Zoe O’Leary – Mississauga, Ontario, Canada
Female, Domestic Short Hair Calico
Born October 31, 2003
Diagnosed with pancreatitis/cholangiohepatitis in Fall 2013
Diagnosed with IBD in Spring 2014
Diagnosed with lymphoma in July 2014
First entry, August 12, 2014: July 2013: 4.8kg (10.9 lbs.) at regular check-up. Slightly elevated liver values, nothing else – just watch! I went away to school and while my husband was looking after her for two weeks she was sick often, really lethargic and vomiting a lot. Seemed sick to him but he didn’t take her in anywhere as it was hot, both cats were zonked and mine was possibly missing me. I was also very sick. Had laryngitis, throat infection, needed puffers and had to delay my flight home. She seemed better when I got home although she did vomit a few times in the week I returned. I moved in Aug 2013 to a small, 1 bedroom on the ground floor. I was alone a lot, my husband was retired and at the cottage. I was working long hours, lots of OT. Zoe was alone a lot. She slowly lost weight all fall. She had some weight to lose but it started to be a lot. Hard for me as I saw her every day. When he came back, he said, I think she needs to go to the vet, she doesn’t look good.
End November 2013: Began throwing up and loose stools more often. Not just a little, quite often. I really noticed how lethargic she was and she was looking very small and thin. Poor baby. Vet visit, 2.8 kg (6.2 lbs). Blood work; high liver enzymes (near 1000 when should be upper level of 100); high eosinophils, low creatinine, liver issue? food sensitivity/allergy. Meds 1: metronidazole and Denamarin; switch to single protein diet source (d/d venison/duck). Poops firming up, seems to be starving, ravenous. Eating d/d like crazy. Moving in right direction.
December 2013: Went away, put Zoe into vet boarding care. Directions to include some dry to boost her calorie intake. Back to vomiting and diarrhea when I got her home, really sick kitty. Vomit in litter box, really flat, withdrawn, drinking a ton of water, not pooping for 24 hrs and not keeping food down. Went to my vet next day. Weight 2.4 kg (5.4 lbs). Ultrasound and X-ray for liver, slightly enlarged gall bladder. Cholangiohepatitis/triaditis diagnosis. Meds 2: urosodial, Denamarin and Clavaseptin over Christmas holidays – awesome!! Better for a couple months (Jan-Feb), gaining weight (back up to 2.8/2.9 kgs), happier (mountain climbing up on top o wall unit) etc. Solid poops on/off, some soft at times but more often firmer.
March 2014: Started to be sick again. Food seeking and eating well but pooping 3-5 x a day, loose stools, losing weight, back to 2.5 kg (5.8 lbs). Labs again, same results, not hyperthyroidism (vet was surprised) Zoe was ravenous. Meds 3: prednisolone and metronidazole (10/7 days). No change, still liquid poops. One day I saw oil on the surface of her liquid poop that she didn’t bury. Too tired and exhausted to clean up after herself. Threw up 2x that day in litter box as well. Called vet, she did research. Chronic pancreatitis is the possible diagnosis given the symptoms, causing pancreatic insufficiency. Ordered fPLI and B12 testing.
March 16, 2014: Started on Meds 2 again. Still liquid poop at day 3. Really sleepy, looking really down – flat, eating okay. Food seeking weird things like croutons, pasta. Keeping her on venison crunchies and d/d duck or duck/rabbit mix. Some rabbit treats to put meds in.
March 21, 2014: Blood work results fPLI for pancreatic insufficiency/pancreatitis. The latter is true, range is 12-82, Zoe’s level 254!!! Pancreatitis for sure. B12 range 600-1800, Zoe’s level 111!!! Current diagnosis: chronic cholangiohepatitis with concurrent pancreatitis. Plan: Pancreatic enzymes for her food since the enzymes are being spewed into her system and not into the intestine; B12 injections to improve absorption of nutrients and a new antibiotic of a different spectrum from Clavaseptin to destroy any bacteria. Vet is suggesting Baytril. Ongoing: finish Clavaseptin (5 more days). Stay on SAMe and ursodiol “indefinitely”. I will learn how to give her the B12 shots tomorrow. Food: continuing with d/d or natural balance duck/venison wet, 3 tsp of pumpkin spread throughout feedings, grain/starch free venison crunchies “shake and baked” in FortiFlora probiotics. She has been eating (and pooping) like a horse the past few days. Just can’t seem to digest and get it to stick. She is so skinny. Looking forward to seeing the effects of the enzymatic supplements and B12 increased absorption. It’s a lot to take in but I feel like we tested for the right things and they gave us answers and pointed us in an actual direction.
March 22, 2014: Day 2 on pancreatic enzymes and after B12 shot. Eating much less, not food seeking/ravenous like before, but eating well. Mellow demeanor, sleeping more. Four poops in 24 hours – two small semi-formed, two larger well-formed but still a little soft… NO LIQUID!!! YEAH!!!! Seems like a lot better to me except for the mellow/sleeping/quietness. I thought B12 was supposed to help with energy/perkiness?
March 23-28, 2014: Still having wet poops, same as above. Much more mellow. Not super hungry, tentatively eating? pancreatic enzymes at ½ tsp in food causes her to reject the doesn’t want the food, maybe too strong. Some partially formed poops with S. Boullardi probiotic 2x per day; some still liquid. Overall mood is happy (except after diarrhea – then quiet).
Early April 2014: Improvement seen when I got the SAMe in daily. Did “emergency stop” diarrhea with S. Boullardi, and waiting a bit longer after adding pancreatic enzymes to food before feeding to increase digestion. Had it worked out and then went on vacation and left hubby in charge.
April 15-28 2014: Good/picky with food; off food with enzymes entirely; he stopped giving her enzymes so she would eat. Ran out of ursodiol.
April 28/29 2014: I moved this week and she was stressed. Liquid poo the entire time. Slowly tried to get her back on track with food. Cooking turkey and rabbit for her to eat in broth. S. Boullardi etc. Eating better after one week poops still soft.
May 2014: Slowly getting back on track. S.Boullardi, venison, crunchies and rabbit. Firming up, some good poops, some soft-serve ice cream, REALLY SMELLY!! LOTS OF GAS. Towards end of week, back with pancreatic enzymes 2x per day at big feeds (in capsule), crunchies all day with S. Boullardi. FANTASTIC poops at end of first week but back to liquid by mid month. Picked up new ursodiol & SAMe to add back into the mix. Tracked symptoms. Heading for a full vet workup again in June. New symptoms; Lip lick/head shake. Rapid around the time of food. Also “meditates” over the water bowl. Slow drinking, dipping mouth, sitting with face in water. Water up nose/ sneeze “trying to off herself”. Some yowling near water, usually after eating but mostly if water bowl is low, asking for more. Drinks one cup water per day. Nausea, often staring at a wall right in front of her. Faces into wall/fridge/corner and puts face 1-2” from object and stares. Looks like she is in sleeping posture but is laying with her eyes open. Two days of liquid poo, given her Kaolin-Pectin for pets. 5ml 4hrs apart 2 x 2days. Awesome poop in a.m., splat at noon. Letting her wear calming collar most days. Sometimes I see her sitting in meatloaf position with eyes closed and I’m not sure if she is in pain. She has been sleeping under the bed during the day more often but is friendly and will meow and come out and give you love if you lay down and talk to her.
June 2014: New vet. Full lab workup, blood work, fecal PCR panel. Here is her report. “There is an improvement with the liver values : Alk Phos was 208 is now 199 and ALT was 1126 and is now 159. These values are only mildly increased above the normal range so I think the cholagitis/cholangiohepatitis is under control. The red blood cells have decreased from 6.5 (normal) to 5.4. She may eventually develop anemia which we often see with chronic illness in cats. The eosinophiles which were normal on last blood work are increased indicating general inflammation which can be from a parasite, IBD or lymphoma. The spec fPLI was mildly increased above the normal range indicating mild pancreatitis likely a chronic low grade pancreatitis.” Still thinking severe IBD or lymphoma. Drugs started: Codeine 2.5 mg .1ml transdermal 2x per day; Cerenia ¼ tab every 3 days as needed. Mirtazipine ¼ tab every 3 days as needed; prednisolone 5mg .1ml transdermal 1x day; B12 every other week, sub Q fluids 2X week. Meds initially well tolerated, eating well, drinking, less lip licking head shaking. Sitting outside on balcony whenever I am. Lovey, seems okay but liquid poo still happening.
June 8, 2014: PCR result back. Clostridium perfringes positive. (causes gaseous, smelly poops and gas!) Treatment, metronidazole 50mg 2x day, pilled, started June 9. “PCR test indicates a positive for clostridium perfringes. This organism is sometimes considered an incidental finding and likely a secondary cause of the diarrhea. The treatment is metronidazole” (quotes from the vet). When I looked up this organism it causes excessive gas and is responsible for the smell of putrification in dead bodies. I thought this sounds about right, Zoe’s gas smells like the dead! Also given the amount of pooping 4-5X per day 2-3X overnight – liquid, vet said to up pred to 2x per day and if still liquid after 3 days, go to 3x per day.
June 9-14, 2014: About the same. Poop smell doesn’t seem as overpowering but she is having many liquid poops, down the side of litter box, when she is digging, poor honey. She is worse. Lots of scrubbing cat feet, litter box, floor etc.
June 14, 2014: Day five of metro, rough morning for Zoe. Woke up to a baby who couldn’t walk straight, was disoriented and whose little legs kept sliding out from under her. When I held her she was so lethargic and limp, I thought I was going to have to make a horrible decision this morning. Quick calls to my normal and new cat vet got me in to a last minute cancellation at my regular vets straight away. It was an experienced and very kind vet, Dr. A., who examined her and noted that although she seems weak/unsteady physically, she was sharp, feisty and still licking her bum (apparently a great sign!). So we have 100 ml fluid on board, Cerenia and Clindamycin 2x day. It now five hours later and she is walking much better, still a little unsteady and can’t jump up to her normal water bowl, but looks like she is moving back towards normal.
June 19, 2014: Zoe is still having liquid poo although up to yesterday it seemed to be reducing in amount and then this morning and tonight she was like a fountain. I gave her fluids and she is eating/drinking well but she is so frail and seems tentative when moving around. Still weak in the back end. Since the new vet all that has been good is her poop no longer smells like death and she is eating consistently. Other than that, diarrhea worse. She seems more spacey and is a little shaky/lethargic at times. She still hangs out with us, has been laying outside on the balcony with me most of the night, now after food and drink is in bed beside me as I type. I just don’t know how much she can take and if it will ever get better or if I am just prolonging the inevitable.
June 20, 2014: Reviewed side effects of metronidazole with IBD group. Zoe had many of the neurological symptoms; four limb weakness, staggering, dizziness etc.!!!!! Emailed vet stating my concerns. Agreed that her symptoms could be due to the antibiotic. Advised to stop metronidazole immediately. Up fluids to 1x per day. Ensure she is drinking/eating well.
June 23, 2014: Received Jarrow S. Boullardi + MOS in mail. Started Zoe on “stop diarrhea” protocol every 2 hours. Liquid poo still, seems a bit less and heavier/not as runny. She also trotted to the door to go out and back in to get food. YES TROTTED. Nice to see the little bounce in her step.
June 24, 2014: Vet follow up. Vet basically said Zoe is at the end of her disease. Her intestines feel really ropy but no masses or tumors are felt and would not likely survive surgery/anesthetic to diagnose IBD vs. Lymphoma. With her reaction to the metro my options are Atopica (if I want to try but she doesn’t think at this point anything will stop the diarrhea). Her suggestion – keep her comfortable, give her codeine 2x day and fluids every other day, use Cerenia/Mirtazipine when necessary, count each day as a blessing, watch her for signs of pain and she will let me know when she is ready to go. That said, when she left the room, Zoe wanted to follow her so she said “let her, I want to see her walk” and Zoe bolted. First to the back of the clinic and then down the hallway and a flight of stairs to the front door, the vet tech caught her. The vet was shocked, wow! I am doing all of that but doing the S.Boullardi with MOS (vet: okay if you want to, it wont hurt), giving her oral vitamins (vet: yeah, okay that’s a good idea, it won’t hurt) and researching Atopica as my next option. I don’t know what I expected, but this vet was a new consult and I got the feeling after she said “I get it, you’re not ready to let her go yet” that her solution was just to euthanize my cat. Not happening. Not while she is eating, drinking, coming for love, sleeping in my bed, coming when I call her, trotting to go outside! No thank you.
My plan going forward: Keep pred 2x day for another week then if no change, wean her off as per vet’s instructions. Keep codeine at 0.05ml unless she looks uncomfortable and then give her .1ml. Continue SB w/MOS every 2hrs as I am home until poop is firm/normal. Renew life Adult Probiotics for good bacteria. Continue Cerenia and Mirtazapine every 3 days as needed. Add vitamin supplement 2x day. Sub-Q fluids every 2-3 days (as needed). B12 every Friday. Lots of love, brushes, snuggles; as much time on the porch as she wants. Keep her clean and brushed. Cottage time, walk on leash out in the grass, time in screen room. Keep her on good foods, duck, turkey etc. and return for care at home with Dr. F.
June 25, 2014: OMG OMG, two small soft serve and one voluminous poop with intestine shaped soft pieces! I actually screamed woo hoo and hugged her little head gently. I then popped another S. Boullardi and gave her a shot of vitamins.
June 26, 2014: Same overnight as yesterday. After work one of two beige colored soft serves had a small brownish TURD in it! I could not believe my eyes. Wondering if it is just the Jarrow brand SB with MOS. or is it that plus the pred now that she is three weeks on pred? Is it the fact that she isn’t having diarrhea/reaction to the metro? I DON’T CARE.
June 29, 2014: Bloody bum, rectal exam by Dr. F. showed partial prolapse. Epsom salt compress and polysporin. Need to resolve diarrhea.
June 30/31/July 1, 2014: S. boulardii stop diarrhea treatment (with MOS): Real turds! o Eating like a champ; Within 1 week +1 lb 2.95kg (6.8 lbs.); Good for about two weeks then… slow slide again.
July 20, 2014: Weak/stumbling, not eating well. Looks very bloated in the middle. Thin hips, I can feel her intestines distended like little sausages when I pet her. Need to decide if I am going to do that ultrasound and get a better diagnosis for treatment or are we at the end. Decided to call vet.
July 24, 2014: Weight, 2.6 kg (5.11 lbs), US with fine detail:
– GB, pancreas and kidneys – inflamed/thickened
– Liver looks good
– Intestines uniformly thickened in muscle layer vs. spotty internal villi changes – lymphoma > IBD
– Some fluid in abdomen – leading to discomfort/gas
– No lymph node involvement
– No masses elsewhere – early stage
– Triaditis with lymphoma and either inflamed or low level kidney infection
– Treatment – Covenia for kidney, ursodiol for gall bladder, Leukeran for lymphoma
– Food: high fiber wet, w/d formula. Additional protein as she will tolerate. No need to restrict to certain proteins.
Meds going forward: Daily – prednisolone (50mg/ml) spread 0.1ml in one inner ear 2x day (right at night). ursodiol (250mg) 1/6 tablet 1x day. Vitamins, Amino Bplex, 0.5 ml 2x day. Frequency to be determined. Leukeran (STRENGTH) dose *Dr. F. to call next week once she orders it in and does some research on appropriate dosing (Dr. P. – 1x week; Dr. F.’s initial research 1×3 days). Determined that it would be once every 72 hours. Will need baseline blood work and CBC follow up monthly to ensure no BM changes (leukemia). Dr. B’s notes; response is variable but average is + 2 years of life after starting treatment. As needed. Codeine (2.5 mg /.1ml) spread 0.05ml in one inner ear 1x per day as needed (max dose 0.1 ml 2x day). Cerenia (16 mg). ¼ tablet every 3 days as needed (max dose ¼ tab per day for 3 days). Mirtazipine (15 mg) ¼ tablet every 3 days as needed. Sub-Q only if severely vomiting/diarrhea, fluid replenishment.
August 9, 2014: Nearly two weeks on Leukeran. Zoe is eating well, rarely drinks or meditates over her water now as she is eating the wet food and getting her water that way. Her poops have been formed turds ever since starting the ursodiol. She hasn’t looked bloated in the middle and when I pet her I can’t feel her bloated sausage intestines. She hasn’t been hunching or looking in pain so no Codeine for quite awhile. She is actually sleeping now with her eyes fully closed and is definitely asleep! Today we go down to just 1x day prednisolone and keep all else as is. Fingers crossed.
She definitely seems to be feeling better – she is engaged, watching animals from the porch and not sleeping inside as much. Seems to be tolerating the Leukeran well. The only “side effect” I may have noticed is that she is losing a bit more hair than usual and because she is feeling better and grooming she did barf up a hair ball the other day. I just gave her a 1/4 Cerenia and water with ice cubes to encourage her to drink and have not noticed any other weird side effects. Blood work after 2 weeks on Leukeran coming up in a few days. I will also weigh her. I’m excited as I think she is over 3kg (6.9 lbs) now. That would be awesome!
August 13, 2014: Zoe went to the vet today to have blood drawn since she has been on Leukeran for two weeks. We weighed her and she is just shy of 7 lbs. This is awesome!!! She was down to just 5 lbs 3 ounces when she was really sick in May/June. My goal for her is to weigh 8 lbs. If she keeps doing as well as she has been on the Leukeran we will be there before we know it. She is eating like a champ, her poops are perfect and she is a happy and engaged kitty again.
August 14, 2014: Zoe’s blood work is back. Bone marrow is fine and given that her blood cells are fine this is terrific news, two weeks after being on the Leukeran. Most other out of range of values have come back into range most likely because she is no longer a malnourished she is actually retaining and using her food. Only one a value is still out of range. It has been the one that has been out of range ever since she was younger. And while it is out of range it is not astronomically high, it is only slightly elevated. So overall excellent news and my vet is super happy with her progress. We are going to increase the time between Leukeran pills to see if we can stabilize her at a lower dose.
Sept 21, 2014: So happy to have made it here with Zoe and have her healthy. It was my hope but everyone (including two vets) warned me that I had to think about putting her down. So far, she has fought a good battle and is still going strong. Zoe has now been on Leukeran for 2 months. She is down to once every 4 days (from the original dose of once every three days). She has had formed and normal colored poops since going on this medication regime. She is eating like a champ; high fiber Hills w/d as her main food and lots of meat (both cooked and raw to supplement). She now weighs 7.1 lbs and the vet is impressed by her level of hydration and muscle rebuilding that is happening.
We are taking down her prednisolone again given how well she is doing. We will be doing 25mg/ml transdermal dose 0.05ml 1x per day (down from .1ml 1x day and previously 2x day). She is playing again, the first time in over a year, with whip toys and also alone with springs and catnip toys. It is so nice to see. Her long hairs (guard hairs) have now all fallen out along with a few whiskers. She looks so cute though, like a baby with her fuzzy undercoat. She is also sleeping in bed with me rather than under the bed and choosing to snuggle beside me on the couch! LOVE!! I am thankful for every day with her!
October 31, 2014: **Update on Zoe’s 11th Birthday** Zoe is doing really well. Still holding fast at 7.2 lbs. Poops are perfect – if a little on the small and firm side; NEVER thought I’d say that. Medicine: ursodiol & liquid multivitamins (with B12) daily. 0.1 ml of 25mg/ml transdermal prednisolone every other day. Leukeran every 4th day. Food: High fiber w/d mixed half and half with other good quality wet. She is drinking a good amount daily. (1/4 -1/2 cup). Attitude: She is spunky and playing. Mountain climbing onto cupboard tops. Snuggling, social and well adjusted. She travels with me as I go to my brother’s house, the cottage and to my apartment each week. Blood work: Her three month blood work follow up after starting Leukeran was PERFECT! All blood work values have returned to normal! AMAZING!!
January 8, 2015: Brought Zoe for 8 week checkup, all has been well. The only thing I noticed is that she has been drinking the high end of normal amount of water for her ~1/2 cup per day and also peeing a bit more. Poops are still great – smaller, darker, firm. She needed a progress checkup and I wanted to be sure that these signs (drinking/peeing) were okay and not a possible early warning sign of diabetes or kidney disease (possibly related to long term steroid use?). There is also the possibility that since it is winter here, everything is dry and we are all drinking more water, using lip balm, fighting static etc. and it is nothing!
The vet was amazed – saying she looks great. If she didn’t know she had been sick, she would have no clue. Her fur is perfect, eyes and ears clear, all physical observations check out perfect. Including the fact that when palpated, her belly feels normal – not squishy, gassy or ropy. She weighs 8.5 lbs! Up 1.3 lbs in two months!
Did blood work both to check for Leukeran side effects (bone marrow suppression) and kidney/diabetes indicators.
• Most results still in normal range – best of all previously super high liver enzymes are normal again and reduced sodium, potassium, etc. related to her malabsorption/malnutrition are all normal.
• Elevated platelets, minor amount (opposite of bone marrow suppression)
• Creatinine & Urea – moderate and high normal – not a concern, verified that this could be elevated when on a high protein diet and Zoe is eating all canned Fancy Feast now – no dry, no high fiber/low fat etc.
• Glucose – normal
• So – conclusion: all blood work looks fine – nothing concerning!
Given that she is doing so well, we have decided to decrease the prednisolone down to 0.1 ml every 3days and continue with the 2 mg Leukeran every 4th day. The vet’s rationale was that cats tolerate Leukeran and have less side effects from it than they do on steroids. She is also on Ursodiol and liquid vitamin (Amino BPlex) daily. These are ALL her meds. Haven’t used cerenia, mirtazapine, fluids, or any other meds since last summer (knock on wood). If all is good with this decrease in prednisolone, we will stay like that for a while and continue with complete blood count every 8 weeks, full blood work biannually!
February 26, 2015: I needed to refill Zoe’s prescriptions today so I decided to take Zoe with me to the vet and put her on the scale for fun just to ensure she is on track (She actually has seemed to me like she was still gaining so I wanted to check. She was 9.2 lbs (4.2kg)!!! Woo hoo!!! Before this whole ordeal started in July 2013 she was 4.8 kg so she is nearly back to her normal weight! Her meds are the same as the last update – she is stable on this combination and I’m good to just keep status quo! The most different thing is that Zoe’s poops are actually on the more firm side; sometimes tending to too firm. After consulting with the vet, we decided to add the natural Laxatone to the regimen (~3-4ml dose) and that alone makes a difference. I try not to give it to her every day; give it to her until she has more ideal poop and then hold off for a bit.
Attitude-wise she is great!!! She seems to be a happy girl and is loving to chase and play with her new little brother. It is really nice to see her playing again! I only notice that since she is a little heavier and I think she has muscle loss during her illness and it takes her a bit more effort to jump on the bed. That said, she is still mountain climbing up to the top of the kitchen cupboards, so still spry. Overall she is a gorgeous girl again!
May 26, 2015: Nearing the time for full check-up and blood work (end of June) and I will be away/she will be boarded for about a week in early June, so I wanted to be sure all was good before hand. Behavior for her has been 100% – playing, sleeping, eating, interacting with siblings and us – all normal. Poops are still great; usually about 6-8 pieces, 1” or so long, intact and semi firm. The vet was smiling as soon as she saw her saying “Zoe, you’ve gained some more weight. She’s looking kinda chubby, that’s okay!” we put her on the scale and “Oh yeah, she is up!!! 10.2 lbs (4.6kg)”. She was 4.8kg before this whole ordeal started! She remarked how fluffy and shiny her fur is, that she is so clean she is obviously taking great care of herself now, she must be feeling terrific. On the exam, eyes and ears clear, all physical observations check out perfect. Belly feels normal still; not squishy, gassy or ropy. No heart murmur heart this time – she had noted it before and said it can be physiological when animals aren’t well and it can resolve. Yeah!
Did blood work both to check for Leukeran side effects (bone marrow suppression) and normal chemistry to check how her values were progressing. ALL RESULTS IN NORMAL RANGE!! Vet is very pleased!!!! We are leaving the prednisolone at 0.1 ml (50mg/ml) every 3days and continue with the 2 mg Leukeran every 4th day. Because she is eating Fancy Feast “not the best quality food” (quoting the vet – although I re-read the W/D label while I was there and there is corn starch and other crap in that that FF doesn’t have!) – she can continue with the AminoBPlex vitamin supplement I am giving. Vet said all gall bladder and liver enzymes look perfect, so she would like to us to try taking Zoe off the ursodiol instead of keeping her on it indefinitely. I’m a little scared but of course I want her to take less drugs if she can. We decided to keep status quo now until I return mid-June and then try to take her off. That way I can keep a close eye on her and give her the Usodiol again if need be. That’s the next step on the path to continued good health and wellness for Zoe.
July 21, 2015: Zoe has been off ursodiol for 1 month. All is PERFECT. She is not vomiting or meditating over water or looking in any way uncomfortable. Behavior for her has been 100% – playing, sleeping, eating, interacting with siblings and us – all normal. Poops are great now. Had a bit of constipation about two weeks back – added pumpkin to her wet food. Resolved. Didn’t take her in for weighing, but she is chubby and eating well. Still on prednisolone every 3rd day, Leukeran every 4th day. Daily liquid vitamins including B12.
Vet and I agreed to try decreasing her prednisolone to every 4th day so it is in line with the Leukeran and see how she does. Ideal is to decrease dose but keep symptoms under control. She is a lovey happy girl and we are coming up on July 28th which is her “Leuke-versary” of when she started Leukeran and the big turn around. I am so lucky I listened to my gut and the IBDkitties group. I have had another year of love and awesomeness with a cat that the “specialist” wanted me to write off.
Aug 28, 2015: Zoe’s meds now are reduced to oral Leukeran (2mg) and transdermal prednisolone (0.1 ml of 25mg/ml = 2.5mg). THAT IS IT!!! She has been on these doses and a multivitamin liquid daily for the past month. All is well! Her weight is up since May – she is now 10.9 lbs or 4.94kg (right before she got really sick she was 4.8kg)!! So, fully back to herself. She is a chubbo now that she has her little hanging belly back… but I’m so happy to see her so healthy and happy and interactive with all of us and her fur siblings.
Oct 31, 2015 – Zoe’s 12th Birthday: Today is Zoe’s 12th Birthday!!! Thanks to the IBDkitties support group, she is doing so well…She eats FF classics (in rotation). She takes prednisolone and Leukeran every 4th day. She is back to her normal weight ~10.5 lbs (up from her very ill 5.3 lbs). She occasionally needs pumpkin in her food to soften her stool a bit or help her poop if she gets constipated (this for a cat who has liquid diarrhea for months!?!). She is super happy – plays with her toys, spends time on the balcony in her dog crate watching the world go by, snuggles in bed with me and travels to the cottage a couple times a month. It’s a good life!
November 6, 2015: I noticed Zoe licking Kleenex a couple mornings. I know people have talked about cats eating strange things like plastic and paper before and this week I have found Zoe licking Kleenex sticking out of the Kleenex box and occasionally, first thing in the morning, taking a few bites. I find pieces on the ground so I’m not sure what she is swallowing. Got me thinking and perhaps we should do a follow up visit/blood work. Maybe it is something in her diet that she’s missing?
I called a vet and he said to just watch her, limit her access to kleenex. Could just be a new brand she likes more. I noticed it happens mostly in the morning when I am hitting snooze…he said she could be hungry and trying to get my attention which she gets when she starts licking pulling off pieces. I stated getting up right away when she wakes me the last two days to feed her and she has shown little interest in the Kleenex (I left it exposed this morning to see if she would still go for it… nope). Let’s hope that is the end of it. All other bowel movements and behaviors are normal.
November 24, 2015: It has been SIX MONTHS since our last vet visit. I called Dr. F to arrange blood work and to discuss tapering her meds further. Zoe is doing so well that my vet wants me to take her off prednisolone and just keep her on Leukeran. She said that there is more risk with long term steroid use than Leukeran, which I have seen/heard. I am concerned about disturbing the balance when all is good right now, but I can also appreciate reducing medication to minimize long term side effects.
After the blood work, we had unfavourable results. Zoe’s white blood cell count has dropped significantly (normal range for WBCs is 3.9-19; she is usually around 8 and yesterday she was 3.6!). We were talking prior to her visit about taking her off the prednisolone as she has been doing great for over a year and just keeping her on Leukeran. All was well at her visit (although she dropped a bit of weight (4.78 kg from 4.9). So, while she is still perfect (behaviour, symptomatically etc.) the blood work is concerning and we are taking her off both the prednisolone and the Leukeran. She is already at the lowest dose for both (once every 4 days) so I don’t need to wean her off, but I have to admit… I’m nervous about what is going to happen; we spoke about remission/relapse/going back on meds if needed/what to watch for now/check up for blood count in 2 weeks etc.).
December 14, 2015: Zoe is now two full weeks past her expected dose of Leukeran and prednisolone and she is doing great. No diarrhea, no vomiting, normal eating and behaviour. If anything, she is more loving and tolerant and snuggly – I am loving it. She is so friendly with my mom and my nephews when they visit. A few family members have mentioned how sweet she is being. They have noticed that she is looking well for quite awhile now, but now they are mentioning her demeanor and personality. Honestly, I think for her, feeling well and being off prednisolone (which I know makes some cats more aggressive) is fantastic!! She is the most loving and sweet she has EVER been in her 12 years! She was back up that little bit of weight to 4.82kg so no issues there. We took blood today to repeat the CBC and see where her blood counts are – hopefully they have rebounded from the last time now that she is off the Leukeran.
December 15, 2015: Blood work is great! All WBC’s back to normal – especially neutrophils which were of the greatest concern. Overall WBC’s perfect. Platelets a bit higher than before but not alarming. All WBC morphology normal. YEAH!!!! Thank you IBDkitties & Dr F. for listening to me and learning alongside me and Zoe J.
Oct 31, 2016 – Zoe’s 13th Birthday: Today is Zoe’s 13th Birthday!!! Thanks to the IBDkitties Facebook support group, she is doing so well…She still eats FF classics (in rotation). She is off all medication now except for lactulose every few days if her poop is hard. A couple of items I have noticed – a little mark on her lip (vet said a single blackhead); a click in her right front arm (vet checked for range of motion and pain – no concerns on that exam – consider supplementation to push off arthritis development); itchy and warm ear – irritation– given an antibiotic/anti-inflammatory cream to get rid of it.
Her weight is 10 lbs (so a bit down from this time last year) but still in her normal range from pre-illness. We will just keep an eye on this. Her blood work is perfect! Mental note: some people noted that they had issues with FF in terms of illness and itchiness. Will have to see if this goes away with the cream and if not, I will need to consider limiting some of the foods in rotation that others have noticed itchiness with. I have purchased FoodFurLife supplement to try home cooking for her. Other than these irritations, she is super happy – plays with her toys, goes to my brother’s home to hang out with my nephews once a week, enjoys sunshine on the balcony, and is super snuggly. Happy 13th birthday to Zoe and Happy Hallowe’en to all!!!