I think this is the end. Please, what is a safe antibiotic injection?

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Just as I was about to start typing, Edwina came in and now she's on my lap, saying hello! She probably saw that cute photo of Echo!

I can't believe how slow the vets are to get in touch with you, that's just terrible. (It really makes me appreciate our vet, who's really good about calling back, particularly if a cat's very sick.) One thing I asked if the inflammation was considered extreme or more mild and she said she considered it mild. That's good at least.
Aw Edwina!

Yes it's been frustrating. Her regular vet in particular. I called and left a voicemail a day or two ago and have heard nothing back. They closed early yesterday (tried to call last night after not hearing from them just to see what it said). Dont know what's going on.

A vet from the first clinic did respond to me email of many questions which was helpful, but I hadn't connected the panleuk yet so hadn't asked about that. Asked in the reply. We're off to get the first b12 shot today with a tech and be shown how to do that at home....I hope that will help things along in healing. Did you do that with Edwina? Did she have a GI Panel done?

Anyway, the panleuk theory is as good as any right now... and yes, I think it's a great idea to email the NYC vet, who sounded really good. Given how Edwina's case worked out and my "path of least resistance" approach to sorting through symptoms and solutions, I also think you're doing the right thing to focus most right now on this topic rather than the IBD question. At least panleuk or clostridium have fairly standard treatments! And they'd need to be taken care of ASAP.
It looks like the panleuk is mostly supportive care which she did have for those hospital days. Her mood, appetite and all are good now thank goodness. Her poops are still not right though :( I was giving her Rabbit rawz for two days and they did firm up, but looked weird still. Like maybe still not properly digested, but I dont know. I did read rabbit makes for lighter poops. I switched to turkey yesterday and back to fairly mush. So maybe poultry is a problem...it just never was before? Rabbit rawz has bone in it I believe. Maybe that's playing a role too who knws. It also makes it quite high in phosphorous which I dont like since Echo's BW tends to be 1.6-1.9 creatinine...

But IBD is so mysterious, with every cat needing its own set of foods and treatments... I can't even begin to tell you how glad I was when the vet and I had our post-op phone consult and we barely even talked about IBD, despite Edwina's thickened intestines. The first goal was just to get Edwina eating normally again, switch her diet back to only cooked and canned (away from lots of raw meals), and just find some semblance of normalcy in the house again, for everybody's sake! About two months later, so far so good, knock wood and all that. And the new diet is (how to put it?) pretty IBD-cat-friendly, with almost no gums, very low carbs, no fish, no grains, no known irritants, and so on and so forth. IBD is always in the back of my mind -- I just hope to stave it off as long as I can with decent food. I do still need to start probiotics, though I'm a little nervous to because both cats have been eating well and using the box regularly!
Was Edwina on raw at some point? I am dabbling with homecooked. I'm just not sure what protein with chicken and turkey out...I guess I'll try pork. Not sure how beef will go...it could have been unrelated, but the fact that Echo stopped eating and things escalated after Nulo beef + lamb has me hesitant. All the places to order for raw/homecooked kittie meat online seem to have 10lb minimums so hard to get the adventurous meats for now.

Even if this was from a paneuk infection, I worry it damaged her and we now have IBD to worry about as well. I am longing for a normal tootsie roll poop. What a weird thing to say!

IMHO, one of the most helpful IBD posts (ever!) is this one: Cat diagnosed with IBD, feeling overwhelmed
Since IBD is IBD, some of the specifics for this cat differ a lot from what we can feed our cats but it's really interesting to see what this cat's needs are. And how patient his people are!
I will deep dive in to that post! I perused it and it looks so informative. Thank you again for all your support during this lisahe lisahe ! It's made a world of difference. I hope Edwina continues to do well and live her very best kitty life.
 
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lisahe lisahe has so much knowledge and advice on this subject and I can't add anything helpful to the wonderful advice you're getting. But I wanted to say that Echo is so cute!! She has such a sweet expression. :hearthrob:
Thank you! She's sassy/spicy with most people and even me sometimes, but for the most part is a sweetie <3
 

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A vet from the first clinic did respond to me email of many questions which was helpful, but I hadn't connected the panleuk yet so hadn't asked about that. Asked in the reply. We're off to get the first b12 shot today with a tech and be shown how to do that at home....I hope that will help things along in healing. Did you do that with Edwina? Did she have a GI Panel done?
I'm glad they were at least able to get you a b12 shot! I'm pretty sure Edwina did get a b12 dose back in June, though I'm pretty sure she didn't have a GI panel. She skipped a lot of steps because of her scary ultrasound!

It looks like the panleuk is mostly supportive care which she did have for those hospital days. Her mood, appetite and all are good now thank goodness. Her poops are still not right though :( I was giving her Rabbit rawz for two days and they did firm up, but looked weird still. Like maybe still not properly digested, but I dont know. I did read rabbit makes for lighter poops. I switched to turkey yesterday and back to fairly mush. So maybe poultry is a problem...it just never was before? Rabbit rawz has bone in it I believe. Maybe that's playing a role too who knws. It also makes it quite high in phosphorous which I dont like since Echo's BW tends to be 1.6-1.9 creatinine...
I'm glad she seems to be feeling better! Bone, yes, it can definitely change a lot: too much bone in food makes Ireland constipated so it's possible that if the Raw rabbit food has bone it would have that effect. I'm glad you mentioned that because I just looked at the Rawz foods I've been feeding: chicken and duck pates as well as some chicken/liver shreds tonight. The shreds were something like .91% phos, dry matter, whereas the pates were in the 1.5% range... Their shreds are nice and low in carbs, too, despite the tapioca, which I hate feeding!

Was Edwina on raw at some point? I am dabbling with homecooked. I'm just not sure what protein with chicken and turkey out...I guess I'll try pork. Not sure how beef will go...it could have been unrelated, but the fact that Echo stopped eating and things escalated after Nulo beef + lamb has me hesitant. All the places to order for raw/homecooked kittie meat online seem to have 10lb minimums so hard to get the adventurous meats for now.
Yes, our cats used to eat lots of raw food, all commercial raw, some freeze-dried, some frozen. They loved it but (sorry if I already mentioned this somewhere) I switched them off raw because our vet is not a fan (she suspected parasites from raw food) plus I wasn't happy with some of the ingredients in the foods. Particularly the bone but also varying amounts of pumpkin, psyllium, probiotics, and other things, depending on the food. It was hard to keep track of it all! I'm glad to have simplified because Ireland is eating much, much better now. I'm convinced it was the bone even though I was careful not to feed too much of it. I think she's very sensitive to it.

Our cats like pork a lot. (And our vet's a big fan of pork for cats.) I sometimes make plain pork food; sometimes I blend pork with chicken and/or turkey, cooking them all together. I've noticed that the meat selections are generally less adventurous now than they were before the pandemic. And right now even turkey's hard to come by! (Watch out with turkey, BTW: some cuts have a lot of sodium even without added salt.)

I will deep dive in to that post! I perused it and it looks so informative. Thank you again for all your support during this lisahe lisahe ! It's made a world of difference. I hope Edwina continues to do well and live her very best kitty life.
There's so much in that one post that I saved the link! And you're so welcome. It's hard enough to do all this when you have a vet who's responsive, as ours is and as the surgeon and his team were, so I can't imagine how hard this must be for you without much vet help at all. It shouldn't be like this.

Edwina looks very happy, all settled into a nice little box in my office, sending her greetings to Echo and hoping you hear back from the vet one of these days! ❤
 
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So, I'm not sure what to do.
Yesterday while getting the b12 shot, the tech was super nice and sweet with Echo. I brought up the panleuk result and asked about it. She too was puzzled and went to ask the doctor who oversaw much of Echo's case. I mentioned Echo had only been vaxxed a full set of kitten vaccines, but never boostered and was technically overdue by a year.

She relayed to me that the vet there had consulted on this result with the IM vet at IDEXX labs and they thought it could be latent viral shedding, like how coronavirus was also positive. I felt puzzled, but left thinking "ok, so maybe we do have a case of suddenly symptomatic IBD".

But I couldn't sleep and kept reading. Everything I can find suggests a fecal PCR can be insignificantly positive in cats who recently had the vaccine, but otherwise was pretty much stating that a positive result outside of that indicates panleuk. I then paid $5 to ask on PetCoach if this could be latent viral shedding and the DVM that responded said:
"If Echo wasn’t fully vaccinated as a kitten and boostered as an adult, then she isn’t protected from panleukopenia. You’re correct that it can come into the house quite easily. I am not aware of latent shedding with this virus and it usually spreads quite rapidly among litters or colonies of unvaccinated cats and kittens. And once they recover, they won’t get it again. However we now know she isn’t protected against the other viruses we vaccinate for, also which can be brought into the house, so I would recommend she be vaccinated in 3-4 weeks."

Echo was, to my knowledge and understanding, fully vaccinated with 3 rounds as a kitten. Just never boostered since.

Echo's original vet rescues cats a lot. She has kennels in the back exam room that always have kitties in them. When we initially went during all of this, she had 4-6 kittens in the kennels off to the side, and it's not uncommon for some of the longer term resident cats to wander around. I'm sure they test and clean, etc...but it is one possible source if say, the mucus stool was unrelated and the severe illness she developed the following week was from infection.

Other possibility: My husbands job involves walking all around most of the towns around here within a 30 minute drive. This virus lives a LONG time and spreads easily. We could have brought it in on our shoes (though the local tech felt that was very unlikely), the DVM above even mentions this.

So next problem is, naturally, the day I finally schedule the first b12 shot, Vet #1 office calls to schedule an appointment finally. We're scheduled for tomorrow at 2pm. They do have a separate exam room they used to use, but for the last few years they've been using the back room where the kitty kennels are and cats roam. For their sake and Echo's I'm going to request we use the isolated room.

I found a post on here that mentioned news articles indicating a noticeable rise in panleuk in several states, as well as a research proposal for this year at cornell vet university to research the FPV genome and vaccine effectiveness as it was based on viral samples from 50 years ago. It notes the recent widespread outbreaks as possible indication that the long standing vaccines no longer are effective. I wonder...

Oklahoma
Tennessee
New York

Long post again! I apologize. Might be worth someone in the future for a breadcrumb trail of all this, though. I hope I can heal her from all this....I need to find a DVM who understand panleukopenia and how to help her recover. Going to make a separate post to see if anyone else has had adult cats experience something similar and recover in the meantime...
 

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I'm very glad to hear you finally have an appointment! And that you can ask for the isolated room. This "was it or wasn't it" question reminds me of Edwina and the possibility of parasites... my guess is that you may never know for sure on this one either. And it's very interesting that the vaccine effectiveness seems to be waning. More than anything, I hope you can get Echo back on track soon!

Edwina, of course, knew you'd posted so she came to say hello and wish you and Echo well tomorrow.
 

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I would ask the vet about additional testing for panleuk as well - I have heard of a virus isolation (a test to find the virus in different tissue samples), antibody levels, and PCR testing are also available to help confirm suspicions of feline panleukopenia - these are in addition to the fecal testing. I don't know what all they entail, but it can't hurt to ask.
 
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Hi lisahe lisahe Sorry for my long overdue update. I've been overwhelmed.

The vet visit was stressful. That private exam room had kittens in it, so that was a no-go. The vet, while thorough in looking over all the results, kinda stressed me out because she wanted to introduce echo to another cat. Anyway, basically Echo came face to face (with wall of carrier in between) with another kitty. She also earlier in the appointment leaped off the exam table to the office, under the desk and then under the office cat tree. She really gets most aggressive and fearful there (even on 75mg gabapentin), because the vet basically is a kitty rescuer and there's kitties in back rooms, in crates in front of exam table. Echo is an only cat and I think this all really stresses her.

As far as the consultation went though, the vet leans IBD. Didn't think the panleuk test had anything to do with it, but I don't know. She did say we could repeat the ultrasound there in December because the gentleman she uses has done this for 40 years and notes everything in measurements, even if it's within normal range. Which is really useful so you can monitor everything and have all the information going forward.

So in that sense I'm torn, because I do want another ultrasound, to re-evaluate if the inflammation has stayed the same, worsened, or god-willing gone away all together by then. So if I do it there, where there are rescue kitties and my cat hates, I could at least get the detailed understanding. But, the office chaos is the downside. I also do want to discuss with an IM vet about all of the results and how it all went down to get an understanding from someone who specializes in this area.

I called one hospital and got a call back. The initial front desk person, Lisa, was quite curt though helpful in setting things up so I could get the call back. It's a hospital. They're busy, I get it. But so was the one Echo stayed at and the front desk was always kind regardless of who was on shift or what time of day. I wish they had a specialty department, but they are emergency only. The woman who called back from the specialty hospital was nice, answered questions. I confirmed for Nov 1st. They would be taking Echo out of the room to exam, which I don't love. Depending on what they think after evaluating records, they may want to repeat ultrasound that day as well. I'm debating if I would cancel and hold off on all this and just go with Echo's usual vet or not. I will sleep on it.

The other option is Cornell over in Conneticut. The thing that concerns me about there is it has notoriety, is very very busy. Much like the hospital that killed our dog some years ago. So I sort of wanted to find a smaller, well managed place....I don't know. Waiting to see if there are recommendations in the local facebook pets group page in my area.

Echo is doing well. Her poops are mostly normal now with probiotics, enzymes and preforpro on Rawz turkey or Rabbit, but there's a lot of it. Yesterday was 3x in one day! So I worry she's got malabsorption issues going on. I have to get a baby scale to monitor her weight, but at the vets on Saturday it was the same as back on September 15th. That's good at least. I gave her the first at-home B12 shot this morning, which went really well thankfully. Got it done while she ate breakfast. Her appetite is good, she wants to play most days. Talks to me most days. Is sleeping on my desk in her bed at the moment and hasn't vomited at all or been in a nausea loaf. I'm just afraid it could be cancer. I keep envisioning a repeat ultrasound that's all clear and wishing...

How is miss Edwina been doing? Has adjusting meal size taken care of her tummy upsets?
 

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I'm glad Echo is doing well and recovered from the trauma of that office visit.

Seeing the vet and being forced to meet new cats??? That would have been any of my cats nightmare. What is that vet thinking? Can you just tell her no, we can't take another cat now. Echo doesn't want another cat or to even be in the room with another one.

I'd flat out say, I don't know, she's stressed, she might try to hurt them and that would frighten them. Tell the vet you are afraid Echo will hurt the stranger kittens, that Echo will hurt herself on their carrier and you'll expect her to fix that damage for free.

I can't believe your vet did that and I've seen some strange stuff
 

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Echo is doing well. Her poops are mostly normal now with probiotics, enzymes and preforpro on Rawz turkey or Rabbit, but there's a lot of it. Yesterday was 3x in one day! So I worry she's got malabsorption issues going on. I have to get a baby scale to monitor her weight, but at the vets on Saturday it was the same as back on September 15th. That's good at least. I gave her the first at-home B12 shot this morning, which went really well thankfully. Got it done while she ate breakfast. Her appetite is good, she wants to play most days. Talks to me most days. Is sleeping on my desk in her bed at the moment and hasn't vomited at all or been in a nausea loaf. I'm just afraid it could be cancer. I keep envisioning a repeat ultrasound that's all clear and wishing...
Oh my, that's quite a report, Time 2 Recognize Time 2 Recognize ! I'm going to start with this because this is essentially good news.

Yes, malabsorption could be an issue, I guess. Does she have increased fiber in her diet? Even small amounts in the food (or, in our cats' case, in their anti-hairball tablets, which contain psyllium) can really increase the amount of poop in our cats' boxes. It's great that she's eating well, gained back her weight, playful, not vomiting, and not appearing to be nauseous. Is she still taking any medications other than the B-12? Good for you for doing that yourself!

Her progress sounds like Edwina: she's doing very well (thank you for asking after her!) and I could repeat everything you say about Echo! (Except B-12!) The other thing they have in common is possible IBD, which is a bit of a wild card since it can sometimes be controlled so well with diet. There's also uncertainty about what caused their acute symptoms. The big thing where they differ is that you might still be able to get a diagnosis and we can't since the biopsies didn't turn up anything interesting about what caused her inflammation. Case closed for Edwina! I guess your options are further diagnostics (including a repeat ultrasound) or wait and see, right?

On the not-so-happy side, like K Kflowers , I can't believe your vet makes cats meet each other. Our vet does everything she can to make sure cats don't meet each other! Do they do things differently for ultrasounds? I would hope so, since the cats need to stay still! As for the specialty hospital, where they'd take Echo to an exam room... that's how Edwina had her initial surgery consult, too, and it worked really well. I wrote up a summary for the surgeon since we wouldn't meet before he examined Edwina. Then he examined her, and came outside to talk with us at our car. (Their reason for this is fire code: their building is crowded so they can't legally bring clients in!) I felt bad and sad not to be with her for the exam but, honestly, the whole thing worked really well because the talks with the surgeon (and, the next day, when we picked Edwina up) and the vet tech were pretty relaxed. We considered bringing Edwina in for a consult with an internal medicine specialist, about a month after her surgery. But she was doing well by then, I had a good phone appointment with her regular vet, and I felt satisfied that we'd done about everything we could diagnostically. And I do trust our regular vet, who felt confident that everything was under control. Even so, I'm glad to know there are good internal medicine vets at the hospital where she had her surgery. In your case maybe it would be good to have a specialist look at Echo, particularly since it's your regular vet who's often unavailable, isn't it?

I guess I'm thinking through this because these options and decisions sound so familiar. I'm going to stop now both because every option in situations like these has its pluses and minuses and you'll obviously make whatever decision works best for you and Echo... and because Edwina's lying on my lap and making it very difficult for me to type! She really is back to her old self. I'm glad Echo is doing so well, too!
 
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Seeing the vet and being forced to meet new cats??? That would have been any of my cats nightmare. What is that vet thinking? Can you just tell her no, we can't take another cat now. Echo doesn't want another cat or to even be in the room with another one.

I'd flat out say, I don't know, she's stressed, she might try to hurt them and that would frighten them. Tell the vet you are afraid Echo will hurt the stranger kittens, that Echo will hurt herself on their carrier and you'll expect her to fix that damage for free.

I can't believe your vet did that and I've seen some strange stuff
It's very frustrating. Been to 3 local vets and I can't say we're really content with any of them, all for different reasons. This vet had a separate exam room and it was less stressful for all back then, but since she's always rescuing street kitties, it's become a room for boarding rescues now. So the exam room is now the back, where kitty crates are in view and even if she doesn't "introduce" another cat, the scent of fellow feline stranger danger definitely amps up stress for Echo. I need to try one or two other recommendations for vets that I've sought out. I hate putting Echo through visits plus the cost out of pocket just for me to essentially interview the vet, see the office and decide if we'd be comfortable there. But I feel backed into a corner and don't know what else to do. I'm always so jealous when I hear someone rave about having a vet they and their kitty is super comfortable with!

When I'm back from my trip, which is next week for 10 days overseas (very stressed about this!) I will try one place with very positive reviews and recommendations. I still do not trust that because the feline only vet that we really do not like or trust has almost all 5-stars, meanwhile he lied to us about an injection so...long story but reviews are not everything and finding compatible vet is so tough.
 
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Hi lisahe lisahe ! Long overdue reply:

The other thing they have in common is possible IBD, which is a bit of a wild card since it can sometimes be controlled so well with diet. There's also uncertainty about what caused their acute symptoms. The big thing where they differ is that you might still be able to get a diagnosis and we can't since the biopsies didn't turn up anything interesting about what caused her inflammation. Case closed for Edwina! I guess your options are further diagnostics (including a repeat ultrasound) or wait and see, right?
I did book an internal medicine consult, but ended up canceling because I truly believe after diving into research that she had panleukopenia. IDEXX labs themselves has a data/interpretation sheet for fecal PCR tests that states a positive for panleuk is significant unless recently vaccinated, which she was not. So I canceled the IM because at this point I want to do follow up, more detailed ultrasound as next step and go from there.

I can't believe your vet makes cats meet each other. Our vet does everything she can to make sure cats don't meet each other! Do they do things differently for ultrasounds? I would hope so, since the cats need to stay still! As for the specialty hospital, where they'd take Echo to an exam room... that's how Edwina had her initial surgery consult, too, and it worked really well.
I don't think she would make Echo meet another cat for an ultrasound visit, but because she rescues street kitties all the time, some who will wander the back rooms freely when clients aren't around, the scent of stranger cats is everywhere. I think that's part of why Echo is immediately more aggressive at her practice. They would sedate her for the ultrasound, though. I dunno. I'm very torn about going back there. Ideally would like to find a different vet that Echo and I both like but it feels like a crapshoot.

We considered bringing Edwina in for a consult with an internal medicine specialist, about a month after her surgery. But she was doing well by then, I had a good phone appointment with her regular vet, and I felt satisfied that we'd done about everything we could diagnostically. And I do trust our regular vet, who felt confident that everything was under control. Even so, I'm glad to know there are good internal medicine vets at the hospital where she had her surgery. In your case maybe it would be good to have a specialist look at Echo, particularly since it's your regular vet who's often unavailable, isn't it?
I guess I'm sorta at the same spot. I'm fairly convinced this was primarily caused by panleukopenia so I've decided a followup ultrasound makes the most sense. She had the symptoms, the lowered WBC count and positive fecal despite no recent vax so it makes the most sense to me considering she had zero issues prior. . . The only uncertainty is whether or not a week long development of intestinal inflammation from panleuk would likely cause such low B12 levels. I've asked on Petcoach and was basically told that it could, and found this article about it, but I'd like to find a new vet to actually go over things in person and ask these questions to. It seems vets here aren't all that familiar or experienced with panleuk especially in an adult cat. Feel like I am in a pickle on where to get follow up ultrasound.

Clinic #1 her original holistic leaning vet with rescue kitties: so stressful even with gapapentin, she also scoffed at the PCR positive for panleuk and strongly suspected IBD. Yet also scoffed at chicken allergy or gums being any kind of issue. They're hard to get hold of and often out of office when we are in need of help. However, the US internist she uses would do a thorough, detailed report. I feel somewhat uncomfortable asking questions as she can be dismissive, which is another big downside.

Clinic #2 quite a challenge to get a regular, consistent vet there since they rotate clinic hours. The ultrasound was not the most thorough. I could potentially ask they do a more detailed report, but have the sense they will see me as a pain in the ass. I don't actually care if they do, especially since it seems to me a fairly reasonable request, but it's not really ideal to have tension like that. I was also the one to have to ask for all the tests vs them proactively recommending, so. Another downside but that would go for both practices.

As for Echo's overall update, she seems to be doing well on Rawz canned Rabbit. I've experimented with homecooked + EZ Complete and she likes the pork, but it seems to make her noticeably thirsty so that is concerning to me. Poops were good with it as 50% of her diet, though. I add water to all her meals so the fact that it seems to make her thirsty bothers me.... She's also been on S Boulardii, digestive enzymes and visbiome probiotics. B12 shots on Thursdays (one coming up tonight!). I ran out of rabbit Rawz so had a day or two of Rawz turkey and her stool started softening again. Soft logs...so we're going back to rabbit. Don't love the high phosphorus. Uncertain if turkey +/ chicken are issues for her now or not. I suppose trying a different brand of turkey would help identify that, but I can't right away because:

Final complicating factor: I'm off to Europe next week for a 10 day trip to meet my husbands family for the first time. I have debated backing out of this several times...but it would be a big deal in terms of family politics and he hasn't seen his parents in years now, so. I have a pet sitter arranged, mother will also come spend time with Echo daily, pet camera will be set up and aside from some lingering stool irregularities, Echo is doing quite well. Acting like herself, great appetite, no vomit, no nausea loafing or anything like that. She's chatty, good energy, and currently comfortably napping on the desk beside me. I will immediately be on a flight back if anything is reported as being off though and hubby knows this.

Pic of the lady for funsies. Her arm fur is slowly coming back.
Echo October 2022.jpeg
 

lisahe

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Acting like herself, great appetite, no vomit, no nausea loafing or anything like that. She's chatty, good energy, and currently comfortably napping on the desk beside me.
This is all very good to hear! And Edwina just came to settle on my lap and help me type... maybe she saw Echo's picture! She's such a beautiful cat! (And yes, it's very nice when the arm fur comes back...)

I'm very glad Echo's doing so much better but how frustrating that you can't find a vet that you trust and like. I saw your other post, where you mentioned feeling jealous when someone's cat is comfortable with the vet... our cats do pretty well with our regular vet, who sometimes even kisses them! This is such a huge contrast to the clinic where we took our previous cat: her last regular vet there was only helpful about running blood tests. I was glad it was a different vet, someone who'd seen her many times before and is a very kind person, was the one who saw her for her very last visit. Anyway, that's all in the past...

It's odd to hear that Echo's drinking so much. I wonder if it's the EZ or something else. The pork didn't have salt in it, did it? (It can be hard to find plain pork without added salt these days...)

I wish I had some sort of hopeful suggestion or thought for you but I don't. I think you said one of your vets already called IDEXX to discuss those test results, right? (I tend to think of IDEXX as able to do anything because they're in the next town and I know an amazing scientist who works there!)

Most of all, I just hope Echo continues to do well (particularly while you're traveling) and starts to improve even more once you find foods that seem to suit her. Which isn't always easy.

I hope things go well in the coming days and while you're away! 🤞❤
 
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