2 days, 3 and a half hours...... #47

Oh, this is depressing. Really upsetting.

A very strange little seizure, this one was. It started very abruptly, with virtually no build-up salivation. (There was a spot of wet fur on his neck that was only the size of a nickel.) The growling was back, with a little less volume than before. The flopping - oh, the flopping. At one point, he flopped so high that he was almost perpendicular to the footrest. It was all I could do to contain him with the "wall of afghan" so he didn't end up on the floor.

Very short actual seizure - probably 15 seconds or so. The after-period (post-ictal?) - not so short. Slightly over 2 minutes before he moved again once the seizure stopped. One large jerk right after the seizure ended, that I think I caused - I was just going to pet him to comfort him, but never got close enough to touch him. He laid totally still, with his eyes wide open most of the time. (I have noticed - since I've been watching everyone's eyes because of Scruffy's problem - that recently there are occasions when his right eye is more closed than the left. This was one of them. I hope it's not more indication of neurological stuff. Dr. G. thought that the recent dark trail down both sides of his nose lately is herpes-related. It doesn't appear to be conjunctivitis; his eyes aren't red-rimmed.) When he got down, he appeared more coordinated than usual. Raced into the kitchen and started eating last night's leftovers. I started to fix him a fresh can of Fancy Feast, and he meowed plaintively the whole time I was getting it out and putting it in a bowl. He ate about half a can, then headed to the pantry for more/something else.

I thought that he seemed less uncoordinated this time, but he jumped up onto the bench and then came over to my keyboard, and he definitely was having problems navigating the trip. (Scruffy's logbook was there, and yesterday's mail. ) Twice he got as far as the end of the desk and then seemed to be hesitant to move onto either the steps or the window ledge - which usually is just a single step for him. He's just been sitting behind my chair for about 15 minutes now.

Although I couldn't find him Tuesday to take him for bloodwork, I did get him there yesterday. I HOPE they get the results back today - if the phenobarb level is low/low 20's, maybe it's (sadly) time to put back that 1/4 pill I took away in June. I would be sorry to see him lose his minimal interest in food again and to be staggering around, but he can't be having seizures every two days, no matter the ferociousness or the brevity of the event. I was very careful about the size of the Keppra pills all day yesterday, and of getting the pills at exactly the right time again, which didn't seem to make any difference. I am worried, because once the seizures start getting closer and closer, it's so much harder to get any sort of control again, and I'm terrified about having clusters. Back when all this stuff first started, he had two seizures on the same day on two occasions; one of them - he had two seizures in a row, about 10 minutes apart. Frightening.

Dr. G. just called with the phenobarb level - 26.4. Essentially the same range as the last test, and it does fit in with my theory about voluntary eating/seizures occurring/lower phenobarb level. We agreed that there was presumably plenty of room to increase the phenobarb by 1/4 pill - to 3/4 tablet (about 10mg) in both the morning and evening. He had been getting 1/2 in the am and 3/4 in the PM since 7/18. I had just given him his pills this morning, so I tucked another 1/4 tablet into him a few minutes ago.

It just occurred to me that about four or five days ago, I finished up the bottle of Marin ( milk thistle) that I've been giving Milk a half tablet of daily for the last couple of months. I wonder if that could possibly have something to do with the sudden recurrence of these stupid seizures.... Given his previous liver function difficulties because of the phenobarbital, (and my own experience with milk thistle that was extraordinarily successful), maybe ....

Or not, I suppose.

102 days, 3 hours, 52 minutes.........

I feel like I did this to him. I told people today - a lot of people - that he was doing well. I should have just kept quiet and kept things to myself. When I was picking out the pill fragments for his last dose of Keppra at 2AM, the 1/4 pill was a little small, as was the "chunk", and I chose a 1/8 pill that was a little larger than usual on purpose, thinking that it might make up for the difference. And, when we were going to sleep, I got out the blue afghan for him to lay between my ankles, and I actually thought to myself, "Brother, how many seizures did he have on this...." Like foreshadowing. Not that there's anything that I could have done that would prevent it, I suppose. I truthfully don't believe that even if the pieces of the pills had been exact to the fragment of a gram, it would have kept this seizure from happening.

It was very different from the last 20 or 30 seizures. It makes me sick even to write all this. Although it seemed to go on forever, I started to count "one-a-thousand, two-a-thousand" shortly after it started, and I would guess that it lasted, at most 30 seconds, and possibly even a little less for the actual seizure. Aside from making a snuffling sound, like his nose was stuffed up - which I would guess was related to the foaming/salivation - he didn't make any noise. No growling or snarling. And while his body seemed a little stiff, he didn't flop violently like he had before. This was more like the first seizures he had, way back almost a year and a half ago. I was expecting all the horrors of the most recent episodes, and really didn't see anything similar. When the convulsing stopped, he lay absolutely still for so long that it crossed my mind that maybe he'd died. And then he started to jerk - he did it four times, big jerks - and I was terrified that he was going to have another seizure. And I can't remember where I put the liquid valium.... Or the catheter stuff from the emergency hospital. But that stopped, too, and he lay still for probably an entire minute. It's funny how long time is when something like this is involved; seconds seem like endless hours. Anyway, eventually he jumped down and headed wobbily - is that a word? - to the kitchen. I'd left four bowls with 1/2 can of Fancy Feast in each one, because the cats only had raw for their "dinner" tonight and I was afraid they'd be hungry during the night. He was pushing one of those bowls around by the time I got there. I asked him if he wanted fresh Fancy Feast and he peowed and came running over. He ate almost the entire can and was still looking for more, so I got out the raw. But it was cold, and I didn't want to take the time to warm it with hot water, so I mixed it with the leftover FF, added hot water, and put it down. He didn't want it. Anyway, he paced a while, and kept climbing unsteadily up onto my desk. He was standing with one foot on the keyboard when he sort of collapsed. There's not a lot of room for standing where he was on the keyboard shelf. I put him down, but he climbed up three or four more times. Eventually, he settled into the kitty Pi on the bench beside the desk, and now he's asleep there.

I am aware that I'm rambling. I can't even describe how upset I am about this. Not that I had any expectation that he'd be seizure-free forever or anything. But it was so nice not to feel like this was going to be hanging over us again. It's hard to describe, but having "another seizure" embedded in my brain affects the quantity and quality of my sleep. For days now, I've been waking up every time he moves during the night. It's like - even though there's nothing to be done about it - my mind thinks that if I'm alert enough, somehow that will keep the seizure from happening. I can't explain it. Every seizure he has is like a personal horrible attack on him that I can't help but feel that I should be able to save him from. And obviously, I can't . And geez, today he got all of his pills exactly to the minute on time, for a change. No chasing him around and pretending that I wasn't trying to grab him. No delays of any kind.

Okay, the one thing that the rational part of my head - that minute little corner that actually functions these days - is saying is the question of his phenobarb level, which I didn't take him to have checked. I've known ever since he started to eat on his own a few weeks ago that it was probably time to worry. I will have to take him tomorrow for bloodwork, just for my own satisfaction, to see what his phenobarb level is. Maybe it's gotten low, and if it doesn't allow a whole mess of seizures to happen, it could stay low? I doubt it, and he's even lost a few ounces - I just started giving him two bottles of EVO canned again today. What I want is - impossible, I know, but I can't help it - to be reassured that this isn't the beginning of one of those horrible periods when he has one seizure after another at ever decreasing intervals. Lots of the other epikitties seem to have a seizure here or there; he never did that. For Milk, once they started, they just kept getting worse and closer and scarier.

I don't want either of us to have to go through that again. And I can't prevent it if it does happen.


ETA: Lots of odd behavior after this seizure. Even a day later, he was still showing an excessive startle response to common things - the kitchen curtains blowing in the breeze, the noise of cars driving past out front - and hiding; he didn't even come out for Rege's treat routine, which is one of the highlights of his little life.

It occurred to me in the middle of the night....

that Milk has started eating on his own again. Which would be wonderful - he has actually maintained his weight by himself for a couple of days - except that the last time he ate voluntarily, his phenobarb level had dropped to the point where he was also having seizures. Lots of them. I hate to do it to him, but I'm thinking that maybe he needs to have his blood levels checked again. I don't know how it works that other people's cats only get their levels checked every six months or even longer.....

This has been a bad week with the litter box problems . There doesn't seem to be any reason for him to be sick. I added - after taking samples from Toot and Minnie (who had worm treatments) - Albon (3ml SID), and a couple of small feeding syringes of probiotic yogurt, according to the vet's instructions. Which Milky reacted to as though I was feeding him poison. There are speckles/lumps of yellow and white sticky stuff all over the kitchen, and all over everything I've worn for the last 5 days. To say nothing of the adventure of capturing and squirting this stuff down Scruffy and Milk both. Little Toot doesn't object at all, for some reason, and she doesn't even have to be argued with about eating any of it. Just squirt and off she goes again!

Hopefully, if it didn't happen then.....

it won't happen again. (Another seizure.) Last Thursday was the worst day we've had in months for Milk's refusal to let me get hold of him to pill him. It started with the 6:00 PM Keppra, which he didn't get until 8:00 PM. The 10:00 PM phenobarb and Marin, and the 2:00 AM Keppra - well, it took me until 3:15 AM to get them into him. I made a dozen trips up and down the steps. I got out every toy in the house, including the laser mouse, which he loves. I tried to trick him into heading down the hallway where all the doors were shut. I tried food. Bonita flakes. Temptations. Bread crust. (I know - he eats next to nothing, but he loves bread crust.) And nothing worked. At 3 AM, I couldn't keep my eyes open any more. I turned off the television and turned out the lights - which I'd tried earlier, unsuccessfully, thinking he'd be fooled into wanting to go to sleep, too. I must have dozed off, because the next thing I knew, there he was, rolled up in a ball with his head on my ankle. And I fooled him! I already had his water bottle and his loaded Pill Pockets sitting there, just waiting to be able to get hold of him. I'm hoping that the whole evening was just a momentary aberration and he'll knock it off forever.

79 days today. I always hate to even think it. Considering all the stuff I'm doing "wrong" with his medication - dissimilar doses, varying times, generic keppra - I'm feeling pretty lucky so far. Oh, I think I should erase that right now.

The eating has been much better since he's been getting raw - and his teeth, because he likes the chunks of chicken, are much cleaner and less yellow. Unfortunately, a couple days ago, he started having diarrhea. (I hate when people discuss their poop issues, but I now have THREE out of SIX cats with a problem, and no solution.) He didn't seem to have any adjustment problems to the raw from the beginning - he liked the Nature's Variety frozen raw, and he loves Dian's raw. SO, I have no idea what to attribute the problem to. I stopped giving everyone the raw chicken three days ago (much to Busy's delight - he hates everything that's not crunchy) , but the problem has continued to exist. I just collected "samples" from Minnie and Toot to take to the vet today (on the premise that maybe they're having a problem because of the worm treatmen), but 1) Milk hasn't been around them, and 2) he doesn't use their litter box. Scruffy and he do, however, use the same boxes. Maybe I caused the problem to become worse by taking away the raw - that would be ironic. I remember reading that yogurt (with probiotics) is good for the problem; but I'm pretty sure it said "full-fat yogurt", and all I could find was "low-fat yogurt". I wonder if whatever makes it low-fat is a problem for cats? At any rate, I've been giving everyone (except Minnie, for obvious reasons) two syringes of the yogurt every couple hours since last night. How I hope it works.