8/5 Uncle vet visit update and nice picture from this morning

Hello friends, it's been a long while since my last post. Uncle has not been doing very well and I have been trying to keep it together over here -just trying to put one foot in front of the other and hope something, anything I'm doing will help him. He continues to have a terrible if not completely absent appetite, although more times than not it appears he is hungry but seems to stop eating after a tablespoon or so when the food hits his stomach.
His abdomen appears to heave after eating only a few bites and/or he starts breathing heavy. I don't know if he has cramping or it's his breathing. I have tried all kinds of toppers and different foods, just when I think I've found something that will work, he rejects it. Last night he went down to the basement and laid next to his litter box. He's very skinny now and it's hard to see him this way. Two nights ago I was thinking I should make arrangements to let him go. Then he surprised me with a good appetite the next morning -only to refuse food later in the day. He is drinking water excessively and I wonder if it's because he wants to feel full. I was giving him 25 mg every 12 hours of Gabapentin for pain but he was so wobbly (only has one back leg) I was afraid he would fall over. He could barely get in and out of his litter box -which has very low sides. I am having trouble pilling him and haven't gotten any of his heart meds in since he hasn't been eating. I feel terrible about that because I know he needs them. Right now the only thing he is getting consistently is his insulin and Ondansetron. His BG has also been all over the place. Two nights ago it was 559 at PMPS.
I could really use some help trying to sort things out. I feel really lost.

 

Til the pros weigh in, Barbara. Prayers for wisdom and insight as to what sweet uncle needs

 

Thank you so much. I really appreciate your support

 

I can only share my experience and maybe something there will help. With Neko I found that at one point she needed both Cerenia and Ondansetron to help her appetite. They tackle different nausea receptors and the combo helped when just ondansetron wasn't enough. You might also want to ask your vet about the ondansetron dosage. Maybe it can be increased. Excessive drinking can also be a sign of nausea.

I found that "priming the pump" or getting some food in via assist feeding would help Neko eat the rest of her food. I also presented a buffet of options. She did go off of her raw, but I think it was the texture that was hard to eat because of her soft tissue growth. I ended up blending and making a purree of food that she found easier to eat on her own. Bonus, I could syringe feed it if needed. I scoured the shelves finding something she would eat. She liked the Royal Canin Recovey so I held my nose and fed it, al least it was low carb.

Pilling was a killer for me at first. I have lots of experience from my shelter days, but Neko tested me on that. Two things helped. The first was gelcaps, mostly size 4 and 5, though some use the larger size 3. Neko's soft tissue growth in the pharynx made the larger ones not so good an option. I could combine more than one med in a gelcap, and it hid any bitter taste of meds. The second thing that helped was a good pill gun, I used this one.

Best of luck. Keep listening to Uncle. He will tell you what to do.

 

Barbara - Uncle is so special to all of us here. I am heartbroken to read this. Wendy posted some good hints - Murphy is on both cerenia and ondansteron. I also have to give him cyproheptadine as an appy stimulant. I agree with Wendy about priming the pump. When Murphy is really nauseated, it seems like a few bits of kibble help settle his stomach (I realize it is heresy on this site, but it does seem to be the case) A few pieces of Epigen90 or Instinct seems to encourage him to eat his wet. A lot of people are trying canna - I ordered some and hope to get it tomorrow. That's what @Gussie's mom used for Gussie.

So many hugs to you both!!

 

I'm so very sorry Barbara. At the end Max who had been tightly controlled threw me numbers off the roof. I tried both cerenia and ondansetron but he wouldn't eat. He had fluid buildup and it happened quickly. Sometimes they can tap them and it doesn't come back. Then they can take lasix. Have you seen the cardiologist? I don't know what heart condition Uncle has so this could be of no help.

 

Sorry to hear things haven't been going to well. I might make a cardio trip especially if you haven't been able to get the heart meds in. Like Elise said, unfortunately CHF/fluid can build quickly and would cause lack of appy. Sending lots of vines and prayers for you both

 

Hi All, I decided to take Uncle in to the vets right after I posted. Fortunately they got me right in. The doc suggested x-rays and they showed fluid build up around his heart, lungs and abdomen. Sounds similar to Max's condition maybe. He also presented as dehydrated upon examination. The vet is sending images out to the radiologist and Uncle's cardiologist to see if they have any recommendations at this point. Of course I feel terrible that I made the choice to stop giving him the heart meds when he stopped eating 2 weeks ago. I had every intention to get him back on each med one at a time.
My vet said she would call me when she hears from both of the other doctors.
I'm sorry to bring this sad news to the group. I will update when I know more.
You guys are helping me more than you know just by being there.

 

Please try not to feel bad, you're an awesome bean. Hope they can give you some positive answers soon. Hang in there the best you can

 

{{{Barbara}}}

Don't feel guilty. You made the best decision you could, based on what you believed at the time. No one questions your love for Uncle.

I'm glad you got him to the vet. I hope you get some answers soon and can move forward with helping him feel better. Do please keep us posted. You know you have tons of vines and prayers headed your way.

 

(((Barbara))) I can sympathize how overwhelming giving all the meds is. Most of them can be compounded as liquid if that is easier to give. Maybe even combined. I hope the cardio vet has some answers.

 

I'm sorry you and Uncle are having such a hard time.

 

Please don't beat yourself up. You've been doing an awesome job with Uncle. It's so hard to keep pushing the meds when they don't want to eat. I'm glad you saw the vet. You both are in my thoughts and prayers.

 

I'm really glad you got him in to the vet -- that was my first question. Getting the med compounded is also a great suggestion.

 

Don't be hard on yourself. You're doing the best you can under the circumstances. Uncle knows you love him and will do anything to help him. Sending prayers.

 

The vet called and hasn't heard back from the cardiologist yet and she said she thinks his comments are going to be the most important to consider for helping Uncle.
She did get the radiology report which is consistent with what she thought "there is fluid in the abdomen, fluid in the thorax and fluid in the lungs. Mild enlarged liver, gas in the intestines. "
Recommendations from radiologist comments were stated as follows:
Try to tap some of the fluid out of the thoracic cavity.
IV diuretic therapy, Lasix IV and/or try to give a little bit of drip IV fluids (which would require hospitalization)
Repeat ECG, cardiac consultation
Repeat bloodwork
Do an ultrasound to access liver function, GI tract, pancreas and remaining abdominal organs

My vet really wants to hear from the cardiologist to see how he feels about giving a diuretic to Uncle is dehydrated ( she would like to) and if he can recommend any specific medications to get this fluid down.

She asked me to call her and tell her how he's doing since he's been back home. I just counted his RR and it is good, only 22, but his breathing is definitely labored. I really do not want to take him to emergency in the middle of the night. Not sure if I should ask her for some oral Lasix to get through the night.
The office closes in a half an hour (they can leave medication in a bag behind the front door for me to pick anytime though).

Any thoughts or suggestions?

 

Thanks s Tricia, I miss our late night hangouts. Hope your house is feeling great and the kittens aren't too grown up yet!

 

Thanks for checking in Carol. I'll pick up some of that Instinct dry food tomorrow, I know the store I go to carries Instinct canned food so I bet they have some of their kibble too. I hope the canna helps Murphy. I'd love to hear how it goes for him

 

Neko had a chest tap last November. She had fluids build up because of her subq fluids. Her RR had been increasing above her normal, so I stopped fluids and got an IM vet visit. The cardio vet tapped her and she came home. Unfortunately there was a leak somehow, and she ended up with air in her chest, resulting in an ER visit that night to tap the air out and a couple days stay before it was all gone. During that time, they did do bolus Lasix. Home care after than was liquid Lasix. Neko had higher stage CKD than Uncle, but it was more important to treat the heart and fluids than worry about kidneys. I tried to put as much liquid as I could orally into her.

Not sure why a repeat ECG, Neko had a mini echo.

 

Thanks for all those ideas. I did run the Cernia/ Ondansetron combo by my vet and she agreed that it would be a good idea. She wasn't sure if I needed to change to dosage though.

Oh shoot, I remember that now. I was only on the board for about a month when Neko had the tap and the leak. So scary!
I agree with you, the heart stuff has to be dealt with and the kidneys will just have to do their best. It's such a balancing act at this stage.
I want to do everything I can up to the point where I feel like I'm putting him through too much.

 

Just talked to the vet. They are closing soon but she's leaving a loaded syringe with Lasix for me to pick up so that I can get some of the fluid down tonight. I feel a lot better now.

 

(((((Oh Barbara)))) sending loads of vines to you and Uncle. I have no experience with what you are going through but want you to know that I am sending lots of positive and good medical vines yours and Uncle's way.

 

(((((((Barbara)))))))
I'm going to add to the hugs and prayers for your big, special orange guy. And to the gentle reminders that you are doing the very best you can in each changing moment. We can second guess and wish we did things differently but it really comes down to if we could have, we wouldn't have done what we did that we are kicking ourselves forwhat you did was the very best decision you could make for that moment
You are dancing an agonizing dance without choreography, sometimes just keeping up is all that seems possible. Please (tho I know from bitter experience it is easier said than done), be gentle with yourself
I will put in a word with Gussie to add Uncle to his guardian angel client listand I will be keeping you in gentle vines from here

((((((Hugs and gentle scritches)))))

 

Barbara, love the picture of that very handsome boy you posted. He is such a special dear. I so hope the lasix helps tonight.

Holding you and dear Uncle in my thoughts and prayers

 

Sending you lots of hugs and super-mega-giant vines for Uncle

Hope the Lasix helps things.....it really can work miracles.

You're doing everything you can ....He knows that and loves you .....if it gets to be too much for him, you'll feel it in your heart and know it's time to let him go.....but we're all hoping that's not for a long time and he can bounce back and have many more good days ahead!!

 

Thank you Bobbie, that means a lot to me

I hope so too, it was feeling like I may need a miracle for Uncle today. We'll see what the Lasix shot can accomplish tonight and what the cardiologist says tomorrow. Thank you for keeping us in your thoughts

 

Thank

Thank you Carol. I always love hearing from you and Murphy. Thank you for your prayers. You've been a good friend to us

 

Oh Barbara - my heart goes out to you and Uncle. It must be so, so hard for you. It sounds like you are doing everything you can for Uncle, and it sounds like he's got a very special mom in you. Sending many healing vines for you both...take good care...

 

(((Barbara))), so sorry you and Uncle are having to go through this. I don't have any experience with it so I can't really help, but I'm sending tons and tons of prayers, and vines of all sorts. I hope the Lasix helps, and I hope you hear from the cardio doc soon. Don't beat yourself up about the heart meds, you did what you needed to at the time. You are a wonderful bean to Uncle, and I'm sure he would tell you so, if he could talk. He knows that you love him and are doing the absolute best you can for him.

Deep breaths, now, and one day at a time, until you know better exactly what's going on. Do please keep us updated! Hugs to you and gentle scritches to Sweet Uncle.

 

adding more hugs.....

I was going to ask about U/S and I'm glad they did the xray so you know better what is going on inside.

Prayers that the vets can make a difference...
appy vines.... too

 

So sorry to read Uncle is not well at the moment. So hard for you both.
I hope the cardiologist has some positive news for you tomorrow and that the lasix makes a big improvement.
Sending appy and vetty vines.
Lovely photo of Uncle.

 

I remember them well! Our house is still under remodel and the kittens are growing way too fast! But we are well and we are all praying for you and dear Uncle. Keep us posted. I hope you can get some sleep tonight.

 

How is Uncle doing this morning? I hope the lasix helped and you and the vet can come up with a plan.

Many, many and .

Extra scritches for Uncle . Love the picture.

 

I'm sorry your boy isn't feeling well.

 

Lots of vines and prayers for you and Uncle. When I gave Doodles Lasik injections it sky rocketed his BG's but did the trick. Just mentioning it in case you see the same. Hope there is a clear plan for you all that you're comfortable with and helps Uncle.

 

Hoping the lasix is helping and the cardiologist has more helpful info for you.

 

And many prayers for Uncle's healing and your peace .

 

Many vines and prayers for your handsome boy, I hope the lasix makes him feel more comfortable. Don't be too hard on yourself, we all just have to do the best we can

 

Barbara I have no advice, just lots of prayers and vines for your sweet boy.
I miss our coffee mornings.

 

Just checking in for an update.

 

Barbara, I am so sorry that Uncle isn't feeling well. I hope the Lasix will help him and that he will rally. It is so alarming when our kitties can't or won't eat.
Sending many prayers and vines for your boy. What a handsome guy he is.

 

Thank you everyone for your well wishes , vines, prayers and suggestions. You all are helping me and Uncle more than you know.


It's midnight here and the first chance to get on the computer. It's been a heck of along day................
Uncle did well overnight after his first Lasix shot. His breathing is still labored but a little better today than yesterday.
His BG numbers have come down as well.
My vet called this afternoon to let me know that she hadn't heard from the cardiologist yet.
She noted that it was usual for him and thinks maybe he is out of town. So in the meantime she gave me a vial of Furosemide and a bunch of syringes. She wants me to give him .15ml sub q every 12 hours until further notice. Also wants me to bring him in tomorrow morning to take another round of x-rays to see how much the Lasix/Furosimide has helped. She thinks tapping his thorax and abdomen to drain fluid is probably the next thing to do, but wants to take another look first. Also wants me to get him back on all 4 of the heart meds as soon as possible. I am most nervous about the compounded Sotalol because right after they had me double the dose he stopped eating. Not exactly sure how to deal with that. Maybe have them compound it in chicken instead of tuna (he never eats fish or anything with fish in it, maybe it messed up his digestion/or pancreas?) or just get it in a pill form. I am absolutely terrible at pilling cats, so I ordered the pill gun that @Wendy&Neko suggested. I think it will come tomorrow.

I need to keep an eye on Uncle's BG tonight. His PMPS was 192 and his +2 is 149. I know it's not one of his big old swan dives but still...
Makes me so nervous that if he needs carbs I won't be able to get him to eat.
I just gave him some 12%. He didn't eat much of the meat but had about a tablespoon of the gravy. I'm glad I decided to hold on to his .5 u dose even through his high numbers. There just aren't any real discernible patterns right now and his appetite is still REALLY sketchy.

Thank you again for everything. I'm sorry I did post anything until now. I didn't mean to keep anyone on pins and needles.
I will post more tomorrow

 

Good to see his BG has come down, hopefully that's a sign he's feeling a little better.

Ongoing vines and prayers.

 

I'm glad his breathing is a little better. Sending more prayers.

 

I'm thinking of you both and so hoping that things go well... I've crossed my fingers and Girlie has crossed her paws for you both. Lots of love coming your way...

 

Thinking of you.

The first few pilling sessions may be frustrating, they were for me. But you WILL get better at it. I got chicken flavour compounded, the chicken soup version went over better than the roast chicken.

 

Sending more prayers.

 

Chicken soup is good for everything
Sending more vines for Uncle.