5.11.15 Zoey ... At vet

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Rose

Rose

Member Since 2015
(sigh) ... Real fast. SS is up-to-date. Slept later than planned this morning so had to run out the door. Took Zoe with us to office and had it set to leave her there but she just would not eat. She's leaking fluids through her belly tears. She's cold. We've had a heat pad down for her but when she gets off, she's shaking. If you touch her hindlegs, they tremor/twitch. When I say she leaks fluids, I think they're the SubQ and it will leave a large wet mark wherever she lies. Her hind legs are not as swollen but still squishy with fluid and the right hind leg is more so now, than the left.

left her at the vet's office with all of the SS and her lantus and strict instructions to not shoot her until they talk to me first. Her BG was 88, fed her some treats and when I left it was on the rise. I hope it sticks and doesn't drop without the food she's used to having. The ER vet talked about her BG not being high enough to give her more insulin and not having spoken to them about the mechanics of Lantus, I'm afraid they'll goober up all of th hard work with an incorrect shot. I'm also afraid they'll shoot full dose and her not be monitored since she's so unpredictable. I fully plan to pick her up and bring her home tonight even if I have to take her back in the a.m. No one can monitor her like I can. ... Or we can't afford to have someone monitor like we do. That's more accurate.

I'm in meetings (we're waiting for people to arrive right now) and I am unable to have interruptions once things get started so I will have to check in on breaks. Worried sick. Vet tech said not to worry, that they're expecting the Cushing's test results back today and she was pretty convinced herself that with all of the symptoms and the confirmation in the creatine/cortisol test (we're all expecting positive results) that the vet will be comfortable prescribing Cushing meds and that cats show remarkable changes once on it. I sure hope so.

I'm to the point... what is there to lose? Give it to her NOW, please. :/

I will post when I can and catch up with all who have sent me such wonderful advice and things to look for. Could not do all of the research and get on the correct path without you guys, your experience and your archives of amazing information and personal knowledge. Ty, Ty, Ty!

yesterday
 
Rose - for you and DH :bighug::bighug::bighug::bighug::bighug:. For Zoey, tons of healing vines and hoping you can get the meds she needs ASAP.
 
Oh Rose, I'm so sorry Zoey is back at the vet and not feeling good.

I understand only too well the feeling that no-one else can take care of her like you can - I had exactly that feeling with Rosa when I thought she might have to be boarded for a weekend (along with concerns that someone would give her a 0.5u or even 5u dose instead of the 0.05u she was actually on :nailbiting:).

I really hope that they get her test results back today and can start her on some meds to get her feeling better - I agree with you...they need to get her started with them sooner rather than later. And a diagnosis of Cushing's (which I know you've been expecting at some point for a while) would give you the chance to get her on the right meds now and get her on the road to recovery.

:bighug: :bighug: :bighug: :bighug:
 
{{{Rose}}}

I'm sure it's driving you crazy not to be able to check on Zoey while you're at work today. I'm sending a bunch more vines and prayers and we'll all be watching for your update when you do get some info. Hang in there. L&LL vines and prayers are very powerful!!! :bighug::bighug::bighug:
 
Piling on more vines and prayers and hugs for Zoey, you, and DH :bighug::bighug::bighug::bighug::bighug: I hope you get the answers you need today and she gets the medicine she needs to start healing.
 
(((((Rose))))) I am so sorry to read this- all I can do is add my prayers and vines and hugs foryou and Zoey. I am praying that your vet can figure out a diagnosis, and which meds will help her as quickly as possible.
 
Lemonade out of Lemons ... vet visit was successful in that we got all of the meds for the Cushing's Disease. She does have Cushing's based on her symptoms and the creatine/cortisol test. The vet talked with the internist and she said not much luck was had with cats with Cushing's because all cats with Cushing's have diabetes and it's too hard to control. (My translation: The vets in the USA don't treat cats with diabetes on a case-by-case basis, nor arm the beans with information so the beans have no idea how to monitor and adjust their insulin without hundreds of dollars being spent for test from their vets -- therefor, their cats die of hypo -- or beans just give up and PTS. Also, a red flag was raised because I think I read in a study that it's rare, but some cats have Cushing's without being diabetic -- have to double check though. ) The internist said if we wanted to work with her she'd be happy to conduct some tests and help us set up a protocol to try. (I heard: we can spend hundreds or thousands of dollars more and she'll look at the diabetes protocol we're following, we'll have to prove to her that it works, and then she'll maybe do some tests and more and more time goes by and by then it's too late.) So this wonderful vet said he was willing to follow the protocol and give us the meds as prescribed in Dr. Niessen's study. (Thanks again, Wendy) He also finally gave us a bottle of B12 to use instead of that blasted B-complex we had. Hopefully that change in and of itself will start to help her weakened condition. He gave Mirtazapine for her appetite stimulant -- gave her some of that tonight along with the b-12. The Cushing's study in cats had the most success rate with Trylestane (US - Vetoryl). We have that and it very clearly says for use in dogs only. (Kind of scary but I know at this point, we ARE a case study for someone, maybe here, and it's our only option.) We can't start that until tomorrow a.m. because Zoey will have to have labs completed every two weeks and it's a four-hour window to take them after dose. He was very clear that he's never done this before and this was an experiment to see where we can get her. He said he had confidence that we've done our homework and was willing to help us try. Seems when they said they had seen cats with Cushing's that maybe they didn't share the outcome of those cats ... just that they had seen them.

Zoey is not in any obvious pain. He feels her tremors are nerves and maybe tingling and hopefully these new meds will help with that -- again, symptoms of Cushing's along with the diabetes. She's still seeping fluids. They really don't know why other than the 100 ml of fluids and they explained how the Cushing's starts causing all kinds of havoc - of which diabetes is the symptom of the Cushing's and not the other way around. Zoey's test results and BG numbers are all good so with any luck, and everyone's prayers, we might be able to get something going. As I said, at this point we have nothing to lose.

For future searches and the ease of reference, if anyone is interested in the plan: The protocol/info on Cushing's is from Dr. Niessen and this is the study and protocol. (First part is acromegaly and the second part talks about Cushing's) Page 344 is the protocol we're following. If anyone would like to put a fresh set of eyes on the stuff and see if anything jumps out that we should note or inquire or ... anything, it is greatly appreciated. Exhaustion has led to a few mistakes on my part lately so I can tell you it would be easy to overlook something and the vet is really relying on what we bring to him to do this with. Although his participation is logical, in today's litigious world it's definitely a rare occurrence for someone to walk out on the limb with you. We're most appreciative and would never hold him or anyone else responsible. We know each day is a gift and like I said, hopefully there will be something to be pass along that will help the next Cushing's member.

Zoey is now eating again and her BG is really good -- even on the reduced dose. (I'm sure it's because she's not been eating as much so I'm happy with the decision to reduce.) I'm feeding her a MC food for tonight -- as I said, DH and I are exhausted from the long weekend and the unexpected vet trip and of course, lots of family. There's also the matter of tearing out that boat shed that we worked on all day Saturday -- before the all night vet trip. So any one who might be reading this and thinking when I speak of being exhausted it means because of Zoey ...no. Far from it. Best challenge we've ever undertaken and she is every bit as appreciative of us as we are of the people here. We just can't nuzzle you guys to show you. :cat:

I'm going to pop over to the SS and bring it up to date. Then it's off to bed. DH and I are tag teaming Zoe's tests so we can both get more than 3 hours of sleep at any one time. Love that man.

I cannot tell you how much it warms our hearts that you guys are stopping by to send prayers, vines and hugs. We have read them all and benefited from the information that has been shared and the support that has been given. I wish I could thank you each individually but we're sending out a big old group thank you and big old hugs for all.

Sweet dream slumbering vines for all ....
 
Two suggestions that I recall from a previous Cushing's kitty - one was that they put a onesie on her to protect her skin, the other was that they got the fewest possible ear tests to avoid tearing her ear skin.

I don't know that Zoey needs those tips right now, but just tuck those away in your mind in case you need them in the future. I'm glad you've got answers. I'll read the link you provided too.
 
Thanks, Julie -- we use her paws to test and she's been wearing a protective sleeve/muumuu daily, 24/7, for few weeks now. It is definitely good advice to wear that as soon as you first suspect Cushing's. It has proven to be a tremendous help for us to help Zoe without pulling too much on that tender skin; plus it protects her underside from the surfaces she lounges on. Even with that precaution, there are still tears to be dealt with. Really great suggestions -- I'm going to put them in a file so when it's all said and done, there might be some concise information compiled in one place for others.
 
Possibly useful: see my signature link Secondary Monitoring Tools for non-invasive assessments you can make to evaluate her. They aren't as precise as blood glucose, but may be helpful supplements for you.
 
I think your main priority going forward must be to protect her skin at all costs. If you can speak to the vets again, ask how they suggest newly arising tears be treated. How should they be bandaged? Ask for some bandaging supplies plus any ointments they recommend if any. My vet did not allow me to give sub q fluids to my Cushing's cat, for fear of causing tears. Keeping her indoors, away from any altercations with other cats, and give her only the gentlest of lifting, and as little as possible. Her skin is likely the one thing most likely to determine how she does with this disease.
 
Rose

Sorry I haven't been able to pop in but I'm out of town; however, I got a PM asking me to look at her condo. I've read quickly back through the last few days. I'm glad she is better today and now you know exactly what you are treating. I don't know what the label says on Trilostane but it is used in cats and I don't think it's rare to use it in cats. Have you seen this small study on using Trilostane in cats and info from Wedgewood Pharmacy. I've used Wedgewood several times and they are an excellent source for compounding animal meds.

I'm glad there is no CKD...one less thing to worry about. Her creatinine looks good. While it is typical for subq fluids to end up behind the front paws, they will go down the paws and it takes time to resorb. I would not give fluids again until all of them are resorbed...unless your vet directs you to do so but I'd ask him about it. You don't want to overload her ability to absorb the fluid by continuing to give more.

I hope she will continue to eat and feel better. You and your DH are doing an incredible job. Sending many vines.
 
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I'm glad to hear that Zoey is home and that, although it's not a diagnosis anyone wants to hear, it is what you expected and you have the right meds to start her on the road to feeling better. I would agree that having diabetes that is more difficult to keep under control may well be a deciding factor for the decisions people make with Cushing's kitties. But with the amount of testing you already do, and the dedication you're providing to her care, she has the very best chance possible of a positive outcome. I have bookmarked the link you included in your post to read through hopefully with slightly fresher eyes tomorrow (the combination of a sciatica flare-up and a head cold didn't give me the best night's sleep last night for fully taking in anything too technical in nature today).

It does sound as though your vet is excellent - and to be prepared to trial treatments that he hasn't used before is always a good thing when you're dealing with one of the less common conditions.

Many hugs to you and your DH - he does sound like a gem being prepared to split the wake up calls with you and another big hug for Zoey, since scritches are probably off the menu for her right now to protect her skin. :bighug: :bighug: :bighug:
 
Do a search for Vetoryl on this site - you'll find a couple other posts from people with Cushings cats. And places to look for cheaper pricing. Check out this post which contains a list of some other Cushing's kitties we've seen here.

Give Zoey some gentle loving from me. One very important thing that someone said to me when Neko got her acromegaly diagnosis - I will say to you. Zoey is still the same sweet loving cat she was before the diagnosis, you now just have a name for her condition and an explanation for her symptoms. She hasn't changed one bit. And knowledge is power. Rose - you are doing an awesome job with Zoey. :bighug:
 
Rose and Zoey; vines, hugs & scritches (only the gentlest kind) and more positive thoughts for you. I'm so amazed and humbled by the care and effort you are giving to your sweet girl. Glad to know you finally have a diagnosis, a plan and that she is feeling and eating better. Continued prayers and vines and energies sent your way. Please take care of yourself (and your DH as well!).
 
{{{Rose}}}

I'm so glad you have a definitive diagnosis - it makes it so much easier to deal with something when you know what it is! It sounds like you have a fabulous vet - great that he is working with you like that. Your DH is also off the charts!

If you find that the Mirtazapine gets Zoey too agitated, you might ask your vet about Cyproheptadine. I find it is a little easier on the kitties and works as well.

I've had doggie shirts & hoodies and also infant t-shirts on my Civvie, Sasha, since she had her leg amputated and had radiation - it protects the bare skin that is still easily irritated. With a onsie, I just cut off the bottom. Plus it looks cute! If you use those knit sleeves for Zoey's neck, you can by them by the food at a medical supply store, and it's probably cheaper than getting them from the vet.

Sending tons of healing vines for Zoey, and comfort vines for you. You have a wonderful attitude and lots of support, so I just know this is going to go better than anyone could hope. Many prayers. :bighug:
 
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