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Athena: Almost Done with Treatment?

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This post is an overview of Athena’s third month of treatment. If you haven’t already, I suggest reading my previous posts on her treatment. You can find them on her tag page.

Like the previous posts, this one is in a journal-esque format. I’m primarily touching on major/important events and updates, rather than what happens each day.

There are a few medical terms in this post. 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 11

March 4 (Day 71): For the first time, Athena didn’t hiss at either Sandy or Ritz when they approached her. I doubt it’s a permanent “cease fire,” but it’s a step in the right direction to integrating her into the family.

March 6 (Day 73): I took Athena to the vet for her week 11 blood work. Side note: technically, it should be week 12 blood work, but when I booked the appointment, I wanted to get her results before we stopped treatment on day 84. Once it became apparent that we’d need to extend treatment, our vet didn’t have any appointments left during her 12th week of treatment.

Athena is still gaining weight, although more slowly. She’s now up to 8.2 lbs.

Per usual, Athena had blood drawn to run a standard complete blood panel (CBC) and chemistry panel (CHEM). Her tear production is still low, so she was prescribed cyclosporine eye drops, and we were told to discontinue the dexamethasone. Her eye pressure was better this time. Normal is between 12 and 18; her left eye was 18, and her right eye — the one that gets the eye drops — was 16. We’re keeping the dorzolamide drops at once every 12 hours, so I requested a refill.

A bit later in the day, we decided to stop waiting for a response from our caseworkers and just ordered 10 of each type of pill that we’d been told she needs.

Carry over from previous post$11,509.42
10 x 1 kg pills$60
10 x 2 kg pills$120
10 x 5 kg pills$280
Office call: recheck$73
Lab work$227
Schirmer Tear Test$45.50
Tonometry/intraocular pressure$51
Dorzolamide eye drops$34.50
Cyclosporine eye drops$89
Pill Total$475
Visit Total$520
Running Total$12,504.42

March 7 (Day 74): The vet called right at 8:00 am, and my heart dropped. I was terrified that we were going to be told Athena was even worse. However, their “hello!” was far too cheerful for bad news.

Beyond my, or the vet’s, understanding, Athena’s blood work was virtually normal. The two “abnormal” values, total protein and alt, were so close to normal that they were not of concern. Every company that processes tests has a different “normal” range, so a couple of units above or below the test “normal” is still considered acceptable.

Because the only change between Athena’s week 8 and week 11 blood work was an antibiotic to help her teeth, our vet was forced to consider the possibility that the week 8 results were abnormal because of Athena’s tooth problems. She told me, “before these results, I would have said it was impossible for her teeth to cause such abnormal blood work, but now, I’m not so sure.”

TestResultsWeek 8 ResultsWeek 4 ResultsRef. rangeUnit
Hematocrit43.934.93828.2 – 52.7percent
Neutrophils3.6182.2442.62 – 15.17thousands per cubic milliliter
Bilirubin0. – 0.3milligrams per deciliter (mg/dL)
Total Protein8. – 8.8grams per deciliter (g/dL)
Albumin3. – 3.9g/dL
Globulins5. – 5.9g/dL
A/G ratio0. – 1.2
ALT25262827 – 158international units per liter
The IDEXX test our local vet runs has different reference values than the test SouthPaws uses (week 4 results). I’ve included the IDEXX ranges on this chart

Almost all of the other values that were wonky in week 8 were normal in week 11. If her hemoglobin is still low in the week 15 results, I’ll request an iron shot.

  • Reticulocyte Hemoglobin [def]: 14.0, up from 3.7, still 1.3 picograms under the low limit. This points to continued anemia.
  • Sodium: 148, up from 146, just barely within normal range.
  • Chloride: 115 up from 113, just barely within normal range.
  • Cholesterol: 131 up from 89, well within normal range.

So, partially because we’ve been waiting so long to get her teeth done and partially because we needed to rule out her teeth as a cause of the abnormal numbers, we pressed forward with her dental work. Our vet was kind enough to squeeze Athena into her already-full schedule for tomorrow.

In the evening, I noticed Athena was having issues with her eyes. She was squinting a lot, barely wanting to open her eyes, so I skipped the cyclosporine drops.

March 8 (Day 75): Athena’s dental work went smoothly. The poor girl had 13 teeth removed! I feel so bad that she had to deal with that for so long. But it wasn’t safe to put her through the stress of surgery. She only has front teeth — just 14 of them — left.

Her pre-surgery EKG revealed a small abnormality, so they requested an OK — which I immediately granted — to run an additional test to check her proBNP [def] levels.

Based on the irritation caused by the Cyclosporine, we were advised to stop those drops, so she’s back on the Dexamethasone — steroid — drops. We got sent home with Onsior tablets — regular pain medications — to give her for three days and Buprenorphine oral liquid which could help with pain if we saw her having troubles — this one would get her high so she wouldn’t care about the pain.

She was extremely affectionate in her carrier on the way home, and, even with her still a bit stoned from anesthesia, she was clearly much happier. To our surprise, she gobbled down her dry food — which I accidentally brought to by habit instead of wet food — without any complaints.

Surgical bio-hazard waste$20
Electrocardiography (EKG)$54
Heart stretch test$168
Initial Anesthesia$214.25
IV and fluids$72
Continued Anesthesia$210.70
Heart and Blood Oxygen Monitor$36.50
Technician Assistance$40
Dental Procedure Pack$51
Onsior Injection (Pain Relief)$78.78
Clean and Polish Teeth$238.50
4 x 1 root tooth extraction$156
7 x 2 root tooth extraction$560
2 x 3 root tooth extraction$224
Liquid Pain Relief$31
Tablet Pain Relief$36
Credit from dental deposit$76.50
Visit Total$2,114.23
Running Total$14,618.65‬

Also, her pills arrived, so she gets to start those tomorrow. Despite the belief that the week 8 results could have been caused by her teeth, we’d rather not take any chances.

March 9 (Day 76): Athena played quite a bit with Jim today. I’d like to see her play more because it’s very cute. We also had to order more of her liquid medicine for treatment. Hopefully, this will be the last order.

10 vials order$865
Running Total$15,483.65‬

March 10 (Day 77): Athena finally had proper, hard poos. She’s been having soft poos since December, so this is a great step forward.

Week 12

March 12 (Day 79): While Athena was relaxing on the sofa, I pulled a section of the blanket she was laying on over her back and tucked her in. I don’t think she moved for well over an hour. Clearly, warm blankets are nice.

Athena curled in blankets on the sofa

March 14 (Day 81): The vet called with the results of the proBNP heart test. Athena’s count was 114, which is 14 units above the high end of normal. While not great, it’s also not terrible, so our vet felt it’s something to monitor. Athena’s week 15 blood work will include a test of thyroid levels to see if there are any abnormalities there.

Her liquid medicine for treatment arrived, and we ran out of Dexamethasone in the evening, so tomorrow we’ve got to call for a refill. While administering her eyedrops, I noticed some crustiness and reddness around her eyes, which I tried to clean up a bit.

March 15 (Day 82): I called the vet, and they advised that we can stop the Dexamethasone, but we should have an extra bottle in case we notice a resurgence of her previous symptoms. Her eyes had less crusties and the skin immediately surrounding them were less red, so I cleaned it more.

She now weighs 8.4 lbs., so we’re adjusting her food further, and will monitor for weight loss. We also let her stay out while we went grocery shopping, and she seemed to do just fine.

March 16 (Day 83): We ordered more pills, 14 days’ worth. I’ve also noticed Athena is starting to respond to her name like an indoor cat. Rather than just an ear twitching, she’ll turn to look at me when I call her name.

14 x 1 kg pills$84
14 x 2 kg pills$168
14 x 5 kg pills$392
Medicine Total$659
Running Total$16,142.65

March 17 (Day 84): Today would have been her last day of treatment if we didn’t have to extend it. I caught Athena playing with a stuffed mouse toy downstairs. It was really cute. We also made sure to pick up her Dexamethasone eye drops refill.

Eye drops$66.50
Running Total$16,209.15‬

Week 13

March 18 (Day 85): Jim shared a morning update on Athena on Instagram.

Athena drank from the boys’ water fountain. I hope this is the start of being able to fully integrate her into the household. We can’t “kick her out” of her bathroom until she’s using the upstairs litter boxes and regularly drinking from the water fountain. But, she knows it’s there now.

I also think I’ve figured out what the crustiness around her eyes is. I think she had a reaction to whatever they put on her eyes during surgery. Most of it has come off now, but, unfortunately, it took the fur with it, so she’s got bare patches around her eyes.

March 19 (Day 86): Jim introduced Athena to relaxing on the bed. She has associated it with playtime, and had a lot of fun going after “the thing under the covers.”

March 20 (Day 87): For some reason, Athena bled quite a bit after her shot. I had to put some pressure on the injection site to get it to stop. I tried to clean the blood out of her fur, but I’ll probably have to clean it more later.

March 22 (Day 89): While I looked for a decent injection site, I found 3 additional lesions, one of which was rather large. I’m thankful that they don’t seem to cause Athena any discomfort, but I still feel bad for her. Assuming that these three new lesions behave the same as the previous ones, she’ll lose all of the fur in the area each encompasses. Poor girl is going to be so patchy. I hope the fur grows back well. Some of her previous lesions have obvious hair regrowth, but others are still completely bare.

March 23 (Day 90): Athena is being weird about her food. When the automatic feeders drop dry food, she stays on the stairs, staring at the boys like she wants to eat upstairs with them. But, when I give her her bowl of wet food, she only reluctantly eats about half and expects me to take the rest downstairs so she can eat in her bathroom. I won’t even pretend to understand.

On the plus side, her shot was super easy today. Jim didn’t even have to hold her tight. She barely even grumbled. I wish every day was so easy.

March 24 (Day 91): Athena weighed in at 8.6 lbs. We need to stop her weight gain, but I think part of it is her “rage food” treats after her injections. Since we only have 1.5 weeks left, I’m not going to worry about it right now.

Once again, her shot was very easy. However, she’s still bleeding after each shot. I make sure to put some pressure on the injection site after I remove the needle. We give her some head and chin scritchies while I do so to keep her from getting too agitated.

Week 14

March 25 (Day 92): I guess the easy shots were too good to be true. Athena yowled with her injection today. I wish I knew what was different so I could avoid causing her additional pain. But, I’m sure most pet parents to FIP cats wish they could actively communicate with their babies.

March 27 (Day 94): Athena meowed for her lunch like the boys do. It’s the first time she’s done that. I don’t know if she’s becoming more comfortable, or if she’s learning from her housemates.

March 29 (Day 96): If you follow me on Instagram, you likely already know that we had to say goodbye to Sandy unexpectedly. If you don’t, he went into cardiac arrest after a routine application of a diabetes monitor. Our vet isn’t entirely sure what happened, but poor Sandy only held on long enough for us to arrive and say goodbye.

Athena seemed to know something was wrong almost immediately on our return home. She sat with Jim for a while and curled up high on his shoulder, against his neck, as though trying to give him comfort.

In the evening, while I was looking for a lesion-free area to administer her shot, I found 2 more on her left side. I really hope we can end her treatment on Tuesday.

March 31 (Day 98): Athena has been shedding like crazy. It’s spring, so I’m sure that’s part of it, but, as expected, she’s also losing fur where the new lesions are. The two biggest ones are easy to locate because of the patches where her fur is uneven.

Before her shot — which, thankfully, was easy again — Athena let me have belly rubs. She wasn’t as into it as Bumbledore usually is, but she didn’t complain at all, and stayed on her back without any coaxing from me.

If all goes according to to the current plan — basically, if her blood work on the 4th is normal — we’ll stop treatment and move to observation mode. That’s 84 days (12 weeks) of continued blood work every 4 weeks and careful monitoring of her weight, behavior, and any potential symptom resurgence.

I’m keeping my fingers crossed that we’re almost there.

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.

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