haemobartonella felis

mrsgreenjeens

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So she was not actually ever diagnosed with HL, is that correct...only with haemobartonellosis felis?  (not that that isn't bad)  In your other threads you said she had HL, but I'm wondering if her blood tests actually showed that. 

Since Haemobartonelloisis Felis is aka Feline Infectious Anemia, did she need a blood transfusion, or was she not that bad?  It's good if she didn't need one.  Here is a direct quote from http://www.veterinarypartner.com/Content.plx?A=1692

'Treatment

If hemotropic mycoplasma (haemobartonellosis felis) infection is suspected, initiating treatment is probably a good idea as treatment is much easier than diagnosis. All mycoplasma infections are susceptible to tetracycline. In cats, the derivative doxycycline tends to be most easily dosed as it comes in an oral suspension. Tablets must be used with caution as they can stick in a cat's esophagus, and cause irritation and scarring. The quinolone class of antibiotics (enrofloxacin, etc.) is also effective against hemotropic mycoplasmas. Three weeks of medication is needed to adequately suppress the organism.

Killing the mycoplasma is only part of the therapy, however; it is the host's own immune system that removes the red blood cells and this must be stopped. Prednisone or similar steroid hormone is typically used to suppress this part of the immune system so that the red blood cells are not removed as quickly. Very sick cats will probably require blood transfusions to get through the brunt of the infection. Happily, prognosis is fair if the diagnosis is made in time, as cats generally respond well and quickly to treatment.'

So. in response to your list above, this is what I would say

1)  Let her eat anything she will, including, to quote you "crap food".  You said she inhaled about an oz of canned crap food.  Any food is better than no food.  Will she eat that again?  Plus baby food, cooked chicken breast (no spices), tuna, scramble up some eggs, whatever!  Use parmesan cheese as a topper.  Put it in the closet with her, maybe not right next to her, but a little ways away and leave it there with her....she may nibble on it when you aren't looking. 

2)  you could try that, IF she doesn't have H/L, she should NOT be too far gone.  If she DOES have H/L...what does the Vet think her chances are.  Talk to your Vet about why she is acting so lethargic...maybe this is the Haemobartonelloisis Felis.  Or maybe it's exactly as he thinks...she will perk up in a couple of days and not need this.  Maybe his Vet Tech (or your sister) can force feed her for the next couple of days to get her thru. 

3)  see my response to #2.  BUT, only you, of course, can make the decision
.  But truly, you need to have a heart to heart with your Vet, and with Crimmie, to see if she if really that far gone, or just having a lousy couple of weeks.

Believe me, I know right where you are.  Been there before, and actually I'm there right now.  I have a kidney cat who goes up and down, and right now she's down too.  But I've seen her in this cycle before, so not pulling the plug just yet


for Crimmie.

'.
 
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crimmie

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The first vet we saw said H/L based on liver numbers in her blood test, severe jaundice, and her history of anorexia and general tiredness.  I understand that H/L is often a side effect to a host of other medical issues,  Vet #1 said to syringe feed her A/D and gave me the appetite stimulant.  I took a whole week off so I could feed her and try to get her turned around.  The week went by and Crimmie did not improve.  She was still, at that point, eating a small amount of canned food...very small amount.  And still drinking water.  She was obviously sick and tired, but continued to sleep in her favorite spots...the over-stuffed chair or my son's wheelchair (both are in the living room).  

  About 3 or 4 days into this week, I called vet #1 back and told her that Crimmie was not doing well.  She was fighting the feedings, and starting to get more withdrawn.  She encouraged me to continue with syringe feedings, and suggested I come in to get a different size syringe.  I did, and got more food.  One week into syringe feeding, she is still going downhill.  Still eating canned food, but more like licking at it.  And fighting harder with the syringe feedings.  So I called again, and spoke to a tech...the vet was gone for the day.  I told her that I thought it was time to place a feeding tube.  She told me that, "our Dr.s don't place those her.  Dr. XYZ (vet #1) may or may not, I'm not sure."  What?????  How can you not know that?  Turns out this practice is a combination of 2 practices that merged about a year ago...nobody knows what the other half does, apparently.  So I quickly said thank you and goodbye...and called vet #2, on the recommendation of my sister.

  I called vet #2 and explained the story...I wanted a feeding tube put in my cat, who has hepatic lipidosis, and my vet doesn't put those in...please help me...

He was happy to see us the next day.  His first question was, did vet #1 give her antibiotics?  Nope, just appetite stimulant and A/D.  He looked puzzled.  He said he would like to do some blood work, give her some fluids, and go ahead and place an NG tube for feeding.  He said, "I'm pretty sure we have something else going on here".  

  He did a blood smear and dx her with haemobartonella-felis.  Prescribed antibiotics and to feed A/D with the NG tube.  As previously posted, NG tube was a no go after one night.  She hasn't been the same since that day :(

  I took her back yesterday so they could remove the stitches from the failed NG tube.  He then sent me home with sub q fluids and the anti-emetic, and said to syringe feed her again.

She has been going downhill this whole time.  The one time she ate 1/2 of a 3oz can of wet food was a fluke.  She barely licks at anything now.  She is still drinking water.  Pooped today, a little.  She gags at most things.  Hides as much as she can.  My Sister and I gave her the fluids and her meds today and nothing...no change in energy, appetite, mood, nothing.  So I called vet #2 and asked if he thought an e-tube would be beneficial, or if she is beyond that.  He hesitated because tomorrow is the start of a holiday weekend, and they are not open on Saturday (they usually are open from 8-noon on Saturdays).  So he suggested that we start with blood work, and go from there.  We go in at 8am.  I'm either saying good-bye to her tomorrow, or she will get an e-tube placed.  I can't keep torturing her like this.  She deserves to live a long, happy life.  I will do everything I can to make that happen.  But if we are too late for the e-tube to be helpful, I have to let her go.  

I'm so sorry this was so long, but this feels like a safe place to let it all out.  I know that every single one of you can feel my pain, and have been...are...or will be in the same place. 
 
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crimmie

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 yes, this is 'a safe place to let it all out'. we will continue to be here for you, to help in any way(s) we're able to.
Thank you, that means a lot right now.  I wish I could know what she needs.  I wish she could tell me what to do.  I want to help her be healthy and happy again so she can be with us for many more years.  I don't want to prolong a painful last few days.  Why isn't there a damn blood test for that?!  *sigh*  
 

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I can't help you, but have read your thread and feel your heart breaking for your cat. I hope he makes it through the weekend and starts to feel better. Wondering if he would eat some Gerber turkey baby food? I've always given it to my cats when they were sick and they rarely refuse it! How much longer is his antibiotic protocol? Wondering also if he might feel better once he's through with his meds? I will say a prayer for your kitty and hope he rallies so that tomorrow is not goodbye.
 
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crimmie

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I can't help you, but have read your thread and feel your heart breaking for your cat. I hope he makes it through the weekend and starts to feel better. Wondering if he would eat some Gerber turkey baby food? I've always given it to my cats when they were sick and they rarely refuse it! How much longer is his antibiotic protocol? Wondering also if he might feel better once he's through with his meds? I will say a prayer for your kitty and hope he rallies so that tomorrow is not goodbye.
Thank you for your reply and prayers!
She is at the Vet right now.  He was kind enough to fit her into his busy day, and will call me with the blood test results.

I have tried all 4 kinds of baby food meats.  She gagged at all of them.  She is on a 21 day course, today is day 4. 
 
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crimmie

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Well, her numbers look about the same except for WBC.  They are climbing, despite being on antibiotics.  He is going to either add or change antibiotics.  He said he can place an e-tube today if I wanted.  I asked the big question..."If she was your cat, would you do it?"  He said he would, because he feels like she is less jaundice and her numbers are mostly staying the same.  He said he has a lot of hope for her recovery.  So she is getting one placed this afternoon!

He said it would be something she could have for only a few days...I thought that was strange.  I said I was under the impression it was something that could be in for as long as we needed.  He said he would place the tube in a different location if she needed it longer than 5 days....less risk of infection...  He also said to not offer her food while she has the e-tube.  Since the tube is taking up a portion of her esophagus, any food she consumes orally could get caught up on the tube.

I'm happy with the price, though,  $150...That means I have more $ to work with if he wants to place another tube after 5 days.

 

denice

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It is true that there is a limit to how long an e-tube can be in place but I think 5 days is way too conservative.  My kitty had one for at least a month, if I remember right it was 5 weeks.  I did take him back to the vet often.  The vet changed the bandage and looked for signs of infection.

It's my understanding that if the tube needs to come out then they  go to the one that goes directly in the stomach.  That type of feeding tube can be left in place much longer than an e-tube.

My kitty started eating with the e-tube in place.  He was actually eating normally the last week he had the tube.  The vet left it in place as a precaution, in case there was a relapse.
 
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crimmie

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Everything that I have read on this site, on Vet clinic sites, on other boards...says they can be, and you should expect them to be, left in place for few weeks or more.  And the same goes for offering food daily.  How else would I know if she's going to eat on her own?  I will talk to him more about it this afternoon. 

Thanks for your reply!
 

mrsgreenjeens

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I'm SO glad to read that your Vet thinks Crimmie has a good chance of recovery
.  That's really good news.   I could tell from your post yesterday afternoon just how discouraged you were, and now how hopeful and happy you are 
.  Us too 


It IS curious as to why only 5 days on the E-tube, and the "no eating" with it, but you'll get that all squared away.

Can't wait to hear more updates.
 
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crimmie

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I'm SO glad to read that your Vet thinks Crimmie has a good chance of recovery
.  That's really good news.   I could tell from your post yesterday afternoon just how discouraged you were, and now how hopeful and happy you are 
.  Us too 


It IS curious as to why only 5 days on the E-tube, and the "no eating" with it, but you'll get that all squared away.

Can't wait to hear more updates.
Thank you!  I am so happy for her!  She finally has a good chance at beating this!!

I sure wish those Kitty Kollars were sold at major pet supply stores.  I would love to be able to get one for her today.  They look awesome, and comfortable.  I have read a lot of good things about them!
 

mrsgreenjeens

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I'm SO glad to read that your Vet thinks Crimmie has a good chance of recovery
.  That's really good news.   I could tell from your post yesterday afternoon just how discouraged you were, and now how hopeful and happy you are 
.  Us too 


It IS curious as to why only 5 days on the E-tube, and the "no eating" with it, but you'll get that all squared away.

Can't wait to hear more updates.
Thank you!  I am so happy for her!  She finally has a good chance at beating this!!

I sure wish those Kitty Kollars were sold at major pet supply stores.  I would love to be able to get one for her today.  They look awesome, and comfortable.  I have read a lot of good things about them! 
Well, she may come home with one on!  Squeak (another HL kitt) did.  Otherwise, I think you can order one and have it overnighted.  I THINK they're in Southern California (not sure where YOU are)     http://kittykollar.com/
 
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crimmie

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I did email them, and FedEx is closed tomorrow.  But I am going to order one.  

They have it wrapped and secured with vet wrap in red, with hello kitty stickers <3

The vet is not so sure she has HL.  He thinks it just may be anemia and the result of not eating much.  He said her liver profile isn't consistent with HL.  So we will see what the weekend bring.  I just fed her with no problems! 

I'm supposed to feed her 10ml every 2 hours...increasing the volume a little at a time, as tolerated.  

I'm having one of my boys help me so he can do it when I go back to work on Sunday.
 

mrsgreenjeens

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Yay for the first feeding
.  Hopefully you're just wrapping up feeding #2 and all is going well


Once she gets a little nourishment in her, she should start to perk up a little.
 
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crimmie

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Yay for the first feeding
.  Hopefully you're just wrapping up feeding #2 and all is going well


Once she gets a little nourishment in her, she should start to perk up a little.
She has had 2 feedings at home today, one at the vet.  I'm trying for at least 10ml every 2 hours.  The last one I wanted to go for 15.  I think I could have made it but I was trying a 60ml syringe and it was hard to push...she got a little squirmy so I had to stop at 8ml :(

Baby steps...Trying for 10 again in a few minutes.

I'm currently on a mad hunt for O ring syringes that aren't the tiny tip set off to the side.  Her tube is a red rubber tube...12fr.  I know the O ring syringes give a much smoother push and last longer.  The BD ones I got from Vet #1 are already shot.  I got a bunch of Monoject 10ml from vet #2, but they will wear out after a few uses, also.  I would like to find 20 or 30ml O ring with caps.  Am I dreaming? lol
 
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crimmie

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That one didn't go so well...only got 3ml in and 4ml of water to flush.  Maybe it's not smooth enough.  I will try putting it in a bullet tomorrow, and straining it.  I have to keep in mind that 10 ml is alot for her right now.  And to come back in 2 hours thinking I can push 10 more might be asking a lot of her this soon.
 

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There will be some initial ups and downs.  Both of you will get used to the tube feedings and things will smooth out.
 

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She has had 2 feedings at home today, one at the vet.  I'm trying for at least 10ml every 2 hours.  The last one I wanted to go for 15.  I think I could have made it but I was trying a 60ml syringe and it was hard to push...she got a little squirmy so I had to stop at 8ml :(

Baby steps...Trying for 10 again in a few minutes.

I'm currently on a mad hunt for O ring syringes that aren't the tiny tip set off to the side.  Her tube is a red rubber tube...12fr.  I know the O ring syringes give a much smoother push and last longer.  The BD ones I got from Vet #1 are already shot.  I got a bunch of Monoject 10ml from vet #2, but they will wear out after a few uses, also.  I would like to find 20 or 30ml O ring with caps.  Am I dreaming? lol
first, i'm soooo very happy to read that your crimmie now has an e-tube! i've been away from my computer all day, and you and crimmie have been in my thoughts.

and that your girl is doing well with the feedings too -- is great!

i'm not familiar with O ring syringes. however, i use calvetsuppy dot com to order some of my girl's supplies as well as thrivingpets dot com. here looks like what you're talking about, but calvet seems to only have up to 10cc sized -- http://www.calvetsupply.com/product/2049/Feeding_Syringes   they're extremely inexpensive, so maybe you could load up a couple syringes with food and then do a quick switch when you finish the first one -- when your crimmie is able to handle more than 10cc's at a time. i just checked amazon, and they have O ring syringes from sellers there too -- http://www.amazon.com/s/ref=nb_sb_n...h=i:aps,k:o+ring+syringes&tag=&tag=thecatsite
 
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