Krista's Care

[daftcat75]

Thanks, daftcat75 for a very nice summary of Krista's care! I keep losing notices on your thread, so I do try to do 'catch up' when I realize it. But, one question: how long ago did the IBD vs. possible lymphoma diagnosis come up? I only ask because now you are considering chemotherapy, and I wonder if Krista would not have 'declined' much more so than she has if that were the case. Notwithstanding the concept that chemo is not as hard on a cat as it can be on a person, she has gone through so much already...do you really believe this approach is necessary?

My cat before this one had an aggressive oral cancer. The limited advice I could find on the much smaller Internet at the time was, "make her comfortable, give her whatever she wants, and keep a daily cat score journal: how much of a cat's cat she's acting like. When her scores are continually in the toilet, that's when you consider the quality-of-life vs end-of-life decision." With Cabbie, that was a couple of weeks. It was very obvious when she was giving up.

Small cell lymphoma on the other hand is a very slow growing cancer. In many cats, the only symptom is unexplained weight loss and inability to maintain or gain weight. Krista has that and poop issues. Her poop hasn't been consistently solid for very long since before her clostridium infection in summer. It is entirely possible that since Krista has had multi-organ inflammation before and her ultrasound showed inflammation in her liver and "sludge" in her gall-bladder, that Krista just requires a longer period with steroids to heal (and to avoid triggering foods like egg yolk in her raw.) Aside from the weight and poop issues and a little slowness from her arthritis, she shows no decline in her quality of life or interest in life. In other words, if I was giving her cat scores, she'd consistently score high. She's not there yet.

So it comes down to considering approaches.

1. We can continue with the pred and she may continue to stair step down in weight without an ability to recover. Or we may continue to see slow progress until one week she finally can produce consistently solid stools and gain weight again. But she may not.
2. We can do the biopsy which will almost certainly have a recovery period. She has little weight left to lose and no way to gain it back. On top of that, I believe she would have to taper off pred before the biopsy can produce a definitive result. This would be going backwards in her treatment and assuming a lot of risk.
3. We can try a course of chemotherapy monitoring for side effects. If the side effects are too severe, we can discontinue their use putting us back to #1.

In this case, I consider the diagnosis more detrimental and more extreme than trying the chemotherapy, the next logical option when steroids fail to produce a sufficient result.

I'm hoping I can convince the owner of the practice of the same thing. It's more of a risk to do nothing or to cut her up than it is to give her a drug that might not work.

 

[FeebysOwner]

You know what is best for you and Krista. She has certainly given you a run for your money, and you her (and I don't mean finances - at least not monetarily on her end). She has survived all of this because of your confidence, and therefore, her trust in you.

 

[Furballsmom]

her trust in you.

FeebysOwner I know you said you'd missed some alerts for this thread, did you see the video and photos compilation in post 2305 ?

 

[tarasgirl06]

I came home over lunch to swap her plates and check her boxes. I'm glad I did. She must have been waiting for me to come home just for this. She ate half her meal and then went to the boxes. We had solids in the soup. It was a good thing I was home because her next round would definitely be deposited on the carpet if she hadn't looked over her shoulder and saw me watching her. Even that liquid bit wasn't as bad as much of what's been coming out of her lately. I think we're definitely on to something removing the Proviable. I think I'll give it a few days where we are now with the raw rabbit before I try to give her more. Let's see what the yeasty bites and no Proviable does for her.

 

[daftcat75]

You know what is best for you and Krista. She has certainly given you a run for your money, and you her (and I don't mean finances - at least not monetarily on her end). She has survived all of this because of your confidence, and therefore, her trust in you.

I think you misunderstand who has the strength in this relationship. She continues to inspire me to do better by her by how much she does not want to give up. Even at her worst, she would greet every day like first breakfast was the best meal ever! First dinner every night is my favorite time with her. Despite all her struggles, she continues to be a perky, pushy, fur pig. And several times every night, she will come back from eating and want to sit in my lap or lay on my belly. I take my confidence from her perseverance.

I recorded this last week or the week before. This is every night.

 

[daftcat75]

The yeast bites aka rabbit dough are definitely the way to go with the pred now. The first half of the pill she ate up easily enough because she was so excited. The second half took an extra bite. Three yeasty bites and she’s done with her medicine. Now she can have the rest of the portion without any yeast. No wrestling matches anymore.

We have enough left in this bag for another bite later tonight.

 

[daftcat75]

There was poop in her soup! We had a mix of solids and pudding. One box. I appreciate when she poops during respectable hours. Maybe I’ll sleep the night once I get her “midnight” meal and feeders are plated shortly after 11 pm. She’s not patient for this one and I don’t push it. Sooner I plate this and the feeders for the overnight, the more sleep I get until first breakfast at 5:30.

 

[Selarah]

Thanks, daftcat75 for a very nice summary of Krista's care! I keep losing notices on your thread, so I do try to do 'catch up' when I realize it. But, one question: how long ago did the IBD vs. possible lymphoma diagnosis come up? I only ask because now you are considering chemotherapy, and I wonder if Krista would not have 'declined' much more so than she has if that were the case. Notwithstanding the concept that chemo is not as hard on a cat as it can be on a person, she has gone through so much already...do you really believe this approach is necessary?

I’ve been following this thread too off and on! Sometimes I’m not always notified either.

I’m curious to know why you question this approch for treatment? If you have info or experience with it, I’d like to know! I’m not personally familiar with these drugs, but I’ve read up on it a lot, and heard of many success stories of kitties completely being cured on a short round of this.

From what I’ve gathered, leukeran/ chlorambucil is also used for severe unresponsive IBD, as it has strong anti inflammatory effects and an immune suppressant. Some IBD cats need to have it if prednisolone is not effective. So, even if she doesn’t have lymphoma, she could still greatly benefit going on it, given the circumstances. If it is lymphoma, she has a chance of going into remission and actually getting better, rather than keeping on as it’s been going.
There is also new evidence that suggests that cats over the age of 8 have 50% chance of it being lymphoma rather than IBD. Uncontrolled IBD and inflammation has an unfortunate likelihood of morphing into lymphoma if not taken care of properly. Which I think is reason enough to try any and all treatments nessassary to avoid such a fate. There is also not really any indication of when it happens, if it happens(the morph), since the symptoms for IBD and lymphoma are the same. In either case, it really ought to be dealt with.
Unless of course you opt to just let it go on.. But why do that?

 

[Selarah]

I think you misunderstand who has the strength in this relationship. She continues to inspire me to do better by her by how much she does not want to give up. Even at her worst, she would greet every day like first breakfast was the best meal ever! First dinner every night is my favorite time with her. Despite all her struggles, she continues to be a perky, pushy, fur pig. And several times every night, she will come back from eating and want to sit in my lap or lay on my belly. I take my confidence from her perseverance.

I recorded this last week or the week before. This is every night.

Oh my!! She really is adorably pushy!!

 

[FeebysOwner]

I’m curious to know why you question this approch for treatment?

Really, all I was doing was asking in order to better understand!!

 

[MissClouseau]

daftcat75 , I was going to ask what happens if Krista gets chemo but not has cancer, then I read this... (?)

From what I’ve gathered, leukeran/ chlorambucil is also used for severe unresponsive IBD, as it has strong anti inflammatory effects and an immune suppressant. Some IBD cats need to have it if prednisolone is not effective. So, even if she doesn’t have lymphoma, she could still greatly benefit going on it, given the circumstances

 

[daftcat75]

daftcat75 , I was going to ask what happens if Krista gets chemo but not has cancer, then I read this... (?)

Likely it's just a mixed bag of the usual side effects, if any, if there isn't lymphoma. But it's hard to imagine that it's not lymphoma right now since we're seeing a lot of overall improvement from steroids, but not in the poops and not in the weight. The biopsy is definitely a higher risk than giving her the drug without confirmation.

 

[daftcat75]

Likely it's just a mixed bag of the usual side effects, if any, if there isn't lymphoma. But it's hard to imagine that it's not lymphoma right now since we're seeing a lot of overall improvement from steroids, but not in the poops and not in the weight. The biopsy is definitely a higher risk than giving her the drug without confirmation.

Chlorambucil (Leukeran®) - Veterinary Partner - VIN

www.vin.com

This is a great article on leukeran and cats. The main side effect to worry about is bone marrow suppression and immune suppression. But the potential benefit or the risk of doing nothing outweighs these risks in my opinion.

 

[daftcat75]

We had pudding poop. Then a couple carpet bombs. This happened all during the time I'm supposed to be watching the department all-hands live stream. Thankfully the sound goes in one direction. The Spot Bot saw some use this morning.

Krista is not allowed on the stovetop counter. She knows this. How do I know she knows this? She always lowers her eyes and assumes a guilty, "okay, I should get down now?" posture when she sees me seeing her up there. To be sure, I keep the stove top clean and I don't even leave as much as a trivet there for her to lick. But she'll check anyway. Lately, the little booger waits until I sit on the toilet. Once I'm in no position to chase her down, that's when she'll wander into the kitchen and jump onto that counter. Clearly this is a cat who is still active, physically and mentally.

 

[Furballsmom]

Clearly this is a cat who is still active, physically and mentally.

hee, he can't catch me now

 

[daftcat75]

I can hear her little paws thump thump (back paws, front paws) onto that counter from the bathroom. I have tuned into the living room camera that I use while I’m away to confirm that is the sound I’m hearing. She has a Katris path to stair step her way up to the counter she’s allowed on. For this one, she has to make the jump from the floor. And she still can and still does.

 

[Furballsmom]

For this one, she has to make the jump from the floor. And she still can and still does.

My Poppycat too, he's almost 15. They're incredible, these furry creatures, no doubt!

 

[daftcat75]

6 pm pudding poop. Thank goodness for the PFE exclusive (the good) pee pads. If I was using the other brands, the wall would have been left unprotected and cleanup would not have been so much cleaner tonight. Single box affair. No carpet bombs.

I spoke with the owner and founder of the cat hospital that Krista's vet practices at. What a relief to speak with a vet I don't have to argue or debate with. He suggested one more option--a higher pred dose--but agreed that giving chlorambucil (leukeran) is likely the least risk of our options. They have to compound it for me into cat-sized doses that I will give twice a week. We'll give it at least three or four weeks but we'll discontinue if it's poorly tolerated. I will also pick up a new bottle of B-12 as mine has an expiration date of 1/2020.

We seem to be on a 9 hour poop cycle. I'd better get some rest between meals if I'm on 3am poop duty.

 

[daftcat75]

I slept through it. But apparently my estimation was correct. By 4am, when I woke, there was a buried cow pie in the box. Buried. And contained within the box. The pee pads made it through unscathed. It didn’t even smell too bad by the time I got to it. But it still wasn’t solids.

If we can set our watch to her pooper, next one should come around 11am. Good thing I work from home tomorrow until approx 1:30 pm.

 

[daftcat75]

We had our 11am poop a few minutes early. I like this regularity. Now I’d just love some solids. She squirted out a pudding puddle. But then she buried it like a good cat. I was going to try less raw today. But I think I’ll try more instead. I have to make a decision on whether I want to buy 10 lbs of legs for approximately $300 after shipping or continue to buy them at approximately $75/lbs. I don’t know how much of those 10 lbs will be useable meat. But it should still come out cheaper than $75/lbs.