Discussion in 'Prozinc / PZI' started by Pookie, Nov 12, 2020.
11/12 AMBG 91
Hi Lola! and mom Enid!
(by replying to your thread, I'll get notifications on new replies.)
I'm just about to administer her first dose of Ondansetron (1/2 of a 4mg tablet every 8-12 hours for nausea). She actually did eat a decent amount of her own volition at AMBG +5. I started out syringe feeding her and realized that she was willing to just lick the food from the tip. I then squeezed some out on a plate and she cleaned that up. But she's not looking very hungry right now.
I can't wait until the results of the C&S come in so we can get her feeling better.
Can I (should I) give her the pepcid ac along with the Ondansetron? (I also picked up some omeprazole so I have that on hand.)
(ETA: It turns out that my vet and 1/3 of the clinic staff are out on 2-week COVID quarantine.)
I don't know the answer to that question.
Oh no! Hope they are all ok.
Try asking this question over in the Feline Health forum, using the ? mark prefix on the post and a very specific title asking what you are looking for, to get a better response.
11/13: AMBG 85
Wow, does Lola ever like that Ondansetron. Her pupils are like dinner plates! She's scampering about, chasing the laser toy.
I'm going to re-work her feeding schedule since we no longer have to worry about getting food into her post-fast/pre-shot. I'm also going to be smarter about how much I feed her at mid-day. She had a huge meal mid-day yesterday so she was resistant to eating at +9, and that was when she needed the food most to help offset the side effects of the Clavamox.
I do so hope the results of the C&S come in today (but I'm not holding my breath). The clinic is closed on the weekends so it's either today, or Monday (although if the results come in on Saturday I may try to get the new antibiotic from the e-vet). I don't think that Clavamox is the answer, given that she's still drinking a lot of water (although not as much as before), and given the nausea it causes poor Lo I'd like to get her off it as soon as possible and on the road to healing! (And I swear to the gods that the next time I have a cat diagnosed with a UTI I will ask for a C&S first thing as a matter of course.)
The impact of COVID on our clinic is significant. They posted on Facebook that they've had to cancel/reschedule appointments and surgeries, that appointments are now booked several weeks out, and that it may take 24-48 hours to get a prescription renewed. They asked for "compassion" at least twice, so they must be getting beaten up over the phone pretty regularly. It would be dreadful if they were forced to close.
The e-vet just called to tell me that Lola's culture was negative! I'm incredulous. Lola was nailed to the floor in front of her water dish. Her BG readings were rising. The home-test UA strip was bright purple.
E-vet said the Zeniquin must have been working and said that I can continue to give Lola the Clavamox and restart the Zeniquin (since she only took it for 1 week out of the 2).
I have a call in to the vet at my clinic to see where to go from here.
ETA: Just spoke with the vet (whom I like more and more as I work with her). She wasn't surprised that the culture was negative since Lola had been on the Zeniquin for a week. She recommended that Lola stay on the Clavamox until Thursday (which will be 10 days), while managing her nausea with the Odansetron and Omeprazole (1/4 tablet once or twice daily).
Paws crossed here for Lola feeling better soon.
She's hungry this morning; started out eating independently but finished up "assisted" in order to ensure she ate enough to offset the Clavamox nausea.
Same as this morning, a mixture of eating independently augmented by assisted eating to ensure full stomach for Clavamox.
Eating is good. How many more days on the Clavamox for Lola?
At least you have learned from experience that Lola needs to eat a certain amount so she can have the Clavamox antibiotic and not vomit up her food and the pill.
I remember that a couple of my cats had clavamox in the past. It's such a bitter medicine, I can understand why some cats foam at the mouth or vomit after being pilled.
11/15 AMBG 93. She's definitely feeling better. She ate independently this morning, I just "topped her off" because of the Clavamox. And, I heard her eat a few Dr. E's kibble in the night.
A serendipitous side effect of the assisted feeding is the discovery that my civvies LOVE a nice whipped seafood or poultry milkshake. I'd been having some trouble getting them to switch over from kibble to wet, but they are all over Lola's leftovers / rejects. And I'm delighted that far less food is ending up goingdown the disposal. (And for the record, nobody liked the 9Lives pate even though I thought it smelled far less objectionable than the Friskies.)
The vet said that taking the full 14 day course of Clavamox would be best, but that 10 days might suffice. She started it Monday afternoon (11/9) so 10 days would run after the Thursday morning (11/19) dose. On the one hand I don't want to sabotage her recovery by stopping the AB too soon, but on the other hand the culture was negative, she's already had a week of Zeniquin, and, ewww, the Clavamox consequences....
PMBG 88. As before, just topping her off to ensure she has enough food in her stomach. I suppose it's a sign that she's feeling better that she is starting to really resent the assisted feeding. I plan to limit her access to food overnight so she's good and hungry tomorrow morning -- hopefully she'll be hungry enough to eat a sufficiently large meal and not require any intervention from me.
Even though the side effects from the Clavamox are not enjoyable, the few extra days could make the difference between knocking out whatever bacteria were causing the issue and letting the bacteria flare again.
Civies liking wet food! So, how do you convince them to switch from the dry food, to what Lola is eating? Maybe the "chip and dip" method would work. Where you dip pieces of the dry food into the wet food, and put those pieces on a plate. Or perhaps pour a bit of the "milkshake slurry" you are feeding Lola via syringe, over the dry food. Decrease the amount of dry food and increase the amount of wet food gradually.
Dry food addicts are tough. These techniques may not work for all your kitties equally. But the wet food is so much better for the kidneys, because of the water content.
Lola is still doing very well without any insulin. Hope that continues.
11/16 AMBG 82
You're right, of course. I have enough Ondansetron to last through Sunday evening (if I stick to 1/2 tab twice daily), and her last dose for the 14 day regimen is (next) Monday morning, so we should be able to make it. She's becoming extremely combative about pilling, which is nothing new (which is still way easier than trying to get liquid meds into her). While I prefer to manually administer the pills, I'm now using the 'pill popper' to save my lacerated fingers.
She's eating really well today, both pre-fast and post-fast, and she was positively feisty tonight about her test. She must be feeling better. I've discontinued the Omeprazole because it just doesn't seem necessary; she hasn't had any vomiting in days.
Feisty is fine! Those pill poppers can be a lot of help, when Lola is being a bit feisty about getting her pill. Makes it easier to get the pill deeper in the mouth, so she can't spit it out.
11/17 AMBG 93
The train has pulled out of Feisty and is on track for Combative! She's clearly feeling better. I also found a dose of Ondansetron on the bed this morning, not sure what day's dose it was (I suspect yesterday a.m.).
Anyhow, she's eating completely unassisted this morning, both pate and Dr. E's.
PMBG 87. It's so lovely to have her eating on her own!
Guess if she spit up her pill, she didn't need it after all to get her to eat ok.
Yesterday was lovely. Today, not so much. She did eat some Dr. E's overnight and while she woke me early asking for food, she voluntarily ate nothing except the juice from her pate. She tolerated my "assistance" fairly well, but she fought me tooth and nail with respect to getting the Clavamox down her throat.
We are each on the other's sh*t list this morning.
PMBG 88. Happily, her demeanor is much improved this afternoon. She did eat independently, but not enough so I syringe-fed her a bit before we went 2 rounds over the Clavamox.
Could you imagine if you were trying to give Lola liquid Clavamox instead of the pill? What a mess of pink liquid that would be, all over everything.
Have your tried putting the pill in a tiny bit of a pill pocket, or some cheese, or a tiny bit of meat, to disguise it?
Might not be any easier, but it may be worth a try.
Luckily, you are getting close to the last dose of the Clavamox.
11/19 AMBG 80 Not much interest in food this morning, fish or fowl.
So far, that $40 spent on Ondansetron has provided 2 or 3 meals of unassisted eating. Given how adept she is at NOT swallowing her medication it's probably not fair to blame the med, but I have to admit I'm pretty unimpressed considering its cost. I'm going to restart the Omeprazole, once daily. I'm not sure it's going to help, but what's to lose?
Oh, been there, done that. Foaming at the mouth, then shaking her head -- pink everywhere! Which is why I jumped at the option of a simple injection. If only that had worked. <sighhhh>
And we are going to do the full 14 day course. I do not want to go down this road again in a week or two.
Interestingly, since her BG has been normalized Lola has never again jumped into the sink. She only started jumping into the sink earlier this year (June or July, if I recall correctly). I wonder if that is when her BG exceeded renal threshold and she became diabetic? Perhaps the cool porcelain provided some sort of relief?
PMBG 87. Restarted the Omeprazole this evening.
Come on Lola! You need to eat better and stop worrying your mom!
11/20 AMBG: 79 Once again, ate Dr. E's overnight but NO interest in pate at +9. At least she didn't fight my efforts this morning. She's looking good and is playful. I gave the Ondansetron at the +9 meal along with the Clavamox, just to see if there was any difference in appetite from getting it an hour before +9 meal. (Maybe having a pill shoved down her gullet an hour before eating was putting her off her food?) Nope. No difference.
Hubz usually feeds the civvies, but I did so this morning just for the pleasure of watching cats eating enthusiastically. It was music to my ears and a welcome sight for sore eyes.
5 more Clavamox to go....
Little joys in life!
11/21 AMBG 90.
I lay awake last night listening to Lola gnaw on her legs and lick her belly. Her belly has been bald off & on as a response to stress since she joined the family 2 years ago, but now the insides of her legs, front and back, are completely licked clean of fur and her belly is pink from overgrooming. As I thought about it I recalled that her first and only hairball came right after she started the Clavamox. She appeared fine this morning, aside from her refusal to eat; I syring-fed her and gave her her meds. Within the hour she was gnawing on her feet and licking her belly. Coincidence? I did some online research, and YES!, itching can be a side effect of Clavamox. In fact, it's listed as an allergic response.
Enough, already. The vet said 10 days minimum, 14 days optimal. We've just completed day 12. I'm calling a halt to this torment. If she suffers a flare then we'll deal with it, but not with Clavamox.
I've spent the day watching my cat lick and scratch herself, nearly nonstop. I'm too depressed for words.
You're right, enough is enough. Hopefully, the itching and over grooming will improve once the Clavamox is out of Lola's system.
Yikes! on all the fur being groomed off her front legs! Hopefully, she isn't chewing on her legs or belly, and causing herself to bleed. My over grooming civie Libby use to gnaw until she bled. She was on thyroid reducing medication (methimazole), to lower her thyroid levels since she was hyperthyroid. Too much or too little thyroid hormone can cause itching.
At least you did not let your vet inject Convenia into Lola. I understand the side effects from that can last for months.
Have you considered putting some sort of "onesie" on Lola, so she can't lick her belly? I know it won't stop her from over grooming her legs, but at least some sort of barrier between her mouth and her belly would help.
The other idea is some sort of soft collar, so she can't reach to over groom herself.
11/22 AMBG 91 All meds now dc'd. Sorry for the drama of yesterday's posts. I was SO sleep deprived.
Still itching/scratching this morning, but less so. Last night was a trial for poor Lola. She'd be gnawing on a front leg or paw and then whip around and gnaw on her flank, then scratch her ear with a hind leg, then work on her stomach, then BOLT across the room as though she was trying to outrun her tormentor. It was as though she had the DTs.
She appears to be somewhat better this morning. She wasn't interested in pate but I wanted her to have a +9 meal/snack in her stomach so her tests would be under the same conditions as previous ones. (She did not eat a +9 last night; I offered her food but I think at best she only licked up the gravy that came with the pate.) After this morning's meal she started itching again. Since I'd only been awake a few minutes at that point I don't know if the food brought it on or if she had been itching all along. (My initial thought yesterday was that she'd developed a food allergy.) I've decided that for her +9 pm meal I'm going to make a slurry of the Dr. E's to try to remove food from the equation. Hopefully, the Clavamox will have exited her body and removing the possibility of food involvement will result in a more comfortable cat. She did climb onto my chest this morning (and pull my glasses off my nose), which she hasn't done in days so I do think there is improvement.
Actually, we started out with that when she was first diagnosed. Because I'd already had experience trying to medicate Lola, I JUMPED at the option of an injection. Upon reflection, I'm glad we went that route because if I had been having to deal with the Clavamox issues along with the newly-diagnosed diabetes issues at a time when I hadn't yet found the Board and I hadn't yet been able to successfully test her, and my vet was on 6 weeks medical leave, there might have been dire ramifications for Lo. At least the Convenia removed the UTI from the picture, even if it was just temporarily. Oh,what a bleak, bleak time that was. Now that I know more about Convenia I won't jump at the easy out so fast.
I don't have a soft collar, but I do have a hard one, and I thought about using it. I decided that the noise she would make banging around with that on would just exacerbate my inability to fall/stay asleep. (Did I mention sleep deprivation? What a nightmare it is.)
Gotta go. It's 5:08 a.m. and the grocery store is open -- geeze I hate COVID.
Thanks for your continuing support!
Lola was back in the sink this afternoon.
Still itchy, but not frantic about it like yesterday. She ate a full meal of Dr. E's after AMBG. This afternoon she has no appetite. I fed her 3ml of a slurry of Dr. E chicken at +9 and will feed her again soon.
She's drinking & peeing normally. She had a bowel movement this morning so she's not constipated. Not dehydrated; don't think she's running a temp. She chases after (and seems determined to kill) the laser pointer, and is watching birds outside the window. She's a little withdrawn, but I don't think she's meatloafing. Breathing seems normal. But she's still licking, especially her paw pads (but it's nothing like yesterday). And when she walks it's as though her feet hurt her -- it seems she's lifting them higher than is appropriate.
I'm thinking perhaps indigestion from the big kibble meal after 10 days of syringe feeding, and allergies especially affecting her feet. I plan to send an email to my vet in the a.m. to bring her up to speed (she's been out on COVID quarantine the last 2 weeks), and see if I can give Lola Benadryl or Zyrtec for allergy symptoms if they are still there in the morning. (It has been 36 hours since her last dose.) Urine sample goes in Wednesday to see if the UTI has cleared.
UPDATE: I just offered her a sliver of Primal freeze dried pork and that kickstarted her appetite. She ate a few slivers and then moved on to the Dr E’s slurry. Gotta get more of that Primal pork! I’d have to refinance my house to feed it on a regular basis but it sure does the trick as an occasional treat.
Here's hoping Lola does not act like Linda Blair in "The Exorcist" again anytime soon!
Chewy.com carries the Primal pork. Not sure if you order from them. OH my GOODNESS! I see what you mean by the price, $32 for 14 ounces.
Sometimes, if you can just get them to start eating, they continue to eat on their own.
Senior grocery shopping hours here don't start until 6 am. Still too early, but I've done it a couple of times.
11/23 AMBG 90
Good news: She's eating Fr. pate enthusiastically! I tested her at +7 and she was at 97. I offered her Fr. salmon and she went nuts! Probably ate 1/3 of the can. I offered again at +9 and again she ate enthusiastically. (She's not hungry at AMBG, but I can't really fault her since she's eaten so much already.) Water intake/output normal.
Bad news: still itching, better than yesterday but still there. Now she's trying to hide from her tormentor instead of outrunning it. It feels like she's getting little welts in one location on one rear leg. My next task is to send an email to the clinic about an antihistamine (or whatever they suggest).
ETA: Since she's eating pate again, I'm removing the Dr. E's kibble from the menu.
In the early days of the pandemic a few times I drove a bit further to the all-night grocery at 3a. Just me, the stockers, and that guy in his jammies.... (And lots and lots of empty shelves.)
PMBG 119. Poor Lola.
Things were going so well this morning, she was playful, sitting on my chest and pulling my glasses off my nose, and then... she yakked up a HUGE hairball at about +2. Over the next hour she vomited another 2 times, very small amounts, lots of fur. (There was also a lot of fur in her most recent bm.) Then she found herself a quiet corner and curled up and stayed there all day. She's avoiding her usual favorite spots - I think because they remind her of the horrible itching that she endured while in them.
This evening she had no appetite so I syringe fed her 40ml. About an hour later she vomited up about half of it. I feel so bad for her. I'm going to leave Dr. E's out overnight in case she wants to eat during the night. I'll add Forti-Flora to breakfast to see if that helps any. Hopefully this too shall pass.
I spoke with my vet who agreed that the itching/scratching is an allergic reaction to the Clavamox. She doesn't like Zyrtec for Lola but agreed the Benadryl would be appropriate (1/2 of a 25mg tab, twice daily). Since her symptoms have improved so much over the last 24 hours (and they really have) we agreed that I would hold off on the Benadryl tonight and reassess in the morning whether I think it's necessary. She wants to avoid the gnawing turning into a habit and asked me to spray Feliway on Lola's favorite spots, which I have done.
We talked about her hairballs. She doesn't like using Vaseline and, of course, Laxatone is out because of its ingredients. I've been giving her pumpkin in her meals and will continue to do so (which is one of the reasons I was rather keen to get dinner into her tonight).
Urine sample goes in on Wednesday. Wish me luck getting the sample. The clinic is closed Thursday & Friday, so I really need to get it. (Samples used to be so much easier to get when she was drinking all that water. Now I have to stalk her, which I think she finds a bit off-putting.)
I just offered her a shred of the Primal pork, and she was all over it! I rehydrated what was left of the sample I had and she scarfed it down. I’ll be out tomorrow, refinancing my house.
Urine Catching Tips for you.
Good luck with the house refinance.
11/24 AMBG 92.
As far as I can tell, Lola ate nothing further last night. She wasn't interested in food this morning at +8 so I gave her a dose of Ondansetron. Still wasn't tempted by Fr. pate at +9 so I buzzed her food, pumpkin & fortiflora into a milkshake. Since she vomited a large meal last night, my plan was to feed many small meals, hourly, over the course of the morning. I took a BG reading at +9: 118. (I don't know if it was fasting; I suspect it was, but there was food out for her overnight.) I fed her 6mls and went to wash up the dishes. When I returned she was eating Dr. E's kibble. I think she probably ate about 1/3 of a day's ration of kibble. Given that she ate "well" and that she kept it down I decided to wait out the 2 hour fast and proceed as usual.
She laid on my chest all night last night so I have a pretty good sense of the itch factor. It wasn't too bad at night, but this morning at about +10 she was pretty enthusiastic about her itching/scratching/gnawing and I want to stop this ingestion of fur! (My vet said the itch factor could last as long as a week following the last dose of Clavamox.) I gave her the Benadryl after her BG test. Ooof. She held it in her mouth before spitting it out. By the time I finally got it down her throat and followed it with a water chaser she was positively foaming at the mouth. She's now drinking water. I hope the bitterness doesn't impact her appetite later on in the day. If I give it to her again I'm going to have to coat it in butter.
The pet food place doesn't open until +5 (I'm starting to feel like I'm in the military) so I won't be able to tempt her with the Primal pork for several hours. I may try to feed her another 6mls so the food might blunt the impact of the medication on her stomach, but I'm on the fence about that. She's already pretty stressed and unhappy.
I'm looking forward to the day that she doesn't cower when I approach her.
ETA: The issue of whether to feed has resolved itself. She's out like a light. I'm relieved she didn't face-plant into her water dish! One thing is for certain: she's not licking, gnawing, pulling, scratching....
You are being such a good cat momma for Lola.
We all hope the itching and scratching resolves itself soon.
Lola slept 6 hrs straight, awoke hungry (ate Dr. E's kibble) then went back to sleep until +9. She wasn't hungry at +9 so I started feeding her the "jus" from the pate via syringe. That perked up her appetite and she ate at least 1/4 can after that. At PMPS she's still sleepy. Only occasional licking, no gnawing, and that only immediately after eating. I don't like this sleepiness so I'm not going to repeat the Benadryl unless symptoms get markedly worse. I'm leaving pate & kibble out for her to graze on.
ETA. Aw, crap. Just saw that I hadn’t hit post reply, hence the late post
11/25 AMBG 87
Lola (and I) had a lovely night last night. She cuddled with me all night long. I did not give her Benadryl last night and I didn't notice any marked itching activity. She's done a little licking & scratching this morning but not enough to justify the Benadryl 'coma' this morning. (But I reserve the right to change my mind )
The best news is SHE ATE UNASSISTED!!! She snacked on the Dr. E's kibble through the night. She wasn't interested in the Fr. pate at +9, so I was preparing to renew yesterday's plan of frequent, small feedings. But I started with offering her a shred of the Primal pork. Then another. Lola's kryptonite! She ate the Primal then moved on to the Friskies and cleaned her dish. I rewarded her with a half-nugget of Primal, reconstituted with water. She was a happy girl.
And! She just provided me with the requisite urine sample!
All is well in my world this morning.
YAY Lola - so happy to hear the good news this morning!!
I won't lie. Having her eat on her own is a huge weight off my shoulders.
Lola's kind of annoyed with me, though. She hates it when I mess with her litterbox to get a sample. (Is nothing sacred?)
Lola had a stellar day. Ate well all day long. Urinalysis results confirmed no infection. Everything within normal limits. They'll see her in the spring for her annual physical. Was advised to give Lola 1/4 tab of Benadryl (instead of 1/2), as necessary, to avoid the 'coma.'
No more Benadryl comas.
Tiny bits of "kryptonite" to get her to eat.
No more UTI!!!!!
All is well in Lola's world.
I'm going to close out this thread on Thanksgiving with a maudlin expression of thanks to all of you who have shared your time and expertise with me and others. After a month's membership I've seen the incredible investment that you make to the health of diabetic kitties and the well-being of their caregivers. After reading about more cases than I care to think about of cats who suffered illness and death as a consequence of bad professional advice and/or caregiver unwillingness to follow through, I've come to a greater appreciation of the frustration and sorrow you advice givers must face on an ongoing basis. I don't know how you do it, but I am certainly grateful.
Simply put Enid, we are "paying it forward", to those people that helped us in the beginning.
We cry plenty of tears too, when the situation calls for it.
But we keep on going, to help when and where we can.