4/21 Logan AMPS 328, +6 237

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Kelly & Logan

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Last Condo (Monday):
viewtopic.php?f=9&t=12401

Logan went to the vet yesterday for blood work. Originally, we were just going to do a CBC but since he hasn't been feeling well, they went ahead and did a full panel. Most everything looks normal or is in the "to be expected" range b/c of his various issues except for his ALT. His ALT was 175. She's concerned that he's developed some sort of infection in his liver. She said it could be secondary to his unregulated diabetes and/or IBD. She said he could also have inflammation in his pancreas. She said she doesn't think it's lipidosis since he had been eating fairly well up until Sunday night. She thought it was too fast to be lipidosis, but that it was a possibility. So, our options are:

1) Assume it's the beginning stages of hepatic lipidosis and get really aggressive with feedings and retest in a week.
2) Start him on antibiotics and retest in a week.
3) Ultra Sound where she aspirates some cells from the liver for a cytology report. Even if the cytology report doesn't show infection, she would still most likely want to give him ABs.

Since Logan has been through so much already, I think we're going to opt for option 2. We don't want to take him back in and put him through yet another procedure. He may or may not have to be put under for the U/S.

This sucks, but everything about Logan's health these days sucks. I feel like he's never going to get better and we're just making him suffer and suffer. But, what else can we do at this point?! We have to keep fighting, but it's so hard when it feels so hopeless.

I had planned on ordering some Feline Instincts to make his food for him, but it contains a milk complex. The FAQ explains that it does not contain lactose, but the milk complex simply contains proteins and vitamins from milk. Well, he's severely allergic to milk - the protein, not the lactose. So, that's out. See...nothing works out for Logan.

Sorry, I'm just so discouraged and frustrated.

ETA: She doesn't think the Leukeran is causing the ALT elevation. She said she normally sees other abnormalities in the blood work when it's the Leukeran. She also said it's possible that he's developed an ulcer while on the pred. She sent us home yesterday with Sufulcrate (sp?) to give him three times a day. We're also starting the Metoclopramide back up since it looks like he's having some motility issues. She did a quick u/s on his belly yesterday b/c it seemed tender and it looked like he had a lot of food in his belly even though he hadn't eaten much for breakfast. We're decreasing his pred by 25%. His current meds are:

Pred: 5mg in the morning, 2.5mg at night
Metoclopramide: 3 times a day
Sufulcrate: 3 times a day (this one is esp fun since it has to be given either 1 hour before other meds or at least 2 hours after)
Pepcid: 5mg once a day
Lantus: 7.5u bid
Leukeran: 2mg EOD
Mirtazapine: every 3 days

And starting tonight, some AB that'll be twice a day for 2-3 weeks. I mean, we're not doing enough to him, right? He hates me right now.
 
Re: 4/21 Logan AMPS 328 - Vet update

I don't have any advice for you ... just pure sympathy. I can tell from your post you are frustrated. But I can tell you logan does NOT hate you. Sometimes it feels like they do, or should but they don't. What you are doing for him takes how much time in a day? not much, right? That means for the rest of the day, you don't do anything to him but love him. And THAT is what he knows, not the few minutes out of a day where he gets medicine, or pokes. He just knows love, and that comes from YOU.
 
Re: 4/21 Logan AMPS 328 - Vet update

(((Kelly)))

I don't have much to help you with, just thought you needed a hug. I did post on your diet condo on the health forum tho. Not sure if what I said would help as I don't understand all that Logan has going on, but it's there for what it's worth. I hope you can find some answers soon! It's just so frustrating to know you pet/friend is sick, but you can't help him. It would be soooooo much easier if they could talk, wouldn't it?
 
Re: 4/21 Logan AMPS 328 - Vet update

Hope Logan feels better soon I just sent a email to merrick to find out carb content of their dry grain free line to maybe order for Do lou in case he hates evo again. Did your vet say anything about the pred affecting the liver we are taught it can raise liver values where I work. :YMHUG: :YMHUG: :YMHUG:
 
Re: 4/21 Logan AMPS 328 - Vet update

I am so sorry about that Feline Future and the milk Kelly .... Well, for what it's worth, I agree that your plan is the best one for Logan....the ABs and a retest in a week. :YMSIGH: I don't now what to say... ((((Kelly)))) I know you have been through so much with him thus far....but you have to keep on keeping on, right? Maybe this AB treatment will work. Does he take the Fortiflora while on the ABs?
Maybe there is a list somewhere of vitamins to add to food...isn't it in Dr. Lisa's website?
http://www.catinfo.org/makingcatfood.htm
That would be good along with your quickly cooked chicken. Maybe this all will do the trick for him....you know we are all hoping it will! :YMHUG:
 
Re: 4/21 Logan AMPS 328 - Vet update

Kelly -

if you look at Dr. Lisa's recipe for home prepared food, you can use those supplements vs. a pre-mix. That may solve the problem with milk proteins.

Have you given any thought to a consultation with a veterinary gastroenterologist or hepatologist? Perhaps this is something your vet could do.
 
Re: 4/21 Logan AMPS 328 - Vet update

I can only tell you that you're not alone. I've had Belle since she was 5 weeks old, so she's like a daughter to me. About 1.5 years ago I noticed she had lost a bunch of weight, and she developed serious persistent pudding/liquid diarrhea. She has been treated for Hyperthyroidism, IBM, Heart disease, Liver disease, kidney stones, anemia, asthma, metronidazole toxicity, and now diabetes since then. It's been a rollercoaster. With so many issues that all overlap, it's been impossible to figure out what is going on. She blew out a knew ligament the other day, but I had to take her to emergency because the funny walking could have been a blood clot from her HCM, diabetic neuropathy , or even a toxic reaction to some medicine(she had a toxic reaction to metronidazole).

It's always something new. We fixed her Hyperthyroidism, but the IBD stayed and she got HCM. We treated that and she got infectious anemia. We fixed the anemia and she got diabetes. We started diabetes treatment and a new blood test showed hypercalcemia. It never ends. And all this time cancer has been hanging over our heads because she can't undergo a biopsy due to her heart problems. As for your liver numbers, Bell's ALT was off the charts at one point, >1600. Antibiotics brought that down quite a bit, but it's still quite high, and now her AST is slightly elevated. It's been a stressful period, but Belle is actually managing through it all. She still struggles with IBD(prednisolone treatment for this probably caused her IBD), but she is otherwise happy and doing well. I have days(just last Friday) where I look at her and tell my wife she doesn't look well and we need to prepare, but we always get through it(she had a stomach bug). Someday that won't be the case, but it is for today.

I can't say why your liver numbers are high, but I can say that Belle made it through when her's were >1600 plus. I think it was inflammation caused by her IBD, but who knows. I purchased Leukeran a few months back, but didn't need to start her on it. Everyday is a new challenge, but we should all be as lucky to have someone care for us as we care for our cats.

Jason
 
Re: 4/21 Logan AMPS 328 - Vet update

((Kelly))
Was this the new vet you were going to check out?
My heart goes out to you, Logan and DH2B.
I do not doubt that you feel Logan hates you but he understands just how much
you love him.

When Max had his liver issues, and I will see if I can check his numbers, my vet gave me
Denosyl, Sam-e. It is supposed to be very good for the liver, it helps it work.
I am not sure in Logan's case, if it is an actual infection, but maybe ask anyways.
I have used it twice on Max when he had fatty liver and one for Chloe when we did not know
what was wrong with her.
We also used another medication for his liver. I will check the name of it when I get home.
Hugs to you all.
 
Re: 4/21 Logan AMPS 328 - Vet update

I was really glad to read that Logan is tolerating the Leukeran - hope you start seeing some positive effects from that soon. I'm also optimistic because you're starting to cut back on the prednisone. But Logan's elevated ALT really is a mystery. All other liver measures were ok, though, so hopefully that's a good thing. Sorry he has to be treated for something else though. Wasn't Logan's ALT on the high side a month or two ago as well? Maybe he does have a bit of an infection and will respond well to the AB. Poor guy, and poor you too. I hope both of you can enjoy some happy moments, however simple or brief they may seem on a day like today.

I hope you are happy with the vet too, btw. I think it helps to feel like you have a good partner in your pet's care.
 
Logan came down some today - that hasn't happened in a while. Maybe b/c he hasn't been eating as much lately. Last night he ate some EVO 95% turk/chick - turned his nose up at it this morning. This morning, he ate 1/2 can of Blue Buffalo Turkey (3oz can - 95% turkey). This afternoon, he turned up his little nose. So, he ended up eating some Instinct Rabbit - about 5/8 of a 5.5 oz can. Weird - he's never liked that food before. Of course, he probably won't eat it again tonight...or tomorrow. :lol:

I'm picking up some ABs tonight. I can't remember the name of it, but we're doing a week of twice daily injections and then we'll re-check his blood and decide if we want to switch over to pills for the second week. The injections are about twice the cost, but I think it will be better for him at this point.

OMG, Jason, I am so sorry you've gone through so much with Belle. Logan is like a child to me, as well. He's only 6 and he's been through so much. The last 7 months have been awful. I will keep doing everything I can to help him. He met me at the door purring at lunch time. We have 2 dogs and 3 cats and I love all of them dearly, but Logan is just extra special. He has not had an easy life.

I'm wondering if it's the pred that's causing the elevated ALT like Lisa suggested. It's listed as a possible side effect for dogs, but not cats. This number isn't nearly as bad as it was a couple of months ago when he had that nasty bacterial infection. It was in the 600s then. We haven't seen the new vet yet - we had to cancel our appmt last week b/c DH2B's schedule was awful. So, we're still seeing the same one. I do feel like she's trying a lot harder to work with us and Logan. She's been much more responsive lately. She also talks us through our options and why she wants to do what she wants to do. She agrees that the pred is not working. Our goal is to take him off of it completely. We'll stay at the current dose for 1-2 weeks depending on how he's responding.

I've emailed Dr Lisa for a consult. I want to discuss the raw diet with her. My regular vet and the internist are both opposed to the raw diet. I'm hoping Dr Lisa can give me some guidance since he's on the pred and leukeran.

I did discuss his quality of life and long term prognosis with her. She's hopeful that we will find the right balance and get him on track. His diabetes just makes things so much more complicated. She said she will let us know if/when she thinks we've gotten to the point where we need to discuss euthanasia. She knows we want to do everything we can for Logan but only if we're helping him. We don't want to take it too far and prolong his suffering needlessly. If we do get to that point, our regular vet has told us that she or one of the other vets (we use two at the same office) will come to our home and make sure Logan doesn't experience any additional stress. I hope and pray that day is years away, but I do realize that my time with Logan is probably limited. He's so young to have so many issues. It's so unfair. :cry:
 
Sitting here with tears in my eyes Kelly.
I pray that it is many many years from now.
You are loving your boy and he is a fighter.
So are you.
:YMHUG:
 
Randi & Max said:
Sitting here with tears in my eyes Kelly.
I pray that it is many many years from now.
You are loving your boy and he is a fighter.
So are you.
:YMHUG:

Thanks, Randi. I pray every day that God will heal my little boy so we can make some more good memories before we lose him. I don't want the last few months to be for nothing. I want my final memories of him to be good ones! I would give anything to have the old Logan back.
 
(((kelly)))
i'm sorry logan has so many things going on... not to mention the worry and stress you must be feeling. i've heard jojo say food is medicine for the liver. she's emphasized that over and over again to those of us who have kitties with liver problems. when alex became sick almost 7 weeks ago, jojo said to try to get as much food into her as possible. denamarin was also suggested to help support the liver. denamarin contains sam-e and silybin which is the most active part of milk thistle extract. it might be worth looking into.
sending lots of hugs and healing vines...
 
Kelly,

I guess my whole point in posting my experience was to say that I have been amazed at how resilient cats can be. There have been two times that a Vet has told me I needed to make a choice, and I just knew in my heart they were wrong. The first time was 6 years ago, and the last 3 months. We got through both episodes and neither issue turned out to be nearly as bad as the Vet made it sound. You know Logan best, and you will know what's right. It does break my heart that he is so young, but that may also make him stronger and more resilient(Belle is almost 13). There were times I was convinced Belle could not bounce back yet again, and she does. If Logan can, it will be because of all the love and caring you give him. As I said before, I know that there is nobody in my life, including my wife, that would care for me as you care for Logan.

As for appetite, you may want to try Stewart Pet Food Enhancer for Cats. I sprinkle it on my CRF cats food and she attacks her food. It works wonders on those days she isn't quite right. I've seen it on Ebay, and it's probably available elsewhere online too.

Keep the Faith,

Jason


Kelly & Logan said:
OMG, Jason, I am so sorry you've gone through so much with Belle. Logan is like a child to me, as well. He's only 6 and he's been through so much. The last 7 months have been awful. I will keep doing everything I can to help him. He met me at the door purring at lunch time. We have 2 dogs and 3 cats and I love all of them dearly, but Logan is just extra special. He has not had an easy life.
 
(((Kelly))) Logan doesn't hate you. I know it is so hard to do all this stuff to them, and that some days it feels like you only pick them up to hurt them. You sure are doing everything you can. It sounds like your vet is starting to get more creative, and I hope that Dr. Lisa can help as well. Bear did go through a time with very high liver values and cusping on fatty liver. It was awful, but he came through it. It sure is hard when you are dealing with the question of infection vs inflammation, as the treatment for the one will make the other one worse. It is just a horrible situation. I do know that bowel inflammation can spread througout the gut and affect the pancreas and liver as well. Bear takes SAMe, as was mentioned already, and also Ursodiol (also known as Actigall). I don;t have too much more in the way of advice, but I think of you often, and worry about you and Logan so much. Yours is the first post I go to every day. You and Logan have fought long and hard, and I pray that things will improve for both of you.
 
Re: 4/21 Logan AMPS 328, +6 237, PMPS 357

Thank you everyone for your kind words of support and always thinking of us. We appreciate everyone's support. Logan had a decent evening. He almost snuggled on the couch, but decided to stay on the floor. He finished off the Instinct Rabbit at dinner. That was the only can I had so I drove 45 min out of my way to the one pet store in Charlotte that carries it and guess what?! They didn't have any. :evil: I got him to eat some Avoderm select chicken chunks (1/2 3 oz can) and 3/8 can of Ziwi Lamb (6.5 oz can). He seems to feel a little better tonight. We started his AB tonight - it wasn't too bad to give. The AB is Clindamycin and the needle is 25 gauge. A little bigger than our 31 gauge insulin syringes, but he was fine with it...the jar of baby food helped, I think. Yes, I gave him the whole jar out of guilt! He needed the calories, anyway! :lol:

Tonight was Leukeran night! He's had all of his meds except the sucralfate. We're supposed to do that three times a day, but it's just too hard to schedule it in with all of his other meds since it has to be given either one hour before or at least two hours after. So, we're just doing it twice a day. I've informed DH2B that it's his job! I do all the other bad things so it's only fair!

Hope everyone has a good night. I'm beat...didn't get much sleep last night.
 
(((((Kelly))))) You are in my thoughts as well as Logan. You have all been through alot in the last several months. Stay strong and keep positive - it is a powerful thing. HUGS TO YOU AND LOGAN!!!!!
 
just checking in to see how you guys are doing today. Don't worry, Logan understands why you're doing all the "bad things" to him, he knows you're helping him. Get some rest. ((((Kelly))))
 
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