Skinky update. Not good. Tremors...

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skinky44

skinky44

Member Since 2014
Skinky is not doing well. Blood work came back from earlier this week and I had to run in to switch SubQs (bag I was using had added potasium, turns out Skinky's blood work showed elevated potassium). I should've brought her in and PTS, I just think we are going to turn a corner...that being she magically gets better or she peacefully dies in her sleep. Difficult to accept the increasing likelihood that neither of those scenarios will present themselves.

She is trembling very much right now. Her BG w/ Arkray tested 315 at 8:17 pm. Her blood work BG tested about 675. She might be showing some signs of kidney failure as well as pancreatitis. I am so so sad to say that right now I do truly believe she is in pain. Plan now is to bring her in tomorrow to possibly PTS. Past times I've planned this she's always been so much better the next day, so don't hold me to this, although I think the time has come.

In the meantime - does anyone have any suggestions/ thoughts about these tremors?? It is SO difficult to watch, I can only assume she is in pain. She is on Butronex for pain. She will not drink water (again) and she cries when I've tried to give her SubQs...

She got 1.5 units of Lantus earlier (although the insulin might be weak)
2 shots of Butronex
dexamethasone
Mirtazapine
celenia injection
SubQs w/ potassium earlier (before vet called)
DCA and thiamin (to treat possible cancerous tumor)
Zithromax
has had only minimal Hills AD syringed this morning, mixed with B12 and some immune boosters for cats.

As I finish typing and uploading, her tremors have calmed down. I don't know what to do for her other than bring her in for sleep tomorrow... are these tremors as painful as they look?
 

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Hugs, big huge hugs, Laura.
Of course you can see her and I can't, but what you've written sounds like it could be her time. I hope you know how hard it is for me to type that. In 2013, I had to make that decision twice in a matter of a few months and said Goodbye to Mullet (15) and sweet Bob (14). It ripped my heart out. I would give ANYTHING for one of my kitties to take "the decision" out of my hands - to just fall asleep and pass peacefully. In 35+ years, it hasn't happened that way once.

No matter what, you love her, and she knows that. Trust yourself.
Prayers for peace in your heart,
Carl
 
Thanks Carl. I needed to hear that last part....because mostly today when I approach her, she runs away from me. I had even asked the vet about the possibility of removing her eye to access and clean out whatever is in her nose. At this point, the vet said she is even hesitant to sedate skinky. I guess that's it too - I don't want the decision. I don't want to hold her and look in her eyes while she fades away. But I don't want to come home after several hours and find her dead on the floor wondering if she was having convulsions and suffering for a long time either. I always forget that she's 16...she's just my little baby...
 
Laura,
I will say that holding Bob and Mullet, and singing them to sleep was extremely helpful to me. It was very peaceful. I sure did cry the whole time, but it really helped me to deal with the aftermath by knowing they felt loved and safe in my arms.
Not now, but when you feel able to, visit the Grief forum and look at the tributes I posted, and the videos I made in their memory. Do you and Skinky have "a song"? For me, music holds almost magical healing power. It has gotten me through some tough stuff. I can't watch the videos without tears even now. But now they don't hurt like they used to.

Peace,

Carl
 
I'm so sorry.
I had a dog (Pomeranian) that started the tremors having midnight and she was gone by 4:06 am.... that horrible number is forever burned in my brain.... and of course, it seems I always look
at the clock and see it over and over.....

wish we could be with you ....
it's hard, I know.... but it's a gift you can give to her.....
 
I am so sorry skinky has taken a turn for the worse, you have been through so much together. My thoughts are with you both.

I am not sure quite what your tremors look like but remi gets head twitches when he is poorly. The closest I have managed to pin it down to is possibly low potassium. But these are just head twitches.
 
Oh, Laura ... :bighug:

I am so sorry to hear about Skinky's tremors. I've no experience of anything like that. All I can do is keep you both in my prayers.

((((Laura and Skinky))))
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I am so very very sorry that you and your baby are going through this. Sending purr's and prayers
 
Sending hugs and Prayers for you and Skinky. You both have fought a good fight.
Take Care of yourself Laura. Peg and Toby
 
(((Laura))),
I am holding you and Skinky in my heart.

Not so long ago I lost two kitties to cancer.
I didn't want to foreshorten their lives and spent a long time trying to make their lives comfortable. With one of those kitties, I twice made an appt to have him PTS and then cancelled it because he seemed to perk up. But then, one afternoon, there was a sudden and definite change in him. He no longer enjoyed being stroked (something he had always loved). And in that moment of realisation I shifted in my mind from 'trying to keep quality of life going' to 'wanting to end suffering'. Later that day he was put to sleep in my arms.
It still breaks my heart to think of it. But it was the right thing to do.

I do not know if you've reached that point with Skinky. Only you know that.

Wishing you courage and strength, dear Laura,

Eliz
 
I'm so sorry Skinky isn't improving Laura.

She knows you love her. If this is her time to leave, she knows you are doing it out of love. You will cry and mourn when the time comes, but you shouldn't feel guilt. You have loved her and tried to save her. I truly believe that helping to end pain and suffering is a gift we are allowed to give our loved pets.
 
Many of us have had to make the decision for our cats. It's never an easy decision and there are always the nagging questions: but, what if, how, am I sure? you can fill in the rest - you know these questions.

The thing you need to focus on is her quality of life. I've been following this on and off for quite some time and I know you are and have done everything you can for her. But there comes a time when it is time and you need to have the courage to make that final decision, because you don't want her to suffer and have to do it on her own.

You may think if she goes on her own it will be easy and peaceful, I'm here to tell you that in many cases it is just the opposite. Helping them is the more humane way of doing it. It's hard for you, of course, but it's the more peaceful way for them.

Only you can decide what to do, but remember - she is a very senior cat, with a lot of issues that will not magically get better and maybe now it is time to help her and say that final goodbye.
 
Dear ((((Laura)))),
Helping our kitties cross is so difficult for all of us, but for our kitties it is the final act of love. Please don't put Skinky's hour off any longer. Your girl is suffering and, from your descriptions, in great pain. She knows that her time has come and she needs you to be with her and to help her cross so that she can begin her new adventure. She has been so brave, and, truly I believe, she has held on so long because of her love and her concern for you.

Thinking of you and of your beautiful girl. She will be your Guardian Angel forever.

:bighug::bighug::bighug:

Ella
 
Laura, I hope things have gotten better but if not I hope you know that no one could have tried harder and loved their cat more, I am sure she knows it too, I think you are probably right that the time has come, I am so sorry.
 
Laura, I'm so sorry to hear about the difficult time you and your kitty are going through. Letting go of a good cat is one of the hardest things to do, but sometimes it is the most merciful thing to do. I wish the best for you and Skinky, no matter which decision you two make.
 
Thanks for all the responses. I was actually posting about thoughts on the tremors and blood work, which is why I uploaded the recent blood work...and if anyone thought the combination of drugs I was giving might be causing the tremors. I was hoping to get some timely input about the tremors/drug combo/ blood work results back on Sat when I posted...

but thanks anyhow...
 
You have a few things going on there. Kidney and liver levels are high and so is the glucose. I see that potassium is very high and wonder if that is causing the tremors. You aren't supplementing with anything are you?

I don't know enough about blood tests to know what to suggest. I think one is probably having a knock on effect on the other. Can you get better control of the glucose? Are you feeding enough to be able to give it regularly?
 
The trembling could be a sign of high potassium. Have you talked to the vet about them?
I too, would try to get the glucose in better control, and I hope she is getting enough food.
 
I think it was, at least in large part, to the potassium. The fluid bag the vet gave had potassium in it and after i switched it out on Sunday she got better.

Thanks
 
Laura, I'm so sorry. The kidney levels are not bad but the high phosphorus would likely make her not feel too good. I think it is the cancer. I've lost two to that rotten disease and had to make the decision both times. Difficult as it is to do, often going on their own terms is not so great either. It becomes our last gift of love to set them free when we can no longer make them feel better. :bighug: I wish you strength.

I need to add keep doing everything you can until you feel that nothing helps so you never have any second guessing yourself. I know that is what you are doing. If the convenia is helping that sounds like infection. Or did she get a shot of "Cerenia" for nausea?
 
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Laura. I'm glad you got your spreadsheet up and linked to your signature.
When you got that 37 on March 1st, that meant she was getting too much insulin. I would have lowered the dose to 1.00 then. Lantus dosing is not based on the pre shot test but on how low it took her. Lantus likes consistancy and the depot takes time to build up and deplete. It can take 3 days or more for this to happen.

I'm glad you skipped the shot this morning.

Sending feeling better and clear out that mucus vines to Skinky.
 
Hi all,
I got skinky's blood work today, i requested it BEFORE vet called to discuss as i wanted to prepare my questions...

if any of you are somewhat knowledgeable about blood work and could take a look at it and let me know anything in particular i should ask vet about, i'd like to be prepared as much as i can with my questions before she calls..
it's linked to my signature, lab tab. but also am uploading files here...

thanks!
 

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I'm still thinking there is infection present. The elevated WBC was the only blood abnormality last time and this time (with cancer, you'd see abnormal values in the other cbc areas - like platelets/rbc). The elevated calcium on these labs and phos on other labs could be from electrolytes in fluids (are you still giving?) or more likely, bone loss from what ever is going on.

If they haven't done x-rays of her upper jaw yet, you should ask for these, then take them to a dental specialist or even find someone you can email copies too, to get an opinion. The fact that her kidneys and liver look good is promising. Kidneys usually have issues at end of life. The amalayse can indicate pancreatitis, but it's probably unrelated to the other stuff going on. This might be affecting her appetite. I think there are a lot of people here who can guide regarding pancreatitis, and managing the symptoms/food.
 
Hi Meya, definitely infection going on. if it was cancer, would that show up as infection as well? she has - for a while now - LOTS of mucus in that nostril where the "tumor" is. just keeps flowing out. when i ask doctors about it, they say it's the tumor perhaps causing malfunction. I've tried combos of different antibiotics. I had feared chronic kidney failure - what in her blood work indicates that her kidneys are ok?

The issue with dental xrays has been, finding a place that does DENTAL xrays, as opposed to just using a regular xray machine, and anesthesia, which no one wants to do on her due to weakness. for so long I was just hoping to get her strong enough through syringe feeding so that someone would be willing to give her anesthesia for xrays, as opposed to ct scan, but it seems like it's a losing battle. the more i try to force feed her, the more stressed out - and consequently sick - she gets.

and yes - she is still getting lactated ringers. previous ringers had added potasium but then her potassium looked high, so we eliminated that. this subq sack and the last were w/o potassium
 
The indicators for kidneys on these labs (Urea nitrogen, creatinine, bun/creat ratio) are all normal. They really shouldn't have to put her under anesthesia to do x-rays. If she is really that uncooperative, perhaps you could ask if pre-dosing her with an anti-anxiety medication might make her groggy enough to get them done.

Root infections can get REALLY huge, and are treatable, but the longer an infection is there, the more bone loss there is, and it's harder to fix. Antibiotics won't cut it, it's really got to get drained. The first step is figuring out if it's just the teeth, or something else. It's not fair to you both that you don't have answers.

Also, if there is drainage, this is a good time to ask for a culture of that. It would help her feel better to get the correct antibiotic on board, and might help her get stronger if she has procedures. Many bacteria are resistant to antibiotics, so getting the right one is important.

There is calcium and sodium in the lactated ringers (elevated in the labs). It's probably not helping the electrolytes, so you and your vet will need to keep an eye on those values. It's a balancing act with hydration.

With bone cancer or hard tumors (sarcoma, carcinoma) you may see high calcium and phos, as well as elevated ALP. You likely see chronic elevations in potassium when the tumor is large. Also changes in platelet levels are common. With lymphomas blood counts are all over the place. You'd have significant anemia. Early cancers might not have a lot of changes to bloodwork.
 
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Skinky's spreadsheet is now up and running and she's getting some low numbers.

Is there any chance some experienced members could have a look at Skinky's spreadsheet as well, please, and perhaps give some comments on Lantus dose?

Laura, I hope you don't mind me making the above request. I think it would be helpful for you. :)

Thinking of you both and keeping you in my prayers.

((((Laura and Skinky))))

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