So much has been going on this past month. In early October, blood work was done on Katharine and Roxanne; then Katharine and Elizabeth had their annual updates where more blood work was taken and more issues arose.
Roxanne is still testing high for potassium or HYPERkalemia at 5.3 (with 4.9 being high normal.) What does that mean? We need to consider testing for possible hypoaldosteronism which is rare. It may also indicate Addison's disease or diabetes. And is connected to possible renal failure or decline. For now, monitor. We might consider giving her a diuretic if she continues to test for hyperkalemia. Symptoms may cause muscle weakness, nausea, heart palpitations, irregular heartbeat, and abnormal blood pressure.
If a cat has HYPERaldosteronism which produces HYPOkalemia, that could indicate cancer. And low potassium disrupts the body's function, leads to racing heart, weakness, etc.
She also tested POSITIVE AGAIN FOR FIV virus antibodies. The vet is checking to see if there is a test to test for the actual vaccine so that we can determine if she received the vax as a kitten or if she was exposed to the disease since 2017 (somehow despite no other cat in the house having FIV.) We will monitor her for active disease and try to make sure she does not fight or bite or get bitten by any of our other cats.
Katharine developed weakness and inappetence after taking an ACE inhibitor Benazepril for two weeks-she began in mid September. Mirtazapine did not work to spur her appetite. She began losing weight. While her weight was fine around 9.12 or 9.14, when it fell in early October after one week to 9.7 after we thought she was eating well enough, we had to begin feeding her by hand using the trusty 3ml plastic syringe method. (We give her 9ml of Hill's AD in the morning before breakfast, 9ml if she is not eating dinner, and 9ml at bedtime.) We concluded that somehow the Benazepril was prohibiting the absorption or interaction of the Mirtazapine, although there is no known contra-indication.
When Katharine had her annual exam October 19, her heart was racing at 260 (normal should be 140 and no lower than 135 and no higher than 200.) Given her heart rate was high, the cardiologist said to give her Atenolol twice a day; given that she was weak, to pull the Benazepril and to check her heart rate in a week. She recommended that we buy and try a mobile EKG Kardia to monitor the heart rate at home. When we tried it, we got a laughingly low rate of 77-which would indicate she was near death. Given that she was up and about, eating, walking, alert, we knew it was wrong. We took her to the vet the next day and compared the in house heart rate reading to the Kardia device and both ran about 177. This means the Atenolol at BID (twice a day) is working. But she does need an ACE inhibitor if it can be tolerated. We will try Enalpril sometime in the future and monitor. Follow the link to purchase the device if interested. Follow this YouTube video for more information on how it works. It took until almost the end of October for Katharine to stop appearing weak; and it wasn't until this week 11/5/23 that Mirtazapine began working normally to spur her to eat.
We also noticed her breathing rate had increased. But it was difficult to get a true reading. So, in late September, her cardiologist said that it was ok for her to take furosemide once a day every day of 1/4 of a 12.5mg tablet (3mg approx.) Since the tablets were small and crumbled when cut, we changed over to the 20mg tablet, cut that into quarters, and shave off a bit more to reach the same 3-4mg dose.
Because she wasn't feeling well at her annual exam, Katharine hasn't yet had her annual rabies shot so we will soon return for that.
She had her PLI/Cobalmine/Folate panel tested for pancreatitis and gastro issues and she has a high folate. These blood tests are to test for metabolic function. Specifically, folate is B12 and indicates malabsortive issues in cats (or humans.) If the cat cannot absorb nutrients, health issues develop. AND the inability points to issues in the gastro metabolic system which could be disease, irritation, infection, etc. This goes along with the gastro scan she had in early October that showed she had a "smouldering" pancreas, an issue developing. She is already on steroids. The vet suggested we had a different probiotic Visbiome She also received a shot of B12. We can take her monthly to receive them and/or supplement her diet with B12. The vet wants us to give her cobalamine tablets which is B12. I ordered some from Amazon and am waiting on them to arrive.
Elizabeth had her annual exam in October and her rabies shot. She is good. She also needs some probiotic and will take Visbiome three times a week and not daily. Her PLI/cobalamine/folate test was also good except the folate was high. She has the same sort of gastro issues as Katharine but does not present with symptoms (although she was sick in June.)
I think that is up to date on the cats. Jimmy has had a few urine out of the box accidents but we keep at it encouraging him to use the litter box and doing treats and behavioral work.
