Diamond burr debridement for a non-healing corneal ulcer?

[fionasmom]

I think you are right to call and ask about using the Animax. Zymox can be very helpful and I keep it in the house, but it only goes so far if there is an infection. One of my vet's always says that gabapentin is a much of a sedative as a painkiller; in my case it has always made my animals, cat or dog, sleepy.

What the doctor is saying makes sense about the contact not adhering if there is ointment, so this is a good course of action. Ointment may be more soothing in the long run.

 

[WMM201]

Another bad update, and I may need to start a new thread. Mumu had her recheck at the vet school ophthalmology department today after a full week of terramycin, puralube, and her Timolol glaucoma drops. The good news is the dislocated lens in her left eye has fallen back into the eye chamber behind her iris, reducing the pressure in her left eye.

The bad news is that the corneal ulcers have not healed. In fact, they are now developing I to corneal sequestrum (necrotic/dead tissue) in both her eyes. Because Mumu has kidney disease and other system problems that really got bad after her eye surgery, the ophthalmologist doesn't recommend the usual surgical solutions for the sequestrums. We are going to keep going with the same meds and try to keep the eyes as lubricated as possible. The vet said that eventually the sequestrums detach, and the hope is that it detaches without getting deeper and perforating the cornea. Then Mumu would probably need to have her eyes removed and that's really the only situation in which this specialist wants to see her under general anesthesia. My only comfort now is that Mumu doesn't seem to be in a lot of pain or discomfort from the sequestrum, which usually can be quite painful. If they get worse, though, that's another matter. I forgot to ask about antivirals in case feline herpes is contributing to this situation until I was headed out and had to ask the vet student who was shadowing the appointment. She said she'd pass the question up to the vet.

I am so exhausted and drained. I thought that by this point, Mumu would have some improvement, even if just a little. I am so devastated that it's always setbacks for her, when she has been so patient and putting up with all her medications which she clearly doesn't like. She got a big dose of gabapentin today for the appointment, and she's been a little unsteady. Her back legs and tail seem so weak and she couldn't hold herself up to finish her poop. It seems like she's gotten wobblier and weaker over the day, instead of it wearing off. But since Mumu has kidney disease, it takes a little longer to clear her system from the meds. Still, I can't help but worry that something is wrong systemically again and we will need to rush to the ER this weekend. I just want her to have a break from all her physical ailments and mental stress. I am just broken by all that my sweet kitty has to go through with no hope in sight.

 

[neely]

I am just broken by all that my sweet kitty has to go through with no hope in sight.

I have no words of advice to offer except that my heart breaks for poor Mumu. You have definitely gone above and beyond to get her the help she has needed. I understand how disappointed and devastated you must feel but I'm sending healing vibes and special thoughts to both of you.

 

[WMM201]

I have no words of advice to offer except that my heart breaks for poor Mumu. You have definitely gone above and beyond to get her the help she has needed. I understand how disappointed and devastated you must feel but I'm sending healing vibes and special thoughts to both of you.

Thank you neely . Your kind words mean so much to me and Mumu, truly. This is a photo of my sweet darling.

 

[fionasmom]

Such a beautiful little girl. I also wish that I had anything constructive or helpful to add. You have been so much on top of her care during all this and I hope that you both can eventually have some good news.

 

[WMM201]

Such a beautiful little girl. I also wish that I had anything constructive or helpful you add. You have been so much on top of her care during all this and I hope that you both can eventually have some good news.

Thank you so much, fionasmom . Mumu has seemed more uncomfortable with her eyes since last night, of course after we come home from the specialist and on the weekend. I called the vet school to see if I should do anything, since nothing has likely actually changed other than discomfort, and am hoping that whoever is on call will actually call me back.

Such a beautiful little girl. I also wish that I had anything constructive or helpful to add. You have been so much on top of her care during all this and I hope that you both can eventually have some good news.

Thanks so much, fionasmom . Mumu is so sweet and patient and does her best to cope with each new setback and treatment. To have so many good wishes from everyone to give her support means so much.

 

[fionasmom]

You just posted, so I am assuming that no one called yet? Are you considering the enucleation?

 

[WMM201]

Such a beautiful little girl. I also wish that I had anything constructive or helpful you add. You have been so much on top of her care during all this and I hope that you both can eventually have some good news.

Thank you so much, fionasmom . Mumu has seemed more uncomfortable with her eyes since last night, of course after we come home from the specialist and on the weekend. I called the vet school to see if I should do anything, since n

You just posted, so I am assuming that no one called yet? Are you considering the enucleation?

I didn't get a call back but Mumu seemed more comfortable yesterday, and more herself over the weekend. I don't want to jinx it by even writing these words. That gave me a lot of comfort and I am hoping we still can keep her comfortable for an open ended time, or at least until her next recheck in 3 weeks. I have been doing my best to keep her eyes as lubricated as possible. I can just hope with all my might that we get an update that isn't further deterioration or that the vets can advise on a treatment plan.

 

[neely]

I can just hope with all my might that we get an update that isn't further deterioration or that the vets can advise on a treatment plan.

We are hopeful that you get a call back, if not today then definitely tomorrow. I'm glad to hear Mumu seemed more comfortable over the weekend which in turn helps you feel comforted too.

 

[WMM201]

We are hopeful that you get a call back, if not today then definitely tomorrow. I'm glad to hear Mumu seemed more comfortable over the weekend which in turn helps you feel comforted too.

I didn't get a call back from ophthalmology, but today Mumu went to her primary vet for blood draw, blood pressure check, and I had them look in her ears because she seemed unsteady (I referred to the Zymox/Animax thing earlier). They took swabs from her ears and they found some yeast and bacteria in both, so now Mumu is on Animax twice a day for 2 weeks. I hope this does help her feel better, though one more treatment on top of everything else is sad for her. Her ears do get infected from her seasonal allergies, and I hope this year won't be as bad as it had been before. I hope her blood tests show that she is at least stable. Her anemia seems to have improved and her blood pressure seems normal, so at least there is that. Unfortunately Mumu has to go back in 2 weeks to recheck her ears and I really hope the Animax helps.

 

[neely]

I hope her blood tests show that she is at least stable. Her anemia seems to have improved and her blood pressure seems normal, so at least there is that. Unfortunately Mumu has to go back in 2 weeks to recheck her ears and I really hope the Animax helps.

Any updates on Mumu? Were her blood test results okay and how did her two week recheck go? You both have been under a lot of stress so fingers crossed for some improvement or status quo.

 

[WMM201]

Any updates on Mumu? Were her blood test results okay and how did her two week recheck go? You both have been under a lot of stress so fingers crossed for some improvement or status quo.

neely thanks for asking for an update about Mumu. She had a long day this week with an Ophthalmology recheck and then an Internal Medicine work up. Her sequestrums are stable and her corneas have not changed for the better or worse. Right now, we are managing with supportive therapy to keep her eyes comfortable. It may be the case the sequestrums will slough off over time, but that is never a predictable thing. The ophthalmologist doesn't recommend any actual procedures at this point since Mumu seems comfortable.

Unfortunately, Mumu has more to contend with now than her eyes and kidney disease. We decided to do thorough diagnostics again, including ultrasound, to restage her kidney disease. It was then that we discovered enlarged lymph nodes that were sampled through aspiration. The cytology result shows large cell lymphoma. Other than some on/off appetite days and some loose stools, Mumu has been doing quite well and maintaining weight, so this diagnosis came as a shock. This type of GI lymphoma doesn't have good prognosis in most cats even with aggressive chemo treatment, and Mumu has been through so much since May. Her loss of vision makes every trip to the vet more stressful and draining and her advancing kidney disease is another factor I have to consider. We have a telemedicine consult with the oncologist on Monday, and in the meantime Mumu is already on prednisolone. After recovering from sedation and stress of the big vet day, she is doing well and comfortable at home. My heart is broken for my sweet baby girl.

 

[fionasmom]

I am so sorry to read that you are facing GI lymphoma. Sometimes this type presents a mass, but I don't know if you think surgery would be an option for Mumu. Please let us know what the oncologist says.

 

[neely]

My heart is broken for my sweet baby girl.

Our hearts are broken too. You have been a wonderful doting cat mom and Mumu has been so strong with everything she's been through in such a short period of time. We'll be thinking of both of you when you have the telemedicine consult with the oncologist this coming Monday.

 

[WMM201]

I am so sorry to read that you are facing GI lymphoma. Sometimes this type presents a mass, but I don't know if you think surgery would be an option for Mumu. Please let us know what the oncologist says.

fionasmom the ultrasound showed enlarged lymph nodes throughout her abdomen, but no mass. The cytology showed intermediate to large cell lymphoma, and we are doing the flow cytometry test to type it. Because Mumu is having good quality of life right now, and each vet visit now as a blind kitty is more stressful and taxing, I need to talk to the oncologist and think about whether it's fair to ask Mumu to experience side effects along with the weekly stress in the time she has left. I know that my goal is to preserve the highest quality of life for Mumu, instead of extending her life. My heart hurts so much. If I hadn't chosen the surgery for her eyes, that might have made a difference in how she experiences vet visits (being spared 3 months of weekly or biweekly visits). But in a way that process led me to seek out the internal medicine visit and this incidental lymphoma diagnosis. I have been reading the threads and posts on LCL by other members and trying to get information. I will update after I speak to the oncologist on Monday. Thank you and neely for your support during all of these crises. It means a lot.

 

[fionasmom]

You have done everything that you could and that was necessary for Mumu. I cannot tell you how sorry I am that this has come up but everything you did was to help her. I don’t think you could have eliminated any of the previous care that you had for the eyes.

 

[Jcatbird]

I am just getting caught up here. I have had to be absent but I wanted to check in and now want to say that you are so amazing. You have followed up on everything needed. Sending love your way.

 

[WMM201]

I am just getting caught up here. I have had to be absent but I wanted to check in and now want to say that you are so amazing. You have followed up on everything needed. Sending love your way.

Jcatbird thank you so much for your kind words. Mumu is doing well, and she had a fantastic day just two days ago that was like her old self, before her blindness, returning. I had missed my baby girl and her personality so much, and it is such a gift to have that day.

The other day I got the email notification with the latest update on Banjo, because I am still following her story. Your post made my heart sing with joy for Banjo and for you.

 

[Jcatbird]

We do not carry these weights alone. I am so very glad for any good days you are having. Can we really ask for more than good days? I don’t know the end of the story with Banjo but I do know that I cherish every good day. I believe that every life counts and perhaps what we learn as we go will count for our lives and for others. Sending happy cat vibes your way. May your heart sing some more.