Junior Fiorucci – Charlotte, NC
Male, Domestic Short Hair – Brown Tabby
Oct 1998 – March 29, 2015
Diagnosed with intestinal resection in October 2003
Diagnosed with dermatitis in January 2006
Diagnosed with hypertension in 2008
Diagnosed with diabetes mellitus in July 2010
Diagnosed with spinal stenosis in July 2010
Diagnosed with cardiomyopathy/arrhythmia in April 2011
Diagnosed with suspected IBD in January 2012
Diagnosed with small cell lymphoma February 9, 2015
First Entry: March 15, 2012: Junior and I are just beginning our journey with IBD. Or at least we think it is IBD. I have elected not to put my 14 year old munchkin through exploratory surgery just to be able to determine if it is “maybe” cancer or IBD. Instead I have chosen to treat him for IBD and see how it goes. You see as I look back over Junior’s life I now believe there were some precursors that indicated a funky auto immune system. I am not sure whether or not that contributed to his IBD, but thought it might be helpful for others to see.
Junior came to me 13 years ago in July of 1999. I had recently lost my kitty Snickers after just nine months. Snickers had arrived on my mom’s doorstep one day and I decided to take him in. Little did I know he was an old cat with some serious health issues. I still don’t want to believe that someone may have just put him out rather than deal with it. At any rate I got rather attached to Snickers in a relatively short period of time. So when I lost him unexpectedly, after just nine months, I took it really hard. About three weeks after his passing, my mom had convinced me to go look for another cat. I was adamant that I needed to mourn Snickers and not just any cat could replace him. We went to the pet store anyway. I got there, and this little brown tabby caught my eye immediately (you see Snickers was a Brown Tabby). As I was tickling his nose through the cage, a very astute volunteer from the humane society swooped in and said “Here, hold him”. Next thing I knew the little guy was in my arms and licking my face. He then sneezed and I got a full face of kitty sneeze. Junior and I have been inseparable ever since. After the sneeze incident I knew I was about to take home a sick kitty, but he came with a 72 hour warranty so I took him to the humane society vet free of charge. It was determined he had an upper respiratory infection, and some really bad gum disease (really odd for a kitten only 9 months old).
Looking back I now realize this was a precursor for all of his weird auto immune problems. But we got his respiratory infection cleaned up, and the same with his gums. Now it was time for me to get a family vet close to home. About 7 months later, in February of 2000, I decided to have his teeth cleaned. He kept getting these gum infections and I thought it was the best thing to do. After he came out of the anesthesia, he seemed to have a hard time swallowing. He would try to eat but kept throwing it up as soon as he swallowed. My vet watched him for a few days and then took some abdominal x-rays. My vet determined his intestines were bunching up and he must have swallowed a string or something. He said Junior needed surgery right away. So I took Junior to the emergency animal hospital and they did the surgery, only to determine there was nothing wrong. I felt so bad that I had put him through that for nothing. But he bounced back quickly and it was nice to have a playful kitten around the house.
Things remained uneventful until October of 2003. I came home from work one night and noticed that Junior had vomited in several places in my kitchen. He also didn’t greet me at the door which was really odd for him. I went searching the house and found him hiding right smack in the middle under my bed. So I got the broom and swept him out. He emerged as listless as a rag doll and with pupils as big as saucers! I knew something was not right, so off to the 24 hour emergency vet we went. They examined him, and when they palpated his tummy he yelped. They thought something was wrong with his intestines, but after the last unnecessary surgery were hesitant to do anything. We decided it was best if he stay at the hospital for observation for a few hours. When the doctor called me back, she indicated he was not getting any better and we decided to go ahead with exploratory surgery….again! This time there really was something wrong. Junior’s intestines somehow got tangled. He had to have about 6 inches of his large intestine removed. The doctor said I had saved his life by reacting so quickly. I must admit that felt really good to hear, especially after what had happened the first time.
In August and September of 2005 Junior landed at Animal Emergency twice for enema’s for constipation. Things again returned to normal and calm. But in January of 2006, Junior had developed some skin allergies. The constant biting and licking was exhausting just to watch. He began to develop hot spots where he had licked the fur right off. After discussion with my vet, we decided to start him on dexamethasone. This got things under control and we once again had a new normal. In 2008 Junior developed high blood pressure and was put on amlodipine. This got things under control quickly. Life was good, except for another bout of constipation and an enema in February and March of 2010 (do you see a common thread here with his digestive track)? In late June of 2010, Junior began to drink two large bowls of water dry every day, and was urinating boulders not clumps. A visit to our vet resulted in a diagnosis of diabetes. My vet said it was most likely caused by the dexamethasone, so we had to stop that right away. I learned how to give him insulin shots, and we replaced the dex with Atopica, and things were good until June 29th and July 5th resulted in two more bouts of severe constipation and some more enemas. During his stay at the vet the doctor accidentally touched Junior’s back at the base of his tail, and he nearly jumped off the table and tried to bite her.
She quickly realized that the constipation was secondary and was the result of Junior’s back hurting him so much that he couldn’t/wouldn’t pooh! Apparently when he was on the dex, it was also controlling the pain from disk disease that we didn’t even know he had. With steroids no longer being an option, we tried Buprenex and tramadol, but neither could control the pain. So on July 9, 2010 he had surgery to remove the damaged disk. Things went phenomenally well and Junior was back to his old self in no time. Now that he was off the steroids the diabetes went dormant and he also no longer needed insulin injections. That is until April 2011. Junior began to exhibit signs of severe lethargy and not wanting to eat. Off to animal emergency we went, and the vet determined Junior had a really irregular heartbeat and should see my family vet first thing Monday morning. When we got there my vet agreed that it wasn’t even a normal irregular heartbeat, and she also did a chest x-ray. This indicated an enlarged heart and a mass in his chest. I was devastated. We made an appointment with the cardiologist at the specialty hospital. He was diagnosed with cardiomyopathy and an arrhythmia. The mass was just a cyst, he was put on atenolol and his heart beat quickly returned to normal. The atenolol also controlled his blood pressure and he was able to come off of the amlodipine.
In July of 2011, Junior had a bout of diarrhea. My vet mentioned it might be IBD and suggested that we try a prescription diet of canned W/D which was for sensitive gastrointestinal systems. The switch seemed to work (although I continued to mix it with his Fancy Feast Elegant Medley), and things return to normal. In January of 2012, during one of Junior’s follow up appointments with the cardiologist, I mentioned that Junior was always famished and no amount of food seemed to fill him up. She noticed that he had lost some weight and was pretty sure that a blood test would show hyperthyroidism. His blood test results came back perfectly normal on all accounts. I mentioned the hunger to my regular vet and she thought that maybe Junior just wasn’t getting enough nutrition from the W/D (apparently it is a lower calorie food). Although Junior had not had any dry cat food since his diabetes diagnosis, we thought maybe supplementing the canned W/D with some dry food might work. I got Junior some of his favorite dry food and he loved it. After a couple of days he developed diarrhea. So I stopped the dry food, and things went back to normal. I bought some W/D dry, and he loved that even more. He ate two 1/3 cup servings in one day. He again got diarrhea, but this time stopping the dry food didn’t clear it up. After about 10 days I called my vet and asked her if there was any prescription we could try to control the diarrhea. We got Junior started on metronidazole.
She also suggested trying Z/D cat food, but Junior wouldn’t touch it. After 10 days on the metronidazole he did not improve. It was February 15, 2012 and our battle with IBD had officially begun. I still hold myself responsible because I believe the dry food was the trigger event that caused it. Our next step was to have an abdominal ultrasound done. It indicated his pancreas was inflamed and the walls of his bowels were thickened, his gall bladder and kidneys also showed inflammation. Also it was noted that Junior still had food in his tummy, even though he hadn’t eaten in over 18 hours. We decided the next step should be to get a full blood work and Texas A & M gastrointestinal panel. In the meantime we continued to metronidazole, added amoxicillin and metoclopramide. The amoxicillin made him nauseous and after a few days we stopped it. They had also suggested I switch Junior’s diet to a protein source he has never had before. Easier said than done with a 14 year old cat. I went to every pet food store in town and read all the labels. I bought a full selection of rabbit, venison, lamb, and salmon. Junior turned his nose up on all of them. I eventually settled on people salmon which seemed moderately acceptable to him.
On February 21st, the results of TAMU blood test showed is cobalamin level was extremely low. This indicated the disease was higher up in his gastrointestinal tract, and was leading to decreased absorption. It was decided to begin weekly vitamin B-12 injections. They also discussed the recommendation to do a surgical biopsy to determine if it was IBD or lymphoma. Based on Junior’s age and the fact that this too may be inconclusive, I elected NOT to put him through that. We decided I should schedule a face to face meeting with the internist at the specialty hospital. I made the first available appointment for 2/28, one week later. In the meantime when I got home from work that night, Junior was continuing to get worse. Even with all the meds he was on, the diarrhea was worsening, in terms of frequency, volume and consistency, and he began vomiting. I knew I didn’t have a week to wait, and so was able to get an appointment with another internist two days later. On Thursday, February 23rd, we got Junior started on budesonide. This is a corticosteroid, but most of the drug is absorbed locally in his intestines and does not make it into his system. This is especially significant considering his prior bout with diabetes. It has to be specially compounded in a “cat” dose. Junior’s diarrhea continued to get worse, and on Saturday afternoon he began to vomit as well. It started as food, progressed to clear liquid, then white foam and finally bile. After a couple of hours it stopped.
This is the first of my emotional breakdowns. Seeing his little body go through so much is too great for me to handle, and I began to sob. After a while, I pulled myself together. I don’t want to upset him anymore, and I know my first responsibility is to care for him and ensure he is not in any pain or discomfort. Finally by Saturday night I am able to get him to eat a little bit of baby food, I stop feeding him people salmon. At 2:00 am I am awakened to him vomiting again. This time it is just water, mucus and foam. By 4:30 it hasn’t stopped, and I decide to take him to the 24 hour emergency hospital. He was dehydrated, and his body temperature was 98 (low for a cat). He gets subcutaneous fluids and a shot of Cerenia to help with his nausea, and a shot of famotidine (Pepcid). The vet tells me I can give him a quarter of a 10mg pepcid tablet once a day. I have the cat on so many meds, I tuck this info away in the back of my head just in case. That day I call the specialty hospital and get an appointment for the next day. I knew the budesonide would take a little while to kick in, but I wasn’t expecting things to get worse before they got better. The rest of the day is uneventful, except for the constant diarrhea, and Junior does not vomit any more. He ate a little but would not drink any water.
The next day (2/27), we see the internist.He is still dehydrated, so he gets more subcutaneous fluids and another shot of Cerenia. I learned that Cerenia is a really powerful anti-nausea medicine. The roller coaster begins, here I had been really excited that he wasn’t vomiting any more, and the vet told me it was probably because he still had the Cerenia in his system. She gives me some Cerenia in pill form, but says he can’t take it for more than 5 days in a row, but if the vomiting was still happening, it was okay to give him half a pill a day. The rest of the day is calm, and he is still eating (with some coaxing), but still won’t drink water. His diarrhea is virtually liquid consistency, and he goes pretty much every time he urinates. On Tuesday morning 2/28, I am awakened at 3:00 AM to him vomiting again. I give him a Cerenia pill but he immediately throws it up. I lay down on the sofa, and Junior joins me. He snuggles up on my chest and I pet his back and head to sooth him. I again begin to cry, and I let Junior know it is okay not to fight any more. He can let go and although I will miss him very much, I will be okay. I fall asleep on the couch with Junior in my arms. When we get up, I pull myself together again. It is a workday, and I am afraid to leave him home alone all day, so I bring him to my family vet for observation. He gets more subcutaneous fluids, another shot of Cerenia, and a shot of Convenia. He stays there all day and does not vomit. We decide to stop the metronidazole. He had been on it almost a month and it didn’t appear to be doing any good. Besides the shot of Convenia would stay in his system for 10-14 days. My vet also suggested I start him on Fortiflora, to help restore the good bacteria in his digestive track. Again since we are continuing to change so much and he is on so many meds, I tuck this one away too. I am still searching for a new unique protein source that he will eat, and not having much luck.
Wednesday evening 2/29 he again starts to vomit. This time I am able to get the Cerenia pill to stay down. Within 45 minutes it works like a charm, and he is content and peaceful. He is eating a little more regularly, and starting to drink some water. We have no vomiting again for 2 ½ days…a new record. The diarrhea continues, but it seems to be a little less frequent and a little thicker in consistency. I am wondering if it is my imagination or really happening. Today the case of California Naturals Salmon and Sweet Potato I ordered came in. You see Junior liked this one when I bought a can, now that I have a full case, he changes his mind. On Thursday, I head out to continue my quest in search of the perfect natural cat food with a unique protein source. I have tried virtually everything there is, but decide to go through the shelves at Petco one more time. I come across Petite Cuisine. It doesn’t have any chicken in it, but it is a combo of tuna, sole, crab and other seafoods. Gluten free as well. Not quite a unique protein source, but I decide to buy a can anyway. Junior LOVES it, licked the bowl clean. I hold off buying anymore until I can talk to my vet. On Saturday 3/3 we head to the vet to get Junior’s B-12 shot. I give them an update on what is going on, and I am really excited that Junior hasn’t vomited and it seems like things may be heading in the right direction. I get the go ahead from my vet to continue with the Petite Cuisine, not ideal since he has had tuna before, but better than the alternative of not eating (I have since learned that Petite Cuisine contains Soybean oil and soy may not be good for cats. I have elected to allow him to continue to eat it, since he loves it so much and needs to put some weight back on). Saturday afternoon Junior appears to be looking nauseas (meowing, licking his lips, breathing a little heavy), so I give him a Cerenia pill in advance of any vomiting. He is gobbling up his food at a rate of 2-3 small cans a day, and drinking plenty of water. His pooh has gone from thick liquid to pudding consistency!!
On Sunday 3/4 I decide to give the Fortiflora a try. He eats it right up. We continue to make steps in the right direction. On Monday AM I wake up to find fully formed poop in the litter box. I can hardly believe my eyes, and am convinced I am imagining it. It’s 5:00 AM but I call my best friend to share the news! Junior continues to eat well and drink. For the first time in weeks, I sleep like a rock Monday night that is until about 4:30 AM when the vomiting starts again. I had been so excited, we had gone 6 days without any vomiting, and now we are back to liquid, foam and mucus. I am able to get a Cerenia pill to stay in him, and once again we both fall asleep on the couch. When we get up at 6:00 he is hungry and ready to go. Cerenia has become my new wonder drug!!! I am again on a high until….when I get home from work on Thursday night, I find four little puddles of clear liquid that he has vomited up. I decide not to give him the Cerenia because he does not appear nauseas, I can coax him to eat a little, but I can tell he is not quite himself. At about 8:00 he starts to cough. It is a weird kind of cough, and then he would sit there and stick his tongue out. He was breathing kind of hard too. He really scared me. Once things calmed down, I gave him the Cerenia. Things continue to progress, and two nights in a row I come home to find Junior sitting on his perch in the dining room window waiting for me. He hasn’t done this in over a month, and to me it is a sign he is starting to feel better. When I came home Friday night (3/9), there was again formed poop in the litter box. I am once again on a high, after the low from the night before. We have our follow up vet appointment Saturday 3/10. We decide to add Pepcid daily to his regimen, and give him the Cerenia every other day, hoping to pre-empt the vomiting. My vet explained that the vomiting is not good for him in many ways, and may actually aggravate the inflammation in his intestines and pancreas. We will keep all his other meds the same for the next 10-14 days unless something gets worse. He comes home and eats a full can of cat food, and is sleeping peacefully in his favorite rocking chair on the sun porch. At the moment, life is good!
Junior’s treatment for the next two weeks is: Cerenia ½ 16mg tablet every other day, Pepcid ½ 10 MG tablet every day, metoclopramide 1 ml 2XDay, budesonide 1 mg once a day, vitamin B-12 shot once a week, atenolol 15mg ¼ tablet 2x/day (heart med), Fortiflora 1 packet a day. The weekend goes well, and it seems the Cerenia every two days is controlling the nausea. The Pepcid seems to be helping too. His poop is either fully formed or toothpaste consistency, and he is only going once or twice a day. On Monday morning March 12, Junior wakes me up at 5:00 AM. This time it is not the awful sound of his vomiting, but instead he is meowing to let me know he is hungry!! I jump out of bed, mix his metoclopramide in a tablespoon of baby food, and stick his atenolol pill in a soft treat and he gobbles them all down without any coaxing! I give the metoclopramide a half hour to work, and then give him half a small can of cat food. When I come downstairs about an hour later, the plate has been licked clean, and he is sound asleep in a new bed I bought him yesterday. You see during this ordeal he has somehow decided to return to sleeping on top of my kitchen cabinets. Since he has gotten older, and had back surgery, he hasn’t done this in about two years. I decided he shouldn’t sleep on the hard wood cabinet surface, and so bought him a bed that fits perfectly up there, and lets him think he is hiding from me! This has been our first morning of a “normal” routine in I don’t know how long. On the 12th we finally got the hard copy results of the TAMU blood work on Junior. His folate, PLI and TLI are all within the perfectly normal range. Just cobalamin is really low <150. Doesn’t look like he has pancreatitis.
This is a useful tip I learned on line. For those of us who are out of the house all day, when feeding canned food, it can be worrisome to leave them with food in the morning and then nothing till we get home at night. I am usually gone for 12 hours. But if you freeze the food and leave it out when you leave, by mid day it is perfect (as the internet article said) mouse temperature! I have started freezing ½ can squares that I put out in the morning. Works great. Also, I think it was on the Entocort website, I read that you should not give budesonide at the same time as antacids. The antacids actually cause the budesonide to get absorbed into the bloodstream quicker. It also said that budesonide should be given in the morning. I had been giving Juniors about an hour apart, but I am going to start giving his budesonide in the AM and Pepcid at night. Finally I saw a lot of places that talk about budesonide in “beaded” form versus powedered form. So I called my pharmacy to see what Junior got, and he got the powdered. I have a call in to the vet to get that changed to beaded, as everything I have read indicates that is the slow release and doesn’t get into their system too quickly.
March 19, 2012: This week has been another filled with some ups and downs, those I must admit in hindsight the ups far outweigh the downs. I will start with our one and only down. Around last Thursday I started to notice that about an hour after Junior ate breakfast he appeared to be having some abdominal pain. He would sit and stare straight ahead squinting his eyes really tight, or lay fully stretched out on the floor. He didn’t want me to go near him or hold him. After several hours would pass he seemed better and hungry, but the same thing would happen after he ate. I spoke to his vet on Friday and I got the usual, you should expect some ups and downs, maybe the food he is eating isn’t agreeing with him, you should try switching it or feeding him smaller portions. I was frustrated by the response, because it just seemed like he was pacifying me. Saturday morning I had an idea, I realized that I was adding Forti Flora to Junior’s breakfast. I wondered if somehow that was giving him gas and or cramping. I took a shot and didn’t give him any on Saturday or Sunday and Junior was perfect both days. Don’t know if it was coincidence or not, but I am willingly accepting the results. Now for the ups, Junior went to the front door and started meowing and stretching up against the door…his signal for he wanted to go out for a walk. I got his harness and leash and we went for two separate one hour walks. He played with his feather, crinkle ball and EeeK. He has had perfectly normal bowel movements since last Thursday. Only difference is now he is going twice a day instead of once. He hasn’t vomited in over a week, and there doesn’t appear to be any signs of nausea. He is eating well on his own without any coaxing. As for meds, we reduced the Cerenia to ¼ 16mg tablet every other day instead of ½, stopped the Forti Flora, and starting this week I will try reducing the budesonide to every other day.
Now for me. I woke up at 2 AM on Sunday and never got back to sleep. I lay there asking myself, how did I let this being that I love so very much get so very, very sick? As I look back there were indications that things weren’t right. The most notable was for the last 6 months or so Junior had a ferocious appetite. There seemed to be nothing I could do to fill him. Several times I would sit there in amazement and wonder how big his tummy could be that he could finish these huge platefuls of food. It had gotten so bad, that I had to lock him in my laundry room just to eat dinner, otherwise he was climbing all over me and the table to try and get to my food. I had mentioned it to my vet several times, and kept getting no real answers. In addition he was sleeping a lot and instead of coming upstairs to bed at night with me, he would stay down by himself. I chalked it up to he was a 14 and just getting old. Also his diarrhea first started in December and I thought it would clear up on its own. Then in mid-January we first started on the metronidazole and that didn’t do anything. This time his cardiologist did take my concerns seriously, and ordered the full bloodwork. When that came back perfectly normal she recommended the ultra sound as our next step to diagnosing what was going on. You see I didn’t want to face that what might be going on was cancer, and that I could lose Junior, I guess I didn’t really want to know. As such I let things go on for another couple of weeks before getting the ultra sound, and then it took another week or so to get him on medication. In the meantime I easily could have lost him, in the words of Dr. Phil, I created what I feared! So my advice is this. You know your cat better than anyone. You know when they aren’t acting right. Don’t let things smolder, and don’t be embarrassed, as I was, that I was over reacting and being a neurotic pet owner. Get them checked out so that you don’t live with regret if it ends up being something serious.
June 8, 2012: It has been about four months since we first began treating Junior for IBD, and things are progressing incredibly well. Although it was a tough first couple of months Junior is really stable now, and I put his progress at about 98% normal quality of life! Let’s start with his meds, we have weaned him off everything but 1 MG budesonide once a day, 1/4 of a tablet of Pepcid once a day, and a B-12 shot monthly. He of course still takes his Atenelol twice a day for his heart condition. If he stays on his budesonide his bowel movements are pretty normal, going fully formed pooh once a day. Every once in awhile he will go really soft (pudding like), but that happens maybe once a month. The only true sign of his IBD at this point is he will vomit once or twice a week. It used to be quarter size water or white foam, the last couple of times it has been bile. Almost always happens between 3:00-5:00 AM. I have found that bringing his food bowl up to the bedroom at night helps him to continue to eat during the night. I have also found that keeping a bag of treats in my nightstand helps too. Whenever I get up during the night, I give him a few treats. This seams to really help keep his stomach from emptying out, and helps tremendously with the vomiting.
He eats soft treats since he has almost no teeth left! He really likes Natural Balance Perfect Bites. Nutritionally I think they are really good with no corn, soy or wheat, but they are kind of small and sometimes he will choke on them so I smush them between my fingers before I give them to him. The other treat I use as a pill pocket is Friskies Hairball Remedy. Probably not as good for him nutritionally but they are super soft and great to hide a pill in, which makes pilling him much less stressful and I think that counts for something when battling this disease. I have found this a little scarce to find in stores but I was able to order them through Amazon.com. Overall I feel really fortunate to have found Junior great medical care, and to have gotten his disease so under control in a relatively short period of time. He is really energetic and playful now too, so we are enjoying our time together so much!
February 17, 2013: Things are remarkably unremarkable. Junior is doing great. Poop is perfectly normal and he has returned to his favorite food, fancy feast elegant medley dry. He gets a treat of people chicken almost every day, his meds are his atenolol twice a day for his heart, budesonide once a day, and Pepcid once a day. His vomiting is very rare now, maybe once or twice a month and either foam or bile. He can usually be found either curled up on my lap fast asleep, or his favorite winter hide away, the top of my kitchen cabinets, right under the heating vent! I am grateful he can still make it up there in a single bound, although he makes me very nervous on the way down. I am happy to report I have my 14 1/2 year old kitten back, and we enjoy each day we have each together.
October 9, 2013: I suspected Junior was losing his hearing so I took Junior in yesterday. No infection, so we think just old age. Dr. Brown believes he has some hearing. His blood pressure is through the roof. Started at 260, got down to 220 when he calmed down a little. Started him on amlodopine in addition to his atenolol. She thinks his blood pressure may be why he is yowling so much at night. He has also been having intermittent diarrhea for about three or four weeks. At his age could be his IBD, kidney, thyroid, diabetes, although all blood
work was normal about two months ago. One day he poos fine, next day butterscotch pudding!
February 25, 2014: Today was a bad day. My brother and I lost our mom today, after a week of caring for her at home with Hospice. During that week, Junior understandably took a back seat, and I was not at all consistent with his meds. At 3:30 AM, he began to use the litterbox very frequently, when I got up to check on him he was squatting and going diarrhea on the carpeting. Off to animal emergency we went. I felt so bad that I had neglected him and contributed to his distress. He stayed overnight, was giving IV fluids, metronidazole and as the vet put it, when he stopped “leaking poop” was able to come home the next day.
August 2, 2014: After a few days of pooping different consistencies from perfectly normal to butterscotch pudding, and some minor vomiting, Junior began to have very frequent bouts of watery diarrhea every couple of hours. After two days, when things didn’t improve, off we went to animal emergency. We got some metronidazole but everything he was eating was going right through him. So by Sunday morning I took up all his food, and just left him with liquids. This in conjunction with the metronidazole seemed to have stopped the diarrhea. I began to feed him small quantity of chicken every couple of hours Sunday night. No diarrhea since then but no poop either, but he is alert, active and has a great appetite. Finally got some poop on 8/7, back to diarrhea on 8/8. Continued with metronidazole, stopped any canned cat food and went back to dry cat food and boiled chicken. Finally on 8/12, he pooped perfectly normal!!!! I have gone ahead and scheduled an abdominal ultrasound just to see what is going on with the little guy. Will keep you posted on his progress.
November 2014: Junior started urinating outside the litter box. I took him for bloodwork, urine analysis and urine culture. All came back clear, but continued signs of early kidney disease. Vet thought it was behavioral because I was moving, but I wasn’t buying it. Just not like him. Still have not been able to get his diarrhea cleared up since August. Vet recommends starting him on sub q fluids at home. I am resistant.
Early December 2014: Junior not urinating in litter box at all. Took him to another vet for a second opinion. This vet thought that the combination of Amlodipine and Atenolol lowered his blood pressure too much causing strain on his kidneys. This vet stopped ALL his meds, gave him an injection of dexamethasone, Convenia, and started him on prednisolone. I was not comfortable with stopping his heart meds, but vet convinced me to give it a try for three days, and then we would recheck blood work. Junior began using the litter box. Follow up bloodwork looked good. Junior had developed an upper respiratory infection. Started him on Zithromax. Kept all else the same. Diarrhea continued. About a week later began urinating outside litter box again. Theory was the litterbox had become a painful place for him due to his diarrhea. Started him on anti-depressant. He began using litter box. Continued to try different antibiotics to get diarrhea to clear up. No luck.
Mid December 2014: Junior’s heart murmur returned and kidney values rose. Vet agreed Junior needed to be back on the Atenolol. Gave sub q fluids. Junior was now very lethargic and sleeping all the time. Back to urinating outside the litter box.
Christmas morning 2014: Junior is a rag doll. Not eating or drinking. Very lethargic. I take him to animal emergency. Kidney values escalated even higher. Not a good trend. Agree to hospitalize him on IV fluids. Discontinue anti-depressant. Junior is now back on all of his original meds except the amlodipine. Within 24 hours kidney values are down significantly. Agree to keep him hospitalized for one more day. When he returns home, I muster up the courage to begin sub q fluids at home, and get him back on B-12 weekly. He is alert, active, playful, and his mean old self. Diarrhea still not controlled.
Mid-January 2015: Still determined to try and control his diarrhea, I speak to his internal medicine doctor at the specialty hospital. She recommends we try Proviable paste followed by the capsules. I try the paste. No improvement, maybe even a little worse. Urinating in the litter box.
Late January 2015: My regular vet suggests trying him on a raw diet (Natures Instinct Rabbit bites). I am skeptical, one that he would eat it, and two that it would work. I agree. I give it to him as soon as I get home and he LOVES it! Chows down on it, and eats it exclusively for two days. Has a normal bowel movement. I am amazed. Suddenly decides he won’t eat it anymore. I mix it with boiled chicken. Diarrhea returns. I schedule a follow up ultrasound for early February. I need to know what is going on, and he can’t tell me.
Early February 2015: Junior’s diarrhea is getting really bad. He is restless. Goes into and out of the litterbox. Doesn’t poop. Sits in litter box. Cries, seems to be in pain. Eventually goes watery diarrhea. This continues throughout the night. The next day (Monday evening) I start him on the “Emergency Dosing” of S. Boulardii, then down to “Therapeutic” dose after 48 hours. Diarrhea stops immediately, in fact no bowel movements at all. By Friday night he still hasn’t had a bowel movement. I take him to the vet, they palpate him and tell me he has no poop in him. They theorize he has been pooping outside the litter box. I search high and low and find no signs of anything outside the litter box. Overnight he poops perfectly normal! Saturday afternoon another normal poop. I am amazed and ready to tell every vet in town about S. Boulardii. Saturday afternoon, very large dump of soft poop. I discontinue the Boulardi. Starting at about 7PM Saturday and continuing until about 5AM Sunday morning, Junior is going diarrhea every 90 minutes or so. He is definitely in distress and pain. Thankfully ultrasound is Monday morning. He does well on Sunday, eating well, alert and no bowel movement.
Februart 9, 2015: Junior’s follow up ultrasound shows his IBD has likely progressed to cancer. I am heartbroken. All of his other blood values are good, CKD seems to be well controlled with at home fluids. Vet suggest starting him on Leukeran, and rechecking in two weeks. I hesitantly agree. He is 16, and been through so much, I just want to do what is right for him. She says cats can tolerate Leukeran well, and that this is a very reasonable course of treatment. He got his first pill last night. Tolerated it well. No signs of nausea. Good appetite overnight and this morning. No poop yet. Gets rechecked in two weeks.
March 3, 2015: Junior had his two week follow up appointment yesterday and his labs look great! Seems to be tolerating Leukeran fairly well. He got three doses every other day from 2/9-2/13, and has gotten 2mg every other day since Thursday 2/19. Total 9 doses. Have been giving him Cerenia about an hour before the Leukeran. He has not vomited since Sunday 2/15. He seems to be a little more alert and awake than before we started the Leukeran. Appetite is inconsistent. Sometimes he eats really well, other times has no interest in food. What he likes one meal, he sometimes turns his nose up next. When he is in his “I am not going to eat” moods he will be hungry, smell the food and walk away, or take a couple of bites and walk away. He looks like he has a tummy ache after he eats. When he does eat he has been eating rotisserie chicken, boiled chicken, baby food, and most recently Iams Kitten formula dry (which at the moment he loves), and dehydrated fish flakes. I thought kitten formula might be higher in calories and might help him to put on weight. He has lost a little more weight, down to 5lbs. Hoping to be able to turn that around soon.
He really hasn’t had watery, yellow diarrhea in several days. His poos are soft, but dark brown. He seems to struggle to poo. He will visit litter box several times, sometimes just sit in the litter. When he does poo it is about a quarter size in volume and toothpaste consistency. Sometimes he will go a day or two without a bowel movement, other times he will have several small bowel movement in one day. Sometimes he will cry after he urinates. Sporadic yowling. Drinking lots of water. Keeping him on every other day dosing of Leukeran through Friday, then going to twice a week. Will have follow up blood work and ultrasound on 3/23. At the moment I couldn’t ask for more. I did find a pharmacy in NJ that will compound the Leukeran in 1mg capsules. $60.00 for 30 capsules about ¼ the cost of the non-compounded version!!!
Current meds: Atenelol 2X Day; Metronidazole 1X day; Budesonide 1X day; ¼ Pepcid 1X day; Luekeran 2mg every other day; ¼ Cerenia every other day; Buprenorphine as needed; 50 ml fluids every other day (w/B-12) B-12 weekly.
March 30, 2015: I had to let my boy cross the rainbow bridge yesterday. His initial ultrasound (about a month ago), indicated small cell lymphoma. His last ultrasound showed it had progressed to a mass between his gall bladder and pancreas. He was a fighter till the end, but I couldn’t bear to watch him decline. He was a wonderful companion for 16 years and I miss him dearly already.