Preparing For The End? How Far Should I Go With Diagnosing/treatment? Intestine, Heart, Lung Issues

[daftcat75]

None of this sounds unsurvivable yet.

My Krista has had a laundry list of issues starting just before her 14th birthday. (You can read some of it in Krista’s Care thread in the Cat Health forums.) She continues to show me just how resilient cats can be and how much can change with diet alone and the occasional drug support when needed rather than relying on drugs and doing nothing or little for the diet. She had her 15th birthday a couple months ago and is back to her pre-IBD weight. She climbs onto my chest for her fill of scritches most nights or mornings to purr her head off and tell me how happy she is that I didn’t give up on her.

 

[Leomc123]

Gabapentine is more of a sedative and it works on nerves and neurological issues. When i gave gabapentine to leo , he did become drowsy but only when i gave him 6ml because he was a 6.5kg cat as the vet ordered. It made him very legthargic but not enough to make him go to sleep so if he wasnt crated he would be disorientated. He did have some form of pain as he would atack me randomly even though he was on the gabapentine treatment.

Samba looks like a beautiful cat and i am sorry he is in some sort of pain. I would ask for a different kind of pain med. Loxicom is another one but it can cause kidney failure if used for a long time. I hope you find some answers for your sweet little cat. God bless and all the best wishes for little Samba.

 

[SambaLove]

Thank you purrfecttales,

I think she is in pain or at the very least very uncomfortable. It pains me to see her suffering and losing weight rapidly. About 1/2 of the day she looks normal, when she drinks water and grooms herself and wakes up from a nap to stretch, I feel blessed....but then the other half of the time, I am worried and feel horrible to see her "not looking herself." She is my baby... and though I am trying to find the answers, I don't know what to do.... I feel vets are quick to prescribe meds for symptoms but aren't looking at the cause of the problem or on healing... I don't know if I trust all their recommendations...


We have our echocardiogram scheduled in August. It's a long time to wait for the test...that may or may not give us any direction.

What would you recommend to give her some comfort and happiness in the meantime? I was going to buy her a plush new bed and of course, she is barely eating but I do give her, her favorite wet food, which she takes a few licks of a day...

 

[SambaLove]

Thank you LeoMC123,

Thank you for your kind words. Samba is my baby. We lost her litter mate in November, so this has been very hard.

Samba does sleep after I give her the Gabapentine. I hate giving it to her by the way, because I feel I am forcing it on her. I have to hold her down a bit to give her the half (.5) a ml ....If these are her last weeks, months of life...do I want to force meds on her that she doesn't want?

I do want her as comfortable as possible though....any advice??

Thank you,
Samba's mom <3

 

[daftcat75]

Get her back in for the pancreatitis blood test as soon as you can. That becomes priority one if she has it. Vets overlook this one all the time. Do not do the same.

She didn’t go for the chicken stock? Try a turkey stock. Or a fish stock. Or even a beef stock. It’s important enough to keep trying here to see if there is one she will go for.

Yes. Feed her whatever she will eat right now. Pick up a can of all the Tiki Cat fish flavors. Also any Fancy Feast Classic pates. Skip their other lines.

Finally, please consider a feeding tube if she won’t take enough calories by mouth. Poor nutrition is poor outlook no matter what the disease process may be. The feeding tube can come out when she’s eating on her own again. It heals within a week like she never had it. Even when it’s in her, you’ll mind it a lot more than she will.

 

[daftcat75]

Ask the vet about transdermal buprenorphine or a fentanyl patch. You can also get an appetite stimulant as a transdermal medication. Transdermals are as easy as squeezing the dose one a gloved finger and rubbing it into the top of the inner ear. My Krista didn’t appreciate having something wet rubbed into her ear but she visually relaxed when the bupe kicked in.

 

[fionasmom]

I would second fentanyl patch which I have used on cats and dogs, and a transderm appetite stimulant as I think those options free you from forcing anything on her. Fancy Feast has a newer more expensive pate called Savory Centers which supposedly cats are going crazy over.

 

[SambaLove]

Hello cat parent friends,
An Update on my baby Samba:

She was in pain all weekend (actually probably has been for much longer). She just got the Fentanyl patch today.

Also, received today:
* Subcutaneous fluids (as she hasn't eaten in 1.5 days, only had water but still a bit dehydrated)
*B12 shot (recommended by vet to help her feel better) I believe she said cats with inflammatory bowel disease or intestinal issues would benefit from this
*Steriods injection - YIKES!!! :O This is a risk as we can not get in to check her heart with an echo until August. The doctor recommended this and take this risk as we had to try something and couldn't leave her in this condition until we checked out her heart in August.

So B12 shots and steroid treatment begins today!! Along with the Fentanyl patch for pain. I am very nervous about how she will respond to these meds, especially the steroids. I tried unsuccessfully to give her the shots at the vet but she wasn't having it....I hope I can do these injections at home. Also very nervous about this. The technician trained me but I couldn't do it at the vet so the vet gave the shots for me today.

Now I am monitoring her breathing and her behavior at home and hoping for the best.... The vet said that if her breathing becomes hard I should either bring her in to the vet or the E.R.

Any suggestions, tips, or videos on administering shots to cats would be appreciated!!!

Have any of you given steroids to cats? Had any experience with the fentanyl patch? Any side effects I should watch out for?

Do steroids help heal or just temporary pain relief for intestinal issues....

Thanks so much for your support and suggestions friends!
Samba's mom

 

[SambaLove]

Thank you for your wishes Fiona's mom and all your tips and I can't THANK YOU enough for all suggestions daftcat75!! You are awesome!!!

Samba's breathing is looking a little more rapid after the meds today (steroids) hoping it settles...please keep us in your thoughts...

Samba's mom

 

[daftcat75]

Did you get the pancreatitis blood test (Spec fPLI)? That’s worth taking her back to the vet ASAP to rule it out. Your treatment plan changes and it becomes priority one if she has it.

Additionally steroids become a larger risk if she has pancreatitis as you can end up making things worse.

Call the vet and if the vet can’t say, “yes we ruled out pancreatitis via blood test,” (imaging, e.g. X-ray/ultrasound, isn’t always good enough to catch pancreatitis), then you tell your vet, “I am not comfortable giving my cat steroids until we have confirmed that she doesn’t have pancreatitis.”

 

[SambaLove]

Hi daftcat75,
Oh no!!! I did ask about pancreatitis but I don't remember what the vet said...my mind was going in different directions at the time. I wrote it down along with my other concerns....

I remember she mentioned that she had the ultrasound done and that they didn't see anything that would suggest that...

The first shot of steroids has already been given...going to touch base with the vet again. Thanks so much for the reminder daftcat75.

 

[daftcat75]

Pancreatitis may not show up in ultrasound. The Spec fPLI blood test is the most accurate right now.

As long as the intestines are inflamed, the surrounding organs are at risk of carry-over inflammation. That’s how pancreatitis occurs.

I misspoke earlier. I Googled it just now. And steroids can be useful in the treatment of pancreatitis.

But I still say there’s a gaping blind spot in diagnosis and treatment until pancreatitis is ruled out with the blood test.

The first two vets who saw Krista for vomiting and suspected IBD overlooked pancreatitis. Thank goodness I kept vet shopping and found my current one. The treatments, when the vets actually offered one, never really took until we started treating the pancreatitis first.

Pancreatitis is such a challenging (and painful!) condition that can do some real damage. It burns me up how often it gets overlooked. It should be thrown in with the ultrasound. Like if you are spending that much to do an ultrasound, prick off some blood and send it to the lab for one more test.

If she does have pancreatitis, the antiemetic (stops vomiting) maripotant (brand name Cerenia) can be very useful while having pancreatic specific anti-inflammatory action. It could be that her pain is primarily pancreatic and that she won’t need to remain on the fentanyl patch after the pancreatitis is healed. But most importantly, pancreatitis can do damage with every meal. The pancreas is literally digesting itself because its digestive enzymes are being activated early in the pancreas instead of the intestines. Pancreatitis is one that needs to be treated aggressively. So it’s good that she’s getting steroids now instead of waiting until August as long as the vet understands the risk and is monitoring for it.

She may also need an appetite stimulant if the steroids alone don’t perk up her eating. She needs all the nutrition she can get during this period. She either eats with medication or you get her a feeding tube. This isn’t the time to leave her nutrition up to her.

I don’t think the current course she is on is wrong. I just think it’s possibly incomplete and under-informed.

 

[fionasmom]

Fetanyl reacts differently in dogs and cats and I felt that my cat tolerated it well, but the dog was overly sedated which is the usual course that the drug can follow.

I have to agree that pancreatitis needs to be ruled out if that is at all possible.

Are these shots subQ at the back of the neck? Can someone help to hold your baby while you give the injection? Is transporting her back to the vet for the shots out of the question....and it well may be depending on distance, time, or severe stress to the cat to be repeated crated and transported? If you try to give the shot and feel that it did not work, do not readminister unless you are sure that you missed by a mile.

Giving Injections to Cats

 

[SambaLove]

Thanks, everyone.

Has anyone tried the anti-nausea med called Ondansetron? My vet prescribed this for Samba as she has been vomiting for the past 4 days in a row.

It seems like a large dose though, .5 mL and she hasn't wanted to eat since I started giving her this medication. Don't know if there is a connection to this medication or her health condition or the other meds she is currently on:

Fentanyl
Steroids

I am stopping use of the anti-nausea med for a little bit to see if her appetite returns...
I tried force feeding her and she was not having it...

Getting nervous...any advice?

 

[SambaLove]

She has been laying around but with her eyes wide open...not sleeping...what could this mean?

 

[daftcat75]

Pancreatitis? Have you ruled that out yet? If it is pancreatitis, you may need the ondansteron and more. Can you ask for an appetite stimulant?

Also ask for Cerenia. It shuts off the vomit signal in the brain. It will also help with pancreatitis if she has it.

Right now she has to eat. She either eats with the help of medication or please consider a feeding tube. You will not be able to “force feed” by mouth enough food to get her through this. Poor nutrition = poor outlook.

 

[fionasmom]

I have had very good results with appetite stimulants, even in seriously ill cats. She does need to have some nutrition.

 

[SambaLove]

how do i get a feeding tube? Is that only offered in the E.R.? She has not eaten today...

 

[Kflowers]

the vet has to put the feeding tube in. It's done under sedation, it's surgery.

 

[daftcat75]

As surgeries go, it’s pretty low risk. They can put her out with isoflurane, a mild anesthetic gas. The procedure takes about 20 minutes: one small slit and an X-ray to make sure it’s positioned correctly. The vet may want to keep her the day or overnight so that they can give her a chance to rest up and a test feed by tube. Tell them to leave more tube than they normally would. This is so you can get a Kitty Kollar which has a velcro strap to hold down excess tube. It’s easier to cut a “too long” tube than to add length, e.g a new tube. The Kitty Kollar makes cleaning and covering the insertion site (where the tube inserts into the cat) easier than wrap bandages.
Kitty Kollar - Special Hugs for special kitties & kanines

It’s going to be a little stressful at first. I promise you. Most of that stress will be felt by you rather than the cat. Many cats don’t mind or even notice the tube more than maybe the bandaging. Another reason to go with a Kitty Kollar. Besides length and a cap that kept flying off when she shook her head which was easily fixed with masking tape, the only real objections my Krista had to the tube was when I fed her food too cold or too fast. Other than that, IT SAVED HER LIFE!

It’s like one of Newton’s Laws that cats who don’t eat continue to not eat until some external force (drugs or tube) acts upon them. A feeding tube gives you an active hand in your cat’s recovery when she doesn’t feel so great to know what’s best for herself. And a feeding tube doesn’t have to be forever. If she rediscovers the joy of eating getting nutrition from her food rather than her wasting fat and muscle mass, you can have the tube removed and it heals up in about a week like it was never there. Cats can heal remarkably quickly when they get enough nutrition to do so!

Tube Feeding in Cats