Cat update

[redbird]

The short version: no evidence of cancer, yes symptoms of infection, we are giving him fluids.


The good news is that the ultrasound produced no evidence of cancer.

Also, the urine culture came back negative. However, julian_tiger does have an enlarged renal pelvis, which is usually a sign of infection, so we are giving him an antibiotic anyhow. The alternative would have been to send him out to have a urine sample drawn directly from the kidney, possibly under sedation, and decide about antibiotics based on culturing that. The vet recommended against that, and we're following her advice on that. This does mean that the main thing we get by having had this culture done is that we know there's no point doing a culture in a week or two in order to see if the antibiotics are curing him, since finding no harmful bacteria wouldn't be information: we're going to go by symptoms.

It's a six-week course of antibiotics, normally, but the veterinarian started us with one week's worth of pills, in case they disagree with him. (This is to avoid paying for six weeks' supply of pills we can't use, in that case.) He's getting Zeniquin, 25 mg/day (meaning we get to split 50-mg pills), selected on the basis of tending to be concentrated in the kidneys; I think that if the culture had produced something, treatment would have been based at least in part on what bacteria were found.

We are also giving him subcutaneous fluids. We took him to the vet this morning for the first 150 mL and to be shown how to administer it. The process looks basically straightforward, until and unless Julian decided he strongly dislikes it and is feeling enough better to fight us, but probably needs both of us, since it seems to involve three hands. I am hoping he is well enough to stop them by the time I go visit adrian_turtle in October.

As the vet said, the good thing about the evidence of infection is that it gives us something to treat, and the hope that he will be doing much better after the treatment. Otherwise, we'd be limited to changing his diet and hoping for the best.

We will be taking Julian in next Saturday for a blood draw, to see how he's doing after a week of this.

The vet's office sold us some "pill pockets" to make it easier to get Julian to swallow his pills. (or maybe pill play-doh, in that they can be broken up and molded around the pill), after first testing one to see if he liked it. He does, which is unsurprising—it's "duck and pea" flavor, and he likes both of those foods—but good to know.

Comments

[amaebi]

All the best to julian and to y'all.

[kate-schaefer.livejournal.com]

Subcu is, as you say, straightforward. I did it for my cat for five years, and I'm still ambivalent about the whole thing. It clearly made her feel better afterward, but it made her completely miserable during the process. During the period when she was doing well enough that I gave her fluids every three days rather than every other day or every day, I think it gave her a reasonable quality of life and was worth doing. When she needed fluids more often, I am not sure that it was worth it to her, and of course I had no way to ask her.

If you decide to go ahead with it, my advice is to go for smaller needles and slower administration of fluids. It takes longer, but my cat seemed less uncomfortable than with the rapid administration of fluids. If the vet's office tells you that you can re-use needles multiple times to save money, don't do it unless you have reason to believe that Julian is indifferent to being jabbed. The needles get blunt very quickly, just as they would with human skin, and the cat is going to be more uncomfortable.

Good luck. I acquired or unmasked my cat allergy while caring for Momcat's chronic kidney disease, so I also had to change my clothes immediately after hydrating her. Presumably you can avoid that particular irritant.

[redbird]

They explicitly said not to reuse needles—which is what I would have assumed anyway, because why would the safety protocols be different for felines than for humans? Julian seemed okay with a relatively quick administration of fluids, but that's quick compared to the "just let it drip" 60-90 minutes that you'd have with an IV.

[elusis.livejournal.com]

The biggest thing I found with doing sub-q was that it is unpleasant because it's *cold*. I took to storing my bag on top of the fridge, wrapped in a towel, sitting on a heating pad turned to low. Otherwise my poor bony Ophelia probably felt like the icy hand of Death itself was wrapping around her bones every time we did it.

That, and I found that a wire coat hanger made a very good fluid bag hanger, because I could put it over the edge of the cat tree nest or the towel bar in the bathroom, meaning one less thing to juggle.

[redbird]

The hanger/towel bar is a good idea, thanks.

Our vet said we should refrigerate the fluid, but take the bag out a couple of hours before we plan to use it, and putting it in a bowl of warm water to warm (rather than just putting it on a table, which would get it only to room temperature).

[r-ness.livejournal.com]

Those pill pockets are really great, if your cat likes them. Our Oz will, it seems, eat nearly anything wrapped in a pill pocket. This is fortunate, because he is now on three medications. Pilling him is thus very easy. In fact, he looks forward to pill times, as he considers the pill pockets a tasty treat with a crunchy surprise.

Best of luck with Julian. I hope he's back to normal soon.

[nellorat.livejournal.com]

That's good news. I was surprised, but we semi-recently had very good luck putting a rat on antibiotics based on high white blood cells but no direct signs of infection. I hope things work otu for you all! We do sub-q fluids a lot, too.