6/9 Ruby AMPS 65/+2 80/+8 70/PMPS 72/+3 57

Yesterday on The Days and Lives of Ruby C.

It was not a great day in Rubyland yesterday. I could not get her to eat very much, dropped lower than I would have liked in the morning because she had no food in her, and then became an insatiable eating machine after I gave her an appy stim. The IM prescribed prednisolone to start her off on treatment before her oncology visit in July (and basically refused to have any conversation with me about it), and I'm really torn as to whether or not this is a good idea. If Ruby's BGs go totally out of whack I will feel like a hard earned rug will be pulled out from underneath me, but at the same time, the pred is also the most effective proven treatment for the SCL and I feel more capable than ever of handling the highs and lows of her BGs. I just don't know. Today I'm going to get a second opinion from the holistic vet I liked so much--when I talked to her last week, she was all behind prescribing budesonide and doing pulsed dosing with the chlorambucil. I need another level headed voice to add to the chorus in my head.

Healing thoughts for all of the sick kitties, especially Mr Darcy, Miss Minnie, and Miss Butters. Have a good day everyone.

 

Prayers you get the answers you need and that this other vet will have a better solution to treating the SCL. I also hope she starts eating more consistently for you, Katherine.

 

Morning Katherine, I'm glad you got the pred for Ruby
Great she ate after giving her the appy stim
You are doing everything you can and doing a great job!
I know you are frustrated , I would be too
I hope June passes quickly for the visit in July
You and Ruby are always in my prayers ♥

 

Sending prayers.

 

Hi Katherine, what a tough decision. Since Dolly’s diabetes was brought on by a steroid I can imagine what a tough decision this is. I guess it’s a matter of, if there is no alternative, you have to treat the most serious and deal with her diabetes becoming active again. As you said, you are totally capable of dealing with her numbers going out of whack. Do you know how long she would be on the steroid? Life with our kitties seems to often become a balancing act and hard decisions. I wish I could offer something to help. Thinking of you both and sending loving prayers.

 

With steroids, I don't think there's harm in starting one and if it doesn't work, switching to the other. You will have wasted some time, but you should know fairly quickly if it works. And you may have to do tapering. It would be good to hear what the holistic vet says. Third time around, my current SCL kitty is entirely managed by the general practice vet.

Sending eating vines to Ruby.

 

Thanks, Wendy. Ruby is eating better today, thank goodness. I’m starting to think that if she is amenable that the holistic vet should manage this, but she might find Ruby’s case to be too complex and defer to an internist. I liked everything she had to say and she seems experienced enough. We shall see.

 

When pushed, Neko's vet handled quite a bit (acromegaly, diabetes, kidney disease, arthritis, HCM) with just the occasional phone consult with the IM. The SCL and heart failure tipped her over the edge to firing me as a client. For Neko's sake.

 

My concern, FD aside, is the CKD. Pred has been known to increase progression to further stages. I wonder if the IM realized that Ruby is also CKD b/c to me Pred doesn't make sense. You have to keep all of the medical issues in some sort of relationship where treating one doesn't mess with the others, to as much degree as possible. My two cents worth

 

Thanks for bringing this to my attention, Margaret!!! I've written to the IM to ask. Ruby's CKD is diet controlled right now, but you're right and I didn't think about it, being so focused on her diabetes.

 

Healing hugs and prayers

 

I'm glad you're asking about that. This is not to scare you, but CKD can be unpredictable. Cricket had it for 5-6 years at Stage 2 and lived a long life. She was well controlled and rarely had flares. On the other hand, Whisper went from Stage 1 to 2 to uncontrollable decline in a matter of weeks, and I could not stop it. Sometimes when it gets triggered it can be hard to bring back to a manageable stage, in my experience. That is why I have concerns about the Pred. Ruby has many conditions to manage all together, so it seems wisest to not start with that particular steroid.

 

Thanks, Margaret. I did send an email, hopefully I'll get a response. I haven't spoken to Ruby's regular vet yet so I won't start anything until I get answers for my many questions!

 

+3=57. Ruby's been eating well today and had her second meal after this test. The new anti-nausea cocktail is working! The only thing of note that happened was Frank stepped on her tonight. All I heard was a loud screech from the living room. When I came out to see what had happened, Ruby was trotting towards me and Frank had no idea what part of her he stepped on, only realizing it when she screamed. She was probably hiding under the couch with a bit of her sticking out from underneath. I've examined her paws and tail and she doesn't seem to be in pain and she's walking ok.

Sigh. If it's not one thing, it's another.

 

Adrienne, I can only hope that the effect of the steroids, whatever they will be at this point, will leave me with the beautiful blues and greens on Dolly's spreadsheet. I just want Ruby to be well regulated and below renal threshold. That is my best case scenario here. She's been doing so well today, but I know I have to get at that inflammation that is in her and eventually the lymphoma as well. I don't know how long she will have to be on the steroid. Even if she goes into remission with the SCL, the chlorambucil would be stopped but the steroids might have to continue, albeit at smaller doses and less frequently, as long as she still shows symptoms.

 

My loving prayers for whatever has to be done will magically work together all in Ruby’s best health interests. We are all here rooting for Ruby and you with love, caring and support. Poor Frank he must feel terrible, sounds like something Rob would do, Poor Ruby, she must be wondering why Frank is so mad at her he stomped on her . He’ll probably get from her tonight. Take good care Katherine.

 

Actually, the steroids might be tapered off and the chlorambucil continued.

 

Got it turned around in my head. Thanks Wendy.