Next Jennie's pain. Her pain level does seem to be increasing. It's so strange to look at this cat apparently glowing with health, but the difference between right before a buprenorphine dose is due and 10 minutes after is like night and day. She still has the gabapentin every 8 hours, and the piroxicam every 48 hours but is needing the bupe every 12 hours now as well. At first I was trying to keep her at the lowest dose possible, but I just don't see any point in leaving her in discomfort, so I'm just giving it to her every 12 hours now. She is on the Cerenia as prescribed.
I'll give her the details about the compounded version at the visit.
Her appetite is pure Jennie. She's always been an eager eater and with the exception of that one day, over Christmas with the constipation, she is ready to eat at all times. Doing her Song and Dance and all! I am concerned about weight gain so have been gradually reducing her quantity. When I first started her back on canned I wasn't sure how much she would need and was feeding 5.5 ounces a day. I didn't expect a cat with cancer needing to be worried about weight gain! She's down to 4.85 ounces a day now.
Her weight this morning (12/30) was 8 lbs 9 ounces (Salter baby scale), same as last week, so hopefully I can keep her at 4.85 ounces a day. And one week later, weight exactly the same again 8 lbs 9 oz I don't want her having food anxiety on top of everything else. My concern is if the weight gain is caused by too much food, or is there fluid built up or the tumor(s) growing? (Would tumors add much body weight?) I don't feel her ribs getting prominent, so I do think it's too much food, but I'll be glad to have your assessment. Our appointment with you and for her blood draw kidney check is next Monday, the 7th at 5:40.
I remember that when Jennie was on a canned diet, before going raw, she did tend to gain weight and I had to feed her very small amounts, She was only getting 3.5 ounces a day then, which was difficult for her with her food anxiety. That anxiety problem went away mostly with the raw diet, and while she does have a good appetite I am not seeing that same worry over food, with the amount of canned she's getting now.
Her pee habits are consistent with the amount of water she is getting in her canned food. I have the fluids, but haven't used them except twice when she was off her food. She accepts a couple of tablespoons of water in each serving of her canned food, so with 8 servings, she is getting about 8 ounces extra of water a day. She never goes near the water bowls.
She also gets the broth from poached chicken breast, I forgot to mention that. I poach the breasts in water for a long time, and the resulting broth is a lovely aspic when cold. Just like bone broth I freeze in ice cube trays for individual portions. The meat is frozen separately so I can use that as a treat or added to the broth.
Another concern is she seems a bit lumpy on her underside. Dr B will be aware Jennie has always had that lumpy spot low on her abdomen, but lately she feels lumpy all over underneath. I'm not sure if it's only because I am used to her having thick fur there, thinking back I can't remember if I felt those lumps when she was first shaved 2 months ago. That I never recorded lumps though, makes me think they weren't there then, because I usually write things like that down.
There is one lump when she is lying on her right side, near her ribs that seems to slide around. I mean when my fingers find it, I can actually push it around under the skin. I can't always find it. Need to remember to mention that.
She shows no discomfort when having her tummy rubbed, in fact as always she invites it, and even accepts and encourages deep massage there. When I do this, her tummy is almost never gassy. I know the tumor is in her colon, but I'm thinking that if it begins grow in a way to cause blockage problems, along with changes in her bowel habits I might notice suddenly having gas in her tummy?
Since starting the compounded buprenorphine her stomach has started making gurgling noises. I still don't feel any gas bubbles on massaging, and the bupe isn't ingested it is absorbed through the mucus membranes in the mouth so I don;t know what that is all about.
Just one more thing I wanted to mention. I never asked to see the ultrasound, but I am assuming UVS sent those records to you so you know exactly what we are dealing with here. I wonder sometimes if I should have looked at them, to help me have some understanding about how things will progress but I am still reluctant. I don't plan to put Jennie through another ultrasound to check progress, so I suppose there isn't any point to me looking at them now, I worry it will just cause me more anxiety. When we come in next week, I'd like your opinion (and Dr Br's too, if she has anything to add) on how things are going, as far as progression of the disease, based on the ultrasound from 10/26, her original symptoms and my updates to you, and of course your examination when we come in.. I know I've been kind of skirting around that particular subject, but she's doing so well,I think I'm ready to talk about it now. (subject to change!)
So she has a good information basis for the check up and I have a couple more questions to ask her in addition to the ones in the letter including about the eye drops.