Monday 3-30-15 Took Trinity in for the BP and potassium check and I’m left perplexed and frustrated.
Trinity’s bp was 120 something on one machine and 130 something on the Doppler machine. Her potassium (about 2 hours after she ate) was 3.7 (normal range 3.5-5.8)
On the toxo IGG and IGM and crypto antigen test, my vet didn’t run what I requested that the NC State neurologist specialist said to test for. I was given no indication he wouldn’t run what I requested on March 23 or when he called to say the test was negative on March 27th .
Today (3-30-15 I found out Dr. M ran a feline neuro PCR panel for the toxo and crypto.
I mean I imagine there is a reason behind a specialist feline neurologist suggesting such specific test that my cousin/ vet Dr. S. even looked up the test numbers and told me specifically what I was to ask for. I hope that wasn’t of time, money and stress to Trinity
The neurologist specialist is also the one who suggested the Zonisamide over Phenobarb that is less sedating and less irritating on the liver. Seems a shame to me to waste the knowledge of a specialist when it was given.
Dr. M has only Rx Zonisamide for dogs and refilled her Phenobarb with instructions for 1/4 pill 2x a day instead of the 1/2 pill because of what happened on Saturday.
So every time I feel like I’m covering all the bases I can afford and do something to treat, I feel like I’m still missing the mark and just going with idiopathic seizures. We’re back to if she doesn’t start having other problems, or weight loss from an abdominal cancer, it’s probably a brain tumor.
Later the same day update: Bad news / Good news.
When I called Dr. M back and said I was told that the PCR test was pointless unless run on spinal fluid or a cat with a fever, and wouldn’t show it according to the other two doctors who even took the time look up the exact test numbers and what vials needed to be used. My vet said he didn’t agree with my cousin/vet or the NC State feline neurologist specialist because a PCR test would show active toxo and crypto. So that’s why he ran what he chose instead of what I asked for.
He said he’d run what I asked for the 1st time at no charge and to bring Trinity back in a second time later today. Now we have to wait again and the 2nd blood draw and taking her back to the vet 2x in one day didn’t go well. They took her away instead of drawing it with me there. I could hear her crying and it took 20 min. Guess they couldn’t get enough from her legs so they had to move to both sides of her neck. She’s supposed to be avoiding stress for the seizures. I hate her being taken away for stuff and I hate that we wasted time from the 23rd and putting her through more. When Dr. M came out he said it’d probably take 5 to 7 days. (Good Friday in there too) so we wait and I’m back to hoping it’s treatable.
I learned more about why the other anti seizure drugs were recommended over phenobarb. All that if we have to cross the bridge when we finally get back the right toxo/crypto test results.
4-1-15 Even though we are still giving a ¼ of phenobarb since the evening dose on 3-28-15. Trinity was still pretty out of this morning when it was time for the next dose. She had to be enticed to eat her wet breakfast. Also hubby went to pet her when she was on her low scratcher and she always rolls over for petting on it. She walked away instead. When I got out of the shower she was laying in an unusual spot in our bedroom near the door. When I went to pet her she rolled over for petting but as I knelt down she looked fearful, made a sound and walked away from me too. I’m hoping she was just scared I was taking her back to the vet again but it’s now after 2pm and she’s under the ottoman and doesn’t really seem to want to be near me.
I wish we knew the blood work results, as I’m starting to be fearful that my realist, non optimistic husband is right and she is worse than I think. I mean she’s pretty dopey on a ¼ of a pill. She started the phenobarb on the 23rd, then the dose was cut in half on the 28th so 2 weeks on it would be April 6th. Maybe I’m just not giving it enough time for her to get used to it but she is on half of what is typically prescribed for her weight. I hope it’s enough to keep the seizures from happening especially since she’s still lethargic and unsteady.
I learned from my cousin and the neuro specialist that the reason Zonisamide or Keppra is recommended is because the cat doesn’t need to have the therapeutic levels of the drugs or their kidney levels measured like they do when they’re on phenobarb and that both are not as sedating either. That’d be nice because then I don’t have to worry about her falling all the time instead of just if she has a seizure.
Yesterday she didn’t make it when she tried to jump up on the bed. Since we’re supposed to be avoiding stress I’d rather not have to take her in to have test done because of the phenobarb in addition to wanted to see her not so doped.
The neuro specialist also said after we know if it’s infectious or a parasite or not that after a month you usually taper down off the phenobarb to see if they’re still having seizures. He said it could’ve been a head injury and brain swelling that we didn’t see happen. If she has another seizure while off, that phenobarb works faster than the other two so she’d have to go back on it but my thoughts are to also start one of the other two then wean her off the phenobarb after the Zonisamide or Keppra gets to a steady state so she’s not as sedated and we don’t have to check her liver (ARP test) or the drugs levels every six months.
But for now we wait again for the toxo and crypto test. I don’t feel like we can even go away for a day to celebrate our 25th wedding anniversary at this point with her this sedated.
I was informed by Dr. S that it’s way more likely to be idiopathic seizures instead of idiopathic epilepsy at her age too. Epilepsy typical shows by age 3, or latest at age 5. Trinity will be 8 this month. Seizures in cats of this age are typically from a trauma, metabolic, toxicities, infectious virus (FIP, FeLV, FIV, Cryptococcus, rabies), a parasite (toxoplasmosis or Cuterebra) or cancer (brain or lymph).
I’m assuming she’s had the funduscopic exam of her retinas but I don’t know that. She has had the CBC. I don’t know if she’s had serum bio chem panel. She has not had a urinalysis done since last year for the cyrstals. We are not going to do the ultrasound, CT or MRI because we wouldn’t be able to treat what they might find. I don’t think she’s been tested for the other virus infections that could cause seizures.
I would like to know if the neurology specialist has ever seen seizures from being fed food with grains for the last 6 months for the first time in their life. I read about that on a non medical site where the lady used her cat as an example.
The NC State neuro specialist also said Trinity should be on 2 meq of potassium. That her levels were not low enough to cause seizures but that it could contribute to them as it consistently checks on the low side of normal.
Tuesday the 31st. Dr. M only had gel and Trinity is easier to pill or sprinkle powder on her food than take a gel so I ordered ReneKare from Fosters and Smith just in case Dr. M couldn’t get any powder/tables in the next few days but it requires an Rx and I don’t see it’s been shipped yet. Don’t know if F&S hasn’t contacted him yet or if he hasn’t approved it.