1/23 Bear Man - Jojo answers

Yesterday's condo (thanks for all the support): viewtopic.php?f=9&t=3538&p=34108#p34108

Thanks to Jojo for suggesting the theme of Old Timers Day. I truly appreciate it. This will be a long recap for Jojo. I apologize for the length, and also for being a bit of a downer.

Health and medication recap for Jojo:
Prednisolone (15 mg with pm shot) for IBD,
Ondansetron for nausea,
Omeprazole for stomach acid,
Ursodiol for Pancreatitis,
Metronidazole for IBD,
Amlodipine for hypertension,
Methimazole for hyperthyroidism,
Tumil K to supplement his potassium,
Baytril for Pyelonephritis,
Novifit (SAMe) for cognitive dysfunction,
Burprenorphine available as needed.
He is also anemic and has renal insufficiency.
He gets .5U Lantus BID. A recent effort to taper off the Omeprazole and Ondansetron did not go well. There was also a recent incident involving a two week Methimazole overdose. He is due to visit the vet in the near future to have his T4 and all other bloodwork rechecked. SS is up to date.

In mid November, Bear started urinating on the floor. His urine looked very nasty, bloody, and suspicious for infection, but a C&S was negative. He was started on a second antibiotic (Suprax), which caused him to have severe liquipoo and start pooping on the floor. He also started “circling”, a behaviour which he exhibits mostly when he needs to urgently find the litter box and can’t. He went off all antibiotics for a period of time (suspected neurotoxicity), but the circling persisted. He has since gone back on Baytril. Presumably, his urine is still looking foul (there was no improvement after his course of Suprax), and we are not addressing that issue, due to fear of starting off another massive bout of diarrhea with another antibiotic (the next one would be Convenia). Some yellow numbers over the last two days are worrisome.

Today, he is still having attacks of circling, and is house soiling somewhat regularly. He has some difficulty getting around, and spends most of his day in his sleeping basket. His appetite is fair to poor, and he still supplements his wet food with dry Evo. He maintains his weight. He does not seem to feel sick or be in pain, but as I noted in yesterday’s condo, he is a frail shadow of his former magnificent self. He is brave, dignified, and so very sweet tempered. He enjoys his tummy rubs, and his cuddles with Teddy Man. I am having questions in my mind these days about end of life issues. I always thought that the end would come with a big medical crisis where my options would be very clear to me. Now I think it may not be so clear cut. Maybe he will just continue to dwindle away like this. I wonder about his quality of life. I wonder if I am keeping him alive for my sake, not his. I wonder how I will know when it is time.

For today, I will be heading off to tbp, and Teddy will take on his customary role as caregiver to his big brother. These photos were taken last night:

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

I love that picture of Teddy and Bear together.



Happy Old Timer's Day Linda and Bear!

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

happy old timer's day, linda!
LOVE the picture of teddy and bear together...

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Linda,

It gets so awfully hard when they are at this point. If they were still enjoying some things and not in pain I held off. I always saw it in their eyes when the time came. I have a 17yr and I'm not looking forward to that day either.


I'm glad you are keeping Teddy so comfortable. He's lucky to have you has his Mamma bean.

Good luck,

jan and sara

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

What is this OLD TIMERS day thing going on? Tried to find a post about it - and who are considered old timers?

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Nice report Linda, I know he appreciates all you do for him. As for quality of life issues.....if having to swallow a truck load of pills everyday means a poor quality of life than I need to be PTS! If it helps and he doesn't seem to be avoiding the world then I think he is happy, even if he is not truly healthy.

Keep up the good work!

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

(((LINDA)))
so sad to read that.

sharing my situation coz it was barely a month ago. i never believed i'd be able to know when it was time, because i am so bonded to our pets, but it was so so clear with piggy that he was suffering and keeping him would have been torture. he was not eating, and he was just gone by that point, so i insisted DH have him PTS. i've always been the one insisting on treatment and not giving up [we're talking huge fights that always led to terrible bawling] but i just knew it was unfair to keep him longer. there was no question in either my or the vet's mind that it was time. all the things that made piggy piggy were no longer there.

you're saying bear is maintaining weight and fair to poor appetite, so my guess would be that it is not time yet but only you would know so i'd just trust my gut on it if i were you.

i hope this helped you at least a little.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Linda and Bear man,
wanted to say hi and let you know that you are a wonderful mamma bean and keep up the good work. As long as he is sleeping and eating and enjoying a little sunshine he is happy.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

(((((((Linda))))))))
(((((((Bear))))))))))
(((((((Teddy)))))))

I hope it's not time yet.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Linda, I sympathize and empathize. I tend also to feel if an animal is not in pain and is connecting to you and to the world, and if the measures we are taking to care for them are not so extraordinary that we just know in our hearts that it isn't right, then it isn't time. But only you know for your Bear. ((((Linda))))

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

(((Linda))) I'm so sorry. Are there more good days than bad, or has the balance tipped?

Have you seen this? Dr Alice Villalobos's Quality of Life Scale It was written for pet hospice caregivers, so it may not be all relevant, but you may find some of the questions helpful. It doesn't sound to me like he's ready yet, but you live with Bear, you know him best.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

(((Linda)))

I know it sounds repetitive, but either you will know or Bear will tell you that it's time. I had George for 20+ years. For almost the last year we struggled with intestinal CA. I knew in my heart he would tell me when it was time, and he did. It was the hardest decision I ever had to make and it still brings tears to my eyes -- he was an incredibly special cat. You and Bear will know.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

You and Bear Man are so close....you will know when it is time...trust yourself and your instincts.
For now, enjoy the two of them together and know that you are doing all that is possible to make his life
comfortable. There is no pressure to do the "right thing" now. I believe that the time will come with a
quiet understanding between the two of you and you will know when that is....
((Linda)) ((Bear Man)) ((Teddy))
Thank you for sharing your thoughts with us today.....sending love back to the three of you.....

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Hi Linda
Thank you for sharing everything about Bear Man. He is truly loved by you and he knows it.
I agree with everything that has been said so far. I only have lost one cat so far (PTS)
and it was the most heart wrenching day of my life. My sasha had renal failure, she was on iv's that I was giving to her, lost so much weight and I knew she was leaving me.
But she did it on her terms and in her time. She waited for my young daughters (at that time)
to be away from the house - on a Satrurday morning when they were at their dads, to let me know it was time to go. She was lying in bed with me.

Enjoy your time with your Bear Man. Our prayers and thoughts are with you all.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

(((Linda))) (((Bear))) This Old Timer is sending you both lots of love.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Aww, Linda, I am so sorry it is not a happier update. I have no experience with any of this because Putty is our first and he is only 6 so we don't have many issues at this point. I know in your heart you will do the best thing for sweet Bear just as you have been doing all along. I do believe that when the time comes you will know because Bear will tell you.
For now just enjoy the time you have with him until he says otherwise. Give Teddy a big kiss from me for taking such good care of Bear. :YMHUG:

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

((((((Linda))))))) My heart is so heavy reading this--I have been reading about Bear Man for so long now, his daily reports, his problems...It is what everyone of us know, but dont want to face..That these wonderful furbabies, like all things, one day do end..
But we pray everyday to have them for just one more day,, one more month, one more year...YET, we do not want them to suffer, or hurt, or be sick..
So if they are peaceful, sleeping happily, eating enough and not in pain, that means that they are alright, we have more time, worry about it another day..Love lives on and when Bear is ready to leave he will let you know..I admire you for the loving devotion you have for your BABIES--May you have much more time with them..HUGS from us~!

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

(((Linda))) (((Bear))) Love the new pictures. You are doing an amazing job....quite the inspiration.

Thanks for the update.

Sherry & Zoe

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Oh Linda, I know so much what you mean, I went through that path with Ti-Mi, it seems like it was yesterday.
I know how special is your bond with Bear Man, it will guide you when the time will come to make a decision. For what I understand, even though he is losing some quality life, he is still enjoying some moments and not in pain. In the last months with Ti-Mi, I remember thinking about my grandmother who is still alive at 89 yrs and tried to compare the quality life(I know this sounds probably silly) : there is some days she doesn't feel like eating; she walks, drive her car and goes wherever she wants but somedays she can barely stand on her feet because of the pain; somedays she enjoy the company of others, other days she is just to tired and stays in bed; As the months goes by, there is more and more days where she stays in bed, there is more days where she can't drive her car and there is less days where she feels like her former self. But inside her, she is still happy when she sees the loved ones and she still enjoys the moments when she feels great. But as the "bad" moments become more frequent, sometime she start to think that life isn't that great anymore. But still, she says she is not yet ready to go. I felt like Ti-Mi was going through a similar process and that at one point, he became ready to go. I wish I could speak my mind better in english... Feel free to PM me if you need to talk about it or if you still have my email.
Linda, you truly are a wonderfull bean to BearMan, I am sending all the cyber-support in this difficult time

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

((((Linda))))
((((Bear))))
((((Teddy))))

You take such good care of them all. I think you'll know when it's time Linda. Until then, keep loving that precious Bear Man.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

((( Linda ))) You are an exceptional care giver and have given both your kitties wonderful lives. I can tell you cherish every moment with them, in sickness and in health, and have never balked at going the extra mile for them. They are so, so lucky. It's also obvious they trust you. Such a bond you have with each of them. It's hard to go through the bad times, but I agree with others that Bear will let you know. That he still snuggles and wants lovins is a good sign, I think.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

((Linda)).. Oh you are such a wonderful mamabean..
BearMan is one lucky kitty to have you and Teddy.. to love him and care for him!
He has such a wonderful story and has truly paved the path for other kitties...
He is just amazing... and cute too!

Give him a scritch from Pepper and me..

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

(((Linda))) you are an amazing bean, truly. I pray that you will find your answers when you need them. My heart goes out to you. (((Bear Man)))

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

((((Linda & your sweet little Bear))))

Sorry, didn't know that Bear was having this many health issues. He is so lucky to have you and Teddy, he will let you know when it is time.

Hugs, Wendi & Milo

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Happy old timers day Linda, Bear & Teddy. You do such a wonderful job with Bear. Keep your chin up. Hope Bear has a better day today. Snowflakes to you all.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Happy Old Timer's Day Linda and Bear!

Lynn I am so sorry you are going thru all this. I am sending Bear Man lots of healing vines and snowflakes

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

((Linda)) ((Bear)) ((Teddy)) I love that Bear and Teddy are such buddies. I LOVE when kitties snuggle together.
Bear has the best bean EVER who takes such good care of him!!

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

linda first biggest ever ((((HUGS))))). then a few tears.
okay, this happens to be an area with which i have vast experience and have probably been with more animals in their last few moments of life than anyone on board. please feel free to PM me and talk through this (FB has clearer PM's, so use that if you want). here i will keep it simple~ in vet med the most common criteria used for knowing when it is time is simply eating for felines. they are close enough to wild animals that unlike dogs whom have mostly lost that ability due to domestication, cats choose their own time (if no sudden crisis). when they do, the signals are clear~ they refuse to eat, isolate, and don't sleep. it is not the nausea not wanting to eat type of signals, this is different, it is like a mental decision of no longer will they eat. they turn head away from offered food or ignore entirely like it is not even there (a nauseous cat licks lips when food is smelled or tries to bury food or moves away from it, you'll just know when you see what i am talking about, it is just a very different body posture when food is placed in front of them).
looking at the pic of him with teddy i do not think it is time.
remember things that bother us, don't bother them.

i sure don't like the circling though. i didn't know that was still going on, i heard about it, but was under impression that it was tied to tap OD and had cleared up. hmm... i need to think about that for a bit, but need a bit more info... is it always to same side? (like always circles to right?) no head tilt right? assuming good otoscope exam was done (ears). is there any nystagmus? (yes moving back and forth or up and down during the circling events). how often do they happen?
also bladder and u/t systems have had recent x-rays or u/s since the urine turned abnormal?
how is his blood work?
one more question, what about splitting the pred dose into bid dosing? is there a reason why that is not being done? (didn't want to say anything about insulin dose until you had a chance to answer that question)

numbers of meds is not an indication of QOL, my 103 yr old grandmother takes no meds, not even an aspirin and has not good QOL anymore (was good until she hit 101, really going downhill since then) while my 60 yr old aunt takes 20 something pills a day for her multiple conditions and walks 5 miles a day....in the snow...uphill...both ways.
teddy will help tell you too. (i love teddy, he is the best cat ever).

but i cannot lie, you are in the final stretch here, he has had many serious medical conditions for a long long time and eventually there just comes a battle that cannot be won (and yes i am wondering if cancer is not causing much of what is going on now, the anemia, circling, abnormal urine, appy issues, etc). but the one that you have the most control of, his diabetes, is certainly not the one that will have any bearing on why the final battle is lost. you have done so right by him there, and everywhere. more ((HUGS)).

~jojo

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

Thank you Jojo. Teddy would be bereft if Bear were gone.
Some answers:
- He is willingly eating (especially dry).
- He always circles to the right. Very occasional nystagmus, side to side, but more commonly a small side to side head movement. No head tilt. Sometimes left eye droops. A good otoscope exam was done (normal), as well as a general neurological exam by my vet (reflexes, etc). The vet does not suspect vestibular problems or brain lesion, as the symptoms are intermittent, and she would also expect head tilt or falling over. The circling seems to be associated with distress of having to use the litter box urgently, and the house soiling (though I have never witnessed it) seems to be the result of circling. The vet is willing to arrange a neuro consult, but I don't know if we want the expense and stress of something we will likely not be able to do anything about anyway.
- Bladder and kidneys were X-rayed in December - normal. No ultrasound.
- Two C&S showed no growth. Two u/a showed a lot of blood. Possible interstitial nephritis suspected, so we went to a course of sub Q Dex, with no improvement in appearance of urine. Went back to pred.
- We have not discussed splitting the pred dose.
- Theories for diarrhea (besides the a/b reaction): scarring of GI tract no longer allows him to absorb nutrients, or hyperthyroid uncontrolled.
- Started SAMe to help with possible cognitive dysfunction, and also supposed to help IBD.
- Last b/w (Dec 31):
TLI negative for pancreatic insufficiency, positive for pancreatitis.
Blood urea (16.3)/creatinine (188) up a bit more after methimazole overdose (both above normal range), Potassium at bottom of normal range, WBC normal, RBC and hemoglobin below normal range after overdose, hematocrit at bottom of normal range. All else normal.

 

Awww, Linda... I just read Jojo's post. You are the bestest bean for Bear Man! And Teddy is a good babysitter too.

(((Linda))), keep us updated, k?

 

(((Linda)))

It's so sad to read your condo. But you are such a wonderful mama bean and I am just so thankful that your babies have you. I'm sorry things are so sad and hard right now.

 

((((((Linda))))))) ((((((((Bear Man)))))))) (((((((Teddy)))))))

It is hard for me to verbalize just how much I look up to you, Linda. You've been a rock to me, a reference point, and a person I know has always made the best decisions for Bear and the rest of your kitties every step of the way. You may doubt yourself sometimes, but I never have. I've watched you faced with some amazingly difficult things - much more than I have ever gone through - and you've never faltered. In reading Bear's condos over the last year, I have grown so attached to you and Bear, and Teddy, Emily, and Pinkerton.

I am very sad that you are having to think about this right now. You will know when it is time for Bear. The bond the two of you have will make that clear to you, I believe. And we will be here for you through every step. This is your home.

((((((((((((((((((((((((((((Linda, Bear Man, Teddy, Emily, Pinkerton)))))))))))))))))))))))))))))))))

 

Fellow Linda,

I must admit that I could not read your entire post and condo responses. Broke my heart too much.

You seem to be a remarkable bean and I am sure Bear is aware, grateful, and loves you soooo much.

Wishing you guys all the best. We are here for you.

 

Linda, I'm so sorry to hear that Bear Man is having so many issues. I know how worried you must be.

Like others have said, I do think you will know when it is time. I asked the same question about Thomas, as he was starting to eat less, lose weight, etc...but then when we had the sudden event of him losing the use of his hind legs for whatever reason, the decision was made for us in a sense. Even though he still seemed happy, if he had been allowed to try to navigate without his hind legs, he would have begun to feel miserable, and so would I.

I do think you will know. If he is still eating, then that is a good sign it is likely not yet time. Just treasure him to pieces and take it one day at a time. You are an amazing Mama Bean to your boy.

((((hugs)))) to you Bear Man and Teddy

Judith and Thomas (GA)

 

teddy will need you when bearman one day is no longer here. i had that with bad toupee when bunny left, they were attached at the hip.

sigh, no i don't think a neuro consult is worth the stress to him. there is not much that can be done with feline neurological issues. however i do not think it, the circling, is 'stress induced' since there is nystagmus and head tremors during the episodes. however i would invest in a whole bunch of low sided litter boxes and place them all around the travel paths. when my old guy DC was having IE diarrhea when his hyper-t was not yet under control (his was sudden onset and real bad, took a while to get the tap dose right) i did that and then donated the boxes to local shelter once the tap doses and pred doses were right and it stopped. they were worth every penny i paid for them since clean up is so stressful for bean. nothing causes bean burn out like IE diarrhea. trust me i know. (we won't talk about the day i shoved a couch out a second story window to crash onto driveway below because i just could not clean it one more time after he had accident on it).
yeah could be interstitial nephritis, sure the chronic kidney infections have done damage, however since i just had that happen here with bad toupee i have to wonder about bladder or kidney cancer or maybe even stones. okay now i wonder..this is just a thought and i'm typing as i think here..if it was stones if the pain when it is time to urinate cause such stress that he releases a bunch of cortisol and sends his body into a cascade of reactions which due to his long term high dose pred use is more dramatic than the regular cat's (his natural everyday cortisol levels are probably not that of a regular cat's). like increased long term cortisol release causes this:
# Impaired cognitive performance
# Suppressed thyroid function
# Blood sugar imbalances such as hyperglycemia
# Decreased bone density
# Decrease in muscle tissue
# Higher blood pressure
# Lowered immunity and inflammatory responses in the body, slowed wound healing, and other health consequences (quick google of increased cortisol levels gave me that nice list, faster than me sitting here trying to think of each) which does sound like him, and altered cortisol levels in body will also cause that hypokalemia he has. maybe that is something to talk to vet about? i think you can collect urine samples over a day at home and time label them and just drop off at vet's for them to send to lab which is not expensive nor stressful to him and maybe should be addressed? i dunno, have to think more about this, prolly shouldn't be thinking and typing at same time. i know the physiological cascade i'm trying to describe in my mind not typing it out very well i don't think.
let me think on this over night, i'm getting tired and losing it, will be able to think clearer in morning. (morning = around noon for me ;-) ) k?

 

(((Linda)))

I'm never very good at expressing myself at times like this.

I'd like to just repeat word for word what Cassandra wrote earlier if she doesn't mind.

You and your family are so very special.

 

Jojo I appreciate your brainstoming when I know this is taking a physical toll on you.

Wouldn't bladder stones have shown up on Xray?

What would I be looking for in the urine samples?

We'll touch base when you are rested. I can't thank you enough for doing this for us in Lantus Land. It took a lot out of you, but it was a huge community building event, and it meant everything to me to see you posting.

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

I like the way Stefanie explained it:

It sounds like Bear Man is enjoying his moments of pleasure and love. (((BIG HUGS to Linda and Bear Man and Teddy)))

 

Re: 1/23 Bear Man amps 218 and Old Timers Day Recap

I second that.

 

Oh Linda. I wish I knew what to say but I don't. Just know that you and Bear and Teddy are all in my thoughts. Treasure every moment.

 

((Linda and Bear - and Teddy too)) I am just reading your post and my heart goes out to you. Wow - what a time you've had - having not been on here awhile I didn't know that Bear had been so sick.

I am echoing everyone else's good wishes and hopes and sentiments - you've done so much for your sweet boy- and I too LOVE that pic of Teddy and him together - it's precious.

Sending many hugs and good vibes your way.

Emmy & Dude (& Mittsi too)

 

Thinking of you every day. I have a special Bearman-Place where I go in our garden, from where I send vines and special non-frosty African snowflakes and lots of soothing summery breezes. I'm always reminded of Hardy in your condos, another "great going" that can undo you so... We'll be here for you whatever whenever comes. (((LInda and the Cats)))

Jane and Jack

 

Hi Linda,

so sorrry Bear is not doing very well. Winnie had kidney "gravel" that caused blood in her urine. It showed on u/s but not on reg. rads. Just thought I would mention that since they had many things in common.

splitting her dex dose evened her bg cycles out. maybe that is what jojo is wondering. but I should not try to read the mind of nostrojojo. ;-)

I let Winnie decide when it was time. As long as she wanted to keep going I would do whatever. I read what jojo wrote about the difference in refusing food when it is time..... that's what we experienced. Along with other stuff.....

I have edited this post many times after attempting to write more. It hits close to my heart.
I haven't been around much. But if you pm me I can share what happened with Winnie more if you like.

wishing you and bear and teddy many more happy cat times together.
(((((( linda )))))) (((((( bear )))))) (((( teddy )))))

stay warm dear neighbors to the north

 

(((Linda))) (((Bear))) (((Teddy))) I missed ole timers day, but just had to respond here. My heart goes out to you Linda. I know the love you have for all your kitties and have watched you handle things with Bear and Teddy for the past 2 yrs that would dishearten most, yet you kept such a positive, loving attitude. You are someone that I look up to and admire. I echo all the thoughts that have been stated here, but I want to add one of my own. You and Bear and Teddy will be in my heart, my thoughts, and my prayers every day. I may not be able to be here as much as before, but I have not stopped caring. Please give Bear a kiss for me, tell him he's loved by someone he has never met. Take care of yourself Linda. We all love you both!!!

 

Hi Linda,
I'm hoping your Bear gets well real fast, will be sending feeling better vibes to him. The meow in the video was so cute.

Mike & Bo (GA 1/12/10)