Sunday, March 6, 2011

Well, this is distressing.

I just noticed that, of all the blogs for diabetic cats listed on the sidebar here, only Carolyn and Spot's "Sugar Babies" cats and Karen's Pearl  are still with us.  It makes me really grateful that - given Scruffy's unknown age, the melanoma in his eye, the unfortunately inexpert 3+ years of diabetes treatment by me, and now glaucoma - my fluffy boy is still up and kicking. 

Way behind on things here - my intention, last May (2010!)  was to list Scruffy's quite good blood work, and comment on his still diet-controlled diabetes status, his on-going need for a dental, and the continued non-cancerous situation of his left eye.  However.....  being a major procrastinator, I never quite got around to it.

And then, along toward June, for some reason, his eye started looking odd to me.  It's very difficult to explain, and given the fact that his iris is quite distorted as a result of the laser surgery, it has never actually looked "normal"  for the last two and a half years.  Anyway, I made an appointment with Dr. B, and sure enough - and there was absolutely NO way to "see" this - Scruffy now has glaucoma in his left eye.  (There are no visible symptoms of glaucoma.  I'm attributing my thinking there was something wrong to, well, I don't know to WHAT; maybe just the connection we have?  Anyway, I was right!)  The pressure was not terribly high - in the 20's - I need to go and look up the actual report, as I wasn't really intending to write here today.  Anyway, it was not totally unexpected, of course, given the tumor and the surgery.  Just distressing.  We were given a human glaucoma eye drop called Dorzolamide.  Tiny little 10ml bottle for around $55.  Two drops per day in the "affected eye."  And thus started a horrible period for poor Scruffy which I will forever regret.

From the first drop, Scruffy reacted terribly to the drops.  He snarled, he hissed, he hid, and worst of all, he went back to peeing all over the house with a vengeance.  He no longer slept with his little head cupped in my hand, which he had done for years.  I never saw him from one day to the next, except for the times when I tracked him down/grabbed him while he was eating in order to give him his prozac and the miserable eye drops.  I asked several times if there was an alternative glaucoma drop that we could try.  And there was, but it cost almost twice as much, and there didn't seem to be much point in trying it because the ingredients were essentially similar.  Dr. B never really said if the reaction Scruffy had to the drops was normal or not.  I never actually asked, I suppose.

We finally managed, in November, 2010, to get the dental done. It went well, and I requested xrays of Scruffy's lungs to try to make sure the melanoma hadn't metastasized.  (It's fairly common for the cancer cells in the eye to be spread through the tear glands and other pathways to other parts of the body.  Several melanosis cats that I am familiar with ultimately died of lung cancer.)  Dr. G said that the lungs were clear.  He also xrayed Scruffy's abdomen and hips, which he said were normal.  The Puffer doesn't jump very well any more - I was concerned about the possibility of arthritis. Must just be that he's getting old.)

The glaucoma was very well controlled by the Dorzolamide.  The cat, not so much.  In the meantime, we accumulated two more kittens (which Scruffy generally ignored; he's not very "cat-oriented".)  And my mother had a major heart attack, was hospitalized for a month, spent five weeks in a nursing home, returned to her apartment where she needed support and help, had another heart attack, two more hospitalizations.......the essence of it was - there were entire weeks when I was gone 15 hours a day and none of the cats got much attention, although I never missed the medications for Scruffy and Milkshake.  It all added up to Scruffy's turning into a rather sullen, isolated, unhappy cat; the laid-back, sociable kitty just disappeared.  My sweet cat, who had tolerated more than 7000 ear pokes and who-knows-how-many insulin shots over nearly four years without a single objection, became unhinged from the eye drops.  

Finally, at the end of January, 2011, I was running out of Dorzolamide again.  I decided that, regardless of the increased cost, I needed to try the other medication.  In addition to the behavioral reactions, Scruffy was plagued with a black crusty discharge from his left eye; when I wiped it off daily, it left a reddish color on the kleenex, like blood.  Dr. G had said  previously, that it wasn't blood, it was iron and was related to the medication.  He prescribed yet ANOTHER eye drop - I was supposed to be giving Scruffy the glaucoma drops twice a day, Flurbiprofen drops (to treat something or another about the surgical site) every other day, and now, a drop to treat the irritation and infection that was apparently caused by the glaucoma drop.  You think he was miserable before?  We had reached the point where, while I could get both glaucoma drops into his eye every day, there was no possibility of giving him either of the other drops on a regular basis.  So,  I requested a sample of the alternate glaucoma drop, and it was amazing!  It's a thick, gluey white stuff, unpleasant looking, but Scruffy doesn't object to it at all.  No more hissing, no disappearing all day, he's back to snuggling on the arm of my chair and sleeping wherever I am.  Most of the time, when I put the new drop - which is a medication called Azopt, and cost $117 at Costco for a 10ml bottle - he doesn't even bother to blink or close his eye.  The other drops had to have been causing him serious distress, and I am so full of regret for making him so miserable for the last nine months.

Two weeks after starting the Azopt, we had our regular appointment with Dr. B.  Scruffy's eye pressure was 12 in both eyes!  He was doing so well that the opthalmologist felt that it would be possible to decrease the glaucoma drops to once a day.  (Oh, it makes me nervous, but I do have faith in him!)  We've been having an appointment every three months to monitor the glaucoma (and a small melanosis in the right eye,  as well as the former surgical site) and I guess that will continue.   But so far, so good.  I've pretty much got my Scruffy back, with the exception of the occasional litter-box offense.  Although I will probably never be able to totally relax about sniffing and checking all Scruffy's favorite places to "express" himself......