Lulu P.

Lulu2Lulu P – Wiltshire, Southwest Lulu1England, United Kingdom
Female, Somali Cat
Born February 20, 1999
Diagnosed with IBD in June of 2009
Diagnosed with iris melanoma on May 2, 2012
Dianogsed with Idiopathic Feline Orofacial Pain (FOPS)

 

 

First Entry: April 14, 2011: I collected Lulu from a breeder at 4 months old. She was initially fed on a mixture of Iams dry kibble kitten food, High Society and Whiskers Kitten wet/canned food with fresh cooked Coley (white fish), turkey and scraps from the Sunday joint, while at the breeder. I continued with this for some time before gradually progressing mainly to Whiskers canned Kitten food, and then progressing to Felix and Whiskers canned adult food and kibble, which she was fed on until Ted was diagnosed with IBD in May 2005.

It soon became very clear just how difficult it is to keep certain cats on a strict diet, when you have a multi cat household, therefore because the prescription diet of Royal Canin Sensitivy Control (SC31) capelin and tapioca kibble is a complete food diet and considered to be an excellent protein source, all three cats were slowly converted to this food. After the manufacturer stopped production of this food all three cats were converted to Royal Canin sensitivity control Chicken and Rice and/or Duck and Rice moist pouch food and kibble and Royal Canin Blue Whiting sensitivity control kibble.

Prior to diagnosis in June 2009, Lulu had been a member of a multi cat house hold. I was the proud owner of four beautiful cats, different breed types, colors and within various age ranges, none of which were related. Ellie, female, (1990 -2004) beautiful long haired tortoiseshell, mixed breed domestic cat who was euthanized in July 2004 after being diagnosed with terminal and un-treatable cancer of the stomach at 14 years of age. Gismo, male, beautiful silver tabby and white chinchilla Persian cross, moggy domestic cat, (1996 – 2010), (see Gismo’s case history on the Tributes Page of this site). And Teddy, male Somali (DOB: 2001), (see Teddy’s case history in the Tributes section).

Lulu had always been an extremely healthy, hardy, playful kitten and cat. In fact she continued to remain in good health throughout most of her young to mid mature years. However, she was a fussy eater on occasion. Lulu was generally well and fed lightly boiled chicken and/or white fish when a boat of IBD occurred. She had a slow progression to Royal Canin sensitivity control Chicken and Rice and/or Duck and Rice moist pouch food and kibble and kibble and Royal Canin Blue Whiting sensitivity control kibble. Despite her occasional condition Lulu was generally a happy and sociable cat.

As of January 1, 2009, Lulu was fed on 50gms Royal Canin Sensitivity Control kibble and 25gms Royal Canin Chicken & Rice moist pouch food per day. Generally well, happy and content cat. Wormed with Drontal, had occasional occurrences of fresh blood from bottom and occasional vomiting. Prescribed ½ x metronidazole tablet 250mg twice daily for 7 days. On April 26, stools were sent for lab analysis to eliminate the possibility of parasitic and bacterial infections, negative result found. Vet discussed benefits of carrying out a Bile acid stimulation test, pre/post food, in order to understand and diagnose GI, pancreas, and/or liver disease. May 13, blood samples were taken; hematology (hl) and pre-op biochemistry (in house) B12/foliate (b3) to see how well the gut worked/absorbed and any other abnormalities in the blood count including liver disease, GI and pancreatic problems. Generally all samples were within normal range, mild increase in acids, further testing to be done.

On May 18 Lulu was hospitalized where they took 3 dynamic bile acid samples. Bile acid stimulation test were done, looking for Liver disease, GI and pancreatic problems. In the meantime I was to feed a bland diet chicken and/r white fish. On May 22 a gastroduendenoscopy (endoscopy), ultrasound examination and two x-rays were carried out. The vet prescribed 21 x metronidazole tablet 200mg, ½ (100mg) twice daily and 5 x Losec 10mgs, half tablet once daily (am). By June 7th she was very unwell, vomiting clear fluid and not eating. Her general demeanor was not very good. She was tuckered up, miserable and ran and hid when it was time for her medication. I contacted the vet to tell her that she was also losing weight. The vet advised to feed bland diet and Hills Canine Ad (156gms tins). Also to withdraw the metronidazole and treat her with Clavaspeptin, which is gentle on the stomach, but less effective in the lower bowl. She was still vomiting clear fluid, unable to take high dose of metronidazole (bitter taste), was totally off her food, not eating and losing weight. It was very upsetting to see her like that. Vet prescribed 20 x Clavaspeptin 50mgs tablets. The results of the endoscopy were mild GI and IBD.

On June 15 the vet prescribed 1 tube of 15ml Protexin Pro Kolin Paste, 1ml three times and 3 x Cerinia 16mg tablets at ¼ daily for 6 days. Cerenia is licensed for use in Dogs but effective in cats too. It’s an anti-nausea tablet that affects the area of the brain that is responsible for vomiting. Weight 2.6kg (decreased) target weight 3kg. She was underweight due to being starved for three days in order to carry out Endoscopy and related tests, also due to high dose of metronidazole effecting her appetite. Vet recommended to slowly introduce Royal Canin Feline Hypoallergenic food (DR25) and advised to slowly increase the amount of (DR25) while reducing the amount of white fish, aiming to be on 100% (DR25) by June 24th.

I was to Keep Teddy and Lulu on Hypoallergenic food for 5 weeks (first day on 100%) in order to allow all other food substances to expel from their bodies. This would enable us to see the effect of the new food on their digestive systems, and give us an understanding of possible causes, either food allergy OR idiopathic bought of inflammatory bowel disease. She had occasional bouts of vomiting and diarrhea. August 22nd vet examination showed her condition to be good, weight 3.89kg. Given 1 x cat booster (combination booster including feline leukemia) and was prescribed Pro-Kolin and Katalax to protect the bowl and rule out fur balls.

By December 29th, Lulu has developed black ear wax in both ears (in fact Gismo and Teddy had too). The vet said it was a possible ear mite infection, although very late in season. (In retrospect I’ve learned this is a symptom of IBD). She was then prescribed Canaural ear drops, two drops twice daily in each ear for 7 days. Everyone’s bedding was washed. Changed diet to Purina Ha and lightly boiled chicken. By March 24th, she had been de-wormed again with Drontal and vet suggested changing from lightly boiled chicken to lightly boiled turkey and Purina HA. Over the next couple of months we continued with the ¼ Zantac daily and tried various ratios of boiled turkey and Purina HA, working up and down the ratios to either 100% turkey or 100% Purina HA (Gismo was very ill at this point too).

In May, 2010 we continued the above diet, varying the ratios, with 80% Purina HA and 20% lightly boiled turkey, giving the best result. She vomited only occasionally, no particular pattern to the vomiting. Hard dehydrated toilet most days. Generally very good in herself. By June she was on 100% Purina HA biscuits. After the loss of Gismo and the devastating effects of the diseases and treatments on Gismo’s body I had decided to check out alternative, more naturals ways of finding a solution to Teddy’s and Lulu’s on-going health problems. I searched websites informative books on cat care and health in a desperate attempt to ensure Teddy & Lulu did not suffer the same fate as my poor Gismo. I discovered this website, IBD Kitties, and also purchased ‘Your Cat’ simple new secrets to a longer, stringer life by Elizabeth M Hodgkins, D.V.M, Esq.

I discovered each to be an excellent source of accurate information. I introduced one Efavet 330 (oil of evening primrose and marine oil) casual daily (Efavet330, is a known natural anti- inflammatory supplement). Introduced Evian bottled water instead of filtered tap water after reading an article on chemicals in our water supply and page 313 of New Choices in Natural Healing for Cats & Dogs by Amy D. Shojai and the Editors of Prevention for Pets. Evian is free from Chloride and according to this article, chloride can cause bacterial over growth in the digestive process and can cause bleeding in IBD.

With continued use of above products I observed a marked improvement in Lulu’s toilet which was perfect No blood or mucus, firm and no vomiting, it’s truly amazing. I introduced Synbiotic D-C capsule, a probiotic and prebiotic powder in a capsule to restore the gut microflora, once daily. Was on 100% Purina HA biscuits (hydrolysed soya based diet).

July 8th she was drinking 3/4 times more than usual and not vomiting. Urine sample taken showed range 0-35, Lulu’s is 50, a good result. Kidneys were okay, generally healthy, however working hard. Sample indicated Lulu possibly not drinking enough, also could be a combination of eating dry kibble (was on 100% Purina HA) and the hot weather at the time caused a slight weight reduction. Vet suggested that the increase in water intake may be due to the fact that cats have an excellent sense of smell and do not like drinking water that contains chemicals, therefore Lulu may just like the taste of the Evian more. Vet happy with general condition of cat and said that Efavet is a known natural anti-inflammatory and was happy for me to continue administering it to her.

I began searching for a more suitable food since discovering cats are obligate carnivores via ‘Your Cat’ book. Referred to this website for suitable cat food products and suppliers. At that point, almost all of the food on this site was not available in the UK (Europe). Despite contacting manufactures directly in America, they were unable to sell their products within Europe due to importing and licensing laws, the only exception being Orijen Dry kibble. I introduced Orijen Chicken kibble into Lulu’s diet and reduced the quantity of Purina HA biscuits, slowly increasing quantity of Orijen to 100% over the next week (7 days). By July 18th she was on 100% Orijen Chicken kibble and showed a definite improvement in condition of toilet; normal, not dehydrated. And she also liked the taste of Orijen. There still had occasional vomiting, normal toilet, but not dehydrated. I was concerned about feeding dry kibble only, because it makes the kidneys work harder. I began to introduce a 10% canned wet food, Bozita Chicken. Lulu loved the taste of the Bozita (97% pure organic meat with no gain) Perfect toilet, no issues, no vomiting.

I cut her Orijen Chicken kibble to 60% and started to introducing 40% canned wet food Bozita Chicken. I started the withdrawal of Synbiotic D-C capsule, fed 60% Orijen Chicken kibble and 40% canned wet food Bozita Chicken. No issues with vomiting or toilet consistency. Generally, very happy and content cat. Then went 50/50 with dry and wet food and saw a 100% improvement. She had soft, silky fur, lots of energy and was very playful. I was very pleased with the outcome. Lulu was a picture of health and full of energy.

Late October of 2010, Lulu had a vet check–up and an annual boost was given. The vet was very pleased with Lulu’s general condition. Her weight had increased to 3.52 kg, excellent weight for her size. Personal choice, I decided to have the general boost, but exclude FelV (feline leukaemia) because Lulu has limited access to a secure garden, therefore does not come into contact with other cats and have read various article about injection site sarcoma. It has been such a battle to get my cats well that I am afraid to introduce more health risks.

On January 1, of 2011, I introduced 1/2 (1000mg) B12 methylcobalamin (Natural Factors) daily, slowly working up to 1 x (1000mg) B12 methylcobalamin (Natural Factors) daily over the coming month. Continued with bottled Evian water, fresh supply daily in their drinking bowls. Continued mainly with to 50% Orijen Chicken kibble and 50% canned wet food Bozita Chicken. Occasionally I substitute (twice or three times a week) the Bozita with Ziwipeak veal & fish daily cuisine and/or lightly cooked fresh minced turkey tight meat and chicken liver, served in the cooking water for extra moisture. Toilet is perfect, no mucus, no blood. Occasional fur ball vomit, remedied with Katalax. Happy, healthy, playful and loving cat and happy caregiver at last.

October 23, 2011: In March, while we where away for a few days Lulu started to loose interest in Bozita canned food. At first I thought it was because we had been away, as she still ate and very much enjoyed the Orijen kibble. I think it is just that she has gone off it, she still continues to turn her nose up at the Bozita. So I gradually introduced her to Almo canned food, fish varieties and chicken varieties, which included: Ocean fish, Mackerel, Tuna and Chicken and pumpkin, Chicken and shrimp, with each 70gm can contains, 75% meat/fish, 24% broth and 1% rice. My vet recommended “encore” in similar varieties, again with each 70gm can containing: 75% meat/fish, 24% broth and 1% rice. However all fish varieties of “encore” have a minimum of 25% tuna in ALL their fish mix varieties per can, whereas Almo have some fish varieties totally without tuna, within their fish mix varieties per can. And having recently read an interesting article within ibdkitties newsletter detailing how too much tuna in a kitties diet has a negative effect on the vitamin e level within their bodies (it depletes it over time) I have stopped giving all my cats tuna on a regular basis, they can have it for a treat, but not often. Also, both Almo and “encore” are totally natural, therefore nothing is added, not even taurine, so must be supplemented or fed with other complete foods such as Orijen.

Although Lulu very much enjoys eating and licking these canned foods (Almo & encore), as the months have gone by I started to notice that Lulu has what I believe to be, an intolerance to the rice within them, because she started to develop black ear wax, which I cleaned regularly with Clean Aural. She also started to scratch and developed the occasional debris in the corner of her eyes (similar to what poor Gismo had). On a few occasions Teddy has sampled the canned food too, as he is quicker to Lulu’s dish, than me!! He ate up all she had left, which is typical of Ted. However he just vomited it back up on each occasion, I think they both have an intolerance to rice Smartie (my 11 month old kitten-cat) eats Almo and encore with no problems at all.

I tried to source food without rice, grain and tuna, there’s not much currently available on the market, but I did find the following: Porta 21 “Pure Chicken”, Schesir “Chicken & Sea Bass”, Animonda Carny “Ocean” and Terra Felis “Meat Menus”. Lulu has been on these brands for a three months now and she loves these varieties, also the ear wax and scratching have totally disappeared. Her eyes are lovely clear and bright and she is full of energy. So will continue to feed her these with the odd tin of Almo and encore on the days when she is particular fussy and its a case of feeding her these or her not eating.

October 24, 2011: Teddy and Lulu went to the vets today for their flu jabs. I had a biochem of their blood done, so we have a better understand of their body chemist and how healthy they are. We were not able to collect a blood sample from Lulu despite three tries, so she looks like a pin cushion now with a shaven neck and paws! We saw a different vet, one we have not seen before (three vets from our practice have moved on this year). The new vet noticed that Lulu has a slight curve to her spine (scoliosis) she has no history of this. Her back seamed sore when the vet examined her, so this is a new one to me.

Smartie keeps chasing her and is very rough with her, so I try to separate them. But I’m not sure what he gets up to when I’m not around. The vet thinks it is best to do the biochem and when the results are back and everything is ok we can think about putting her on a supplement of glucosamine & chondroitin as she thinks the curve is becoming more pronounced due to arthritis. Lulu has hyper-pigmentation in both eyes but her right one is affected more. The vet said to keep and eye on it, as if it changes and becomes more pronounced or less diffused it could indicate that it is becoming malignant. I explained to the vet that it is slightly less pronounced since I have been supplementing her diet with taurine.

October 29, 2001: Finally got some blood for her biochemist test today, they had to use anesthetic on her to get it, she may be tiny but boy she’s feisty!!! So should have the results back toward the middle or end of next week. Her weight has increased she is now 4 kg, which is half a kg more than before (3.52kg) which I think is the new food because she loves it.

November 18, 2011: Lulu’s blood biochem results came back today and they were very good, so I am very happy. All areas are within the normal range, the only exception was the urea which showed a slightly higher protein level. The vet said it was probably due to slight dehydration at time of testing. We discussed the uses of glucosamine & chondroitin but have decided to await for more info. on Teddy first, as Lulu is not showing any signs of discomfort, and she is still very active and can jump up high without any difficulty.

February 3rd 2012: Spoken with vet today, vet suggested trying Lulu on Metacam for 10 days too see if her back is less sore / inflamed, then we will have a better understanding as to the cause, arthritis or toxoplasmosis. Note: she is not showing any outward signs of pain, discomfort or inability to move. In fact she is quite normal in her movements and manner, but vet was concerned as Lulu complained a lot while the vet examined her back and diagnosed a curvature of the spine, also cats are notorious for hiding pain and discomfort. To collect Metacam on February 8th 2012.

February 19th 2012: 10 day trial of 4ml of Metacam once daily finished yesterday, with no obvious improvement observed, except Lulu complained less when I clean her teeth while she was on Metacam (I clean them 3 times a week with Virbac tooth brushes and tooth paste). Next appointment booked for April 16th, 2012 for a toxoplasmosis blood test, eye and teeth/mouth examination.

April 16, 2012: Lulu went to the vet today, no evidence of infection or decay in her teeth or mouth. In fact they were generally in good condition; she may have some discomfort in her neck, due to arthritis, when cleaning her teeth, because her head is facing upward, creating an angle between her head and back bone. Metacam recommended, as it is not acute pain and can be easily administered at home, buprenex discussed with vet but not recommended by vet for this type of pain, as has to be injected in the surgery, generally only lasts for two days at a time and is generally used for acute pain. Lulu’s right eye has more hyper-pigmentation of the iris than before, resulting in more surface area of the iris having a dark ring effect around the entire edge of the iris and less of the coloured section showing now. Possibly enlarged area of hyper-pigmentation, iris rubinosis, uveitis, appointment book with ophthalmologist for April 25, 2012. Blood test taken for FELV, FIV and toxoplasma.

April 18, 2012: Lulu’s FELV (feline leukaemia virus) and FIV (feline immunodeficiency virus) results were negative, which is excellent, awaiting toxoplasma results next week.

May 2, 2012: Lulu was examined by an ophthalmologist on May 2, 2012. Diffused Iris melanoma was diagnosed in her right eye, which has elevated the pressure within her right eye to 21, in comparison to her left eye at 12, although the right eye is not distorted by the pressure at this stage it is on its way to glaucoma, which in turn leads to blindness and becomes very painful. The only option is to surgically remove (enucleation) her right eye because melanoma can metastasizing and rapidly cause death if left untreated. The ophthalmologist is hopeful of the outcome if the eye is removed within the next two weeks as it has not effected the white section (sclera) of her eye yet, which is very good news. The removed eye will be sent to histology, body CT scan or chest x-ray images and ultrasound examinations could be carried out to see if the melanoma has metastasized, but if they are very small (less than 2mm) they may not show up, but may still be there. Lulu’s toxoplasma results were negative.

May 20, 2012: Lulu had her surgery and spent the night in hospital on May 16th, I collected her the following morning. The operation was very successful and went to plan with pathology results expected in three weeks. Postoperative examination booked with ophthalmologist on May 23rd . The eye area is sore, but she is coping very well without it at the moment. We have been sleeping in the spare bedroom with the mattress on the floor, so we snuggle up together all night, its lovely. I plan to spend as much time with her as I can, to ensure she does not scratch the area or damage the stitches which will disintegrate in 9 days time. She came home wearing an Elizabethan collar but soon made it clear that she was having none of it. As soon as I took it off she settled down nicely. Only had one occasion when the wound was drying up and itching that I had to use it again, but only for about half an hour and she was fine again.

S5001097 S5001102

Its sad to see her like it but she still looks beautiful and will hopefully be healthier now, finger crossed. Lulu’s appetite is good which is a good sign and I have been giving her all her favourites and she is on pain relief and claveseptin twice daily. Lulu’s pre-op bloods were good except the kidney results were elevated, so she probable has slightly less kidney function, but her liver was good. The T4 for hyperthyroid was 25 which is mid range, so she does not have hyperthyroidism thankfully and the vet said that her removed eye did not have glaucoma, so that was caught early too. Her weight pre-op was 3.8kg and the elevated kidney result was 12.8 which is only just elevated.

May 23, 2012: Lulu is back in the hospital, she started to vomit Monday morning (21st May) and had diarrhea once, then vomited twice more during the day with blood in the last vomit of the day. So I took her back up the vets at 7 pm that evening and they gave her a Zantac injection to calm her tummy. All other areas were okay, temperature was normal and she was not dehydrated despite not eating anything all day except two teaspoons full of steamed white fish, so they let me take her home again. Weight is 3.64 Kg. Despite being given the injection earlier that evening and being bright in herself Lulu vomited up a white foam liquid size (two desert spoons full) and small amount of blood at 12 am and 2 am and again at 4 am. Each time with slightly more blood, fresh red blood, although she settled down and went to sleep between each episode of vomit, 6 am brighter and drank some water.  8 am (22nd May) examined by vet who hospitalized her and put her on a drip to hydrate her stomach where she spent the remainder of the day and night on Aantac, losec, Cerenia, cytotex and Antepsin, vet not sure what has caused it, most probable a combination of stress from the operation, anesthetic and post op mediation for pain relief or some other unknown pathological cause. I visited her yesterday evening for an hour and she had not vomited at all while hospitalized, was content and purred for the full hour.

May 25, 2012: Lulu came home on Wednesday after she was examined by the ophthalmologist vet. she is still having losec once daily and antepsin 1.25ml and cytotex three times daily. She is not eating much still, its a real job to get her to eat anything. She just has about 2 or 3 teaspoons three times a day, but I ensure it is moist food. I serve it warm, freshly cooked in the cooking juices, chicken and/or white fish. I offered her encore chicken and ham which she usually loves, but still has no appetite. She is more comfortable at home, loving and bright in herself, so just need her to get her appetite back now.

I went straight to the vets yesterday evening before they closed at 8 pm and got a box of 8 x 100 gm. trays for royal canin Recovery food and ample syringes. By 8.45 pm she had been syringe fed 20 gms of recovery food, which looks and smells delicious when I added a couple of drops of warm boil water to it to make it smell more. I left it till 11.30 pm for the next feed because I was worried I would over load her stomach and it make her vomit it all back up, but at 11.30 pm I got her to have another 10 gms via the syringe. She slept all night till 6.30 am, when she woke me wanting her breakfast, I followed her down stairs and she patiently sat by her place mat waiting for her breakfast. I did the same again and added a couple of drops of warmed boiled water to 25 gms, but this time I put it in her dish and she licked the bowl clean. I offered another 20 gms but she did not want any more, so I binned it and we both went back to bed after her medication. At 9.30 am I offered her 10 gms more but she did not eat it so I syringe fed it and got her to take the full 10 gms. In the last 13 hrs I got her to eat 65 gms, which is really good.

I will see how she goes and continue to syringe fed her and slowly build up the amount she has to the daily recommend requirement. If she still does not have an appetite after her tummy calming meds have finished I will ask for the cyproheptadine, but really only want to add any additional meds if I really have too, because her poor little body has really had a lot to deal with lately and I can manage the syringe feeding as she is so good to feed like that, but its nice to know what to ask for, just in case. She is brighter in herself this morning, but has been scratching her wound, so is wearing her Elizabethan collar at the moment.

May 30, 2012: Finished last dose of 1.25 ml Anseptin this morning, but has no appetite and soft poo with blood in it, therefore booked vet appointment. Vet examination observed slight dehydration, normal temp, weight 3.55 kg which is the same as when recently hospitalised for vomiting. Possibly not eating due to possible pain in lower digestive system, colon / bowels, hence fresh blood in stools, if it was dark blood it would have indicated the stomach. Advised to put on normal IBD diet asap, because the Royal Canin recovery food is probably too rich for her digestive system and causing GI/ IBD flare up. Prescribed 0.2 ml Vetergesic 3 x daily for the pain and 1 ml canikur paste 2 x daily to help eliminate any toxin in the gut left from the anaesthetic, Metacam and recovery food, it will also help the stomach retain moisture. 1st June, within two days of this treatment Lulu is back to normal, has an appetite, bright, content and purring. Last Vetergisic given on 3rd June, still continuing with the Canikur paste and still normal in her appetite and manner today 5th June. Eye surgery wound heal nicely, so she does not need the collar now.

June 13, 2012: I got Lulu’s results back today and the prognosis is fair, without evidence of scleral invasion, therefore a low mitotic rate. So its a good job we got the eye removed before it infected other areas. The ophthalmologist is going to look into a vaccination against melanoma that has just come out for canines and may be suitable for Lulu too. I have attached a copy of the lab report:

Histopathological examination confirms feline diffuse iris melanoma, with early involvement of the iridocorneal angle likely to be responsible for the reported mild glaucoma; at the time of enucleation, secondary changes in the retina and optic nerve associated with glaucoma are not yet manifest. As you are aware, the mitotic index, tumour size, and extension into the ciliary body stroma, sclera or posterior iris epithelium are considered prognostic, and distant metastasis to liver, spleen, kidney and occasionally other organs is documented. In this case the tumour shows extension into the ciliary body but only relatively early involvement of the iridocorneal angle, without evidence of scleral invasion, and a low mitotic rate, and therefore the prognosis is probably fair with enucleation at this stage.

December 4, 2012: Lulu was not interested in wet food for a few days but did not show any other signs of illness, except being less vocal and slightly less active. So I took her to the vets for a check up. Initially the vet thought she may possibly have a urine or bacterial infection, so the vet took a urine sample with a needle. The urine test revealed nice strong urine which meant that her kidneys and liver where working very well and tested her urine for sugar, which was normal. Her weight was 3.60 kg, 0.65kg less than in October 2012. Her temperature was 40.5 Celsius which is high for a cat (normal range 38 to 39.2 Celsius). Most probable cause, throat infection and some back pain, possibly from previously diagnosed slight scoliosis. Metacam and antibiotic injection given due consultation and prescribed 14 x clavaseptin twice daily and 12 x onsior (anti-inflammatory pain relief) once daily. The vet also examined her eye, which was healthy, with NO signs of diffuse iris melanoma evident.

First day of treatment, resulted in Lu vomiting clear liquid after her first onsior tablet, then refused to eat no matter what I offered her, I even tried warm Hill’s recovery food to tempt her. In the end I liquified lightly boiled mini chicken breast and offered little and often. I finally got her to eat one teaspoon full, per five feeds, throughout the day. Second day of treatment I just gave her the clavaseptin in the morning and did not give onsior because she had not eaten properly for about 5 days now, which I explained to the vet during her check up later that day on December 6th 2012. During consultation the vet explained onsior was still needed to get her temperature down, it had reduced from 40.5 C to 39.5 C, but still needed to drop a bit more, I asked for something to settle her tummy, he prescribed Zantac liquid 0.5 ml twice daily. I also asked him to check her teeth as he runs the first opinion dental service, which revealed a slight build up and possibly one small cavity. When she is well, it maybe worth getting her teeth professionally clean and possibly getting her tooth filled or removed, but that was not the reason why she was not eating as there was no sign of infection or gingivitis.  Lulu continued with her medication at home, but it was a real battle to get her to eat, her demeanour improved as the days went by, she was soon back at her window seat watching the birds!

January 4, 2013: Although her medication ended on December 16th 2012, and her appetite returned to normal, I took her for a check up today to make sure her back (scoliosis) was not hurting also, I had noticed that she had been scratching and pulling out clumps of fur. During examination, Lulu’s back did not show any signs of pain or discomfort, her weight was 3.73 kgs, her skin and ears were very clean and did not show any sign of mites or infections. Most probable cause, moulting, due to central heating during the cold weather. Her heart was beating fast during examination, her lungs and temperature where fine.

April 5, 2013: Lulu had her teeth cleaned and she had a blood test taken before the procedure to ensure her kidneys and liver could cope with the anaesthetic. It resulted in no significant anomalies, so it all went a head as planned on the day. Two tiny front incisor had fractures and one had a suspected infection developing around the root. So both were extracted and the gum sutured closed with dissolving stitches. The teeth where examined, scaled and polished, she now has a movie star smile! I was really impressed with what the vet did and how happy Lulu has been since. I thought she would have a sore mouth and would be unwell afterword, but she ate three small dishes of freshly cooked white fish the evening of the procedure, then was very interested in the
birds at the window feeder, in fact since she has had them done she is such a happy, loving little cat.

January 17, 2014: Sept. 2013 Lulu had a sore throat and was prescribed claveseptin and vetergesic oral pain relief for a week and improved greatly. Lulu had her annual booster mid October 2013 and an annual health check. She seemed to be drinking more water so we also took some blood to see how her organs were functioning. The results were all within the required parameters, however there was not enough serum taken to do a thyroid test. But the vet thought this to be a waste of time as she showed no signs of disease. Weight 3.8 kgs, the vet said she was in good nick for an cat of her age.

First week of Dec 2013 she was not eating wet food again, just dry kibble, so she was examined and no evidence of any abnormally in the mouth. Her teeth and gums were all healthy and her general wellness including temperature was normal. So pain relief, vetergesic, was prescribed for 4 days. She had lost a small amount of weight 3.69kg. On the second day of taking vetergesic she was back to normal eating wet food and kibble as normal, this continued over the Christmas period, without pain relief, she especially enjoyed the freshly cooked turkey breast meat.

On Friday evening 10th Jan 2014 I noticed that she seemed to have something bothering her, in her mouth or throat after she has eaten wet food. She had pronounced chewing and kept raising her paw to under her chin as if to scratch it frantically for a few moments, then it passed. I watched her eat breakfast the following morning and all was fine. In fact she was fine all day until the evening and it happened again. But she had been chewing cat grass that I grow in a tub for her to aid digestion so thought that was the cause of it, as I always mash her wet food up with a fork before serving it to her. I looked inside her mouth and could not see anything that would cause it, so thought it must be the cats grass (cocksfoot). No problems Sunday or Monday. It happened again on Tuesday evening, so Wednesday I took video of her eating her breakfast, so I could show it to the vet. But she ate her food normally. She had it once again in the day after eating wet food and again approximately 2 hours after eating her supper Wednesday night, while laying on my lap as we watched TV. It seemed more frantic this time as if something was really bothering her, as if something was in her throat that she could not get rid of, which I captured on video to take to the vet the next day. I also noticed that she had a few scratch marks under her chin, that she had caused to herself in a frantic attempt to rid her self of her problem.

Thursday we saw the vet who watched the video and checked under the tongue for a tumour, as she said the behaviour showed mouth pain. No tumour was found, thank good, and the mouth looked healthy except the area of the gum where the back molars come out of the gum. There is evidence of new gum tissue growth that is growing over the top of the back molars, which the vet thinks may be tooth re-absorption on both sides. We booked an appointment with the dentist vet at the same practise for Monday 8am, this it the soonest I could get an appointment for her, so she is on pain relief till then. The re-absorption should not cause pain so we need to rule this out, but it depends on what stage it is at. We may need to go down the route of an endoscopy to see if there is something in her throat as well. She is otherwise normal in her ehaviour and general appearance, interested in the birds at the outside feeder as normal and very loving still. If it is tooth re-absorption then the effected teeth will need to be carefully removed and she may be on antibiotics to stop any infection, but there is not sign of infection at present. Light increase in weight 3.79Kg.

January 22, 2014: We saw the vet on Monday and Lulu is booked in for an investigation under anaesthetic tomorrow morning. The dentist-vet said he could not carry out a full inspection of her mouth without anaesthetising her. He said there are many possible causes including Feline Orofacial Pain Syndrome (FOPS), Feline Odontoclastic reabsorption Lesion (FORL) or any form of dental disease or any other possible cause. I discussed the possibility of a foreign object, blade of grass and her history. When she was 6 months old she had a foxtail grass seed go up her nose, which my original vet got most of it out and said the remainder would work its way out in time, but that was 14 plus years ago. She is not coughing or sneezing and has no nasal mucus or any symptoms that would indicate that. So we will not know till tomorrow when he has examined her thoroughly.

She will be anesthetized and they will use small mirrors to check every area of her mouth and all the cavities that connect all her head orifices. They will take dental x-rays as this is the best way of finding reabsorption lesions and any infection in the teeth and gums. They have suggested a CT scan, if visual and x-rays do not give any answers to her problem, which I initially agreed to. But I have had second thoughts now because they have to use a dye contract and I am so worried of an allergic reaction and also the cost £700 plus vat at 17% just for the Scan alone, without the anaesthetic, the drip, pre-op bloods and all the other things.

Anyway she is much better with the pain relief, she has not had any symptoms at all, and just normal behaviour, so it must have been sever pain that was effecting her, poor little thing. Sometimes I wish they speak human and could say Mom I have tooth ache or what ever. This morning I was a little late giving her pain relief and she was crying, so I know it is pain that is causing it. So I will do what is best for her as soon as I know what that is. My vets are the best in the area and she is going to a hospital for all this so they have all the facilities including the
CT scan on site.

January 24, 2014: Lulu had her examination under anaesthetic yesterday. All areas of her mouth where examined, including her tongue and under her tongue, her soft palate, teeth and gums. X-rays where taken of her teeth and compared to the previous dental X-rays taken in April 2013, with NO noticeable changes present. However nearly all her teeth are at an early stage in the re-absorption process, but the vet said that they should not cause pain at this stage as none of the crowns were effected. They were not bad enough to require any dental treatment at this stage, it was advisable to leave them as they are for now as extraction could cause more pain. A full head scan was carried out (without contrast dye) from her shoulder to the top of her head, which was clear, with all areas of equal size, density and shape, it did not indicate any inflammation, blockages, infection/puss or tumours in any areas of her head, so a blade of grass or grass seed is a less likely cause too.

The diagnosis is a diagnoses of exclusion, of Feline Orofacial Pain Syndrome, meaning she has pain but the cause is idiopathic. Going forward she has been prescribed Vetergesic 0.2ml three times daily and Gabapentin 25mg twice daily for nine days. The Vetergesic is for the pain and the Gabapentin is to try and calm the nerve fibres down, so that they are less responsive to the pain. Again this is because it is idiopathic and we can just try and treat the symptoms. I started her medication last night and she was very happy and spaced out for ages, but this morning and today she has just been sleepy. But at least she is not in pain and has not had any more episodes of pain reactive behaviour. I will consult with the vet via phone next week and we will take it from there.

January 30, 2014: Update with vet, Lulu much better, no pawing at face or lower movement of jaw in frantic attempt to remove something from her mouth or throat. Vetergesic is good pain relief and Gabapentin calms facial and brain nerves down. So less irritation, less pain. Collected prescription for just Gabapentin for month, 60 tablets, one twice daily, am & pm. No Vetergesic from now on.

February 11, 2014: Update with vet, reported generally calm down occurrence of facial jaw irritation. Two occasions of Lulu frantically pawing at her face desperate to remove something, all other times okay. Still NOT eating wet food well. Vet suggested, keeping her mainly on dry food, keep on Gabapentin, ask for repeat prescription monthly, will assess Lulu again in 2-3 months, may be able to drop the dose down or stop it at some point or may need to continue as is. Need to decide after accessing her. Three days later, February 14th, Lulu vomited in night, sick again in morning, but otherwise okay in self. Following morning (16th Feb) Lulu vomited up small fur ball (1.5 x 0.5cm)  and a long tick shaped blade of grass approx. 3 cm long with 0.5 smaller tick back section, attached to the fur ball by its base, the blade of grass was yellow in colour and was rotting, so had aged. Lulu purr a lot after this, since then has been eating wet food okay even licked the bowl clean and no symptoms of FOPS.

February 25, 2014: Update with vet explained about the above vomit, fur ball and blade of grass, since speaking with them on 11th Feb, and that Lulu has continued to eat wet food okay and no symptoms of FOPS. Vet suggested reducing dose of Gabapentin from one 25gm tablet twice daily to half 25gm tablet twice daily for 4 weeks, to see if it was the blade of grass that was causing an irritation, or if it was just a coincidence and that Lulu may still has the FOPS.

March 27, 2014: Update with vet, Lulu back to normal, no problems eating and no symptoms of FOPS. Vet advised to reduce does to half 25gm Gabapentin once daily, starting this morning.

April 24, 2014: Update with vet, Lulu back to normal and vet advised normal healthy cat now, could continue with Gabapentin, dose as above, as it helps with arthritis pain too or could slowly withdraw, it would be up to me to decide as vet happy with either option. To withdraw continue half 25gm tablet on alternate days for a couple of months, next consultation can be over the phone, no need for physical examination as Lulu is so well. Lulu had her anal glands empty while she was there too. Six days later, after much thought I decided to withdraw the Gabapentin, starting 30th of April, as recommended above. But by 15th May Lulu had been off her food for 3 days prior and yesterday morning started to make a long MEOW!!! cry in the morning at breakfast time. It was best to continue with half 25 gm daily and monitor how she goes.

June 25, 2014: and she is still doing well on half 25gm each morning, has even put a bit of weight of too, so best to continue with Gabapentin long-term I think.

August 27, 2014: Lulu visited vet today due to soft poo with blood, no vomit. Vet prescribed metronidazole 50mg, one, twice daily for 5 days. Toilet still a bit soft and occasional slight blood at end of treatment on September 2, 2014, waited a few days to see if it got better, but did not so:

September 5, 2014: Lulu visited vet today due to soft poo with blood, no vomit. Vet examined her and found no obviously reason for the symptoms, so prescribed Panacur Paste 18.75% in a syringe to give 1ml per Kg body weight for the next 3 days. Ted and Smartie also wormed at the same time.  At end of 3 day treatment all cats poo back to normal.

October 20, 2014: Lulu had her 6 monthly dental check today, the vet examined her and said she was in very good condition for a cat of 15 years of age, also a good weight at 4kg. Teeth look nice and clean, gums looked nice and healthy, although she is still on half a 25mg Gabapentin tablet once daily for Feline Orofacial Pain syndrome. Next dental check up in 6 months, April 2015. Also found new type of canned cat food Applaws senior, which is a nice soft paste with no added grain or cereal, she loves it , finds it easy to eat and always asks for more, but also keeping her mainly on Orijen kibble too.

November 14, 2014: Lulu had Nobi-vac Tricat Trio vaccination today and health check up, heart and lungs all sound clear and healthy, weigh still 4 kg, vet very pleased with her condition for her age.

November 17, 2014: Wormed with Panacur Paste 18.75% in a syringe at 1ml per Kg body weight for the next 3 days because my three little darlings found a mouse in their enclosure and ate it, (not best pleased!!!) so dewormed just in case, to stop possible Giardia spp infections.

January 1, 2015: We started the new year with Lulu occasionally pawing at her month, the symptoms for FOPS have reappeared, but look to be occasional and mild. On 4th January I decided to increase her dose of Gabapentin from half 25mg to one x 25gm daily. 24 hours later, Lulu still showing signs of symptoms, occurrence 3 times a day, especially after eating soft food, otherwise normal in every aspect. We continued with one Gabapentin daily and booked a vet appointment for Monday 12th January. Sunday, 11th January no sign of symptoms at all, but continued with vet appointment. Vet examination of Lulu’s mouth showed no obvious cause of pain and most probably neuralgia, advised to continue with Gabapentin one daily and 0.25ml Vetergesic 3 times daily, to see if the pain relief helps to calm the inflamed nerve. Phone update with vet on Friday 16th January. Continued with medication as advised, but reduced the dose to twice daily on Thursday as Lulu totally zonked out, sleeping all the time. Having to lean against things when sitting or she just falls over, and too sleepy to walk down stairs safely without falling over. Phone update with vet on Friday 16th January. Treatment has worked, no pawing at face at all.

January 23, 2015: One whole week, still no pawing at face – excellent – still on one Gabapentin daily, and generally very well in herself.

February 20. 2015: HAPPY BIRTHDAY – Sweet SIXTEEN !
Lulu celebrated her 16th Birthday today, still no symptoms, which is excellent.

February 24, 2015: Lulu did not want to take her table this morning, it was a bit of a struggle but we did it. This evening I noticed Lulu is dribbling saliva on the right side of her mouth, I wiped it away with a tissue and had a look at her month, it all seems fine to me. The next morning, she did not want to take her table again, within half an hour of having the tablet I noticed a 1 cm long dribble on her right side. She has been salivating most of the day, even when asleep, her mouth area and fur around her neck is slightly wet too. Not sure of the cause, as no
other symptoms and eating soft food well, but just in case it is caused through pain, disease or infection I have booked an appointment with her specialist dentist vet tomorrow evening.

April 23, 2015: Morning I gave the vet an update. Lulu is much better, in fact back to normal. Still on 1 x Gabapentin, but reduced vetergesic to twice daily. However, just after 10 pm that evening she started excessive chewing movements, opening her mouth and moving her jaw about as if something was stuck in her mouth or throat, but I could not see anything, so gave her vetergesic and gently massaged her mouth which seemed to calmed her down and slept peacefully.

April 24, 2015: Lulu started the day OK. I gave her meds at 8 am in the morning with no trouble. But after I fed her at 2 pm with Applaws grain-free canned soft food she started pawing at her face again. She continued pawing at her face for just over an hour, get more frantic which really freighted me as I feared she would tear her tongue with her claws. So immediately called the vet, who was operating so could not see her, but advised to give her second dose of vetergesic an hour early and booked her in for investigation on Monday morning. It was now 3 pm, instead of 4 pm – every 6-8 hours. It immediate calmed it down and she settled down peacefully.

I continued with this over the weekend, but decided not to feed wet food as I think this is triggering it, Saturday went by uneventfully with one occasion of excessive chewing movements for about 10 mins, but soon resolved. Sunday morning I discovered to my horror that I had not been giving her enough vetergesic, I was reading the syringe measuring gauge wrong! I was giving her a quarter of one tenth of 1 ml (= 0.025ml instead of 0.25 ml). The only up side to this is that it is better give less than more of the required dose. Also, the pain was being controlled with less than the 0.25 ml. I gave her the correct dose and she slept most of the day, so only gave twice that day because she was do drowsy. Prior to this I had thought she was becoming immune to the dose as she was very alert after it, so thought the effects of the drug where not so effective, but now I know it was because the dose was so small. (I have never done this before so need to be extra cautious in the future).

April 27, 2015: Starved overnight for investigation under anaesthetic and teeth cleaning and polishing. Lulu has slight gingivitis along her left side because of a small build up of plaque, the only effective treatment is to remove the plaque with de-scaling and polishing; while under anaesthetic her throat, tonsils and nasal cavity where also check with x-rays taken. The x-rays where compared to those taken in January 2014, NO significant changes seen. Pre-op blood where taken with no significant reading found, okay to go home. Diagnosis, idiopathic feline
orofacial pain (FOPS). Advised to continue with pain relief treatment as before. Also prescribed 10 Claveseptin twice daily for the next 5 days. Lulu bright and sociably on collection for vets.

May 1, 2015: Four days since her aesthetic and dental, Lulu is doing well with no sign of FOPS to date. Gave vet message that Lu is back to normal, still on required doses of meds, but reduced the vertergesic to twice daily as too drowsy all-day otherwise, too sleepy to eat even.

May 3, 2015: Still doing OK, had her last Claveseptin yesterday morning, still on vertergesic (0.25ml) twice daily, eating OK too. Her weight is just under 4 kg. I have Feliway plugged in as normal, so I’m doing everything within my power to ensure she does not have another flare up.

July 3, 2015: (less than 24 hours since Teddy died) 4 am noticed Lu rubbing her eye with her paw, the skin around the eye looked sore. 9.15 am vet physically examined her, all organs ok, no lumps, bumps, and kidneys appeared normal. April’s blood test results reviewed, all normal. Urea slightly elevated, top of range is 9.5 and Lu’s was 12.5, probably due to lack of water prior to testing blood in April. The vet applied Lucri-lube to eye and arranged an appointment for later in the day so the eye pressure could be checked. 6.45 pm eye pressure checked, all ok but advised to monitor eye pigmentation in case to changes to melanoma. Eye soreness due to feline oral facial pain syndrome (FOPS) flare up of trigeminal nerve under and above eye and across cheek, therefore given 0.1 ml vetergesic 2 to 3 times daily, reduce to once daily when flare up passes. Continue with 25mg Gabapentin once daily.

July 4-6, 2015: Generally good in herself, good appetite, but eye looks as if it is still troubling her, blinking and possibly a crust – but no discharge. Vetergesic given ever 8 hours.

July 7, 2015: Eye still bothering her, scratching her left eye with hide leg too. Eye half closed and looks sore but no discharge. Generally good in herself, purring and active, but a little spaced out on vetergesic. appetite good, normal poo. I could give vetergesic ever 6 hours but then she would be too drowsy to eat and I need to ensure she eats.

July 10, 2015: 7.30 am vomited/regurgitate up breakfast of white fish and previously eaten Origen kibble, otherwise good in herself. Happy and content, eye looks better today. No evidence of her rubbing it with paw.

July 13, 2015: Generally okay – eye okay, no pawing at eye or month, no FOPS symptoms. Happy and content.

July 14, 2015: 5.45 pm excessive chewing action 20 minutes after eating kibble = FOPS and discomfort, immediately gave 0.2 ml vetergesic. Soon better.

July 18, 2015: No FOPS symptoms or eye scratching in last three days. 4 am awaken to Lu scratching her eye with hind leg = FOPS and discomfort, immediately gave 0.2 ml vetergesic. Generally okay throughout day. 8 pm slight excessive chewing motion but not pawing at face = slight FOPS.

July 22, 2015: No FOPS in last 4 days, but croaky voice today.

July 23, 2015: FOPS: pawing at mouth after eating Applaws grain free soft canned food, even though I cut it up into tiny pieces, it still causes her discomfort. Possible sore throat as croaky voice most of day.

July 24, 2015: Croaky voice and bubbly nasal sound, gave 1/4 250 mg claveseptin at 11.30 am. 3 pm FOPS after eating, immediately gave 0.2 ml vetergesic. Otherwise okay.

July 27, 2015: Still on Gabapentin and vetergesic daily. Slept most of day on warm snuggle pad, its a cold day today. Lu looks old today. No FOPS today, but I am worried she may possibly have thyroid problems as her voice is croaky today and 4th day on claveseptin. She has been vocal on and off for days, but today roaming about crying loud distress calls. She is clearly missing Teddy, as they spent 14 years together as house mates and sleep next to each other, so my remedy for that is to take her to bed with me and cuddle her up and comfort her, although I find she is comforting me just as much, as my heart is broken with the loss of Teddy 25 days ago. No FOPS today.

August 1, 2015: Dropped down to 0.2ml vetergesic twice daily as no FOPS for eight days. Generally very good. Voice frail on loud cry, call type crying. Missing Ted and getting confused, looking for Ted all around the house. Clear to see her heart is broken just as much as mine over the loss of Teddy.  Animals definitely grieve the loss of a companion animal, I have no doubt, it is clear to see.

August 6, 2015: Vomited up Cosmo snacks freeze dry chicken at 8 pm, otherwise generally very good, out in garden in sun am, as lovely sunny warm day and on my bed remainder of day. Still has croaky voice which continues till August 9.

August 19, 2015: Still sometimes cries in the morning and again at around 10 pm or 11 pm – a deep cry – must check thyroid when next at vets.

September 1, 2015: 8.45 am wondering around up stairs and loud vocal calling/crying till I go to her then loud purring, as if lost and looking for me, needing my presence to reassure her. She has been acting odd for the last week on and off, hiding in unusual places and roaming about, crying  – generally unsettled.  Vets today at 5.15 pm, examined, normal on presentation, blood test taken at vets to test all key parameters, plus T4 for hyperthyroid.

September 2, 2015: Generally okay today, but purr sounds throaty as if she has a cold, but no signs of cold, eyes and nose clear.

September 4, 2015: Vomited three times over the last three days, otherwise good.

September 7, 2015: Blood test results = Urea slightly up at 12.6 (range 2.8 – 9.8) and kidney function was 171 (range 26 – 140) possibly kidney disease or dehydration. T4 was 30 (range 15-50) therefore she does not have hyperthyroidism. Haematology was normal, no infection, no inflammation. Need to collect urine sample to see if she is able to concentrate her urine to determine if she has kidney disease.

September 14, 2015: Finally got urine sample after 6 attempts. Generally good in self, still crying and confused on occasion but she is still grieving for Ted and elderly (16 and half years old) and on an opioid(Vetergesic), so I have to expect some behavioural changes.

September 16, 2015: Urine sample results: No protein, no glucose, no crystals, no urine tract infection. All normal and fine.

October 21-23, 2015: Wormed with Panacur over three days, no FOPS for such a long time now, still cries and roams about, but comforted by me which settles her. Still on maintenance dose of 25 mg Gabapentin once daily and 0.2ml vetergesic twice daily.

November 9, 2015: Six monthly dental check up today. Blood pressure taken, slightly elevated at 145 (range up to 130) but stressed at vets, vet said it was normal for a cat in that situation or close to normal. Examination of teeth, mouth and throat all normal, no evidence of any lumps or bumps throughout her body on examination. Eye pupil dilated on examination with light- it did not respond to light – so appointment booked with ophthalmologist. Otherwise generally good, repeat check with dentist vet in six months time.

November 10, 2015: Found sore patch under chin today. 3 mm bloody crusty scab caused by Lu scratching due to FOPS.

November 11, 2015: FOPS after eating, possibly sore throat, croaky voice too. Vomited once during day possibly because of FOPS.

November 12, 2015: Ophthalmologist examination: Eye normal for her age, no Glaucoma, normal pressures of 12 and 14 taken in her only eye (two readings taken in the same eye). Iris reacting to light – not able to fully close in bright light – iris muscle not so strong. Nothing to worry about, no brain tumour or eye cancer. Possibly sore throat – croaky am and discomfort on eating – claveseptin prescribed for 7 days, one twice daily.

November 24, 2015: Vomited/regurgitated food twice today, otherwise good.

November 25, 2015: 12 am slight FOPS – excessive chewing action after eating soft food, after just licking it. 6 am soft food eaten, FOPS symptoms have passed. Vomited once in day.

November 28, 2015: Vomited up kibble, otherwise good.

December 2, 2015: 1 am slight FOPS – exaggerated chewing. 6 am slight FOPS – exaggerated chewing, I gently massaged her facial area – soon better.

December 7, 2015: 8.40 am exaggerated chewing (after eating, also 40 minutes after giving vetergesic) I gently massaged her facial and lower jaw area – Lu stopped showing signed of discomfort – soon better.

December 14, 2015: 6 am vomited up kibble otherwise good.

December 20, 2015: 9 am and 9.30 am vomited up clear foamy liquid, otherwise generally okay.

December 25, 2015: 7 am small quantity of kibble regurgitate, otherwise good.

December 31, 2015: 7.10 am vomited up partly digested kibble, otherwise good.

January 1, 2016: Happy new Year! – Lu confused, meowing today.

January 9, 2016: Confused meowing when I am not present – soon settles then starts again. I was away all day today, when I came home my partner told me Lu had been going around the house looking for me and crying till I got home. Otherwise generally good, good appetite, normal wee and poo. Still on maintenance doses of 25g gabapentin and 0.2ml vetergesic twice daily.

January 14, 2016: Vet check up and vaccination. Tricat Trio non adjuvant. 6pm defleaed with frontline (we sat by a stray cat in the vets awaiting room, poor thing had fleas). Vet suggested retesting blood and urine samples again in mid March.

January 16, 2016: Seems unwell, quite and slightly tucked up – under the weather – ain’t doing good. Otherwise okay in self – slept most of the day, no crying, good appetite, normal wee and poo.

January 17, 2016: 3.30 am vomited up partly digested food, then 4 am vomited up same again twice but more fluid, then 8.30 am vomited up lots of patches of fresh blood and pink stomach fluids (see photo). Vet examined and prescribed 1/2 10mg omeprazole once daily, given and 12.30 pm. Otherwise okay in self. I also took a stool sample to the vets too, but they did not want to examine it or send it to a lab at this point in time.

January 18, 2016: Not eating much today, only got her to eat 2 tsps. of wet food. Next day Lulu is brighter in morning, ate small amount of kibble, slept most of day, generally good but not much of an appetite. Cooking white fish for her, as its light for her tummy to digest.

January 23, 2016: Generally good today, appetite better.

January 27, 2016: Very active and restless during earlier hours. Weather very wild and windy outside, it has unsettled her, she wants to go out into in – instead she is zooming around the house for half an hour at 2.20 am. Later in day at 6.30 pm regurgitate up food in shape of tube, however, generally good and good appetite.

January 29, 2016: Still on maintenance medication and 1/2 10 mg Omeprazole daily. 7 pm Loud distress crying in kitchen – so gave her some cooked white fish – she ate it and soon settled. Noticed eye socket more sunken in today than normal, possibly dehydrated.

January 30, 2016: Distress call at 4 pm – sat by food bowl, did not eat – okay after a cuddle n bed with me.  Last 1/2 10 mg Omeprazole.  Next day I wormed her with Drontal.

February 4, 2016: 6.30 am FOPS symptoms, exaggerated chewing, massaged facial and lower jaw area – Lu stopped showing signed of discomfort -soon better. Still on maintenance medications.

February 5, 2016: Very vocal, urgent loud crying when I came home at 4.15 pm. Found table spoon sized pool of vomited up clear liquid, pink in colour due to blood in it. 5.45 pm vet examination, lungs and heart normal, bloods taken for routine blood panel. Possibly ultrasound next week if still problems depending on blood test results, prescribed omeprazole.

February 6, 2016: Blood test results (in-house) = 13.8 (normal range 2.8 – 9.8). Creatinine and urea slightly elevated, awaiting external blood tests – blood count. Need urine sample to see how bad renal failure is, vet requested, suggested changing her diet to Hills i/d food. I said I was very uneasy about doing this as Lu has IBD and is intolerant to grains, but vet thought it still best to change to Hill i/d as it contains less protein. Yes, less protein but full of rubbish! Full of sugars and cereals. I looked online for a low protein grain free alternative, but none found in any form of kibble in any make in uk. I am horrified at the thought of possible renal failure – we saw a young newly qualified vet, we had not seen before.

February 8, 2016: Got urine sample and pouch of Hill i/d salmon pouch food and Royal Canin Renal pouch food. I mixed a small quantity of the Hill’s in with Lu’s normal food. The result the next day was DIARRHEA !!! for the next two days.

February 10, 2016: Results back, urine results = concentrated – so Lu is able to concentrate her urine, so her kidneys are working fine for 16 + years old. Urine sample 1.04 (mid range of normal). External blood results: All within normal parameters, white cells normal too. Lu does NOT have RENAL FAILURE – Thankfully. Back on normal grain free food for remainder of day and always.

NOTE: Lu’s vet practice has changed to a referral practice which has subsequently meant we are seeing younger, less experienced first consultation vets. Before it was a referrals practice the first consultation vets where more mature and very experienced. However they do still cover their own out of hours and a lot of vets don’t, so if we have an emergency out of hours they have assess to all her history instantly.

February 11, 2016: No poo since diarrhea yesterday at 6 am. No poo for the next 3 days, till 14th February.

February 20, 2016: HAPPY 17th BIRTHDAY Little Lulu!!! Generally good today for an old-timer.

February 21, 2016: 5.30 am FOPS symptoms after earing kibble – gave 0.2ml vertergesic and gently massaged Lu’s month and throat area – soon better.

February 22, 2016: FOPS – flare up symptoms after eating kibble early am. 4.10 am, excessive chewing and pawing at face. 7.30 pm vomited up kibble and liquid, gave 0.2ml Vetergesic after in case of FOPS. 10.15 pm gave 9 mg  =1/8 of 75 gm Zantac.

February 23, 2016: 1.15 am vomited/regurgitate up tube of soft cooked white fish with 1 cm spot of fresh blood on it. 8.30 am I freshly cooked white fish so as to give her stomach acid something to digest instead of damaging her stomach, she ate it thankfully. 9 am vet examination and more Omeprazole prescribed, blood samples taken again. Weight 3.22 kgs which has declined since August 2015.

February 24, 2016: 1.15 am crying waiting for food but hesitant to eat.
2.30 am Crying waiting for food but hesitant to eat.
4.00 am Crying waiting for food but hesitant to eat.
7.30 am medication.
8 am 1 tsp. of white fish eaten. Giving 0.2ml vetergesic ever 6 hours now. Offered soft white fish throughout day and evening but Lu just licks it, got her to eat 2 tps at 5pm.

February 25, 2016: Got Lulu to eat 13 tsp. of home cooked white fish throughout the day at 2 tsps. per meal. Still on same dose of medications.

February 26, 2016: Vet called with blood test results:  T4 normal- no hyperthyroid, Pancreatitis test result 5.3 (range 0.1 –3.5).  Lulu has Pancreatitis. Advised to keep on bland low fat diet and continue with medications as before. Advised Hill’s kibble is low fat. Again full of rubbish including sugar and cereals, so I decided to give her low fat soft pouch food PORTA 21 Chicken, also PORTA 21 Tuna and shrimp and small quantity of Acana kibble instead, as its hard enough having two diseases to manage without further aggravating her IBD and have problems the other end as well and possible diarrhoea. Still on maintenance medication: 25 mg Gabapentin once daily, 0.2ml vetergesic four times daily, 1/2 10 mg Omeprazole once daily and 9 mg = 1/8 of 75 gm Zantac twice daily as well.

February 27, 2016: Clearly unwell today, tucked up all day until 12 pm, but got her to eat 16 tsp. of white fish.

February 28, 2016: Better today – still unwell, vocal, active, following me around, not tucked up today.

March 2, 2016: 4 am meowing and asking to be fed – first time in ages – I am soooo happy!!  Generally inactive remainder of day, but better in herself, asking for food throughout the day, eating little, light and often, home cooked chicken and white fish.

March 5, 2016: Good appetite, good generally, purring and happy.

March 6, 2016: Due to the bitter taste of Zantac I have to wrap her 1/8 of tablet in low fat cream cheese in order to give it to her as she has been salivating and drooling each time, and its taking up to 5 attempts to get it down her. I am conscious of the fact she has trigeminal nerve pain due to FOPS so I don’t want to keep trying as it distresses both of us, but the cream cheese does the trick, I can usually get it down first go now.

March 9, 2016: Spoke to vet on phone as Lu has been sick a few time in the past few days and was licking her lips as if nauseous at 7 am this morning, although Lu has not been sick today. Two Cerinia tablets prescribed to be used as and when necessary.

March 10, 2016: 5.30 am purring, settled, content and happy. 6 pm Uninterested in cook chicken or white fish. 7 pm diarrhoea, but otherwise good. The following days and weeks Lulu has been generally good.

March 26, 2016: Not hungry or interested in food. 10 am gave cooked prawns but she vomited then straight back up. Bubbly sound in nose, throat, breathing but very good in herself – very happy and active in garden, lovely sunny day. Vomited the next day too, freshly cooked white fish straight after eating it at 9 pm at night.

March 29,2016: Vomited/regurgitated some food up early am, otherwise generally good. 6.45 pm pawing at face after eating white fish, gave vetergasic soon after – soon better.

April 2, 2016: Generally good but not interested in home cooked chicken or fish or Origen or Acana kibble today so gave Porta 21 tuna an shrimp ate 60 gms on pouch food.

April 3, 2016: 5am FOPS after eating kibble, massaged for 10 minutes and 0.2ml vetergesic– soon better.

April 5, 2016: Blood retested for pancreatitis, to see if the level of inflammation has dropped. Blood tested for B12 and foliate, weight 3.04 kgs, Lulu has lost 0.18 gms since last weighed on 23rd February 2016. B12 injection given after blood sample taken prior to knowing but just in case her levels are low. Generally good in self, appetite better.

April 8, 2016: Gave vetergesic at 11 pm, FOPS at 11.15 pm after eating wet pouch food, massaged throat area on both sides and all along under chin area for 20 minutes till the vetergesic took effect and she started to purr and settle. I cuddled her up and we went to bed together.

April 9, 2016: Bright today, out in garden for a roam about first thing after meds, slept most of day but generally good. Ate half a tub of freeze dry chicken snacks today.

April 13, 2016: 5.30 am FOPS after eating dry kibble gave vetergesic and gently massaged throat and neck areas, as I think this is where she is experiencing discomfort- soon better.

April 14, 2016: Vomited /regurgitate food back up, no FOPS.

April 15, 2016: Blood retest results back: B12 and foliate normal, so no need to give further B12 injections. Pancreatitis retest came back still elevated at 5.4, slight increase despite 46 days of treatment prior to testing, therefore need to continue with treatment as before and reweigh in one months time. Generally good in herself only eating a small quantity of kibble but loving the freeze dry chicken so she has as many of those as she is interested in.

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