Introducing Betty White

[daftcat75]

First dinner in the books. But I needed to feed her the last bits off the carpet.

Chirps have started.

I sure hope she eats enough of the rabbit mix. It’s currently fewer calories than the A/D mix. The nice thing about having two more meals tonight is that at midnight I can evaluate whether she still likes the mix or if I need to whip up an A/D mix for the overnight.

 

[daftcat75]

I wonder if I should be trying a food change right now. She’s only nibbling at the I/D rabbit mix. But she’s also got the burps. So maybe it will take a couple days for her gut to catch up. Hopefully the mirtazapine will keep her eating until then.

 

[lisahe]

I wonder if I should be trying a food change right now. She’s only nibbling at the I/D rabbit mix. But she’s also got the burps. So maybe it will take a couple days for her gut to catch up. Hopefully the mirtazapine will keep her eating until then.

Yes, burps -- and, even more so, gas -- can be big old warning signs. (I really regret not thinking more of a gas sign from Edwina last week.) I hope the night went okay.

 

[daftcat75]

Yes, burps -- and, even more so, gas -- can be big old warning signs. (I really regret not thinking more of a gas sign from Edwina last week.) I hope the night went okay.

I don’t think we should be trying a food transition and the gut distress that comes with it when she’s already feeling under the weather. Still. She ate about 2/3 of her portions last night. She showed up on the counter a few times. Once even between meals as if to say, “I’m hungry. But not for what you have out.”

While she did great with lunch and first dinner. Second and overnight came with remainders. And she didn’t even touch overnight until breakfast time. Ten minutes before breakfast alarm goes off, she’s helping herself to the untouched overnight. I laid in bed debating whether to even go forward with breakfast. She seemed hungry. But not for what I was serving. I mixed breakfast anyway. I went back to a slightly leaner mix of A/D which won’t get as soggy as it sits out. She showed up on the counter. Good sign. I took her down to her medicine meal spot and she took her pills like a pro. Then she snubbed the entire breakfast plate without so much as a lick. She did just have breakfast before I woke up. At least she took her meds. And now that it’s my turn, she would rather sleep than seek fuss while my breakfast cooks.

So she’s better. But still off.

 

[tarasgirl06]

I don’t think we should be trying a food transition and the gut distress that comes with it when she’s already feeling under the weather. Still. She ate about 2/3 of her portions last night. She showed up on the counter a few times. Once even between meals as if to say, “I’m hungry. But not for what you have out.”

While she did great with lunch and first dinner. Second and overnight came with remainders. And she didn’t even touch overnight until breakfast time. Ten minutes before breakfast alarm goes off, she’s helping herself to the untouched overnight. I laid in bed debating whether to even go forward with breakfast. She seemed hungry. But not for what I was serving. I mixed breakfast anyway. I went back to a slightly leaner mix of A/D which won’t get as soggy as it sits out. She showed up on the counter. Good sign. I took her down to her medicine meal spot and she took her pills like a pro. Then she snubbed the entire breakfast plate without so much as a lick. She did just have breakfast before I woke up. At least she took her meds. And now that it’s my turn, she would rather sleep than seek fuss while my breakfast cooks.

So she’s better. But still off.

Yeah, Elvis isn't too pleased about refrigerated being left out to come to room temperature. It doesn't get soggy but it does change the nature of it. Cats' sense of smell is 14 times ours, so it may smell different to him. If I can't adopt again I'll probably have to start buying the small cans so I don't have to do this. He probably doesn't like having the same thing two days in a row, either. Our variety has become less with the pandemic etc., but he does still like choices.
Hoping you find the right mix/balance for Betty, and the right way to get it to optimum temperature and consistency. Cats are very discerning, and Betty is VERY discerning.

 

[daftcat75]

Because she ate smaller portions of the I/D Rabbit mix, I switched back to an I/D A/D mix. I think even with the ondansetron, she’s still nauseated, not wanting to eat. It’s like she’s hungry, but she doesn’t want to chew very much. She seems to eat the more liquid bits of the slop and leaving behind the stew chewies. She’s become a gravy licker. Except that she seems very picky about just how soggy it can get before she wants none of it.


We may have to plow forward with the food transition if she’s not interested in the AD mix. I’ve left her breakfast out. She may or may not get to it by lunch. But if she’s not eating by lunch, I’ll offer her a little of the I/D alone or the rabbit alone or the two together.

I‘ll pick up some store bought bone broth over lunch. I did pick up some chicken thighs, livers, and gizzards this weekend. I could make a batch of homemade or raw or bone broth or….

I just want her eating again and feeling better.

 

[daftcat75]

I spoke with the IM specialist last night. I asked him how many cats he’s treated with pred were able to get off the pred. He gave me a very discouraging answer: about 20-25%. The rest need some kind of long-term immune-modulating therapy for the rest of their life. So I told him I wasn’t far off calling this the pred and pray approach and that I wanted to consult with AnimalBiome before putting her on steroids for the rest of her life. So discouraged right now.

 

[tarasgirl06]

I spoke with the IM specialist last night. I asked him how many cats he’s treated with pred were able to get off the pred. He gave me a very discouraging answer: about 20-25%. The rest need some kind of long-term immune-modulating therapy for the rest of their life. So I told him I wasn’t far off calling this the pred and pray approach and that I wanted to consult with AnimalBiome before putting her on steroids for the rest of her life. So discouraged right now.

But your intuition is right IMHO and her mouth may be sensitive from what you say. That may be why she's a gravy-licker right now. If she can get a good cleaning, it might change this for the better.

 

[daftcat75]

But your intuition is right IMHO and her mouth may be sensitive from what you say. That may be why she's a gravy-licker right now. If she can get a good cleaning, it might change this for the better.

A teeth cleaning is so far out. It took us almost two months to get our last dental appointment only to have to cancel it because she wasn't doing well with eating and hairballs at the time. I want to stabilize her before a dental. The ER vet yesterday said that, she's not a dentist, but she only saw one tooth that really looked like it may have to go. And it's unlikely that it is a tooth that's causing her pain. Of course, the only way to really know what's going on is a full dental exam with x-rays.

 

[artiemom]

What I have been advised, with Geoffrey: if you think he may need a dental; you should book it now. Dentists are booked up 6 months in advance. You can always cancel it.....

Do you think Betty may have a chicken allergy? Just a thought. Rabbit seems to be a hard switchover for some cats.

 

[daftcat75]

I managed to get her to eat about 15 to 20 grams of pure A/D. It's the only food she will eat today. And even that was a tough sell. I tried to syringe feed her but that just wasn't going well. Fortunately, I was still able to convince her (with far too much effort) to take the rest of the syringe amount off the carpet. But she's once again weakened and not feeling well. I can see the nausea and she weakly meows like she's in pain or discomfort or hungry. But nauseated. I've never seen her this nauseated before. I set out plates of rabbit on its own and I/D on its own and she still has a breakfast plate of I/D and A/D mixed together. I even gave her a plate with some store bought bone broth and she just looked, sniffed, and walked away from them all.

The urgent care who saw her yesterday, I am waiting on a callback from "any doctor who can review her case history and call me back." The IM specialist in another hospital says, "Well, she rallied on the steroid shot yesterday. Unless you wanted to drop her off for an ultrasound and X-rays, we don't know what else to tell you except perhaps she should start the prednisilone."

I feel like my hand is being forced into starting her on the pred. But I don't know how long I want to drag her along with another day at the vet's (and another $1500, I'm sure) and possibly another "fever of unknown origin" diagnosis if I can give her a pill tonight that will get her started on the healing path.


So I'm waiting on doctors and I'm waiting on pharmacists. Hopefully we'll get her pred tonight.

I really wanted to wait on the pred. But I don't know that she's doing well enough to wait. And I'm probably just in denial about how bad her gut really may be. I keep telling the specialist, "if we can only solve the hairballs, she doesn't have the spits or sh*ts" and he always responds, "You shouldn't have to solve the hairballs. That's your symptom of GI disease even in the absence of the more common symptoms." And from what I remember with Krista, we should be able to discontinue the mirtazapine and she will start drinking water. At least the specialist has a plan. He wants to start her on 5 mg/day daily for 14 days and then re-check. I imagine that re-check is an ultrasound. I sure hope he's not signing me up for monthly ultrasounds.

She's been dragged along long enough. Here we are past her five monthaversary and she's still not healthy. I'm thinking I'll start her on pred tonight. If she still doesn't rally, we can go with ultrasound and X-rays tomorrow or the next day. And if the pred gives her the munchies like it is supposed to, perhaps we'll transition her--much more slowly--to rabbit over the next two weeks.

 

[Margot Lane]

O am SO sorry. Was really rooting for the poop pills. Well the pred ought to definitely give her the munchies: my boy is constantly winding under my feet for MORE. One good side I think about the hungries is they are less fussy…have been feeding him Farmina‘s quail & pumpkin for months with no snubbing. (He loves rabbit too). I find I have to watch his munchies: it’s so important to give them ‘digestion time’ as you know, so you don’t overstuff the sausage. Are you planning one more chat w/ the Poop Pill People or is this it? I feel as if we’re all owed a better explanation of why this happens…really feel you were on to something, but understand the need to try new options.

 

[daftcat75]

O am SO sorry. Was really rooting for the poop pills. Well the pred ought to definitely give her the munchies: my boy is constantly winding under my feet for MORE. One good side I think about the hungries is they are less fussy…have been feeding him Farmina‘s quail & pumpkin for months with no snubbing. (He loves rabbit too). I find I have to watch his munchies: it’s so important to give them ‘digestion time’ as you know, so you don’t overstuff the sausage. Are you planning one more chat w/ the Poop Pill People or is this it? I feel as if we’re all owed a better explanation of why this happens…really feel you were on to something, but understand the need to try new options.

I sent AnimalBiome an email. But I don't want to get too stubborn here. I too really wanted to give the poop pills a chance. But I fear it's going to take too much to get her to rally from here. I would love it if I could just let the fever run its course. But as you know, letting her undereat for too long is bad news.

I see no reason why she can't take both the pred and the poop pills. Maybe the poop pills will help her get into the 20-25% that can get off of pred.

If she was just having her weekly hairball/mystery spit, I might be more willing to hold off on the pred. But my options right now, as I understand them, are rather limited:

1. We do nothing and see if it resolves on its own. This, of course, is the riskiest option, and the one I'm least interested in.
2. She drags along for more tests (and more $$$ out the door) and we still may end up with FUO (fever of unknown origin.) Meanwhile she languishes without treatment or they give her fluids and another steroid shot. I don't know how soon they can give another dexamethasone shot.
3. Since she did rally on dexa- yesterday, this would make the most sense to pursue first. One of the things that's important with fighting a fever is staying hydrated--which she is not doing. So if pred will make her drink water (and it sure did with Krista), let's get her on a path to recovery tonight. Then we can revisit option 2 if she's still not rallying.

In the meantime, I laid my pajama bottoms on top of her in her poof like a blanket. A little extra warmth will do her good for fighting the fever.

I just got the text that her pred Rx is ready for pickup.

 

[lisahe]

I'm sorry to hear it's been such a rough day. But I think I'd be thinking the same thing you are about the possibility that the poop pills would put Betty into the 20-25%. I'm so rooting for her! She's such a sweet cat

I know this is way, way off your plan, daftcat75 , and isn't likely to fit in with pharmaceuticals... but has Betty ever had slippery elm bark syrup? It does wonders for lots of cats' nausea and inappetence and is alleged to help with hairballs and digestion in general, too. Edwina gets SEB several times a day and loves it; it seems to settle her gut. (It's considered very safe but apparently it's best not to give it too close to a pill, lest it hinder absorption...)

That's more an aside than anything else since it sounds like you're getting ready for the pred. (Which is probably exactly what I'd be doing, too, in your position.)

 

[Furballsmom]

apparently it's best not to give it too close to a pill, lest it hinder absorption...)

yea, a couple hours is suggested

 

[lisahe]

yea, a couple hours is suggested

Yes, that's what I've seen/heard most, too. I gave it even a bit longer last week when Edwina was taking Cerenia... though when I asked the vet and tech, neither had real concerns about it.

 

[tarasgirl06]

I sent AnimalBiome an email. But I don't want to get too stubborn here. I too really wanted to give the poop pills a chance. But I fear it's going to take too much to get her to rally from here. I would love it if I could just let the fever run its course. But as you know, letting her undereat for too long is bad news.

I see no reason why she can't take both the pred and the poop pills. Maybe the poop pills will help her get into the 20-25% that can get off of pred.

If she was just having her weekly hairball/mystery spit, I might be more willing to hold off on the pred. But my options right now, as I understand them, are rather limited:

1. We do nothing and see if it resolves on its own. This, of course, is the riskiest option, and the one I'm least interested in.
2. She drags along for more tests (and more $$$ out the door) and we still may end up with FUO (fever of unknown origin.) Meanwhile she languishes without treatment or they give her fluids and another steroid shot. I don't know how soon they can give another dexamethasone shot.
3. Since she did rally on dexa- yesterday, this would make the most sense to pursue first. One of the things that's important with fighting a fever is staying hydrated--which she is not doing. So if pred will make her drink water (and it sure did with Krista), let's get her on a path to recovery tonight. Then we can revisit option 2 if she's still not rallying.

In the meantime, I laid my pajama bottoms on top of her in her poof like a blanket. A little extra warmth will do her good for fighting the fever.

I just got the text that her pred Rx is ready for pickup.

*PRAYERS* and hope. In your corner 100%, and so hoping Betty perks up, eats and drinks very soon.

 

[daftcat75]

As I was picking up the prescription, I asked the tech, "if this fever is an infection, is this the right thing to do? to be starting her on immunosuppressing therapy?" Thank goodness I asked that question. She got one of the internist's nurses to meet with me in an exam room to discuss this further. And she said to me, "Dr G would really prefer that Betty be brought in for more imaging (ultrasound and X-rays) and not just leave this as fever of unknown origin." He also agreed with me that starting pred may not be the best idea right now.

I will drop her off in the morning and she'll get an ultrasound and X-rays.

And because I was calling everyone today, her regular vet called me and I caught her up. She suggested that Betty may have been one of those rare outliers that is having a complication from the endo; perhaps biopsy site irritation or . She also agreed that more imaging is the best course from here.

Oh ! Now that I think about it...

Dr G did say during one of the procedure day phone calls that there are rare cases where the endoscopy tube itself causes irritation or a tear.

That may be the reason why she's having such severe nausea right now.

So for tonight, I'm going to do my best to get a couple more portions of something in her before 8:30 (probably 20-30 grams of pure A/D.) And I'll make certain she gets her ondansetron and a Cerenia tonight. And then I probably won't get much fuss from her tonight about the fast.

 

[Furballsmom]

Thank goodness I asked that question.

Wow, good on you for being on your toes!

 

[daftcat75]

Wow, good on you for being on your toes!

It just didn’t feel right to me. I thought she could certainly have a bug whose only symptom is a fever. If we start suppressing that immune system, we could be making matters worse. A doctor from yesterday’s urgent care hospital finally got back to me. I’ve talked to three doctors in three different establishments today and they all agree now that this warrants further imaging rather than accepting an FUO diagnosis.

Now my worry brain is thinking, what if there is a tear or rupture. Though I’m sure if there was a rupture, she would be crying in pain. But how long is this recovery and will she need a feeding tube to get her through it? I would do it if that’s what she needs. But poor girl. I hope it doesn’t come to that.