2/25 Ruby Home from the vet! PMPS 131/+2 72/+4 78

Yesterday on The Ruby Show.

So far Ruby is still eating after her dose of mirtazapine two days ago. Started giving her SEB last night. Have mixed it with George's Aloe and I've been putting it in her food. She doesn't mind it now, I think because I mix it with her raw duck that she seems to adore.

Right now she is purring in my lap. She has no idea I will be torturing her with a visit to the vet in a few hours. Wish us luck.

Healing thoughts for all of the sick kitties and hugs to you beans who love them so. Have a wonderful day!

 

Good luck with your travels to the vet and the vet visit Glad to hear Ruby is eating and hope you all have a wonderful day

 

Just dropped off Ruby at the animal hospital. She cried the whole ride on the bus despite four drops of Rescue Remedy in her food before we left. At least her numbers were good this morning but they’re going to be through the roof later I am sure. Feeling very apprehensive. It is so terrible that I can’t be in there with her. Can’t wait for this pandemic to be over.

 

Oh no I'm so sorry. It's so difficult to leave them there alone.
I hope you have her back very soon!

 

Oh, I know . Isn't it just the worst that we can't be in there with our animals.

I have found that the best way I have of getting what I want it to make a list of everything that I want them to do. The last time I took a sick animal to the vet (not my sugar boy, Mr. Darcy, but a civvie, Jane) the vet ran up a big bill on testing for her (not my regular vet who was off that day). He did a bunch of x-rays and bloodwork. I only wanted antibiotics for her and for him to listen to her heart and lungs. I didn't like her breathing, but I wasn't going to do a whole bunch of diagnostics right off the bat unless he heard crackling in her lungs or something (I have too many cats to be able to afford that each time). Blood work was all fine and she got better on Zenequin. This was two days after my Julius died (Jane really loved Julius and we think she got sick from grief). Anyway, I digress. But I hate leaving them because they can't sit with me. While we are waiting, I used to be able to be in a room with my kitties and hold them and let them hide under a blanket if they wanted to.

I hope you will have good results on Ruby! He BG numbers are very good. You must be doing something right!!

 

I hope everything goes well at the vet visit and Ruby will be calmer on the trip home. Sending prayers.

 

wishing you a good vet visit and ruby’s gentle return home

 

We're home! Ruby wasn't happy on the trip there and back and the whole thing took hours but I'm relieved to be home. They shaved her floppy belly but otherwise she's fine.

The vet did an ultrasound as the last one was done 6 months ago. The radiologist has not completed his report yet, but the preliminary findings relayed to me by the internist is that the inflammation shown in the ultrasound from September looks to have improved, which is great news! The radiologist did not mention any issues with her pancreas, her kidneys or liver, so that is all good. However, we still don't have an idea of what is causing her inappetence and diarrhea, so she took a blood sample and is sending it to Texas A&M to do a GI panel. She said that she trusts this lab more than IDEXX, so I agreed to spend the extra money. If the tests come back with low B12 or folate (Ruby already had an IDEXX test in September showing low folate but normal B12), then we would have to have a conversation about an endoscopy. (@Marje and Gracie , I didn't bring up the VDI test for SCL yet because I felt it was premature and didn't want to jinx anything, but I will do it if and when the time comes!) If the PLI comes back negative for pancreatitis and her B12 and folate are normal, then it's likely her CKD causing her current issues. The internist says Ruby has Stage 2 CKD.

I'll post the ultrasound report when I have it and have had a chance to talk to the doctor about it, but I feel somewhat heartened by the fact that there wasn't something glaringly bad on the ultrasound. Maybe the blood test will tell us more. Unfortunately because of the weather "event" of last week, everything having to do with Texas is delayed so it will be at least a week before we have the results.

Thank you all for the support and virtual hugs over the last few weeks. It means so much to me and to Ruby.

 

I'm glad to hear you've got that vet visit behind you. Sorry that it upset Ruby to ride on the bus to and from, but at least you've got her home now.

Fingers and paws crossed for a good report on the US when the final report comes back.

Have a pleasant evening Katherine!

 

PMPS = 131

Poor Ruby's BG is high after her long afternoon of buses and prodding. Gave her SEB an hour before her full meal and she's eating up a storm so it might be helping with nausea.

 

Hi lady! So glad you and Ruby are home safe and sound, and that the ultrasound showed improvement. IBD can cause the current issues as well (even with a good ultrasound - so we will see if the Budesonide helps with any of the symptoms). What is her most recent CREA and BUN (kidney values)?

Do you supplement B12 injections at home? I've found them to be so useful!! Why endoscopy, what would they be looking for? I am not sure I see the connection yet. I'll know more if you tell me you already supplement with B12 injections. I think you can also get folate as a supplement.

Thanks for your comment on my condo today - I am so tired I've hardly written anyone yet today, but wanted to pop by and check on Ruby girl!

 

Evening Katherine, sorry Ruby had a rough time going and coming home from the vets. Tyler is the same way, he cries and howles there and back.
It's so loud that you would think he would lose his voice
I'm glad Ruby is eating .Happy to hear the ultrasound findings were good.
I hope they can find out about her lack of appetite.
I hope you both have a good night ♥

 

Hi Margaret! Ruby’s primary vet decided to hold off on the budesonide until she saw the internist. I’m glad we did because I think I’m going to hold off on treating anything until I have a more definitive idea of what’s going on with Ruby. The vet today offered to give her a B12 injection but I declined until I know what her B12 and folate levels are from the blood work. No point in spending money on an injection she might not need. As of January her creatinine was 2.4 and her BUN 34, so both are high.

 

Yes, those are Stage 2 numbers but not awful! Depending on the cat - my Cricket held onto reading like that for 3-4 years. My cat Whisper increased more quickly. Do you know how to do sub q fluids at home? You may want to learn that next, that can be quite helpful (unless cardiac issues for Ruby prevent).

If you do end up needing the B12 (which is common with IBD), then the vet can sell you a vial and you administer weekly sub q, just like insulin.

I hope the test results come back with good news for miss Ruby!

 

I'm so glad the vet visit sounds productive! I know it can be hard not to have any clear answers, but it sounds like a good plan.

FWIW, when Fortune had "just IBD" he would have improvement and still have what we called "flare ups." If she does have IBD, there are plenty of low carb, novel protein diets available, too! The B12 subQ is super easy, and a much tinier needle that the insulin

Hoping that everything is very boring from the lab!

 

Good news! BTW, sometimes a transitory intestinal issue can cause a low folate. That happened with my boy and I supplemented a low dose of folate for thirty days and he has been absolutely done since.

 

I have a vet tech coming to my house once a week to do fluids for Ruby because she just.will.not.let.me.do.it. The internist suggested that it's not doing her any good to be doing it once a week, so I might consider stopping it until she really needs it but it depends on what this blood test tells us. B12 shots sound much easier than subQ!

Glad to know Cricket was able to sustain her levels. I am hoping that the lower phos foods I've been feeding her since January have made some difference, and hopefully the incorporation of raw into her diet will lower whatever inflammation might be present.

 

Thanks, Rachel! I'm transitioning Ruby to raw and I'm wondering if she might have an allergy to chicken. Prior to FD I fed her kibble and wet food that was fish, and so I'm wondering if removing the dry and the fish might have improved her situation. Since CKD came on the scene, a lot of the lower phos foods contain chicken and an allergy to that might be the cause of her inappetence now. I'm feeding her small bits of raw duck right now and I plan to transition her to some raw turkey next and maybe rabbit to incorporate some novel proteins. Even if she doesn't have IBD, eating some novel proteins might lower her level of inflammation over all. It's a work in progress.

 

I'm really hoping that's the case with Ruby. When they did the ultrasound in September she was experiencing DKA so her whole system was in crisis. Like the inflammation that showed up in her intestines then, the folate might have improved as well. Fingers and paws crossed.

Have you or anyone else here had any experience working with the GI labs at Texas A&M? I'm wondering if it's worth the trouble and extra cost.

 

Thank you for the kind support, Suzanne. This internist works at an animal hospital and they email me estimates of everything before they go ahead with any procedure so I don't get saddled paying for anything I don't need. Today's bill was pretty hefty though. It just drives me crazy that I can go to the doctor for myself and be in close proximity to doctors, administrators, nurses, technicians, but they won't even let me in the door at the vet where I've shelled out thousands for Ruby's care and she's alone and upset and scared.

 

I have and it is 100% worth it IMHO. I had the GI Panel done for Gracie (she needed B12) and also for my boy, Tobey. I’m glad I had it done for him, too, so I’d know to give him some folic acid which helped him. Again, his was transitory...it’s a long story.

 

Yes. I have found the Texas A&M GI panel to be well worth it. Very good information there and I haven't had any problems getting the results back fairly quickly.

 

The vet visit sounds encouraging overall. And I agree, her kidney values aren't too bad. She can do well on that for a long time. Just keep feeding low phosphorus foods and monitoring her kidney values. I can tell from reading all your posts that you take great care of Ruby! The once a week fluids probably aren't doing much for hydration, that's true. You can cross that bridge when you come to it later. I hope she starts to eat well. SEB, Visbiome probiotics, S. Boulardi are all good. Do you have any transdermal Mirataz (mirtazapine) for an appetite stimulant? Of course, that would only be if you are giving Cerenia and/or Ondansetron if you think she's nauseated. And I think you already have been giving Cerenia. I hope she'll be back to her normal self very soon. She sure is adorable looking.

 

Have you seen the EZ IV harness? Neko couldn't take IV after a point due to her heart, so I had to rely on lots of fluids in her food.

Even from Canada Neko's internist sent her b/w to Texas for their GI panel.

 

Yes, I've looked at it at your suggestion but Ruby RUNS when I stick her and the needle falls out. I'm scared to attach it to her with the harness. I was the one poking her with the needle and holding her down while DBF held the bag and opened the valve. Now our plan is he will be the one holding her and inserting the needle as she is less prone to take advantage of him than me. We shall see.

Glad to know Texas's reputation is good among so many of you here. Makes me feel better about taking her to this doctor today.

 

I don't have the transdermal mirtazapine but I find Ruby gets really loopy on the oral so I'm going to try cyproheptadine the next time she has one of these extended no-eating episodes. I'm really impressed by the effect of the three doses of SEB I've given her so far, so my hope is that I won't have to rely on anti-emetics and appetite stims all the time.

And thank you for saying that I take great care of Ruby. She and her sister Olive are my first cats as well as my longest and most steadfast companions. I wasn't very good at taking care of them before Ruby got sick, so now I am trying to make up for it.

 

I just thought of one more thing. I’ve had fairly good luck with using Metronidazole lately in a few of my cats with diarrhea. Not sure if you have tried it, but I thought I’d mention it.

 

Ruby was on Metro for 5 days last week and ended her course of it on Tuesday. I think it helped but I also put her on a therapeutic dose of S. boulardii so it's hard to say which was effective. Her poos have definitely gotten better.