a B-Complex. Jarrow B-Right capsules are great and can be divided up into about 12 size 4 gelatin capsules and given once daily. Just something to think about. Lots of info on felinecrf.org.

Meanwhile, keep loving on that boy! Sleep and take turns with hubby. God bless you all!
 
Butters & Lyla said:
Soooo...I just caught up on yesterday's drama with Fortune's dropsie. Your bunny responded very nicely to my threat.
But that aside, I'm so sorry you had yet another scare with him today. :bighug::bighug::bighug:
Sending many prayers.
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Thanks Lyla! It's a roller coaster over here! :bighug:

Thank you, Suzanne! I'm Jewish, so we do the whole "bring food" thing, too - new neighbor, new baby, death, or just a hard time. There's a reason we call chicken soup, "Jewish penicillin," lol!

I am giving him low phos, low carb food as of last week, I just thought it was very telling that the doctor didn't even bring it up...I appreciate the suggestion of the B complex. I'll look into it, though he gets SO MANY PILLS, so I want to see him stabilize a bit before giving him something new right now.

We aren't drawing blood every day...it would be the week after his chemo treatment, a blood draw for a CBC panel to make sure his WBC doesn't dip. Appreciate the kind words and thoughts. We are pretty exhausted and it's hard to think clearly. We are worried that the end is coming a lot closer than we had thought. I hope it's just me being overly pessimistic and Fortune does another somersault as he does...
 
So, Fortune has eaten 3/4 of one can of weruva...I’m waiting another hour (it’s been two hours since we showed food, but only 3 since mirtazapine and almost two since the cerenia and ondansetron).

Last night his appetite kicked in about 4 hours after mirataz.

We were hoping to use the no shot to move our time up, but then messed the timing of the other meds.

Who has great tricks to get a kitty to eat?? My usual coos and hand feeding aren’t working. :( Tried kfc chicken (w/o skin and bone), warming up the weruva (which worked!), tried tuna broth...sending DH to get baby food.

Give me your low carb, low phos tricks, please!
 
RachelG said:
Thanks Lyla! It's a roller coaster over here! :bighug:

Thank you, Suzanne! I'm Jewish, so we do the whole "bring food" thing, too - new neighbor, new baby, death, or just a hard time. There's a reason we call chicken soup, "Jewish penicillin," lol!

I am giving him low phos, low carb food as of last week, I just thought it was very telling that the doctor didn't even bring it up...I appreciate the suggestion of the B complex. I'll look into it, though he gets SO MANY PILLS, so I want to see him stabilize a bit before giving him something new right now.

We aren't drawing blood every day...it would be the week after his chemo treatment, a blood draw for a CBC panel to make sure his WBC doesn't dip. Appreciate the kind words and thoughts. We are pretty exhausted and it's hard to think clearly. We are worried that the end is coming a lot closer than we had thought. I hope it's just me being overly pessimistic and Fortune does another somersault as he does...
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Oh I cannot bear to even think of the end of Fortune. I mean it. And he’s not even my cat! He just has to get better and get some QoL for more time. His mama needs him. I’ve had too much grief already just this year. Can’t take any more. Breaking down in the shower this morning. No! Fortune, you HAVE to get better! Hugs and love. You are doing great. I didn’t want to suggest any more pills for him right now. He needs to stabilize a bit for now. Keep us posted. I will be praying tonight.
 
The Fortiflora helped! He ate about 1/4 can!

Has too much time past to shoot his dose? We are at +12 now...we were trying to move the shot up but no luck.
 
How much can we give! He seems to only be interested in eating the parts with it...lol he is no dummy!
 
A small amount of insulin, say .25 since he’s so high. It’s so late though fir you. Skip and start up in the morning I think.
 
I just don’t want him to be even more uncomfortable because he will have two skips in one day. It is pretty late...what do you think? I realize we should have shot like half a dose when he ate the 3/4 can, right? :banghead:
 
Yeah, I wasn’t sure, when I had posted it...just not thinking clearly and don’t trust my judgement!

We have to give him the mestinon at 6am, and we are absolutely exhausted tonight. I don’t think we can stay up any later, and I feel so guilty about it. We are going to skip...

Fortune is smushed in my arms in bed right now. He came all on his own and I’m very proud of him.
 
For future references, if a cat is going to have anaesthesia and cannot have any food at all, (much less having eaten 3/4 of a can), vets suggest half a dose. Insulin does more in the body than combat carbs in the blood stream.

High blood sugars can also make a cat lethargic.
 
Thanks! We weren’t sure and couldn’t stay up any later to wait for advice. I feel terrible he has gone without two shots now and is likely going to feel awful.
 
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