Leo (Leoberry) - the high doser

Discussion in 'Acromegaly / IAA / Cushings Cats' started by JeffJ, Aug 25, 2016.

  1. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Poor little boy. I hope the meds work and he starts feeling better soon. Give him some scritches from me!
     
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  2. apple

    apple Member

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    Apr 15, 2017
    Sending lots of vines for Leo and you.
     
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  3. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Thanks
    1) Tube site - cleaning with chlorhexidine and then applying a salve. Reviewing daily. I'll look into silver Sulfadiazine.
    2) eating - Leo ate about 1/3 normal today. And was a bit more active.
    3) Chlor - we are getting liquid. I will be applying it thru the feeding tube.
    We receive it on Monday. I was surprised it was so inexpensive - $25 for 2 month supply. Heck, flea medicine costs more than that.

    LD was helping Leo feel better tonight. Our sweet boys.
     

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  4. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Is that "Chlor" liquid chlorambucil? The SCL group is very much against using the liquid form. It is too easy to contact it yourself. Chlorambucil is a carcinogen so you need to be very careful when handling it. And when I inquired about it, the shelf life of the liquid form was something like a week. In the US you can get the dose compounded into a capsule. I just used the Leukeran pills (which have a coating) and used gloves to handle it.

    Leo looks pretty relaxed in that photo. Good to hear he's eating a bit. :)
     
  5. JeffJ

    JeffJ Well-Known Member

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    We will be using gloves, and maybe a mask just in case. It is compounded into a liquid - chlorambucil.

    It sounds kinda weird that a chemo drug that kills cancer is itself a carcinogen. I haven't read much about it. Here is it 1:20am, and I finished working around 12:30am. Trying to get a data center (set of servers) ready for an audit.
     
  6. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Nice pic! Sounds like Leo is feeling a bit better. Good luck with the chlor.
     
  7. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    I posted a Q and A about SRT on the Acro forum here.

    Leo got his tummy stitches out on Monday - from the biopsy surgery. His shaved belly is NAKED! and so soft. The wound is hardly there. I know everyone wants to rub it, so I rubbed his tummy for all of you :D

    Leo has been getting prednisolone as a precursor treatment for his Small Cell Lymphoma (SCL), a few days ago. The good side effect was an immediate appetite increase. He has been eating a lot. He lost a lot of weight in just a month, so we are happy with the increased eating.

    Leo started chemo today. We are doing the "Every Other Day" EOD protocol with Chlorambucil liquid to start. No side effects yet since he just started. I hope we can knock this cruddy cancer into submission. My sweet boy, my little trooper.

    Spreadsheet - new leftmost tab for 2nd half 2017.
    Drugs today: Insulin, prednisolone, chlorambucil, cerenia (for nausea)
     

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  8. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Good to hear the pred had an almost immediate effect on his appetite! Good luck with the chlorambucil - I found the day after was when the nausea hit the worst, though it did last a few days.
     
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  9. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Been peeking in on the thread. It's amazing what you and Theresa are doing for your boys :). One of our Prozinc members had the same diagnosis but her kitty wasn't an Acro cat. I hope Leoberry is feeling a little better with the meds :bighug:
     
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  10. JeffJ

    JeffJ Well-Known Member

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    Thanks Yong. Someday, Leo will be gone. I hope this historical thread helps someone.

    Leo has stabilized. He is pretty tolerant of the chemo. The prednisolone is helping a lot - creating a great appetite. His weight is stable. If the chemo puts the SCL into remission, Leo could be loving us for years to come! I am hopeful for at least one more year.

    A new second tab on Leo's spreadsheet - shows meds and feeding method. We have a vet visit in the morning. I hope his feeding tube comes out. It smells, and he keeps trying to pull it out. I had to push it back in multiple times and affix it. I don't like the design, but won't rant further about it.

    I estimate we spend 90-120 minutes a day feeding, cleaning, medicating, etc, including the other 2 healthy cats. Aside from the high vet bill, the medicine costs are pretty small. Overall, the cost to keep a sick cat healthy is mostly a lot of personnel time. So I can understand why some people can't do it.

    June vet bills were $3,000. That's $2,000 for Leo's exploratory surgery, biopsies, tests, and the esophagus surgical implant of the e-tube. Plus the meds from the vet. And ~$800 for Little Dude's surgery and recovery from his outside 3am fight (he lost). Now LD is a 99% inside cat except for doing his duty. We have almost converted a wild cat to a safe inside kitteh. Lots of happiness there. Plus LD loves Leo. :)
     

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  11. JeffJ

    JeffJ Well-Known Member

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    Feeding tube out today - YAY. The insertion site looks bad, but with luck it will heal nicely. Weight is stable at 16.5 - last column on main sheet. Leo is real happy to have the e-tube collar off. :)

    Rewarded with a no-eating period after return from vet, then a minor Hypo. Recovery was fast, and eating resumed. Chart updated.

    Then dogs and Theresa were making noise and moving around during PM shot - and I probably did a fur shot. First one in 6 months. No more of that. We will now resume former protocol - they all need to be out of the room. So Leo will probably be 450 in the morning.

    Leo finished the day by eating a 1/2 can of Fancy Feast, 4 hours after chemo. We can't ask more than that!:cat:
     

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  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You do such a great job with your kittehs, Jeff! :smuggrin:
     
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  13. JeffJ

    JeffJ Well-Known Member

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    Thanks Kris. It is a rewarding experience. Little Dude is totally healed, and acts like a kitten. It's great. He is a gravy loving addict.

    Leo is doing good. 7 chemo doses given since 7/5/2017. He doesn't have much nausea at all. The prednisolone is helping a lot with hunger, and maybe nausea. He is active, and plays a bit with LD. I'm keeping Leo's BG a bit high to avoid hypo territory. There is a threshold with Leo's insulin and if I cross it, his BG drops like a stone.

    I rarely talk about Chinus. She is Daddy's girl and stays by my side all the time.
     
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  14. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    There is another SRT option through Pet Cure. They are a private company with multiple locations in the U.S. Unfortunately none are in Texas.

    https://petcureoncology.com/locations/

    This Thread <<<--- has a discussion about apple's experience at Pet Cure, and it was a good experience. I sure wish that thread had been posted to the Acro subforum.
    .
     
  15. Bronx's dad

    Bronx's dad Well-Known Member

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    Nov 30, 2016
    How is Leo doing?
     
  16. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Thanks for asking. Leo is now
    - week 5 of chemo + prednisolone
    - 11th month post-SRT
    - 24 months insulin treatment

    He is doing great.
    - good appetite, probably from prednisolone, eats a lot, loves cooked/diced chicken and Fancy Feast, table scraps
    - good normal weight (16.5 - 17.0) with a little fat
    - alert, responsive, hydrated, nimble, playful
    - plays and wrestles with Little Dude daily...a sick cat wouldn't
    - CBC (blood eval) taken on Friday 8/4/2017...need to check results
    - BG is a bit high, hard to regulate, now at 4.0-5.5/dose, partly due to prednisolone
    - no noticeable neuropathy
    - thickened claws, that never became normal

    He has a small trouble eating. I feed him on stacked platters (4 inches high). I think soft tissue growth in his throat makes it hard to swallow. If I was a visitor to the house, he would appear as a normal healthy kitteh. We are approaching his 1 year SRT anniversary. Without SRT, he probably would be gone by now. Compared to last year, his improvement is dramatic. There were 2 or 3 times in the past 2 years we considered the "big decision". Leo is proof that dedicated and proper treatment can resolve deep issues for some kittehs, providing some life extension.:)

    Overall, it seems Leo is responding to the prednisolone. The blood work will verify if there is some chemo response. I believe the general goal is Small Cell Lymphoma (SCL) remission. He may be permanently on these drugs. The chemo is EOD (every other day), chicken flavored Leukeran in liquid suspension.

    Leo and Little Dude are the best brothers; it's great. They hang out quite a bit. I think a healthy social life with people and other cats is a contributor to cat (and human) health. About once a day they get supervised "out back" into a 40' x 100' fenced backyard for stimulation. Attached pic - 'Hi everyone, we are "outside" ' (10 feet from the back door). Our sweet boys.
     

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  17. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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    That album is so beautiful @JeffJ ! :bighug:
     
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  18. Kris & Teasel

    Kris & Teasel Well-Known Member

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  19. JeffJ

    JeffJ Well-Known Member

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    Thank you. It's easy to get complacent about the online photo albums. Just updated LD's pics with last 2016 pics. (LD's 2016-2017 flickr page)

    Leo's health summary - January 2018
    - on chemo since July 2017 (6 months) and doing well, dose is now every third day as approved by oncologist
    - daily prednisolone tabs, no issues
    - BG averages: AMPS = 300, Nadir = 130, PMPS = 220
    - Levemir averages: AM = 4.5U, PM = 3.0U
    - 18.2-18.5 pounds (good), and good appetite
    - no noticeable neuropathy
    - December 2017 CBC values mostly normal

    Leo still appears externally to be a healthy kitteh. He is fairly active, and hangs out with Little Dude inside and on the back porch. Leo still loves people, and loves to sit in your lap when it's TV time. Leo has a big appetite, but still has swallowing issues. If we continue with this streak of luck, Leo will achieve his 12th birthday in April 2018. We are looking forward to it.

    (late edit - added pic)
     

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    Last edited: Jan 7, 2018
  20. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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    @JeffJ you're an amazing kitty dad! :bighug:
     
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  21. Magic Johnson

    Magic Johnson Member

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    Mar 2, 2018
    Jeff your photos were fantastic!!! Very heart warming I loved seeing your two cats so close! Sleeping together! I wish I could have another cat too but Maji is highly aggressive towards other cats other than her Timba who she grew up with since she was 9 weeks. He passed 3 years ago.
     
  22. JeffJ

    JeffJ Well-Known Member

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    Thanks. Yes, Leo is quite the lovebug. He has always wanted to sleep with a person or one of the other pets. So we are lucky that Little Dude has become his junior mascot. Leo loves the heck out of him! It makes us happy every day. I have held back on the pictures. We probably take 3-10 pictures a day!

    It has been 2 months since Leo's health report here. There is little to report
    - responsive to the meds, no bad signs
    - fairly stable insulin doses...4.0-4.5 in AM and 2.0 in the PM
    - good appetite and maintaining weight

    He is relatively healthy despite the underlying issues. We continue to hope each day that the chemo continues to stay effective on his SCL and that he will be with us for months/years to come. Here is Leo on his favorite chair - just 3 feet from the back door. Silly boy cries "Dad I really need to go outside." Then he goes out 3 feet and jumps up in the chair. It doesn't get any better than that.
     

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  23. Magic Johnson

    Magic Johnson Member

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    Mar 2, 2018
    He is so lucky to have you AND he looks happy!! He really does!!!

    You are so lucky to have found little dude and the two cats are so compatible! What I wouldn’t give to have the same. And you saved a feral cat on top of that! So cool - pls share your pics !!!

    It looks like little dude is a hunter - Timba’s mom was feral and taught him to hunt - i had to keep him in during the day occasionally he would bend screens and get out gone for 3 days - he would stay at a distance but he could hunt successfully unfortunately... and self feed but eventually he would get hungry enough to come home... I would let him out only at night where birds were safe. He occasionally caught bats.

    I love your pics and all that you have done with Leo is amazing!!!

    Did you have to trap little dude because he was feral?
     
    Last edited: Mar 8, 2018
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  24. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    I'll respond when I get back. This was a long day while on business travel. There is a thread where I listed how we got LD. He is a true sweetheart.
     
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  25. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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    Dec 11, 2016
    Hi You give all of us Acrocats moms and dads determination to help our little ones God Bless:bighug::bighug:
     
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  26. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Thanks Pamela. Leo and other acro-cats are worth saving. I like the Cabergoline trials - and they seem effective. The SRT was definitely effective on Leo. But the CSU price is so high.

    Here is Little Dude's adoption story.
     
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  27. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    A 2 month, positive update on Leo. He is now missing some teeth.

    April 2018: Leo's general health is good.
    - 3/21 liver toxicity check - all good, no issues
    - Daily insulin and BG averages
    .....AMPS 300, then 4.0 - 4.5 units (often AMPS is food influenced by leftovers)
    .....AMPS+6 = 110-150
    .....PMPS 180-250, then 2.0 - 2.5 units, PMPS

    In general, Leo's BG and insulin are pretty stable.
    - Great appetite
    - 17.5 - 18.0 pounds
    - Chemo given every 3rd day, prednisolone every day

    3/28/2018 Dental summary
    - resorption in multiple teeth
    - minor abcesses on the teeth removed
    - both upper canines removed, and a single upper premolar removed
    - Leo has not had many dentals thru the years, my bad

    3/6/2018 Hypo
    - I had to go to NYC for business
    - Leo's normal PM dose is 2.0-2.5 units
    - Theresa gave him 4.0 units
    - He hypoed down to 50. We were on the phone together until 2am when he stabilized.
    - There was no bounce the next day. The next day, Leo said: "What was all the fuss about Mom?"

    Spring 2018 - Leo and Little Dude - best buds
    Aside from the medical crud, Leo is doing very well. He loves to eat. And he adores Little Dude, who in turn loves the attention. Leo also loves attention, and he gets daily brushings. Leo and LD are almost inseparable. They are usually within 5 feet of each other. We like it when they wrestle on the ground, then they both get up and look the other way like "we weren't really doing that Dad".

    I also sneak Leo a few crunchies every day. You never know if this will be his last month. We are taking the gift of his daily life with us and going with it. Leo and Little Dude's daily antics are so much fun. How did we get so lucky? Our sweet kitteh boys.....now picture time.
     

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  28. Magic Johnson

    Magic Johnson Member

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    Mar 2, 2018
    So adorable!!! Loved all the pics!

    Great to hear all of the updates in one place!
     
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  29. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Out of curiosity, was Leo seeing hypo symptoms at 50? Cats not on insulin can test in the 40's. We just don't like them to go there because it gives no room for margin of error. Neko often wouldn't show symptoms in the 30's, other than hunger. More than once I woke her up in the 30's. :eek: Having said that, some cats show hypo symptoms at higher numbers than others.

    Glad to hear Leo is enjoying life with a happier mouth.
     
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  30. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Thanks for the kudos.

    Leo was not showing any hypo symptoms in the Feb 2018 hypo. Theresa told me about the dosing, then we measured him and it was 50. To avoid going lower, we treated it like a hypo until he was 80 and rising.

    Leo's worst hypo was last year when he wasn't eating. He was 30 or 40. He was yowling in the morning and that resulted in an ER visit. That was a nightmare. Mostly because he had not been eating. The followup on that was the feeding tube, then the SCL diagnosis, and subsequent (permanent) medicine treatments. Leo had a tough time last year, but he's a trooper and he's doing real good now.

    I do not expect Leo's insulin demand to drop any further. It has been ~18 months since SRT. I just hope we don't get resurgence of the Acro. We have already decided that if Leo gets into another state where he needs a feeding tube, then we will let him cross. I hope that is 3 years from now.
     

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