Aby-a-Day – 17 Juni: The nose knows (Medical Movie Monday)

This happened two summers ago. Jacoby was acting like he had something stuck in his nose or throat. I checked his mouth to make sure a string or something hadn’t gotten caught under his tongue, but there was nothing there. The way he was acting reminded me of when I’ve gotten a grain of rice stuck in the back of my throat in my nose; Jake was coughing and snorting in the same way.

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This is what he was doing (click the photo to watch the video in Flickr). We were growing cat grass on the balcony that summer, so I suspected that Jake might have inhaled a blade of grass and gotten it stuck in his pharynx or nasal passages.

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So we went to the vet, and they flushed out his nose and checked him out. They noticed some irritation, but didn’t find any grass or plant matter. They prescribed antibiotics, just in case.

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After we got home, however, I found what looked like some dried, clear cat barf on the floor in the room Jake ate in. But it wasn’t like a regular hairball or food barf…it was a tiny leaf! I had been right – Jake did have something stuck in his nose! He just managed to get it out by himself before the vet appointment.

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So, I did a little research and discovered that it was a small leaf of Yarrow! I only know Yarrow from the Warriors books (the medicine cats use it, and there’s a cat named Yarrowleaf in the more recent books, but I had no idea it was growing in our lawn! Because they mow once a week, it never gets a chance to grow tall or flower. Jake must have accidentally inhaled the little leaf when we went outside – he loved chewing on the grass, and the yarrow is mixed into the lawn. It was an interesting mystery, and I’m glad I was able to solve it.

Aby-a-Day – 9 April: Update on Jacoby

This morning, I had a message on my phone from Dr. Cecilia. Jacoby was moved to the ICU because his blood pressure had dropped. He’s still on fluids, plus pain medication. At the time she left the message, they thought he might have leakage in his abdomen from the biopsies, but when I called her back, they discovered that was not the case. They had gotten his blood pressure stabilised. His albumin is also slightly elevated. He also has some fluid in his thorax, but it isn’t affecting his breathing or his heart.

Later this afternoon she called again. He’s still in the ICU, and he is now on a feeding tube. He cooperated well with that, and she let me talk to him on the phone. He heard my voice, but he was so very tired he didn’t react much. Dr. Cecilia told me she had been discussing treatment options with the oncologist, and they think he is stable enough to start reduced-dose chemotherapy today. Apparently, it’s a delicate balance between starting as soon as possible vs waiting until he’s stronger and giving him bigger doses of the chemo cocktail.

That’s all we know so far. I’ll get another call from Dr. Cecilia tomorrow.

Aby-a-Day – 8 April: “Cancer is a fight to the death. Either you kill it, or it will kill you. Get ready to brawl.” (Medical Monday)

Cutting to the chase, the vets think Jacoby has Lymphoma.

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On Friday, Jake and I repeated the trip we took back in August when we went to Djursjukhuset in Jönköping to try to find out what was the matter with him.

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They have the best cubbies for cat carriers in the cat waiting room.

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When they called us back, they put us in a really nice, sunny room. Anicura puts birdfeeders outside the windows of the cat exam rooms. Birds came to the window whilst we were there…but not when I could take a photo of any of them.

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The first thing they did was weigh him. As you can see, 4.35kg (9.6lbs). On 3 March, he was up to 4.9kg (10.8lbs). When I weighed him on the 31st, just under a month later, this is what he weighed. I called the vet the next day.

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After the nurse took some blood samples, he went back to the sunny windowsill.

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The vet felt something when she palpated his abdomen, so she ordered an another ultrasound, which they managed to squeeze in that same afternoon. They sent me off for a couple of hours, and when I came back…the news was not great.

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They suspected Lymphoma, and scheduled another exploratory surgery for this morning. I was meant to bring him back on Sunday afternoon.

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It was a pretty long day, and Jake was exhausted. He didn’t even get out of his carrier on the train ride back.

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On Saturday, Jake was worse than ever. He spiraled in the 24 hours after our visit the day before.

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He wasn’t eating or drinking, just lying on the kitchen floor. I tried putting him in comfortable places, but he kept going back to the floor. I knew he needed to go back to Jönköping, but I wasn’t sure that the train would get me there fast enough. Björn got home from work at 5, and I asked him if we could borrow one of our neighbours’ cars. He did, and we drove to Jönköping.

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We saw a majestik møøse on the way to the vet!

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When we got there, we were put into the same exam room we’d been in on Friday.

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You can see how much worse he looked than the last time we were in that room.

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Despite having no appetite, Jake was still interested in the treat jar.

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When the nurse came in, she gave him a few…and he ate them!

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Then there was some paperwork to fill out…

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…farewells to be said…

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…and then he needed to go into the hospital transport cage.

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At first, he didn’t want to lie down so she could close the carrier.

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Finally, he cooperated, and they rolled him away.

One of my favourite things about Anicura is that they send good morning texts with a photo of your cat. This was this morning’s text, after being on fluids for a day, before his surgery.

They called me after his surgery was finished and he’d woken up. He was doing well, and the samples from the biopsy were sent to the lab but from what they observed when they had him open was that they were fairly certain that Jake does have Lymphoma, and they are going to start the chemotherapy as soon as they can without waiting for the results.

Cats respond differently to the treatment, and can live for three or four months to three or four years. We just don’t know how he will respond. According to this article I found, “Feline lymphoma cases currently appear to fall into three groups from a prognostic point of view. There are some that fail to show a good response to any chemotherapy offered. For these patients, their lymphoma is unfortunately fairly rapidly progressive. Patients in the middle group tend to show a degree of response to the treatment but never achieve complete normality and for these patients there is an average life expectancy of approximately 4 months. The third group achieve complete remission from their lymphoma and their life expectancy is measured in years.” We just need to wait and see which group Jake falls into.

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I wish I knew what else to say. I mean, his 10th birthday is next Sunday. I can’t imagine not having him with me.

Aby-a-Day – 11 Februari: All clear! (Medical Monday)

A couple of weeks ago, I got the following email from Dr. Cecilia: Hi Koshka!
I just got the results back and all cats are free from Tritrich! Great job!
Hope you haven’t waited too long for the results. They appeared in a weird place in the journal, so I hadn’t seen them before. No more restrictions. Hope Jakey is doing fine. Otherwise get back to me to discuss treatment with prednisolone.

I wrote back: I knew it! There’s been no diarrhea and he’s gained weight. We’ve been feeding him sensitive stomach food and kitten food, but he is still a little growly. It took me a while to get all five cats’ poops. Angel is a very stealthy pooper. So no, I didn’t wait too long at all! Great news! What do we do about the prednisolone?

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She responded: Hi! If he’s had no diarrhoea and gaining weight I wouldn’t put him on pred for now. The best would be to put him on a hydrolysed feed. There are a few different ones, but I recommend them in this order of priority (based on protein and fat content): Purina HA, Hills z/d, Royal Canin Hypoallergenic, Specific CDD Allergy Management Plus. Also I’ve written a prescription for folic acid and B12. He should be on it for 6 weeks, then off for 2 weeks. After that I recommend a revisit to check his B-vitamin values, evaluate the feed and recheck his albumin and proteins, which were abnormal before the treatment.
Is that an OK plan for you?

My answer was: It’s a great plan! to which she said: Super! I’ll put him up for a revisit in 8 weeks. We’ll call you to make the appointment.

But what AWESOME news! We have successfully conquered both Giardia and Tritrichimonas Foetus. I am earning my cat-parent merit badges!

Aby-a-Day – 21 Januari: Tritrichomonas Foetus (Medical Monday)

You may recall that Jacoby has been having some sort of vague mysterious ailment. We spent much of the summer shuttling to the djursjukhuset in Jönköping to try to figure out what the problem was. But we have finally gotten to the bottom of it. It took a while because I needed three separate fecal samples from Jake…and I was having a devil of a time catching him in the act! But finally the first week of September I got that third sample, and a week later Dr. Cecilia emailed me with the result: “Today I’ve finally recieved Jacoby’s fecal sample results. We have significant findings that may well explain his weight loss and (quite possibly) also his change in behavior. He has the parasite Tritrichomonas foetus that in chronic cases may induce chronic intestinal inflammations. He also has toxin-producing Clostridia in overgrowth.”

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TriTrich is a protozoan parasite that can infest multi-cat households. But it’s good news, right? At least we know what the problem is. I mean, we have already dealt with Giardia, which is a huge problem to deal with, and we managed to survive that…so TriTrich is at least better than that, right?

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Well, yes and no. Whilst Giardia is harder to kill in the house because the protozoa are shed encased in cysts which are hard to destroy, the medication is readily available in any Apotek. The TriTrich protozoa have no such protective “shells,” but the problem with treating TriTrich is that the medication for it, Ronidazole, is toxic. Like, wear rubber gloves when giving the pills (for four days), and also wear a face mask when cleaning the litterbox during medication and three days after the last pill has been given. Dr. Cecelia had to get specific licenses from Läkemedelsverket (the Swedish bureau that deals with prescription medication) for each cat based on their weight. This was delayed a bit because, as usual with Swedish government agencies, the instructions on the paperwork weren’t entirely clear, and there was an error on the original paperwork so it needed to be redone…and Läkemedelsverket only sends the denial notifications by snail mail.

But we finally got ahold of this highly-regulated, super-toxic medication, which I had to give to five cats once a day for fourteen days…yeah, good times. The exact written instructions were as follows: “All cats are treated with 1 capsule per day for 14 days. They are prescribed and will be sent directly home to you. The drug is toxic and is excreted through feces and urine. Therefore, you need to use disposable gloves and masks when you’re cleaning the litter boxes. The most common side effects (still uncommon), are neurological. Contact us immediately if any of the cats show any neurological abnormalities or other symptoms.” Now, that’s not at all daunting, is it? At least I’m not the only person who’s been through this! And hey, this time I didn’t get bitten, either!

I also had to bathe all the cats. I wasn’t sure when during the medication timeline I should bathe them all, so I emailed some researchers at North Carolina State University for advice, and was pleasantly surprised at their quick and helpful response! They told me: “To my knowledge, no one has looked at the optimal time for performing a disinfection during treatment for T. foetus (ie. at what point during the treatment, on average, is T. foetus no longer being shed by the cat). The good news is, the T. foetus organism is not particularly robust once outside the host. We have observed the organisms in feces are no longer viable 24hrs after being voided into a litter pan, in the absence of litter; the presence of litter likely speeds the process up via desiccation of the feces.” So, towards the end of the dosage period, we cleaned one room, washed all the cats, locked the cats up in the clean room and then cleaned the rest of the house. We used liberal amounts of Virkon (which is actually better than bleach for sanitizing – and without the smell and turning things white).

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Another importan part of eradicating TriTrich is to thoroughly clean all the litterboxes, since it is mainly transmitted in feces.

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It wasn’t easy, cleaning six litterboxes, but between the two bathrooms, I managed to wash them all.

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We got all the freshly cleaned boxes back in their places…

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…and filled them up with clean, fresh litter. We use two types, PeeWee pine pellets, which are wonderful, and Cat’s Best Öko, which is a plant-based wood fibre clumping litter. Both of these make collecting fecal samples very easy – much easier than clay litter.

This is important, because once we were done with the medication and the bathing and the cleaning, we needed to test all five cats’ poops. Which involved catching each cat “in the act,” so to speak. Izaak and Lorelai were easy – just catch them when we’re at a cat show. Jacoby, as well, was simple: he eats in a room with a box in it, so just catch him after he’s been fed. But Alfred and Angel…it took me weeks to catch them, especially Angel! I finally managed it, though…

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So now, we are TriTrich free…no diarrhea at all, and Jake seems happier and less growly, although he still hisses and growls at the younger cats…but I think now it’s just become a habit to be a grumpy old man towards them more than an actual medical symptom.

(And yeah, I wasn’t going to post a photo of anyone actually using a box, so have a shot of Jake having his perfect teeth checked instead.)

Aby-a-Day – 10 September: There ain’t no party like a South Boston party, ‘cos a Southie party don’t stop! (Medical Monday)

Last week, we went to the South Boston Animal Hospital’s grand opening party at their new 9 West Broadway location…the building I used to live in.

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After Jacoby and I toured the medical facilities, we went to check out the new exam rooms. At the old location, there were only two rooms…I don’t remember how many are at the new place, but it’s at least double that.

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One room was set up as a photo room, with decorations and props, and guests were invited to use them and take photos. As you can see, there was a luau theme. So we started with the lei, and shot a few poses…

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…before adding the grass skirt.

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Jake wasn’t sure about that bit.

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Okay, Jake, we’ll take it off and move on.

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In the new location, there were exam rooms specifically for cats! No dogs allowed.

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In one exam room, there was a rocking cardboard scratcher.

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I didn’t think Jake would go for it at all, but he surprised me. He ROCKED that thing!

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Then he noticed the mechanical mouse-in-the-cheese toy.

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The yellow plastic mouse would pop out of the white plastic cheese wedge at random.

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Apparently not randomly enough for our Jake.

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“When the bloody hell is this sodding thing going to pop out?”

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And then, finally…

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“Well, that wasn’t worth all the excitement, now was it?” No, Jake…and welcome to about half the TV shows I watch.

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Next we encountered a good, old-fashioned scratching post.

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Finally, a toy I can relate to! Thought Jake.

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“Oh, scratching post…you understand me.”

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In another exam room, there was a catch-the-string machine.

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Despite having a similar toy at home that has, the entire length of its career, been completely and utterly ignored.

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Oh, but downstairs, it’s the Best. Toy. Ever.

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And you know when we went back upstairs the toy we have? Totally ignored.

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But no playtesting session of the exam rooms would be complete without a bit of a schmooze with the vet.

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Jake and Dr. Natalie really did have a connection.

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I know I miss her…I wonder if Jake does, too?

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At the snacks table, there was, of course, ham…and Jake did get a bit.

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He handled it extremely awkwardly, but he got some ham.

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Finally, I just have to share this lovely painting of a white cat and a martini. It reminded me of Kylie.

Aby-a-Day – 27 August: “Birth control is the first important step woman must take toward the goal of her freedom” (Medical Monday)

Lorelai is on the pill.

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We started her on Perlutex last Wednesday.

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We do want to breed her someday. Just not yet. And since Izaak is the same age, even though he’s not displaying any “maturity” signs…ya just nevah know.

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We want to let Zak mature as much as he can before giving him Suprelorin. So starting Rory on birth control now seemed like a good idea.

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We want to show Rory to Grand Championship before she is spayed. We also want to breed her, since I do have a registered cattery name. I also want to experience having Aby kittens. But not now. Maybe in a year or two. We were going to breed Logan…but boys are hard. We are not planning on breeding Zak, and as soon as he shows any signs of maturity, he’s going on Suprelorin.

Meanwhile, our liberated lady will, happily, be on the Pill.