Pantheramycine has oxytetracycline as active ingredient. To review the medications: Pantheramycine IV, dextrose IV, Metabolase IV/SC, Dodex (cyanocobalamin) SC, Buscopan (butylscopolamine) IM, Metpamid (metoclopramide) IM. Metpamid was suggested in case of persistent vomiting. She didn't vomit all that much throughout her sickness and there is very little drooling now, so unless she vomits the food we'll give her tonight, no more Metpamid. Also, as I wrote in of my earlier posts, she showed the first signs of recovery in the emergency clinic. I've browsed through the bills and found the "wonder injection," which seems to be a Vitamin C shot. Would you recommend extra Vitamin C shots, or does Metabolase cover that necessity? I will get the exact name of the shot ASAP.
Roferon A has interferon alpha-2a. It was recommended to boost the immune system in case the FIP virus was present. It may yet be a preliminary stage of the disease where the cat can fight off the virus, I hope? There is a scientific paper covering this low-dose oral interferon therapy (I'll post this article too.) As for the FIP test, I called the hospital lab and got the answer that they had the rapid FIP test kit, not the PCR/titer. (Am I correct to assume that this test would be less reliable?) If you strongly recommend the PCR/titer test, I will get it done as soon as Neco's condition has improved a little more. The vets also told me that FIP was quite widespread, but my cat never leaves the house. There is a population of stray cats in our backyard. She escaped only once, and that for a few moments. Is infection that easy?
I am very glad to hear that the liver structure we saw in ultrasonography is not FIP-specific. Is it possible to deduce/approximate the level of globulins from existing bloodwork? As far as I know, globulins and albumin make up most of the proteins in the blood serum. Can I say that Neco's globulin levels are below 4.3? [7.0 total blood protein, 2.7 albumin level] Her total blood protein is actually within acceptable range, which is 5.4-8.2 according to the paperwork, while I read that FIP is associated with very high blood serum protein levels. (Though perhaps I'm deluding myself with false hopes.)
Anorexia persists. I've fed minimal amounts so far but today, I'll try feeding more. I'm very glad to see that she didn't throw up the food we gave her yesterday. I do use a digital rectal thermometer. IV feeding and medication continues. K/D wet food has been suggested to alleviate the stress on her liver. I mix the wet food with water, fifty-fifty. How many mL's should I feed daily?
Thank you for your expert help.
Cat Drooling Excessively and Refusing to Eat
Re: Cat Drooling Excessively and Refusing to Eat
The Metabolase contains vitamins plus B12, so I would NOT give the cyanocobalamin because it also contains B12, you don't want to end up giving Neco megadoses of B12 and risk excess supplementation.
The butylscopolamine, in my opinion, is not necessary since Neco is also on fomatidine/ulcuran and metoclopramide. If she's not vomiting, she probably does not need an antispasmodic.
NO vitamin C necessary, the metabolase is a pretty hefty dose of vitamins. As in humans, there is pretty much insufficient evidence that megadoses of vitamin C has any real additional benefit, most is excreted in the urine.
Roferon-A: there isn't enough evidence to support use of Roferon-A (much of it is anecdotal), and it is not without serious side effects, including lowering platelet counts and could exasperate anemia conditions (not to mention potential liver damage). Neco cannot afford those platelets any lower than they already are, nor further insult on her liver.
Since there is no confirmation on FIP at this point, I think it's premature to be considering Roferon-A, particularly since it is probably NOT helping hemobart recovery.
Re: the albumin and globulin ratio (A:G) - we would need to know the exact albumin level and the exact globulin level, then interpret the A:G ratio.
Please see: http://www.dr-addie.com/WhatIsFIP.htm
Scroll the page for an immense database of information/links on diagnostics. This is among the foremost information sites on FIP, testing and potential treatment. Get your vet to look at it in greater detail.
Please remember that Roferon-A is a human recombinant interferon, if there is any success with interferons in treating FIP, the type chosen should be the feline interferon omega (IFN omega), and it might not be easily obtained, your vet would have to investigate the availablility.
Again, the vet MUST be able to differentiate Neco's current and subsequent bloodwork that indicates hemobart from FIP. It is so easy to assume, that's why so many parameters must be opted for. I think at this point, it is more productive to treat hemobart, test for FIP, but be extremely cautious in interpretation of any FIP titer results, to avoid mistakes, and remembering that hemobart and some blood parameters can mimic FIP and other immune conditions.
You mentioned you're now feeding K/D. Did you mean to say A/D? Whichever you're feeding, it should be around 25 ml's per feeding or more (at least 4-6 times a day spread out every few hours) if she can handle it and does not vomit. If she's nauseated, she may not be able to handle that much. Rule of thumb, feed whatever she will take in, in small amounts, she will let you know if she can't take in more (by fidgeting, fighting you, possibly gagging). If she absolutely refuses ANY feeding attempt by you, you must contact your vet for further direction. Her nutritional support is paramount.
Btw, if you truly meant K/D, this isn't the best food to be feeding now. It should be A/D or L/D or G/D, canned, mixed with water for easier feeding. Are you hand feeding or syringe feeding?
Are you saying she's still hospitalized and you're feeding her at the hospital? Or is she now home with you?
The butylscopolamine, in my opinion, is not necessary since Neco is also on fomatidine/ulcuran and metoclopramide. If she's not vomiting, she probably does not need an antispasmodic.
NO vitamin C necessary, the metabolase is a pretty hefty dose of vitamins. As in humans, there is pretty much insufficient evidence that megadoses of vitamin C has any real additional benefit, most is excreted in the urine.
Roferon-A: there isn't enough evidence to support use of Roferon-A (much of it is anecdotal), and it is not without serious side effects, including lowering platelet counts and could exasperate anemia conditions (not to mention potential liver damage). Neco cannot afford those platelets any lower than they already are, nor further insult on her liver.
Since there is no confirmation on FIP at this point, I think it's premature to be considering Roferon-A, particularly since it is probably NOT helping hemobart recovery.
Re: the albumin and globulin ratio (A:G) - we would need to know the exact albumin level and the exact globulin level, then interpret the A:G ratio.
Please see: http://www.dr-addie.com/WhatIsFIP.htm
Scroll the page for an immense database of information/links on diagnostics. This is among the foremost information sites on FIP, testing and potential treatment. Get your vet to look at it in greater detail.
Please remember that Roferon-A is a human recombinant interferon, if there is any success with interferons in treating FIP, the type chosen should be the feline interferon omega (IFN omega), and it might not be easily obtained, your vet would have to investigate the availablility.
Again, the vet MUST be able to differentiate Neco's current and subsequent bloodwork that indicates hemobart from FIP. It is so easy to assume, that's why so many parameters must be opted for. I think at this point, it is more productive to treat hemobart, test for FIP, but be extremely cautious in interpretation of any FIP titer results, to avoid mistakes, and remembering that hemobart and some blood parameters can mimic FIP and other immune conditions.
You mentioned you're now feeding K/D. Did you mean to say A/D? Whichever you're feeding, it should be around 25 ml's per feeding or more (at least 4-6 times a day spread out every few hours) if she can handle it and does not vomit. If she's nauseated, she may not be able to handle that much. Rule of thumb, feed whatever she will take in, in small amounts, she will let you know if she can't take in more (by fidgeting, fighting you, possibly gagging). If she absolutely refuses ANY feeding attempt by you, you must contact your vet for further direction. Her nutritional support is paramount.
Btw, if you truly meant K/D, this isn't the best food to be feeding now. It should be A/D or L/D or G/D, canned, mixed with water for easier feeding. Are you hand feeding or syringe feeding?
Are you saying she's still hospitalized and you're feeding her at the hospital? Or is she now home with you?
..........Traci
Yes, she's back home. I'm taking her twice to a vet daily for IV feeding and medication. Let me write down the doses as well.
Pantheramycine/oxytetracycline: twice per day, 2.2 mL IV with dextrose
Dextrose, twice per day, 50 mL IV
Metpamid/metoclopramide: once per day, 0.5 mL IM
Ulcuran/fomatidine: twice per day, 0.3 mL IV/IM
Metabolase: 5 mL SC (not specified, once per day I assume)
Dodex: 0.8 mL SC
Buscopan: once per day for five days, 0.4 mL IM
Roferon: 30 units per day
The vet suggested that we discontinue Metpamid in the absence of vomiting, and so far we have none. You said drop Buscopan, since Metpamid covers the same area. Which med should I discard, Metpamid or Buscopan?
Both the clinic (not the paracetamol guy) and the animal hospital suggested the use of Roferon, so I cannot rule it out at this point. We have been prescribed a very, very dilute form. There is no sign of anemia in the blood tests carried out this Sunday, erythrocytes were actually higher than normal. I prefer to take this risk.
http://www.dr-addie.com/treatment.htm#intron
K/D was recommended to alleviate the stress on the liver and the kidney, the urea levels being high. They also mentioned something about the protein levels in K/D. I still have A/D, perhaps I can alternate between them. I am syringe-feeding: she still doesn't eat food by herself.
Thank you for the link. I'll be reading once I finish Neco's evening meal and take a brief rest.
Pantheramycine/oxytetracycline: twice per day, 2.2 mL IV with dextrose
Dextrose, twice per day, 50 mL IV
Metpamid/metoclopramide: once per day, 0.5 mL IM
Ulcuran/fomatidine: twice per day, 0.3 mL IV/IM
Metabolase: 5 mL SC (not specified, once per day I assume)
Dodex: 0.8 mL SC
Buscopan: once per day for five days, 0.4 mL IM
Roferon: 30 units per day
The vet suggested that we discontinue Metpamid in the absence of vomiting, and so far we have none. You said drop Buscopan, since Metpamid covers the same area. Which med should I discard, Metpamid or Buscopan?
Both the clinic (not the paracetamol guy) and the animal hospital suggested the use of Roferon, so I cannot rule it out at this point. We have been prescribed a very, very dilute form. There is no sign of anemia in the blood tests carried out this Sunday, erythrocytes were actually higher than normal. I prefer to take this risk.
http://www.dr-addie.com/treatment.htm#intron
K/D was recommended to alleviate the stress on the liver and the kidney, the urea levels being high. They also mentioned something about the protein levels in K/D. I still have A/D, perhaps I can alternate between them. I am syringe-feeding: she still doesn't eat food by herself.
Thank you for the link. I'll be reading once I finish Neco's evening meal and take a brief rest.
Re: Cat Drooling Excessively and Refusing to Eat
Ask the vet about discontinuing the buscopan.
Keep using ulcuran/fomatidine and metoclopramide. The fomatidine helps prevent regurgitation as well as helps esophageal irritation. The metoclopramide helps to prevent nausea.
Well, the kidney and liver might both be slightly compromised just due to anemia and not eating sufficiently.....also they might be recovering from the paracetamol incident. The K/D is lower in protein, but may not be providing sufficient calories to support the liver (while the A/D is high in calories). Yes, ask the vet if you can alternate.
Do you know if Neco has lost any weight in the last month, and particularly in the last several days? If so, she might benefit more from the A/D.
If the vet and you are going to insist on an immudomodulator, then at least find out if the vet has access to the feline recombinant type, as opposed to the human recombinant. The latter can have side effects that you don't need Neco suffering from. Please remember that, Neco doesn't feel good right now, she doesn't need side effects from all the meds she's on, and in fact, any side effects can delay recovery.
Ask the vet how much to be feeding. Ideally, smaller meals, but several times a day is beneficial to help curb vomiting, as well as may help increase her metabolism.
Hopefully, the vet is keeping an eye on Neco's PCV (packed cell volume) and platelet counts (included in the CBC).
Keep using ulcuran/fomatidine and metoclopramide. The fomatidine helps prevent regurgitation as well as helps esophageal irritation. The metoclopramide helps to prevent nausea.
Well, the kidney and liver might both be slightly compromised just due to anemia and not eating sufficiently.....also they might be recovering from the paracetamol incident. The K/D is lower in protein, but may not be providing sufficient calories to support the liver (while the A/D is high in calories). Yes, ask the vet if you can alternate.
Do you know if Neco has lost any weight in the last month, and particularly in the last several days? If so, she might benefit more from the A/D.
If the vet and you are going to insist on an immudomodulator, then at least find out if the vet has access to the feline recombinant type, as opposed to the human recombinant. The latter can have side effects that you don't need Neco suffering from. Please remember that, Neco doesn't feel good right now, she doesn't need side effects from all the meds she's on, and in fact, any side effects can delay recovery.
Ask the vet how much to be feeding. Ideally, smaller meals, but several times a day is beneficial to help curb vomiting, as well as may help increase her metabolism.
Hopefully, the vet is keeping an eye on Neco's PCV (packed cell volume) and platelet counts (included in the CBC).
..........Traci
Neco is progressively getting better. Today, she showed some interest in her usual dry food. She ate very little but that's progress, we've been feeding her K/D anyway. Today we switch to A/D. We gave her 100 mL food+water mixture yesterday, small doses each time. She complains a little but doesn't fight back during feeding. She's getting stronger, though. She was too lethargic to fight the injections a few days ago, but today it was a wrestling match! She hates intramuscular injections with a passion.
She has lost 200 g. in a week. I believe you are talking about feline interferon omega. It is a very expensive treatment, offered by a single company, and my country is not listed among the countries where it is commercially available. I would have to convince a professor or at least a research assistant in the university hospital to import it. If Neco does not respond definitively to haemobartonella treatment in two weeks, we'll bring this option to the table. I understand that only 25-30% of cats respond to this treatment, but something is better than nothing.
We started the pantheramycine therapy two days before Roferon and she started getting better at that point, so I am inclined to think that haemobartonella must have been guilty of the symptoms. Which doesn't rule out FIP, I know.
Also, the parasitology department in the university/state hospital suspected another blood parasite, ehrlichia, at some point. (I believe ehrlichia was the name mentioned, not 100% sure, and we were told that the treatment would be similar to haemobartonella's anyway.) The lab technician said that the results were doubtful, and that she would consult with a professor. She called yesterday and told me that they ruled out Ehrlichia. A minor point perhaps, but I wanted to mention this also.
She has lost 200 g. in a week. I believe you are talking about feline interferon omega. It is a very expensive treatment, offered by a single company, and my country is not listed among the countries where it is commercially available. I would have to convince a professor or at least a research assistant in the university hospital to import it. If Neco does not respond definitively to haemobartonella treatment in two weeks, we'll bring this option to the table. I understand that only 25-30% of cats respond to this treatment, but something is better than nothing.
We started the pantheramycine therapy two days before Roferon and she started getting better at that point, so I am inclined to think that haemobartonella must have been guilty of the symptoms. Which doesn't rule out FIP, I know.
Also, the parasitology department in the university/state hospital suspected another blood parasite, ehrlichia, at some point. (I believe ehrlichia was the name mentioned, not 100% sure, and we were told that the treatment would be similar to haemobartonella's anyway.) The lab technician said that the results were doubtful, and that she would consult with a professor. She called yesterday and told me that they ruled out Ehrlichia. A minor point perhaps, but I wanted to mention this also.
Re: Cat Drooling Excessively and Refusing to Eat
The vet should be performing a CBC for Neco at least once a week, this helps determine response to treatment.
The fact that she's interested in her own food and is stronger, is a good sign of response to treatment.
The weight loss is a concern, but not extreme, it's to be expected with anorexia. Next time the vet performs another CBC, make sure she is weighed too.
If Neco is no longer nauseated, dehydrated, nor vomiting within the next day or two, ask the vet to discontinue the metoclopramide. If it's being injected IM, you should be aware that IM injections are painful and can cause inflammation, pain in cats can often prohibit rapid recovery. The CBC will show her electrolyte levels in which to determine hydration status.
In the meantime, encourage her to find interest in her normal food, and drinking water on her own. Don't force her, just provide it, and make sure it is available to her if she chooses.
Thank you for the update, please keep us posted, Neco remains in our thoughts and prayers!
The fact that she's interested in her own food and is stronger, is a good sign of response to treatment.
The weight loss is a concern, but not extreme, it's to be expected with anorexia. Next time the vet performs another CBC, make sure she is weighed too.
If Neco is no longer nauseated, dehydrated, nor vomiting within the next day or two, ask the vet to discontinue the metoclopramide. If it's being injected IM, you should be aware that IM injections are painful and can cause inflammation, pain in cats can often prohibit rapid recovery. The CBC will show her electrolyte levels in which to determine hydration status.
In the meantime, encourage her to find interest in her normal food, and drinking water on her own. Don't force her, just provide it, and make sure it is available to her if she chooses.
Thank you for the update, please keep us posted, Neco remains in our thoughts and prayers!
..........Traci
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Tina B and crew
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Re: Cat Drooling Excessively and Refusing to Eat
I am glad to hear there is some improvement with Neco...I continue to send positive healing thoughts.
Tina B and "what a crew!"
How we behave towards cats here below determines our status in heaven ~Robert A. Heinlein
How we behave towards cats here below determines our status in heaven ~Robert A. Heinlein
Re: Cat Drooling Excessively and Refusing to Eat
Ditto Tina's sentiments! Sending Neco healing prayers.
Re: Cat Drooling Excessively and Refusing to Eat
Neco, thank you for your post Sending my thoughts and prayers to you and your kitty for a full recovery.
Lisa
Lisa
Thanks everyone, for your concern and support.
So far we have discontinued Dodex, Buscopan, dextrose, and Metpamid, in this order. We were scheduled to a new angiocath today but I declined this also, since Neco has suffered a lot of pain and stress already. She's neither dehydrated nor nauseated at this point, drinks normally and accepts food, so IV feeding should be unnecessary. We have been giving her a minimum of 100 mL water+food mixture every day. She is very picky at the moment and eats Whiskas treats only, which I assume isn't the ideal food for a convalescent cat. So I will continue syringe-feeding for now. We will take her to the university hospital on Monday for tests, especially to ascertain whether she has FIP.
Traci, do you know if oxytetracycline can be administered orally? If so, in what dose? I find it increasingly difficult to take Neco to the vet twice a day, not to mention the stress the injections cause, and the length of the treatment.
So far we have discontinued Dodex, Buscopan, dextrose, and Metpamid, in this order. We were scheduled to a new angiocath today but I declined this also, since Neco has suffered a lot of pain and stress already. She's neither dehydrated nor nauseated at this point, drinks normally and accepts food, so IV feeding should be unnecessary. We have been giving her a minimum of 100 mL water+food mixture every day. She is very picky at the moment and eats Whiskas treats only, which I assume isn't the ideal food for a convalescent cat. So I will continue syringe-feeding for now. We will take her to the university hospital on Monday for tests, especially to ascertain whether she has FIP.
Traci, do you know if oxytetracycline can be administered orally? If so, in what dose? I find it increasingly difficult to take Neco to the vet twice a day, not to mention the stress the injections cause, and the length of the treatment.