Oscar's visit to the specialist

On 2007-11-15, nik Simpson penned:
jmcquown wrote:

I never did the butter thing but Persia's pills were very small.
Blowing on the nose while holding her mouth shut automatically
induces the swallow reflex. After a couple of times she just sort
of sighed, "Okay, here we go again" and it wasn't a huge struggle
to medicate her. (I tucked her under my left arm, though, rather
than hold her between my legs. And the vet never said I needed a
syringe with water, although this sounds like a good idea.)


I wish Mojo was that easy, he's as strong as an Ox and really
doesn't like to be pilled. Ideally it's two man job, one to hold him
down and one to pry open his jaws, and even when you think you've
succeeded, there's about a 50% chance you'll find the pill spat out
somewhere around the house a day or so later. Just as well he heels
well, because treating him is next to impossible, even the vet
agrees ;-)

-- Nik Simpson

Mojo sounds like Oscar in this regard. I've only given her liquid meds
so far, and it's torture for both of us, and she gets more difficult
with every dose. And she avoids us for days. I'm hoping pills will be
easier, but I'm not holding my breath. If it's too traumatic for her,
I'm not going to force the issue. It's not like she'll ever be cured;
the best we can hope for is a chance at a remission. It's not worth
making both of us miserable.


--
monique, who spoils Oscar unmercifully

pictures: http://www.bounceswoosh.org/rpca

Monique Y. Mudama wrote:

DH, Oscar and I went to an internal medicine specialist today.

Oscar has not been acting like a sick kitty in the slightest -- she's
alert, and I've heard her thundering around the house, chasing
who-knows-what from here to there. The main difference is that she's
avoiding us (probably because we are Those Who Medicate) and that she
seems to dislike most of the foods she used to adore.

All of that doesn't change the fact that she has cancer, though, so
...

Apparently, online reading materials aren't all that accurate, since
they tend to conflate a lot of different cancers into general terms.
According to this specialist, small cell lymphoma has different
factors than other types of lymphoma, and that it's in the GI tract
even further changes the situation.

Apparently "small cell" is a positive thing -- it means that the cells
are only slightly mutated, meaning they are not behaving as
aggressively as blast cells, which are a much worse situation.

And apparently, cancer feeds on carbs, so I wish Oscar liked wet food
better. The specialist thought dry kitten food was a great idea (higher
in protein than dry cat food), but I just checked and Evo has min. 50%
protein compared to the kitten chow's 40%. So I put down some Evo and
we'll see if Oscar will accept that.

We talked a lot about chemo and the pros and cons -- it sounds like
the particular chemo pill, Leukaran, is pretty benign compared to most
chemo treatments. The main question is, can we pill Oscar and can we
do it without traumatizing her? snip


Lots and lots of purrs,
Polonca and Soncek

On 2007-11-15, Karen penned:
I am keeping you all in my thoughts. There is also another food by
Nature's Variety that is a "low carb" dry food, Instinct. It might
be more palatable. You could try the Evo and NV canned foods, she
might like one. It's true, carbs are like food for cancer. I hope
you find a treatment regime that works.

Thank you for the ideas.

There's a food we got a sample of -- made with Venison and salmon! --
that Oscar likes. I think it's a local product, rocky mountain
somethingorother. It's dry (sigh) but guaranteed min 42% protein,
better than the Purina kitten food (40%), not as good as the Evo (50%).

--
monique, who spoils Oscar unmercifully

pictures: http://www.bounceswoosh.org/rpca

On 2007-11-15, jmcquown penned:

Purrs for Oscar, and for your and DH's nerves. I know you'll make
the best decision.

And really, pilling isn't all that difficult once you get the hang
of it. After a while Persia (who also doesn't like being picked up)
just sort of looked at me like "Here we go again" and didn't put up
such a fight.

I didn't answer this earlier because I was really angry at the "not
all that difficult" comment, and I know you were saying that to be
helpful and reassuring. So I didn't want to blow up at you. Oscar
has been so difficult in many ways, and historically she *has* held
grudges for medical treatment.

Anyway, we just gave her her first chemo pill today, and it went
surprisingly smoothly. We used the technique the vet recommended -- the
pill went right down the hatch. Oscar swallowed a few times, then
looked at us, waiting for the other shoe to drop. "What, you tackled me
and that's it? Where's the torture?" I followed up with some treats.
If she has any side effects from the stuff, we'll probably know in a
few days. Hopefully it continues to go this smoothly.

The liquid prednisone is much worse. It's prednisone, which is bitter
enough that when I've taken it it activated my gag reflex, flavored by
the manufacturer with cherry, then put in a bacon-flavored suspension
by the pharmacy because they say it's the only flavor strong enough to
mask the cherry. Oscar *hates* it (and I can't blame her). The first
time we gave it to her, she foamed at the mouth and drooled
uncontrollably. The second time, she vomited clear liquid. Every
time we give it to her, she licks her lips and generally acts like
she's queasy. Also, probably because it's so awful, she doesn't clean
it off of herself very well. I also have concerns about getting it
onto my skin, which I seem to do every time we try to dose her.

So I've asked the vet to give us a prescription for injected steroids.
That will be DepoMedrol. She thinks it's more likely to cause
diabetes than the ingested form; I'm thinking, how likely is it really
that she'll get diabetes before the cancer gets her? The injection
would only be once every three weeks, too, so a lot less torture for
Oscar ... unless of course it *does* trigger diabetes. But she's been
at risk for that all along, getting steroid shots for her EGC.

--
monique, who spoils Oscar unmercifully

pictures: http://www.bounceswoosh.org/rpca

On 2007-11-15, Steve Touchstone penned:

So much of the decision has to be based on the personality of the
patient. Of my three, LB is easy to medicate, and a couple minutes
afterwards all is forgiven. Spotty isn't difficult, but she harbors
a grudge for quite awhile and hides out after each dose the one time
I had to treat her. Sammy is a real trial and fights the meds. She
doesn't hide out after being dosed, she sits across the room glaring
at me plotting her revenge.

Oscar fights, hides, runs, generally makes us and herself miserable --
but recently she seems to have decided that after the meds are over,
she has at least a few hours of safety. At least, the last few times,
after we've medicated her she hasn't bothered to go into hiding. Once
I noticed this, I've been encouraging it by offering treats after the
meds.

--
monique, who spoils Oscar unmercifully

pictures: http://www.bounceswoosh.org/rpca

On 2007-11-15, Elise penned:

My Jeeves had an instance of megacolon and was prescribed a pill to
take twice a day for the rest of his life. This is a cat who has to
be heavily sedated for a routine visit to TED and even then the
adrenaline kicks in and he can burn right through the sedatives.
The sweetest boy at home but I didn't want him to start hating us
for twice a day cramming a pill down his throat.

There is a product called "Pill Pockets", a small soft treat with a
pocket in it to put the pill. I insert the pill, squish the treat
around it so it becomes a little round treat and Jeeves BEGS for it!

I tried it -- she won't even eat it plain!

Unfortunately she has always been a very picky eater, and her illness
is making her much more so. She won't even eat chicken breast or
tuna, foods she used to beg for! (Never though I'd miss her begging
....)

--
monique, who spoils Oscar unmercifully

pictures: http://www.bounceswoosh.org/rpca

Monique Y. Mudama wrote:

Anyway, we just gave her her first chemo pill today, and it went
surprisingly smoothly. We used the technique the vet recommended -- the
pill went right down the hatch. Oscar swallowed a few times, then
looked at us, waiting for the other shoe to drop. "What, you tackled me
and that's it? Where's the torture?"

I'd be interested to know what this technique is. Occasionally I have
to pill my cats, and none of them are particularly receptive.

The liquid prednisone is much worse. It's prednisone, which is bitter
enough that when I've taken it it activated my gag reflex, flavored by
the manufacturer with cherry, then put in a bacon-flavored suspension
by the pharmacy because they say it's the only flavor strong enough to
mask the cherry. Oscar *hates* it (and I can't blame her). The first
time we gave it to her, she foamed at the mouth and drooled
uncontrollably. The second time, she vomited clear liquid. Every
time we give it to her, she licks her lips and generally acts like
she's queasy.

Oh, poor Oscar! That foaming at the mouth thing sounds scary, or
at least, an indication that her body really wants to reject the stuff,
at least if ingested orally. That sounds like a miserable experience
for everyone. The shots do sound like a much better idea.

Purrs and good luck,
Joyce

On 2007-11-20, penned:
Monique Y. Mudama wrote:

Anyway, we just gave her her first chemo pill today, and it went
surprisingly smoothly. We used the technique the vet recommended
-- the pill went right down the hatch. Oscar swallowed a few
times, then looked at us, waiting for the other shoe to drop.
"What, you tackled me and that's it? Where's the torture?"

I'd be interested to know what this technique is. Occasionally I
have to pill my cats, and none of them are particularly receptive.

Hrmm. There isn't really a "trick" to it -- and it may not work quite
as well the next time; who knows. But here goes.

There are two things -- one is to tilt her head straight up, the other
is to put pressure on either side of her jaw to open her mouth
slightly. These are very small pills. Then you drop it and because
her head is tilted straight up, the pill goes right to the back of her
throat. The idea is to keep it from dropping on her tongue, because
she can use her tongue to wiggle the pill back out. What we did is, I
held her and positioned her face while DH dropped in the pill. With
one person I imagine it would be much more difficult.

Now, this is all assuming it really worked and that I won't find the
pill on the carpet somewhere someday ...

The liquid prednisone is much worse. It's prednisone, which is
bitter enough that when I've taken it it activated my gag reflex,
flavored by the manufacturer with cherry, then put in a
bacon-flavored suspension by the pharmacy because they say it's
the only flavor strong enough to mask the cherry. Oscar *hates*
it (and I can't blame her). The first time we gave it to her, she
foamed at the mouth and drooled uncontrollably. The second time,
she vomited clear liquid. Every time we give it to her, she licks
her lips and generally acts like she's queasy.

Oh, poor Oscar! That foaming at the mouth thing sounds scary, or
at least, an indication that her body really wants to reject the
stuff, at least if ingested orally. That sounds like a miserable
experience for everyone. The shots do sound like a much better idea.

My understanding is that the foaming at the mouth is a response to the
bitterness of the pill. It's really foul stuff, prednisone. I guess
this stuff is technically prednisolone.

Purrs and good luck, Joyce

Thank you.

--
monique, who spoils Oscar unmercifully

pictures: http://www.bounceswoosh.org/rpca

Monique Y. Mudama wrote:

Anyway, we just gave her her first chemo pill today, and it went
surprisingly smoothly. We used the technique the vet recommended -- the
pill went right down the hatch. Oscar swallowed a few times, then
looked at us, waiting for the other shoe to drop. "What, you tackled me
and that's it? Where's the torture?" I followed up with some treats.
If she has any side effects from the stuff, we'll probably know in a
few days. Hopefully it continues to go this smoothly.

snippage

Glad to hear the chemo pill went down so well. It sounds much more
sensible to give her the steroid shots than the supension. Many purrs on
the way for all the medicating. I went through a lot of similar things
with Frank and Nikki in their later years. It's tough. Hang in there!

--
Marina, Miranda and Caliban. In loving memory of Frank and Nikki.

On Nov 14, 6:56 pm, "Monique Y. Mudama" wrote:
DH, Oscar and I went to an internal medicine specialist today.

Oscar has not been acting like a sick kitty in the slightest -- she's
alert, and I've heard her thundering around the house, chasing
who-knows-what from here to there. The main difference is that she's
avoiding us (probably because we are Those Who Medicate) and that she
seems to dislike most of the foods she used to adore.

All of that doesn't change the fact that she has cancer, though, so
...

Apparently, online reading materials aren't all that accurate, since
they tend to conflate a lot of different cancers into general terms.
According to this specialist, small cell lymphoma has different
factors than other types of lymphoma, and that it's in the GI tract
even further changes the situation.

Apparently "small cell" is a positive thing -- it means that the cells
are only slightly mutated, meaning they are not behaving as
aggressively as blast cells, which are a much worse situation.

And apparently, cancer feeds on carbs, so I wish Oscar liked wet food
better. The specialist thought dry kitten food was a great idea (higher
in protein than dry cat food), but I just checked and Evo has min. 50%
protein compared to the kitten chow's 40%. So I put down some Evo and
we'll see if Oscar will accept that.

We talked a lot about chemo and the pros and cons -- it sounds like
the particular chemo pill, Leukaran, is pretty benign compared to most
chemo treatments. The main question is, can we pill Oscar and can we
do it without traumatizing her? It would be once every other day,
possibly (depending on how she does) reduced to once every three or
four days. Also blood tests for the first few months to monitor her
white blood cell count. We'd also need to give her
Prednisone (actually a variant that's more feline-friendly), either
daily in a suspension or as a shot once every three weeks. Apparently
there's a pharmacy in town that will compound in pet-appropriate
flavors, too.

So .... DH and I are still discussing all of this. We have
prescriptions for both the meds if we decide to go that route. Both
of us agree that if we try chemo and Oscar refuses to be pilled, is
traumatized by the pilling, or has unpleasant side effects from it, we
will not continue to force it on her.

But we came into that visit being so sure we wouldn't do chemo. Now,
not sure. Honestly, I don't want advice; I think I understand the
situation pretty well, and I can talk to the vet further if I need to.
I just wanted to let you guys know what's going on.

Right now, Oscar at least appears to be healthy and comfortable, and
that seems to mean that I am coping much better than when she was
frail and I thought she wouldn't make it. I mean ... when I thought
she had a few days or weeks at most, it was all pretty traumatic.
Now, it sounds like she has a chance of one or two relatively pleasant
years ... it's hard to feel that with the same immediacy. (Or it
could be six months. Or fewer. As the vet said, this is where a
crystal ball would be helpful.)

I do think these visits where Oscar might be picked up, but otherwise
isn't manhandled, are maybe good for her comfort level with vets. We
did pull her out of her carrier to look at her stitches, and the vet
showed us how we can try to pop a pill into her ... but other than
that, it was pretty mild. The vet even took Oscar's temp via her
armpit! Wonder why they don't do that more often.

--monique, who spoils Oscar unmercifully

pictures:http://www.bounceswoosh.org/rpca

I am so sorry to read this. I am late in posting but my computer had
an untimely death.
Purrs going out for you Monique and Oscar. Please keep us posted on
Oscar's progress.

Belated Happy Birthday and Happy Thanksgiving!

Winnie