Introducing Betty White

daftcat75

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It may still number a reaction/side effect of yesterday. Do not panic, yet.

It took Artie several days to get back to normal. Almost 10 days.
Geoffrey was different—-only one day.

Each cat is different.
She ate well yesterday.

She’s definitely off this morning. I did manage to get her meds in her and about a 1/3 portion before she pulled up. Thinking she’s probably going to pop anyway, I gave her her hairball treats plus an extra. Maybe it will work. Maybe it’s all coming back up later. More than anything, I know she’s off because she’s not sitting in my lap during breakfast. She picked an alternate cloud on the bed and has been staring at the wall for the last ten minutes unable or unwilling to put her head down. Oh. There she goes. Head down. Let’s see how long we get before she pops.

Or rallies? The other half of her partial breakfast is left out for her. I didn’t plate a full breakfast seeing as she didn’t look willing or able to eat a full portion.

I wonder if this morning is a side effect of a rebound effect of ceasing the famotidine. Yesterday that was looking like a good call the way she was eating so well without the usual hesitation or fussiness. Maybe it took awhile for her body to adjust or rebound.

And her head is back up. She’s going to pop today. 🤦🏼‍♂️😿
 

tarasgirl06

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She ate well yesterday.

She’s definitely off this morning. I did manage to get her meds in her and about a 1/3 portion before she pulled up. Thinking she’s probably going to pop anyway, I gave her her hairball treats plus an extra. Maybe it will work. Maybe it’s all coming back up later. More than anything, I know she’s off because she’s not sitting in my lap during breakfast. She picked an alternate cloud on the bed and has been staring at the wall for the last ten minutes unable or unwilling to put her head down. Oh. There she goes. Head down. Let’s see how long we get before she pops.

Or rallies? The other half of her partial breakfast is left out for her. I didn’t plate a full breakfast seeing as she didn’t look willing or able to eat a full portion.

I wonder if this morning is a side effect of a rebound effect of ceasing the famotidine. Yesterday that was looking like a good call the way she was eating so well without the usual hesitation or fussiness. Maybe it took awhile for her body to adjust or rebound.

And her head is back up. She’s going to pop today. 🤦🏼‍♂️😿
Hoping she doesn't, but I think artiemom artiemom is absolutely right. That was a pretty heavy day for her yesterday. Takes time to bounce back.
 

daftcat75

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Hoping she doesn't, but I think artiemom artiemom is absolutely right. That was a pretty heavy day for her yesterday. Takes time to bounce back.
I don't understand why it would come a day late though. She was fine yesterday. She ate well and without hesitation. She bunted with vigor. And while we didn't sit together for baseball--and our team had a travel day anyway--she did show up to all her meals and reconnected at least once in the night for cuddles.

This morning she did not come off her cloud at 5:30. I went through all the motions including preparing a tiny portion and no interest in so much as waking up. She picked her head up briefly, said "fluff it!", and went back to sleep. So I put that tiny portion back in with the rest of her food for the day and went back to bed myself. When I woke about two hours later to make my own breakfast, I still couldn't get her interested in coming off her cloud. What finally did it was when I got down to the floor to start some exercises for my back. She came over to bunt me. But it was just a shadow of her usual vigor. Once she was up off her cloud, I briefly got her interested in eating. Just long enough for her to take her two capsules (ondansetron and the FMT pill) and about 10 grams of an already reduced 20 gram portion. I didn't expect her to eat the whole 30 grams she usually gets for medicine meals. But I kinda hoped she would do better on the 20 gram portion. She did her morning business. She's not constipated. I decided if she's going to pop, she's going to pop. But in the off chance the hairball treats can work for acute situations like they say (4 treats twice a day until the hairball has passed), I decided to give her three instead of the two she's almost up to. They are shaped like fish and we are up to 1 fish plus 1 fish head. (🎶"Fish heads, fish heads, roley, poley fish heads"🎵) I was planning to try two whole fishes with her this weekend anyway.

I've seen her on hunger strike but still wanting to interact with me. She doesn't seem much interested in either right now. 😿

On another note, I've been reading all morning and can only find confirmation that taking her off famotidine was the right thing to do (and that leaving her on it for so long was not such a good idea. 🤦‍♂️) I'm not finding documentation of a rebound effect like PPIs. But certainly couldn't I expect her to feel different for a day or two after taking this drug for so long? I honestly thought I was seeing an improvement yesterday. She was eating with more vigor and less hesitation. I got to wondering if suppressing acidity was making her worse as acidity is needed for proper digestion and motility.

In any case, waiting for this to resolve in one manner or another is the worst. I just want to poke her and squeeze her and see if I can move this along to whatever next phase is coming.
 

artiemom

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my thoughts would be: Betty was given Cerenia for the endoscopy. (Geoffrey was). She ate great yesterday because of it. Today, it is slowly leaving her system; and, she feels blah 😒 from yesterday.
Thinking it is all from yesterday

Artie was “off” for 10 days. I was about call Vet, when he perked up.
 

daftcat75

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my thoughts would be: Betty was given Cerenia for the endoscopy. (Geoffrey was). She ate great yesterday because of it. Today, it is slowly leaving her system; and, she feels blah 😒 from yesterday.
Thinking it is all from yesterday

Artie was “off” for 10 days. I was about call Vet, when he perked up.
I could put Cerenia in her repacked tic tac tonight. Do you think that would help? Or do you think it's just going to need to pass? She takes ondansetron. I would think that would be enough. And maybe it might be. Purrhaps when she does wake later this morning, the ondansetron (or the hairball treats) will have done its thing.
 

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I would let her be. Is Cerenia an every other day dose?

See if she can settle this on her own. Obviously, if she vomits, I would call the vet.

If Betty is not improving tomorrow;, I would call the Vet for advice.

It was a stressful day for her. She is recovering from it — in her own way.

:hugs:

I was told that Geoffrey could be “off” for a couple days. And not to give full meals that day. The next was ok to go back to normal amounts.
 

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It may still number a reaction/side effect of yesterday. Do not panic, yet.

It took Artie several days to get back to normal. Almost 10 days.
Geoffrey was different—-only one day.

Each cat is different.
I don't understand why it would come a day late though. She was fine yesterday. She ate well and without hesitation. She bunted with vigor. And while we didn't sit together for baseball--and our team had a travel day anyway--she did show up to all her meals and reconnected at least once in the night for cuddles.
On another note, I've been reading all morning and can only find confirmation that taking her off famotidine was the right thing to do (and that leaving her on it for so long was not such a good idea. 🤦‍♂️) I'm not finding documentation of a rebound effect like PPIs. But certainly couldn't I expect her to feel different for a day or two after taking this drug for so long? I honestly thought I was seeing an improvement yesterday. She was eating with more vigor and less hesitation. I got to wondering if suppressing acidity was making her worse as acidity is needed for proper digestion and motility.
I think you're dealing with so many issues right now, that to know which exact one is causing Betty to feel 'not herself'...is difficult.

Since they did 'biopsies'...that has to cause 'some pain'...after the anesthetic wears off.
(my human sister had biopsies in colon, and did feel lousy for a week,...needed pain meds)

I was thinking about the famotidine,...and what the Vet Specialist told you about what he saw.
Perhaps the famotidine was indeed helping Betty with stomach acidity, ...since he didn't see any stomach ulcers.
How can we be sure that the 'prior meds' you were giving Betty, plus the food,...didn't have a good beneficial effect, and therefore her Endoscopy looked clean.

What is going to be difficult...is knowing 'which med to discontinue first'.

As in I would probably choose the mirtaz, and lessening of it....and then wait for results from that.

(I'm not up to date on reading about the ondansetron, ..so would not know how well that is stopping Betty from vomiting at this point.
I actually always thought it was for acute vomiting.)

Then the introduction of the 'poop pills'...and any other supplements...have to also be factored in.
As well as the 'hairball treats'...since...everything that is going into Betty....will have some affect on her.

Basically, it will be really difficult at this particular time...to know which med to discontinue first.

She was eating well, and with vigor, perhaps because of the mirtazapine dosage,...but you also have to take into consideration not causing her too much serotonin, since it's not only in the brain cells, but also intestinal cells as well.
 

daftcat75

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I think you're dealing with so many issues right now, that to know which exact one is causing Betty to feel 'not herself'...is difficult.

Since they did 'biopsies'...that has to cause 'some pain'...after the anesthetic wears off.
(my human sister had biopsies in colon, and did feel lousy for a week,...needed pain meds)

I was thinking about the famotidine,...and what the Vet Specialist told you about what he saw.
Perhaps the famotidine was indeed helping Betty with stomach acidity, ...since he didn't see any stomach ulcers.
How can we be sure that the 'prior meds' you were giving Betty, plus the food,...didn't have a good beneficial effect, and therefore her Endoscopy looked clean.

What is going to be difficult...is knowing 'which med to discontinue first'.

As in I would probably choose the mirtaz, and lessening of it....and then wait for results from that.

(I'm not up to date on reading about the ondansetron, ..so would not know how well that is stopping Betty from vomiting at this point.
I actually always thought it was for acute vomiting.)

Then the introduction of the 'poop pills'...and any other supplements...have to also be factored in.
As well as the 'hairball treats'...since...everything that is going into Betty....will have some affect on her.

Basically, it will be really difficult at this particular time...to know which med to discontinue first.

She was eating well, and with vigor, perhaps because of the mirtazapine dosage,...but you also have to take into consideration not causing her too much serotonin, since it's not only in the brain cells, but also intestinal cells as well.
Per usual cat nap cat nap , you leave a lot to unpack. Don't ever change that. But forgive me if I miss something here.

But the gist of it before I get too long-winded is this:

Her endo was not clean, famotidine doesn't heal ulcers, the poop pills may be the single best meds she's taking right now, and she's in no way ready to discontinue Mirataz or ondansetron.

Her endo confirmed the two previous ultrasounds. There is thickening of the intestinal walls and reduced pocket depth. The pockets help absorb nutrients. What the endo did not show was any signs of ulcers in her stomach. "Possible ulcer" was one of the guesses the ER vet threw about during one of her pink spit visits.

Famotidine doesn't heal ulcers. It makes the stomach less hostile if there is an ulcer. You need a gastroprotectant like sucralfate to bandage the ulcer and allow the body to heal itself. Many ulcers take longer than the three days I was giving sucralfate. In my reading on ulcers, we should have seen more vomiting and more appetite issues than we have these past two months. The literature on famotidine in cats is mostly lacking. Much of what is said about famotidine in cats is extrapolation from humans and dogs which have higher stomach/gut pH than cats to begin with so it's not an apples to apples comparison. One study I did see was that famotidine loses effect on stomach pH with twice daily dosing over two weeks or longer. Other reading I have done suggests that raising stomach pH can allow unfriendly bacteria to thrive where it would normally be too acidic. This may be the reason she had a surge in strep and sarcina in her last poop report. I was keeping her on famotidine long enough to get a negative confirmation via endo and now I'm not convinced that that is what she needs right now.

She felt better--her appetite improved, her nausea lessened, her hairballs nearly disappeared--while she was taking the poop pills. In the two weeks since she finished the first course while we were waiting for the "after" report before deciding on another course, she backslid. Her fussiness returned. Her hairballs returned. Having seen the "after" report, I can clearly see it was doing what it purports to do. As long as she is willing to take them, I'm willing to keep her on these as a regular part of her med stack. I am also willing to test her after each course to see if we still need them. $100/mo for the pills and a $100 for the test. That's spendy. But that's nothing compared to a single ultrasound.

I'm not ready to ween her off her meds yet except the famotidine. The premise for using it was flawed. The premise for continuing its use was flawed. Now that I have definitive confirmation that it is not needed, I will not be giving it anymore. But I see no similar confirmation that either the ondansetron or Mirataz usage can be unwound yet.

artiemom artiemom I have Cerenia on hand. But I don't give it to her regularly. It used to suppress Krista's appetite. And while I know every cat is different, I thought I would try ondansetron with Betty.

It's past lunch time and I don't have a rallying Betty yet. I may sweeten her I/D to A/D ratio (more A/D) to see if I can tempt her to eat more while getting more calories for less food. Let me see if she has any interest in that when I am fixing my own lunch.
 

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Per usual cat nap cat nap , you leave a lot to unpack. Don't ever change that. But forgive me if I miss something here.

But the gist of it before I get too long-winded is this:

Her endo was not clean, famotidine doesn't heal ulcers, the poop pills may be the single best meds she's taking right now, and she's in no way ready to discontinue Mirataz or ondansetron.

Her endo confirmed the two previous ultrasounds. There is thickening of the intestinal walls and reduced pocket depth. The pockets help absorb nutrients. What the endo did not show was any signs of ulcers in her stomach. "Possible ulcer" was one of the guesses the ER vet threw about during one of her pink spit visits.

Famotidine doesn't heal ulcers. It makes the stomach less hostile if there is an ulcer. You need a gastroprotectant like sucralfate to bandage the ulcer and allow the body to heal itself. Many ulcers take longer than the three days I was giving sucralfate. In my reading on ulcers, we should have seen more vomiting and more appetite issues than we have these past two months. The literature on famotidine in cats is mostly lacking. Much of what is said about famotidine in cats is extrapolation from humans and dogs which have higher stomach/gut pH than cats to begin with so it's not an apples to apples comparison. One study I did see was that famotidine loses effect on stomach pH with twice daily dosing over two weeks or longer. Other reading I have done suggests that raising stomach pH can allow unfriendly bacteria to thrive where it would normally be too acidic. This may be the reason she had a surge in strep and sarcina in her last poop report. I was keeping her on famotidine long enough to get a negative confirmation via endo and now I'm not convinced that that is what she needs right now.

She felt better--her appetite improved, her nausea lessened, her hairballs nearly disappeared--while she was taking the poop pills. In the two weeks since she finished the first course while we were waiting for the "after" report before deciding on another course, she backslid. Her fussiness returned. Her hairballs returned. Having seen the "after" report, I can clearly see it was doing what it purports to do. As long as she is willing to take them, I'm willing to keep her on these as a regular part of her med stack. I am also willing to test her after each course to see if we still need them. $100/mo for the pills and a $100 for the test. That's spendy. But that's nothing compared to a single ultrasound.

I'm not ready to ween her off her meds yet except the famotidine. The premise for using it was flawed. The premise for continuing its use was flawed. Now that I have definitive confirmation that it is not needed, I will not be giving it anymore. But I see no similar confirmation that either the ondansetron or Mirataz usage can be unwound yet.

artiemom artiemom I have Cerenia on hand. But I don't give it to her regularly. It used to suppress Krista's appetite. And while I know every cat is different, I thought I would try ondansetron with Betty.

It's past lunch time and I don't have a rallying Betty yet. I may sweeten her I/D to A/D ratio (more A/D) to see if I can tempt her to eat more while getting more calories for less food. Let me see if she has any interest in that when I am fixing my own lunch.
*YES!* on that last para.
Heat. Invasive procedure yesterday, with undoubted stress. Possible adrenalin yesterday causing her to exhibit a more "normal" behavior, which has since worn off and been replaced by, as artiemom artiemom said, the "blahs" post-procedure-and-stress.
I agree with Cindy -- if Betty was my cat, I'd give her a day or even another day before worrying overmuch. As long as she's eating SOMETHING, drinking, and using her box, not exhibiting signs of distress, and comfortable, I'd leave her be for now.
 

daftcat75

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*YES!* on that last para.
Heat. Invasive procedure yesterday, with undoubted stress. Possible adrenalin yesterday causing her to exhibit a more "normal" behavior, which has since worn off and been replaced by, as artiemom artiemom said, the "blahs" post-procedure-and-stress.
I agree with Cindy -- if Betty was my cat, I'd give her a day or even another day before worrying overmuch. As long as she's eating SOMETHING, drinking, and using her box, not exhibiting signs of distress, and comfortable, I'd leave her be for now.
Y'all are confused on the days.

Her endo wasn't yesterday.

She had her endo on Wednesday.

She had a really good day yesterday. Her pre-procedure Cerenia probably wore off early yesterday morning. When they told that her procedure wasn't going to be until the afternoon, I asked that she be given her Cerenia dose sooner than later so she didn't have any acid spits waiting for her procedure. She was spunky yesterday. She showed up on the kitchen counter for every meal. I've got some adorable pictures and a video from last night when she decided to make herself comfortable on the counter while I was doing some "pre-feed housekeeping" (aka washing my own dishes.)

I sweetened her mix by 50% and reduced her lunch by half. If this isn't what the A/D food is for, I don't know anymore. I'm not entirely sure what the ratio is or how to do this again for dinner. I took 8 grams of her regular mix and to that I added 8 more grams of A/D. 🤔 She had a total portion of 16 grams (half a med meal, a little more than half her regular 36 gram lunch) which she ate pretty eagerly. If using A/D to get her to eat isn't the whole point of the A/D... I think we'll just do this for the next few meals until I start to see her perking up again. I may have to underfeed her for a few days. But that's better than letting her starve herself.
 

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Y'all are confused on the days.

Her endo wasn't yesterday.

She had her endo on Wednesday.

She had a really good day yesterday. Her pre-procedure Cerenia probably wore off early yesterday morning. When they told that her procedure wasn't going to be until the afternoon, I asked that she be given her Cerenia dose sooner than later so she didn't have any acid spits waiting for her procedure. She was spunky yesterday. She showed up on the kitchen counter for every meal. I've got some adorable pictures and a video from last night when she decided to make herself comfortable on the counter while I was doing some "pre-feed housekeeping" (aka washing my own dishes.)

I sweetened her mix by 50% and reduced her lunch by half. If this isn't what the A/D food is for, I don't know anymore. I'm not entirely sure what the ratio is or how to do this again for dinner. I took 8 grams of her regular mix and to that I added 8 more grams of A/D. 🤔 She had a total portion of 16 grams (half a med meal, a little more than half her regular 36 gram lunch) which she ate pretty eagerly. If using A/D to get her to eat isn't the whole point of the A/D... I think we'll just do this for the next few meals until I start to see her perking up again. I may have to underfeed her for a few days. But that's better than letting her starve herself.
Same applies. Information overload at times here.
That sounds good on the A/D.
Would love to see those pix and video! if you're of a mind to share.
 

artiemom

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Y'all are confused on the days.

Her endo wasn't yesterday.

She had her endo on Wednesday.
I am sorry. I have too much going on. I apologize. I got Betty's days and Geoffrey's (antibiotic) days confused...

Since it is the week-end, if she does not rally, I would try a dose of Cerenia. It should not hurt her; at least I do not think so..
I am not up to date with information on ondansetron. I have to read up on it.

If you are unsure, you could still call the Vet.

I am really hesitant to offer advice, because you have handled things so well. I am not familiar with the poop pills, although I am aware of them. You seem to have a good handle on things.
Do you think the ondansetron (Zofran) would mess up her biome? You know much more about it than I do. I have too many things running around in my head.. Geoffrey is really having an 'off' day today. So I am probably not the best person to give advice. I need to keep my mouth shut.. Sorry

For myself. I am going the traditional route. I do not know enough about holistic things.

I am aware that Pepcid does not cure ulcers. It, as all PPI's work on the ph of the stomach to keep it less acidic; thus decreasing the chance of ulcers to form.

((hugs))
 

daftcat75

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I am sorry. I have too much going on. I apologize. I got Betty's days and Geoffrey's (antibiotic) days confused...

Since it is the week-end, if she does not rally, I would try a dose of Cerenia. It should not hurt her; at least I do not think so..
I am not up to date with information on ondansetron. I have to read up on it.

If you are unsure, you could still call the Vet.

I am really hesitant to offer advice, because you have handled things so well. I am not familiar with the poop pills, although I am aware of them. You seem to have a good handle on things.
Do you think the ondansetron (Zofran) would mess up her biome? You know much more about it than I do. I have too many things running around in my head.. Geoffrey is really having an 'off' day today. So I am probably not the best person to give advice. I need to keep my mouth shut.. Sorry

For myself. I am going the traditional route. I do not know enough about holistic things.

I am aware that Pepcid does not cure ulcers. It, as all PPI's work on the ph of the stomach to keep it less acidic; thus decreasing the chance of ulcers to form.

((hugs))
Pepcid is an H2 blocker. Not a PPI. My vet would never let me give her a PPI for this long. And those PPIs definitely have rebound effects when discontinued. I keep Googling for things like Pepcid rebound and it doesn’t happen. Everything. I’ve read seems to suggest she should actually be feeling better since we stopped the Pepcid. I thought yesterday’s feistiness including the way she showed up on the kitchen counter for every meal without the usual encouragement was all pointing to that conclusion.

The rep at AnimalBiome said that any or all of her meds can be affecting her biome in their own ways. But as long as they are helpful in keeping her stable, their benefit must be weighed against that impact. Since we finally got a confirmation that there’s no ulcer, there is no benefit and only impact to keeping her on famotidine. I don’t see a compelling reason or any evidence that she needs the other meds reduced or eliminated. If anything, she may get a slightly bigger dose of Mirataz tonight as I had reduced that the other week. There is some headroom to up her dose if it will help her through this.
 

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She may be rallying. She finally got off the bed and was sitting in the sun watching the outdoors through the deck door. She had some chirps and quacks to say to me and even got up for some bunting when I got down to her level. Then as I started to head back to the office, she started to follow but stopped about halfway. I interpreted that as, "oh, I thought you were going for food." So I went to the kitchen and brought her a fork full of her enriched mix. Probably another 8 to 10 grams.

I called the specialty hospital that did the endo. The internist who did the procedure was out today. But another on staff said I could give her up to half a Cerenia tonight if it seems like she's nauseated. And if she doesn't improve by tomorrow, I can bring her in to have her examined.

She must have been listening on that call because she's starting to look better already. Let's see how she does with evening meals with a touch more Mirataz and a slightly richer A/D mix. I don't know if 50% richer is necessary.
 

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She may be rallying. She finally got off the bed and was sitting in the sun watching the outdoors through the deck door. She had some chirps and quacks to say to me and even got up for some bunting when I got down to her level. Then as I started to head back to the office, she started to follow but stopped about halfway. I interpreted that as, "oh, I thought you were going for food." So I went to the kitchen and brought her a fork full of her enriched mix. Probably another 8 to 10 grams.

I called the specialty hospital that did the endo. The internist who did the procedure was out today. But another on staff said I could give her up to half a Cerenia tonight if it seems like she's nauseated. And if she doesn't improve by tomorrow, I can bring her in to have her examined.

She must have been listening on that call because she's starting to look better already. Let's see how she does with evening meals with a touch more Mirataz and a slightly richer A/D mix. I don't know if 50% richer is necessary.
Hoping and praying! First paragraph is very hopeful.
 

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She came down off the bed at dinner time and even joined me on the counter during prep. But only after several weak meows from the floor.

After doing the math on lunch’s mix, I decided on something less rich. After all, she does have to digest this. It’s not enough to get food in the cat. Lunch’s mix was almost 50/50 A:I. Dinners and overnight will actually be richer by only 50%. 3:4 ratio (60 grams A/D to 80 grams I/D and then subdivided into meals.) I plated 22 grams. Of that she ate 16. And she took her meds (ondansetron and I gave her a 1/4 Cerenia just in case there is some nausea. The other IM doc said I could give her a half Cerenia. But I’ve never given her a half before and I’m not going to start tonight.)

She’s rallying. But not quite back yet. She’s eating about 50% of her calories today. But she’s a little more interactive and more vocal too.

I was even able to get pictures for her weekly Caturday post on my baseball card Instagram. Here’s Bowman Betty! (Bowman is the card manufacturer.)
BE5C63C8-7FCD-4D04-BF70-70EE6C33B66D.jpeg B2258A8A-8217-4F94-B361-C8553EEFDD69.jpeg
 

daftcat75

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29 grams (usually 36) second dinner, slightly richer A:I mix (1.05 vs 1.04 calories/gram) is in the books and she’s pit sitting while we watch the news of the day. She’s rallying. Give her another day and this will be a memory. 😅😮💨
 
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