Fluid In Cat's Chest - Advice Needed

[Mia6]

Antonio,

How is dear Pallina today? I hope better.

Hugs,

Mia

 

[babiesmom5]

It sounds like you are keeping close tabs on Pallina which is good.

I would not be too concerned about the unaccounted for 55 ml of fluid. Not all fluid intake is excreted. Some is absorbed by cells and tissues, some goes to make blood, some bathes organs and intestinal tract, some goes into feces, some hydrates, eyes, nose, mouth, and a small part goes out during respiration process. While the diuretic drains off excess fluid from the chest cavity, she still requires sufficient fluid intake to regulate body functions.

The appetite stimulant Cyproheptadine, is actually an antihistamine (helps decrease allergic reactions), however it is not as efficient for that use in cats and is more often prescribed for its side effect of increasing appetite. I had a CKD kitty(also my hyper-T kitty), who was prescribed this to stimulate appetite. If I recall correctly, it does have a "carry-over" effect, so after 4-5 days, the increased appetite may continue for a while. I think if needed, it may be stopped for a period of time, then re-started at a later time if necessary. You could ask your vet. Hopefully, Pallina only needs it temporarily.

One thing I do recall is that Cyproheptadine, like most antihistamines, even for humans, does have a tendency to cause sedation. So Pallina's sleepiness may be partly caused by this, or she may just be tired out from stress of the procedures and just needs to regroup.

Give Pallina some strokes from me.

 

[Antonio65]

Mia6 ,
I checked on Pallina during my lunch break and she was a bit slow and sleepy. She preferred to lay in the sun outside the door rather than walking around the backyard as her usual. But she ate all her can of food and I gave her another one.
Thanks for asking

B babiesmom5 ,
I called the vet and he told me that the water intake/urine log is a good idea, but just like you say, these numbers must be take in account cautiosly.
As for the slight lethargy, yes, the vet told me that the Cypro could be responsible for that. Now that Pallina has a rather good appetite again we could stop it and see if in a couple of days she's back to a brighter life
I know that Artie is taking Cypro daily or nearly daily so I wonder why my vet told me not to extend the treatment for longer than 4-5 days and Artie is taking it everyday.

We also had the third report today, the one for the needle aspiration, but the sample was scarce and not enough cells were sampled, so it was non-diagnostic... a lost chance!

The vein shunt shouldn't be a problem, the vet says that it hasn't given Pallina any trouble so far and we shouldn't worry about it.

Next step is, wait a week then do another chest ultrasound to see whether and how much fluid has built up and if it's the case the vet could aspirate a small amount of it and test it with PARR and with a bacteriological test.
The vet says that he knows the answer already, that nothing will come up and we'll be left with no clear answer to it, but at least we would do every step. The only advice, after all these tests, could be the cortisone for some day and see whether the fluid stops or slows down.

 

[artiemom]

@antonio,
Glad Pallina's appetite is improved, and she is feeling a bit better.. ((hugs))

I do give Cyproheptadine quite often to Artie; however, I do not do it daily.
I find that if Artie has it a few days in a row.. or a few doses in a row---every 12 hours..Then he gets a bit of the serotonin syndrome. He will yowl a lot, driving me crazy. He gets that reaction automatically with Mirtazapine;
Perhaps, that is why the Vet does not want you to dose longer than 4-5 days. It seems to build up a bit in their system.


If I have to resort to a few days of doses, I am now giving him: 75% of a 1/2 tablet~~~ which means approx 1/3 of a tablet. It does seem to make a difference.

I have also learned, because Artie's issues are with his stomach and bowels, that when I give the cyproheptadine, I give a dose of Cerenia also. Pallina has much different issues~~ you do not need the Cerenia.

I have not really noticed Artie getting drowsy on the Cypro; but each cat is different.

Wishing you the best!!! keep us updated.. Your love and dedication to your babies is so remarkable. You are an inspiration to me.. I am not sure if I could do what you have done with both Lola and now, Pallina....

 

[Antonio65]

artiemom ,
thanks for your words of support and appreciation, but honestly I don't think to deserve the latter, I'm just doing the best I can as the guardian of my kitty. Thanks so much!!!

A bit of update.
As I wrote yesterday, Pallina was a bit slow and sleepy since the night before. Later in the afternoon she kind of woke up and liked to be outside for a while and walked around. She was lively, rather clingier than her usual and very vocal.
She didn't want to eat much, though, even after her 1/4 pill of Cyproheptadine.

Though she had her Furosemide in the morning, she hadn't produced much urine in her litter box.
After dinner (it means past 8 pm in this part of the world) she was very clingy and wanted to stay with me on the couch, she also kneaded a little on my stomach
She finished her bowl.
Then, at 10 pm, she started coughing, as she was choking on a hairball, but she wouldn't stop and went on for a long while. We were a bit worried. Nothing was expelled, then she curled next to me on the couch and I could clearly hear that rasping sound from her throat again. I was nearly going to take her to the clinic again, but I wanted to think rationally and wait some more minutes. As a matter of fact that sound stopped and she fell asleep.

Tonight, at 3:40 am, she started meowing loudly, nearly screaming and howling!
I jumped out of the bed and checked what was going on. She was fine, just very playful and started rubbing on my legs. I thought she was hungry, but I didn't feel like preparing her bowl at that time of the night!
So I cuddled her for a couple of minutes and went back to sleep. She meowed and howled two or three times, then silence... too much and sudden silence. So I got up again and found her trying to open a pack of salted crackers. I don't know whether she succeeded in getting one. I cleared the area and went back to sleep.
Her being vocal at night remembered me when she was very local in the late afternoon. This was what Artiemom meant in her last post, I think.

This morning at 6:30 am she was rather active, though less than during the night. I prepared her bowl, I thought she would wolf it down, but she barely licked it and about 20 minutes later she threw up a brownish liquid, water with some traces of food in it.
She hid in the other room. About 20 minutes later I gave her a shot of Ranitidine as per vet's instructions and half an hour later she was eating, though not much.
I also gave her the 1/4 pill of Furosemide and soon she ran to her litter box (*) where she produced some urine and some poo. This was particularly smelly, probably darker than usual, and a small part of it was clearer and softer. Absolutely strange!
I reckon that she ate a bit of those crackers and being her intolerant to grains she threw up and had some belly issues later.

At 8 am I left to go to work. During my lunch break I will go back home and see how she is.
To be honest, I don't like this situation.

(*) Pallina doesn't love to be manipulated, she gets easily distressed and when it happens she runs to the litter box to pee and poo

 

[artiemom]

((hugs)) Yes, the yowling could be from the cyproheptadine. That is what I found with Artie. He would just sit in front of me and yowl. During the night, he jumps on me, yowls in my ear, walks all over me, just to get me up.. thing more than that.

Poor Pallina.. She does not know what she wants. She feels horrible, is telling you this, but she cannot tell us exactly what it is.

I get that with Artie, also. When he does not feel well, he will be a constant cuddler. It is as if he is trying to tell me to 'help' him. When his discomfort increases, he will then hide in his tent.

Her urine is probably more concentrated. That is why it is smelly. The concentrated urine is because she is not eating and drinking much.. and the smelly poop could be because of the changes in her medications. I am just guessing at this point.

You are doing everything, right.. do not question yourself.

Again, I am sending and your way...
and
to Pallina.

 

[Antonio65]

Poor Pallina.. She does not know what she wants. She feels horrible, is telling you this, but she cannot tell us exactly what it is.

Sometimes she seems a little confused.
That yowling had been noticed some days ago too, I can't remember if she was on Cyprohepatdine already. She would howl from room to room, as if she was looking for someone and she didn't know who they were.

Her urine is probably more concentrated. That is why it is smelly. The concentrated urine is because she is not eating and drinking much.. and the smelly poop could be because of the changes in her medications. I am just guessing at this point.

Only her poop was smelly and only this morning. I will keep an eye (and nose) on it

During my lunch break she was quite alert, but just like yesterday she preferred to lay in the sun rather than walking around. She had eaten all her food, this is good!

Thanks for your loving support, Artiemom!

 

[artiemom]

Antonio65 I am ALWAYS here to support you... such a kind, caring, person, who would go to the ends of the earth for his kitties...his family...

 

[artiemom]

Antonio65 any recent updates? I have been lurking for a couple of days, thinking about you guys....((hugs))

 

[Antonio65]

Antonio65 any recent updates? I have been lurking for a couple of days, thinking about you guys....((hugs))

Hi artiemom , thanks for asking.
In the last few days she's been quite fine. She's been eating three cans a day (80 grams each), drinking her usual and using the litter regularly. She's only a bit quieter and somewhat sleepier, especially around midday.

She's still taking her 1/4 pill Dimazon (diuretic) and 1/4 pill Periactin (Cyproheptadine). The latter was advised for 4 or 5 days, but since she's eating with a good appetite I'd rather keep administering it, I wouldn't like to see her not eating like she's eating now.

She hasn't been yowling at night anymore, she does that at 6 am, though, even on Sat and Sunday, because she's used to have her first meal in the early morning

On next Monday morning we'll have a new ultrasound scan to check on that fluid in her chest. Hopefully the diuretic is working fine, though she was peeing more in the first days of this new med.

Yesterday and the day before I counted her breathing while she was sleeping, it was 36-38 per minute, a bit too fast I think.
Today she was at 28-30 per minute.

No more noises or rasping sounds from her throat.

I think that things ha improved in the last few days

Thanks for asking, give lots of kisses to General Artie

 

[artiemom]

Antonio65 This sound like really great news!! I am overjoyed!

Fingers, toes, paws, all crossed for the next ultrasound!!!

Artie is sending Pallina tons of kisses!!

 

[Antonio65]

Just back from the vet's.
The appointment was at 9:30 am, I took a 60 minute leave from work, it should have been more than enough. After 30 minutes waiting in the waiting room without a voice from them I left and went back home, where Pallina had her breakfast.
I would like to see their faces when they realized that I wasn't there anymore!

I will go to another clinic as soon as possible.

Have you ever been left waiting for a long time at your vet's? Is this normal?

 

[babiesmom5]

This was a very frustrating experience, for you, for Pallina. It is a total disregard for your time, especially when you have to take a leave of absence from work.

I have never encountered this type of delay. On very rare occasion, when there has even been a few minutes delay, the vet tech would come out into the waiting room with an explanation. Usually, it was because the vet was dealing with an emergency with a pet. They always told approximately how many more minutes delay before the vet could see me and they also offered sincere apologies. Additionally, the vet apologized when they saw me.

In my opinion, this clinic does not deserve any more of your business. I hope there is another clinic nearby which can offer the same service...and be more appreciative of your business and your time.

Here's wishing a much better outcome at the next clinic...for you and for dear Pallina.

 

[artiemom]

Yes, unfortunately, We have been the victims of waiting for the Vet.

If this was for an ultrasound, yes, you should have been updated about the wait. Sometimes animals need sedation for the exam, which takes a while and backs up all the other appointments.. like a domino effect..
Not to be informed about the delay, is appalling. It is stressful enough, to have an ultrasound, never mind fasting your baby... add the unknown delay is even worse.

At the Evil Hospital, it was routine that we waited at least 30 minutes for the Vet..I really hated that.. but, at the time, I just felt it was because of emergencies... not overbookings... later, I discovered it was from overbookings; not enough time allowed for each visit.

The first time couple of times I went to NVet, I had to wait a long time.. I took this to be because of emergencies.. and I was correct. He is such a busy vet, who is through, fast, but explains things completely. He follows things through with you. I remember the care he gave me, following me to x-ray, taking the extra time to show me the x-ray- explain things, and then checking up on Artie, after he had an enema, before being released.

I think, if this is a new Vet office, and has a good reputation, you would have to give them the benefit of a doubt. But, I would definitely voice my displeasure over the incident.

My own regular Vet tries to keep on schedule, but she also devotes a ton of time to each animal, and owner.

(((hugs)))

 

[Antonio65]

This was a very frustrating experience, for you, for Pallina. It is a total disregard for your time, especially when you have to take a leave of absence from work.
[...]
In my opinion, this clinic does not deserve any more of your business. I hope there is another clinic nearby which can offer the same service...and be more appreciative of your business and your time.

Yes, B babiesmom5 , it was an absolute lack of respect for me and Pallina.
When I arrived and sat in the waiting room the vet showed up and said "we'll be with you in a minute". After 25 minutes I left! It's a small practice, there's no receptionist. The handy part of it is that they're very close to home, have some equipment and are somewhat related to the clinic where I usually go but it's 10 miles away. Some of the staff work in both places, so there's no need to have a long chat or exchange of information.
My vet (who works at the clinic 10 miles from home) referred me to them because all we had to do was a simple chest scan to assess whether and how much fluid had built up and have a sample of this fluid and blood for a couple of tests.

Yesterday I thought to inform my vet about this incident and reschedule a new appointment at the regular clinic, but then I thought that had they told me to go to them in a couple of days I would have had Pallina fast again and I felt sorry for her. In about three weeks time Pallina will have a new thyroid check, so I think we can do everything at the same time.
She's doing fine, eats a lot and doesn't show any sign of discomfort or difficulty. So I think that it isn't an emergency at the moment.
She still has a raspy voice, not always but she has it, and on a couple of occasions I heard a rasping breathing from her throat, like when she came home from the CT scan.

Before going to the vet yesterday morning I weighed her and she has taken 250 grams since October 5. I don't know if it's a real gain and how much of that weight is from fluids in her chest. I'm still giving her the diuretic and if it's woking fine she shouldn't have any or very little fluid in her chest. So I hope that these 250 grams come from the fact that in the last 10 days she's been eating 50% more than her usual, because of the Cyproheptadine.

I think, if this is a new Vet office, and has a good reputation, you would have to give them the benefit of a doubt. But, I would definitely voice my displeasure over the incident.

artiemom , These new vets took over an old practice, it was the first practice ever opened in this town about 40 years ago. The previous vet retired in 2014 and they took his place. But the new owner is an idiot. I had to argue with him before. I know that other people are disappointed by hiw work, and even a few other vets say he's not the right person for that job.
He has staff and the other vets are a bit better than him, but not excellent.
I used this practice last year when my sweet Lola had to receive her injections of chemo. They accepted to store the syringes in their freezer and do all the injections free of charge. After all they didn't do much, just an injection of a med that I had already paid for. But I witnessed and understood their ability with other pet owners and kept asking myself what on Earth could make a person take their pets to them!
I think they got the message yesterday.
I doubt I will ever go to them. My wife told me to forget them.

 

[Antonio65]

At the end of the day I didn't call my vet to tell him this weird story, neither did I schedule another appointment.
In three weeks time Pallina will have a new thyroid levels check, so I thought that in a single appointment I will have her checked for chest and all.
She's fine, hungry, loving and alert, so I think she's not in a situation that requires a prompt intervention. Furthermore, I wouldn't like her to fast again, say, tomorrow and then again in three weeks time.

Here she is yesterday, right after sunset, during her last walk out in the courtyard
She's never too happy or cooperative when it comes to being photographed.

 

[artiemom]

At the end of the day I didn't call my vet to tell him this weird story, neither did I schedule another appointment.
In three weeks time Pallina will have a new thyroid levels check, so I thought that in a single appointment I will have her checked for chest and all.
She's fine, hungry, loving and alert, so I think she's not in a situation that requires a prompt intervention. Furthermore, I wouldn't like her to fast again, say, tomorrow and then again in three weeks time.

View attachment 200821

Here she is yesterday, right after sunset, during her last walk out in the courtyard
She's never too happy or cooperative when it comes to being photographed.

Beautiful Pallina! Such a sweet face..

 

[Antonio65]

Three days ago I suspended the Cypro (Periactin, a quarter of a pill a day) pills that I was giving Pallina.
I think that the "carry-over" effect that B babiesmom5 mentioned some posts earlier is fading away and this morning she wasn't as hungry as in these past days.
I was glad to see her eating much more than usual, I think she was also gaining some weight. Now I presume she would stay as she is or even lose a little weight.
I wonder if I should consider giving her a quarter of a pill of Cypro every now and then, just to keep her appetite awake.

 

[artiemom]

Glad to hear Pallina is eating... that is a big thing!

Just for thought. Since Artie gets very vocal with repeated doses of the Cypro (1/2 tablet); the specialist suggest trying to decrease that dose. He, being a very precise person, said the dose should be 75% of what I was giving....

ok, 75% of a 1/2 tablet is 1/3 of an entire tablet!!!!!

I ended up cutting the dose of 1/2 tablet into quarters and then into a half a piece.. What a pain.. but it still works, not as strong as a full dose but it does help a bit....

I hope you understand what I was trying to say.. so complicated..

I think I would just watch Pallina, see how she is doing with her food intake. If it seems to decrease a bit, I would try the 1/4 of a pill. And then just go from there.

Perhaps the carry-over effect is from repeated doses.. You do not want her to get immune to Cypro, for when you really need it. At least, that is what I do; watching Artie and acting upon his symptoms.. If he can do without the cypro, I would prefer it.. but it is there when I need it.

 

[Antonio65]

artiemom , you made yourself perfectly clear
Recently Pallina had been taking 1/4 pill a day already, so you're suggesting me to give her less than a 1/4?
Anyway, I will watch her in the next few days and see if her appetite decreases. She's been eating much lately, it was a joy for me to see how she was asking for more food. I'm sure that her belly is a bit rounder than it was a month ago. She had lost much weight during the year prior to the I-131 treatment, I would like to see her as she was, or close to it.

I didn't know that she could get immune to Cypro, thanks for the info!