Elizabeth Spent 2025 Battling Gastro Issues and That Continues

So, Elizabeth. She has had CKD-kidney disease-since March 2024. She has spent two years being mostly hand fed, going through few times of eating without assistance. She has had to be fed five times a day at 50ml of canned food at a time-or less if she is eating enough during the day. Her weight was down to almost 11lbs this fall, and then we got it up to 12lbs in order for her to maintain a level that leaves room for any future weight loss before we must be aggressive with hand feeding. (We need to prevent fat and muscle loss and muscle wasting which can happen with CKD.) For more on CKD, check out the comprehensive site "Tanya's Comprehensive Guide to Feline CKD" blog guide.

We use Hill’s KD canned because it is very easy to syringe up in a 10ml syringe and then to gently feed her. It takes about ten minutes. You cannot rush pushing food into their mouths. They can’t choke or inhale. Too much food and they spit it out. When she developed gastro issues in 2025, we had to feed her Hills’ ID which is not as easy to syringe up. But too much ID and her CKD increased; too much KD and her gastro issues increased. So, late in 2025, we began to mix almost half and half KD and ID canned food in one Tupperware dish, then spend a day or two feeding her from it (how quickly it goes depends on how much and how often we need to feed her via syringe.) Some days I try to do 2/3 ID and 1/3 KD; then 2/3 KD and 1/3 ID; then half and half or something akin to it. 

She receives a ¼ Mirtazapine pill once a week. When her gastro system is doing well, she responds and will eat enough for a few days on her own with little hand feeding from us. But we do feed her 3 times a day at 30ml to 40ml per feeding depending on her needs. She often eats overnight which is a good sign. What is not a good sign is when she does not eat overnight or the Mirtazapine does not respond well and she barely eats despite it. 

She has gone through these bouts of not feeling well. She has had bouts of diarrhea since the fall since she had surgery (more on that with another post.) Since she does not eat enough on her own, I have been since the fall, giving her daily by mouth with a syringe, a packet of Forta Flora mixed with 2ml of water or rice water (more on that in a moment) which she receives in the afternoon. She receives it in the afternoon because she is on an antibiotic and stomach supplements (antacids, fiber) tend to interrupt the absorption of antibiotics. That seems to help her. Rice water-1/2 cup of rice and three cups of water boiled until the rice is cooked but just cooked and the rice is not left to soak up the water; I scoop out the rice with a slotted spoon, put that into a container and freeze it, drain the water into a plastic container, and I should have enough for a week; any more than that and I put it into a container and into the freezer-works fast and is easy to make. (It can spoil so that is why I make sure I have enough for a week and put the rest in the freezer.) I give her 6 to 10ml of rice water twice a day depending on if she has diarrhea or how much she has (is it soft, liquid, more than once a day, etc.) If her bowel movements are solid, then I can skip it for a few days. But I have to monitor it closely so that it does not return too severely. (Diarrhea is uncomfortable, causes a loss of fluid and in the fluid a loss of electrolytes which makes the body feel run down and then that depletion of sodium [which regulates the body] causes more diarrhea [and vomiting if a cat or human is vomiting] and can lead to other gastro issues like stomach acid, ulcers, bleeding in the lower GI, etc.) 

Why does she have gastro issues? She has IBD, at times pancreatitis, a thickened GI tract, and some liver issues. This means she has inflammation. But because she has CKD, she really should not have steroids. And she recently developed a minor heart issue so I do not want to risk her heart health by giving steroids. Yes, her gastro system would likely improve with steroids but then the rest of her would likely severely fail-her kidneys would tank (we saw that in December 2024 with Roxanne-more on her later; and we know that heart disease cats cannot have steroids due to the risk of CHF, and once CHF kicks in, the race is on to stop the heart from failing.) 

I can tell when she is not feeling well by how she looks or appears to be uncomfortable, and does not eat. She is on medication to help her. She has taken Veraflox antibiotic for two months this past November 2025 into January 2026 but it worsened the diarrhea. It can cause gastro upset with prolonged use (we did not see that in Jimmy when he was on it for a month.) She has been off of it now for three weeks and her diarrhea cleared almost immediately. Typically, it’s given for 14 days on and then off but the vet wanted to use it longer to help her organs be less inflamed and infected. It can lead to higher levels of glucose, liver values AST, ALP, ALT (some of which we saw in her bloodwork and Jimmy’s blood work), as well as an elevated white count (not sure why.) Additionally, she is on Metronidazole which we hope is helping. Also, she had been on Visbiome probiotic-the capsule was opened and the powder was added to water and given by mouth since she was not eating. But that also increased diarrhea; it too can cause gastro upset. When ceased, the diarrhea lessened. Her ultrasounds however, do not show improvement regardless of antibiotics or fiber.

Lizzie

Jimmy Had Chemo Summer 2025 Post Lung Surgery

In May 2024, when Jimmy’s left shoulder developed an egg size lump-which was later removed and found to be not cancerous-the CT at the time showed he had a small lump in his right lung that looked like a small “curved vessel”.  By March 2025, it was a small marble size nodule. He then had surgery April 2025 to remove it. Test results came back positive for cancer. 

But he had clean margins-meaning they removed the part of the lung lobe that had the cancer. Chemo was not necessary but I was afraid that if we were not aggressive when we could be while he was medically stable with his heart and kidneys, that the cancer could spread or return. 

So, in May, for once a month for four months, ending in August 2025, he had chemo. He had to be slightly NPO-he could eat a small amount in the morning but nothing past 10 a.m. He had chemo around 3 p.m. The process was less than 15 minutes but we were usually there for about 30 minutes as they wanted to make sure he tolerated it well. He never needed anesthesia although some cats do. In that case, he would have had to have been NPO-nothing to eat in the morning at all. I did have to make sure he was not vomiting once we were home and that he recovered well during the month. He never had vomiting or gastro issues like humans do and he ate well and moved around well. But he did become more exhausted as time went on but nothing that was concerning. 

He was given ondansetron to take twice a day-a medication that helps with chemo treatment nausea. He continues to take the drug still. He was expected to take it for a few weeks after his last session which was late in August but when we tried to remove it in December, he ate less. While a cat may not seem to be sick from chemo, does not lose their hair or vomit from it, they can still be nauseous, and are physically worn out. Listed below is the March 2025 CT report and the April 2025 lung cancer test results. 

His March 2025 CT scan report prior to surgery to remove the lung lobe and nodule:

“Mar 18, 2025

Thoracic CT, pre-contrast and postcontrast, transverse, dorsal and sagittal images:

Lungs: Within the 6th IC space ventrally, there is a well-circumscribed, mildly irregular nodule, approximately 1 x 1 x 1 cm, larger than on the previous study. This is suspected to be within the caudal aspect of the right middle lung lobe, previously thought to be within the right caudal lung lobe.This is near the pleural surface and adjacent to the cardiac silhouette. There is mild enhancement of the pulmonary nodule. 

Heart and pulmonary vessels: Definitive cardiac abnormalities are not identified. Unremarkable pulmonary vessel size and shape. Mediastinum: No masses. Unremarkable trachea and esophagus.

Sternal lymph nodes are mildly enlarged with mild contrast-enhancement. Tracheobronchial lymphadenopathy is not identified. Pleural space: Significant abnormalities are not identified. 

…

CONCLUSION:

Solitary right mid-pulmonary nodule, increased in size compared to the previous study, new sternal lymphadenopathy. This is suspected to be within the caudal aspect of the right middle lung lobe, less likely cranial aspect of the right caudal lung lobe. Metastatic neoplasia is the primary differential. A primary pulmonary tumor or granulomatous mass is not ruled out.

…

CONCLUSIONS:

Nodular hepatopathy. Rule out vacuolar hepatopathy, chronic hepatitis, less likely metastatic neoplasia. Subjective focal small intestinal thickening...

Discussion: Jimmy's CT scan revealed that he continues to have a single pulmonary nodule that has increased in size now measuring ~1cm. There are no other pulmonary nodules noted. Mild sternal lymphadenopathy is a non-specific finding. Although a single nodule of this size could be consistent with metastatic disease (unknown primary), I am more suspicious of a primary tumor. If this represented metastatic disease I would expected more nodules over the last several months. The most common primary lung tumor in the cat is called a bronchoalveolar carcinoma and arises from the cells that line the lung. The majority of bronchoalveolar carcinomas in the cat are high grade and tend to grow quickly and metastasize quickly. My suspicion therefore is that if Jimmy does have a primary lung carcinoma then it is more likely to be low grade given that it is growing relatively slowly (~1mm monthly). However, the reality is that we never know the answer to this question without removal of the mass and histopathology. This may represent a less common tumor or even a benign tumor (although this is considered less likely in the lung). 

The treatment of choice for primary lung masses is surgical removal via lung lobectomy. I did have our surgery service evaluate the CT scan and they would approach this tumor laterally (approach between the ribs) versus having to perform a median sternotomy. If surgery is something that you are interested in then we can set up an in-house surgical consultation where the surgeon calls you at home to discuss the surgery. They can provide an estimate and can even schedule him if you would like. 

Alternatively, if surgery is not desired then we could continue to monitor this mass with pulmonary radiographs to continue to assess its growth rate over time. This is a more palliative approach but not unreasonable especially in cats as they age.

…”

Lung Cancer Test Result:

“ Jimmy's histopathology results were consistent with a diagnosis of a pulmonary adenocarcinoma that has been removed with complete surgical margins. The removed lymph node only revealed evidence of reactivity (lymphoid hyperplasia) and multifocal lipogranulomas; no evidence of any lymph node metastasis which is great news. There is no consistent grading system for pulmonary adenocarcinoma in cats however based on the mitotic rate (9 per 10/hpf) and mild/moderate atypia I would consider this tumor to be of low/intermediate grade. 

Per our original conversation; there is not a lot of information on low/intermediate pulmonary adenocarcinoma in cats since most cats diagnosed with this cancer have rapid progression. The overall metastatic rate of this disease is thought to be >50% in cats and many cats have evidence of metastasis at the time of diagnosis. 

In Jimmy's case; we watched this mass grow quite slowly over a several month period and there was no evidence of any movement therefore it is reasonable to believe that surgery may be curative or provide long term local control. At the same time, it would not be completely wrong to consider further intervention with chemotherapy since we are definitiely in a position of the unknown. I think both are reasonable directions. 

If we decided to consider a monitoring schedule then our plan would be to perform a physical exam and recheck thoracic radiographs once every 3 months for 1 year and then twice yearly. This can be performed here or with your primary veterinarian (whichever is most convenient). 

If further intervention is desired then I would recommend that we consider using a drug called carboplatin. Carboplatin is an IV chemotherapy agent that is given once every 4 weeks in cats for a total of 4 treatments. Carboplatin tends to be well tolerated in the cat with a side effect rate of ~10-15%. Possible side effects include: lethargy, inappetance, nausea, diarrhea and/or bone marrow suppression. Side effects usually occur 3-5 days following therapy, persist for 1-4 days and then resolve. Medications can be provided if needed and dose adjustments can also be made (most side effects are dose related). An estimated cost of carboplatin is ~$900 per treatment. Recheck thoracic radiographs are performed at the time of the 4th treatment to look for any evidence of metastasis in spite of therapy. 

Overall, I am very happy with these results. We know that this mass was growing quite slowly and has been removed with complete surgical margins. We are just hampered by the lack of data in cats for this type of cancer therefore it is hard to predict the future in Jimmy's case. He may do absolutely fine without further intervention and he is an older cat with other co-morbidities. At the same time, I cannot be completely confident that metastasis will not form in the next 6-12 months. Please do not hesitate to call with any questions or concerns.”

We began carboplatin chemotherapy protocol May 2025 until August 2025. He had follow-up xrays in August. 

“We are so proud of Jimmy! He looks amazing! His physical exam was unchanged and his recheck thoracic radiographs did not reveal any evidence of regrowth or spread of his pulmonary carcinoma which is great news! Jimmy's complete blood count from yesterday was ok for chemotherapy and Jimmy received his fourth and final carboplatin treatment in the hospital today as planned. At this time I recommend that we place Jimmy on a monitoring schedule consisting of a physical exam and recheck thoracic radiographs once every 3 months until we hit the year from surgery and then twice yearly after that. Please do not hesitate to call with any questions or concerns.”

There was one concern on the xray:

“ Aug 20, 2025 

Three-view thorax, three images:

There are metallic clips near the hilus associated with lung lobectomy.

Discrete pulmonary nodules are not identified.

Within the right mid thorax, there is a poorly defined soft tissue opacity…

CONCLUSION:

Right sided lung lobectomy.

Pulmonary nodules are not identified.

Poorly defined right mid thoracic soft tissue opacity. Rule out atelectasis, fibrosis. Poorly defined neoplastic re-growth is not highly suspected. This can be re-evaluated at scheduled follow-up imaging with the oncology service. **This is most suspicious for fibrosis.”

We were concerned that this was a return of cancer or fibrosis. Fibrosis is when tissue in the lung is damaged-from disease, the environment, or cancer-and scar tissue builds up. If too much tissue builds up, the lungs cannot produce oxygen and the patient eventually suffers from not being able to breathe nor send oxygen to the rest of the body, heart, kidneys, muscles, etc. 

However, his recent February 2026 checkup with oncology showed that the fibrosis is decreasing and healing so that it is likely post-surgical scaring that will hopefully improve but it is not yet worsening. When I spoke to his cardiologist about this in September 2025, she said that the lung-the rest of the lung and the other lung lobe-can compensate for fibrosis as long as there is enough of a lung remaining that is not scarred. And that she has seen cats with far worse fibrosis than Jimmy’s and do very well. 

So, as of February 2026, we are breathing a sigh of relief for now regarding his lungs. He returns in May for another checkup with oncology at which time they will schedule another CT with contrast if he is able to have anesthesia. And he will have a cardiology checkup prior to that to determine if he can. 

March 2025 Jimmy Had Cancer Surgery to Remove a Lung Lobe and Nodule

Well! Once again, I find that I have not updated the blog in a year! Although I have posted updates to the Facebook page. 

The last blog post of March 2025 stated that Jimmy has lung cancer and would need to have the lump removed. I will explain the process, how we came to find out, what happened afterwards, and the medications we have been using.

His xray from March 2024 showed a speck of dust on the film. Six months later, it was a tiny dot. A year later, it was a small marble size. A CT showed it was cancer. Surgery was scheduled for April 8, 2025. I dropped him off at the hospital where he stayed overnight and came home later the next day after recovery. He had a wonderful surgeon, and an oncologist that took care of him. They removed about one third of his right lung lobe, then stapled it closed, then sewed up the incision. He came home with a fentanyl patch that was on him for four days, and 2ml of gabapentin every four hours for weeks. He was to be restricted to “bed rest” in the small guest room without much movement for a week. We then slowly allowed him to move about the hallway, then into the other bedroom during the day after two weeks. After a month, when fully healed, he was allowed to use the stairs and go downstairs and have normal access to the house.

We bought cat stairs to have around the beds-the tall wood stairs was tall enough for the regular queen bed that is tall; the short foam set of two I bought fit perfectly around the lower guest bed in the room where he and I slept and spent most of the day. This allowed him to move easily on and off the bed without jumping (although he did that as well despite my attempts and furniture blocking what I could of the bed.)

I set up the room for food and water, a low to the ground litter box, a scoop, litter bags, cat cleaning wipes, wipes for me, paper towels, tissue box, bandage pads and bandage tape (the type that looks like an ace bandage that doctors use on humans), and plastic10ml syringes and 3ml syringes to give food and water if needed.) I did not need to change the bandage every day and one was removed after a couple days. And the sweaters and new born onesies he wore covered the incision very well. The incision site was along the side of his right chest, slightly below the shoulder. I also moved out some furniture so that he wouldn’t get under and be difficult to retrieve. And I put down blankets all over the floor so that he could walk without sliding since he would be weak and on heavy pain meds. Here's a link about post-surgical care information.

Since he did not bother it-and we had to monitor him-he did not need it covered all the time with a bandage nor needed to wear a cone. Cats do not bother their stitches as much as dogs do. If your vet says the cat needs a collar, perhaps a shirt will suffice. But we had to monitor closely. His surgeon did not allow us to use Benadryl anti-itch lotion if he did bother it. The incision had to remain dry. We had to monitor the site for bleeding, swelling, redness-all of which was present when he was first home. BUT after a couple days, the red line of dried blood along the incision cleared up, the slight swelling decreased, and the redness was light bruising which also quickly faded.  After the first two weeks, I took the shirt off for a couple of hours at a time, then eventually longer; monitored him for bothering it, and put the shirt back on if I was not in the room with him, or when we slept at night. After a month, his vet said the site was well healed, and that he did not need the shirt, and that he could move freely about. 

Regarding movement-after three weeks I began to do light physical therapy with his front legs because to remove the lung nodule, the surgeon cut deeply into his chest cavity. They were able to get at the lung through the ribs without breaking them but they did cut through muscles. We had to monitor for loss of use of front legs and any swelling or numbness due to any surgical issues. He did flick his legs for the first few weeks as if something bothered him. This ended after a month. He was able to move about so there was no loss of movement or strength. But it was still worrisome because there could have been tingling or numbness that we were not able to appreciate. So, after two weeks, once up and moving around more into the hall and down the hall to the other bedroom, I began light therapy. I recalled the therapy I did with Bette (who died May 2023 of brain cancer from her tumor of the spine-see those posts. She had lost the use of her back leg but maintained blood flow through therapy.) I gently held him, then gently extended a front leg-one at a time-stretched out front, then to the side, then got each joint to bend towards the chest as if mimicking jumping. I got him to resist-to push against my hand-by pushing his foot joint towards him. I rubbed his front feet. I did five sets of this at three times a day. I thought it would help the chest ligaments ease up as well as help his leg muscles. His vet said as long as it didn’t hurt, it was a very good idea. Of course, I had to make sure his incision was not being bothered by my actions and that I was not working the chest. 

The food and medicine remained in the kitchen and I would get it from there when I needed to feed or administer his meds. He was not on a full supplement regime except to receive Renal K, a vitamin paste, lysine gel for the first two weeks because he was not that physically active and I did not want to stress him out attempting to hold him for a lot of supplements.

The fentanyl patch made him bonkers. This was not like getting neutered, or when he had the shoulder lump removed in 2024. He was not himself for a week.(I’ll explain in a moment.) I thought something was wrong. I called his surgeon the next day and was reassured he was normal. I texted daily with his regular vet. I thought we should cut his gabapentin because he was not normal. But she said not to reduce his pain meds because his DEEP surgical site is causing more pain than we can imagine (unless you’ve had such a surgery); a reduction in pain med increases the pain; and an increase in pain causes stress on the body, the heart, the kidneys, etc. And such a response can cause the opposite of healing and cause his body to go into a pain response that would become too hard to manage and he would need to be hospitalized again. If he was in pain, breathing would increase as well as signs of agitation and being uncomfortable. The fentanyl patch was worn until Saturday and once that was off, he was able to move about more freely.

To know if he was healing well immediately after surgery, we had to monitor his litter box use-was he able to pass anything? At first, no-the first couple of days there was nothing. I was a little worried so we began to give him 9ml of water by mouth every three hours. Finally, he passed urine easily. ( We added water to canned cat food that he was eating and cats get a lot of fluid from canned food.) We monitored his eating (he was ravenous and that was never a problem.) And then his BREATHING RATE-was that normal, too high, too deep? Any signs of CHF?  (To monitor breathing rate-one up and down chest movement is ONE COUNT. How many in 15 seconds? Six and the cat is normal. Over ten and the cat might be in CHF-congestive heart failure. Count, give a minute, and count again. If over ten and does not calm down, count again after 10 minutes of rest, then give DIURETICS if you have them; if not go to the vet/ER vet immediately. A cat in CHF does not have the luxury of time. A post-surgical breathing issue could be a sign of CHF or other complications. A cat with heart disease can too easily get CHF. Better to go to the vet to find out instead of waiting it out at home.) No, all was normal. Those, his vet said, were signs that he was doing well despite seeming bonkers. 

Regarding food-He ate every hour a large spoonful for the first week or so. Then a can of 3oz every three hours after that until after a month, when he was back to normal. No-he did not gain weight. Post-surgical recovery needs a lot of calories so let your cat eat what they can and want to BUT DO NOT LET THEM STUFF THEMSELVES because anesthesia, fentanyl, and high levels of pain meds can cause nausea and vomiting which can be a dangerous thing for a cat. They can lose fluids and electrolytes BUT ALSO THEY RISK INHALING IT and that will kill them. 

Why was he bonkers? He spent the two days sleeping in the litter box. Not near it but in it. I kept removing him but he refused to sleep elsewhere. (HOW DID I PICK HIM UP? Very carefully with one hand on the left side where there was no incision, and the other hand on the back legs of his right side., then pulling him to my chest.) He had two cat beds on the floor, the regular bed, and blankets. But no. I tried putting a towel under his head as he rested it on the edge of the box (we used a low flat box for easy access) but he kept putting his head in the litter. And I had to gently pick up him to scoop the box and then wipe him off without touching the surgical site. I kept changing his shirt a couple times a day when it got wet with urine. He slept all day. But he was ravenous when he ate. He was also wide eyed. But breathing normally. After a couple days, he moved to the floor, then a cat bed, then to a footstool next to my bed and slept there all day and night when not using the box or eating. Then he moved to my bed. Then he moved on to me when I was sleeping-literally on my head and chest. Those were the best four days because he wanted to be on my chest and head and to cuddle, and this was a cat who never cuddled and who to this day STANDS on my lap when he wants to be petted. After the first two weeks, we put up a baby gate at the top of the stairs and he was allowed to spend a couple hours sleeping in the hallway. Then eventually, the next week, to the larger bedroom. 

We did not use a surgical cone or collar. Instead, I used two cat sweaters and a pack of newborn onesies from Target that fit perfectly. The neck was wide enough to get over him gently, and the body was long enough to cover the incision site. The sleeves were too long so I trimmed them up leaving a short sleeve. He kept chewing on them for some reason so I had to cuff them and sew them in place. Between the sweaters and onesies, all went into the washer and dryer easily. 

Aside from gabapentin 2ml every four hours, he also had his regular buprenex at .3ml twice a day, his daily Prozac .60ml, half a cerenia twice a day to help with post-surgical nausea. 

His Prozac did get reduced when the gabapentin was given in such high amounts that first month because Prozac and gaba and contraindicated. Not knowing what might happen, I slowly reduced the Prozac from .60ml to .30ml after the first week and a half; then increased it again once the gaba was reduced to 1ml q 8 hours after a month (gaba was reduced over time to .50ml BID or twice a day until fall of 2025 when he needed it .50ml q TID or three times a day for UTI and litter box use-a different blog post soon.)

After a month, his vet declared him healed and he was free to go shirtless and move about the entire house as normal. 

He did have cancer, and needed chemo-a separate update soon.

Here are some Facebook posts from that time at Cats With Hypertrophic Cardiomyopathy:

4/9/25 Jimmy Stewart had lung surgery yesterday. He’s doing well. He had the marble size nodule removed along with a portion of his lung yesterday. They will test it and likely it is cancer and he’ll start chemo treatments after healing at some point. But we will know more in a week. He comes home later today. I’ll take more pictures and post them later. He’s not allowed to climb run or jump. He will be on pain meds, which hopefully keep him quiet for a few days at least. We took all the bedroom furniture out of the small guest bedroom except for the bed and the desk. So he’s got plenty of room to lay comfortably around, and I have two sets of pet stairs around both sides of the exposed sides of the bed which hopefully he uses. He hasn’t used them yet when climbing around the bed in the past because he doesn’t like using them; his sisters, however used them without any issues. So hopefully he uses them. I’ll take more pictures and post more later. We are praying for a smooth recovery. 

4/11/25 Jimmy is doing well. He’s eating moving and resting. He was sleeping in his litter box most Wednesday night and Thursday but Thursday afternoon he decided to start sleeping in the bed. And then on the floor. And he even climbed up into the regular human bed. And he finally started using his litter box. He hadn’t gone since he got home Wednesday. And I realized Thursday he wasn’t drinking water so I started giving him water by mouth. And so a few hours later, he used his litter box and then a few hours after that he used it again. So we will continue to give him water by mouth just to help him. He had of course, gotten fluids at the vet until Wednesday afternoon when I picked him up. And he had been chowing down food. He was ravenous and eating wet food almost every hour through Wednesday night into Thursday. So he was getting probably a lot of water through that but maybe not enough. So we will continue to give him water by mouth with a syringe. I give him three of 3 mL syringes. Small syringes are easier to handle for water. He’s on meds, of course around the clock. And he has a fentanyl patch that can come off Saturday afternoon. And then the white onesie will come off and he’ll just wear his regular onesie. And then he can venture out into the hallway for a little bit, but not go down the stairs. I put pads up on the wall and around on the floor in case he had accidents and couldn’t use the litter box. But he’s been able to get in the box. So, some of those might come down on Saturday when I let him out of the room and I clean the room. 

4/12/25 Jimmys tail is moving like a cat clock. (I had posted a video at the Facebook post.) We removed his fentanyl patch today and so now he can get out a bit. We put the gate up at the top of the stairs and let him have the hallway. And then we let him eventually into the larger bedroom. He wanted up on the trunk so because we can’t allow him to jump up or down we put him up there. And he has been up for about 40 minutes. (There is a window in the photo at the Facebook post.) I’m sure he’s enjoying the change of scenery. He will go back into the nursery soon enough. But for now it’s not that cold and its sunshine and he’s doing well. He’s breathing well. He’s eating. He is sleeping a lot. But I checked with his vet – that is still normal. Of course I was concerned. 

4/13/25 A three pack of newborn onesies for $9.99 from Target fits Jimmy perfectly. The sleeves are too long so I will have to trim the sleeves on the other two. I put this one on him to see if it fits and it does so I’m not taking it off. I did roll up the sleeves. Time will tell if he’s able to get it off or get to the stitches under the sleeves. It’s cheaper than buying a onesie surgical shirt or pet shirts. But we’ll see if they work. The purple shirt that he was wearing since Wednesday needs to go in the wash. I was waiting for to remove his fentanyl patch, which was yesterday, and then I couldn’t find any more pet shirts that would work because he needed sleeves to cover his stitches, and then I thought of the baby onesies to try.

4/13/25 With the baby gate up so he can’t go downstairs and the door is closed to the other rooms because there’s too much he can climb Jimmy gets to stretch his legs for a while and have the hallway to hang out in. 

4/19/25 Jimmy is recovering well from his lung surgery last week. We now let him stretch his legs and go into the larger bedroom down the hall. Again using the baby gate at the stairs and closing off the other rooms. We have pet stairs so that he can get up on the trunk next to the window and onto the big bed. He is wearing a new shirt. Isn’t he the cutest? 

4/20/25 When your little boy is recovering from surgery and decides that he no longer wants to sleep in the litter box and begins to sleep on the bed and then finally decides that you would make a great cushion-you don’t remove him and you don’t budge. You just put up with the fact that his paw is pressing into your cheek. And that he at some point wants to bury his head into your neck and your hair. And then he wants to sleep on your neck cutting off your air supply. You just make one tiny little adjustment so that you can at least get a modicum of oxygen.

4/22/2025 Jimmy’s pathology report came back positive for cancer, but they got all of it out in the nodule and he has clean margins which means no cancer was found in the material around the nodule. So this is primary and not secondary and we know from the CT that he has not metastasized. I think we will go ahead and do chemo. Chemo is a once a month infusion. He might be sick for a few days we’ll see. They say cats don’t get as sick as humans do. If after a couple of months, I think he’s not doing well on it we can stop. They said chemo actually is recommended but not necessary. We could take a wait and see policy. But I think because they got it all out and he’s doing so well and he’s still young and strong even at age of 16, he’s not really that old of a man at 16, I think now is the best time to be more aggressive. Because later who knows. And I don’t want to take the risk of it coming back. I don’t want to take the risk of it being some speck of dust on an x-ray that six months from now is the size of a marble and in a year it’s the size of a ping pong or something. Tomorrow I will call his oncologist and we will discuss further details. He’s still healing. He goes next week to see his regular vet for a check up. And then sometime I assume in late May or June we will begin treatment. We’ll see how it goes. I’ll let you know. 

4/23/25 Jimmy gets to go without a shirt now that it’s been two weeks. I will have him wear one at night. And as long as he doesn’t bother his stitches he can go without a shirt a little bit more each day. We are also cutting back on his gabapentin starting today, which means an increase in Prozac so hopefully he doesn’t have accidents out of the box. I don’t know what’s on his back. But the hair on his back above where they shaved him is goopy and dried, and when I tried to comb it out, he did not want me messing with it. We will leave it for now. Maybe I’ll trim it with the scissors. (I did.)

There were no more Jimmy posts regarding recovery after this.

Jimmy in one of his shirts.

Jimmy in a onesie.

The other sweater.

Jimmy Needs Lung Surgery

 Jimmy will need lung surgery to remove a nodule "in the right caudel intercostal space in the 6th IC space ventrally (between the 6 and 7 ribs). Well circumscribed, mildly irregular nodule approximately 10cm in the caudal aspect of the right middle lung lobe, near the pleural surface and adjacent to the cardiac silhouette." [CT report.] They suspect cancer because it is rare that a nodule is in the lungs-for cat or human-and not be cancerous. The recent CT did not find cancer in the rest of the body for now. The nodule will be removed with the half of the lung lobe and will be tested for cancer and if needed, chemo might be warranted. We expect to schedule this for the first week of April.

He had an updated ultrasound in February and there are more lesions/nodules on his liver, which have been there for the last few years. But some have grown. We then had xrays taken to check his chest and a nodule was discovered.  A CT in early March revealed that the nodule has grown in a year-from a speck on the March 2024 xray, to a 2 cm "curvilinear vessel" from his April 2024 CT (for the lump on his shoulder that was removed last May) to now a nearly 10cm object. 

We do not want to put him through lung surgery. But if we do not do it now while it is small, it will grow too large to easily remove through the ribs without cracking open his chest, which is what we do not want to do. If we wait too long, it will grow to put pressure on his pulmonary system, creating breathing issues, creating CHF, putting pressure on his heart, causing it to be weak. He has developed a mild heart issue now as it is: 

"The echocardiogram showed that he has developed a mild degree of left atrial dilation. He also had intermittent irregularity of his cardiac rhythm due to premature beats called APCs. There is no evidence of cardiomyopathy, but these abnormalities indicate that his heart is under some stress. This could stem from hypertension or even from an underlying cancerous process. He is not currently at risk for congestive heart failure and cardiac medications are not indicated. He can still be considered an acceptable candidate for anesthesia, if needed."

So, now is a good time while he is a good candidate. BUT the recovery process is difficult and he'll be home THE NEXT DAY. They do not keep them-not this hospital. I will try to arrange home visits with his vet or a visiting vet. I will also need help taking the girls for twice weekly fluids for the first week or so at least. He is supposed to have BED REST for two weeks. So, he and I will be hold up in the small guest bedroom that I continue to use to stay with the cats because it is easy to get to them, the bed is very low-and we have soft stairs to the bed-and the cat does not have far to walk to eat and use the litter box. Stitches will be removed after two weeks. 

His CT also found mildly enlarged sternal nodes-too difficult to remove to test and could be signs of future cancer but no one is concerned at this time. The nodules on his liver did not present as cancer which is a good sign. And the CT showed he has mild arthritis in his spine-not unusual for a 16 year old boy. There was a mild nodule on his kidney but not cancerous and not unusual for a senior cat. 

Below are images of lung information and Jimmy's xrays. 

Jimmy xrays

2024 Updates

I have not had the time nor inclination to make blog posts since the last one of May 2024. I thought I had kept up with this but no. I have posted items to the cat Facebook pages, however.

There has been a lot going on. As of March 23, 2025, Jimmy and Elizabeth and Roxanne are still with us.

Roxanne and Elizabeth developed CKD. 

Elizabeth developed it in March 2024 and we struggled through most of 2024 with stabilizing her issues. She would not eat. We used cyprohepatidine and mirtazapine and Mirataz ear gel to stimulate her eating. When she was feeling sick, neither medication would work to make her eat. The Mirataz ear gel did not really work well but it did greatly irritate her ears. They became red, dry, scaly and we had to stop using it by the end of the summer. We began hand feeding her and continue to do so as needed. We struggled to keep her weight above 11 lbs. I put her on numerous supplements and vitamins as I did for Myrna Loy for her heart and for kidney support (see Vitamins and Supplements and Goop mixture here at the blog in word searches, Medication tab, etc.) The vet started her on once a week fluids from March to June. Then we began twice a week fluids. We also put her on Zenequin antibiotics because the fall ultrasound showed that her kidneys were inflamed. Finally, by November, she began to eat something on her own, and 1/4 of Mirtazapine pill helped her begin to eat on her own. Blood work from the fall and currently shows slight improvement in kidney blood values. She is more of a CKD stage 2/3 than stage 3/4 now. She continued to do well until late January when she stopped eating on her own. We fed her by hand four times a day-40ml per time because only 30ml or so makes it into her mouth. Her weight remained stable. In March she began eating something on her own and began responding again to Mirtazapine which helps her eat enough on her own that we hand feed her 20ml four times a day-as long as her weight remains over 11.10 lbs. I give her 1/4 Mirtazapine once a week. It tends to wind her up a bit but eventually she settles down and eats. We do not want her to lose weight and fat and muscle mass. We have seen cats before lose weight and get below 10lbs and get very sick and go into end stages of life, and pass away once they begin to lose fat and muscle mass. She is also on Zenequin (originally Baytril which she did not tolerate)-first for one month, then two weeks on, and two weeks off. This was recommended for her inflamed kidneys and gastro issues. Elizabeth has a leaky tricuspid valve that appeared in 2024 and we continue to monitor. But she has no CHF or HCM issues. 

Roxanne: She has had a difficult few months. She was showing early signs of something-CKD stage 1; gastro issues; she had been tested positive for FIV in 2023 but subsequent tests in 2024 showed no infection. We ran the ELISA and PCR tests three different times. She saw the internist at a hospital in October because of questionable blood values, possible FIV, and how she seemed run down at home. 

(Hospital report:)

"DIAGNOSIS:
1. Chronic hyporexia, vomiting, lethargy, weight loss r/o chronic inflammatory enteropathy, IBD, small cell GI

lymphoma, infectious (toxoplasmosis, less likely fungal, other), less likley EPI

• Diffuse small intestinal muscularis thickening

2. Low normal to mild neutropenia r/o individual variant, spurious, contributing FIV, less likley immune mediated,

   consumptive

3. Biliary cystadenomas

4. Chronic kidney disease (stage 2)

• Left pyelectasia (3.2 mm)-suspect CKD, less likely pyelonephritis, partial obstruction

5. Discordant FIV positive results

6. Focal thickening base of L interventricular septum (heart murmur

   "She was seen 7/3/24 for weight loss and hyporexia, with an ongoing history of intermittent vomiting that would respond to cerenia. CBC was normal (Neut 3976). Chemistry showed azotemia (Creat 2.3, BUN 33, SDMA 17, otherwise normal (P 4.2, K 4, Alb 3.3, Glob 4.7, ALT 29, gluc 88, choles 244, spec cpl 1.3 ug/dL, T4 2.3 ug/dL). UA cysto USG 1.028, pH 6.5, 30 mg/dl protein, no glucose, ketones, bili, quite sedi. BP was normal (130-162). Baytril was prescribed for one month though lead to anorexia after about two weeks and was stopped, then appetite returned after also receiving an unmeasured amount of mirtazapine.

...9/11 she was seen for report blood work and was noted that she overall was doing better than the prior month, with main concerns including intermittent hyporexia, lethargy, and weight loss. CBC showed mild neutropenia 2147, lymphopenia 8742, WBC 3.2, otherwise normal. Chemistry showed creat 2.1, SDMA 17, otherwise normal including T4 2.4 ug/dL. Owner requested aldosterone level due to concerns with prior pets which was low 90 pmol/L (194-388) with normal K 4.8.

She is struggling with lethargy and inappetance, though that has improved somewhat. Owner is providing supplements to address her high potassium (see above). Owner is handfeeding...This week she has needed hand feeding at night, her appetite is intermittently decreased. She is fed in the morning and she will graze all day, then offered at night time, usually hand fed, and food is always available overnight. If she doesn't eat her breakfast than the hand feeding will start. She comes right away to the bowl, but walks away. Owner had tried Cyproheptadine but didn't see much response for appetite stimulation. The mirtazapine isn't working as dramatically for her as it does their other cat. Her weight is stable (around 10.6 lbs). She used to vomit frequently, but owner started her Cerenia 1/2 tab SID almost a year ago and vomiting has resolved.

...CONCLUSION:

Biliary cystadenomas. Chronic kidney remodeling. Left pyelectasia associated with pyelonephritis or CKD. Ureteral distention was not visible to evaluate for a ureteral calculus. Abdominal radiographs could be performed to evaluate for a ureteral calculus not visible sonographically (Radiographic images are not available to me).Altered small intestinal wall layering. Rule out IBD, neoplasia.

... ASSESSMENT: Based upon Roxanne's chronic gastrointestinal localizing signs it is suspected that she has primary intestinal disease...revealed stable biliary cystadenomas, chronic kidney remodeling, mild dilation of the left renal pelvis, and diffuse small intestinal muscularis thickening. The renal pelvis (outflow of kidney) dilation is suspected to be secondary to chronic kidney disease (CKD), though can be seen with infection, and is less likely secondary to partial obstruction and given the degree as well as lack of ureteral dilation.

...It is common for cats to have intermittently mildly decreased to low normal neutrophil counts that doesn't necessarily represent pathology. Severely decreased neutrophil counts can be seen secondary to overwhelming infection and immune mediated conditions, as well as primary bone marrow disease. Roxanne's neutrophil count has not been low enough for this and may be within her normal fluctuation, though if she does have FIV this could be a contributing factor...we have submitted toxoplasmosis levels (which can rarely cause decreased neutrophils and can infect the GI tract) as well as a GI panel (to assess for decreased vitamins supporting a malabsorptive process, pancreatitis, or issues producing digestive enzymes), both are pending...

That being said with her chronic GI signs and intestinal thickening primary intestinal disease is likely. The most common processes are chronic inflammatory enteropathy or small cell GI lymphoma. The causes of chronic enteropathy are not well known but are suspected to be a result of an abnormal response by the body to certain intestinal bacterial (uncommon) or dietary antigens/proteins (common), or immune driven inflammation (common). Treatment often employs diet (hydrolyzed, novel) and for some steroids or immunomodulatory medication and supplements if deficiencies are present based on the GI panel. While small cell GI lymphoma is cancerous, it is typically a slower advancing process, causes signs, blood work changes (often none), low B12, and intestinal thickening very similar to inflammatory bowel disease. However this process can only be distinguished from chronic enteropathy based on biopsies +/- additional tests performed on biopsy samples. Cats with therapy for small cell GI lymphoma (which in part overlap with inflammatory disease), if they have a positive response often have a median survival time (50% do better, 50% less) of ~2 years. Treatment mainly involves steroids and (generally oral) chemotherapy if tolerated..."

RESULT:
Roxanne was given steroids for her gastro issues and seemed to do well on steroids in October and into November. She began eating a lot due to steroids and drinking a lot. Then she began to drink excessively into November and getting her chest wet (from putting herself into the water bowl) and began to seem tired and was not moving around the house as much as normal. Then she began to not eat as well as she had been and her weight began to slowly drop. There were many signs that she was not doing well. In early December I took her to the vet for blood work updates. Her formerly NORMAL blood work was sky high off the charts, showing CKD stage FOUR and diabetes, and internal damage. Her body could no longer handle the steroids and the steroids had damaged her kidneys.

Glucose: 403-September was 93, normal high is 175.

Creatinine: 1.9-normal is below 1.6.

BUN: 44-normal is below 35.

Cholesterol: 504-normal below 276.

Triglycerides: 3308-normal is below 90.

Urine had glucose and protein indicating that the kidneys could not filter properly and items were spilling into the bloodwork, and that her body had so much glucose that it was not being filtered by the kidneys but spilling over. 

We quickly titrated the steroids down for the next two weeks. I increased her fiber source to help absorb the cholesterol and triglycerides (high cholesterol and triglycerides are due to kidney/liver/diabetes/steroids.) And I increased the fish oil which was also recommended to help. 

We fed her Royal Canin glycol balance diabetic food as well as Hill's KD and other renal diets until February when her glucose levels appeared normal again. Now she is fed renal diets only.

When she stopped eating in January, we began hand feeding her four times a day-and continue to do so. Hill's KD is easily syringed up to hand feed.

She began receiving fluids twice a week with Elizabeth and continues.

She was also put on Zenequin (could not tolerate Baytril) and received it for a month, then two weeks on and two weeks off. She continues to follow this regime.

Finally, in March her blood work improved and she now seems to be at CKD stage one. BUT she will not eat on her own. She still seems lethargic at times. She does not always choose to roam the house as she used to prior to steroids making her ill in late November.  We can only continue hand feeding, giving supplements, etc. and monitoring. Her latest gastro ultrasound shows no issues. 

VARIOUS OTHER ISSUES:

Ears-all three have had ear issues. We use Tresaderm or Animax. I use this when the ears feel hot or look hot, when the cat reacts by shaking their head when petted, or is found scratching at them. Since the girls are in enough, the vet has checked their  ears often. There are no mites in any of the three AND we use Revolution (Revolution Plus, also) for monthly flea/tick/worm/mites protection. 

All three have had eye issues. We use Tobramycin for conjunctivitis, running eyes, redness and irritation. 

AS FOR JIMMY STEWART: that will be a separate post update. 

Elizabeth

Jimmy

Roxanne

Jimmy's Lump Seems to be NON CANCEROUS Lipoma

Pathology Report:

"Jimmy Stewart's mass is thought to represent an angiolipoma. Angiolipomas are a variant of a lipoma.
Lipomas are benign connective tissue tumors composed of histologically normal adipose tissue. It has been
postulated that lipomas may represent regions of nodular hyperplasia or altered lipocyte metabolism
rather than true neoplasia. Because lipomas have no defined microscopic borders, gross inspection at the
time of surgery is often a better indicator of completeness of resection than microscopic examination.
Development of multiple lipomas is common, and close observation for additional masses would be prudent.
Surgical excision is typically curative.

 A vascular derived neoplasm was considered, but is less favored at this time. Additional recuts and
 re-trims to further characterize the lesion are pending...

  HISTOPATHOLOGIC DESCRIPTION:
  The specimen consists of multilobulated nodules of well-differentiated adipocytes supported by modest
  bands of fibrocollagenous tissue that occasionally are partially encapsulating the nodules. There are
  multifocal random branching vascular structures within this mass that are interspersed among lobules of
  mature adipocytes. Individual adipocytes have abundant cytoplasmic lipid and small compressed nuclei.
  Mitoses are not seen. Inflammation is not present..."

Jimmy CT Shows Lung Issues/Stomach Hernia, etc. Skin Lump Well Defined

There's so much going on here. I've not had a chance to stop and write-between cats, house issues, garden, personal, etc.

Lizzie-doesn't want to eat, isn't feeling well lately, was in for blood work and scans in April and has approaching CKD. We are feeding her renal foods, fluids, extra vitamins, etc. And Mirtazapine once a week and very little of it BECAUSE of the complications long term use had on Katharine (see posts December/January.) But we are hand feeding her daily three times a day and her weight is stable at 11.3 lbs. Some days she eats well on her own but not all. I want her to stay over 11 lbs because when they get down to 10 or less, they become weak, with less fat and muscles which is what we saw with Katharine.

Jimmy-as I posted in March, had two biopsies of his back lump and the second one came up possibly cancer. We had a CT in early May and THAT report came up with---a possible lung issue AND a stomach hernia and other issues. The lump? Smaller than in March and well defined and NOT spreading. SO-the CT specialist thinks it's likely not cancer but needs to be removed and tested to know for sure. We were supposed to remove it this week BUT NO ONE CAN TELL ME ABOUT THE CT REPORT and if anything is serious. The vet hospital sends them out so there's NO ONE to talk to. Our state's vet school is without a rad/onc/CT/MRI specialist since February so no one there can discuss it with me. No one else in the area will read someone else's CT unless MY VET sends it to them. AND MY VET hasn't yet despite me requesting it a week ago; AND the surgeon to remove the skin lump still hasn't called me to discuss the CT report and if there's an issue to resolve before he has surgery. His cardiologist said she can't see anything of concern on the xrays from March and feels the CT report is too vague and to continue removing the skin lump to test for cancer. BUT if the lung issue is concerning, then he can't have surgery or daily intubation for radiation treatment on the lump area if it is cancer.

I'm worried about either waiting to find out more about the lung-but where, when, who??-or risking surgery now and having something go wrong. Or waiting to remove the lump and what if it's cancer but not ACTING like cancer? And then waiting spreads it?

The CT report:

"Thoracic CT-
In the right caudal lung lobe ventrally there is an irregularly marginated, ovoid soft tissue attenuating structure, measuring approximately 2.9 x 3 mm. (VERY SMALL) This is closely associated with vessels and an airway. On the dorsal reformatted image, this appears to be associated with a curved vessel. This structure is less discrete and poorly defined on series 2, the initial scan.
There is patchy groundglass appearance within the left cranial and right mid ventral pulmonary parenchyma.

...On the second scan, the pylorus of the stomach is displaced into the caudal thorax and there is esophageal distention. There is adjacent poorly defined soft tissue attenuating material, not identified on the initial scan.

...Sternal lymph nodes are mildly enlarged with homogenous enhancement...

CONCLUSIONS:
Solitary ovoid pulmonary structure. Given that there is only 1 structure, this could represent a granuloma or neoplastic nodule, however, on the dorsal reformatted image, this has a curvilinear appearance, therefore, this also could represent a curvilinear vessel which has a nodular appearance on the transverse images.
Mild sternal lymphadenopathy.
Chronic lower airway changes. (WHAT?? Serious?)
Sliding hiatal hernia."

Jimmy

Elizabeth