2/10 Sid PMPS Hi & anemic

Hi everyone,

Yes, Sid is actually tolerating the IM shots better than he did SQ - kind of strange. So far anyway.
He has developed a bad case of diarrhea. So we made a vet visit today and I received some metronidazole - maybe that will help (I can put it in his tube with water so he doesn't have to taste it). I know pumpkin works too so maybe a bit of that will help also. the bad news is that they ran some blood work and his HCT is 19% - that's pretty anemic. :sad:
It might be the leukeran affecting him? They sent out a CBC and hopefully we will get the results tomorrow. I'm just concerned because this HCT value has progressively gotten worse since he's been hospitalized. I do have some linotonic I believe it is called. It is an iron supplement for cats. I did not yet ask about using that for him.

Karrie, I did receive the max cal today. It is Iams prescription canned food? I was thinking it would be liquid. Maybe I asked the vet to order the wrong product? Well, Sid ate about 1/3 of a can before his PMPS. He seemed to like it.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=63298

Hi guys .. sorry to hear sid has developed diarrhea and that he is now anemic .. when will you guys catch a break? :YMHUG: Just hang in there, things are sure to turn around for the better .. continued thoughts and prayers ..

Glad his new food has arrived. Isn't this the stuff you'll need to put through the tea strainer if it needs to go via his tube? I wouldn't have thought it would be liquid??

So glad he's taking his IM shots well too, it's seems that tolerance for IM is an ECID thing too and it does seem to be helping him along. Yuk on the PMPS though, come down Sid come down.

I don't know if it's the same for cats but for humans with an iron deficiency it is advisable to take Vit C at the same time as the iron to help with absorption. Maybe you can ask the vet about that when you ask about giving the linotonic - or maybe the linotonic already has Vit C in it?

Anemia is a possible side effect of Leukeran. You could also be dealing with anemia of chronic disease, or a GI bleed. Is the loose stool black coloured or tarry? ("Melena" is indicative of upper GI tract bleeding). Renal disease can also lead to anemia, but it is more likely that in Sid's case it is the drug or the GI situation. I believe that sucralfate can be given to protect the GI tract, if GI bleeding is suspected. If the anemia is due to the Leukeran, the Leukeran should be stopped, and the anemia should start improving after a couple of weeks.

They can check to see if the anemia is regenerative (Sid can make new red blood cells, but is losing them) or non-regenerative (Sid cannot make enough new red blood cells). The reticulocyte test for this may not be accurate unless there has been anemic for a while (PCV < 20 for over five days). An iron supplement may be of some use if there is regenerative anemia, but I would lean towards an iron dextran injection rather than an oral iron supplement, especially with Sid's delicate GI tract.

ETA: You should consider B12 (cyanocobalamin) injections if you are not already giving them.

This link discusses leukeran and anemia:

http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=19257&start=0

This site has good anemia info, though it leans more to anemia caused by renal disease:

http://www.felinecrf.org/anaemia.htm

Hey Lydia, Linda gives great advice in her post. I hope it will help you with Sid's issues. Many people here sprinkle FortiFlora on the food to help with the diarrhea.
http://www.purinaveterinarydiets.com/Product/FortiFloraCatNutritionalSupplements.aspx
It is a pro-biotic and good tasting. It will get those "good" intestinal bacteria to do their job. You can get it at your vet's, or through Amazon or any of the pet food online sites.

We are thinking of you and sending healing thoughts for your boy. He is so brave and has been through an awful lot. I'm glad that the IM shots are not a problem and that he is eating. Those bgs should be heading down soon. Come on, bgs, get down to a better level!!

Lots of hugs,

Ella & Rusty

I came looking for a Sid update. Glad he is hanging in there. I know nothing about anemia but you seem to have gotten good advice. The lymphoma group may have some input for you also.

No the MaxCal is a food but calorie per ml is the best you can buy. Blend it in a blender or Magic Bullet with enough warm water that it will go through the tube. Not too much water. And strain it. This will prevent the tube blocking. Warmed up food and water went through the seive much easier. I just kept banging it on the tupperware and spatulad the underside of the strainer and then rinsed the gritty bitts off and kept doing this until it was all strained. I would try and get a can of this into him a day if he will handle this - including a night feeding or two. It is very high in fat though.

Honestly I don't know if cats willingly eat this food. Its recommended a lot for anorexic cats recovering from liver failure - that need a lot of calories. Most are syringe or tube fed.

Goodness...sorry to hear there's more on your plate, Lydia-
though the more on Sid's dinner plate is encouraging
Sending vines, prayers, and healing energy for your tough little guy!

much love-

Celi, Binks, and the girls

Thank you for the continued good thoughts! I appreciate all of the advice. His bg is down already. At +3 it was 357.

Sid ate about 1/3 can at PMPS of the Max Cal. If I have to tube feed him, I will follow your advice, Karrie, and strain it well. But he seemed to like it or else he was really hungry. Typically he will want to eat again when he starts going low - usually about +4 or +5 and then I will offer him more.

I love fortiflora and have used it a lot for my cats. Unfortunately, Sid hates it and he will not touch any food it is sprinkled on so I mixed some with water and put it in his tube

An early blood test showed that Sid had nonregenerative anemia - that was before the leukeran and before his anemia got so low. When that test was done he was still around 30. I am anxious to know what the results tomorrow will show though I'm not sure the CBC tests the retriculytes. He is receiving b-12 injections weekly. Good point about getting him the iron supplement by injection. I will ask my vet about that.

I doubt my vet will recommend that but Vit C is safe for cats so I could give him some regardless of what my vet says - though I will mention it to him just in case. I honestly really resisted giving him the IM shots for the longest time (I could kick myself now!) because I didn't think it would make a difference and I thought it would be painful - but it is definitely making a difference and it doesn't seem to bother him. I think my vet was right that Sid is too thin and has so little body mass that he wasn't consistently absorbing insulin. It's so unfortunate I'm learning all of these lessons the hard way because I feel if I had know them early on - Sid would be doing much better.

I don't suppose it will make you feel any better but I think we're all learning a lot from your experiences here too.

Don't be hard on yourself; we can't know everything about our cats-heck, even our vets don't know EVERYTHING! You are doing an amazing job with Sid!

Does he have renal disease? Anemia due to renal disease is treatable with ESA's.

Linda, No actually he does not have renal disease. I just received about 25 pages of paper work from the specialist so I have all of his blood work. When he was first hospitalized, he had clinical kidney failure because his numbers were BUN 109 CREA 5.5 low potassium, etc. That was in late December. Now, his kidney values are completely normal. The staff at that hospital told me he probably had permanent kidney damage but so far he doesn't appear to. I give him fluids every day to keep him hydrated and hopefully avoid ketones.


(just as an aside, Sid was supposed to have a CBC check the second week after starting the leukeran. He was hospitalized then and they did not run a CBC!! They did 25 pages worth of bloodwork and couldn't run that test that he needed? It's my fault for relying on them to do what they were supposed to - I should have verified they were going to do it.)

Serryn, If Sid's experience helps save even 1 other cat or prevent DKA in another cat - then I am grateful. I know Sid is in pretty delicate health right now but I'm not giving up on him.

no advice, just checking in on sweet sid to see how he is today.

hindsight can be brutal - you did the best you could at that time. we know you enough to know you wouldn't do anything less! sid is lucky to have you! :YMHUG:

The day I took in Bk I found out he was FIV+ - the next day I found out he had FD. . .
Anyway, I read a book about taking care of FIV+ cats and this vitamin was recommended.
I give it to all my kitties.

just stopped by to check in on you & Sid, I am so sorry this is so hard but so glad to see you both hanging in there.

Tawny was anemic also when she was so sick along with everything else. She got B12 shots.

Lydia, every time I read your posts and think about what you & Sid are going thru my heart goes out to you both, it is so hard. Has Sid put on any weight? Tawny is up to 12 pounds. She was under 9 when she first got sick the first of November 2011.

Karrie is right about the straining. When I mixed Tawny's food for the etube I actually strained it 3 times (OCD). I used a fine mesh sieve with a handle. Each time I strained it I washed the gritty bits out of the strainer, and I was so surprised the first time to see some of those gritty bits after the 2nd strain that I just strained it a 3rd time to be safe, tho it probably wasn't necessary. I used glass canning jars to strain it into. I set 3 on the counter and strained it into one, rinsed the sieve, strained the mixture out of the 1st jar into the 2nd, rinsed the sieve, and strained the mixture out of the 2nd jar into the 3rd. Hopefully Sid will just eat on his own but it is really important to strain any food that goes down that tube.

You go girl. You too Sid.

We continue to send healing vines and wishes and prayers.

Desi & Tawny & Everybody Else

dropping by to say hello on this Caturday, Sid & Lydia

:YMHUG: