ScruffyPumpkinPattyPaws

The Ups and Downs of Having a Cat with Cancer......

2012-02-14T12:55:00.000-05:00

and kidney failure and a heart murmur..... At this point, it appears that it's mostly the downs. Maybe it was because all this happened so quickly and so unexpectedly - the first week of January, when I took Scruffy for bloodwork so he could have a dental and his calcium level was elevated, cancer and kidney failure were certainly not anything that I would have ever expected to be dealing with just two weeks later.

Last week, (Feb. 9) I left Scruffy at the Hospital for his ultrasound and bloodwork. Although the schedule included another chemotherapy treatment, I had pretty much decided that - unless there was shockingly good news from the ultrasound , indicating that the chemo was working - I was going to tell the doctor that we had had enough, and would just allow Scruffy to live out his life. Since the ultrasound scheduling is uncertain because they only have one machine and emergencies have priority, I had to drop him off at 8:30 AM. When, by 2PM, I hadn't heard anything, I called and asked if anyone had seen my Scruffy. The oncologist got on the phone and told me that the ultrasound had found that the tumors in his liver and spleen were gone. "No evidence." I was so shocked and surprised that I had to ask him to hold on a minute while I cried. Nothing in Scruffy's appearance or behavior would have led me to believe that he was suddenly tumor-free. In fact, I had cancelled an appointment with his ophthalmologist on Monday because he was so lethargic and miserable. Additionally, the bloodwork showed that the ionized calcium level was back in the normal range - 1.31! Hematocrit and hemoglobin were both low, but the oncologist felt that it would be safe to give another treatment. I agreed, although I didn't understand at that time why it would be necessary if the tumors were gone. Obviously, my knowledge of lymphoma is minimal. As we were ready to leave the hospital, I asked if they had done a phosphorus blood test. Choy-Foong had sent me Meowzi's can of aluminum hydroxide, and I wanted to know what his most current phosphorus level was. To compare the huge improvement I foolishly expected to see, as it turned out. The level was 10.1. Horrifying. (Normal is 2.6 to 6.0.) His other kidney values were not good, either. BUN was 114 (norms - 15-34), and creatinine was 4.6 (normal - 1-2.2) The assumption was, with low protein/low phosphorus food, and the addition of the aluminum hydroxide, those values would improve significantly.

Anyway, I brought him home after the treatment. This time, like two of the previous three chemotherapy treatments, he didn't seem to have any particular reaction. He wasn't lethargic, he ate voraciously (on his own - I have given him very little cyproheptadine (appetite stimulant) since he started treatment, maybe five or six 1/4 pills.) His fur was less spiky. He was up wandering around more. He was just himself. He still smelled unpleasantly like urine- my theory is that, since he has such long fur, when they shaved his stomach for the first ultrasound, he could no longer gauge exactly where he was on the kitty litter when he peed - every time he hopped out of the box, he was soaked from his neck to his tail. It has been very cold, inside the house and out, and I really was hesitant to give him a bath, but the odor was becoming hard to tolerate, and it seemed like we could use a sort of "celebration." I have some wonderful vet shampoo that smells like coconut, and without a whole lot of commotion or carrying on - although with a lot of growling! - I scrubbed up my little Scruffy, from his shoulders down to the untouchable tail. He even let me dry him with the hair dryer - noises like the hair dryer and the sweeper have never bothered him. Except for his tail, which was unfortunately still wet and tangled four or five hours later.... Anyway, he looked wonderful. And he doesn't hold a grudge. (See how much softer and less spiky his fur looks!)

This week, since the "no tumor" news, has been a stress-filled blur, pretty much. I had already made a list of low phosphorus canned cat foods that he might eat, and had bought three or four different kinds of "kidney diet" vet foods. Armed with these foods, and the aluminum hydroxide, I started what I hoped would be a dietary routine that we could maintain and that would keep the kidney failure at bay. Not so much..... The first problem that came up was the fact that - despite how pleased I was that Scruffy's appetite was so healthy - his pattern has always been to eat his own food, and then to cruise all the other cats' dishes and polish off whatever he finds there, too. With the aluminum hydroxide, my plan was to add a measured amount - based on his weight and the dosage on the can - to his food. It's supposedly tasteless and odorless. And after the first couple tries, Scruffy didn't appear to care that it had been added. (Unlike the Miralax, which he needs because he had been constipated a week before and I don't ever want him to have to go through that again, and aluminum hydroxide is likely to be constipating.) The goal is to make sure that no food is ever permitted to be in his stomach without an accompanying dose of aluminum hydroxide to bind to the phosphorus and carry it out of his body, instead of allowing it to get to his kidneys. Hence, a "phosphorus binder." So, I had to find someplace to put the dishes for the other cats where they could eat, but Scruffy couldn't get to their food. And, conversely, to prevent the other cats (especially Milkshake, who had had low phosphorus on his last bloodwork!) from eating Scruffy's stuff. Everyone else appeared to be convinced that Scruffy's food - special diet and additions aside - was WONDERFUL and TASTY and WELL WORTH GETTING YELLED AT. Scruffy has not been jumping very well since beginning chemotherapy, so I thought that maybe if I put the other dishes on the cat tree, he wouldn't be able to get to them. Which worked exactly one day. The second morning, I carried all the dishes to the living room, which required half a dozen trips - and before I finished delivering all of them, Scruffy was up on the second level, chowing down on Fancy Feast..... Feeding is now still a work in progress - the best success so far involves feeding Scruffy up on the counter after he gets his pills while everyone else waits. If he fills himself up first, he's less intent on eating from the other dishes. Less intent, however, not "disinterested." :-(

The second problem is that Scruffy's a nibbler. He eats for a couple minutes, then wanders away and comes back in an hour and nibbles again. Since he has been off insulin - 2008 - I've always free fed. They can eat whatever they want, whenever they want. Which does NOT work now that Scruffy can't eat anything that doesn't have the phosphorus binder in it. I don't think I can solve this one. I can't make him eat when he's not interested. Well, yeah, I could force feed him, I guess, but when he's eating well on his own - just not conveniently for me - I think it's a quality of life issue that I don't have the right to interfere with. The best I can do appears to be to stay with him while he's eating, chasing away anyone who wants to share his food, and to pick it up and put it away somewhere when he's done. And then, to watch and see when he strolls back out to the kitchen (or climbs the cat trees!) and get out his previous dish again and see if he'll eat from it. It's taking quite a chunk out of my day.

Third problem: I have to write to someone on the Feline Phosphorus Management Yahoo Board and find out about this aluminum hydroxide management stuff. I can't get in my head why dosing for it should be based on the cat's weight. The formula is supposed to be to give a specific amount mixed in with food - 100mg x the weight - 10 pounds, for Scruffy, divided into two. Well, if he only ate twice a day, maybe that would work. But it seems to me - and I'm sure wiser, more experienced people developed the formula and there are dozens of reason why I'm wrong, believe me - that it should be based on the amount of FOOD instead. If he's eating six times a day, then there are presumably four times when he doesn't have any concurrent aluminum hydroxide in his stomach when the food's there, right? I don't know. I do know, I'm making myself crazy trying to get all this stuff right.

Last night, I took Scruffy to our regular vet, to make sure he wasn't constipated, and to see if he thought that B-12 should be added because of the newly developed anemia. (I'm sort of floundering around here - there are all these medical problems, but the oncologist isn't supposed to be handling all the specialty needs, I guess, like cardiology and internal medicine. The diabetes, I can handle. Everything else, not so much.) To my surprise, he didn't think it was particularly necessary, or that there was any reason to add B-12 for anemia at all - I don't know enough to know if that's true or usual, just that many of the people on the Yahoo CRD board seem to be giving B-12, and I thought, since it's water-soluble, that it would be safe and useful. He was willing to order some injectible B-12 for me. Since we were there, I asked for bloodwork to be done to check what I just assumed would be the "improvement" in his phosphorus levels, and the hematocrit level. To my distress, there was NO improvement. None. His phosphorus level, after all this fiddling around with special foods and phosphorus binder and whatever - was still 10.1, and even worse, the total calcium was 14.6, which is an indicator that the Ionized Calcium is no longer in the safe normal range. BUN was 100 - slightly better, but not good - and creatinine was even worse - 5.0. Hematocrit was 19, had been 20. I'm so depressed.

I also asked for a referral to a cardiologist for evaluation of the new heart murmur - referred to as a "II-III/VI" murmur. I want to be sure that giving fluids is safe for him, and to have an amount that's correct. Also to know about his blood pressure - many of these CRD/F cats seem to be on blood pressure medication to benefit their kidneys. We just were given an appointment for Feb. 24 at 1:00. We have TWO appointments for Feb. 23 at the same place, one for the ophthalmologist, and one for another chemotherapy treatment.

Are we approaching the point of "diminishing returns"? When exactly is enough enough? Can I justify the stress and distress for both Scruffy and me, as well as the incredible expense, when it is starting to look horrifying apparent that there isn't going to be a good outcome for my sweet boy? I felt justified in not having "put him to sleep" - how I hate that phrase, they're not sleeping, they're DEAD - a couple weeks ago as a variety of people seemed to feel I should have done. But where is the cut-off point? When is it hopeless? I'm not ever going to be "ready" to be without him. But I don't want to keep him alive if he's in pain or if he's clearly ready to go. At this point, he's exactly who he has always been. A little scragglier, a little wobblier, but not near the time when some horrible decision has to be made. He's not. He's really not.

Chemotherapy

2012-02-03T00:38:00.000-05:00

Scruffy is getting the Madison-Wisconsin Protocol (25 weeks total)

Week 1: CBC, Vincristine IV, Asparaginase (Elspar) SQ, Prednisone PO

Week 2: CBC, Cyclophosphamide (Cytoxan IV, Furosemide (Lasix) IV, Prednisone PO

Week 3: CBC, Vincristine IV, Prednisone PO

Comes Week 4, at which point there's a problem to be solved: Scruffy's kidneys are not doing well. The Week 4 drug - Doxorubicin (Adria) IV, Diphenhydramine IM, and Prednisone PO is very hard on kidneys. I didn't retain all of the discussion with the oncologist, but it appears that, if we don't use the Doxorubicin, then we're no longer doing the Madison-Wisconsin Protocol. And he named another Protocol - I want to say "CHOP", although I'm not sure that's right.

Week 4 also includes "CBC, ECG, *ECHO" as well. Dr. E said that he thought it might be a good choice to do another ultrasound next week, to see if there has been any change in the tumors that would indicate that the treatment is having a positive effect. I don't know what *ECHO is. I have another paper they gave me that is a description of a variety of chemotherapy options; maybe it's listed in there.

Week 5: CBC - blood work only.

Week 6: CBC, Vincristine IV

and so on, alternating the 3 drugs. Six months of treatment, when the life expectancy they gave us for "successful treatment" was four to twelve months........

The only good thing about all this so far is that there appear to have been NO side effects or reactions to the chemo at all. Scruffy was in the hospital for the first dose of vincristine, but I did see him the next day, and aside from the trauma of hospitalization and catheterization and chemo and not eating....... Well, he didn't look good, but he was responsive, and he actually ate a little bit for the first time in more than two days. The second treatment, also no side effects. I do think that he's mildly nauseated generally, and have been giving him Zofran (ondansetron) every 12 hours since he came home on Jan. 23. He's eating fairly enthusiastically - I have only given him cyproheptadine twice in the last week and a half; it seems to make him hyper, and he was eating adequately without it. Peeing and pooping appear to be normal, also.

Sadly, the steroids (dexamethasone IV, then prednisone pills) immediately raised his glucose level. When he came home, I got ketodiastix and started checking his urine. (He's not nearly as regular as he was in the old days!) Always above the renal threshold, which for him seemed to be around 180. So, on Monday, Jan. 30, I started him on Levemir again. (Day 1392 of his being OTJ, which breaks my heart. Everything breaks my heart these days....) Tiniest little dose - under the zero line - seems to have a significant effect. And whatever I remember from four years ago - which isn't much, apparently - I don't know that it will apply now. Because now, in addition to the cancer, he's got daily fluids added to the mix. Today, for example, (recorded in his spreadsheet, linked on the righthand column) he started out at 258. I'm pretty sure there was virtually no insulin in the shot I gave him the night before, hence 258. I gave him another "under the zero line" shot this morning, and he apparently dropped most of the day - he didn't appear to have started back up until +12, and was only at 119. I don't think I can risk shooting that low without any idea how he's going to do. Maybe this method won't work so well with Lev, which needs patient, stable dosing, but given the other circumstances we have to deal with, I don't see that it can be helped. Every hour that he spends under 180 is a plus for his kidneys.

One heart-wrenching day after another

2012-01-30T14:44:00.001-05:00

While there can really only be one more horrible day - yet to come and not even to be thought about - than the day that Scruffy was diagnosed with cancer (and a heart murmur and kidney failure, like one awful disease was not nearly enough...) - this morning was definitely in the running for Day I Never Wanted To Come.

It was clear that - only 3 months from the fourth anniversary of being officially OTJ (off the juice, in feline diabetes speak) - the introduction of dexamethasone by IV in the hospital and prednisone pills at home were going to wreak havoc with Scruffy's glucose levels. His last official lab test glucose level - on January 17th - was a lovely 51. (Which was actually a smidge lower than I would have expected. Maybe cancer does eat sugar?) From the introduction of steroids, on January 23, 2012, Scruffy's been around 200-250 each time I tested him. I bought urine test strips, and sure enough, there was glucose spilling into his urine.

It's been so long since I had to worry about any of this stuff, and my mind has definitely deteriorated in the last 4 years. But, I clearly can't risk DKA or further kidney damage from lack of treatment of diabetes.

I wanted to use Levemir again - a human insulin that produced the OTJ status the first time. It was gentle, long-lasting, didn't sting when injected, and gave him good control. My expectations and goals are totally different this time, though. I simply want him to be under the renal threshold. I'm not interested in doing a whole bunch of testing or fine-tuning dosages. I don't know how long I will have him here, and I don't want to make him any more miserable with treatments than he already is. He was such a good diabetic cat the first time around - more than 7,000 ear pokes and who knows how many shots, and he never protested. Except for the time I bought ReliON syringes.... he could apparently tell the difference between them and the BD's that I usually used. The most efficient way to purchase Levemir for use with a cat is in the form of a "pen," a measured cartridge that humans can use by dialing the size of the dosage they wish to give and allowing the pen needle that is attached to inject the insulin. Since this doesn't permit the tiny doses that cats generally require, we still need to use a syringe to withdraw the insulin from the pen and inject it into the cat. Levemir comes from the pharmacy in a box with five pens. Given the usual small dosages needed for treating a cat, five pens would last a very long time, and it's sadly unlikely that Scruffy would even be here long enough to use up that many pens.

So, I "networked" - asked a few very good friends if they might have any extra Lev pens, and was kindly offered four different pens by Pamela, Vicky, Melissa, and Dian. Two of them would require shipping, which makes it more difficult in the winter, but Melissa and Dian are within driving distance. Yesterday, Melissa and I met - and had a nice lunch at Cracker Barrel and a good visit - and she gave me a partial pen of Lev, a box of syringes, and a box of Kleenex to mop the tears that seem to appear unexpectedly and often. Tomorrow, I'll met Dian - more lunch and more understanding friendship! - and she has another partial pen. Of all the many pleasures Scruffy has given me over the eight years he's belonged to me, meeting and loving the special people from the Feline Diabetes Message Board is right up there on the top of the list. Crazy cat ladies - well, maybe. But smart, caring, thoughtful, wonderful humans - for sure. I have been so fortunate.

This morning, I tested Scruffy again. I'm really kind of quivery about this whole thing - I can't see well enough to fill the syringe, my math skills are so minimal I can't even figure out the dosage by the lines on the syringe - oh, and I really DON'T want to have to do this. But..... He was at 200. So, I fed him - and of course, today was the first day he wasn't determined to eat out of every plate on the floor. he did finally eat a little Gourmet Chicken FF and drink some lactose free milk, so I figured he was good to go. I oh-so-carefully drew just a tiny little bit of insulin into the syringe - as close as I could get to the first line on the barrel, which is some totally unknown amount, but presumably way less than a half unit. I made the tent, and poked poor Scruffy. He probably got next to no insulin, I don't know. At least, it was a first step, I guess.

At +3, he's 180. Not a lot of movement, lol. I'm not gonna keep poking his ear. If he pees, I'll check and see what the strip says. That's the best I can do for him, except to tell him again how sad and sorry I am that all this has happened to him. It's really not fair. I gotta go find Melissa's kleenex.

Glucose level - 243 :(

2012-01-24T14:37:00.001-05:00

Scruffy's home.

2012-01-24T01:47:00.000-05:00

Jan.23, 2012

I wasn't sure that I'd even get to write that. This is Monday night. This morning, Dr. E called from the Specialty Hospital and said that he thought that the Puffer could come home today. His ionized calcium level this morning was 1.34 , down from 1.38 yesterday. But - his creatinine was 3.3, up from 3.1 yesterday. He weighed only 10 pounds, 2 ounces today, no surprise since he had eaten virtually nothing from Thursday afternoon until Saturday afternoon, when he began to voluntarily eat small amounts of Fancy Feast Gourmet Chicken. (Which was his "go to" food when he began to eat again after being diagnosed with diabetes back in 2004.) Speaking of which, his glucose level has climbed steadily since he was hospitalized and since he was being given dexamethasone by IV for the last three days. It was 184 on Jan. 21, 210 on Jan. 22, and 251 today, Jan. 23. The doctor thought that stress from the hospitalization could be impacting the glucose level. Truthfully, I'm hesitant to even test him now that he's home, but I suppose I'm going to have to.

The official report, made on information gathered between Jan. 20 - Jan 23, 2012, after ultrasound and other assorted tests, includes the following information:

"Diagnosis: Large cell lymphoma of liver and spleen; kidney failure, history of diabetes mellitis, history of urethral obstruction.

Radiographs: Possible cardiomegaly, decreased detail within the cranial abdomen suggestive of mild effusion or inflammation. Hepatomegaly was noted as well.

Ultrasound abdominal: On the spleen, there were multiple large, hypoechoic, heterogenous masses up to -80mm to the right of the midline. On the liver, there was a single 27x20mm mass similar in appearance to the liver mass. The peritoneal cavity had mild/trace effusion. Single small mass between stomach and liver of questionable origin.

Ultrasound-guided aspirate: consistent with large cell lymphoma

Ascultation of the heart reveals grade II-III/VI systolic murmur.

Urinalysis: SG: 1.014, remaining values WNL (Because his kidney values - creatinine, etc - showed virtually no improvement even though the calcium level is approaching normal, they have added "kidney failure" to the diagnosis.)

We came home with:

Azopt drops for glaucoma (already prescribed since June, 2010.)
Prozac (already prescribed since August, 2010, discontinued for 4 months in 2011, restarted in December, 2011.)

Prednisone - 5mg - 1 tablet every 24 hours until evaluation at appointment on January 26, 2011. May be tapered off at that time.

Cyproheptadine - 4mg - 1/2 tablet every 12 hours to stimulate appetite.

Famotidine (Pepcid) 10mg - 1/4 tablet every 24 hours until recheck. For nausea.

Renakare: 1 2meQ capsule every 12 hours with food. Potassium supplement. (However, this is actually a huge white pill, not a capsule, and even broken into small pieces, was a real problem to get into Scruffy. He's very difficult to pill, and we've now got a ton of pills to give him.) This will hopefully be discontinued at the Thursday appointment if his potassium level has normalized.

Buprenorphine - to be given if he appears to be uncomfortable, although they don't expect that he should be "overtly painful."

Next Thursday's appointment is to include bloodwork to recheck CBC, and Chem 8 test, and IV cytoxan/lasix chemotherapy. It makes me shudder to think of it. I am not convinced/committed to completing the entire schedule of chemotherapy, which includes treatment virtually every week for six months. I think at either four weeks or six weeks, they plan to do another ultrasound to see if there has been reduction in the tumors. If there does not appear to have been any progress toward remission at that time, the option seems to be to stop and do nothing further, or to change to another protocol. Given that the predicted survival of my sweet cat was "four to 12 months", I'm not sure I want to waste six months of that time making him sicker, and I am sure that I would not want to start another kind of treatment. They are insistent that cats don't suffer the distress that humans do with chemotherapy; I'm not sure how they know that, and we all know how expert cats are at hiding their pain.

There is much more depressing information that I don't have the energy or desire to add right now, although I will post it maybe tomorrow, since it's potentially of interest to others who may be contemplating chemotherapy for their cat.

Here's a little more upbeat stuff:

It took FOREVER to get Scruffy sprung from the hospital. Although we had made what we thought was an "arrangement" to pick him up at 2:30 (and my husband had a doctor's appointment of his own at 3:30), it was almost 4:30 before I finally had poor Scruffy in my arms. And then, we were taken to one of the exam rooms to get the medication and instructions and information sheets about the chemotherapy program - which is the Madison, Wisconsin protocol, by the way. Then we waited a little longer for Dr. E to come and actually hand over the discharge papers, the buprenex, and Scruffy's kitty pi, which must have been left in his cage.

We finally got out of there about a quarter to five. And by the time we'd gone a mile or two, it started to pour. Tons of rain. As we entered the area of Wexford, the most amazing thing happened: an enormous, brilliantly colored, complete rainbow appeared in front of us, with a second rainbow forming to its left. Stunning, defined stripes of color, and funniest of all, it looked like the end of it would be right in our back yard! Well, of course, it wasn't, but it sure was close. We decided that that was Scruffy's good luck rainbow, and hopefully, it means that he will survive whatever chemotherapy he ends up having, and that we will be allowed to have him for what will hopefully be a lot longer.

When we got home, I carried him upstairs and put him down in the living room. There has been a sort of manic quality to his movements since being in the hospital - kind of jerky, unplanned-seeming movements, and his back legs aren't totally functional, which may be one of the side effects of the chemo. Anyway, he looked around for a minute, and then headed immediately to the kitchen, where he climbed into one of the litter boxes and sat, looking kind of dazed, for the longest time. When he got out of the box, I went to sit in my chair and he galloped over to assume his usual position on my right leg, with his little head cupped in my palm. He had trouble jumping up onto the table, and when I went to "help", I discovered that his whole bare-shaven little stomach was wet. With chemo-infused urine, lol. And we were instructed not to touch any of his "productions" for five days.... (He had what they thought might be a urinary tract blockage while in the hospital, although there was very little sediment when they catheterized him. The catheter was removed just minutes before we got him, so I assume that it had caused some irritation and maybe lack of control.) Anyway, he sat there, and purred mildly for about a half hour. Then, he jumped down and headed for the kitchen again, to see what the other cats had left in their dishes. He snuffled around, while I opened a can of Gourmet Chicken and gave him a little plate of lactose free milk. He gobbled down half the can of FF, and I put the other half down for him and he ate that, too. My poor cat that hadn't eaten a total of an entire can of food in two weeks! He continued to make periodic food searches until around 9:30 or 10:00, when he got up and peed again, then climbed up on his window ledge and curled up in his kitty pi on the heated mat.

None of the other cats showed much interest in him. He has a really odd smell to him, and I was a little concerned that maybe the others would reject him or not recognize him because of it, but it didn't seem to be a problem. My little Milkshake was the only one to make any effort to "greet" Scruffy. He jumped up beside The Puffer, and tried to lick his head, but all he got for his kindness was a whack with Scruffy's paw.

The one odd thing seemed to be that he didn't put his head down. He just sat, eyes open and his head in the air, for nearly an hour. I wondered if he was sleeping with his eyes open. He didn't react to sound or noises, except for one unpleasant exchange between Minnie and Burble, when he turned his head toward the noise. He got up twice to drink some water, and did a long, involved circling thing before laying down again, this time with his head down. He's been generally napping now (although right this minute, his eyes are open halfway.) It seems a little odd.

One other matter of interest, I suppose, is the cost so far. (No one has mentioned the cost of the chemotherapy itself.) I did say that I didn't think we could afford another regular charge of $900 for the several scheduled ultrasounds, and Dr. E said that it would likely be more in the range of $300 or $400; the original one include the aspiration and a ton of lab work. Somewhat comforting.

The two page bill, which included the information that the charge for the "Hospital Level 2" is $90 for weekdays and $108 for weekends - summarized the charge for all of things that had been done to/for Scruffy on Friday, Saturday, Sunday, and Monday as $2,264.00. A fairly shocking amount. (It was my intent to tell the person doing the money collecting NOT to say all that financial stuff out loud, but unfortunately, just as she started reciting all of the gruesome and expensive details, my husband wandered over to the desk and, of course, was regaled with all of the numbers. It was even more shocking to him, I guess.....

At any rate - with the exception of the fact that I don't know how I'm gonna get the potassium pills into Scruffy twice a day, and that I'm not convinced that Pepcid/famotidine is going to control nausea sufficiently now that he's eating again - my sweet kitty is home again. I have cried practically non-stop for four days, and now, to be able to hold him and pet him and just have him here is wonderful. He's such an odd little guy, with probably the most interesting personality of any cat I've ever had. I'm going to concentrate on treasuring however many more days we have.

Scruffy's Rainbow

First meal at home

Milkshake's greeting

Scruffy has lymphoma.

2012-01-21T01:33:00.000-05:00

It hurts my heart to write that. In his liver and spleen. And the hypercalcemia is causing kidney failure.

I thought this post would be a report of the results of the second bloodwork, and the arrival of the results of the fPLI test. (He got a 14; normal is 1.0 to 3.5.) And to mention that I weighed him again this morning and he was down to 10 pounds, 5 ounces. And that there is a sort of odd, squishy quality to his abdomen when I pick him up.

To summarize the second bloodwork, AST and ALT were elevated more, although not horrifically. Amylase was high/higher. Glucose was 51. I wish I could laugh about that. Total calcium was significantly higher, and his creatinine and whatever the other kidney thing is were both abnormal this time, although they had been fine just a week ago. The vet sent a referral for an ultrasound. When I called them, they said two weeks. It was becoming apparent that we didn't HAVE two weeks. I flung everything I could think of into the conversation with the receptionist, including Dr. B, the ophthalmologist. And somehow, she discovered an appointment she hadn't seen before for this Friday, only two days away.

In the meantime, although Scruffy would turn up in the kitchen every time I put food down for the cats, he couldn't seem to bring himself to eat. I started putting a whole handful of kitten chow on his plate, and carrying it around to wherever he ended up sitting down. He also would still wander out to the living room where Milkshake eats, but instead of inching up closer and closer to sneak a bite of Milk's food, Scruffy would just meatloaf down a couple inches from Milk and watch him eat. I picked up a couple of cans of AD because even the ham baby food wasn't enticing him, and I was getting worried about taurine and all the other neutrients he wasn't getting enough of. The one thing he wanted and ate eagerly - and which was probably a terrible thing to give a cat with calcium in his blood that was killing him - was lactose-free milk. I never give any of the cats milk, although Black Kitty started every morning of his life inside with a nice dish of regular old milk and we never thought a thing about it.

I have the dates all confused in my head. I need to get a calendar, I guess. The Sunday after the second bloodwork was done - and there was an error that delayed the testing and the return of the results, so it was right after we got the report - Dr. G. said he thought that we should start doing fluids. It has been one of my fondest desires NEVER to have to do fluids with one of my cats. I have been needle phobic forever; it took me months to be even moderately comfortable with insulin needles, and they were 31 gauge. But - it had to be done. We took Scruffy down to the office and got a quick demonstration of how to do it. I thought Rege was intending to help, but the next day, he announced that he was NOT going to. I managed to do it myself, and my sweet cat never fussed at all. Not a move, not a peep out of him. I expected, though, that it would make him feel so much better. It didn't seem to. And he wasn't peeing any more than usual, which also surprised me. I discovered that Costco sells/will order Lactated Ringers - a case for $26.19 or there abouts. Dian gave me a website that sells the needles - Terumo's, too! - Dr. G. gave me disgusting Monojects that stuck to Scruffy's skin like glue; they were horrible to use. And I bought sets of tubing. All set to go. Scruffy and I got through five days of "giving fluids" without much trauma, and without his making the least protest. I took pictures, for no particular reason. I guess I wanted to prove that I was able to do it, no matter how I hated it, and what a good cat I had for tolerating it when he felt so lousy. As you can tell from his fur, he felt crummy, and he was still purring when I rubbed his ears at the end.

Another installment of this nightmare tomorrow.......I'm too weepy and exhausted to do any more tonight. And I miss my Puffer terribly already and it's only been 13 hours.

10 pounds, 11 ounces. :(

2012-01-11T09:50:00.001-05:00

Scruffy's not doing very well.

2012-01-11T02:10:00.001-05:00

Tuesday, January 10, 2012

He's been licking his lips for two weeks or so, and doing some throwing up. Nothing very major, nothing particularly unusual. His teeth are again in need of a dental, so I made an appointment for him to have bloodwork. He's never, in all his years, had any bloodwork results that were abnormal except for glucose and cholesterol.

But, this one came back with:

ALT 154 (high) ref. range 10-100
AST 106 (high) ref. range 10-100

Calcium 12.8 (high) ref. range 8.2 - 10.8

Amylase - 1407 (high) ref range 100 - 1200

Plus:

Neutrophils (high) 9225 ref range 2500 - 8500 75%

When Dr. G. called with the bloodwork results, I was shocked that there was something wrong, and even more by what it appears to possibly be. Hypercalcemia. Excess calcium. Most often an indicator of lymphoma, or also of parathyroid adenoma, or kidney disease/failure, or hyperthyroidism. Only, his kidney values were just fine, as was his Total T4.

Also, he's lost somewhere in the range of at least a half pound. His little face is tiny, suddenly. And then I realized that his fur is horrible - getting dandruffy and sticking up all spiky in every direction. When he lays down, meatloaf-style, the fur on the tops of his back legs sticks out like clumpy batwings. He's never had nice fur, but this reminds me of all those months of uncontrolled glucose levels in the 300's and 400's......

Spiky hair from his ears to his feet. :(

Poor Scruffy's been very sniffly for several weeks. He did finish a course of zeniquen for herpes in early December, successfully. I had thought maybe the lip-licking might have had something to do with his ears, actually; he has a history of ear infections, and if I rub in front of his ears, he shakes and scratches at them in a fairly frantic manner. He's been sleeping significantly more than usual for the last week. One night, he didn't even show up to sleep with me for the first time in months, although he's always tucked away with his little head in my hand in the morning. For the last two days, he's been throwing up foam once or twice a day, usually when his stomach is empty. And he's drinking water very frequently, although he doesn't seem to be spending any more time in the litter box than usual. (Unless, of course, he's wandering downstairs to pee on the rug when I'm not around. ) I was consoling myself by thinking that at least he was still eating in Scruffy fashion. Scruffy never not eats. Until this morning, when he ate only a few bites, sniffed and wandered slowly away. (And the final blow - the melanosis in his right eye - I can't see it totally clearly and I haven't been able to get a picture of it - seems to have a second area of discoloration suddenly.)

It was the vet's suggestion that we wait two weeks or so and then retest the calcium level, and add in testing on a bunch of the other possibilities. And an ultrasound - which would be interesting, I guess, solely because everyone who has ever examined his abdomen has thought that there was Something Wrong In There. (That was the reason that the Emergency Hospital thought that he had FIP, way back when I first brought him home in 2003.) He did have xrays with the last dental, about a year ago, that included his lungs and the area around them, and his hips and spine; there didn't appear to be anything abnormal then.

Anyway, with today's rare and frightening lack of interest in food, I called the vet and asked about cerenia, which he had mentioned the last time I talked to him a couple days ago. We have never resolved our definition of "vomiting" and "regurgitating" - I think Scruffy's throwing up his whole life has been "regurgitating" - the food never hits his stomach; he just gobbles it down, and within seconds, it comes right back up, untouched by teeth or digestive process. The vet says that cats don't "regurgitate", and that it's vomiting. Not that all of that is of any particular import, it's just an issue that has come up repeatedly. Anyway, I thought I would try pepcid, but after thinking about it, I realized that, with all of the other stuff that seems to be going on, maybe it would be better to just start out with the Big Gun instead. Turns out cerenia, which I know people on FDMB have had very good experiences with, is an injectible. Dr. G. says it stings. And that it can be given with an insulin syringe, sub q. Thank God, I guess. It took me forever to get used to giving Scruffy insulin, and the only other time I ever had to inject anything, they gave me four HUGE syringes full of Reglan to inject into my little 3 pound kitten, Burble. With one of those enormous thick syringes and needles that are NOT insulin equipment. I could only bring myself to do that once, and it was horrible. I just don't know if I can do injectible cerenia, and I have mixed feelings about doing something that will cause him more pain and discomfort. So, anyway, there's a pill form, which may or may not last 24 hours, like the injectible does. I picked up 4 pills - I don't know why that number, since it's Tuesday and the fifth day is Sunday, when the vet's not open. I guess to see if it works or not. I came right home and gave him the first pill, with his prozac, because he's really difficult to pill, unfortunately. Another reason to consider the injectible, I guess. Waited three or four hours for the pill to start circulating, and then got out the food. He did come out to the kitchen and wait in his usual place for his dish, but he didn't really eat any of it. He likes to wait until I fix the dishes for Tootie and Milk - adding a little dry kitten food for them, and I always put three or four pieces on his plate at the same time; he did eat that dry, and a couple of snuffling bites of the canned. And then he went back to sleep for three or four hours.

Dr. G. said today that 12.8 isn't exactly the level of calcium that is considered an alarm sign for hypercalcemia/lymphoma. That's closer to 15, apparently. And he says that electrolytes can vary - we might have just caught him at a time when it was unusually high. But it's high enough to need to be checked, because high calcium can cause kidney disease, among other awful things. An elderly cat who had totally uncontrolled glucose levels for more than two years and still manages to have well-functioning kidneys doesn't need anything to damage them. I spent a long time reading stuff I didn't really understand about hypercalcemia today; everything that I thought might be an explanation for his level seemed to be negated by all the other stuff that's suddenly going wrong with him all at once. The weight loss is worrying and sudden. What if he's working up to hepatic lipidosis and that's why his liver values are screwy? See, why didn't I ask the vet that? Should I call him and ask him tomorrow? Wouldn't he have mentioned it if he thought it was a problem?

I have literally spent every minute that this poor cat has lived with me keeping him alive. He had a urinary blockage a half hour after I brought him home - the first of three that required surgery in the first two months I had him. And then the "FIP scare", and the "sinus infection" that turned out to be herpes, and the diabetes and DKA, and the iris melanoma and subsequent laser surgery, and then the glaucoma, and now - after worrying for 3 years about the possibility of melanoma metastasis - now lymphoma, maybe? Not fair. I am so weepy I can hardly look at him. The poor thing, none of this should have happened to him.

More ophthalmology stuff

2011-11-01T19:13:00.000-04:00

Another visit - apparently there was an eye-related emergency, because we had to wait almost an hour for Scruffy's appointment. Dr. B. seemed rushed and stressed during the time we were there - although I notice that we were charged for the SST test, they didn't do it. Only $17, I guess.

Anyway, eye pressures were very good again - 13 in the right and 14 in the left. Under 20 is desirable. I got refills of the Flurbiprofen, and of the ulcer solution, and a prescription to send to Canada to order Azopt. A couple months ago, a woman that I knew from the EpiKitty Yahoo board posted on Facebook that she had some glaucoma drops that her father had purchased for his dog. (The dog had died.) Turned out, the drops were Azopt! The bottles were only 5ml, as opposed to the 10ml that I've been buying at Costco, but I was paying $117 for one bottle - these were $28 for two or three! I just finished the second of these bonus bottles, and despite an article I read from Consumer Reports about the hazards of ordering from Canadian pharmacies, I had no problems with the anti-convulsants I was ordering for Milkshake, and I don't expect any problem in getting glaucoma medication from there.

General report - 1) no regrowth of the iris mass, ocular pressures controlled, and 2) no change in the focal iris pigmentation

So, good news and no more appointments hopefully until January, 2012.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

8/11/11 Animal Communication

(I forgot to post this months ago, and now, since it's somewhat lighthearted and I am definitely NOT, I'm just trying to figure out a way to tack it onto an older post, instead of having it show up on top with all of the cancer stuff.....)

By August of 2011, Scruffy's "inappropriate elimination" was pushing me right over the edge. I was cleaning the carpets downstairs every week, and crawling around with my black light at night; sniffing when I came in from the garage, and paddling around in my stocking feet to see if there were wet spots. He was spending most of his time hiding. A couple of times a week, he'd poop right beside the litter box downstairs. I was so annoyed with him I could hardly bear to look at him. He hadn't come to sleep with his little head in my hand for months. He had also started what appeared to be an intentional technique for avoiding the prozac pill every morning - he would just go from dish to dish, vacuuming up the cat food, until he threw up. Once the pill was disposed of, he'd eat some more. I was feeling persecuted and angry and guilty about all the eye drops he hated and the pill-giving. I mean, after all, who rescued him from a short and miserable life outside? Who spent almost 4 years testing him and giving him insulin shots, and who got the tumor in his eye removed??? He OWED it to me to use the damned litter box. Only, unfortunately, he didn't seem to feel the same way.

Someone from the Feline Diabetes Message Board mentioned that she had been in contact with a new "animal communicator." It was a person who had been around the board for years and had been/is fostering a ton of diabetic cats. I had positive feelings for both the communicator and the communicated-with. And I was so desperate for help that I decided to try it.

My only other experience with animal communication was a couple of years ago, when Hope and Linda and Dale gave me an hour with a communicator in Ohio. (It doesn't matter where the communicator is; location isn't significant.) And it was very interesting. The communicator said that both Milk and Scruffy had spinal issues; I took them to the holistic vet here, who does chiropracty, and sure enough, without even knowing what the communicator said, he diagnosed the exact same problem location she had for both cats. And she had suggested some herbals for Milk's uncontrollable seizures. (I actually bought them from her, but couldn't bring myself to give them to him.) There were some other things she said that weren't particularly applicable, but......

So, I made the appointment on-line. Very well set-up website, very easy to pick a time. Kind of expensive - $30 for 15 minutes, one cat and $60 for 30 minutes, two cats. But, well worth it if works, right?

I wanted to be very organized about what I needed to know from her. My concerns were, well, of course, the Scruffy-peeing stuff, and Milkshake's weight loss. When the time came for our appointment, she asked only for the name of the cat and the color of its coat. (I think I was so desperate for help that I may have told her that Scruffy was making me crazy, but I'm not sure.) At any rate, she went away and came back in a couple of minutes and said, "Scruffy thinks you're mad at him." I said, "Well, DUH. I'm enraged!" She talked to him some more, and he told her that he didn't like the Prozac. He didn't like the way it made him feel. (And I had increased his dosage as his peeing got worse, which made me feel even more guilty.) He said he'd use the litter box if he didn't have to take the Prozac. I was VERY unsure about making such a deal. (And thinking that I had to be NUTS!) But, I agreed, as long as he actually was going to cooperate. He had to understand though, that because he was having a herpes attack, I still needed to give him zeniquin. She said he didn't have a problem with that. And she had to tell him that there was no choice about the eye drops, either. We talked about Milkshake, who she felt had something going on internally, but couldn't identify what the problem was, and then hung up.

That was at 2:00 PM on a Sunday afternoon. At 7:00 PM, Scruffy wandered into the kitchen and for the first time in months, PEED in the box. Right in front of me! I was stunned. That night, he turned up the minute I was ready to go to sleep, and snuggled into his old place. He started following me around again, waiting for me to sit down so he could sit on my lap. It was all amazing. And for a good two weeks, he seemed to have gone back to his old diabetic pattern - he peed twice a day, at the same time, right in the middle of his meal. I was ecstatic. At the end of that time, I again talked to Claudia. I wanted her to ask him how he thought he was doing with our little agreement. I didn't get that she understood my question, or that he answered it, but anyway, I felt comforted.

And then, I discovered a puddle in the laundry room. On the vinyl floor, and when I tried to get the smell out, it got worse and worse. (That was when all the downstairs peeing started - I moved a nice big litter box to the laundry room, thinking that he'd be happy to have a box down there. He wasn't, apparently; he peed all over the floor a dozen times and never hit the box once.) Eye-wateringly stinking. I tried talking to him. It seemed more hit and miss; sometimes he'd use the box, sometimes he didn't. I noticed, to my extreme dismay, that both Burble and Duncan were beginning to watch when Scruffy was in the litter box and to chase him afterwards. Not exactly what we needed.

And then - this was about 3 weeks ago - he peed on the floor right in front of me, twice. I was in a frenzy. I rushed to the computer after the second episode and looked up Claudia's website. And tried desperately to get an appointment to become available. Which never happened - I finally noticed that she was on vacation. So, I had time to calm down, and I "discussed" with Scruffy my annoyance and disappointment with his behavior.

The outcome of all this - well, in the end of November, 2011, or the beginning of December, I started him back on Prozac. Half the dose he had been on before. And it seems to have been successful. Haven't found more than a couple puddles on the rug since then. I hated doing it to him, but I just didn't feel like there was any choice. One more thing that I will be eternally sorry happened to my poor cat....

6/14/11 - catching up on ophthalmology

2011-11-01T18:51:00.000-04:00

We're still having the every-four-months-appointments. And eyewise, things have been good. The eye-dryness measure (I don't know what its actual name is - they put a small tab of treated paper in each eye and hold it closed for a few seconds; I posted a picture of it before) which is reported as "STTs" on the appointment record, was 12 in the right eye, and 13 in the left eye. The eye pressure, which is how the glaucoma is monitored - was very good - 11 in the right eye, 13 in the left. (The melanoma and surgery were in the left eye.) Although I haven't taken any pictures of his eyes to Dr. B. lately, he feels that there has been no change in the melanosis that remains in the right eye. It always looks a little more spread out to me; I do need to photograph it, I think. At any rate, if it's growing, it's doing it very slowly.

At the end of this appointment, the technician mentioned that I was to continue putting the Azopt in BOTH eyes. I didn't know that. I could swear that I never heard Dr. B. even say that he needed the drops in both eyes. So, obviously, I hadn't been doing it. And Scruffy's personality changes had not improved - adding even one more drop of that thick white stuff was just likely to make him even less cooperative. The essence of it is, I am keeping two drops a day in the back of my mind, but the reality is, when there appears to be no problem with the pressure in the right eye, I just don't know if it's going to get done until it becomes medically unavoidable.

Aside from that, the appointment summary was:

OU (both eyes): lens sclerosis
OD (right eye): focal iris pigmentation site (ventral quadrant) 6:00 position
OS (left eye): previous laser surgery (for iris mass) - no evidence of regrowth.

We had the usual discussion of Scruffy's presumptive age again - almost three years ago, Dr. B. said that he felt, judging from the condition of his eyes, that he was between 10 and 13 years old. So, that would make him somewhere between 13 and 16 now, I guess. And he continues to have adequate vision in the eye that had the tumor, which is good. All in all, except for the spitting and hissing and biting that went on, a pretty good trip. (Except for the guy in the waiting room with the enormous black dog with the ear-piercing barking. One of the technicians said that he has three more of that same dog - can't remember the brand - at home. I hope he wears a hearing aid that he can turn off.....)

Well, this is distressing.

2011-03-06T12:33:00.001-05:00

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......

It's been a long time, sadly......

2010-03-26T19:47:00.001-04:00

Since Halloween, which is kind of amazing. It's not that there hasn't been anything going on with The Puffer. He's had another good report on the condition of his eyes - both the one that had the laser surgery and the other eye, which has a new melanosis that we're watching. He had bloodwork that was good - I think his cholesterol level was the only thing that was out of range. Despite the much-discussed dental that still needs to be done, he continues to have reasonable blood glucose levels - I just tested him a few minutes ago and got a 68!   (Which is significantly lower than usual, I have to admit.)

This has been a bad winter for the state of Scruffy's fur. It was so awful that a few days ago, I bought a wonderful cordless clipper, and started shaving him. It's amazing to see him without his fur, because he looks so chunky with it. Without it, he's really quite svelte. (I'm cutting back on the pictures because my computer died a few weeks ago and I don't want to fill up this laptop with stuff until I get a new desktop. I am going to take a picture of his new "do" to post here, even though it's not quite "done.") It also appears that the lumpy lipoma on his right side has either diminished in size (do they DO that?) or gone away.

Back in January, when we went to Dr. B, the ophthalmologist, I mentioned that our regular vet had suggested trying famciclovir for Scruffy's herpes, which has been awful for months. The sneezing, the snorting, the nose-running - the poor cat. Dr. B. - who uses famciclovir because he has patients with herpes eye problems, agreed that it was well worth a try. He wrote a prescription for twelve 125mg pills, to be given 1/4 pill twice a day for no more than 2 weeks. Verrrrry expensive stuff, that famciclovir - almost $6 a pill. Fortunately, it was a round pill, which made cutting it into quarters somewhat easier, but .... I've been giving Scruffy (along with his prozac for "inappropriate urination" ) a nightly 1/4 chlortrimeton to try to help with the nasal/sinus problems. During the duration of the time he got famciclovir, I stopped the chlortrimeton to see if I could determine whether there was any significant effect of either of the drugs. As it turned out, I couldn't give him the morning famciclovir pill - every morning for four days, after I gave it to him, he'd eat and eat and eat in a really driven fashion until he threw up. So, I just gave it to him in the evenings with his 2AM snack, and it stayed down. There really wasn't any huge improvement, sadly. After the two weeks was up, I went back to the 1/4 chlortrimeton nighly. A month or so later, I again refilled the famciclovir prescription, and tried it again. There seems to be an initial positive response, but it doesn't last, and it never did seem to be completely effective. I think - although Dr. G, our regular vet, didn't seem to agree - that by now, it's possible/likely that he's got sinus inflammation/infection going on. I found an unexpired packet of a week's worth of clavamox, and gave it to him, and in my opinion, it was effective.   I think I'm going to ask Dr. G for a prescription for something antibiotic, and schedule the dental in the very near future.

So the essence of Scruffy's life is, we're still plodding along. He needs the prozac still, I guess - I found a puddle in my craft room three times that I'm pretty sure were Scruffy Productions. I never see him in the litter box anymore, but I also never see him spraying or digging at the carpet or furniture, so I'm assuming things have been better with the addition of another cement-mixing litter box in the laundry room downstairs. (The EIGHTH!) He's about ten years old now, in the estimation of the ophthalmologist, so he and Busy are Senior Citizens of our household. (Well, aside from my husband and I, oddly.)

The Countdown Clock to keep track of how many days (and hours and minutes!) Scruffy's been off insulin has given up the ghost. I can't figure out what could have happened to it; it just disappeared, even though the html code is still there. I tried repeatedly to replace/fix it, without success.   I really miss having it up there, because we're coming up very rapidly on the TWO YEAR ANNIVERSARY of his OTJ! April 8, 2008 - still an amazing thing that makes me shake my head every time I think of it. I wrote to the Pyzam people (whose website contains all sorts of interesting things like countdown clocks) to see if they have a solution or a suggestion. I have one on Milkshake's blog, put up at the exact same time as Scruffy's, and that one's still perfectly functional.

I need to go and hunt up the blood work report, and the ophthalmology report, and a new picture of The Puffer with his crew cut.

Halloween

2009-11-01T00:06:00.002-04:00

Of course, I have to annoy the boy cats (not the girls, because they're way too vicious, and the kittens are too uncooperative) - with Halloween costumes. It's been a couple of years since we dressed up for the occasion, and no one is any happier now than they were the last time. I don't care if they're annoyed; they're so darn cute.

On to the important things:

1) Started prozac on Tuesday, October 20, 2009. After a highly unsuccessful two and a half months on paxil. And Wonder of Wonders - it seems to be working! I have to admit to still having the occasional twinge when Scruffy heads off for unknown parts in the middle of his breakfast. But, I've seen him actually USING the litter box (or ONE of the 8 litter boxes I've got all over the stupid house!) every single day but two since we started. Okay, so now that I do the math, that's only 11 days, but it seems SO much longer. Sadly, I don't notice any particular improvement in the Fearsome Tootle's behavior, but maybe it will just take a little longer for the prozac to affect her.

2) Postcard to set up Scruffy's next ophthalmologist's appointment arrived in today's mail. If you look closely at his right eye in the Pumpkin Picture, you can see the distinct brown circle at its lower inside edge - that's the next iris melanosis. Which has darkened, become more distinctly circular, and gotten bigger since the last time I was able to get a picture of his eyes. (Missed having a picture to take to an appointment with Dr. B for the first time in three years!) He's to be scheduled for a January or February appointment. I guess we'll aim for January. I hate the thought of all this potentially starting again.

3) Still no dental. And he's had some pretty horrifying numbers occasionally - the worst was a 188, out of the blue and presumably some hours after he'd eaten. (Although I think that he may have gotten trapped downstairs by/with Tootie, which would be a good reason for increased glucose levels. We had a brief, very brief period of about a week when the herpes seemed to have taken a vacation. I should have hiked him down to the vet's immediately and had the dental done. But, I didn't, partly because of inertia and other stuff that had to be done, and partly because I am thinking that he's going to need complete blood work, as well as xrays of his hips and lungs. The thought of dragging him down there twice was just more than I could bear. But, given the potential of needing a dental's likelihood of screwing up his OTJ status, I know it HAS to be done. Soon....

Anyway, it was a very quiet, damp, chilly Halloween here in The Land of Kitty Delight.

No. (and TMI alert, too)

2009-08-28T13:07:00.007-04:00

To answer the question from the previous post. Paxil does not seem to be doing much of anything to address the peeing/spraying problem. In the last two weeks, I've watched Scruffy like a hawk every morning. I follow him all over the house. I sit on the steps while he's downstairs, watching the little stinker pretend that he doesn't have the intention of peeing down there someplace the minute he sees me go back up the steps. I have actually seen him poop in a litter box twice in that time span, and pee three times. Unfortunately, in the same three weeks, I've watched him back up to the china closet (3 times) and the bookcase (2 times) and spray. Right in FRONT of me. The first couple of times, I just watched helplessly. I have no basic information about spraying - what exactly the process is, or anything. I assume that it's an expression of severe displeasure on the cat's part, obviously, but other than that.... I have always heard/believed that once a cat starts to pee, they can't stop. (I do apologize to anyone who might be reading this, but I have to get it off my chest. I only WISH I could get it off the rug!) The last two times I came around the corner of the kitchen to discover Scruffy making a puddle in front of the china closet, I yelled, "HEY, what are you DOING?" and he scrambled off in mid-stream. So, if this is spraying, rather than peeing, he does appear to have a modicum of control over it. Not that that fact - correct or not- has any relevance to the problem at hand. Or at foot. I think at least a dozen times a week that I am SO glad that I didn't get that new carpeting.

In addition, Scruffy seems to be hot all the time now, too. Well, yes, he's got that really long, fluffy fur, but he seems to sleep restlessly lately, and he gets up frequently and moves to what appear to be cooler places - from my lap to the table top, from the kitty pi on the window ledge to the wooden shelf beside the ledge; he gives me the definite impression that he's uncomfortably warm now. Anyway, I'm not satisfied with paxil, (which is doing NOTHING for Tootie as well - it doesn't even make HER sleepy!) - and as soon as this last so-called refill of 10 pills (shared between Puffy and Tootle) is gone, I'm asking the vet for Prozac. Plus, he prescribed this tiny amount of itsy-bitsy pills - only 10! - and they charged $1.70 PER PILL. I am willing to sign all sorts of pledges or whatever that no one will use this medication but the two cats - if only he will please give me a prescription for a decent number of pills so that they are a reasonable price.

Scruffy's eye looks pretty good. I am still trying to get a decent picture - the last ophthalmologist appointment was the first time I didn't have a picture to leave with him, and at the time ( a month or so ago) I really thought that the eye that had had the laser surgery looked greatly improved. The small, faint melanosis in the right eye looks slightly darker to me, which could be my imagination. I really want to get a picture to compare it to. His next appointment is, well, at some unspecified date, because I thought I hung the appointment card on the fridge, but apparently not. I think it was six months this time, which might put it in January or so of 2010.

I just read a paper from Cornell regarding feline iris melanosis/oma that I came across by accident. (Checking the Site Meter listings, it was on the same Google page as Scruffy's blog.) 18 pages of information that made me feel kind of uncertain about whether or not I should have just had his eye removed, instead of doing the laser surgery. (And that also made me think that that first ophthalmologist, Dr. K - who I did not care for in the first place! - should have never allowed the growth of the melanosis to have gotten as far as it did. The statistics quoted in the Cornell paper - for a study of 34 cats with iris melanoma - were pretty bleak in terms of the number of cats who had metastasizes of the cancer. But the data was only gathered from the eyes that were removed, since there doesn't seem to be a way to really detect malignant/benign iris growths in cats, for some reason. So, hopefully, the laser treatment will be effective and protect the Puffer. Particularly if we may be faced with the necessity of making the decision a second time....

The photo below, while blurry, of course - I am the Queen of Blurry Photography! - shows at least an idea of the improvement in the left eye that has occurred in the last couple months. The brown goblet-shaped remnant of the surgery has become smaller. The pupil is still pulled out of shape, and will undoubtedly not show much improvement, since the adhesion will probably alway be there.

Is the Paxil successful?

2009-08-08T22:02:00.002-04:00

Got me. I haven't seen this cat - whose litter box habits I monitored twice a day for FOUR YEARS - use the litter box one single time in almost two weeks. I have NO idea where he's going now. He apparently must be, or he would have exploded by now. (Although, he does look significantly more "rounded" than he did...) I have added two more cement-mixing trays, one in the living room and one in the dining room, in what seem to be two of his favorite target spots.

I am pretty sure that he was, at some point, peeing on my beloved heart-shaped braided rug in the laundry room. So, I threw it out. He does stroll in a leisurely fashion down the steps in the middle of every meal, which I would assume is a very bad sign, but I have no proof.

He started the Paxil on Saturday, August 1. The culture and sensitivity urine test was negative, which meant that there was no bladder infection to contribute to the problem. (I had been told that Prozac would be more effective, but my vet was insistent that we try Paxil first, and since I had already filled the prescription for Tootle, I agreed.) The dosage is 2.5mg. The pill is 10mg, so that's 1/4 of a pill. A teeny-tiny, minute little dose. And, for the last week, that tiny little pill has turned poor Scruffy into a zombie. He sleeps virtually non-stop. Well, yes, I know he's a cat, and that's what they do, but this is EXCESSIVE. Nothing like his usual pattern. As additional evidence, there's a huge difference between what Scruffy seems to be doing with Paxil and what Toot's doing with it. She's minimally calmer and less aggressive, unless there is food involved, and she's awake; she's patrolling the food dishes, she's guarding the bathtub, she's watching the kittens through the screen - in essence, she's still got a life. Poor Scruffy - I'm not so sure.

So, here's my dilemma: 1) I don't know if it's working. 2) It's turning him into a fur-covered log. While it is absolutely necessary for the peeing and spraying to stop, I feel a need for Scruffy to have some of his normal life going on - looking out the screen door, trailing around behind me in case I might sit down and he could sit on my lap, playing with the occasional toy, knowing when it's time to eat without having to be poked....

What to do, what to do? Well, for today, and possibly for much longer, until I gather some evidence that the litter box avoidance problem has returned/never left, I didn't give him any Paxil. And he still slept deeply virtually the entire day, but I figure that's because he's got some quantity of the drug left in his body.

I don't want to ruin the quality of his life because I haven't found homes for the kittens. He deserves much better than that. He's been a patient, loving, placid cat through all of the disturbance of feline diabetes, and herpes, and laser surgery for what was probably a melanoma in his eye - I owe him something for all that, don't I?

(That said, the annoyance - nay, possibly "rage" is a better word! - I felt the day he backed up to my bookcase in the dining room and sprayed right in front of me makes me more than a little concerned if there's some long-term fallout from stopping the drug so early.)

"Inappropriate Elimination...."

2009-07-26T12:38:00.003-04:00

or, a less emotionally-charged way of saying, Scruffy's peeing all over the house. I've added two more large cement-mixer litter boxes, and variety of cardboard boxes - love those priority mail packages! - as hopeful obstacles to his use of any of the six or seven target sites I know for sure he's used. (I hate to even contemplate how many other places he may have "visited." )

I am inclined to think that this is a behavioral thing, rather than an infection of some sort, mostly because 1) he's NEVER had a UTI, despite three blockages that required surgery years ago, and 2) I know he hates the kittens in the bedroom. And, if a good and loving and safe home for all five of the little sweeties would turn up tomorrow, I would let them go in a heartbeat, although it would kill me. But, for now, they're here and he's here and we can't have this "inappropriate elimination" thing going on. Period.

I made an appointment for him to have a cystocentesis tomorrow afternoon. I asked the technician if she knew if the vet DID them, and it became apparent that she didn't know what I was talking about. Scruffy is NOT fond of Dr. G. Scruffy is the proud possessor of The Massive Fluffy Tail That Must NEVER Be Touched. I don't know how this procedure is done, but I'm sort of hoping that it involves the use of anesthetic gas of some sort, for the sake of the well-being of all of those involved.....

One last sad thing - I think I will have to stop and buy another carrier this afternoon on my way to my mother's house. The only one I have that's big enough for Scruffy's tubby little body is the carrier that my sweet MommyKitty died in last week. I don't think I can use it, ever again. Even with Scruffy's own kitty pi inside. It's too painful a reminder of her loss, and I can't deal with it now. Or ever, probably.

This is my sweet MommyKitty, who will stay in my heart always. She should have lived a long and happy life, being cherished and loved.

I would sincerely appreciate three or four days without any sort of crisis, if anyone Up There is listening.

Good news eye appointment!

2009-07-09T11:59:00.002-04:00

This was the fourth post-laser surgery appointment with the ophthalmologist. (And the only one that I didn't have a picture of the eye to give him! Despite my best efforts - I am the queen of blurry photography.) Scruffy's left eye has changed fairly significantly over the past few weeks - the shape and color of the small, martini-glass shaped "attachment" between the pupil and the edge of his eye are both improved; the size and shape of the attachment are smaller, and it's a lighter shade of brown than it has been. His pupil is still pulled out of shape by the adhesion that formed after the surgery, but his eye still looks better.

Other good news - normal eye pressure is between 10-20/under 25; Scruffy's measured 10 in the right eye and 12 in the left, so glaucoma is not a current concern. The retina and other eye structures were all normal, and his vision is apparently unimpaired. I had noticed some squinting - including an alarming experience where he hopped up on the table beside my chair and his left eye was completely closed! But, there didn't appear to be any particular problem going on. Because of the adhesion's effect on his pupil's ability to change shape, he's more sensitive to light in that eye, but daylight/low lamplight doesn't seem to cause discomfort. Although at the last visit, both of his eyes were somewhat dry, they were both acceptable this time. He is still to get the Flurbiprofen drops every two or three days.

Further good news is that the size of the newly developed melanosis in the right eye appears to have remained the same. Dr. B. did not feel that there were any changes to its appearance.

We were late for the appointment. Scruffy feels that he needs to supervise any showers I take, and while I was getting ready for the trip to the vet, I made the in credibly stupid mistake of including in my general conversation with him (well, he's there - I'm not gonna ignore him!) a comment about "going for a ride in the car." He didn't react immediately, but the minute I opened the bathroom door, he was gone like a flash. And no amount of bribery - even a piece of the dreaded dry kitten food wasn't effective! - could entice him to show his furry little face. I finally found him - after I'd already had to call and explain that we were not going to be on time - hiding behind the massive big screen tv downstairs. I can't move it, and there was no way to get behind it from either side. So, I tossed a magazine over the top of the tv - I don't know where exactly it landed, but I definitely heard Scruffy shuffle to the opposite end of the television. Two more magazines, and he showed up in grabbing-range at the side of the couch. He was more than normally "spitty" during the appointment. He hissed and spit at the technician and her newbie, at Dr. B., and at me, after I'd returned him and his favorite kitty pi to the carrier. And even after the door was closed, I could still hear the hissing. It must be hard to be small enough to be smooshed and carried around against your will. Anyway, he was happy to be home, and within minutes, was cheerfully sitting on the window ledge beside my computer, slurping at his paws and watching the birds.

The next appointment is not until November, barring changes in either eye. This was really good news.

Poor Scruffy....

2009-06-04T13:31:00.004-04:00

Just finished making an appointment for the long-put-off dental. I did make a stab at cleaning his teeth last week. It didn't go nearly as poorly as I expected (and yes, I did watch the Cornell video that says you should take a month to get them used to the idea of teeth-brushing).

The sinus stuff is still present, but so much improved that I think it'll be okay to finally get the dental done. His glucose levels have been back to normal, it seems - there have been some pretty awful numbers in the 100's over the last month or so. I am still giving him both the chlortrimeton and zeniquin once a day. He is breathing more easily and less noisily, and the obnoxious sneezing-in-your-face hasn't occurred for a good week or so. Small steps, major gratitude to the Powers that Be.

Cinnaminnie is in heat again. For the 322,456,798,543rd time. Scruffy has suddenly decided that it is his civic duty to try to assist her in her quest for a boyfriend; he didn't seem to notice her previous attempts to entice him by her wiles. He apparently doesn't realize that he's no longer equipped for the job. (And he's the only one of the four male cats who's ever presumably actually had experience - the others were neutered as kittens.) As I said in another context, poor Scruffy....

MAY I help you?

2009-05-26T13:03:00.004-04:00

I have a "site meter" here. It's an interesting way of keeping track of how many people look at Scruffy's and Milk's blogs - I was amazed to see the number of places all over the world where people had seen the names of my cats! Every country you can think of. (Google is an amazing thing!) Many were just here by accident, and a bunch seem to be attracted by that horrible "cheezburger" picture that I don't know what to do about. But, unless someone leaves a comment, I really don't have any way to communicate with anyone specificly.

That said, a person that Site Meter says is from Buffalo, New York - but who seems to be reading Scruffy's blog in what I think might be Dutch (?) - has been here a LOT. Frequently, several times a day. Everytime I see on the record that there was another visit, I wish desperately that he or she would leave a comment about what they're looking for - if there's any way at all to help, I would be very happy to do so. I would guess that this might be a person with a cat that has iris melanosis, judging from the pictures here that he or she is looking at. Anyway, it's a disease with a limited amount of time to have treated, and if there's any information I might have, or some other way to help, please leave me a comment. It doesn't need to be posted publicly. I'd love to hear what you're looking for and to try to be of assistance.

Another visit to the ophthalmologist

2009-05-02T18:46:00.005-04:00

Well, rats. I can't find the papers from Scruffy's appointment on April 8. I don't remember the numbers, but his eye pressure was good in both eyes, and unlike the last appointment, his eye didn't appear to be irritated or to be too dry. The eye test with these strips is done prior to each examination, and measures the amount of moisture in his eyes. It doesn't seem to bother him at all....

This is the most current picture of Scruffy's left eye, which Dr. B. says is doing satisfactorily. The vision is still good in it, there is no indication of glaucoma, and it continues to be his belief that the brown goblet-shaped "attachment" at the lower edge of his eye is not the tumor that was previously there. There is no thickening of that brown tissue. As is easily visible, the shape of his pupil has changed, however. Dr. B. feels that that is the result of an adhesion that has developed that is pulling the pupil out of shape, and limiting the ability of his eye to react as effectively to light. I have noticed that he squints now in bright light.

I am still to give him a drop of flurbiprofen every other day, to combat the tendency toward inflammation. The drops seems to bother him more now than they did previously - he flinches and fusses after every drop; Dr. B. said that we can change him to another kind of eyedrop if it becomes too much of a problem. I think it's tolerable for now, but when this bottle is empty (which should be fairly soon), we'll change to the other drop.

There was NO change in the size or shape of the melanosis in the right eye. Thank God.

One final issue was the ever-present sinus problem. (Which has been different from his customary herpes episodes ever since it began last summer.) It occurred to me to worry that maybe some of the melanoma cells from his eye might have drained into his sinuses and could be the source of the sniffing/sneezing/dripping stuff. Dr. B. said that it was possible, although unlikely, and that at some point, if it continues to be intractible, Scruffy could/should have another chest xray, and possibly xrays of his sinuses or an examination of them. He wrote a prescription for Baytril, which The Puffer has only actually gotten one dose of into his system. He throws up within minutes of getting the pill, no matter what time of day I give them to him. I give him 1/4 of a cholortrimeton tablet a couple of times a week, which does help to dry up some of the dripping. It was "sinus" infection that gave him diabetes, way back in the fall of 2004; the vet we were going to then gave him a shot of depomedrol for it, and three days later, he was grabbing food off our plates and started losing weight. He hasn't exactly led a charmed life, has he?

One Year! No Insulin!

2009-04-09T22:19:00.002-04:00

Celebrate, celebrate,
Dance to the muuuusic!

It's an older picture, but one of my favorites. (His eyes are still normal....) It really doesn't seem like it's been a year. I remember how nervous I was, and how at the last minute - just the very end of the two-week OTJ period to make it official - he had some higher than usual numbers. But, we persevered. And here we are.

Congratulations, my sweet Puffer. You did good!

Brother, am I sorry I did THAT.......

2009-04-08T17:32:00.006-04:00

Today was our 3-month visit with the ophthalmologist. The morning went well, I got hold of Puffer and crammed him in the carrier with no problem, and then, I got lost on the way. Ended up - with only 5 minutes left before the scheduled appointment - making a huge loop and right back to where I'd started out, almost. Every road seemed to be full of potholes and sharp S-curves and right angles. We finally get to the Speciality Hospital, and there is a couple waiting to pick up two yipping white Scottish terriers. And waiting and waiting, yipping all the while because only one dog was brought out to go home; the other one apparently had an unfortunate accident and had to have a last minute bath, according to the technician I was eavesdropping upon. But the waiting room is cavernous, full of hard stone surfaces and nothing at all to absorb sounds, and the dog barking made my ears hurt. Scruffy kept scrooching further and further back into the carrier, trying to escape. It was not felicitous. Then the appointment, where, aside from the paper tapes in the eyes, they really don't do anything unpleasant to him. But he seems to feel obliged to hiss and spit anyway. ScruffyPumpkinPattyFractiousPaws. Eventually we checked out, went home by way of the route I should have taken this morning, and once he was home, he seemed more relaxed. He nibbled at the breakfast that was left.

Purely out of curiousity, because Scruffy was not a cat who ever seemed to exhibit much in the way of vet stress, I thought I'd test his glucose level. Bearing in mind the messy, unpleasant sinus stuff and the difficult two+ hours he'd just been through. And got a 170. One Hundred Seventy. Suffice it to say, my heart fell. My heart plummeted. My heart fell off a cliff into the ocean. Tomorrow's his first anniversary as a diet-controlled, non-insulin dependent cat. And he's got a 170. Is it stress? Is it the cancer in his eye? Is it those awful teeth? Is it illness? Is it falling out of remission? Is it too close to having eaten a little? I have no idea. All I know is, it was very upsetting. SO, now he's been napping on the window ledge in the big fuzzy black pi for the last couple hours, and he's eaten three more times, a little here and there - and he was just 117. Better, I guess. BUT - good enough? Dear God, I HOPE so.

ETA: 83 at 2:30 AM! And we're officially at The Puffer's One Year Anniversary. I still can't quite believe it.

Scruffy's snuffly....

2009-03-30T12:42:00.003-04:00

This has been going on since last August - and possibly even earlier. I just remember August because the ophthalmologist wanted whatever's going on in The Puffer's sinuses cleared up before the laser surgery. He gave me a prescription for - rats, can't remember what antibiotic it was (Zithromax - the ophthalmologist looked it up at the next appointment), but it cost like $5 a pill because they prescribed the brand name - and increased the amount of lysine. That seemed to work for a couple of weeks, and then everything started over again. Scruffy's been on clavamox twice since the beginning of December, 08, and he's still really miserable. I know at least a portion of it is herpes, since he's having these really extended periods of reverse sneezing. But he's also got a drippy nose. No watery right eye, though. Which may have something to do with the laser surgery; who knows?

Dr. G (regular vet) suggested giving Scruffy 1/4 chlortrimeton pill, which does seem to dry him up somewhat. I don't know if there's a warning about using it for the long term, though. We have an ophthalmologist appointment next week, so I can at least ask Dr. B what he thinks. What worries me is the possibility that there's something more going on in his sinuses. I wonder if an xray would show anything? He's still getting double lysine twice a day; it hasn't seemed to help.

I realized the other day that it's my fault that Scruffy has all those orange "Fractious" warnings on his folders at various vets' offices now - I don't think I ever thought to tell any of the vets that he has NEVER allowed anyone to touch his big thick tail, and now he's clearly having pain/discomfort in his hips. They're probably trying to drag him out of his carrier and he's reacting uncooperatively because it hurts him. I feel really bad. He used to be the most mellow cat ever born. Nothing bothered him. I did ask Dr. G. to xray his hips, but he didn't want to anesthetize Scruffy just for the xray. (Or maybe he just doesn't want to risk being ripped to shreds?) If his head clears enough to have a dental, I guess we can combine all the various xrays with it and do everything at once.

Unintended result.......

2009-03-16T11:58:00.004-04:00

There has been a sudden surge of people looking here at that horrible picture of the cat with the incredible eye disease from "icanhazcheezburgers.com". It just seemed kind of odd. I was never able to find out if the complaint I made at the cheezburger site about the picture got any follow up, and if it was removed.

The other day, in an idle moment, I googled "cat eye" or words to that effect, and sure enough, there was that stomach-turning picture. ONLY - Scruffy's blog address was underneath it! Like I was the person who posted that obscenity. Now I don't know WHAT to do about it. It's presumably up there on Google for eternity, so it wouldn't do any good to remove it from the blog, would it? This is obviously a PRIME example why you shouldn't post naked pictures in your blog, or pictures of crimes being committed, or whatever.

The recent ophthalmologist visit

2009-02-12T18:32:00.005-05:00

I forgot to record the results of the appointment with Dr. B on 1/13/09.

It started with unloading The Puffer from his carrier - for some reason, his kitty pi wouldn't slide out, and he wasn't about to leave the carrier without it, so it took two of us to tilt the carrier almost straight up and down and convince him to come out. One of the things I like about this ophthalmology practice is that they always put a nice soft towel on the stainless steel table. Then the technician gathered up her equipment, and with a kind of odd tone, asked me if I'd hold Scruffy's head so she could put the strips in his eyes. I said yes, but was a little surprised, because normally, the tech does everything. Anyway, I held his little chin, she stuck the strips in his eyes (and WHY didn't I have my camera turned on for THAT spectacle?), and Scruffy never moved a muscle. When she had read the strips, she said, in a surprised tone, "Well, he wasn't nasty." I said, "No, did you expect him to be?" And she showed me his folder, which had a big orange sticker on the front of it which said "FRACTIOUS"...... He's been treated in this clinic for more than two years, and has NEVER been "fractious" in the office. But then, I remembered Dr. B. saying that my poor kitty was extremely uncooperative when they were trying to get him ready for the surgery. And then I realized that he's generally gotten pretty crabby lately. I wonder what's causing that? Old age? Arthritis? The misery in his sinuses? Transference from his negative experiences at the regular vet's office?

On to the examination. Despite my concern about the larger amount of dark brown tissue in Scruffy's left eye, Dr. G felt that it is not related to the melanosis/oma. He thinks that the large dark area is possibly an indication of: 1) some burned tissue left from the laser treatment; 2) dark brown pigment underneath the iris, which has been thinned by the laser to the point where the pigment is visible; and 3) there may still be more post-surgical healing. There was no "re-elevation of the brown iris laser site since the last exam." (Elevation is considered to be an indication of malignancy, apparently.) There appeared to be no change in the vision in that eye, although there was increased dryness and inflammation. (Which I felt bad about - I had noticed a few days before the appointment that Scruffy was squinting, which is a sign of discomfort and inflammation - who knew? I had plenty of the Flurbiprofen eye drops left - I just didn't know that they should be used.) Pressure in the eyes was good - 13 in the right eye, and 14 in the left. The treatment was to begin giving him the Flurbiprofen eye drops and the atropine ointment again.

The bad news is that the melanosis in the right eye is "slightly wider (but not elevated." In about 9 months, the growth in the right eye has gone from being a pinpoint to being a noticeably larger brownish area that sort of resembles Saturn. Dr. B's intent is to watch it closely. It took only a year and a half for the first melanosis to go from virtually invisible to having tentacles and requiring surgery.

The next appointment is April 8, 2009.

A few more pictures:

Scruffy weighs 12 pounds, 11 ounces.

2009-02-12T18:18:00.002-05:00

Which would be just fine, if his little legs were two or three inches longer... Knowing how rotund he is now, I have a hard time picturing what he must have been like when he weighed 14 pounds, the week before he got the Depomedrol shot that gave him diabetes.....

And he's had the most miserable sinus stuff going on for weeks now. Clavamox (pills, this time, instead of the messy liquid) hasn't touched it. Wherever he sleeps, there's a little puddle when he moves his head, because his nose runs and he sneezes and sprays all over the place. He looks just miserable.

Picture 3 months post laser surgery

2009-01-23T21:12:00.006-05:00

January 13, 2009. About three months from the surgery to deal with Scruffy's iris melanosis/noma. (Dr. B., the ophthalmologist, is still convinced that it was the latter.) Here is this visit's eye picture - well, I spent two days taking pictures trying to get a really good one, but this was the best of a bad bunch:

It shows, in the lower outside section of Scruffy's left eye, the brown tissue that had me worried that it might be the return of the tumor. It has changed shape since the surgery, and size. But Dr. B. is convinced that what is showing is not a remaining tumor, but that the iris is significantly thinned now, and there is colored tissue under it that is now visible, and brown. He saw no elevation of the brown tissue, and no sign that there was anything unusual about it. He also said again that some of the discoloration might be detritis from the laser's burning of the tissue during the surgery. He did not feel that three months was necessarily the limit for any sort of further changes that might happen with the left eye. He felt that the eye was healing satisfactorily at this point. The pupil is somewhat distorted in shape now, and if you look at the eye from the right angle, you can see that there is a slight irregularity of the surface of the eye, I suppose caused by the removal of tissue that the laser demolished.

I picked this picture specifically, however, because it had a good view (relatively speaking) of the iris melanosis in Scruffy's RIGHT EYE. Which is growing, at least as rapidly as the left one did. I compare the left eye pictures from May 5, 2006 to September, 2008 - just over two years, and the incredible growth and branching out - those awful tentacles - that occurred in it in such a short time. And I stew about what the progression of this melanosis in the other eye means - if it continues at the speed it seems to be demonstrating, I suppose the likelihood is more laser surgery on the other eye, at the least.

We will be continuing the every-six-months appointments, to monitor the left eye's situation, and to hopefully prevent the right eye from getting into the same shape because it was allowed to grow so much before the surgery was done. The plus of the situation is that we are now Dr. B.'s patient, which I am much happier about.

This is sickening.

2009-01-12T20:47:00.007-05:00

Just came across an I Can Haz Cheezburger lolcat that has me really upset:

It says that it was submitted on September 27, 2008 - and I wonder if that poor cat is still alive. (Judging from the wasted appearance of his jaws, possibly not.) I looked all over the place for some indication of a way to contact the owner, but didn't find it. I did submit a complaint to the cheezburger website.

I can't believe that ANYONE would allow a cat's eye to be in this condition, much less that they'd submit it as a joke.

Merry Scruffymas!

2008-12-12T23:34:00.002-05:00

Another Christmas with The Puffer - I do wish I knew how old he is. He showed up in Baden at Thanksgiving, 2003, so I know he's at least 5 years old. Dr. B thinks that he's about 8 - no more than 10; I don't know, maybe it's the arthritis or something, but he sure seems older than that to me....

Happy Holidays from the Fluffy One!!

Lookin' Good (the slideshow)

2008-10-29T12:55:00.002-04:00

Lookin' Good!

2008-10-29T00:30:00.010-04:00

(The slideshow above is of today's appointment. I can't figure out how to get it and the narrative together in the same post.)

Today was Scruffy's follow-up appointment with Dr. B. Three weeks after the laser surgery. He seems to be pretty much back to himself, although he's been off alone more than usual - for some reason, he's taken to huddling on the love seat downstairs, despite the cold.

So, Dr. B. was very happy with Scruffy's eye. There is a noticeable area - perhaps 1/4 of the size of the melanosis - of dark brown tissue at about 5:00 on his iris. This, the doctor felt, is most likely burned tissue left from the laser itself; he thinks that it may eventually be sloughed off. There is also - apparently invisible to the naked, non-professional eye - a small area of tan-ish tissue, which is the actual remains of the tumor, I believe he said. He was very happy with the "regression" of the melanosis, and said that it is somewhat likely/possible that it might regress even more over the next few weeks. It was a very good sign that the regression started during the procedure. He is convinced - though there's no way to prove it- that the growth was malignant, but doesn't feel that there is anything that needs to be done about it, unless the area would regrow rapidly or significantly; laser surgery could be done again, presumably. He felt that check-ups using xrays or MRI or whatever to search for more melanomas would be more risky to Puffer than helpful. A concern with iris melanosis is the possible development of glaucoma, and he again checked the pressure in Scruffy's eye(s) - 15 in the right eye, 16 in the left eye (where the melanosis was). Both are good numbers and indicative of no pressure problems. Dr. B did say that, had there been an indication of glaucoma at the previous appointment, he would not have done the surgery, but would have recommended enucleation. (And because of my awful experience with my beloved Black Kitty, I would have agreed, sadly - I would never want another cat to go through what Black did because I didn't understand the treatment options.) Dr. B. feels that Scruffy's procedure was very successful, and that the eye appears to be healing, although there is some inflammation still. "Mild uveitis"? (The directions they gave me only included medicating the eye for two weeks, and, instead of calling and asking if I should continue, I just quit using them. I feel really bad about that.) He has re-prescribed the flurbiprofen drops for 4 more weeks and as needed after that, and the atropine ointment every other day for 10 days. Contrary to their warnings, Scruffy had absolutely NO reaction to the atropine ointment, but he certainly hates the flurbiprofen. (Sounds like a cartoon name, doesn't it?) His pupil is a little distorted, which will probably not change, but isn't likely to cause him much trouble. And he is likely to be sensitive to light, which the atropine is supposed to help with - it will encourage the pupil to change sizes so that adhesions don't develop. He also said to watch for something like brown "glitter" floating around in the eye - it's a sign of something bad, but I don't remember what.

Other general information - the procedure took about 40 minutes. I thought that was a long time; the doctor thought it was pretty quick, considering how many times he had to apply the laser. (Five, I think he said.) And they did check his blood pressure during the surgery- 115, 90, and 80. Dr. B. said anything under 150 they regarded as being acceptable. They checked his glucose level, too, but I don't remember what it was - I think it's in the previous post, anyway. There was some discussion about the fact that he wasn't their most cooperative patient - I don't know what happened to my laid-back kitty who loved everybody and was so pleasant.

We slid him in and out of the carrier in his kitty pi - boy, that makes it so easy. He just sits in it while everybody does whatever to him. And then, after he slid back into the carrier, he hissed and spit three times at the technician standing beside the table. Just to let her know that her efforts were NOT appreciated, I guess.

I had taken my camera along because I wanted a picture of the doctor using this fascinating machine to look into Scruffy's eye. I hadn't said anything to Dr. B about taking a picture, because I was just going to take it without a flash, which wouldn't bother anyone. Only, the stupid camera - I pushed the button with the lightning bolt picture on it, which I believe is the Controller of the Flash, and when I took a picture - after they'd turned off the room lights so they could look at Scruffy's eyes - the stupid flash flashed. Dr. B and Scruffy and the two technicians all jumped. I felt so dumb. Haven't looked at the pictures yet - but I will put his picture here. I don't think I got a very good shot of the interesting eye machine, unfortunately, and it'll be quite a while, probably, before I take a picture of Scruffy's poor eye.

The next appointment, barring complications, is January 13 at 2:00. Now I won't have to worry about the appointment card falling off the fridge and disappearing forever.....

Great improvement!

2008-10-13T13:21:00.004-04:00

Scruffy's doing very well. Moving around normally - although he seems to prefer to stay on the bed, eating as usual (like a horse!), peeing okay and has finally pooped (after 6 days and Miralax), and in general, being his old self. Headbutting and a hairball. He is not fussing with the eye, although I do believe that his face must hurt still, because he is cautious about, for example, laying down (without the cone on) on that side of his head, and he still does an odd thing - seems surprised, or something - when he yawns. There seems to be some swelling left around the eye, but it's hard to tell. The fur's been shaved there, and it could be that those bones have ALWAYS stuck out..... He has been incredibly cooperative with the medications - ten times a day, but several of them will be given less often after tomorrow - the 7th day since surgery. I've kept the bedroom blinds closed, which he seems to still need. There's good light from the bathroom window, but he never goes in there, which I interpret to mean that light is still uncomfortable. (`I moved the litter box into the bedroom.) His atropine eye ointment was reduced to every other day, so that may make a difference in his reaction to light. The only difficulty medically at this point seems to be the sinus infection, for which he's taking zithromax, but he's thrown up two days in a row within twenty minutes of taking the pills, so I don't know if he's gotten much benefit from them or not. (Yes, I did sickeningly poke around in the STUFF, which he very thoughtfully placed every single drop of in the food bowl, but I couldn't identify anything that looked like the pills.) He is very snorty and congested, although there does seem to have been minimal improvement.

I'm not sure what to do about letting him out of the bedroom. The last two mornings, he's been sitting at the screen door waiting for his breakfast, and I know he'd like to see what's going on in the living room. But, given Busy's propensity for gnawing on the other cats, and Toot the Brute's chasing habits, I just think he's better off being separated for another week or so. We'll see, I guess.

His pupil is still very enlarged (from the atropine, I assume.) I can't see the edges of his iris, where the melanosis/noma tissue is hopefully shrinking significantly. I am making up a list of questions I want to be sure to remember to ask when we go for his follow-up appointment on the 28th of October.

Forgot to add that his glucose levels have been very good. Highest I found was 102, yesterday was 63, today was 72 (but I had to poke him THREE times - I seem to have lost the knack. Well, it was a little dark to see the blood on his dark ear.....) What a relief.

It's so nice to have him back again. I've been spending a couple hours a day snuggling with him, and it's wonderful. (Okay, we've been napping for much of that time, but it's STILL nice!) He is truly a treasure.

He's feeling better.

2008-10-11T11:41:00.002-04:00

Got the little bounce back in his step, his ploofy tail's waving in the air, and - while he didn't eat much this morning after the Metacam-laced "teaser meal" - he enthusiastically gobbled down the treats where his antibiotics were hidden. This ordeal is turning me into a really deceitful person. My whole day is devoted to figuring out innocuous-seeming actions that will result in medication being delivered to his mouth or his eye without his expecting it.

I checked his bg level this morning - 91, after no food or water from 1:30 AM. Given the stress of the cone, the medication, the isolation, the presumed pain and everything else, 91's a pretty good number. I'll take it. The next problem to come up is that he hasn't pooped since Monday, the day before the surgery. I'm NOT accustomed to being interested in who's leaving what in the litter box, so this is a whole new world for me. I did get Miralax yesterday while I was out, but I'm hesitant to use the recommended 1/4 teaspoon because his water intake is restricted. I do squirt a little water in whenever I can, but he's not much interested in water in general, even when he isn't wearing a cone. I add water to his food, but..... He is peeing, so I supposed that's a good sign.

He looks brighter and happier this morning. He rarely gets off the bed, and he's chosen to spend most of his time in the kitty pi (there are two for him to use) that's on the heated cat mat, so I guess he's cold. I've been keeping the room dark and as calm as it can be with five other cats sitting at the door for vast quantities of time - everyone wants in, for a variety of reasons: The Girls think it's THEIR room and they want it back, and please fill up our bowls with Kitten Chow RIGHT NOW; Milk wants to snuggle up with the Puffer, which I considered letting him do, but I don't know if Puffy's up to it. Busy wants in because he's a pain in the neck and there's absolutely no reason he needs to be in there, and Burble would like to get the pi with the heated mat back again - he was using them last week. And Burble and Minnie have perfected a sort of harp duet - they sit at the screen door and pluck, plink with one claw, over and over, endlessly, until I want to scream. Or squirt someone.

Still no sign that Scruffy wants to scratch that eye, even when the cone's off. Yesterday, he groomed himself for almost an hour. (Hairball city is probably coming up.) But he never went anywhere near his eye. I am SO looking forward to taking the cone off on Tuesday, although I don't know if there's a criteria for doing it. The directions from the hospital just said to wear it 1 week and then "as needed." And I just reread the constipation part of the instructions; I guess I'm gonna have to get the miralax into him somehow. (When I gave him his actual "breakfast", he sniffed at it, and then went over, and climbed into his pi with his back to me. Wouldn't touch the stuff. I refilled with Tender Beef FF, and no Miralax, and he ate about 1/4 can.

All in all, feeling better as the days go on. I can't see anything around the edge of his eye yet, because the atropine makes the pupil so huge, so I can't tell if the tissue is "regressing" any more or not. I am going to take my camera to the follow-up appointment just for general purposes.

Getting a grip...

2008-10-09T22:15:00.005-04:00

on the medication schedule, and managing to feed him what's getting to be close to a normal amount of food. Unfortunately, through the night, he developed a really stuffy nose - whether it's from the passage of the medications through the eye to the mouth, or if it's leftover from the previous sinus infection before the surgery, or if it's a new herpes attack because of all the stress this week - WHATEVER the cause, the outcome is that he's absolutely miserable. He takes a bite, has to sniff to swallow it. It does not appear to be the customary herpes snorting. I called today and got a prescription for the same antibiotic they had given him prior to the surgery - zithromax. Unfortunately, I had them call it in to Walgreen's, not knowing that they 1) don't deliver and 2) close at 10:00. At 7:00, I went out and got in the car to go pick up the prescription and more Fancy Feast, because we're out of the last of Dian's Homemade Raw - and once again, got no further than the stop sign at the corner when the power steering started to shriek again. I made three right turns and ended up back in the driveway. Rege wasn't home, there was no way to contact him, and no one to go pick up the medicine. I looked in the garage, where there was no visible bottle of anything labeled power steering fluid. I SHOULD have taken the car somewhere on Wednesday. Well, yes, I SHOULD have, but I had other things on my mind and it never occurred to me. So what do I do with it tomorrow? I have to get the pills picked up, and we need milk and bread and light bulbs. Maybe I can borrow some fluid, drive to the drugstore and the grocery store and then to the Dodge dealership, and ask them to bring me and my groceries home? Why didn't it occur to me before Walgreen's closed to transfer the prescription to CVS, which is closer, cheaper, and open 24 hours? Well, WHY???

What I can't stand here is that I try so hard to do stuff right for the cats, and somehow, it never quite works out.

Okay, Mr. Wonderful came home. Had a little more power steering fluid, put it in the car, ranted about why I haven't gotten the stuff fixed in the last two days - SICK CAT! SICK CAT! - and now, the automotive shrieking is stopped, at least for tonight. The human shrieking also, thank goodness, lol. Now, as long as I can get down the road to the stores tomorrow morning, then maybe I can go and fling myself on the mercies of the Dodge dealership and they'll figure out what's wrong. (Is it odd that the oil and the power steering fluid have BOTH disappeared at the same time in a car with only 21,000 miles on it? Got me.)

Have to go and tell Jojo that I don't need her BF's "toe truck."

Over, but not done with.......

2008-10-08T00:40:00.004-04:00

The laser surgery's over, and the sad little cat's tucked away in the bedroom with his awful plastic collar. Unfortunately, he's not eating or drinking or peeing or pooping, and the ophthalmologist feels certain that the no-longer-with-us tissue from his left eye was malignant. Not exactly what I'd expected to hear, somehow. And certainly not what I wanted to hear, or think about or see, or know, actually.

These are the medications he came home with: (nothing steroidal, to try to keep the OTJ status)

1) flurbiprofen - antibiotic/painkiller? - 1 drop 4x a day for 1 week, then 3x a day, I guess until the next appointment. I need to call them, I suppose.
2) BNP ointment - Bacitracin-neomycin-polymyxin veterinary ophthalmic ointment - Small amount 2x a day for 1 week, then 1x a day at night.
3) Atropine - Atropine Sulfate Ophthalmic ointment - 1x a day for 4 days, then every other day for 10 days.
4) Metacam - .05ml by mouth once a day for 14 days. Not to start until tomorrow because they gave him a shot of metacam today.
5) lysine - usual stuff to try to keep the herpes under control.

Here's the problem: most of this stuff travels down inside his little head from his eye through his nose and into his mouth. And most of it tastes really bad. And he won't eat. Also, none of it can be given at the same time as anything else, which pretty much guarantees that he's not gonna be able to eat much of anything the whole time he's using all this medication. Assuming that I can concoct and maintain a schedule of dosing for him, plus coordinate it with Milkshake's already time-consuming pilling schedule. And, please give me pills any day. In the mouth, wrapped in a pill pocket and gone. Ruining his sense of taste - what's the point? I was also warned to be sure to carefully wipe my hands after giving him the atropine because it could end up having a similar effect on me that it does on him, only very long lasting: drastically dilated pupils. I need to look that up, I guess. Whatever, it sounds like a threat for both of us.

They said not to feed him until 6:00 PM. Unfortunately, I hadn't noticed over the past five days that the Flurbiprofen must be one of those nasty tasting eye drops, because the minute I put it in his eyes, he started spitting and dripping and that was the end of eating or drinking anything at that attempt. After the first unfortunate experience, I waited until I could get at least a little food into him before trying one of the ointments. Which was a good thing, because that taste seemed to be the direct cause of the crying-with-whimpery-baby-noises. I did get maybe an ounce of canned EVO - with water and lysine and taurine into him with Milk's baby bottle. And a minimal amount - drops, maybe - of water with another bottle. Then, after I'd left to put the things in the kitchen, I noticed that he had tried to eat the little bit of Fancy Feast I'd left on a little china coaster from Old Economy. The stupid cone must have gotten hooked under the edge of the coaster, though, because it was backed up against the wall and the FF had slid off. I guess it was a good thing that he wanted to eat; too bad he didn't get to. I will make another stab at it again before I go to bed. The directions said that the horrible cone could be taken off if he was supervised, which seemed like the best way to entice him to eat later. Wasn't. And it's a pain. I couldn't figure out which way it needed to go to replace it. The good thing about it is that the directions say that, instead of making him wear it for 3 weeks, which is what the original instructions said, the new paper says "one week, then as needed." Hopefully, one week will be all that's needed.

Scruffy's miserable. I can't comfort him, I can't get him to eat, he can't sit or lay right because of the cone. I am debating trying to sleep in the extra bedroom with him - I hate to have him be alone, and he's slept on me every night for years, but he's not supposed to jump, and I don't think I'd survive the arthritic agony of a night on the floor. His eye is kind of distorted, and it's an odd color - bruised, I suppose, or burned - but it looked like the bottom part of the melanosis/melanoma was still there; a little triangular artifact. I remember that the ophthalmologist said that he was delighted to find that the tissue had started to "regress" while he was still working on it, and that that was good because some eyes take a couple weeks to see the regression. It didn't register that that may mean that the ugly thing is still going to be there in some form, threatening him, for an extended period of time. Actually, if the odds are only 65% of being able to remove the tissue, maybe it'll always be there. I hope not.

This was a horrible day, and a pretty horrible outcome. Not the actual outcome, I guess, of the laser surgery, but the idea that it could even have BEEN a melanoma is horrible. I spent four years trying to repair the damage I did to the poor cat by giving him diabetes, and now - cancer. My old refrain about his walking into the wrong garage springs to mind once again.

Last minute minutia:

- total cost (next follow-up visit is included) - $1051. Plus, $146 for Dr. B. appointment last week, $100 or so for Dr. K appointment the week before, $271 for xrays and bloodwork at Dr. G's. I hope that's enough money for the Universe to say , "Okay, cancer, out of there; Scruffy's covered."

- I have two kitty pi's and a heated electric pad for him to lay on. It's chilly tonight, although that room is usually the warmest place in the house. I want him to be comfortable and pain-free and to have a full-happy stomach. Probably not gonna happen tonight, any of it...

- checked his glucose level just before cramming him in the carrier this morning - 76. And at the hospital, after the surgery, they checked him and he was 80. It would be nice to be able to maintain that; the thought of having to start testing and shooting him again makes me sick. It's about time he gets a break.

-really not crazy about giving him metacam every day for the next two weeks. It's purpose was as an anti-inflammatory, not a painkiller. Still seems like an undesirable plan. I think I'll post and see what others think.

- the litter box was empty - not too suprising, although I would have thought that they'd have given him fluids during the procedure. I gave him the box with the Feline Pine Clumping in it - for a week now, he's been waiting to sneak in and pee in that stuff as soon as I open the door for The Girls to come out in the morning. Now he'll have it all to himself. I do hope he pees soon.

I love you, my sweet Puffer.

Preparations for surgery continue....

2008-10-02T11:59:00.003-04:00

Yesterday, Scruffy went to our regular vet for xrays of his lungs (to look for possible metastatic disease) and blood work. I couldn't imagine how they were going to get him to cooperate for the xrays, but was actually spared the agony of knowing - they took him off into the back room - which I don't remember Dr. G. ever doing before, but of course, the xray machine is back there somewhere..... I did hear a huge amount of hissing and spitting, but apparently they were able to do what needed to be done. He got the blood, too, at the same time.

Results were fine for both. He said there were some changes in something about the heart touching the sternum. (? I have no idea.) Blood work was fine. All in all, pretty good, I guess for a cat of uncertain age who was a totally uncontrolled diabetic for three and a half years.

We started the eye drops this morning. Flurbiprofen. (Doesn't that sound like something from a tv cartoon?) Every 8 hours, one drop in the left eye. Scruffy was NOT delighted. I assume he'll have all sorts of drops after the surgery, too, so he might as well give up and get used to it. Useless protest does seem to be a cat's most kneejerk response, though. After biting and scratching.....

I posted on FDMB last night about the cone, and learned, to my relief, that it's not the enormous plastic umbrella-sized thing I had in my mind. I couldn't even figure out how I was gonna get him in the carrier to bring him home with one on his head. But, I saw a picture of a cat cone, and it was small and manageable. Well, manageable for me; I'm sure Scruffy won't be thrilled. Anyway, that was one more thing I'm not going to stew about any more. The significant thing was that he has to have something to prevent him from being able to rub that eye against anything - furniture, the floor, the walls, his foot, whatever - until the tissue has healed. Three weeks. Gonna seem like a looong time, I'm afraid.

I'm worried about this whole thing, but hopefully, when it's over, that will be the end of our Iris Melanosis tale. (At least, until the one in the other eye does whatever it's going to do.) I hope that Scruffy's one of the cats who only needs to have the procedure done once.

Another trip to the chiropractor/holistic vet

2008-09-25T13:27:00.003-04:00

Scruffy's been increasingly cranky about being touched below his "waist" - or however you would describe the lower regions of his chunky little body. And he seems - although he's still hopping up on the bathroom sink and the table beside my chair and stuff without appearing to have any difficulty - but he seems stiffer and less mobile somehow. I had had an appointment for chiropractic follow-up back in December, which I cancelled because of the weather and then never got around to making another one. So, this morning, we got up early - a lot earlier than planned because Milk had a seizure at 6:30 AM - and got ready - oh, so casually so as not to alert the Cranky One! Who, in that mystical way cats have, apparently was fully aware that I planned to cram him into the carrier again and drag him someplace where he didn't want to go for the 3rd time in a week. And who, immediately, disappeared into the lower reaches of the house. I went downstairs, accompanied by the sea of furry creatures that trails along behind me everywhere I go (except for Milk, who was under the couch upstairs) to try and grab Scruffy and get on the way. No luck. I got out the feather toy - although he did watch Tootle play with it, he wasn't about to come near it himself. And then he started racing around the perimeter of the room, behind all the furniture and Rege's boxes and bags and folders and junk. I opened the sliding door - thinking that he would never be able to resist peeking outside from downstairs, where the door is almost never open, but it wasn't enough to entice him, either. I finally located him behind the recliner. I climbed on it, reached around the back and attempted valiantly to grab him by his scruff. He's bulky, and quite strong, and there's NO loose skin anywhere. Eventually, it was quite clear that I wasn't gonna be able to get hold of anything but one of his front legs and I'd better do THAT fast because he was about to squirt out of my reach. So, apologizing fervently, I dragged him around the corner of the chair by his leg, and plunked him in the carrier. And he hissed and spit and POUTED the entire one-hour trip to Vanport. He actually sat with his back to me in the car - meaning he was looking at the closed end of the cat carrier most of the trip. Even when I stuck my finger in the grill and tried to pet him - no interest.

When we got to the office, they called him in almost right away, but the vet didn't come for about ten minutes. He carried on royally about getting OUT of the carrier. When I slide the kitty pi out, which always works because he just sits curled up in it and ignores everyone - even that wasn't a success - he climbed out of it in the carrier and let it go without him. Expressing his displeasure required quite a lot of hissing and spitting. And in the meantime, the technician said she had to poke around him - for a "required" wellness exam - and that included the ultimate insult, temperature-taking. Needless to say, not a happy camper by the time the vet arrived in the room.

More hissing during the treatment, and personalized glares that include eye squinching so we'd know he MEANT it followed. There was one spot in the middle of his back that provoked the most violent reaction yet. All in all, the whole treatment took only a couple of minutes. I asked about the possibility of his having arthritis in those hips. Dr. K. said - examining what he could of them through the spitting and commotion - that he thought that xrays would be necessary to be sure, and that he could give me a sample tablet of a glucosamine preparation he uses in his practice. I told him about Scruffy's telling the animal communicator that he didn't NEED cosequin any more. (I thought he, of all people, would appreciate that story; didn't appear to...)

Anyway, we left it that I would bring Scruffy back for a follow-up adjustment after the surgery and the cone-wearing-period were over. Which I'm sure would be just fine and dandy for the Puffer.

Additional comments - teeth are a mess. (Yes, I know.) About two pounds overweight, at 12 pounds, 8 ounces. (Well, he's solid, that's for sure.) He's not happy being here. (Duh.)

Oh, and most of the way home, Scruffy was SO happy he spent most of the trip rolling around on his back, with his feet in the air! Rubbing and purring and rolling. It was hysterical. So, I guess we can conclude with some reliability that the treatment worked....

Surgery is scheduled.

2008-09-23T17:05:00.002-04:00

We had our appointment yesterday with Dr. B, who was also the ophthalmologist who cared for my Black Kitty when he had glaucoma back in 2000. Dr. B. did say that he has not done the laser surgery for a cat, either, but he has done five or six dog iris melanosis treatments. At this point, I am confident with his ability and skill, and the reality of trying to arrange to have the procedure done elsewhere is too difficult. So.......

Here's the plan:

Surgery is scheduled for 10/7/08, when I'm supposed to appear at the hospital with a starving Scruffy in hand at 7 AM. The surgery will be performed (under general anesthesia - isofluorane) somewhere between 9:00 and 10:00 or so, and is expected to take about an hour and a half. He will recover at the hospital, and I will be able to come and pick him up later in the afternoon. He will have to wear a cone to prevent his rubbing or scratching his eye. He will have eye drops, metacam for the post-surgical inflammation, probably buprinex for pain, and I don't know what else. Oh, Dr. B said that it would be possible to use non-steriod eyedrops afterward, which is a plus. He's gonna be one unhappy little cat. I want to be sure to remember to tell them about not touching his tail or his back legs, particularly the left one, too. I wish I'd thought of it yesterday while we were talking to the doctor.

About a week prior to the surgery (presuming that the new antibiotic prescribed yesterday for what seems like an herpes attack/possible sinus infection is effective) , Scruffy is to have the "met check" xray package - three views of his lungs, intended to ascertain that there has not been any sort of metastases of possible melanoma from his eye. And blood work, to check his kidneys in particular, because of the anesthesia, and because Dr. B feels that the best anti-inflammatory treatment for post-surgery is metacam. This stuff will be done at our regular vet. Who Scruffy is not fond of, to say the least, but I think it's preferable to having them done at the specialty hospital. He's never had xrays, to my knowledge, and how they're going to convince him to let them do it is a total mystery to me. I don't even want to think about it.

Here's the surgical caution we were given:

"Laser surgery is approximately 65% successful to induce regression (in some cases) of the pigmented iris mass (iris melanosis site.) Some patients will need additional laser (and/or other) surgical procedures. There is the potential for post laser-induced ocular lesions such as glaucoma, uveitis (inflammation), cataract, lens luxation, retinal changes, tumor spread, misshapen pupil, others. He may need maintenance ophthalmic medication. He will need to wear the E-collar for ~3 weeks post-op. " There is also an additional warning regarding anesthesia and patients with "metabolic abnormalities (ie. diabetes)."

Not exactly a bright and sparkling prospect, huh? The cost estimate is between $935 and $1057.

I did finally get copies of the doctor's notes from the previous visits, but there is really not much of any significance on them. (Aside from the note that there was "slight" (underlined!) progression in the left eye's melanosis between the appointments on 9/28/07 and 2/21/08. The pictures are posted below - it sure didn't seem "slight" to me. And despite Dr. K's overt disinterest in my pictures at each visit, you certainly couldn't have looked at the squiggles she made on the report form and had even the remotest idea what that thing in Scruffy's eye looked like.

Just to make the poor cat really miserable - and in case there's any extra money left in the account (two $150 appointments at the Speciality Hospital in a week!), I'm taking the Puffer back to Dr. Doug on Thursday for a chiropractic appointment. I had cancelled his last one, back in December, because of the weather. But he's gotten increasingly cranky about having his "lower forty" touched, and he seems to have major discomfort/difficulty doing things like standing up now. I would like to know if he's got arthritis or something that can be treated back there. I really don't want him in unnecessary pain. His life is hard enough as it is.

One last thing - Dr. B. estimates that Scruffy's about 8 years old. He said that - I guess judging from the condition of his eyes - he is definitely not 10 or near that. That fits, I guess - when I first got him, back in 2003, the guess was that he was around 2 years old. And I've had him now for 5 years. My sweet boy.

I'm very nervous about all this. The metacam, and diabetes, and the cone, and the cancer possibility, and everything else. Nothing to do but hope, I guess. And try not to embarrass myself by bursting into tears at the least provocation.

It just occurred to me to wonder how you put a cat wearing a cone into a carrier?

Today's appointment

2008-09-10T00:39:00.002-04:00

Well, it appears that Scruffy will be getting his melanosis lasered, and in Pittsburgh. Dr. K offered today to ask Dr. B - who was the ophthalmologist for my beloved Black Kitty some years ago - if he would do the surgery. They took Puffy back for him to take a quick look at the eye, and he apparently agreed to do it. (Although, if he was able and had experience with it, which is what Dr. K said today - how come she had to get a protocol from some vet in Virginia?) The initial plan was for me to bring him in early (next Monday, it appeared) to meet with Dr. B, and then for them to do the surgery right afterward. That set up - which I had a little trouble with because I always need time to "prepare" for stuff (to stew and moan and whine and adjust to the potential change) also was troublesome because of Milk's morning medication, which I try very hard not to mess around with. Eventually, we decided to schedule an afternoon appointment for me to meet with Dr. B - I guess I'm supposed to bring Scruffy with me, since he really didn't get to look at the Puffer's eye with his instruments, etc. - and then they will schedule the surgery at that time. I think that's better anyway. I'm nervous enough about the whole thing to begin with.

I took along a bunch of the "diet-controlled diabetic" information today, as well as the eye picture from 8/9/08, but there wasn't any discussion of either. Nor did I get to ask for any sort of summary of the visit again. I did get a bottle of some sort of eye drops that I'm supposed to give Scruffy for several days prior to the surgery. At first, they were going to be steroid drops, but Dr. K said that there was a non-steroid option. Unfortunately, he will probably need steroids after the surgery, though. I'm torn - I feel like I should have enjoyed this last five months without insulin a whole lot more than I have, and despite the fact that I feel much better informed about using Lev, etc, now than I was before, it's still not a happy prospect to think that he might end up insulin-dependent again. For him, I mean - I'm so tied down with Milk's medications that it doesn't make much difference to me if Scruffy needs shots or not. Plus, now I have a spreadsheet...... Whoopee.

I'm scared for my poor sweet old brown kitty. Nothing I've ever tried to do for him that was supposed to be beneficial has worked out that way. It was my fiddling around that made him end up a diabetic in the first place.

Melanosis comparison by date, pt. 1

2008-08-24T20:49:00.007-04:00

As we get closer (slowly, oh-so-slowly) to Scruffy's next ophthalmology appointment - 9/9/08 - I was thinking that it might be interesting to try to show the development of what's growing there all in one place. I have never received (or, to be truthful, requested) a copy of the ophthalmologist's report after an appointment. That should be on the list for the September visit, I guess. She doesn't know yet that his diabetes has been diet-controlled since April 9, 2008, either - we had had a mild conflict at the last appointment because she was insistent that he had to have a fructosamine before any procedure, and I had my meter with me, with more than 500 tests in the previous 3 months - much more valuable information than some test that would simply give the average of his levels for two weeks.

This came out somewhat better than I expected, but for some reason, the dates and text are moving all over the place, instead of sitting obediently where I efficiently, and with such great hope, put them. Rats.

** 11/5/05 **

Tiny pinpoint of brown in the left eye. Going on three years ago now, which is hard to believe.

** 5/3/06 **

Although it's a little blurry, there's only the tiniest little dot in his left iris. Pinprick size, almost. And, at this time, there's no indication (to the naked eye) of anything in the right eye.

** 7/21/06 **

Hardly anything in right eye, left eye just slightly darker.

** 12/7/06 *

Slight but noticeable enlargement and darkening of the melanosis in the left eye. (At this point, the ophthalmologist was referring to these things as "iris nevi.") A fairly good-sized darkened area has developed in the right eye also.

Melanosis comparison by date, pt. 2

2008-08-24T20:35:00.005-04:00

** 1/29/07 **

The left eye is hard to see, but the tip that's showing is noticeably darker, and presumably larger. The right eye nevis is positioned slightly differently and a little larger.

**9/3/07

Both larger and darker than in January, 07.

** 2/18/08 **

This one is disturbing. I'm not sure where the pictures from 2007 that were between this one and the January, 07 one went, but there has been a very large amount of change in the right eye.

** 8/9/08 **

Some color change, slight change in shape and orientation.

******

I thought that it would be good to have all of these in one place, instead of having to scroll around all over, but it's a little overwhelming.

At last!

2008-08-20T14:51:00.006-04:00

What I've been trying to figure out how to show here - the drastic change in Scruffy's numbers at the point where Jojo said she thought he was rebounding on 1.25u BID, and the subsequent insulin activity/numbers from then until he no longer needed insulin. The "rebound test" began on February 18, 2008. I lowered his dose to .75u BID of Levemir, and gave R with each shot, depending on the preshot - around 200 and over, he got .5u R; under that .25uR. This continued until 2/27/08, when I dropped the R. About 3/10/08, I lowered the dose again to .5u of Levemir BID - no R. By the last week of March, he was getting .25u, mostly BID. Between April 6 and April 8, he went 59.5 hours without insulin. (He had a 165 and then a 154 and I panicked and gave him a "shot" - on the "0" marker of the syringe.) I gave him another 0+ shot in the morning of April 9, and that was his last shot, I can only hope FOREVER.

This is the printout from my OneTouch Ultrasmart meter that shows very clearly the amazing results of using the right dosage. The pinkish band is what the One Touch insisted is the "desirable glucose level range" - for humans, I guess - of 90-140. One other interesting fact - the two spikes in glucose level, on March 14 and March 28, were both reflections of a dosage change. On the 14th, he had an extended duration of 24 hours from his previous shot, and on the 28th, I lowered him to .25u. Amazing - if ONLY I'd realized that Lev was going to be so consistent with that reaction to changing the dosage months before.....

As his spreadsheet shows, once he was off insulin, he had quite a few numbers that seemed to be higher than might be desirable, but he brought himself back down to good numbers easily. He free feeds, so unless there was some reason I wanted to see if food would lower him, he made his own judgments on when he needed to eat. I will freely admit that I had a really hard time adjusting to the fact that his numbers OTJ were not nearly as nice as they had been with Levemir, although spot checks now are usually between the 60's and the 80's.

I don't know why I feel such a sense of relief finally getting this chart posted. It's been making me crazy for months now that I couldn't show the miraculous - well, it WAS miraculous! - difference Levemir was able to make once we removed the things I was doing that caused all that rebound and gave low, steady, appropriate doses. I still think that Scruffy is a prime example of a fortuituous combination of a great insulin, a perceptive advice-giver, a persistent although basically clueless caretaker, and a whole bunch of good luck. And I guess there's nothing wrong with any of that, right?

The spreadsheet

2008-08-19T16:28:00.003-04:00

Since I managed to conquer doing Scruffy's spreadsheet for the last four months that he was on insulin + his OTJ tests (even though it never did really demonstrate what I wanted it to - all that work for not-so-much reward!), I figured that I might as well do the entire year he was on Levemir. Always a glutton for punishment, obviously. It's been pretty upsetting, so far, and I've only done two or three more months.

Despite the reading that I did, I clearly missed the point of working with Lev. I READ the Tilly protocol, I truly did, several times. I was too intimidated to try the Insulin Support Group on FDMB. (Not even sure it was in operation when we started on Lev.) But apparently, nothing sank in. I just finished recording the April, 2007, numbers, and I can see that I was still operating on a PZI/TR sort of mode, just using a different insulin. One which didn't work quite right with that kind of usage. There are brief glimpses of the potential that Lev has every now and then in April, but for the most part, I totally missed the point of using it. There are places where I actually noticed that Scruffy was having a good day or two and then a bad day - a pattern that continued right up until I finally managed, with Jojo's help, to get the dosage right months later; the trouble was, I never caught on that I was CAUSING that pattern, changing doses every couple days or even more frequently. Like you could do with PZI, no sweat. And even though I did my little "experiment" - one shot of R the first week, that had wonderful results - I was convinced that I didn't want to use R, that the Lev and Scruffy and I would all do our jobs and it wouldn't be necessary to use a booster of any kind. I have no explanation for that idiotic determination; I just had it in my head that this would work the way it was supposed to. Period. So there are TWO reasons why it took so long to catch onto how Levemir works. (Or, in this case, DIDN'T work.) On the other hand, there were those times when there were stunningly gorgeous numbers - that I'd certainly never seen on PZI - and that was enough incentive to keep me going, despite the rough patches. (At one point, I proudly showed my graph of one month of Scruffy's numbers to someone, and she said, "Well, yeah, but look how it zigzags up and down and up and down here. Do you WANT it to do that?") The sad thing was, I was so thrilled with the LOW numbers - the ones that were under the 300's that I'd been used to for so long - that I just kind of ignored the HIGH ones. In my defense, if there is a defense for excessive stupidity, given the fact that eventually - and despite me - Scruffy no longer needed insulin, I gave him an extended time for his pancreas to heal. (Is that a defense? Well, it's an excuse, anyway.)

Aside from the fact that I've got a ton of work left if I'm going to finish the spreadsheet- because I seem to have disposed of the actual logbook pages by accident, so I have to transfer everything from the blog to a notebook and then to the spreadsheet - it's embarrassing to think that anyone might look at the spreadsheet and know immediately that I had NO idea what I was doing. On the other hand, if the truth hurts, so be it, I guess.

Where has everything gone?

2008-08-09T18:25:00.010-04:00

I am convinced that a whole bunch of posts have disappeared from here. Surely I've had stuff to say about the Scruffer since May, wouldn't you think? I thought maybe posts were somehow trapped in the "drafts" folder, but nooooooo. I don't know - it just seems PRETTY odd.

So what did I miss during the last three + months that Scruffy's been doing? Well, not all that much. He's still OTJ, which is amazing. I've been able to assert a little more control over myself and my need to test him - I'm substituting testing myself for poking him. (But only if there's a non-violent/non-needle-involved source of blood. Accidental bleeding, I'm right there with my Ultrasmart meter. If I'm a diabetic, I really don't want to know right now. Or ever.... ) And oh, wait - I MADE A SPREADSHEET! Google Docs - template courtesy of someone named cyncyn on FDMB. It only includes the data from Jan. 1, 2008 to the present, though. Because #1 - it took me hours and hours to get all that stuff typed in as it was, and #2 - I seem to have accidentally thrown away all the Levemir information from 2007, apparently. The numbers are recorded here in his blog, so I'd have to copy and transfer them twice, and also, the information about vet visits and ear infections and herpes attacks are pretty much gone. But, the main reason I wanted the spreadsheet was to demonstrate the amazing improvement in his numbers after Jojo said, "He's rebounding," and I started lowering the dose. That was in mid-February, and by the beginning of April, the difference was stunning. It's not easy to see in spreadsheet form after all, to my disappointment, but on a graph, it looks like falling over a cliff! Which, come to think of it, might be possible to show using Google Docs, maybe. I wish I was more computer literate. Oh, and if you want to admire/criticize my first successful spreadsheet work, there's a place to click over on the lower right-hand column.

Let's see - we've gone to everyone eating about half/half Dian and Wheezer's wonderful raw chicken/Fancy Feast over the last month. Scruffy has been eager to eat it fairly consistently since the beginning. And he's more than willing to polish off his bowl and then move along to the next one. Having seen the improvement that eating the raw chunks has made in Milkshake's teeth, I'm desperately hoping that Scruffy will have similar results, because otherwise, he's gonna need another dental in the very near future. Aside from the unpleasant smell, this afternoon he yawned WIDELY right near my eyes, and what's going on in there does NOT look good. Lots of browns and reds and yellows and other colors I don't want to see again. The most unfortunate aspects of a dental are the fact that he hates the vet, and the risk of screwing up his OTJ status. (I don't know if that really happens or not, it just seems like something worth worrying about.) I don't know what happens to him when I drop him off at the vet's for a dental; I do know that he's highly unlikely to be cooperative. (The last two appointments, he's pooped right on the examining table. And shrieked when they touched him.) He's pretty bulky and strong, and I do worry about whatever's going on with his right rear leg/hip area; I wouldn't want him injured while they're wrassling him out of the carrier.
So CHEW UP, Chunky Boy!

Making an appointment with the ophthalmologist for next week, hopefully. (Well, rats - she's booked up until September 9th.) There has been some change in the shape of his melanosis. And sometimes I think that he's looking out of that eye kind of oddly. Not squinting, exactly, but it just looks different. I took - finally - a fairly decent picture to leave with the doctor; not that she thinks that my pictures are significant, when she's making her little pencil drawing of the growth, but...... The shape of the top of it has changed, and the color seems a little darker. The last picture was so good that this one really suffers by comparison, but I took about a dozen pictures and this was the best of them: (It's clickable.)

This is a link to a very good article/picture collection of iris melanosis/melanomas: http://www.animal-eye-specialists.com/iris.htm . Still quite depressing.

Other than that, he's my same old cranky but sweet ScruffyPumpkin. He's still obsessed with the bathroom. The other day, he actually teetered on the edge of the tub while I was taking a shower; he was absolutely determined not to get down, and there wasn't enough room on the sink for him to sit there and wait for me to finish. He and Milkshake have become my constant companions. Wherever I go, there they are, six inches away. I like to think that they treasure me as much as I treasure them.

On that weepy note, enough's enough, I guess.

August , 08 #'s

2008-08-03T22:55:00.005-04:00

8/01/08 (Day 114)
82

8/2/08 (Day 115)
101

8/3/08 (Day 116)
81

8/6/08 (Day 119)
69

8/9/08 (Day 122)
66

8/11/08 (Day 124)
69

8/17/98 (Day 130)
78

July, 08 numbers

2008-07-01T14:07:00.012-04:00

7/1/08 (Day 83)
67

7/3/08 (DAY 85)
82

7/6/08 (Day 88)
76

7/10/08 (Day 92)
82
83

7/13/08 (Day 95)
67

7/15/08 (Day 97)
69

7/18/08 (Day 100)
63

7/21/08 (Day 103)
90

7/22/08 (Day 104 )
52

7/24/08 (Day 106)
68

7/25/08 (Day 107 )
72

7/31/08 (Day 113)
89

8/1/08 (Day 114)
82

Numbers for June, '08 OTJ

2008-06-11T12:29:00.007-04:00

5/31/08 (Week 8, Day 4)
+1260 76

6/1/08 (Week 8, Day 5)
+1281 69

6/2/08 (Week 8, Day 6)
+1293.5 82

6/3/08 (Week 8, Day 7)
+1309 94

6/5/08 (Week 9, Day 2)
+1356 104
+1363.5 83

6/6/08 (Week 9, Day 3)
+1384 65

6/7/08 (Week 9, Day 4)
+1416 53

6/9/08 (Week 9, Day 6)
+1452 64

6/10/08 (Week 9, Day 7)
+1488 65

6/11/08 (Week 10, Day 1)
+1503 77

6/13/08 (Week 10, Day 3)
+1548 132
+1560 98

6/14/08 (Week 10, Day 4)
88

6/17/08 (Day 70)
85

6/19/08 (Day 72)
84

6/22/08 (DAY 74)
81

6/23/08 (Day 75)
110

6/25/08 (Day 77)
62

6/26/08 (Day 78)
73

6/29/08 (Day 81)
72

7/1/08 (Day 83)
67

Average bg numbers for June, 2008:

# of tests...... # of days...... Average
5 ............... 7 ................. 77
8 ............... 14 ................. 83
23 ............... 30 ................. 86
105 .............. 60 ................. 99

I am obsessed.

2008-05-03T11:04:00.003-04:00

With what will happen to my cats if something happens to me. You'd think that Scruffy's being OTJ would be helpful, but.... not really. (Although Rege said to me last night that Scruffy'd come down and napped on his lap three times in the last couple days - now that's real progress. Maybe Scruffy's worried about the future, too.)

I was thinking that other blogs seem to give more of a picture of the cat's personality; mine, not so much. I just ramble on and on about numbers, etc. So here's a capsule of my sweet boy:

From the minute I brought him home (and an hour later when I had to take him to the emergency vet because he'd developed an instant urinary blockage!), I was amazed by what a laid-back cat this was. I plunked him down in the midst of three other cats - one of whom was the famed Picklefritz, one of the world's oddest cats ever - and he was totally unconcerned. (Well, maybe not, since there was that blockage that I assume came from stress. And a second and third blockage that probably also were stress-related.) Anyway, he has never been particularly interested in and/or threatened by other cats. He just seems to take what comes. He's always been friendly and unafraid of strangers. His two main interests in life are eating and trailing around behind me waiting for me to sit down so he can sprawl across my lap and rest his head in the palm of my hand. It's very touching to me, this kind of closeness he wants so badly. Especially when you think that for the last going-on-four-years, I've been poking his ears and sticking needles into him on a regular basis. To say nothing of dentals and ear infections and ear and eye drops. I'm surprised that he even lets me touch him, much less that he's so determinedly "my boy."

I used to have to nudge him with the sweeper to get him to move out of the way. Nothing bothered him. Except that NO ONE touches his tail. He's been like that from the very beginning. There doesn't seem to be anything wrong with it; he just doesn't want anyone going near his tail. And his legs are way too short for the rest of his body, although he doesn't care if you touch them. He's got that awful fur that has the undercoat "reversed" - the stuff that's supposed to be on the bottom is on the top with him - but, oddly enough, it always looks pretty good when it's photographed (see the picture at the top of this blog) - in person, it sort of sticks up in every direction. Not smooth and soft and pretty. Although, since he's been off insulin, his fur does seem softer and smoother.

Lately, he's developed this interest in the bathroom. He insists on being in there when I take a shower. He even sits beside the door for hours on end, just so he doesn't miss my making a trip. A number of times, he's been sitting on the toilet lid when I went out, and when I came back four or five hours later, he's STILL sitting there.

Scruffy's reason-for-being is food. But only cat food - no people food. He literally inhales every meal. He stands in front of his bowl and eats and eats and eats, frequently until he throws up right into the bowl. And then he goes around and empties everyone else's dish. When he was diagnosed with diabetes, he had lost 4 pounds in a week - down to ten pounds. He managed to get back to 12 pounds within six or seven months, despite being an incredibly poorly managed diabetic. He's up to something over 12 pounds now.

Every vet who's ever examined him has thought that there was something wrong with his abdomen. During his first hospitalization, they announced that he had FIP and we should take him home to be isolated until he died. (That was five years ago, and he's STILL HERE!) When he was in the hospital with DKA, they wanted to xray him because they thought he had vital organs in the wrong place. (Or else, as I discovered when I got the copies of his records - the vet had personally given him way too much fluids and she was afraid that his lungs were full....) At some point, we'll probably have an ultrasound done, and that'll hopefully put to rest the speculation about what parts are where inside him.

Right now, he's got what's supposedly a lipoma on his right side - (gonna shave him again this summer so I can keep my eye on it) - and a horrible creepy sickening iris melanosis in his left eye that I can't decide what to do about. Dr. G says just ignore it - that lots of cats have them and they don't turn into melanomas. Dr. K wants to laser it out of there, even though she's never done the procedure before. I have the name of a clinic in Ohio that I think I'm going to take him to for a second opinion.

Despite his unknown age, at least a couple times a week, Scruffy will come thundering and thumping across the living room floor and bounce up four or five levels of the cat trees like he thinks he's a kitten. I guess as long as he's able to do that, he'll keep on truckin'. He is such a sweet, affectionate cat, and what a fortunate thing it was for both of us that he showed up when and where he did. (Of course, he wouldn't have gotten diabetes if someone else would have taken him in; it was my insistence on treatment for the "sinus infection" that got him the shot of depomedrol that did him in.) Anyway, he's a very special cat and brother, do I love him.

May, 2008 glucose #'s OTJ

2008-05-03T10:58:00.018-04:00

4/30/08 (Day 21 ends at +504 and start of Week 4)
+501.5 86
+512.5 86

5/1/ 08 (Day 22 ends at +528)
+525 88
+536 82

5/2/08 (Day 23 ends at +552)
+550 119
+555.5 81
+564 67

5/3/08 (Day 24 ends at +526)
+523 81
+589.5 114

5/4/08 (Day 25 ends at +600.)
+547 102
+604.5 98
+613 95

5/5/08 (Day 26 ends at +624)
+621 141
+624 146
+627 67
+632.5 88

5/6/08 (Day 27 ends at +648)
+645 102
+655 96
+660.5 95

5/7/08 (Day 28 ends at +672 and Start of Week 5)
+669 149
+672 68
+676 107
+680 91
+ 686 64

5/8/08 (Day 29 ends at +696)
+694.5 88
+704.5 102
+709 87

5/9/08 (Day 30 ends at +720)
+718.5 109
+726 112
+731.5 90

5/10/08 (Day 31 ends at +744)
+741 125
+743.5 107
+749 133
+755 64

5/11/08 (Day 32 ends at +768)
+765.5 207
+767 154
+769 59
+771 73
+776 89

5/12/08 (Day 33 ends at +792)
+784.5 117
+789 161
+793 81
+805 101

5/13/08 (Day 34 ends at +816)
+810 106
+813.5 112
+818 85

5/14/08 (Week 6, Day 1)
+833.5 161
+837 125
+845.5 101
+848 120
+853 70

5/15/08 (Week 6, Day 2)
+861.5 105
+865.5 77

5/16/08 (Week 6, Day 3)
+886 146
+892.5 169
+895.5 133
+899.5 74
+903 85

5/17/08 (Week 6, Day 4)
+909.5 124
+914 65
+920.5 104
+923 106

5/18/08 (Week 6, Day 5)
+933.5 73
+941 103
+948.5 78

5/19/08 (Week 6, Day 6)
+957.5 110
+965.5 65

5/20/08 (Week 6, Day 7)
+982 115
+989 86
+994.5 96

5/21/08 (Week 7, Day 1)
+1005 112
+1017 88

5/22/08 (Week 7, Day 2)
+1045 91

5/23/08 (Week 7, Day 3)
+1058.5 87
+1067 124

5/24/08 (Week 7, Day 4)

5/25/08 (Week 7, Day 5)
+1100 127
+1103 117
+1117 85

5/26/08 (Week 7, Day 6)
+1131 53 (ate dry kitten food.)
+1136.5 91

5/27/08 (Week 7, Day 7)
+1148.5 77
+1159 137

5/28/08 (Week 8, Day 1)
+1176.5 102
+1182 91
+1189 76

5/29/08 (Week 8, Day 2)
+1198 114

5/30/08 (Week 8, Day 3)
+1221 108

5/31/08 (Week 8, Day 4)
+1260 76

No purpose for this

2008-04-24T00:08:00.004-04:00

I just think the expression on Scruffy's face is priceless. How much more pleasure can an old diabetic cat have than this?

After all the anticipation and nervousness.....

2008-04-23T22:42:00.004-04:00

today was supposed to be Scruffy's official OTJ day. Only, I got sick in the middle of the night, and what with the wandering around that was going on, no one got much sleep. And when Rege left for work, he apparently gave Scruffy more than the approved ONE Temptations treat, which, even at this stage, seems to be a recipe for glucose level disaster. Then I was awakened for the day by the sound of Scruffy heaving up a healthy hairball. I can't remember for sure, but I don't recall him having ever had a hairball, which is odd and hard to believe, given how long and fluffy his fur is. Anyway, when I tested him, he was at 150. Which made me want to cry. He didn't want anything to eat, so maybe his stomach was upset, too.... And a couple hours later, I tested him again and he had only come down to 105. So, I officially cancelled the "celebration" - not that there was going to be any fussing anyway, since it was all only in my head. But I feel sad. By 6:00, he was back down to 69, which was a relief, but it left me feeling sufficiently uncertain that I'm just going to wait and not say anything about his OTJ.

I went to vote yesterday afternoon, and Dr. C was standing, as usual, at the bottom of the steps in the town hall. And I couldn't resist - we hugged, and then I said, "Do you ever see Jay anymore?" (because I know, even though I haven't been to their hospital for four years, that he sold the practice to Dr. O'L.) And he said that he does, so I said that I'd left their practice because I just wasn't able to do what they wanted when Scruffy was diagnosed, but that he had been on this wonderful new human insulin for a year, and now he was OTJ. And Dr. C was very nice about it, and congratulated me, and acted like he may have had some clue what I was talking about. I was wishing afterwards that I'd offered to teach any of their diabetic patients' families to hometest. I always had this fantasy of telling Jay all the stuff I couldn't accept and why - not nastily, because I always considered him a friend as well as a vet. Oh, well.

What I never expected would happen....

2008-04-13T11:56:00.006-04:00

seems to have. Scruffy's been without insulin for going on four days now. (Actually, except for two 0-line unit shots I panicked and gave him earlier this week, he's almost to a week of doing it on his own.) His numbers were way better with Levemir than they are without, but I've been assured (ha!) that they'll improve as time goes by.

Being as regressive as I tend to be, I would be perfectly happy to still be giving insulin. I loved Levemir, and Scruffy was never a fussy cat about either the shots or tests. (It always made me laugh - with Levemir, I mostly ended up shooting while he was eating, and before he'd start to eat, he'd turn around to look at me, and I'd have to show him the syringe and say, "It's just your shot," before he'd go ahead and attack the food.) I do, of course, think that it's an amazing thing that cats can be diet-controlled, and I know how incredibly lucky this is to have ocurred. And if it doesn't last, I will still be amazed that it happened at all, and happy for Scruffy that he's had at least a small break from all those years of poking for something that wasn't his fault in the first place. And I will NOT think of any other reasons why a formerly long-term-insulin-dependent cat even went OTJ..... mostly because I can't bear the thought.

Now, if only someone would invent a way for feline epilepsy to be diet-controlled - I'd have a life again....

April '08 numbers

2008-04-02T11:19:00.034-04:00

3/31/08
AM PS (+11.5) 89 fed .25uLevemir
+1.5 78
+4 53
+6 66
PM PS (+10.5) 137 fed .25uLevemir
+5 66

4/1/08
AM PS (+13) 161 fed .25uLevemir
+5.5 78
+11.5 48 fed
PM PS (+13.5) 114 .25uLevemir

4/2/08
AM PS (+10.5) 143 fed .25uLevemir
+4 58
+5.5 59
PM PS (+11) 99 fed .25uLevemir
+5.5 95

4/3/08
AM PS (+11) 185 fed .25uLevemir
+3 89
+9.5 67
PM PS (+11) 86 fed .25uLevemir
+4.5 99

4/4/08
AM PS (+13) 127 fed .25uLevemir
+3 54
+5.5 74
+8 59
+12 77 fed
PM PS (+14) 142 .25uLevemir

4/5/08
AM PS (+9.5) 96 fed .25uLevemir
+5.5 73
+9 100
PM PS (+10) fed .25uLevemir
+4 111

4/6/08
AM PS (+13.5) 118 fed .25uLevemir
+6.5 76
+10.5 67 fed
+11 73
+13 90
+15 82 fed, threw up, ate again

4/7/08
+24 102 fed, threw up, ate again
+26 72
+31 87 snack
+32 105
+34 98
+35.5 fed
+37.5 117
+41 82 fed

4/8/08
+48 99 fed
+50.5 91 self-snacked
+52 87
+ 55.5 131 fed
+57.5 149
+58.5 165 fed
PS (+59.5 ) 154 0+uLevemir
+3.5 113
+5.5 120

4/9/08
+12 104 fed
PS (+15) 105 0+uLevemir
+4.5 69
+7.5 113 fed
+10 113 fed
+14 137

4/10/08 (Day 1 ends @ +24)
+22 107 fed
+25.5 109
+31.5 107
+33.5 99 fed
+35 168 offered food, didn't eat
+37 142 fed

4/11/08 (Day 2 ends @ +48)
+43.5 129 fed
+45 126
+48.5 69
+51.5 110 fed
+53.5 231
+54.5 211
+55.5 197 fed
+59 72
+61.5 90 fed

4/12/08 (Day 3 ends @ +72)
+70 201 fed
+72 127
+75 75
+77 110
+80 129 fed
+83 135
+85.5 121 fed

4/13/08 (Day 4 ends @+96)
+94 169 fed
+98 98
+99.5 72
+101.5 101
+103.5 fed
+108.5 90 fed
+110.5 134

4/14/08 (Day 5 ends @+120)
+117 139 fed
+119 123
+121 84
+129 125 fed
+131.5 131
+134.5 132 fed

4/15/08 (Day 6 ends @ + 144)
+143 99 fed
+145 150
+148.5 90
+151 122 fed
+154 112
+157.5 159

4/16/08 (Day 7 ends @+168 and start of Week 2)
+164 164 fed, threw up, ate again
+166 147
+171 63
+174.5 88
+176 fed
+178 114
+181 101 fed

4/17/08 (Day 8 ends at +192)
+190 126 fed, threw up, ate again
+191.5 130
+194 72
+200.5 104 fed
+205.5 74

4/18/08 (Day 9 ends at +216)
+213 121 fed
+215 100
+220 73
+224 fed
+227.5 112

4/19/08 (Day 10 ends at +240)
+237 174 - Rege gave handful of Temptations treats. fed
+238.5 124
+242.5 62
+245 71
+246.5 85
+248 fed
+249 87
+252 108 fed

4/20/08 (Day 11 ends at +264)
+261 119 fed
+264.5 65
+266 63
+271.5 83 fed
+276.5 79

4/21/08 (Day 12 ends at +288)
+284 85 fed
+293 83
+297 66 fed
+302 74

4/22/08 (Day 13 ends at +312)
+309 71 fed
+320 93 fed
+326.5 100 (Was all this the build-up to producing that disgusting hairball?)

4/23/08 (Day 14 ends at +336 and start of Week 3)
+333 150 fed (He ate too many Temptations AND had a hairball.)
+336 105
+339 69 fed
+341 86
+345 69 fed
+349 132

4/24/08 (Day 15 ends at +360)
+357 121 fed, threw up, ate again
+361 81
+373.5 71

4/25/08 (Day 16 ends at +384)
+381 164 Another hairball. fed
+385 60
+391 78

4/26/08 (Day 17 ends at +408)
+405 135 fed
+409 62

4/27/08 (Day 18 ends at +432)
+428 156
+429 192
+431 134
+435 85
+438 76
+448.5 85
+445.5 79

4/28/08 (Day 19 ends at +456)
+452 124
+456 65
+469.5 78

4/29/08 (Day 20 ends at +480)
+478.5 77
+485.5 74
+492 107

4/30/08 (Day 21 ends at +504 and start of Week 4)
+501.5 86
+512.5 86

The Jojo Connection

2008-03-22T13:22:00.004-04:00

I don't think I mentioned the source of the miraculous Levemir/diabetes improvements here. And I definitely need to express my incredible gratitude to Jojo. Back in February, out of the kindness of her exceptionally large heart (well, not physically large, I hope! ) Jojo took a look at The Puffer's numbers. Which weren't anywhere near as horrific as they have been multiple times in the past, but which weren't good. He was getting 1.25u of Levemir bid. Still a little erratic, and I wasn't seeing the Levemir "hang", for instance. She has a knack - unparalleled! - for interpreting glucose testing. And she said, to my surprise - that she thought that Scruffy was rebounding on that dosage. ( November '07's numbers were shockingly good - and he was functioning - for the first time - on .5u on a fairly regular basis. In December, he had a major herpes attack that threw him off track completely. And I eventually raised his dosage to 1.25. Didn't seem to make much difference one way or another. )

I had already seen many examples of Jojo's ability to discern the solution to these feline diabetes problems. She recommended trying .75u bid and going back to using a smidge of R at the beginning. So, around 2/18/08, the big experiment began. And sure enough, she was right. The last couple weeks of February were definitely better than the beginning. And March! March! Ah, the affection I feel for March!!! And for Jojo.

I had long ago given up any hope of ever getting Scruffy "regulated." Totally. And now, here he is - with lovely numbers in the under-100's for much of the time, and even getting only one shot a day every other day! Who would ever have believed it? Not me, that's for sure. And, on top of all the other delightful outcomes, it turned out that .75u was a smidge too much, and .5u was pretty much JUST FINE!

To say I am grateful to Jojo is way beyond understatement. What an incredible human being she is, and how fortunate we are at FDMB to have her contributions for the benefit of all of our cats.

And for Jojo - a

Averages

2008-03-22T10:43:00.005-04:00

Didn't much like last night's numbers, or this morning's, actually. My little furry person sat between 157 and 139 for 11 hours, which is not particularly great news. Things have been so good for the last two months that I have the nerve now to be unhappy with those numbers. Which are, in actuality, below the mystical "Renal Threshold", after all. How quickly we forget, I guess - all those years, not months, when not only did he never get out of the 300's, but I was terrified to give him one unit for fear he'd end up in the hospital again with DKA. That said, now that I've been spoiled by the good Levemir numbers, I feel I must insist to the Universe that they continue.

I'm fascinated by the averages now on my meter. I wish they'd print out here in a neater fashion, though. (They look straight, and then when they're posted, they zig-zag all over the place.) Never really paid any attention to all the extra stuff that this One Touch UltraSmart does, since most of it's for humans, like "#'s after exercise", etc. Scruffy's really not into exercise. There's a graphing function that I never could use before because all of his numbers were so high they wouldn't fit on the graph; now they not only FIT, they're all below the magical line!

Here are the averages for the "last three months" - don't know how precise that time frame is - it says "90 days", so I guess I'll assume that's what it is: (approximately 12/20/07-3/20/08)

# of tests ... Days ...... Average
42 .......... 7 .......... 105
89 .......... 14 .......... 109
180 .......... 30 .......... 135
359 .......... 60 .......... 174
524 .......... 90 .......... 201

Amazing.

The eye situation

2008-03-22T00:31:00.003-04:00

Cancelled the appointment in Erie because the ophthalmologist didn't have the diode laser - she would have been willing to give a second opinion, or to refer us to another veterinary ophthalmologist in Syracuse, but that adds another three+ hours to any trip there, and I just don't want to do that long a trip with both Scruffy and Milkshake involved. The good thing is, I did call the doctor's office she would have referred us to, and they were very nice, so I'm keeping the information for emergency purposes. If an emergency that would require a six hour drive is, in fact, doable. Probably not....

After a not-so-brief period of moping and misery about what to do about all this, I called Dr. K and asked the technician - still can't talk to the vet herself - for a little more information about where the "protocol" she thinks she's going to use on Scruffy came from. Someplace in Virginia. I did try to explain that I was not impugning her skills and knowledge, but that I felt strongly that experience in a procedure of this nature was very important to me. Scruffy may be just an old dumpy brown cat, but he's MY old dumpy brown cat, and I want him to have the safest care possible. I don't know exactly how they think the situation has been left - I might as well go ahead and have the bloodwork done. In fact, given the information that I'm about to type below, I will most likely just keep doing what I've done - taking a picture of his eye/s ( - since the other melanosis is growing, too) and having Dr. K continue on a regular basis - 3 months was suggested by Ohio State - to monitor the growth and make sure that it doesn't begin thickening. Apparently, size doesn't matter, but thickness is a very bad sign of melanoma. And it takes her specialized instruments to determine if it's getting thicker.

I contacted the Ophthalmology Department at Ohio State's vet school in Columbus. Very nice and helpful person I spoke with - she actually asked me - when I said that I had a picture of Scruffy's eye - if I wanted to email it to her and she'd show it to the vets there. Which we did. (And she complemented my photography.) I asked about complaints that I'd heard from people who took their cats to Ohio State for treatment - that it took forever to get appointments, student involvement, etc - and she said that if I want to take Scruffy to them - either for a second opinion or for the actual laser treatment, it would take about a month to set up the initial appointment. But that, once an animal is a registered client of theirs, they get immediate appointments whenever they're needed. I also talked to the MedVet office which is outside Columbus - this is where Jennifer and Dylan's IM vet that recommended Dr. Champagne previously worked. They were also very nice - they have the appropriate laser, and have done the procedure many times. There was also a Veterinary Eye Clinic in Akron that I have the number for, but it was the same number as a man named Johnson in a nearby town, and when I called, I got Mr. Johnson instead of the clinic, and I didn't want to risk calling him again.....

All in all, I have a significant amount of information now that was lacking before, and the beginning of a "plan" to deal with this. Despite my concern about the rapid growth that the melanosis has undergone recently, that is apparently not a huge danger to Scruffy. Monitoring is necessary, and can be done by Dr. K, if she's willing. (If she isn't, then I could be stuck doing a whole lot of unnecessary driving....) There are resources out there that can help us, which I didn't know for sure before, and that is good news.

This probably falls under the category of "give it a rest, already".....

2008-03-09T12:30:00.004-04:00

but I'm already stewing because Scruffy's numbers have been so good for the last month. Same insulin, same syringes, same food, and there certainly hasn't been any increase in my skill or treatment methods. He could already have cancer brewing in his eye. He could have cancer brewing in that lump on his side, for that matter. As soon as it gets warm enough, I'm shaving the fur around the bump so I can see if it's grown.

Because of my unfortunate need to worry about everything to the greatest extent possible, I'm trying to figure out what to think/say/do - aside from bursting into hysterical tears - if the new ophthalmologist says that laser surgery isn't an option now. Well, I suppose there's really no question - he'd have to have the eye removed. Which I could deal with - it's the OTHER eye that is worrying me. Given how fast this one went from the tiny little brownish pin-prick to this big dark octopus in his eye, I hate to think that I could be doing the exact same thing this time next year. And my cat would be blind. It's not much of an achievement to keep him alive with diabetes if I'm having body parts lopped off/scooped out every couple of years.... He really DID pick the wrong garage to wander into.

I don't know if there's any real relevance to this, but it seems like progress:

Current average glucose test results: (approx. Dec '07-Mar '08)

36 tests .......... 7 days ........... 149
75 tests ........... 14 days ........... 151
175 tests ...........30 days ........... 187
356 tests .......... 60 days ........... 208
511 tests ...........90 days ............ 231

(Stick THAT in your old fructosamine, Dr. K.)

March, 2008 #'s

2008-03-02T10:20:00.035-05:00

2/29/08
AM PS (+11) 244 fed .75uLevemir
+1 157
+3 77 fed
+4.5 85
+6.5 86
PM PS (+11) 139 fed .5uLevemir
+1.5 236
+4.5 210

3/1/08
AM PS (+12) 395 fed .75uLevemir
+6 182
+10 150
PM PS (+11) 140 fed .5uLevemir
+4 97

3/2/08
AM PS (+12.5) 317 fed .5uLevemir
+2.5 241
PM PS (+11.5) 267 fed .75uLevemir
+3.5 408

3/3/08
AM PS (+12) 295 fed .75uLevemir
+8 144
PM PS (+11.5) 156 fed fat.5uLevemir
+4 193

3/4/08
AM PS (+12) 232 fed .75uLevemir
+3 164
+7.5 95
+10.5 139 fed
PM PS (+12) .75uLevemir
+2.5 78
+5 62 fed

3/5/08
AM PS (+13) 168 fed .75uLevemir
+3 88
+9 164
PM PS (+9.5) .75uLevemir
+1 fed, threw up, ate again
+3.5 271
+5.5 187

3/6/08
AM PS (+13.5) 135 fed .75uLevemir
+2 101
+5.5 46 fed
+7.5 129
PM PS (+11.5) 117 fat.5uLevemir
+4 119

3/7/08
AM PS (+13) 197 fed .75uLevemir
+2 222
+7 173
PM PS (+11.5) 141 fed fat.5uLevemir
+4.5 53

3/8/08
AM PS (+12) 156 fed, threw up, ate again fat.5uLevemir
+5 113
+8.5 90
+10 93
+12 102
PM PS (+14) 129 fed .5uLevemir
+2.5 116

3/9/08
+10 126 fed
AM PS (+11) 175 .75uLevemir
+4 122
+6 103
+9 88 fed, threw up, ate again
+10.5 103
+12 115
PM PS (+13.5) 137 .5uLevemir
+3 114

3/10/08
+8.5 121 fed, threw up, ate again
+12.5 81
AM PS (+16) 122 .5uLevemir
+3 81 fed
+7.5 184

3/11/08
AM PS (+16.5) 173 fed .5uLevemir
+3 105 fed ( because I had to go out)
+9.5 101
+12 87 fed
+14 107
PM PS (+16) 126 .75uLevemir

3/12/08
+7.5 132 fed
+10 89
+13.5 86
+15 91
+18.5 89 fed
PM PS (+20) 139 .75uLevemir
+3.5 45 fed a ton
+4.5 68

3/13/08
AM PS (+12) 239 .5uLevemir
+2 180
+7 80
PM PS (+11) 136 fed .5uLevemir
+3.5 88 fed

3/14/08
+12.5 100 fed
+15 97
+16.5 92
+21 94
PM PS (+24) 120 .5uLevemir
+4.5 90 fed

3/15/08
+12.5 97 fed
AM PS (+15.5) 126 .5uLevemir
+4.5 106
+7.5 83 fed
PM PS (+12) 127 .5uLevemir

3/16/08
+8.5 79 fed
+12 93
+14.5 91
+18.5 84
+20 72 fed, threw up, ate again
PM PS (+22) 140 .5uLevemir

3/17/08
AM PS (+10.5) 155 fed .5uLevemir
+4.5 85
+11 103 fed
PM PS (+14) 135 .5uLevemir
+1.5 88 fed

3/18/08
AM PS (+10.5) 175 fed, threw up, ate again .75uLevemir
+2.5 57 fed
+3.5 56
+7 106
+11 97 fed
+15.5 113
+16.5 98

3/19/08
+23 110 fed
+24.5 125
AM PS (+27) 145 .5uLevemir (fur shot? - reeked of insulin)
+3 94
+6.5 108
+8.5 100 fed
+10.5 110
PM PS (+13) 127 fed .5uLevemir

3/20/08
+7.5 111 fed
+10.5 61
+11.5 66
+13.5 60
16.5 84
PM PS (+19.5) 153 fed .5uLevemir
+4 97

3/21/08
+12 65 fed
+14 75
+19 106
+21 117
+23.5 121 fed
PM PS (+26) 157 .5uLevemir
+3 146

3/22/08
AM PS (+11) 139 fed .5uLevemir
+5 66
+8.5 60 fed, threw up, ate again
+14 61 fed, threw up, ate again
PM PS (+16.5) 119 .5uLevemir

3/23/08
+7 52 fed
+10.5 47 fed
+11.5 60
+16 71
+17.5 59 fed
+19 94
PS (+22) 123 .5uLevemir
+2 72 fed

3/24/08
+8 108 fed
+11.5 67
+15 72
+19 95 fed
+23 83
+25 128 fed

3/25/08
AM PS (+33) 144 fed, threw up, ate again .5uLevemir
+4 45 fed
+5 64
+8 94
PM PS (+12) 118 fed .25uLevemir
+1.5 99
+3.5 73

3/26/08
AM PS (+12) 141 fed .25uLevemir
+3 62
+4.5 41 fed
+6 51
+7 93
+9 92
+10.5 89 fed
+13 86
+16 75

3/27/08
+21 101
AM PS (+24.5) 219 fed skinny .5uLevemir
+1.5 220
+4.5 42
+5.5 56
+9 91
+10 fed
+10.5 87
+14 78
+15.5 70

3/28/08
AM PS (+23.5) 192 fed skinny .25uLevemir
+1.5 145 fed
+5 60
+10.5 99 fed
PM PS (+13.5) 128 .25uLevemir
+2 120
+3 134

3/29/08
AM PS (+10.5) 116 fed .25uLevemir
+3 120
+6 68
+11 fed
PM PS (+13.5) 106 .25uLevemir
+2 103

3/30/08
AM PS (+10) 126 fed .25uLevemir
+5 100
+10 91
PM PS (+12) 127 fed .25uLevemir
+3.5 72

3/31/08
AM PS (+11.5) 89 fed .25uLevemir

Iris Melanosis

2008-02-17T15:49:00.003-05:00

I need to make an appointment for Scruffy to see the ophthalmologist again. I take a picture of the left eye and the growth in it each time, for comparison. Today's picture has really upset me. It has grown significantly since November. (I tried to find the November picture - no luck yet.) I asked the ophthalmologist then to refer me to someone who could laser the thing out of there .

Update: I made an appointment for 2/21/08. And in the course of my mumbling about the difficulties of arranging an appointment (because of the timing of Milk's first two doses of medication each day), the receptionist said that she spoke with the ophthalmologist, and that they DO now " have the equipment and if I'd bring Scruffy in to see her on Friday at 8:45, instead of Thursday the 21st, she'd do the procedure that afternoon." I was so surprised that none of the normal questions occurred to me: 1) Is she talking about the laser treatment? Or removing his eye? In which case, I think I'd want a little time to get ready for that huge of an ordeal. To say nothing about blood work, etc. And fasting, and what to do about his insulin? 2) If they didn't have the equipment and she had never done laser stuff - which is what she told me at the last appointment - did she become an expert in three months? I really want someone to do this who's got lots and lots of experience.

I am dreading this whole thing, no matter how it turns out.

Is anybody home?

2008-02-16T12:28:00.003-05:00

Inside my brain? Apparently not. Here's yesterday:

2/15/08
AM PS (+12.5) 195 fed 1.25uLevemir
+4.5 338
PM PS (+10.5) 450 fed, threw up, ate again .5uR, 1.25uLevemir
+4 272
+6 259

Decent preshot. Usual dose. I have a clear memory of filling the syringe, and even of holding it up to the window and thinking that I wanted to take out just a drop, and doing that. And then I put the syringe in my teeth to warm the insulin while I got Scruffy, and put the Muffer on the window ledge to eat and get his shot. And that is where the "blank" occurred. The needle was in his side, and the plunger was depressed, but I had NO memory of pushing it. His fur wasn't wet. I don't know if there was insulin in the syringe when I poked him or not. Going by the incredibly rising numbers, NOT. I actually looked at the syringe when it was still in his skin, wondering why the plunger was depressed and I didn't remember doing it. I always hold the orange cap in my teeth so it doesn't get misplaced while I'm shooting. (My whole life seems to be a massive, sadly ineffectual attempt to keep from losing things.) I don't recall tasting insulin from the cap, which you'd think would be the disgusting case if I'd squirted the stuff in there instead of into Scruffy. No drips.

The whole event seems, in retrospect, to have been absolutely the same as virtually every other morning shot in the last three years, with the exception of that plunger I can't account for and the fact that it appears that there wasn't any insulin inserted in the brown furry cat in front of me. And that now I'm thinking that any day now, I'll just wander away from home in the snow without a coat and freeze to death because I can't find my house again....

Averages improving......

2008-02-11T10:32:00.000-05:00

(Remember this fortune-telling lady on television infomercials a few years ago - with the wonderful Caribbean accent?! I always liked her, even if she was a fake. What was her name, though?)

Averages as of 10:30 AM on February 11, 2008:

7 day average ***** 36 tests ***** 189
14 day average ***** 81 tests ***** 181
30 day average ***** 177 tests ***** 225
60 day average ***** 333 tests ***** 248
90 day average ***** 529 tests***** 234

Well, things have improved, relatively speaking. And that 189 number includes yesterday's unfortunate 406, which came after a very late dinner and a six hour power failure during an exceptional cold spell. (That counts, right?) First November, 2007, and now February, 08, is looking pretty good so far; two good months out of each year? Not wonderful, but at least a step in the right direction.

I 'm always a little surprised at the total number of tests. If there was ever proof that 1) your cat won't hate you - the minute I sit down, Scruffy's sprawled on my lap and 2) their ears won't "abscess", or show ANY sign of distress - Scruffy's IT.

I wonder why it is that it's impossible to make columns here and on FDMB - the program just smashes the stuff together no matter what I try to do. I'd also like to know what people do to get multiple pictures included in their posts here, and how you get the pictures/graphics to go where you want them to without spending two hours copying and pasting..... Life's little mysteries, I guess.

February, 2008 #'s

2008-02-03T11:08:00.015-05:00

1/31/08
AM PS (+12.5) 157 fed, threw up, ate again 1.25uLevemir
+1.5 204
+6 64
+10 86 fed
PM PS (+12) 174 1.25uLevemir
+3 233

2/1/08
AM PS (+12) 66 fed
+13.5 78
+14.5 116 fat 1.0uLevemir
+3 121
+5 96
PM PS (+7.5) 132 fed 1.25uLevemir
+2.5 165
+6 93 snack, threw up
+7 111

2/2/08
+9.5 92
AM PS (+13) 101 fed, threw up, ate again 1.25uLevemir
+3 152
+8 81
+10 79 fed
PM PS (+12) 153 1.25uLevemir
+3.5 209

2/3/08
AM PS (+12) 303 fed, threw up, ate again 1.25uLevemir
+3.5 350
+7 188
+11 68 fed
+13.5 100
+14 102
PM PS (+15) 123 1.25uLevemir

2/4/08
AM PS (+9) 64 fed
+10.5 61
+14 92
PM PS (+15.5) 117 fed 1.25uLevemir
+3.5 271
+7.5 327

2/5/08
AM PS (+16.5) 382 fed 1.25uLevemir
+3 257
+8 67
+10 73
PM PS (+12) 103 1.25uLevemir

2/6/08
AM PS (+11.5) 139 fed 1.25uLevemir
+3 185
+6 292
+10.5 386
PM PS (+11.5) fed 1.25uLevemir
+6.5 350

2/7/08
AM PS (+13.5) 293 fed 1.25uLevemir
+5.5 96
+8 93
+10 88 fed
PM PS (+11) 110 1.25uLevemir
+3 183
+5 232

2/8/08
+13.5 105 fed, threw up, ate again
+16 88
AM PS (+18) 137 1.25uLevemir
+3 151
+6 117 fed
+11 107

2/9/08
AM PS (+19) 200 fed 1.25uLevemir
+6 157
+10 122 fed
PM PS (+12) 134 1.25uLevemir
+5 76

2/10/08
AM PS (+12) 139 fed 1.25uLevemir
+2.5 225
+7.5 294
PM PS (+11.5) 406 fed 1.25uLevemir
+4 374

2/11/08
AM PS (+12.5) 263 fed 1.25uLevemir
+5.5 294
PM PS (+10 ) 188 fed 1.25uLevemir
+5.5 355

2/12/08
AM PS (+13) 422 fed 1.25uLevemir
+1 435
+7 296
PM PS (+12) 234 fed, threw up, ate again 1.25uLevemir
+3 230

2/13/08
AM PS (+12.5) 146 fed 1.25uLevemir
+3.5 90
+6 72
+10.5 62 fed
PM PS (+14) 376 1.25uLevemir
+2 402

2/14/08
AM PS (+9.5) 356 fed 1.25uLevemir
+3 261
+7.5 53
+9.5 78
+10.5 87 fed
PM PS (+12) 101 1.25uLevemir
+2.5 140 ate, threw up, ate again
+5 109

2/15/08
AM PS (+12.5) 195 fed 1.25uLevemir (Or not - see 2/16 post)
+4.5 338
PM PS (+10.5) 450 fed, threw up, ate again .5uR, 1.25uLevemir
+4 272
+6 259

2/16/08
AM PS (+13) 240 fed 1.25uLevemir
+2 232
+4.5 177
+9 170
PM PS (+11) 200 fed 1.25uLevemir
+5 342

2/17/08
AM PS (+121.5) 181 fed 1.25uLevemir
+2.5 120
+5 78
PM PS (+10) 130 fed, threw up, ate again 1.25uLevemir
+5 283

2/18/08 The Experiment begins
AM PS (+14) 396 fed .5uR and .75uLevemir
+2 201
+4 106
+5 81
+7 67
+7.5 105
PM PS (+10) 180 fed .25uR and .75uLevemir
+4.5 72
+6 77

2/19/08
+9.5 153
AM PS (+13) 426 fed .5uR and .75uLevemir
+1 385
+4 242
+8 210
PM PS (+11) 304 fed .5uR, .75uLevemir
+2 278
+5 222

2/20/08
AM PS (+13) 138 fed .75uLevemir
+1.5 161
+5 210
+7 305 .25uR
PM PS (+11) 212 fed .25uR, .75uLevemir
+5 152

2/21/08
AM PS (+12) 437 fed .5uR, .75uLevemir
+3 228
+4 170 (AT VET!)
+10 192
PM PS (+10.5) fed .5uR, .75uLevemir
+2.5 120
+6 151

2/22/08
AM PS (+13) 267 fed .5uR, .75uLevemir
+4 77
+7 118
+9 133
PM PS (+11) 125 fed .75uLevemir
+3 241 .25uR
+5 130

2/23/08
AM PS (+12.5) 152 fed, threw up, ate again. .25uR, .75uLevemir
+2.5 84 fed (had to leave for wedding)
+3 88
+9 339
PM PS (+10) 347 .5uR, .75uLevemir
+4.5 117
+5.5 220

2/24/08
AM PS (+14) 216 fed .5uR, .75uLevemir
+6 215
+7.5 310
+10 345 fed, threw up, ate again.
PM PS (+10.5) .5uR, .75uLevemir
+3 178
+5 72

2/25/08
AM PS (+13.5) 233 fed .5uR, .75uLevemir
+3 90
+9.5 134
PM PS (+10) fed .75uLevemir
+5 145

2/26/08
AM PS (+13) 184 fed .25uR, .75uLevemir
+5.5 68
+6.5 73
PM PS (+10) 190 fed .5uR, .75uLevemir
+5.5 83

2/27/08
AM PS (+14) 139 fed, threw up, ate again .25uR, .75uLevemir
+7 77
+10 69
+12 67 fed
PM PS (+13) 112 .75uLevemir
+2.5 189

2/28/08
AM PS (+10) 159 fed .75uLevemir
+5.5 38 fed
+6 73
+10 101
+11 fed
PM PS (+13) 261 .5uLevemir
+3 322

2/29/08
AM PS (+11) 244 fed .75uLevemir
+1 157
+3 77 fed
+4.5 85
+6.5 86
PM PS (+11) 139 fed .5uLevemir
+1.5 236
+4.5 210

Not even a smidge of an idea what's going on here.

2008-01-27T21:02:00.000-05:00

Lousy, stinky numbers again. I have been giving him 1.25u for the last day or two - I'd have to go back and look it up, but I think that that's about the highest amount of Levemir I've ever used, and it doesn't seem to providing either duration or effective glucose lowering. I don't think - well, unless it's dental-related - that there's anything wrong with him. He's behaving pretty much the same as always, for a somewhat tubby cat of unknown age. He bounces around when Burble chases him, he hops all over the cat trees, he acts perfectly normal, and he eats just like he always has. I do think that he probably needs his teeth done again - there is one in particular that I can see on quick - verrrry quick - inspection that has a little pocket of red at the bottom of it. And there's always the issue of the melanosis in his right eye, which I need to make an appointment with Dr. K, the ophthalmologist, in the very near future.

I'm discouraged. I like Levemir, but aside from the miraculous November Blessing Period, it really isn't doing much for him. On the other hand, neither is my standard half-unit of R, these days, either. So maybe there is something infectious going on. I wanted to get the fPLI done again, too, but I can't bear the thought of fasting him.

Nothing's ever simple.

Time to get back on the job.

2008-01-10T00:25:00.000-05:00

Okay, a month of pretty much one horrible number after another in December. (Not that January appears to be planning to be a whole lot better....) Anyway, I've been distracted and busy and depressed, among other things, and haven't spent much time trying to get Scruffy organized.

Started a new Levemir pen. Didn't notice much difference. He's had a long seige with very active herpes stuff going on - snorting, sneezing, eye watering, and lousy numbers. And the iris melanosis in his left eye has grown significantly. I called and asked that the ophthalmologist call me to discuss it - we'd left the situation that I'd monitor the size of the thing, and she would check and see what she could find out about laser removal before it turns into an actual melanoma. Which didn't exactly happen - I called, but it took her three days to call back, and when she did, she left a message that I had to come in and bring Scruffy, and then she'd tell me what she'd found out about laser surgery. (She had said at the last appointment that she had no experience with it.) I'll bet that the ophthalmologist at that nice hospital in Akron does laser surgery......

I have been STILL putting off getting his bloodwork done, too. I just hate putting all three of us - Scruffy, me, and Dr. G. - through all that commotion. I do want to get the fPLI test done again. I finally got a copy of the first results:

test done on 5/25/06; results - 6.8
reference range - 2.0 - 6.8 (coincidentally?)

I noticed from a link that Hope posted the other day that they're supposed to fast for 12 hours prior to the fPLI test - I don't know if Scruffy had been fasted or not, but I kind of think NOT, since I wasn't aware of that. Anyway, it's on the Things To Do (Someday) List. I also ordered Marin and Denosyl for Milkshake and for Scruffy to take - Milk because of the phenobarb, and Muffer just on general purposes. Made by the same company that makes the Cosequin that he's so unfond of - he told the animal communicator/neurologist from Ohio State, Dr. W., that he didn't NEED Cosequin. It stinks like something burned. I hope the two new ones aren't as unpleasantly fragrant. (I ordered them from an online place - VetAmerica, I think it was called. And days after I placed the order - and PAID - I got an email from them that said, "We regret to inform you that your order for #260806 Bird Sulfa has been cancelled. We will not be stocking this item any more." So, I called them and said, #1 - I don't even know what "Bird Sulfa" is, and #2 - I didn't order any. The person from VetAmerica disappeared four different times, leaving me to listen to some of the most annoying Muzak ever. When she came back, she said that the Bird Sulfa email was an error - it wasn't intended for me to receive. But, unfortunately, they only have one box of Marin in their warehouse, and they won't be restocking it, so the essence of the mistaken email was still true. Did I want the one box they had? Instead of the two boxes I'd ordered to save $6 on the postage? I don't thinnnnnnk so..... Geez.)

Oh, well.

January , 2008 #'s

2008-01-09T23:22:00.000-05:00

12/31/07
AM PS (+11) 307 fed 1.0uLevemir
+2 324
+6.5 232
+11 172 fed
PM PS (+14) 341 1.0uLevemir
+2.5 325

1/1/08

AM PS (+10.5) 389 fed 1.0uLevemir
+4 317
+8.5 341
PM PS (+10.5) 401 1.0uLevemir
+4 374

1/2/08
AM PS (+11) 362 fed 1.25uLevemir
+8 267
PM PS (+12) 315 1.25uLevemir
+4 342

1/3/08
AM PS (+12) 337 fed, threw up .75uLevemir
+3.5 236
+7.5 60
+10.5 91
PM PS (+12.5) 105 fed .75uLevemir
+4.5 353

1/4/08
AM PS (+12) 342 fed 1.0uLevemir
+5 350
PM PS (+11) 352 fed .5uLevemir
+5.5 364 fed .5uR

1/5/08
AM PS (+13.5) 101 fed .75uLevemir
+3 103
+7 65
+9 95
PM PS (+11) 167 fed .75uLevemir
+4 283

1/6/08
AM PS (+12) 325 fed .75uLevemir
+4 311
+6 246
+10 fed
PM PS (+12) 258 .75uLevemir
+3 404

1/7/08
AM PS (+12) 381 fed .75uLevemir
+5 300
PM PS (+10.5) 231 fed .75uLevemir
+5 178

1/8/08
AM PS (+14) 121 fed, threw up? .75uLevemir
PM PS (+10) 132 fed, threw up, ate again .75uLevemir
+5.5 320

1/9/08
AM PS (+12) 224 fed .75uLevemir
+3.5 136
+7.5 133 snacking, threw up pepcid
PM PS (+11.5) 129 fed fat .5uLevemir
+5.5 126

1/10/08
AM PS (+12.5) 151 fed, threw up, ate again .75uLevemir
+4.5 140
+9.5 157
PM PS (+11) 210 fed .75uLevemir
+5.5 364 ate 1/2 can FF

1/11/08
AM PS (+12) 347 fed 1.0uLevemir
+3 338
+5.5 146
+10 99 fed
PM PS (+14) 395 .75uLevemir
+2.5 378

1/12/08
+9.5 164 fed
+11.5 144
+13.5 173
AM PS (+14) .75uLevemir
+3.5 345
+6.5 fed
+7.5 432
PM PS (+8) 1.0uLevemir
+1.5 483

1/13/08
AM PS (+12) 325 fed .75uLevemir
+2 342
+6.5 156
+11 112 fed first Marin
+12 122
PM PS (+13) 215 .75uLevemir
+3.5 333

1/14/08
AM PS (+10.5) 378 fed .75uLevemir
+3.5 323
PM PS (+10.5) 139 fed fat .5uLevemir Marin
+3 154
+5 119

1/15/08
(Ate FF left after Milk's seizure)
+9.5 419
AM PS (+13) 431 fed .5uR, fat .5uLevemir Marin
+2 397
+4 281
+8 196
PM PS (+10.5) 234 fed, threw up .75uLevemir
+2.5 386

1/16/08
AM PS (+12) 370 .75uLevemir Marin
+2.5 433
+8.5 370
PM PS (+12) 310 fed 1.0uLevemir
+3 298
+5 272

1/17/08
+9 248
+13 146 fed, threw up Marin
AM PS (+15) 132 fed .75uLevemir
+2 157
+7.5 158
PM PS (+9.5) 354 fed .75uLevemir
+5 427

1/18/08
AM PS (+12) 387 fed .5uR, .75uLevemir Marin
+2.5 233
+4 186
+8 295
+10.5 360 fed .5uR
PM PS (+14) 259 .75uLevemir
+1.5 234

1/19/08
+9.5 77 fed
+12 86
+13 87
AM PS (+15) 99 .5uLevemir
+3 347
+5 442 fed .5uR
+9 (+4) 388
FORGOT TO GIVE PM LEVEMIR SHOT. Geez

1/20/08
AM PS (+18.5) 480 fed 1.0uLevemir
+6 165
+8.5 101
+9.5 fed
+11 66
+12.5 69
PM PS (+14) 112 .75uLevemir
+1.5 170

1/21/08
AM PS (+10.5) 191 fed .75uLevemir
+3.5 164
+5.5 92
+9 127
PM PS (+10.5) 214 fed .75uLevemir
+4.5 419

1/22/08
AM PS (+13) 438 fed 1.0uLevemir
+7 295
PM PS (+10) 353 fed 1.0uLevemir
+2.5 342

1/23/08
AM PS (+12) 122 fed .75uLevemir
+2.5 281
+7 367
PM PS (+11.5) 347 fed 1.0uLevemir
+5 298

1/24/08
AM PS (+12.5) 255 fed .75uLevemir
+9.5 279
+11 fed
PM PS (+12) 326 1.0uLevemir
+1.5 274

1/25/08
AM PS (+12) 488 fed. threw up .5uR, .5uLevemir
+2 413
+8 411
PM PS (+10.5) 441 fed 1.0uLevemir
+4.5 438

1/26/08
AM PS (+13.5) 352 fed 1.25uLevemir
+3 354
+8.5 195
+9.5 165 fed
+10.5 139
PM PS (+12.5) 156 1.0uLevemir
+4 305

1/27/08
AM PS (+11.5) 459 fed 1.25uLevemir
+6.5 283
+10 276
PM PS (+11) 288 fed 1.25uLevemir
+5 375

1/28/08
AM PS (+12) 120 fed, threw up, ate again 1.0uLevemir
+5.5 67
+7 76
PM PS (+11) 129 fed, threw up, ate again 1.0uLevemir
+4.5 104

1/29/08
AM PS (+12.5) 221 fed 1.25uLevemir
+4 365
+7.5 337
PM PS (+12) 293 fed 1.25uLevemir
+4 238

1/30/08
AM PS (+12) 157 fed 1.0uLevemir
+4.5 334
PM PS (+11.5) 382 fed, threw up, ate again 1.25uLevemir
+5 388

1/31/08
AM PS (+12.5) 157 fed, threw up, ate again 1.25uLevemir
+1.5 204
+6 64
+10 86 fed
PM PS (+12) 174 1.25uLevemir
+3 233

Merry Christmas!

2007-12-18T19:52:00.001-05:00

Well, now I REALLY feel bad....

2007-12-16T01:34:00.000-05:00

Out of desperation, I gave Scruffy a zenequin (left over from the last ear infection a couple months ago) two days ago. He's now had three of them. And, if you look at his numbers, it's abundantly clear that he's had all these awful numbers because he's got some sort of infection going on. I did poke around in his mouth the day I started the zenequin, and he has a couple of red spots. (He just had a dental last spring, though.) Could it be the mouth stuff plus herpes has done this to him?

I have been trying to avoid having to take him to the vet because he turns into such a maniac there. And then I have weeks of his hiding every time he hears the car keys jingle. I really don't know what to do about the situation. It seems wrong to make him go for appointments with someone he has such a definite negative response to. He was always the world's most laid-back cat, and now.... He's touchy with the holistic vet, and the ophthalmologist, and the dermatologist, but nothing like the hissing, spitting, jumping, clawing and actual pooping that Dr. G. gets. I have sort of associated the start of all this commotion with the last dental, but I don't know if that's accurate or not. I do know Scruffy has quite a long memory for slights and upsets.

I guess he'll have to go and see what the vet thinks about what's going on. And Jojo has really been encouraging me to have another pancreatitis test done. The last one was borderline. He's throwing up a lot lately, but it doesn't seem much different than any of the other periods that he did that. I think that maybe the zenequin has loosened some stuff in his sinuses, too - he's really snorting up a storm in the last couple days. And sneezing. Poor cat. It's really crappy to have all this stuff wrong with him. It's encouraging to see that Levemir still is willing to make a go of it, at least. I really want to get back on the right track with the insulin.

The return of herpes

2007-12-10T18:38:00.001-05:00

While I can't blame all of the horrible December numbers on herpes, I do think that's at least part of the problem. Within the last couple days, the snorting has started. And like everything else that goes wrong, this is my fault, too - I bought a huge bottle of the Lysine I had been using for years, and then noticed that it now contains propylene glycol, which is to be avoided. So, I ordered on line - buy one bottle of lysine, get two free. Only, when the bazillion pills came, they were coated with such a hard covering that my pill chopper could hardly get through them. And, since I have to be able to chop up the mucho expensive Keppra pills for Milk, I made a less-than-executive decision to stop chopping up Lysine for a while. So, Scruffy hasn't had his lysine for probably more than a month, and here I am, having ruined his good numbers and made him miserable besides. I started the lysine again last week, but who knows how long it's going to take to do any good. The moral of the story is, nothing I do ever turns out right.

Aside from the above stupidity, this last two weeks has been horrible for him. I've checked his urine half a dozen times, and it's always been ketone negative (thank God), and 1/2% glucose. The average on his meter is up more than 150 points for the 7 and 14 day averages from what it had been. Every time I turn around, he's in the 400's. He's dropped to sub-40 numbers on both .5 and .75 units. I don't know where to go with all this. I have been debating taking him to the vet, but that's such an ordeal for all of us that I've been putting it off. This is so discouraging; I'd actually gotten used to those wonderful numbers from last month - not so obsessive about testing, and not worrying about when I had to go out, and sleeping....... Not no more.

Poor Scruffy. I've always told him that he'd have been so much smarter to have wandered into someone else's sister's garage.