Purrcy Drury – Southeastern Massachusetts
Male, Maine Coon
February 18, 1997 – October 15, 2011
Diagnosed with possible transient lesion in August 2005
Diagnosed with a hemangiosarcoma in December 2008
Diagnosed with feline hepatic lipidosis, Pancreatitis
and suspected IBD in December 2009
Diagnosed with triaditis on June 30, 2010
Diagnosed with gallbladder & liver disease (cholangiohepatitis) on October 21, 2010
Diagnosed with hyperthyroidism in October 2010
Diagnosed with lymphoma October 13, 2011
First Entry, May 3, 2010: Purrcy’s mother and grandmother were Maine Coon cats from, where else…Maine. They both had the polly dactyl trait that Purrcy and his two litter mates also inherited. We call them “double pawed” in this part of the country. I brought Purrcy home when he was 10 weeks old, and a few days later I brought home his sister Whispurr. They were pretty little peaches and cream kittens. I took them in for their first vet visit within days and my vet – who had taken care of all my animals since the early 80’s – pronounced them healthy. The first night Purrcy was in my home he managed to find his way upstairs and onto my bed. He woke me up sucking on my eyebrow and he sucks on my ears until this day. We have developed a terrifically strong bond. They were spayed and neutered at 6 months of age. Whispurr died from a tragic accident before her first birthday. We miss her still.
At this time we have four cats: Purrcy age 13. Jeepurrs Creepurrs, 12, a traditional tabby Bengal spayed female; Grizzly, 9, a silver gray neutered male; and Caspurr Snowberry, 6, a snow leopard Bengal neutered male.
September 2002: Purrcy was allowed outside early in his life and he became a terrific hunter. He evidently ate a poisoned squirrel when he was about 5 years old and spent several days in kitty ICU. He recovered and came home with no complications.
August 2005: At age nine, Purrcy was stricken by what my vet called a “neurological event”. He became unable to use his right legs. We treated him with prednisone and eventually he regained the use of his legs. He still has some residual weakness and loss of sensation. When he kneads only his left paw works. He became an indoor only cat at this time. The etiology of this event was never clear, my vet said it was NOT a stroke because he found no nystagmus, but he could have had a transient lesion at the time. For a definitive answer, my vet said we needed a CT scan. He also did not recommend that because it would have cost about $3,000 and if something was found, such as a brain tumor, it might not be curable anyway.
December 2008: At age 11 Purrcy had an hemangiosarcoma removed from his right ear. It was malignant, but it was removed with thin but clean margins. He has not had a recurrence.
July 2009 through May 2010: At the end of July 2009, Purrcy was taken to the vet because of vomiting and depression. We had been in for a health check and boosters the week before and Dr. Phil found his abdomen to be “doughy” on palpitation – consistent with an irritated bowel. He was lethargic and not eating at all well. He was treated with an antibiotic and responded well. My family and I were scheduled to go on vacation, so Purrcy and the rest of the clan were taken to the cats only kennel that I have used for over ten years. I wasn’t real comfortable about leaving Purrcy, but the vacation plans had been made for months. I received a call from Bob, the kennel owner, about three days later. Purrcy hadn’t eaten the night before and was lethargic. I asked him to take Purrcy to my vet right away and he did. I was in touch with my vet twice a day for the rest of the vacation. Purrcy began eating and improved. I picked him up as soon as I got home. I hated being away from him while he was sick, it was incredibly stressful. He came home on antibiotics.
Purrcy was well from the rest of August and all the way through the beginning of November. And then he stopped eating consistently. He would lick his food for a bit and then walk away. He became depressed in his behavior – hiding behind the couch, not greeting me at the door, and generally was not his usual friendly, loving self. I made an appointment to take him into my vet, but I unfortunately became sick from the flu and became bedridden for a few days. I asked my life partner, Paul, to take Purrcy in for me, but he said, “Purrcy’s fine” and cancelled the appointment. Since Purrcy was still eating a little, I hoped he could hang on a couple of days until I was able to take him in myself. We stayed in bed, Purrcy and I, for the next few days. I only got up to feed the cats and crawled back into bed. I started to feel better, but Purrcy did not. He became jaundiced so I made an appointment and took him in. He was a very sick boy. His liver enzymes and bilirubin were elevated, he was dehydrated and he had lost over 2 pounds. He was admitted to the hospital for rehydration and they began force feeding him. My vet mentioned triaditis to me for the first time. I did some on-line research and came away feeling less than hopeful. I visited Purrcy everyday while he was hospitalized and because he seemed more alert while I was there and somewhat interested in eating, and because my vet’s hospital is not a 24/7 facility, I had to take Purrcy home on Friday evening and attempt to force feed him. His diagnosis was feline hepatic lipidosis (FHL) or fatty liver disease. As you probably know, the only way to reverse the process is by feeding. He also was to be given prednisone and pepcid.
I had set up a kennel in my living room so I could keep a constant eye on him and when he first got home Purrcy seemed to feel pretty good – he had been hydrated before he was discharged. I started giving him feedings of Hill’s Max cal every 2 hours and forcing fluids too. It was exhausting and traumatic for both of us. By Saturday evening, I knew I was fighting a losing battle. Purrcy was becoming lethargic and dehydrated. He was dying before my eyes. I needed to do something for him, so I rushed him to the nearest animal emergency about 45 minutes away. I had asked for a copy of his lab values from my vet so I was able to give them that information. He was started on an IV drip right away and had further labs drawn that night which showed further elevation. The kept him stable through Monday when an abdominal ultrasound was done. Monday morning, I also had to take my 88 year old mother to the hospital for hand surgery. I got home shortly after noon. While I was gone the animal hospital had called. I immediately called them back. My call was transferred to a veterinary surgeon who explained what the ultrasound findings were. She told me that Purrcy’s bile duct was obstructed and that he appeared to have pancreatitis. She said they needed to do a liver biopsy and that he needed surgery to bypass the bile duct. I literally had to make a split second decision because she felt he needed the surgery that very afternoon. I gave them permission to go ahead with the surgery – what else could I do? She made it pretty clear that he would not survive without it. The surgery started at about 2 pm. She called me about 5:30 pm and told me that the surgery had gone well.
She had done biopsies of the liver bile duct and portions of his bowel. She said that the bile duct was uncommonly thickened and that because of that, she could not rule out cancer. His liver and portions of his bowel were inflamed and he did had pancreatitis. She said the rest of his internal organs were essentially normal. An esophagogastrostomy tube (e-tube) had also been inserted. She said he was stable, that his blood pressure was 150, and that he was being given IV pain medication so he was comfortable, but sedated. The name of the surgery was a cholecystodudenostomy. The day after the surgery Purrcy needed a blood transfusion because cat’s gallbladders are tightly adhered to the liver and the surgeon had to kind of pry his gallbladder away from the liver in order to do the bypass, so he lost quite a bit of blood. They had to blood type him to do the transfusion. I was told that cat’s have two blood types – A and B. Purrcy has type A blood. He tolerated the transfusion very well with just a slight elevation in temperature. His blood pressure throughout remained around 150. I went to see him the day after his surgery. He had a huge abdominal incision. He was sedated, but responded to my voice. I had brought his favorite brush with me and he brushed his whiskers a few times and fell back asleep with his head in my hand. I cried and held him for a while. It was horribly painful to see him so sick, but I knew I had done the right thing and given him a chance to live. Over the next few days his tube feeding began. They started him at 25% of his DMR and increased the feeding daily. He tolerated the feeding remarkably well and only vomited once. I visited each day and saw him improve in alertness and strength. By Friday he was ready to come home. I learned how to give the feedings and we started with four feedings per day. I had to medicate him with denosyl, ursodiol, pepcid, and clavamox. I also discovered that I needed to hydrate him with about 200cc of water daily, too.
I purchased a digital baby scale so I could monitor his weight on a daily basis. I kept a record of everything I did, how much water I gave him, how much food, meds, his bladder and bowel, and medication times, dates, and amounts were written in as soon as I had done whatever I did. And I also noted how he had tolerated each treatment. The dressing over the e- tube made him very itchy, he soon began scratching the dressing apart, so I had to replace it myself several times a week. The first few weeks with the e-tube were challenging at times. It blocked up regularly and I had to play around with different unblocking techniques. The adapter broke fairly frequently so I learned that I needed to keep a couple on hand. It was definitely an ongoing learning process. The tube site became infected and we started back on antibiotics, and he vomited on occasion. All of these things I learned to take in stride. I took Purrcy weekly for bandage changes for his e-tube. The staples from his abdomen were removed a week after the surgery and the incision healed beautifully. I gradually decreased his tube feedings and he slowly began to eat. His first weight at home was 8.8 pounds. He now is maintaining his weight around 11.3 pounds, and that is good enough for me! Although I never got a definitive diagnosis, such as triaditis or IBD, I was told that his bowel biopsy revealed white cells had invaded the mucosal lining of the bowel. He does not have chronic diarrhea, but he does vomit on occasion. I give him pepcid when that happens. The feeding tube was removed in the middle of February and he has done very well since that time. I pretty much feed him on demand – when Purrcy’s hungry – he gets fed!
Current diet: I feed Purrcy whatever he will eat at this point. And he will eat Fancy Feast cat food. That is pretty much what I have always fed them. I realize NOW that it is not the best food, but I thought I was giving my cats the best I could afford. I wish I could switch them to a grain-free food or even to a raw diet, and I may work on that in the future, but for right now I am concentrating on keeping Purrcy eating consistently – that is of main importance for now. Current medications: famotidine (pepcid) 5 mg by mouth as needed.
April 2010: Recently he had stopped eating very well and I flew into the vet with him. Fortunately it was a mild mouth infection this time and easily treated with antibiotics. Purrcy has always been my precious boy. We love one another so much. For well over three months my whole life was focused on helping him to get better. I spent hours and hours of my time feeding, hydrating, pilling, and comforting him. I spent time worrying and being stressed over the tube being blocked, and was attuned to the slightest symptom he exhibited. I spent thousands of dollars as well. It will take me a long while to pay off my credit card. This was, by far one of the most stressful times in my life, and I would never want my boy to be so sick again, but if I had to do it all again – I would – in a heartbeat!
October 16, 2010: Things have not been well with Purrcy and because his mom is having such a hard time, I’m going to update his page the best I can for her. Since this page was written, Purrcy began having some bad episodes again. On June 19th Purrcy had to be re-admitted to the hospital because he was throwing up bile and not eating. He was there for a couple of days where they gave him fluids, antibiotics, took blood and did an ultrasound. His liver enzymes were elevated but not too high and his ultrasound looked normal. He still wasn’t eating that well and on June 30th, he was officially diagnosed with triaditis and put on Clavamox for three weeks.
On August 5th, his checkup went very well and the vet said he’d gained 3 ounces. His blood work looked better and he was pleased with progress. As of September 4th, Purrcy was doing pretty well. He’d just finished a four week course of Clavamox for a flare-up of triaditis. He remained on his denosyl and ursodiol and was eating well and acting like his usual loving self.
September 28th he had to go back to the vet for vomiting and had more blood work, fluids administered, was put back on antibiotics and his mom was shown how to give him fluids at home. On Oct. 2nd he was again brought to the ER for not eating, being lethargic and vomiting.
October 3rd they did another ultrasound on Purrcy which showed some mineral opacities in his gall bladder – more than last time. He was switched from denosyl to denamarin for his liver and put back on Clavamox for three more weeks. He was then diagnosed with chronic active fibrosing cholangiohepatitis and mild chronic lymphoplasmotic enteritis.
On October 8th Purrcy became sick again and it was clear his antibiotics were not working at all. Last time he was in the hospital they did a TLI/PLI/Colbalamin/Folate test which came back in the normal range. He went back to the hospital and was given mirtazapine for his inappetance and buprenex for pain. The mirtazapine caused him to pace the floor and act agitated but wore off pretty much the next day. His thyroid function tests came back high so he was start on Tapazole as soon as he was eating regularly.
On October 10th he was eating a little bit better, not great, but better and seemed to be feeling better. The ER tests said that triaditis was inconclusive but since the ultrasound did show liver inflammation (fibrosing cholangiohepatitis and bowel inflammation), his regular vet feels he definitely has triaditis.
As of October 14th Purrcy was being force fed and becoming very unhappy and depressed. They don’t know how much more fight he has left in him. I will try to keep this page updated for Purrcy and his mom as it’s just too hard for her. We’re all hoping for a miracle for him – signed Alex’s mom.
October 19, 2010: Today Purrcy was seen by internal medicine and emergency and critical care specialist, Patricia Walters, VMD. She has been consulted in Purrcy’s care several times over the past year. She stated that she does not, given the results of his recent testing, think he has Triaditis, and – based on his bowel biopsies a year ago – she does not think he has IBD. She stated that he has liver and gallbladder disease – or – cholangiohepatitis. She is concerned about the number of flare-ups he has had over the past year and is not absolutely sure if this is an inflammatory or infectious process. For this reason she would like to biopsy his liver again, and obtain a culture of his bile. She wants to do this a week or so after Purrcy finishes his current course of antibiotics. By doing the biopsy she hopes to be able to determine whether we are dealing with infection or inflammation. The bile culture would show what sensitivities to antibiotics the pathogen has. The biopsy can be done via laparoscopy or by needle aspiration. She said that the laparoscopic procedure is best because a better specimen can be obtained. She said possible treatment modalities could include a change in antibiotic, chronic antibiotic dosing, or the use of prednisone. Labs to determine coagulation and bleeding factors would be drawn prior to the procedure.
The cost of this procedure would be about $1200. They drew labs again today to see if his liver enzymes are still elevated. She would also like me to start him on the Tapazole (methimazole), to see if his decreased weight is related to hyperthyroidism. She also mentioned giving him an appetite stimulant, but I explained that he had an adverse reaction to one given during his last hospitalization, so she decided that would not be a good option. She stated that the use of cleaning products and diet were NOT factors in his disease process. Although she said starting him on a limited diet, such as duck, might be beneficial, but only if he can be persuaded to eat it.
Current medications: ursodiol 1 ml daily, Clavamox 125mg twice daily, denamarin 90 mg daily (on empty stomach), methimazole 2.5 mg twice daily, pepcid 5mg daily, vitamin E 40-50 iu daily.
Procedure history: cholangiocystosuodenostomy (Nov. 2009) – Dr. Walters said his liver and pancreas were extremely inflamed and his gallbladder was very inflamed, also. The common bile duct was obstructed. Mild bowel inflammation. Biopsies were taken of his liver, pancreas, and bowel. His bile duct histopathology showed no cancer, which was a concern.
Abdominal ultrasound (June 2010) – showed mineral opacities in the gallbladder, hepatic inflammation. Abdominal ultrasound (Oct. 2010) – increased mineral opacities, hepatic inflammation, mild bowel inflammation.
The visit with Dr. Walters was great. She is very personable and explains things in a very understandable was. She seems to have a genuine fondness for Purrcy, and called him a handsome boy, even though he doesn’t look his best right now. I am hoping that we can find out what is causing the flare-ups so that we can treat Purrcy in the best fashion possible. I want my boy to enjoy a good quality of life – and I KNOW this is an attainable goal.
October 21, 2010: We saw an internal and critical and emergency care specialist. She has been consulted several times over the past year in Purrcy’s care. She is concerned that he has had so many flare-ups since his surgery in Nov. and would like to find out why. A few weeks ago Purrcy had labs drawn for specific pancreatic enzymes drawn – this testing is done through Texas A&M. Those tests came back completely within normal limits, indicating that he does not pancreatitis. The specialist also said that the bowel biopsies taken at the time of his surgery did not indicate that he has IBD. She said he does not have triaditis. But he does have gallbladder and liver disease or – cholangiohepatitis. His liver enzymes which were quite elevated (5 times normal) 2 weeks ago are now almost back to normal levels. Our plan is to draw more blood for liver enzymes 2 weeks after we stop the antibiotics (4 more days on those) and then see if he has another flare-up. At that point, we will not start the antibiotics until he has a liver biopsy and bile culture. She is unsure if we are dealing with an inflammatory or infectious process – the biopsy and culture will help her to determine the best treatment for Purrcy.
At this time, Purrcy is feeling pretty well, eating fair and acting like his usual self, but when he has a flare-up he just drops right off the plateau and is very sick – there are no warnings at all when this will happen. In the past year with the surgery, ultrasounds and numerous visits to the ER for flare-ups of his illness, medications and treatments, I have spent about $16,000 for Purrcy’s care. I would spend that again to help him, but what I’d really like the most is for him to have a comfortable quality life. That’s what I hope Dr. Walters can help us with. He’s had a slightly elevated T4 for about a year. My regular vet just wanted to watch it for a while, but now the level is higher. They’ve diagnosed him with hyperthyroidism and the internal specialist decided to start him on 2.5 mgs of Tapazole twice daily. Unfortunately he had an allergic reaction and it was stopped immediately.
December 11, 2010: Dec. 4th Purrcy had a liver biopsy done. It was done laparoscopically and during the procedure, they aspirated some bile from his gall bladder to culture. The procedure was done under general anesthesia. He came through the procedure just fine. I got the results back from the vet regarding Purrcy’s liver biopsy and bile culture. The bile – which should be sterile – is harboring 3 organisms – 2 of which are resistant to Clavamox. Dr. Walters recommended that I start Purrcy on a new antibiotic called sulfamethoxazole(TMS) once daily. I got the med from my pharmacy after she called it in and gave him his first dose yesterday afternoon – he promptly vomited it up and it made him drool. Could be the delicious cherry flavoring? He seemed subdued after this, so I was worried he was going into another flare-up, but he perked up later in the evening and ate some a/d food.
While he is on the TMS she also wants him to take folate (folic acid) to prevent anemia. I could only find it in 400 and 800 mcg doses at the pharmacy. She wants him on 2mg per day, so I will have to give him several pills to make the required dosage. Purrcy is also to start on a probiotic called Prostora. She wants to actively introduce good bacteria into his intestines in the hopes that he will have fewer flare-ups. The vet hospital will send that on down to me. And he is to be on vitamin E 50 IU per day. I am to continue with the ursodiol (Actigall) and Denamarin (SAMe with milk thistle) for liver support. I also give him Pepcid A/C 5mg to keep his belly feeling good. Purrcy is doing pretty well. He is eating fairly consistently, drinking okay and is acting normally – he can relapse very quickly so I’m careful to say for the moment. I can give him sub-q fluids for dehydration if he doesn’t drink enough. He’s lost a bit of weight so building him back up is high on my list of priorities. His poor belly is shaved (again) so we have to keep the house a little warmer so he won’t be cold and one of his incisions is a little lumpy, so I’m keeping an eye on that as well. He’ll need blood work done in about 2 weeks.
February 20, 2011: In early January Purrcy’s lab work showed that his liver enzymes were still elevated. Dr. Walters started him on a low dose steroid called budesonide (Entocort). This drug clears through the liver so it was her hope that it would help reduce the existing inflammation. His liver at that point, was fibrosing because of the inflammation. Purrcy’s latest blood work came back showing his liver enzyme levels to be within normal limits! We are hoping that the budesonide that he has been taking (fairly willingly) is helping to decrease the liver inflammation and to curtail the scarring. He just finished a 2 week course of amoxicillin because of another recent flare up. Dr. Walters wants to continue this for another month and then maybe decrease the dosage until he is on one pill every other day. We may have to pulse an antibiotic every so often if he has a flare up though. She was quite pleased with his overall health, he has good tone and substance. His coat looks healthy and he seems bright and alert. He has been sneezing, she felt this is a viral infection and his left eye is a bit inflamed too, so I have been applying a prescribed ointment twice daily. She would like him to gain some weight, so that will be the goal over the next month or so – I think that we can do this, if he doesn’t have another flare-up and stop eating again! But for now, he is eating pretty well and acting like he is happy and healthy. I sure hope it continues!
February 27, 2011: Just when things are going so well, Purrcy gets yet another flare-up. We think he’ll need to be on antibiotics chronically from now on. Every time he comes off of them he starts with another infection within a few weeks. So he’s now on amoxicillin, 100mg 2x daily.
July 23, 2011: Our last three visits with our internal specialist, Dr. Patricia Walters have been fairly uneventful. Purrcy’s liver enzymes have remained within normal limits. We have changed his meds around just a bit. budesonide has been decreased to 0.5 mg every other day (the decrease is because of possible chemically-induced diabetes – his glucose has remained within normal limits). Tapazole has been increased to 5 mg twice daily (his T4 was still elevated with last labs). ursodiol remains a 1 ml daily, Denamarin 90 mg daily, amoxitab 100 mg daily (I can increase this to twice daily if he has a flare-up), and vitamin E 50-60 IU daily. Purrcy has been a bit sluggish about eating lately. I dish up food buffet style – if he refuses one food, I try another. His food tastes range from the cheapest foods to the most expensive depending on his mood and taste buds on a given day/time. At this point, just getting him to eat is the most important thing, not what he eats. His diet at the vet is listed as “kitty buffet”! I have tried my hardest to get him to eat grain-free foods, but he has no interest in any of them. I think the extreme heat we have experienced lately has contributed to his lack of appetite to some degree.
His weight ranges from 10.8 to 11 pounds, I still weigh him weekly. (He gets on the scale by himself most of the time). Dr. Walters and Dr. Phil are both happy with his weight and condition at this time. Purrcy saw Dr. Phil at the beginning of this month for his annual exam. Dr. Phil said to ask Dr. Walters when she plans on writing a paper on Purrcy. I thought that was pretty funny, but he really is amazed that Purrcy has survived this long. I’m not sure if that makes me feel good or not. Purrcy got his rabies vaccine during his recent visit, but will have to go back in a week or so to complete his vaccines – Dr. Phil was concerned about giving him all of his vaccines at the same time because he is immunosuppressed. One thing that concerns me is that Purrcy has become very hard of hearing recently. I don’t know if it is related to a medication, or a pathological condition – or if it simply age related. Since it has only been apparent for a couple of weeks, I suspect it may be related to medication. I will call Dr. Walters on Monday to ask her opinion.
In August my family and I will be going on our annual camping trip to the White Mountains in New Hampshire. I have been going to the same campground since I was a young child. This year, because I am reluctant to leave Purrcy, he will be joining us! Both Dr. Walters and Dr. Phil have given us their blessings. They both feel that the ride (about 4 hrs) will be less stressful for Purrcy than him being boarded for a week. I bought a new small station wagon and a kennel to fit in the back for Purrcy. I will take a larger kennel so that he will be comfortable in the outdoor setting. I also purchased a cat holster and leash. Purrcy has been practicing walking on it and is doing great! I will also take his stroller. I am hoping for a good vacation with Purrcy.
October 15, 2011: We went on our camping trip and Purrcy did very well. He seemed to enjoy exploring the outdoors on his new harness. He lost a little weight on the camping trip, about 8 ounces! Before we left he’d weighed 10.14 lbs. When we returned from camping he was down to 10.8 pounds. We were working on gaining that back, but he wasn’t really interested in eating. I’d offer him food several times a day and he would eat a little each time. He’d lost most of his hearing, so when it was time to eat, I’d have to go and get him. He was taking 6 meds every other day and 7 meds on the other days.
Today I set Purrcy free from his earthly body to join the angels. He was diagnosed with lymphoma on Thursday and had abdominal swelling. His breathing became somewhat labored and I felt it was time to let him rest. My heart is sad, but filled with joy also that he is no longer suffering. Purrcy was a special cat. He LOVED everyone, but he loved me most of all and I am grateful for the years we had together. I will miss my precious boy more than words can tell. Fly free my beautiful angel – We will meet again my honey boy.