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

Gus - Pentoxyfylline success part 2

Continued from part 1 http://onecatlife.blogspot.com.au/2015/01/gus-pentoxifylline-for-fip.html
Gus's foster carer Nicole kindly answered my questions in detail - texting on a phone! That's dedication for you.

Diet- no special diet. Gus always ate just Purina dry indoor formula. Once he got his Dx, he was spoiled rotten and I added canned friskies plus whatever protein I happened to be having for dinner- shrimp, ham, turkey, ect. Whatever he wanted. He was never put on an antibiotic that I can recall. When Dr. Ciance of Allenwood veterinarian hospital (in Allenwood NJ 732-528-7444) Dx'd  him she put him on 2 ml of pred a day to stimulate appetite and make him feel better. She also prescribed doxy ( doxycycline? a  broad spectrum antibiotic ) in pill form but I couldn't get him to take it, and her opinion was to not force it on him, let him enjoy his remaining time. We may have tried liquid, I can't recall. But he was never on antibiotics for an extended period of time.

Uncle Gus

Then I took him to Dr. Falk (Ocean County Veterinarian Hospital Lakewood NJ ). He was so kind and compassionate, even recommended a support group for me. He looked at the initial bloodwork and agreed that it looked like FIP. (see Gus's labs in previous post) He suggested adding pentox in addition to the pred. So, he was on 2ml of pred and 1 ml of pentox daily. This went on for about 5 months, the whole time Gus very slowly lost his belly bloat, gained muscle tone, and became more energetic. The two meds combined cost about $90/m from Diamondback, including shipping. (60 ml bottle of chicken flavored prednisolone and a 30 ml bottle of chicken flavored Pentoxifylene.) Always got the meds in about 3-4 days flat rate mail but I do believe they offer offer expedited shipping as well. They were great and very easy to deal with.

Gus tolerated the pred well, he did NOT tolerate the pentox. I would say on average he would vomit 7/10 times after I gave it to him. Broke my heart. I tried mixing 1ml of pred with 1/2 ml of pentox 2x daily, that was a little better but he would still throw it up occasionally. I played around with the timing and what seemed to work best was giving it to him about an hour after he ate. 

( Note: when we tried Mishka on pentox we follwed the advice to use a cream - she had no upset other than she didn't exactly like cream smeared on her ears ) Please note how careful they were about not taking Gus off any meds until he was definitely better on bloodwork and they wean slowly.

He isn't on any meds at all now, hasn't been since October 2014. When Dr Falk did new bloodwork and declared him either misdiagnosed or "cured", we decided to ween him off all meds. I stopped the pentox almost immediately since he hated it so much- did every other day for about a week and that was it. I went much slower with the pred, as u know u can't just stop it cold turkey. I slowly decreased his dose over a month, down to 1ml, then did 1ml every other day for about 2 weeks, then 1/2 ml every other day for about a week, and that was it.

the Fab4 including Gus

I Have fostered about 75-100 kittens over close to 3 years... as far as I know none of them have ever been Dx'd with either form of FIP. I did have 2 pass away from dehydration and Giardia (they passed away 2 days after I had them, they were in very bad shape when I took them in). Every other cat/kitten has been a success story as far as I know. I have 3 other cats and none of them have ever had any major ailments -unless u count my 12 yr old Oscar just having 5 teeth pulled Poor guy.

Yes, I stopped fostering. I actually had 12 wk old brother and sister kittens in my house when Gus was diagnosed, I immediately had the rescue take them back (a friend's mother has since adopted them both)!

Gus is strictly and indoor cat. I live on a busy street. I fostered his pregnant mother and he has been with me every day since birth. My mother kept his mother and his sister, and I keep in touch with the woman who adopted his brother and other sister. As far as I know none of them have had any major health issues to date.

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 - PCR negative for FIP

oh dear dredged out of my drafts so it's older than this by months but rest easy Tomten seems to still be fine as far as I know. This was written before Dr. Plotnick gave Cassie his helpful email in .

"The News I have been hoping for is finally here..... Dr. Ratti just called me a few minutes ago. UC Davis Vet Hospital just called her. Acting on Dr. Addie's advice she has sent a PCR of his effected tissue to a researcher there. The verdict is this is not FIP!!!!!! (second time in his six years I have heard that and its just as sweet the second time around. First time it was herpes when he was a kitten).

Since we had tested him last year when he first got sick for Lymphoma they have ruled that out. The current hypothesis is he has some foreign bodies embedded in the intestine that has caused the granulomas and with surgery maybe there is still a chance. Because it will be a complicated surgery (two granulomas) and he is weak she wants him at a full service surgery center with access to ultrasound equipment at the operating table and the 24 hour critical care. She will be researching Redbank and Garden State Hospital. Because Tomten is somewhat stable, not getting worse but not getting better she wants us to wait until after the Holiday week so where ever he goes they will have a full staff.

I am elated by the news but terrified for him. He will die without the surgery and with it at least I know he has a chance. He is truly a fighter. In his six years I have been told he is dying 4 to 5 times and he battles back. I hope he has it in him one more time.

The foreign body theory makes some sense to me as he has a bad habit of eating wrapping paper ribbon, rubber kids toys, and straw etc. As much as we try and keep these out of the house they sometimes slip in unnoticed. 3 months ago my son brought home a party favor bag and we didn't realize it was tied with wrapping paper ribbon. He got it ate , got sick and passed it... but I can't help but wonder if he didn't pass all of it. Ditto there have been numerous other incidents over the years so its possible.

Sorry I am rambling on today... A lot of emotion. We have been in Limbo with FIP for so very long." ~ Cassie

I don't know what to say other than Tomten is one sick cat. His fur has not been so shiny and nice apparently for the past month. One has to wonder if the interferon is contributing significantly by holding the herpes at bay or in some other way. I don't suppose you should just withdraw it after all this time - but the latest news on Tomten was he pulled through again and in  Cassie finally got some diagnostic insights and peace of mind from a very  unexpected source read on - where-do-you-go-when-your-cat has stumped all the vets?

Murphy - misdiagnosis of wet FIP

Mischievous Murphy from Germany is a kitten successfully treated for bacterial peritonitis which was initially mis-diagnosed as FIP in April 2013 when he was 8 months old. Fortunately Jennifer did not give up. She found a second opinion from another vet, who although she could not rule out FIP even though his abdominal fluid tested negative for coronavirus, committed to save him and went for treating the treatable in the face of uncertainty. Murphy was given Suanatem (Metronidazole and Spiramycin) and recovered quickly.

This continues the series on misdiagnosis. Please make sure you check out Dr Addies's diagnostic algorithm's for FIP on treatment page before losing hope. And donate to FIP research which is working towards a fast and reliable diagnostic tool. In australia this is University of Sydney with Jaqui Norris.

Tomten's Birthday

"...for us physicists believe the separation between past, present, and future is only an illusion, although a convincing one." ~ Einstein on the death of his friend Besso

Just wanted to drop a note to say that Tomten & Gizmo celebrated their 6th birthday last week! Yeah! Happy Birthday Tomten & Gizmo! For those of you who are newly diagnosed and feeling at a total loss. I wanted to share that bit of news. Tomten was diagnosed July 1st 2012 with dry FIP. He has been on the feline interferon and pred ever since. While he has his good days (totally normal mischievous Devon Rex) and his slow days (sleeps all day and scares us to death) his quality of life seems good. We never thought we would see this birthday so we celebrated with a nice long walk outside on his leash, a can of tuna fish, and plenty of cat nip! I don't know how long he has but we treasure each day! Thanks to everyone who helped him see this birthday! ~ Cassie (details of treatment here )

Many happy returns to Tomten and his littermate Gizmo (who doesn't have FIP)! Cassie is so thoughtfully posting his updates to keep our spirits up  as we watch the steady stream of kittens dying from FIP on the FIP fighters facebook community.
This month Mihoshi Barner - the little Ferret with FIP who has been on PI for over a year, passed away leaving a very sad owner behind. Ferrets do not live as long as cats so in ferret years I wonder how old he was? Mishka was 27 in accelerated cat time when she died, which is some sort of cold comfort. Tomten and Gizmo are the equivalent of 41 human years old wow, nearly middle aged by the catyears calculator ( in the right column menu overthere ) - no wonder he's catnapping all day. Hiphip hooray! Kill Da virus!

Gizmo on left Tomten on right

Dorothy - Somewhere over the rainbow

Today I got the news that Marcelo's cat Dorothy has also lost her 8 month fight with wet FIP.  Marcelo is in Brazil, not a native english speaker so it was hard to piece together her story. From what I gather Dorothy had a litter of kittens and developed wet FIP of the abdomen last year around the same time as Mishka. The effusion resolved on corticosteroids and human interferon by late october 2012 when Marcelo wrote to the facebook group for advice:

"Hello everyone, news on Dorothy condition. She is still doing fine, playing and eating, but she is not gaining any weight, is there anything I can give her as a supplement to food? Thanks for any help you can share."

Members reccomended Nutrical and a change from her kibble diet to something like Hill's a/d. John Robbie's mum reccomended colostrum powder (which I then started to give to Mishka who was not a fan of Nutrical as JR has been doing fantastic on PI) 

 "I've used Colostrum powder mixed wither with some water (force feed if they won't drink it) or added to wet food. I have used it on John Robie since he's eating well, but I used to give it to my FIV+ cat when he started declining as well as to unhealthy rescue dogs and cats. It really helps with weight gain and overall health and builds a healthy immune system."

Dorothy was given Nutrical twice daily. On November 22 it seems she was also started on PI and the steroids were weaned. In december 2012 she was on 1.0 ml Interferon and reduced from 2 ml to 1.5 ml of PI. but Marcelo did not say  how often she was taking these. In January the dose was further reduced to 1ml of PI and still 1ml of Interferon. In february after Mishka died Dorothy was still alive and very well. "Dory is better than ever, she is still on PI and Interferon, also on Nutri-cal. She seems to be in normal health now."  

Alas she suddenly crashed - like Mishka. Perhaps this is the best that PI can do for wet FIP, perhaps it's better to just leave it out and use the steroids early with interferon.

"My friends, yesterday was a very sad day for me and my wife, Dory health was downhill since last week, it was fast and cruel, so we had to put her to sleep. It seem that even miracle cats ends like this with this terrible disease."
Goodbye Dorothy dear ... if anyone deserves to wake up in heaven FIP cats do.

"Someday I'll wish upon a star And wake up where the clouds are far behind me."

 

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!

Die another day - Toby and 0029

"I'm checking out. Thanks for the Kiss of Life." ~ James Bond (Die Another Day)

oh heck - just as the rest of her seems to be rallying kitty has a 'funny lump' under the skin which is possibly getting bigger. The vet is ignoring it strenuously and I'm not thinking straight - perhaps I should have jumped on it last week and investigated while she was under for the drain. The thing neither of us want to face is the prospect of a malignancy.

Seems she is simply dying more slowly, as our vet puts it - or living to die from something else like Toby - who was an uneutered Tom cat from Woodstock Ontario Canada. Toby lived the bachelor lifestyle, out partying every night and returning home in the daylight hours for food. When he got wet FIP he survived due to the ministrations of his owner, homeopathy and a change of diet (he stopped Taste of the Wild dry food and the pokeweed prescribed by a naturopath amongst other things); Toby fast tracked from having a FIP belly drained in August 2011 to normal function, including the partying, by September a few weeks later. He had places to be and cats to see - ladies to romance, guys to fight I guess and in April 2012 walked off into the night, sporting a swollen leg from an encounter of the 007 kind, never to be seen since by his human, Monika.

There was similar kitty, known only to me as "29" who was one of the original cats on the Polyprenyl Immunostimulant study. 0029 had dry FIP with neurological symptoms, who during treatment got well enough to get back to the killing business but met his match in a coyote. "when he was sick he was hanging around the house, once he started feeling better, it was hunting again, it was bringing little presents to the owners on a regular basis." ~  Dr Legendre WINN Feline Symposium transcript

But of course I am the eternal optomist. Unlikely things happen such as Miko the red burmese being reunited at the grand old age of 17 with his family in Essex, UK after a staggering ten years AWOL thanks to his microchip. Who knows, Toby is merely MIA he may reappear into Monika's life somewhere down the road.

from humortrain

New Years Tomten

"Winters come and summers go, year follows year. but as long as people live at the old farm in the forest, every night the Tomten will trip around between the houses on his small silent feet."

Cassie from New Jersey just updated Tomten's status and the news is great!

"Hi everyone,

I just got back from Tomten's ultrasound. Good news. No GI tumors. His Lymph nodes are still enlarged but have visibly shrunk since last September's scan.

Bad News: Dr. Harrison who has secured the the Virbagen Omega from the UK and helped Dr. Ratti with his treatment plan is leaving Animerge for Chicago. (Good news for all the felines in Chicago!!)I have reached out to Dr. Ratti to see if she can take over ordering his meds. I bought a 24 week supply so hopefully we have some time.

I have also suggested to Dr. Ratti we do the feces PCR to see if he is is still possible for the virus. Though my bank balance might want to defer that for a few weeks as the ultrasound and 24 week supply of his liquid gold was steep!

He had a great weekend. Wrestling with his brother, counter surfing, hunting bugs... Right now he is cuddled up next to his brother Gizmo and the two of them are on the ottoman looking out the window at our lake and watching the geese. Its too cute.

I hope everyone's furry friends have a good day as well.

Cassie"

Frank

"Life isn't about waiting for the storm to pass...it's learning to dance in the rain. " ~ unknown

This is Frank, a three legged Canadian alley cat who is going through treatment with PI for dry FIP.

Frank has started PI back in April 2011 on the Winn Foundation Study by Dr. Legendre. Here's his new family's report from Jan 2013.

"In the summer of 2008 Frank was found in an alley by some very kind people. He was taken to a vet clinic as a very sick little boy with a fractured hind leg that was very infected, unfortunately they could not afford to care for the kitten and relinquished him to the clinic for care. The vet clinic took excellent care of this little boy setting his leg and nursing him back to health. 

Soon after he was well enough to leave the clinic we were asked to foster him. Frank came into our home with a cast on his back leg but full of energy. We had 4 dogs at the time but he fit right in, he soon became the boss of the house. Soon after his cast was removed Frank began to limp again. He was brought into the clinic to investigate and it was discovered that the infection had spread to the bone and the only solution was to remove the leg. After his surgery he returned to our home, by now we couldn't imagine life without him and the decision was made to make him a permanent part of our family. He was as active and playful as ever even playing with our miniature schnauzers. 

In the winter of 2011 we noticed that Frank had lost weight and brought him to the clinic for examination. He was diagnosed with dry FIP. Thinking it was a death sentence for him we were prepared for the worst but desperately looked into treatment options. Dr.Kremeniuk at Park Pet Hospital found out about a drug trial for cats afflicted with this terrible disease and Frank was accepted into it. Since he has been on the PI he has returned to his normal self and we are so happy! Frank loves to go camping with us in the summer, he wears a harness and eagerly explores the campsite. He is so loved by the whole family and we are so grateful for PI giving him a second chance at life. He is a fighter and is determined to live as long as he can. Thank you Dr.Sass and everyone involved with PI for saving his life".

I'm not yet sure if Frank is still on the PI and at what dose. He's been through a lot and he's obviously determined to enjoy life to the full - thanks to his wonderful new family and vets for giving him that chance! Goodluck to you Frank.

Blade

" For everyone of us that succeeds, it's because there's somebody there to show you the way out. " ~ Oprah

 Blade lies in Michigan USA with Joni Swanson, still hale and happy in Jan 2013 over two years since first diagnosis. When I stumbled across Blade's story I was amazed and hopeful to see he was having weekly drainages of his effusion. At that time Mishka was up to her 4th drainage and i was unsure if we were going to slowly starve her to death by doing more because that was the most any other cat I heard of ever had to have before they either died or got better. So seeing Blade in such good health after 2 whole years gave us courage to proceed even though I do not have details of bloodwork or diagnostics. His veterinarian is Dr Paul Crawshaw at the Wyandotte Animal Hospital in Wyandotte, Michigan.

"Forget the ridiculous amount of toys, I just want to sit in the basket!"

October 9 2012 Joni Swanson writes:

"He will be 8 on October 30th, couldn't believe we were dealing with this at his age, but other than his little belly, you would never know he was sick. We have 5 cats and he is the most feisty. We have gone from once a week to once every four weeks, as of last week. 

The dr uses the ultrasound machine while using a catheter to remove the fluid. Every once in a while they say he starts flipping his tail and becomes vocal, but is a good boy for the most part. The fluid removed is between 1/2-1lb...was 410cc, used to remove 300-400 per week....when they bring him back, he acts perfectly fine. Jumps off the table, is a little nosey, then goes to his carrier. Dr gave me some medication to give him before i take him next time, said it will take the edge off. Otherwise he hasn't been given anything. It is about $86 each time......don't even know how we did it financially 2 yrs ago when he was going every week, guess I always hoped for a miracle.....it kept me going. I call him my million dollar kitty. 
He gets 1ml of interferon and 1ml of prednisone. The vet charges us $20 for the interferon (good for 2 mths) and the prednisone prescription is $32. Also crush 250mg of Rutin, a dietary supplement vitamin, to put on a spoonful of canned food 2-3 times per day. 
Was told by another vet that I didn't have to bother after he confirmed the FIP, but I continue to do what I had been for the previous year. I could talk all night about my little Blade.....sorry to keep blabbing......my heart breaks for all the babies lost to this horrible disease."

November 23, 2012 Joni Swanson writes:

"He is doing good....had 320 ml removed on Tuesday. He had a plateful of turkey and is napping now Talked to the dr about the different vitamins I have seen and asked about PI (polyprenyl immunostimmulant,). He said he would look into the PI, but said Blade is doing so well, why change anything."

Blade update: good news from visit on January 2nd 2013

"only 200ml was removed, down from 260ml removed 3 weeks prior, ultrasound showed less fluid and Blade weighed the same as the did after the 260ml was removed. Dr says he is an exception....just can't figure it out, but whatever it is, it is working. I know FIP is not curable, but Blade sure gives me high hopes! I also cut back on prednisone and interferon, used to have no problem giving him the medication, but when he started running and hiding from me, I wasn't going to force it down him. Could the steroid cause more fluid buildup? I don't know, but other than that darn fluid, you would never know he was sick. He is the king of the house"  

Long live the king :)

FIP makes you paranoid

"It is also useful to have the client remember a time when the cat was healthiest, and write down the cat’s 3 favourite activities. Then the cat cannot accomplish two of those activities, quality of life is compromised and euthanasia should be considered (Wright & Rogers, 2010)." ~ Dr Dianne  Addie wet FIP – case study 

eating - tick, sleeping on anything black and getting white fur all over it - tick, going outside and hunting (badly) - tick 

It's a few days after christmas. I was absolutely dreading having to be cheerful while surrounded by people who think "it's just a cat"  For a while I even had an awful idea playing in my head that I might be asked to euthanase the cat because it would be more convenient than having an awkward drama at Christmas. (yup FIP makes you paranoid) What would the cat hating grandfather make of my devotion to furball's care over cooking xmas dinner? Would there be A SCENE ... well guess who donated a massive cash injection to Mishka's fighting fund - one of only five people to do so.

The Christmas drama did indeed happen. On christmas eve she got some nasty reaction to the injection of sedative  - didn't wake up on schedule and then developed a nasty looking haemorhagic rash at the site ( we thought at first she was going to go into a hemorhagic crisis ) Turned out to just be she had scratched and licked the itchy spot to death. 

So we got to road test plantain herbal poultice - just mush ribwort plantain leaves up and bandage over the sore spot. Worked quite well - also on my itchy toe (bit by a jack jumper that morning) but she was still worrying the spot over the next few days and in danger of tearing out a lot of fur so we tried swaddling with a "Thunder shirt" (bad idea although it stopped her licking it really should have been introduced very very gradually. Wearing a weird t shirt made her anxious - more licking and scratching when she had it removed but this settled quickly.)

Not quite the christmas day we had hoped for Mishka but she's partying on.

Alfie

FIP is notoriously hard to diagnose if it is dry form - but even the wet form does have a differential.

Dear all,
Today we had to say goodbye to our 11 week old baby Alfie. 3 days ago he started to get sick; his appetite was gone, he was lethargic, I could feel his spine and ribs while his tummy felt "healthy" as if he just had eaten.

All these symptoms worried me, so I went with him to the vet the day after. They took blood samples to send to the lab. The abdominal puncture fluid was clear, colourless and not stringy.

The following day we got back the results from the lab and they were not consistent with fip. Today, we took him to a clinic for an ultrasound, a Rivalta test and an analysis of the puncture fluid. The Rivalta test was very clearly negative and through the ultrasound we learned Alfie had a congenital disorder; his pericardium contained not only his heart but also a big part of his liver... This is not a inherited disease but "just" something in the embryonic development that went wrong :(

Without surgery there was no chance for Alfie, so we didn't have a choice but to give him this chance and left him there for surgery later today. Unfortunately Alfie was already too weak or maybe just too young too cope with the anaesthetics and died even before the surgery could start. Obviously we are very sad about this...

For three days I lived with the sadness, stress and insecurity that a lot of you have been through too when you discover your kitten might have fip. I have been in contact with some of you and I searched the internet for information about fip and differential diagnosis while at the same time I was afraid to believe it could be anything else but the much dreaded fip... It's for this reason that I want to share Alfie's story. If you think your kitten might have (the beginning of) wet fip, insist on all the tests at once. Blood and puncture fluid analysis, Rivalta test and ultrasound of abdomen and thorax, because my Alfie is proof that this can give some of the symptoms presented by fip.

PS On the picture you can see Alfie in better days... We miss him so much :(

from Cattery SmittenKitten

Dr Pedersen's comments on expensive diagnostic tests

"Okay, I'm not going to do many graphic pictures, but I do not understand why veterinarians have so much trouble diagnosing it like me, okay. I do not understand it because there are just the two forms. There is the wet form and the dry form and sometimes there is a little intermediate as they can switch from one to another and you can catch them in that transition stage, but people seem to have a hard time making this diagnosis, and like Al said, if you have a young cat from a shelter cattery that has a distended abdomen and has this yellowish, mucinous fluid that contains the right kind of inflammatory cells, high protein… gee, what else is this? What else can we call it? And the problem that we have is that because the diagnosis of FIP as I said, once they become clinically apparent, they’re going to die, okay, and I tell you right now, they’re going to die. There is no treatment. Okay… that I know of, that has been successful to reverse this thing. Okay, so basically because it’s a fatal disease, people especially veterinarians, and especially owners and especially pathologists; do not want to tell you that this is a fatal disease. They say, just as Al says. You get tired of seeing a path report that describes, there's a clinical history just like FIP, lesions that cannot be anything but FIP and then they say, characteristic of FIP, typical FIP. What does that mean? You tell me, does it have FIP? Just tell me.

And so, the problem is that in any of these kinds of diseases where there is a 100% mortality and believe me, owners are just as guilty because owners will push that risk, and is there a chance that it is this, or it is that, toxoplasmosis is one million, you know, is it the mycosis, one in a million, you know, all of these things, and so, they are always grasping for stuff and they are pushing it, and the more they push you, the more diagnostic tests that you ask for, and the problem is that hardly any of those diagnostic tests are 100% correct. And so, even the PCR test maybe only 80%. Immunohistochemistry might be 70-80% depending on what you do. The blood work is not 100%. They are all just little things that help you make the diagnosis, but there is not a single test that’s simple, short of taking a biopsy or taking some fluid, and doing a specific test by a lab that knows what they are doing, which is another problem, okay, to get a decent result back. And then, you know, then there are still veterinarians refusing to believe that antibody titers are not necessarily diagnostic, so they will continue to do the FIP virus serology on a whole bunch of cats. One cat will die of FIP in the cattery. They will test every cat for $30 or $40 a cat, and then they’ll get the results back and then they will say, “Well, I don’t know what they mean.” So then they’ll call me up. Well, I didn’t order 50 serologies at $50 a piece, you know, and so they wanted a free consult, you know, as far as I never charge for consults, but they want a consultation as to what that test means, well, no veterinarian should ever ask for a test that they do not know how to interpret it.
If the results come back [Applause] if the results come back and they can’t interpret it, why the hell did they ask for it in the first place?"  from WINN feline foundation 2011 FIP symposium

How to Give Medicine to an Uncooperative Cat

Step 8: Get spouse to lie on cat with head just visible from below armpit. Put pill in end of drinking straw, force mouth open with pencil and blow down drinking straw.
Step 9: Check label to make sure pill not harmful to humans, drink glass of water to take taste away. Apply Band-Aid to spouse's forearm and remove blood from carpet with cold water and soap.
- from HOW TO GIVE YOUR CAT A PILL IN TWENTY EASY STEPS

Shironeko - Results may vary

< Some cats are Zen masters. Sub cutaneous fluids seemed sooooo easy from the video demonstration by the very pregnant lady vet (nope). We are talking about a longhaired cat that thinks fur brush is medieval torture device so the road to health was always going to be a little extra challenging. She didn't even like the pentoxifylline transdermal cream (pea sized blob rubbed into ear twice daily) The only patient more uncooperative than the cat is my husband - the doctor.

Fortunately Mishka eats size 3 capsules pretty reliably like kibble if we put them in a teaspoon of moist food served as the entree when she is hungry. Most supplements have to be downsized anyway - get empty gelatine capsules. More excellent tips on medicating cats from Joel Kehler. Here's one method for getting the little pills down without upsetting kitty. (although it looks like i faked it she did eat the pill!)

What's worse than pills? Liquids. Even 6 mls is a lot of liquid for a cat if it tastes bad. Their natural response is to drool like Niagara Falls and squirting too much in fast may choke kitty. It doesn't actually need to be medicine. The early days of FIP with a dehydrated, inapetant cat required some syringe feeding of electrolytes and food. We found the process so distressing initially - and then we discovered the magic of soothing music. It still wasn't a picnic and if she hadn't perked up within 48 hours we would have pulled the plug. Here's a how to give liquids video from Lauren via FIP fighters on facebook. Her cat doesn't look impossibly upset by the whole process.
"One thing I would like to add that Brian (giving the syringe) did during the video: It looks like when she turned her head he was giving the syringe head on/under nose. Try and avoid this at all costs. It's a lot easier on the cat if you do it on the side and they naturally open their mouth when you do it there.Here's a few pointers:- Smaller syringes are MUCH easier to use. If you're doing this long-term always keep a few on backup because they do tend to break a lot.- If the medicine/food is cold, you can take the syringe in-between your hands and hold it/roll it for a few seconds to warm it up.- If your kitty is nervous be sure and massage the back of her neck and talk to her while you're administrating the medicine/food.- This is A LOT less of a mess but still keep a napkin nearby. You can still make a papertowel bib if needed.- If your kitty doesn't like being on her back AT ALL you can still do this technique but have her on her tummy instead. Still go from the side and still hold her close, it'll make her feel more safe and secure. You don't have to grab the scruff hard. It's only for a little bit of control and comfort on her end. I'm fully against hurtful techniques against cats even if a vet is doing it to get medicine in. I can assure you this in no way harms your cat and it should be instinct for them to accept it.Be sure and give your babies lots of love and kisses after this and possibly a treat if they're not too stressed over it so they associate this with some kind of positivity instead of a majorly hated event."

Polyprenyl immunostimulant is a taste issue for some cats, the insert says 1%. It was initially tested via injection - now it is approved for oral use so unfortunately the company are refusing to advise on injection except to say it will sting as it is hypertonic. After a somewhat traumatic first effort when i tried mixing the entire dose into Mishy's lunch we settled on a pattern of putting it a ml at a time into a well in a level teaspoon of moist food and carefully pushing this shut and serving it piecemeal to a very hungry breakfast kitty. Any higher ratio leads to rejection. If she starts to look satiated we stop and start again an hour later - she is sometimes full after 3-4 mls. A heaped teaspoon is actually a prey sized meal for a cat. The PI is only stable after mixing with food for about 30 mins and must be kept out of the light. Video of how we do it

here is Tanja's unhappy experience of using PI with her cat Sampson :

 I chose to go with PI as I was looking for that miracle that would keep Sampson alive a lot longer, and the successful cases looked better on paper than the interferon; unfortunately for Sampson he threw a clot and with everything he was battling at the same time I could not morally try to make him recover from that plus the FIP. 

Personally I do not think the PI was working for Sampson, before he threw the clot I had already decided to stop the PI treatment, his belly was also starting to feel quite fluidy and I believe it was transforming into the wet form. It is a gamble and I do and don't regret using PI. If I hadn't I would always wonder but the process of giving him the PI in such a large amount by mouth was quite stressful for him and I wish we hadn't spent our last days doing that.

 Sampson, he was honestly the furry love of my life and miss him so much that it feels like a piece of me has been torn to shreds, if i could go back and they could offer me an injectible, absolutely without a doubt i would do that, giving it orally was the worst part of the whole thing, no matter how i did it.

Videoing the method could be good, i was giving S-man the full amount in one go because he wouldn't eat the food with any on it, and i didnt want to give him the meds more than once in a day because i felt bad making him do it again, we just had a big treat of chicken loaf afterwards.

Injecting sub cutaneous vitamin C was actually orders of magnitude less stressful than a misguided attempt to use ascorbic acid in her food or as a syringed supplement. (note: Sodium ascorbate though is virtually tasteless to a cat.) Although it must have stung like a bee, it was quick and we were forgiven eventually. We decided 4 shots only after the IV was removed to taper the dose down and give her the best start at the beginning of her illness. Mishka now gets interferon by injection. Actually it is knowing the routine that makes it unstressful - shot and then noms. It really helps to be given at a consistent time and the same 'medicine location' not used for sleeping or feeding, held by her bff Michael. She even stays relaxed with him in the car and at the vets.

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!