[Felvtalk] FW: Greetings & Bogey's Doc Visit

Thu Jan 5 20:24:14 CST 2017

I was leaning that way Amani and you just cemented it for me. I am just
going to dump that powder down the middle the best I can and give her half
AM and half PM. I think I will do the same with the Pred (split the pill).
5mg at once seems like a lot for this little cat. (6lb 5oz). She may feel
better having it that way anyway.

I have to say, I have trouble getting Bogey to take that Doxy. It must
really taste bad. I am going to try to crush it and put it in ice cream or
yogurt this time around. I also feel that the dose she is on for that is
high. 25mg twice a day. They cut the pills poorly the first time around and
the “parts” were smaller. When they refilled, they had the 100mg cut in
actual quarters and she took ill shortly after we started her back on it in
December. 

My hope is that Bogey will be able to come off the meds for some periods
like your Zander did. I thought I was getting better at noticing pinkness in
gums and nose but clearly I haven’t mastered that yet. I looked at her gums
today and they looked awfully pink compared to 4 months ago. I tried to get
her to sit still while I took a pic of them for reference…gonna have to get
another pair of hands for that kind of photography. :-)

We are about 4.5 months into this treatment. I hope that by restarting the
regiment of meds, with some changes, her numbers will come up to where they
were in December. I think we were really making progress.

Yea I don’t understand the “icteric” either. Just gonna accept that
something looked off to the tech and trust the results. (and you)

Your Zander…was a lucky little boy to have you!

From:  Felvtalk <felvtalk-bounces at felineleukemia.org> on behalf of Amani
Oakley <aoakley at oakleylegal.com>
Reply-To:  <felvtalk at felineleukemia.org>
Date:  Thursday, January 5, 2017 at 8:47 PM
To:  "felvtalk at felineleukemia.org" <felvtalk at felineleukemia.org>
Subject:  Re: [Felvtalk] FW: Greetings & Bogey's Doc Visit

I would suggest 1 mg 2x a day then, Sherri. I had Zander on 2 mg 2x a day
but only right at the start for a month or so to “kickstart” the process
because his haematocrit was soooo low. I think the usually recommended dose
for Winstrol for cats is 1 mg twice a day. I gave Zander his pills all at
once – prednisone, Winstrol and Doxycycline. I suspect that the problems you
encountered are far more likely to be related to the higher Winstrol dose
than the staggering of the medication.

Now that you have clarified the dosing for Bogey, I think that the problem
was the high dosing of the Stanazolol. I think if you drop it by half, and
keep everything else the same, you might get a better response. Frankly,
though, it is the very fact that the numbers tumble every time the meds are
pulled, that convinces me that it is definitely the meds that are making
such a significant difference in the levels. I really found, with Zander,
that it took more than 10 months before the numbers would “stick” – ie –
when I discontinued the meds, that the numbers wouldn’t start to immediately
decline, and I was testing him weekly. I could always see an immediate
reaction in the blood work, if I pulled him off the Winstrol.

With Zander, after the 10 month period, I was able to wean him down, but
that probably took another 6 months or more. Thereafter, I watched him like
a hawk, and any time I saw his gums or ears fading in colour (and I got
pretty good at seeing it, as you might imagine) I would put him back on the
meds for a 6-8 week course, and that tended to straighten him back up again.

I don’t know what to make of the description of icteric, because, like I
said, the only way serum would become icteric is from an elevated bilirubin
count, and the bilirubin was completely normal. However, even if the tech
mixed up the description, that doesn’t mean the lab results are mixed up.
The latest results are awfully close to the results from before December, so
I wouldn’t assume they belong to another cat. Determining if a sample is
icteric simply requires the tech to hold up the tube and look at the colour
of the serum. It is possible she wrote down icteric on this sample, but it
was another sample which was icteric. I am fairly confident that the serum
was not icteric, though.

Amani

From: Felvtalk [mailto:felvtalk-bounces at felineleukemia.org] On Behalf Of
Sherri Godschalk
Sent: January-05-17 8:43 PM
To: felvtalk at felineleukemia.org
Subject: Re: [Felvtalk] FW: Greetings & Bogey's Doc Visit

Hi Amani. Thanks for writing. Bogey actually was taking 2mg of the
Stanazolol once a day. (one capsule) Is that what your Zander was taking?
Doc said I could try every other day, or try 1mg twice a day if she starts
to become ill again. I think it is going to be a real balancing act here. In
that 22 days since she was hospitalized, she only had 7 dozes of Stanazolol
and 8 of Doxy. I am going to try to space them out some on a daily basis.
Not give her any medication within 3 hours of taking another. Did you give
your baby meds all in one sitting (both the steroids)? She is to be on the
Doxy for 10 days and recheck around that time. I am watching her food intake
more carefully. If she starts to slow down eating like she did when her
liver problems started last month, maybe I can catch it before it is a
crisis and give her a break from them briefly.

I wouldn’t have guessed that her numbers were so bad. I was actually taken
aback when he showed them to me. She is eating so well. Has gained almost a
pound in the last month. Active.  I thought she was doing a lot better than
she was as far as test results go. I was glad to see her platelets were not
bottomed out like they were in the past.

Amani, did you ever get to the point with Zander that he wasn’t on constant
medicine? Was he able to sustain pretty good numbers for any period of time
without the medication?

I had to look up the word “icteric” that she had written on the results.
Bogey’s  stool and urine have no issues at this moment as far as color. Nor
does her skin. That surprised me too. In all honesty, after I left there I
thought “did they get my results mixed up with someone else's?”

Thanks,

Sherri

From: Felvtalk <felvtalk-bounces at felineleukemia.org> on behalf of Amani
Oakley <aoakley at oakleylegal.com>
Reply-To: <felvtalk at felineleukemia.org>
Date: Thursday, January 5, 2017 at 7:27 PM
To: "felvtalk at felineleukemia.org" <felvtalk at felineleukemia.org>
Subject: [Felvtalk] FW: Greetings & Bogey's Doc Visit

Hi Sherri

As you’ve said, the good news is that the liver enzymes are dropping down.
The bad news is the anemia is back. I think if it were me, I would probably
go back to the 1mg a day dose of Stanazolol, along with the ¼ tablet of doxy
twice a day and the 5 mg of Prednisolone. I agree you could try halving the
prednisolone and giving ½ tablet, twice a day, but I am not sure that is
very significant.

My other concern is that the lymphocytes have jumped up quite a bit as well,
which is not a good thing since that is usually the result of the FeLV virus
load. I also see a significant drop in the platelets. With my cat, I found
that each time I took him off the Stanazolol, I would get a nose-dive of the
red cells/haematocrit/hemoglobin as is apparent in Bogey’s most recent blood
results. That is why I ended up deciding to ignore the high liver enzymes.
However, I did not have a situation as you described, with Bogey feeling
very unwell with the high liver enzymes. Zander really didn’t exhibit much
in the way of changes when his liver enzymes increased, but I sure saw a
difference when he wasn’t on the Winstrol, so I opted to keep him on the
Winstrol and ignore the liver enzymes. Obviously for you, you will have to
see how Bogey does both on and off the medication and play it by ear.

(By the way, I don’t think the tech was right about the icteric blood. The
total bilirubin was only 1.4 so I don’t see how it is possible for the serum
to be icteric.) 

Amani

(Sorry – I ONCE AGAIN had to delete the rest of the message, since ONCE
AGAIN, the message bounced.)
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