5/12 Boomer update, decision made on meds

[Traci and Boomer]

He didn't seem to feel well this morning; he wouldn't eat or take a pill pocket which is unlike him. I pilled him and he bagan to eat soon after.

I called both vets to get thier opinion regarding pred and diabetes versus leukeran. IM vet doesn't think I should use pred on a cat who got diabetes from it in the first place. She thinks it would be very hard to contol it while on the pred. Is this correct? Is it hard to control diabetes while on pred? Are the numbers crazy? She said that with Leuk I'd need to get his blood tested to make sure his white blood cell count doesn't go too low. If it does go too low you take him off the pill or lower the dose and he'll get better. I wanted to know if he'd get a terrible disease or some terrible side effects from the pill and it didn't mention anything else. To the people who use leuk - has your cat's white cell count ever gotten too low? Have you been able to wean your cat off leuk or lower the dose? My IM vet says you can over time. My regular vet hasn't called yet. I need to make a decision soon, as I can't stand it when he's not feeling well or acting like himself. My BF says he thinks I've not accepted the situation and I'm letting my emotions control me. It's probably true. I know I'm not handling this well. The reason is because he is 3, soon to be 4. It's a very young age to be in this situation taking such serious drugs and have to be blood tested every few months for the rest of his life? OMG.

 

[Michelle & Scrabble (GA)]

Re: 5/12 Boomer update

Hi Traci!!!! Wish I could give you some answers but I have no clue as to what you are dealing with! I am so sorry you have to deal with this! Hopefully someone will come along to help, maybe try posting a help question in your subject? Hugs and kisses to you and Boomer!!!

 

[jan and Hep and sara (GA)]

Re: 5/12 Boomer update

Traci,
I can't give you advice on the drugs. I just want to give you support and hope you can find some balance that will help Boomer feel better. I know, he is a young cat to be so sick and I am thinking of you two.

Did you put these questions on Health also. That way you'll have even more input on these drugs.

:YMHUG:

jan and sara

 

[D and Noisy]

Re: 5/12 Boomer update

Cheryl and Winner would be very helpful here. I'd PM her.

ETA: I PM'd Cheryl and Winnie

 

[Nicole & Baby]

Re: 5/12 Boomer update

Hi, Traci & Boomer too.. I do not always comment because the threads get lengthy enough, but thinking of you both & hoping things get lined out soon.. so you & Boomer can have some sense of "normality" back in your lives! :YMHUG:

 

[Hillary & Maui (GA)]

Re: 5/12 Boomer update

Can't advise about the drugs, I do know that pred is a steroid and will affect the BG's. However, from what I've learned, sometimes you have to treat what's more important and deal with the Bg issue later.

That's not an endorsement for using or not using it, just something that's been said on this board before to others with conflicting issues.

I'm sending soothing thoughts and comforting snowflakes to help you and Boomer.

 

[Linda and Bear Man]

Re: 5/12 Boomer update

(((Traci)))
Teddy's red blood cell count dipped once, but recovered within a week or two. He has never had any problems with his white blood cell count. I think that once you have established that the kitty's bone marrow is tolerating the treatment well, you may be able to reduce the frequency of testing.

You are dealing with this very well. It is an emotional issue. You have a lot of info to consider, and really difficult decisions to make. It is not an easy thing. I don't know for sure, but I don't think the plan would be to keep the kitty on Leukeran for life, when used as a treatment for IBD. I would hope that the Leukeran, if it works, would help get the inflammation under control, and then give the dietary changes you want to make a chance to kick in. Did you ask the vet how long he thinks the treatment might last?

I like D's suggestion to get Cheryl's input. I don't think you have to rush to make a decision. I think you should gather as much info as you can, and decide once you feel good about your course of action. I don't get the feeling that you are there yet with the Leukeran.

 

[D and Noisy]

Re: 5/12 Boomer update

Linda is here, perfect, another wise person in this area.

 

[Pat+Raja+Shadow (GA)]

Re: 5/12 Boomer update

Hi Traci....stopping by to say hello and send hugs....I don't know anything about the drugs....but hopefully, you will study up on it and get suggestions for everyone here. So many knowledgeable people, right?


Wondering if Boomer ate better today than this morning...thinking of you both... :YMHUG:
Oh, and here is your link to your last condo:
viewtopic.php?f=9&t=14274

 

[Kelly & Logan]

Re: 5/12 Boomer update

Logan has been on the Leukeran for over a month now and so far his blood work has been normal. His ALT was elevated, but we don't think it was the Leukeran. The vet thinks it was an infection of some sort. It's now back to normal. We're doing a recheck in two weeks and after that we'll go longer between checks. Leukeran is a lifetime drug but you will get him down to the lowest dose possible. Dr Lisa seemed to think we could eventually take him off of it all together once he was on a raw/slightly cooked diet for a while.

Logan was extremely insulin resistant on pred. We're at 7.75 units and only started consistently getting into the 200s after we cut the pred to 5mg once a day. Others seem to not be as resistant while on it. For us, we were willing to work the insulin around the pred but the pred just wasn't enough to control the inflammation. Logan also had some side effects from the pred. He would just lie next to the water fountain with his mouth hanging open. He would breathe really heavily, too. He just felt like crap on it. We did see a little aggressiveness from time to time while on the higher doses.

Just take your time, Traci. Boomer will be ok.

 

[Traci and Boomer]

Re: 5/12 Boomer update

Hi Everyone-
Thanks so much for all your thoughts and hugs. Having a cat with IBD is pretty challenging. I've now spoken to my regular vet along with the IM doc. Regular vet thinks we should be aggressive now to get it under control-if it's controlled now it may not ever turn to cancer. I asked about whether using this treatment now would affect his treatment should he get cancer, she said that she thought it was more important to fix what he has now with the leukeran. She was against using the pred because she said it would be much harder to control his diabetes. I asked about the blood tests and she said he'd need the first in ten days, the second in 3-4 months and if he was doing well at that point we can wait longer. I decided to go with the leuk. Luckily when I got home tonight he was a totally different cat than this morning. Perky, active and insanely hungry. He's eaten a 5 oz can and a pouch of Wellness. I was able to get his leuk into him with a pill pocket. He's still on reglan and remeron so hopefully this will help with potential vomiting and not wanting to eat.

My vet says when it's under control I could wean him off and try budesonide again. My vet is more open to different options where the IM doctor doesn't seem like that-she's more by the book. Once I feel that he's gained enough weight back maybe I'll try the raw again too. I'd love to think that changing his food would help solve this but I've not gotten that from wither vet, less so from the IM. She thinks it's not a food allergy at all. I'd like to think she's wrong.

So....he's on 2 mgs of Leuk every other day for now. I'm going to test his BG's in a little while-it'll be a PM +3. Thanks everyone for your help and support.

 

[Libby and Lucy]

good luck with the new treatment, Traci. It sounds like both vets think this is the way to go, so I hope you feel good about it too.

 

[Sienne and Gabby (GA)]

I'm glad you made the decision. Sometimes, that's the hardest part.

Once you see that Boomer is doing well, maybe a consultation with Dr. Lisa would help. She talks about having a cat with IBD on her site and she obviously looks at how diet and health interact.

 

[Kelly & Logan]

Best of luck with the Leukeran! Don't be too discouraged if you don't see immediate improvement. My internist said she sees some cats respond in a few doses while others (Logan was one) took a little longer.

2mg? How much does Boomer weigh? That sounds like an aggressive dose - but I think it's the normal dose that you can get at a regular pharmacy. Logan is on 2mg but he weighs 19 lbs! I told you the wrong price the other day, btw....it was $104 for 30 pills not 15, so that's a two month supply. Not too awful. Quincy is on 1mg three days a week if I remember correctly. To get the 1mg dose, you do have to get it from a compounding pharmacy.

 

[Laura and Quincy]

I posted a response in your thread on the diabetes health forum, cross-posting here: viewtopic.php?f=3&t=14278

Like Kelly, I wondered about that dose size given Boomer's a l'il guy. And yes, Quincy's on 1mg. He was always on 1mg, what's changed is the frequency. And of course, he's not on prednisone anymore. Was on it for 1 year until he was diagnosed with diabetes.

So far - every finger crossed! - Quincy has not had any side effects attributed to the leukeran. Baytril was way harder on him. My vet said cats generally tolerate leukeran very well. Quincy has pretty much a boundless appetite, so that wasn't a problem for him. Even when his vomiting is bad, he's ready to eat minutes later. (TMI?)

 

[Ann & Tess GA]

I'm glad you've made your decision. it is always the hardest thing to do. Now you can spend all that "worry energy" on positive things, like playing w/ Boomer of just cuddling him and loving him. You do that anyway, but now, just enjoy it. He will fet better.

 

[Cheryl and Winnie]

He's still on reglan and remeron so hopefully this will help with potential vomiting and not wanting to eat.


does he do ok w/ the reglan? is he still nauseous and/ or vomiting? there are better meds for nausea in cats. I have several reference but they are all PDF..... so if you want them for you and/or your vet I am happy to email the pdf file. ondansetron works great and is very safe if you need a good med for nausea and is available pill or injectable. I have always used pill form. is very inexpensive.
oh found this by todd tams dvm -- he has updated this same paper for at least 10 years. kind of info overload as the paper is about all causes of vomiting for cats and dogs. He does talk about why reglan is not the best for cats somewhere in there. ( except in cases where gastric motility is an issue) If you scroll down almost to the bottom, he finally gets to IBD in cats. might find something there to help you ?

http://www.dcavm.org/07sep.html

She was against using the pred because she said it would be much harder to control his diabetes. I asked about the blood tests and she said he'd need the first in ten days, the second in 3-4 months and if he was doing well at that point we can wait longer.

I personally have no issues with shooting around steroids *if necessary*. -- health issues must be prioritized, and FD can be worked around. That said, Boomer has choice in treatments and I think your decision to use leukeran is a good one. Yes it can cause low wbc, it can also sometimes cause anemia. We tested after 2 weeks then every month. It is important to continue to monitor as long as your cat is on it. You might wish to talk to your vet about the follow up testing sced. Perhaps it was b/c I was on the lymphoma board that I saw cats develop problems later on, but my vet felt it should be watched judiciously. Here is a link on IBD that includes a blurb on the use of leukeran and the need for testing.

http://www.michvet.com/library/medicine_IBD.asp

you might also wish to post on health forum as there are many members that have and/or do use leukeran and might have other cbc testing protocols to share.

Is boomer on any supplements? (ie. pro biotics ? pre biotics? anti oxidants? )
injectable B12 has been used to great effect in helping cats with IBD and other gastro disorders.
here is a link from texas a &m about that and their protocol. It is very inexpensive .

http://www.cvm.tamu.edu/gilab/research/cobalamin.shtml

has boomer also been tested for p-titis? often IBD and p-titis go together and symptoms can overlap.
b/c boomer is diabetic he is more likely to develop p-titis. If he hasn't already been tested (fPLI) I would highly recommend it.

to note-- when Winnie started leukeran, she got very gassy :shock: . maybe that won't happen w/ boomer. it was nasty, but got much better. we had to stop after a few months, as Winnie had a very rare complication .

Best of luck to Boomer and his new treatment !

 

[Jason & Belle (GA)]

Traci,

Since he's such a young boy, I think you've made the right decision to get things under control as early as possible.

As for dosage, Belle is in the 12lb range and she was prescribed 2mg every 3 days, so it seems there is some variation in recommended protocols.

Jason

 

[Traci and Boomer]

Dr. Lisa is always on my back burner! I'm not quite there yet, but at some point I will be. Thanks!

I'm glad you made the decision. Sometimes, that's the hardest part.

Once you see that Boomer is doing well, maybe a consultation with Dr. Lisa would help. She talks about having a cat with IBD on her site and she obviously looks at how diet and health interact.

 

[Traci and Boomer]

Boomer weighs 8 lbs. IM vet suggested 2 mgs and because of all of you I double-checked the dose with regular vet AND reminded her that he is only an 8-pounder. She said yes. Believe me, I'm thinking about this too. When I gave him his pill last night I cut it in half with my pill cutter to get it in the pill pocket and thought "what if I only gave him half" but then I thought better of it. It's SO hard to have vets say one thing and people who use the drug on their larger cats take less. Grrrr. I guess I have to have faith in the vet???? If I question them they get pissy.

Best of luck with the Leukeran! Don't be too discouraged if you don't see immediate improvement. My internist said she sees some cats respond in a few doses while others (Logan was one) took a little longer.

2mg? How much does Boomer weigh? That sounds like an aggressive dose - but I think it's the normal dose that you can get at a regular pharmacy. Logan is on 2mg but he weighs 19 lbs! I told you the wrong price the other day, btw....it was $104 for 30 pills not 15, so that's a two month supply. Not too awful. Quincy is on 1mg three days a week if I remember correctly. To get the 1mg dose, you do have to get it from a compounding pharmacy.

 

[Traci and Boomer]

Hi Ann-
You are right about redirecting the worry energy to something else. I feel SO much better today. The decision is made. It doesn't seem so dire. He's doing great. Eating like a horse, acting like a crazy cat. I woke up and found a toy in my bed because he's taken it with him! He's happy and it makes me happy. :lol:

I'm glad you've made your decision. it is always the hardest thing to do. Now you can spend all that "worry energy" on positive things, like playing w/ Boomer of just cuddling him and loving him. You do that anyway, but now, just enjoy it. He will fet better.

 

[Traci and Boomer]

You and Quincy and Kelly and Logan have been so helpful to me, thank you so much! Now me and Boomer and Jason and Belle are in the leuk club...woohoo with you guys. :roll: I am so lucky to have your experience to learn from. Please thank Quincy for me!!! And I think it's awesome that Q has a good appetite-I like an eater myself.

I posted a response in your thread on the diabetes health forum, cross-posting here: viewtopic.php?f=3&t=14278

Like Kelly, I wondered about that dose size given Boomer's a l'il guy. And yes, Quincy's on 1mg. He was always on 1mg, what's changed is the frequency. And of course, he's not on prednisone anymore. Was on it for 1 year until he was diagnosed with diabetes.

So far - every finger crossed! - Quincy has not had any side effects attributed to the leukeran. Baytril was way harder on him. My vet said cats generally tolerate leukeran very well. Quincy has pretty much a boundless appetite, so that wasn't a problem for him. Even when his vomiting is bad, he's ready to eat minutes later. (TMI?)

 

[Linda and Bear Man]

When I gave him his pill last night I cut it in half with my pill cutter to get it in the pill pocket and thought "what if I only gave him half" but then I thought better of it.

Is your Leukeran pill film coated with a hard colored shell? Mine is. If so, it may not be meant to be cut before administration. You could check with the pharmacist.

 

[Traci and Boomer]

does he do ok w/ the reglan? is he still nauseous and/ or vomiting?
Yes-he's doing great. He'n not puked in long time thank goodness. He DOES have stomach motility issues that's why reglan was chosen.
Is boomer on any supplements? (ie. pro biotics ? pre biotics? anti oxidants? )
injectable B12 has been used to great effect in helping cats with IBD and other gastro disorders.
Boomer gets B-12 once a month and we just tested to see if its working and it is normal so I will continue to give it once a month. He gets fortiflora daily. I also put nutritional yeast on his food daily-he loves the taste and it's loaded with vitamins and minerals, especially B vitamins. It's gluten free.
has boomer also been tested for p-titis? often IBD and p-titis go together and symptoms can overlap.
The IM vet called me this morning to let me know that the TLI test found that he was "low" meaning he has "exocrine pancreatic insuffiency"-he doesn't produce enough enzymes, so she wants me to add some powder to his food to help. The powder she suggested are: viokase or pancreazyme. She says this should help him gain weight. He was diagnosed with p-titis in the past-the vets don't think that is contributing to this issue now.
to note-- when Winnie started leukeran, she got very gassy :shock: . maybe that won't happen w/ boomer. it was nasty, but got much better. we had to stop after a few months, as Winnie had a very rare complication .

Boomer is gassy regularly! :lol:
Thanks for all the information and links! You are a sweetheart!quote]

 

[Traci and Boomer]

Really??? Holy crap! I'm tellin' ya! Who would think it wasn't ok to cut a pill? I'll call. Yes, it's the one with a hard colored shell.

When I gave him his pill last night I cut it in half with my pill cutter to get it in the pill pocket and thought "what if I only gave him half" but then I thought better of it.

Is your Leukeran pill film coated with a hard colored shell? Mine is. If so, it may not be meant to be cut before administration. You could check with the pharmacist.

 

[Laura and Quincy]

When I gave him his pill last night I cut it in half with my pill cutter to get it in the pill pocket and thought "what if I only gave him half" but then I thought better of it.

Is your Leukeran pill film coated with a hard colored shell? Mine is. If so, it may not be meant to be cut before administration. You could check with the pharmacist.

You really shouldn't cut these pills - they are a mustard gas derivative, and if you cut through a hard coating or capsule, you can absorb some of that through you skin or via inhaling. Not a good idea to take it if you don't need it! I strongly recommend you consider compounding if the pills you've gotten are too big for Boomer to swallow without much resistance.