End of life care: Liver disease and fluid in the lungs?

[cat nap]

J Jenny22
this was in the Comments section of Dexter's report.
(I think the mods might have removed the report accidentally...since it was in post #15...and they usually will remove any identifying info due to privacy...but then place the report back into the post. I'll flag the post and ask them.)

Pathologist Report:
...No evidence of an infectious agent or neoplasia in this sample

And in the Comments:
Differentials to consider include cardiac insufficiency, neoplasia, cardiomyopathy, FIP, vascular disease (eg. Thromboemboli), organ torsion or inflammation.
Is there evidence of a mass lesion?
Is there evidence of cardiac disease?
The neutrophils may be present due to irritation of the fluid or underlying low grade inflammation.

So really they want D Dexy ....to either do an ultrasound...or more testing to rule out...the above differentials.
**(Edit to add: The lung fluid was worrisome...and that is what caused the second Vet place ...to not insert the feeding tube.)

I would have thought that the Vet would have already seen any mass lesions, or cardiac disease...if a fine needle aspirate was done...with guided ultrasound.
Since don't they do fine needle aspirates with ultrasound guidance?
Or maybe I'm mistaken....if the FNA (fine needle aspirate)...was only done on the lung fluid or exudate around the lungs...then maybe the Vet did not use an ultrasound...in this case.
Not sure.

Also strange that they don't do proBNP...on blood panel labs.
I didn't see that number anywhere in the blood labs that Dexy posted, above.

 

[Dexy]

So they did do an ultrasound guided needles and did not seeing anything of concern. I have booked him for an ultrasound for Friday if he can hold on and an ekg for his heart. They thing it is fatty liver but don’t know if it is a different liver diesease. I took him to a diff cat only vet to put a feeding tube in and they said they couldn’t do it because of the fluid and that it would not help as it’s not the primary reason he is sick. But could not say the primary reason.

they suggested stopping force feeding him as it is making him very u comfortable. I decided that night that I would spoil him and let him go when he was ready, then he started eating again.

today he still ate a bit during the night, I’m going to try and force feed him the rest of his calories today and see if he will take it. I don’t want him to be in pain more so from feeding if he’s too far gone.
The issue is he has two main health problems the liver and the lungs. Hopefully the ultrasound can shed some light.

I will try the zentonil play today as well while feeding him.

Thank for the help

 

[cat nap]

they suggested stopping force feeding him as it is making him very u comfortable. I decided that night that I would spoil him and let him go when he was ready, then he started eating again.

Your Dexter does sound a bit similar to Jenny's Lulu.
Whenever you both decided to spoil them, and then let them go...then both cats just decide the entire opposite.

It's like they both said, "nope, not yet".
(It's also like our cats can read our minds...or else they just know when we feel so awful, and we decide one way...then they decide to do a complete 180 degree turn. They begin to eat again.)

today he still ate a bit during the night, I’m going to try and force feed him the rest of his calories today and see if he will take it. I don’t want him to be in pain more so from feeding if he’s too far gone.
The issue is he has two main health problems the liver and the lungs. Hopefully the ultrasound can shed some light.

I will try the zentonil play today as well while feeding him.

If you can try the syringe feeding using a whole bunch of smaller syringes...like Jenny recommended...then that might work even better.
It is slower...but if you can do it every one to two hours...then it might not stress Dexter so much.

(The only benefit of using larger syringes...is that you can pack more cc's into the syringe.)
But use whatever you have available.
Another member even said that she used a popsicle stick to place some food onto her cat's tongue.

I'd try to feed him anything.
The vets have that Critical care food...Hills A/D or Urgent care food...which is a smooth pate....and easily syringed.
Hill's Prescription Diet a/d Wet Dog/Cat Food

Some other pates...can be pureed with a hand blender...add some water...and make them like a slurry, too.
The Gerber baby food (meat and gravy)...no onions or garlic... that jenny mentioned.
Kitten foods have higher calories.
Whatever your Dexter would like, just give it to him.
Even high smelling foods that we humans eat...like tuna, tuna juice, chicken toppers, lickable cat treats, or those lickable cat smooth foods at walmart.

As per being difficult to syringe - I found the Gerber baby food (meat & gravy) to be the easiest and most palatable. Not only did it come out of the syringe effortlessly but Lulu did not fight me on it. She fought me on everything else. I actually really like the small syringes because they are more gentle and less intimidating. But they take forever to get the calories in with. I syringe very quickly into the side of the mouth while she is resting (never from the front or down the throat - do a little to the side so the cat swallows it back on her own). I walk towards her from behind, put my hands on her jaw from above and quickly squirt the baby food into the side of her mouth. I may put a dollop on my finger for the next syringe to see if she would eat on her own. This actually worked for us - if she would lick off my fingers, then I would basically hand feed her the rest. But I usually had to syringe at last the first ml and in the beginning I had to syringe all of it as she really wouldn't eat anything - not even treats.

That's a pretty good method, and good tips for doing it faster, using smaller syringes...but more often.
I guess you could get all the syringes ready ahead of time.

(Or put them in the fridge...or in zip lock bags...in the fridge...then warm them up...in the sink...in a pot of warm water...to bring them to room temperature or a bit warmer. But try to test one out...to make sure it's not too hot.
Most cats do like either room temp food...but not cold food)

D Dexy ...I'm just going to post the same video, that I did over in the other thread.
I know you don't need it,...but maybe others reading this thread might.



This thread also talks about a 'liver shake' recipe. I've never tried it, but who knows, it may work.
"liver Shake" Recipe For Inappetant Cats

And finally, just a bit of info on the different things they do to treat hepatic lipidosis.
Again, D Dexy ...I do know that you already know all this...but sometimes just posting added websites....may help others get more ideas, too.
https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951913

I'm still going to be rooting for your Dexter to try and eat on his own, again.
He must feel sick, but still going to hope that he can somehow fight it off, if it is an infection, or inflammation...whatever it is.
Wishing you and Dexter all the best.

 

[Dexy]

Thank you all so much for the help. Previously I was force feeding him the vet recovery diet but I’m going to try the baby food. It just put him into such a depression every time after, and the one vet scared me into thinking it was causing him pain.

Right now he is sleeping peacefully but when he wakes up I will give it a go.
I really like the idea of preloading syringes that will make it far easier.

 

[Jenny22]

So really they want D Dexy D Dexy ....to either do an ultrasound...or more testing to rule out...the above differentials.
**(Edit to add: The lung fluid was worrisome...and that is what caused the second Vet place ...to not insert the feeding tube.)

I would have thought that the Vet would have already seen any mass lesions, or cardiac disease...if a fine needle aspirate was done...with guided ultrasound.
Since don't they do fine needle aspirates with ultrasound guidance?
Or maybe I'm mistaken....if the FNA (fine needle aspirate)...was only done on the lung fluid or exudate around the lungs...then maybe the Vet did not use an ultrasound...in this case.
Not sure.

Also strange that they don't do proBNP...on blood panel labs.
I didn't see that number anywhere in the blood labs that Dexy posted, above.

You know - I completely forgot about the fluid and that was an issue I did not have to deal with. Poor Dexter.

I see that Dexter did have an ultrasound guided FNA - if they still couldn't find anything, then I'm confused why they think there is a primary reason? Isn't it a process of elimination - whereas if they don't find anything of concern, it can usually points back to fatty liver and the primary concern simply being that Dexter stopped eating from stress? For me, I opted out of the FNA or a biopsy - so I was left guessing on the primary concern but at least had enough information from the ultrasound to think it wasn't cancer or anything that would have required surgery (though even that could have been inaccurate). I guess the fluid in the lungs is the biggest issue as I don't think that is generally related to fatty liver?

 

[Dexy]

Ya exactly the fluid is confusing. On Friday it will be a full ultrasound abdomen and heart so if anything we will eliminate things. She never saw any evidence of a tumor on th X-ray and the ultrasound wasn’t detailed it’s just used to guide the needle she was saying.
If it was just his liver he would have a tube in and I feel like I could help him.

I will say he took the baby food quite easily (I got the higher calorie beef in gravy). Not sure if it’s because of the taste and texture or if he’s weak. I upped his gaba to 50mg today and he seems more comfortable.

going to give him the zentonil shortly and see how he does overnight. He is weaker today but was self eating less yesteday and today so hopefully the syringes will help him.

he’s being so good through all this. He needs to get sedated at the vet for aggression so my biggest fear is him passing at the vet during the ultrasound. I really want him peaceful here at home with a hospice vet. But if the ultrasound can somehow guide us to helping him or at least knowing he’s suffering and to give him a humane out sooner than later then I have to do it.

 

[Jenny22]

So they did do an ultrasound guided needles and did not seeing anything of concern. I have booked him for an ultrasound for Friday if he can hold on and an ekg for his heart. They thing it is fatty liver but don’t know if it is a different liver diesease. I took him to a diff cat only vet to put a feeding tube in and they said they couldn’t do it because of the fluid and that it would not help as it’s not the primary reason he is sick. But could not say the primary reason.

they suggested stopping force feeding him as it is making him very u comfortable. I decided that night that I would spoil him and let him go when he was ready, then he started eating again.

today he still ate a bit during the night, I’m going to try and force feed him the rest of his calories today and see if he will take it. I don’t want him to be in pain more so from feeding if he’s too far gone.
The issue is he has two main health problems the liver and the lungs. Hopefully the ultrasound can shed some light.

I will try the zentonil play today as well while feeding him.

Thank for the help

I'm so sorry - you are definitely stuck between a rock and hard place. And I sympathize so well - I am constantly there with Lulu even after she seems to have recovered from the fatty liver. Just today at her vet, we are again discussing the obstacles we are facing in getting over this nightmare that the fatty liver left us in.

Just taking a wild guess here and from looking back at the comments from the vet, but could Dexter have had heart disease and heart issues before he stopped eating? Maybe the fluid in the lungs is the primary reason Dexter stopped eating? Not sure when that started, but it does seem they might be considering heart issues as the primary reason based on their comments. And since you are already doing an EKG, then you're doing everything you can at the moment with regards to that.

I still think the fatty liver is simply related to Dexter not eating for an extended period of time, especially since nothing was found through diagnostics. I mean, your vets should have at the very least seen inflammation if it was related to cholangiohepatitis or triaditis or cancer or anything similar internally. The fact that your vets didn't see anything of concern but are still looking for a primary reason leads me to believe, again, that they think it is related to the heart. Otherwise, I have no idea what they are looking for. Process of elimination should have suggested simply fatty liver.

I don't personally know anything about heart disease in cats or fluid in the lungs. I don't know if it is terminal and irreversible or untreatable. If that is the case, then I could understand why you were not being pushed to force feed - as what is the point of causing a cat to suffer through something he can't make it out of. But if whatever is going on or they think could be going on is treatable or manageable, then I still question why you're not being told to address the fatty liver more aggressively. Fatty liver is so difficult to bounce back from and overcomplicates everything else so even my vet kept enforcing that we focus on the fatty liver first without addressing the dental issues which I strongly feel contributed to the primary source in my cat's case. That was the priority with each vet over the primary source (which of course needs to also be addressed simultaneously).

And cat nap is right - your Dexter sounds like my Lulu. They surprise us. It sounds so cliche, but being able to compartmentalize what is going on, and just giving your cat lots of love and space and allowing him to dictate the rest of his days is sometimes what gets them over that hump. Neurotically following my cat, making sure she was eating, chasing her for meds, giving subQ fluids, crying (lots of crying) - it was a nightmare for both of us. I put out a bowl of food & stopped syringing her the night before I decided to put her down. I woke up to her eating 200 calories overnight! That was when I realized that she had fight left in her. But I think giving her space helped tremendously. I had to syringe feed her to get to that point though - if I threw in the towel earlier, I wasn't going to get a miracle. But it kind of played out like this - give and do as much as you can for your cat...then scale back...then give her as much support again, then scale back...She bounced back on the times I scaled back but I still think she needed my help to get where she is now.

As for syringes...these are the ones I was using that I really liked (when I say I was syringe feeding every 1-2 hours, I really meant that I was doing that for 24 hours straight, even setting alarms at night). For you, Dexter is eating, so I would syringe feed during the day and see what he eats on his own at night. Lulu was getting a portion of prescription CN which is 210 calories per can.

https://www.amazon.com/dp/B08MJM5Q7P/?tag=thecatsite

You can find cheaper ones. But I haven't tried the others, For these, I could use the same syringe rinsed for at least 4 days before it would start to get stuck and I'd have to try another one. I would refrigerate the baby food overnight, but I did actually leave it out for lengths of time to keep it room temperature for her. I would give about 1-3ml every hour or so. If she would willingly lick more off my fingers I would let her. I let Lulu dictate how much food was ok to give. When she had enough, she would turn her face away and run from me.

https://www.amazon.com/dp/B0835QJFPY/?tag=thecatsite

I gave Lulu ham because she can't have the other proteins. But this is the brand. It is 90 calories a jar. I would aim to get 2 jars into Lulu by the following morning. Now, her calories are up to 250. No baby food anymore. Just CN (which I need to transition off of) and temptation treats - which she LOVES. Try them if you haven't. It is literally kitty crack.

Thinking of you both.

 

[Jenny22]

Ya exactly the fluid is confusing. On Friday it will be a full ultrasound abdomen and heart so if anything we will eliminate things. She never saw any evidence of a tumor on th X-ray and the ultrasound wasn’t detailed it’s just used to guide the needle she was saying.
If it was just his liver he would have a tube in and I feel like I could help him.

I will say he took the baby food quite easily (I got the higher calorie beef in gravy). Not sure if it’s because of the taste and texture or if he’s weak. I upped his gaba to 50mg today and he seems more comfortable.

going to give him the zentonil shortly and see how he does overnight. He is weaker today but was self eating less yesteday and today so hopefully the syringes will help him.

he’s being so good through all this. He needs to get sedated at the vet for aggression so my biggest fear is him passing at the vet during the ultrasound. I really want him peaceful here at home with a hospice vet. But if the ultrasound can somehow guide us to helping him or at least knowing he’s suffering and to give him a humane out sooner than later then I have to do it.

I'm so glad to hear about the baby food. I hope it takes less stress off of you if you have to continue syringing. Finding out what worked for me was so stressful until I tried that.

Best of luck with you and Dexter regarding the ultrasound.

 

[Dexy]

Thanks for the advice. Yes it definitely could be his heart hence why I really want to do the ultrasound. The x ray does show his liver swollen but it was the cat specific vet which mentioned the liver and that she didn’t think force feeding him would be good. His primary vet said to keep doing it to keep him going. Since he was eating on his own the day after the cat vet I let him do his thing as he started to eat more and more that I didn’t need to syringe.
As of Sunday his good u take started dropping so today I’m syringing him again.

They just don’t know what it is, and for the fatty liver all I can do is force food into him as sub q fluid makes the fluid in his lungs worse. I had been force feeding him until the cat vet mentioned he was in pain.

Hope he can make it to Friday would be so comforting for me to know what happened to him. And if we can fix the liver aggressively without causing him harm or pain I will do it.

he took a 10ml syringe of baby food no issue. So will give him another 2 before bed tonight.

 

[cat nap]

....Yes it definitely could be his heart hence why I really want to do the ultrasound. The x ray does show his liver swollen but it was the cat specific vet which mentioned the liver and that she didn’t think force feeding him would be good. His primary vet said to keep doing it to keep him going. Since he was eating on his own the day after the cat vet I let him do his thing as he started to eat more and more that I didn’t need to syringe.
As of Sunday his good u take started dropping so today I’m syringing him again.

It could be the heart...but that may be treatable...(with meds).
Dexter does have a higher SDMA number...but not overly high...so it might get tricky to treat heart issues and ckd...at same time...but not impossible to do.

There was also evidence of the liver swollen, spleen swollen, biliary mucocoele obstruction

I actually wonder now, if Dexter still might have that 'swollen liver'...so there is 'inflammation in that liver area'...which can be caused by inflamed gallbladder...or inflammation in the bile ducts?...(and I would think that 'fatty liver' itself...might cause the liver to look swollen until the 'fat cells' actually clear out from the liver.)
(I have to go back to Lulu's ER report...and see if they mentioned 'hepatomegaly' at all.

What if the 'fluid'...was caused by the "inflammation spilling over"...into the nearby organs and tissues?
I mean...inflamed cells can rupture...and seeing inflammation in the body....you also see fluid build up at that site, heat, and pain,...so maybe and hopefully...that 'fluid'...which the pathologists...did not find any neoplasia in...may very well be 'spilled over fluid'.
(I have to look this up, online, as well,...since I do think that I read something similar...but I want to know if it was specific enough to dealing with the liver, bile system, or abdominal cavity.)

They just don’t know what it is, and for the fatty liver all I can do is force food into him as sub q fluid makes the fluid in his lungs worse. I had been force feeding him until the cat vet mentioned he was in pain.

So the cat specific vet noticed that Dexter was in pain, on her examination....but I wonder why she thought that syringe feeding would ..cause him more pain?
That's just odd.
Some Stress and reluctance...I can definitely see 'assist feeding' causing...but why pain?

(A member here, mrs. greenjeens,...just recently said...that her old vet had told her...that a cat will not eat...if they have fatty liver.
She said that they just can't ...and so us humans have to assist feed them...to somehow get that liver to function properly, again.)
(I'm paraphrasing...but I think that is mainly what she meant.)

Hope he can make it to Friday would be so comforting for me to know what happened to him. And if we can fix the liver aggressively without causing him harm or pain I will do it.

he took a 10ml syringe of baby food no issue. So will give him another 2 before bed tonight.

I hope Dexter can make it till Friday, too.
Way to go Dexter...for taking that syringe with no issue.

 

[cat nap]

As for syringes...these are the ones I was using that I really liked (when I say I was syringe feeding every 1-2 hours, I really meant that I was doing that for 24 hours straight, even setting alarms at night). For you, Dexter is eating, so I would syringe feed during the day and see what he eats on his own at night. Lulu was getting a portion of prescription CN which is 210 calories per can.
https://www.amazon.com/dp/B08MJM5Q7P/?tag=thecatsite

I never knew you were using the 1ml syringes.
I always thought they were the 3ml...or the 10 ml.
Wow. Now I kind of understand even more...about how hard and difficult...and time consuming...it had to take you...to get all those calories into your Lulu.

It's still a great method...you wrote out...about using more syringes...and casually sneaking up on her.
(I'm going to try to remember that.)
(Taking our cats by surprise...and done quickly...while giving meds...works well, too.
They don't have a chance to think about it, and protest.)

You can find cheaper ones. But I haven't tried the others, For these, I could use the same syringe rinsed for at least 4 days before it would start to get stuck and I'd have to try another one. I would refrigerate the baby food overnight, but I did actually leave it out for lengths of time to keep it room temperature for her. I would give about 1-3ml every hour or so. If she would willingly lick more off my fingers I would let her. I let Lulu dictate how much food was ok to give. When she had enough, she would turn her face away and run from me.
https://www.amazon.com/dp/B0835QJFPY/?tag=thecatsite

When the syringes would get stuck...do you mean the 'rubber stopper'...or 'rubber ring"...parts?
Did you try to put a dab of vegetable oil, or margarine,...into the syringes...to lubricate the rubber a bit,...and then rinse them out.
(I had to do this, with certain brands of syringes. the margarine or vegetable oil would help coat the rubber, a bit.)

Also, when filling or loading the syringes...I also separated the two pieces...and pulled out the entire plunger.
Dabbed it in vegetable oil, and then filled the larger syringes with a spoon, or my hands..from the top open part.
(at first I was trying to syringe up the slurry, ... and then thought..."man, there has to be an easier way"...so I went online, to youtube, and watched a whole lot of videos...at the time.)

Little tips and tricks...were always helpful to know.
People would often write about them, also in comments sections, too.

I gave Lulu ham because she can't have the other proteins. But this is the brand. It is 90 calories a jar. I would aim to get 2 jars into Lulu by the following morning. Now, her calories are up to 250. No baby food anymore. Just CN (which I need to transition off of) and temptation treats - which she LOVES. Try them if you haven't. It is literally kitty crack.

Yeah, 'kitty crack' treats...is absolutely right.
I only wish they had more calories.
But sprinkling and crumbling on top of some wet food, also sometimes works.
We have 'kitty crack' cats.

 

[Dexy]

I had been force feeding him since 2 weeks ago when we thought it was just fatty liver, but three diff vets think it’s something more sinister they just don’t know what until an ultrasound.
He magically started eating on his own after the cat vet suggested based on his X-ray with his liver and spleen swollen and fluid in his lungs he’s in pain and consider euthanasia. The other vets think heart issues or tumors but there has been no evidence found yet.

i was hopeful he was eating but has stopped again. The ultrasound would give answers if it’s heart disease or If it’s something else with his liver or bile duct or gallbladder.
I have been force feeding him again since yesteday but he’s not doing well. I also don’t know how much more fluid is in his lungs but he’s not overly stressing to breathe as of now. He’s probably dehydrated but I can’t give him sub q fluids because of his lungs.

his abdomen is also much more swollen. I wish I could help him but he’s depressed and I know he’s not well.

No More cuddles or purring. He sits in a catloaf with his head on the floor. I gave him more gabba to help hin be more comfortable. I’m not sure I can put this poor guy through more. Trying to get him to Friday would be more my own selfish reasons for an ultrasound to know how bad things are and what happened to him .I need to make a decision for him, feel he deserves better than this.

 

[cat nap]

he’s being so good through all this. He needs to get sedated at the vet for aggression so my biggest fear is him passing at the vet during the ultrasound. I really want him peaceful here at home with a hospice vet. But if the ultrasound can somehow guide us to helping him or at least knowing he’s suffering and to give him a humane out sooner than later then I have to do it.

I had been force feeding him since 2 weeks ago when we thought it was just fatty liver, but three diff vets think it’s something more sinister they just don’t know what until an ultrasound.
He magically started eating on his own after the cat vet suggested based on his X-ray with his liver and spleen swollen and fluid in his lungs he’s in pain and consider euthanasia. The other vets think heart issues or tumors but there has been no evidence found yet.

i was hopeful he was eating but has stopped again. The ultrasound would give answers if it’s heart disease or If it’s something else with his liver or bile duct or gallbladder.
I have been force feeding him again since yesteday but he’s not doing well. I also don’t know how much more fluid is in his lungs but he’s not overly stressing to breathe as of now. He’s probably dehydrated but I can’t give him sub q fluids because of his lungs.

his abdomen is also much more swollen. I wish I could help him but he’s depressed and I know he’s not well.

No More cuddles or purring. He sits in a catloaf with his head on the floor. I gave him more gabba to help hin be more comfortable. I’m not sure I can put this poor guy through more. Trying to get him to Friday would be more my own selfish reasons for an ultrasound to know how bad things are and what happened to him .I need to make a decision for him, feel he deserves better than this.

D Dexy ...I know that whatever decisions you make for your Dexter will be okay.
Since only you can see him there, and see how he acts, how he moves, if he's drinking water, able to get to the litterbox, or in too much pain,...and you know him the best...so whatever you decide is only going to be made out of the tremendous Love you have for him.

You have done so much already.
So go by what you think is best for your Dexter.

None of us here, can actually see your Dexter, or know all that he's been through, but from all that you have written, it's extremely clear how much Love you both have for each other.
We all have made these decisions...and they are never easy to make.
If you decide to do the home euthanasia, with a hospice vet, and in his most favorite surroundings...then call for that.
Whatever you decide, there is no wrong here.
Only Love, ..for our most beautiful and trusted cat companions.

 

[Dexy]

Well he seems more relaxed today, I’m sure the force feeding has helped. But he’s so lethargic my heart breaks for him. Still planning on taking him for the ultrasound tomorrow if he’s not too weak. I am going to ask them for zofran tomorrow for the nausea as I stopped the cerenia I don’t think it made him feel well or at least didn’t seem to make a difference.

he’s at least resting on the bed now instead of the bathroom floor which was really sad.

yesterday I took him to the backyard to lay on the grass in the sun which seemed to have lifted his spirits.

i just found him now on the spare bed resting on top of a Betty white magazine I was reading.she Loved animals so much it’s like he knows

 

[cat nap]

Well he seems more relaxed today, I’m sure the force feeding has helped. But he’s so lethargic my heart breaks for him. Still planning on taking him for the ultrasound tomorrow if he’s not too weak. I am going to ask them for zofran tomorrow for the nausea as I stopped the cerenia I don’t think it made him feel well or at least didn’t seem to make a difference.

he’s at least resting on the bed now instead of the bathroom floor which was really sad.

yesterday I took him to the backyard to lay on the grass in the sun which seemed to have lifted his spirits.

i just found him now on the spare bed resting on top of a Betty white magazine I was reading.she Loved animals so much it’s like he knows

Wow. Thank you so much for this update.
I can't stop getting teary eyed...reading this post. But they are happy tears.

Maybe Dexter had a slight fever, and that is why he was resting on the bathroom floor.
(one of my animals would do this when the weather was too hot, and my old rainbow cat Spotty would go into the basement and sleep there, too.)

So glad you took him outside for some fresh air and sun, and grass.

And Dexter laying on the magazine of Betty White...is just awesome, to see.
Thank you so much for posting that photo.
yeah, Dexter does look like he knows about Betty White and her love of animals.

Sending you both more major Health Vibes...and all the Luck I can for tomorrow's appointment.
Hoping that Dexter can get stronger, and not weaker, and be in less pain.

(If he has anything like gallbladder issues, then I know the amount of pain that us humans feel with that. It's awful, but comes and goes. And when human doctors tell you to control it with not eating certain things...I don't really think that they've ever had the gallstone or gallbladder sludge issues,...because if they had...they would do things a lot quicker, too. Some of the pain meds they give to us humans just makes us itch, and itch, and then finally fall asleep. It's so annoying with some meds/opiods.)

 

[Dexy]

Thank for the info on the gallbladder I didn’t know how painful it could be. The opioids kept him up all night so I felt so bad giving them to him. I just kept him on gabapentin right now. Maybe I should give a extremely small dose of the beupenorphine? He’s spent all day on the bed relaxing but I’m happy he is. I fear tomorrow will be a lot of stress for him at the vet . But if they see gallbladder issues maybe I can get some antibiotics to at least see if that helps him. The other issue is of course the lungs…. This poor guy. Regardless I hope I get a better idea of what kind of pain he’s in to help make that horrible decision.

 

[cat nap]

Thank for the info on the gallbladder I didn’t know how painful it could be. The opioids kept him up all night so I felt so bad giving them to him. I just kept him on gabapentin right now. Maybe I should give a extremely small dose of the beupenorphine? He’s spent all day on the bed relaxing but I’m happy he is. I fear tomorrow will be a lot of stress for him at the vet . But if they see gallbladder issues maybe I can get some antibiotics to at least see if that helps him. The other issue is of course the lungs…. This poor guy. Regardless I hope I get a better idea of what kind of pain he’s in to help make that horrible decision.

No, I think you are doing great D Dexy ...on how you are giving Dexter his meds.

(I should have clarified...and written my above post a bit better and more clearer.
I actually did feel better myself on advil...as opposed to oxycocet. I just took more of the advil, (for my gallbladder sludge and gallstone), and the advil actually worked way better. It did not have all the strange side effects that the opiod oxycocet had.)

I'm sorry for confusing you so much.
(I don't think our cats are actually in as much pain, as us humans feel, when they go through certain health issues...since our cats can tolerate so much more pain, and not even show it.
What comes to mind, is how our cats don't show dental pain, at all, but we humans do. Or when members have said that the chemo treatments that they have given their cats, are not as bad as when humans have gone through them. That makes me think, that our cats can tolerate health issues, at much better levels than we humans can. That's just my opinion, though, so others can see it differently.)

I only meant that your Dexter may be feeling crummy still, until his inflammation goes away.
(And if it is gallbladder related, then the pain usually waxes and wanes, and changes due to the position a person is in, and even just riding in a car, and bouncing down a roadway, makes some of the pain in the gallbladder lessen, since somehow, the stones/sludge gets moved around.)

Unfortunately for our cats, most of them don't really like riding in cars, so we cannot just throw them in a car and go for a leisurely ride.
Plus, like you mention, our cats do get stressed more.

(I'm sorry for causing you that added confusion. Sometimes I shouldn't really be mixing my human experiences, when talking about cats...since it's really not the same, at all. I often forget this, and ramble away.) My mind sometimes goes off on tangents, instead of focusing on the issue at hand.

**Getting back to your Dexter, I would not give him the buprenorphine, since you've already observed how strong it could be, and does not allow him to sleep or relax. It just seems that at whatever dosage they gave you, it may be too high for him, or the medication itself is just too, too strong, and not helpful for what you want it to do. The side-effects are not worth it, in Dexter's case...if it keeps him from sleeping and resting.
I'm really not sure if even a small dose would help him, and not cause him to be sleepless, agitated or restless.

***Has your Vet at all recommended to give your Dexter some more gabapentin...before going in to the Vet appointment?
It Must Be Magic: How Gabapentin Can Change Your Cat’s Vet Visit - Just Cats Clinic

**If you call your Vet beforehand, they may recommend this, so that your Dexter is much more calmer, and not as stressed.
Some members have mentioned other meds that helped their cats with Vet appointments...so perhaps calling your Vet tomorrow, before you go, will help. Or calling tonight, if they are still open.
Or even calling another clinic that is open, too. Doesn't hurt to ask.

 

[Dexy]

On don’t apologize at all! It was in the back of my mind but ya I will lay off the opioid. And yes he takes a large dose before the vet to sedate him more. However they will give him sedation there for the ultrasound so I may call the vet and see if I should give him a bit less to sedate him like 100mg. He’s weak right now and not as strong as when he went before. First time I sedated at 200 but I thought that was a bit much. Second was 150. On a regular basis I give him a 25 pill and half a 25 pill, so about 37 mg that doesn’t make him too drowsy and seems to be a good dose right now for twice daily.
My biggest concern is him making it through the ultrasound. Want him to go peacefully at home not scared at the vet. However his vet is really good they use safe sedatives. The cat vet I went to do the xray and feeding tube(that never happened because of his lungs) sedated him heavily with ketamine and something else. Poor guy couldn’t walk for hours after. His primary vet uses reversible sedatives which is nice but did t ask what they actually use.

 

[cat nap]

On don’t apologize at all! It was in the back of my mind but ya I will lay off the opioid. And yes he takes a large dose before the vet to sedate him more. However they will give him sedation there for the ultrasound so I may call the vet and see if I should give him a bit less to sedate him like 100mg. He’s weak right now and not as strong as when he went before. First time I sedated at 200 but I thought that was a bit much. Second was 150. On a regular basis I give him a 25 pill and half a 25 pill, so about 37 mg that doesn’t make him too drowsy and seems to be a good dose right now for twice daily.
My biggest concern is him making it through the ultrasound. Want him to go peacefully at home not scared at the vet. However his vet is really good they use safe sedatives. The cat vet I went to do the xray and feeding tube(that never happened because of his lungs) sedated him heavily with ketamine and something else. Poor guy couldn’t walk for hours after. His primary vet uses reversible sedatives which is nice but did t ask what they actually use.

I actually think that you and Jenny22 are quite amazing, in the fact that the way you know how to use the meds that you have been given, for your cats, and to know when to change them slightly by observing your own cat's reactions.
Plus the fact that you both think ahead, and logically, (eg, the fact that you just mentioned that he will be sedated for the ultrasound...is something I would probably have never thought of, ahead of time.)

I think it is difficult for us regular cat people, to always know what to ask our Vets, and to know what to ask during the consultations, or after the examinations, too.
I often forget, and have to write everything down...ahead of time.
And then I still forget to ask about certain things.

Not to mention, that after I get home, decompress, and then later start to look up some more things...then I usually get more questions to ask.
Some vets are excellent at explaining things, but some are not.

I do understand that Fear you have of thinking that Dexter will not make it through the ultrasound.
Maybe if you think about it, from the perspective that the ultrasound may actually help you, in making further decisions about Dexter's health Plan, and what you can do next...then it may help to alleviate some of that fear.

Even if there is a possibility that Dexter will pass away, during the ultrasound,...he will actually be asleep during it, under anesthetic...and if the alternative was euthanasia at home, then the euthanasia would be final...but the ultrasound just carries some risks...but does not mean final in all cases. I'm not explaining this well at all, but I hope you can understand it a little.

( Last november, I had to take my Tripp in, for what I thought was a broken front leg/elbow, but turned out to be an inflamed abscess cat bite,...he was also given ketamine, plus some other sedatives. The Vet said he had a seizure, but the Vet managed to bring him out of it okay. I was a bit stunned, so it didn't really hit me until later that my 6.5 yr old cat, could have actually died...from what I thought was a simple x-ray. He was being aggressive and growling, which he never does at home, and it was actually me who asked for the x-ray, just to be sure. Now they have it written that he is allergic to ketamine...in his chart. But if I ever go to a different vet clinic, then I'll have to be the one, to always remember to mention this.)

I guess my whole point is that we are just never sure when our cats could leave us, and there's not really much we can do about it.
We have to trust the vet professionals, and hope they have all the training and experience to help our cats out, when unexpected emergencies do come up, or when they do procedures, and reactions take place.

I'm probably not giving you more assurance, and maybe making you worry more.
Which I hope I'm not doing at all.
If I am,...just kind of skip over all those parts...and always think positively but realistically too...which I kind of know you are already doing.

You just want what is best for your Dexter.
Take it day by day.
And whatever you decide tomorrow, and whatever you see in your Dexter...just go from there.

(Have to say, once again, though, that the picture you posted of your Dexter laying on the magazine with Betty White on the cover is just beautiful.
Makes my eyes get teary,... but I smile, every time.)

 

[Mamanyt1953]

D Dexy , I'll have a candle lit for Dexter tomorrow.