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- Thread starter eeraby
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Anonymous
Re: Bud update: vet visit
Beth,
I have'nt been keeping up. I am so deeply sorry to read this. Oh Hon, I wish I could make it all just go away. So very sorry,
Love,
Lori
Beth,
I have'nt been keeping up. I am so deeply sorry to read this. Oh Hon, I wish I could make it all just go away. So very sorry,
Love,
Lori
Joanna & Bix (GA)
Member Since 2009
Re: Bud update: vet visit
((((((Beth)))))) I am so sorry Bud is having problems! I don't know if you remember me from the PZI forum, but someone PM'd me since I have some experience with Leukeran and IBD.
From everything I have read or heard from vets, Leuk is supposed to work well in keeping IBD/cancer from getting worse. From what I can tell it does not necessarily *improve* things, but it can dramatically slow the rate at which they get worse. I have actually tried it with 3 cats (with all the years of dry food
IBD has been a theme in our house). The first had an uncommon reaction where it made her nauseaus so we had to stop it. With Bix, he clearly was feeling unwell despite the Leuk and numerous other meds and was still having problems with nausea, so I opted to stop it. I felt like if it wasn't making him feel BETTER, it didn't make sense to continue with it - if it would just keep him feeling unwell for a longer period of time, that didn't seem like the humane route to me. With my civie who now has intestinal cancer, I tried it but for her it has been the same as Bix - I didn't see any improvement in using it, and she still had enough symptoms otherwise that it hasn't felt right to me to continue it.
My recommendation would be that if you are comfortable with the cost and the possible side effects (which are relatively low, but you do need to get blood work periodically to make sure they are tolerating it ok), go ahead and try it if your vet thinks she should be on it. Might help, can't hurt - or if it does cause side effects, you discontinue it and they go away (as far as I know it doesn't cause lasting problems). The best price I found for it was $4/pill at Walmart. The specialist charged more like $8/pill, so it is worth shopping around.
I agree on skipping the biopsies and stuff. When I have been at the specialist I have asked a lot of questions about what difference the tests will actually make in the treatment plan, and have concluded that unless you are planning to pursue surgery or chemo (other than Leuk), it's kind of irrelevant. I've asked both my regular vet and the specialist if there is something *else* these symptoms might point to and the testing would tell us that and they kind of sigh and say well, not really, it's almost certainly going to be IBD or cancer.
For us the medicine that has been the most effective and given my IBD kitties the best QOL has been the steroids. It's a pain b/c of the potential side effects and long term issues, but they really do seem to work amazingly well for a cat who isn't having good QOL otherwise. If you are considering steriods, you can try starting with Budesonide, which is local to the intestinal tract and does not affect BGs the same as systemic steroids. That worked really well for Bix, but for my latest civie (with intestinal cancer), she did not respond to Bude, but has responded well to Prednisolone.
Caveat is I only have the IBD perspective, I don't know a lot about the other conditions you are dealing with so I don't know if for instance Budesonide would be in order - could be Pred is needed to help with other inflamation issues.
Hope you are doing ok, and I hope Bud's new suite of meds will help her feel better soon! The Bupe should at least - liquid is the only form I have seen.
If you do try the Leuk, be sure to keep it refrigerated, and wear chemo-safe gloves when you are administering it - I've been able to find those in the pharmacy section at drug stores.
((((((Beth)))))) I am so sorry Bud is having problems! I don't know if you remember me from the PZI forum, but someone PM'd me since I have some experience with Leukeran and IBD.
From everything I have read or heard from vets, Leuk is supposed to work well in keeping IBD/cancer from getting worse. From what I can tell it does not necessarily *improve* things, but it can dramatically slow the rate at which they get worse. I have actually tried it with 3 cats (with all the years of dry food
IBD has been a theme in our house). The first had an uncommon reaction where it made her nauseaus so we had to stop it. With Bix, he clearly was feeling unwell despite the Leuk and numerous other meds and was still having problems with nausea, so I opted to stop it. I felt like if it wasn't making him feel BETTER, it didn't make sense to continue with it - if it would just keep him feeling unwell for a longer period of time, that didn't seem like the humane route to me. With my civie who now has intestinal cancer, I tried it but for her it has been the same as Bix - I didn't see any improvement in using it, and she still had enough symptoms otherwise that it hasn't felt right to me to continue it.My recommendation would be that if you are comfortable with the cost and the possible side effects (which are relatively low, but you do need to get blood work periodically to make sure they are tolerating it ok), go ahead and try it if your vet thinks she should be on it. Might help, can't hurt - or if it does cause side effects, you discontinue it and they go away (as far as I know it doesn't cause lasting problems). The best price I found for it was $4/pill at Walmart. The specialist charged more like $8/pill, so it is worth shopping around.
I agree on skipping the biopsies and stuff. When I have been at the specialist I have asked a lot of questions about what difference the tests will actually make in the treatment plan, and have concluded that unless you are planning to pursue surgery or chemo (other than Leuk), it's kind of irrelevant. I've asked both my regular vet and the specialist if there is something *else* these symptoms might point to and the testing would tell us that and they kind of sigh and say well, not really, it's almost certainly going to be IBD or cancer.
For us the medicine that has been the most effective and given my IBD kitties the best QOL has been the steroids. It's a pain b/c of the potential side effects and long term issues, but they really do seem to work amazingly well for a cat who isn't having good QOL otherwise. If you are considering steriods, you can try starting with Budesonide, which is local to the intestinal tract and does not affect BGs the same as systemic steroids. That worked really well for Bix, but for my latest civie (with intestinal cancer), she did not respond to Bude, but has responded well to Prednisolone.
Caveat is I only have the IBD perspective, I don't know a lot about the other conditions you are dealing with so I don't know if for instance Budesonide would be in order - could be Pred is needed to help with other inflamation issues.
Hope you are doing ok, and I hope Bud's new suite of meds will help her feel better soon! The Bupe should at least - liquid is the only form I have seen.
If you do try the Leuk, be sure to keep it refrigerated, and wear chemo-safe gloves when you are administering it - I've been able to find those in the pharmacy section at drug stores.
Marcy & Klinger (GA)
Member Since 2010
Re: Bud update: vet visit
No advice. Just wanted to give you a hug and let you know we're thinking of you and BudBud.
(((((((((((((((((((((((((Beth & BudBud))))))))))))))))))))))))))))))))))
No advice. Just wanted to give you a hug and let you know we're thinking of you and BudBud.
(((((((((((((((((((((((((Beth & BudBud))))))))))))))))))))))))))))))))))
Darlene & Jack
Member Since 2011
Re: Bud update: vet visit
I don't have any experience with that either...but glad Bud is feeling better, eating and purring. The only advice I can offer is follow your heart, it will know what's best for Bud. Keep her happy and purring and she will love you!
I don't have any experience with that either...but glad Bud is feeling better, eating and purring. The only advice I can offer is follow your heart, it will know what's best for Bud. Keep her happy and purring and she will love you!
Joanna & Bix (GA)
Member Since 2009
Re: Bud update: vet visit
I don't know about the Triaditis part, but I think it's possible you are looking at things that are more a sideways slide than a downhill one. Hard to say really, but I have been surprised how long they can do ok with some management with meds. Even with cancer and without chemo, they can do surprisingly well. If it is the slower-growing cancer, Leuk can buy them up to a couple years from what I have read. And if it isn't cancer, IBD & pancreatitis at least can be managed pretty well I think. I don't know about the liver stuff though. And ECID definitely applies, how advanced the disease is, age, how many other things are going on with them, etc. Sometimes it is downhill fairly quickly, and other times it is more maintenance for a longer stretch.
I don't know about the Triaditis part, but I think it's possible you are looking at things that are more a sideways slide than a downhill one. Hard to say really, but I have been surprised how long they can do ok with some management with meds. Even with cancer and without chemo, they can do surprisingly well. If it is the slower-growing cancer, Leuk can buy them up to a couple years from what I have read. And if it isn't cancer, IBD & pancreatitis at least can be managed pretty well I think. I don't know about the liver stuff though. And ECID definitely applies, how advanced the disease is, age, how many other things are going on with them, etc. Sometimes it is downhill fairly quickly, and other times it is more maintenance for a longer stretch.
Peggy and Mickey (GA)
Member Since 2010
Re: Bud update: vet visit
Glad Bud is feeling better, purring and all. Sending healing vibes.
Glad Bud is feeling better, purring and all. Sending healing vibes.
Vicky & Gandalf (GA) & Murrlin
Member Since 2009
Re: Bud update: vet visit
You know, at least she is eating now!
I'm sorry, I should have asked about her eating - when she did get stuff in her mouth did she make kind of smacking noises or sound like there was something wrong with her jaws or any noise which sounded unusual? Cats which are dehydrated badly can do that. I guess it's because they don't have any saliva, I'm not sure. I remember someone posting about the odd noises their cat was making when it ate and that was what was wrong.
Her fPLI is not very high. Gandalf's was 28!
I'm sorry I don't have any experience with Leukeran, thankfully. Joanna gave a great rundown about it though, so I think that's the best advice you're going to find on that! Thanks for checking in on Bud Bud, Joanna!!
It's really hard to deal with news like this and all the treatment options. I'm surprised you didn't have a screaming headache. So don't worry about not posting for a while. You have to be at your best to help her, it's understandable.
There is not a buprenorphine pill that I know of, but it can be injected, so you might want to find out if they can give you that.
I have given Pepcid (make sure it's famotidine or Pepcid AC if you get the brand name) every 12 hours if I thought he needed it. Watch for lip licking when no food has been eaten, which may indicate nausea.
I would really recommend Denamarin, which is sam-E plus milk thistle. You can get it from Amazon.com for cats and small dogs. You don't need a prescription. It's about $23 so you could order a little something extra to get over $25 for free shipping.
I also think you're right about not doing further diagnostic testing. Why put her through all that? The only other thing I would recommend is an ultrasound - I don't remember if she's had that done or not. It's not invasive and the worst that happens is she would get her tummy shaved!
And the fact that some treatments are not cures but can maintain their level of health is a good point. Even if a drug doesn't completely correct the problem, if the drug helps them manage and feel better, then it's worth using. So as far as giving it to you straight, I think this is something which can be managed fairly well, if you are a caregiver who is up for all the pill popping and scheduled aspects, like with same-E or Denamarin which is supposed to be given an hour before eating. That is harder than it sounds. I am frequently forgetting it.
Everything the vet said to use is what we know works for pancreatitis/triaditis, so you're on the right path! Sounds like you have a pretty darn good vet!
You know, at least she is eating now!
I'm sorry, I should have asked about her eating - when she did get stuff in her mouth did she make kind of smacking noises or sound like there was something wrong with her jaws or any noise which sounded unusual? Cats which are dehydrated badly can do that. I guess it's because they don't have any saliva, I'm not sure. I remember someone posting about the odd noises their cat was making when it ate and that was what was wrong.
Her fPLI is not very high. Gandalf's was 28!
I'm sorry I don't have any experience with Leukeran, thankfully. Joanna gave a great rundown about it though, so I think that's the best advice you're going to find on that! Thanks for checking in on Bud Bud, Joanna!!
It's really hard to deal with news like this and all the treatment options. I'm surprised you didn't have a screaming headache. So don't worry about not posting for a while. You have to be at your best to help her, it's understandable.
There is not a buprenorphine pill that I know of, but it can be injected, so you might want to find out if they can give you that.
I have given Pepcid (make sure it's famotidine or Pepcid AC if you get the brand name) every 12 hours if I thought he needed it. Watch for lip licking when no food has been eaten, which may indicate nausea.
I would really recommend Denamarin, which is sam-E plus milk thistle. You can get it from Amazon.com for cats and small dogs. You don't need a prescription. It's about $23 so you could order a little something extra to get over $25 for free shipping.
I also think you're right about not doing further diagnostic testing. Why put her through all that? The only other thing I would recommend is an ultrasound - I don't remember if she's had that done or not. It's not invasive and the worst that happens is she would get her tummy shaved!
And the fact that some treatments are not cures but can maintain their level of health is a good point. Even if a drug doesn't completely correct the problem, if the drug helps them manage and feel better, then it's worth using. So as far as giving it to you straight, I think this is something which can be managed fairly well, if you are a caregiver who is up for all the pill popping and scheduled aspects, like with same-E or Denamarin which is supposed to be given an hour before eating. That is harder than it sounds. I am frequently forgetting it.
Everything the vet said to use is what we know works for pancreatitis/triaditis, so you're on the right path! Sounds like you have a pretty darn good vet!
pamela and tigger
Member Since 2009
Re: Bud update: vet visit
Tigger had Triaditis four years ago. And he is still here!
We treated it with CLavamox for eight weeks initially (bloodwork done as well during this time to see how well it was working). That was easy since we just mixed it with his food and he ate it.
Then Flagyl (metronidazole) which was not as easy, for three weeks.
Also injectable Reglan for nausea. The Pepcid you can give injectable too if that would help.
We also initially had an ultrasound and xrays.
The vet that did the US and xrays said he didn't think it could be cancer. After six months of treatment and his liver values didn't come down my vet was wondering if it was, indeed, cancer. It wasn't.
We didn't do pred but would have if the AB's didn't work. Finally after doing the AB's all summer, first the Clavamox and then the Flagyl (I wish we had done them together in the beginning - that would have helped a lot), we tried Actigall (Ursodial) and that helped the most it seemed in the end. I wish we had done this sooner too. He then was on this med for two years (this was easy since it was compounded fish flavor - just mixed it in his food).
We also gave the Denamarin (Sam-e plus Milk Thistle) once a day on an empty stomach. I would use the smallest portion of the pill pocket that was possible so he didn't feel he had to chew it. He just swallowed it. Sometimes he would spit out the pill and then we would just wrap it again. We did this for over three years successfully.
So going from memory on most of this. You can read further of our journey in my profile. Just skip down to 2007.
There is a thread on Health right now regarding administering the metronidazole since it is indeed bitter tasting.
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=46358
Just my experience. I will post if I can think of anything else. I hope she continues to eat.
BTW what were her liver values? Were you able to get a copy of her bloodwork?
Also, if you have questions you should also post on Health. There are lots of people with experience with Triaditis on FDMB.
eeraby said:
Tigger had Triaditis four years ago. And he is still here!
We treated it with CLavamox for eight weeks initially (bloodwork done as well during this time to see how well it was working). That was easy since we just mixed it with his food and he ate it.Then Flagyl (metronidazole) which was not as easy, for three weeks.
Also injectable Reglan for nausea. The Pepcid you can give injectable too if that would help.
We also initially had an ultrasound and xrays.
The vet that did the US and xrays said he didn't think it could be cancer. After six months of treatment and his liver values didn't come down my vet was wondering if it was, indeed, cancer. It wasn't.
We didn't do pred but would have if the AB's didn't work. Finally after doing the AB's all summer, first the Clavamox and then the Flagyl (I wish we had done them together in the beginning - that would have helped a lot), we tried Actigall (Ursodial) and that helped the most it seemed in the end. I wish we had done this sooner too. He then was on this med for two years (this was easy since it was compounded fish flavor - just mixed it in his food).
We also gave the Denamarin (Sam-e plus Milk Thistle) once a day on an empty stomach. I would use the smallest portion of the pill pocket that was possible so he didn't feel he had to chew it. He just swallowed it. Sometimes he would spit out the pill and then we would just wrap it again. We did this for over three years successfully.
So going from memory on most of this. You can read further of our journey in my profile. Just skip down to 2007.
There is a thread on Health right now regarding administering the metronidazole since it is indeed bitter tasting.
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=46358
Just my experience. I will post if I can think of anything else. I hope she continues to eat.
BTW what were her liver values? Were you able to get a copy of her bloodwork?
Also, if you have questions you should also post on Health. There are lots of people with experience with Triaditis on FDMB.
Vicky & Gandalf (GA) & Murrlin
Member Since 2009
Re: Bud update: vet visit
The brand name Denamarin by Nutramax (I think the very large Sam-E pill is also) is much smaller although I wish it wasn't blue because that must be some kind of dye. It's about the size of a 200mg ibuprofen for comparison. Still should be given before food. I like the pill size and it's pretty slick so it goes down easy.
eeraby said:
The brand name Denamarin by Nutramax (I think the very large Sam-E pill is also) is much smaller although I wish it wasn't blue because that must be some kind of dye. It's about the size of a 200mg ibuprofen for comparison. Still should be given before food. I like the pill size and it's pretty slick so it goes down easy.
pamela and tigger
Member Since 2009
Re: Bud update: vet visit
The largest size available for cats is 90 mg. I personally didn't think this small tablet was huge since it fit nicely into a pill pocket that I had just 'formed' around it (discarding the rest of the pill pocket or save for later). I don't know how to describe how 'big' it is except like Vicky said it is about the size of an ibuprofen tablet for people. Here are the different sizes:
http://www.nutramaxlabs.com/Vet/Products/Denamarin.aspx
But at this time I wonder if just getting her antibiotics down her shouldn't be the first thing you should be concentrating on and getting her to eat? The Denamarin is a long term thing for liver support and regeneration. Important yes, but if she is fighting you then the most important meds first?
I would still just consider asking your vet about the Actigall (Ursodial - look it up to see what it does). You can get it compounded in a fish flavor and mix it in her food - real easy. I am just wondering if your vet has ruled this out as part of her treatment.
All any of us can do here is give you advice based on our own personal experiences and/or links to what other's have gone through. I have done extensive research on Triaditis and still have lots of questions because I am not a vet. I did rely on my own research though to suggest things to my vet which ultimately is when he said okay to using the Actigall.
So I am just trying to say just do a lot of research so you can pose the right questions to your vet. Research Cholangiohepatitis which is part of Triaditis, which means inflammation of the liver and the bile ducts which also ultimately effects the pancreas (pancreatitis) and the bowel (IBD).
Please don't just rely on what your vet suggests. Even though I really like my vet and I feel he was looking after Tigger's best interest for his health, in the end I felt there was some things he could have done differently. But it all worked out but probably the outcome could have been sooner rather than later. But all is well with Tigger now. He is as healthy as he could be at 16 years. Bud will be too.
eeraby said:
The largest size available for cats is 90 mg. I personally didn't think this small tablet was huge since it fit nicely into a pill pocket that I had just 'formed' around it (discarding the rest of the pill pocket or save for later). I don't know how to describe how 'big' it is except like Vicky said it is about the size of an ibuprofen tablet for people. Here are the different sizes:
http://www.nutramaxlabs.com/Vet/Products/Denamarin.aspx
But at this time I wonder if just getting her antibiotics down her shouldn't be the first thing you should be concentrating on and getting her to eat? The Denamarin is a long term thing for liver support and regeneration. Important yes, but if she is fighting you then the most important meds first?
I would still just consider asking your vet about the Actigall (Ursodial - look it up to see what it does). You can get it compounded in a fish flavor and mix it in her food - real easy. I am just wondering if your vet has ruled this out as part of her treatment.
All any of us can do here is give you advice based on our own personal experiences and/or links to what other's have gone through. I have done extensive research on Triaditis and still have lots of questions because I am not a vet. I did rely on my own research though to suggest things to my vet which ultimately is when he said okay to using the Actigall.
So I am just trying to say just do a lot of research so you can pose the right questions to your vet. Research Cholangiohepatitis which is part of Triaditis, which means inflammation of the liver and the bile ducts which also ultimately effects the pancreas (pancreatitis) and the bowel (IBD).
Please don't just rely on what your vet suggests. Even though I really like my vet and I feel he was looking after Tigger's best interest for his health, in the end I felt there was some things he could have done differently. But it all worked out but probably the outcome could have been sooner rather than later. But all is well with Tigger now. He is as healthy as he could be at 16 years.
Bud will be too. - Status