Preparing For The End? How Far Should I Go With Diagnosing/treatment? Intestine, Heart, Lung Issues

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daftcat75

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how do i get a feeding tube? Is that only offered in the E.R.? She has not eaten today...
Also, as surgeries go, it’s one of the cheaper ones. The tube itself is maybe $20. What you’re paying for is the gas and the X-ray. Krista got it as part of a larger hospitalization stay. But if I add up just those line items, it was maybe $250. This is SF Bay Area, California prices. Your area may be less expensive.
 

daftcat75

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And some vets are split on this but mine said as long as it didn’t pose a clogging risk, it was okay to give medications by tube. Those that should be given with food should be given with a syringe of food before giving the medicine. The tube makes giving medicines a lot easier if you can get the medicine compounded into a liquid or crushed into a slurry.
 
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SambaLove

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Thanks Daftcat75!
That does sound stressful. Could a cat with a possible heart condition tolerate and heal with a feeding tube? I wonder why my vet never recommended this before?

Right now I have been giving her the transdermal appetite stimulant and I just started with subQ fluids at home....still not much eating today but she had loads of cat treats yesterday. About 20 Temptation treats.

Today, she had 4 small bouts of diarrhea, which makes me worried.
The vet only prescribed 100 mL of the fluid a day, wondering if I can give her more since I have a whole bag...like at least doubling it?

She looked a lot better the first hour after fluids at home...like she "woke up" but now she is back to looking sick again...

One of my friends found this video from a vet that recommended 200 -300 ml of the fluid a day for sick cats....why would my vet only prescribe 100mL? Anyone know??

Thanks, everyone!
 

daftcat75

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It’s stressful for a week until you get the hang of everything. Then you get into a rhythm. I found Krista was a lot more receptive if I prepared all the syringes (food and water) ahead of time and set them down on the floor in a deep dish for her to sniff it out and know what’s coming. Then I gently squished her down to a laying position and off we went. She was remarkably patient and only squirmed if the food was too cold or too fast.

I think it would be okay for a cat with a heart condition. But here’s the thing. Your appointment to know what that condition is isn’t for at least a couple more weeks. She can’t under-eat that long. At some point it becomes life-threatening. At that point, the treatment is a feeding tube. Why wait that long? It only makes the recovery harder.

Anyway. I’m not a vet and that’s a conversation you should have with the vet. But I don’t think you should wait for the echo to get the tube.

I can’t comment on fluids. Another question for your vet. Sometimes they start conservative and rely on you to tell them if the treatment is not working or if there are side effects that should be addressed.
 

daftcat75

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More treats than normal plus less food can definitely result in diarrhea. Another reason for the tube. You can get back to giving her food rather than treats. You can also mix a probiotic in with the food without getting objection from her so you can reestablish good poops once the food is running through her again. Ask the vet about proviable. It’s a good probiotic. Better than fortiflora. My favorite is Pet Flora from Vitality Science.
 

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Just chiming in to say, feeding tube for cats is almost unheard of in some countries and not popular with all vets anywhere. Not to say one is better or worse, I'm not in a place to judge when even vets' opinion seem to differ but, this might be why your vet never mentioned it.

Where I live they would much rather hospitalize the cat and have them on IV fluids and/or syringe feed than to insert a feeding tube.
 
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SambaLove

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Thanks so much Daftcat75 and freinds!!!!!

My vet is closed on Sundays and I wonder if I should take her in for a feeding tube or even an IV put in her. She hasn't eaten anything yesterday except for a few temptation treats. She had 5 soft stools/diarrhea yesterday and hasn't had a lot of water except for the 100 mL of fluids I gave her yesterday.

The concern for the feeding tube is sedation. Our vet suggested we wait to "clear her heart" for sedation after the echo echocardiogram, which is scheduled for July 25th...

Right now I am debating taking her in the Emergency Room to have IVs put in her or ask if the feeding tube is a possibility....I hate stressing her out...and she has had so many ER visits the past month, that pains me to see her stressed...though now she just looks weak.

I have SubQ fluids at home but wish I could give her more than the recommended dose as she "woke up" the hour or two after I gave them to her yesterday at 5 p.m.

Any suggestions would be greatly appreciated...

Worried,
Samba's mom
 

daftcat75

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Krista was hospitalized for ten days early this year. They put an IV in her and they were giving her medications and fluids by IV. I kept asking about nutrition but the IV wasn't helping with that. It was actually at my insistence that they put a tube in her. Sometimes vets get stuck on a particular diagnostic and treatment path, and need a little nudge to see the bigger picture.

The bigger picture is this. If she's not eating, she may not make it to her echo or her overall health may have degraded to the point where a low risk procedure has now become a high risk procedure. Either she's intubated now or she's intubated later as a last ditch effort. I'd rather not see it go that long.

In general, you want the cat at home and the cat wants to be at home. Hospitalization is expensive, stressful, and I'm not sure it's appropriate yet. You already have fluids at home. What she needs is food: protein that isn't her own muscles, and fat for energy from food will be easier on her liver than conversion of body stores.

While just about anyone could perform the tube placement, I would prefer it be your own vet. She'll know Samba better than the emergency hospital and she'll likely be in a better position to support you and her every step of the way from showing you how to do the feedings, cleaning the wound and changing the bandages, and any adjustments to the tube placement that may be needed. You may need to return a couple of times to get an extra stitch placed or the tube positioning checked. It's best if you can do this with your own vet rather than having to go emergency every time.
 

daftcat75

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For your tube appointment,

1. Ask for the pancreatitis blood test already. "Spec fPLI" is the name of the test.

2. If going with the tube, ask them to leave a little more length than they normally would. It's easier to cut a tube that's too long than to add length once it's been inserted (you can't.)

It's hard to see in this picture. There is a button-hole midway between the velcro end on the left and the vertical velcro strap in the middle. That distance from the button hole to the strap that holds the tube down is a couple of inches. Even if the tube doesn't reach all the way across and lay flat, you don't want the tube to be so short that the button-hole is going to rub against the cap. That may either cause the cap to come off or pull on the tube. Even if you don't get the tube to lay down flat where the strap is placed. If you're handy with a stitch, you can take up that vertical velcro strip and place it nearer the button-hole.
kitty-kollar-regular-front.jpg

3. Either ask the vet to do this or you can probably do it yourself the first time you clean the wound. Take a permanent ink pen ("Sharpie") and mark an upside-down T on the tube where the tube meets the skin. The tube will move around a little bit naturally. Sutures do become loose. The base of the upside-down T marks the skin line and the length of vertical line meeting that skin line will give you a rough estimate of how low the tube may dip if it moves into her. But more than likely, the tube will slowly rise out of her. That's why you mark the skin line. For a very small movement, it may be okay to gently push it back in place yourself. For larger movements or if you don't feel comfortable with that, take her back to the vet. Having the skin line marked on the tube saves you an X-ray.

4. Order a Kitty Kollar and the protector pads. Familiarize yourself with the resources and Faq on that page. It will make the whole experience easier if you have an idea of what to expect and what challenges you may face. None of these match up to the benefit of getting the tube though and they shouldn't dissuade you against it.
» Kitty Kollar®
 
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SambaLove

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Thank you Daftcat75!!!
Please tell me there is a happy ending with Krista.
What happened to her after the feeding tube and hospitalization?



How long was she on the feeding tube? How do you think she felt with it on? Did she recover and extend her life? How old was she when it was placed??

Send pics of Krista with the feeding tube if you have them, please! I would like to gain a better picture of this...

Thanks so much!! <3
Samba's mom
 

Kflowers

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Feeding tube happy ending. My cat had surgery then went into pneumonia. I'd lost two to pneumonia before. This time the vet put
in a feeding tube. He got his medicine and food through it. He recovered and lived many years afterward.

The thing was they only had short feeding tubes, I guess for kittens
because he wasn't a long cat. That meant carefully only putting in the amount for one normal sized bite at a time. Why? The connection between his esophagus and stomach still worked as it would without a feeding tube. To put in more than a bite at time made him sort of choke.

When he got better and I put his medicine - pink and sticky - down the tube, he pulled away from and whipped his head from side to side. pink medicine every where. We got the tube removed that day and went to an injection for the rest of his antibiotic.
 

daftcat75

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Thank you Daftcat75!!!
Please tell me there is a happy ending with Krista.
What happened to her after the feeding tube and hospitalization?



How long was she on the feeding tube? How do you think she felt with it on? Did she recover and extend her life? How old was she when it was placed??

Send pics of Krista with the feeding tube if you have them, please! I would like to gain a better picture of this...

Thanks so much!! <3
Samba's mom
Krista was hospitalized in January. She had a number of things going on—teeth, ibd, pancreas, liver, it all flared at once. Or rather the teeth first and everything else trying to feed her whatever she might eat despite her teeth and her IBD, which was well managed at that time. That didn’t work so well. On top of that, she had an ear infection with a ruptured eardrum. Which now that I think about it, it’s also related. That ear gets angry and inflamed and filled with fluid whenever she has food she’s allergic to.

Long story short: Krista persevered and had her 15th birthday in April. She’s still going though showing signs of slowing down. Except her appetite. She’s gained back all her lost weight and still gaining. I’m going to have to work with that fur pig to figure out how many calories she really needs vs how often she’d like to eat.

It’s all blogged here since January with pictures of her and the tube in probably the first or second page. I still post occasional updates.
Krista's Care

Krista resumed eating on her own very quickly after the tube was inserted. She got it on the 4th or 5th day at the hospital. By the time I took her home on day 10 or 11, she was eating again on her own. I left the tube in for meds as I still had to give a few. I was planning to leave it in for a month because it is easier to leave it in too long than to put it back in if you removed it too soon. But Krista had other plans. In the second or third week since I had her back at home, I had to take her back in for another suture for the tube (it was rising out of her.). The Dr said she had the tube in her hand and was ready to put the suture in when Krista got frisky and I don’t know what actually happened, but the Dr was left with the entire length of tube in her hand minus a liberated Krista probably grooming herself in satisfaction. She had the tube maybe three weeks. It took longer for her shaved neck to grow back.

Her bliss face when she rides my belly to get scritches around her neck and head.
80CB4070-3E4F-49BB-816E-B63FAF15D629.jpeg
The others are “I must touch you while I sleep”, the day after she got the tube but she also had the ruptured eardrum and dental surgery in the day or two before aka the worst she’s ever looked, and a picture of her shaved neck with the tube removed.
 

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daftcat75

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For about two weeks, I gave Krista medicine by tube. And because one of those medicines made her very nauseated, I would give her 5 cc of food before I gave her medicine. I made up all the syringes beforehand and placed them in a bowl along with a second tape-wrapped cap. Keep extra caps handy. Hers kept flying off when she shook her head. I also had a small amount of fish flakes back when I could still give these to her (she’s allergic now) in another dish upside down to give to her afterwards as a treat. I brought both of these bowls to a spot by the glass door so she could watch the bird and squirrel channel while we did the food and meds. She caught onto the routine quickly and was mostly very patient with me. The only times she got squirmy was if the food or water was too cold or too fast. Other than that, she laid patiently until I was done. Then I’d replace the cap and let her have the fish flakes.
 

Libby.

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I am sorry to hear about Samba.

For her heart murmur. Get her on CoQ10 (or ubiquinol which is the newer more potent version) asap. I would get her started on 50mg of ubiquinol. 37 years ago I had a cat that had been diagnosed with hypertrophic cardiomyopathy at 7 years old. I reversed the HCM with CoQ10. He lived to be 18 years old. CoQ10 also boosts the immune system.

Coenzyme Q10

I would also recommend you start her on medicinal mushroom powder which also has antitumor properties as well as immune boosting properties, also very supportive of the liver and kidneys.


I have my Patches on this mushroom powder:

along with milk thistle and sam-e to support her liver. She does not like any of that very much but I found mixing a little liver powder in helps her tolerate it. I portion out the sam-e and milk thistle from their respective bottles and put in a small sauce cup and then add her wound vite, iron supplement (she's anemic too), mushroom powder and a little bit of water to pull up in an oral syringe and she complains a lot less. She's a tortie, so she's gonna complain no matter what, lol.

This is the liver powder that I use. I only use about 1/4 tsp.

Here's an article on medicinal mushrooms that I found when looking for remedies for Patches when the vet thought that she was dealing with cancer along with the liver issues (going by blood tests, no x-rays at that point). The mushrooms I think were quite helpful along with the milk thistle and sam-e in getting all those liver enzymes down.

Understanding the power of medicinal mushrooms in your practice - IVC Journal
 

Libby.

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I am sorry to hear about Samba.
Dangit! none of my links showed up in my first reply. Here they are. I wish we had the ability to edit replies.

For her heart murmur. Get her on CoQ10 (or ubiquinol which is the newer more potent version) asap. I would get her started on 50mg of ubiquinol or higher. 37 years ago I had a cat that had been diagnosed with hypertrophic cardiomyopathy at 7 years old. I reversed the HCM with CoQ10. He lived to be 18 years old. CoQ10 also boosts the immune system.

[URL]https://www.cancer.gov/about-cancer/treatment/cam/hp/coenzyme-q10-pdq[/url]

I would also recommend you start her on medicinal mushroom powder which also has antitumor properties as well as immune boosting properties, also very supportive of the liver and kidneys.
Pure Mountain Botanicals Mushroom Immune

www.amazon[dot]com/Mushroom-Immune-Including-Certified-Cordyceps/dp/B00SLTZCQ4

I have my Patches on this mushroom powder:
Jetsu Mushroom Extract Powder - Powerful 10 Blend, 112ct - 2200MG Organic Lions Mane, Cordyceps, Reishi, Shiitake, Turkey Tail Mushrooms

https://www.amazon[dot]com/Mushroom-Extract-Powder-cordyceps-Polyporus/dp/B07DCGDCKM

along with milk thistle and sam-e to support her liver. She does not like any of that very much but I found mixing a little liver powder in helps her tolerate it. I portion out the sam-e and milk thistle from their respective bottles and put in a small sauce cup and then add her wound vite, iron supplement (she's anemic too), mushroom powder and a little bit of water to pull up in an oral syringe and she complains a lot less. She's a tortie, so she's gonna complain no matter what, lol.

This is the liver powder that I use. I only use about 1/4 tsp.
CurEase Argentine Grass Feed Beef Liver Powder Undefatted Desiccated (dried) Pesticide and Hormone Free 1lb One Pound (454grams) 908 Servings

https://www.amazon[dot]com/CurEase-Argentine-Undefatted-Desiccated-Pesticide/dp/B00N2YJNBS

Here's an article on medicinal mushrooms that I found when looking for remedies for Patches when the vet thought that she was dealing with cancer along with the liver issues (going by blood tests, no x-rays at that point). The mushrooms I think were quite helpful along with the milk thistle and sam-e in getting all those liver enzymes down.

Understanding the power of medicinal mushrooms in your practice - IVC Journal
ivcjournal[dot]com/understanding-the-power-of-medicinal-mushrooms-in-your-practice
 
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SambaLove

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Dear friends,
With a deep and heavy heart, I tell you that

My dear sweet angel Samba was put to rest Saturday morning
....a vet performed an at-home emergency euthanasia

She hadn't eaten or drank anything at all in the 3-4 days prior to her death and the lack of nutrients and food exacerbated her illness...she quickly looked thin and boney the last 2 days while I stressed and continued to give her subQ fluids, pain meds, and steroids...

Samba got worse over the weekend...still in pain and then started limping first on her front right leg, then Monday on her back right leg.

Last Monday, my vet said that her illness was terminal (she thought it was an aggressive cancer that caused her to lose strength in her legs) and handed me a pamphlet for euthanasia services...I felt defeated :( on Monday and consulted with a hospice /end-of-life vet...He did an at-home consultation on Wednesday and gave me suggestions for pain management and palliative home care.

He made me feel like "I had time" just adjust the dosage of her pain meds to meet her pain needs, and told me to take it one day at a time...but my poor baby didn't have days....she suffered greatly and I stressed at her not eating giving her daily fluids, pain meds (under the skin) 3 times a day, and steroids...

I feel horrible that I couldn't intervene properly and help her out of this illness... I took her to the vet 8 times and the ER twice in the last 6 weeks...and my poor baby girl hung in there...through the pain of what the vet thought was cancer (though undiagnosed)...She was a strong baby and I think hung in there for me...until the vet realized there was nothing to be done(???) and until I was ready to let her go...

I am left with an immense sense of guilt, regret, and emptiness in my home...
She was such a blessing to have and such a beauty....I hope my sweet baby is in a better place now and left knowing I love her and I tried....

Thank you, friends, for your words of advice and support...

Enjoy your cat babies to the fullest, hug them tight, and count your blessings...

<3 Samba's mom
IMG_3795.jpg


IMG_6139.jpg
 

Kflowers

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I know your dear Samba is in the best of all places meeting all those she loved who went before and telling them about how wonderful her life was with you. No doubt she is bringing old friends to visit you and telling them, "She is mine, she was there for me every minute of my life. No one could have loved me more. I will wait for her time to
join me. You can wait with me."

In the moments of quiet you will feel her presence with you. You will feel the brush of her fur, her steps on your bed and you will sense her love and that of her mother and siblings as they visit you.

The bond of love is now and forever, it continues through all eternity. The timing of her going was as it was, in she knows
everything you did, you did from love. You wrapped her in a beautiful shining garment of love. She wove a garment of love for you too. That is the alpha and omega of everything.
 

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:alright: I am so sorry. RIP little Samba. :angel3:

Please, if/when you are ready, memorialize Samba in our Crossing the Bridge section. It is where we go the share our stories/pics about our lost loved ones, and to pay homage to them for what they have given to us in their short time on this earth. They all deserve a place where they can be honored... here they have one.

Bless you and Samba.
 

Libby.

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Aww hon. I am so sorry. Samba knew you loved her and she's no longer suffering. She was a beautiful cat.
 
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