Shmee's Pituitary Gland Removal Surgery

Thank you guys, the doctor just called this morning and said he’s still doing well, and they switched him to one unit of Lantus. He said he was around 240 at his highest and 140 at the lowest. So I think he will be keeping him on the one unit for now to see how he does on that. He’s still saying we should be able to go home by the weekend which is great news. I will update again after I see him :) you all are wonderful.
 
Can't wait to hear how dear Shmee is progressing. So exciting to see how he and Titan are progressing. Hugs! Heal fast, sweet Shmee!!! And, Amanda, take a breath and take some time to chill!!!
 
It was great meeting you today Amanda. I am so happy for you and Shmee. :bighug::bighug:

We met at the front of the Animal Medical Center, then we went to lunch for about 2 hours! Then we talked about cats and FDMB almost the whole time. I got to hear about Amanda's current and also her new upcoming second job. And she got to hear some really boring security stuff that I do at work, and about Leo, LD, and Chines.

We are a community in FDMB, and the world feels just a little smaller when you get to talk about it firsthand. My favorite pics attached. I don't know why the AMC doctor had to shave my head too!!!
Jeff and Amanda AMC 2.jpg
 

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Love the photos Jeff!
It was SO nice seeing and talking to him yesterday.

John Irene and TITAN said:
Of course, lovely to see pictures of JeffJ and Amanda! But, how is Shmee looking? :)
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Dr. McCue says Shmee is doing well overall, but I am not doing that great with all of this honestly. I think this is the saddest I have ever felt. He is not himself at all. I feel so terrible for him, and someone on the Facebook page that got this surgery done at the RVC said their doctor told her that it could take up to three months for their personalities come back, and sometimes they may even come back a little different. Thats all I think about. I want my cat back. I am also trying to work on getting everything ready to go for my second job, so I am overwhelmed with that too because I have never done something like this before (promote myself as a travel agent, take calls and emails about planning vacations) and the training for the job has not been great... so I am basically trying to figure it out on my own. I am sort of a perfectionist... and it is really freaking me out to launch this Facebook page and get started. And every time I try to work on it I start thinking of Shmee and how he is so scared, confused, and not himself at all.... Its really hard.

Dr. McCue said they started him on his hormone replacement therapy. This is one reason he probably isn't "himself" which kills me to think about. His hormones are all out of whack since the pituitary gland is gone. They started him on both the Cortisol (stress hormone that his body isnt producing anymore), Pregnisalone (?) (steroid), and eye drops for tear production I believe. The eye drops will not be needed forever, but for a few weeks maybe. I am actually electing the injection for this instead of the eye drops, which he said does a better job anyway. The hormone (and steroid) replacement will be needed his whole life. They both come in pill and liquid (flavored) form. As of right now he is eating them as a full pill in his food. I know this won't be the case once he returns to his normal self as he would never let a pill go unnoticed in his food - so I am hoping he will let me put the flavored liquids in his food. I think I got everything - I should be writing this all down, sorry I am a little rusty on what exactly they are all for.

I just read another comment about the cats personalities after this. I attached it below. Its all just so overwhelming but I am trying my best to stay grounded.

As for today's status on him - Dr. McCue tried to call this morning, but at 2am I took Melatonin and put ear plugs in to try and help me sleep. It worked because I didnt wake up until about noon. I just got his call back while writing this - he said Shmee is doing well and his blood sugar has been hanging out around 140 for the past 16 hours on one unit of Lantus so he wants to talk about our plan to come home during my visit today which is great to hear. It makes me really nervous to take him out of their care but I want him back so bad. I will probably be leaving the airbnb soon to start making my treck up there since it takes about an hour and get some fresh air if its not raining.

I am bringing my laptop and hopefully having time to check it before I go into my appointment -- @Wendy&Neko @LuvinThisPig or anyone else - please try to help me think of questions to ask the doctor before we are discharged. I am not really myself either these last few days and I need help trying to get all the information I need from the doctor to keep him safe and healthy.

Hugs to you all thank you! :bighug::bighug::bighug:
 

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You are doing great things for Shmee. I think the eye-drops/ injections are for the concentration of the urine to enable him to pee urea without peeing out too much water and other good stuff. One other hormone lifelong is hydrocortisone for the thyroid, and there is another. I imagine we will have to give them in their food, and if they don't eat it we have to refuse to give them anything else to eat, unless it is also dosed up. Titan has been desperately hungry for the last month or two, and has eaten anything we give him, but it may well get more difficult as his diabetes comes under control.
I would be surprised if there are any permanent character changes in Shmee or Titan; after all it's just the removal of the pituitary gland, not really part of the brain, and it's certainly nothing like a frontal lobotomy.
I would ask Dr Mc Cue
how many calories he should be getting once he is out of recovery
How often to get blood tests done for sodium , potassium, and fructosamine etc.
Is he going to be healthy and strong or will he be at risk and what warning signs to look out for
 
I'm glad Dr. McCue is happy with Shmee's progress. He's seen a few now, so knows what to expect. Shmee is undergoing hormone changes in his body. Anyone remember what it was like to be a teenager? There will be ups and downs until things settle down. I would ask about expectations in behaviour, both short and long term, what to worry about, what not. Also longer term monitoring and bloodwork suggestions. Short term, does he have any strategies and thoughts on insulin dose.

If prednisolone is the steriod you are adding to the regime, you can get them compounded into chew treats. The big on line pharmacies like BCP, Roadrunner, etc. can make them up for you. I have heard BCP will even send you a sample of blanks, so you can see what flavour he likes.

Sorry I won't be on line when the great trip home comes. I am about to head out on a sailboat for a week, no wireless. But I will be thinking of you and Shmee. :bighug:
 
The eye drops are desmopressin - this is a hormone that acts on the kidneys to reduce the flow of urine. It is used in certain disorders to control increased thirst, frequent urination, and urination with large amounts of dilute urine (diabetes insipidus). I had a friend whose cat has diabetes insipidus and she uses an injection form. The steroids/hormone replacement will tell the adrenal glands to produce it. That is why a replacement for it is only needed for a short time, unless the cat has adrenal problems.

The personality changes are a concern. I'm actually looking forward to finding out who Sophie really is as so much of her personality has been wound up in food seeking and living in the kitchen waiting for her next meal since I adopted her.
 
Hi Amanda - you are doing great. Sometimes it takes a big change to make a kitteh or a person healthier. And there will be adjustments afterwards. In a month or two, everything will be back to normal.:bighug:

I've been through a lot with Leo too. And he gets prednisolone every single day. We give him a pill. Then he gets a treat right after that. Wendy is also correct that there are different ways to deliver the prednisolone. We just find the pill handy. Since prednisolone is a gluco-corticoid, it raises Leo's BG for the AM cycle. I don't know if Shmee will be similarly affected.

When I am gone for a week (like this), our kittehs are just a little different when I come back. Then everything returns to normal. It will be a little like that for Shmee too. Plus he is not at home in his comfortable environment. Once you get him back home, I bet he will become his old self again.
 
Amanda & Shmee said:
Love the photos Jeff!
It was SO nice seeing and talking to him yesterday.


Dr. McCue says Shmee is doing well overall, but I am not doing that great with all of this honestly. I think this is the saddest I have ever felt. He is not himself at all. I feel so terrible for him, and someone on the Facebook page that got this surgery done at the RVC said their doctor told her that it could take up to three months for their personalities come back, and sometimes they may even come back a little different. Thats all I think about. I want my cat back. I am also trying to work on getting everything ready to go for my second job, so I am overwhelmed with that too because I have never done something like this before (promote myself as a travel agent, take calls and emails about planning vacations) and the training for the job has not been great... so I am basically trying to figure it out on my own. I am sort of a perfectionist... and it is really freaking me out to launch this Facebook page and get started. And every time I try to work on it I start thinking of Shmee and how he is so scared, confused, and not himself at all.... Its really hard.

Dr. McCue said they started him on his hormone replacement therapy. This is one reason he probably isn't "himself" which kills me to think about. His hormones are all out of whack since the pituitary gland is gone. They started him on both the Cortisol (stress hormone that his body isnt producing anymore), Pregnisalone (?) (steroid), and eye drops for tear production I believe. The eye drops will not be needed forever, but for a few weeks maybe. I am actually electing the injection for this instead of the eye drops, which he said does a better job anyway. The hormone (and steroid) replacement will be needed his whole life. They both come in pill and liquid (flavored) form. As of right now he is eating them as a full pill in his food. I know this won't be the case once he returns to his normal self as he would never let a pill go unnoticed in his food - so I am hoping he will let me put the flavored liquids in his food. I think I got everything - I should be writing this all down, sorry I am a little rusty on what exactly they are all for.

I just read another comment about the cats personalities after this. I attached it below. Its all just so overwhelming but I am trying my best to stay grounded.

As for today's status on him - Dr. McCue tried to call this morning, but at 2am I took Melatonin and put ear plugs in to try and help me sleep. It worked because I didnt wake up until about noon. I just got his call back while writing this - he said Shmee is doing well and his blood sugar has been hanging out around 140 for the past 16 hours on one unit of Lantus so he wants to talk about our plan to come home during my visit today which is great to hear. It makes me really nervous to take him out of their care but I want him back so bad. I will probably be leaving the airbnb soon to start making my treck up there since it takes about an hour and get some fresh air if its not raining.

I am bringing my laptop and hopefully having time to check it before I go into my appointment -- @Wendy&Neko @LuvinThisPig or anyone else - please try to help me think of questions to ask the doctor before we are discharged. I am not really myself either these last few days and I need help trying to get all the information I need from the doctor to keep him safe and healthy.

Hugs to you all thank you! :bighug::bighug::bighug:
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aww Amanda, I am glad you got some sleep and are hanging in there.

I know it’s hard, but I would try not to predict personality changes right now. When we discharge people after surgery, we tell them that they may feel really wiped for about a week after surgery. Add in being in a strange place and pain medication, I definitely wouldn’t expect him to be even close to his old self until after he has been home for at least a few days. It will take him time to recover but I know that he will. I would try not to read other people’s comments about personality because it’s only gonna make you more anxious. The surgery has been done, and every cat recovers diffeeently and at their own pace. I think once you get him home things will be much better. That’s the next step to look forward to.

Also, I think the hormone replacemtns are thyroid hormone, cortisol (prednisolone), and ADH - this one is the one that comes in eye drop or injection form. Just wanted to clarify that part for u. I know it’s a lot of information all at once.

Keep us posted!! Can’t wait to hear that you guys are heading home.
 
Hydrocortisone or prednisolone is a corticosteroid that would replace cortisol.
Levothyroxine is a human thyroid hormone. I’m not sure what the name of the thyroid hormone is that is given to cats, but I see that there is a little bit of confusion about the medication in some of the posts so I wanted to clear it up.
Hope that helps.
 
Have fun sailing @Wendy&Neko! Sounds fabulous!

I did not see the questions until after my appointment unfortunately, but we talked about most of it and we are going home tomorrow morning! I can't wait to finally go to sleep so I can wake up and get on the road.

One of the things he said to look out for is nose discharge or sneezing, because of the incision in the back of his throat. If food irritates it too much, he could need surgery to get back in there and close it up. So hopefully not.. but I will be on the lookout. The medications are all on a 12 hour schedule which is nice, so everything will get done with his insulin shot. He is on a 6am/6pm schedule right now, which is good because at home he was 630 and 630. He has had my SS from the beginning so he said he is confident in me with his blood sugar and insulin since I have been doing well so far. He asked about how I have been doing his insulin changes and I explained an abbreviated version of TR, and he said that .25 changes sounded safe. He will also continue to stay in touch with me regarding his insulin changes, and all of the "tweeks" to the medication he may be getting in the next few weeks depending on bloodwork. His first bloodwork needs to be completed in one week. He also said they did a biopsy on the nodule just in case and it came back negative for any cancers, and the nodule / tumor had what looked to be a capsule around it which means that it should not return and they got every bit of it.

So tomorrow morning I am picking him up at 6am (before valet opens which saves me $40!! :)) and I am thinking I might put the litter box in the crate... with the hopes of not having to stop as much. We will see. He will be having all of his meds before I come, plus a higher dose of pregnisone because it is a stressul situation :( which worries me about future vet visits since we will eed so much bloodwork... the doctor said he will need more pregnisone for stressful situations.

Going to try and work on some job stuff before bed. So happy we will be on the road tomorrow!
 
That is great news Amanda. I'm glad you guys are going home kinda early.

Leo gets daily prednisolone too. Lemme know, or let others know if you have questions. There are lots of kittehs here who have received it.

Wendy&Neko said:
Off topic, sort of - did anyone else notice how close the picture Sarah post of Jeff here, looks a lot like the real pics above?
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LOL, I love it. I showed Theresa that other pic when it got posted and she said the same thing! I don't really miss my hair
- I glide thru the pool like a seal, a chubby one
- annual cost for shampoo is....well one bottle!
 
Thank you everyone :bighug: We made it home safely. He has not meowed at all.. which is very weird for him, he's a talker. But he seemed very calm and slept some on the road. Since we have been back he has laid in his favorite spot, and has just been following me around. Quiet and a little wobbly. He got the Gaba, other regular meds plus Buprinex this morning. He also got Covenia. Which I have refused before when he got the dental, I know it is a little risky from what we have discussed on the Lantus forum, but the doctor said it was safe and I honestly did not want to have to give him pills on top of what he's been through.. so I just said ok. I greatly hope that was an ok decision. We shall see.

He has been very hungry which is good. Since he got all of his meds around 5:30am he must have eaten around then. I stopped around 9 and he ate, again at noon, and then when we got home at 3 I fed him some more. His blood sugar was 191 at 9am, and 114 at 3:30pm :eek: so that was good. Now he is just laying on my lap while I type. About to read the discharge papers soon.

So made snort noise with his nose which already makes me worry about what Dr. McCue said about the incision in the back of his throat... :facepalm: but it was just once so I will be on the lookout.

So glad to be home.
 
I am so happy for you guys!! Since like he’s already returning back to his baseline despite being on pain and calming medication. It’s amazing, and the sugars are really good too. Yay!!
 
Welcome home Amanda and Shmee!

Glad you had a good trip and that Shmee is now back in his favorite spots. Have a good night. Shmee, your aunties and uncles are so proud of you and your wonderful mamabean.

P.s. Rusty got Convenia because he was impossible to pill. He didn’t have an adverse reaction. He got the shot a number of times. No problems.
 
Overall, this sounds like a highly successful surgery and a highly productive round trip. Since he is sitting on your lap, all the worries from Shmee and his bean just melt away. Those are good BG numbers. I hope his ultimate destination is OTJ (off the juice).
 
Amanda & Shmee said:
Thank you everyone :bighug: We made it home safely. He has not meowed at all.. which is very weird for him, he's a talker. But he seemed very calm and slept some on the road. Since we have been back he has laid in his favorite spot, and has just been following me around. Quiet and a little wobbly. He got the Gaba, other regular meds plus Buprinex this morning. He also got Covenia. Which I have refused before when he got the dental, I know it is a little risky from what we have discussed on the Lantus forum, but the doctor said it was safe and I honestly did not want to have to give him pills on top of what he's been through.. so I just said ok. I greatly hope that was an ok decision. We shall see.

He has been very hungry which is good. Since he got all of his meds around 5:30am he must have eaten around then. I stopped around 9 and he ate, again at noon, and then when we got home at 3 I fed him some more. His blood sugar was 191 at 9am, and 114 at 3:30pm :eek: so that was good. Now he is just laying on my lap while I type. About to read the discharge papers soon.

So made snort noise with his nose which already makes me worry about what Dr. McCue said about the incision in the back of his throat... :facepalm: but it was just once so I will be on the lookout.

So glad to be home.
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Sooo very happy for you and Shmee. Also, can I say you did an AWESOME job! It was a big week for Shmee, but YOU made it happen. What you did was epic!
 
Amanda,

I have been following along! I promise! I just have not been able to comment much. Its been pretty insane here.

I am soooo glad that you and Shmee are home and doing well. All in all, it sounds like a really good report. I don't think that I would worry overly much about the personality changes just yet. I mean, considering that he just went through a major ordeal with already was a massive thing and is now suddenly experiencing some huge hormonal imbalances, he probably feel quite a bit off. Not to mention, I think I would be a bit subdued after being whisked off and away for a while. Stress like that wears the body out, your muscles stay tense and your senses on high alert. Give Shmee a bit of time to reestablish himself at home and to process what it is that has happened and I bet he comes back to the same old kitty.

I sometimes wonder if we do not create the issues out of our own worry. As in, we see what we fear? I proved that this week with Pig. I just knew something was wrong, but $700 worth of tests later simply told me the story that @Wendy&Neko was telling all along, that it was just lack of insulin. What I mean to say is, do not see a change in his personality just because you fear one, but be open enough to realize if there really is. But, even if it does change his personality will you love him any less? Probably not, so as long as he is happy and healthy then you did what you went to accomplish. To give Shmee a happy and long life. He won't know if he acts slightly differently.

And most importantly... BREATH! You did it! And marvelously so! There are not many people that could pull off what you did. Be proud of yourself for that. :bighug:

Time to take it one day at a time. Focus on his recovery and securing where it is you will get his prescriptions from. Formulate a plan so you never have to miss a dose of those hormones. And breath. Let him recover. And remember, some behavior changes could be simply because he is reading your worry and stress. I can tell you Pig reads mine. Boy does he get grumpy!

You did it Amanda! You brought Shmee home safe and healthy!!! Whoop! :)
 
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