Cat in ICU (now out) 7/26 [bg broke 200's]

Discussion in 'Lantus / Levemir / Biosimilars' started by apple, Jul 19, 2017.

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  1. HWright

    HWright Well-Known Member

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    I wish I had magic answers to help your kitty and you. What a mess that happened. Idk about meds you've mentioned. But for food: might try the old standbys, baby food diluted with a little water if need be ....spoon feed or assist feed?
    And sending heaps of :bighug::bighug:healing vines :bighug::bighug: for you both
     
  2. apple

    apple Member

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    Apr 15, 2017
    We are heading home and I'm having a crying jag. Leaving means leaving the opportunity to receive medical intervention for my cat and taking home my happy cat. He's not happy. He was so happy before we came. He was off his meds and back to himself and he was happy. I ruined his happy.
     
  3. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    Can your regular vet intervene with a vet in the area where you are now?
     
  4. apple

    apple Member

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    Apr 15, 2017
    No, the university vet will not change mind.

    I told her that I don't want the quality of life for him that he is now in. He's been here before and the only way it's been fixed is when I bring him to the u and get Mannitol.

    We came down last year. With the same doc, I said he needs Mannitol. Doc saI'd no. Doc said would do and MRI. I'm guessing doc thought MRI would prove doc right. It showed fluid on the brain. He had Mannitol. Did the same thing another time.

    Because he can't have and MRI, and all I have is behavioral evidence and the full knowledge that I am the expert in my cat's behavior, it's not science.

    Doc told me the previous times when I requested Mannitol and the MRI showed fluid, was coincidence.

    My local vet told me the pressure in his head is the worst headache anyone could every experience. Pain like you can't image. I don't want him to live in pain and said so. U doc said, 'If you are telling me that you will euthanize him just to get me to do Mannitol, I won't do it."

    So, I appreciate all your suggestions, I don't know what would make things change to get him Mannitol.

    He is in pain.
     
  5. apple

    apple Member

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    Do any of you have vets that would and could do Mannitol? Would they tell you if you asked?
     
  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I am so sorry you are going through all this. Gentle scritches for your kitty.

    My Neko had an issue while undergoing anesthesia for a CT at a vet teaching university, and it was a completely different experience. She had a heart block and they rushed in the specialists and called me right away. I loved the customer experience at that vet school. Too bad not all are the same.
     
  7. apple

    apple Member

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    Apr 15, 2017
    If it was a pill doc would give it, bit wouldn't because it is done via iv.

    Then said: Mannitol is not good for diabetic cats.
     
  8. apple

    apple Member

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    Apr 15, 2017
    CSU

    Edit: I didn't go to CSU, was asking if you did.
     
    Last edited: Jul 22, 2017
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Sorry to hear that, I had a great experience there twice. In the internal medicine and radiation oncology departments.
     
  10. apple

    apple Member

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    Apr 15, 2017
    I was asking if you went to CSU?

    I didn't go there. Considered it. Just calling there and dealing with the people on the phone ($10 to talk with someone) and trying to get him set up there was an unpleasant experience.

    Juat the phone calls were nothing like Jeff described.

    I was told there is more demand than capacity. Not enough people so, it seemed very cookie cutter. You fit their mold, not meeting the needs of the cat.
     
  11. apple

    apple Member

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    Apr 15, 2017
    This makes me sad. We are at a rest stop and he loved to look out the window and people watch. He has no idea there is any one to watch. He's just sitting in my lap. I gave him his bupe and we are back on the road.
     
  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I am sure he will feel better once he is home. :bighug:

    Yes it was CSU. I never paid for a phone call, did all the bookings via email.
     
  13. TempestsMum

    TempestsMum Guest

    God love you both. :bighug::bighug::bighug:

    Have you spoken to your regular vet, could they intervene on your behalf?
     
  14. apple

    apple Member

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    Apr 15, 2017
    No I haven't. It won't change the university.

    Please see comments in above sections.
     
  15. TempestsMum

    TempestsMum Guest

    I have read them but, thought if your vet intervened he/she may be able to 'refer' you to them for that treatment specifically?
    The only other option is to find somewhere else, even if it's far away?

    Here I have been referred to other vets for specialist care for certain conditions by my own vet and had the hospital and my vet work together, it's probably different there. I'm just trying to think of any way round this for you that I can. Sorry if I'm repeating stuff others have suggested.
     
  16. apple

    apple Member

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    Don't be sorry. I need all the help I can get in order to help him.

    The local vet can refer. What happens at the u is decided at the u. If the local vet could say give Mannitol and the u would do it. I wish the local vet could make the u give the drug.
     
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  17. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    I have worked at university medical centers for literally decades. There are a few things you can do.

    Make an appointment to speak with the Department Chair of Anesthesiology to discuss how your cat and you were treated. (You might want to ask your vet to request your cat's records from this recent incident and then get the copy of the records from your vet.) You can also make an appointment to speak with the Dean of the medical school. It sounds like this is a distance from you so doing this by phone may be easier. Be as clear as you can about how you were treated and what the consequences were to your cat. Both the Dept. Chair and the Dean should have the authority to make this situation right. I might also suggest you ask if the vet hospital has someone in risk management. (This is the hospital attorney. This is the person that does whatever he or she can to prevent you from suing for malpractice. If they have a risk management office, it's often a good place to start.)

    Report the anesthesiologist to the State Veterinary Board. All professionals are licensed. The licensing board is empowered to investigate what happened. At the most extreme, they can pull a license. Not every intervention is that extreme but given that your input was ignored, this is a concern.

    One thing that most universities rely on are donors. People do not donate when there is bad press. Put comments about your experience on social media (e.g., Yelp for the area where the vet hospital is located.) I don't know if there is enough information for local news to investigate but you could contact the campus newspaper.

    My biggest concern is that you were being ignored. If you had told these vets your cat was allergic to something, would they have likewise not listened and figured they knew your cat better than you?
     
  18. apple

    apple Member

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    Apr 15, 2017
    Thank you.

    I've been refused records for this week. I was told they have to be signed-off on and will be sent.
     
  19. apple

    apple Member

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    Apr 15, 2017
    My cat was behaviorally not himself and the vet said, he looks great. I've never seem him like that before. He was walking and because he couldn't see he was walking over and in things. If you didn't know him, he looked like a cat exploring. That is one of the exact reasons I know he's off. He would never do that. He sits at the vet and hisses and spits.

    She can make a decisions visually, but when it's my cat. My visual input in not valid.
     
  20. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    Jul 9, 2012
    I found it in writing about not giving it to diabetic cats....

    I am going to tag @Marje and Gracie
    because she might be a resource to find out who else could administer this besides the place you went.


    I have dealt with Dr's who can't think outside of the box.... and so far I've luckily been able to find ones that at least try to move past their formal training. My ear dr is wonderful and knows that I know my ear better than he does.... so he listens to me, my input counts.

    I'm sorry you had to deal with a closed minded one who dismisses you summarily.
    It's obvious you will put up with whatever you have to to help his pain.
    I hope when you get home , and he relaxes that he will feel better ....

    continued prayers....


    this situation reminds me of when I first got here and saw a member who was rushing to the vet hospital, got stopped for speeding, and she argued with the officer who handcuffed her, arrested her, took her to jail and left her cat in the carrier in the backseat when she was crying that it was a life and death emergency.
     
  21. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    Jul 9, 2012
    I looked up veterinary neurologists

    found this website.... http://find.vetspecialists.com/

    i actually have a neurologist vet in Algodones, NM.... good to know.
     
  22. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    @rhiannon and shadow (GA) tagged me but since I don't know where you live or what state you are close to, it's difficult to make any suggestions on neurologists. I don't know, right off hand, of any that give Mannitol but then I've never needed it for veterinary purposes so there may be someone.

    If you are anywhere near Arizona, I've have used Dr. Scott Plummer at Veterinary Neurological Center. I found him to be extremely knowledgeable and compassionate. But, I have no idea if they use Mannitol.

    Do you think the anesthesia could have caused Horners Syndrome? I've seen this in several cats as a reaction to anesthesia.

    Sending many vines for your sweet boy.
     
    Last edited: Jul 22, 2017
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  23. apple

    apple Member

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    Apr 15, 2017
    No to Horners.


    We are home and he has:
    Eyes that don't move in their sockets
    Tail that drags behind him or is horizontal, not vertical
    Walking low on back legs
    And he's constantly on the go, stops for a second or two. Even if he lays down, it's for a moment and then he goes. He has no reason or purpose for going, he just goes. And goes, and goes, and goes. If you try and stop him, he gets ???? not sure of word I want to pick, but he will try and chew his way out. He was chewing on the bars of his cage, arms out of the cage.
    He was a good rider. Been rising since he was 10 days old. I could take him anywhere. He washed, looks out the bars, stretches out, washes some more, then sleeps.

    He was awake the while time. He no longer sleeps.

    He was in his wire pen at the hotel, so I could have some mental rest (not much sleep) and he was trying to break out of the bars.

    When the Neuro was watching him "patrol the perimeter march" she commented on how "he's never behaved like this, look at him go" when I express that in the context / rubric that is my cat this is inappropriate, I get told not to argue.


    Stating my opinion and standing up for my cat is not arguing. Yes, she did tell me that I constantly argue. However, I don't. I state my said.
     
  24. apple

    apple Member

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    Apr 15, 2017
    Gave first dose furosemide .3ml. Starting small.

    Should I throw the lantus out? I have another in the fridge, so if the travel bottle should be tossed, I'm still okay for supplies. Not sure how high the furosemide will raise him. Not sure if I can get him off patrol to test.
     
  25. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    Oh dear, I feel so bad for you and your kitty. There has to be an answer to get him some relief, somewhere! Is there another university that might have the mannitol and be willing to at least listen to you??? Nobody knows your cat better than you. I can't believe that vet accused you of constantly arguing. Once you've had a chance to get a bit of rest, start calling everywhere you can think of to see if anyone can help.

    Your Lantus should still be good. It will keep out of the fridge, just not as long.

    I hope the furosemide helps Apple at least a little bit. :bighug::bighug:
     
  26. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    How is Apple doing today, any better? Keeping you both in my prayers. :bighug::bighug:
     
  27. TempestsMum

    TempestsMum Guest

    Also holding you both in my prayers x
     
  28. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    Jul 9, 2012
    the going and going sounds very much like dysphoria. That would be because of the bupe.
    What is the dose you are giving?

    Shadow had that with pain medicines. She would pace, roam, sit lay down in one spot just to get up and move again. Her eyes were fixed and she could not sleep.

    It usually can be lessened by lowering the bupe dosage. I had to keep Shadow on the lowest dose possible. She just didn't tolerate it well
    at all.
     
  29. apple

    apple Member

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    Apr 15, 2017
    Not from bupe. He was like that before bupe. He's like that after it wears off.
    Dose recommended .2ml
    Dose given .05ml
     
  30. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Hi Apple Mom,

    So so sorry about what you have to go thru:bighug:

    My DH, human med professional read the symptoms you posted and questioned Apple’s electrolyte balance… First off, he believes that brain compression is doubtful because it would give Apple lethargic state, at least that’s how it is with humans. He would not be walking at all but lying down.I thought it was good news.

    About the electr. balance: if Apple was on diuretics (is that right?) one of the side effects of diuretics is washing out sodium and potassium ions. That by itself will cause weakness and frustration and disorientation causing him walking back & forth without purpose or reason. You said: ..”And he's constantly on the go, stops for a second or two.”

    Different diuretics wash out different ions. Is there a chance to run electrolyte test?

    Also due to diuretics an organism can become water depleted and Ringer’s or isotonic salt solution 0.9% (for humans) is recommended.

    How much does he urinate?

    What is his diagnosis?

    The remainder of the issues can be addressed after the electrolytes are in balance. It might take several days.

    Our hearts go out to you and Apple. I DO NOT GIVE YOU ACTING PLAN but rather a food for thoughts and something to research further. My DH is talented in HUMAN diagnostics, but Ducia is his first sick kitty and it was a while since his med training. The difference between cats and humans is lesser than we used to think but MUST be accounted for as a factor. Perhaps discussing the electrolyte issue/ SQ fluids therapy with vet over the phone is the best way to proceed.

    I just wish we could do something to help Apple right away…
     
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  31. apple

    apple Member

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    Apr 15, 2017
    No

    Post edited.
     
    Last edited: Jul 23, 2017
  32. apple

    apple Member

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    Apr 15, 2017
    Thank you. It means lot that you would ask someone on his behalf. I don't think the ICU took blood. Blood before CT was good. Don't think he was on any diuretics. He has done the no stop movement since he was returned to me.
     
  33. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Symptomatic of water depletion/dehydration or hypo valemic state.
     
  34. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I thought you posted he was on furocemid..? It washes out the potassium.
     
  35. apple

    apple Member

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    Apr 15, 2017
    His first dose was last night. The non stop motion has been happening since I got him back on Thursday.

    Immediately, when I got him back, I went over what was not right and requested Mannitol. I was told no.

    Now, he's trying to get out if the bedroom. He doesn't know I'm here. He's biting and pulling the carpet and chewing on the door. He can't get out so he's in motion moving and over vocalizing. If he was himself. He'd be snuggled on my face. He went to the window and now he's moving again.

    When he gets like this, His behavior has been journaled and I have note books of this constant activity.
     
    Last edited: Jul 23, 2017
  36. apple

    apple Member

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    Apr 15, 2017
    Somehow for him, his head doesn't clear fluid.

    Grabbing his face, tilting head back, insert pill. Will create pain and fluid on the brain.

    My mom accidentally hit his head with a book inside a canvas bag and all this happened. He had an MRI, fluid on brain, Mannitol, back to normal.
     
  37. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Oh, my...
    Still, the thought here is to get the electrolytes test ASAP...
    Sq f therapy is easy to do at home and you only need to confirm by A vet that it wouldn't make any damage. DH says you have nothing to loose.. Think about it. If you have a plan I think you yourself will feel better. And you need to restore you strength.
     
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  38. apple

    apple Member

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    Apr 15, 2017
    He has no idea I'm in the room. I'm laying on the floor and when he patrols, he just walks over me. He doesn't place his feet strategically or carefully and loses traction and grips and slips and slides.

    My cat doesn't even know I exist.
     
  39. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    Jul 9, 2012
    Prayers for you as you observe and make your decision. I had to let mine go far too early so it's a gut wrenching decision.
    Your love for him is obvious and if he can't improve and doesn't. It's the last gift you have.

    I pray for him to turn around on his own.
    :bighug::bighug:
     
  40. TempestsMum

    TempestsMum Guest

    I wish I could convey my absolute empathy with you right now. I wish I could create my tone through written words and I mean this in the gentlest way.

    If mannitol is out of the question, its may be best you try not to fixate on it. I know and understand that it works and has worked in the past.

    It's time to consider other possibilities and open your mind to them. Isn't it worth taking a chance and trying something, anything at this point?
    At least speak to your own vet?

    I know you are beyond tired and beyond weary, and I'm sending a massive hug to you both. Just please don't give up yet. :bighug::bighug:

    I just remembered there is a site online called do I need a vet it's run by a retired u.k vet, it may be worthwhile getting his opinion?
     
  41. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Not until you tried the SQ f .....
    I am not being sadistic, truly.
    Yes... but he cannot have it, unfortunately.
    From the very bottom of my heart: it is not as awful as it sounds. I promise. Or can it be done at a vet?

    I would certainly give it a try before making irreversible decision...

    I understand that Mannitol gave him immediate relief and that's how it stuck in your mind - a magic solution... But what if something as simple as balancing the electrolytes can help? DH says that Manitol was used when operating on a human brain - the liquids literally drained from the head in minutes causing hypovalumic condition. I do understand why you value it so much...How much fluids was in the brain and where was it located? How long ago?

    Forgive me if I appear to be pushing you, I don't...Only there might be a way to help other than Mannitol..I honestly think it cannot be ruled out completely, not yet.:bighug:
     
  42. apple

    apple Member

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    Apr 15, 2017
    https://en.m.wikipedia.org/wiki/Mannitol

    As a medication, it is used to decrease high pressures in the eyes, seen in glaucoma, and to lower increased intracranial pressure.[3][2]Medically, it is given by injection. Effects typically begin within 15 minutes and last up to 8 hours

    Mannitol is in the osmotic diuretic family of medications and works by pulling fluid from the brain and eyes.[4]

    The discovery of mannitol is attributed to Joseph Louis Proust in 1806.[5] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system

    I wonder if injection really means injection since iv is usually written differently. I've always thought it must be delivered via iv filter in hospital.

    I'm going to test his Bg to see where he is at.
     
  43. apple

    apple Member

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    Apr 15, 2017
    I think of his behavioral expression as manic. Could manic and dysphoria be the same idea?
     
  44. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Yes, but it is an emergency medication and should be Rxed only once in the EMERGENCY situation. If given more often or on a regular basic it will harm the organism by hypovalimia/water depletion...
    The organisms need balanced liquids.
    Mannitol isn't a safe medication at all.
     
  45. apple

    apple Member

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    Apr 15, 2017
    Is there any one that knows if Mannitol can be done by injection? If so, more options.
     
    Last edited: Jul 23, 2017
  46. apple

    apple Member

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    Apr 15, 2017
    7/23 Bg 143
    Yesterday's dose of furosemide .3ml
    No lantus shot at this time.
    Force feed ad.

    I need to do some positives:
    He held his tail a little higher while walking.

    I guess that's not much of a list
     
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  47. apple

    apple Member

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    Apr 15, 2017
    It's what he's got.
    To get blood vet sedates. Not an option for him after what happened.

    He is usually the most compliant animalin the world. Will do anything for me. Loves having his toes tested. He purrs and helps me. Not anymore. He didn't seem to know I was there.

    Force feed. He never mineded it. Like a little bird he would sit in my lap and open his mouth. Today it was a struggle. I now have an idea of why people say force feeding is hard.

    My mom is here. Another pair of eyes. She says his motion has no purpose. He just goes. She agreed he was in one of his Mannitol needing states.

    Fluids, there is no way I could get him to do that.

    I'm going to email to neurologist and ask for help.

    She saw him motor non-stop I the exam room, maybe if I write about context and seeing a snippet of something colors one's view.

    @Tanya and Ducia Where does you husband put the non stop motion?
     
    Last edited: Jul 23, 2017
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes.
     
  49. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Can you video him with your phone and send to neurologist? Maybe it would help persuade them.
     
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  50. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Mannitol is iv only. Your regular vet should be able to give it. They might have to order it and if they do surgeries where they use iv they can administer it. If nothing else they should be able to find someone local for you.
     
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  51. apple

    apple Member

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    Apr 15, 2017
    He sat for 2 minutes and is back in motion.
    Gave 3 ml furosemide.
    Got hopeful when he sat for a moment.
     
  52. apple

    apple Member

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    Apr 15, 2017
    I have Mannitol. I carry it with me when I have him with me. What I don't have is someone administer it. I don't know how a vet would get a catheter in without sedation.....my emotions go up and down in waves.
     
  53. apple

    apple Member

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    Apr 15, 2017
    Sorry, we did not find any results for your search.- that's what my search said
     
    Last edited: Jul 23, 2017
  54. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    He still stands by what I posted earlier:

    1.Enough liquid in the brain that can cause brain's compression would give Apple lethargy, not walking back and forth (ECID, of course). Having small amount in, the one that does not cause compression doesn't call for Mannitol;

    2. Electrolyte imbalance could cause dysphoria symptoms/disorientation/being frightened;

    3. Getting electrolytes checked ASAP/normalize the levels ASAP is the way to go - given it is approved by vet professional;

    4. Small amount of liquid in the brain can be addressed surgically later on, if necessary, AFTER the electrolytes are balanced to norm and the clinical condition is assessed after the SQ f therapy.

    Again, he/I do not give an action plan but rather what to research/to try/to discussed with a vet if emergency relief of Mannitol is unavailable.

    Without seeing blood-work results, CT scan images, current and past diagnosis all of it is only an educated guess by human med professional given in order to let you know that there maybe other ways to get Apple feel better in the absence of Mannitol.
     
  55. Squalliesmom

    Squalliesmom Well-Known Member

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    Exactly what I was going to suggest!!! I think that's a great idea!
    ETA: The neuro knows Apple, right? Then he/she should recognize that this is not normal behavior for Apple.
     
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  56. apple

    apple Member

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    Apr 15, 2017
    What about his eyes? They still do not move.

    He gets fluid if another cat licks him and moves his head.

    I don't know how much fluid has been on his brain in the past. I've never known quantity.

    Could he do something like Pedialyte?
     
  57. apple

    apple Member

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    Apr 15, 2017
    She and I both sat and watched the same behavior. She called it wonderful, he's never looked so good. I called it inappropriate and was told I argue.
     
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  58. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    If there is liquid in his brain pressing against/ compressing the stem area of the brain then it could affect the eye motion properties. We need to know if brain ventricles are dilated. Again: only a guess in absence of MRI/ brain scan images;
    any chance to ask for/ request/ demand the copies? Not only it would make this conversation meaningful, any vet professional would need to see them....
    Instead of SQ f? No, it is not a substitute. But you can try it.
     
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  59. Squalliesmom

    Squalliesmom Well-Known Member

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    Well, maybe if she sees him stumbling heedlessly around in his own natural environment she will realize it's not the wonderful behavior she thought it was. It might not help but it can't hurt to try, right?
     
  60. apple

    apple Member

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    Apr 15, 2017
    I can't access Google docs at the moment, so putting notes for myself here.....
    1m:07sec eat
    Wander
    1m:22sec man cave
    Wander
    1m:20sec in cat bed
    Wander
     
  61. apple

    apple Member

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    Apr 15, 2017
    He doesn't stumble. I think of it like and army tank. He goes forward over anything. He doesn't go around things he should and used to go around. It's always over and forward.

    Thank you for the suggestion. I think journaling his constant movement might help.
     
  62. apple

    apple Member

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    Apr 15, 2017
    The last image he has done, his body was right in all manner of function. The issues arose after the CT. I don't know how to get new brain info.
     
  63. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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  64. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    Can you regular vet check electrolyte levels? Seems like that could be a serious, pressing issue, if there is an imbalance.
     
  65. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Regular vet can call to get reports. I doubt they would deny him. Vet can also give a sedation without anesthesia to get the iv in.
     
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  66. apple

    apple Member

    Joined:
    Apr 15, 2017
    I will check with the Dr tomorrow.
     
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  67. apple

    apple Member

    Joined:
    Apr 15, 2017
    I will ask them if they got the records. Every time I check in they (the university) read the list of vets that are to be notified and sent records.

    I thought sedation and anesthesia were the same.
     
    Last edited: Jul 23, 2017
  68. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Not by a long shot. Different drugs; different procedure.
     
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  69. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It's a question of degree. Sedation meds can be used to relax and quiet the animal while leaving it with some degree of consciousness. Airway intubation is not involved. General anesthesia renders the animal unconscious and airway support through intubation is required.
     
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  70. apple

    apple Member

    Joined:
    Apr 15, 2017
    Hi all,
    Since our kitties are a team effort, I wanted to say thanks for the moral and mental support. It means the world. I'm the only one that was at the u and had nobody for support except this board. So, thank you, thank you, thank you.

    My mom watches him for a bit and I left the house for a bit.

    The plan for now:
    Give Pedialyte
    Force feed ad for nutrition
    Check #
    If over 200 post on the board for opinions
    Bupe for pain

    Contact vet for records/ electrolytes
    Ask vet if he can offer supportive care while he tries to recover.
     
    Last edited: Jul 23, 2017
  71. Judy and Boomer

    Judy and Boomer Well-Known Member

    Joined:
    May 23, 2014
  72. HWright

    HWright Well-Known Member

    Joined:
    Jun 19, 2016
    @apple
    My heart is still wrenching over what you're both going through.

    In mind with all that's being discussed here, I will add a few ideas/possibilities for consideration in the context of this discussion and what you are going through

    What @Tanya and Ducia mentioned about electrolytes possibly being off rings familiar and imo worth considering at least as a possible contributing factor.

    Unflavored pedialite would be a quick go but it does have dextrose which could affect his bg. (mentioning so you won't be alarmed if it affects his bg). Alternatively, a home made beef or chicken broth or "raw liver shake for sick cats" might be worth a try.

    Here is link to an fdmb thread about bone broth re electrolytes. It's about dehydration (idk if your kitty is dehydrated but it's information) with discussion and info about pedialite and electrolyte alternatives (bone broth mentioned) that don't contain the dextrose that pedialite has in it:

    http://www.felinediabetes.com/FDMB/threads/what-to-give-to-a-dehydrated-cat.138658/

    In this thread is also a link to home testing for dehydration (it's in bjm's signature):
    https://docs.google.com/document/d/1r6ktdF7AMJCYHgPkVQWFUFy5Ag6OnbmfNfQqL3zX_88/mobilebasic

    Also, Here is link for raw liver shake recipe:
    http://www.felinediabetes.com/FDMB/threads/the-liver-shake-for-sick-cats.30432/

    Bone broth (and even plain meat broth such as chicken) and the liver shake have gotten us through some rough spots with some seriously sick kitties in our household.

    Hang in there and Heaps more feel better vines :bighug::bighug:for you and you kitty. :bighug::bighug:
     
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  73. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    Sending more prayers. :bighug::bighug::bighug:
     
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  74. apple

    apple Member

    Joined:
    Apr 15, 2017
    Thank you. I looked at the bottle for quite some time reading dextrose.......and thinking, I think that's sugar, hmmmmmm.

    I bought it and figured if I don't use it for him, I can for me.

    I'll read about the broths.

    He probably won't get Pedialyte today. He got his sugar from another source. He found a Perkins muffin my mom brought and ate a bite. Yes, not healthy, but he found it, asked and ate in his own. Right now, he gets almost anything he wants to eat.
     
  75. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    at this point... eating a muffin is a nice normal behaviour..... so that's a plus.

    from earlier today....
    dysphoria in a cat - symptoms can be vocalization, agitation, pacing, withdrawal from owner or from environment, lack of grooming, abnormally rapid breathing




    the zombie like walking that you describe sounds like he can't see where he is going ( imho)
    the swelling could be pushing on his optic nerve.


    I hope that tomorrow your local vet can have some ideas and suggestions
     
  76. HWright

    HWright Well-Known Member

    Joined:
    Jun 19, 2016
  77. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    So sorry you had to face that whole horrible university experience all by yourself. :bighug::bighug::bighug: Know that we're with you in spirit and you've got all our support! I'm glad you're going to look into the electrolyte imbalance, I think that has the potential to become critical. Sending more prayers and healing vines for Apple, and for you, as well. Hope you can get a little rest, too. :bighug::bighug::bighug:
     
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  78. Ozzy Pawzbourne

    Ozzy Pawzbourne Well-Known Member

    Joined:
    Dec 4, 2016
    Sending prayers to you and your kitty.
     
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  79. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Not at all. Ask your vet if it's possible. They might be able to give the mannitol this way.
     
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  80. MJW

    MJW Well-Known Member

    Joined:
    Mar 29, 2017
    Is he off furosemide now? That can affect electrolytes. I had a cat that had too much furosemide. She was dysphoric and very thirsty. She had other problems though too possibly causing the dysphoria.
     
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  81. MJW

    MJW Well-Known Member

    Joined:
    Mar 29, 2017
    Can you count his breaths per minute? Is he breathing normally?
     
  82. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    How is Apple today?
     
  83. apple

    apple Member

    Joined:
    Apr 15, 2017
    He got one does sat & one does Sunday. The patrol walking was happening before the furosemide. The furosemide is to reduce his head swelling.
    He didn't get any today because he asked for muffin again. I'm trying to walk a line between he asked and ate muffin (normal behavior) and head is swollen (needs meds that

    Started this then needed to leave......will post more later today.

    The muffin is a hit. He ate part of a burger,- cat food, won't self feed.
    Bought a food scale and a people scale to start weighting him and his food. I usually go to the vet to weight, I don't think his mental health is up for goong to the vet, even if it's just for a weight.

    More later today.
     
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  84. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Thanks for the update, we worry about all the kitties here like they were our own! So glad the muffin is a hit! And the burger. Better than not eating anything! Yeah, I wouldn't subject him to another vet visit if you don't have to. I use a baby scale to weigh my guys at home. If you don't have one, you can usually pick one up on Amazon fairly cheaply. Is he still doing the patrol walking? Hoping the furosemide helped at least a little bit. What did his regular vet say about electrolytes? Sending hugs for you, and gentle scritches for sweet Apple. :bighug: :cat:
     
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  85. Marvin's Mom - Nat

    Marvin's Mom - Nat Well-Known Member

    Joined:
    Apr 10, 2017
    to weight Marvin, I get on the scale weigh myself, pick him up, weigh both of us, subtract mom's weight = Marvin's weight. So if you have a people scale try that :)
     
  86. apple

    apple Member

    Joined:
    Apr 15, 2017
    7/25
    Action plan:

    1. Now have digital people scale to weight cat (if it works, no vet trips for weigh-ins)
    2. Now have digital food scale to more accurately monitor food intake
    3. Allowing muffin eating; behaviorally appropriate, asks for muffin, takes a bite, goes to new spot, puts muffin bite on whatever surface he's on and then eats muffin; similar to pre-anesthesia event behavior......bites are about the size of a penny and depth to two stacked pennies
    4. Allowing free feeding of Solid Gold Indigo Moon crunches, placed out about 10/15 at a time to track intake
    5. Force fed A/D cut with water; quantity undecided
    6. BG tested daily; numbers will be food influenced; with the anesthesia event, I don't want 2 hours without food available
    7. If food influenced number reaches 250 or above, if he seems like he can handle 2 hours with out food, regular ambg/ pmbg to be done
    8. Furosemide to be administered .3ml-.5ml ? How often, undecided / bg checked prior to administration; above 250 no dose
    9. Buorenex administered .05-.2ml between 1 to 3 times per day depending on head & neck pain and activity level.
    10. Recontact vet for how he can help support recovery
    11. If needing to return to insulin ?? Which one....

    Feedback:
    How is my thought process in balancing the self feed with nutrients vs pushing his luck with sugar and exiting remission?

    His muffin behavior is normal and he eats with some enthusiasm. I'm willing to go with some higher bg numbers in return for continued self feeding.

    Force feeding- wondering if I should cut it with Gerbers baby food to increase the calorie count. Concerned the corn starch + muffin could over load his numbers. Not sure where to hedge his bets.

    Higher fat food. Vet would like more fat in his diet. Suggestions for and easy to syringe food with higher fat content?

    Insulin: before he went off the juice we were going to switch from lantus to lev. If he needs to return to insulin, would you go with lantus, what you know and have data on or would you make your move to lev?

    Reason/s we were going to switch.....he expressed neurological symptoms while created by lantus; along with stinging when injected; over all lethargy during the first 6 hours after injection, he was miserable, like clock work. And the list of negatives goes on......that said it was what pushed him to remission. Unknown if lev could do that

    Goal: gain weight
    Mental health goal: return to mentally safe state. Carrier making any noise (cleaned it &/or moving it) and he changed his personality, worried he will be put in carrier. My guy is a road warrior, loves his carrier, would nap in his carrier etc..... now, need to get feeling okay with the carrier.

    Afternoon bg 195
     
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  87. Marvin's Mom - Nat

    Marvin's Mom - Nat Well-Known Member

    Joined:
    Apr 10, 2017
    I hear a lot of good things about Lev. From what I hear a lot of people switch to it because of the sting and because it seems to provide flatter BG numbers, I believe that the nadir is not in the middle of the cycle but more toward the later part of the cycle (+ 8 or 9), again every cat is different. I would switch to Lev if Marvin was on a larger dose, I may look into it if his BG are getting too low when I am away at work. Right now I am off so I can monitor and at this low dose on Lantus it is not stinging him.
     
  88. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Your action plan looks good. I would definitely try the baby food. I think Hi-Tor Neo is pretty high in fat, and blends with water easily for syringing. If I were you I would also try the Liver Shake. Pretty sure someone already gave you a link but to save you from going back through all that I'll give it to you HERE. Everybody says it works wonders.

    Keep us posted! :bighug: :cat:
     
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  89. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I'm glad you have a plan moving forward. Good luck and keep us posted. :bighug:
     
  90. HWright

    HWright Well-Known Member

    Joined:
    Jun 19, 2016
    Wow and :bighug: with what you've been doing and your plan of action. As Lucy (squallie's mom) said, I also think your plan of action makes sense.

    Re liver shake: yes worth a try and I'm glad Lucy reshared the link I included earlier. I make it with either chicken or beef liver (the chicken liver seems to appeal more with my Tribe), carrot juice and either spirulina, kelp or dulse granules. These items should be available in your local health food store. If you don't want to use raw egg yolk or if that doesn't appeal (as is the case with my fiv renal civie Azalea), I make it with plain powdered egg white and powdered egg yolk. ECID!
    (Btw: adding that learned about liver shake here in fdmb thanks to members suggesting it during crises...so thanks to them it's become a staple go to with our Tribe).

    Re baby food: yes but if you use it or other whole meats exclusively, I suggest adding a food supplement. I use ezcomplete food fur life. I mix about a teaspoon in with water and about 1/2 jar of the beechnut baby plain meat food (I often add in a bit of plain pumpkin or baby food plain squash).

    Here's the link to ezc food fur life. Also
    The owners, Laurie Goldstein and Carolina Liima, will send you a free sample pack to try. There might be a link on the site or you can email them directly from the site.
    http://www.foodfurlife.com/

    They've just started offering egg yolk powder, too. If you can't find egg white or egg yolk powders locally, here's where I've been getting my supply (I get the small packets bc a little goes a long way):
    http://www.modernistpantry.com/egg-white-powder.html

    I'm glad to send you some of my stash of these dry ingredients to help get you started.

    Oh yes, re your vets suggestion to add fat to Apple's diet: perhaps try a bit of unsalted butter with his muffin bits? Light cream, diluted with a bit of water or mixed with assist food mix?
    Egg yolk, whether raw or powdered, is a good source of lecithin (and not soy-based) that, while technically not a fat, may help assimilate fat and supports brain health.

    Another thought I've had is to ask you if you've thought about homeopathic support in the mix with the traditional meds and nutritional support? If you're open to that, I'll gladly pm you or post here the name of my long-distance homeopathic vet who has helped us through several severe situations (he does telephone consults only so no vet treks needed).
     
    Last edited: Jul 26, 2017
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  91. apple

    apple Member

    Joined:
    Apr 15, 2017
    7/26

    Current weight 12.2lbs ish (ish because number from new at home scale. Unsure how it correlates with vet scale)

    Goal weight 13.5 lbs

    Increased water intake

    Dropping (or trying to reduce) muffin intake

    Feed .06oz ad cut with water am

    Edit: To do blood work vet would want anesthesia and I don't want that for him. So, no electrolyte information at this time.

    2nd edit:
    Patroling: still there, pace is not as frenetic. Will stop at moments and sit
    Civvies: they give him a wide berth, kitten doesn't harangue him, others let him be
    Poop: one poop since home
    Sleep: I don't think he's slept since we got home
    Purr: hear my first normal purr while testing his toes yesterday
    Bathing: he's not had a normal bath since getting him back. Its spot washing kind of like I'd we had a bug on us and we swat that spot. He must quickly and with urgency was a spot, right there, NOW
    Sitting: he does seem to sit in a spot for a moment or two longer
    Over: yesterday he stepped over my mother's ankles instead of bulldozing his was over/on/through....
     
    Last edited: Jul 26, 2017
  92. apple

    apple Member

    Joined:
    Apr 15, 2017
    Thank you for the suggestion. My scale doesn't have partial units. (Old school dial up) New one is digital. Althought the first reading made me think it was defective. Sixteen pounds. He's never been over 13.5lbs..... Next reading was 12.2lbs. He's got some eating to do.
     
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  93. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    If your scale gets jostled or moved it will affect the calibration and your next results can be out of line with the prior ones.

    Is Apple particularly hard to deal with at the vet? I don't know why your vet would want to anesthetize him to draw blood! Even my most truculent and difficult cat doesn't need to be anesthetized to draw blood.
     
  94. apple

    apple Member

    Joined:
    Apr 15, 2017
    In his youth, he'd rip you to shreds. (So he'd say.....He was more talk than action, but, boy could he talk!) He would slap the vet or tech. Never bit or turn on you, just talk and slapping.

    He (cat) gets very scared.

    Vet thinks if would be less stressful of him to be out while blood is drawn.

    Prior to the FD zillion vet trips, things has settled down to where he was calm at the vet.
     
  95. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Given his serious issues with anesthesia I'd have the vet try everything they can to get blood without anesthesia, maybe a mild sedative (kitty valium-ish thing).
     
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  96. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    I agree.
     
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  97. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    My vet uses a cat bag and muzzle for Gizmo. If the tech is good, once the cat is in the bag and muzzle in place it shouldn't take them more than 2 minutes to get the blood.

    https://www.amazon.com/Guardian-Gea...=1501092842&sr=8-8&keywords=cat restraint bag
    https://www.amazon.com/ASOCEA-Groom...1501092978&sr=8-32&keywords=cat restraint bag

    Once the muzzle is on him he kinda goes limp for a bit and then the bag goes on and before he can react they are usually done. Less stress on him and safer for the techs/vet.

    My vet won't even consider sedation for routine blood work - too risky.
     
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  98. HWright

    HWright Well-Known Member

    Joined:
    Jun 19, 2016
    I agree about finding alternatives to anesthesia for blood draws, especially in Apple's situation. Idk if even light sedation would be problematic for Apple. but at least light sedation can be just enough to calm and it clears the system quickly.

    Idk if some other ideas are worth a try but I'll mention them just in case. I've had some reasonably good results with these for calming pre-vet visits (re three of my cats who've gotten the "fractious" moniker for different reasons: high kill shelter fear-aggression defenses; high kill shelter induced fear of abandonment panic attacks; the third (azalea) got a bad rep one time when she was sick, had severe nerve pain and was initially handled by a new tech who wouldn't listen to me and had no nuance skills.

    I've had best pre-vet visit calming results with:
    Bach rescue Remedy (pet or kids version) starting the night before;
    Nat mur homeopathic (in lieu of rescue Remedy);
    Thunder shirt or lightweight leash harness (for my fear-aggression kitty who responds as if she's temple grandin in her calming compression device).

    Tried Valium once with my fear-aggression kitty, having been warned ahead of time by the vet that Valium can go either way. In Spunky's case, even 1/2 of the lowest dose had her literally climbing the walls til it wore off. ECID.

    Members have mentioned other calming meds but, alas, I don't recall what they are.
     
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  99. Judy and Boomer

    Judy and Boomer Well-Known Member

    Joined:
    May 23, 2014
    My vet uses a plug-in that has a smell that calms kitties. And he uses a clip at their scruff; he swears by these natural methods of calming pets. I don't remember the name of it but I'll try to find out tomorrow for you.
     
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  100. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    I have heard before about the scruff clip, sounds like it really has amazing results!
     
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