This post is an overview of Athena’s second month of treatment. If you haven’t already, I suggest reading my posts on her first week of treatment and her first month of treatment. If you want to dive deep into her story, check out her tag page.
Like the previous posts, this one is in a journal-esque format. I intend to only touch on major/important events and updates, rather than what happens each day as I did in the first week post.
Because of Athena’s setback, I had to include some medical terminology. I tried to link to easy to understand information, where possible. When I had to use medical terms for which I couldn’t find an easy plain language equivalent, I provided explanations through [def] (definition) links.
Week 6, continued
February 3 (Day 42): For some unknown reason, Athena bled after her shot. I suppose I must have nicked a blood vessel. She’d run upstairs after her shot was done, and we realized there was a trail of blood drops following her. I grabbed her out from under the chair and put pressure on the injection site while Jim cleaned up the floor. Thankfully, it didn’t take long at all for the bleeding to stop. What a way to celebrate finishing half of her treatment.
Week 7
February 4 (Day 43): Athena weight in at 7.8 lbs. I also brought her upstairs to eat lunch with the boys, and she finished about half of her food. We’ll need to work on teaching her to eat her meals at once instead of over the course of the day. But that’s work for later.
February 6 (Day 45): Athena got her last weekly B12 shot. Moving forward, she’ll get them monthly through June.
February 7 (Day 46): The boys have accepted that Athena is part of the household now. They don’t hiss at her when they see her, instead, they’re curious. Dante and Ritz, especially, were trying to get close to her, and earned some strong hisses when they tried to sniff her butt. I noticed some discharge around Athena’s eye. Something to monitor, but hopefully nothing major.
February 8 (Day 47): Athena weighed in at 8 lbs! She’s come so far! This took her to the next medicine threshold with a dosage of 1.9ml per injection.
We also adjusted her food intake to suggested levels, rather than weight gain levels. We wouldn’t want to compound her issues by letting her get overweight.
Per usual, I brought her upstairs for lunch, but she ran back downstairs while I was getting everyone’s food ready. Surprisingly, she came back upstairs when I called for her. I don’t know if that was an anomaly, or if she’ll do that regularly.
February 9 (Day 48): The new needles Jim ordered arrived. He’d tried to find thin-wall needles to see if that would be less painful, but he couldn’t find any in 20G, which is what we need. However, from his pre-med days, he was familiar with Terumo brand needles, and ordered a box. I’m sure part of the benefit is that this way I’m switching out the needles after drawing up the medicine, so Athena gets poked with a brand new needle. However, this first use was SO EASY. The needle slid in like a hot knife through butter. It didn’t take any force, unlike the other needles. I don’t think Athena even noticed when it pierced her skin.
Unfortunately, Athena had more discharge around her eyes, and I’m concerned she may have an eye infection again. She certainly had several before FIP, so she might be predisposed to them. It could also be allergies, so we’re keeping an eye on it. Hopefully it won’t require a trip to the vet before her 2/13 appointment.
February 10 (Day 49): I found another injection sore on Athena, poor girl, which takes her up to at least 6. They don’t seem to hurt, so that’s good, but I imagine they must, at least, be uncomfortable. The Vetericyn seems to be helping, so that’s good. I look forward to the end of her treatment so she can heal up.
Week 8
February 11 (Day 50): By some miracle, Athena’s injection today was perfect. She didn’t seem to be in any major pain (no yowling, just her typical grumbling). She didn’t even rage eat. If only every day could go like that. I’m almost positive she has another eye infection. Definitely a good thing that her next vet appointment is only two days away.
February 12 (Day 51): Athena weighed in at 7.987 lbs., so her food levels must be OK for maintenance. Jim placed another order for her treatment. As long as we don’t have to extend treatment, this is the last order.
| Item | Amount |
|---|---|
| Carry over from previous post | $10,515.92 |
| 10 vials order | $865 |
| Running Total | $11,380.92 |
February 13 (Day 52): Athena had her week 8 checkup. Her weight is great, she weighed in at 8.1 lbs at the vet. Allowing for differences in scales and that she’d already had breakfast, I’d say that roughly equates to what she weighs at home.
Her eyes, though, are worrisome. The pressure in her right eye is back up to 19, after having gotten it down to 10 in December. NOTE: the readout I was given does not list the units, just the number and date.
On top of that, both eyes are rather dry, with her right eye very dry. Average tear production is about 18 on the Schirmer Tear Test, according to the vet. Athena’s values were 15 in her left eye and 8 on her right. Per the vet, dry eyes are usually signs of autoimmune issues, and would typically be treated with cyclosporine. However, she’s uncertain of how to proceed given that Athena has FIP and is undergoing treatment. This is uncharted territory for their practice.
So, we have a couple of questions out to our FIP Warriors caseworkers: 1) are dry eyes a typical side effect with FIP treatment or a typical first sign of relapse? 2) Can Athena have cyclosporine while on treatment?
Jim also posted about eye issues in the FIP Warriors support group, and the resounding answer is that steroid eye drops help. However, it wasn’t a question specific to dry eyes, just eye problems in general.
We are desperately waiting for Athena’s blood work results (standard complete blood panel (CBC) and chemistry panel (CHEM)) to come in, hopefully tomorrow, as that will give us a better idea of how she’s doing, and also let us know if she can have her dental work next week, because she DESPERATELY needs it.
In the meantime, we’re increasing Athena’s Dorzolamide drops to once every 12 hours, although still only in the right eye, and she’s also getting Erythromycin 0.5 ophthalmic ointment 3 times a day for a week. If it’s an eye infection, that will clear it up, with the bonus side effect of helping keep her eyes moisturized.
Overall, not exactly what we were hoping for.
| Item | Amount |
|---|---|
| Office call: Recheck | $73 |
| Lab Work | $227 |
| Schirmer Tear Test | $45.50 |
| Tonometry/intraocular pressure | $51 |
| Ointment | $32 |
| Visit Total | $428.50 |
| Running Total | $11,509.42 |
February 14 (Day 53): Unfortunately, we definitely DID NOT get the news we wanted from the vet.
While not horrible, Athena’s results point towards a regression, rather than an improvement.
| Test | Results | Last Results | Ref. range | Unit |
|---|---|---|---|---|
| Hematocrit | 34.9 | 38 | 28.2 – 52.7 | percent |
| Neutrophils | 2.24 | — | 2.62 – 15.17 | thousands per cubic milliliter |
| Bilirubin | 0.1 | 0.1 | 0.0 – 0.3 | milligrams per deciliter (mg/dL) |
| Total Protein | 9.0 | 8.9 | 6.3 – 8.8 | grams per deciliter (g/dL) |
| Albumin | 2.4 | 2.9 | 2.6 – 3.9 | g/dL |
| Globulins | 6.6 | 6.0 | 3.0 – 5.9 | g/dL |
| A/G ratio | 0.4 | 0.5 | 0.5 – 1.2 | |
| ALT | 26 | 28 | 27 – 158 | international units per liter |
There were also several other abnormal values, most of which I can’t find a good answer for online.
- Reticulocyte Hemoglobin [def]: 13.7, 2.2 picograms under low limit. This points to continued anemia.
- Sodium: 146, 1 millimoles per liter (mmol/L) under low limit.
- Chloride: 113, 1 mmol/L under low limit.
- Cholesterol: 89, 2 mg/dL under low limit.
Beyond the obvious blow of a potential relapse, we also had to cancel Athena’s dental appointment. There’s just too much potential of setting her back even further as a result of the associated stress. To help buy us some time with her teeth, she was given an oral antibiotic, clindamycin 25mg/ml at a dose of 1.4 ml every 24 hours until gone.
Because of the response from the FIP Warriors support group, Athena’s also been given steroid eye drops, Dexamethasone Ophthalmics 0.1%, to see if we can further help with the dry eyes and discharge.
We sent the blood work results to our FIP Warriors caseworkers to find out what we do now, and we’re still waiting on an answer from them about dry eyes and FIP and cyclosporine.
It’s disheartening to almost be back to where we were in October, although her blood work isn’t quite as bad, and, of course, her weight is much better.
| Item | Amount |
|---|---|
| Steroid eye drops | $66.50 |
| Antibiotic | $15.00 |
| Visit Total (We used our deposit for Athena’s dental work) | — |
| Running Total | $11,509.42 |
February 15 (Day 54): Still no response from our FIP Warriors caseworkers. I sent a follow-up message tagging them both again to see if we can get a response.
On the bright side, Athena’s eyes are already looking better; she had less discharge today. And, her shot went really well. She didn’t have any extra pain and didn’t feel a need to rage eat.
February 16 (Day 55): In different circumstances, we would have celebrated only having a month to go. But, while we wait for either a solid answer from our caseworkers or Athena’s next bloodwork, we’re in limbo.
We did finally receive communications from our caseworkers. My first set of questions got answered:
- Is there any indication that dry eyes might be a side effect of FIP treatment or a primary sign of relapse? Answer: No, there is no indication that it is either.
- Can Athena have cyclosporine while on treatment? Answer: Yes, there are no known contraindications.
However, in response to her blood work results, we only got confirmation of our concern and a request for additional information (current weight and dose), which I provided.
Week 9
February 18 (Day 57): I’ve started playing a new video game, and I’m using the time I’m downstairs to leave Athena’s door open so she can go in and out of her bathroom at will, without us worrying about her peeing on everything. She was playful, batting at a few toys, and had a minor case of the zoomies, darting in and out of her bathroom. She also did a little exploring, familiarizing herself with the various corners of the basement.
February 19 (Day 58): We celebrated Athena’s official gotcha day anniversary. We got her microchipped on February 19, 2022. She did some more exploring, even going upstairs while her door was open, before coming back downstairs and sitting with me.
February 20 (Day 59): It was Athena’s last day of eye ointment. Her eyes are doing much better, but we’ll be continuing her steroid eye drops and glaucoma eye drops until it’s either unsafe to continue them, or she goes for an extended period without problems. I opened Athena’s door at wet food time, but didn’t carry her upstairs. She came up when she heard food bowl noises, but only finished half of her food while upstairs, per usual.
She got to spend some extended time out of her bathroom with us, which she definitely enjoyed. She’s a great cuddle cat.
February 21 (Day 60): I sent a follow-up message to our caseworkers, as we still don’t have an answer about Athena’s continued treatment. For now, we’re staying the course. She’s doing well, and her weight is stable, so that’s good.
February 24 (Day 63): Athena stayed out of her bathroom for about an hour with Jim in the basement. She came upstairs for a while to watch me making dinner. The boys are cautiously interested in her. They don’t hiss or growl at her, but they approach slowly and take off when she hisses.
She stayed out alone while we had dinner, and she managed about an hour without peeing on anything. Progress!! She has also decided that if we are downstairs, she should be out of her bathroom. What we can’t decide is if she has decided she’s part of the whole family, or if she’s marked out the basement as her territory.
Week 10
February 25 (Day 64): I sent a second follow-up message, asking if treatment changes at all given the disappointing blood work, or if we just stay the course and see what her next results look like. Given the severity of FIP, I’m unhappy with the lack of communication. It’s been 11 days since we provided her week 8 results and 9 days since we received any message.
For some reason, Athena has decided she doesn’t like being weighed, and won’t hold still long enough to get a definite weight, but the scale fluctuates around 8 lbs., so she doesn’t seem to be losing or gaining weight, which makes me happy. She also, thankfully, shows no signs of her dry FIP transitioning to wet FIP, which is a possibility I was worried about, given her most recent results.
We finally heard back from the caseworkers, mainly because Jim posted in the FIP Warriors support group to see what advice they had, given the lack of caseworker communication. I’ve now learned that the eye pressure issue Athena has been having is related to FIP, and is as much an indication of her regression as her blood work results.
We’ll be increasing Athena’s daily dose to include oral medication (pills). They requested Athena’s exact weight (which turned out to be 8.1 lbs.) to figure out dosage.
Had things gone according to plan, we would have been celebrating going into the final three weeks. But, hopefully the adjustment to her treatment will get her moving in the right direction again.
February 26 (Day 65): Our caseworkers are still slow to respond, but we’ve found out that we’ll be adding three pills a day (1 5 kg pill at $28, 1 2 kg pill at $12, and 1 1 kg pill at $6). So her daily medicine price will be increasing by $46. We’re still waiting to find out how long we’ll be extending treatment so we know how many pills to order.
We’ve also started having trouble with Athena’s skin tightening in the general area of her shots. This is another known problem, but, as of yet, I don’t have a good way to mitigate it. All I’ve found is suggestions to massage the area, which I do as much as possible.
In happier news, Athena spent almost the entire day out of her bathroom. She loves our downstairs sofa. She still hisses at the boys, but only Dante still responds with hisses of his own.
February 28 (Day 67): After multiple days of easy shots, Jim and I were both surprised at how much Athena fought her injection today. She yowled, struggled, and even turned sideways in attempts to get away. I gave her a stern talking to, and she seemed to settle down a bit, but I had to finish her injection on the other side of her body to make sure I didn’t get too close to the first injection spot.
The odd thing is that after we finished and we gave her her rage food, she didn’t complain. She didn’t seem to have any lingering pain. So I don’t know why she fought the injection so much.
We know we’ll be extending her treatment past the 84 days/12 weeks, but we don’t know how much longer. I would like to see her have two good results in a row before we stop, but I don’t know if that’s enough. Once we get the medicine squared away, we’ll see if we can get an answer out of our caseworkers.
Given the extension, and increase, of treatment, if you’re willing to share our GoFundMe, we’d really appreciate it. We’ve definitely blown way past the amount we thought we might end up spending.
Thanks for reading to the end, I hope you found this update on Athena informative. If you’d like to keep up with her progress, be sure to subscribe to my blog, check her tag page, or follow the AthenaUpdate hashtag on Instagram.
