Cami update 4-25

Status
Not open for further replies.
I picked her up this morning. She looks really good. Very bright and well hydrated - happy to be home. Now I just have to keep her that way.

Her treatment plan includes cisapride (bid), lactalose (bid), subq fluids (75-100 sid), pepcid (sid), pred (sid), and probiotics, enzymes, and pumpkin added to her food daily. She is supposed to go back in a week.

The ER place (Blue Pearl) gave a bunch or differential diagnoses on her discharge sheet that included anemia (we knew already), poss bone lesion (cancer? causing low BC production), renal insufficiency (could still be from inflammatory situation), hyperparathyroid, hyper Vit D production, and something else I am forgetting. The anemia and renal issues will be the ones to follow for now, I think. I don't know how treatable the other stuff is, or how possible they are. I feel like they just threw out all the possible reasons for a particular lab result.

She is such a different cat now than back in October. In the carrier on the way home she was flopping over and looking at me upside down - making eye contact and then leaning her head on my fingers when I stuck them through the mesh door. Clearly she has bonded with me and was grateful to be home.

I have a feeling she will end up needing a lot of daily care for the rest of her life. I just hope we don't have to go through something like this again - not unless I win a lottery or something! At least her FD is under control. Her BG has been between 80-115 this week and was 79 this morning when we got home. Knock wood / anti-jinx.

Laura, she is certainly a different cat than the one I took over there 30 hrs ago when I thought she was going to die. But I think she realized that I came back for her so I am "mom" and this is home and not just a place to live. I also think that SHE realized how much better she feels now than she did yesterday morning.
 
So glad she is home and feeling better. And that she truly understands now that you are Mom and she is Home. Sometimes I have found that goes a long ways in getting them to rally and get better. Its like it gives them a reason to fight off the other stuff that is wrong with them, because they now have a purpose for living and a person they don't want to leave.

Continued prayers for you both and that Cami gets better and better everyday...give her scritches for all of us here.

They are just so cute when they do that flip over and look at you upside down, I know when Autumn does that I ask her if I look better that way..lol

Mel, Maxwell, Autumn & The Fur Gang
 
Hi Sheila -

Just checking in and I'm sorry you've had such a crazy ride these past couple of days. Grayson went through the poop blockage about a month ago. He's now on ~3/4 tsp Miralax BID - I put in bowl, dump FF on top & mix up, then add water - he gulps it like any other food! He has Lactulose, but seeoms to be okay without it. I used to give ~1/2 tsp punkin with his food. I cooked a Halloween punkin in the pressure cooker, skinned it, then mushed up the meat, added equal amts water, and poured into ice cube trays. I took out one cube every day or two, so it didn't go bad. Worked great in auto-feeder as well.

G has IBD, but the x-ray showed blockage; he had 2 enemas the first day, then went back for #3. Doing it saved his life - so know that regardless how much it cost, it was worth it to her!!! :-D

Hopefully she's feeling better and things will start moving normally again soon. Any poop is a good poop!!! Hang in there!!!
 
I may be looking up the steps to a poop dance (as in rain dance -to induce...). I think we are going on about 18 hrs since she pooped at the ER overnight. If she doesn't poop tomorrow I am going to be very worried.

(ETA: I take that back. I think she pooped in one of the LBs. She has been going on pee pads for so long that I didn't look in the LBs. There was a nice, long poop I am pretty sure was hers.)

Cami is probably feeling right now like she doesn't even know who I am anymore - after my first attempt at subQ with her. I'm not even sure how much went in. Her fur was wet and I had to stick her twice. The second time was after wrapping her in a towel so she couldn't get away. I knew it was not going to be easy. I'll have to come up with something "better" in my approach.

Please send "smooth move" vibes her way - if you know what I mean, wink, wink.
 
I do fluids on the table, he faces left, the bag is hanging high. chiseled side of the needle is facing upward. grayson's face is IN a food bowl. FOr the time it takes for 100 mL, it's about the same as to eat 3 oz FF and 3 oz water mixed in.

Hopefully that will help you some. Good luck!!!
 
Unfortunately, Cami "resource guards" her food and will growl and dive her face into the bowl and wolf it down if you touch her, walk near her, or sometimes even speak to her. No way could I infuse her while she is eating.

I will think of something - I hope! nailbite_smile
 
At last! I get to see my Cami update - I will spare you the explanation of drama on my end because there's always something going on medically at my house these days with either the kitties or me. :YMSIGH: Spring+cats+hairballs yields a multi-vomiting cat household=FUN. :smile:

I'm so glad she's home with you Sheila. How is she doing now? So nice that she got to show you her loving upturned chin face. "I feel good, Mommy, I'm with you and I know you'll never leave me." cat_pet_icon

Maybe you've already figured the SubQ's out but I've found the best place to do it is unique for each cat, depending on their personality and what they will tolerate. I can see why Cami wouldn't go for the food-bowl diversion trick being a resource guarder. Is there a special place that she sits or sleeps that you could convert into a SubQ station? For example, Harley loved sleeping on my dirty cloths in my laundry basket. So I got the idea of just picking up the laundry basket and carrying it into the bathroom and doing the fluids while he sat in the basket. I hung the IV bag from the shower rod and closed the bathroom door in case he escaped the basket - which he did from time to time. So that's kind of my default SubQ station I start a new cat out with and adapt as they tell me what they do and don't like. Bagheera (GA) just lay in the bathtub and let me do fluids. Gouda (GA) stood in the laundry basket, he wouldn't sit down. Princess wants to sit on the toilet (lid down, of course) she won't have anything to do with the basket or confinement of any kind. I've head some people do SubQ's on the kitchen counter. Maybe Cami's ear-testing spot can be converted into a SubQ station? Just some thoughts...

Please let me know if you want to meet so I can give you the supplies.
 
Sending Cami good movement vibes. I tried to give sub-q's to Klinger in the bathroom, but it wasn't for him. We ended up on the bed, where he likes to relax and sleep. I hung the bag from the drapery rod and just snuggled with him while he got his fluids. I hope you find what works best for Cami. I'm sure she'll let you know.
 
We are still looking for that "perfect" place/position. I have been sitting on the kitchen floor, hanging the bag from the wire shelving I have on one wall and putting Cami on my lap with her face in my elbow. And wrapping her with a towel. She is not liking this. Last night I think I got 60ml in, not the 75ml, but that was because it was about 90 seconds before I felt the wetness in my lap! Not sure if the needle came out or I went all the way through her very thin skin. It is really hard to get a tent on her to find a place to stick the needle. She has zero subq fat so it is like trying to stick a needle into a fold of plastic wrap, not into the fold of, say a nice thick blanket. She is well hydrated though.

At the other end :roll: she is pooping about once in 20 hrs, but it is hard and clumpy, like 3-4 grapes or blueberries stuck together. It doesn't seem like the lactalose or pumpkin is softening it at all. She is eating a ton too. I may have to put more pumpkin into her food (her dish) so that the ratio is better.

She has a checkup on Thurs. so I will ask about maybe using Miralax instead. Do any of you have any words of wisdom in stool softeners?

Still, this whole thing perplexes me. I mean that it happened in the first place. She has not had issues although she has had large stool that occasionally caused her to stain enough to get nauseated, but she always passed stool. That happened maybe 3-4 times over 6 months. Normally, she has two large BMs/day, or maybe every 15 hrs or so. She eats canned food with water added to it and drinks loads of water, so she should not be dehydrated. She does pee a lot. We still hadn't found a cause for the PU/PD yet. ER vets think renal failure/insufficiency. Her BUN has been high, 53 & 41 (15-34) and the 41 is the later test after 6 wks of pred and ABS. Her creatinine in in the normal range: 2.0 & 1.7 (0.8-2.3), her albumin is in normal range and she has been both hyper and hypokalemic (potassium). The specialist vet thinks these could still be markers of bacterial infection of the kidney and/or inflammation. So, I guess too soon to tell what is going on with her.

However, I feel like this poor little girl isn't going to ever be disease free. I wonder if the period of time that she was untreated for FD caused chronic dehydration and started the CKD ball rolling and it was just too late by the time I got her.
 
Sheila & Beau & Jeddie (GA) said:
At the other end :roll: she is pooping about once in 20 hrs, but it is hard and clumpy, like 3-4 grapes or blueberries stuck together. It doesn't seem like the lactalose or pumpkin is softening it at all. She is eating a ton too. I may have to put more pumpkin into her food (her dish) so that the ratio is better.

She has a checkup on Thurs. so I will ask about maybe using Miralax instead. Do any of you have any words of wisdom in stool softeners?

Lactulose and pumpkin act differently on the stool. Pumpkin is for fiber and the logic behind adding fiber to the diet is that it will bulk up the stool enough to stimulate the bowl into producing the pooping response. To put it crudely - if the bowl feels it's there, it will move to expel it. Lactulose works by pulling water into the intestines to actually physically soften the stool. It may be that Cami just needs a higher dose of lactulose - or you can talk to the vet about using Miralax to get the same effect. It took a lot of trial and error to get Harley's dose right in the beginning. 1ml BID wasn't enough so we ended up at 1.5 mls BID and even upped it to TID the week before he died. Unless Cami doesn't like you giving the lactulose by mouth I wouldn't give up on it yet.

Sheila & Beau & Jeddie (GA) said:
Still, this whole thing perplexes me. I mean that it happened in the first place. She has not had issues although she has had large stool that occasionally caused her to stain enough to get nauseated, but she always passed stool. That happened maybe 3-4 times over 6 months. Normally, she has two large BMs/day, or maybe every 15 hrs or so. She eats canned food with water added to it and drinks loads of water, so she should not be dehydrated. She does pee a lot. We still hadn't found a cause for the PU/PD yet. ER vets think renal failure/insufficiency. Her BUN has been high, 53 & 41 (15-34) and the 41 is the later test after 6 wks of pred and ABS. Her creatinine in in the normal range: 2.0 & 1.7 (0.8-2.3), her albumin is in normal range and she has been both hyper and hypokalemic (potassium). The specialist vet thinks these could still be markers of bacterial infection of the kidney and/or inflammation. So, I guess too soon to tell what is going on with her.

However, I feel like this poor little girl isn't going to ever be disease free. I wonder if the period of time that she was untreated for FD caused chronic dehydration and started the CKD ball rolling and it was just too late by the time I got her.

Oh sister, I can sooooo relate to what you are going through with Cami. It's so hard to take in a cat with one medical condition that we know how to treat and find others either concurrent or complications of the primary condition that are not so easily treatable. And it's so hard to know which came first, the chicken or the egg. But I think you've hit on the right assessment. Either by virtue of age (12+years old) or through untreated diabetes, Cami most likely has the beginning stages of CKD. PU/PD, low urine specific gravity, weight loss and constipation are often the early symptoms. Or, because she's a diabetic, the culprit could be a flare of pancreatitis that caused a state of temporary dehydration more severe than her usual state. And there's the issue of fluid in her abdomen - sure, she's drinking a lot of water but she's also retaining it in her abdomen and also peeing it out so then there isn't enough going into her intestines to soften the poop - voilla, constipation. But then, I'm not a vet, and can't diagnose - unfortunately. :lol:

Ironically I'm working through some of the same things with my newest little black boy Stormy, recently adopted through DCIN. Supposedly he's 4 years old and happily OTJ, but if he is that young, then he's lived hard and fast because he looks and acts like a senior kitty in my assessment - or, a kitty that has that "ain't doin' right" vibe. We are just starting the round of diagnostics with him but CKD is definitely on the table with an elevated BUN, low urine specific gravity of only 1.012, PU/PD, food-guarding, ravenous hunger so bad I have to confine him at mealtimes, and a fur coat that is dry and bristly. He also has a kind of puffy belly that I'm worried about so an x-ray is on the agenda for his next vet visit along with testing for hyperthyroid. Ahhh yes, time to ride the diagnostic merry-go-round again. :dizcat

:YMSIGH: It's not what we signed on for at the start, but we are in this together. What else can we do? Once those little paws wrap themselves around our hearts, we are theirs forever.
 
I don't know her USG. It was 1.038 last July, but her blood work showed normal values for almost everything at that time (time of FD dx). I *know* her USG is low because her urine smells like nothing. We haven't been able to get a sample from her yet.

Interestingly, she is drinking less with the SQ fluids. I guess she utilizes them better. Also, this first unit is plasma-lyte, not lact ringers. Don't know if it makes a difference. After all the costs for the stuff the ER vet gave her IV (that I could not take to give at home), the specialist's vet tech just handed me this unit.

BTW, Laura, DCIN sent me two units, tubing and some needles, so I am set for a while. Thanks for you offer though.

I am so sorry that Stormy is having all these issues. Don't you get the feeling like it just this one thing you re missing that if you could figure it out and either add it to his diet or subtract it, then he would be ok? I hope you hit on some answers for him.

Well, time to go do fluids. I really dread this every night. And so does Cami! angry(2)_cat
 
Each day seems to get a little easier doing SQ fluids. Cami is getting more stubborn about coming for a treat (lure) when I call her. Had to pick her up and bring her over and sit down (on floor) holding on to her. She swears through the whole thing. Maybe some day she will find it a bonding experience and, at least, tolerate it without trying to squirm and get away. Got 100ml into her, and no leaks! Got it on the first try.

Nice big poop today too. Tomorrow is a check up, so probably an xray and labs.

Also, tomorrow I see someone about an illustration job. Please send positive vibes my way for that. I desperately need the money.
 
Hurray for big poops! :thumbup All fingers, paws, toes, and tails here are crossed and we are sending good juju your way for a the vet visit and interview today!!!

I love your description of Cami "swearing" at you - sounds just like Stormy when I try to take him away from food, or administer meds. I live in fear of the the day I have to do fluids with him 'cause he's going to be a real hurricane!
 
Fingers, toes, paws and tails all crossed that you get the job and that Cami keeps improving a little everyday.

Mel, Maxwell, Autumn & The Fur Gang
 
Congrats on the job. Little jobs help and here is hoping it will lead to lots of larger jobs as the word gets out.
 
Status
Not open for further replies.
Back
Top