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Leo not so good

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  • hemizonia
    Over the past few days, Leo seems to have gone downhill. It s not his heart or CHF. It s more like lasix overdose, even though he s been getting only 1/2 tab
    Message 1 of 10 , Apr 3, 2014
      Over the past few days, Leo seems to have gone downhill.  It's not his heart or CHF.  It's more like lasix overdose, even though he's been getting only 1/2 tab (6.25mg) daily.  I took him to his doctor today because Leo was rather listless, looked horribly dehydrated, and really hasn't been eating well. 
       
      Leo has always had normal kidney #s, but although not out of the reference range, his creatinine was 1.5 today, with a BUN of 53.  What was most alarming though was his potassium ... 2.7 (3.5-5.8).  He's getting potassium gluconate now.  Lasix probably caused him to dump too much potassium. 
       
      Our PDVM also gave me some benazepril to help Leo's kidney function.  However, he was so dehydrated, I wanted to get his fluid status better before giving him an ACE inhibitor and maybe lower his BP more than what it might be just due to reduced circulating volume.  Doc said to give Leo subq fluids, cautiously of course, maybe 50 ml at a time.  I know that when there's significant dehydration, subq fluids are absorbed very rapidly, causing also a rapid rise in circulating volume that a compromised heart can't handle.  So for about 10-12 hours, periodically I would syringe between 5 and 10 ml of water into Leo's mouth.  It was just a quick enough situation where he didn't get stressed.  I lost count of the amount total he's had, but it's between 2 and 3 ounces (60 -90 ml).  He's looking much better, but still acting very down.
       
      My poor Leo.  He's such a sweetheart, and a real character.  One of those cats who are the life of the party.  It's painful to see him so.  I've been watching/monitoring him, but mostly for his cardiopulmonary status, which has been good.  I also admit to being distracted by his sister, Willow, whom I've been watching closely for adverse side effects from an anti-cancer medication (she has multiple metastatic masses ... sarcoma).  Willow is doing very well, seems to improve daily, although the sarcoma will ultimately take her.  And I've got my beloved rottie girl, Sam, who has confounded even the specialists at UC Davis with her mystery endocrine problem. 
       
      I'm worried that Leo may be developing hepatic lipidosis ... he hasn't been eating much the past few days.  I've tried syringe feeding him a bit, but he gets stressed very quickly.
       
      Doc has told me to stop giving any lasix unless Leo needs it.  After having a heart/kidney kitty years ago, I have a fair grasp on how to see CHF coming.  I might ask about switching Leo over to spironolactone/HCTZ which is a milder diuretic combo and is potassium sparing.  Or maybe even just dandelion extract which is milder yet (but still works!).
       
      Send Mr. Leo McCool some good thoughts if you can.  Strange how 2 or 3 weeks ago, before Willow started getting palladia (her cancer med), she was so very sick.  Leo and she would cuddle together in their favorite snuggle bed.  Leo would wrap his arms around her, and lick her face to comfort her.  Now Willow is feeling better, and it was she who snuggled around Leo, licking his face tonight.
       
      thanks
      mary & Leo
    • Laurie Stead
      Just thinking out loud... but could you reduce the Lasix to 1/4 pill instead of removing it altogether?  I don t have experience with treating low potassium
      Message 2 of 10 , Apr 3, 2014
        Just thinking out loud... but could you reduce the Lasix to 1/4 pill instead of removing it altogether?  I don't have experience with treating low potassium but Boo has been on Lasix for several years now (every day!) and it has not affected her potassium.  I wonder if Lasix is truly the issue?  Hopefully others can chime in that have closer experience. 

        As for food, I finally went to "junk food" for Boo because all the fancy prescription foods she just wasn't eating.  The new food, albeit not the most healthy, has triggered her interest in food again and she already put on a few of the ounces she had lost.  In the end, they have to eat, even if it isn't the best food.  Nothing will make them more lethargic than not eating.

        Hoping Leo continues to improve. Keep us posted!

        Laurie and Boo
        On Thursday, April 3, 2014 6:41 AM, "goldenhlls@..." <goldenhlls@...> wrote:
         
        Over the past few days, Leo seems to have gone downhill.  It's not his heart or CHF.  It's more like lasix overdose, even though he's been getting only 1/2 tab (6.25mg) daily.  I took him to his doctor today because Leo was rather listless, looked horribly dehydrated, and really hasn't been eating well. 
         
        Leo has always had normal kidney #s, but although not out of the reference range, his creatinine was 1.5 today, with a BUN of 53.  What was most alarming though was his potassium ... 2.7 (3.5-5.8).  He's getting potassium gluconate now.  Lasix probably caused him to dump too much potassium. 
         
        Our PDVM also gave me some benazepril to help Leo's kidney function.  However, he was so dehydrated, I wanted to get his fluid status better before giving him an ACE inhibitor and maybe lower his BP more than what it might be just due to reduced circulating volume.  Doc said to give Leo subq fluids, cautiously of course, maybe 50 ml at a time.  I know that when there's significant dehydration, subq fluids are absorbed very rapidly, causing also a rapid rise in circulating volume that a compromised heart can't handle.  So for about 10-12 hours, periodically I would syringe between 5 and 10 ml of water into Leo's mouth.  It was just a quick enough situation where he didn't get stressed.  I lost count of the amount total he's had, but it's between 2 and 3 ounces (60 -90 ml).  He's looking much better, but still acting very down.
         
        My poor Leo.  He's such a sweetheart, and a real character.  One of those cats who are the life of the party.  It's painful to see him so.  I've been watching/monitoring him, but mostly for his cardiopulmonary status, which has been good.  I also admit to being distracted by his sister, Willow, whom I've been watching closely for adverse side effects from an anti-cancer medication (she has multiple metastatic masses ... sarcoma).  Willow is doing very well, seems to improve daily, although the sarcoma will ultimately take her.  And I've got my beloved rottie girl, Sam, who has confounded even the specialists at UC Davis with her mystery endocrine problem. 
         
        I'm worried that Leo may be developing hepatic lipidosis ... he hasn't been eating much the past few days.  I've tried syringe feeding him a bit, but he gets stressed very quickly.
         
        Doc has told me to stop giving any lasix unless Leo needs it.  After having a heart/kidney kitty years ago, I have a fair grasp on how to see CHF coming.  I might ask about switching Leo over to spironolactone/HCTZ which is a milder diuretic combo and is potassium sparing.  Or maybe even just dandelion extract which is milder yet (but still works!).
         
        Send Mr. Leo McCool some good thoughts if you can.  Strange how 2 or 3 weeks ago, before Willow started getting palladia (her cancer med), she was so very sick.  Leo and she would cuddle together in their favorite snuggle bed.  Leo would wrap his arms around her, and lick her face to comfort her.  Now Willow is feeling better, and it was she who snuggled around Leo, licking his face tonight.
         
        thanks
        mary & Leo


      • Elfinmyst
        Hi Low potassium would make him feel terrible and can cause weakness and lethargy. It sounds like he is developing chronic kidney problems so the new drugs
        Message 3 of 10 , Apr 3, 2014
          Hi

          Low potassium would make him feel terrible and can cause weakness and lethargy. It sounds like he is developing chronic kidney problems so the new drugs should help with that, also the sub Q. With a urea of that he won't be wanting to eat so you are right to be worried, can you get some kitten milk powder or puree his food to make it as watery as possible to syringe. If his BUN goes up, he may need IV fluids for a few days, so its good his heart is stable. 
          Lyn

          www.furkids-selkirks.com:-)
        • JOHN LEVENS
          I am so sorry to read about Leo and Willow...this must be extremely hard for you.  I don t have any answers to offer for Leo, but I just wanted to tell you
          Message 4 of 10 , Apr 3, 2014
            I am so sorry to read about Leo and Willow...this must be extremely hard for you.  I don't have any answers to offer for Leo, but I just wanted to tell you that I have been down this road too and feel your pain.  Please give yourself a good hug today...this is very stressful.  Glad that Willow is doing well enough on her meds to comfort Leo, and hope that he's feeling a little better today...good luck from Judi and Tucker and Angels Max (HCM) and Cleo (HCM)


            From: "goldenhlls@..." <goldenhlls@...>
            To: feline-heart@yahoogroups.com
            Sent: Thursday, April 3, 2014 5:41 AM
            Subject: [FH] Leo not so good

             
            Over the past few days, Leo seems to have gone downhill.  It's not his heart or CHF.  It's more like lasix overdose, even though he's been getting only 1/2 tab (6.25mg) daily.  I took him to his doctor today because Leo was rather listless, looked horribly dehydrated, and really hasn't been eating well. 
             
            Leo has always had normal kidney #s, but although not out of the reference range, his creatinine was 1.5 today, with a BUN of 53.  What was most alarming though was his potassium ... 2.7 (3.5-5.8).  He's getting potassium gluconate now.  Lasix probably caused him to dump too much potassium. 
             
            Our PDVM also gave me some benazepril to help Leo's kidney function.  However, he was so dehydrated, I wanted to get his fluid status better before giving him an ACE inhibitor and maybe lower his BP more than what it might be just due to reduced circulating volume.  Doc said to give Leo subq fluids, cautiously of course, maybe 50 ml at a time.  I know that when there's significant dehydration, subq fluids are absorbed very rapidly, causing also a rapid rise in circulating volume that a compromised heart can't handle.  So for about 10-12 hours, periodically I would syringe between 5 and 10 ml of water into Leo's mouth.  It was just a quick enough situation where he didn't get stressed.  I lost count of the amount total he's had, but it's between 2 and 3 ounces (60 -90 ml).  He's looking much better, but still acting very down.
             
            My poor Leo.  He's such a sweetheart, and a real character.  One of those cats who are the life of the party.  It's painful to see him so.  I've been watching/monitoring him, but mostly for his cardiopulmonary status, which has been good.  I also admit to being distracted by his sister, Willow, whom I've been watching closely for adverse side effects from an anti-cancer medication (she has multiple metastatic masses ... sarcoma).  Willow is doing very well, seems to improve daily, although the sarcoma will ultimately take her.  And I've got my beloved rottie girl, Sam, who has confounded even the specialists at UC Davis with her mystery endocrine problem. 
             
            I'm worried that Leo may be developing hepatic lipidosis ... he hasn't been eating much the past few days.  I've tried syringe feeding him a bit, but he gets stressed very quickly.
             
            Doc has told me to stop giving any lasix unless Leo needs it.  After having a heart/kidney kitty years ago, I have a fair grasp on how to see CHF coming.  I might ask about switching Leo over to spironolactone/HCTZ which is a milder diuretic combo and is potassium sparing.  Or maybe even just dandelion extract which is milder yet (but still works!).
             
            Send Mr. Leo McCool some good thoughts if you can.  Strange how 2 or 3 weeks ago, before Willow started getting palladia (her cancer med), she was so very sick.  Leo and she would cuddle together in their favorite snuggle bed.  Leo would wrap his arms around her, and lick her face to comfort her.  Now Willow is feeling better, and it was she who snuggled around Leo, licking his face tonight.
             
            thanks
            mary & Leo


          • karenborga@yahoo.com
            Hi Mary, Will Leo take food if you spoon feed him? I m sending well wishes to all of you. Karen B **** Mary wrote: I m worried that Leo may be developing
            Message 5 of 10 , Apr 3, 2014
              Hi Mary,

              Will Leo take food if you spoon feed him?

              I'm sending well wishes to all of you.

              Karen B

              ****

              Mary wrote:
              I'm worried that Leo may be developing hepatic lipidosis ... he hasn't been eating much the past few days.  I've tried syringe feeding him a bit, but he gets stressed very quickly.

              Sent via BlackBerry from T-Mobile
            • hemizonia
              From doing better on Saturday, Leo has gone downhill Sunday. I ve been cautiously rehydrating him, and not giving lasix (he had been on just 6.25 mg daily,
              Message 6 of 10 , Apr 7, 2014
                From doing better on Saturday, Leo has gone downhill Sunday.  I've been cautiously rehydrating him, and not giving lasix (he had been on just 6.25 mg daily, but he became very dehydrated and hypokalemic).  Saturday, Leo was starting to nibble at food, he even did some grooming.
                 
                Sunday, I noted that he was showing just the slightest bit of paradoxical breathing (stomach going in while taking in a breath, and use of accessory muscles for breathing).  I gave him 1/2 tab of lasix.  His respiratory rate today has been slightly elevated, but not bad, up to 30-32/min from his normal 20-24.  He absolutely refused food Sunday.  I even poached him some fresh sole with a bit of butter.  Nope.  Fancy Feast?  Nope.  Human tuna?  Nope.  I've been putting globs of Nutri-Cal type paste on the roof of his mouth, and he's been getting that down.  No subq fluids (he got 75-80 ml Saturday night), but got 100-120 ml of water into him orally.
                 
                Last Thursday when I took him to the vet, I did mention that Leo has had a runny nose, just his left nostril, but it was minor and the vet didn't think much about it.  Over the weekend it's gotten worse.  Several times today, I noticed quite a bit of runny mucus.  Saturday, I saw that there was a bit of pink tinge to it occasionally.  Evidently, he has a URI that has gotten a lot worse.  Thought it might be a herpes outbreak (although I've never seen it here before) and I gave him 500 mg of lysine Sunday.  Just took his temp as he felt warm to the touch (contrary to earlier Sunday).  104.7.  Damn.  Got some baytril into him, and have gotten his ears wet with cool water.  Took away his cuddle bed and gave him just several folded soft towels to lay on.
                 
                Well, over an hour now since I started baytril and cool down.  Leo's temp has come down to 103.9.  Am sure glad I didn't give him more lasix.  If his URI has gone into a bronchitis/pneumonitis, lasix would make it worse.  Leo seems a bit more alert now too.
                 
                Can't afford an ER visit right now ... just to walk in the door costs $120.  My vet opens in 4 hours, and I'll be taking Leo in. 
                 
                Who needs sleep anyway?  Sure glad too that I have a home-based business and don't have to be in a cubicle somewhere at 8am.
                 
                mary & Leo
              • Elfinmyst
                Hi Mary Well spotted with the warning sign of hard breaths when they use their stomach. It does indeed sound a bad infection and a temperature that high
                Message 7 of 10 , Apr 7, 2014
                  Hi Mary

                  Well spotted with the warning sign of 'hard breaths' when they use their stomach. It does indeed sound a bad infection and a temperature that high would definitely stop him eating. I would ask for some of the recovery food too which is syringed with water, but until his temperature is down he might not eat. I hope he gets the antibiotics he needs and they work quickly. 
                  A green discharge is almost certainly bacterial , herpes and other virus cause a clear discharge, so it should respond to antibiotics:)

                  Lyn

                  www.furkids-selkirks.com:-)
                • hemizonia
                  Leo is in the hospital. It s been a rough ride for both of us over the past month or so. In February, Leo was diagnosed with nasal lymphoma, and radiation
                  Message 8 of 10 , Apr 23, 2015
                    Leo is in the hospital.  It's been a rough ride for both of us over the past month or so.
                     
                    In February, Leo was diagnosed with nasal lymphoma, and radiation treatment is extremely effective at treating this.  As Leo's heart situation was stable, he has 2 moderately bad valves), we went ahead with radiation.  This has taken quite a toll on him.  He had 14 treatments over 3 or 4 weeks.  Each time, he needed to be anesthetized.  He did all that well.  However, the treatments result in copious nasal discharge from inflammation and dying tumor mass.  At one point, he aspirated some of discharge, had a collapsed lung and went into CHF which turned around within a couple hours with lasix and oxygen.  He was on lasix twice daily, but that dehydrated him horribly.  It was cut back to once a day.  Still dehydrated.  He got his last rad treatment last Friday.  He was still dehydrated from the lasix, so in consultation with his cardiologist, I withheld lasix until he was a bit more hydrated.
                     
                    Last night I took him to the ER because he was so weak.  His respiratory rate was in the 40s (normally in the low 20s).  They put him in oxygen and he perked up.  At 3 am, they gave him a dose of lasix and this morning, his chest rad looked decent. 
                     
                    His heart may be worsening rapidly.  The nasal drainage is very difficult for him.  Because of being dehydated, even a little bit, the mucus dried to a thick, crusty blockage.  He can't breathe through his nose.  That stresses his heart, and he starts going into CHF.  While in oxygen at the hospital, they are also adding humidity to thin out his nasal discharge enough for him to more easily clear it.  Poor Leo would sneeze and rattle, and hardly anything would come out.  It's exhausting him.  He won't eat, I have to assist feed.  Hardly drinks water.  I gave him 25 ml SQ the other day (with cardiologist's ok), and it helped, even that little of an amount, but the effect was short lived.
                     
                    The doctor this morning told me that Leo is better ... they are weaning him off the 40% oxygen he was on all night.  Humidity seems to have helped a bit.  They said he ate a little for them.  The doctor and I talked about getting him oxygen for home use, as well as a nebulizer.
                     
                    The intense nasal discharge post rad treatment is supposed to last up to 2 weeks, but there will always be some amount of drainage.
                     
                    I had such hopes for the rad treatments.  Cats can live a good quality life for a year or two, maybe more.  It's that effective.  But I fear his heart will take him long before that.
                     
                    Send little Leo some healing energy, if you would.  Everyone at the hospitals is in love with him and his antics.  He's a loud, gregarious, incredibly friendly and compliant blue point siamese.  I lost his sister in December to sarcoma.
                     
                    mary & Leo
                  • Susan
                    Mary,You and Leo are in my prayers. I hope he will improve and have a good quality of life. Susan, Tati, Vivi, and Angel Opie
                    Message 9 of 10 , Apr 23, 2015
                      Mary,
                      You and Leo are in my prayers. I hope he will improve and have a good quality of life.

                      Susan, Tati, Vivi, and Angel Opie
                    • createpeace2
                      Mary, Sending you and Leo lots of prayers and good wishes. I hope he is doing better now. I tried to send an email a few days ago but I don t think it went
                      Message 10 of 10 , Apr 28, 2015
                        Mary,

                        Sending you and Leo lots of prayers and good wishes. I hope he is doing better now. I tried to send an email a few days ago but I don't think it went through. Wondering how he is doing now? I'll continue to send energy and strength for him to feel better soon.

                        Hugs,
                        Cindy, Angel Sage, and Basil
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