5.13.15 Zoey amps 363 ... fluid retention question

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Rose

Rose

Member Since 2015
Good morning!

Our sweet Zoey has seen better days, that's for sure. Here's the new issue:

QUESTION:

Zoey had a lot of fluid retention after I gave her the 100 ml on Saturday. She went to the ER vet that night, labs were good - no kidney issues and felt it was from the fluids and/or Cushing's and to give it time and definitely do not give more fluid. The fluid was so built up that it was seeping from her tears on her stomach (Cushing's related). On Monday we called reg. vet and they said bring her in. Her test results indicated she could be Cushing's and with her symptoms she was exhibiting they made the call that it was definitely Cushing's and gave us the meds. On Tuesday a.m. we started the meds. She had tried to have a BM and the pellets were very close to being literally, hard as a rock. We took her in yesterday to have an enema. At that time her legs (both hinds) were very swollen with fluid and it was up through her hips and still seeping from tears. When we picked her up from the vet, after the enema, the fluids were gone. We thought ... TY, Lord, and it must've been she was so impacted that the fluid had no where to go. Well, this morning the fluid is starting to settle in again. She's been drinking an awful lot of water. Up to this point I've not been measuring her fluid intake but I'm thinking that I should. Is there a certain amount of fluid I should limit her to?

OTHER STUFF:

The latest bump in the road (and there's always a bump or a hurdle) is that the Great Vet is out town for the next week and the Dr. Google vet is the one I would have to deal with. He's already shown his colors that he's not interested in anything that doesn't fit in his box so I really don't want to call and ask anything until the Great Vet returns.

I can tell you that if it weren't for getting this medicine prescribed for Zoey then we would definitely be putting her to sleep Her quality of life has rapidly deteriorated and if it weren't for the hope of maybe this medicine turning off the cortisol that's causing the sickness, then we would not want to watch her just lie there on a rug and struggle to eliminate and stand at a water bowl. While she's still bright eyed and loving, we wouldn't let her continue to decline this way as much as we want to keep her with us. Thankfully we've got a small glimmer of hope and are willing to give it a few weeks to see if she can regain some of the strength she's lost and the appetite returns. She did lick some of the baby food this morning but we ended up syringe feeding two 3cc syringes so she had something on her stomach for her meds.

I'm also trying to not take as may BG readings from her. The neuropathy has gotten worse and she flinches now when I'm ready to prick and then when I do prick, her whole lower half of her body trembles as a reflex. I imagine that's nerves (so does vet). He says it's okay and not to worry, that it could very well be part of the Cushing's and we might see that decrease if the medicine helps. None of us really knows though.

So ... with that total of picture of our situation, would you please let us know if you have any experience or thoughts on the fluid issues. I hate to see her build up like she was because it was just awful.

Please keep our sweet baby in your prayers and know that we do the same for each of yours and you.

Yesterday
 
I wish I had an answer about the fluids situation, but all I have are a boatload of prayers. You are doing an amazing job with sweet little Zoey. I totally agree about going easy with BG tests, given all that she has going on. Praying that the meds start helping soon...
 
Rose, no advice on Cushing's from me but I think you are doing an amazing job with Zoey. Keep holding on to that glimmer of hope until it proves otherwise, Zoey will tell you when it's time. Sending hugs to you and your DH :bighug: and many prayers for sweet Zoey. Take care.
 
I had the same thought as Sienne. I know when people have fluid buildup, they give diuretics. I know you don't want to call the Google vet, but you might need to, rather than wait for the Great Vet to come back.

Sending lots of vines and prayers.
 
Thanks @suki & crystal for the support and prayers. Wouldn't be where we are without 'em. :D

@Sienne and Gabby and @Tricia & Cinco ... I asked the Great Vet specifically about diuretics (day before yesterday) for Zoey and he said no, that she had no issues with her heart and it wouldn't be good for her. He felt it was Cushing's related. Now what that means, I don't know. I thought diuretics just helped eliminate fluids. ?? I do have some diuretic here (about two years old) that I would consider using once I know that it's still good and only if she gets to the point of being miserable and crying on touch like she was two nights ago. Otherwise, at the moment, we're trying exercise (assisted walking across the room, every couple of hours), massage and elevating her paws when possible. (For instance when she's resting with her dad he will position her to get them elevated above her head while she's on her back. And we'll both massage them with them raised and work the fluids down as often as we can throughout the day. She will sit over the bowl and drink and drink ... I'm afraid to limit her water intake but if it continues to build, I'll probably start measuring to see just how much she's getting. I'm thinking about picking up some dandelion while I'm out. That's supposed to help with fluid retention and I know that it is one of the ingredients in the Cushex so it should be safe. (I'm not giving her Cushex now that she's on Trelastane). I'm trying to figure out how to make a compression sock for a kitty's narrow leg and foot. :bookworm: I would want to be sure that it wasn't cutting off circulation so it would have to be something like a tube sock. I'm thinking of getting a baby's sock and running a seam down it and see if that helps at all. (So glad I'm working at home today so no one can see just how much work I'm NOT doing. :rolleyes:)

On a positive note: She is eating portions of her food on her own. She ate .5 ounces without any coaxing or intervention. The other 1.0 ounces has been coaxed and syringed. We also add in the meds when using the syringe so we can get those out of the way. She's on lactulose syrup (which we know that has sugar in it) so I doubt her BG is going to be too low. I plan to test her around +7 since she's been eating most of the morning, here and there. That will give her two hours without food.

Thank you for looking in on us. And keep the questions coming. Maybe there's a rock that hasn't been turned over yet.
 
I'm glad she's eating!

I had the same thoughts as Sienne. How does your vet know she doesn't have heart problems? The only way to tell is with an echocardiogram (ultrasound of the heart) that is usually done by a board certified cardiologist or a radiologist.

Cushings can cause excessive thirst. Although typically the cortisol produced suppresses the thyroid, I'm wondering if your vet checked her thyroid levels? Higher BGs will also cause them to drink more water even if they are getting insulin. I think it's generally not a good idea to limit their water intake but you should definitely ask the vet. Fluid retention can also occur in Cushings but I'm not sure what else could be causing it. I would not ever give a cat a diuretic without the vet prescribing it.

I have read that it can take 1-2 months on trilostane for cats to see an improvement in coat, decrease in skin tearing, and overall improved clinical signs. So don't give up hope.
 
Thanks for feedback @Marje and Gracie. Also for the link to the wedgewood pet rx. I was just online looking at the side effects of trilostane and the common side effects are the same as the seek-help-now side effects. The vet said she may seem tired and she does. It seems to me that Zoey just keeps hitting hurdle after hurdle. I know what will happen if I take her back to Dr. Google. It will be a wasted trip because his attitude is that it's a waste of time and cats don't do well with diabetes and that was BEFORE the Cushings diagnosis. He won't be willing to prescribe anything that isn't of his own opinion. He's the one who told me that I didn't need to home test and that he could regulate her on Caninsulin and not Lantus. He also does not believe in his patients doing their own thing or consulting with anyone on the internet ... he calls this Dr. Google. (Thus his nickname). You go to him and his expertise from the schooling that he did at (he named it) under (he named him) and that's how you treat diabetes. End of story. I just can't go back to him. It's unfortunate that the Great Vet is out of town but he's all we've got, I'm afraid.

I was just in there taking her BG and massaging her legs. I got to thinking that her leg swelling was probably less when she came home from the vet and having her enema because she was probably on her back and it was not pooling in her legs. When she's home, her hind legs are the lowest part of her body in the position she prefers. When we love on her and give attention to her, we try to lay her on her back with her feet elevated. We can work the fluids down her legs and out of her feet so the tightness dissipates. She's been up and walking around some but she's still extremely weak in her left hip and doesn't get very far without a break to rest. Those breaks are longer in duration now. She's resting heavily on her side and acting pretty lethargic at the moment. I'm greatly concerned about her but I just don't know what else we can do ... that we can afford. Specialists are out of the question. (Very recent financial hardship has us making some hard decisions here in this house -- wish it weren't so.)

I'm hoping that given enough time her fluid issue will resolve itself. As long as she continues to wake up each day and not be in pain, we will take care of her needs and do everything we can afford to help her recover to a better state of life. As soon as the Great Vet gets back to town, we will consult with him if the issues are ongoing. I really don't know what else to do. :/
 
Rose

From readings I have done on Cushing's fluid retention is a fairly common occurrence (at least in people, who most of the literature is written about) and in dogs. This is due to the off balancing of the endocrine system which in short terms messes with the sodium content in the body, which in turn affects the water retention. It is suggested that after a week or so of medication the fluid retention should start to alleviate. There are some diuretic available (for people anyway) that do not affect the sodium/potassium ratios. If there is another vet working on Zoey's treatment program perhaps you could revisit the use of diuretics, at least temporarily.
 
We had fluid buildup and a pleural effusion (he has a tumor in his lung, too). Probably from the corticosteroid and other health issues. Doc gave us Lasix - small dose 3x/day at first, now down to one, and we supplement sub-q in small amounts at night. Really helped his fluid buildup. In Eegie's case, he's also getting very good results for his neuropathy from the Methylcobalamin/Folic acid meds we've been giving. I hope this is helpful. I wish you and your Zoey get through this, and that she gets to feel better. In Ee
 
@Sgans I do have Lasix here at the house but not prescribed for Zoey, for another cat that passed two years ago. He had fluid build up so I'm familiar with it through his ordeal which was never diagnosed. Even after autopsy. I've just started Zoey on B12 but not methyl. No vet around here seems to think there's a difference and without them, I can't get it. MethylB12 would be what I would prefer to give to her. I was giving her Zobalene for a while but I read that it's probably not being absorbed efficiently with all of the issues she has ... the reason why I asked for B12 injections. (Previously was using Bcomplex for injections.)

@Tuxedo Mom .. i read that about the potassium levels being depleted by diuretics and I know that when family members have taken Lasix they would get terrible muscle cramps from the potassium deficiency. Makes me think Lasix is not one that would be used. :/ There is not another vet and even the emergency room vet didn't want to prescribe a diuretic. I don't know if it's Zoey's protocol that we are following, or what, but we're just not getting much without asking for it.

Which leads to: This whole thing is somewhat frustrating in that it seems that we have to be the ones who bring each and every detail to the attention of our vets and ask for the specific course of action. I mean, Zoey's been to two different vets in three days and neither of them said, hey, she's impacted. Even after we tell them her poo is clay like and hard and why we're giving fluids. I've not had a very good experience with vets. I don't know that it's their fault. I don't know if they know what to do in this particular situation because I think most beans have euthanized by now. If they're Dr. Google's clients, if they didn't euthenize, then he surely killed them by now with his well-learned skills. It seems to me that the vets are sitting around talking about what to do just like we are and they just don't know. And they miss stuff and they make mistakes. If any progress is made, it will be in spite of the vets. Even the Great Vet -- as wonderful as I think he is.

Aggravating.
 
Holistic literature says that Dandelion helps with fluid retention. That's my next course of action if there's not some relief by morning (2 full days of new drugs behind her).
 
You are asking all the right questions, Rose, and doing your best. Just keep at it....you are Zoey's advocate. I think it's hard for vets who see so many cats and dogs. Diseases are different in the two and if you get a rare disease for cats...like Cushings....than we all learn as we go.

I also wonder if the enema caused her to lose fluids as well as the poo. There's probably a good chance of that but doing what you are doing is also likely helping her.
 
Oh Rose - you and DH and Zoey really are going through it right now. I'm so sorry she's having all these issues and I really hope that with longer on the new meds she'll start doing better. I don't know enough about Cushing's to offer anything on the medical aspect, but please know that you are in my thoughts and I'm hoping and praying for some improvement for Zoey soon. :bighug: :bighug: :bighug:
 
Rose, I'm SO sorry your vet is so obstinate! Mine wasn't familiar with the difference, but I was lucky in that he read what I read and suggested it strongly. It sucks that she can't absorb it with her issues - but if there's any chance she can do it in smaller doses (they're sublingual, although we give it like a regular pill - but they're small - I originally got http://superiorsourcevitamins.com/microlingual-tablets/no-shot-b12-vitamin-b/ - the No Shot Methylcobalamin B-12/Folic Acid 400 mcg version. I think he may have been responding better to IT than he is the Zobaline... I don't know why. I'm actually upping his dosage, so including both in his regimen the superior source morning and mid-day, and the Zobaline at night... but I started just the SuperiorSource 3x/day. It may be worth trying (got it at the health food store for not that much money) because it dissolves very quickly, so may be absorbable further up in the GI tract? Like... mouth or throat?
Eegie still gets cyanocobalamin in his Sub-q for well-being - but I can't believe your vet wouldn't shoot methyl! That would make me angry. I'm sorry......

I've also gotten lucky. My vet doesn't know everything - especially with cats - but he cares and even if he doesn't know, he calls specialists, he researches, AND he takes my suggestions. I can't afford a specialist either (can't really afford HIM), but that helps me a ton....

Where are you in FL? If you're near my relatives, I can ask them for a vet referral....
 
Thank you, April @manxcat419. We appreciate you very much! :bighug:
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Stephanie, @Sgans --- Dr. Google (Great Vet's partner) is the one who's obstinate and full of himself. Great Vet is not in the office for the next week and I'd be stuck with Dr. Google. I showed great restraint the first time around .. I don't know that I have it in me to hold my tongue if it happened again. :eek: I'll wait and see how Zoey is in the morning and look into those supplements. I'm a big fan of supplements. I appreciate you sharing your information with me. I want to devour all of the information I can get so thank you!

I am worried about Zoey. I've been feeding her some medium carb food, plus sugary lactulose and her BG this evening is 199. I shot a skinny 4 because I honestly don't know how much food I'll be able to get her to eat. She's not eating on her own again. The swelling is all of a sudden gone. And she's only peed once with assistance. I did check it then for ketones and it was negative. We have given her several massages and elevated her paws and worked the fluids back a couple of times, but within the last few hours, it's all gone. All that has me on alert. I'm hoping that it means she's turning a corner but I really don't know. As I explained earlier, all of the symptoms are also the same as the seek-help-now signs. We don't have funds to spend on extraordinary measures. I don't think she's healthy enough to survive any attempts even if we did.

DH and I keep rationalizing all of this but truth is our hearts are breaking. Keeping positive thoughts though that our do-what-I-want-when-I-want brat cat will rally and stick around with us a little longer.
 
I have the same kind of situation with my vet. The old guy is a good guy, but not as...... with it as he used to be. Still smart, but no memory, so I can't trust him with Eegie - but at least he's not an @$$#013! I have ask Eegie to time his stuff for between Wednesday and Saturday, when my regular vet is in. Eegie does not cooperate with this schedule - perhaps 'cause he can't read the calendar? Ugh!
I'm pissed about your vet, if you haven't noticed...

On the GI stuff, I'm experienced, although Eegie always manages to give me something new to stress me out... but the diabetes stuff... still relatively clueless. I'm glad to share whatever I've learned that may help Zoey. I know the worry and fear - and rage...

And this neuropathy is totally new with me - I'd been getting told his weird walking and deteriorating mobility was due to cystitis! It was only after the certainty of diabetes (which was slow to get diagnosed, too), that I recognized the signs from someone else's post. I really do hope you can find a way to get that Methyl into Zoey... Eegie's still slow, still not moving like he was, but the difference even between April 26th to May 4th was huge!

Maybe someone else in the office can give you the name of someone else to see while Great Vet's out? You can be honest with the staff, if you feel Dr. Google's not doing you right....
 
Sorry I have no answers Rose, but know that you and sweet Zoey are in my thoughts.:bighug: Sending truckloads of appy and feel better vines your way.
 
(((((Rose)))) My heart is breaking for you and Zoey and DH as well! FWIW- Dr.Google is a name I give when myself or someone else cares enough to try help and find answers online. :rolleyes: Whereas, your "Dr.Google" should possibly be re-named Dr.Doom (or Dr Douchebag :mad:) sorry... I probably wouldn't use such restraint with him in your position....

As inadequate as it is, I am sending Vines & prayers for a miracle--you are in such a tough position! :bighug::bighug:
 
I also have no experience with Cushings, but it seems to me you are on track asking the right questions and seeking out answers. As far as the vets not knowing what to do, I experienced that with acromegaly as well. Vets just don't see these diseases. All you can do is keep trying.

Hang in there for the next few days until you can see signs of the meds working. If Zoey can't make it that long, as hard as it is to hear, you're very in tune with her and she'll let you know if she can't take it anymore. As long as she's bright-eyed, she's enduring/doing ok.

Sending big hugs your way, along with many healing vines. :bighug::bighug::bighug:
 
I will keep Zoey in my prayers that she will soon turn the corner towards recovery and start feeling better.

Methylcobalamin is the appropriate supplement for neuropathy but it does not absorb well when given in subq injections. You'd be wasting money. Cyanocobalamin is not going to address neuropathy but might help her feel a little better.

Hang in there...you have a ton of L/L prayers coming your way and they can work miracles.
 
So it looks like we've got to work on a way of making that pill absorbable. Through the gut.

I can tell you that that little pill I referenced above. The methylcobalamin plus folic acid. That absorbs very quickly, and maybe that would help.

At this point it might be one of those things where it couldn't hurt to try.
 
Rose (((HUGS))) and prayers for you and Zoey and DH.

You are definitely doing the best you can for your beautiful little girl and I am sure she knows it!! Fingers, paws and claws all crossed for a speedy recovery!!
 
oh Rose; I have absolutely no medical advice I can offer, just as much good energy, prayers, paw crossings, vines and any other juju that might get through to sweet Zoey and you and DH. You are inspiring beyond measure, and it goes w/o saying I completely understand and sympathize w/ the Dr. Google situation, being in that myself. No matter the outcome, Zoey couldn't have a better mama bean (and DH bean!) and she knows how much you care. Praying she can hang on enough for the new meds to really work. :bighug::bighug::bighug::bighug::bighug:. Somehow, manage to get out in your garden and renew yourself when you can.
 
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