2/7/2019 Leoberry status

JeffJ

JeffJ

Member Since 2016
Leo's previous thread is here

The hypo
It has been almost 3 weeks since Leo's severe hypo, (BG = 22 on January 20). In the week after the issue, he seemed to slowly bounce back. But the past week, his interest in food and exploring has decreased considerably.

In retrospect, over the past few months, his food intake has been very challenged, leading to the hypo event. He gets Fancy Feast Classic mixed with water, warmed up. And he eats a few bites, drinks the gravy, and that's it. To make up for it, I was giving him 10-12 meals a day. And occasional mirtazipine.

Past 2.5 weeks
The week after the hypo, we were hoping for some improvement. His mobility and gait did not change. His eyesight seems partly okay, but he is having issues focusing or concentrating. His right pupil is slightly more dilated than the left pupil, except in strong sunlight. Maybe he got some brain or neurological damage from the deep hypo. So now I feel even more cruddier for letting it happen.

We went to the vet Tuesday Feb 5. They always perk up at the vet, don't they? The noticeable issue is a 1/2 pound weight loss from 3 months ago, now 15.75 pounds. And his backbone has hardly any fat or muscle on it. We should get the blood test results tomorrow (Friday). He still has swelling in his hocks, so we are doing another course of Zeniquin (anti-biotic). In this state, he is not getting chemo - because he will just stop eating. I'm not going to have his last days filled with nausea...if that is the stage he is in.

He is getting brushed and rubbed after each meal. And some treats. He really likes both. But hardly any purrs this week. Pic is from Feb 4. Leo adores Little Dude. Our sweet boys. They are the best.
Leo and Little Dude 02-04-2019b.jpg
 
:bighug::bighug:

Are you giving B12 orally or via shot (or both)? Anything for nausea (Ondan/Cerenia)?

I hope the BW gives some answers and can get the issue resolved.
 
Thanks.

Leo is getting occasional Cerenia for the nausea. Another part of the eating issue is swallowing. He has stridor (fleshy growths) in his throat from the acro. The vet said she can't do an operation there, so it would have to be some specialist. Right now he isn't strong enough for an operation.
 
The healing thoughts from the group seem to be helping Leo today. He is a little perkier.:)

Plus I cheated on his food. The last 4 or 5 days he wasn't eating much. Today I put in a tablespoon of FF turkey gravy food in each of his meals. He seemed to enjoy it, or at least he ate quite a bit more. And it pumped up his BG, but I am glad to see he ate some good meals today, instead of just a few bites.

40 degrees outside today in Austin. The boys always cuddle more when that happens. I think Leo seems to feel better when he is next to Little Dude.
Leo and Little Dude being sweet - 02-08-2019b.jpg
 
You know, I was about to suggest the same. If it helps his appetite, personally I would add in the FF gravy for now too. You've got enough on your mind to have to worry about nutrition too. And he needs his strength for his continuing recovery. Well, he needs that and LD lovin' :p

:bighug::bighug:
 
I came by to say hi and see how you and Leoberry were doing and I am so sorry to read this Jeff!! How scary :( I love the photos - they are so cute. I hope he continues to heal, hugs to all of you
 
Thanks everyone. I like the reinforced suggestion to give some FF gravy food addition to his food. It worked pretty well today. He ate quite a bit more (in one day) than he ate (in one day) for the past few months. Maybe I can get his energy levels back up this way.

Theresa was looking at Leo's eyes today and said they aren't that different, but it is noticeable. If there is neuro damage, I hope he can recover from it.

@Amanda & Shmee - I hope Shmee is doing well. It seems like such a long time ago for his surgery and our nice lunch meeting in NYC. I hope you are doing well too. Here's some "warm" 40 degree weather from Austin to you, to warm you up. We had a white full size iris flower bloom in our backyard last week when it was warm. And we have white snow drops blooming now too. :bighug:
 
Love to sweet little Leoberry, he is in my heart and thoughts, as are you and Theresa as you care for this wonderful furbaby. I know you are doing everything you know how to do to make each day a good one for him. Healing energies for Leo, hugs to you and Theresa as you walk this path. Please continue to let us know how you are doing, ok? :bighug:
 
Sending some healing vines over to Leo. Ondansetron worked much better that Cerenia for her nausea. At one point she needed both. You might want to experiment there. As well as trying different types of food. She went off her regular, but a completely different type/flavour of food sparked interest. As did blendering into a finer purée.

Neko has some eye size differences between her pupils too. Vet checked it out, and we figure it might have been acro related.
 
Thanks for the healing vines. Leo is doing a little better over the last 1.5 days. For some reason he is up and walking around, and also eating more often. I am still doing the "trick" of putting a dab of gravy food in the top layer of his FF Chicken. His BG is up as a result, but we are happy to see him eating more food.:)

Thanks Wendy - I'll try the different anti-nausea medicines. We have both in stock at home.

Also Leo is sleeping with Little Dude the past couple of days. When he was feeling bad, he was sleeping by himself. That was part of our worries - that he might feel so bad that he was going downhill. Anyhow, he is doing better. And who wouldn't - sleeping with Little Dude would make anyone feel better. A fluffy orange pillow that purrs whenever you rub him.
Leo with Little Dude tucked in 02-09-2019b.jpg
 
Healing vines are helping Leo, and he is doing better today. :bighug:

AMPS+5 - dipped to 76
Usually that is good in most cats, but for Leo, that means he is heading into a hypo. So he got a tablespoon of gravy food on his FF Classic. Leo seems to be walking around a bit more as well. He slept with LD for the past 2 days and soaked up a bunch of LD's purrs.

It's possible the zeniquin (xeniquin) anti-biotic is helping. He is on day 5 of the 2 week dose. We are expecting the blood test results on Monday (tomorrow). Leo has been off chemo for over a week. Long term, I probably need to apply some chemo to suppress the small cell lymphoma. He is not having any pain - no reactions to probings or touches (well, except irritability).

We have seen many cats on the forum go into these low spots and you never know if they are coming out of it. Sometimes they do. This might be another lucky life for Leo. I think he is past the 9 lives and is on his 15th or 20th.:)
 
{{{Jeff}}}

I'm so sorry Leo is having a tough time, but encouraged to see he seems to be rallying.

With Harvey's lymphoma, I gave Cerenia and Ondansetron, both separately and together (it's safe to give them at the same time). A lot of times, the combo worked best for his nausea and inappetance. Don't be afraid to experiment.

I think Leo is just jumping into the lagoon to get some more of the yummy gravy food! He's pretty smart!

Sending mega healing vines and :bighug:s to you and Theresa.
 
Thanks Tricia. We haven't used the anti-nausea pills much in the past year. But you and Wendy are right - it is time to break out the medicine to help Leo out. And you are right - he went "low" today so that he would get more gravy food. I wish he could have gravy all the time.
 
Ondansetron - does anyone know the pill-form dosage for kittehs? We have a bunch of 4mg tablets that were prescribed to a human.

I saw the CKD article that Wendy posted, but that refers to the injected form.
Chronic Kidney Disease in Cats article pg 232 top

Mirtazipine - Leo did well on this. It makes him kinda weird, and frantic about food. But it certainly stimulated his appetite.
 
JeffJ said:
Thanks for the healing vines. Leo is doing a little better over the last 1.5 days. For some reason he is up and walking around, and also eating more often. I am still doing the "trick" of putting a dab of gravy food in the top layer of his FF Chicken. His BG is up as a result, but we are happy to see him eating more food.:)

Thanks Wendy - I'll try the different anti-nausea medicines. We have both in stock at home.

Also Leo is sleeping with Little Dude the past couple of days. When he was feeling bad, he was sleeping by himself. That was part of our worries - that he might feel so bad that he was going downhill. Anyhow, he is doing better. And who wouldn't - sleeping with Little Dude would make anyone feel better. A fluffy orange pillow that purrs whenever you rub him.
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That picture is so adorable. I'm so glad Leo has Little Dude to snuggle with. I'm sure it brings him additional comfort. Hope Leo is doing better.
 
JeffJ said:
Ondansetron - does anyone know the pill-form dosage for kittehs? We have a bunch of 4mg tablets that were prescribed to a human.
Click to expand...

You can give up to 4 mg. You could start with 1/4 tablet, as Kris mentioned. I generally found 1/2 tablet worked well. If Leo is a larger kitty, perhaps the 1/2 would be better.
 
For this "down" period, I think Leo has gotten through it. He is doing pretty good now, relatively. When the issue started - he was literally laying on the kitchen towel for 2 days. His health is back to ~60%. Most of his meals today were small with one exception - 1/4 can FF. But at least he was up and about today, and also spent time with Little Dude.

We are going to supplement Leo's meds with appetite stimulants.

Leo is currently ~16.0 pounds. At his pre-diabetes peak, he was 18 pounds (2010-2015).

@Kris & Teasel - thanks for the dosage info on Ondansetron. I will try it tomorrow.
@Tricia Cinco(GA) & Harvey - thanks also for the dosage info. I'll use a 1/2 pill - 2 mg.
 
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JeffJ said:
For this "down" period, I think Leo has gotten through it
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:bighug::bighug:

2mg of Ondan 2-3x/day.

It could be the AB causing the nausea and feeling icky in general.

You could also try slippery elm bark, but +/- 2 hours from any other meds.

Please keep us posted.
 
Thanks Lizzie - Leo got his first 2mg Ondansetron this morning. Leo is much more alert this a.m., and hanging with Little Dude.
- BG is high from all the carbs
- drinking lots of water from high BG, so I will try to get the BG down in next 3 cycles

LD woke me up at 3am - he wanted to go out after another rat. So Leo got PMPS+ BG tests.
 
The ondansetron dose is 0.5 mg/kg twice a day to start and can go as high as 1.0 mg/kg three times a day. At 16 lbs, Leo is 7.28 kg, so you could even go to 7.5 mg a dose. I was told 2 mg for Neko. It wasn’t enough, even though she was smaller. I didn’t find out the guidelines above until too late. :( Experiment, if a lower dose works, then great. If not, you have room to go up.
 
Thanks Wendy. Leo got 2mg this morning, and it didn't seem to make much difference. He seemed to eat a normal amount today. Whereas the mirtazipine made him kinda frantic for food. Tomorrow I'll try 4mg and see if that dose affects him. Leo is not going to get it at night (today) since LD had me awake at 3am last night.

Leo is doing pretty good today. A "normal" day from 2 weeks ago, not like the 2 days of laying on the kitchen towel.

Since the past 2 weeks we now have a large hawk that lands in a tree for 5 minutes in the property behind the house. So now I accompany the little dogs and the cats whenever we go out. Little Dude saw the hawk today and then he puffed up into an orange beach ball size. Plus LD did not take his eyes off the hawk once he spotted him.
 
Hey Jeff, I'm just seeing Leo's condo and am very glad that he is doing better after that scary hypo event. Sending him lots of vines for continuing improvement. Love your pictures of Leo and Little Dude--so sweet to see them together. Sending lots of hugs to you and Theresa.

:bighug::bighug::bighug:
 
Thanks. With all the sick kittehs on the forum, it is sometimes hard to tell when they are in their final slump, or just having a couple of bad days.

We think Leo is through this slump, and I will be proactive in driving his appetite at this point. Leo needs to get back on chemo as well. Maybe in a couple of days. If the chemo takes him into another slump, I might stop giving it.

Leo was snuggled with Little Dude on the couch all day long. They are such good brothers. It makes us happy that Leo has a kitteh soul mate.
 
Thanks for the vines. Leo is back to pre-issue health. Still he is in the 50-60% health region. His backbone and spine are very evident, and no muscle or fat there. :bighug:

He is still getting 10-12 meals/day. And some tablespoon gravy supplements to stimulate appetite. He gave me leg lovins before several meals. He got brushed a bunch today. And laptime in the backyard. For the past few weeks, he growls when I take him off my lap and move him to a cat bed. He really likes laptime - living up to his nickname "Leo the Loverboy" :bighug:

4mg Ondansetron this morning didn't seem to have much effect. But he ate pretty good today. Picture is from Monday evening (2/11/2019).

Little Dude and Leo - bedtime 02-11-2019b.jpg
 
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Leo is having a particularly good day today. Eating a bit more. And a bit more active. The nice 70 degree weather helps. Leo walked around the backyard and explored with LD. I made them both come back into the sun room, as we are currently afraid of a large hawk that is hanging around. Leo growled at me, as he wanted to stay out more - so funny.

Bloodwork came back, and there are no outstanding issues. Including normal white blood cell count. But maybe the zeniquin is having an effect on his slightly swollen back ankles. No group pic today, because the profile pic came out great. Our handsome boy posed for this pic.
Leo in February sun - 02-13-2019b.jpg
 
Handsome indeed!
Good news on the bloodwork results and it's nice to hear Leo's eating a little more and was copping a 'tude about coming into the sunroom. Gotta love that :cat::bighug:
 
Thanks. For all the crud that Leo has been through, it is kind of amazing he is in fairly decent shape :p
- 8/2015 diabetes, with minor hypos and the recent stupid deep hypo
- 2016 Acro, then SRT in 9/2016
- mid-2017 small cell lymphoma

With this health resurgence, Leo will resume chemo in couple of days. And we will reduce the gravy spoonfuls as well. The 4mg Ondansetron may have helped this AM. I'll try it again tomorrow.

Moving his doses from 9AM-9PM to 7AM-7PM. Theresa will dose in AM. Then I can test through PMPS+6 to avoid hypos.
 
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