Artie and his Issues

artiemom · Dec 27, 2016

Margret said:
Well, you're probably already asleep by now so this is gratuitous, but two cans of food sounds huge to me. I doubt that Artie can handle any more than that! Jasmine gets 1/2 can, twice a day, and almost always doesn't finish it. In all fairness she also gets all the grain-free dry food she wants, but even without that I can't imagine her eating two whole cans in a single day.

Just to make sure I understand correctly, the calcifications are inside his bowels? Not, for instance, embedded in the intestinal wall?

The reason I ask is that when they found calcifications in a routine breast X-ray, they wanted to do a biopsy, because in the breast calcifications can be caused by a tumor. If they're basically something loose in his bowel, my only concern, off the top of my head, would be whether they're rough and might be painful for him to pass. At least they're not kidney stones. But I really can't figure out where they would have come from. This is the disadvantage of basically knowing nothing about it. The areas of medicine that I know anything about are rather limited. The proper way to use a cane or crutches, how to climb stairs with a bad knee, the correct way to treat a sprain, managing diabetes, basically all inapplicable. (But if they ever prescribe a cane for Artie, let me know. After I get done swearing at the idiot who wrote the prescription I'll be happy to tell you the proper way to use a cane. For a human.)

Good night, all. Margret

The calcifications are inside the bowel.. looks like something embedded inside the retained poop.. at least that is what the R Vet and I thought.. was not able to talk to the S Vet or Radiologist about it..

I was wondering if it was from the food I am feeding him.. I am giving him Natures Variety. That food has some of the monomite clay in it as a thickening agent. It is a health food thing.. I am wondering if that is clumping inside of Artie causing the constipation? but I cannot find any evidence of issues like that, on the web.. and he refuses to eat any other food. Lord know that I have tried.... sigh.. I am thinking too much.. it is getting too much for me..

I need to just give it up and go with the flow.. I cannot, in my limited experience, handle all of this.. it is really doing a number on me.. Artie is just lying there.. His life exists of: medications, litter box, medications, Vet Visits, medications, sleeping, eating a bit of food, ..

sorry, just feeling sorry for myself and him...

kind of at a low point, again.. and it is first thing in the morning..

I guess if he ate more and had formed poops I would feel better.. and he would too. that is what we are trying for..

I am almost ready to throw out a lot of this medicine.. but I do not know what to do......

thanks for listening to me..

What kind of a life is that for a cat.. He is alert, he purrs occasionally, he is so skinny...

verna davies · Dec 27, 2016

Don't know if this is of any help but when my old cat wouldn't eat I tried Sheba Soup Pouches and Gourmet Classic Soup. She loved them both and it got some food and a lot of liquid into her. I live on UK so don't know if you can them in US.

stephenq · Dec 27, 2016

Artiemom said:

@Artiemom

Sorry for the delay. I have 2 thoughts, one more optimistic and the other a bit less so. Also has he been tested for pancreatitis (fPLI test)?

Reading everything, the cycling of constipation, gas, enemas, soft stool, loss of appetite, and recent finds that he is not constipated. What if we blame the lack of appetite on simple nausea? Chronic nausea not unlike my simon with his advanced IBD and flare ups of pancreatitis. If this were the case he could potentially obtain great relief from Cerenia in a bolus of sub q fluid to prevent the sting, and a sub q injection of zofran (need not be with fluids, but can be). And pepcid AC. Cerenia and zofran are 2 very effective and differently acting neural blocks for nausea. If this worked, he'd be eating well very quickly, and it would be diagnostic for the problem.

The zofran has to be given every 6 hours like clockwork. The cerenia once a day. If he's eating he could take the cerenia by pill. I agree that your vet could teach you how to give fluids. If artie is calm and not prone to jumping around, its quite easy once you learn the tricks of getting the needle in (not hard, just don't be squeemish about it, he won't feel it), and then adjusting the drip, keeping everything sterile, and pinching off and holding the injection site so he doesn't leak. If he he doesn't mind a carrier (top opening) this can help confine him and i found makes it easier for one person to do.

If this worked, then oral cerenia and possibly pepcid ac could be a daily part of his life, and sub q cerenia, fluids and Zofran for flare ups.

---

Here's part 2: He's tired, your tired, and you are fighting for him because not only do you love him, but he loves you and loves life. Artie only knows today, never thinks about tomorrow, and so if the bad days start to outweigh the good ones, with no improvement or new options in sight, it may be helpful for him to contemplate the idea that sometimes rather than reach for one more treatment, that it can become time to recognize the hard to accept concept that eventually all treatments fail us all. I'm not saying he's there yet, and none u]of us here can, but it is important that with all the treatments he is going through, that he maintains his loving relationship with you, and that if that were threatened without reasonable hope of improvement, I might elect to pull back on treatments, and if possible give him some happy remaining time with him and with me.

I would still want to talk to my vets about 1) cerenia daily, 2) fluids, 3) pepcid ac, 4) Zofran for a couple of days and see if that jump starts his appetite. And i just want to repeat my question about pancreatitis testing, using the fPLI test. "The most common clinical signs of feline pancreatitis include lethargy, anorexia, dehydration, and low body temperature. “Cats with this disease typically don’t vomit,” says Dr. Goldstein, “and they typically do not have obvious abdominal pain. They just lie there like any other sick animal—they’re lethargic and they don’t want to eat....“So pancreatitis is very hard to pick up in the examination room,” he says. “But you always have to have a suspicion of it. If you don’t, you’ll never be able to diagnose it and move forward with treatment.” from http://www.vet.cornell.edu/fhc/Health_Information/pancreatitis_serious.cfm and also http://www.2ndchance.info/pancreatitiscat.htm

If you do a round of anti nausea meds with fluids and they work and even if they don't, its diagnostic as it will tell you if nausea is at work. He has very complicated bowel issues which appear to be in opposition to each other, megacolon on the horizon which is constipating, IBD while not causing diarrhea in his case is complex in itself, eating issues, food intolerances.....

That's all I have for now.

Big hug.

stephen

Alicia88 · Dec 27, 2016

Artiemom said:
The calcifications are inside the bowel.. looks like something embedded inside the retained poop.. at least that is what the R Vet and I thought.. was not able to talk to the S Vet or Radiologist about it..

I was wondering if it was from the food I am feeding him.. I am giving him Natures Variety. That food has some of the monomite clay in it as a thickening agent. It is a health food thing.. I am wondering if that is clumping inside of Artie causing the constipation? but I cannot find any evidence of issues like that, on the web.. and he refuses to eat any other food. Lord know that I have tried.... sigh.. I am thinking too much.. it is getting too much for me..

I need to just give it up and go with the flow.. I cannot, in my limited experience, handle all of this.. it is really doing a number on me.. Artie is just lying there.. His life exists of: medications, litter box, medications, Vet Visits, medications, sleeping, eating a bit of food, ..

sorry, just feeling sorry for myself and him...

kind of at a low point, again.. and it is first thing in the morning..

I guess if he ate more and had formed poops I would feel better.. and he would too. that is what we are trying for..

I am almost ready to throw out a lot of this medicine.. but I do not know what to do......

thanks for listening to me..

What kind of a life is that for a cat.. He is alert, he purrs occasionally, he is so skinny...

You asked what kind of life that is for a cat.

My mom used to work at a care center for severely disable and medically fragile children - I'm talking wheelchair bound, feeding tube, unable to speak, etc. Many would think these kids have absolutely no quality of life. While I agree that life was difficult for them, when they smiled or giggled, it lit up the room like you wouldn't believe. Regardless of their issues, they could still find joy and that is a beautiful thing. My sister and I used to talk to them and play with them when mom took us with her to pick up her check or during the Christmas party or when we were helping out with their special olympics. Making them happy was one of the greatest feelings ever. My mom worked there for 10 years. In all that time, they only lost 2 kids - every one of them had outlived their life expectancy by years. I have a feeling that you feel just as much joy when Artie is happy and purring. Am I right?

artiemom · Dec 27, 2016

@StephenQ Artie is taking daily pepcid AC and Cerenia.. he has had sub-q's several times lately.. that does pick him up a bit.. I do have some zofran in the house... wondering if I should try it...but he has so much medicine..

I will ask about the pancreatitis test, next time he goes in.. perhaps tomorrow.. until then, I am on my own.. I cannot keep bothering everyone with all my anxieties, questions...

I just gave him some tuna water with some tuna.. he gobbled it down and then regurgitated it.. It was Star Kist Tuna..people food..

I spoke with the Vet Tech thru to the S Vet..He is not going in today. I did take the last available appointment for tomorrow.. I have to update them tomorrow morning. He is to cut back on the amount of lactulose, continue with the cerenia and the cisapride..

I also specified that I am concerned about his quality of life--revolving around medicine, and vet visits.. his feeling horrible and lethargic.. I told her that I am concerned that this may be his time.. She assured me that the S Vet would definitely not delay in advising me about that.. I am very anxious.. I do have an anxiety complex so this is really hard for me..The Tech also told me that it is up to him if he improves.. some cats do not.. so we are all getting on the same page.. I think it may be soon...

Artie is going to hide in his tent now.. I still have more meds to give him.. oh how I hate to torture him with them.. I guess I should just start writing a journal about my feelings instead of letting it all out to you.. it is not fair to any of you...

It seems that everything I try to do for him is backfiring.. I can not do anything to make him better..

He loved the tuna water and some of the tuna I gave him, yet he regurgitated it.. I may try to syringe feed him later today.. but I am wondering if that is really going to help in the long run..if the eventuality of life will just win out...

He did want to be brushed this morning. He slowly came over for it. He did follow me around as I was putting the clothes away. He is peeing a lot.. oh ph--digging again in the box--nothing....

Oh, how I love this little boy.. it really pains me to see him so sick.. I sound so selfish because all of you have gone through this, and I am focusing on me...

I feel, in my heart, to decrease the dose of cisapride to what it was before.. wondering if I should do that.. I do not want him to shut down completely but at this point. I am just wondering..and questioning..

Wondering if he is reacting to side effects of the cisapride also...

I am crying now.. I do not want to cry in front of Artie or for him to see me upset.. but I cannot help it.. he is everywhere with me..

such a little creature who can give us so much love.. and so much hurt when they are sick..

I am trying to keep busy, but it is not easy..

thank you...

Margret · Dec 27, 2016

Verna davies said:
Don't know if this is of any help but when my old cat wouldn't eat I tried Sheba Soup Pouches and Gourmet Classic Soup. She loved them both and it got some food and a lot of liquid into her. I live on UK so don't know if you can them in US.

We have Sheba in the U.S.. The problem is that Artie needs novel sources of protein -- things like lamb, rabbit, etc..

StephenQ said:
Artiemom said:

Click to expand...

@Artiemom

Sorry for the delay. I have 2 thoughts, one more optimistic and the other a bit less so. Also has he been tested for pancreatitis (fPLI test)?

Reading everything, the cycling of constipation, gas, enemas, soft stool, loss of appetite, and recent finds that he is not constipated. What if we blame the lack of appetite on simple nausea? Chronic nausea not unlike my simon with his advanced IBD and flare ups of pancreatitis. If this were the case he could potentially obtain great relief from Cerenia in a bolus of sub q fluid to prevent the sting, and a sub q injection of zofran (need not be with fluids, but can be). And pepcid AC. Cerenia and zofran are 2 very effective and differently acting neural blocks for nausea. If this worked, he'd be eating well very quickly, and it would be diagnostic for the problem.

The zofran has to be given every 6 hours like clockwork. The cerenia once a day. If he's eating he could take the cerenia by pill. I agree that your vet could teach you how to give fluids. If artie is calm and not prone to jumping around, its quite easy once you learn the tricks of getting the needle in (not hard, just don't be squeemish about it, he won't feel it), and then adjusting the drip, keeping everything sterile, and pinching off and holding the injection site so he doesn't leak. If he he doesn't mind a carrier (top opening) this can help confine him and i found makes it easier for one person to do.

If this worked, then oral cerenia and possibly pepcid ac could be a daily part of his life, and sub q cerenia, fluids and Zofran for flare ups.

---

Here's part 2: He's tired, your tired, and you are fighting for him because not only do you love him, but he loves you and loves life. Artie only knows today, never thinks about tomorrow, and so if the bad days start to outweigh the good ones, with no improvement or new options in sight, it may be helpful for him to contemplate the idea that sometimes rather than reach for one more treatment, that it can become time to recognize the hard to accept concept that eventually all treatments fail us all. I'm not saying he's there yet, and none u]of us here can, but it is important that with all the treatments he is going through, that he maintains his loving relationship with you, and that if that were threatened without reasonable hope of improvement, I might elect to pull back on treatments, and if possible give him some happy remaining time with him and with me.

I would still want to talk to my vets about 1) cerenia daily, 2) fluids, 3) pepcid ac, 4) Zofran for a couple of days and see if that jump starts his appetite. And i just want to repeat my question about pancreatitis testing, using the fPLI test. "The most common clinical signs of feline pancreatitis include lethargy, anorexia, dehydration, and low body temperature. “Cats with this disease typically don’t vomit,” says Dr. Goldstein, “and they typically do not have obvious abdominal pain. They just lie there like any other sick animal—they’re lethargic and they don’t want to eat....“So pancreatitis is very hard to pick up in the examination room,” he says. “But you always have to have a suspicion of it. If you don’t, you’ll never be able to diagnose it and move forward with treatment.” from http://www.vet.cornell.edu/fhc/Health_Information/pancreatitis_serious.cfm and also http://www.2ndchance.info/pancreatitiscat.htm

If you do a round of anti nausea meds with fluids and they work and even if they don't, its diagnostic as it will tell you if nausea is at work. He has very complicated bowel issues which appear to be in opposition to each other, megacolon on the horizon which is constipating, IBD while not causing diarrhea in his case is complex in itself, eating issues, food intolerances.....

That's all I have for now.

Big hug.

stephen

Artiemom said:
Margret said:

Well, you're probably already asleep by now so this is gratuitous, but two cans of food sounds huge to me. I doubt that Artie can handle any more than that! Jasmine gets 1/2 can, twice a day, and almost always doesn't finish it. In all fairness she also gets all the grain-free dry food she wants, but even without that I can't imagine her eating two whole cans in a single day.

Just to make sure I understand correctly, the calcifications are inside his bowels? Not, for instance, embedded in the intestinal wall?

The reason I ask is that when they found calcifications in a routine breast X-ray, they wanted to do a biopsy, because in the breast calcifications can be caused by a tumor. If they're basically something loose in his bowel, my only concern, off the top of my head, would be whether they're rough and might be painful for him to pass. At least they're not kidney stones. But I really can't figure out where they would have come from. This is the disadvantage of basically knowing nothing about it. The areas of medicine that I know anything about are rather limited. The proper way to use a cane or crutches, how to climb stairs with a bad knee, the correct way to treat a sprain, managing diabetes, basically all inapplicable. (But if they ever prescribe a cane for Artie, let me know. After I get done swearing at the idiot who wrote the prescription I'll be happy to tell you the proper way to use a cane. For a human.)

Good night, all. Margret

Click to expand...

The calcifications are inside the bowel.. looks like something embedded inside the retained poop.. at least that is what the R Vet and I thought.. was not able to talk to the S Vet or Radiologist about it..

I was wondering if it was from the food I am feeding him.. I am giving him Natures Variety. That food has some of the monomite clay in it as a thickening agent. It is a health food thing.. I am wondering if that is clumping inside of Artie causing the constipation? but I cannot find any evidence of issues like that, on the web.. and he refuses to eat any other food. Lord know that I have tried.... sigh.. I am thinking too much.. it is getting too much for me..

I need to just give it up and go with the flow.. I cannot, in my limited experience, handle all of this.. it is really doing a number on me.. Artie is just lying there.. His life exists of: medications, litter box, medications, Vet Visits, medications, sleeping, eating a bit of food, ..

sorry, just feeling sorry for myself and him...

kind of at a low point, again.. and it is first thing in the morning..

I guess if he ate more and had formed poops I would feel better.. and he would too. that is what we are trying for..

I am almost ready to throw out a lot of this medicine.. but I do not know what to do......

thanks for listening to me..

What kind of a life is that for a cat.. He is alert, he purrs occasionally, he is so skinny...

Take a deep breath. Take another. When you're calm again, keep reading.
Artie purrs. As of yesterday, he was eating enthusiastically. He's playful. He sleeps a lot. Right? So, what kind of life is that for a cat? Answer: That's a cat's life. Perfectly normal.
It sounds to me as if there are two things worrying you right now. Artie has lost so very much weight, and he hates his medications. So let's take those in order.
Yes, Artie has lost a dangerous amount of weight. Yes, that's very frightening. And Artie ate two whole cans of food yesterday, enthusiastically. 'Nuff said about that (she says, dusting her hands off).
I know that the Cerenia is for vomiting. I also know that it's available in injectable form. If Artie doesn't like taking it by mouth (and I've never met a cat who likes oral medications), please ask about injections instead.
Cyproheptadine is an antihistamine and an appetite stimulant. This is the appetite stimulant that got him eating yesterday; therefore it's necessary. And if that means he has to take a pill a few times a day, he'll get used to it. I have diabetes. Do I like sticking my fingers every day to check my blood sugar? No, of course not. Do I do it? Yes. Am I suicidal over it? Heck no!
Mirtazapine is another appetite stimulant, apparently one that doesn't work for Artie. Check with your regular vet first, in case it's needed to make the Cyproheptadine effective, but if not, dump it! (i.e., ask your vet to dispose of the remainder in a safe manner so it doesn't enter the water supply for all of us.)
Prednisolone is a steroid, and I'm not at all sure why Artie is on it. I believe it's sometimes used for diarrhea in cats, but Artie's IBD manifests as constipation, so that doesn't seem to make sense. And steroids are very scary drugs. They can play all kinds of havoc with the body. However, prednisolone should never be withdrawn cold turkey. http://pets.thenest.com/can-just-stop-using-prednisone-cats-6535.html Ask your regular vet whether there's any good reason for Artie to be on this, and then ask her how to get him off of it safely.
Lactulose is a laxative. Artie obviously needs a laxative, but there's a chance that there's a different one that's more palatable. Ask.
Reglan is for Artie's upset tummy, and is also available in injectable form: https://www.vetinfo.com/treating-gastritis-cats-metoclopramide-reglan.html I think you should ask your vet about this.
It should be possible to get a probiotic that gets sprinkled over Artie's food or mixed in with it. There's no reason in the world (that I know of) why it needs to be a pill.
And that leaves the various antacids. I think the Reglan should be doing the job and am not certain why Artie is on so very many things for upset stomach. I think you need to ask about that.
Tell me if I've missed any of the drugs.

I'm disturbed by the sheer number of things that have been prescribed for Artie. Drugs frequently have interactions, and I think these need to be looked at. I also think that part of the problem is the number of vets Artie has. I understand the need for a specialist, but primary care falls to his regular vet, and she's the one who needs to be aware of all of Artie's meds and deciding how to manage them.

Regarding the calcifications, if they aren't inside of hard poop then I really wonder what it is that they are inside of, and I suspect your vet does as well. As for being caused by the one brand of food, I think you need to ask her that question as well.

There is something I discovered the hard way with Sweet Thing that all pet parents need to be aware of: Vets will not tell you that it's time to consider euthanasia unless you specifically ask them! Before you make the drastic decision that you've been considering, you need to ask your regular vet, the one you really trust, "If Artie were your cat, would you decide that it's time to put him to sleep?"

Margret

margd · Dec 27, 2016

Artiemom said:
@StephenQ Artie is taking daily pepcid AC and Cerenia.. he has had sub-q's several times lately.. that does pick him up a bit.. I do have some zofran in the house... wondering if I should try it...but he has so much medicine..

I will ask about the pancreatitis test, next time he goes in.. perhaps tomorrow.. until then, I am on my own.. I cannot keep bothering everyone with all my anxieties, questions...

I just gave him some tuna water with some tuna.. he gobbled it down and then regurgitated it.. It was Star Kist Tuna..people food..

I spoke with the Vet Tech thru to the S Vet..He is not going in today. I did take the last available appointment for tomorrow.. I have to update them tomorrow morning. He is to cut back on the amount of lactulose, continue with the cerenia and the cisapride..

I also specified that I am concerned about his quality of life--revolving around medicine, and vet visits.. his feeling horrible and lethargic.. I told her that I am concerned that this may be his time.. She assured me that the S Vet would definitely not delay in advising me about that.. I am very anxious.. I do have an anxiety complex so this is really hard for me..The Tech also told me that it is up to him if he improves.. some cats do not.. so we are all getting on the same page.. I think it may be soon...

Artie is going to hide in his tent now.. I still have more meds to give him.. oh how I hate to torture him with them.. I guess I should just start writing a journal about my feelings instead of letting it all out to you.. it is not fair to any of you...

It seems that everything I try to do for him is backfiring.. I can not do anything to make him better..

He loved the tuna water and some of the tuna I gave him, yet he regurgitated it.. I may try to syringe feed him later today.. but I am wondering if that is really going to help in the long run..if the eventuality of life will just win out...

He did want to be brushed this morning. He slowly came over for it. He did follow me around as I was putting the clothes away. He is peeing a lot.. oh ph--digging again in the box--nothing....

Oh, how I love this little boy.. it really pains me to see him so sick.. I sound so selfish because all of you have gone through this, and I am focusing on me...

I feel, in my heart, to decrease the dose of cisapride to what it was before.. wondering if I should do that.. I do not want him to shut down completely but at this point. I am just wondering..and questioning..

Wondering if he is reacting to side effects of the cisapride also...

I am crying now.. I do not want to cry in front of Artie or for him to see me upset.. but I cannot help it.. he is everywhere with me..

such a little creature who can give us so much love.. and so much hurt when they are sick..

I am trying to keep busy, but it is not easy..

thank you...

If Artie gobbled down his tuna, the reason he threw it right back up might be because he ate it too fast, and not for any scary reason. Cats do this all the time. Try lifting his bowl up a couple of inches off the floor to slow him down.

About your posts not being fair to us - no one is complaining. Also, this is The Cat Site and the extraordinary stress of dealing with a sick cat is part of life with a cat, so posting about your feelings is completely appropriate. I think it is probably very helpful for people dealing with these issues for the first time to read your posts and recognize that their own feelings are perfectly normal. The point is - don't worry about what you write. Not only is it useful information, it is a way for you to cope and everyone here is in favor of that. Seriously, if you ever started being inappropriate (which frankly I can't imagine), one of the Mods would PM you about it. So, please don't worry so much about the number or nature of your posts. They're absolutely fine!

I'm not sure I understood something you wrote. You said Artie is peeing a lot but it sounds like when you checked out his box, there was nothing there? Did I understand that right? Because if so, I'm sure you know the drill - time to check for an UTI. I'm hoping I misunderstood that because the absolute last thing poor Artie needs now is another medical issue.

Hugs to you and our boy and please keep your posts coming.

stephenq · Dec 27, 2016

Margret said:
Prednisolone is a steroid, and I'm not at all sure why Artie is on it. I believe it's sometimes used for diarrhea in cats, but Artie's IBD manifests as constipation, so that doesn't seem to make sense. And steroids are very scary drugs. They can play all kinds of havoc with the body. However, prednisolone should never be withdrawn cold turkey. http://pets.thenest.com/can-just-stop-using-prednisone-cats-6535.html Ask your regular vet whether there's any good reason for Artie to be on this, and then ask her how to get him off of it safely.

Excellent post. I do take issue though with the prednisolone/steroid part. Corticosteroids are generally very well tolerated in cats, the exception being a risk for diabetes, and long term decreased immune system, and its specific use in IBD cats is to reduce inflammation of the intestines and while the inflammation usually leads to diarrhea, the inflammation's biggest effect is to make it increasingly difficult for a cat to absorb nutrients which leads to wait loss. But i do agree that any drug should be evaluated for long term use, and yes Artie is on a lot of meds.....

Margret · Dec 27, 2016

StephenQ said:
Margret said:

Prednisolone is a steroid, and I'm not at all sure why Artie is on it. I believe it's sometimes used for diarrhea in cats, but Artie's IBD manifests as constipation, so that doesn't seem to make sense. And steroids are very scary drugs. They can play all kinds of havoc with the body. However, prednisolone should never be withdrawn cold turkey. http://pets.thenest.com/can-just-stop-using-prednisone-cats-6535.html Ask your regular vet whether there's any good reason for Artie to be on this, and then ask her how to get him off of it safely.

Click to expand...

Excellent post. I do take issue though with the prednisolone/steroid part. Corticosteroids are generally very well tolerated in cats, the exception being a risk for diabetes, and long term decreased immune system, and its specific use in IBD cats is to reduce inflammation of the intestines and while the inflammation usually leads to diarrhea, the inflammation's biggest effect is to make it increasingly difficult for a cat to absorb nutrients which leads to wait loss. But i do agree that any drug should be evaluated for long term use, and yes Artie is on a lot of meds.....

As I said, I'm not sure what the point of the prednisolone is. That's why I keep saying "Ask." There's a whole slew of questions that need to be answered, and this is one of them.

I was aware of the diabetes risk, and I'm hypersensitive on the issue of diabetes, for some odd reason.

If Artie needs prednisolone, then he needs it. I just want to be sure that he actually needs everything he's taking. My feeling is that the vets have been throwing every drug they can think of at him, looking for what works. Well, now that they have some data, it's time to start withdrawing a few things and then see what works.

Margret

artiemom · Dec 27, 2016

Artie is just curled up on his bed, next to me.. I saw that he had pooped all over his quilt tent last night, so he must have had bad diarrhea from the meds.. I cut back on the amount of miralax today.. perhaps I was giving him too much..

I completely agree that he is on too many meds.. but the S Vet is the one prescribing them.. I hate to do it, but I think I am going to keep that appointment for tomorrow..

Artie is now meat loafed on his pillow bed.. it is normally his nap time, but I am taking everything to heart.

I can understand giving the steroid for the inflammation.. the probiotic to help with his bowels, the cisapride was because he would not poop very often--perhaps a few times a week and it would be hard. But to double the dose seems a bit drastic in addition to all the other drugs he is taking..She is insisting that I take him off the cisapride because it of all the side effects..

Artie always had a hard time with poop...never diarrhea.. always on the verge of constipation, but I was always able to remedy that with miralax..When it got to be too bad, that is when they prescribed the cisapride..

I am so confused..

Artie is not purring today..

he did follow me for a bit, but then just curled up and hid.

He ate only 1/4 of a small can this morning. not much last night.

This is very different from yesterday.. the appetite stimulant caused him to constantly go over for food.. today, nothing.. and I know he took the pill..

If he does not perk up and eat something, I will syringe feed him again.. I hate to do so, but...

He is acting almost the same as he did on Christmas Eve.. His gums do not feel sticky, so I do not think he is dehydrated.. I am giving him water.. and will try the tuna water again, soon...

The lactulose was ordered by his Rvet because he was constipated. The Reglan was ordered by the SVet because he was still constipated and seemed to be on track for megacolon.. this was supposed to help with the peristalsis action (muscle action of the colon)... The Reglan really seemed to put him over the top.. he hates it, and I discovered perhaps it was just a coincidence with having the second enema, of really effecting him with lethargy.. I think he was exhausted and his belly was inflamed and hurting. I think it still is because of all the drugs to make him poop..

Now that he has diarrhea, it has to be time to stop some of them.. that is why I decreased the lactulose, on my own.. I do not want to stop anything cold turkey because dire results could happen..

The Cisapride is something I am concerned about.. My friend researched it for her cat and found tons of side effects to this drug. That is why it is banned from human use.. But it is supposed to be safe for cats.. It seems to be a 'go to' drug for megacolon and constipation.. I think I will cut back on it, a bit..

I started writing a journal..

I may call my friend and ask her stuff. I know the more people I ask, the more opinions I get, the more confused I get....

Columbine · Dec 27, 2016

I absolutely understand getting more and more confused as you ask more people's opinions. Ultimately, keep in mind that you and your vets are the ones who know Artie best. Trust yourself and the vet's guidance - and ask as many questions as you need to. It is never wrong to ask for information or explanations, especially where meds are concerned, so never feel bad for 'bothering' the vets - it's part of what you pay them for. You're the one who has to give all these meds, after all

With what your friend said about Cisapride - do remember that you can find horror stories about just about every medication on the internet. I've yet to find a drug that doesn't list a ton of side effects - keep in mind that this is because if even ONE person reports a side effect, it gets listed as a possibility on the information leaflet. That doesn't mean that all, or even most of the side effects are common...or even very likely - just that they CAN happen.

Now, I'm not saying that Cisapride is right or wrong for Artie, just that it's something to discuss with your vet. I do agree with the others that Artie is on a lot of medication, and it is well worth discussing all his meds with your vet and working out which to keep, and looking at devising a less stressful method of administration.

stephenq 's suggestion of giving meds with sub-q fluids or by injection is a good one, and is likely to be far less stressful for Artie than multiple oral meds throughout the day.

Lastly, NEVER feel bad for posting here. You are most certainly NOT being selfish. So many of us have cared for sick cats of our own, and we know just how hard and how draining it can be. You deserve the same support that any of us would find here in your position. Far better to vent here than sit driving yourself crazy with worry :alright:

Mamanyt1953 · Dec 27, 2016

And even when we dont have concrete information to add, know that a world of love and support are flowing from us to you and Artie EVERY MOMENT OF EVERY DAY!

DreamerRose · Dec 27, 2016

So true, so true. You're on my mind every minute, all day, Artiemom.

2Cats4everLoved · Dec 27, 2016

Oh @Artiemom - I'm so sorry to learn this news of your sweet boy.

Meanwhile, you sent me comforting pm's for my loss and here you are with your own troubles with Artie. Proves what I said, you are very kind and thoughtful.

I'm sorry I have no medical advice to offer and I agree, it's between you and your vet, but please know I'm here for you.

And please journal away, don't worry about "ranting", we all understand. Write whatever comes to your mind and we will be here to support you.

Writing Simon's Journal helped keep me on track and focused, especially during times of uncertainty and discouragement.

Please, try, and I know this is hard, but please keep yourself well, I know as many here do, it's stressful taking care of our sick loved furry wee ones. Plus, I truly believe he will pick up on your anxiety.

I wish you all the best, and will keep you in my thoughts and prayers

Warmest regards, Hope

Margret · Dec 27, 2016

It's beginning to sound to me as if none of the appetite stimulants work for longer than a day or two. Now that is worrisome. I suggest asking your vet about it, and if she agrees then it may be time to ask her about a feeding tube for Artie.

The goal is to make Artie as healthy and happy as possible, for as long as possible. I think we all agree that there are circumstances that warrant euthanasia. And I know we all agree that making that particular decision hurts like h***. The problem is, it can be extremely hard to judge when the time has come. So, don't just ask your vet "If Artie were your cat would you be putting him to sleep now?" Tell her that you want to be informed if or when the time comes that the answer to that question is "Yes."

Margret

cat nap · Dec 27, 2016

@Artiemom...just sending support for you and Artie.

I have read some threads about Megacolon, on here, but don't remember all the issues.

It seems that if Artie's problem is a 'motility issue' with his colon, and he gets 'painful gas' or 'constipated quickly' then the Vets would be trying to prescribe meds that help with that.

Unfortunately, I don't think the 'fine-tuning' of the meds, has happened, yet.

It sounds like the R.Vet, tries one treatment, and the S.Vet tries another, but both in the hopes that it will lessen Artie's symptoms.

On top of that, having a 'functional heart murmur',...not sure if the sub'q fluids would have to be limited, to not stress Artie's heart.

(My sister has IBS, and has been told that it is related to motility, and for some reason 'probiotics' make her feel more gas pain, and diarrhea. I know it is different in people and cats, but still wanted to mention it.)

I would keep those daily journal logs, like @Angels mommy, had mentioned, ...and that you have already been doing on your calendars,

Write out all the food Artie ate, the medications he was given with the time given, and 'if any positive or negative reactions were noted'.

Then his bowel, and litterbox habits, and general daily routines.

Try to take it day by day.

Write out your main questions for your Vets.

Make sure to ask your top ten, or more, focused questions, concerning Artie's treatment, and how some of the things you are seeing is worrying you.

I find it difficult for you, since you are getting medical opinions, from two different Vets, but both are valid.

You are doing a great job, in Artie's care.

The questions about the NV food, containing the clay, or even some cat food having bits and pieces of fish bone material, may make some calcium deposits appear on x-ray, but I'm not sure about to what extent, and how that would affect the motility.

With the motility, Artie's food may be going too fast through his system, and not being absorbed properly, hence the weight loss,...but then you're faced with it being too slow, and constipation happening.

It's like you have to achieve the right balance of food, medication, water, to keep everything in balance...and also his gingivitis, affecting his eating, may or may not be an issue.

Sending you all positive vibes, for tomorrow's S.Vet appointment, ...that you get understandable and proper answers to your questions.

And of course, that Artie gets to feeling better, and like his old self.

LTS3 · Dec 27, 2016

@Artiemom

It wouldn't hurt to ask both your vets to consult with other vets about Artie's issues. They could do a phone or email consult. It's probably a big pain to drive all the way to Angell but it may be well worth the trip if a vet there can help Artie feel more comfortable.

cat nap said:
The questions about the NV food, containing the clay, or even some cat food having bits and pieces of fish bone material, may make some calcium deposits appear on x-ray, but I'm not sure about to what extent, and how that would affect the motility.

Bits of bone and calcium does show up in the digestive tract on x rays. When Emma had ileus, the vet (not our regular one) took x rays and was puzzled why Emma had bits of bone in her stomach. She thought Emma might have eaten a bird or mouse. Nope, Emma eats raw food that has ground bone in it. The vet didn't think the bone had anything to do with the ileus. She prescribed a medicine to help the digestive tract restart motiity again.

tallyollyopia · Dec 28, 2016

All right, I have nothing to add other than sympathy and support, but I'm posting so I'll get updates on the thread.

2Cats4everLoved · Dec 28, 2016

Good morning @Artiemom -

We're all concerned about you and "OUR" sweet boy Artie and are here for you.

I realized this past year, even though these kitties live all over the world, I consider them part of "my family", all of these kitties on TCS hold a special place in my heart, as well as their most trusted humans. So if anyone is hurting in anyway, it weighs heavy on my heart.

Although it's easier said than done, try not to get overwhelmed. I know I was easily confused at times with Simon, mostly because my brain got clouded with emotions, which is why keeping his journal helped me, as well as all of the fabulous members of TCS.

Be strong my TCS friend. Big hugs - Warm regards, Hope

Kat0121 · Dec 28, 2016

I've been thinking about sweet little Artie this morning (and you too, Cindy!) How is our boy feeling today? As always - much love to you both and healing vibes to Artie. I hope he has a good day today

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