Tag Archives: Feline health

I’m Home: Day 2 of My Captivity

I got out early! My Mom got a call at 10:07 this morning from the vet’s office that I got through surgery and was ready to come home any time! They had told my Mom that I could go home any time after 3:00 PM! My Mom called my Dad and he came right home and picked her up and they came together to bring me home. I was such a hit, and everyone was so happy!

I am so tired. I still have some anesthetic in me. My boy things are gone, and I was wormed in case I had worms, and I got a rabies shot and some kind of 4-way vaccination too. I’m supposed to get those every year. What I am proudest of is my microchip. It means my vet will have a care diary to refer to, and any vet can see it. I feel loved and important to have it. Effie has one too.

My Mom took the photo of me sleeping off the anesthetic in my carrier. She put a bowl of water and a little bit of food out for me in case I wake up thirsty and hungry. I can only have a little bit of food at a time or I could throw up.

Thank you for all your prayers and kind wishes! I feel more loved than I have ever felt in my whole life!

–Paladin

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Effie’s New Frontier: Explored, found wanting, and for now abandoned

Our late cat Coolidge never had his teeth cleaned, nor was I willing to subject him to such a trauma, until he was 15. His teeth were all in place and found to be without decay, with some tartar. My diabetic 15-year-old Coolidge survived my worst anxiety, the anesthesia. I still felt my now former vet showed poor judgment. I simply do not believe it was worth the risk.

Effie is 19 months old, and her breath is sweet and her sharp teeth are white. I thought, and confirmed with our vet’s tech, that it would be good to start getting her accustomed to having her teeth brushed. Even just twice a year would likely waylay the necessity later in life of anesthetized cleaning by the vet. I thought it was worth a try, though I still harbor the observation that cats have lived long and prospered without ever undergoing the trial of having their teeth brushed.

Nevertheless, I dutifully picked up this  kitty dental kit at Petco today–finger and handle brushes so she has a choice, and chicken-flavored toothpaste.

Praise God Effie doesn’t hold grudges. She does, however, make her preferences clear. She also has a way of communicating that she is appalled with my incomprehensively insulting suggestion, and it must be retracted at once and never repeated. Acknowledged. Purina is not likely to make kibbles that will destroy a cat’s ability to eat kibbles. Effie eats both kibbles and a high-protein, low-carb tinned food.

Who wants to see a grin without a cat anyway?

P1010467 An idea whose time evidently has gone, at least until symptoms demand its return.

P1010468I cannot believe you would demonstrate such misapprehension of my sensibilities. . . !

P1010473Human, human, thy name is so Mud.

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Whoa! Coolidge is eating!

There aren’t a lot of things more horrible than watching a beloved companion starve.

Coolidge pretty much quit eating two days ago. I began giving him sugar water from a syringe. He took it well, but it didn’t get him back to eating his food. This morning I diluted some of his special renal diet soft food with some water and tried to get it into a syringe. The uptake hole was too small to draw much, but what he got in his mouth he took with the same relish as the sugar water.

I dumped the remaining tinned food, along with a fair amount of water, into my Kitchen Aid’s bowl, and used the whipping attachment to make a thin slurry the syringe could draw. I fed Coolidge the slurry and he downed what didn’t dribble down his chin with increasing gusto. Oh God, my cat was never inappetent! He just didn’t have the strength to stand over his bowl and eat!

It’s not an easy maneuver to syringe feed a cat while sitting in a chair, and it’s hard on my back, sitting on the floor with Coolidge in my lap while I draw his life-sustaining food into the syringe and slowly express the slurry into his mouth. His acceptance is my magnificent reward. We knew it was going to be tough terrain along this journey—which was, after all, assigned to us.

Our vet called to check on how Coolidge is doing. We are blessed to have a vet who is so thorough, comprehensive, earnestly interested in Coolidge, and encouraging to work with. I presented some concerns about Coolidge’s ability to stand and walk capably, his receding desire to eat a sustaining amount, and urinary and bowel retentiveness. Our vet thinks these likely indicate a Vitamin-B deficiency. My syringe-habituated hands will give Coolidge a new weekly injection.

Some might consider these things heroic end-of-life measures, but I have come to see that you cannot be your cat’s hero, unless your cat is a hero.

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At the Front: Coolidge and the Great Glucose-Thyroxine Wars

It’s been a while since I’ve updated the Chronicles with a snapshot of how Coolidge (and his keepers) are faring as his diabetes and hyperthyroid conditions battle not only against my poor cat’s well-being, but appear to be engaged in a struggle for supremacy over his endocrine system. I suppose it could be compared to wars between nations. One side tries to wipe out another, never considering the disadvantage of mutual annihilation.

Coo’s thyroid came down to a glowing normal 3.3, using locally compounded methimazole transdermal formula I smear in his ear twice daily. My delirious joy was not durable. His glucose revived a trend we had believed defeated. He launched a new high-wire act. He was again capable of 12-hour glucose swings from 52 to 420. You can’t treat this sort of thing with any predictability. You stay the course. You email your vet a quick “any ideas?” with means and ranges. You are thrilled with relief to learn that a normalizing thyroid can up-end glucose values in a diabetic cat, that you are doing everything possible, and even to reduce the insulin a bit when he needs it, even when the number on the meter is huge and terrible (HAT). Sometimes Coolidge’s glucose is too low to give him any insulin. That almost always leads to a HAT number at the next check point. I don’t treat that number. I treat the condition. Eventually his numbers begin again to hover around his average. But my cat is not average.

I am thankful my vet has access to top-line experts at the College of Veterinary Medicine at WSU, and that she will confer with them when Coolidge throws an implacable turn.

He is a Cat, I need to remember, and Cats will duck predictability, dodge rules, and be quite cavalier toward your sleep rhythms, even if they have food, water, and everything they need, but simply feel like broadcasting at 1:28 AM, and again at 4:10 AM, in a nerve-frazzling yowl at 141 db. . .which, ultimately, must be what we adore about them.

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The new Coo-nundrum

So now the patch of skin between Coolidge’s shoulder blades is ulcerated. I can no longer dose him there with the transdermal thyroid medication. There isn’t anyplace else he can’t reach.

He had been snuggling up for his insulin and the simple application of his thyroid medication to the skin on his back, but this morning he tried to bolt. I could see why. I dabbed the stuff around the perimeter of the shaved area. The center is a cluster of raised sores. I can’t stand it.

The compounding pharmacist will have to reformulate the delivery substrate. I thought of other possibilities: grind up pills and put them in a capsule so maybe the taste doesn’t make him inappetent again? Sugar water for the transdermal application? —it’s the carrier, not the drug, that’s causing the ulcers. A homeopathic remedy? Just to brighten the moment, my husband mentioned the anecdotal cure-all, mercury pills.

I’m not ready to concede that it’s checkmate. My all-time favorite scene in American cinema is the one in which Indiana Jones is confronted by a saber-swirling guy in harem pants. He watches the saber whirring around at eye-blink speed, gets bored, and finally takes out his gun and shoots the guy dead.

There just has to be another way through this, Chewie. . . .

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Gaining

Thankful tidings! A certain resilient cat has resumed eating his canned food—the low-carb, grain-free, gluten-free food that keeps him from gaining excessive weight and has made his diabetes management possible.

He accepted some Beast (< Fancy Beast < Fancy Feast) via handfeeding, and then tucked into it on his own. I have never been happier to be wakened at 4 AM to replenish his food than I was this morning. What a relief!

We have no way to know whether Coolidge’s restored appetite is due to the antibiotic injection kicking in, or to switching the delivery system of his thyroid meds from oral to transdermal. He’ll have another u/a next week to check the status of his UTI, and a blood test to check his thyroid level. He is definitely a much happier and brighter-eyed fellow than he was two days ago.

Of course, we remain vigilant, given Coolidge’s age and health status. But one more time, the emergency is deferred. I’m grateful for the meaningful support of true friends when my apprehension was coming close to despair. Murphy, Maddy, and Lily know whom I mean.

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Chasing phantoms of the flesh

Coolidge’s u/a revealed a UTI, which could be the troubler that robbed him of his appetite. The thyroid pills he took for a couple of weeks also remain suspects. We have since replaced the bitter-tasting pills with transdermal medication administered by syringe to his ear. I wear nitrile gloves so an errant dribble of the stuff won’t kill my thyroid.

The fix for the UTI was supposed to be oral cephalexin twice daily for 14 days. It’s the swift and sure cure for the 50% of cats who can tolerate it. Not surprisingly, Coolidge is in the other 50%.

I spritzed the entire content of the 3 ml syringe of pink liquid into his mouth at once, and cheered in amazement that he swallowed it. A few minutes later, he announced his cohort affiliation. I have never seen Coolidge vomit that much before. Thankfully it was only 4:20; my vet’s office was still open. As I cleaned up his trail (he has a knack for travel vomiting), I received instructions to bring him to the office in the morning for an injection of an antibiotic that is supposed to last for two weeks. My vet doesn’t quite trust its efficacy, but our trick bag is about depleted. She is going to consult with a WSU College of Veterinary Medicine professor, her longtime mentor.

Coolidge is eating enough kibbles for sustenance. The remaining problem spawned by his total inappetence is his continued rejection of canned food. The kibbles will pack weight on him and his diabetes is out of control. Endocrine and immune systems just don’t contain any isolated variables. They are the domains of the phantoms of the flesh.

All in all, we’re having a peaceful day at Rabbitbrush. The sun is shining, and it’s 29°, up from 19° this morning, when I took Coolidge in for his antibiotic shot.

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spiral

Coolidge, my companion cat of 15-1/2 years: we’ve gone through some rough diagnoses together. We’ve kept each other comfortable. I’ve treated his diabetes since 2006, and he’s purred at my side and diminished my discouragement since my diagnosis with Addison’s disease in 2007. Now he has also developed hyperthyroid. It seemed a simple thing to regulate—just a very small half-pill, morning and evening.

But the methimazole was treacherous. My cat stopped eating. The pill form of the drug can cause inappetence. He refused any and all low-carbohydrate canned foods he had eaten before the hyperthyroidism arrived. This was especially frustrating because kibbles jack up his glucose so much. I fought back with gradual increases in his insulin. Untreated, his thyroid would blow up his heart. Surgery and radiation aren’t thinkable at his age. Better to stay with methimazole and chase down the glucose numbers.

My vet and I decided it was worth the additional complexity to ditch the pills and go with transdermal methimazole, which doesn’t have the liabilities of the pill form, but it doesn’t have the simplicity, either. This formulation is prepared by a compounding pharmacy. I have to syringe a small amount of the medication into my cat’s ear. It resolves inappetence and GI issues in most cases, but the pills are normally prescribed first because they’re so much simpler to administer. If this would resolve his increased glucose levels, and even more critically, restore his appetite, it would be worth everything.

Inappetence in a diabetic cat can quickly bring on hepatic lipidosis—it took Coolidge only four days back in 2006— and a feeding tube was necessary for nine horrible weeks that summer. Pancreatitis also menaces the inappetent diabetic. And, obviously, so does starvation. So initially we fed him kibbles and the most wholesome treats we could find. They were like junk food, full of carbs, but they were the best food in the world, because my cat would eat them.

I broke into sobs the next morning when the heartless glucose meter read 372. It was 365 the previous evening, after Coolidge’s first transdermal dose. I have a low tolerance for slow progress.

My vet wanted me to try a diabetes management kibble, Purina D/M. I picked up a bag this morning, along with two cans of D/M, in case he might still transition back to the lower-carb canned form. Coolidge is finicky, but by God’s merciful grace, he tucked into the D/M kibbles with renewed alacrity. He snubbed the canned D/M, but at least he can get off the high-carb kibbles. Not only did he eat a small but sustaining portion, which in itself was enthralling, but his evening glucose was only 95!

There’s a reason this chow costs $34 for a six-pound bag. It’s the only Hail Mary trick I have left. Time—I hope not much time—will tell whether the transdermal formulation will restore Coolidge’s appetite and lower his glucose to more tenable levels on the diabetic spectrum.

My cat’s diseases are necessarily complicated because they interact. You can’t treat any of them as a discrete circle, stack the circles, and celebrate a series of victories; you have to chase them through a pernicious spiral formation. You always end up in a broken ring. It’s like Mutually Assured Destruction, only it’s Assured Destruction of Patient. That is because all patients are mortal beings; there was a Fall, remember? And now all creation groans under the sentence of death. It sucks, but it is what it is, and for the very most part it is very beautiful and very wonderful. Still, there are snakes in every paradise.

I can’t know how long Coolidge or I or anyone else has to live in our unique assigned spirals. All I can know is that I’m throwing metaphorical hail Mary passes and we’re keeping each other comfortable, as long as there’s a goal post left standing.

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