Toby vomiting and losing weight, fine otherwise

[barbb]

Yes I'm thinking of doing his ultrasound elsewhere, although it seems ridiculous that existing clients at the center cannot just make an appointment at the facility like the rest of the public and instead must wait until there is time between existing appointments. I have never heard of anything so ridiculous, especially since his next visit is two weeks away, which is plenty of time to book an appointment there or anywhere else in the city. It makes you wonder why this is the case. 

And as for her saying I could go elsewhere, in fairness, it was in response to my saying that these kinds of things that increase Toby's stress where he has to sit in the car longer and wait for hours to be treated at the center for no good reason, are not ok. Those things are out of her control. What is important is that she offered to address the one issue within her control, i.e. her offer to be the primary interface and not a weekly handoff by technicians. The lack of communication and perfunctory handoff each week was my biggest issue and I think it will be a lot better now that the oncologist will take over that role. It is only 5 minutes but it is a very important 5 minutes. 

And what you said Laurie about the doctor being there in case they can't answer your questions, that was not happening for me; instead they were like gatekeepers and I never saw the doctor. Having said that, my appointment time is 1/2 hour later than their typical chemo drop-off, something I had not been told until I spoke to the doctor today. That also clears up this mystery as to why I had to make 20 appointments at 10AM whereas everyone else apparently drops their pet off between 7:30 and 9:30 for chemo. Apparently they were accommodating me bc I said I could not bring him earlier with how much he hates the car, but I did not know there was a standard drop off time that is earlier. I had been thinking how insane it was that everyone who brings their pet for chemo has to schedule an appointment each week for the duration.  

Diane and Booboo, my problem is that I have been giving them my concerns and questions before each visit and then after each visit the tech hands me a paper with the same information written on it each time and my questions are not answered. Also there is no information about what is going to happen at the next visit. They faxed me a schedule of treatment after our first meeting but there was no discussion regarding what was involved with each visit and I was not informed that this visit he would be getting the chemo that will hit him hardest. Instead I was just given different medications and told they are in case he needs them. Then I had to sit there and ask questions to pry out of them the information I need. 

I really hate that I was losing it with them, but I am Toby's mom and have to be his patient advocate. If they don't prepare me, then I can't prepare him and there would be more days like today. I have a feeling this isn't the end of it all, given that I still haven't been given the big picture. It's like being on another planet where everything makes sense to the people that live there and you are the only one who is wondering what's going on. Since you don't live there, you don't even know what questions to ask. 

. 

 

[barbb]

Stella and Chewy's freeze dried raw, I was so caught up with everything to do for Toby's treatment, and when I went to his new vet she just put dried S&C out for him to eat, so I never read the part where it says add water LOL. I had planned to wait until Toby's chemo was done to start converting everyone, but he kept tearing open the bag at night, this is part of his frantic eating. So I put the dry version in his food dish and didn't think anything about it except "this is really neat, and I can use it instead of crunchies for now!"

Anyhow today I saw the dry sitting there and I added water and put it down on the floor, since he hadn't eaten a whole lot of his tiki cat wet food. Sure enough he went over to it and ate all of it 

. Very happy that he is a big fan!!! And I hope he keeps it up!!! 

 

[ldg]

Well at least it seems you go things sorted. But yeah, the "specialist" treatment thing IS like a different planet, and a real bummer when communication is an issue.

Around here, most of the vets use a mobile ultrasound service. So you have to drop off your cat in the morning, and you don't know when you can pick them up. I HATE it. The local vet here has their own ultrasound system. The owner does the ultrasound, and it's sent to a radiologist for interpretation (to verify what the vet sees). For Lazlo's 2nd ultrasound, we took him to the vet that diagnosed the cancer to begin with - we KNEW it was the mobile US service, but the oncologist felt it was important that it be done on the same machine by the same tech. So we drop off Laz at 8:00am. We were told they're usually there in the morning. So we haven't heard anything by noon or whatever, and we call. Hasn't been done. Finally, at 3:00pm, we just drive over there. it STILL hasn't been done. And because it is his stomach, he has had NOTHING to eat since the night before - and he's been stressing in a crate all day! :wife: Gary flipped out. AND when the service finally showed up, it wasn't even the same tech, even though we'd made it clear that was the POINT of going back there.

That's when we found out the local vet has a US machine (he called the owner of the practice to ask/rant), and does it themselves, and it's not a drop off thing. We figured it simply wasn't worth the same machine/same tech thing - especially if they weren't going to guarantee the same tech would even show up.

So for all the frustrations. For Lazlo, the last treatment of every cycle was difficult. And after that 2nd ultrasound, we stopped bothering to get them done after the completion of each cycle. We figured we were going to follow through to the end, so it just didn't matter. The next ultrasound we did was about two weeks after his last treatment. :nod:

 

[barbb]

Thanks Laurie, this is extremely helpful info, especially your decision about the ultrasounds and the 4th treatment. I am so sorry that happened to Lazlo too :-( :-(. It sounds very similar to my experiences. It looks like each specialist area operates independently while the center presents themselves as one big group- but they aren't except to the extent that they may share some support staff- but when the oncologists weren't there on Monday, what I got was "sorry can't help you". 

I haven't heard from anyone today so I don't know when or if I will get a call about the ultrasound. I would like to see if the mass has gone down and what is the situation with Toby's colon, is is massively full of food or what is the case. When he gained weight in the past, it was all over, i.e. his face and body, but now it is just his stomach that looks like a round barrel when he eats a lot. It frustrates me that no one is commenting on the nature of his weight gain. I'm sure for the doctors it is pointless since all they care about is whether his cancer is going into remission, but I am concerned about IBD too. I was able to talk to the doctor a little bit about that yesterday, and she said we will see how he is doing on this chemo and if need be, switch him to the oral, but one step at a time. 

This is what frustrates me, I don't like that there is a murkiness about how the initial report seemed to indicate small cell but the declaration in the end was large cell. There shouldn't be any in-between so far as I have read. I do understand IBD is sometimes treated with the oral chemo but am concerned that if we are compromising his immune system we should be positive we are treating the right illness.

And yes I had the same situation as you, with Toby yesterday. I was told no food after midnight, and then his appointment was at 10, then they call me at 1 to pick him up, I get there at 2, we don't get home until after 3 and he has still not eaten since the night before and he was just sitting in a holding area for a stupid echocardiogram which takes what, 10 minutes? This is a kitty who is food-crazed. I brought some with me but he doesn't like the car and all he was doing at that point was coming unglued, which unglued me too. And also I can always hear him crying in the back when I get to the center, I'm sure they are moving him around but it makes me very upset. Also they razor-burned his front leg shaving it yesterday so now he has an owww-eeee on there too. Poor little baby. I have been VERY upset that they seem to be treating him like an object. He is my dear little boy 

 and I can't stand to see him suffer needlessly. 

 

[ldg]

When you're calm and collected, you should write a note to the customer relations person (whatever they call that position) at the specialist practice. :nod: Gary is .... Gary. :lol3: He ended up talking to the owner of the place, and they wanted that feedback. So we highlighted the positives, but got in all the issues. The doctors, I think, see such a high volume of patients, they DO forget they're individuals with concerned, worried parents, and their "bedside" manner needs.... reminding of that. :nod:

But yeah. We got the ultrasound done after the first and second treatment cycles. When we were sure he was responding to the chemo, we stopped paying for ultrasounds, and just saw the treatments through to the end at that point, then took a look inside when it was all over. :nod:

FYI, the one thing the vet techs/vet checked in on with Lazlo - even though he doesn't have IBD - seems just a normal part of their "check list" was his colon. The first few times it was full (the oncologist just palpated Lazlo, and could feel stool in his colon), which is why he suspected he was constipated, and we treated him for it with the pumpkin. Every time after that, his colon wasn't full, so we figured the pumpkin was working. :lol3: But they had a "quality of life" check sheet we had to fill out each time, and the diarrhea/constipation thing was on there, and the vet always made sure to address it.

So especially given Toby's IBD and constipation issues, I'd definitely make a point of asking about that (and getting the US done). But I should think they don't need the US for THAT. Knowing that he does have issues with constipation - and we know his colon is partially blocked because of the inflammation, I'd be giving him pumpkin or miralax or something.

Actually, I think you asked about Diagel in Carolina's thread. I addressed that there. If Toby likes pumpkin, and since he's so food crazy, I'd ask the oncologist about that. In fact, I'd consider calling. I don't know that vaseline will help or is a good option. I don't know which vet recommended it. But I'd ask if miralax or pumpkin can be considered instead, and I'd get him on something. :nod:

 

[barbb]

They told me he would likely have diarrhea after this treatment and they gave me metronidazole in case this happens. Of course they neglected to tell me it was a liquid form that needs refrigerating, so when I opened the bag today I was pretty dismayed. I'm not sure what I'm going to do about that bc I don't want to get ticked off again. 

I am giving him weruva, soulful and tiki cat with pumpkin as part of the cat food and he likes it. I have tried canned pumpkin and he's not into that. But everything I am giving  him is designed to keep his stool moving. I watch what he is eating and how much, all the time. If I see he has gorged himself, even if he's eaten pumpkin, I will give him a half finger-ful of laxatone before bedtime because it is painful to see him so distended and somewhat uncomfortable. 

The doctors don't seem to think he is blocked at all, and in fact nobody is thinking about it except me. He hasn't had any xrays or ultrasounds since before his surgery. I ask them to check him for constipation every time and they always say he is fine. He doesn't look fine to me (you can see his belly in the picture lol) but I guess we'll have a better look when his ultrasound is done. 

 

[ldg]

Well then they're RIGHT.

 

[mrsgreenjeens]

Oh gosh...sorry this visit didn't go as planned, as especially that Toby got so stressed out.  Did he pant all the way home?  Poor little guy!  But sounds like you've got a plan now for the next time, so that's good.

for Tony, and

for you (and

for the Chemo Clinic!!)

 

[barbb]

Thank you for the vibes! Yes he did pant all the way home. I think it was because he had not eaten and the chemo made him sicker than usual.

On a good note he seems to be doing very well. He is not eating as much as usual, but that is probably a good thing since he was eating fanatically up until now, and now he is eating more normally. 

He is so sweet, here is his latest picture 

 

[mrsgreenjeens]

Awww...looks like he's hugging a little pillow there

,  He looks really healthy, sweet boy.  I know you said he's been eating lots, and I saw his last picture where he looked really good, but I guess I always expect a sick kitty to look like my

Sven

, who was just skin and bones, literally

.

I'm so glad he's doing well!!!!!!!!

 

[ldg]

Now THAT is a smile!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! He looks so happy and content! :rub: :heart2:

Ooooo, and now he gets a week off! :bigthumb:

 

[barbb]

Yeah, I think the fact that he is eating a lot keeps him looking good. His fur is still really bad and he is preoccupied with food all the time. But overall he has stopped vomiting which is a good thing and so far we have not seen any severe diarrhea which is apparently common after the doxyrubicyn cycle of chemo. 

He is also eating the reconstituted stella and chewys cat food which really pleases me a lot!

I am just hopeful that we will be able to see what is happening on the ultrasound and that we can make an appointment for him to have it. If I do not hear from the oncologist I will schedule a conference call with her and me/my husband. Very frustrating there, she said she would speak to the ultrasound doctor and we have heard nothing. 

 

[carolina]

Awww sweet baby boy :love:
I am so glad you have Laurie and Lazlo here for you
Barb, I have no idea if this is completely off, or even if you can use it at all, but I can imagine so..... Can you give him a gel cap of krill oil a day? It's for omega3.... Bugsy's skin was a mess, he was itching badly, to the point of injuring himself..... After krill his skin and fur got much much better..... I am also putting a spot on tratment on him, all natural called allederm; by virbac. I think it helped too, :dk: I just know that ue is way better..... I know that his skin is suffering because of chemo, but both Therese things working on rebalancing the skin, so I don't think it would do any harm..... I would ask the vet anyways, to make sure.....

 

[ldg]

Oooo, good point Carolina! I wish someone had recommended that for Lazlo when he was going through chemo. It's also anti-inflammatory. So many benefits if oncologist says it's OK to use during treatment!

Aw Barb, I'm so sorry! SO FRUSTRATING!!!!!!!

 

[blueyedgirl5946]

I am so glad to see the picture of Toby.  He is adorable.  I hope things progress well for him.  Hang in there Barb

 

[barbb]

Thank you for the tip, I will try that! My regular vet gave me omega 3 but it is in flakes and Toby doesn't like it. I will try some the way you suggest! 

I am a little worried that he isn't absorbing enough nutrients, and I am going to see if I can up his dose of B12 too. He is still eating like crazy and he is gaining weight but he doesn't look normal still :-(. 

 

[ldg]

Barb, ask about using digestive enzymes. :nod: That may REALLY help.

 

[carolina]

Barb, ask about using digestive enzymes. :nod: That may REALLY help.

Totally!!! Prozyme is a good one! Just takes a tiny bit.....

 

[ldg]

Barb, I've been wondering about Toby. And about you. :heart2: How are you two doing? :cross:

 

[mrsgreenjeens]

Gosh, I hope everything is ok

. She hasn't posted anything for at least a couple of weeks

.  Maybe she's just really, really busy

.  Life does have a tendency to get in the way!