Am I overreacting?

[FeebysOwner]

Good news! Just make sure you and/or the pet sitter/vet tech are checking her for dehydration each time before giving her fluids!!

 

[Twylasmom]

To say I am frustrated is an understatement right now. Went in to have Twyla’s T4 checked and it is still .7. This is ridiculously low and it’s possible that it has been even lower previously since .7 is the lowest reading the machine will give! So she has basically had six weeks of increased stress on her kidneys due to her low thyroid state. Starting today we are taking her off the methimazole completely for a month to see if her thyroid values will reset at a normal level. Kidney values were not checked today, but I really hope this hasn’t accelerated damage.

Her slightly improved appetite is best attributed to the subqs and weekly Mirataz. Her weight is stable between 11.2 and 11.4 pounds, but I will need to monitor to see if she starts losing even if she is eating well as that could mean she has gone back to being hyperthyroid. Right now the vet and I agree her kidney health is priority and we need to do a reset on the thyroid.

Poor girl is such a trooper with all the vet visits, and then putting up with two days of Hooper freaking out because she smells like the vet’s office.

Tonight she gets a break from any pills. She usually gets gabapentin/methimazole at night, but no more methimazole and she got a sedating dose of gaba at 1:00 pm so I won’t start back with that until tomorrow night. So she is down to gaba am/pm, Cerenia every other day, Mirataz once or twice a week and her inhaler.

 

[FeebysOwner]

Glad to see she is finally being taken off of methimazole.

 

[Twylasmom]

Glad to see she is finally being taken off of methimazole.

I am, too. We briefly discussed 1.25 mg once a day, but vet agreed that stopping for now would be better for her kidneys, which is priority right now. I just feel like a bad cat mom.

 

[FeebysOwner]

I am, too. We briefly discussed 1.25 mg once a day, but vet agreed that stopping for now would be better for her kidneys, which is priority right now. I just feel like a bad cat mom.

Your vet is as much, if not more responsible for this. Anytime a cat's T-4 goes below the normal range, the advice is always to stop the meds and let it reset itself - kidney issues or not.

 

[sidneykitty]

I am, too. We briefly discussed 1.25 mg once a day, but vet agreed that stopping for now would be better for her kidneys, which is priority right now. I just feel like a bad cat mom.

You are NOT a bad cat mom. You're doing a wonderrful job for her. You are clearly doing everything you can for your Twyla and trying to do all the right things for her! I'm glad your vet is on board with this plan. Here's hoping your girl continues to improve.

 

[Twylasmom]

Twyla has been off the methimazole for a week and is acting so much more like her old self. She is social, grooming more and eating well. I am getting lots of snuggles. Her weight has stayed steady so far (between 11.3 and 11.4 pounds) but I am monitoring in case she starts to lose on her current calorie intake. I have no idea how long it will take for her thyroid to go back into hyper-t territory, but she will be reassessed in three weeks. Fluids seem to be helping her a great deal and she is taking them like a champ - her pet sitter is great! I am enjoying moments like this:

 

[sidneykitty]

oh yay! go Twyla, well done to you and your support team (mom and pet sitter!)

 

[Twylasmom]

Twyla weighed 11.1 pounds today, despite eating well with the help of Mirataz about every 5 days. Beginning to wonder if that is her thyroid levels rising, since she has also been more active and playful (it was also post poop and after a more finicky eating day, which doesn’t help). A while back I posted that she had no interest in her catnip banana - that interest has returned! So either the hypothyroid state or the methimazole was contributing to her lack of interest. Even with the occasional finicky eating days the past couple of weeks have been her best in months, and I am so appreciative for this stability for as long as it lasts.

Also, my pet sitter suggested purchasing a pressure infusion bag for subq fluids. I highly recommend it! It puts pressure on the bag to make the fluids flow faster, which is great when you are near the end of a bag, or don’t have a free hand to squeeze it. With Twyla, anything to speed up the process for my squirmy girl! Just thought I’d share.

 

[Twylasmom]

Even with an experienced person doing the subqs Twyla can be a challenge! We got 100 ml in today but it was a challenge, even with treats. It might have been because she was unsettled by the weather (rain which she hates). It is very difficult to keep her still.

 

[Twylasmom]

Yesterday was a finicky day, so she got mirtzed. Appetite has returned to normal. She also gifted me a rare 6 inch long hair ball. After that she ate her lunch and half of Hooper’s! Payback for all the times he tries to eat her dry food. We are having a stormy day today, which can unsettle her, so trying to get meals done in between downpour.

 

[Twylasmom]

Twyla goes in for a recheck on Monday. I’m trying hard not to worry about the results. She seems to be doing well on her current regimen but I’ve been proven wrong before. This past month has outwardly been the best she’s been in six months. The fluids and Mirataz seem to be helping a lot and I am trying to keep her phosphorus intake down, even though for her that means more fish based wet foods (which are probably not ideal for her thyroid). Those are less than half of her diet, but are also the magic bullet when she won’t eat. Surprisingly she loves Hill’s Tender Tuna which is .54 phos on a dry matter basis. I wish she would eat more chicken based foods. But she eats her prescription dry food consistently, which is about 60% of her daily intake.

Fingers crossed!

 

[Twylasmom]

Twyla’s vet visit today was - not bad! They weren’t going to run a full blood panel, but I asked for that and a cysto. Compared to her last full blood panel 6 weeks ago:

Weight is stable at just above 11 pounds. Heart rate normal. Coat looks great!

Thyroid - Her T4 went up from the dismal .7 to a high normal of 3.8. Since it is expected that it will continue to go back up she will be taking 1.25 mg of methimazole just once a day and will get checked again in three weeks.

Kidney values - the best news is her creatinine went down from 3.6 to 2.4! That puts her back down to IRIS stage 2. Her BUN remains above normal at 57. Phosphorus is also high normal at 5.2, though down slightly from 5.4 six weeks ago. I’m going to try and introduce a small dose of aluminum hydroxide in her higher phosphorus wet food. Her hydration was normal 48 hours out from her last subq fluids - also good.

However, her urine specific gravity was really low and urine appeared slightly cloudy so they are running a culture to see if she has a UTI. No outward symptoms, but since she has big kidney/little kidney we don’t want anything to affect her better kidney. If culture is positive she will need a round of antibiotics.

Staying with just twice a week for the subqs since she is maintaining her hydration, continuing with Cerenia, Mirataz and gabapentin, as well as her asthma inhaler.

She is a favorite at the vet’s office, offering commentary throughout procedures but not aggressive.

 

[Furballsmom]

She is a favorite at the vet’s office, offering commentary throughout procedures but not aggressive.

Awwww

 

[Twylasmom]

Twyla update - she went in for a T4 check today. On the 1.25 mg of methimazole once a day her thyroid is sitting at 3.4, right in the middle of normal range. She is also maintaining her weight (11 lbs, 3 oz) with the twice a week Mirataz to keep her appetite stable. So we are keeping up her current dosage and treatments and, barring anything unexpected, her next vet visit is in three months! She has been to the vet eight times since March so this is fantastic news, we both could use a break (and so could my wallet!).

 

[Furballsmom]

this is fantastic news

WOW good for you!!

 

[Twylasmom]

All has been going well with Twyla, eating well, alert, social and playful. However, this week she has vomited up a sizable hairball and regurgitated several times after eating, averaging about once a day. It is definitely regurgitation and not vomiting. She has been very enthusiastic about eating all week, even though her last Mirataz dose was Sunday morning. I already use a raised bowl because she has gone through periods of regurgitation in the past, which eventually resolved. I’m wondering about the cause (eating too fast? More hairballs?) and how to remedy this. It usually happens when she eats her wet food - I usually mix a small amount of her dry food with the wet in order to meet her daily calorie goals. Could the dry expand in her esophagus as it absorbs moisture after she eats?

So far this hasn’t caused weight loss, but it surely will if it keeps up. I try to feed five or six smaller meals a day, but that isn’t always possible when I have a longer work day. Usually happens after her breakfast, but not always. Same foods she has been doing well on for weeks, subqs twice a week and all her other meds.

Suggestions for hairball remedies? She hates the tuna flavored laxatone. Can you mix laxatone in food and still have it be effective? Do hairball treats even work? Any other thoughts? I really don’t want to haul her back to the vet yet again.

 

[FeebysOwner]

You could try one of the simpler hairball remedies with butter/margarine - a dab on her paw or from your finger for her to lick off. Maybe 2-3 times a week. Or a couple of drops of olive oil in her food would probably work as well.

Regurgitation after breakfast might mean she is eating faster because she is hungry. How many hours go by between her last meal of the day and breakfast. Maybe adjust her schedule so that there are less hours between the two? There are slow feeders for wet food that you might want to try, and still be able to add dry to it too.

 

[Twylasmom]

You could try one of the simpler hairball remedies with butter/margarine - a dab on her paw or from your finger for her to lick off. Maybe 2-3 times a week. Or a couple of drops of olive oil in her food would probably work as well.

Regurgitation after breakfast might mean she is eating faster because she is hungry. How many hours go by between her last meal of the day and breakfast. Maybe adjust her schedule so that there are less hours between the two? There are slow feeders for wet food that you might want to try, and still be able to add dry to it too.

Butter seems like a good thing to try. They get dinner around 10 pm, and usually wake me up for a snack at 4 am. Then breakfast around 7:30 and a midday meal between 4 and 6 (depending on when I get home). If there is leftover wet breakfast I leave it out while I’m gone. I can’t leave Twyla’s prescription kibble out because Hooper will eat it.

However, the plot thickens! When I got home today there was another regurgitated gift for me. On closer inspection I noticed bits of black hair and kibble that is the shape that Hooper eats. One other regurgitation I found yesterday also had black hair. Twyla can not get to Hooper’s food and doesn’t groom him enough to ingest much of his hair, so it turns out they are both regurgitating, even though I have only seen Twyla do it. What the heck? There hasn’t been any food changes (they eat the same wet foods but different dry food) and it is happening after different meals, so it doesn’t seem to be tied to a specific food as Inrotate three different foods. Both seem perfectly fine otherwise, playing with each other, snuggling, and don’t seem to be in any discomfort.

I will try butter and see if things calm down over the weekend. If they do, I guess it could be attributed to stress? I will try and groom them a little more to see if that helps but I am stumped otherwise.

 

[Furballsmom]

Hi
Just a thought --and I apologize if this has been mentioned up-thread, but do you use Cat Music for them?