Keppra level returned from Auburn today (even though I haven't paid for the testing yet) - 38.2. Dr. G said (and I haven't seen the form they use to report, as to whether it has any more detailed information or what) that the approved level is 5-21. Which leaves us almost 2 times the maximum, although there's no way to know exactly what the basis for setting 21 as the max is. (And I think - it sticks in my mind - that those are the HUMAN numbers, which would make sense, since they had said that they don't have enough cats to begin to establish what dosages should be. So, I need to relax about that. I think I will call them on Monday - I know that Karen talked to a researcher there who said that they regard Keppra as being so safe and unlikely to cause side effects that they don't worry much about dosage. I am envisioning a horrified reaction anyway. And my ending up in tears, because we have virtually no options, since he was toxic on phenobarb before. And since, on this dosage of Keppra, he still had 6 seizures between 4/30 and 5/16.
Just as sickening, I increased the phenobarb just 3 or 4 mg BID (a tiny 1/4 pill) two days ago or so, and this morning, Milk's not even willing to sniff his food bowl. It was so wonderful to have him eating again on his own, and coming into the kitchen when everyone else did, and starting to look less emaciated. And not having to bottle feed him.
This is sickening. Stomach-turning, repulsively sickening. And unfair.
Saturday, May 17, 2008
Friday, May 16, 2008
Crummy crummy crummy night.
totally aside from/in addition to the seizure. Milk didn't sleep very well. He was up half a dozen times grooming and licking and making noises that I woke up thinking were pre-seizure. And then he got up at 5:30 and started pacing around. And gnawing on stuff. Back when he first started having seizures, I was convinced that he must have chewed on something with lead in it - he used to gnaw things then, too, but it had slowed down over the last few months. Now it's back again, I guess. He went from the window-opening-crank knobs to my yarn-winder handle to the plug for the lamp. He chewed on the edge of the table beside my chair, and on the drawer shelf of my desk. At the point at which he started endlessly licking the yarn in my afghan, I couldn't stand it any more, and put him on the floor. Maybe he's got pica. Too bad he'll eat all sorts of inanimate objects, but give him a bowl of FF, and he tries to bury it. I have given him two additional 1/4 phenobarb pills so far. Now to watch and see if he starts falling off the furniture again. And I have to call and beg for liquid valium for him today, too.
Then Burble had what must have been a massive hairball about an hour after the seizure, and I CAN'T FIND IT. He woke me up getting rid of it, and I know it's here somewhere...... A couple of weeks ago, he had a moderate sized hairball that he kindly left on the back of the couch. And I heard him throw up, and I actually saw it, but I got distracted and forgot about it. Until Andy and Michelle came to visit, Andy sat down on the sofa, and when he went to lay his arm along the back of it, Michelle jumped up and shrieked, "Oh, don't do that!" She thought it was poop, which is actually not a whole lot more repulsive than a dried up hairball. The whole episode speaks volumes about my housekeeping skills, or lack of them.
Busy spent more than a half hour during the night banging the doors of the cabinet under the kitchen sink. That's where the bin of dry food for the ferals is, and I've got a pair of twisted gumbands on the knobs so he can't open the doors all the way. But unfortunately, he can get his foot in between the doors and get them open just enough to SLAM after they get to a certain point. He knows he can't get in there, but he just keeps trying. Thank goodness he doesn't have opposable thumbs. He'd rule the world.
And my sweet Scruffy - well, suffice it to say, he was 146 this morning. I know he's going to drop, but how much I hate those numbers when he was so beautifully under 100 virtually all the time with Levemir. And no one who's still giving shots twice a day is interested in commiserating with someone whining about their cat's being OTJ. I wrote to Cindy and Tritone and said, I never expected him to be off insulin, and now that it's happened, I thought it would be a whole lot more FUN.
And the damned turkeys - they start gobbling at the bird feeder at 5:30. Not that there's any reason for them to expect that there will be seed for them at that hour. Not that there's ever BEEN seed for them at that hour. Hope springs eternal, I suppose, even if you're a big dumb clucking turkey. Which they are. And male-stupid beside - there's one that keeps "displaying" - that thing they do with all the feathers on their backs that makes you think about Thanksgiving and Pilgrims - every time a car comes down the road. He apparently thinks that he's so attractive that even vehicles will succumb to his featheriness. Geez.
I'd like to go off by myself for about a week and do only things that I want to do, when I want to do them. The ultrasound lab report said yesterday that I have - according to the receptionist at my doctor's office (who won't be my doctor much longer, since the company is changing from Blue Cross to UPMC - another whole set of crises) - "just a little bit of fat in your liver." I said, "Fatty liver disease?" No, just a "little bit of fat." It isn't able to show fibrosis anyway. Probably just a wasted 12 hour fast and insurance money. I still have to have the blood work.
I am whiny.
Then Burble had what must have been a massive hairball about an hour after the seizure, and I CAN'T FIND IT. He woke me up getting rid of it, and I know it's here somewhere...... A couple of weeks ago, he had a moderate sized hairball that he kindly left on the back of the couch. And I heard him throw up, and I actually saw it, but I got distracted and forgot about it. Until Andy and Michelle came to visit, Andy sat down on the sofa, and when he went to lay his arm along the back of it, Michelle jumped up and shrieked, "Oh, don't do that!" She thought it was poop, which is actually not a whole lot more repulsive than a dried up hairball. The whole episode speaks volumes about my housekeeping skills, or lack of them.
Busy spent more than a half hour during the night banging the doors of the cabinet under the kitchen sink. That's where the bin of dry food for the ferals is, and I've got a pair of twisted gumbands on the knobs so he can't open the doors all the way. But unfortunately, he can get his foot in between the doors and get them open just enough to SLAM after they get to a certain point. He knows he can't get in there, but he just keeps trying. Thank goodness he doesn't have opposable thumbs. He'd rule the world.
And my sweet Scruffy - well, suffice it to say, he was 146 this morning. I know he's going to drop, but how much I hate those numbers when he was so beautifully under 100 virtually all the time with Levemir. And no one who's still giving shots twice a day is interested in commiserating with someone whining about their cat's being OTJ. I wrote to Cindy and Tritone and said, I never expected him to be off insulin, and now that it's happened, I thought it would be a whole lot more FUN.
And the damned turkeys - they start gobbling at the bird feeder at 5:30. Not that there's any reason for them to expect that there will be seed for them at that hour. Not that there's ever BEEN seed for them at that hour. Hope springs eternal, I suppose, even if you're a big dumb clucking turkey. Which they are. And male-stupid beside - there's one that keeps "displaying" - that thing they do with all the feathers on their backs that makes you think about Thanksgiving and Pilgrims - every time a car comes down the road. He apparently thinks that he's so attractive that even vehicles will succumb to his featheriness. Geez.
I'd like to go off by myself for about a week and do only things that I want to do, when I want to do them. The ultrasound lab report said yesterday that I have - according to the receptionist at my doctor's office (who won't be my doctor much longer, since the company is changing from Blue Cross to UPMC - another whole set of crises) - "just a little bit of fat in your liver." I said, "Fatty liver disease?" No, just a "little bit of fat." It isn't able to show fibrosis anyway. Probably just a wasted 12 hour fast and insurance money. I still have to have the blood work.
I am whiny.
So much for that.
Seizure # 45. Quite a surprise, as I had dozed off and Milk was curled up in my right arm. I don't know what woke me. When I looked over, he had a little foam dripping off his mouth, but he hadn't started to seize, so I quickly picked him off my arm and put him on my lap, with my hand firmly on his abdomen, hopefully out of reach of his claws. Which I trimmed last night, but which were still like razors. Very little movement of anything but his head - a lot of volume with the growling and snarling, and two very harsh, different pitches during the course of the seizure. When it was done - seemed longer than usual, although I'm not sure and I didn't think to look at the clock - he just lay against my stomach. I started to wipe him off, and it brought on a lot of tiny little jerks from his front legs and from his head, so I stopped. After about 4 or 5 minutes, he jumped down, very uncoordinated, and went to eat. He never eats quite right anyway, even when he hasn't just had a seizure - something about the way he licks up food isn't right - and this looked very awkward. He moved all around the bowl before he was done. And then he wanted more, so he checked out all of the other dishes while I fixed him a fresh can of FF. His coordination is still very poor, almost a half hour after the seizure. He keeps wandering around across my desk and keyboard. Which, come to think of it, he was doing earlier tonight. I had to go out around 7:30, and he was sleeping on the bench beside my desk. When I came back, around 10:00, he was still sleeping there. He got up to see what was for supper, but didn't eat anything. And he was doing the same kind of annoying wandering around on the desk then, too. Very persistent, up and down, onto the floor, onto the bench, onto the desk, knock over my (empty) mug, and around all over again. I wonder if that was significant behavior. There has never been anything in the past year+ that I could say seemed to be a signal that a seizure was about to occur.
I was feeling very glad this morning that I hadn't increased the phenobarbital. It seemed, silly me, like the Keppra increase was going to be sufficient. After all, three days without a seizure? Surely an indication of a cure..... Damn it. I think that I am going to increase the PB, by a small amount - maybe a quarter of a pill for this last dosage of the day at 2 AM and see if that helps. I hate to have to keep dragging him out for blood work, but I don't want to ever get the point where his liver is at risk again. And maybe the report from Auburn will suggest that it would be okay to increase his Keppra. (Although that didn't seem very successful last week when I tried it for one day. And although I don't know if that's even something that Auburn does. If they don't already have standards set, I suppose they'll just give an amount and add him to their database.)
My poor little white boy. When he's had a seizure, the pink areas around his eyes and ears get very discolored and bizarre looking. And his whole face gets sort of pinched-appearing. Plus, Dr. G. had to shave his neck to get the blood from his jugular this time because he couldn't get enough out of his thighs. Both of them. So his wispy little neck has this big gap in it where there's no fur at all. I'm not sure why this one has been so disturbing, but I don't usually cry after he has a seizure, and I'm sitting here now with tears rolling down my cheeks. I just want this to stop. I want him to have a normal life and I want to not have to worry about doing more damage with the stupid medications. It's so unfair to him.
I was feeling very glad this morning that I hadn't increased the phenobarbital. It seemed, silly me, like the Keppra increase was going to be sufficient. After all, three days without a seizure? Surely an indication of a cure..... Damn it. I think that I am going to increase the PB, by a small amount - maybe a quarter of a pill for this last dosage of the day at 2 AM and see if that helps. I hate to have to keep dragging him out for blood work, but I don't want to ever get the point where his liver is at risk again. And maybe the report from Auburn will suggest that it would be okay to increase his Keppra. (Although that didn't seem very successful last week when I tried it for one day. And although I don't know if that's even something that Auburn does. If they don't already have standards set, I suppose they'll just give an amount and add him to their database.)
My poor little white boy. When he's had a seizure, the pink areas around his eyes and ears get very discolored and bizarre looking. And his whole face gets sort of pinched-appearing. Plus, Dr. G. had to shave his neck to get the blood from his jugular this time because he couldn't get enough out of his thighs. Both of them. So his wispy little neck has this big gap in it where there's no fur at all. I'm not sure why this one has been so disturbing, but I don't usually cry after he has a seizure, and I'm sitting here now with tears rolling down my cheeks. I just want this to stop. I want him to have a normal life and I want to not have to worry about doing more damage with the stupid medications. It's so unfair to him.
Thursday, May 15, 2008
Three days!
Since the last seizure! I'm surprised and pleased. Interestingly (to me, at least) is the fact that he's doing the same thing he did one other time - I tried to go back and find it in the blog, but it was taking too much fiddling around..... Anyway, on each of these last three mornings with no seizures, he's awakened abruptly at 6AM and started roaming aimlessly around. Like it would have been a seizure, but didn't quite get all the way there. He waits till Rege gets his shower and passes out the treats, and then comes back and snuggles until the alarm goes off at 10:00. Today, he didn't even react to the alarm - I really think, if I hadn't had to grab him so I could be sure to get his pills in him on time, he would have slept for quite a while longer. We're all exhausted.
I did pick up a new prescription for the phenobarbital, but haven't increased the dosage. And if it's possible to avoid, I'd really rather not. It seems that the slightly increased Keppra has taken effect even with the previously ineffective phenobarb amount, which is wonderful, I think. (Unless they come up with recommended dosage levels for Keppra that he's way out of range on. A possibility, sadly.) Today, the tests at Auburn should be done. (And they have to send a bill, too, because I can't find my checkbook and they didn't want to use a charge.) I'm a little nervous, but at this point, no matter what their results are, if he continues to be controlled, I am not going to mess it up.
It would be nice to get another three seizure-free months out of this rearrangement...
I did pick up a new prescription for the phenobarbital, but haven't increased the dosage. And if it's possible to avoid, I'd really rather not. It seems that the slightly increased Keppra has taken effect even with the previously ineffective phenobarb amount, which is wonderful, I think. (Unless they come up with recommended dosage levels for Keppra that he's way out of range on. A possibility, sadly.) Today, the tests at Auburn should be done. (And they have to send a bill, too, because I can't find my checkbook and they didn't want to use a charge.) I'm a little nervous, but at this point, no matter what their results are, if he continues to be controlled, I am not going to mess it up.
It would be nice to get another three seizure-free months out of this rearrangement...
Tuesday, May 13, 2008
Seizure Avoidance/Subversion?
First - no seizure this morning, thank God. Although, I still didn't get any sleep, since Milk abruptly jumped down at 6:00 AM - prime seizure time- and started eating out of a bowl of food nearby. So, I had to get up and get him fresh food, and then sit and watch him for an hour and a half to see if he was going to have a seizure or not. Which led me to wonder, can a seizure be knocked off track by some distraction, for example, and then not occur? Since I wake up so immediately when he starts getting ready to have a seizure, I wonder if maybe there is something that could make his brain say to itself, "Oh, that's way more interesting than what I was GOING to do; I'll save this seizure for later....." Like, what if a seizure is just getting ready to start, and he sniffs something he just loves, or something horrible, say, or if - like the last two, I had to pick him up and move him to a safer place to have the seizure? Probably not likely. I'd gladly do all sorts of dances if it'd stop the process.
Yesterday afternoon, after much trauma and agony - Rege screwed up the printer AGAIN, and he never mentions that he's done it; in fact, he always denies that it was him, the jerk - I had made an appointment to take Milk to the vet to get bloodwork done 1) to send to Antech for phenobarb levels, to test my theory about why he's suddenly eating again and having seizures all over the place. (The phenobarb level has fallen to a place where it's not ruining his appetite, but it's also not controlling the seizures.) and 2) to Auburn for testing of the Keppra levels. Which takes at least 10 days, I guess. I couldn't print out the Auburn forms that I had to have because the PRINTER WASN'T WORKING, so I ended up emailing the pages to my friend Sandy, and then she printed them, I went to her house and picked them up, came home and packed up Milk in the carrier and we dashed off to the vet's. With the gas tank on EMPTY and the little gas tank picture all lit up. Story of my life. I'm still waiting to hear from Dr. G. about the phenobarb levels - usually, the results would be back by now. I don't know what I'll do if it turns out that the levels aren't low. I did try a day of increased (by another 1/8 pill) Keppra, but it really made Milk wobbly and uncoordinated. I hadn't ever seen side effects like that till the last increase at the beginning of May when this round of seizures began.
Okay - just got the phenobarb results :
24.? something-or-another-that-I-can't-remember-even-though-I-asked-Dr.-G.
-what-it-was-twice. SO, I do think my theory is right about the level having fallen to too low a point to effectively contribute to controlling his seizures. Now, the question is, how much do we increase the phenobarb by, if anything, before it screws up his eating again? Dr. G. thought that it might be worth trying to see if there's some sort of "pattern" to his seizures - like, it was three months with no seizures, and then a bunch of them, and wait to see if it was repeated. Well, #1, although I didn't say it to him - that's information that's visible with his seizure record (over on the left side here), and there's clearly NO pattern. And my tolerance for never getting more than three hours sleep is pretty much at its end. Plus - it's bad enough that most of his seizures have occurred when he was sleeping on me - what if it starts happening when I'm out? There was a guy on the epikitty board last week who said that his cat wedged itself between the wall and the couch and then had a seizure, and when he got home from work, the cat was covered with blood from bashing his head against the wall. I can't bear the thought of him having seizures (and frantically looking for food!) alone. I need him to be controlled as fully as possible. Period. If I have to go back to bottlefeeding him, so be it.
I still have to call and see if the IM vet will give me another vial of liquid valium. I hate the thought of even asking them. Plus, they are moving to their new office building in June, so the place is probably mass confusion. Nothing's ever simple.
Yesterday afternoon, after much trauma and agony - Rege screwed up the printer AGAIN, and he never mentions that he's done it; in fact, he always denies that it was him, the jerk - I had made an appointment to take Milk to the vet to get bloodwork done 1) to send to Antech for phenobarb levels, to test my theory about why he's suddenly eating again and having seizures all over the place. (The phenobarb level has fallen to a place where it's not ruining his appetite, but it's also not controlling the seizures.) and 2) to Auburn for testing of the Keppra levels. Which takes at least 10 days, I guess. I couldn't print out the Auburn forms that I had to have because the PRINTER WASN'T WORKING, so I ended up emailing the pages to my friend Sandy, and then she printed them, I went to her house and picked them up, came home and packed up Milk in the carrier and we dashed off to the vet's. With the gas tank on EMPTY and the little gas tank picture all lit up. Story of my life. I'm still waiting to hear from Dr. G. about the phenobarb levels - usually, the results would be back by now. I don't know what I'll do if it turns out that the levels aren't low. I did try a day of increased (by another 1/8 pill) Keppra, but it really made Milk wobbly and uncoordinated. I hadn't ever seen side effects like that till the last increase at the beginning of May when this round of seizures began.
Okay - just got the phenobarb results :
24.? something-or-another-that-I-can't-remember-even-though-I-asked-Dr.-G.
-what-it-was-twice. SO, I do think my theory is right about the level having fallen to too low a point to effectively contribute to controlling his seizures. Now, the question is, how much do we increase the phenobarb by, if anything, before it screws up his eating again? Dr. G. thought that it might be worth trying to see if there's some sort of "pattern" to his seizures - like, it was three months with no seizures, and then a bunch of them, and wait to see if it was repeated. Well, #1, although I didn't say it to him - that's information that's visible with his seizure record (over on the left side here), and there's clearly NO pattern. And my tolerance for never getting more than three hours sleep is pretty much at its end. Plus - it's bad enough that most of his seizures have occurred when he was sleeping on me - what if it starts happening when I'm out? There was a guy on the epikitty board last week who said that his cat wedged itself between the wall and the couch and then had a seizure, and when he got home from work, the cat was covered with blood from bashing his head against the wall. I can't bear the thought of him having seizures (and frantically looking for food!) alone. I need him to be controlled as fully as possible. Period. If I have to go back to bottlefeeding him, so be it.
I still have to call and see if the IM vet will give me another vial of liquid valium. I hate the thought of even asking them. Plus, they are moving to their new office building in June, so the place is probably mass confusion. Nothing's ever simple.
Monday, May 12, 2008
Longer, louder, more violent.
This is really getting me down - I fell asleep around 3:15, and here I sit at 5:05, having just weathered another seizure. Alarmingly shorter interval since the previous one, too. I had tried giving him the phenobarb separately at 12 hours for several days, and it didn't matter; he still had seizures. So last night and tonight, I just gave it at 2AM with the Keppra. No seizure yesterday morning, and one this morning. I am increasingly more convinced that there is a connection between his ability to eat again on his own and phenobarb dosage. I wanted to wait to send away his blood to Auburn and get both Keppra and phenobarb levels done, but maybe that 's not practical to do. I hope to go back to sleep in a few minutes, and when we get up again for the day, I'll print out the forms and call Dr. G.
Description of the seizure, before I forget: only two quick odd lip-licking sounds before it actually started, and again, he was snuggled into my armpit, so I had to get him moved. Which I just barely managed to do before he started practically roaring - very loud snarling. And unlike the last one, this was very physical - a lot of flopping around. For much of the seizure , which lasted probably 40 seconds, his tail was sticking straight up in the air, which struck me as somehow oddly humorous. I don't know how anything can seem funny when your poor little cat's flopping and banging and snarling uncontrollably, but there you have it. And then, which I have never seen before, he started to crane his neck backwards in a pretty alarming position. I kept my hand on his back - only the second time I've ever touched him during a seizure, so I didn't have to worry so much about him flopping onto the floor. When it ended, I had a kleenex that I started to wipe him off with, but it seemed to alarm him - two big post-seizure jerks when I touched him with it, so I just let him be. He laid quite peacefully for a good two minutes, and then jumped down and went to the kitchen to look for food. He ate about 3/4 of a can of FF, and a few pieces of dry. I wiped him up with paper towels. And now he's been circling around from the kitchen to the dining room, in the other kitchen door, up on my desk, and back down again. He's still quite wobbly, and it's been almost a half hour.
Tomorrow, also, I am going to do a dedicated search for the liquid valium/catheter stuff that Dr. L. gave me. I don't like the frequency increase that's going on here. I'm pretty sure the valium's expired, so I'll probably have to call and see if she'll give me another vial of it. If not, I don't know what I'll do, since Dr. G. doesn't have any. Wonder if you can get it from the drugstore?
I am exhausted.
Description of the seizure, before I forget: only two quick odd lip-licking sounds before it actually started, and again, he was snuggled into my armpit, so I had to get him moved. Which I just barely managed to do before he started practically roaring - very loud snarling. And unlike the last one, this was very physical - a lot of flopping around. For much of the seizure , which lasted probably 40 seconds, his tail was sticking straight up in the air, which struck me as somehow oddly humorous. I don't know how anything can seem funny when your poor little cat's flopping and banging and snarling uncontrollably, but there you have it. And then, which I have never seen before, he started to crane his neck backwards in a pretty alarming position. I kept my hand on his back - only the second time I've ever touched him during a seizure, so I didn't have to worry so much about him flopping onto the floor. When it ended, I had a kleenex that I started to wipe him off with, but it seemed to alarm him - two big post-seizure jerks when I touched him with it, so I just let him be. He laid quite peacefully for a good two minutes, and then jumped down and went to the kitchen to look for food. He ate about 3/4 of a can of FF, and a few pieces of dry. I wiped him up with paper towels. And now he's been circling around from the kitchen to the dining room, in the other kitchen door, up on my desk, and back down again. He's still quite wobbly, and it's been almost a half hour.
Tomorrow, also, I am going to do a dedicated search for the liquid valium/catheter stuff that Dr. L. gave me. I don't like the frequency increase that's going on here. I'm pretty sure the valium's expired, so I'll probably have to call and see if she'll give me another vial of it. If not, I don't know what I'll do, since Dr. G. doesn't have any. Wonder if you can get it from the drugstore?
I am exhausted.
Saturday, May 10, 2008
Or this one.
I think I'm being punished for being smug about how well Milk's seizures were being controlled for almost three months. With a vengeance.
This morning's was odd - very short, almost no flopping, but a ton of very harsh growling and snarling. It started without any warning - usually I wake up because he's starting to chatter his jaws, but not today. And even worse, he was sleeping snuggled up in my armpit, where I would have no ability to keep him from flopping onto the floor, or banging into the table, or who knows what. Plus, I didn't want him that close to my face and eyes while he was having a seizure. So, while he was snarling away, I couldn't think of anything to do but to pick him up and plop him down on my lap, where I could keep him in one place. Just a smidge scary. But he really didn't move at all. He continued to growl for just a few seconds. No clawing, no flopping, no bouncing around - just stiffness and noise, for probably not much more than 20 seconds. And then he laid with his eyes huge and round and black (pupils all dilated, I assume) for another minute or so. He jerked three or four times, and then just laid there. Eventually, he jumped down, without seeming uncoordinated, and I thought I saw him disappear down the steps. He always is ravenous after a seizure, so I figured I had a couple of minutes to fix him something to eat. (He used to pace after every seizure, around and around the living room and dining room and kitchen. Hasn't done that for many months, though.) Anyway, he wasn't downstairs, as it turned out, he was going from nearly empty bowl to nearly empty bowl licking up the food that I'd left out for overnight for Scruffy. I put down a fresh can of FF for him, and he ate about half of it. Then he started looking to see what else there was to eat. I try never to miss an opportunity to get food into him, so I gave him a tiny handful of EVO/Wellness dry, which he ate a little of, but by then, the other three had discovered that he was eating crunchies, and started jostling for position to wedge themselves into his bowl. He ate another 1/2 can or so of a different FF, wandered around across the computer desk several times, and then sat down behind me here, seeming perfectly relaxed and just fine.
I'm starting to get nervous about the frequency of this new round of seizures. I was hoping that increasing 1/8th Keppra TID would get things back on track, but apparently not. I can't remember where I put the liquid valium that the IM vet gave me - haven't seen her since she referred us to the neurologist in Ohio, and although I left her his most current seizure record the last time I had Scruffy at the Specialty Hospital, I never heard anything from her. I'm guessing, given that she only saw Milk that one time (although it cost me almost $400 for ONE APPOINTMENT that was pretty much useless), that she doesn't necessarily regard him as her patient. Would she give me a fresh tube of valium if I called? Don't know. There was a six month expiration on the stuff - which is long past. I don't want to panic, but we're sort of beyond a place where I have the least idea what to do, besides increase his Keppra again.
I do have a theory - related to the fact that he has just barely started eating voluntarily again in the last two weeks or so. I wonder if the phenobarb dosage - 1/2 pill (8mg) BID has become somehow ineffective - thus allowing the seizures to start again, and lessening the suppression of his appetite? He just had bloodwork fairly recently, but I suppose it would be worth it to not only check his phenobarb levels, but to send blood to Auburn and let them do the Keppra levels, too. I know that they'll do both, which will save the extra costs of Antech doing the phenobarb levels. Maybe that would be a good place to start. I'll have to call Dr. G. next week and ask them to get the blood pick-up/transportation arranged, and make copies of the information Karen posted from Auburn on the epi-kitty site. Which possibly leads to consideration of what to do if they say that he's on too high a dosage (even though it's not working any more?) I did notice - for the first time - with this last tiny increase in Keppra (generic) that he seemed to have more visible symptoms of the greater dosage. I had never really noticed any wobbliness or incoordination since he's been taking Keppra, although others had mentioned that their cats showed it. But this time, although certainly not even close to what phenobarb did to him, there was a noticeable difference. He was just starting to seem to be getting over it.
I wish this was something you could snap your fingers and Zap! it'd be gone..... I am frankly terrified about the possibility of cluster seizures and the frequency increasing.
This morning's was odd - very short, almost no flopping, but a ton of very harsh growling and snarling. It started without any warning - usually I wake up because he's starting to chatter his jaws, but not today. And even worse, he was sleeping snuggled up in my armpit, where I would have no ability to keep him from flopping onto the floor, or banging into the table, or who knows what. Plus, I didn't want him that close to my face and eyes while he was having a seizure. So, while he was snarling away, I couldn't think of anything to do but to pick him up and plop him down on my lap, where I could keep him in one place. Just a smidge scary. But he really didn't move at all. He continued to growl for just a few seconds. No clawing, no flopping, no bouncing around - just stiffness and noise, for probably not much more than 20 seconds. And then he laid with his eyes huge and round and black (pupils all dilated, I assume) for another minute or so. He jerked three or four times, and then just laid there. Eventually, he jumped down, without seeming uncoordinated, and I thought I saw him disappear down the steps. He always is ravenous after a seizure, so I figured I had a couple of minutes to fix him something to eat. (He used to pace after every seizure, around and around the living room and dining room and kitchen. Hasn't done that for many months, though.) Anyway, he wasn't downstairs, as it turned out, he was going from nearly empty bowl to nearly empty bowl licking up the food that I'd left out for overnight for Scruffy. I put down a fresh can of FF for him, and he ate about half of it. Then he started looking to see what else there was to eat. I try never to miss an opportunity to get food into him, so I gave him a tiny handful of EVO/Wellness dry, which he ate a little of, but by then, the other three had discovered that he was eating crunchies, and started jostling for position to wedge themselves into his bowl. He ate another 1/2 can or so of a different FF, wandered around across the computer desk several times, and then sat down behind me here, seeming perfectly relaxed and just fine.
I'm starting to get nervous about the frequency of this new round of seizures. I was hoping that increasing 1/8th Keppra TID would get things back on track, but apparently not. I can't remember where I put the liquid valium that the IM vet gave me - haven't seen her since she referred us to the neurologist in Ohio, and although I left her his most current seizure record the last time I had Scruffy at the Specialty Hospital, I never heard anything from her. I'm guessing, given that she only saw Milk that one time (although it cost me almost $400 for ONE APPOINTMENT that was pretty much useless), that she doesn't necessarily regard him as her patient. Would she give me a fresh tube of valium if I called? Don't know. There was a six month expiration on the stuff - which is long past. I don't want to panic, but we're sort of beyond a place where I have the least idea what to do, besides increase his Keppra again.
I do have a theory - related to the fact that he has just barely started eating voluntarily again in the last two weeks or so. I wonder if the phenobarb dosage - 1/2 pill (8mg) BID has become somehow ineffective - thus allowing the seizures to start again, and lessening the suppression of his appetite? He just had bloodwork fairly recently, but I suppose it would be worth it to not only check his phenobarb levels, but to send blood to Auburn and let them do the Keppra levels, too. I know that they'll do both, which will save the extra costs of Antech doing the phenobarb levels. Maybe that would be a good place to start. I'll have to call Dr. G. next week and ask them to get the blood pick-up/transportation arranged, and make copies of the information Karen posted from Auburn on the epi-kitty site. Which possibly leads to consideration of what to do if they say that he's on too high a dosage (even though it's not working any more?) I did notice - for the first time - with this last tiny increase in Keppra (generic) that he seemed to have more visible symptoms of the greater dosage. I had never really noticed any wobbliness or incoordination since he's been taking Keppra, although others had mentioned that their cats showed it. But this time, although certainly not even close to what phenobarb did to him, there was a noticeable difference. He was just starting to seem to be getting over it.
I wish this was something you could snap your fingers and Zap! it'd be gone..... I am frankly terrified about the possibility of cluster seizures and the frequency increasing.
Tuesday, May 6, 2008
No doubt about this one.
8:05 AM. It started with a minimum of jaw-chattering, and I was expecting that there wouldn't be much foam, but his head and neck were soaked. This was very quick - maybe 40 seconds, but quite violent in the middle, when he was flopping around with his butt way up in the air. There was growling, but not as loud as before, I don't think. (I've managed to put all that out of my mind. ) He was laying on his side on the afghan, and his left rear claw got stuck in the yarn. (Which is relevant, I think, because just a few minutes ago, he got up from the window ledge and was limping terribly. Either he was limping because of the claw, or there's something wrong with his whole leg. It's alarming, whichever way. He walked like he'd had a stroke - his leg kept sort of folding in on him.) When the actual seizure ended, he laid there quite calmly. There was one large "jerk", but not the five or ten minutes of stuff that he used to do. He got down easily - without seeming uncoordinated - and went out and ate almost a whole can of FF. He was affectionate and wanted to rub and nuzzle afterwards.
I don't know what to think, or what to do now. When he had the first seizure the other day, I thought that maybe my adjusting the times of his phenobarb had finally caught up with him. (Instead of giving it separately at noon and midnight, a few weeks ago I started giving it with his Keppra at 10 AM and then with the Keppra again at 1:00 or 2:00 AM - just to cut down on the number of times I had to chase him around and shove things down his throat.) So, three days ago, I started giving him the 10:00 PM phenobarb again, by itself. I wouldn't think that that would make the difference, although, who knows? And now, do I try to increase his Keppra? He's getting approximately 3/4 of a 250mg pill (such a stupid oval shape for chopping in four.) I'm tempted to try to add 1/2 of that last quarter, but I'd never be giving the same dosage because of the shape - the top part is usually significantly smaller than the bottom. And the stuff is so expensive that I really don't want to waste any that I don't have to. Maybe I should try Karen's technique of using some sort of apothecary scale. I sort of hate to go right up to 250 mgs TID, for no particular reason other than that it seems like an awful lot. I wonder, too, if it has something to do with the phenobarbital. He's been showing a smidge of interest in eating lately - ever since I discovered that he likes the freeze dried Nature's Variety. He's not exactly "eating" when I put his food down, but he's taking longer to bury the bowl, and he does occasionally lick the stuff a little. Last night, I actually saw him eat five or six bites of FF. So maybe the phenobarb is having a reduced effect, both on his eating and on the seizure control? I hate to put him through more blood work - it's only been a couple of weeks since the last levels were done.
This is so upsetting. He was doing so well. It feels like we're right back to the beginning again. And I haven't learned a thing in the last year to make me think that I can deal with this any better now than I did then.
Enough whining. I guess I'll go and write to Karen and ask her about her scale and where she got it. I wonder if there's any function in trying to call the neurologist to see what he thinks.
Oh, and I've about decided that that wasn't a seizure the other day. Although maybe it was... Decisiveness, one of my best qualities. Anyway, there was meowing, and I've never heard him meow during a seizure, and the fur was sticky on his lower body, not near his head/mouth. Maybe Busy was just chewing on him again.
I don't know what to think, or what to do now. When he had the first seizure the other day, I thought that maybe my adjusting the times of his phenobarb had finally caught up with him. (Instead of giving it separately at noon and midnight, a few weeks ago I started giving it with his Keppra at 10 AM and then with the Keppra again at 1:00 or 2:00 AM - just to cut down on the number of times I had to chase him around and shove things down his throat.) So, three days ago, I started giving him the 10:00 PM phenobarb again, by itself. I wouldn't think that that would make the difference, although, who knows? And now, do I try to increase his Keppra? He's getting approximately 3/4 of a 250mg pill (such a stupid oval shape for chopping in four.) I'm tempted to try to add 1/2 of that last quarter, but I'd never be giving the same dosage because of the shape - the top part is usually significantly smaller than the bottom. And the stuff is so expensive that I really don't want to waste any that I don't have to. Maybe I should try Karen's technique of using some sort of apothecary scale. I sort of hate to go right up to 250 mgs TID, for no particular reason other than that it seems like an awful lot. I wonder, too, if it has something to do with the phenobarbital. He's been showing a smidge of interest in eating lately - ever since I discovered that he likes the freeze dried Nature's Variety. He's not exactly "eating" when I put his food down, but he's taking longer to bury the bowl, and he does occasionally lick the stuff a little. Last night, I actually saw him eat five or six bites of FF. So maybe the phenobarb is having a reduced effect, both on his eating and on the seizure control? I hate to put him through more blood work - it's only been a couple of weeks since the last levels were done.
This is so upsetting. He was doing so well. It feels like we're right back to the beginning again. And I haven't learned a thing in the last year to make me think that I can deal with this any better now than I did then.
Enough whining. I guess I'll go and write to Karen and ask her about her scale and where she got it. I wonder if there's any function in trying to call the neurologist to see what he thinks.
Oh, and I've about decided that that wasn't a seizure the other day. Although maybe it was... Decisiveness, one of my best qualities. Anyway, there was meowing, and I've never heard him meow during a seizure, and the fur was sticky on his lower body, not near his head/mouth. Maybe Busy was just chewing on him again.
Saturday, May 3, 2008
Did he have another seizure?
I was sitting at the computer in the kitchen when Milk came and jumped up to walk across the keyboard. I noticed an odd looking patch of fur on his side - it was sort of stiff and sticking out. Like he'd been grooming, only not soft. I picked him up, and his tail was damp, as was his stomach. Didn't notice anything around his neck or head, though, where he usually has foam after a seizure. I sniffed him - didn't smell like urine. Maybe he was in the bathtub? I didn't hear any growling or snarling, although, I did think a little while ago that I heard a cat meowing. A lot. (Thought maybe it was Cinnaminnie outside.) I opened a can of FF - the ultimate test of seizure-having - is he willing to eat? And he sniffed it and licked a little of the food. Bad sign? Maybe. I got dry kitten food out for the ferals, and he came over and ate quite a bit of it. Another bad sign? I have no idea.
I walked all over the house, and didn't see anything that looked like a wet spot. If he'd had a seizure upstairs, I'm sure I would have heard him growling. Rats, this makes me sick. I don't know what to think. And it's only been three days since the last one. Do I need to think about increasing the Keppra? Or should I go back to giving the phenobarb at 12 hour intervals, despite the fact that it's been working fine for weeks now stretching it out to longer periods?
The weeks of peace and reduced anxiety about seizures have apparently come to an end.
I walked all over the house, and didn't see anything that looked like a wet spot. If he'd had a seizure upstairs, I'm sure I would have heard him growling. Rats, this makes me sick. I don't know what to think. And it's only been three days since the last one. Do I need to think about increasing the Keppra? Or should I go back to giving the phenobarb at 12 hour intervals, despite the fact that it's been working fine for weeks now stretching it out to longer periods?
The weeks of peace and reduced anxiety about seizures have apparently come to an end.
Wednesday, April 30, 2008
I had such high hopes.
Milk hasn't had a seizure since February 6, 2008. That's, let's see, almost three months. Two months and three weeks. Oh, how I was hoping... I was able to think that the two seizures in January and the one in February were just medication/dosing failures, and I do think they were. But this one - he's had all of his pills, at the regular times. I just gave him his second Keppras for the day at 6:30.
Can't really describe this one, because he was in his cave when it started. He growled really loudly, and then the cave started to rock, and by then I was over there, but didn't want to move him or anything. He didn't growl the whole time, and it seemed like a fairly short seizure. His head and neck were wet, as was the bottom of the cave, but I'm pretty sure it was just drool/foam, because there was no smell, and it was a very small amount of wetness. (I was worried, though, because Burble and Busy were definitely sniffing around suspiciously at the cave.) When it was over, he jerked just once that I saw, and then laid still for maybe forty seconds. When he came out, he was very wobbly. I called him to come and get something to eat, and he had already been nibbling on one of the food bowls from breakfast. He ate about 1/2 a can of Fancy Feast. He meowed very plaintively and loudly twice before he ate. I gave him a few pieces of dry EVO and Wellness - hate to pass up any opportunity for him to voluntarily eat. He ate them eagerly, too, and then went back to the FF bowl.
I was just thinking yesterday that it's such a wonderful thing not to keep waking up for every sound during the night. So much for that.... I hope - pray - beg - that this was just a breakthrough and not the beginning of another round of seizures that get worse and worse and closer and closer. There was discussion on the epikitty board about how much Keppra can be used, and I said - and I am pretty sure I still feel this way, although I certainly wasn't expecting it to be tested so soon - that I would not expect to hesitate to increase his Keppra if this dosage (about 187mg TID) didn't work any more. I am not interested in starting anything new, and I certainly don't want to increase the phenobarb if it's at all possible to avoid.
Crap. Crap, Crap, Crap.
Can't really describe this one, because he was in his cave when it started. He growled really loudly, and then the cave started to rock, and by then I was over there, but didn't want to move him or anything. He didn't growl the whole time, and it seemed like a fairly short seizure. His head and neck were wet, as was the bottom of the cave, but I'm pretty sure it was just drool/foam, because there was no smell, and it was a very small amount of wetness. (I was worried, though, because Burble and Busy were definitely sniffing around suspiciously at the cave.) When it was over, he jerked just once that I saw, and then laid still for maybe forty seconds. When he came out, he was very wobbly. I called him to come and get something to eat, and he had already been nibbling on one of the food bowls from breakfast. He ate about 1/2 a can of Fancy Feast. He meowed very plaintively and loudly twice before he ate. I gave him a few pieces of dry EVO and Wellness - hate to pass up any opportunity for him to voluntarily eat. He ate them eagerly, too, and then went back to the FF bowl.
I was just thinking yesterday that it's such a wonderful thing not to keep waking up for every sound during the night. So much for that.... I hope - pray - beg - that this was just a breakthrough and not the beginning of another round of seizures that get worse and worse and closer and closer. There was discussion on the epikitty board about how much Keppra can be used, and I said - and I am pretty sure I still feel this way, although I certainly wasn't expecting it to be tested so soon - that I would not expect to hesitate to increase his Keppra if this dosage (about 187mg TID) didn't work any more. I am not interested in starting anything new, and I certainly don't want to increase the phenobarb if it's at all possible to avoid.
Crap. Crap, Crap, Crap.
Wednesday, April 23, 2008
Well, that's something!
Yesterday, I was poking around in the cabinet under the kitchen sink, and I came across a foil bag of Freeze Dried Nature's Variety Chicken and Turkey Formula. (I remember being a little suspicious about why it was suddenly a "formula" when I bought it.) It's been there for weeks, I guess. Anyway, I opened the bag and found these dried-up, not-unpleasant-smelling "medallions" of yellowish stuff. So, I crumpled one of them over all the food dishes. (One medallion for all, not one for each, because it wasn't marked on the package, but I have a vague memory of being horrified by the cost of this freeze-dried stuff - more than $20, I think, so I'm not about to waste it.) When I set Milk's bowl in front of him, he started to bury it, and then he paused, and THEN, right before my very eyes, he actually ATE the freeze-dried stuff. Not all of it, but at least some. That's one of the few things he's eaten voluntarily in a year. He's had three meals since then, all with the Freeze-Dried stuff on them, and he ate it once more. I even gave him a little bit of the crumpled medallion and added a few drops of water, and he ate a little bit of it. (Busy came by and polished it off.) So that feels like a major step forward. It would be so nice if he'd just start eating again.
Monday, April 7, 2008
The "Eyes" have it.
Conjunctivitis, that is. Poor Milk. Yesterday, I noticed that he had a big blop of clear water on the left side of his nose. I wiped it off. And a little while later, there was another one. Last night, there was a drop on the right side. Okay, I'm a little slow on the uptake, but it was clear that there was something going on. To say nothing of the sad look on his tiny little face....
Tonight, we went to the vet. Herpes-caused conjunctivitis. The rims of his eyes are a little pinker than usual, but nothing like they were when I first brought him home and black gunk was pouring out of both eyes. So now he's got eye drops added to the routine of stuff he really doesn't want me to do to him.
While we were there, I had them take blood for another phenobarb level test, too. I am hoping that it says that the levels are SO minimal that there's really no reason to even give him the stuff any more. (And then I want the report to include a guarantee that there will be NO seizures if I stop giving it to him. NONE.)
The last two days, he has actually eaten a bite or two when I put his bowl down. He does seem to like the Nature's Variety Frozen Raw. I was thinking that I should order some Feline Pride for him - it was so yummy looking; I bet he'd like it. If only it wasn't so incredibly expensive.... Anyway, the really bad news of the vet trip was that he's lost - according to the vet's scale, which I noticed still said "35" on it even when there was no cat sitting there - a half pound since the last time he was there - maybe a month or so ago. Down to 9 pounds, 2 ounces. I was feeling pretty good about his weight until tonight. He's certainly not anywhere near the sleek, wholesome cat he was before phenobarbital, but he seemed to have lost some of the "pile of bones in a fur bag" aspect. Maybe not. When I give him his last pills tonight, I'm gonna weigh him here. He's been pretty consistently 9 pounds, 13 ounces on my nice scale.
The other accomplishment, which seems to be working out VERY well - is that I did some fiddling around with his medication times, and now, suddenly, I feel like I'm starting to have a life again. He was getting Keppra at 10AM, 6 PM, and 2AM, and phenobarbital at 12PM and 12 AM. Five ordeals, plus two or three bottlefeedings every single day. I was trying to cram everything I needed/wanted to do into the hours between noon and 6:00. I was afraid about making the change, but so far, so good. And just not having to chase him around that extra two times a day has done wonders for my psyche, and hopefully for his, too. So now, we do Keppra and phenobarb at 10AM, Keppra at 6PM, and Keppra/phenobarb as close to 1AM as possible. (That's the time that he's still most likely to be uncooperative, for some reason.)
Now, if only the Spring Crazies would stop, we'd be doing pretty well. Damned Busy has taken to gnawing on Milk's neck the minute I head for the bathroom, and now Milk's doing - or trying to do the same thing to Burble. Only Burb's got a good four pounds on Milkshake - if he chooses not to be chewed on, Milk gets the worst of it. Males. Geez.
** 4/9/08 Phenobarb level - 27.2 Which is an improvement. Unfortunately, because I never manage to change only one thing at a time, I don't know if it's due to the reduction of the total amount of phenobarb daily, the addition of the Marin (which he hasn't had for about a week), or a combination of the two. I was really hoping that it'd be way way down and I could maybe cut the dosage in half again. It would be so nice if he'd eat on his own, and gain back some of the weight he's lost. And his right eye is still a sore-looking, squinty mess.
Tonight, we went to the vet. Herpes-caused conjunctivitis. The rims of his eyes are a little pinker than usual, but nothing like they were when I first brought him home and black gunk was pouring out of both eyes. So now he's got eye drops added to the routine of stuff he really doesn't want me to do to him.
While we were there, I had them take blood for another phenobarb level test, too. I am hoping that it says that the levels are SO minimal that there's really no reason to even give him the stuff any more. (And then I want the report to include a guarantee that there will be NO seizures if I stop giving it to him. NONE.)
The last two days, he has actually eaten a bite or two when I put his bowl down. He does seem to like the Nature's Variety Frozen Raw. I was thinking that I should order some Feline Pride for him - it was so yummy looking; I bet he'd like it. If only it wasn't so incredibly expensive.... Anyway, the really bad news of the vet trip was that he's lost - according to the vet's scale, which I noticed still said "35" on it even when there was no cat sitting there - a half pound since the last time he was there - maybe a month or so ago. Down to 9 pounds, 2 ounces. I was feeling pretty good about his weight until tonight. He's certainly not anywhere near the sleek, wholesome cat he was before phenobarbital, but he seemed to have lost some of the "pile of bones in a fur bag" aspect. Maybe not. When I give him his last pills tonight, I'm gonna weigh him here. He's been pretty consistently 9 pounds, 13 ounces on my nice scale.
The other accomplishment, which seems to be working out VERY well - is that I did some fiddling around with his medication times, and now, suddenly, I feel like I'm starting to have a life again. He was getting Keppra at 10AM, 6 PM, and 2AM, and phenobarbital at 12PM and 12 AM. Five ordeals, plus two or three bottlefeedings every single day. I was trying to cram everything I needed/wanted to do into the hours between noon and 6:00. I was afraid about making the change, but so far, so good. And just not having to chase him around that extra two times a day has done wonders for my psyche, and hopefully for his, too. So now, we do Keppra and phenobarb at 10AM, Keppra at 6PM, and Keppra/phenobarb as close to 1AM as possible. (That's the time that he's still most likely to be uncooperative, for some reason.)
Now, if only the Spring Crazies would stop, we'd be doing pretty well. Damned Busy has taken to gnawing on Milk's neck the minute I head for the bathroom, and now Milk's doing - or trying to do the same thing to Burble. Only Burb's got a good four pounds on Milkshake - if he chooses not to be chewed on, Milk gets the worst of it. Males. Geez.
** 4/9/08 Phenobarb level - 27.2 Which is an improvement. Unfortunately, because I never manage to change only one thing at a time, I don't know if it's due to the reduction of the total amount of phenobarb daily, the addition of the Marin (which he hasn't had for about a week), or a combination of the two. I was really hoping that it'd be way way down and I could maybe cut the dosage in half again. It would be so nice if he'd eat on his own, and gain back some of the weight he's lost. And his right eye is still a sore-looking, squinty mess.
Sunday, March 23, 2008
Another sad anniversary
In about an hour and a half, it will be the exact moment of the anniversary of the first seizure my little Milkshake ever had. If I'd known then what I know now...... Well, no, I suppose it wouldn't have made much difference. Although, I would have not waited until he'd had 10 MORE seizures to start giving him phenobarb, that's for sure. Sometimes being "hopeful" is really not a good thing.
Maybe the most significant thing is that we survived this past year, and we know that we'll get through the next one, too. And the one after that, and..........
Saturday, March 22, 2008
**Antijinx**
It's been a month and a half since Milk's last seizure. (Whispering....) He seems to be doing very well, generally. Except for the not-eating, things have been quite normal for my little Milkshake. You should see him sproinging around the living room. Like he's got little tiny trampolines on his feet......
I am sort of fiddling around with the times of his pills - getting hold of him five times a day is a major pain in the neck. I can combine one of the phenobarbs with either the first or last Keppra, but the Marin needs to be given with food, so it's just as easy to put it in a pill pocket with the phenobarb and give him a bottle of EVO at the same time. I wish that I had the courage to try cutting the phenobarbital in half again, (which would be about 3 and 1/2 mg bid) with an intent to remove it completely, but I'm really afraid. Our experience has been that, with a dosage change, when the seizures start up again, they're even more resistant to being controlled. Karen from the epi-kitty board got forms from Auburn to report about the Keppra usage, and I'd like to have the pheno levels tested again, too, so I suppose that should be the next project. If his Keppra levels came back incredibly high, I would still not be inclined to lower his dosage, though; it's working now, it wasn't before at a lower amount, and I'm not willing to change things if it's not totally necessary.
Sunday, March 9, 2008
Found a pill..........
laying on the kitchen floor this morning. It appeared to have been in a Pill Pocket - the surface of the pill looked rough, like it had been exposed to dampness - and there was a little tiny chunk of brownish taffy-looking stuff on it. It was one of the 1/2 Keppra pills. No way to know how long it had been there, or who chewed the Pill Pocket off from around it. At least there hasn't been a seizure - oh, how I hope that's a good sign. As to how it got to the floor - who knows? I think I can only remember once in the last couple days that he managed to spit out a pill, which I know I picked up and pushed back into the corner of his mouth.There has been a smidge of progress on the Food Front. Several times in the last couple days, I've seen Milk go over to one of the food dishes (I've become, somewhat to my surprise, a "free feeder" again) and actually eat a little bit. I've been giving them the Nature's Variety Frozen Raw again for about two weeks, and he seems to like it. Have to get some more. He seems less pleased with the canned/bottle EVO now, though. He liked the 95% beef EVO, but it was really greasy and fatty - those little blops of white fat! - and it didn't mix well with the water for bottlefeeding. I'm going to keep my fingers crossed. Things would be much simpler if he'd just eat on his own again - especially if I have to take him along to Erie or New York for Scruffy's potential eye surgery.
Saturday, February 16, 2008
He's driving me crazy.
It appears that we have a very minimal leeway for pilling with Milk. Two of the last three seizures seemed to have been specifically related to getting his pills late. That said, I am making myself crazy - and ruining what's left of my knees - staggering up and down the steps and lifting up the couch and trying to trick him into standing still long enough for me to grab him. We've got all the bedroom doors closed all the time (screwing up the furnace!) so he can't get under the beds. It doesn't help that he won't eat voluntarily, either; food is no incentive. Except Temptations treats, which he will only be fooled by if my husband rattles the bag. He's no dummy. (The cat, that is.)
Someone posted the other day on FDMB a website with clicker information. I actually BOUGHT a clicker back in November, but I have no idea what I did with it. (Story of my life.) Four dollars for what is essentially exactly the same as those little froggy clicker things they had when I was a kid, that cost a penny.... This is miserable five times a day for both of us. (Not the pilling, which isn't fun but is manageable - the catching/grabbing.) I'm about to see if I can find one of those short-handled butterfly nets Hope talked about.
And yet another problem - this poor little cat. Busy has spent his whole life - seven years - desperately wanting to be the Cat In Charge. And no one else has ever paid the least bit of attention to him. But Milkshake - smaller, wobbly, scrawny, vulnerable - the Perfect Target for the Putative Cat In Charge. Busy never misses an opportunity to knock Milk over, stand on him, and chew on his neck. Milk has two sores - dime sized - one on each shoulder. I was going to try to put neosporin on them or something, but I guess it has to be a substance that both cats can get in their mouths and won't hurt them. Going to get vaseline today. I thought about trying to wrap a scarf around Milk's shoulders, but that's too risky. He's a little wobbly on his feet still, and I'd be afraid that he'd fall and get hooked by the scarf or something. I have to drag one of them with me every time I go to the bathroom, especially - that's Busy favorite attack time. Bright cat, isn't he? - "My mother's incapacitated, I can gnaw on this little white cat."
Now - it's 11:38. He gets 1/2 phenobarb tablet, and a Marin pill, wrapped in a pill pocket - which he won't eat, it has to be pilled, too - and a 2 ounce bottle of soupy EVO canned Cat and Kitten Chicken and Turkey in 20 minutes. And about five minutes ago, he hopped up on the bench beside me here and curled up in a kitty pi. Will I be able to get hold of him? Will he slither away as though his fur is greased? Will this on-going contest of wills ever END? Scruffy's so cooperative about all the ear-poking; I hope THIS ONE never becomes a diabetic.
Okay, I'm going in now......
Someone posted the other day on FDMB a website with clicker information. I actually BOUGHT a clicker back in November, but I have no idea what I did with it. (Story of my life.) Four dollars for what is essentially exactly the same as those little froggy clicker things they had when I was a kid, that cost a penny.... This is miserable five times a day for both of us. (Not the pilling, which isn't fun but is manageable - the catching/grabbing.) I'm about to see if I can find one of those short-handled butterfly nets Hope talked about.
And yet another problem - this poor little cat. Busy has spent his whole life - seven years - desperately wanting to be the Cat In Charge. And no one else has ever paid the least bit of attention to him. But Milkshake - smaller, wobbly, scrawny, vulnerable - the Perfect Target for the Putative Cat In Charge. Busy never misses an opportunity to knock Milk over, stand on him, and chew on his neck. Milk has two sores - dime sized - one on each shoulder. I was going to try to put neosporin on them or something, but I guess it has to be a substance that both cats can get in their mouths and won't hurt them. Going to get vaseline today. I thought about trying to wrap a scarf around Milk's shoulders, but that's too risky. He's a little wobbly on his feet still, and I'd be afraid that he'd fall and get hooked by the scarf or something. I have to drag one of them with me every time I go to the bathroom, especially - that's Busy favorite attack time. Bright cat, isn't he? - "My mother's incapacitated, I can gnaw on this little white cat."
Now - it's 11:38. He gets 1/2 phenobarb tablet, and a Marin pill, wrapped in a pill pocket - which he won't eat, it has to be pilled, too - and a 2 ounce bottle of soupy EVO canned Cat and Kitten Chicken and Turkey in 20 minutes. And about five minutes ago, he hopped up on the bench beside me here and curled up in a kitty pi. Will I be able to get hold of him? Will he slither away as though his fur is greased? Will this on-going contest of wills ever END? Scruffy's so cooperative about all the ear-poking; I hope THIS ONE never becomes a diabetic.
Okay, I'm going in now......
Friday, February 8, 2008
The 2nd Adoption Anniversary Meltdown
February 8, 2006. The day I brought home the scrawniest, sickest, most malnourished kitten I'd ever seen. I've been thinking about what a wonderful two years we've had with Milkshake for days now, and trying to plan what to write here about him. And it hasn't turned out to be any of the things I thought it would be.......
Yesterday morning, he had another seizure. First one in three weeks, and third one in two months. And I'm pretty sure, as I said in the earlier entry, that it was related to the fact that I couldn't get my hands on him twice to give him his pills on time the previous night. So, I was determined to make sure to get them right from now on, because the more seizures they have, the more seizures they have, if you know what I mean. The "kindling" effect - it's like each seizure makes the path through the brain a little wider and easier to travel. Definitely NOT desirable.
Unfortunately, for some reason, Milk was determined not to cooperate. I did get the first two sets of pills in him - 10 AM and 12 PM. I usually give him his bottle of EVO with the noon pills, because that's when he gets Marin, which needs to be given with food. But, since he'd eaten so much after his seizure, he wasn't interested in eating, so I skipped the bottle and the Marin, thinking that I'd give them to him in a couple hours. And that was the last I saw of him for the entire afternoon. Normally, he's plastered up against me or one of the other cats. Not yesterday. Didn't come when I called. Didn't come when I got the feather toys out. Didn't come for Temptations. Didn't come to see why the front door was open when it was so cold and damp out. Twice, I saw his tail zip by behind the couch. Came time for his 6:00 pills, and I actually knew where he was: under the bed. Where it is totally impossible to get him, because there's only about a 4 inch space between the mattress and the floor, and because the stupid Select Comfort motor and stuff weigh a ton. You can't move it. So, I started the enticement all over again. Finally, he came out, but dashed downstairs. My knees are so bad that I try to do as little stair-climbing as possible, but I had to try to get him - it was now 7:00. An hour late. Three trips up and down the steps - no success. Finally, at 8:30, I thought - Aha! Bonita Flakes! I got the box out of the kitchen, took it and Busy and Burble - who are Bonita Freaks - into the bedroom, and waved the lid around so the aroma (disgusting - smells like dirty feet, but they seem to think the stuff is tasty) would waft down under the bed. And sure enough, a little white ear poked out, then a pink nose, and then a foot. He grabbed one piece of flake, and zipped back under the bed. I put a little more down, he came out far enough to grab, and I dragged him into the kitchen and pilled him. And fed him.
Unfortunately, there were still two more doses of pills to go. I started trying to casually get hold of him at 11:00 - preparing for the midnight phenobarb. No luck. Four more trips up and down the stairs. I called, I crinkled, I shook, I squeaked - nothing worked. And finally, I just sat down on the steps and sobbed. Did it help? No. And afterwards, I was mad at him. Really mad. I got the bonita flakes out again, and put the box on the living room floor, open. And let everyone else come and eat whatever they wanted out of it. Milk came over, tentatively, ate a little bit, and hopped up on the table beside my chair. I didn't want to lunge at him and miss, so I pretended I didn't know he was there. He walked across me, to the table on the other side, and of course, the minute I grabbed at him, he was gone. So I cried some more. (Still not the least bit helpful.) And decided to ignore him. Within fifteen minutes or so, he jumped up on the table, and this time, I was faster than he was. So that was one more miserable set of pills in him. The last ones were due at 2 AM. There was no way he was gonna let me grab him now. This was the worst day I've had with him. Ever. Finally, at ten minutes to three, I just turned out the lights, turned off the TV, and let him think I was going to sleep. I was so exhausted I did doze off once. Or three times. Anyway, at 3:30, he jumped up and flopped down with his head on my ankle - his normal sleeping position. I wasted not one minute getting hold of him. Took him in the kitchen, pilled him, gave him his bottle, told him how important it was for him to get the pills when he's supposed to and how mad I was at the horrible day we'd had, and I went to bed. Fuming. And totally worn out.
When I woke up this morning, there he was, sleeping like a furry log on my leg. If I get him real quick before he's awake, I can always get the first pills in him with no trouble. And, my mind must have been stewing over the problem while I was sleeping, because I knew what to do to hopefully make today go better - put his walking jacket and leash on him. He doesn't fall over with the jacket on - in fact, once he's used to it, he's the best walker of the four cats. But it slows him down a little. I had a soft short leash - I wouldn't leave it on him if I weren't home or in the room with him, but it worked just like I wanted it to. (Burble thought he'd gotten a pet of his own - he kept picking up the leash in his teeth and strolling along behind Milk. Funny.... ) Came time for the noon pills, he tried to get away, and I just stepped on the leash dragging behind him and got him! I could tell he wasn't happy, so after the pills and feeding him, I took the leash off. And then thought, oh well, might as well take the jacket off, too. (He has a sore on his neck that I didn't want the jacket to rub on, besides.) So, we'll see if I can get hold of him at 6:00. If not, I guess we'll have to leave the jacket on and be done with it.
And now I've spoiled his celebration day. Aside from the fact that the only time he eats voluntarily is after he's had a seizure, I don't even have a car today to go get him something treatful anyway. So, I guess this is as good as it's gonna get:
I love you, Milkshake, my sweet little pink and white boy. How sad it would have been if you hadn't been sitting in that cage at Petsmart waiting for me. I will do my best to take good care of you, and to thank you for your affectionate personality and your amazing eye contact and your snuggly cuddling. We've been so blessed to have you.
your mother, who loves you with all her heart and soul.
Thursday, February 7, 2008
#40
Dale asked me last night how Milk was doing, and I said that, excluding the two seizures back in January that I discount because I'd screwed up the time or he missed the pills, he hadn't had one since Dec. 1, 2007. I'm discounting today's, too. (How much self-delusion can fit on the head of a pin, or whatever those expressions are?) Anyway, the excuse this time is that I was doing something, and not watching the clock, and his midnight phenobarb wasn't given until 1:38AM. And then I compounded the error by - since it was so close to 2:00 AM, when he gets his last keppras, giving him the Keppra at the same time. So, one pill was almost two hours late, and the other ones were almost a half hour early. Is that a formula for seizures? Maybe. Apparently. Possibly. And he was odd during the night - woke me up at least four times, jumping around. Usually, he falls asleep, and that's pretty much it for the night. In the AM, he's so deeply asleep that I have no problem grabbing him to give him his pills at 10:00. So, anyway, while I'm really disappointed that it's happened again, there seems to have been a reason. Now I'm worrying about if there's gonna be another one, and how soon - it scares me to think that they' might be two or three days apart again.
Description of #40: very little preparatory jaw snapping. In fact, he was actually growling before I realized what was happening. And I couldn't remember what I should do - it seems like it's been so long since the last time. (Well, not really, only 3 weeks, but....) I didn't have my glasses on, so I don't know if there was a lot of foaming that got wiped off on the blanket; his face and neck weren't terribly wet by the time he started to eat. This was one of the milder seizures physically - very little flopping, and not the violent stuff from before. Growling, but more a less-ferocious continuous background noise than previously. And instead of the abrupt ending that the last three or four have had, when he stopped flopping and growling, there was more occasional jerking afterwards. Duration - oh, probably 40 seconds for the whole actual seizure, and maybe another 20 or 30 seconds before he was totally still. Then he just laid there for a minute or so before getting down to look for something to eat. No pacing. Quite a little appetite - he ate just about an entire can of FF, and then I gave him a little dry EVO and FF, too, and he ate almost all of that. (I can't bear to miss the chance to actually get a few calories into him.)
So, my conclusion this time was - timing error once again. It appears that there's a very close line between dosing that controls the seizures and the outcome when I screw that up. I had already decided that it seems that he's within a half-Keppra (125mg) of control with the present dosages. And now it appears that the timing of his medication is becoming more of a cause. On a couple of occasions, because I couldn't find him, he's gotten his pills as much as three hours late. Going by this seizure, that may be an increased risk now, for some reason. And also, this seizure makes me think that maybe totally removing the phenobarb might not be a possibility, no matter how desperately I want it to happen. There has been some discussion on the epikitty board about TID and BID Keppra, and the problems with phenobarb levels recently. I am pretty much convinced now that, unless his next bloodwork shows even worse levels, he should just stay on half a phenobarb BID and be done with it. (The last bloodwork was taken on the same day I had decreased the phenobarbital to a half pill, so even though it showed a higher level, it wasn't reflecting the current dosage. Hopefully, that'll make a difference. Hopefully.)
All in all, a very disappointing way to start a day.....
Description of #40: very little preparatory jaw snapping. In fact, he was actually growling before I realized what was happening. And I couldn't remember what I should do - it seems like it's been so long since the last time. (Well, not really, only 3 weeks, but....) I didn't have my glasses on, so I don't know if there was a lot of foaming that got wiped off on the blanket; his face and neck weren't terribly wet by the time he started to eat. This was one of the milder seizures physically - very little flopping, and not the violent stuff from before. Growling, but more a less-ferocious continuous background noise than previously. And instead of the abrupt ending that the last three or four have had, when he stopped flopping and growling, there was more occasional jerking afterwards. Duration - oh, probably 40 seconds for the whole actual seizure, and maybe another 20 or 30 seconds before he was totally still. Then he just laid there for a minute or so before getting down to look for something to eat. No pacing. Quite a little appetite - he ate just about an entire can of FF, and then I gave him a little dry EVO and FF, too, and he ate almost all of that. (I can't bear to miss the chance to actually get a few calories into him.)
So, my conclusion this time was - timing error once again. It appears that there's a very close line between dosing that controls the seizures and the outcome when I screw that up. I had already decided that it seems that he's within a half-Keppra (125mg) of control with the present dosages. And now it appears that the timing of his medication is becoming more of a cause. On a couple of occasions, because I couldn't find him, he's gotten his pills as much as three hours late. Going by this seizure, that may be an increased risk now, for some reason. And also, this seizure makes me think that maybe totally removing the phenobarb might not be a possibility, no matter how desperately I want it to happen. There has been some discussion on the epikitty board about TID and BID Keppra, and the problems with phenobarb levels recently. I am pretty much convinced now that, unless his next bloodwork shows even worse levels, he should just stay on half a phenobarb BID and be done with it. (The last bloodwork was taken on the same day I had decreased the phenobarbital to a half pill, so even though it showed a higher level, it wasn't reflecting the current dosage. Hopefully, that'll make a difference. Hopefully.)
All in all, a very disappointing way to start a day.....
Thursday, January 24, 2008
He ate!
Well, sort of. I always put down a bowl for Milk when I feed everyone else, and he always either tries to bury it, or races to get away from it. Night before last, I gave him his bowl, and a few minutes later, I saw him stop in front of it, sniff, and then actually lick it five or six times! I was so excited. The next morning, he did the same thing. It's only twice in all these months, but maybe it's a start. This morning, I put a few pieces of dry food on top of the canned for him, but that wasn't enough to interest him - plus, as soon as Busy and Burble and Scruffy realized that there was dry on there (and how DO they know?), they jostled Milk out of the way, so even if he'd wanted to eat it, which he didn't, he couldn't have. But it's a start.
And the generic Keppra from Canada arrived on Tuesday afternoon - 7 days from the day I was notified that it had entered the US. I'm idly curious where it's been all that time. I feel a little bad that for years - since my beanie baby trading days, actually - I've had not-nice things to say about the Canadian Postal System. Maybe the problem isn't Canada - it's here?
Saturday, January 19, 2008
Where is the Keppra?
Because of the greatly increased dosage of Keppra (generic), I've used up the last prescription from Canada a long time before I expected to. And I wasn't aware, until it was too late, that there were no REFILLS on that original prescription. So, I called Dr. G and asked him to fax a prescription for 200 pills this time (should give me a little more than 2 months worth and they won't have to break up a bottle). Which he did. I debated about using a different Canadian pharmacy because of the free shipping issue, but when I figured out the prices, even with the $10 shipping charge, my pills were considerably less expensive than the ones that other people on the epi-kitty site were buying in Canada. So, I decided to stick with the original. They were able to send the pills out on Monday of this week - and I got a tracking number that shows that they entered the "destination country" at 5:53 AM on 1/17/08. So where are they? It's 1/20/o8 as I type this. It says "Expresspost" as the carrier - but I don't know if that's only in Canada, or here. I have enough for one more dose of generics tonight at 2 AM, and then I have enough of the 90mg compounded capsules that we started out with to give him 180 mgs TID for the next two days, which I hope will be close enough to his usual dosage. Tomorrow, I guess I'll call Dr. G and get another prescription for a local pharmacy. Trouble is, the 250 mg pills aren't usually kept on hand here in pharmacies, because most humans take the larger dosage pills...... I know that Sam's Club had to special order their Keppra pills and I had to wait over the weekend for them to get the 250 mg pills in. (Wonder if I used up all of those pills? I must have - I cleaned up the pill corner last week, and the only extra keppra there was the bottle of compounded capsules.)
I noticed that on the email notification of shipping, it says that if I give permission, they can ship from their "international shipping center." One of those is in Texas, the person I talked to a couple months ago said. If that's the case, why am I waiting for deliveries from Canada? Need to check on that. It probably has something to do with getting a generic that isn't available yet in the US, I suppose.
I'm sure there's a lesson to be learned from this: I have to make sure the next time that I reorder EARLY. EARLY. EARLY. But WHERE ARE THEY NOW?
I noticed that on the email notification of shipping, it says that if I give permission, they can ship from their "international shipping center." One of those is in Texas, the person I talked to a couple months ago said. If that's the case, why am I waiting for deliveries from Canada? Need to check on that. It probably has something to do with getting a generic that isn't available yet in the US, I suppose.
I'm sure there's a lesson to be learned from this: I have to make sure the next time that I reorder EARLY. EARLY. EARLY. But WHERE ARE THEY NOW?
Thursday, January 17, 2008
PHEW!
It happened again - I had to take my mother-in-law for a doctor's appointment, and Milk was nowhere to be found. I thought I'd wait and be "casual" until a half hour before I had to leave, in the hopes of being able to grab and pill him, but noooooooo...... So, the whole time I was gone, I was in a panic that he'd have another seizure the next morning - today, actually - since I don't know if it was the three-hours-late phenobarb pill on Monday that produced Tuesday morning's seizure. As it turned out, he was still among the missing when I got home. By the time I found him, managed the agony of kneeling on the floor, lifted up the sofa with my left shoulder and tried to grab one of his body parts with my right hand to drag him out, and then staggered to my feet again, his pill was two and a half hours late. So, I cleverly thought, I'll give him a smidge more phenobarb and see if that helps make up for the vanished hours. I still have a ton of the compounded 10mg capsules, so I gave him one of those, and - don't know if that's what did it or not - but anyway, no seizure this morning.
It should only be that simple and successful all the time. The little stinker has such an exquisite sense of time - he wanders through the kitchen at the exact time his pills are due every single day - that I know that these disappearances lately at pill time are intentional. Maybe he knows that the phenobarbital is doing major damage....
I have to go out this afternoon, but I was sneaky and grabbed him before I got ready to go. Not giving any more hints that it's time to hide.
Tuesday, January 15, 2008
#39 - short, but not all that sweet.
6:45 AM. It started very abruptly, with virtually no salivation, but a little jaw-snapping. The flopping was significantly reduced in violence - in fact, this was the first time I ever touched him while he was having a seizure; I was afraid he was gonna fall off, so I just sort of grabbed him by his lower body - he was laying on his right side - and slid him back away from the edge. The noise was different, too - instead of the distinct separate snarls, he made almost a continuous moaning kind of sound. All in all, the seizure lasted probably not more than 15 or 20 seconds. When it ended, he lay absolutely still for at least two minutes, with fairly frequent body jerks for the first 30 or 40 seconds, and then nothing. Eventually, he jumped down and headed off to the kitchen to find food. His coordination seemed unaffected, and while he clearly wanted something to eat right away, he wasn't panicky about it or anything.
So, now I'm left once again wondering if this was my fault. I couldn't find him yesterday for hours - crawled around looking under the couch and under the bed and up and down the stairs, with no sign of him. I did all the little tricks that usually get him to come out, and none of them worked. Finally, when his phenobarb pill was three hours late, he just appeared out of nowhere. I've never understood the whole thing about having to give the phenobarb at exactly the same time every day, when you can do a blood test anytime at all on the assumption that the drug reaches a level in the blood that stays consistent. Anyway, was the late pill the cause? Or was it that I'd reduced the phenobarb dosage 20% (2mg. per dose) a week ago? Previous occasions that I reduced the dosage, it seemed to take about a week to show up in a seizure. While the last phenobarb blood level was in the acceptable range - 32.4 - it was quite a bit higher than it had been, and I don't want to take a chance on going back to the higher dosage if there is any choice at all.
I'm so sorry to have seen the wonderful five and a half weeks of no seizures end.
So, now I'm left once again wondering if this was my fault. I couldn't find him yesterday for hours - crawled around looking under the couch and under the bed and up and down the stairs, with no sign of him. I did all the little tricks that usually get him to come out, and none of them worked. Finally, when his phenobarb pill was three hours late, he just appeared out of nowhere. I've never understood the whole thing about having to give the phenobarb at exactly the same time every day, when you can do a blood test anytime at all on the assumption that the drug reaches a level in the blood that stays consistent. Anyway, was the late pill the cause? Or was it that I'd reduced the phenobarb dosage 20% (2mg. per dose) a week ago? Previous occasions that I reduced the dosage, it seemed to take about a week to show up in a seizure. While the last phenobarb blood level was in the acceptable range - 32.4 - it was quite a bit higher than it had been, and I don't want to take a chance on going back to the higher dosage if there is any choice at all.
I'm so sorry to have seen the wonderful five and a half weeks of no seizures end.
Monday, January 7, 2008
It was my fondest desire.....
never to be sitting here again at the crack of dawn recording another damned seizure. But here we are, #38. I have been lulled into a false sense of security, right? I didn't even have the radar turned on for the preparatory foaming noises any more, so I don't know exactly what the beginning of this one was like. By the time I woke up enough to realize what was happening, he was flopping, and then the growling started, quite loud and vicious sounding. I didn't think to put my glasses on and turn on the light until after it was over, so I'm not sure about the salivation and other stuff. It seemed like it took forever to end, but that was probably because I was concentrating so hard (physically) on keeping him from flopping onto the floor. When it ended, he laid absolutely still for at least two minutes. Then he jumped down and headed off to look for something to eat. (Yay - food into him - I took advantage of an appetite that has been missing for days now, and after he ate about half a can of FF and wandered off, gave him some high-calorie, food-of-the-devil EVO dry.)
This may have been my fault. Five weeks seizure free. It seems almost miraculous. The signs that something was going on were there, however - and I even took him to the vet yesterday afternoon for bloodwork to see what his phenobarb level is. He has been wobblier lately than he has been for months. He fell off the cat tree twice in the last week - not when he was asleep, just didn't seem to physically have the strength to cling to it. When he shakes his head, he nearly tilts over. He has been eating virtually nothing voluntarily for days now. I'm back to bottlefeeding three or four times a day. And offering him everything under the sun to eat, (9 different kinds of dry food and another 7 of canned!) none of which he is interested in. Anyway, I have this need to reduce the phenobarb as much as possible because I'm afraid of what even the smaller dosage is doing to his liver. So, I thought I could go down to 1/2 of a 15mg tablet BID to replace the 10mg. compounded capsules. Only, and I don't know if this was solely inattention on my part, or what, but twice in the last 24 hours (10 separate doses of pills), I discovered one of his pills - once the 1/2 Keppra, and once the phenobarb tablet - outside his body long after I thought I got them into him. And now I'm on the verge of hysteria, afraid that this is going to precipitate one of those whole new series of seizures that happens when the medication dosage fails and it's harder to get control again. Puhleeze don't let that happen, God.
My poor sweet Milk.
This may have been my fault. Five weeks seizure free. It seems almost miraculous. The signs that something was going on were there, however - and I even took him to the vet yesterday afternoon for bloodwork to see what his phenobarb level is. He has been wobblier lately than he has been for months. He fell off the cat tree twice in the last week - not when he was asleep, just didn't seem to physically have the strength to cling to it. When he shakes his head, he nearly tilts over. He has been eating virtually nothing voluntarily for days now. I'm back to bottlefeeding three or four times a day. And offering him everything under the sun to eat, (9 different kinds of dry food and another 7 of canned!) none of which he is interested in. Anyway, I have this need to reduce the phenobarb as much as possible because I'm afraid of what even the smaller dosage is doing to his liver. So, I thought I could go down to 1/2 of a 15mg tablet BID to replace the 10mg. compounded capsules. Only, and I don't know if this was solely inattention on my part, or what, but twice in the last 24 hours (10 separate doses of pills), I discovered one of his pills - once the 1/2 Keppra, and once the phenobarb tablet - outside his body long after I thought I got them into him. And now I'm on the verge of hysteria, afraid that this is going to precipitate one of those whole new series of seizures that happens when the medication dosage fails and it's harder to get control again. Puhleeze don't let that happen, God.
My poor sweet Milk.
Tuesday, December 18, 2007
Monday, December 10, 2007
The middle-of-the-night freight train
Well, we're still having the periods of intense activity during the night. Every night. As I said before, better this than seizures...... In a way, it's kind of funny. He spends endless amounts of time either stealing the straws from my tea mug, or finding the out-of-the-way places he's hidden them, and triumphantly carrying them around all over the house. Twice last night, he woke me up - I thought he was having a seizure - the jaw-clicking - but it was actually the straw snapping when he chewed on it.
His need to always be snuggled up against one of the other cats has diminished recently, and now, he wants to be curled up in my armpit as soon as I sit in my chair. (Which does interfere with knitting.) It's very touching. He keeps trying to get closer and closer, and then he stretches his skinny little front leg out and pats me with his paw. Honestly, I am convinced that inside this wispy little white cat is some sort of miraculous being that I've been blessed to find. I look in his eyes and see - well, I can't even describe it. I was so driven to see him in that cage at Petsmart almost two years ago for some reason I can't explain, but I am absolutely positive that it was meant to be. And I am so glad.
Monday, December 3, 2007
Well, it happened again.
Only earlier. Up at 4AM this morning - no seizure, but bouncing all over the place for two hours. I really wonder if this is related to the Keppra. None of my cats wakes me up anymore before the alarm goes off. And once he finally did get back to sleep, he was really out of it. I am worrying - hopefully unnecessarily - about this huge dosage. Although, I don't see any physical signs that there's anything going on aside from this weird middle-of-the-night thing. His coordination is quite normal, appetite about as stinky as usual, everything in general the same. I'd like to call and leave a message for Dr. Axlund to ask him if this is normal, and if he thinks that maybe we should do the Keppra blood test he mentioned somewhere along the way. Or someone who knows about Keppra. (I was even questioning the technician at Dr. G's, who takes it. Of course, she's not a cat....)
Also ordered the compounded phenobarb from the pharmacy in Michigan that Hope uses. I didn't even ask what the cost would be. I just hope that it gets here by Friday.
Also ordered the compounded phenobarb from the pharmacy in Michigan that Hope uses. I didn't even ask what the cost would be. I just hope that it gets here by Friday.
Sunday, December 2, 2007
Curious/weird
Milk just woke me at 5:20. Prime seizure time, but he wasn't having a seizure. He walked around on me a little bit, hopped on and off the furniture, and eventually raced around the living room. It was definitely odd behavior, but since it didn't seem to involve incipient brain damage, I wasn't about to discourage it. I thought maybe he'd want something to eat - if it was actually some sort of "substitute seizure" - but he really didn't. After maybe 10 minutes of activity, he hopped to the top of the cat tree tunnel - a good five feet off the ground - and just sat there, quite relaxed. At 5:40, he closed his eyes and started to nod off, which made me nervous for no particular reason. I went into the kitchen to record this, and he followed me, then went back out to sit on the short cat tree.
I'm not sure what to think. The timing makes me think that, if he hadn't awakened, this would probably have been a seizure, but I don't know if that's likely to happen or not. I would happily be awakened every day at 5:30 if he just wants to wander around and no seizures are involved.
He seemed to be feeling the effects of the greatly increased dosage more late yesterday. There were a couple of times that I noticed that he had a sort of hard-to-describe "startled" look on his face. (Yeah, I know, I know, but he did. Something odd about his eyes....) And when he was ready to go to sleep for the night, he just flopped down and never moved a muscle . No turning around to make a nest, no last minute grooming, just awake one minute and sound asleep the next.
It's possible that one of the other cats woke him at 5:20. I'm beginning to think that the four of them spend the night stomping around on top of me, and I'm such a sound sleeper that I just don't know it. I have noticed that the ones I start out with when I go to sleep are not necessarily the ones who are there when I wake up, no matter what time that is.
And now I kind of hate to go back to sleep - it's 6AM, though - because I'm afraid that I'll be unpleasantly awakened by snarling and growling in a half hour. Rats. Never satisfied.
I'm not sure what to think. The timing makes me think that, if he hadn't awakened, this would probably have been a seizure, but I don't know if that's likely to happen or not. I would happily be awakened every day at 5:30 if he just wants to wander around and no seizures are involved.
He seemed to be feeling the effects of the greatly increased dosage more late yesterday. There were a couple of times that I noticed that he had a sort of hard-to-describe "startled" look on his face. (Yeah, I know, I know, but he did. Something odd about his eyes....) And when he was ready to go to sleep for the night, he just flopped down and never moved a muscle . No turning around to make a nest, no last minute grooming, just awake one minute and sound asleep the next.
It's possible that one of the other cats woke him at 5:20. I'm beginning to think that the four of them spend the night stomping around on top of me, and I'm such a sound sleeper that I just don't know it. I have noticed that the ones I start out with when I go to sleep are not necessarily the ones who are there when I wake up, no matter what time that is.
And now I kind of hate to go back to sleep - it's 6AM, though - because I'm afraid that I'll be unpleasantly awakened by snarling and growling in a half hour. Rats. Never satisfied.
Saturday, December 1, 2007
And another one, huge dose of Keppra and all....
#37 . Although, I want to make myself feel somewhat cautiously optimistic that it was "better", somehow. Near as I can figure, the new dosage of Keppra is 187mg and a little more. That's a lot, it seems to me; at least, it's a lot more than he was taking before, especially when you multiply it by TID. He's had four of the increased doses. But there was a noticeable difference in this seizure compared to the last four or five. It didn't take as long to get started - he did a small amount of preliminary jaw snapping, but the growling started almost immediately, and it continued as almost a high-pitched wail until it abruptly ended. The flopping was very strong - I was almost sure he was going to end up on the floor - but very quickly over. I would estimate that the entire seizure lasted somewhere between 20 and 25 seconds. It ended like the video seizure did - he just stopped flopping and growling, and laid still. There was a minimal amount of jerking after it was over, too - his tail did a sort of "whiplash" thing twice, but that was really pretty much the extent of it. He laid for at least a minute, possibly more. When he jumped down, he was more coordinated than he has been - he didn't fall or act shaky. He did start to walk off in the opposite direction of the kitchen, but when I called him to come and eat, he came and did eat. He seemed to want to walk, but it wasn't the pacing that I used to see with the earlier seizures, either; then, he would rapidly, almost seeming driven, walk in a huge circle all around the living room and kitchen. This time, he seemed more interesting in being in the living room/dining room than eating. Right now, he's meatloafing nearby. Waiting for me to finish this so he can go back to sleep, I guess. Except that the blanket's soaked.....
I don't know now who exactly to report this to. Dr. A., the neurologist from Ohio, said that Dr. L, the Internal Medicine vet from here, should be our contact, but I don't have any idea what her reaction to the dosage increase (and the lack of pressure to have an MRI) is. I feel like he's the one that should know that there are differences in this seizure, not that there's anything I want him to do or say, I suppose. But it would seem like he's the one who would know if the change means anything or not - if it represents positive improvement because the seizure was so much shorter, or if it represents negative/failure because it happened so soon after the last one, or if it doesn't mean anything at all. I wish I could just email him or something. I just realized that it's Saturday. Maybe next week, I'll call his office and ask what they think I should do. It would be different/better if I had more of a relationship with Dr. L., or if I could actually talk to her when I call, instead of relaying messages through a technician. And it just occurred to me that I don't know if there is any testing/bloodwork that should be done on a regular basis or what, to see if his liver's okay or his kidneys, since Keppra's processed through the kidneys, I believe.
Milk's been calmly sitting in the same place, looking around but not jerking or acting very post-seizure-ish for more than a half hour. I guess I'll record Scruffy's information and see if he needs to be shot, and then try to sleep a little more, till time for Milk's next pill. Not much of a life for any of the three of us, sadly.
I don't know now who exactly to report this to. Dr. A., the neurologist from Ohio, said that Dr. L, the Internal Medicine vet from here, should be our contact, but I don't have any idea what her reaction to the dosage increase (and the lack of pressure to have an MRI) is. I feel like he's the one that should know that there are differences in this seizure, not that there's anything I want him to do or say, I suppose. But it would seem like he's the one who would know if the change means anything or not - if it represents positive improvement because the seizure was so much shorter, or if it represents negative/failure because it happened so soon after the last one, or if it doesn't mean anything at all. I wish I could just email him or something. I just realized that it's Saturday. Maybe next week, I'll call his office and ask what they think I should do. It would be different/better if I had more of a relationship with Dr. L., or if I could actually talk to her when I call, instead of relaying messages through a technician. And it just occurred to me that I don't know if there is any testing/bloodwork that should be done on a regular basis or what, to see if his liver's okay or his kidneys, since Keppra's processed through the kidneys, I believe.
Milk's been calmly sitting in the same place, looking around but not jerking or acting very post-seizure-ish for more than a half hour. I guess I'll record Scruffy's information and see if he needs to be shot, and then try to sleep a little more, till time for Milk's next pill. Not much of a life for any of the three of us, sadly.
Friday, November 30, 2007
Neurologist appointment in Akron.
more to follow; just wanted to make sure the date got recorded.
Dr. Todd Axlund
Metropolitan Veterinary Referral Group
1053 S. Cleveland-Massillon Road
Akron, OH 44321
1-330-670-2358 (office)
1-330-666-2976 (main reception desk)
Also to remember:
Physician's Compounding Pharmacy
1-248-758-9100
1-248-758-1831 (fax)
ordered 3 mo. worth of compounded 10mg phenobarb capsules - great service. Cost $78.
And:
Universal Drug Services Ltd.
5B 851 LagimodiereBlvd
Winnipeg, Manitoba R2J 3K4
toll free #: 1-866-456-2456
toll free fax #: 1-866-783-4223
email: info@universaldrugstore.com
website: www.universaldrugstore.com
Free shipping is available for pet medications, but not for human ones. BUT - the price for the generic Keppra is still significantly lower than other Canadian drugstores even with the shipping.
(generic) Levetiracetam:
250 mg 150 tablets $179.50 +$10 shipping (10/12/07)
250 mg. 200 tablets $225.00 + $10 shipping (1/15/08)
250 mg. 200 tablets $225.00 (Coupon for shipping - $10) 3/18/08 (arrived in SIX days!)
Dr. Todd Axlund
Metropolitan Veterinary Referral Group
1053 S. Cleveland-Massillon Road
Akron, OH 44321
1-330-670-2358 (office)
1-330-666-2976 (main reception desk)
Also to remember:
Physician's Compounding Pharmacy
1-248-758-9100
1-248-758-1831 (fax)
ordered 3 mo. worth of compounded 10mg phenobarb capsules - great service. Cost $78.
And:
Universal Drug Services Ltd.
5B 851 LagimodiereBlvd
Winnipeg, Manitoba R2J 3K4
toll free #: 1-866-456-2456
toll free fax #: 1-866-783-4223
email: info@universaldrugstore.com
website: www.universaldrugstore.com
Free shipping is available for pet medications, but not for human ones. BUT - the price for the generic Keppra is still significantly lower than other Canadian drugstores even with the shipping.
(generic) Levetiracetam:
250 mg 150 tablets $179.50 +$10 shipping (10/12/07)
250 mg. 200 tablets $225.00 + $10 shipping (1/15/08)
250 mg. 200 tablets $225.00 (Coupon for shipping - $10) 3/18/08 (arrived in SIX days!)
Wednesday, November 28, 2007
#36.
This one makes me question how long all of Milk's seizures have been. I had the camera sitting beside me, so I was able to video from shortly after it started until he jumped down. And it was around 3 minutes, which was a surprise. Very violent, very harsh growling.
Only three days since the last seizure. This is exactly what I was afraid of. I will call Dr. L. again, I guess, although she didn't offer any suggestions about what to do two days ago, except for the bile acids test, which I can't do now because he has to fast for 12 hours, and he has to eat after he has a seizure. Once again, there was a lot of physical movement, and I had to worry about his falling on the floor. There was less jerking after most of the activity ended than usual. He started to jump down and then was too wobbly, so he just sat and stared into space for a minute or so. I was distracted by trying to keep the camera on him.
I don't know if anyone would want to see the video anyway. It is very distressing. I'm feeling a little numb now. This seems to be way out of control, and I have no way to help my sweet boy.
Somehow, this video finally got uploaded. It's very disturbing, to me anyway. Anyone who watches might want to turn down the volume on their computer.
Only three days since the last seizure. This is exactly what I was afraid of. I will call Dr. L. again, I guess, although she didn't offer any suggestions about what to do two days ago, except for the bile acids test, which I can't do now because he has to fast for 12 hours, and he has to eat after he has a seizure. Once again, there was a lot of physical movement, and I had to worry about his falling on the floor. There was less jerking after most of the activity ended than usual. He started to jump down and then was too wobbly, so he just sat and stared into space for a minute or so. I was distracted by trying to keep the camera on him.
I don't know if anyone would want to see the video anyway. It is very distressing. I'm feeling a little numb now. This seems to be way out of control, and I have no way to help my sweet boy.
Somehow, this video finally got uploaded. It's very disturbing, to me anyway. Anyone who watches might want to turn down the volume on their computer.
Monday, November 26, 2007
The Plan.
Talked with Dr. L this afternoon. She feels that Milk is at the maximum dosage of Keppra that she has heard of cats using. We don't want to increase the phenobarb. There is another drug that might be a possibility, but she hasn't used it herself, or in combination with Keppra and phenobarb. She seemed to feel that, if a third drug were to be used (and I can't remember what it was called) - it should be prescribed and monitored by a neurologist.
I explained my concerns about Milk:
1) increased severity of seizures
2) increased frequency
3) diminished appetite, although it is improved somewhat
Dr. L feels that we need to get a post-prandial bile acids test done as soon as possible, and based on that (and the comparison between the previous test, which was pre-prandial), she would refer me to a veterinary neurologist in Akron. Where it would be decided, I guess, about doing an MRI and spinal tap. Neither of which I'm eager to do. The neurologist's name, I believe, is Todd Ecklund or Acklund - can't find the paper I wrote it down on a couple weeks ago. (Correction: Axlund.) He was a professor at Auburn. I asked if it was customary for seizures to escalate in severity, and if not, what it might mean. She said it wasn't necessarily usual, but since they don't have the information from an MRI to be sure exactly what's going on in Milk's head, there's really no way to know. She felt that, given his age, it was not particularly likely that he has a brain tumor, but that inflammation might be a possibility, along with something else that I can't remember. Speaking of possible brain tumors.... Anyway, I will have another bile acids test done this week, and then I guess we will go from there. She did say that the 25 he had on the previous bile acid test was not a huge reason for concern - that the area of 50 is more of a problem. I guess that's good news. I'm not totally convinced/positive that he was absolutely food free during the last test anyway. Although, Antech said that they do a "random" bile acids test that does not require fasting and retesting after food. I asked about the urine bile acids test, but Dr. L felt that it would be as traumatic to Milk to have the cystocentesis (and I don't know what Dr. G.'s experience with doing it is) as it would be to have the blood work done. I told her that I would prefer getting blood work done at his office because of the distance, the waiting time, the dogs in the waiting room, and the way that her technicians take the blood. She didn't react with horror.
I am in a state of panic about all of this. I couldn't sleep last night. I stayed up till 6AM, when I was so exhausted that I figured I wouldn't be laying there waiting for Milk to have a seizure. That is disfunctional, obviously. There has to be an answer to this. I feel like he's a bomb, ready to explode at the least provocation, and that there doesn't seem to be any solution. Even if we have the MRI, and it shows something fixable (affordable?), or if it shows something UNfixable, then what?
I explained my concerns about Milk:
1) increased severity of seizures
2) increased frequency
3) diminished appetite, although it is improved somewhat
Dr. L feels that we need to get a post-prandial bile acids test done as soon as possible, and based on that (and the comparison between the previous test, which was pre-prandial), she would refer me to a veterinary neurologist in Akron. Where it would be decided, I guess, about doing an MRI and spinal tap. Neither of which I'm eager to do. The neurologist's name, I believe, is Todd Ecklund or Acklund - can't find the paper I wrote it down on a couple weeks ago. (Correction: Axlund.) He was a professor at Auburn. I asked if it was customary for seizures to escalate in severity, and if not, what it might mean. She said it wasn't necessarily usual, but since they don't have the information from an MRI to be sure exactly what's going on in Milk's head, there's really no way to know. She felt that, given his age, it was not particularly likely that he has a brain tumor, but that inflammation might be a possibility, along with something else that I can't remember. Speaking of possible brain tumors.... Anyway, I will have another bile acids test done this week, and then I guess we will go from there. She did say that the 25 he had on the previous bile acid test was not a huge reason for concern - that the area of 50 is more of a problem. I guess that's good news. I'm not totally convinced/positive that he was absolutely food free during the last test anyway. Although, Antech said that they do a "random" bile acids test that does not require fasting and retesting after food. I asked about the urine bile acids test, but Dr. L felt that it would be as traumatic to Milk to have the cystocentesis (and I don't know what Dr. G.'s experience with doing it is) as it would be to have the blood work done. I told her that I would prefer getting blood work done at his office because of the distance, the waiting time, the dogs in the waiting room, and the way that her technicians take the blood. She didn't react with horror.
I am in a state of panic about all of this. I couldn't sleep last night. I stayed up till 6AM, when I was so exhausted that I figured I wouldn't be laying there waiting for Milk to have a seizure. That is disfunctional, obviously. There has to be an answer to this. I feel like he's a bomb, ready to explode at the least provocation, and that there doesn't seem to be any solution. Even if we have the MRI, and it shows something fixable (affordable?), or if it shows something UNfixable, then what?
Sunday, November 25, 2007
this was horrible.
#35. Absolutely the worst one yet. Started off kind of slowly, laying on his side on a blanket between and parallel to my calves. By the time the growling and snarling started, he was also beginning to flop violently. He flopped (like a fish out of water) so hard that he sat himself up in the meatloaf position. I couldn't get to him because he was facing me, and all that snarling is very scary - lots of teeth showing. A couple of his claws were stuck in my right calf. And he kept bouncing and bouncing. I was scared that he was going to fall off onto the floor, and all I could think to do was to try to gather the blanket up tightly to try to keep him from falling and to pull him closer, but also to not have to get too close. It sounds like Three Stooges, but it was truly awful. And for the second time, I forgot to put the camera out before I went to sleep, but I don't think that 1) I would have been able to manage taking a video without letting him fall on the floor, and 2) I ever want to see that again. I was so afraid he would hurt himself.
It took about 30 seconds after the flopping stopped for him to come out of it. There wasn't the "moment of consciousness" that was so distinct the last two seizures. He still seemed out of it when he jumped down, and he was very wobbly on his feet. He went to the kitchen to look for something to eat. He ate about 1/3 of one can and then came looking for something else, so I opened another can. He's huddled on the living room floor right now, almost a half hour afterwards.
There were no indications that he was going to have a seizure today. No excessive sleepiness, no differences in food preferences, or activity level, no changes with medication (except that his second Keppra was about 45 minutes early because I had to go out.) Early, you wouldn't think would make a difference, right?
This was a rarity - a "full moon" seizure. I truthfully don't think that the moon phase seems to have anything to do with it. What does worry me is that it's only been six days since the last seizure. This happened before, where they kept getting closer together, until they got to the place where there was only two days between events. I do NOT want that to happen again. I can't say that I've seen anything in his personality or abilities or anything that has been damaged by having three dozen seizures in eight months, but it can't be doing his brain any good, and it's breaking my heart.
I am really upset by this one.
It took about 30 seconds after the flopping stopped for him to come out of it. There wasn't the "moment of consciousness" that was so distinct the last two seizures. He still seemed out of it when he jumped down, and he was very wobbly on his feet. He went to the kitchen to look for something to eat. He ate about 1/3 of one can and then came looking for something else, so I opened another can. He's huddled on the living room floor right now, almost a half hour afterwards.
There were no indications that he was going to have a seizure today. No excessive sleepiness, no differences in food preferences, or activity level, no changes with medication (except that his second Keppra was about 45 minutes early because I had to go out.) Early, you wouldn't think would make a difference, right?
This was a rarity - a "full moon" seizure. I truthfully don't think that the moon phase seems to have anything to do with it. What does worry me is that it's only been six days since the last seizure. This happened before, where they kept getting closer together, until they got to the place where there was only two days between events. I do NOT want that to happen again. I can't say that I've seen anything in his personality or abilities or anything that has been damaged by having three dozen seizures in eight months, but it can't be doing his brain any good, and it's breaking my heart.
I am really upset by this one.
Monday, November 19, 2007
#34, damn it
Totally out of the blue, except that it's been on my mind today that it's been almost 10 days since the last seizure. Is ten days going to be the time frame that has to be acceptable? Well, anyway, it's the 9th day. I was sitting in the kitchen when the growling started. Milk was sleeping in one of the caves on the heated mat in front of the furnace vent - could hardly get much warmer and snugglier. The minute he started growling, all three of the other cats came running, which has almost never happened. And, because he was in the cave - very soft, but confined area, with only two round circular holes at each end, he was thrashing around without much room for the flopping stuff he did during the last seizure. I manuevered the cave around so that he could work his way out of it. Then he could stretch out on the floor.
Lots of saliva this time. A LOT of jerking and body-snapping movement. Again, it seemed like a much more physical, unpleasant seizure than his norm. Even after most of the movements stopped and he was just laying on his side, there were still frequent hard jerks - of his torso, not of his extremities - no paddling movements. He lay for probably a minute unblinking, and then got up but was very wobbly. He didn't come into the kitchen for food until I called him, which is odd, too - usually, he's out here waiting for me to get him something to eat. He seems okay now. No pacing. Ate almost two whole cans of Fancy Feast. His appetite the last week or so has been very poor, and I've been bottlefeeding him again at least once a day, so eating that much is good to see. The only other thing of note today is that he has slept most of the day - in the cave, instead of with me or one of the other cats. He really seems to appreciate the heated mat. I guess I'll watch and see if extra sleeping happens before the next seizure. It might be helpful to have some idea of triggers/forecasters. Not that there's anything to do about any of it....
I would like to know if it's possible to just use Keppra by itself. And if his phenobarb could be decreased any more - I'm thinking that maybe he should have his levels checked again, even though it's only been a couple of weeks since the last test. And if the Keppra could be safely increased. And I don't have a mechanism for conveying information to Dr. L. about what's going on with Milk, either. I would like to be able to email her the seizure record, or this stuff, or whatever. Faxing doesn't seem to be something I'm gonna be good at.
Lots of saliva this time. A LOT of jerking and body-snapping movement. Again, it seemed like a much more physical, unpleasant seizure than his norm. Even after most of the movements stopped and he was just laying on his side, there were still frequent hard jerks - of his torso, not of his extremities - no paddling movements. He lay for probably a minute unblinking, and then got up but was very wobbly. He didn't come into the kitchen for food until I called him, which is odd, too - usually, he's out here waiting for me to get him something to eat. He seems okay now. No pacing. Ate almost two whole cans of Fancy Feast. His appetite the last week or so has been very poor, and I've been bottlefeeding him again at least once a day, so eating that much is good to see. The only other thing of note today is that he has slept most of the day - in the cave, instead of with me or one of the other cats. He really seems to appreciate the heated mat. I guess I'll watch and see if extra sleeping happens before the next seizure. It might be helpful to have some idea of triggers/forecasters. Not that there's anything to do about any of it....
I would like to know if it's possible to just use Keppra by itself. And if his phenobarb could be decreased any more - I'm thinking that maybe he should have his levels checked again, even though it's only been a couple of weeks since the last test. And if the Keppra could be safely increased. And I don't have a mechanism for conveying information to Dr. L. about what's going on with Milk, either. I would like to be able to email her the seizure record, or this stuff, or whatever. Faxing doesn't seem to be something I'm gonna be good at.
Saturday, November 10, 2007
A very different quality, somehow.
This morning's seizure was very different from the last five or six. It was very short, and much more physical. I was going to say "violent" - but it wasn't really violent, I guess. He must have been laying on his side when it started, and the jaw-clicking that accompanies the salivation seemed to take a very long time to get going. I usually try to gently stroke and wipe him up and talk to him during a seizure, but he was a little too far away to reach. (And I'd had the camera sitting there at night for days now; forgot to put it out last night...) The "violence" was mainly his body flopping like a fish; there almost appeared to be a sort of rippling from his head to his tail. There hasn't been that much movement during a seizure for quite a while. Growling started a few seconds after the beginning of the seizure, and was much reduced in volume. This was a quick but mean one, I guess. Over rapidly and very abruptly, with a distinct moment in time when it appeared he was himself again, although he didn't move. After it ended, he just laid there, with his eyes wide open and unblinking for a good minute and a half. And then, he abruptly stood up, jumped down, and headed for the kitchen to eat.
It's been 10 days since the last seizure, which is good, not that it wouldn't be nice if it had been 10 weeks, or years...... He started the generic Keppra from Canada earlier this week, and last night, he had the last of the 6 month old phenobarb Vet Chews. He's a little wobblier these days than he was, say, a few weeks ago. And he's not eating as well. I've started giving him the occasional bottle of Wellness again; he won't eat it from a dish on his own.
Today he's scheduled for another chiropractic appointment. I was thinking that maybe I should cancel it, but upon further consideration, this might be a good time for the treatment, since his muscles and joints have been through this ordeal so recently. Boy, I hope he never has a seizure in the carrier.
It's been 10 days since the last seizure, which is good, not that it wouldn't be nice if it had been 10 weeks, or years...... He started the generic Keppra from Canada earlier this week, and last night, he had the last of the 6 month old phenobarb Vet Chews. He's a little wobblier these days than he was, say, a few weeks ago. And he's not eating as well. I've started giving him the occasional bottle of Wellness again; he won't eat it from a dish on his own.
Today he's scheduled for another chiropractic appointment. I was thinking that maybe I should cancel it, but upon further consideration, this might be a good time for the treatment, since his muscles and joints have been through this ordeal so recently. Boy, I hope he never has a seizure in the carrier.
Tuesday, November 6, 2007
A whole big screw-up with the medication
We're coming to the end of the brand name Keppra, and at the same time, of the now-expired chicken-flavored phenobarb Vet Chews from BCP. I called the compounding pharmacy that was so unhelpful about fixing the liquid Keppra, and they were even more unhelpful about making me capsules with 10mg of phenobarb in them - they said they wouldn't do it; they would only make a 10mg liquid. We didn't have much luck with liquid before, and it was very traumatic for Milk (and for me!), so I guess we'll have to spend the $40 a month for Vet Chews. Tuna flavor, this time.
Milk won't eat the Chews - apparently regards them as being too similar to Pill Pockets - but they do make pilling him simpler. I asked Dr. G. to fax them another prescription, as the original refills had mysteriously expired (less than a week ago, of course) in only six months. I thought that everything was arranged, only to find out that, because phenobarb is a controlled substance, they have to have the actual prescription in their hands. I am HOPING that Dr. G's office was able to get the prescription in the mail yesterday, because I only have enough 10mg chews left to last until Friday. If the mail works efficiently, and BCP does the same and gets the chews in the overnight mail, hopefully, it won't screw things up any further. It's been another week since the last seizure. I could live with two a month. I'm a little nervous about the generic Keppra working the same, and they're larger than the brand name was. I wrap them in Pill Pockets and pop them into Milk's throat, so they should go down just like the other ones. If only they WORK like the other ones.....
Milk won't eat the Chews - apparently regards them as being too similar to Pill Pockets - but they do make pilling him simpler. I asked Dr. G. to fax them another prescription, as the original refills had mysteriously expired (less than a week ago, of course) in only six months. I thought that everything was arranged, only to find out that, because phenobarb is a controlled substance, they have to have the actual prescription in their hands. I am HOPING that Dr. G's office was able to get the prescription in the mail yesterday, because I only have enough 10mg chews left to last until Friday. If the mail works efficiently, and BCP does the same and gets the chews in the overnight mail, hopefully, it won't screw things up any further. It's been another week since the last seizure. I could live with two a month. I'm a little nervous about the generic Keppra working the same, and they're larger than the brand name was. I wrap them in Pill Pockets and pop them into Milk's throat, so they should go down just like the other ones. If only they WORK like the other ones.....
Wednesday, October 31, 2007
A very unpleasant surprise
Milk's been so "normal" lately that I really had sort of put seizures out of my mind. Well, not totally, but there was absolutely nothing that would have made me think that he'd wake me this morning in the beginning of one.
I'd guess it lasted about 30 seconds - it's hard to judge. There was a digital clock right there, and it said 5:20 when I first looked at it, and 5:21 when the seizure activity appeared to be over. This one continued the recent pattern of having very little physical involvement, but lots of growling/snarling. He was laying on his side, and never changed position at all until he got up to jump down and go to the kitchen to get something to eat. My mind was caught on his tail, which had extended out from his body in a sort of "c" shape when the seizure started, and just stayed in the same place the whole time. There was a moderate amount of foaming, not a ton. He ate most of two cans of Fancy Feast afterward, and then curled up on the floor, waiting, it appeared, for me to finish typing this.
I'm really disappointed, but at least it's been two weeks since the last seizure, instead of two days....
I'd guess it lasted about 30 seconds - it's hard to judge. There was a digital clock right there, and it said 5:20 when I first looked at it, and 5:21 when the seizure activity appeared to be over. This one continued the recent pattern of having very little physical involvement, but lots of growling/snarling. He was laying on his side, and never changed position at all until he got up to jump down and go to the kitchen to get something to eat. My mind was caught on his tail, which had extended out from his body in a sort of "c" shape when the seizure started, and just stayed in the same place the whole time. There was a moderate amount of foaming, not a ton. He ate most of two cans of Fancy Feast afterward, and then curled up on the floor, waiting, it appeared, for me to finish typing this.
I'm really disappointed, but at least it's been two weeks since the last seizure, instead of two days....
Sunday, October 28, 2007
Chiropracty and bloodwork
I took Milk on Thursday and had blood drawn to test his lead levels, phenobarbital levels, and bile acids. (I also wanted the ALT and AST, etc, but Dr. G. didn't seem to feel that that was significant if we had the bile acids.) Results came back on Friday: phenobarb level - 25, lead level - 0, and bile acids, 17. Previous bile acids result, done when he was first diagnosed, was 6.8. I don't know how significant this result is, though. He wasn't really fasted prior to the test, because he ate a few pieces of dry kitten food three or four hours beforehand. And there wasn't any feeding/follow-up blood test. The fact remains, the bile acids are supposed to be below 10. I assume that I'll hear from Dr. L next week when she gets her copy of the testing. I still don't know what this test shows about the condition or function of his liver, particularly after the excessive phenobarbital levels. I would like to know if there are supplements (milk thistle, actigall, etc ) that might be helpful for him to take. Not that I'm eager to give him a whole mess of new pills.
Saturday, we went to Dr. Doug for a chiropractic exam and treatment. There were a whole mess of vertebrae out of whack; I counted 9 times when the Dr. stopped and worked on an area. Milk was his usual sweet, silent little person - not a peep out of him during the two hours in the car, or while we were at the vet's. He was very glad to be home again, and ran around and let everyone else sniff him. He spent most of the evening napping in the dining room under the rocking chair; he just seemed worn out.
Eleven days without a seizure......
Friday, October 19, 2007
Phenobarb reaction again?
I don't like what I'm seeing here. I've noticed a distinct increase in Milk's wobbliness earlier this week. This morning, he jumped up on the bathroom sink, and stepped off into space twice with one of his back legs. His appetite is decreasing again, too; I've been giving him a kitten bottle or two of Wellness again every day for a week.
I called the Speciality Hospital this afternoon, but Dr. L. wasn't in. Milk's supposed to have bloodwork done next week anyway - phenobarb levels, bile acids, and something else I can't think of. I made an appointment with Dr. L for him for Tuesday, but I am going to call Dr. G tomorrow and see if he might have time in the AM (before I take Scruffy to the chiropractic appointment) to do the bloodwork. I prefer his method of getting blood - he uses Milk's thigh, rather than the jugular or wherever it is the Speciality Hospital technicians have to make multiple pokes around his knees. Plus, I don't like them taking him away to do it; he's such a shy little person, and I think it matters to him to have me there. Additionally, someone posted the other day on the epifelines site that Antech has a - well, I don' t know what it's called - system, program, schedule - whatever - they do a bunch of tests all at once to determine blood levels of therapeutic drugs. Antech isn't the same company that the SH uses, but I'd rather know on Sunday if his phenobarbital level is high again than wait till the middle of the week. Plus, if I can't get him in to Dr. G on Saturday, I can do it Sunday and still be ahead of the report game.
I would like to know if there are people whose cats are just on Keppra. Or what about the person on the epifelines board whose cat takes 250mg TID of Keppra? Would that work for Milk? That 250mg cat weighs 20 pounds or something, though; Dr. L seemed to believe that weight is significant in Keppra dosing.
Speaking of which - the Canadian generic Keppra came today. It's been maybe four days since I got the email saying that it had been shipped. The whole experience - except for my faxing disaster - was relatively painless, and I will be happy to do it again. www.universaldrugstore.com. They were very pleasant and cooperative. Someplace in Manitoba. Interestingly, although the package came in a big plastic mailing pouch, and you could hear the pills banging around if you shook it, and it was addressed to me and to "pet Milkshake" - there was no indication anywhere on the bag that it contained medication.
Around 9:00, I heard a funny noise in the kitchen. I thought Milk was having a seizure. When I went to see, there was a huge dark yellow puddle of clear liquid all over the floor. And a smaller puddle beside where he was sitting. He plainly looked like he didn't feel well. There was no solid stuff in the puddles, and no sign of his 6:00 Keppra pill, thank goodness. He hadn't eaten anything at 8:00 when I fed everyone, and he kept licking his lips. Hope didn't think it was anything to get hysterical about, though. (I immediately was imagining liver failure from the phenobarb.) Anyway, when I got up the next day, there was a fairly large spot on the rug of orangish stuff - ick - with three very tiny little hairballs in the middle. So, presumably that's what the problem was. Hopefully. I had gone to the store for Pepcid AC last night, and gave him 1/4 tablet then, and another 1/4 with this morning's Keppra. He ate a few treats, although I didn't see him eating any cat food. He's peppier today anyway, so I guess that's what it was....
How come nothing's ever simple?
I called the Speciality Hospital this afternoon, but Dr. L. wasn't in. Milk's supposed to have bloodwork done next week anyway - phenobarb levels, bile acids, and something else I can't think of. I made an appointment with Dr. L for him for Tuesday, but I am going to call Dr. G tomorrow and see if he might have time in the AM (before I take Scruffy to the chiropractic appointment) to do the bloodwork. I prefer his method of getting blood - he uses Milk's thigh, rather than the jugular or wherever it is the Speciality Hospital technicians have to make multiple pokes around his knees. Plus, I don't like them taking him away to do it; he's such a shy little person, and I think it matters to him to have me there. Additionally, someone posted the other day on the epifelines site that Antech has a - well, I don' t know what it's called - system, program, schedule - whatever - they do a bunch of tests all at once to determine blood levels of therapeutic drugs. Antech isn't the same company that the SH uses, but I'd rather know on Sunday if his phenobarbital level is high again than wait till the middle of the week. Plus, if I can't get him in to Dr. G on Saturday, I can do it Sunday and still be ahead of the report game.
I would like to know if there are people whose cats are just on Keppra. Or what about the person on the epifelines board whose cat takes 250mg TID of Keppra? Would that work for Milk? That 250mg cat weighs 20 pounds or something, though; Dr. L seemed to believe that weight is significant in Keppra dosing.
Speaking of which - the Canadian generic Keppra came today. It's been maybe four days since I got the email saying that it had been shipped. The whole experience - except for my faxing disaster - was relatively painless, and I will be happy to do it again. www.universaldrugstore.com. They were very pleasant and cooperative. Someplace in Manitoba. Interestingly, although the package came in a big plastic mailing pouch, and you could hear the pills banging around if you shook it, and it was addressed to me and to "pet Milkshake" - there was no indication anywhere on the bag that it contained medication.
Around 9:00, I heard a funny noise in the kitchen. I thought Milk was having a seizure. When I went to see, there was a huge dark yellow puddle of clear liquid all over the floor. And a smaller puddle beside where he was sitting. He plainly looked like he didn't feel well. There was no solid stuff in the puddles, and no sign of his 6:00 Keppra pill, thank goodness. He hadn't eaten anything at 8:00 when I fed everyone, and he kept licking his lips. Hope didn't think it was anything to get hysterical about, though. (I immediately was imagining liver failure from the phenobarb.) Anyway, when I got up the next day, there was a fairly large spot on the rug of orangish stuff - ick - with three very tiny little hairballs in the middle. So, presumably that's what the problem was. Hopefully. I had gone to the store for Pepcid AC last night, and gave him 1/4 tablet then, and another 1/4 with this morning's Keppra. He ate a few treats, although I didn't see him eating any cat food. He's peppier today anyway, so I guess that's what it was....
How come nothing's ever simple?
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