Steroids for IBD-Katharine Doing Better

Katharine seems to be doing better on a longer course of steroids. We did ten days of two; then five of one; then every other day of one; now every other day of 1/2 for five days; then we will do 1/4 every three days until the supply runs out. Meanwhile, despite less steroids, she is eating well. The first time this summer when we did steroids for IBD, she didn't eat as much as soon as we stopped giving the med twice a day; and then stopped altogether when we finished the course. And she's gained weight-back on a diet! She's 11.6 up from 10 lbs in June.

Baby Develops UTI; Katharine Update

Baby-who was perfectly fine this weekend and earlier this week-suddenly developed a UTI. Now on antibiotics and was on a touch more pain med than what she receives daily. She typically receives .15 Buprenex to prevent inflammation and the sudden onset of cystitis. She went to the vet yesterday and three hours after a course of antibiotics, she was already improving. It began Tuesday night when she had trouble passing urine and a bowel movement. Not sure which came first but she tried to do both for a few hours. I gave her more pain med at bedtime (she receives .15 BID-twice a day) and this calmed her down and made things less urgent. But she was still having trouble passing either. I got up with her twice in the middle of the night and scooped the litter box which had many dime size amounts of urine and some fecal matter. Eventually, she produced a half dollar size urine but paper thin in the litter. Today, she is back to large balls of litter (we use clumping litter.) She is on antibiotics for a week. Will retest urine in two.

The vet gave sub q fluids-necessary to help hydrate the body, fill the bladder to help flush out bacteria and crystals (if present); did a CBC/chem panel-all is well; and gave the antibiotics Zeniquin and a probiotic pill Proviable.

Katharine is doing well on steroids for IBD and is eating well on her own. We'll see how she does as we titrate down the dose.

Vitamin D for a Sick Cat; Too Much May Be Toxic-Proceed With Caution

The vet recommended a vitamin D blood test (last week during the scan) and the result came back that the level is very low. She recommends a supplement. PROBLEMS: too much and it's toxic. Giving too much of a supplement and causing toxicity would be easy since cats do not need that much vitamin D to increase their levels unless they were not eating or absorbing nutrients. In Katharine's case, she has IBD so her body was not absorbing nutrients effectively. She also was not eating well and not at all a few days prior to the test (although we were hand feeding her.) So, her level may have been temporarily low anyway. We will try it for a few days-next week as the vet needs to order it. I will give very little and we will retest her level in a month. She's eating better on her own so I'm expecting the level to improve.

Here's an article about vitamin D and cats. 

Katharine Struggles to Eat on Liquid Phenobarbital-Trip to Vet for Scan and Meds

Katharine update since 7/11: she had been eating well enough once I cut a small amount off of the phenobarbital pill half that she received in the morning. She ate well enough for a week. We had to hand feed in the evening but she did eat some in the evening. She had not lost weight during this time. But then 7/13, we switched to liquid pheno. Since I couldn't accurately cut the pills in half (not scored, easily fell apart) I never knew how much more or less of 7.5mg per dose she actually received. The liquid version was supposed to help us figure this out, titrate down as needed, and track efficacy. But she immediately lost her appetite. The script was 7.5mg/1ml-one dose was one ML liquid pheno. To decrease the dose, I began giving her .95, then .90, then .85, then .80. She would not eat. We had to keep hand feeding her. The goal was 150 calories a day which was difficult to do just because it required multiple feedings of 21 ml or more per feeding. Each ml was approx. one calorie.

Her gastro scan was already scheduled and that was this past Thursday. She's fine. No liver damage or disease; still no pancreatitis. But her small intestine, the mucosa, is a bit more thickened since May's scan. They suspect IBD-irritable bowel syndrome-because all blood work is normal, and there are no signs of disease or cancer. She is to ONLY eat hypo food-rabbit, venison, duck-and NO fish based foods. She is on steroids for a few weeks (which are tapered down over time.) She received a B12 shot and will receive them every 2 weeks until late August. (They sent the supplies home, expecting me to administer the shot since I learned how to give shots sub q when I had to inject lasix into Myrna. I declined to do this with KH and will take her back to the vet for each shot. I'm not up to it frankly and since it's not life saving such as lasix, it's not something I MUST do.) While she could take by mouth, vitamin B12, since she has IBD, she may not absorb the needed amount, so hence the shots. They also tested her vitamin D levels which-just like with humans-if low, creates all sorts of issues (I have been low on iron and vitamin D and both caused the same symptoms for me: muscle aches and weakness, inability to breathe/move, feeling as if a major disease is attacking your nerves, etc. I take supplements for both.)

I also switched back to pheno pills in case the liquid version has put off her appetite. By shaving a bit off the end, she returned to eating-but after beginning steroids (which can increase appetite) and receiving the B12 shot. She's not eating enough and we continue to hand feed as necessary. She has lost 3 oz. since last week and is down to a bony 10 lbs. So, we must make sure she reaches her caloric daily goals. We will try the pills for a few days, then switch back to the liquid version and see how she responds. If she looses her appetite again, then I'll have the pharmacy redo the formula.

Cure for Cat Car Sickness/Vomiting in the Car

Solution to no vomiting on the way to the vet: I finally hit on a plan to prevent Roxanne from vomiting in the car on the way to the vet. And I don't know why I didn't think of part of the solution beforehand. She vomits in the car regardless of duration of trip or if I give her Cerenia before we leave. So, it occurred to me today that perhaps if she ate very little in the morning and didn't eat at all for two hours before departure, that she wouldn't have food in her stomach to vomit. AND since giving Katharine Pepcid to stop stomach acid, I thought I would give it to Rox to see if that helped. Perhaps nerves creates acid; perhaps acid creates nausea; and nausea leads to vomiting. I gave Pepcid yesterday and this morning and 1/8 more before we left. I gave Cerenia before we left. And it worked. She only vomited up some foam. But she was calm on the way there and while there.

She saw the cardiologist today and all is well. No disease signs at all. So, she does not need to return annually. I will take her back if she needs dental or other surgery (which I hope we avoid) or if there are signs or other illnesses that require a full check-up.

Katharine's Appetite Improves with Less Phenobarbital

Today Katharine ate on her own all day long. And she has eaten nothing but AD in a bowl. And she demanded food every hour. By 3 p.m. she had had 115 calories. We weighed her last night and she's at 10.4, up one ounce from 7/3. So,no weight loss which is good. And maybe she only needs about 165 calories a day. She hasn't eaten since 3 and may need hand feeding a bit or maybe she'll eat again on her own. But titrating down the pheno seems to help her eat.

We had her pheno compounded but I think the vet got the script wrong. I'll call the pharmacist tomorrow first. We want to titrate down one dose and make the evening dose a regular 7.5mg dose. She receives a total of 15mg a day. The script compounded says 7.5mg/1ml-7.5mg is in one ML of concentration. That means one dose is 1ml which is a lot to syringe up and try to give her. That also means the TOTAL for the day is 2ml. If it were 15mg/1ml then I could easily give .5ml per dose and titrate down as needed. I need to use a syringe with hundredths measurements which I have but which is hard to read accurately and we are aiming for accuracy. We need to give the exact dose each time so that we can see how it affects her appetite as well as monitor for efficacy for seizure control. This should be more accurate than trying to cut pills that are not scored and that shatter easily.

However, the really confusing part is the script label says to give .9ml per dose. That would only be 13mg total instead of 15mg (.9+.9=1.80ml instead of 2ml.) That would really decrease her pheno which might be dangerous.

Hand Feeding Technique

Katharine isn't eating enough on her own so we are still hand feeding her. Saturday and today, she ate well throughout the morning and afternoon but then slowed down and then wouldn't eat at all. We are counting calories and on her own, she'll consume 100 in eight hours. She needs another 65-80 or more. So, we are supplementing.

Here are photos that somewhat show my towel technique to calm and contain her while I hand feed her. The towel is draped over her chest, under the neck, and the ends wrapped snuggly over her back. I hold the ends at her neck as if I'm holding her at the scruff. I hold the towel in one hand and syringe feed with the other. (No photo yet for that.)