Update on Puddy; she's gone*9/29* see post #421

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Originally Posted by Moesha

Is there any kind of iron supplements that you could add to her diet and see if that would increase her levels?

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I had to look up the drug her vet recommends, I'm not familiar with that one myself.

The information I found indicates that the anemia her kitty has is not just a lack of supplement.


http://www.vin.com/VINDBPub/SearchPB...00/PR00043.htm

Erythropoietin as a Therapeutic Agent. Erythropoietin (Epogen[TM] - Amgen) is used almost exclusively in treating anemia associated with feline chronic renal disease. Dosage is 100 to 150 units/kg subcutaneously every two to three days. As it is a human recombinant product, about one fourth to one third of cats receiving this hormone will produce antibodies against it in six to eight weeks. Care must be taken against overzealous use of this product, which can lead to as polycythemia with severe to fatal results. As the Hct reaches the reference level, the interval dosage of erythropoietin is reduced to every fourth or fifth day. The underlying renal disease is unaffected, but the quality of life is markedly improved.

Ahh, I'm familiar with the name erythropoietin from use in humans.

Mary - seems to me iMom has had clients who need out-of-the ordinary medication. Why not try them?

Is it possible that after a while she would be able to go down to fewer injections?

And we here will help too!
(PS - would it be any cheaper if you learned to do the injections? Just a thought.)

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Originally Posted by Catlady711

the quality of life is markedly improved.[/I]

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It's this line that got to me. If Dr. Lee had said that it might not make a difference in Puddy's overall health, I'd say that I won't do it. But he told me that he has seen remarkable results w/it. So I'm going to ask him if giving her iron supplements could possibly help or maybe a homeopathic remedy. And if the shots are given under the skin, I can probably do it myself if they teach me how. I just don't know. I'm going to think about it over the weekend and see how I feel. I want to give Puddy every chance but I also have the rest of my Fur Posse to think about and my own health problems. If I'm not well myself, I won't be able to take care of my cats. I hate it when it comes down to money!

I know she will need the shots for the rest of her life - but always three times a week? Ask Dr Lee

I think Jen's BraveHeart (RIP) was on that, and perhaps Mr Meow also. You might want to ask her.

Again, try iMom for initial help with the cost, especially if it won't always be that high.

And your Abundance Check just might come through unexpectedly! ;)

Epogen is one of the things cyclists take for doping. It has been in discussion with Filou as well ( who also is anemic). I don't know what it would cost here but I know 400 € a month would be trouble :(

Jst now catching up on your day yesterday, Mary. Prayers for you and Puddy, she is such a sweet lady, I hope a solution can be found for all of this. Best get that UTI heading outta town! {{HUGS}} to you, Mary.

There is a good article on Epogen use for cats in renal failure at


http://www.felinecrf.org/anaemia.htm

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Originally Posted by nepeta

There is a good article on Epogen use for cats in renal failure at


http://www.felinecrf.org/anaemia.htm

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Thank you so much for this article. I haven't read the entire site because it's quite lengthy, however, I did read much that pertains to Puddy and I'm leaning towards not giving her the Epogen. Dr. Lee had indicated to me several months ago that she had possibly a year left and giving her these injections may help her feel a little better but, seeing that she has only one kidney, the risks appear to outweigh the benefits. I will still talk to him again tomorrow, though.

Puddy is still behaving strangely. She purrs a lot which, as you may know, doesn't necessarily mean contentment. Cats also purr when they're comforting themselves and it's also a symptom of anemia. Puddy hisses and she hasn't done much of that lately at all. It's Puddy's hiss that tells me she's herself. When I first began her subQ treatments a couple of years ago, she really put up a fuss, partly due to my lack of confidence and fear of hurting her and also because who likes to have a needle jabbed into them every day? However, after I got the hang of it, she accepted it w/grace, sat there calmly during the treatment and scampered off afterwards. Now she cries during the entire subQ treatment and she quivers. I fear that 3 more injections of Epogen a week will just be too much for her body and even for her strong spirit. I've contemplated iron injections but they're intramuscular and painful and I will not put her through that. She had one during her last vet visit a few days ago and that's enough. I will talk to Dr. Lee about the possibility of giving her iron supplements, though, perhaps in liquid form. I've had to accept that Puddy's care from here on may be palliative. I've also emailed Nancy Efrusy to see if she could schedule me for a reading. Her insight couldn't hurt.

Something else to consider is that Dr. Lee told me that most vet clinics do not stock Epogen; it has to be special ordered. He has it in stock but he's a 45 minute drive each way, so I'd have to put Puddy through the stress of the drive plus the injection and I'd have to figure out how I would take time off from my work schedule to do that. So until I talk to Dr. Lee tomorrow and get a reading w/Nancy, I'm just not going to rush into a decision. It isn't the money. I've decided that I'll do whatever it takes to get the money. It's Puddy's quality of life that is my main concern. She's my "heart kitty" and has been my loyal friend and companion for 14 years and it's my obligation and pleasure to make her as comfortable as possible during whatever time she has left.

Epogen is a drug used in humans, so you can order it on-line through a specialty pharmacy and they will deliver it to you door (that will save you the drive to see Dr. Lee).

There is a liquid form of iron supplements used for babies called Fer-In-Sol, you can also pick that up at your local pharmacy.

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Originally Posted by emily_the_spoiled

Epogen is a drug used in humans, so you can order it on-line through a specialty pharmacy and they will deliver it to you door (that will save you the drive to see Dr. Lee).

There is a liquid form of iron supplements used for babies called Fer-In-Sol, you can also pick that up at your local pharmacy.

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Thank you for the info about Epogen. I wondered also if perhaps Pet Meds would deliver it. As for the iron supplements, thanx again. I will definitely ask Dr. Lee how much I should give Puddy. I love Pet Talk!

FYI - if you start Puddy on any sort of iron supplement, you'll have to watch for constipation. That's one big problem with iron supplements.

There are iron preparations for humans that include a stool softener. Maybe something similar for animals?

Mary I agree fully with you- for a cat at the end of her life you really have to decide through how much therapy you want to put her. As we know renal failure cannot be cured and I know that Filou would not like a life that gets him to the vet daily. He is now fine with going one time per week but you should see how he always jumps in the carrier from the table when he thinks it's time to go back.....
Let's hope you can get Puddy to be in hissing mode for some time with the iron.
Hugs....

Thank you, Grace, I'll definitely remember that. And Barbara, thank you so much for your understanding. I fear that, in the beginning, I may have sounded mercenary where Puddy's treatment is concerned. I was just shocked at the amount of money that the injections cost but, as I said, money is secondary to Puddy's comfort and quality of life. If she was a kitten instead of 14 years old or wasn't in CRF or didn't have the host of other health problems that she has, if, if, if......However, I have to be realistic and along w/that realism I need compassion and I love this cat as I've never loved an animal before. If I have to help her to the Bridge one day, there will be a hole in my heart the size of Ohio. But I'm praying that Puddy will get her hiss back and that she'll have some loving and comfortable, sweet days yet w/me and the rest of the Fur Posse.