Wednesday, May 6, 2015

Fighting the good fight.

I again apologize for my lack of updates. It's certainly been a whirlwind this past couple of weeks. Rosie is still fighting her battle with pancreatitis, amongst a number of other possible physiological aggressors. I guess it's time to catch you up to speed, so I apologize for the length this post will probably be, and for any rambling I might now do...

My last post was last Thursday, after I had given Rosie mirtazapine (appetite stimulant). I mentioned to you how she seemed a strange mixture of agitated and drowsy on it. Well, those side effects didn't stop there, and that night she seemed wobbly, had a noticeably increased respiration rate, and ended up urinating on my bed (with me beneath the sheets) rather than making the trip to her litter box. That certainly surprised me. I called the vet first thing the next morning and dropped Rosie off for a recheck, and for them to monitor her side effects of the mirtazapine. Upon arriving at the vet Rosie was weighed. She was down to 8.5 lbs, after having been 9.25 just a little over a week earlier. Although I've been syringe feeding her when she refuses to eat on her own, neither Rosie nor I have been able to give her the nutrition she was previously getting. As for the rest of her vet visit last Friday, after the vet looked at her she called me and indicated that just as Rosie tends to be somewhat sensitive to a number of pain meds (such as butorphanol), she is also obviously sensitive to drugs like mirtazapine. However, even though Rosie's heart rate and respiration rate were slightly elevated, the vet advised me that Rosie was overall managing the drug and its side effects pretty well and would be fine. That was a relief. At that time the vet also prescribed Rosie Cerenia (anti-nausea/anti-vomiting medication), as even though Rosie had not been vomiting, her persistent smacking and drooling whenever sniffing or attempting to eat food were classic signs of nausea. Whereas the vet had previously told me to try giving Rosie subcutaneous fluids twice a day in order to combat her persistent dehydration, she now told me to back off to once a day again. Her reasoning was that Rosie's hydration was still not great but had improved, and Rosie showed an especial dislike for having her skin tented when her hydration level was checked, and the vet did not want her to become unduly stressed by receiving fluids twice daily.

Now, on the mirtazapine Rosie's appetite did increase a bit, although inconsistently so. She ate decently well last Friday morning before I dropped her off at the vet, but then after taking her back home she would not touch her food the rest of the day. I syringe fed her throughout the afternoon in hopes of combating further significant weight loss. She did a little better on Saturday, nibbling at her food throughout the day. That night, though, she started acting very uncomfortable and would not eat, drink, or hardly even move. She again urinated in my bed, and after then watching her struggle to rather uncomfortably defecate, I gave her some leftover buprenorphine (pain med) that I had received from the vet earlier last week. Within a couple hours of receiving the pain med she seemed far more content and alert.

Sunday morning, then, Rosie started lapping at her food the second I put it in front of her. She drooled quite excessively as she was eating, making a royal mess of herself, but she was eating! She did that throughout the day, and even though her appetite was nowhere near what it used to be, I was so excited! The new issue, though, was that she also started a new habit of drinking water like there was no tomorrow, sometimes even lying with her head in the bowl and drinking for minutes at a time. She also started urinating more frequently. The volume of her urine remained normal, but she started urinating around five times a day rather than her usual two to three times.Also, her hind limbs started to appear especially weak. I started frantically going through the potential causes in my head -- had she developed diabetes from the pancreatitis? were her kidneys now acting up? was she developing liver disease?

So, I called the vet's office Monday morning. Rosie's usual vet was not in, but I told the other vet that Rosie was eating decently well, but that she was drinking and urinating more than usual. I also told him that she was starting to look and feel more dehydrated. Since this particular vet had removed Rosie's eye but had not seen her since, he went through her recent records and then got back to me. He told me that he is concerned that her increased thirst and urination and her dehydration could be signs that her kidneys are starting to suffer. He advised me to begin giving Rosie fluids twice a day again, 150 ml's each time. He also gave me the okay to refill her cerenia and buprenorphine so as to continue her on those.

Now, for today...This morning and through this afternoon Rosie suddenly did not want to eat on her own again. She also, however, has not really drank anything today. Throughout the day she acted alert, and I've convinced myself that she looks maybe a tad bit more hydrated since receiving a whopping 300 ml's of fluids both yesterday and today (600 ml's total in two days!). Yet, she won't eat. Occasionally today she has done a bit of smacking, especially when offered food or when attempting a bite of food. It seems her nausea has returned, therefore, even though she's still getting Cerenia. I guess that's why it was perfect timing when Rosie's usual vet called me earlier today to check in on her old gal of a patient. I told her of Rosie's lack of appetite. I did inform the vet that Rosie is due for a bowel movement, and when she needs to defecate she typically refuses to eat. So, the vet decided that we will give Rosie through the night to see if she defecates. Regardless, though, I scheduled to take Rosie in tomorrow at 4:30 pm for a recheck exam and bloodwork. They will check her glucose to rule out diabetes, check her renal values to see if that is what's causing her persistent signs of illness, and check her liver enzymes to see if she's okay in that area. I'm sure they'll also do a recheck pancreatic SNAP test to see if she's still fighting pancreatitis.

Needless to say, my Rosie has me worried sick.  I just really want to see my furbaby like this again:
Remember this, Rosie? See? Food's yummy. Eat it!

I thank you all for your kind purrs and prayers through all of this, and I appreciate any more you can spare for my sweet old girl! Also, thank you for your patience with this worried sick momma. As I'm sure you can tell by now, I tend to cope with stress and worry by writing everything out and sharing my thoughts. If you've made it through all of my tomes of posts lately, I commend you.


meowmeowmans said...

It is so stressful to have a sick kitty! We tend to adopt older cats, and what you are going through is the hardest part. Please know we are purring and praying for your sweet Rosie, and for you. We hope your vet can figure things out, and get Rosie back on the right track. Hugs!

Annie Bear said...

I so agree meowmeowmans above. This really is the hardest part. Her leg weakness very much sounds like CRF. I think there can be several causes but I think all the causes come from CRF but can also be treated. It reminds me of our CRF kitty Simba. He had to have a phosphorous binder in his food because phosphorous really causes a lot of problems in CRF kitties. It could also be a potassium deficiency.

I'm so glad she's getting regular pain medication and fluids! It's so hard because they can't tell us and it's so stressful to always be wondering and trying different things. If you have time, I encourage you to look at Tanya's CRF site if you're familiar with it. It's the best CRF resource for kitties I've ever come across and also has a whole symptom index.

I'm so very sorry Rosie and you are going through this. You're doing your very best for her, which is awesome. Never doubt that!!