2/28 Fortune AMPS 207 +1 351 +2 377 +4 369 +11 409 - back in the hospital :(

Yesterday

Keeping a close eye because his AMPs was lower than usual, and he has barely eaten today. Gave him a half dose to be safe. Last time he was low at AMPS without eating he went hypo, but that doesn’t seem to be the case now. Phew!

Trying to figure out if his poor appetite is just a “bump” and if we should bring Fortune to the ER for help, or keep him home and make a harder choice... He did eat yesterday, but it is not normal for him. And of course I worry about hepatic lipidosis.

He came over and nudged my back to flip over and let him under the covers with me. He is just so tired, but still himself, and clearly not feeling well.

 

It took my lymphoma cat a month to start to feel better once she started chemo. Remember buying her rare roast beef. It didn’t take that long to start eating better but to seem to feel better.

 

I’m hoping it is the chemo - which isn’t great for long term, but hoping short term he will improve.

It’s just so hard to know!

We spoke to the internist about SubQ and she will prescribe them for us to pick up. He did eat better after getting fluids on Friday. Still not great, but I’ll take it.

I’m hoping that helps. He is acting more unwell today, cuddling by my legs vs my arms, head down on his bed. I’m so worried.

How did you get her to eat? We bought all the high carb gravy foods and toppers, Parmesan cheese, brewers yeast (DH read something and did a big ol’ shop).

He took a couple of licks from a tuna in gravy topper and a mixed gravy thing but it’s nothing.

I’ll try rare roast beef, I could go for some myself!

 

Sending prayers.

 

I found that syringe feeding helped Neko eat. They feel bad and without food feel worse, getting some food in helped "prime the pump". Have you tried any of the TikiCat Velvet Mousse packages? All meat baby food?

Too bad on the half dose today. Cycle count starts over tonight on 2.5 units.

 

We tried the all meat baby food, but will pick up some velvet mousse tonight! It looks like the half dose was fine - but he has barely eaten today. A few licks and bites here and there.

I think we are going to need to try syringe feeding again. Ugh he HaTEd it when we tried a few weeks ago, and started eating just with breaks every 20 min. Maybe if we do it again he will kick his but into gear!

Thanks for sharing what worked for you and Neko. How do you get past being afraid they’ll choke?

 

Thinking of you. Eat, Fortune, Eat!

 

I was worried Butters would choke. I just went super slow and made sure she was swallowing. This post on how-to assist feed has a fantastic video that I watched repeatedly when I was syringe feeding butters. It helped me feel much more confident with my technique and less worried that I might do something that would cause her to choke.
Paws crossed that syringe feeding him some food will get him to start eating on his own.

 

Thank you! I think I watched that video but made my husband do it and was freaking out. Did you make you own food or buy something specific?

 

Ok - an update.

We spoke to the internist - I had emailed the hospital about the sh*tshow on Friday, and got a call from them to apologize/explain.

I was able to speak to her about Fortune, and she recommended SubQ fluids, because we told her it seemed to help. She offered to prescribe for us to use at home, and pickup at the hospital, or for the hospital to do fluid therapy for him.

Because he is clearly not feeling well, we decided to bring him in to have eyes on him, and ensure that there wasn’t something underlying that was being missed.

Turns out his kidney values have progressed since Thursday, his creatinine is higher as is his phosphorus. He also has trace ketones

We decided to admit him overnight. Plan is for fluids - the treating doctor said they can give him potassium via IV. They will also add in antibiotics (we weren’t able to get the internist to prescribe them Friday, but I explained that Fortune started feeling worse off of them, and he heard me).

They may also do another ultrasound, and possibly an X-ray since he has been a bit constipated.

Hopefully this means he will be feeling better and eating again and getting his full 2.5 IU!! Let’s make progress on your BG, Fortune kitty!

Ugh he is my whole heart and it never gets easier to drop him off for the night.

 

Oh, Rachel, I am getting teary because I know how much it hurts you to drop him off AGAIN at the hospital. But, I feel so good about them giving him potassium and IV fluids and the other care he will get. I will pray for Fortune tonight.

 

More prayers.

 

Thank you Elise and Suzanne!

This is the only place I feel safe sharing what’s happening, and not feeling judged for helping Fortune feel well for the time we have left.

 

I’ve seen Janet’s comments.

 

Sending prayers.

 

I'm glad I didn't read Janet's comments, because she's been dancing around this point in other posts and I didn't like it before and I don't like it now. So I'm glad I didn't read anything on that list today (well... except the part about the woman inquiring about vaccines this morning... just trying to help there).

But, everybody has to make their own decisions about this. Nobody knows... NOBODY... how things will go with Fortune. I don't think that I could live with myself unless I tried everything to help if Fortune were my kitty. I would always be wondering... what if we had just tried this... or done that... maybe it would have been successful and Fortune would still be with me.... you and your husband will make the call... not the vets or anybody else.

When Darcy was REALLY ill with DKA and hepatic lipidosis, they didn't think he was going to recover. One morning while dropping him off at the regular vet after picking him up from the ER Vet where he'd spent the night (they close down in the morning so I had to take him out of the ER vet every morning and drive to the regular vet and drop him off for the day and pick him up at the end of the day and take him to the ER vet for the night again).... anyway, one morning when I had him there and was waiting in the parking lot... the head vet tech came out to see us and she said, "this cat is not going to get better." And then she said she could "take him" and put him out of his suffering if I wanted her to! It was all I could do not to freak out on her (I was already in tears because he was quite weak at this point). I said NO.. we are going to FIGHT! Later that night, we put in the feeding tube (which I think should have been done earlier) and it was only then that things really started to improve.

Anyway... I didn't mean to get off on a tangent of my personal story because right now this is all about Fortune and you and your husband. Don't give up until you both are in agreement and until Fortune tells you it's time.

And yes, you will make him feel a whole lot better most likely!!

 

Couldn't have said it better than Suzanne Your family will make the best decision for all of you Sending lots of strength and prayers <3

 

Oh no...more prayers, Rachel.

I used the prescription a/d food because of the very smooth texture and I blended it with some water. It does have more carbs in it but also more calories and butters really needed calories, so I prioritized that and didn't worry as much about her DM. So you may want to go with something smooth that is low carb, like the tiki cat mousses perhaps? Just a thought.

 

I was referring to the fact that all of my friends think I am absolutely insane for everything we are doing to help Fortune. This board, and a few others I have found through recommendations, have helped me tremendously through what had been two very hard months. Having folks that “get it,” and the hard choices involved, has been so invaluable, not only from a mental health perspective, but from the shared and lived experiences.

Suzanne, we experienced something similar when Fortune was first hospitalized. He was discharged with “only days, maybe weeks” to live. I hope he will prove them all wrong!!

 

Sorry to hear Fortune had to go back to the hospital. But sort of good that they found the ketones, hopefully early so your timing and instincts were good. Something to keep in mind when it comes to dosing in the future.

When Neko was dealing with acromegaly, diabetes, arthritis, kidney disease, heart disease and small cell lymphoma at the same time, we found out who our true friends were. They are still our best friends. FDMB folks are included on that list. And that's one of the reasons you see so many people here, even after we no longer have diabetic cats at home.

 

Wendy suggested Tiki Cat Mousse, too! I need to look into the phosphorus levels - but hopefully when he comes home he will be eating. In any case I may get some just as a back up. Thank Lyla!

 

Thank you - I am trying to remember to listen to Fortune. He always makes it clear what is going on. I hate bringing him back to the hospital, but he hasn’t given up yet, and neither can we!

I stopped updating my IRL friends and social media after Fortune’s collapse/ hospitalization on 2/3. It showed me who actually gave a cr*p and asked about him. And I realized posting here every single day, and frequently in another group, there are people like me out there. People who follow up on visit notes, ask questions, do research and aren’t afraid of some work to help their companion animals feel well. And everyone one I have interacted with has been kind and supportive. We have been emotionally exhausted, but sharing what is happening and getting input has tremendously helped us be able to push on his doctors and get good care for him, and made us feel less alone when we are figuring out how to navigate these BG numbers - you know how much I have relied on you, Wendy, to help me navigate things. No one told us what to do about hypoglycemia back when we would shoot 3IU at “approximately 12 hrs apart,” with no idea what we were doing! It’s crazy how much we didn’t know.

In fact, I wish I had found these groups much much sooner when Fortune was first diagnosed with SCL in 2018 and diabetes last year. Looking at where his BG was headed in the end of January, just three weeks after joining, will always have me wondering “what if” regarding his advancing kidney disease.

Appreciate you, and this board, so much!

 

Rachel - Thought it might help to look up the phosphorus for you...other wiser people may have better/more accurate numbers. Maybe you already have them, but just in case - this is what I found (below) from TANYA'S COMPREHENSIVE GUIDE TO FELINE CHRONIC KIDNEY DISEASE.

I also attached a file I downloaded in the last 5 days but unfortunately don't remember where from!

Tanya's data - calculated on the basis of dry matter analysis (DMA). The information on the cans or on most brand websites will not have been calculated in this way.

Brand and Variety - Tiki Cat Grain-Free Velvet Mousse Chicken with Egg* Foods marked * are minimums for protein, fat and in some cases phosphorus. The actual values could be much higher.
Phos 1.01 (this list has several Tiki mousse varieties with Phos ranging from 1.01 to 1.3, but this site doesn't list the carbs)
Protein 54.55
Sodium na
Fat 36.36
Carbs na
Calories 28.21
Obtained 30-Jan-20

My heart goes out to you. You are in good company here. I will be thinking of you and Fortune this evening.

 

Rachel, I'm praying for Fortune every day, to love a kitty that I have never met is how I feel about Fortune. Keep on fighting Fortune we all love you.
Rachel, you and your husband are the best parents Fortune can ever ask for.
I hope you and your husband can get some rest tonight ♥

 

I know what you mean about friends (and family too) not understanding when you are really fighting for your pets. I've had a lot of that. I choose not to talk to some people about it. You're safe here.

 

Oh yes. Diane is right! She has said it so well.

 

It didn't attach so here's a link Diabetic CKD Foods (Low Carbs, Low-moderate Phosphorus) Updated, February 16, 2021

https://drive.google.com/file/d/1UdSi4Dp3PvG03dTRoZBP9SzJMypQ9_zb/view?usp=sharing

 

Thank you for the kind words, and thanks for the spreadsheet, Liz! Really helpful.

 

I'm sorry little Fortune is back at the hospital. I'm so incredibly grateful I found this board. There is a lot more heart in the ethos of this forum than in others where people tend to be more hung up on lab results and hard science than they are about love. The love is what is most important here. Hugs to you, dear Rachel!

 

@Liz & Minnie Can I ask where you got this list? I've seen it before, wondering if we should store it somewhere here.

 

I could be mistaken but I believe that list in google drive is from the Facebook Feline Chronic kidney disease group. I used it to find foods for Darcy (because I wanted to feed low carb low phosphorus). A man named Andrew Hall is on that group and does a lot of hard work putting together these food lists.

 

♥

 

His food lists are very comprehensive and helpful: https://drive.google.com/drive/folders/1aqmnoTbHkDckpbds_4CSn9wi-dBAMJp-

 

Just rereading this, so I figured I would ask now lol.

How would I change his dosing? I know we plan to speak to a new internist tomorrow, and share our spreadsheet. Would love to hear your thoughts and POV

 

Less reduced shots and skips.

 

Happy to report that Fortune ate VERY well tonight at the hospital!

Our boy has a rep for having a voracious appetite, and I’m so happy he is living up to it!

Yesterday he only ate 9 out of his usual 12 oz, and today he barely ate 6 so of course we were worried.

Sounds like the fluid therapy is helping him already. Hopefully we have more good news and a plan tomorrow.

I need to become an expert in CKD, with Fortune’s increase numbers and our civvie Marty getting dx’d with early CKD!

Thank you all for rooting for him!

 

I had to go through my browsing history to figure it out since I didn't make note of the source. Lo and behold I downloaded it because @Suzanne&Darcy posted it on this condo so all thanks go to her. All I did was file it locally in my 'diabetic food' folder!!
https://felinediabetes.com/FDMB/threads/2-22-sandy-ot-questions-about-ckd.243617/

 

Oh wow this is fantastic! Does he ask for donations for all this work?? Thank you so much for sharing!

 

Oh tha IS good news. What an uplifting way for me to start off my day. Good old Fortune!

 

Any updates Rachel?

 

Extra prayers for Fortune. He could not possibly have better, more loving parents.

 

Thanks for checking in, Paul

Fortune is doing much better tonight (anti-jinx) and ate almost 9 oz for dinner alone! He also had a large part of his breakfast. What a relief! They are feeding him 200g wet and 50g dry for each meal, prioritizing eating over his DM and CKD for now.

They also got rid of his ketones, but wanted to keep him a little longer overnight for more fluid therapy since they think he can improve further. It looks like he had “early DKA,” - trace ketones and mildly acidic. Grateful we caught it early.

I think that may be why he wasn’t eating as well, combined with the CKD, and possibly the chemo all colliding. Poor bunny

We are also getting the report that he is showing his “feistiness” when they have to check his vitals which also makes me feel better, and tell me he is more himself

We also learned more about his recent weight loss, which is scary especially with the cancer, but he already started gaining some back and the doctor thinks we can help him regain it all back (temporary weight loss).

It is SO HARD to have him at the hospital - for him AND for us - but I’m glad I listened to my instinct to have him seen, and he is already feeling more like himself. The staff also sent us a picture of him tonight, with his cone of shame (cuz of the IV).

The IM doctors have told us his DM is “impossible to control,” and he is at “super high risk for DKA and hypoglycemia.” Because of what I have been learning here I feel much more equipped to support Fortune - I just ordered a blood ketone meter. I cannot wait for Fortune to prove them wrong!

I have learned the past few weeks that sometimes what the drs tell me is different than what they document (if you’re familiar with CYA ) but we are feeling cautiously optimistic he will feel better when he comes home.

I am keeping my fingers crossed he comes home tomorrow based on the morning b/w!

Appreciate so much the kind thoughts and well wishes for him! It means the world!

 

Thanks so much for this update on Fortune! I feel better reading this. I’m encouraged. I can’t believe that his diabetes is “impossible to control.” Surely that cannot be true?? I will keep praying.

You definitely did the right thing taking him in. Eating is good! Feistiness is good! . Keep us posted as you are able. Hugs!!!

 

I’ve just been reading through the past week of threads. You have certainly had a roller coaster of a ride. But you are wonderful parents!

Don’t take any notice of people who don’t understand why you care so much for your pets..........I think most of us have experienced ‘friends’ who tell us we are crazy or mad. I just feel very sorry for them that they can’t experience the love of a pet and for a pet. Pets are not disposable. They are part of our families.

I also think you are much better equipped to look after Fortune and his DM than the IM vet gives you credit for.
I would also feed small frequent meals instead of just the two main meals.
Sending a plane load of strong Aussie healing and appy vines to Fortune.