Shmee's Pituitary Gland Removal Surgery

Amanda & Shmee

Very Active Member
Hi everyone,

I have been meaning to put an update in this group.
My Shmee has acromegaly and we will be traveling to the Animal Medical Center in NYC August 27th to have the pituitary gland removal surgery. I found out that AMC has donor funds that will be covering the surgery (normally $16,000 - $20,000), so as scared as I am, I could not pass it up. We will be driving through the night Sunday the 26th from Cleveland. I am active in the Lantus forum, and this is my latest thread. If you are interested you can go back and read my last few threads where I talk about it more. After I talked to Dr. McCue at AMC for about an hour over the phone, I asked him questions via email as well. I am attaching those in case anyone is interested. :)
 

Attachments

So I have a dumb question about this - is Dr. McCue the one that is going to be doing the surgery?

The reason I’m confused is that in human medicine world, neurologists treat neurological conditions with medication, and neurosurgeons do the surgery. It took me a little bit to realize that veterinary medicine is not that specialized yet :smuggrin: although they have come a really long way with so many different specialists available.

Before I got Frosty, I never imagined that animals could pretty much undergo a lot of the same tests and medical procedures as human (such as SRT). SRT, which I believe we call “cyber knife” in humans? is considered a relatively new, more advanced type of radiation even for humans!

Very cool. Still a little sad I didn’t become a vet like I always wanted to when I was little. :cat: :bookworm:
 
Definitely watching this thread for updates.

Before I got Frosty, I never imagined that animals could pretty much undergo a lot of the same tests and medical procedures as human (such as SRT). SRT, which I believe we call “cyber knife” in humans? is considered a relatively new, more advanced type of radiation even for humans!
Cyberknife is also available for kitties. Yonkers was the first place to offer it. It's even more expensive that SRT! :eek:
 
All the best to you Amanda and Schmee. Titan is scheduled for the same surgery two days later in England. Thanks for sharing your correspondence; Dr Mc Cue sounds like a nice person, and the information is very interesting. Until this morning I thought they would just be taking a tiny tumour off the pituitary gland but it seems they take out the whole thing. We have been told we have to give eye-drops which is a bit of a worry....an injection would be much easier! Our email from the VET is here.
 
Thank you so much John and Irene for posting the RVC UK email. Please, Please followup with us to let us know how the operation goes. It will help future potential patients who come here.

I'm summarizing the RVC email here for future reference since google docs tend to disappear.

from RVC Feline Diabetes and Acromegalic Cat Clinic
  • Hypophysectomy will be done thru incision in roof of the cat's mouth
  • RVC hypophysectomy clinic running since 2012
  • 80 operations to date
  • 93% survival rate = 7% mortality rate (5 or 6 of the operated-cats died)
  • 65% of patients have full diabetes cure
  • typical 7 day hospital stay after operation
  • £ 6,000 pounds (cost) for typical surgery and hospitalization (very reasonable)
  • Post-op meds include oral steroid, thyroid hormones, vasopressin eyedrops, revised insulin dosage
  • Lifelong meds steroids and thyroid hormones
  • vasopressin supplementation can be discontinued in many cats after a few months
 
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Thanks for posting that email from Ruth Gostelow at RVC. I found her comments on the risks of surgery very interesting. Also the idea that the tumour can reproduce from a tiny piece left behind. Neko's tumour came back after her first SRT- makes me wonder if the beams didn't quite get all of it.
 
Thanks for posting that email from Ruth Gostelow at RVC. I found her comments on the risks of surgery very interesting. Also the idea that the tumour can reproduce from a tiny piece left behind. Neko's tumour came back after her first SRT- makes me wonder if the beams didn't quite get all of it.
Yes, dr. McCue told me the same thing about the Cushing’s tumor - tumor cells can be left behind and start secreting excess hormone again. He said recurrence rate at 5 years is 25-35% in dogs and humans. Not sure if RVC has statistics on recurrence in cats.
 
There will be a whole slew of alumnae from NYC soon. My Sophie will be having surgery the last week in September. Nice long conversation with Dr. McCue this evening - he mentioned about the possibility that some tumor cells can hide in the bone, etc. He also elaborated that they use a different approach than Dr. Owen in Washington. Dr. Owen uses a pilot hole technique to pin point where to find the pituitary. NYC uses MRIs and other advanced imaging to figure out where to go and what the size of the tumor is. The advantage is that they have an idea of how big it is as opposed to going in and relying on anatomical landmarks. That is why the cat spends a day sedated on Monday getting all the imaging done, and that gets analyzed before the actual surgery on Tuesday. The surgery takes anywhere from 2.5 to 6 hours, depending on how it goes, the size of the tumor, etc.
 
I am so sorry I don't come into this group as often as I should and I do not remember getting any notifications for this thread! I will have to check my notifications better!

So I have a dumb question about this - is Dr. McCue the one that is going to be doing the surgery?

The reason I’m confused is that in human medicine world, neurologists treat neurological conditions with medication, and neurosurgeons do the surgery. It took me a little bit to realize that veterinary medicine is not that specialized yet :smuggrin: although they have come a really long way with so many different specialists available.
I was under the impression that Dr. McCue performs the surgery, yes.

All the best to you Amanda and Schmee. Titan is scheduled for the same surgery two days later in England. Thanks for sharing your correspondence; Dr Mc Cue sounds like a nice person, and the information is very interesting. Until this morning I thought they would just be taking a tiny tumour off the pituitary gland but it seems they take out the whole thing. We have been told we have to give eye-drops which is a bit of a worry....an injection would be much easier! Our email from the VET is here.
Thank you so much for this, what a great resource. I will be saving this and looking it over later after work!
 
That is very exciting Sue. I hope the surgery for Sophie goes very well. I see from her spreadsheet that she is still unregulated:
https://docs.google.com/spreadsheet...CbDiiPwyo-v3tzox_Ek5T5eBQ/edit#gid=2110605851

Please post back here after the surgery. It will be real helpful for others following in your footsteps.

I have been having an awful time trying to get her regulated, even to bring her consistently into the 200s, without jumps into the 300s. Asked Dr. McCue about this, and he said to just keep on doing what I am doing, that eliminating the excess growth hormone should make a big difference. Her tumor might be in a growth phase, can't really tell until she is there and they do the scans.

Sophie is also insulin resistant. He didn't really think it was worth my while to go through all the fuss to trying to break that right now. Just keep her healthy and update him on any issues/changes.
 
Some cats do not regulate easily. Leo is an example. Even 2 years after SRT - barely regulated. With luck, most of Sophie's insulin issues will dissipate with the surgery.
 
Hi everyone good morning,
One week from NYC and just wanted to give an update. I spent all day yesterday going through my to-do list, shopping, organizing, and setting up his crate in the car. It took me a few times to get it "flat" with three layers of blankets and a layer of bubble wrap underneath. The more I think about it, I want to leave the litterbox on the outside of the crate on the floor because I really do not think he is going to use it while driving and it gives him more room (I actually was thinking about maybe putting a small cardboard box in there for him to hide in if he wants). Or at least leave it out for the first few hours, and then after our 30 minute break if he does not use the litterbox maybe I will put it in the crate then. This is my tentative schedule:
Google Maps shows the drive taking 7 hours and 20 minutes. Google also has a feature where you can pick the departure time, so I did that for a Sunday night into Monday morning. This added 1.5 hours. Dr. McCue also said to add three hours to that for Monday morning Manhattan traffic :blackeye:. So that brings us up to 11.5 hours, or leaving at 10:30pm (10am appointment). The travelling with diabetic kitties document said to allow ample time on breaks, so you can open the crate and let them walk around in the car (possibly outside, he has the harness and leash but I have not tried to put him on the leash yet. I think he might be more scared outside, he's not used to it). Anyway, I am planning two 30 minute breaks so that brings us up to leaving at 9:30pm. My vet also said Shmee can only have the Gabapentin every 12 hours....

- 6:30pm - Give Gabapentin (and PMPS food/shot)
- 8:30pm - Give a few drops of Rescue Remedy
- 9:15pm - spray Feliway in the car and crate
- 9:30pm - start journey
- Drive four hours until 1:30am, break until 2am. (open crate, test sugar, show him where the litterbox is/encourage litterbox use, give more RR with treats if he will eat them, see if he will eat any - he usually gets 1/2 can at 9:30 so he will be hungry by 1:30. I was thinking of leaving food in the crate but I really don't think he will eat it in there and it might be a mess. So I think he will be ok waiting until the break. If he is meowing a lot like he's hungry maybe I will stop for a break at 12:30 instead)
- Drive another four hours until 6, break until 6:30am. 6:30 should be his shot time, and 12 hours from the last Gaba dose so I will give him another Gaba. Although the doctor said he is not allowed to eat the morning of the MRI.... so I am lost here. He said he should also get a half dose shot. If this is the case, then maybe I will give him a very small amount of food for the Gaba and that is it. I really don't know if I should even give him a half shot...?

I am also nervous that we leaving way too early. Dr. McCue said to add on 3 hours for traffic, but Google has the feature that estimates traffic on its own and added on time like I explained above, so... is the extra three hours really necessary? I am mostly nervous about my 6am break. This will be 8 hours in... and Google Maps said it should only take 8.5 hours with traffic. So is waiting until 6:30am for a break cutting it too close to being in Manhattan? His shot is at 6:30 though.... so if I do give him a half shot it needs to be at that time unless I move up his times.
I was doing well yesterday getting everything ready, but last night when I was driving with the crate in the car it really hit me.... I really do not know how I am going to do this, I cannot imagine driving with him back there all that time and then leaving him a week at the hospital.... I am getting cold feet. He is SUPER attached to me, is not used to traveling/going outside at all, and sleeps with me every night (he's the little spoon). This is terrifying.

Things I have packed so far:
- Emergency hypo box - honey, oral syringes, a few cans of HC and LC food, (@LuvinThisPig @Wendy&Neko @JeffJ - did you strain the gravy on the road? If so that's fine I was just thinking I should probably do that beforehand, but then again it would have to go in the cooler then if its needed I know he won't eat it cold). HC treats, flashlight, Ziploc bags. I chose not to do an ER vet list because I wasn't sure what areas to look for, I think typing in emergency vet in Google Maps would be better to find a closest location at any given place? I know it could be hectic but I picture myself finding my paper then checking Google Maps anyway to be sure its the closest location.
- Spare blankets and towels
- Front seat bag: my snacks, his testing supplies, an old Spacekeeper (90's much?) lined with bubble wrap for his RR, Feliway, and Gabapentin, and the food/water Tupperware containers.
- Cleaner box: paper towels, multiple garbage bags and plastic grocery bags, Ziploc bags, baby wipes, Lysol wipes, dish soap, sponge, washcloth, small towels.
- Two large jugs of water for both of us
- Small cooler with his insulin; packing his vial wrapped in bubble wrap as well as a pen just in case. Both will then be put in a Tupperware and then put in the cooler with an ice pack.
- His food box: he usually gets 2.5 cans a day, packing 30 cans of LC with three different flavors. Not sure how many HC cans to bring... I'm thinking 15?
- Vet bag: catnip toy, tee shirts from DH and myself, his favorite blanket, a chasing toy that I'm sure he won't be in the mood for but bringing it just in case he wants to play when I visit, and all three of his brushes.
- Two jugs of kitty litter, scoop

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(I haven't put the top blanket layers over the pee pads on yet)

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This is on the passenger side (opening on my side). I thought he might like to explore the car on our breaks and I really don't think he will use the box in the crate so I might leave it here?

-hHhv_qET9k1BS4wk9U89TYl082STin09NbVuYAYLqlfvWkact-i_DLCRwTs49VvwiqNwJK65pmjCQNxP1mlBOXBE1sDJ9pZMHyvms0-5SIP-YjJE0rQjgW1n623lu4P1ECTPW1O

YTpo_mfC6do_kw1KMOhYTTb0qVb9bKLQceu1FUGvmuqcg4otqRNL7uDBrnOXWXMzpz__rRHfhu9mqLpCHwK_weFwgfEiqia8G1oLXciFSJKfqpJnUEUAgTTZN4ikMtWEfDCPL4V1


All advice / comments welcome please & thank you :bighug:
Last night I was honestly feeling very alone in all of this. I do not have many good friends, and the few I do have rarely ask about how this is going. I don't want to come off sounding bad about them either, I know everyone has their own things going on in their lives. We went to a party last night where there were a few people I haven't seen in a long time so we were talking and I explained the trip, I just feel like so many people probably they think I'm crazy.... I really don't care what others think but it still kind of hurts. I am so grateful for this group I want to cry.
 
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Big hugs Amanda.you are definitely not alone here. :bighug::bighug::bighug::bighug: anyone in their right mind would be scared to pieces and second guessing themselves. Just breathe through it. Schmee knows no different. He will get you thru it all. You are doing a great thing and are getting to take advantage of a great opportunity. I think it was brought to you for reasons unknown to you. Your doing a great job. Can't wait to hear about all the adventures. Just remember when you are feeling that loneliness creeping in, just come here!! We will help you through it too.:bighug::bighug::bighug::bighug::bighug:head bumps and scritches for Schmee.
 
You are ready.

A few things I did.
- kept Leo caged the whole time while moving, to keep him safe
- covered the whole "Leo area" underneath with plastic sheeting, in case of pee (consider this cheap insurance)
- first day of trip, stopped every 2 hours for 5 minutes to give Leo direct special attention

You are NOT alone. We are here for you. I felt a little bit alone too....well because I was driving alone. Everyone here is hoping that Shmee's surgery goes like clockwork. Theresa is following Shmee's progress thru me too. She loved the shaved cat-velvet belly pics.:bighug::bighug::bighug:

I have been in Manhattan (Tribeca, Soho) area during morning and evening rush hours several times this year. We are talking PARKING LOT. I don't know the exact hours, but the cars barely move. I was on foot, so the sidewalks were faster than the cars. You want to get there before the PARKING LOT effect occurs.

My Manhattan advice:
- know exactly where you are driving to, I would replay it in your mind
- know exactly where you are going to park, there is almost no street parking

Animal Medical Center in NYC - is in MidTown East. It will have the same traffic. Perhaps you could talk to the receptionist about morning traffic hours. I looked at the Google street pics of AMC on E.62nd. They have a parking garage on that entrance. I would double check to ensure you will get an assigned spot.
 
Thank you so much everyone, I appreciate the hugs and kind words. It means a lot to know you all are here.

@JeffJ thanks for the NYC advice, I am so nervous about it. The doctor said AMC is right off a major highway, so that is good at least. They also said they have their own parking lot so I would not have to worry about finding a parking spot. I unfortunately do not drink coffee, never liked it, so I am stocked up on Monster energy drinks. Something I hardly drink so I will have to be careful because they definitely give me the wide awake buzzed feeling. I do also have potato chips :) Kettle cooked salt & vinegar, my favorite!
 
A couple random things. First, relax, you got this! :bighug: This opportunity fell into your lap which I believe means good luck will follow you. I think you are incredibly brave and admire what you are doing for Shmee. Best mommabean ever!

OK, other comments, in no particular order. First, ditch the Lysol, toxic to cats. Next, I started out with the idea of keeping Neko in her carrier, but she was so upset we relented after crossing the border. We opened the kennel door. She stayed in the kennel most of the time, but much happier with the door open. I never let her outside the car except in the kennel. She mostly used the LB when we stopped, so letting him out at breaks may be the way to go. Pee pads in the carrier are excellent, in case he can't hold it. Bring laundry soap for whatever else you have in the carrier. Voice of experience there. :rolleyes:

I never strained the gravy, ever. Neko got the chunks too, the protein can help sustain their surf. You worry about overfeeding if you have a picky kitty or one that fills up. Never had that problem with my acro.

Except for her dental where the vet said it was OK, I never fed in the AM and did half shot. The exceptions being a fur shot, sigh! And one token dose when I didn't trust her AMPS and she proved me right by hitting 72 on their AT before anesthesia. The dental vet said I could feed up to 1/3 of food before 6 AM, which was 6 hours before anesthesia. I would do what the vet's suggests and expects. Lower dose OK if worried.

From your list, a couple cans HC should be more than enough. Don't forget the therapeutic chocolate for you.:bighug:
 
I just feel like so many people probably they think I'm crazy
Do you know how many times I have said this? In fact, when I was planning our trip and had to ask for so much vacation time from work, word got out and spread throughout my company and suddenly I was the laughing stock. :rolleyes: Oh, the judgement. However, I will say this, that I quickly learned that my real friends, the ones that knew me best, never even questioned the why. They all just questioned about Pig because they knew at the end of the day that was just who I was. Who cares what others think? If you allow their judgements to sway your decisions and anything bad were to happen to Shmee because of it, think what that would do to you? Naw. You just do you girl and f*** the rest. :smuggrin: Its right in your heart, so its right in reality. Follow that.

I am also nervous that we leaving way too early. Dr. McCue said to add on 3 hours for traffic,
I won't add to many things. You definitely have a good handle on it. What I will say is this, the most important thing I learned (and fast!) was that Pig could care less about all the stringent scheduling I devised.. o_O Our first day we had mapped out to the mile and minute from city to city. We had gas stations planned, snack breaks, and pee breaks. All of that went out the window. Immediately. All I am saying is, you will never have too much extra time. I even planned 3 extra days into our schedule incase something happened and had a backup appointment just in case as well. I ended up tacking 5 extra days over what I thought I would need. So, we used all those initial 3 extra days and added 2 more.

The most important thing, listen to what Shmee is telling you. He will let you know if he is tired or ready to be done with traveling. Allow for error without panic because none of the travel will go exactly according to plan. You will be working on Shmee's plan. Not yours. :D

- 6:30pm - Give Gabapentin (and PMPS food/shot)
I would try to give the Gaba last. I found it much easier on Pig if he had his Gaba and then we went in the car. This will ensure that the Gaba is effective for the maximum amount of car time. Its sedative effects do not last the full 12 hours. Typically, Pig will shed his sleepies about 2-3 hours after a sedative dose, but remain more relaxed. This wears off the longer after the Gaba has been given.

I just gave gravy and all with the FF gravy lovers. You will want some form of protein to hold the increase as the gravy, alone, will not do it. You will end up giving FF several times! Well, that is how Pig works anyways! :p Here is to hoping you will not have to use it.

I gave a half shot on the morning of the CScan and wish I had not. He was pretty low when we came out - eating a ton of foods. I did not shoot the morning of the procedure. With numbers like Shmee... I would not give the shot, but ask someone more knowledgeable about that. @Wendy&Neko would know for sure...
 
word got out and spread throughout my company and suddenly I was the laughing stock.
That is really too bad, because Sarah you are one of the Cat Mom Goddesses!
Wendy is a Cat Grandmother Goddess, twice over for the two SRTs!
And soon Amanda will also be a Cat Mom Goddess!
So that makes me a Cat Grandpa Caregiver.

At our company, when I took Leo for SRT in 2016, many co-workers including my manager gave me best wishes and asked everyday how it was going. Some good people there.
 
I’d like to address the question about leaving early. I went to a concert in NYC on Thursday night and the navigation will take 1.25 hours with traffic, and it took 2.5. The total distance was like 40 miles too... And this was at night and technically I was going against traffic bc most people were leaving the city by then. So having said that, I would definitely err more on the side of more time rather than less. NYC traffic is only second to LA traffic, from what I understand. I would rather you take an extra break or wait in the waiting room, rather than stress and feel rushed, especially in NYC. Not a fun place to drive.

As for gabapentin, I wouldn’t give it to him at 6:30 am, bc I wouldn’t feed him anything if he’s gettjng general anesthesia that day. I’m in a similar boat with Frosty - he can’t eat or drink the morning of his abdominal ultrasound bc he will need anesthesia, and it really sucks but I can’t give him the gabapentin and will unfortunately have to drive an hour to the vet with him screaming and peeing everywhere lol. But I think it’s better than the alternative which is risking him vomiting while he’s sedated. Not worth it in the long run.

I definitely understand the alone feeling. I talk about Frosty to anyone who will listen, and most people I know don’t like cats or just think I’m out of my mind, but whatever! They’re the ones missing out if you ask me...

I wish we weren’t away during your trip so we could meet for coffee or something while you’re in the area. While I probably won’t be coming online during my week away, Frosty and I wish you guys all the best and we have our paws and tails crossed for ya!!! You are amazing and strong for doing this. I can’t wait to come back on and read all about it.

:bighug::bighug::bighug::bighug::bighug:
 
- covered the whole "Leo area" underneath with plastic sheeting, in case of pee (consider this cheap insurance)
Thanks I forgot about this. I just got back from Walmart with some plastic tarping stuff used for painting. I will use that. Shmee is OBSESSED with plastic though, he doesn't just like chewing it, he will sniff it out and eat it. So I will put it on the bottom and try to make sure the blankets on top cover it nicely. We will see how that goes. Lol. I'm thinking it might make the plastic noise and he will find it, but hopefully not.

Except for her dental where the vet said it was OK, I never fed in the AM and did half shot. The exceptions being a fur shot, sigh! And one token dose when I didn't trust her AMPS and she proved me right by hitting 72 on their AT before anesthesia. The dental vet said I could feed up to 1/3 of food before 6 AM, which was 6 hours before anesthesia. I would do what the vet's suggests and expects. Lower dose OK if worried.
Lysol has been removed!
I am a little confused. Since he's not eating in the morning you think a no shot is a better option than a half shot? Sarah said she regrets giving Pig the half shot the morning of the cscan, and I think I will do. It makes me nervous since the doctor doesn't want him eating in the morning and I really don't know how long the MRI is going to last / when the next time he will be able to eat is.

That is really too bad, because Sarah you are one of the Cat Mom Goddesses!
I agree, don't people remember what their moms told them, be nice or don't say anything at all! I am glad your work was supportive Jeff.

Do you know how many times I have said this? In fact, when I was planning our trip and had to ask for so much vacation time from work, word got out and spread throughout my company and suddenly I was the laughing stock. :rolleyes: Oh, the judgement. However, I will say this, that I quickly learned that my real friends, the ones that knew me best, never even questioned the why. They all just questioned about Pig because they knew at the end of the day that was just who I was. Who cares what others think? If you allow their judgements to sway your decisions and anything bad were to happen to Shmee because of it, think what that would do to you? Naw. You just do you girl and f*** the rest. :smuggrin: Its right in your heart, so its right in reality. Follow that.

I won't add to many things. You definitely have a good handle on it. What I will say is this, the most important thing I learned (and fast!) was that Pig could care less about all the stringent scheduling I devised.. o_O Our first day we had mapped out to the mile and minute from city to city. We had gas stations planned, snack breaks, and pee breaks. All of that went out the window. Immediately. All I am saying is, you will never have too much extra time. I even planned 3 extra days into our schedule incase something happened and had a backup appointment just in case as well. I ended up tacking 5 extra days over what I thought I would need. So, we used all those initial 3 extra days and added 2 more.

The most important thing, listen to what Shmee is telling you. He will let you know if he is tired or ready to be done with traveling. Allow for error without panic because none of the travel will go exactly according to plan. You will be working on Shmee's plan. Not yours. :D

I would try to give the Gaba last. I found it much easier on Pig if he had his Gaba and then we went in the car. This will ensure that the Gaba is effective for the maximum amount of car time. Its sedative effects do not last the full 12 hours. Typically, Pig will shed his sleepies about 2-3 hours after a sedative dose, but remain more relaxed. This wears off the longer after the Gaba has been given.

I just gave gravy and all with the FF gravy lovers. You will want some form of protein to hold the increase as the gravy, alone, will not do it. You will end up giving FF several times! Well, that is how Pig works anyways! :p Here is to hoping you will not have to use it.

I gave a half shot on the morning of the CScan and wish I had not. He was pretty low when we came out - eating a ton of foods. I did not shoot the morning of the procedure. With numbers like Shmee... I would not give the shot, but ask someone more knowledgeable about that. @Wendy&Neko would know for sure...
I am sorry you had to go through that. No matter what anyone says we know we would do anything for our kitties because they are members of our family, so boo to the haters.
I will keep that in mind about the schedule for sure, thank you. I know it is better to arrive too early than too late, so I will stick with 9:30 to be safe.
And as for the Gaba - that was my original plan, to give it to him right before we were going to leave, but since I am only allowed to give it to him every 12 hours I thought I should give it to him early so I can give it to him again early morning, so by the time we hit the NYC traffic he should be in the beginning/middle of his Gaba dose and not the end / it wearing off. I hope that makes sense? I am most worried about the morning, so I want to be sure the Gaba is in his system and active, not at the end of its cycle.
In the beginning I would give him the chunks too, but he always ate around them :rolleyes: so I made a comment about that on here and I think it was Chris that said to strain it to get the gravy because her kitty was picky like that too.

I’d like to address the question about leaving early. I went to a concert in NYC on Thursday night and the navigation will take 1.25 hours with traffic, and it took 2.5. The total distance was like 40 miles too... And this was at night and technically I was going against traffic bc most people were leaving the city by then. So having said that, I would definitely err more on the side of more time rather than less. NYC traffic is only second to LA traffic, from what I understand. I would rather you take an extra break or wait in the waiting room, rather than stress and feel rushed, especially in NYC. Not a fun place to drive.

As for gabapentin, I wouldn’t give it to him at 6:30 am, bc I wouldn’t feed him anything if he’s getting general anesthesia that day. I’m in a similar boat with Frosty - he can’t eat or drink the morning of his abdominal ultrasound bc he will need anesthesia, and it really sucks but I can’t give him the gabapentin and will unfortunately have to drive an hour to the vet with him screaming and peeing everywhere lol. But I think it’s better than the alternative which is risking him vomiting while he’s sedated. Not worth it in the long run.

I definitely understand the alone feeling. I talk about Frosty to anyone who will listen, and most people I know don’t like cats or just think I’m out of my mind, but whatever! They’re the ones missing out if you ask me...

I wish we weren’t away during your trip so we could meet for coffee or something while you’re in the area. While I probably won’t be coming online during my week away, Frosty and I wish you guys all the best and we have our paws and tails crossed for ya!!! You are amazing and strong for doing this. I can’t wait to come back on and read all about it.

:bighug::bighug::bighug::bighug::bighug:
I cannot imagine not giving him the Gaba in the morning. He will be terrified both in traffic and at the vet, and I do not want to do that to him. I will ask the doctor about that. I have oral syringes so if I really cannot give him a little food I can do that? I think this could be an option for you too? I know the pill is huge and I cant imagine doing it but I would rather do that then him being terrified in the car and at the vet.
I loved this - "They’re the ones missing out if you ask me..." so true. :bighug:
Thank you so much for the good wishes. Jeff J is actually going to be in the area for work coincidentally so we may meet up :)
 
I’m not familiar with oral syringes - you can give a pill with that?

As for the insulin, in my case, Frosty is also on a lower dose (relative to some Acro cats). He’s getting 2.25 units right now, so I would give him 1. But he also won’t be getting his Vetoryl that morning either, so I expect him to run hig. Anyway, that’s just my personal stance on that. Frosty also tends to run really high with his sugars regardless of insulin LOL, so we have a little leeway.
 
And as for the Gaba - that was my original plan, to give it to him right before we were going to leave, but since I am only allowed to give it to him every 12 hours I thought I should give it to him early so I can give it to him again early morning, so by the time we hit the NYC traffic he should be in the beginning/middle of his Gaba dose and not the end / it wearing off. I hope that makes sense? I am most worried about the morning, so I want to be sure the Gaba is in his system and active, not at the end of its cycle.
Yes. That makes sense. Who knows, Shmee may surprise you and totally chill out in the car after an hour or so. The larger kennel will certainly help, but I will second Wendy here that keeping it shut all the time was counter productive for us. Pig got anxious. He wanted out. But, Pig is used to travel. He has done so his whole life, so he's a dash cat. Has to see everything. Shmee maybe will be to after this trip!

Good job accounting for his anxiety in traffic. That will help you be calm as well and having someone along for the ride is a definite bonus.
:p:bighug::bighug::bighug:
I like your harness color. I got Pig a pink one for visibility. The idea was that no one was to open the car door unless we saw the harness and leash on him and the carrier locked.

Your gonna be great, Amanda. It's nerve-wracking now but you really are doing a phenomenal job! :bighug::bighug::bighug:. I am so proud of you for making this decision and sticking with it. Your are simply amazing!!
 
I’m not familiar with oral syringes - you can give a pill with that?

As for the insulin, in my case, Frosty is also on a lower dose (relative to some Acro cats). He’s getting 2.25 units right now, so I would give him 1. But he also won’t be getting his Vetoryl that morning either, so I expect him to run hig. Anyway, that’s just my personal stance on that. Frosty also tends to run really high with his sugars regardless of insulin LOL, so we have a little leeway.
Yes oral syringes are just for water (or honey), and they are free at Walmart pharmacies (I assume any pharmacy?). Tracey & Jones suggested it for me one time because I had to give him appetite stimulants and he hates the pills. Filling up the syringe with water helps "wash it down". She said to not spray it directly into the back of the throat, but rather off to the side and gently push so it trickles down. @LuvinThisPig @Wendy&Neko @JeffJ do you know if Gaba can be given orally or does it need to be with food? I can ask my vet. I also just thought - I wonder if the hospital is going to give him Gaba every day.... I kind of hope so depending on if that is safe? I assume so because lots of kitties are on it daily. I will have to be sure I have enough pills if that is the case.

Yes. That makes sense. Who knows, Shmee may surprise you and totally chill out in the car after an hour or so. The larger kennel will certainly help, but I will second Wendy here that keeping it shut all the time was counter productive for us. Pig got anxious. He wanted out. But, Pig is used to travel. He has done so his whole life, so he's a dash cat. Has to see everything. Shmee maybe will be to after this trip!

Good job accounting for his anxiety in traffic. That will help you be calm as well and having someone along for the ride is a definite bonus.
:p:bighug::bighug::bighug:
I like your harness color. I got Pig a pink one for visibility. The idea was that no one was to open the car door unless we saw the harness and leash on him and the carrier locked.

Your gonna be great, Amanda. It's nerve-wracking now but you really are doing a phenomenal job! :bighug::bighug::bighug:. I am so proud of you for making this decision and sticking with it. Your are simply amazing!!
I would love to let him out of the car, but I am super nervous he would come by me on the highway or go down by my feet. He is rarely out of the house, except the 5 minute vet visits where he is crying the whole time, lol. I wish I had someone with me so I can take him out and hold him... or at least be sure he doesn't go by the driver. But since I am the driver it makes me nervous.
I got a bright color on purpose too, since we are driving at night and he is black like Pig I think you are right and it will help a lot. Speaking of the harness I forgot - he has been doing well in it, I had him in it for a few hours today, but he will not eat in it. I started to freak out earlier because his appetite has not been the greatest lately, and for his PMPS meal he would not eat at all. I opened three different flavors he normally will eventually eat, and nothing. Finally I was like oh! You have never eaten in your harness before. Took it off, and he ate. :rolleyes: So that will be a challenge because I know he should have it on at all times for safety. Maybe I will take it off while he eats only as long as all doors and windows are shut.
Thank you so much for everything, you and everyone have been so helpful.
 
but he will not eat in it.
You know, some acro kitties can have enlarged organs. I noticed, with Pig's harness, it put pressure on his abdomen in uncomfortable ways when he laid jauj right. Maybe this is why he does not want to eat in it. Or he could just be being a cat .. :smuggrin:

I didn't leave the harness on Pig the whole time. Only when we were outside of the car and hotel rooms. If I knew all doors were locked then I removed the harness. It's a bit different since you will be by yourself, so probably better that he adjust to it being on all the time. He will.
 
You know, some acro kitties can have enlarged organs. I noticed, with Pig's harness, it put pressure on his abdomen in uncomfortable ways when he laid jauj right. Maybe this is why he does not want to eat in it. Or he could just be being a cat .. :smuggrin:
Ohh, poor guy. When Shmee had x-rays in the beginning when he wasn't eating my vet said his liver was slightly enlarged. Interesting.
 
I just asked my vet what she thinks about giving him Gaba every day at the vet, and about the food/shot situation the morning of. I assume Gaba every day should be fine since a lot of cats are on it for pain, but I am not sure. I asked her if it could be given orally too if he cant eat.
 
Ohh, poor guy. When Shmee had x-rays in the beginning when he wasn't eating my vet said his liver was slightly enlarged. Interesting.
Organomegaly. The enlargement of some particular internal organs. I have heard that it is fairly common in our Acro kitties, but I have also heard not so much. Jury is still out on this one, but it does happen. Its that wacky GH at it again... :rolleyes: (41777777777777777777777777777777777000000) <------- Tail said hi. :)
 
I just asked my vet what she thinks about giving him Gaba every day at the vet, and about the food/shot situation the morning of. I assume Gaba every day should be fine since a lot of cats are on it for pain, but I am not sure. I asked her if it could be given orally too if he cant eat.
They are gonna give him pain medication after surgery, which will also help with anxiety, that’s what Dr McCue told me when we spoke on the phone.

Also, did he respond to you about the subsequent MRIs? Will u guys have to come back or are you exempt since you live so far? Just wondering.
 
Pig gets 50mg Gaba BID, everyday. I have never given on an empty tummy. I try to avoid that with any meds. I am fairly certain Gaba can be pilled. It all depends on if Shmee's tummy can handle it. ECID.
 
Organomegaly. The enlargement of some particular internal organs. I have heard that it is fairly common in our Acro kitties, but I have also heard not so much. Jury is still out on this one, but it does happen. Its that wacky GH at it again... :rolleyes: (41777777777777777777777777777777777000000) <------- Tail said hi. :)
Interesting.
Haha hi Tail!

They are gonna give him pain medication after surgery, which will also help with anxiety, that’s what Dr McCue told me when we spoke on the phone.

Also, did he respond to you about the subsequent MRIs? Will u guys have to come back or are you exempt since you live so far? Just wondering.
Oh yes I forgot to update you on this! Yes he did, he said the follow up MRIs are not required, but recommended. If I had the money I would definitely do this because I would be VERY curious. Maybe I will save up for it and do one a few years down the line.


PS here is another cat velvet photo of Shmee just now, just because :) @JeffJ show Theresa :)
39500567_321883688212709_3495726684542337024_n.jpg
 
That’s great! Sorry for the confusion. I hope he didn’t mind that we discussed it and compared notes, haha. That’s good to know that it’s not mandatory, because it definitely was a big downside on my pros and cons list as well. Maybe one MRI post op, but idk about 4... that’s a lot of anesthesia,
 
Wow, you've really put a lot of time into planning, but, then again, you have a much longer drive than me. I like the carrier that you have gotten for Shmee. What kind is this? I don't think the regular carrier I have will do for Sophie having to travel for 6 hours. I'm lucky with her as she is fine on the leash, outside. I was thinking I'd take her for some drives, after I get the vet to prescript something for her travel anxiety, and see how she does for 2 hours in the car a couple of times. If that works out, she will be fine for me to travel to NYC.
 
I am a little confused. Since he's not eating in the morning you think a no shot is a better option than a half shot? Sarah said she regrets giving Pig the half shot the morning of the cscan, and I think I will do. It makes me nervous since the doctor doesn't want him eating in the morning and I really don't know how long the MRI is going to last / when the next time he will be able to eat is.
Not all insulin is used in the body to counter the carbs in food. It has other uses in the body. You will almost always hear vets say it's OK to give a 1/2 dose in the morning. In my experience it was. Otherwise they could be sky high at night, especially with the stress. The only time I did not, I was execting Neko to dive that day. I knew her patterns well enough that I thought she was close to asking for a reduction. The staff should be closely monitoring his blood sugar. I always asked for any BG checks done at the vet. That said, if he gives you a number in the AM that would make you nervous even at home, reduce even further, or skip. Or if he's been running in lower numbers than you'd like on the dose, reduce a few cycles away from your trip. Better he run a little higher than you having to worry about blood sugar during the trip on top of everything else. The reducing ahead of time is to drain the depot.

Do take his regular food in for the vet to give him when it's OK for him to eat after anesthesia. Neko's CT scan - different procedure but similar scanning goals, she was out less than an hour. Again, you can always ask before hand.
 
That’s great! Sorry for the confusion. I hope he didn’t mind that we discussed it and compared notes, haha. That’s good to know that it’s not mandatory, because it definitely was a big downside on my pros and cons list as well. Maybe one MRI post op, but idk about 4... that’s a lot of anesthesia,
Oh no don’t be sorry! It’s information we can all use. They definitely want the information, so it’s highly recommended. I’m sure he doesn’t mind, I would hope they want as much info out there as possible.

Theresa loved that new "cat velvet" picture. I hope you rubbed it for us too!
View attachment 38312
O my gosh this is too cute! I have to show Steve in the morning. Although I don’t want Shmee to be healthier than any other cat.... I wish they could all be equally healthy :(

Wow, you've really put a lot of time into planning, but, then again, you have a much longer drive than me. I like the carrier that you have gotten for Shmee. What kind is this? I don't think the regular carrier I have will do for Sophie having to travel for 6 hours. I'm lucky with her as she is fine on the leash, outside. I was thinking I'd take her for some drives, after I get the vet to prescript something for her travel anxiety, and see how she does for 2 hours in the car a couple of times. If that works out, she will be fine for me to travel to NYC.
I followed Sarah’s lead and watched her YouTube blog video about the setup she had for Pig :) she got hers off Chewy.com. I found one that was a little cheaper on amazon. Has 4/5 stars, most of the bad reviews I read were because of big dogs so I figured what the heck, I’m a bargain Betty. Haha. And I really don’t see us using it much after this trip. Here is the link: https://www.amazon.com/dp/B016XU65TK/ref=cm_sw_r_cp_api_.yIEBbJ5Z64GQ
And yes practice runs are a great idea! I wish I would’ve had time to do that today. He’s actually going to the vet tomorrow for the microchipping so that will be his first time in it. It’s only five minutes away though.. haha.

Not all insulin is used in the body to counter the carbs in food. It has other uses in the body. You will almost always hear vets say it's OK to give a 1/2 dose in the morning. In my experience it was. Otherwise they could be sky high at night, especially with the stress. The only time I did not, I was execting Neko to dive that day. I knew her patterns well enough that I thought she was close to asking for a reduction. The staff should be closely monitoring his blood sugar. I always asked for any BG checks done at the vet. That said, if he gives you a number in the AM that would make you nervous even at home, reduce even further, or skip. Or if he's been running in lower numbers than you'd like on the dose, reduce a few cycles away from your trip. Better he run a little higher than you having to worry about blood sugar during the trip on top of everything else. The reducing ahead of time is to drain the depot.

Do take his regular food in for the vet to give him when it's OK for him to eat after anesthesia. Neko's CT scan - different procedure but similar scanning goals, she was out less than an hour. Again, you can always ask before hand.
Ok thank you for explaining. I will think about this and I am going to write it down too, to help me remember come that Monday morning. It makes sense, he’s probably going to be high anyway from the stress and even higher at the vet, but we will see. And side note - I asked the vet about testing him throughout the week and he didn’t really answer. But I don’t know if I was very clear, I’ll have to go back and look. I’m very curious because someone posted a photo from the RVC in the facebook acro group of what they do there - you’ve probably seen it? It’s a circular device that attaches to their body and tests their sugar....? It’s so modern. I wondered if we have that technology here yet. I assume they aren’t going to be pricking his ear like I do... I’m not sure. Which makes me think twice about how you said to reduce his dose beforehand, to drain the depot a little. I like that idea. Especially because I don’t kbkw how often they are going to be testing him.... ugh gives me so much anxiety. Shmee just got down to 69 at 10:30pm. This hospital is open 24 hours but I doubt someone’s going to be checking his sugar as often as I do... so it definitely needs reduced beforehand.
 
Another reason for a reduction before hand, sounds like many of the surgery kitties go off insulin or greatly reduced dose quite quickly. Getting rid of the depot is a good thing. I'm sure most of the kitties they operate on are not as regulated as Shmee and probably run higher.

Yes, I have seen the continous monitoring device. Looks pretty cool.
 
Just catching up after being away for a few days ... can’t believe the surgery is almost here. You are doing amazing. I would be a nervous wreck as well. Will be sending positive thoughts and prayers your way! Come on Schmee ... you’ve got this!:bighug:

And ... many of my own family never understood why I would change plans or rush home from a party to take care of Gizmo, but I just felt bad for them that never never had such an amazing bond with their animals. ;)
 
Latest email and response from Dr. McCue:

Hello, My vet said he is only allowed to have the Gabapentin once every 12 hours, so I was planning on giving him it at 6:30pm the night before and 6:30am Monday morning, to be sure he is drowsy for the traffic and the hospital. Is he allowed to have a tablespoon of food or so for the Gaba in the morning, or none at all? If he isn't allowed to have any I wonder if I can give him the pill with water / an oral syringe. Its a large pill so that scared me that it would get stuck, he has gagged on very small pills before, so this is my last option.
I'm also a little hesitant on giving him a half shot now in the morning if he's not going to be eating and I'm not sure what time he will be able to eat again. The last thing I want are his numbers going too low, so I might do no shot in the morning if you think that's ok?
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Hello, Gabapentin can be given every 8 hours if needed. However if it works to help him be calm every 12 hours then stick with that. He can have a small amount of food to take his Gabapentin. This is OK.
We will be placing an intravenous catheter and monitoring his blood glucose so a dangerous decrease should not happen.
As long as he has been feeling OK with stable blood glucose levels you can skip his insulin altogether that morning.

---
Ok thanks. Will the intravenous catheter be in the whole time or just while he is out of it in the beginning? I really don't want to traumatize him... :( Will I be able to hold him when I come visit with the catheter in?
How do you monitor his blood sugar? I use a human meter, but I assume this isn't the procedure. I have seen a circular device used / inserted into their body to monitor blood sugar at the RVC, I didn't know of the US has that technology yet.


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I feel like every new I hear I just feel worse and worse. I want him to get better but I do not want to traumatize him. He is such a scardy cat already, hates the vet, going to be there a week, and now he has to have a catheter?! I assume because he will be too medicated to use the litterbox.... oh my poor guy. All I have been doing is crying today.
 
((((Hugs)))) Girl! You are making a wise and educated decision in the face of emotions. That is NOT an easy thing to do. With that being said, that fear will always be there. Overcome it. You got this. :bighug::bighug::bighug:

Cats do get traumatized and yes, some hold those past memories. But, a kitties memory works in a strange way. It works by association. This is how Tail went through so many bad things, but knows nothing of it until something reminds him. The likely hood that Shmee will associate anything in your home with the hospital is minimal. Different smells, sounds, ect..

The Gaba will help a lot. Chances are he won't even notice the catheter. All that means is he will have an IV. Easy to put in and easy to take out. Once they have it placed he will be alright. Search YouTube.. often kitties get them while wide awake.

The best thing you can do you are already doing. Being there by his side the whole time is what he needs. He WILL remember you and it's you that makes him feel safe. Your presence should fend off the worst of it. Just hold that boy tight!
 
Kittehs get over trauma real fast. They live in the moment. After Shmee is back home , he will probably forget the whole thing after a week.

Anyhow, that's what happened to Leo. How do I know? I just asked him.

LD and Leo getting over trauma.JPG
 
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