4/18 Leoberry - general health 5/10 (pictures)

Discussion in 'Lantus / Levemir / Biosimilars' started by JeffJ, Apr 19, 2019.

  1. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    previous thread - link here

    Leoberry is not doing very well.
    In general I would rate his health at 5/10.
    - his general appetite loss in January has continued, resulting in more frequent hypos
    - significant weight loss
    > Jan 2019 - 15.5 pounds
    > April 18, 2019 - 13.5 pounds
    - he has almost no body fat, and no muscle/fat along his backbone:(

    We stopped chemo (for small cell lymphoma) in January. He wasn't eating. the chemo was making it worse. Since January 1, he is getting fed about every 2 hours, except 1am-5am.

    I guess I was in denial until I weighed him tonight. We are hoping he makes it to his 13th birthday (June 19).

    He is still getting around. He still hangs out with Little Dude. But he appears weaker and retreats quickly to his bed on the kitchen floor.

    He is responsive to mirtazipine, and he will be getting it more often. He will also be getting gravy food. I will make his last days or months as enjoyable as possible. Our sweet Leoberry.

    tags: @LuvinThisPig
    adding link to previous update
    Leo and Dad - special laptime in backyard 03-04-2019c.jpg
    Leo and LD 04-18-2019c.jpg
    LD and Dad 03-27-2019c.jpg
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    I am sorry Leo seems to be declining. How frequently had you been giving the chemo? I found it made a huge difference going from the every other day protocol to every two weeks. A couple rough days then over a week of good appetite. Like you, I gave a little bit higher carbs, when her appetite was off.

    Looks like Leo did not like that dose increase. :eek:

    Managing multiple conditions is tough. :bighug: I hope Leo rallies a bit and makes it to his next birthday. And gives you lots more good memories and pictures of good times.
     
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  3. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Sending prayers. :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
     
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  4. Olive & Paula

    Olive & Paula Well-Known Member

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  5. Kris & Teasel

    Kris & Teasel Well-Known Member

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  6. Ti-Mousse (GA) Pepe (GA)

    Ti-Mousse (GA) Pepe (GA) Well-Known Member

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  7. JeffJ

    JeffJ Well-Known Member

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    Thanks everyone. For the chemo, I'll see what the vet says. Leo has a health checkup on Monday with a full blood CBC test.

    The last time he was feeling down, there were two small infections in his front elbows. So he went on antibiotics and that improved his appetite and general health.

    The hypo from last night lasted until 4am. I am toast.
     
  8. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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    Love,Light and Healing your handsome little man and love ones:bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug:
     
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  9. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

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    I'm curious. When you say "Hypo" do you mean he was showing signs like loss of consciousness or shivering? My cat has dropped into the 30's I just gave him 12% carbs & he was fine. His BG came up in 30 mins.
    (he didn't show any signs of hypo)
    Sorry to hear he isn't feeling well. Maybe what Wendy said would work. Give him the chemo every 2 weeks? It's worth a try:)

    Such a sweet photo of him with his brother :) I sure hope he hangs in there as long as possible!
    I give my cats CBD oil when they go off their food. The only side effect? It's makes them Hungry!
    Blanket of LOVE.jpg
     
    Last edited: Apr 19, 2019
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  10. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    Hi Jeff,
    I'm so sorry to hear that Leo is in decline. It is so difficult to see our kitties get thinner and thinner. Rusty was down to 6 lbs when he passed (he had weighed as much as 17-18 lbs). I hope Leo will have many good days with his wonderful Papabean and his brother LD. Those are lovely pictures.
    :bighug::bighug::bighug:
     
  11. Susan&Felix(GA)

    Susan&Felix(GA) Well-Known Member

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    Vines for sweet Leo to feel good, to enjoy his food, and to have many, many more lovin's with his family.
     
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  12. Sharon14

    Sharon14 Well-Known Member

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    Jeff I’m so sorry to read this. Vines for Leo and :bighug::bighug:for you and Theresa.
     
  13. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Jeff I am sorry your boy is not doing well. I hope there is a miracle and he is here till his birthday. :bighug::bighug::bighug:
     
  14. Idjit's mom

    Idjit's mom Well-Known Member

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    Oh Jeff, love the pictures so much. Every moment with Leoberry is so precious, you are such a good dad. You and Theresa have provided more peace, love and years than he might have received from anyone else. Hugs, loves and comfort to all in your home.
     
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  15. JeffJ

    JeffJ Well-Known Member

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    A hypo = hypoglycemia. If their Blood Glucose (BG) goes under the standard, then the kitteh is experiencing hypoglycemia. I use AlphaTrak, so the value is 68. Many here use human meters, and the hypo cutover is 50.

    You are using Relion Prime for Ravan, so Ravan's cutover is 50. Anytime Ravan is under 50, and lime green, then that is hypoglycemia.
    49 is probably fine
    36 is pretty low
    0 is death (literally) - there is no usable glucose at the cellular level, and cells in the body and brain die

    Many kittehs do not show symptoms until they go real low - such as in the 20's.

    Anyhow, in general, you are doing a great job with regulating Ravan. I wish Leo had been stable like that - anytime in the past 4 years.
     
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  16. JeffJ

    JeffJ Well-Known Member

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    Thanks everyone for the additional healing vines. Leo had a moderate day today, but he needs to improve.

    I work from home. I tried to take a nap at 11:30am (I was up until 4am last night with Leo). I kept thinking "Jeez, I wish I could fall asleep". Next thing I looked and it was 2pm.

    @Ella & Rusty & Stu(GA) - That is interesting Rusty got down to 6 pounds. He was a big beautiful boy.

    I'll tell Theresa there is some hope at these lower weight levels. Maybe we are just used to seeing Leo chubby. I wish our kittehs could live forever. It's so hard to lose them. We had Leo since he was a baby in 2006. It seems just like yesterday...
    Leo - baby 2006.jpg
     
  17. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

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    Thank YOU! I spend many sleepless nights but I truly do LOVE my kitties. Right now Ravan isn't doing very well. He has a UTI & high blood pressure on top of everything else!
    I'm one of those people that do NOT like to give Pharmaceuticals. But I'll do whatever is necessary to help my boy.

    Keep positive thoughts about Leo. Years ago I was told my kitty was in total kidney failure They said she wouldn't last a month. I started giving her a few drops of a herbal formula for her kidneys. She lived 6 more years to age 22! :)

    Her vet was amazed! Our animals are much stronger than we know.

    Just saw Leo's Baby Photo. So cute. I get very emotional. Got me crying!

    I hope he has more time with his loving family :):bighug:

    Positive.jpg
     
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  18. nslade001

    nslade001 Well-Known Member

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    Thinking of you with love :bighug:
     
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  19. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Leo and Chinus both - were the best kitties. Both grew up and became the best adult kittehs ever.

    And for us, money is not the issue either. That's why we did the SRT for Leo's Acromegaly in 2016 (it was $6k or $7k).

    We know Leo had (or has) small cell lymphoma. So that really is our worry. I'll tell Theresa your kitteh lived to age 22. That is a great success story.
     
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  20. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    Me too Jeff.
    My thought for Leo is to be in a pain free, loving space... and I believe you are making sure this is to be :bighug:.
    You two are in my prayers tonight... and tomorrow, and-
     
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  21. Bronx's dad (GA)

    Bronx's dad (GA) Well-Known Member

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    So sorry to hear Leo is not doing well Jeff.

    My prayers and thoughts are with you and Leo :bighug::bighug::bighug::bighug:
     
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  22. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

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  23. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Another day of Leo hardly eating, and living in hypo territory, even with a reduced levemir dose. Just got a mirtazipine into him. Next time he's up, he will get Cerenia.

    I tried ondansetron in the past, and it did not seem to have an effect. Since he has not been eating much in the past week, his energy is way down.
     
  24. nslade001

    nslade001 Well-Known Member

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  25. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Hi Jeff
    Just seeing this. I’m so sorry Leo is not doing well. It is so hard watching them decline. You and Therese are wonderful beans. I love the photos.
    Sending many vines. :bighug:
     
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  26. Sonia & Leo

    Sonia & Leo Well-Known Member

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    :bighug::bighug::bighug::bighug::bighug:
     
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  27. JeffJ

    JeffJ Well-Known Member

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    Thanks all. Leo probably ate 1/3 - 1/2 of his allotment today. I'm trying mirtazipine and cerenia. We did syringe feeding in the past. But not this time. To us, that method is to get them thru a gap. We will find out if there is a treatable underlying problem on Monday afternoon. But we're also realistic. If it comes to the end, we have a contact who provides home visits for that final time.:(

    Leo did eat a bit more at dinner. We spent an hour on the backyard with him on my lap. One of his very favorite things to do. Little Dude sat next to us and enjoyed the time too.

    Tonight - a very reduced dose. Then more attempts to get him eating.
     
  28. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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  29. Sonia & Leo

    Sonia & Leo Well-Known Member

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    Jeff, I hope you get to spend a lot more time with Leo and Little Dude, my heart goes out to you and Theresa. :bighug::bighug::bighug::bighug::bighug:
     
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  30. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Thanks Sonia.

    Today Leo is eating quite a bit today, so I'm real glad to see that. Perhaps because of high BG, or maybe from the cerenia and mirtazipine. The back-to-back multi-hour hypos from Friday and Saturday wore out Leo and me both.
     
    Last edited: Apr 21, 2019
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  31. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Oh Jeff... This is so sad to hear. There are no words! But, Leo is a fighter, just like Pig! I do not see why you cannot give him all the gravy food he wants.

    It seems that Pig and Leo are of the same age. Pig was born the day after Valentine's day (2-15-2006). I am sending all of our love your way. Leo and yourself have been an inspiration not just to us but to many, many others. :bighug: I am still curious if you would be willing to try, at least, a homecooked diet for Leo. I know that FF is your go to, usually, but I somehow managed to pack on several pounds on Pig with just homecooked Lamb and EZ complete and you know about his digestive trouble. I am just curious if that would maybe help or if Leo would even be remotely interested.

    Please, if you guys need anything at all do not hesitate to ask. Pig and I have only made it this far with your help alongside others. We owe you quite a lot. :bighug::bighug::bighug:
     
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  32. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Thanks Sarah. I didn't realize Pig was the same age - your signature shows 2007. Anyhow it is close enough, and our boys are in the Acro club together.

    At the last vet visit, he got a course of anti-biotic. That seemed to really energize him. He had inflamed ankle joints, which are still full of extra Acro tissue.

    I'll consider the home cooked food. Leo needs to get thru this down period. He ate a lot of gravy food in the last 3 days. You can see his dose had to be dropped significantly in the past 3 weeks. Theresa did a good job when I was in NYC (4/6 - 4/12), but Leo hypo'ed twice on her too.
     
  33. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I see from your comment that you have tried ondansetron in the past. Do you remember the dose? As I found out with Neko, many vets suggest too low a dose. :( I went through the food struggles too. I like Sarah’s comment on lamb. There are some higher calorie, but still lower carb foods out there. Lamb and duck are fattier meats as examples. I tried serving higher calorie, low carb to Neko and it did help, cause she didn’t need to get as much food down her to maintain weight. I also ended up puréeing food. She had soft tissue growth in the mouth that made eating a challenge, but she could do mousse like texture just fine.
     
    Last edited: Apr 21, 2019
  34. JeffJ

    JeffJ Well-Known Member

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    Good suggestions Wendy. We discussed ondansetron in February, and I wrote a dose chart for Leo. At the time, with the correct dose, Leo didn't seem affected by it.
    • Ondansetron dosing
    • 0.5 mg/kg twice per day to start
    • 1.0 mg/kg three times per day after
    • 6.1 mg dose for Leo at 13.5 pounds (updated 4/21/2019) - from Leo's 2/7/2019 thread
    Leo has the soft tissue growth too. His appetite is back to 7/10 today, and eating almost normally after 2.5 days of non eating. We have pureed different foods in the past. He looks at it like it is alien mush from planet Yuck.

    My heart can't take these scares every month. It could be that mirtazipine is working. I really thought he was going to die by Monday. At one point yesterday, he wouldn't even let me syringe some karo in.

    Pictures from today, Leo was on my lap for almost an hour. He does a small growl when we go back in...because he doesn't want to get up. My sweetie.
    Leo on Dads lap 04-21-2019b.jpg
    Backyard Amarillus and Roses  04-21-2019b.jpg
     
  35. nslade001

    nslade001 Well-Known Member

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    Nov 12, 2018
    I'm glad to see Leo had a good day and is eating! How often do you give the mirtz, or is it still at a as needed? I was just looking over Tanya's site again and saw that for late-stage (CRF) cats mirtz can be given daily if required; it's a bit down this page: https://www.felinecrf.org/persuading_cat_to_eat.htm
    Lovely pic :) With love, Nikki
     
  36. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Thanks Nikki.

    I read Tanya's page in the past, but missed that discussion on mirtzapine.

    Leo has not been getting mirtz very often. But that might change because it seemed to work well! His prescription bottle says:
    1/8 tablet every other day, as needed

    So according to Tanya's web page, that is probably 1/8 of the 15mg tablet. The bottle has the tablet already split up. Net:
    1/8 x 15
    = 1.875 mg

    In general, I have been avoiding daily drugs except the pred. Most of them have side effects. We will see how Leo does this week. Thanks again....Jeff
     
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  37. Sue and Luci

    Sue and Luci Well-Known Member

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    Sending warm hugs and prayers your way that Leo exercises one of his nine-lives options. Best to you and Theresa. :bighug:
     
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  38. Shoeskitty-GA

    Shoeskitty-GA Well-Known Member

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  39. Bellasmom

    Bellasmom Well-Known Member

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    Jeff, I’m just now seeing this as I’m out of town, my heart breaks for you and I’m saddened to read this, sending lots of love, prayers and vines your way:bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug:
     
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  40. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Leo is eating more food today - mostly FF gravy stuff. It's not great for him, but at least he is eating. Then he got some mirtazipine today, and was eating even more. It feels artificial to stimulate his hunger. I know it is important to put calories in him. The FF gravy is driving his BG way up. And ZERO ketones - thankful for that.

    His vet visit is moved - tomorrow 8:30am. These 2-3 day down periods are tough on him and on us too. Especially when he just won't eat anything...it felt like the end this weekend.:(

    Leo spent 40 minutes on my lap outside today - and we both wished it was longer.
    Leo - laptime outside 04-22-2019c.jpg
     
  41. Sonia & Leo

    Sonia & Leo Well-Known Member

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    He's so sweet. :bighug: I hope the vet visit goes well. :bighug:
     
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  42. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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    Dec 11, 2016
    Hi Was wondering how Leos Vet visit went??:bighug::bighug::bighug::bighug:
     
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  43. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Leo is doing well. Thanks everyone for the continued interest and healing vines.

    weight = 13.75 pounds, so 2.0 pounds lost since January

    Net summary:
    - zeniquin antibiotic for next 2 weeks to address potential infection
    - full press to gain weight via Mirtaz ointment (mirtazipine), and any food he will eat
    - sebaceous cyst removed from back
    - deep exam under anesthesia - very enlarged, almost tumorous salivary glands

    Details:
    Leo has enlarged salivary glands
    - can't be operated on (easily)
    - probably from the Acro
    - likely impeding his eating. Food may be getting caught there.
    - The danger of surgery is that his salivary glands could be blocked or ruined.

    The vet said if we can get him to maintain or gain weight, then he can be around for awhile. There was no real prognosis on how long that could be.
    Leo ate 1/2 can upon getting home, and 1/2 can at 9pm. I just hope that continues.

    Leo's blood work is somewhat fine. Lymphocytes were the potential worry, and they are fine. We have dosed Leo with Zeniquin in the recent past. It perks him up. If this dose has a a similar positive effect, we will pulse dose him monthly to help his immune system.

    Adoptable KITTY alert - Theresa went with me. The vet sponsors adoptees. There were 3 - six week old little beautiful babies. I got to hold one. OMG - I could barely give her back. She also had a curly tail - Cuteness factor OFF THE CHART.

    Leo - cyst removed from back 04-23-2019b.jpg
    Leo - CBC values 04-23-2019b.jpg
    Kitten at vet office 04-23-2019b.jpg
     
  44. carfurby (GA)

    carfurby (GA) Well-Known Member

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    I hope you have many more days with Leo. Sending prayers.
     
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  45. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    I’m glad Leo’s doing better. Hope the AB’s do the trick and Leo has lots more quality time with you, Theresa and LD.
    That is really a cute kitten.....:cat:
     
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  46. nslade001

    nslade001 Well-Known Member

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    Thank you for sharing the update; hopefully Leo will feel better soon :) Thinking of you with love, Nikki
     
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  47. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Did the vet say anything about Leo’s anemia? His red blood counts are all on the low side.

    I hope the antibiotic and transdermal Mirtazapine help Leo feel better.
     
  48. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Thanks for the kudos. Leo seems to be doing well today. He has been living on gravy food - so it should be lots of fun to wean him off it again.

    Leo is eating fairly well today.:):p YAY

    For the Red blood counts - I literally can't remember. We had a 25 minute session with the vet, including discussions about Acro. I updated her about the FDMB experiences
    - cabergoline (news to her)
    - SRT patients
    - the 3 or 4 hypophysectomy patients (also she never knew a patient who had this)

    That way she has info to help other owners. She only had 3 acro patients that she knew of, and one is Leo. The other 2 didn't fare well, and were pre-Leo.

    The oldest cat patient she had was supposedly 28. She wasn't sure if the birthday was accurate. She has had multiple 20-23 year old patients.

    For Leo, our treatment is the antibiotic, Mirtazipine, and food. Then we return in a month for another blood test.

    Leo also got a B12 injection. I didn't know until after, but I guess it doesn't hurt. She is worried about the enlarged salivary glands, but there is really not much that can be done.
     
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  49. JeffJ

    JeffJ Well-Known Member

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