Something's wrong....

(I have to put this picture of my sweet Milkshake and Burble snoozing together up here. It's one of Milk's many charms that he loves his "brothers" so much. Okay, maybe a picture of Milk with Scruffy, too, and one with Busy, what the heck.... Only I never can get the pictures to end up where I want them to without a whole bunch of copying and pasting.)



Milk just isn't himself. He's sleeping a lot, and he's really wobbly. In addition, he has taken the "pile of bones in a fur bag" appearance to a whole new high. He just looks flat when he lays down. I weighed him this morning, and he was only 9 pounds, 4 ounces. It amazes me that there are cats like Hope and Wheezer who weigh only 7 pounds or so, and they look so healthy. Once Milk started getting food on a regular basis, he got really tall and long. I know he's a whole lot bigger than Wheezer. I don't know. He just doesn't seem right. And the decrease in Keppra - so far, crossing fingers and banging on the desk and **antijinx** - seems to be able to hold off any seizures. So, I don't know what to think. He did actually eat a couple of bites on his own this morning, which makes me nervous now, since the last time he ate voluntarily, he also had 6 seizures in two weeks because the phenobarb dosage had gotten below his "threshhold." I've been giving him one bottle of EVO a day for the last two weeks or so, but I guess I"ll try to up that. Lots more phosphorus to add to the problem....

Even odder, for a week now - since the last dosage reduction, actually - he hasn't been sleeping curled up between my ankles. He's done that for as long as I've had him; now all of a sudden, he's sleeping in the kitchen, usually in my computer chair, or on the window ledge. I want him back. I want the old Milk back. Whatever is going on is scary. I don't want anything to happen to him.

And then, having said that, a couple of nights ago, I noticed that he had black stuff from his eyes on the sides of his nose, and the normally pink tissue around his eyes was all red. Conjunctivitis - exactly what it looked like a couple of weeks ago when I took him to the vet. And got a bottle of Gentamycin drops. So, I looked around the kitchen, and there was a box with a label with no name on it, and the words "Gentamycin Sulfate .03% ophthalmic solution" on it. "For Veterinary Use Only." So, I shook it a little, opened it up, and managed to squirt one drop into his right eye, and two into the left. And noticed that it smelled really strong and bitter. Chemical. He jumped down indignantly and ran off into the living room. At which point, I thought - oh, no, what if I gave him the wrong medication? I am pretty sure that the bottle said "OTIC" on it - Gentamycin Sulfate "OTIC" .03%" OTIC - that means ears. But the box said the "ophthalmic solution" stuff. (I threw it away, so this is never going to be resolved.) Anyway, then I panicked because I noticed that the expiration date was 3/07. So maybe it smelled bad because it was expired? Did I put ear medication - EXPIRED ear medication - in my cat's eyes? Oh, I was a wreck. So, even though it was 1:30 AM, I called Hope and shared my hysteria with her. She was looking stuff up, and I thought maybe I should call the emergency hospital place. Which I did - after being on hold for 15 minutes, the person I talked to put me back on hold and asked a doctor there about the expiration issue - and said that the doctor wasn't hysterical about it and I should wash his eyes out with saline solution. Which would have been fine if I HAD any saline solution. Which, of course, I didn't. I did slosh around his face with regular water - chlorine, I know, but I didn't even have a bottle of bottled water to use........ He seemed okay. But he kept rubbing his eyes with his deformed little white paws. And then, to compound the confusion, I found - in the fridge - a second, smaller bottle of UNEXPIRED Gentamycin Sulfate, dated 07/09. Same other stuff on the box as in the bad bottle's box. No idea about the bad bottle itself. Anyway, now I'm convinced that I've blinded him. Maybe that's why all he wants to do is sleep. He can't see anyway. I try so hard to take good care of these cats. The miracle is that they're all still alive as I type this.

Experimenting

Nervously, very nervously, but experimenting, nevertheless. I've pretty much given up the hope that I'm going to be able to wean Milk off phenobarb, possibly EVER. As desirable as that would be, I don't think that it's possible, and to continue to hope for it and to try to decrease again is just too risky. If the dosage he's on now can control his seizures (hopefully long-term), then I just have to accept the anorexia and the wobbliness and all the other side effects as inevitable. It makes me sad. However, I do think that maybe it might be possible to reduce the amount of Keppra (generic) he's getting, since there was the tiny increase in phenobarb that seems to be holding him. I'm antsy about it, but I think it's worth it. Because almost all of his seizures have occurred in the very early hours of the morning, I'm thinking that the most medication needs to be available to cover that period of the day. Plus, he has always been sleeping when he had a seizure, and during the day, he's awake much more of the time. So far, it's been about two weeks since I reduced him by one Keppra "chunk" - yes, a very imprecise measurement, but no dosage he gets is ever exactly like the one before or the one after..... I started at first to take away the chunk from the afternoon (6PM dose), but thought that maybe it might be better to try the AM dose instead, since he does get the additional phenobarb AND the big dose of Keppra at 2AM. And that seems to be working. (I'm afraid to even write this.) Two days or so ago, I removed a second "chunk" dosage, so now, at 10 AM and at 6PM, he's only getting the 1/2 and the 1/4 Keppra pills. I want so much for this to work, and I'm so afraid it won't.

Just in case, for some reason, MAYBE IF - someone else out there needs to give Milk his medication - here's his schedule as of today, June whatever, 2008:

All amounts are estimated, sadly.

10 AM
8mg phenobarb (1/2 of 16 mg pill)
180 mg generic Keppra (1/2 and 1/4 of 250 mg pill)

6 PM
180 mg generic Keppra (1/2 and 1/4 of 250 mg pill)

10 PM
12 mg phenobarb (1/2 and 1/4 of 16 mg pill)

2 AM
210 mg generic Keppra (1/2 and 1/4 and 1/8 of 250 mg pill)

I ordered the 500 mg generic Keppra pills this week from Canada. I am hoping that they will not be any more difficult to chop up than the smaller pills. The cost was enormous - $274, but I got free shipping and a $10 discount for having an order that was more than $250. Every little bit helps, I suppose. I can't picture exactly how much larger the 500's will be. I have a new pill chopper than I just hate because it jiggles the pill-to-be-chopped just before I click it shut, and the pieces NEVER come out the same size. In fact, I'm getting quite a collection of unusable little bits of Keppra; maybe I can sort of glue them together with Pill Pockets and make up a few regular size doses........

My fingers are crossed. And my toes, and ankles, and eyes and whatever else is flexible enough to move around.

Shhhh! (Still seizure-free....)

I really don't want to blow the good luck - we're coming up on another month without a seizure, although yesterday and especially last night, his behavior was so peculiar that I was really nervous about whether it was significant or not. He was doing a lot of racing around, meowing, leaping, trying to chew Burble - all sorts of unusual behaviors, especially since he's been a little dopey-seeming lately. And his weight is dwindling again, along with his only-newly-found appetite. For a while, he was willing to eat as long as I crumbled freeze-dried Nature's Variety raw medallions on his food, but for the last couple of days, that's not sufficiently enticing. (Although the others can't wait for him to sniff and walk away so THEY can eat his share!) I guess we'll go back to bottle-feeding and see what happens.

The urge to reduce his medication just a smidge has come upon me - he was doing so well for a while there, but he just seems different now, and aside from the again-diminished appetite, he's sleeping for long periods during the day and evening when he would normally have been up and watching the birds and playing and snuggling. Two nights in a row, he's slept on my computer chair in the kitchen. While it's been incredibly hot and sticky and miserable here for a week, the air conditioning has been on and I don't think that whatever's going on with him is weather-related. Anyway, I digress. As usual. I just gave him his morning pills, and left out the additional "chunk" of Keppra that he has gotten three times a day since the last round of seizures. I just want to drop that one amount - the Yahoo seizure people recommend that dosages be identical, but it's worked so far to give two differing amounts of phenobarb, so maybe giving him a smidge less Keppra will be successful, too. Come to think of it - maybe it would be better to drop the chunk from the second (6PM) dose of Keppra, since he's already getting the lowered dose of phenobarb in the morning. I sure don't want to end up with him having seizures in the afternoon because he's low on both drugs in the AM. (This is the problem with being impulsive - second thoughts when things have already been screwed up.) I am praying not to precipitate another whole round of seizures, that's for sure. It is apparently not going to be possible to wean him off the phenobarb, but maybe, since it was increased just slightly, he can do with a little less Keppra. I don't know. Every experiment is scary because the potential aftermath can be so extreme.

Busy figured out how to open the door to my craft room (which I keep closed solely because Scruffy wandered in there TWICE and peed right on the rug! He's NEVER gone anywhere but in his litter box except for that.) And, in the picture above, little Milk found himself a nice soft place to nap. There's a huge pile of Fun Fur underneath him. Surrounded by unborn kitty pi's..... and enough yarn for an army of sleepy cats. I love this little white cat so much.

Not much new.

No seizures since the "group" in the beginning of May that precipitated the small dosage increases in both the phenobarb and the Keppra. Seems - fingers crossed - to be working. I do feel that my theory about the sudden return of Milk's appetite (well, partially, at least) and the appearance of multiple seizures was right - it had to do with the reduction (for unknown cause) of the level of phenobarb in his blood. It was very difficult to bring myself to increase the amount again, even by as little as 1/4 of a pill - about 4mg- SID, but it seems to have worked. The last couple of days, he's been wobbly, though. (It's been three weeks or so from the increases, so I don't know what that means, and I really really hate to put him through more blood-drawing - the last time, they couldn't get enough from his thighs and had to use his jugular. ) And not eating as much. I thought I had more canned EVO in the pantry and could start giving him a bottle of it now and then, but it turned out to be the 95% stuff. I'll get more tomorrow. He does seem doped; he spent most of today sleeping. Usually, he's up and wandering around, snuggling with me or the other cats and watching the bird feeder. I can't decide if he seems dehydrated or not. When I give him his pills, I am squirting extra water into him. Not that that'll be enough, of course.

On the Keppra front - still haven't received a bill from Auburn. (And haven't gotten around to calling them, either - "I've been sick, " she whines.) And the 5-21 standards/levels do turn out to be the human levels - I didn't think that Auburn had said that they have enough data to set feline levels. I don't know how significant that is - I was so depressed that he was way over the human standards - what will I do if he's over the cat ones???

Two people (including the epileptic vet tech at my vet's office who takes Keppra herself) have mentioned recently that there is some regulation that generic drugs only have to contain 80% to 100% of the drug in order to be acceptable, and that with drugs that affect the brain, maybe that's a little too much variation? I never priced the brand-name Keppra at the Canadian Universal DrugStore where I buy the generic Keppra on-line. I guess I'll check next time I order. (Mylan Labs, in which I own a big 12 or 13 shares of stock, is supposed to release a generic version of Keppra in October. Big deal.) Just opened the second bottle of Keppra yesterday, so we'll have a month or so to go. I wish the stupid pills came in a shape that you could actually chop up to give varying doses. (Yes, I KNOW that's not what the drug companies want, but it's still annoying.)

The kittens - or a portion of them - I have NO idea what I'm doing with little Toot - will be moving to Rochester, New York on Saturday. I considered taking Milk with me, but I think the stress of being in the car, with all the assorted car noises and strange cats and Dian and Beverly - not the quietest of passengers - for such a long trip would be very hard on him. I just hoping that we can arrange the time so that I get back for his 6:00 Keppra.

Nothing's ever simple.