Jeddie to oncologiest today for 2nd chemo-update

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We are heading out in about 30 mins. I have to fast him, which last night didn't seem an issue because he wasn't eating much, but this morning he WANTS FOOD. Arrgh! I hate having to fast a cat that has not been eating well.

I am not very optimistic about his future. It is short term anyway - no more than 11 months at best (it was been 6 weeks since I first spoke to a vet - can't believe that). He is having so much trouble eating. I think the tumor keeps him from being able to shut his jaw to chew, so food falls out. This is recent, in the past week. He has had poor mobility of his tongue for a month now so getting food back to his chewing teeth has been an effort, but he was able to do it. Now, I just don't think so.

It is so sad, because this tumor is still fairly small, but where it is it is having an extreme effect on him ability to take in food - and that is the crux of it and will be the reason I make that final decision - and not because his body is failing and his will to live is gone. I will see what the oncologist says, but I don't think he has responded at all to the first chemo. Which I thought was supposed to stop the growth and "hold" him where he was for as long as possible.

I hate this. I just hate it. And it's ripping a big hole in my heart.
 
Re: Jeddie to oncologiest today for 2nd chemo

((((Sheila))))) I am so sorry. I hope the vet gives you some encouragement at the appt today. Keeping you and Jeddie in my thoughts and prayers.
 
Re: Jeddie to oncologiest today for 2nd chemo

(((((Sheila))))) Good luck today, I hope this treatment works better than the first one.
 
Re: Jeddie to oncologiest today for 2nd chemo

Sheila - My heart hurts for you and Jeddie. I hope you receive encouraging news today and that the treatment goes well. Jeddie is so fortunate to have a mama who loves him so much.

Prayers and hugs for y'all -

Libby (and Hershey, too!)
 
Re: Jeddie to oncologiest today for 2nd chemo

Oncologist said: tumor has grown (I knew that) and 1st chemo did not work for him (I guessed that), but the one scheduled for today might because it works differently and the cancer might respond to it. He has lost a little over a pound in 3 weeks (I guessed that too). She thinks his tongue is now causing pain, so pain meds going forward. She asked how he was doing otherwise and what I wanted to do "next". I think this is where I was supposed to say "Stop" and let's end this.

THE issue is his eating, which he tries to do but is not too successful with. Up to 3-4 days ago, he would stay with it for up to 30 mins and keep trying, managing to finish all that was on the plate. Lately, though, he starts pawing at his mouth. She thinks that is from pain more than anything.

I decided to go ahead with this planned chemo and hope that he responds to it. And we decided on a fentynal patch supplemented with oral bupe. They also gave me Cerenia to start tomorrow regardless of if I see nausea or not. This chemo is the strongest and hardest on them, so I guess they don't want nausea and vomiting to get a toe hold. This all cost twice what the estimate was. We go back in 10 days instead of 21 this time.

She didn't come right out and say it, and I didn't ask, but I get the feeling that she thinks he doesn't have much longer. We could put in a feeding tube, but, as she put it, will that give him quality of life worth having or would we just be keeping him alive because we can?

I am afraid the pain meds will turn him into a zombie. He did not like being on the bupe before (after the biopsy) and didn't eat well on it, so I might give half the dose at first. And I am supposed to give that every 8 hours starting tomorrow also. Plus sub-Q fluids - Thank you, Laura, for giving me two units and the necessary accessories when we met last month.

He ate a little when we got home and is now lying down in the well where I put my feet at the computer desk (so I am sitting back to accommodate him). Poor guy.

He was so happy for the past couple of years, up to just about the time of the biopsy. He loved his life here. I know it. Now....? It is so unfair and heartbreaking that his time is coming to an end so soon and so fast. And I am so sad to be losing such a loving and affectionate cat before his time. My poor, poor Jeddie.
 
Re: Jeddie to oncologiest today for 2nd chemo

I am so sorry Sheila. You are right, this is so unfair. I am sure he doesn't understand what is going on either, but he does know how much you love him and are trying to help him to feel better. I wish the news from the oncologist was better too. That is crappy that the tumor has grown. :( If you didn't try this last treatment though you would always wonder, what if? I am praying for strength for you and for Jeddie to get better and have much more time with you.
 
Re: Jeddie to oncologiest today for 2nd chemo

aw, sheila. i'm so sorry the two of you have to go through this. poor kitty.
prayers and hugs... scritches for jeddie. :YMHUG:
 
Re: Jeddie to oncologiest today for 2nd chemo

((((((Sheila)))))) I am so sorry you and Jeddie are going through this. I hope and pray this session will give better results so he can eat better and feel better.
You are the best caregiver he could ever have.
 
Re: Jeddie to oncologiest today for 2nd chemo

Thanks guys. I don't feel like anyone else would really understand, well maybe my sisters (one is a member here and the other volunteers at a no-kill shelter, both have cats). The roller-coaster ride is so stressful.

He has stayed under my desk all afternoon (got him out for a few bites of food, but he went right back under). I had to do an illustration and I must have bumped him with my feet a half dozen times. Sigh....
 
Re: Jeddie to oncologiest today for 2nd chemo

I'm sorry you are going through this. :sad: I hope Jeddie will be able to hang in there and give you a little more time with him. Usually my experience has been that you can tell when the cat has given up, so it must be especially tough to have to base your decision on pain when his spirit is still strong. I know you'll end up doing what is best for Jeddie. ((((Sheila))))
 
Re: Jeddie to oncologiest today for 2nd chemo

Oh Sheila,
I am so sorry for everything
I am praying that this chemo will do some thing for him
Please hang in there...we are all here for you
 
Re: Jeddie to oncologiest today for 2nd chemo

This is gut-wrenching. I am so sorry he's getting worse. I know the hell you are going through. It seems like nothing is working and all you can do is watch him decline and try to help him feel normal. Maybe this round of chemo will help stabilize his condition. We will be praying for that.

Was Gabapentin mentioned as a pain option or is that counter-indicated with this type of chemo? You might ask about it if he doesn't do well on the bupe. I have no experience with that patch but have heard good things on the board.
 
Re: Jeddie to oncologiest today for 2nd chemo

I just decided I have to resort to syringe feeding NOW. Well, tomorrow. He is not getting any food in - a bite or two each time. So I have been looking on line for info and videos. I have syringe fed Beau, and another cat, but I was not very successful with it and it was a huge mess with cats that had working tongues. I have to get this right or he will hate it - and me.

I know about Hills AD and Max Cal (is that Iams?) Anyone have other suggestions? Tips? Words of wisdom?
 
Re: Jeddie to oncologiest today for 2nd chemo

youtube appears to be having issues at the moment, but maybe you'll have better luck than i did. this is probably one of the best videos i've seen on assisted feeding: http://www.youtube.com/watch?v=U6o17wH6ujk.

there's also a yahoo assisted-feeding group which is supposed to be very good: http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/.

if you have a blender, puree the food with water or something like nutri-cal and pour in large syringes (10 - 12 ml). you don't want it too runny... more like the consistency of pudding.

seems like a lot of people use hills AD, but i've only used wellness.

it can be a messy business. i put a baby's bib with a velcro closure on kitty. although, before grandchildren i used a kitchen towel and pinned it around kitty's neck. you want to feed from the side... not shoot it down their throat. i don't know how you feel about cats on kitchen counters (some people don't like it), but i find kitchen counters are just the right height for me to be able to work comfortably as well as maintain some control over kitty's body. the latter is only important if they want to bolt. i also put a bath towel on the counter. kitties seem to feel more secure on the towel and the towel catches a lot of the mess.

try to remain as calm as possible. remaining calm will make things easier for both you and jeddie.

hope this helps a little...

(((hugs)))
 
Re: Jeddie to oncologiest today for 2nd chemo

Thanks Jill.

Right now, though, I feel like a complete idiot.

I decided I did HAVE to get food into him tonight so I hunted for my medicine droppers/syringes and none were right, but I figured I could get at least something into him. I mixed, and then pureed, a can of kitten pate - so the 3 oz can and about 1/3 can water - poured that into a yogurt cup, assembled syringe, towel, damp cloth, dry cloth, and cat. I told Jeddie I was doing this to help him eat. He seemed interested in the cup of food and let me squeeze a bit into his mouth - twice. Then he started resisting, let out a huge snort and food flew all over - including a big slab of turkey embossed with the ridges from the roof of his mouth. That damn thing much have been there for two hours. Poor guy.

After that he was having nothing to do with the process and growling at me, so I let him go and he made a bee-line for the yogurt cup. I had an empty food bowl within reach, grabbed it and poured some of the puree into it. He dove into it. I did not think his tongue worked too well for drinking, but he managed to get a third to a half of it down pretty quickly. Not cleanly, but I think effectively enough. Heck, half of that soup was way better than I hoped for with the syringe thing. I did wipe his mouth off, but he growled at me again so I stopped. Enough for the night. He is now washing himself in proper cat fashion, but of course really smearing stuff all over his face. I will clean him tomorrow.

I'll offer him the rest of the puree in 3-4 hours.
 
yep. it can be messy. i've had food everywhere... walls, floor, my hair, and we'd both be wearing it.
don't feel like an idiot. although, i do know the feeling. i not only felt like an idiot the first few times i tried syringe feeding, but it reduced me to tears.

at least he ate some of the food on his own!!!

hang in there.
 
Reading about the blender brought back memories of a ferral cat we fed that was very sick, (infected gums) she stopped eating completely. I blended baby food with FF classic and thinned it with tuna juice, she managed to get that down completely. Our vet suggested mixing in 1/2 baby aspirin for pain since there was no way to catch her, even with a hav-a-heart. Obviously, Jeddie does not need the baby aspirin, but the blended food did the trick and she even thrived for many months after that. I also used part of sardines at times. Disgusting, but it helped. Pudding consistency. Maybe Jeddie would hopefully be able to eat this on her own?
Sending prayers and ((((hugs))))
 
Re: Jeddie to oncologiest today for 2nd chemo

Sheila & Beau & Jeddie said:
...Anyone have other suggestions? Tips? Words of wisdom?
If you get back to syringe feeding, the most important tip is to make sure to let him swallow each 1/2 tsp (3cc or so) before introducing more. Fill several 12cc oral syringes before you start and be firm but most of all calm.

And you can puree anything appropriate he may like, the a/d is made for tube feeding so you can use something better than that to syringe. A magic bullet makes a perfect batch of syringe food/soup. I syringe fed a kitty for two months, and for part of that time it was all she was getting. I tried to give her 24cc every 4 hours to combat nausea, and it was a little crazy but worth it because she did start eating again and still is to this day.
 
Sheila is he able to lap at all....When I was tube feeding Musette they gave me Rebound that is a complete liquid diet. If he can't deal with solid food of any type what about an all liquid diet that he can just lap up?

Mel, Maxwell, Autumn & The Fur Gang
 
Sheila -

I know it's very trying on your last nerve to do the feeding. On the video I saw when Kim was thinking Kitty needed to be fed, it looked like the kitty was really cooperative. Well, after eating that way for a long time, maybe, but I can't imagine my guys tolerating it without putting up a food fight!

Good luck w/ this round of chemo. When Murphy went through it, the first infusion was her worst. After that she did really well. I'm sure there are differences between the varying types, chemo drugs, and other issues, but wishing you & Jeddie the best. Hoping this round will take for him and that you'll at least see a halt in the growth.

You know your baby better than anyone. And I expect he knows that everything you're doing is in his best interest, in spite of the look of "you're not doing that to me again!" in his eyes, or the growling. Keep strong and know that everyone here is holding you & Jeddie close in our thoughts and prayers. :YMHUG: :YMHUG: :YMHUG:

Lu-Ann
 
Oh ((((Sheila)))

I want to talk to you about something that I think is very important to consider here. We've got a lot of people on this board that have syringe fed for one reason or another and have syringe fed successfully for those conditions.

Jeddie has something very different. He has oral cancer; and at this point, he has had a surgical resection, he has a growing oral mass, he is on active chemo, will be taking pain medicines that dope him up, and has a painfully swollen tongue. This creates a very different scenario when considering whether to syringe feeding.

Although normally swallowing is automatic, it is a complex series of sequential neuro-muscular events. It requires coordination of the lips, tongue, teeth, mandible, soft palate, pharynx and epiglottis. If a problem exists in one these areas (could be weakness from chemo, pain from the swollen tongue, nerve damage from the mass itself or surgical resection, or even the ongoing change in his oral anatomy itself), the likelihood of aspirating increases significantly. And this is all for someone trying to eat and swallow on their own. Add to it using a syringe to force food into a system that isn't working properly.....it's a recipe for disaster. You have enough on your plate right now....aspiration would be tragic.

If there's a concern about him getting enough nutrition while you are waiting to see if this chemo takes, I don't think you have any choices besides allowing him to eat what he can, hoping he knows his limitations and weaknesses (aspiration risk still exists), or putting in a feeding tube so that you bypass the oral-pharyngeal route all together.

Sheila this is so terrible and I am heartbroken just writing this. I can't imagine going through what you are going through. (((You are so brave))).
 
I have been checking this thread periodically - thanks everyone.

I tried feeding him after his shot and hew as interested, but maybe nauseated because he would not actually eat any. I got about 2-3 tsp into him. He wanted the dry food kibbles I use as treats that I haven't given him for a few weeks. Out of 3, he managed to swallow 1. Then I decided to sprinkle crushed freeze dried chicken over his food, but he wanted the actual pieces of chicken, which he can't manage. The whole thing was a bust. Mostly (I hope) because I have the wrong tool.

I ended up with him cradled in my left arm, trying to get food into him. He wasn't struggling to get out of that somewhat upside down position, which worried me because normally he would. He ended up staying there for almost an hour and a half! I let him be and told him all the thing I love about him and will miss. And I told him it was ok to leave, but that I didn't want him to think I was giving up on him. Of course I cried. Appalachian Spring was on the radio, the window was open with a nice breeze. It was pleasant except for my back and the whole reason we were there together.

I am off to pay my estimated taxes and buy some feeding syringes and will also get a kitten bottle (Thanks, Pamela, for the link to the old post). I'll also get some varieties of Wellness. I only have one large can of that left - need to stock up for the others, but I don't have time now. I need to get home so I can try and get some food into him.
 
OK - got about 20-24 cc into him. A lot went down the front (I mean I started with ~35cc). He was interested in the smell of the food and I offered it in a dish first (and after), but he didn't take it, so I used a syringe. The damn syringe is too big for my hand! Will try the bottle next. He did start to lick at the end of the syringe but there was no way for me to control the amount in a trickle so he could just do that. He is sitting in the closet looking at me right now. I hope he feels better with some food in him.

And if this were not bad enough, I came home to find they were painting the doors to the condo units on my floor - with oil base paint - STINKY! I have two fans blowing in from the windows, but it isn't helping. Jeddie really doesn't need this. Ugh.
 
(((((Sheila)))))

I'm wracking my brain to think of any additional helpful assisted feeding tips that have not already been thought of. About the only thing I can suggest is that when I assist fed both Harley and Princess I did it in my tiny bathroom and I let them walk around restraint-free. I put bath towels on the floor since 8t was winter and I have a concrete foundation under the tiles which made them super cold. If I got food on me, the kitty, the walls, floor, towels, etc. no problem because I could either wipe it down or throw it in the wash. You've already received adive about what syringes to use, food to feed, etc. so I wn't go there again.

Regarding possible post-chemo nausea - color me skeptical, but I'm not convinced that Cerenia alone is going to cut it for handling any post-chemo nausea Jeddie may be experiencing. My vet and I tried Cerenia for Harley during the worst of his pancreatitis attack and it stopped his vomiting cold and made him really sleepy but he still didn't want to eat anything. (This was on a weekend so the vets were closed) On the following Monday, he still wouldn't eat so I took him to my now regular vet's office and begged for something else for nausea. They gave him a shot of Anzemet and sent us home. When I got home I gave Harley a 1/2 can of Friskies and he ate the whole thing - this after not eating voluntarily for 4 days. 3 hours later he ate the rest of the can of Friskies. The next morning he ate again, at Noon his appetite waned and by evening he wouldn't eat at all again. Back I went to the vet for more Anzemet and we've been using that for nausea ever since and I haven't looked back. I know Jeddie's situation and Harley's just don't compare in terms of the differences - all Harley needed was an anti-nausea drug and he could eat again. Jeddie has more serious physical challenges to contend with and I'm not trying to minimize those. But if you are interested in trying Anzemet with Jeddie this weekend to see if part of his inability to eat is from nausea, let me know. I can draw some syringes with individual doses and deliver them to you or we could meet somewhere. Anzemet is either compounded into an oral liquid or given SubQ. I have the large institutional sized multi-dose vial and have always given Harley his SubQ because if he is nauseuos and vomiting, I want to bypass the oral route and go for the bloodstream.

Continuing to offer up prayers for both you and Jeddie, strength for both of you, wisdom to know when it's time to part and peace.

:YMHUG: :YMHUG: :YMHUG:
 
Laura, he was given anzemet at VSC before discharge home. I guess that has worn off by now. Let me ponder your offer and see how he seems tonight. He was salivating this morning - as opposed to drooling, there is a difference that I have noticed although I am sure a vet would tell me I couldn't :roll: - and that stopped after the cerenia kicked in. He gets cerenia once a day and I haven't noticed any more salivating.

He is actually sleeping all curled up right now, and not just lying there stretched out, which to me looks like he is a more comfortable. It will be time to try feeding him again in an hour or so.

Knowing when to part is going to be hard, I think, but maybe there will be some event that tells me for sure.

Here's a laugh: the discharge papers had instructions for all the things I am to give him and when including to "continue taurine, probiotic, enzymes as directed". Those were all things I told the oncologist I added to his food. Sounds like she is trying to take credit for it, lol, but that is not the funny part. The funny part was that I am to continue "Levamere as directed" I actually started to ask what drug that was before I realized the extreme misspelling! Again, they never "directed" me to give Levamere (or Levemir)...

Oh, and another laugh: at PetSmart, I was looking at the ingredients in AD (OMG!) and a sales person asked if I needed help. I said, "No, just looking at my options for a cat with cancer and this isn't going to be one of them", to which she helpfully said "You have to ask your vet if they will let your cat eat that food and get a prescription" :roll: I just said, "Let me put it this way, if I wanted my cat to eat a certain food, I would tell my vet to give me a prescription for it, but it would not be THIS food, the ingredients are horrible". She made a troubled sideways glance at the Banfield vet counter and said. "Oh, ok". I had to stop myself from telling the man with a Chihuahua that was being given two cans of Hills Rx, to forget about it. Sigh.
 
I know we're not close & convenient, but if the pain meds discussed above don't fit your needs, you may want to touch base w/ Kim (kse), as she had pain, appetite stimulants and other meds for Kitty - some of which worked and others that didn't do as well. I know Cerenia was one of them.

Continuing to wish you all the best!

Lu-Ann
 
I can't compare our experience with Scruffy's chemo, Sheila, because truthfully, he never seemed to have much reaction to it one way or another. (Well, the second drug, maybe he seemed a smidge lethargic for a couple hours.) And while he never really lost his appetite, I did give him 1/4 tablet of cyproheptadine once in a while, and 1/2 tablet of ondansetron more regularly. But he didn't have the mouth issues that poor Jeddie does. I think both those drugs taste nasty, too. We were offered the choice of pill or injectible ondansetron.

I had to laugh about my old kitten-bottle theory - leave it to pamela to find all that stuff. I am still using it occasionally for Milkshake, actually, although cypro made him gain weight for the first time in four or five years when nothing else has worked.

I am so sorry for Jeddie, and for you. I think now - didn't have any perspective before losing The Puffer - that it's the surging of hope and then the subsequent period of despair that makes caring for a cat with cancer even harder. It's all you can think about - what can I do today that will fix him? Is there something wonderful that will miraculously make all this horror go away? And the compression of time that wraps itself around you and makes you feel strangled; you keep thinking that you HAVE to find an answer that will fix everything, and it seems like the time's running out and you haven't found the solution.

If the decision were mine, Sheila, I couldn't tell you what I'd do.


(I just deleted that last couple of sentences, because I typed them late last night and I appear to have been delirious. We just put our mother into a nursing home on Thursday, and it feels like we've condemned her to death because we're too weak or self-absorbed to be able to take care of her. Between this and losing Scruffy, I am a huge puddle of apparently incoherent tears.....)
 
Lynda, the bottle is working much better. But you can't get the last half ounce out of it, so now I know I have to keep it "topped off". I also took a clue from Scruffy's blog and made a chart of all the things I have to give him and when. It isn't the amount of stuff you were managing, but it really helps to have a list to remind me of what and when. You are so right about the roller coaster ride of hope and despair.

Jeddie has his feedings (x5-6), cerenia tablet, fluoxetine, insulin (x2), bupe (x3), but so far I am only giving that at night, and sub-q fluids. I think that is it. He is tolerating the feeding much better than I had hoped - but not so fond of sub-Qs.

Laura, you might be interested that the oncologist vet said that the bupe is the same for oral or injections, so, yes, I could have just put a needle on those syringes and injected them (after the biopsy). That was the one question I didn't know to ask after the surgery, but Laura did. The vet tech said no. I guess she didn't want to go against the surgeon's instructions.
 
Oh, Sheila - I swear you're the only person who's ever tried the kitten bottles! It's really hard to find the soft ones; I don't know if it was brand differences or what. I only have one soft bottle left now, and Someone bit six holes into it last week. I can't bring myself to throw it away, but it's pretty much useless now. I don't know what your water is like, but it was also suggested to me, years ago, that it's a good idea to use bottled/distilled water to feed a sick cat, rather than city water that's full of chlorine and heavy metals, etc.

One other quick thing - Scruffy seemed to be almost comforted by getting fluids. (Not something I ever wanted to learn how to do, needless to say, but his kidney situation was abruptly really bad right from the beginning.) He just snuggled into his kitty pi on a towel on the counter and relaxed. He never developed the big pouches of water anywhere - it was like he just needed the fluids so much he used them right away or something. Anyway, I was warming the bag in a big pot each time, and never really knew what the temperature was. Once or twice, he shivered during/after the fluids, so I went to the grocery store, intent on finding one of those little plastic strips they had when my children were little that you held on their foreheads to see if they had a fever. Apparently, they don't exist any more, but I found a wonderful - if expensive - new thermometer that just needed the tip of it held against the bag to get a reading. It made a huge difference. Anything under 100 degrees made Scruffy more uncomfortable; 101-102 degrees seemed just right.

It occurred to me reading my previous post to you that it sounded like chemotherapy didn't help Scruffy, or that I regretted it. Which isn't true - he had large cell lymphoma, which is apparently extremely aggressive, but after the third treatment, I wanted to give up and stop the chemo, so they did another ultrasound, and every tumor was gone from both his spleen and liver. GONE. In only two weeks. It didn't do any good for Scruffy, because he had already started into the kidney failure that led to the decision to euthanize him, but it still seems amazing to me that that nasty cancer responded so quickly and thoroughly. So, I'm keeping my fingers crossed for Jeddie. And if he's still interested in food, that's the one thing that to my mind means they're not ready to give up yet.
 
Lynda, I'm not sure that the kitten/puppy bottles I got are "soft" like you mean, but they do the trick - I mean I can gently squeeze them to get the food out. I found this is one other area where the "cat" version cost twice as much as the EXACT SAME THING in the "dog" section. Grrrrr! I found them on clearance at Pet Supplies Plus so I got an extra one. Could have used it this morning.

I ran out to do errands and get back within 4 hours of his last feeding. When I walked in the door, with 15 mins to spare, he was eating from the regular cat food dish! Making a huge mess, and probably not getting much, but at least he was trying. After I cleaned him up I told him he should go outside (on the balcony) and he did! Didn't stay long, I think because it was pretty warm out there. I delayed that feeding, so have to get to it in about 10 mins.

And, no I didn't think that you meant the chemo didn't work, just that it didn't give Scruffy side effects.
 
Sheila & Beau & Jeddie said:
Laura, he was given anzemet at VSC before discharge home. I guess that has worn off by now. Let me ponder your offer and see how he seems tonight. He was salivating this morning - as opposed to drooling, there is a difference that I have noticed although I am sure a vet would tell me I couldn't :roll: - and that stopped after the cerenia kicked in. He gets cerenia once a day and I haven't noticed any more salivating.

Phew, I'm glad they gave him Anzemet with the treatment. It lasts about 18-24 hours. Cenernia lasts from 24-36 hours. If you feel the Cerenia is working then that's enough for him. No sense giving extra meds. if they are not needed. Good for you being able to tell the difference between the drooling and the salivating. Most vet's wouldn't be able to because they don't know him like you do.

Sheila & Beau & Jeddie said:
Here's a laugh: the discharge papers had instructions for all the things I am to give him and when including to "continue taurine, probiotic, enzymes as directed". Those were all things I told the oncologist I added to his food. Sounds like she is trying to take credit for it, lol, but that is not the funny part. The funny part was that I am to continue "Levamere as directed" I actually started to ask what drug that was before I realized the extreme misspelling! Again, they never "directed" me to give Levamere (or Levemir)...

LOL, yes, don't you love those discharge papers/instructions? I'd interpret it the same way as you did - like they are trying to take credit for your treatment. Or maybe they are figuring that some other vet prescribed the supplements and so you are to continue to administer those as directed by someone else. Because we just couldn't possibly have come up with such things on our own. Mercy, me. I'm glad to see that this year when both Bagheera and Jeddie were at VSC they at least have heard of Levemir (even if they can't spell it). Bagheera's vet tech said that he worked at another vet clinic that regularly uses Lantus and Levemir for their diabetics. I didn't have the presence of mind to ask him which one it was...I was a bit preoccupied at the time. I noticed the IM vet that I had so much trouble with last year is no longer there...hmmmm....

Sheila & Beau & Jeddie said:
Laura, you might be interested that the oncologist vet said that the bupe is the same for oral or injections, so, yes, I could have just put a needle on those syringes and injected them (after the biopsy). That was the one question I didn't know to ask after the surgery, but Laura did. The vet tech said no. I guess she didn't want to go against the surgeon's instructions.

I'm glad you asked and got the "straight dope" (pun intended :lol: ) directly from the oncologist. I knew the answer we'd been given was wrong but didn't want to say anything to contradict her. I'm sure she was just following doctor's orders. I'd asked 2 of my vets the same thing and was told by both of them that bupe was just as safe to inject as to administer orally that they both came from sterile sources. Harley and Princess have been getting bupe as needed SubQ for over a year now.
 
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