32 Flavours...and then Some!

Where the routine turns to somewhat chaos!

So Diva's not had a full blood panel in several months. She's been a bit quieter than normal, shedding a lot and grooming a lot, feels thinner. Could something be wrong with her thyroid? Only way to find out--full blood panel.

Called and made the appointment for today at 1100. She's on the bed when it's time to go. Prep the carrier by opening the door so I can just shove her in once I grab her. Shove her in the carrier...hmmm, she's fighting me more than normal, that's odd...

Put carrier in car. Drive to vet. It's quiet, which is normal for Diva--Jazz is the talker in the car. That is, until I'm about 3-5 minutes away from the vet at the second to last stop light. Loud wretching ensues. I turn back to look--Diva NEVER gets carsick. I see a red collar instead of a floral one. Ra's in the carrier!!! I picked up the wrong cat?!?!? Should've looked closer, as the story will attest...

Get to the vet, run in and tell them I somehow grabbed the wrong cat and is there time for me to drive back home (15 minutes one way, 30 round trip) and get Diva and come back or should we reschedule for after lunch. No, come on back. Drive home without speeding (much). Wait for Ra to shit the carrier as well, which he does as we're pulling into the driveway. Get *my* shit together and get into the house with my purse and the carrier. Open up the cage and...wait for it...BOTH DIVA AND RA RUN OUT!!! HOLY HANNAH!! Ra must've snuck in the cage for a looksee and I didn't see him in the back of the carrier in the shadows of the hallway. Remove soiled towel, check carrier for clingons, replace with new towel, re commondeer The Deets cat and head back out to the vet AGAIN.

Fortunately her exam was uneventful. Dr. B. talked me into a full exam including urine test and x-rays by giving me a deal on both the x-rays and the urine test. X-rays look good, will get the bloodwork and urine test back tomorrow morning. Asked how we can put a bit of weight back on Diva and Dr. B. suggested what we're already doing--putting a/d in with her regular turkey wet food. Says her muscle mass is fine, she's not too far off from where she should be weight wise anyway and not to worry too much about it. Mind, she weighs in at about 10 pounds right now and when we first brought her in to the clinic down her she was a hefty 22 pounds--lost more than half her weight from a combo of a diet we put her on followed soonafter by her kidney disease taking off even more.

Will report her results as soon as I get them...

Well she seems to be in better spirits, interacting with J and I more than she was last week. Problem is she's not eating terribly well even with 1/2 dose of the appetite stimulant pill to perk her appetite up...

I gave up on the Royal Canin renal wet food--she would eat around it no matter how well I thought I mixed it in with her mature formula turkey and dash of A/D. In fact, my "dashes" of A/D have gotten a little bigger in hopes she'll be more interested in her food. I've had mixed results with that the past few days.

I give her the appetite stimulant dose in the morning before breakfast. Yesterday she ate a moderately okay breakfast and almost all of her lunch but she barely nibbled on her dinner before I left for bowling. Time to call the vet. Dr. B said if she ate well for her first two feeds just wait a little while to attempt to feed her again--perhaps she was still full from lunch? J reintroduced her to her bowl about an hour or so later while I was at bowling and she ate most of what was left in her bowl. A good sign...

Then it's time for her post sub-q feed, which was a disaster. She might have licked at it a couple of times and left the rest. I tried to coax her by mixing up the food some more in her bowl with the "magic knife", but no love. This is Not Good.

This morning she got the appetite stimulant at 0730 and I fed her at 0830ish. Usually long enough for the dose to kick in. She ate maybe a third of her breakfast. :( Call the vet and talk to my favorite tech. She suggests bringing in Diva when I bring Jazz in for a looksee. Fine. It will be so...

Bringing two cats to the vet with a bum back in the rain by oneself is, to say the least, an interesting and challenging experience. Dr D came out and helped me with the carriers, thank goodness.

It was decided by both Dr B and Dr D that a week was sufficient time passed to check Diva's kidney numbers again. Blood drawn. Physical exam done. Kidney numbers came back a smidge lower than last week. The new fluids regimine is working!

We're to keep her on the twice daily sub-qs regimine for the time being. While her appetite is poor (which could be caused by the amoxicillin she's still on) we're to give her the appetite stimulant pill in the morning first thing and again in the afternoon. We can even up the dose to the full dose twice per day if needs be. Dr. B also encouraged me to keep adding the A/D to her mature formula to make sure she's eating enough--I think he wants to see some weight back on her again; she's so thin right now! Don't need to go back in on Christmas Eve for the originally scheduled follow-up because they took care of everything today. Keep an eye on her eating, give her a higher dose of the appetite stimulant if the lower dose isn't cutting it and if she's still not really eating well enough I'm to call. Dr. B even gave me his cell number to call him in case something goes sideways over Christmas and New Year's when their hours are shorter/are closed. I love my cat clinic! :)

Well so far she's eating and using the box alright but she's a bit lethargic. She won't leave the spot between the pillows on our bed unless it's time to eat or if she's got to use the box. We wrapped presents for shipping last night and usually if something like that's going on she'll at least come check things out to see what all the ruckus is about--last night, no.

Got her to eat the Royal Canin renal wet food for her Thursday night feeds and three of her four feeds yesterday, but she outright rejected it on her last feed. So I dished her out some mature formula turkey with a generous dab of A/D in it and she wolfed that down. This morning I didn't even bother to try the renal food--just gave her what I figured she'd eat and she did a pretty good job.

Called the vet to ask about the lethargy. Dr. D says she should bounce back after a couple more days of the increased sub-q fluids therapy. Basically we're flushing all the extra toxins out of her body right now and she's likely to feel poorly until most of the toxins are voided. He said as long as she's eating and using the litter box we should be fine. If she starts not eating while on the appetite stimulant pill or if she starts vomiting, then it's time to worry. Good to know. He also said to keep trying to push the renal food on her, even if it's a dab mixed in with her regular food. So it's off to the vet to pick up more supplies (needles for sub-qs and more renal food) this morning.

So we wait and see what happens. Her follow-up is on Christmas Eve at 1000. Will continue to keep y'all posted.

Yes, AGAIN!! After making me a proud Mommy on Sunday morning at the crack of dawn, nothing but a tiny download this morning. Not enough to cut it after four days, so into the vet she went.

X-rays showed she was blocked up again, though not as bad as the last couple of times. Curiously there was a large gas pocket at the end of her colon and the block was up further. That hasn't happened before that I can recall. Enema deployed successfully, all is clear.

Dr. B had some novel alternative suggestions as to how to keep her guts going. First one was once weekly home administered enemas of a couple of ccs of Lactulose. Second was once weekly home administered suppositories of some unnamed sort. Third was introducing mineral oil either orally or rectally, but he was primarily talking orally. Once a week 9ccs of mineral oil orally at once--three syringes of 3ccs each. That, to me at least, spells a recipe for vomiting soon after, or of explosive downloads once a week. :( So he backed down and said we could break it down in half and give her half in the AM and half PM. Still spells a recipe for disaster for me, but...

I dunno. For some reason Dr. B doesn't believe in the powers of Miralax. I've barely gotten a chance to get her on the right dose for her--it took me at least a month the last time to get it right last year. He says "What worked before can change and no longer work. The key is to keep her going without having to bring her in for enemas." That much I get, but I think we should give the Miralax more of a chance.

Dr. B wasn't there when we picked her up so I talked to Dr. D what he thought about things. Dr. D has more faith in Miralax and its powers. I told him how last time she was on Miralax she was getting 1/2tsp three times a day with her last meal of the day being kibble. Up til now I was giving her 1/2tsp twice a day with 3/8tsp every other feed (usually 1-3 additional feeds of wet food with no kibble as she won't touch kibble anymore). I figured with the extra feeds at 3/8tsp she was getting more Miralax than her last time on it so I couldn't understand why it wasn't working the same. Dr. D suggested I give her the three feeds at 1/2tsp and additional feeds at 3/8tsp and dial back as needed. Try to add small amounts of mineral oil orally or try to mix it in her food to see if she'd tolerate it in her food. No more Lactulose.

Since Dr. D's methodology is a lot less hard on Diva than Dr. B's in my opinion, I'm going to keep trying with the higher amount of Miralax and adding a bit of mineral oil in orally and see what happens. I hope Dr. D and I are right... :/

She's been sequestered in the guest bedroom since Monday night. As I predicted she spends most of her time sleeping under the blankets on the bed unless it's time to eat, she needs to use the box, or if J or I are in the room. She sleeps a lot normally, but it's a bummer she feels compelled to "hide" like that rather than look out the window from time to time or play with her catnip pillow. So far, though, not showing any signs of depression. I sleep with her every other night (tonight's a Diva night) and she really seems to enjoy that. I also try to spend time in there with her throughout the day.

She finally downloaded in the middle of the night on Wednesday night/Thursday morning. It only took 6cc of Lactulose a day plus her food concoction (Science Diet mature formula turkey with a little Science Diet A/D added plus miralax, benefiber and baby food squash) to get that to happen. We're waiting for one more download before we consider releasing her into the rest of the house to make sure the concoction is working regularly. We'd release her now, but she and Jazz use the same box and it's become quite difficult to tell the difference between their respective downloads now that they're both constipated. Now that Jazz is on Cisapride I'm hoping hers start looking like they used to before the constipation hit, thus making them easier to distinguish.

My obsession with cat shit is breath taking, is it not? ;/ Le sigh. But for the risk of megacolon developing, which is very bad indeed, I would worry less about how often they downloaded. But because of the risk of megacolon...there but go I. It's like having toddlers or something...

Sorry for cluttering your feed with my cat woes. I natter on for additional record keeping purposes. Feel absolutely free to scroll past.

Yep. The log book doesn't lie. As of this morning Jazz hadn't gone poo for fiveish days (last was on the 29th) and Diva had only very small amounts of output over the last few days. Not A Good Thing for either girl...

Talked to Dr. D--he suggested bringing both of them in, particularly Jazz because it had been so long since her last known poo.

Palpation noted some back-up in both girls, but he decided he wanted to be sure by taking xrays. He only charged me for one for each girl. Sure enough, Jazz was fully packed and Diva was about halfway packed in her colon. Godsdammit. We've been giving them their Lactulose religiously and they've been keeping it down, too. It's simply not working, it seems.

Pre-xray, Dr. D mentioned perhaps putting Jazz on a med called Cisapride to help out with gut motility, which would, in turn, help with the poo situation. Post-xray it will be so--new med for Jazz. :/

In the past I used a concoction of Miralax and Benefiber for Diva to keep her regular and it worked a wonder when she actually ate it. I've been slowly reintroducing it into her diet over the last couple of days. So far so good as far as eating it, but no poo action as of yet, obviously. Dr. D wants me to try it with Jazz as well. She's so small I don't know how much to use! I'll have to very gradually introduce it as to not have a buttsplosion.

So anyway, both girls are still at the vet getting their second enemas in just about a week. This is costing me a small fortune. This cannot abide. The girls and I shouldn't have to take this stress and I can't afford this regularity of high vet bills for very long. Something's gotta give...

I simply don't know what set this off! Jazz never had a problem and Diva's seemed to be under control pretty well. No real change in diet outside the normal switches between wet and dry food as they decide to eat whichever one they're craving--now it's wet which I think would be easier to digest. About the only thing I can think of we switched from Enulose brand of laxative to Lactulose brand of laxative. Allegedly it's the same thing, just different names, but I swear it doesn't work as well, or, it seems, at all judging by how plugged they both were despite being on the right respective doses every day.

Diva's had problems dating back several years with constipation. Jazz has had gut motility issues but not constipation issues. Both Dr. B and Dr. D are chalking up the new problem with constipation up to her advanced age. Hopefully the new pill will help things, and perhaps I can get her on the right dose of miralax if she'll eat the food with it mixed in...I'm at a loss. So stressed out and worried about my girls...

Wow, what a madhouse! We just got back from our 1845 appointment about a half hour ago! Lots of what should've been short appointments ended up running way long so we ended up waiting a bit because Dr. B. left early and Dr. D. was there by himself running the show...No big, we can wait.

Did short blood panel for the kidneys and liver, etc. and a CBC to make sure she wasn't anemic again. All her numbers came back within normal to acceptable ranges, Thank Gods!

We're to give her 50ml more on her sub-qs for a couple of days along with Reglan twice a day for a couple of days for nausea. She got a B-12 shot as well. If she's not doing better by end of same couple of days I'm to call back.

Seems as though she's just a bit under the weather for some unknown reason. I'll take it. Better than her kidneys deteriorating again or some other Bad Thing. My poor, sweet girl. :/

Jazz is still peeing decent amounts as for me not to worry. Diva downloaded a fairly decent sized present for me overnight.

And all is seeming right with the world....

It's been awhile since I updated, so...

DIVA: Her appetite was great for awhile, got her off the appetite stimulant for a few weeks, then her appetite started to wane again end of last week. Put her back on it again on Sunday. It's working--she's driving me nuts! Such is life--she needs to eat. I figure we'll keep her on it a couple more days, then wean her back off and see what happens. If her appetite flags again after we wean her off, then a call to the vet is likely in order...

JAZZ: Well we were about to start weaning her every other day on 1/4 of a 5mg tab of pred and she got pukey again over the course of the last week or so more often than she should have. :( Back up to 1/2 tab for at least a few days to stablize her, then try to go back down to 1/4 tab again and see what happens.

Her appetite also started to wane a bit again, too, around the same time as Diva's did. Same story, back on appetite stimulant as of yesterday, which is also when we upped the pred. If I'm up and about she's almost constantly bugging me to be fed. Thing is, though, she's still not eating quite enough each feed. I'm still on the 1 1/2 tsp to 2 tsp of food every hour to hour and a half, so she's not getting much to begin with. It's not that she's drastically eating less--she's almost finishing what I give her each feed--it's just that she's not finishing it all as she definitely should be if nothing were amiss. That being said, she's eating more now than she was before we put her back on the appetite stimulant, so that's A Good Thing.

Things were going relatively well for a few weeks there, too, dammit! Oh well, what can you do except roll with the punches and keep going forward. This is the way things go with geriatric cats, I guess...

DIVA: Tomorrow we start weaning Diva off her appetite stim pill--every other day for about a week, then off if things go well. I'm able to leave the room for quick amounts of time when she's eating and not disrupt her, so I'm going to try leaving her alone in the room once today and see what happens. I don't mind sitting with her while she eats, but she should have the concentration/confidence/whatever to be able to handle being by herself in the guest room to eat as she was before Jazz got sick. If this ends up not being the case, we'll adjust to the new normal. Anything to get her to eat enough on a regular schedule!

I've almost got her weaned off the A/D food entirely--just a pinch in with her turkey. She's at a full usual dosing of miralax, which might be too much now without the benefiber and baby squash added as a buffer to keep things more solid. Her output has been...less than solid...so I'm dialing back a bit on the miralax to see if that helps without stopping up the works entirely. Back to calibrating the works again, I guess. Hopefully I'll get her on the right daily dose quicker than I did the first time...ugh! What a pain that was!

JAZZ: She's keeping her food down, and I'm feeding her 1 1/2 tsp of I/D every feed now every hour and a half or so. She usually starts begging for her next feed about an hour after she's been fed, which can get maddening. Today's she's got the double whammy of appetite stim pill and pred so she's been a pest and a half and Mama's not feeling well so Mama's patience level is slim today. She's very persistent today, let's just say that. :/

She's had bits of Ra's kibble here and there and kept it down, but I'm not really ready to test those waters yet; nervous Mama's nervous about the vomiting coming back. I asked the vet about I/D kibble; his concern was Jazz would take a liking to it and not want to go back to her K/D kidney kibble. I/D's not particularly kidney friendly or unfriendly, just not optimal for her overall needs. Evidently the I/D wet food is fine for her, though, so I keep giving it to her, and she keeps nomming it down like a champ. The key, still, is to keep her eating enough and often so she doesn't vomit or stop eating entirely, so I'll do what I have to do.

Regardless, I do need to get in touch with Dr. D. in a few days to see what the game plan is going forward as far as how long to keep her on I/D and when to start the kibble again and whatnot.
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All and all the girls appear to be on their way back to normalcy *knocks wood*. I really hope so--these past few weeks have been nerve wracking!!