Am I overreacting?

[Twylasmom]

I have a pill splitter that works pretty well to divide Felimazole into quarters (not the same one I use for amlodipine). Besides, Feeby gets it twice a day, so if I am a tad off, it is more or less made up for with the second dose. I don't understand the only once a day dosing for the thyroid meds; twice daily keeps the med at a more even keel throughout a 24 hour period. Just what I have read and what my vet thought was best.

Right now, due to Feeby's med schedule, she gets amlodipine around 3PM. I only did this because there are just so many pills I can get down Feeby at a time, and she was already on an AM/PM schedule for her Felimazole and her ondansetron. So, I just split the difference in the day to administer amlodipine (0.625 mg). Feeby's BP, at last check, averaged between 150-160.

Twyla was going hypothyroid on the twice a day hence the once a day dosing. My vet didn’t think it was feasible to split the pills into eighths so we tried once a day, which worked great for six months.

 

[FeebysOwner]

Twyla was going hypothyroid on the twice a day hence the once a day dosing. My vet didn’t think it was feasible to split the pills into eighths so we tried once a day, which worked great for six months.

Yeah, I wouldn't want to try to split the Felimazole into eighths either! Quarters are doable, but that is about it!

Good luck with all of this!

 

[Twylasmom]

Yeah, I wouldn't want to try to split the Felimazole into eighths either! Quarters are doable, but that is about it!

Good luck with all of this!

Thanks! I’ll feel better once we’re past the dental. I hate it anytime a cat has to go under anesthesia.

Do you give amlodipine with food/at a mealtime?

 

[FeebysOwner]

Continue to keep us posted!

 

[Twylasmom]

Twyla’s dental is tomorrow morning. She will get subq fluids tonight and fluid supplementation during her procedure. Hopefully it will just be a routine cleaning with no extractions. If all goes well I should be able to pick her up by 2:00. I am anxious, but she is in a good place right now so a good time to get it done. She has been doing great with the new dose of methimazole and the amlodipine. Only needs Mirataz about once every 5 days and is eating well, playful and really affectionate.

My most immediate concern is the “no food after midnight” requirement. Twyla is a nocturnal eater so I expect I won’t get much sleep as she will be bugging me for snacks! I have to get up at 6 to give her gabapentin and get her to the vet by 8.

Wish us luck!

 

[FeebysOwner]

My most immediate concern is the “no food after midnight” requirement.

That means an 11:59 feeding, IMO!!!

 

[Twylasmom]

That means an 11:59 feeding, IMO!!!

Absolutely!!

 

[Twylasmom]

Twyla is already home from her dental procedure! She did need to have her left front canine removed (not a surprise) but everything else looks good. She is currently stoned out of her mind and sleeping wrapped in a blanket. She received a Convenia injection and a long acting topical buprenorphine (Zorbium) that will last for four days. Not thrilled that she was given Convenia but I have to remind myself that it is widely used and generally safe, even though I know there are risks.

I will feel better once I can get her to eat and she perks up a bit. I am working from home the rest of the week so I can keep an eye on her and keep Hooper at a distance (he always goes through a couple of days of non-recognition aggression whenever Twyla comes back from the vet).

So feeling pretty stressed seeing her in this state, but happy she is home!

 

[Twylasmom]

She has already been eating a little, though I can tell her mouth is sore as she is approaching food gingerly and she is trying to figure out what happened to her left canine. I gave her the option of wet or dry, she gave the wet a couple of licks but ate about half a tablespoon of dry. I shook her dry food container and she trotted right into the kitchen!. She is actually overdue for her Mirataz so any eating is good! I’m going to give her 24 hours before I consider applying her next dose since she has so much other stuff in her system.

 

[Twylasmom]

Now that the gabapentin has worn off Twyla definitely has the bupe crazies - eyes dilated and intermittently restless - but is eating really well. Would rather eat dry rather than wet, which surprises me, but got her to eat some wet with dry on top. I was afraid it might be difficult to pill her because of mouth pain, but got it done. Hasn’t pooped, but has used the litter box. We’ll see how much sleep I get what with her restlessness and Hooper’s growling and hissing at her!

 

[Twylasmom]

Had a pretty good night, all things considered. Twyla even snuggled a bit this morning and got a belly rub, but is definitely still stoned on bupe and spending a lot of time staring into space mixed in with random bursts of activity.

I am debating giving her a Mirataz dose - she is already beyond her usual dosage window and her appetite has dropped off significantly since yesterday. Plus she is more likely to eat wet food after dosing, which should be easier for her to eat. She is struggling a bit with the mechanics of eating what with missing an important tooth and having a sore spot. Any thoughts?

She is drinking and gets fluids tomorrow so hydration is not a concern at the moment.

 

[Twylasmom]

Twyla is doing really well! She is acting so much more like her normal self and is spending lots of time snuggling and being more focused. I did give her Mirataz yesterday and she is eating much better and asking for food, though would still rather eat dry food over wet (an eternal problem with her, but is even turning up her nose at her higher phosphorus rescue foods). I’m thinking that may be because the wet food makes more contact with the area where her tooth was removed and is causing discomfort. Finally pooped as well.

Hooper is still hissing and growling when he gets close and sniffs her. However, he is OK with her sleeping practically on top of him if there is a blanket in between. Silly boy. He is usually better after 24 hours but Twyla must have had more intense vet smell than usual.

 

[Twylasmom]

Twyla went in for a thyroid check and 2 week post-dental checkup today. Her mouth looks good, though the spot where her tooth was removed is still healing. She has been eating really well and needing Mirataz less than once a week. She is now almost 12 pounds! Her blood pressure is also in normal range with the Amlodipine.

That’s the good news. The not-so-good is that her thyroid levels went from 5.1 (too high) to .9 (too low) with the increase of her methimazole from 1.25 mg once a day to 1.25 twice a day. Not quite hypothyroid again but almost. She is so sensitive to changes in dosage. Vet wants to stay at this dose for 2 more weeks and recheck again when she goes back for her Solensia on May 4th. My vet always uses the generic methimazole (I guess because it’s cheaper than Felimazole) which is 5 mg so not easily split into smaller doses than 1.25 mg. If a reduction is needed I will ask her about Felimazole since it comes in 2.5 mg tablets, correct? I just hate that she has to have a blood draw again so soon (third time in two months) she just hates it and gets so stressed, even with gabapentin. Plus having to go through 24 hours of Hooper growling and swatting at her when she comes back from the vet. I had to go back to work right after the appointment today so I separated them to give her some peace.

The vet also detected a stage 2 heart murmur today. That was new. So something else to worry about. Will recheck that in 2 weeks as well.

 

[fionasmom]

Fiona took Felimazole for about 3 years, never the other. Chewy has it for $21 for 100 tablets of 2.5 mgs which is not expensive as medications go. Ask your vet if they would prescribe it if you think it would be easier. Maybe they are trying to save you some money?

As I recall, heart murmurs are on a scale of 1 to 6, so don't panic and just get it rechecked when you go back.

 

[Twylasmom]

Fiona took Felimazole for about 3 years, never the other. Chewy has it for $21 for 100 tablets of 2.5 mgs which is not expensive as medications go. Ask your vet if they would prescribe it if you think it would be easier. Maybe they are trying to save you some money?

As I recall, heart murmurs are on a scale of 1 to 6, so don't panic and just get it rechecked when you go back.

Yes, the 5mg generic is around $8 for 100 pills. Given how much her other meds cost the Felimazole seems reasonable to me!

 

[Twylasmom]

Back from the vet yet again. T4 is around 1.1 so we are going to maintain the current methimazole dose. A little lower than ideal, but with potential heart issues lower is better. Kidneys were not assessed today. Miss Twyla weighed in at an even 12 pounds - up a pound and a half from where she was a year ago! She looks and acts great.

The heart murmur was rated a stage 3 today. I am concerned that this problem has come on in just the last couple of months. There was no sign of a murmur in any past check up, including the one just prior to her dental. The vet says that her heart rate is in normal range and her respiration rate is, too (I check that at home). Those are positive signs in the scheme of things.

So the next step will be to get her scheduled for a cardiac ultrasound. I admit that the mere hint of heart problems fills me with dread. My cat Lucy, who passed in 2018, had CKD and HCM. Hers was quite possibly genetic (part Maine Coon). One morning she snuggled with me in bed, got up and walked into the other room, made an unworldly sound, and dropped dead. It was the most traumatizing cat loss I have experienced.

 

[fionasmom]

I lost a relatively young boy, at 7 years old, that way. It is shocking and you never forget it.

 

[Twylasmom]

Twyla had her cardiac ultrasound today and it showed very mild HCM. The doc who performed the ultrasound could barely detect a murmur today and her heart rate was normal, despite being at the vet. So no need for treatment and a follow-up in one year. I am relieved.

Nothing else was checked except her weight, and she has gained another 9 oz. since May 4. I think I need to cut back her portions a little bit as she doesn’t need to gain anymore.

 

[Twylasmom]

I hesitate to post because I don’t want to jinx things, but Twyla has been like a different cat since her methimazole dose was raised, she started on amlodipine and had her dental About two months ago. She looks great, is very social and playful and maintains her weight at a little over 12 and a half pounds (which is actually a bit overweight for her, but I’m not complaining). She rarely needs Mirataz and I have trained myself to not dose if she has a day where she eats a little less, she consistently picks back up the next day. She is doing well with the Solensia and has been totally off of gabapentin for the past three weeks. She still gets Cerenia 3 times a week, fluids twice a week and her inhaler daily. She is eating more dry food than wet food, but that is the compromise we are making. Fingers crossed we can maintain this for a while. It is great seeing her so happy and playful.

 

[silent meowlook]

This is awesome. Since you said you don't want to jinx it, it officially cannot be jinxed due to your sharing of the fear of jinx factor. At least that's the nonsense I have made up in my mind for these situations where I fear I have jinxed myself.