10-8-18 Jones AMPS 121, +3.5 131 Update, Questions

Happy Thanksgiving to all the Canadians here!

Previous

It has been awhile but I have been focused on spending time with Jones. He has lost a ton of weight lately. Originally the all turkey diet seemed to be working. The weight loss stalled and he started to have a normal poop every once in awhile. I did add in some rabbit (haven't been able to source a non-raw only rabbit protein food here in Canada. I know Rawz is in the midst of bringing one to market but it isn't here yet.)
Then the weight loss began again with big drops of 200g in 3 weeks and another 100 grams in 2 weeks. He has lost just over 1kg since his dental that is 2lbs! He should be around 11lbs and he is 8.2lbs.

Went to the vet on the 6th. Truthfully the visit was to determine if Jones' body is not able to give him the ability to continue living a normal life. He has the will but will the body comply? She did a very throughal physical exam. She felt no obvious lumps or bumps. Lymph nodes seem normal, liver, kidney, bladder all seem normal on physical exam. No fever, heart is normal and lungs sound clear. He is clearly anemic as he as pale gums which we knew and that is why he was on folate to help with. We did a blood draw (which should be in Wed/Thurs due to the holiday Monday) and seeing who is the first available person to do an ultrasound is. Hope to get that done in the next week or two.

During the course of the exam she asked about his meds. I did indicate that he still gets diarrhea every 3/4th day and will have a normal poop, then one where he strains and then soft serve to water then the cycle starts over again. I also mentioned he is now on a very low dose as well, his numbers dropped and he even had some n/s shot days recently. And yes I know, the testing wasn't done while I was gone and DH has decided not to do them during the day. To be honest, I am not sure I don't disagree which you can see from my testing lately. He is literally a bag of bones and at his lowest weight ever.

Here is to the questions or if any one has a comment. I am trying to figure what to do here as I wait for the other information.

1. The vet suggested he go off of insulin and I actually should try to find a turkey or rabbit only kibble to help put weight on. I am so confused by this one. I understand kibble will help with weight on a non-diabetic but does that theory really work with a diabetic? That and going off insulin does not equate for me at all. Jones would love such a kibble if I could find it.
2. The metronidazole - it is at an incredibly high dose. She wants me to drop it in half (which was the dose he was on before) if we can get two weeks of good poops (yeah, not going to happen). But thought here....what if I drop down the metronidazole any way? It is an antibiotic which in theory is killing his probiotics in the GI. So what if I drop it? Would that help? Is that is what is causing the strange poop cycle? I know it would not help the weight loss per se...but would that help the overall health of the GI?

Until we get the bloodwork and ultrasound results, we don't know what we are dealing with which means has his IBD moved to SCL and what will we do about that?

@Wendy&Neko - the pulse dosing...is there a link I can send the vet on this about using that dosing method vs. EOD? Pros and Cons? We did EOD before and his RBC/WBC tanked which with him being anemic may put an end to the discussion.

 

I have no advice for you.

 

That doesn't make any sense to me. Dry food will raise his BG. I don't have any advice. Sending prayers.

 

This is for anyone with an old cat who is pondering the big question,
What exactly am I doing? Any newbies who have come upon this thread should just turn away now.
Hi Tracey. We've talked about this before, namely the weight loss. Honestly I sometimes look at Noah and I wonder what I'm doing. He's actually less nervous now than at any point in his life but he looks so scrawny it just breaks my heart. I do all his medical stuff so when Cynthia asks what his numbers are etc. I just mumble something and stare out the window. He's still unregulated, I don't even keep a spreadsheet on him. The strange part is that he has no in between from high numbers to ideal numbers. What I mean is I can get him down to slightly above where he should be but if I increase the dose by 1/4 unit he'll go straight to scary low numbers.
Unlike Nigel who had his every three months partial checkup Noah has not seen any vet in years. I order his BUPE and insulin and a few days later I pick it up. He has not had a urinalysis, a dental checkup or a blood panel in forever. The truth is every time he gets in a car wrapped up in piddle pads and towels I thing this is the day he'll have a cardiac event. Unlike you and Jones, Noah has zero related medical problems other than his teeth and enlarged heart. No diarrhea, no hairballs, no vomiting ever. Lately for the first time ever I have seen him look a little unsteady when he gets up. He has the extra long fur between his pads and we have ceramic floors and the BUPE for his rotten teeth and probably has arthritis so that's one thing. Then I give him his shot, he sniffs the food and walks away.
I know we read a lot into my often repeated story about him being the last of a family of six and how we remember him as a big yellow 18 pound cat. I don't have him weighed anymore, what's the point anyways? All the scale does is make me cry. And now our home will be turned upside down with my mother in law moving in. Noah doesn't like change.
We have been friends for a long time and we both know how much we love our pets. And now Christmas is coming which has brought us bad luck forever. I'm not just keeping him going, and neither are you, because we can't let go. For Noah and his cardiomyopathy and enlarged heart it will be the same story as his brothers. One morning he'll be short of breath, it will just get worse and within 48 hours it will be over. That is how Zoe, Simon and Andrew went, Nigel and Jacob had cancer.
None of this is an answer. It's been too long since we've had a heart to heart and I just needed you to know I know how this feels. Noah is still a fighter, loves being brushed and even let's me clip the knots on his tummy. I'll know when the time comes, I just cannot believe it hasn't come before this. He has a new basket by the back window and the other cats all leave him alone so I'm thankful for that.
That's it. You know I love you and Jones and I know he means the world to you. Hope you have a good Thanksgiving and the turkey isn't too dry. Don't forget the Brussels sprouts and the gravy.
Your pal Dickson
That was not supposed to be all about me, I'm having another bad day. Friggin' Tinnitus, migraines and TGN are sucking the life out of me.

 

Like Dickson, I can relate to a lot of what you shared. I don't have any sage advice. For Grandpa, we focus less now on doing things perfectly and customize his care to what seems to work at the time. A couple vets suggested we stop insulin, but he felt worse so we started again. Grandpa is also very thin. It's tough to feel his poor bones. But he's bright eyed and enjoys walking around the yard and grabbing our fingers. My vet always says that if he is "present" and interested in life, it isn't his time. I try not to think ahead. For Grandpa, shots of Convenia seem to help when he gets pancreatic flares and stops eating. But we have also relaxed our vigilance against dry food. We were really strict, closing him in my bedroom when dry food was out for the others. But when he ran outside one day, he discovered the cheap dry food we keep out for the ferals in the area. He hadn't been eating much at all, so seeing him chow down happily made me happy. Since then I gave up on TR and I don't worry if he eats some dry. At least he eats. I have to say that he seems much happier now that we're more relaxed. He will pee and poo in the yard much faster than he will in a litter box and he seems satisfied with a bite or two of the previously off- limits foods.

Hang in there. As Dickson said, you're not alone in this.

 

I so get it, it's almost to the point I don't want to run my hand down her back because I can feel every bone. But then that look happens, where she looks at me and I can't pet fast enough. It's amazing how much we can love these 4 legged animals.
Sorry I have no answers for you my friend. I can give you these all day. Give scritches to Jones.

 

Lots of love and prayers

 

(((Tracey))) I love little Jonsey and you're doing everything for him. I don't remember the specifics but there are some consequences of using metro long term. They wanted to put Doodles on it but I never did. It had something to do with liver I think but don't hold me to that. Of course with any med some benefits out weigh the risks and vice versa. I might try the 1/2 dose and see how it goes.

Is it because he's not eating enough or is he eating pretty good and still losing weight? They IBD may have turned into SML which is common and could be the reason behind weight loss etc. Getting the U/S is helpful but it's my understanding only a biopsy will say for sure and if it were me I wouldn't do that at this point. Your vet will guide you on that and many treat on symptoms rather then the evasive biopsy process.

Not sure I'd stop the insulin myself, however it's your call. I understand not testing much but would still try to get a mid-cycle as often as possible. As for dry...well, Doodles never completely gave up his dry food. At one point he was a skinny 14lb (down from 20lbs) at the beginning of dx. Purina DM dry is about 15% carbs and is prescription from the vet. It did help put weight back on Doodles. It's loaded with crap so not sure if Jonesy would tolerate it or not. I eventually switched to Nature's variety Chicken (15% carbs), the Rabbit limited ingredient has pork and is around 21% carbs. As long as I gave Doodles a few small tablespoons a day, he would eat his wet food I tried to get rid of it all together but Mr. Bossy Pants was in charge. The saying is...it's NOT food if they don't eat it. Their QOL is important and IMHO, if a little dry will make him happy so be it.

Sending vines and prayers...give your boy extra scritches for me.

 

And prayers!
My heart goes out to you. I’ve been there with several of mine.

 

Sorry for the late reply. Still on the road from Thanksgiving Day get togethers. There is a document like you are looking for in the Feline small cell lymphoma group.https://groups.io/g/Feline_Smallcell_Lymphoma If you join there and look in the Files section, you'll find it. I used it successfully to get my civvie's vet to switch our dosing method. And referenced the papers when conversing with Neko's IM vet.

Good luck.

 

Big hugs for you and Jones! I really hope you find an answer soon! We're pulling and praying for you Jonesy!!

 

Thank you everyone for the support and comments.

@Doodles & Karen - he is eating his daily calorie requirements but losing weight any way.

@Wendy&Neko thanks for the link.

 

@Noah & me (GA) Love you my friend sending you hugs.

 

Ach Trace.
I've missed you but being me, don't intrude.

All hugs. No words of any sorta wisdom.

Your Bag'O'Bones Jones is in the very best of care .
You take care of you.

M

 

from Noah to everyone.