Gus - pentoxifylline success part 1

Gus is the kitten of a pregnant shelter cat who was kept by hs mother's foster carer Nicole after she rehomed his mom and siblings. He was a more mature cat, and physically strong when he started getting sick. He never got very dehydrated or stopped eating so he stood a much better chance when Nicole went in to bat for him with Prednisone and Pentoxyfilline. These anti inflamatory drugs are easy to get and relatively cheap. pentoxifylline was an early choice for treating wet FIP that didn't pass trials - we still tried it, as have others on the facebook group.

Gus was a big cat- at 2 yrs old, he was 13 lbs! At one point, I sensed something wasn't right with him. He seemed lethargic (wouldn't interact with new kittens, in the past we had called him "Uncle Gus" because he always took the foster kittens under his wing, grooming and playing with them). He also felt bony along his spine- and his belly was bloated. I will admit, I wasn't too concerned at first. I thought worst case scenario, maybe he had gotten worms from one of the foster kittens he loved to groom. After a few weeks when he was still wasn't being his usual self, I took him to the vet.

October 26, 2103 The day my world crumbled.

I went in expecting a Dx of Giardia or a tapeworm... relatively easy fixes. Instead, I was told Gus had wet FIP. The vet actually withdrew fluid on the spot from his belly and showed it to me - thick, yellow, protein filled fluid. And he weighed 10.5 lbs. Still hate myself for not noticing the huge weight loss.All his lab values were abnormal , and he had a fever to boot. 

Initial lab work

I cried ( that is an understatement) in the exam room for about half an hour before i was gently escorted out.The only hope the dr. could offer me was palliative prednisone to improve appetite and the kind offer to come to my house to do the euthanasia when the time came.

I immediately started him on pred, and frantically searched for a second opinion/treatment options. A friend of mine worked for a local vet, and she told him my story. I reached out to him, and after a lengthy phone consultation he mentioned a drug called Pentoxifylene. He said it might help prolong his life. It's a drug normally prescribed for humans, for autoimmune disorders. A pharmacy in Arizona (Diamodback Drugs http://www.diamondbackdrugs.com/contact-us/) compounds it into animal dosages. I brought Gus to see him in the hopes that he would disagree with the original Dx. He broke my heart when he said all signs pointed to wet FIP and he couldn't go against my primary vet's Dx. BUT - he suggested the Pentoxifylene, saying it could potentially help prolong his life.

After 9 months on prednisone and pentoxifyllene Gus visited this vet again. His A/G ratio which had been very low, was back up and the other values that had been abnormal were all good.

New lab work

All lab values were normal, and the ultrasound showed NO fluid in his abdomen. His old chart had a WBC of 30,000 and very abnormal liver/kidney functions. And a fever. His WBC is now 9,000, within normal limits. He is also back to his playful mischievous self, a very happy cat. The difference between the two was amazing. The vet said if he did not know Gus's history he would say he was a perfectly healthy cat.

I am grateful for every day I have with him, and I don't mean to offer false hope. I know FIP is a terminal illness. All I know is that he is seemingly happy healthy and no longer shows any signs of the disease. Part of me hopes he was misdiagnosed, but another part of me hopes that maybe he did (does?) have this dreadful disease and there is in fact, hope. I am slowly weaning him off the meds while monitoring him constantly for any signs of a relapse. My heart goes out to everyone who is dealing or has dealt with this terrible disease. I'm fully aware Gus may be (probably is) living on borrowed time. I just feel like I need to share this in the hopes that it can help another.

 Gus part 2 http://onecatlife.blogspot.com/2015/05/gus-pentoxyfylline-success-part-2.html

Tomten - Where do you go when your cat has stumped all the vets?

A: a cat specialist - case solved by Dr Plotnick! http://manhattancats.com/
The first blog post on I wrote on his case was the Winter Tomten "Yuletide " the midpoint of winter - the cosmic balance between life and death". I feel like we are poised on such a tipping point - and i cant help thinking being in the southern hemisphere the december solstice signals the descent." If you want to follow his story in graphic detail use the labels to find the other posts but now for the news i should have updated months ago! Tomten was originally thought to have FIP around the same time as Mishka. He had already started feline interferon so I drew a lot of strength from the kindness of Cassie answering my emails 2 years ago. For Cassie the drug was a really really big ask as it is hard to import to the USA as well as super expensive. 

"He who asks a question is a fool for five minutes; he who does not ask a question remains a fool forever." - Chinese proverb

 So glad her persitence paid off: June 2014 Cassie posted -

Finally a possible explanation for Tomten's illness. Ok I have truly crossed over to crazy cat lady. While making Tomten's next appointment for his Cardio check up I began feeling frustrated that he still has no diagnosis. So I broke down and submitted an e-mail to Cat Fancy magazine's ask the doctor. I felt a bit silly but figured what could it hurt? 

My 7 year old Devon Rex has stumped all the vets he has seen. 2 years ago he stopped eating, started throwing up and was hiding. An emergency trip to the local ER showed that he hadgranulomatous tumor in his intestines. An aspiration of the tumor ruled out lymphoma and based on his blood work he was diagnosed with dry FIP. He was put on feline interferon and methyl prednisone and sent home to die. Only a “miracle” happened and he appeared to get better over the course of two months. Three months after diagnoses scans showed that his tumors had disappeared through his lymph nodes remained swollen and abnormal. 12 months after the first tumor appeared he stopped eating again. Scans showed 3 new granulomatous tumors one of which was in danger of perforating his bowel. At this point his vet moved him to an excellent large regional vet hospital. They consensus was that he didn’t have FIP (based on his longevity). Since he was no longer responding to the feline interferon the thought was to do surgery to remove the tumors. All 3 tumors where removed in a double bowel resection and subsequent gram staining of the tissue was negative for FIP. He appeared to recover for a bit and then went into a tail spin hiding and not eating. He was placed back on the methyl prednisone and within a week was recovering once again. 3 months later he developed an ear polyp and infection and lost his balance. A month of antibiotics and dedicated ear cleaning and he recovered much of his balance but his counter surfing days where behind him. When he was being evaluated to remove the ear polyps it was discovered that his heart had become greatly enlarged and he was in heart failure. We made the decision to leave the ear polyps and focus on managing his failing heart.

Tomten has been lucky to have better care than many human beings and we are very grateful to his vet teams, who have given him an additional two years of life. The vets have all been unanimous that what ever is causing his health problems is an unknown and perhaps is some sort of an autoimmune disease? While we have tried to make peace with the fact that we will probably never know what is wrong with him its hard not to wonder if we took him somewhere else would someone know what is causing his condition? And could we do anything to stop it other than to treat each symptom as it comes up.

Dr Plotnick's Reply:

I think the ear polyps and the heart disease are separate issues. Devon Rexes are at increased risk of developing hypertrophic cardiomyopathy, which is the heart disease I suspect he has. As for the intestinal disorder, it sounds like your cat has granulomatous enteritis. This is a mysterious illness. Inflammatory bowel disease is a common disorder in cats. With IBD, most cases are due to infiltration of the intestines with either lymphocytes and plasma cells, or with eosinophils. These are types of inflammatory cells. Every now and then, we see a case that doesn’t fit into this pattern. We see what they call granulomatous inflammation. In these cases, the intestines are infiltrated with lymphocytes, plasma cells, macrophages, neutrophils..a whole mishmash of inflammatory cells. It often affects a discrete region of the intestine, rather than diffusely infiltrating the intestines. (Diffuse infiltration is the more common scenario.) (The disease has sometimes been called “regional enteritis” because it affects a discrete region of the intestine). FIP likes to cause granulomatous inflammation, but not all cases of granulomatous inflammation are due to FIP. When granulomatous inflammation is seen on an intestinal biopsy, the specimen should be stained with a special stain that detects coronavirus in the tissue. If the stain comes back positive, the cat has FIP, and the prognosis is terrible. If the stain comes back negative, it rules out FIP. However, the prognosis for granulomatous inflammation in the intestine is unknown. It’s a mysterious disease that no one has really figured out. Some people try steroids, and they work for some cats, in some cases. Other people suggest surgically removing the affected area. There are no big case studies of cats with this type of enteritis, so we don’t really know what the best treatment is. Unfortunately, I think the best approach is the one you’ve been doing, i.e. treat the symptoms as they come up. With him having heart disease, steroids are not recommended because steroids expand your cat’s blood volume, which can put a strain on the heart. I’m not sure how you would treat another bout of granulomatous enteritis if it were to develop again. Good luck with him. I hope he does well.

Dr. Arnold Plotnick

I've asked Cassie for an update - i know some on the facebook group had reccomended the raw diet as she was investigating IBD - Irritable Bowel Disease.  

PS. I love Dr Plotnick's idea of a cat only vet - cats hate the fuss and stress of a regular clinic full of dogs. Poor Mishka's worst moments were not from FIP so much as the 'system' - I won't spoil this feelgood post with the details of that - contact Dr Plotnick http://manhattancats.com/

Tomten - thoughts on inflammation

"drink the wine drink the wine- music, good friends, I'm not dyin' today" ~ Tori Amos

Tomten has been doing the Lazarus cat dance back from the brink for past eight months. He was heading downhill in late June and a surgery was performed hoping the granulomas were from a foreign body like string. However he crashed after the surgery and was very poorly for several weeks.

"Tomten continues to fight but is growing steadily weaker. He has taken to spending the entire day in a pile of stuffed animals in the kids play room. My husband can get him to eat a little bit. He is becoming wobbly on his feet. My husband is still hopeful and when he eats I am too but in my gut I think he is in his final weeks."

But his vets didn't think he was in pain, didn't toss in the towel and a week later on July 26th he turned the corner with last ditch antibiotics, steroids and high energy paste.

 Cassie wrote - "I am scared to to even post this in case it jinxes us but Tom has had a great two days. Since going on the last ditch antibiotics and back on pregnazone (sic) and the high calorie paste he is feeling so much better. He is eating!! He is hanging out with us and Gizmo instead of hiding in the stuffed animal pile. When he got sick last year we did 3 things. Interferone, prednasone, and a course of antibiotics for the herpes which was bad. Since surgery Tom was off the pregnazone and he had antibiotics on the operating table but none since. Keeping my fingers crossed he is turning a corner but too scared to hope. Is it possible he has 18 lives?"

I wonder if I've been underestimating the support antibiotics can provide an ailing cat - even if it's not the primary illness, knocking down the numbers of bacteria multiplying out of their normal range due to host debilitation, may allow the cat enough space to muster his reserves for the fight. "lipo polysaccharides (LPS ) from many bacterial species will initiate acute inflammatory responses in mammals". Maybe we should have tried harder with Mishka's lump.

So his ultrasounds didn't show any other lumps - he went back to happy and active. And Cassie was back to square one diagnostically.

"He continues to do well since the antibiotics and the return to Pred. I caught him playing kitty smack down with Gizmo last night first time in 3 months. I don't know who was happier Gizmo or me. I think Gizmo was letting him win since he out weighs Tomten 3 to 1 at this point. Tomten couldn't have a more loving brother. Now that I have him back again my thoughts are turning to how do I keep him alive and delay the granulomas from coming back. I started doing some internet research trying to figure out what besides FIP causes granulomas and responds so dramatically to antibiotics and prednisone. I came across Inflammatory Bowel disease (IBD). The literature says its rare but can cause granulomas."

 Some informational links and my thoughts on IBD and inflammation:

• http://feline-nutrition.org/health/feline-inflammatory-bowel-disease-nature-and-treatment - My gut feeling (haha a pun) is that Feline Irritable Bowel its not far off human IBD. What you eat determines the gut microbiome. We have a little human friend who had to have a fecal transplant to get rid of his awful colitis. He is a very sick boy who is now off all his meds! Anyone with Crohn's disease or colitis who wants to get cured contact Dr Borody in Sydney.

• http://www.2ndchance.info/inflambowelcat.htm Although i dont have direct cat experience with IBD per se I noted our other pets have better skin on a proper raw diet, which I imagine reflects the state of the gut as it is basically the same as skin - both are made of epithelial cells. Mishka was the big diet fail - i always thought she'd come a cropper on dry food diet but figured (wrongly) I had time to transition her to a 'better' diet. Wrong again - commercial petfood is just wrong, I had no idea it was all so dreadful until she got ill. Now i know even the tinned food, though 'complete', is still highly inflammatory.

• http://raypeat.com/articles/nutrition/carrageenan.shtml  - carageenan is seaweed - not meant to be eaten by cats but it's the thickener in most commercial petfood. It is known to incite inflammation, in fact it's used experimentally to do just that when you need to make a wound to test a cure on!  I have no idea why they dont use gelatin instead, which is anti inflammatory and being connective tissue supplies all the right things for building connective tissue for both humans and animals http://raypeat.com/articles/articles/gelatin.shtml

 

Tam

Tam is a beautiful "Neva Masquerade" or "Colour Point Siberian" who is currently in remission from possible wet FIP (lung) living in France with Virginie. At the end of January 2013  6 month old Tam was diagnosed by her regular vets with wet FIP.  FIP specialist Dr Addie is in France and she is also consulting on the case.
Tam had trouble breathing and a high fever up fever up to 40°C. Her lungs were full of filthy lemon yellow liquid drained twice in 3 days. Amazingly she responded rapidly to antibiotics and prednisone, looking quite well by day 5, and perfectly healthy by day 18.  As you can see Tam is still a picture of health and beauty in April.

Happy May 1st ("Lily-of-the-valley" day for us in France) from Tam!

As usual poor Virginie went through the terrible agony of despair and uncertainty of how to proceed surrounding a diagnosis of FIP which I hope to help ease by chronicling some cases. There are some differences in Tam's presentation to Mishka's which I'll list later.

The Siberian is one of the 3 forest cat breeds that were originally wild breeds from Russia. From Tam's case I have also learned of the new Russian drug Skulachev ions (Visomitin, SkQ1)and eventually also found exemplary breeders Forest Wind who provide a 10 year genetic health guarantee including for FIP! (See breeders database for contact details.) Tam had four and a half shots of Feline Omega Interferon,  a lot of raw beef and is on two drops daily of "Skulachev ions" which are a targeted mitochondrial antioxidant currently used for human eye diseases in Russia. (A similar item Mitoquinone is more frivolously applied to the face to cure wrinkles by the New Zealanders. The lower regulatory hurdles for cosmetics allow the fast tracking i suppose.) Her latest blood tests show significant drop of the AGP level ( a non-specific marker of inflammation raised with infection) compared to 3 months ago.

Virginie tells her story:

Tam, a female 6 months-old kitten is healthy, but little bit more tired as usual. Breath seems heavy. 10 pm, we're trying to think this could wait open hours, but no, something is not right, we went to vet emergency : fever is there, and liquid in chest too.
the day after (saturday), x-rays confirmed the pleural effusion. On Monday (day + 3), we sent blood and pleural liquid to the Vet. University of Glasgow for a FIP profile.
Results are "clear" : for my vets, FIP is confirmed. So prednisolone + antibiotics in routine treatment for supporting the kitten.

Last week X-rays (day + 10) shown improvement : liquid is still there, but far reduced.
At day+18, Tam is as healthy as a kitten could be, ... running in the garden, purring on our laps, eating a lot, fighting with our 6 others cats (all have been coronavirus tested, and are negative to mild-loaded).

We are waiting to start feline interferon treatment (the bottle is ordered)
Or is it something else as FIP-cats are not likely to run the way she is (according to other breeders I asked for advices) ???

There was no bacterial culture of the effusion sample sent to Glasgow University for a FIP profile as suggested in the comments of the lab report so some question marks remain as to whether she had a bacterial infection since there was a high white cell count seen. Dr. Diane Addie has slight reservations about the diagnosis of wet FIP (perhaps based on Tam's speedy response to antibiotics and prednisone?) Tam's own vets are sure what they saw in January was a kitten with wet FIP.  "at that time, we were convinced it was FIP and no hope left, we didn't ask [for the culture]. Later when Tam was so well, it was too late : no more liquid remained (no more in Glasgow, and no more in Tam's lungs !)" The vets nicked a vein when drawing off the effusion, so Virginie says a little bit of blood may be the cause of the high cell count but personally I have reservations about the logic. Looking at it the white cell count seems too high compared to the red to be from simple contamination. Also really if they were so sure it was FIP then why send off an effusion sample all the way to another country for an expensive test? and furthermore especially  on a tight budget wouldn't it make more sense to go for the bacterial culture because you'd have a fighting chance of a good outcome if you treated for it? They gave Tam antibiotics for FIP - I'd think they'd want to be sure it was the right one, or is that just the standard response for a cat with a fever? Mishka had the high fever and mild cold like illness months before she got fluid in the lung (and belly.) At that stage there was nothing to culture except perhaps a straight blood sample. She spent a night at the vet's and was given a shot of a long acting antibiotic.  Months later when she presented like Tam with a day's worth of extreme difficulty breathing the vet drained the chest urgently - it was a transparent fluid amber tinged with blood from the needle. She analysed Mishka's effusion sample in house for cells and protein. Based on that excluded infection - she didn't request the sample be sent for further testing.

From what I can gather Tam only had 4 and a half doses of interferon beginning mid February spaced a week apart starting before being pronounced "in remission". Although Virginie says her vet is following the Isheda protocol it doesn't sound like it to me as that protocol begins with second daily injections. She wrote: 

March 16 Thanks. By now, Tam is still perfectly well. She received her 4th weekly interferon injection last saturday. Dr Addie adviced to continue interferons once a week ; but my vets told the published use of interferon is only 4 injections, and preferred to stop the interferons, to re-do a series in few months if needed. I really don't know what to do !!!

nothing has been published yet on the use of interferons in FIP cases : the manager knows about Dr Addie and Dr Jacqui's work, but as nothing has been validated, and against the lab commercial interests, she advised my vet not to continue interferon (because Tam is asymptomatic ; she is "completely OK", no sign at all of any FIP matter), and to re-do if needed later.

March 20 I was in touch with Diane Addie (I'm currently trying to translate the fip-book in French) ; the problem is that cases of remission already happened in the past without any interferons - and failures with interferons too : so it is difficult to affirm that interferons are really the key.
I read about Ishida and german study. I guess interferons may help, but just help, not cure. I also have to take in account that going to the vet weekly is a trial for Tam : this will not help her, for sure (as soon as she sees the crate Tam is hiding deeply, running into a rush - she really suffers to go to the vet, I think she had a bad experience during her transport from her board cattery to my home, and it is not the time to re-educate her right now).

Money is not really the problem: I want to be sure this would be really useful.

She is doing well for 2 months now, there is no difference before/after these 4.5 (she received what remained in the bottle last saturday - just half a dose) injections of interferons. I even don't know if these made her good or not : there has been no improvement, as there was nothing to improve (she already looked like she was healthy five days after the first "FIP-day").

I'm not that convinced interferons are key in FIP case. Tam is eating a lot of raw beef, I wonder if this is not better.
We did 4 interferons injections (once a week) current march (she was still "healthy" before we started - actually, she was ill only few days, she soon got better, and better, despite her results at FIP-profile ).

On Dr Addie advice and with her help, we've just started to give Tam some "Skulachev ions" ; we asked for FIP-profile at Glasgow vet university just before we started, so maybe we could see a difference between before/after.

Yes there was a big difference,

• from Alpha-1 AGP  2240 in Jan 
• to 540 before SkQ1 
• then 500 which is normal on april 22nd (after 15 days of skulachev ions) and Albumine/Globuline is 0.84

Even though AGP is not a specific FIP marker ( it is raised with other infections ) it is great news consistant with recovery - way to go Tam! Virginie says "Champagne!" Take home message may be that we are in danger of giving up too easily once the idea of FIP is on the table; repeated drainage and at a pinch it seems prednisone, antibiotics and don't forget the raw beef, are potentially able to cure something + they are cheap. Even interferon added to the mix did no harm to Tam. "I cannot affirm interferons, or skulachev ions have cured her; my opinion is that Tam has recovered on her own, we've just helped her. I cannot affirm either Tam is cured ; she is still here 4 months later, growing, eating, playing and her results are very encouraging, that's all"

 Update March 2014 A year later Tam is still alive and well.

Her photo also reminded me of FIP's link to another lovely spring flower, the snowdrop, Galanthus Nivalis which may hold a cure for both FIP and cancer. see 'treatment' page.

Leap of Faith

"Healing takes courage, and we all have courage, even if we have to dig a little to find it." - Tori Amos

I wrote this just before Mishka died on Feb 1st but I've decided to post it unchanged. Update: a few edits and see the comment from Dusty's mum below!
--------------------------------------------
Dusty is the reason we are treating Mishka. Dusty survived wet FIP of the lungs in part thanks to injections of feline interferon and oral prednisone in 2007. I first wrote about him in a post about Hope http://onecatlife.blogspot.com/2012/10/hope-is-black-swan.html

Virbac sent me the case history and amazingly here was a cat I could believe in because I knew the vet practice in Sydney (I think my mum even took our old cat there on occasion. Chloe was a stray my brother took in who lived to be 17 on a commercial diet without ever getting regular vaccinations btw)  so I phoned the vet, Simon Craig who verified the cat was still kicking and had made it off the interferon. Based on Dusty's outcome we did the math and decided we could afford the treatment on the basis of expecting a dead cat or a cure in a little over two weeks - but there you have it, each case is unique and Mishka has not progressed as well - but she's not dead either, so the budget is completely blown by five months worth of extra drugs. We have apparently converted an acute illness into a chronic one - as allopathic medicine does so well.

Possibly due to her more advanced disease ( she has abdominal FIP as well) her own genetic challenges (she is a Birman, Dusty is a Scottish Fold) or that two week delay or not using the steroids first up. Dr Addie does mention in her wet fip case study, which I only recently read, that the wet FIP response to FOI is higher for cats with FIP of the lungs, and doesn't seem to work as well on abdominal FIP.

My suspicion is this is because abdominal FIP can be cryptic for longer in that area without causing distress. Mishka had abdominal fluid for a few weeks to a month perhaps before we knew she was sick.

It wasn't until her lungs really filled up that we rushed to the vet. Perhaps she was also dehydrated somewhat and thirstier than usual. Here she is the night before, mucking about and looking ok:

She may have been sick for much longer as the earliest signs are so hard to detect as abnormal, if indeed they were - she started being more sleepy (thought that was natural as a cat growing older and not being a kitten any longer), more cuddly and purry - well she got to know us and that's a nice thing, she was very hungry and insisted on 4 am snacks - well she's a growing cat. She got so chubby she was stuck in her cat door - that was cute (ok my son had at that stage twigged something was up. "mum Mishka is not a cat anymore" ? "Definition of a cat - fits anywhere the head fits" ??!!! )

Definition of a cat - fits anywhere the head fits

 Mishka's Leap of Faith

 
and so we followed the example of Dusty. I feel like a cartoon character that's headed over the cliff - can't stop running to look down now or gravity will reassert itself. Hoping to make it to the other side on pure momentum. Courage kitty - leap!

Back from the brink - Lilly

"If you are going through hell, keep going." - Sir Winston Churchill

Lilly and Alethea's journey shows it is possible to come back from the brink but it is only if the owner will devote to two hourly nursing including horrible syringe feeds for as long as it takes. If one can't do that i think don't bother looking for miracle drugs - immune stims need time and basic building blocks in the cells to work a miracle.

"I initially gave Lilly 5ml of PI twice a week. Honestly she seemed to improve in the first week so much I was shocked." ~ Alethea via facebook January 16, 2013

"I want to give an update - if only to give others much hope. In November (2012) my cat Lilly who is about a year and a half old was diagnosed with dry FIP. I was told based on her condition that she would be dead in a few days. She was not eating and I was giving her subcutaneous fluids hourly.

I was told by my vet that the meds are probably not gonna work and that if Lilly recovered it was because she does not have FIP. I don't know really - all the test indicated she did. The uveitis in her eyes was so severe and she was dying right before my eyes.

I gave her her first dose of PI on November 18th and continued to force feed her with a syringe this high end prescription cat food. The food is a/d critical care and I would mix it with water and give it to her by syringe at least 1/2 a can a day.

After a week of being on PI and me feeding and caring for her around the clock she began to show improvement! I was hopeful. Lilly had what looked like uveitis in her eyes and it began to clear. She started eating a little on her own. I continued feeding her by syringe [twice a day] for one month even though she was eating on her own - and giving her the PI.

The uveitis and her blood filled eyes cleared in two weeks from the the time she started the meds. I gave her two [5 ml doses] a week for about a month and a half but now it's only once every seven days. I only give it to her once a week now because a. she seems completely well and b. it's insanely expensive. Lilly weighs about 7 pounds - probably 8 now because she has gained weight.

She hates the taste of PI - but I have learned to give it to her quickly and make sure she gets a treat after. 

Lilly is now 100% - she seems as if nothing ever happened. She runs around and plays just as she did before she got so sick. I pray for her every day that she will live a long and healthy life with me - and so far it looks good.

Best of wishes to all of you - it is so hard to watch the animal we love so much get sick. Just a side note - Lilly was not on steroids except for maybe a week and I never gave her any antibiotics either when she seemed to have a cough. I also took her in for IV fluids in her veins every time she sunk to near death so I could manage her condition better. The little hairless spots on Lilly's leg is where they shaved her for the iv:)" ~ compiled from two Facebook posts from Alethea January 2013

To really fight FIP tooth and claw on behalf of a kitty who really doesn't understand is a hard decision as the outcome is far from certain - Sampson's owner sort of regretted making him miserable with the PI. Others who have ultimately lost their kittens have as well. I can only say whatever happens be kind to yourself, forgive yourself everything and be at peace. When I look back I will look all the way back and remember the happy times, for there were many.

The Christmas Tomten

“Winters come and winters go, Summers come and summers go, Soon the swallows will be here.” thinks the Tomten.

Yuletide "the midpoint of winter - the cosmic balance between life and death". I feel like we are poised on such a tipping point - and i cant help thinking being in the southern hemisphere the december solstice signals the descent.

Mishka has been going 4 months on the FIP roller coaster. She's on Feline interferon twice a week and a weekly abdo drainage and one week into a trial of PI to see if we can tip the balance over toward life.

There are a few other kittens diagnosed around the same time still alive and well including Tomten - who is named after a scandinavian gnome who talks to the cat in tomten language, "a silent little language a cat can understand."

Nov 2012 "Our biggest fear in the storm was how to keep the feline interferon cold when we lost power. (My vet is importing it from the UK). Jan 1 will be the six month mark so we are thinking about doing another ultrasound then to see how everything looks. Knock on wood Gizmo also seems ok. Not sure how Gizmo would ever handle it if we loose Tom as they are inseparable." ~ Cassie

Gizmo and Tomten, the darker kitty who has FIP, live with the Hallbergs in New Jersey USA. He was diagnosed back in July 2012. His mom Cassie posts updates to the FIPcat support yahoo group. In october his dosages were prednisone 2mg daily and Feline Interferon injections .4ml weekly. Now it is down to every 2nd day for the prednisone and every ten days for the interferon.

Good Yule Tomten and family! Here is a video interpretation of the children's book 'The Tomten' to enjoy http://www.youtube.com/watch?v=ABMDcIJp784

Wednesday, December 12, 2012

Hi everyone- sorry its been a while since I posted. Hurricane Sandy did a number on our internet.

Tomten continues to do well. He will be at the 6 month mark since his initial diagnosis on Jan 1st 2012 (Big Day!!!) So for everyone who is new to this site and feeling at a total loss (That was me 6 months ago) there is hope!

For the most part he continues to do well. He is now on the feline interferon injections once every 10 days plus Prednisone every other day. The last two weeks he was a bit withdrawn and less active but the last two days he seems back to himself. (we live in total dread when his behavior changes the least little bit)

I took him and his brother Gizmo for their annual check up last Saturday. His regular vet (he also sees an internal medicine specialist who is leading the FIP treatment) was amazed by him. We decided to never vaccinate him again so as not to stress his immune system. She also took some blood to run a blood pannel. Both Vets agree that they want to rescan him again in January to see if the intestinal mass is still gone and if the lymph nodes are still inflamed.

I think his blood pannel looks much better: The Alb/Glob ration has gone from .44 back in July to .9. Which I think means no longer consistent with FIP. They key change is the alb which in July was 2.2 and now is 4.4. The glob hasn't changed much, its gone from 5.0 to 4.9.

There are some parameters that are really high but Dr. Harrison (the internal medicine vet was pleased. Marlene I would love to get your thoughts on it....

Bets wishes to everyone,

Cassie

Tomtens blood panel

CHEM 21 with COMPREHENSIVE CBC : CHEM 21 (1272)
Test Result Reference Range Low Normal High

ALK. PHOSPHATASE 6 0 - 62 U/L

ALT (SGPT) 35 28 - 100 U/L

AST (SGOT) 30 5 - 55 U/L

ALBUMIN 4.4 2.3 - 3.9 g/dL HIGH

TOTAL PROTEIN 9.3 5.9 - 8.5 g/dL HIGH

GLOBULIN 4.9 3.0 - 5.6 g/dL

TOTAL BILIRUBIN 0.0 0.0 - 0.4 mg/dL

DIRECT BILIRUBIN 0.0 0.0 - 0.2 mg/dL

BUN 37 15 - 34 mg/dL HIGH

CREATININE 1.2 0.8 - 2.3 mg/dL

CHOLESTEROL 142 82 - 218 mg/dL

GLUCOSE 114 70 - 150 mg/dL

CALCIUM 11.8 1
8.2 - 11.8 mg/dL

PHOSPHORUS 4.2 3.0 - 7.0 mg/dL

CHLORIDE 118 111 - 125 mEq/L

POTASSIUM 3.7 3.9 - 5.3 mEq/L LOW

SODIUM 157 147 - 156 mEq/L HIGH

A/G RATIO 0.9 0.4 - 0.8 HIGH

B/C RATIO 30.8 HIGH
INDIRECT BILIRUBIN 0.0 0 - 0.3 mg/dL

NA/K RATIO 42
HEMOLYSIS INDEX N 2

LIPEMIA INDEX N 3

Comments:
1. RESULT VERIFIED BY REPEAT ANALYSIS
2. Index of N,+,++ exhibits no significant effect on chemistry values.
3. Index of N,+,++ exhibits no significant effect on chemistry values.

CHEM 21 with COMPREHENSIVE CBC : CBC COMPREHENSIVE (1272)
Test Result Reference Range Low Normal High

WBC 6.3 4.2 - 15.6 K/uL

RBC 8.07 6.0 - 10.0 M/uL

HGB 12.8 9.5 - 15 g/dL

HCT 39.7 29 - 45 %

MCV 49 41 - 58 fL

MCH 15.9 11.0 - 17.5 pg

MCHC 32.2 29 - 36 g/dL

% RETICULOCYTE 0.1 %
RETICULOCYTE 8 3 - 50 K/uL

NEUTROPHILSEG 58.8 35 - 75 %

LYMPHOCYTES 30.5 20 - 55 %

MONOCYTES 5.0 1 - 4 % HIGH

EOSINOPHIL 5.4 2 - 12 %

BASOPHIL 0.3 0 - 1 %

AUTO PLATELET 192 170 - 600 K/uL

ANISOCYTOSIS SLIGHT
REMARKS SLIDE REVIEWED MICROSCOPICALLY.

ABSOLUTE NEUTROPHILSEG 3704 2500 - 12500 /uL

ABSOLUTE LYMPHOCYTE 1922 1500 - 7000 /uL

ABSOLUTE MONOCYTE 315 0 - 850 /uL

ABSOLUTE EOSINOPHIL 340 0 - 1500 /uL

ABSOLUTE BASOPHIL 19 0 - 100 /uL
_______________________________

14 December  2012

I love CR!!!! Cure is better but I love Clinical Response.

His total protein has gone up from 7.2 in July to 9.3. His Calcium has also gone up from 7.7 to 11.8.

He is eating well. Tomten has always lived to eat. I notice he sometimes now eats smaller amounts and then goes back and finishes it off 15 minutes later. In July his weight fell to 8.0 lbs he is up to 9.6 lbs.

Unfortunately he is addicted to fancy feast cat food which I fear may not be the most healthy but per Dr. Addie's recco I am supplementing it with a teaspoon a day of either Applepaws chicken, Tuna, Salmon. And he is getting raw steak 3 times a week. (Which he loves!!!) Makes up for the injections which he is increasingly getting more agitated about.

I will keep you posted on the scan in January.

For everyone who is new to the site and feeling hopeless (that was me in July- after all this was his second diagnosis of FIP- the first being a misdiagnosis when he was a kitten and actually had herpes. And I figured he couldn't get lucky twice and this was it). Hang in there! There is hope. Every day I have with Tom is a gift. I don't know how many we will have but we all treasure each day we have with our goofy fur ball and his brother.

Thanks to everyone for your continued support!

Cassie
__________________________________

22 September 2012

Subject: [FIPCatSupport] Update on Tomten- still doing well

Hi Everyone,  Its been a while since I posted. I contacted Dr. Addie and she agreed to consult with Dr. Harrison to see if Tomten really has or had fip and if he does to give us some advice on how to manage him since he is doing so well on the feline interferon. Now I am just waiting for the two to connect. Knock on wood he continues to do well. Went for a walk on his leash today outside and he was in kitty bliss!We are so grateful to still have him with us.

Dr.Addie was extremely helpful she suggested we immedietly take him off the L-lysine paste he has been taking for herpes since he was a kitten. Apparently, it interferes with the L'argine uptake. She also recommended we add raw red meat to his diet which Dr. Harrison is open to. So he is now getting chopped steak everyday and canned salmon from COSTCO. The steak is expensive but compared to the feline interferon a relative bargain! I also just ordered some applaws from amazon.com. Hopefully they will like it. His brother is super finkly and they really love their fancy feast but I am increasingly concerned I am feeding them yummy junk food. So we will see how it goes with the applaws.

Tomten is doing great but he is losing patience with us jabbing him every week. Upsetting for me as my once "velcro cat" is now nervous every time I pick him up that he is going to get jabbed. So hard because we can't explain it may be whats keeping him alive. But that being said the weather today was amazing and he loved going out for a walk with his brother.

One super goofy FIP moment is the family has taken to singing to Tomten and his brother Gizmo every night the "Kill the virus song" Modeled after Elmer Fudd's of bugs bunny fame "kill the wabbit song". I don't know that its helping but makes us all laugh and that seems to make the cats happy.

best thoughts to everyone, Cassie

14 January 2013 - click here for Tomtens update Great News!

John Robbie

"My beautiful John Robie. Still doing well 8 months after his FIP diagnosis. He is a miracle thanks to PI. ( Polyprenyl Immunostimulant ) " ~ CatMom: Lisa Cone

7th Dec 2012

John Robie on the stove - a favorite place. 33 weeks on PI and still going strong!

Happy Catmas John Robie and Lisa!

The charming Jon Robbie is named after the antihero of "To Catch a Thief" since he stole Lisa's heart!

• John Robie (approximate BD of June 25, 2010). 

  "John Robie is an active 2 year old, curious, kittenish loving brat. His Dry FIP is concentrated in his intestines and it can be uncomfortable for him to poop (he meows in the cat box), but he's otherwise a normal cat and has even gained some weight. He actually looks (and acts) like a normal (but not fat) teenage cat. It is difficult to remember that he has a fatal disease. But, he's a feisty one and strong. He bounced back from exploratory surgery like it didn't even phase him. I think I knew then that he was going to be my fighter and he sure has.

  He was dumped in a parking lot at 5 weeks old and found by me. He's probably some exotic mix as he is VERY different from all of other street cats. He had terrible fleas and ear mites when I found him and a slight URI but was otherwise healthy. He was just going to be a foster, but he was too amazing and I fell in love, so he became a part of a household with 8 other cats. When he was a year old, I fostered 3, 4 week old kittens for a few months. He was always and indoor cat. He started losing weight in late March and we took him in to our vet almost immediately. My normal vet diagnosed FIP immediately and told me he had a few weeks tops. I have too much experience with vets not being proactive so I went exploring. A client of mine (I'm a pet sitter) had a recent great experience with a vet that works with pug rescue (I also have pugs) so I took him there for a second opinion. They were much more proactive, did exploratory surgery, took a biopsy and was willing to work with getting him PI. 

  That vet was Airport Irvine Animal Hospital Irvine, CA. They also started him on Prednisone, Trental (pentoxifylline) and an appetite stimulant right away. He responded pretty well right away to the meds. We got approved for PI and he started on that on April 7. I weaned him slowly off of Pred, but when we got to the point where he had stopped the pred completely, he started doing badly again. I upped the pred to normal dosage again until he stabilized again, then weaned him down to .25 mg every other day. He has remained on .25 pred every other day, 1/8 Trental every other day and PI every other day since then and it has been the perfect combination thus far. 

  Oh, one other thing...None of the 8 other cats in my household (who are older than JR) have shown any signs of FIP (yet), nor have the foster kittens that were "raised" by JR shown any signs of FIP. I hope it stays that way. " ~ Lisa

  
  

  Amen to that.
  

  April 2013 update:

  
  

  

  still doing amazing!
  John Robie is still on Prednisone at one year. A dose of .25 ever other day seems to be the ticket for him. He does NOT do well when he is off completely.
  

  May 2013 update:

  His update is currently in flux. He was stable on the same dosage of all 3 meds. We decreased his Pred and he took a turn for the worst.

  We upped it back up to the original dosage then slowly decreased it weekly. As of 2 days ago, he is started showing symptoms again with the Pred at .25 every other day.

  So now we have increased it again to .25 every day.

  Hopefully that will stabilize him.

  The trental and PI dosage remains the same.
   
  Fortunately John Robbie is back to his playful self on the daily prednisone. Please be cautious when the cat is doing well; they really do look normal and start perhaps fussing about medications so that people try to scale the medications back. I have collected several case histories of cats who have had problems when their doses were scaled back like Abbey. Oliver Mackinnon takes his 5mls of PI DAILY for 3 years and only now is starting to think about scaling back, Blade has been chugging along on his meds for 2 years - if it ain't broke dont fix!

Where iz my cheezeburger?

 " A great many things in my life would be different if only I could open the door to the refrigerator. "~ Henri, le chat noir

 

 Grains and carnivores - not a happy mix

It is nice to have Mishka back to normal - hunting around the house in the wee hours for snacks ... bang bang bang at 4 am opening cupboards, finding her in a pile of kibble ....

oh crap - waiting for the sound of puking

She was vomiting again on tuesday evening / wed morning. Perhaps it was a bit of plastic from chomping into the loaf of fruit bread on the bench, or the bread itself.  Thankfully settled by midday but for many hours I thought it was all over though she is stronger; still playing with me after 4 chucks! took five to take her down a bit, and she remained well hydrated. Previously one or two chucks made her a limp fur rag. She was examined and cleared by our vet for continued treatment, so drained again wed pm and perked up straight way as usual - so we put it down to scoffing kibble accidentally left out for the other cat on top of the illicit snacks. We are not serving even a  mouthful of this junk food even as a treat anymore though she does miss it since Friskies Indoor was all she ever ate when she came to us.

Mishka wasn't particularly fippy belly leading up to the vomiting so it caught me by surprise. Might be magical thinking but let's pretend the fluid is slowing down marginally. After a week we only drained 465 mls. The time before we took off that much after only five days. No hairball has come up, and also no grass yet even though she has also scoffed her nommy new wheatgrass today which astonishingly seemed to make her feel better almost immediately.

Firstly i stopped the curcumin and pentoxifylline cream since they can both upset the tummy with no difference in Mishka's constitution except she is happier ( the pentoxi cream was was getting increasingly unsettling applied even just twice daily instead of the required three. i wasn't going to renew the prescription as it hasn't made huge inroads into her disease for the emotional cost - just tried replacing it with curcumin as the anti-inflammatory. We haven't missed the prednisolone.

Curcumin extract suggested by a friend was originally rejected because i thought it would be hard to dose ( not true ~ she likes the flavour or ignores it but it stains fur pink! ) and I have read it may be immune suppressive although possibly in away that is ok For starters it hammers the TH1 and TH2 systems even handedly  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1810449/ 
Too many long words - waiting on comment by Dr Norris. We can't get Thorne brand Curcuvet in australia but herbs of gold sell an easy to get product containing the same bioavailable Meriva extract Thorne uses.

And still waaaiting for the customs clearance to get PI - come on Santa!