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Boo-Boo's getting his Epogen! (Health updates)

post #1 of 185
Thread Starter 
Boo has his Epogen all ready at the pharmacy, but I can't get it until Friday. I didn't realize it also went under the names Procrit and Epoetin .. in any case, it's 53 bucks and hopefully I will be able to pick it up Friday, and also will be taking Boo by to see her to show me how to inject and use the Epogen. He's been doing very well. I caught him making a poo earlier this morning, and it was just the most beautiful little poo

Was a big one tho!

Now Chickster is getting irritated when I touch her hiney, and she has NOT pooped so I am wondering about giving her a touch of miralax. She is eating the Purina One, but won't eat wet food.

Anyway, Boo's doing great. He almost won't come out of that tent and hollers for me to come upstairs to sit here in the comp chair beside him. Moving the tent on my bed did NOT work and he went back to the empty corner and sat there looking around, waiting. So, my feelings are hurt, but I'll get over it. At least I can see him in the tent from here.

Sub-q's didn't go so well, it's been butter for the past few days, but today I caught the worst of several places. The first place was fine, I thought, until he started growling so loudly that I immediately stopped. Barely got anything in there. It was the fourth stick that finally worked.

Anyone had experience with that feeling like you've gone between skin layers instead of UNDER the skin? Like maybe you're between 2 and 3 or 1 and 2 instead of UNDER 3?, and if you move it around, you'll feel the needle sort of pop or move out of something? It wasn't in a muscle, bone or lung or anything, it was something in his skin. Perhaps I am not going in at enough of an angle? I noticed once or twice that I was going in a bit too horizontally.

Anyway. Things are really good right now. Just hoping that I can get that Epogen on Friday. Thank you all so much <3 <3 And the World's Best Cat Litter works like a CHARM. I am so AMAZED. It may be 18 bucks for a bag, but it's lasted me, what, nearly a month? I was having to buy a 28 lb bag of clay litter every 2 weeks, for 4 pans, and that stuff gets heavy when it's wet not to mention it ruined the entire room with dust.

This stuff is light. Only con is if you leave it in a bag (I save up 2 used bags then throw them away, sometimes I am lazy) they get condensation in them and start smelling spoiled. (I use grocery plastic bags, so they don't seal nicely all the time)

Was interesting to me. Poop is even worse. Like the worst curdled milk you could ever imagine. In any case. Things are great right now!!! I Wish it was not 91 degrees outside or I'd take him out, and he didn't feel like going out this morning (Went straight to his tent)

<3 <3
post #2 of 185
That is great news.
I am glad you will inject the shot yourself.
I had to take Stripe to the vet for the injections.
Did you ask about the Azadyl?
The Miralax will be ok for the other cat but I would ask the vet about the doasage for her.
I once hit Cocos spine with the needle.
It happens.
I am glad you are doing everything for Boo.
post #3 of 185
Yes, good news! By the way, did you ever get the name of the other drug (the $150/month one) so Mews could see if she could locate it for you cheaper? We could all look around for you, but Mews seems to have lots of experience with pharmaceuticals (for cats)!!

Maybe Boo just isn't sleeping with you right now because it's hot out. My cats have an entirely different sleeping pattern in the summer than in the winter. I never thought I'd say this, but I miss Stinkpot sleeping on my head right now, and I believe I am quoted on this very site that I wasn't looking forward to summer and having a fur coat on my head. What's the old saying? Be careful what you wish for? It's true!
post #4 of 185
I will try to find it cheaper for you if you gave me the name of the med.
Today I have 3 sphynx together in a box.
Coco and Meeko on the floor together and Oreo and Sasha together.
post #5 of 185
Epo is usually administered by hypodermic syringe (standard type) or by one of those injector pens - at least for humans. When my son was on dialysis he had to inject himself with Epo.

Not sure which you will get but the vet will have to show you how to use it.

Epo does a good job of boosting the red blood cells and is used as standard treatment in ESRD (End Stage Renal Disease) in humans i.e. those on renal dialysis.

Boo will feel a lot better once the red blood cell count comes up.
post #6 of 185
Thread Starter 
From what Dr. Pierce told me and what I am reading on Tanya's CRF site, the Epogen will be given by syringe and sub-q'd. No veins yay!!!! I am not a vein girl.

This is the link where I have learned about Epogen: http://www.felinecrf.org/anaemia.htm..._eprex_procrit
Epogen is what my vet called it, but we also talked about .. erythropoietin and when she called me to tell me she had found it at a pharmacy for 53 bucks, she mentioned the name of the Poetin stuff. Come to find out, it's basically all the same thing (Epogen, Procit and Erythropoietin -- just under different names and/or made by different companies in the USA. So as for the 150 buck one, I am not sure on that one and will have to talk to her again. The 53 dollar one is the Epogen and it is waiting for me at the Pharm. I can't get it until I get paid Friday AM and then will make an appt today to take Boo tomorrow AM after I get the Epogen and I guess drop it off there first so it can stay refrigerated while I go and get Boo. This whole thing will take most of the morning. The Pharmacy is across town from the vet who is across town from me, so it's a HUGE triangle I am going in. She was so sweet to offer to pick it up for me but I did not want her to go out of her way, she is already been so helpful. I am only concerned about the syringes, I guess I will have to buy a whole new set for the Epogen. Which is fine, I hope they are not much, because the Terumo needle tips for his Fluid lines were sooooo inexpensive.

But we will see.

Boo is sleeping in a red velvety type domed tent. My mom turns on the fan at night (not pointed at him, just in the room) and the windows are closed. Since it's upstairs it never really gets cold up there, but he won't even set foot on my bed for nothing, and I only have one sheet and a thin fuzzy blankie on it Oh well. Back to work, almost quitting time! Hugs and loves to you and your furbabies!!
post #7 of 185
Thread Starter 
This is what I was replying to in the old thread before I realized I was in the old thread (To mrsgreenjeans) Actually, the Dental and then Separate procedure he had for his lower canine extraction, both times put under, the new vet said was concerning as far as his CRF. He was in fine health then, and we had done a senior blood panel as far as I can recollect, and everything was fine before that. That was in April of 09. Then March of '10 he crashed hard. I don't know. I am the type that would love to point at the Dental and Extraction and say, that is what it is. The Amforal didn't cause it, b/c he already had CRF/anemia and was given that about a month ago, but the Amforal was one med that should NOT have been used in a kidney-compromised cat. Ever. This is the info I have from the new vet.

I am glad I am not seeing them anymore either, but like several people mentioned, Boo is the victim here.

As for the stones, she only did an ultrasound, so we have no idea if he does have cancer/lymphoma (Possibility, which other vet completely denied), and when or exactly why the stones happened. It could be because his urine is so dilute now, it could be cause his struvite crystal issue went the other way (But that is the old vet's theory that it could happen so I am not apt to believe it, but who knows)

All I know is ... the past two days, yesterday and today, he has been feeling SO GOOD. I have no clue why. Maybe the Pet-Tinic is starting to take a bit of effect on him you think? He's been on it for what, about two weeks now or so? Funny I keep all these receipts and keep guessing at dates (The folder is downstairs and I am tired, I am not going to get it right now LOL)


I have got to go rest, but not before letting Boo go outside before it hits nearly 95+F today and feels like 100+ with the humidity, but I passed out at work and slept for like two hours. EEK!!! LOL .. Anyway. Boo and I thank you so much for your concern and vibes and care!!!
post #8 of 185
I'll be watching for updates on how the epogen goes.

post #9 of 185
Quote:
Originally Posted by Snickerdoodle View Post
From what Dr. Pierce told me and what I am reading on Tanya's CRF site, the Epogen will be given by syringe and sub-q'd. No veins yay!!!! I am not a vein girl.
Pretty much the same as with humans. My son had to inject his Epo into his thigh. Tiny needle, no more than 1/2 inch long and very thin.

Boo will need regular blood tests as Epo needs to be monitored and the dose adjusted if necessary.

It will take several weeks for his red blood count to come up but he should feel much better - be livelier in a relatively short space of time. I always used to know when my son needed his Epo increased - he would get very lethargic and would look even more anaemic than he normally did.

Hoping everything goes well for Boo. Keep us posted of his progress.
post #10 of 185
Thread Starter 
Just want everyone to know Boo got on the bed with me this evening for a bit and got lots of petting, even though I was struggling to keep my eyes open. But that is the first time in 3 months. I was so happy
post #11 of 185
Quote:
Originally Posted by Snickerdoodle View Post
Just want everyone to know Boo got on the bed with me this evening for a bit and got lots of petting, even though I was struggling to keep my eyes open. But that is the first time in 3 months. I was so happy
YAY!!!!!!
post #12 of 185
Must not be the weather that was keeping Boo from sleeping with you. Whatever it was, glad he's back!! Yippee
post #13 of 185
Thread Starter 
I do not know what is going on or if the Pet-Tinic helped him, but at today's vet visit we decided to wait on using the Epogen. Once we start we have to commit to it, you can't just stop it or he could become, basically, immune to it.

So! His PCV is 19% !!!!! She didn't use an ISTAT handheld machine or anything, she used a tiny little stick with his blood in it in one end and fluid in the other, and a small lamenated chart to show me where his anemia was at. I asked her if it was because he was dehydrated. She said when he was getting 200mL it could have been lower because of that, but his skin is saggy because he is old (I am so glad she said what I was thinking!!) and she checked his skin "tent" as she called it and said it looked pretty good, so she doesn't think he is dehydrated. He has also had TONS of energy and has not collapsed ONCE. Also he is not sleeping in his tent. He is sleeping everywhere else and curled up when we got home on the back of the lounge chair on my coat, and really slept great.

So I have the Epogen in the fridge and it will last until February of 2012 so it's all good. We have the option there, and I know how to give it now, she showed me without giving it to him or opening the bottle. But we want to wait until his PCV goes back down. She also advised me to just let him eat whatever it is he wanted. She said the C/D really wasn't that bad for him to eat and it is really fattening. The only bad news was that he lost wait. He weighed 6.4 last time and today he weighed 5.8 which she said wasn't seriously concerning but it was something I need to keep an eye on. She said if he DOES have cancer, which we are not sure of, it could cause his appetite to go down. I told her his appetite isn't being bothered, he just prefers to eat Purina One and C/D dry more than he prefers refridgerated Hi Tor!!!

I need to buy him some more Hi Tor come to think of it.

I really love his new vet, she is so great. Boo doesn't get so stressed out on the drive, he just lays down and chills out. But then tries to hide once we get there. He had a bit of a whining, crying, grumpy thing going on when they tried to take his blood (From the thigh, which is odd, they always took it from the neck at the old vets, any ideas/experience on that?)

So... there it is. Everything is going great right now. IT has been a very very very long day and night so I am going to go pass out, and I will update Boo's weebly blog later on.

Thank you guys so much!!

OH! I also got a free Weight Watchers scale from my reward points from my bank card, and I am trying to figure out how to get it to weigh him. It acts like it won't register it, so I am going to try a few more times and see if we can get it to work. I may just have to try to find a baby scale, .. but I really want to know why the 2 different vets got 2 VERY Different weights...

post #14 of 185
I have the WW scale and you have to stand on it and hold the cat or it wont register.
All those digital scales are the same way.
All my vets take the blood from the neck.
I hope Boo feels better.
When Stripe was on the procrit we had to get her blood tested all the time.
I think I will look up what her numbers were so we can compare them to Boos.
post #15 of 185
Thread Starter 
So you are saying I have to weigh myself, then grab him and weigh WITH him in my arms, then figure the difference?
post #16 of 185
Yes you do.
Sometimes it is off though.
I think I will by a baby scale.

post #17 of 185
No wisdom to impart, just wanted to let you know I'm still following Booboo and you!
post #18 of 185
So, I'm guessing PCV of 19% is good? I don't know what that is, and checked Sven's labwork and don't see that on his to get a comparison. Anyway, I weight ALL my cats weekly on my Wii. And I DO have to pick them up and hold them to do it.
post #19 of 185
Thread Starter 
No. A PCV of 19% is still severe. Anything under 30%, from what my vet said and what I've read on Tanya's CRF Site (www.felinecrf.org) is "severe". But she said if it's jumped from 11, to 13, to 19, we could wait and take another test in a week or two to see if it's gone up even more. If so, we may not need to use it, but better to wait to use it if it's not going down.

His energy has just skyrocketed lately, I am amazed. He is scratching on his 2x4 with a lot of vigor and doesn't get tired out from it. He starts his motor at 7am when I get up (or home) and takes naps through the day.

I will get the scale and weigh him today, later on.
post #20 of 185
Thread Starter 
(On blood work paper it might say "Hct", this is PCV)
post #21 of 185
I was just going threw Cocos vet records and her PCV was 18 when she had the severe anemia in 2001.
If you would like to see i can post what her other numbers were then.
I am glad he is feeling better.
post #22 of 185
Thread Starter 
Yes I would be interested to know her other PCV numbers. Boo's lowest was 11%, but his BUN was also high then so I guess he wasn't feeling like running around. Then his BUN came down and he felt better, then the collapsing started.

He has not collapsed at ALL. He's been doing very well. That's about it for updates, he is still begging to go lay on the front porch (Already 82 degrees!!) and while sunshine is important, I think maybe today we will stay inside and just let him sit in the window. The mosquitoes are terrible, have to get some of those skeeter donuts to put around the house (Mom has a pond with a waterfall, three birdbaths and another birdbath/fountain)

We had a very great weekend. Thank you all.
post #23 of 185
I hope he keeps feeling better.
It is 81 here right now an dwe are going out now before it hots over 100.
I will post some of the numbers later.
post #24 of 185
I'm so glad he's feeling better!

Our Tuxie had severe anemia - different problem, very young cat. We fought it for four years.

For those who don't know, PCV stands for Packed Cell Volume and refers to the red blood cell count - it is otherwise known as an Hematocrit. Refers to the same thing.

Actually, normal PCV is 30-40. 25 or below is technically anemic. 25-30 is OK, depending upon the cat. (This is why it's so important to get baseline blood work done at various points in your cat's life. Cats born feral tend to have lower normal levels).

Anyway, mid-teens or lower is not sustainable for a long time, and under 25 is dangerous and needs very close monitoring. Tuxie, at his worst, was 7, and he hit 11 or 12 a number of times.

"Erythropoietin" is the name of a hormone the body produces that regulates red blood cell production. Some doctors (or vets) refer to the name of the drug Epogen as "erythropoietin" because that's basically what it is. Epogen and Procrit are the brand names: Epoetin alfa is the generic name.

Cats have far more complicated blood than humans do - blood transfusions can often only be given once; after that, a cat will often reject the transfusion (the blood will coagulate during the mixing, so it cannot be delivered). I don't know about humans developing "immunity" to Epogen, but it is definitely a risk with cats, so it is best to wait until you have no choice.

Congrats on the rise to 19!

I know that our Tuxie, when he was anemic, would ignore us and leave the room, and not want attention. When we got to the point that we were only at the vet every couple of months, Tuxie wanting to be alone was an "alert" to us that we had to go get his hematocrit taken.

I REALLY hope the Pet Tinic keeps working! It didn't for Tuxie - we also tried an iron supplement we had compounded into tuna flavor. His condition was quite different though.

If your vet says it's safe, I would consider a higher caloric food - I don't know if Boo is already on a/d, but if c/d is safe, it's what we feed our kitties, and they did gain weight on it, so we had to adjust how much we fed them. Tuxie, on the other hand, we have continued to encourage to eat - we're packing as much weight on him as we can, in case we ever go through another bout. He got down to 7-something pounds, and was skin and bones. Since his disease was diagnosed in 2003 (early 2004?), we managed to get him - at his last vet visit a few weeks ago - back up to 11 pounds 3 oz, and a hematocrit of 38!

When Tuxie's bouncing off the walls, we joke that he "must be 42!" (Referring to his hematocrit level ).

I hope we'll soon be applauding Boo crossing that 25 line!
post #25 of 185
Thread Starter 
Thank you so much LDG. And yes, we are giving him C/D dry and I am trying to keep the Purina One to a minimum of a treat after fluids. But since he knows about the Purina he's a little uppity about the C/D. But he WILL eat it. And I never tried the A/D and he was never on it, and I think that is only for temporary feeding situations? The K/D was a total no go, he wouldn't eat that even when he was starving. The Hi Tor Neo was the miracle food and he loves it. I am getting ready to give him some more now.

We were surprised at such a rise in his PCV. We have never done a test to find out if he has non-regenerative anemia, but perhaps it was due to testing him so often at the old vet that his poor body couldn't keep up with the blood being drawn? Mind you they didn't do the prick of an ear and a drop of blood. It was a blood draw. A couple of times he came home with bruises. (He gets very ornery, or WAS very ornery with that vet anyway)

I hope the Pet Tinic keeps working. I am to give .25mL twice a day, and then the vet mentioned giving 1mL ... I was like, 1mL Are you sure? That's a full dropper..... that's not even what's on the back of the label. I am going to ask again before I do anything like that.

Things continue to go well. He is grooming his legs now So happy to see. I wiped him down with a warm baby wipe rinsed in water to get some of that orange stuff off of his inner thighs and belly. I have no idea what that is. a Friend said possibly dirt, but parts of it are kind of waxy. I wiped and got a good deal off and he loved it.

His itching and restlessness have almost completely gone away. Actually, I haven't caught him jumping up and scratching/biting/chewing/licking frantically in... a week or two!!!

Thank you everyone <3 <3 <3
post #26 of 185
Don't know what that was on his leg - I'd ask the vet. But glad he's grooming again!

Yes, a/d is usually a short term thing to boost weight. c/d has a fairly high fat/calorie content, thus kitties tend to gain weight on it if they eat the same amount of whatever they were eating before - but it's designed to be pH neutral, so help avoid issues with crystals in such in urine. I imagine that's a good diet for kitties with kidney problems. Our boys all had urinary tract issues - I'm not familiar with what's involved with CRF (yet, knock wood), but we stopped all treats, actually. We simply put their c/d dry in a container and act like we're giving them a treat. Just make sure he stays hydrated. You can always try adding a little water to the dry and microwaving it and turning it into a warm mush. ))))))))

In a non-regenerative anemia, the bone marrow responds inadequately to the increased need for red blood cells. Anemias due to hemorrhage (an accident that causes excessive bleeding - or taking lots of blood!) or hemolysis (where a disease is causing the red blood cells to die before they usually do) are usually regenerative.

Anemias that are caused by decreased erythropoietin or an abnormality in the bone marrow are nonregenerative.

Given the increase in his PCV with the iron supplement, we have to guess the problem is regenerative, or it likely wouldn't be helping.

That was the problem with Tuxedo - they never figured out the disease that was causing his anemia - he had nonregenerative anemia (we did a bone marrow aspiration), but his bone marrow was still capable of producing red blood cells. In the end what saved his life was treating him with the blood transfusion and Epogen (and he needed Nupogen for a while too - that was to boost his white blood cell count) - that basically "kick-started" his bone marrow again - and THEN treating it like they would Feline Hemolytic Anemia (an autoimmune disorder, but a type of regenerative anemia where the red blood cells die too soon). Thank goodness we had a fabulous vet.

But yeah - if he's producing red blood cells, just more slowly than he should, I'd think a lot of blood draws would contribute to the problem. On the other hand - Tuxie did have weekly hematocrits for a while, and I don't know how often they were pulling blood from your Boo. But yes, to do a PCV, they need to pull a tube of blood.

Whatever it is that's doing it - it's thrilling! Just do know that if he starts wanting to be off on his own again, I'd take that as a sign that his PCV is falling.

How often does this vet want to test his PCV?
post #27 of 185
Ok, completely off subject, but what is your weebly blog? I've seen you mention it a couple of times now, but don't know what you are referring to!

Also, am finding your discussion with LDG fascinating! It's amazing what I'm learning just be reading stuff on this site!!!!!
post #28 of 185
Thread Starter 
I'm sorry! http://graysonsedge.weebly.com/ That is his website or here is an actual link http://graysonsedge.weebly.com/

The vet was wanting to take his blood weekly on the Epogen, but I will have to call her tomorrow to see how often she would like to take it since he is not on the Epogen yet. I am guessing every 2 weeks unless his behavior changes.

My old vet was completely against me feeding him any C/D. He really wanted him on K/D and I kept telling him, Look, he won't eat it. The vet was even more against Cat Chow (But I agreed seeing as how he would not RX -any- phos binders, said they were more toxic and caused more problems than helped, and he wasn't having problems eating at the time) so I went here and then Thank God found Tanya's CRF Site and the Hi Tor Neo ... and he loves it. His BUN dropped to 77 and I liked to have fainted.

The old vet had never heard of it, and my new vet hadn't either but was very interested in keeping the info I brought about it to research it so she could tell other CRF kitty owners about it! I think she likes to research and is very proactive, so I am thinking of telling her about Tanya's CRF site so she can look around. I'm sure she knows all of it, but can't hurt right?

We will ask the vet about the orange waxy stuff on him. I know he still has stud tail. At least, I think it is, that was so low on the priority when I saw the new vet I didn't ask about the orange dirt or the stud tail. He has the stud tail looking stuff on the back of his rear legs as well. They look like little black heads all over. His tail is oily. I am going to wipe it down with a warm rinsed baby wipe later this evening.

The C/D was prescribed for his struvite crystals, and it worked wonders. I was concerned the old vet told me it could cause it to go the other way too far and cause stones, which he know has, but we have no real clue if that's why he has stones. When he was diagnosed, we let him continue to eat it, but then tried to get him and the other cat in the house off of it because she was getting super fat. I tried weighing her (Both of us together) today, and it claimed she was at most 7 pounds and some ounces. Bald face lie! She HAS to be more like 10-12 pounds!!!

But I am letting him eat the C/D again because the phos at a min is .08 and max is .8 so I was staring at it one day at the vet whilst waiting to pay for it and thinking "Why did I take Boo off of this?? It seems decent enough, if he wants it and is eating primarily Hi Tor?"

one of those doh moments

I am wondering if it is possible that two different vets can get two different numbers. Such a rise was just so curious to me, I wondered... has it been 19%, maybe the old vet's tests were off? Were we taking too much blood? Maybe the pet tinic DID help? Within 2 weeks, maybe... I was thinking a lot of questions. The new vet is happy about it, and I loved her graph reading she did for the PCV. The ISTAT Machien I don't trust so much anymore. Her graph machine and stick test looked much more... I don't know, concise somehow.

Anyway. Gotta try to get some more sleep! Boo woke me up for some water and C/D!

<3 <3
post #29 of 185
The values can be different at each vet.
What numbers do you want me to post from Stripe?
I have the numbers from when she went in a coma also.
I also have Meeko and Cocos numbers when they had severe anemia.
post #30 of 185
The numbers can definitely be different at each vet. Every time our vet took blood for a hematocrit, he'd always take enough to send it out to the lab. They're very good at our vet, but he explained all the things that could cause a wrong reading - and there are a number of them. (It has nothing to do with the amount of blood taken, but the way the test is run). We always officially went with the number from the lab, which was sometimes 1 or 2 different from the reading at the vet. But when you're down at 11 or 12, a reading of 9 or 14 is very different!

I'd go with a confirmatory hematocrit within another week or two, especially if his behavior stays more normal. And I expect you're right - especially if his hematocrit is on the rise, she'll probably only want to do it every couple of weeks.

As to the c/d - the formulation has changed within the past... couple of years. It was originally for cats with struvite crystals. x/d was for calcium oxalate crystals. What causes them is a genetic disposition combined with stress and diet - combinations of basically magnesium and other minerals in the diet. Because they had the problem you mentioned (c/d could fix the struvite, but may swing a cat to having oxalate), they got rid of x/d altogether, and rather than trying to "move" the pH of the urine one way or the other through diet, they changed the formulation of c/d to be pH neutral.

The biggest help, actually, in preventing crystals is keeping urine dilute - so the more water the better. (That's why some people and vets maintain that the worst wet food is better than the best dry food for the overall health of a cat... different forum for that discussion LOL). We continued to free feed our cats dry food, but added one wet meal a day. Then we went to two wet meals a day. We have a fat kitty, so we've stopped free feeding altogether, and we're feeding 2-3 meals of wet a day (amount for 24 hours divided into however many portions we're going to feed that day), and a little bit of pre-measured dry (individual for each cat). The amount of pee I'm scooping has gone up dramatically, so clearly we're keeping their pee a lot more dilute!
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