Update on Gem - guarded prognosis

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jkbank

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Hi All
I know lots of you have been waiting for an update on Gem's condition (which is still mind-blowing to me, all the strangers out there in the world thinking of us!). Sorry for not posting earlier, been getting the kids from school etc

First I want to start by saying Dr Peterson is a wonderful, compassionate doctor, and should you ever need an endocrinologist, and are in the NY area, I highly recommend seeing him. He is calm and gentle, yet straightforward where needed. So…

He wishes he would have seen Gem way earlier in all this; I will try not to spend too much of my time beating myself up for not pushing the Cushing's diagnosis earlier, as that serves none of us. But it's there, in the back of my head.

He agrees that her condition is poor, mainly because the skin has deteriorated so much. However, based on what I told him, and his observation of her behavior, he feels we have nothing to lose with trying the Trilostane and seeing where that goes. He would not want to put her through more testing, or anything invasive, but if she takes the medication, there is some hope that we can see improvement. Of course, Cushing's is a life sentence, but if we can get the cortisol levels under control, that would help with the diabetes as well as the heart & kidney conditions. That said, she is at risk for infection with the skin tears being so severe. He admits that wound management to this degree is not an area he is strong in, but is asking around for some creative ideas. He agrees, as some have mentioned here, that it might be best to cover it up in some way to prevent further damage. Ideally, we could get someone to come to the house a few times a week to help clean and care for it, as well as take her temperature to make sure there is no infection. Also, with heart disease, there is always a risk of clot or heart failure.

His best hope is that we keep the skin where it is now, and give the trilostane some time to work. We would do blood work in a few weeks to see where the cortisol levels are. He did say he would not disagree if we felt this was more than we could manage, and it would not be wrong to put her to sleep, but he sees no down side to trying, as she does not appear to be suffering. He said this is what he would do if it was his cat.

So I am putting out there a call for expertise in wound management! I know someone (sorry, can't remember which one of you!) talked about vetericyn. I will get my hands on some. But if you are in the NYC area, or know of someone, who I could have come over periodically and help me with this, I would be most grateful. I will speak to my vet as well, as I know all the techs there do home visits, but I don't know if this is beyond their capabilities. Also, creative ideas to cover the wound would be great.

So, I am happy that I don't have to make the decision to put her down right now, but have to remember that her prognosis is not great. I pray that I will know when it gets to be too much for Gem - she has been such a trooper through all this.

I want to thank all of you again for your support and good wishes. It's been helpful beyond measure. Fingers crossed that we can bring some comfort to Gem.

Karen

PS Dr Peterson says to not get too caught up in her BG numbers right now. Best case scenario, that will improve with the improving of Cushing's. He says to continue with her 3u twice a day, which is not an unreasonable dose, don't try and test her and cause more skin damage. He said, honestly, the diabetes is the least of her problems for right now! I will of course monitor the other symptoms and address them as they arise i.e. urine, water intake etc.
 
Oh and one other thing that crosses my mind…perhaps this time, even if it doesn't ultimately help Gem, will help us as a family come to terms with saying goodbye to her. My kids seem to be understanding more and more that her time with us is short, and see that we're doing all we can and not just giving up on her.
 
So glad you took Gem and went to Dr. P and FWIW, I totally agree with giving that med a chance. You would always wonder if you didn't try it and just PTS. This way you know and miracles can and do happen. Time is what is needed now and many prayers coming that this all works out well for Gem. Some meds do take a lot longer to kick in so besides time, patience is going to be needed. Thanks for posting the update for all of us.
 
Thank you for keeping us up to date and that is much better news than I was expecting to hear. Sending prayers your way.

My kids seem to be understanding more and more that her time with us is short, and see that we're doing all we can and not just giving up on her.
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What an awesome statement that is! The kids will remember more than anything else how much Gem is loved, and how not giving up "matters". That's a huge thing.

Carl
 
Hi Karen,

I am happy that you found Dr. Peterson to be helpful, and that he gave you the option to try and treat Gem. I think that this is encouraging.

I think that what some people have mentioned in the past about treating with Trilostane that it is crucial, especially when first starting treatment, to monitor for side effects. At the first sign of adverse side effects (and I believe that nausea and inappetance are particularly of importance) you should immediately see the vet. I haven't used Trilostane, but I think that this is something you should get clear direction on from the vet when you start treatment.

I think that getting a vet tech from an animal hospital to come in would be your best bet. I wonder if there is a veterinary dermatologist nearby that might have a tech who could help. Another idea might be a veterinary ER where the techs would be experienced with wounds. A third possibility might be a nurse (for people). You might put a separate post on Health with the title(s) of "Help needed in NYC" or "help needed with wound care" or words to the effect of what you need.

I wonder if one option for covering the wound might be a tubular stockinette bandage. These come in various widths and elasticities. You would buy a length of it, and poke holes in it for the front arms. They are used in human medicine for things like covering the arm under a cast or brace, or applying compression to a limb. One of my cats came home from chest surgery wearing a nice loose one. You could probably find it online, or in a medical supply store, or ask your vet.

Here is Teddy wearing one (he isn't the one that had the surgery, but he was the unwilling model for these photos (note these are clickable thumbnails):





I have my fingers crossed that Gem will respond to the medication. I think that you are doing an absolutely amazing job with her, and that your kids are also learning a lot from you about respect for life and caring for loved ones who are ill.

I don't have advice about the insulin use, as I am not much of one for giving dose advice (or contradicting Dr.Mark Peterson), but I would just caution that at the least sign that her appetite is off or that she may not eat normally, you should consider lowering the dose.
 
No real advice but lots and lots of healing prayers for Gem and her entire family that loves her so much...We see miracles happen all the time around here, and really praying we can list Gem among those miracle kitties.

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
Linda and Bear Man said:
Hi Karen,

I am happy that you found Dr. Peterson to be helpful, and that he gave you the option to try and treat Gem. I think that this is encouraging.

I think that what some people have mentioned in the past about treating with Trilostane that it is crucial, especially when first starting treatment, to monitor for side effects. At the first sign of adverse side effects (and I believe that nausea and inappetance are particularly of importance) you should immediately see the vet. I haven't used Trilostane, but I think that this is something you should get clear direction on from the vet when you start treatment.

Interestingly, he didn't say much about side effects specific to the trilostane. Perhaps because I am monitoring her so closely for any changes, he didn't see the need??

I think that getting a vet tech from an animal hospital to come in would be your best bet. I wonder if there is a veterinary dermatologist nearby that might have a tech who could help. Another idea might be a veterinary ER where the techs would be experienced with wounds. A third possibility might be a nurse (for people). You might put a separate post on Health with the title(s) of "Help needed in NYC" or "help needed with wound care" or words to the effect of what you need.

That's a good suggestion, thanks. I am going to speak to my vet and see if one of the techs can help me

I wonder if one option for covering the wound might be a tubular stockinette bandage. These come in various widths and elasticities. You would buy a length of it, and poke holes in it for the front arms. They are used in human medicine for things like covering the arm under a cast or brace, or applying compression to a limb. One of my cats came home from chest surgery wearing a nice loose one. You could probably find it online, or in a medical supply store, or ask your vet.

This is along the lines of what I'm thinking, though we need something with no compression, and that won't stick to the wound. The hitch is that, looking at your photo, where the "shirt" ends sort of lines up with the where the wound is so if it rides up a bit, it will be exposed. I think I need something more like a baby onesie that covers lower down, though I don't know how she goes to the bathroom with that on.

Here is Teddy wearing one (he isn't the one that had the surgery, but he was the unwilling model for these photos (note these are clickable thumbnails):





Adorable :)

I have my fingers crossed that Gem will respond to the medication. I think that you are doing an absolutely amazing job with her, and that your kids are also learning a lot from you about respect for life and caring for loved ones who are ill.

Thank you

I don't have advice about the insulin use, as I am not much of one for giving dose advice (or contradicting Dr.Mark Peterson), but I would just caution that at the least sign that her appetite is off or that she may not eat normally, you should consider lowering the dose.
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I agree, I will monitor appetite, thirst, urine output, and test her urine when I can, and discuss any changes with the vet.
 
Carl & Bob in SC said:
Thank you for keeping us up to date and that is much better news than I was expecting to hear. Sending prayers your way.

My kids seem to be understanding more and more that her time with us is short, and see that we're doing all we can and not just giving up on her.
Click to expand...

What an awesome statement that is! The kids will remember more than anything else how much Gem is loved, and how not giving up "matters". That's a huge thing.

Carl
Click to expand...

Thank you Carl, it would be nice to have something positive come out of this awful situation
 
MommaOfMuse said:
No real advice but lots and lots of healing prayers for Gem and her entire family that loves her so much...We see miracles happen all the time around here, and really praying we can list Gem among those miracle kitties.

Mel, Maxwell, Musette, Autumn & The Fur Gang
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Thanks Mel
 
jkbank said:
This is along the lines of what I'm thinking, though we need something with no compression, and that won't stick to the wound. The hitch is that, looking at your photo, where the "shirt" ends sort of lines up with the where the wound is so if it rides up a bit, it will be exposed. I think I need something more like a baby onesie that covers lower down, though I don't know how she goes to the bathroom with that on[/i].
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You cut it to the length you want (it is generally sold by the yard), and you definitely want it to fit loose. But the baby shirt would work well too.
 
Hi ((((Karen & Gem and Family))))

Oh my gosh, I had such a sigh of relief when I read your post. It sounds like Dr. Peterson is just wonderful!!
The one thing I will stress as did Linda, is with Trilostane if there is any inappetance (anorexia) you must contact your vet immediatly. The trilostane is a powerful drug and if the dose isn't where it needs to be and Gem stops eating even a meal or two it is very important to contact the vet. Our internal medicine vet told us that in that case the cat basically flips from cushings to addisons disease, one of which the symtoms are inappetance/anorexia. I can't quote exactly but that is the jist of what I understood. The IM vet said it is an easy fix, but must be attended to by the vet right away. (Sadly we were out of the country when Witty stopped eating. She had been on trilostane for 3 1/2 weeks. Our caregiver called our regular vet, and with cushings being so rare in cats the staff just told her to watch Witty) When we got home two days later and rushed her to the University ER she spent two more days there and than we lost her. Again I don't tell you this to upset your, just so you are aware how important it is to contact your endocrinologist right away if she stops eating. I'm not sure what would have been done because we did not get to that point, but I believe the dose would have been changed and they would have given adrenaline. As I mentioned our IM vet said it is an easy fix as long as you see them right away.
Of course as with Gem, Witty had other health conditions and I can't be sure, but I can't help but wonder if we hadn't been out of town and had gotten her right over to the IM vet, that maybe it could have been different. I guess I will never know.
Sending big hugs to Gem and you and your family!!
 
I'm sorry to read about Gem's prognosis. I had a friend several years ago with a Cushings cat. Once she was on medication she improved and lived quite happily for a while.

I Recently came across a new pet medical shirt company. http://www.medicalpetshirts.com/pages/44uk_usage.html. This site is for their distribution overseas but supposedly they are available In the US through vets who buy from MWI. MWI is a pretty big veterinary products supplier so you cold ask your vet. Not sure if something like this would help but I figured it worth posting just in case. It's nice that is wont rub since it is securely fitted and these are the first medical clothes made for cats so they can still use the LB withouth soiling their shirt.

Wishing you and Gem the best!
 
Cheryl & Whiskers (GA) said:
Hi ((((Karen & Gem and Family))))

Oh my gosh, I had such a sigh of relief when I read your post. It sounds like Dr. Peterson is just wonderful!!
The one thing I will stress as did Linda, is with Trilostane if there is any inappetance (anorexia) you must contact your vet immediatly. The trilostane is a powerful drug and if the dose isn't where it needs to be and Gem stops eating even a meal or two it is very important to contact the vet. Our internal medicine vet told us that in that case the cat basically flips from cushings to addisons disease, one of which the symtoms are inappetance/anorexia. I can't quote exactly but that is the jist of what I understood. The IM vet said it is an easy fix, but must be attended to by the vet right away. (Sadly we were out of the country when Witty stopped eating. She had been on trilostane for 3 1/2 weeks. Our caregiver called our regular vet, and with cushings being so rare in cats the staff just told her to watch Witty) When we got home two days later and rushed her to the University ER she spent two more days there and than we lost her. Again I don't tell you this to upset your, just so you are aware how important it is to contact your endocrinologist right away if she stops eating. I'm not sure what would have been done because we did not get to that point, but I believe the dose would have been changed and they would have given adrenaline. As I mentioned our IM vet said it is an easy fix as long as you see them right away.
Of course as with Gem, Witty had other health conditions and I can't be sure, but I can't help but wonder if we hadn't been out of town and had gotten her right over to the IM vet, that maybe it could have been different. I guess I will never know.
Sending big hugs to Gem and you and your family!!
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Thank you for the advice Cheryl…not sure why Dr Peterson didn't stress this with me, but I will definitely keep an eye on her eating. All this is so much to take in, I'm still struggling with whether I'm doing the right thing, or putting Gem through unnecessary difficulties for my own benefit. I also beat myself up for not pushing this diagnosis earlier - perhaps we could have avoided so much of this. But like you say, I will never know.
 
Jacspets said:
I'm sorry to read about Gem's prognosis. I had a friend several years ago with a Cushings cat. Once she was on medication she improved and lived quite happily for a while.

I Recently came across a new pet medical shirt company. http://www.medicalpetshirts.com/pages/44uk_usage.html. This site is for their distribution overseas but supposedly they are available In the US through vets who buy from MWI. MWI is a pretty big veterinary products supplier so you cold ask your vet. Not sure if something like this would help but I figured it worth posting just in case. It's nice that is wont rub since it is securely fitted and these are the first medical clothes made for cats so they can still use the LB withouth soiling their shirt.

Wishing you and Gem the best!
Click to expand...
Thanks Jaclyn, wondering if this could work for Gem, I will see what the vet thinks, and if we can get it.
I hope we aren't too late to give Gem some more quality time.
 
Hi,

There is just a lot of info to absorb. That is why this blog is so helpful, we can share our experiances and then talk with out vets about it.
Hang in there, we are all keeping you guys in our thoughts and prayers and many of the cushings mom's and dad's are here now so you have a wealth of experiance to draw from. Just make sure to pass all the ideas and suggestions on to your vet. Your doing a GREAT JOB!!!!!
(P.S try not to beat yourself up, you have done just great with Gem and your family)
P.S.S Do you know how to send a PM in case you need to get in touch with someone. It sends a message to our email's that you have sent a PM private message. That way if we are not on FDMB but have checked our emails than we know your are reaching out. I'll send you one now and you can check it out.
 
Cheryl & Whiskers (GA) said:
Hi,

There is just a lot of info to absorb. That is why this blog is so helpful, we can share our experiances and then talk with out vets about it.
Hang in there, we are all keeping you guys in our thoughts and prayers and many of the cushings mom's and dad's are here now so you have a wealth of experiance to draw from. Just make sure to pass all the ideas and suggestions on to your vet. Your doing a GREAT JOB!!!!!
(P.S try not to beat yourself up, you have done just great with Gem and your family)
Click to expand...

Thank you for saying that. I know it does no one any good for me to beat myself up, so I have a few minutes of a pity party and then I try and move forward. The support here has certainly been helpful in doing that. It's hard not to feel alone when even Dr Peterson says he's only seen a handful of cushings cats!
 
jkbank said:
... It's hard not to feel alone when even Dr Peterson says he's only seen a handful of cushings cats!
Click to expand...

See how special Gem REALLY is? She's teaching lots of people lots of things right now. Your and her struggle thru this will guide others as they have babies dx'd with this...

BIG HUG! And gentle kiss for Gem...
 
i think you are an awesome mom to gem - you've done everything you know how to do. big hug and high five from me and punkin. i'm glad you've also connected with some others who've been through this.

for now, one foot in front of the other, doing what you can. just deal with the hour in front of you and try not to worry about the future.

Dr. Mark sounds wonderful.

:YMHUG:
 
Squeaky and KT said:
jkbank said:
... It's hard not to feel alone when even Dr Peterson says he's only seen a handful of cushings cats!
Click to expand...

See how special Gem REALLY is? She's teaching lots of people lots of things right now. Your and her struggle thru this will guide others as they have babies dx'd with this...

BIG HUG! And gentle kiss for Gem...
Click to expand...

LOL, my daughter wants to know why Gem has to be so special!!
Thanks for your good wishes
 
Thanks Jeanne and Julie - I am trying to take it one step at a time. Like I said, Gem has been such a trooper through all this, going along with all the medicine taking and trips to the vet without a fuss. I think that is the only thing giving me strength to keep the fight going.

I just got a bottle of vetericyn and am hoping that helps with the wound so we are not confronted with an infection.

To be continued….
 
Hi Karen. I'm happy to hear the hopeful news for Gem. I'm will keep her in my thoughts and hope that the medication works for her.

Have you looked into Hospice care for pets? I'm not implying that Gem is dying by any means. The reason I suggest it is that I've read a few articles about hospice service here in Chicago and they have a lot of experience dealing with these types of ailments. Many of the animals live for years that receive hospice care. They come to your home which is great for the animals because they don't like going to the vet as we all know! Additionally a good hospice provider will also help the humans coping with the emotional aspects of dealing with disease.

I'm currently taking Gus to a vet that has switched over to only doing alternative medicine. We are going for acupuncture. I feel it is just as therapeutic for me as for him because she talks to me about my bond with Gus and about our journey together and his quality of life. Regular vets usually don't talk about this stuff because they are busy trying to control numbers on tests. Both types of care are necessary though.

I'm wishing you and Gem lots of good luck with the treatment.
 
Oh I'm so happy that you had a good experience with this vet! I know it is to early to tell if the meds will work or not, but you can't help but smiling right? Gem, show us what you can do! Fingers crossed these meds are just what she needs, to live a happy life with you guys :YMHUG:
 
There's a list of secondary monitoring tools, with hints, in my sig line.

{{hugs}}

And a little something for you to read.
 

Attachments

depending on the severity of the wounds, you could try triple antibiotic ointment with pain reliever (my allergy cat likes it - and hates the no-pain-reliever kind).
 
So good that you connected with Dr. Peterson.
You are doing all you can for Gem.

Hoping the Trilostane begins to work. If there is anything I can offer with regard to Cushings/Trilostane just ask.
Please do feel free to PM me as I can't monitor the Board too much but will reply to an email during the daytime.
Thinking positive and healing thoughts-
 
Hugs to Gem and family. I agree that doing what you can will teach your kids many lessons as well as that living creatures have worth and are not disposable, that's an important lessen for all, as well as giving them time for the difficulty of limited time. Gem will say when enough is enough, sounds like she still has love, and interest in life, and her family. Rachel has a wonderful suggestion on hospice as their focus is comfort care and symptom relief, as well as family support.

Even with humans doctors and family tend to not call it in until way too late due to not wanting to give up too soon, there is palliative care for humans which has different focus on symptom relief, not sure if it exists with our furred kids.
 
So glad you got to see the specialist and have some options now that will hopefully benefit Gem and certainly give your family the chance to work thru things no matter what happens. Sounds like you have some good sugestions on garments for Gem to wear - that would seem like a much needed step in all of this. I have to say you have all my admiration and I hope I would be up to all this for any one of my animals. Much good vibes to you and Gem and we'll be holding a good thought for you as you continue to work thru the process of caring for her.
 
Thank you, thank you all….

Rachel - I will certainly keep the hospice option in the back of my head. I am fortunate to have sympathetic people in my life that I can talk to about the stuff vets don't really deal with. Though I have to say, my vet has been really supportive of everything I'm trying to do.

Peter - thanks, not sure I'm quite at smile stage, but at least the tears have stopped for now :)

BJM - thanks! I am definitely trying to use those secondary tools to keep an eye on things. My own personal therapist is trained in biofeedback/meditation so we work on breathing & relaxation all the time!

Phoebe - the first time I tried putting the ointment on, I found it nearly impossible to spread - for one thing I am so tentative in handling Gem, and also given that the exposed skin is moist makes it hard to spread. The vet suggested silvadine which she thought might be easier. I am going to give the vetericyn a try and see how it goes.

Cheryl - the interesting thing here is I feel like the specialist I saw was the opposite, she seemed ready to give up before I was ready. I was happy to have a voice of reason in Dr Peterson, who said it would not be unreasonable to let her go but still felt it was worth a shot. I hope I will know when I am holding on too long for me more than for her.

Ellen - thanks for those kind words. I don't think I am doing any more than any one of you guys would do….that's part of having a pet and bringing them into our lives. And I agree, even if things really don't turn around for Gem, at least it gives us time to process and accept it. Right now would have seemed too soon and too sudden.

Dr Peterson has been reaching out to colleagues for ideas re wound care. Someone suggested some type of powder that is compounded into a lotion that gets applied and then saline is sprayed on to activate and form a shell, which will both medicate and protect. It was a lot of medical jargon, he just cc'd me on the email to my vet. I will talk to her tomorrow and see what that's about. Much as I want to protect the wound, I am really trying to avoid putting her in the carrier again, as that only does further damage.

Anyway, sorry for rambling…..thanks again to all who are posting or just reading, we feel your good wishes here in NYC :)
 
Just a quick comment - having used slivadine for personal skin tear issues in the past I can say the stuff is amazing - Not sure about your challenges of putting it on Gem (what I used was a cream that spreads easily) but it does work quickly.
 
RobbiesMom said:
Just a quick comment - having used slivadine for personal skin tear issues in the past I can say the stuff is amazing - Not sure about your challenges of putting it on Gem (what I used was a cream that spreads easily) but it does work quickly.
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Thanks Ellen….not sure what to do as I don't want to put too many things on there at once. I think I am going to try the vetericyn for a few days and see how that goes. I do have silvadine in the house from prior burns so I can start it quickly if needed.
 
Hi Karen

I posted a reply earlier but apparently didn't post it. If it does show up and I'm repeating myself, I'm sorry. This actually has to be briefer because I wrenched my wrist a little and it hurts to type!

I have seen these kinds of wounds and I know they are difficult to deal with and difficult to see on a loved one. What will help most is getting her cortisol under control. Once this is done, her body will heal up the wounds quite nicely. I spoke to a friend who has treated some Cushings cats and he found that if people could hang in there with the wounds (with proper medical care of course) until the trilostane got up to speed, the skin recovered. Now in vet med, surgeons are the experts in treating traumatic wounds (although a dermatologist wouldn't be a wrong choice for this type of wound either) so if anyone is unsure, you can make an appointment to go see a surgeon or derm specialist. As far as transport, it might be best to use a box with towels at the bottom and a few airholes, and take a car service so you don't have to carry it far. Otherwise using a plastic carrier that comes apart easily (the snap kind) might work, you'd have to put her in it and then close it on top of her.

I do know of a few techs who make housecalls in the NYC area. How is your cat's temperament? You can PM me with info on your location if you'd like, and I can see if I know someone.

The stockinette that someone else mentioned might be a good choice. You would have whatever salve you use, then a nonstick pad, then the stockinette. It is a long tube so you can cut the holes as you wish, and the fabric has a lot of give. They are disposable too.
 
Hi Karen,

Jess is a vet tech in the NYC area, and very well respected on this Board, so if you do need someone to come in to help at home, I am glad that she may be able to provide you with some names.
 
Jess & Earl said:
Hi Karen

I posted a reply earlier but apparently didn't post it. If it does show up and I'm repeating myself, I'm sorry. This actually has to be briefer because I wrenched my wrist a little and it hurts to type!

I have seen these kinds of wounds and I know they are difficult to deal with and difficult to see on a loved one. What will help most is getting her cortisol under control. Once this is done, her body will heal up the wounds quite nicely. I spoke to a friend who has treated some Cushings cats and he found that if people could hang in there with the wounds (with proper medical care of course) until the trilostane got up to speed, the skin recovered. Now in vet med, surgeons are the experts in treating traumatic wounds (although a dermatologist wouldn't be a wrong choice for this type of wound either) so if anyone is unsure, you can make an appointment to go see a surgeon or derm specialist. As far as transport, it might be best to use a box with towels at the bottom and a few airholes, and take a car service so you don't have to carry it far. Otherwise using a plastic carrier that comes apart easily (the snap kind) might work, you'd have to put her in it and then close it on top of her.

I do know of a few techs who make housecalls in the NYC area. How is your cat's temperament? You can PM me with info on your location if you'd like, and I can see if I know someone.

The stockinette that someone else mentioned might be a good choice. You would have whatever salve you use, then a nonstick pad, then the stockinette. It is a long tube so you can cut the holes as you wish, and the fabric has a lot of give. They are disposable too.
Click to expand...

Thanks Jess

While at Blue Pearl Gem was seen by both a dermatologist and a surgeon, both to assess her overall skin condition as well as treat the wound. Additionally, Dr Peterson has consulted with a surgeon who focuses on wound care (works out of AMC). Hopefully they will all collectively be able to get us through til the cortisol can work. Gem's carrier is a soft-sided one, and we do cab it, but she still rubs against the sides while turning around. WHile out last night I got a call from my vet regarding Peterson's recommendations - I will reach them today and see what they say. After that, if we still feel I need someone at home, I will definitely PM you. Gem is a mellow cat who has given no trouble to any of the doctors who have attended to her. Thank you so much for your help.
 
Jess & Earl said:
Hi Karen

I posted a reply earlier but apparently didn't post it. If it does show up and I'm repeating myself, I'm sorry. This actually has to be briefer because I wrenched my wrist a little and it hurts to type!
Click to expand...

PS I have an excellent physical therapist who specializes with hand issues should you need :)
 
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