Monday, November 24, 2008

A Busy Deterrent (hopefully!)

I noticed a post on the FDMB by a wonderful person named Sandy, who had a picture in her signature of her cat, Black Kitty, after some surgery. And he was wearing what looked like it might be the answer to the Busy-gnawing-Milk's-shoulders problem! So, I wrote to her and asked her where she'd gotten the wonderful protective garment, and she said she'd made it herself. And she was willing to make one for my little Milk!

This weekend, the prototype arrived. And it's perfect! It was stretchy enough to put on him easily, it's tight enough to stay in place and protect those bare little shoulder blades that Busy seems to think are so tasty, and it actually looks like a "muscle shirt". Well, not that Milk has much in the way of muscles, but the idea is still there. He's still staggering around the house like it weighs 20 pounds - cats are such hypochondriacs. But I think that this may be the solution to the problem, and maybe it'll keep Milk warmer, too, this winter. He's spending most of his time napping in a kitty pi on a heated mat.

I'm thrilled! and grateful! and about to decide what color kitty pi to send the gorgeous Black Kitty in thanks!

Friday, November 7, 2008

More information on the study

(Anyone reading this who might be interested can contact Dr. Brewer - information is in previous post, I believe.)


Hello again, I'm very excited about all the responses I've been
getting about the use of zonisamide for cats. I wanted to reply to
give some more details on the study. here are some things for you guys
to think about in the meantime while we are still waiting on approval
of the this project.

requirements:
1. diagnosed with idiopathic epilepsy (meaning that seizures can't be
due to other diseases such as viral, tumors, infections, etc); because
of this, ideally cats will have a normal MRI and spinal tap performed.
pending our trial approval, we may be able to offer financial
assistance for this aspect of it.

2. owners must have a WRITTEN seizure log for the past 2 months prior
to starting the zonisamide showing at least 2 seizures per month and
maintain a log during the study

3. ideally each cat will be evaluated by the neurology service at
Cornell. As this may be difficult for some to do, as long as your cat
is evaluated by a board certified neurologist, we may be able to
coordinate through them and have your records faxed.

4. routine blood work (CBC, Chem, U/A, and zonisamide level) will need
to be obtained at 0, 30, 60, and 90 days.

5. no changes to other seizure meds (ie phenobarbital) dosages can
occur in the 2 months prior to starting the trial and during the trial.

I know that all of these requirements may causes some problems for
some of you, but please understand that when performing clinical
trials, it's crucial to have some degree of consistency in order to
prove a drug is effective or not.

as discussed, we are hoping to get the approval and hoping funding
within the next 2 months. Hopefully, most of you will be able to make
it up to Cornell to be evaluated. if you can't and still would like to
be a part of the study, please see if there is a board certified
neurologist in your area that we may be able to work through.

look forward to working with you all!

David

While I'm interested to see if zonisamide might be a more reasonably priced, easier to use seizure medication, I don't want to put Milk through an MRI and spinal tap - at our own expense! - or a trip to Cornell - my son went to lacrosse camp there, and it was a nine hour trip. With the pitiful mileage my car gets, it would cost hundreds of dollars just for gas. To say nothing of the wear and tear on the world's most frightened little white cat.

Nothing's ever simple.

Thursday, November 6, 2008

Interesting study and vicious attack

First, the study:

This showed up this morning on the epikitty site:

Clinical trial evaluating new anti-epileptic drug in cat
Posted by: "dmbrewer1977" dmbrewer1977@yahoo.com dmbrewer1977
Thu Nov 6, 2008 5:53 am (PST)


Hello everyone, my name is David Brewer and I am currently a
veterinary neurology resident at Cornell University. We are getting
ready to launch a new clinical trial involving the use of zonisamide
to treat epilepsy in cats. Zonisamide is currently used in people
and dogs for the treatment of epilepsy. A kinetic and safety study
has been performed and this medication is well tolerated by cats,
however a clinical study evaluating its effectiveness has not yet
been performed. Benefits of zonisamide are that it can be giving
ONCE A DAY to cats, it's safe with minimal side effects, and is
inexpensive. If anybody is interested or would like more
information, please feel free to reply.

Here are some general requirements for the clinical trial:
-cat must already be on phenobarbital and have adequate blood levels
-must have a seizure log, and currently have a seizure frequency of
at least 2 seizures / month for the last 3 months.
-must be free of other illnesses
-clinical trial will last 3 months

As we all know, there are few medications out there than can be used
in cats for the treatment of seizures. This clinical trial will
hopefully show that zonisamide works. In my opinion, one of the
biggest benefits of zonisamide is that can be give once a day, which
can be a large relief to owners who have cats that are difficult to
pill ( I have 2 cats that are extremely difficult to pill). There
will be more information on this topic later, but mainly wanted to
see how much interest would be out there.

Thanks!
David Brewer DVM
Neurology / Neurosurgery Resident
Cornell University

Now, the idea that Milk's medication could be reduced to once a day - well, twice, including the phenobarb - is definitely attractive. Way more than attractive, actually, particularly since Milk's so generally uncooperative about letting me grab him four times a day for pilling. But, I guess he wouldn't necessarily be eligible for this study anyway, since he doesn't meet the number of seizures/month criteria. (Thank God.) The worst part of it would be whether it would be necessary to take him off either/both keppra and phenobarb in order to participate in the study. I don't think I could risk losing whatever precarious control we have now; his tendency to have the seizures get closer and closer together is too scary to take the chance, I'm afraid.

I did write for more information, and it will be interesting to see if it's possible to follow this study and see if it might be an option to replace Keppra.



As far as the Vicious Attack, I don't know WHAT I am going to do with Busy. He started gnawing on Milkshake back last spring. (I think it was before the girl kitties came inside, although I'm not positive.) I believe it's an offshoot of his eternal and unfulfilled desire to be the Alpha Cat around here. What he has done is to pick the most vulnerable, weakest of the other cats, and then torment him mercilessly. And poor Milk, who wants nothing more than to snuggle with everyone else every minute of the day, does not make any attempt to defend himself. He's scrawny, and all doped up, and his balance is not what it might be, and all Busy has to do is nudge Milk, and he's on the floor. The initial attacks were significantly less damaging. There would be a tiny - about the size of a dime - irritated, red area, usually on the upper shoulders/neck.

But since then, the damage that's being done is significantly worse. Milk now has three separate injuries that have sort of melded into one, two-inch long open wound.

Photobucket

And now, because the area is so much larger, he can reach it himself, and he's aggravating the injury by licking it. Whole chunks of skin and fur are being torn off. I tried putting neosporin on it - he wants to lick it off. I put a little tee shirt on him. He did the "Oh, I'm falling down, I can't walk with this awful heavy shirt on me" act, and then, even though it wasn't huge, and it was actually MEANT for small dogs/puppies, somehow he managed to get himself all tangled up in it, and the neckline in the back stretched way down to below the raw areas. I pinned the neck in a pleat to keep it in place and stop the sleeves from getting in the way when he walked. No go. I got out one of the walking jackets, which has a panel that goes from where it's attached at his neck to the larger band that goes around his stomach. The neck panel was in the perfect place, but it's a rather stiff nylon, and I didn't like the possibility of its rubbing against the sore spot. Plus, the more he wore it, the more the whole jacket shifted around, until there was nothing covering the injury at all. I am going to see if I can find a slightly smaller, differently shaped tee shirt that would be less likely to shift around and get wrapped around his legs.

I also tried to make Busy responsible for the problem. I put him in the bedroom when I had to go out. But, all the cats like to sleep on the bed in there, with the kitty pi's and the heated mat. And it's not fair for him to have the benefits, while everyone else is sitting sadly peering in through the screen door. I put Scruffy's cone on him. And in four minutes, he trotted into the living room, coneless. (I have no idea how he got it off. I've always said, if he had opposable thumbs, he'd rule the world. ) I watch him like a hawk. His favorite attack time is when I'm in the bathroom. I try to always take one of the two of them in with me, but that's not always possible, and it's horrible to sit and listen to Milk shriek and not be able to do anything.

There has to be a solution, but I have no idea what it is. I can't bear the thought of how much that skinless, furless area must hurt Milkshake.

(Hi, Marianne!)