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

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

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)

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?

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...."

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!

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....

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?

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

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!

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.......

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....

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.......

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

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.

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

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.

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!

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)

Lookin' Good!

(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!

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.

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...

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.......

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....

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

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.

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

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

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

** 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!

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

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.

General stuff

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.