Help kitty just got a feeding tube

mrsgreenjeens

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How are things going?  Just doing a check-in, hoping things are really smoothing out with Squeak
 
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squeakyflorida

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Well it's day 10 of feeding tube feeds, day 5 of taking a full can of food for the day approx 106mls. She's still peeing/pooping. No strength in her legs to jump up onto ottoman. Her legs have atrophied ALOT. She does walk out to screened in porch to watch the birds, to her litter. Her ears /skin still yellow. Anyone have any idea how long it takes to reverse HL with proper nutrition? Will the yellow go away? We take her in on Tuesday for bloodwork.
 

denice

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It is a long recovery which differs from kitty to kitty.  It took Patches a month before he was eating normally and longer for his liver numbers to come back now.  The yellow will go away.  I can't remember if you are giving any supplements like Denamarin or milk thistle.  If not I would ask about those when you go back.  The denamarin does have a safety coating on it so it has to be swallowed whole and then it breaks down in the intestines rather than the stomach.
 

mrsgreenjeens

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And remember what Denice said before...some of the liver values might still go UP before coming back down to normal.  Maybe you could massage her back legs and work them back and forth to try to help her regain strength.  Kind of like with human physical therapy?  Definitely discuss with the Vet on Tuesday.

But GREAT that you are getting a full can of in her daily
.   Nutrition is obviously critical at this juncture.   AND that she is pooping and peeing on schedule.  Also vital


Her coloring will get back to normal in time.
 
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squeakyflorida

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Day12 of feeding tube feeding
Day 6 of a whole can 5.5 ounces, 1 tsp pumpkin, 18mls water. Today we added 1/4 of a can. So total 1 1/4 can.
Squeak sees vet tomorrow. Her respiration is up. About 42 breaths per minute. She's not mouth breathing, but I am concerned something is going on. She sniffed a piece of dry food and licked it, didn't eat it. I really worried bout her breathing. She seemed to calm down a bit with
Zofran. She doesn't appear to be in any stress. So hope the vet can tell us good news.

Prayers please.
 

katkin9

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Day12 of feeding tube feeding
Day 6 of a whole can 5.5 ounces, 1 tsp pumpkin, 18mls water. Today we added 1/4 of a can. So total 1 1/4 can.
Squeak sees vet tomorrow. Her respiration is up. About 42 breaths per minute. She's not mouth breathing, but I am concerned something is going on. She sniffed a piece of dry food and licked it, didn't eat it. I really worried bout her breathing. She seemed to calm down a bit with
Zofran. She doesn't appear to be in any stress. So hope the vet can tell us good news.

Prayers please.
I noticed Bucket breathes a little faster after feedings (maybe just a full stomach pushing on her lungs?) it was on my list of things to ask her doctor.

I am so happy to hear your kitty got a whole can down!!! Yay!!! That's big progress. We've also both made it past the one week point, which I've heard is the toughest (I hope they are right). Bucket and I will keep squeak in our thoughts and prayers.
 

mrsgreenjeens

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Good news on the amount of food she is getting


That breathing is a little worrisome to me too, only because of her medical history
.  But if she doesn't appear in distress, then I take that as a good sign.  Hopefully her Vet appointment will go well tomorrow and all our minds will be set at ease
 
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squeakyflorida

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mrsgreenjeens mrsgreenjeens
Today's appointment didn't go so well. She had fluid in her chest requiring a chest tap and drainage of 250 ml of fluid. Echo, abdominal ultrasound completed. Heart looks ok. Liver looks abnormal.
Vet decided to do liver needle aspirate. He believes because Squeaks liver values are still bad/worsening (particularly ALT which is nearly back to 3800 where it was at beginning of all this) the increased Prednisone dose may not have the effect of masking any findings. Believes this because in spite of the meds she is still clinical, even more so re several values. ultrasound reflects Inflammation in abdomen, mild and abnormal appearance of one kidney. Undetermined cause.

We won't know complete blood results and liver aspirate results till tomorrow. She went all day without water 10:00 - 7:30. Refused litter while at vet. Wet herself while in carrier. She's exhausted & stinky. I tried to wipe her down with warm wet towels. But I think she's had it for today. Gonna let her rest for about an hour then try to feed her. She drank water like crazy when she first got home. She's wet, abdomen shaved, feeding tube and smells like pee. My poor baby. Hubby has been with her all day and he's wiped out too. Any tips how to "bathe" her without sticking her in sink? I don't want to stress her out anymore.
 

crimmie

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Poor Squeaks :(

Crimmie and I send all our love and strength


I guess I would just get some nice warm water and a washcloth or three...Put a dry towel under her, and wipe her fur as best you can without making her soaking wet.  Have another dry towel on hand to pat her dry...maybe even a heating pad on low to help keep her warm. 
 

mrsgreenjeens

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I'm guessing by now you've got her cleaned up by just wiping her up with some damp clothes.  I usually just use warm damp paper towels whenever the need arises (usually from cling-ons), but there are actually things called kitty wipes, similar to baby wipes, just for cats, in case they lick afterwards. 

I was afraid she might has some fluid in her chest because of her breathing, but didn't see where you were giving sub-q fluids, so hoped I was wrong on that
.  But knew she was on Lasix, so knew there was an issue with fluid build-up.  At least know it's been drained, so she can breath easier.  As to the raised ALT, remember what Denice said, that her cat's ALT actually got higher as he got better, so I wouldn't panic about that just yet.  The abnormal kidney is disheartening, because if she's getting kidney disease on top of things, with the issue of needing Lasix, that's going to be tricky
.  But, then again,  it's possible she's had an abnormal kidney her entire life. But this isn't her first ultra sound, is it?  Well, I guess we'll just have to wait for the blood results to see.  And the ultra sound showed imflammation in her abdomen, NOT a mass.  So that sounds good.  (Lymphoma would show up as a mass, I believe, so that's one thing that can be checked off I would think)

So what is the Vet speculating...anything?  Any change in meds?  Or is he just waiting to see the blood test and biopsy results right now? 

Now that she's been back home for at least 16 hours, how's she doing?  Is she settled back into her routine?  Have you heard back on the results?  I'm very anxious to hear more, but will not be available most of the day today.  You and she will be in my thoughts though
(and hubby too, as I suspect she is hubby's dear heart, is she not?  I know our little girl cat is truly "daddy's little princess
)(and the boys are all mine!)

 
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squeakyflorida

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mrsgreenjeens mrsgreenjeens . Thank you and everyone for thought and prayers! Yes Squeak is daddy's dear heart! He calls her that all the time. How did you know?

Pathology results of liver aspirate not back yet. T4 up to 15, vet said ok to resume Tapazole low dose 0.05 ml 2x day transdermal. Also they want to add Tumil-K (potassium gluconate) 1 pill (big) 2x day (ok to be crushed and mixed with food)

I bought the wipes and going to clean her up a little more tonight. She was so exhausted last night she went to her kitty litter and just sat in it. (That's shortly after coming home and me trying to clean her up. Hubby says she slept a lot today. He got I about 79 Ml's of food in her so far.had to back down to about 26mls per feed today. As her tummy was shrunk from all day no food yesterday since 6 am. We have one more feed tonight.

We will hear from vet once pathology of liver aspirate results are back. Prayers it's not lymphoma of liver. It's all in Gods hands (that's what I'm trying to express to hubby) he wants to "fix" her now. So now another night and day of waiting. I work half day tomorrow then off 4 days so I will be loving on her a lot. Have to share: Squeak is missing her mom a lot! We are still keeping them separated. Mom will attack her as she smells different from all vet visits. When we switched rooms and mom just sat where Squeaky was she started to growl and hiss. So we don't want any fights with the feeding tube involved. Last couple of nights I lay on floor on my side near Squeak and she will eventually moved closer and closer to then almost nuzzle into right into my chest or arm. soo sad and loving at same time.



Yesterday's note:

Thoracic free fluid evaluation: significant amount of pleural effusion
- Chemistry panel: elevated ALT (3336 U/L); hyperphosphatasemia (798 U/L); hyperbilirubinemia (10.4 mg/dL); hypoalbuminemia (2.0 mg/dL); hypercholesterolemia (387 mg/dL); hypokalemia (3.0);

Diagnosis/Assessment:
- Pleural Effusion (250 Ml's removed from chest wall)
- Hyperbilirubinemia (improved)
- Anorexia, weight loss ( not that much vet said could be b/c weighed in different office different scale? I'm going to start weighing her on my scale at home)
6/16/15 11 lbs vs 7/7/15 10.12 lbs
- Liver enzymes elevated (progressive) - Hypoalbuminemia
- Hypokalemia

Med list
1. Metronidazole(antibiotic) 50 mg/mL suspension: Give 0.9 mL through the esophageal tube twice daily for fourteen days.
2. Cerenia 10 mg/mL injectable: Give 0.45 mL (contents of one syringe) subcutaneously once daily, up to five consecutive days.
3. Ondansetron (zofran): Give 1 mg through the esophageal feeding tube twice daily. Anti-nausea.
4. Prednisolone 5 mg/mL: Give 1 mL by mouth twice daily
5. Lasix

Added
5. Denamarin: ok to resume 1 hr before food or 2 hrs after food
6. Ursodiol ok to resume
7. B12 injection once a week got injectable from vet
8. Tapazole low dose 0.05 ml 2x day transdermal
9. Timing l-K (potassium gluconate) 1 pill (big) 2x day (ok to be crushed and mixed with food)

Ok to start the Denamarin & Ursodiol again. But we are going to resume tomorrow. Want to see how she reacts to Potassium.

Which brings me to next question. Anyone have any issues with giving cats potassium? I crushed it, mixed with 2 Ml's of warm water and then mixed with 4mls blended food. Vet says to give with food. The side effects for kitties online kinda scary.
 
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denice

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Don't be surprised if the liver aspirate comes back inconclusive.   The vet did one and the results came back as too few cells to be conclusive but looked suspicious.  The vet did a second one with a larger needle, she debated on that because larger needle means more bleeding in the liver.  That one came back with the same results as the first.  Patches is still here 4 1/2 years later.
 

mrsgreenjeens

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I see she is hypokalemia, which is low potassium, and giving potassium pills can make an absolute world of difference, in a good way.

Try to brushing both cats on shoulders and sides I think I mentioned once before to transfer scents.  Works wonders. 

Dear Heart
.  I don't know how I knew.  I just did.  Funny, huh? 

That weight loss is to be expected, considering.

I didn't realize you had stopped the Denamarin and Ursodial.  Good you are starting it up again. 

Continued vibes
 
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squeakyflorida

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Only gave her half dose of potassium pill. I'm worried she'll vomit. We'lol give her rest in the morning.
denice denice I think u might be right. She's been on prednisone for some time.that can change cell structure too.

We stopped the Demarin & urisidiol when she vomited after first 3 days of successful feedings. As we weren't sure what triggered that bout. She wasn't on the Cerinia/zofran combo the. The compounded Demarin is really thick.. hubby gonna try them tomorrow.

Do I have to worry about any side effects from potassium ?

11pm update!
Setback or no? Worry or no? This kitty is gonna kill me. We fed her 945ish 28.5mls food then 2.5 ml of 6mls (1 crushed potassium oil, 2 Ml's water, 4mls food slurry) then water flush. She stayed on bed calm resting, moved around twice but stayed on bed with head down . I fell asleep into exhausted "cat nap" then hubby came into bedroom. About 45 min later? She lifted up head JUMPED OFF bed. No face plant, but not the agile landings of out little athlete. Then she runs onto her bed that's on floor near bathroom, jumps off that and dashes into bathroom jumps in litter box and vomits in litter box. Not a lot about 6mls. Not like the last time where it was the whole feeding. And this time some time had passed versus last time where she vomited immediately. Hubby thinks she puked up the potassium, I think the force of landing caused reflux causing her to hurl. She's wiped out now. She calmed down, was meowing alot after she vomited, I gave her a small syringe of warm water. She seemed to want it, didn't turn her head away or move away. I put her back in her bed. She rested for a minute then moved back onto floor. We did not give her Cerinia. We will tomorrow
 
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squeakyflorida

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mrsgreenjeens mrsgreenjeens denice denice
From the hubby:
Pathology update:
Cytology results: no obvious CA cells
Inflammatory cells present, hence a little inflammation
Some atypical cells present. Could be hyperplasia
A lot of fat, hence Hepatic Lipidosis

Stay with current treatment plan
Key is getting calories in her
Upping the Pred to 1.5 ml twice a day

So, she still has a chance at recovery.
 

mrsgreenjeens

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@mrsgreenjeens @Denice
From the hubby:
Pathology update:
Cytology results: no obvious CA cells
Inflammatory cells present, hence a little inflammation
Some atypical cells present. Could be hyperplasia
A lot of fat, hence Hepatic Lipidosis

Stay with current treatment plan
Key is getting calories in her
Upping the Pred to 1.5 ml twice a day

So, she still has a chance at recovery.
NO cancer sounds good!  We already knew she has H/L, so no surprise there    And the "could be hyperplasia"  I guess "could be" just about anything, although I can't find much of anything on other than very in depth medical jargon on hepatic hyperplasia, so I really have no idea what it means.

On the Tumil K, I read that it's ok to crush the pill and actually spread it out across ALL the meals through the day, to try to alleviate vomiting.  So since you are tube feeding, I would think this would be very easy to do. 

Did hubby tell the Vet that she vomited after starting up her meds again?  I definitely think it's worth mentioning.  You really need to try to figure out if its the meds, or what, and if it is, WHICH med.  Then maybe your Vet can figure out something else to give her.

Yay that she still has a chance for recovery. 
Keep hanging in there
 

crimmie

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Crimmie sends all her love, and a little bit of strength (she doesn't have much, either
) to Squeaky...keep fighting!!
 
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squeakyflorida

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Thanks crimmie crimmie she seems weaker today. But I think the 12 hour vet trip on Tuesday wiped her out. (Chest tap & liver aspirate) The vet said we can crush the potassium pills and mix with her syringes of food. Tried that today no vomiting. Really I think she vomited last night due to force of the jump off the bed.

Today we added the Urisidole & full crushed potassium pill (dispersed into food slurry). We hope to add the Demerin tomorrow.

Anyone ever send their cat for physical therapy? Any tips? I need to start strengthening her hind quarters. She walks short distances, and can jump over litter box sides. But she's done more laying than walking. I found interesting assisted weight bearing PT video

http://youtu.be/sceIXo8lNjo

She lays on her side and kneads me with front paws, when she tries with hind paws they just tremble with weakness :(
 
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katkin9

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Thanks crimmie crimmie she seems weaker today. But I think the 12 hour vet trip on Tuesday wiped her out. (Chest tap & liver aspirate) The vet said we can crush the potassium pills and mix with her syringes of food. Tried that today no vomiting. Really I think she vomited last night due to force of the jump off the bed.

Today we added the Urisidole & full crushed potassium pill (dispersed into food slurry). We hope to add the Demerin tomorrow.

Anyone ever send their cat for physical therapy? Any tips? I need to start strengthening her hind quarters. She walks short distances, and can jump over litter box sides. But she's done more laying than walking. I found interesting assisted weight bearing PT video

http://youtu.be/sceIXo8lNjo

She lays on her side and kneads me with front paws, when she tries with hind paws they just tremble with weakness :(
I'm glad she's getting the full potassium now. I don't know if humans and cats are the same, but I have to take Lasix for a brain disorder and it depletes your potassium... I felt so weak before they got my potassium levels up, my legs were jelly. I bet the potassium will help her with her leg strength.
 

mrsgreenjeens

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Thanks @crimmie she seems weaker today. But I think the 12 hour vet trip on Tuesday wiped her out. (Chest tap & liver aspirate) The vet said we can crush the potassium pills and mix with her syringes of food. Tried that today no vomiting. Really I think she vomited last night due to force of the jump off the bed.

Today we added the Urisidole & full crushed potassium pill (dispersed into food slurry). We hope to add the Demerin tomorrow.

Anyone ever send their cat for physical therapy? Any tips? I need to start strengthening her hind quarters. She walks short distances, and can jump over litter box sides. But she's done more laying than walking. I found interesting assisted weight bearing PT video



She lays on her side and kneads me with front paws, when she tries with hind paws they just tremble with weakness
I'm glad she's getting the full potassium now. I don't know if humans and cats are the same, but I have to take Lasix for a brain disorder and it depletes your potassium... I felt so weak before they got my potassium levels up, my legs were jelly. I bet the potassium will help her with her leg strength.
Yes!  Low potassium definitely causes weakness in the hind legs, so hopefully this added to her food will help immensely. 

Hooray for no vomiting today
 
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