Mystery illness, Possibly Lymphoma, Not Eating

[white shadow]

By the way, the prednisolone medi-melts from Wedgewood say "chicken flavor" but they smell strongly of marshmallow to me. Not unpleasant to my nose, but I can't imagine a cat would eat something that smells like that. Could they have mixed them up? And if so, could they have gotten other parts of the prescription wrong - like the medication itself???

I would call them........they have an excellent reputation for service. I expect that they'll be diligent in investigating this, likely replacing the Rx.......which is exactly what I would want/expect.
.

 

[RussellsMom]

I just spoke to Wedgewood and they said they only compounded prednisolone for cats in chicken and fish flavors, so-??? But you're right about their good customer service: it was very nice to be able to speak to a person on the phone, not just a machine.

 

[FeebysOwner]

I just spoke to Wedgewood and they said they only compounded prednisolone for cats in chicken and fish flavors, so-??? But you're right about their good customer service: it was very nice to be able to speak to a person on the phone, not just a machine.

Did you mention what it smells like to you? Did they have an explanation for that?

It seems a lot of these meds, even compounded ones have some sort of sweetener added. I was hoping that they might have explained if this is the case with medi-melt pred.

 

[RussellsMom]

Yes, I explained it - I said it smelled strongly to me of marshmallow, or like cake or cookies. I said it smelled nice to me but not like something I thought a cat would go near. I didn't really get an adequate explanation, really, just that they didn't offer it in marshmallow flavor (though she did say they had some marshmallow-flavored cat meds - why, I have no idea), so it couldn't have been a mix-up. I tried to ask questions a number of ways, but got only simple answers back. At a certain point, I felt there wasn't more I could ask, since she'd said 3 or 4 times that if it says chicken it must be chicken. The conversation was friendly enough but had the whiff of "gatekeeper" about it to me (or is that my medical trust issues?). I'll try another medi-melt this afternoon and hope it goes better. I only have 2 of the old pred tablets left, which he took very easily, but I want to save them for emergencies until I can get some more.

 

[white shadow]

.
How about calling once more but requesting the pharmacy manager (emphasize) this time...be firm and get around the 'gatekeeper'. Have the exact invoice with you for precise info - this time you are going to insist that it be replaced using your prior line (to us): “if the flavour is wrong, how can I trust the drug“ ?

I suspect you'll have success.
.

 

[RussellsMom]

Hi friends - a slightly new issue that I would love to have some advice about. Danno has been doing OK - some days excellent, with good appetite and good energy - some days less than that. Just the past two days he hasn't been eating enough.

I'm no longer staying at my brother's place, so I'm not observing him 24/7 as I was the first week of his chemo treatment, so I can't say for sure how much he's eating. His people don't do what I do to ensure he eats (getting on the floor, plying him often with many varieties of foods, hand-feeding, etc.). His people also aren't very observant, so I don't really have the full story, but they are saying that he hasn't been eating as well as he was for the past two days.

I'm still going over there every afternoon to give him his 5 mg prednisolone, to change his water bowls, and to make sure he gets at least some food while I'm there. So I'm able to observe him for about an hour a day, and yesterday and today he has indeed been harder to interest in food. I'm able to get him to eat a little (I'm focusing on A/D today since he's eating so little). I wouldn't say he's inappetant - he is eating - just not nearly as much as he should. Should I give him mirtazapine? I thought that was for times when he wouldn't eat at all.

Yesterday I gave him 1/2 ondansetron before the pred, thinking he might be eating so little because he's nauseated. His appetite has been so fantastic until yesterday, so I haven't been giving him mirtz or cerenia or ondansetron all this time, not wanting to drug him unnecessarily. But should I just be giving him these medications every day regardless?

Any advice/experience would be greatly appreciated, as always!

 

[iPappy]

Hi friends - a slightly new issue that I would love to have some advice about. Danno has been doing OK - some days excellent, with good appetite and good energy - some days less than that. Just the past two days he hasn't been eating enough.

I'm no longer staying at my brother's place, so I'm not observing him 24/7 as I was the first week of his chemo treatment, so I can't say for sure how much he's eating. His people don't do what I do to ensure he eats (getting on the floor, plying him often with many varieties of foods, hand-feeding, etc.). His people also aren't very observant, so I don't really have the full story, but they are saying that he hasn't been eating as well as he was for the past two days.

I'm still going over there every afternoon to give him his 5 mg prednisolone, to change his water bowls, and to make sure he gets at least some food while I'm there. So I'm able to observe him for about an hour a day, and yesterday and today he has indeed been harder to interest in food. I'm able to get him to eat a little (I'm focusing on A/D today since he's eating so little). I wouldn't say he's inappetant - he is eating - just not nearly as much as he should. Should I give him mirtazapine? I thought that was for times when he wouldn't eat at all.

Yesterday I gave him 1/2 ondansetron before the pred, thinking he might be eating so little because he's nauseated. His appetite has been so fantastic until yesterday, so I haven't been giving him mirtz or cerenia or ondansetron all this time, not wanting to drug him unnecessarily. But should I just be giving him these medications every day regardless?

Any advice/experience would be greatly appreciated, as always!

I would maybe try the mirtz, at least a half dose to see it his appetite picks back up again. Is it the transdermal type?
It's so sweet you're going over there daily for him, and to give his people a bit of a break. I'm sure Danno loves your visits

 

[RussellsMom]

Thanks, iPappy - to be honest, I'm not feeling very sweet. I'm so angry about Danno's people's lack of interest in learning how to care for him in his hour of need. They have no interest in giving him his medications or getting creative about feeding. They love and enjoy him, but they're completely passive. At least they allow me to come over daily to give him his medications and try to get him to eat as much as I can and interact with him in the hour that I'm there.

It's the weirdest situation, quite alien to me, and it's making me angry, miserable and incredibly stressed. I've tried not to talk about this aspect of the situation too much, because it's not strictly about cat health and I'm not sure what others could learn from it. I suppose it's a little-discussed aspect of cat health: assuming responsibility for caring for a sick cat who lives with someone else. I wish I could just bring him to my home and care for him properly here. I so appreciate everybody's support on this forum - the practical help as well as the emotional support. It make this unusual and difficult situation much more bearable, so thank you!

Tomorrow we're going to the oncologist for chemo round 2. Please send this sweet little boy good, healing wishes!

 

[fionasmom]

Bayer-AAFP study breaks down why 52 percent of cat owners avoid regular vet visits
There are a lot of these articles online from various sources; this one highlights reasons why cats receive much less medical care than dogs. Your relatives are much more in the majority than you think, although I am in no way defending their behavior.

It is the old "cats can survive/cats have 9 lives/when I was a kid there was a cat in town who lived to be 20 and never had a home" mentality.

 

[RussellsMom]

Thanks, fionasmom - the article you linked to was interesting. My brother certainly waited far too long to take Danno to the vet when he first became ill, and in fact he got angry and defensive every time I said I thought he should go immediately to the ER. The fight went on for many days before he finally did go. I couldn't relate to that way of thinking at all. However, now that Danno's been diagnosed with lymphoma, my brother is stepping up to meet the oncologist's appointments. As much as he loves his cat, I wasn't expecting him to agree to try to this treatment, so I'm happy about that.

What he and the others are not doing is feeding, medicating, and spending sufficient quality time with Danno at home. I come over for an hour or two every afternoon to give Danno his medications and try to get him to eat as much as I can while I'm there. They report that he's not eating, but when I'm there I am able to get him to eat. As just about everyone on TCS can attest, it takes a lot of patience, stamina, good will and creative thinking to feed a sick cat. When I'm at my brother's, I'm on the floor the whole time, going where the cat goes, plying him with a wide variety of food flavors and textures, hand-feeding, all the tricks. It's difficult but necessary. I show them how I feed him, but I'm pretty sure they're not doing it. They aren't uninterested in Danno's well-being, but they seem uninterested in participating in the hard work of helping him recover.

Everyone here knows how much physical and spiritual energy it takes to involve yourself in that level of caring. I'm always so touched by the stories of profound and dedicated care on this forum. That I can relate to, and I'm so grateful to have this place to turn to for moral and practical support in this unusual situation.

 

[silent meowlook]

Hi. You’re in a very tough situation.

Sometimes people cannot deal with certain things. Some people honestly cannot handle the emotions and pain that goes along with caring for a very sick cat. They, instead of doing what they need to do, go into their happy place in their brain and refuse to be realistic or even rational. Not their fault. Just people deal with things differently.

I once had a lady, when I was working specialty I would give people my cell number, call me and tell me that her cat , who had end stage cancer, renal disease and other issues, was okay, but had been in the closet for over 24 hours. And that he had started “ sleeping with his eyes open”. Really sad. He had died.

Family members can be frustrating. Especially when it comes to cats. Unfortunately, this isn’t going to end well if they don’t step up and do their part.

Sometimes people feel they are hurting their cat by doing the needed treatments. Or, they just can’t handle that they are so sick.

You are in a rough position by being the only care provider to a very sick cat that is getting very serious drugs.

Any decline in health has to be immediately reported to the oncologist. Some things can be due to the disease, some due to the drugs. None of this should be figured out by anyone other than your oncologist, as when you get into these chemo treatments it is far too complicated to figure out on your own.

One of the biggest risks is that the chemo will kill off too many healthy cells along with the cancer. So, if Dani isn’t eating, you have to tell them right away. It may be something simple like nausea that isn’t responding to the anti nausea medications, or it could be that the white blood cells are too low, or many other issues could be happening.

Has any of the vets discussed you doing subcutaneous fluids at home? It may be an option for Dani. His potassium may also be low or any of his electrolytes or blood values may be off.

I know it’s hard to be doing what you are doing without any help from the actual owner.

Dani is incredibly cute. I hope he is feeling better by now.

 

[silent meowlook]

I know your cats name is Dano, but my phone auto corrected it to Dani and I don’t have an edit option on this device.

 

[IndyJones]

I once had a lady, when I was working specialty I would give people my cell number, call me and tell me that her cat , who had end stage cancer, renal disease and other issues, was okay, but had been in the closet for over 24 hours. And that he had started “ sleeping with his eyes open”. Really sad. He had died.

Family members can be frustrating. Especially when it comes to cats. Unfortunately, this isn’t going to end well if they don’t step up and do their part.

Sometimes people feel they are hurting their cat by doing the needed treatments. Or, they just can’t handle that they are so sick.

Unfortunatly this isn't just limited to pets either. I remember reading an article where someone had been living with a human corpse for a while.

I've also hear of people withholding food and water and medication from the elderly.

 

[RussellsMom]

Thank you both! Yes, you've both described my relatives. They're not able to handle any type of sickness even in people. They shut down completely at the doctor's office/hospital and become immobilized and even...disgusted? So, as much as I hate hospitals, I step in and do all the necessary things there, too: peppering the docs and techs with questions, making a million phone calls, keeping the meds straight, bringing food and books, sitting with the sick, preparing the home for when the invalid gets back. I don't like it any more than anyone does - though it does focus the mind and give a sense of purpose for sure. And I don't mean to say it boastfully - I just believe a) it's necessary; b) I couldn't live with myself if I didn't do it; and c) I do for the sick one what I would hope someone does for me when I need it. But my family of origin just shuts down. I've seen it numerous times - including, very unfortunately, the withholding of food and water from the elderly, and now, I think, the cat. It's very upsetting.

As for Danno, he's Day 2 post-chemo round 2. He's eating well for me today (I gave him a half dose of Mirataz yesterday afternoon). He got up from his bed to greet me when I came in. His tail is up but he is very weak and wobbly. My brother said he jumped up on his desk earlier. He seems better than yesterday.

The oncologist gave him an excellent report yesterday before round 2: his WBC and RBC were perfect, and she said he was "an excellent candidate for continuing chemo". I'm trying to trust that! He was so improved in week 1 (post chemo round 1), but this past week he's been considerably weaker.

Today he won't touch the A/D but he's tucking into FF ocean whitefish!

 

[RussellsMom]

Sorry if that sounded clinical? Of course the number one reason I want to help Danno is because I love him!

 

[fionasmom]

You did not sound clinical and it is very fortunate that people like you can "step up to the plate" when others cannot or will not.

 

[Mac and Cats]

Thank you both! Yes, you've both described my relatives. They're not able to handle any type of sickness even in people. They shut down completely at the doctor's office/hospital and become immobilized and even...disgusted? So, as much as I hate hospitals, I step in and do all the necessary things there, too: peppering the docs and techs with questions, making a million phone calls, keeping the meds straight, bringing food and books, sitting with the sick, preparing the home for when the invalid gets back. I don't like it any more than anyone does - though it does focus the mind and give a sense of purpose for sure. And I don't mean to say it boastfully - I just believe a) it's necessary; b) I couldn't live with myself if I didn't do it; and c) I do for the sick one what I would hope someone does for me when I need it. But my family of origin just shuts down. I've seen it numerous times - including, very unfortunately, the withholding of food and water from the elderly, and now, I think, the cat. It's very upsetting.

As for Danno, he's Day 2 post-chemo round 2. He's eating well for me today (I gave him a half dose of Mirataz yesterday afternoon). He got up from his bed to greet me when I came in. His tail is up but he is very weak and wobbly. My brother said he jumped up on his desk earlier. He seems better than yesterday.

The oncologist gave him an excellent report yesterday before round 2: his WBC and RBC were perfect, and she said he was "an excellent candidate for continuing chemo". I'm trying to trust that! He was so improved in week 1 (post chemo round 1), but this past week he's been considerably weaker.

Today he won't touch the A/D but he's tucking into FF ocean whitefish!

Not sure if this is helpful to you at all, but when I had a cat with large cell lymphoma, the only thing I could get him to eat regularly was Royal Canin Mother and Babycat. He would eat both the wet and the dry food. The wet is really soft. I now have a cat with possible IBD/possible SCL and recently we had to up his dose of Pred because he stopped wanting to eat much. Out of desperation and to hold him over until our ultrasound, I bought some of the mother and babycat food and he gobbled it up. Might be something you could try if everything else fails.

Thank you for helping Danno and I'm sorry your family doesn't put more effort into his care. I have several people in my family like that as well and it makes me sick to think about their past animals and how they have ended up because they feel differently about their pets than I feel about mine. I can't even talk to my in-laws about pets aside from lighthearted topics about pets. I can't talk to them about medical issues or medical expenses because their responses just upset me. My FIL use to have two dogs and he didn't even keep food or water inside the house for them. They had an old cleaned out paint bucket (yes, an actual 5 gallon paint bucket, not a clean 5 gallon bucket -- don't get me started on what I think about this) for a water bowl outside around the far end of the house. There was always algae in it too. One time I dumped it out and tried to clean it and his family was like "What on earth are you doing???" They were partially right, I should have bought a fresh food grade bucket instead of trying to clean that out. I'm getting upset just thinking about it!

 

[iPappy]

Sorry if that sounded clinical? Of course the number one reason I want to help Danno is because I love him!

I still stand by my original statement, you are a very sweet person
I wonder if the family is hesitant to do the work, partially because it's something they naturally shy away from and they see you having so much success with him they don't want to risk messing anything up. The members who have said that everyone deals with these things differently are right IME, and sometimes people just don't want to face it because they don't believe anything they will do will actually help. It's a horrible situation for everyone around, but it sounds like Danno is doing pretty darned well considering!

 

[RussellsMom]

Thank you, all! Your kind words help me keep my spirits up and also are a great help in thinking through meds, food, and questions for the vet.

Danno had a good day today. Like everyone else whose lymphoma threads I've read, there are definitely ups and downs, but today was good and I'm hoping it's a trend. He ate quite well, even going to his food bowl himself to eat (usually I'm hand-feeding or at least holding the bowl up to him wherever he happens to be lying). He gave me some kisses, scratched the stair carpet with gusto, had a fairly energetic bath, and explored the house a bit. He's still quite weak, but I definitely felt like he was feeling better today.

Today's Thursday. Monday he had COP (chemo) round 2 and an injection of ondansetron. Tuesday he was doing pretty poorly, not eating well and very weak and what I call "tufty" (unwell cat's spiky fur), so I gave him about 1/2 a dose of transdermal mirataz on his right ear plus the still-daily 5 mg pred tablet. Wednesday he was also very weak and lethargic, though eating a bit better (with much coaxing). I gave 1/2 dose of mirtz on his left ear plus the pred of course. Today, Thursday, he seems so much brighter - brighter eyes, smoother fur, more energy, a bit more playfulness and sociability. I decided not to do the mirtz today, thinking I might try every other day. I've generally not given him cerenia or ondansetron at home (I have both to use as needed and have only used them a few times), because he hasn't vomited or drooled or smacked his lips at all. I really don't know if that's the right call. I'm scared to over-drug, and scared to under-drug!

Here's a bright-eyed picture from this afternoon's visit:

 

[IndyJones]

He shouldn't need a bath and it could dry his skin out just brush unless he is obviously dirty. Most cats don't like baths which is why he was "energetic" as you describe it.