FIV Cat with nasal adenocarcinoma developed gut issues and lost a lot of weight

[BrendaT]

You're very welcome!

Yes, the Miami Herald article, which nicely sums up the approach described in the book and at HA!, was very slow to load on my end as well. However it did loaad.

Hi @Dr. Jeff !

Miami Herald page appeared as "access denied" on my end I will look it up later anyway but thank you for sharing as always.

How is he with the SQ fluids? Was his appetite off by Sunday?

His appetite was fine on Sunday and the month before.

There was no significant display of increased comfort with the SQ fluids so I tried taking a break yesterday, his appetite was better today. I gave him another round of fluid this morning after breakfast (trying to do alternate days).
I forgot the other thing that changed was his food, I gave him locally made fresh food from mid week and back on raw today. Maybe he still prefers the raw meals. But he was also licking his lips and sitting around and not eating with the fresh meals which were the same symptoms from Jan and Feb before acupuncture turned it around.

This could be a great symptom to share with your homeopath (if you haven't already done so).

The next appointment with Dr Yasson is March 31, I am trying to get an earlier one next week.

If I may ask one conventional question at this point before we get our next homeopathic remedy (I foresee at least another 2 weeks by the time it arrives), should Jerome get on with oral telmisartan for his proteinuria first ? what are the side effects, or rather implications for Jerome? I have been holding off for a week as I am so uncomfortable giving him any drugs but Dr Yasson said before to give him the injectable antibiotic to help him if it was necessary and Dr Geoff once said "we must not let him suffer"... aargh t'is so tough !

sincerely,
x b

 

[BrendaT]

Hi Brenda. I am not anywhere I can do the conversions but from what I can tell these numbers do not seem that bad. Lipase is worthless in cats. Don’t know why they bother! Micromanaging for individual blood values is unrewarding and can create other problems elsewhere. As Dr Jeff said, focus on keeping him feeling good, don’t fix what isn’t broken, and enjoy your time with him.

Hi @Dr. Jean Hofve

Thank you for checkin' in, I love your response on the lipase

I was asking Dr Jeff about telmisartan for Jerome's proteinuria, is that also worthless in your opinion

I have been doing a deep dive on CKD and of course I still don't understand any of it lol. Sorry I forgot about the unit conversion for US, I am just going to ask the angels to resolve the numbers as Dr Christina advised !

xx b

 

[Dr. Jeff]

Miami Herald page appeared as "access denied" on my end

Maybe try the Sacramento Bee written or audio version of this article:

https://www.sacbee.com/entertainment/living/wellness/article298657753.html

should Jerome get on with oral telmisartan for his proteinuria first

Do you know what his most recent albumin was? The body can lose lots of protein in the urine yet still maintain a normal blood protein level.

Here's what Gemini (Google AI) says about physiological side-effects in people:

Common Side Effects (1–10% of users)

• Dizziness and Lightheadedness: Particularly when sitting up or standing quickly, due to lowered blood pressure.
• Upper Respiratory Symptoms:
  Sore throat, nasal congestion, and sinus issues.
• • Fatigue and Weakness: Generalized tiredness or influenza-like symptoms.
  • Gastrointestinal Distress: Diarrhea, abdominal pain, heartburn, and nausea.
  • Pain: Back pain or pain in extremities.
    

Serious Side Effects and Warnings

• Kidney Function: Telmisartan can cause renal impairment or failure, especially if taken with NSAIDs (ibuprofen, naproxen).
• Fetal Toxicity: Avoid use during pregnancy as it can cause harm or death to the fetus.
• Severe Enteropathy: A rare syndrome of severe diarrhea and weight loss, mimicking celiac disease, which can appear months or years after starting.
• Hyperkalemia/Metabolic Changes: Potential for high blood potassium levels and increased liver enzymes.
• Hypotension: Excessive reduction of blood pressure, causing fainting.
• Allergic Reactions/Angioedema: Rare but serious swelling of the face, tongue, or throat.
  

Other Considerations

• Withdrawal: There are no specific addictive withdrawal symptoms, but stopping blood pressure medication abruptly can lead to a rebound increase in blood pressure.
  
  
• Long-Term: Chronic use may be associated with rare risks such as severe skin reactions or metabolic issues like high cholesterol.

Energetically, any synthetic drug can be an obstacle to deep cure.

And tho I feel that less is more, I agree with Dr. Geoff!

 

[BrendaT]

Maybe try the Sacramento Bee written or audio version of this article:

https://www.sacbee.com/entertainment/living/wellness/article298657753.html

Hiiii @Dr. Jeff I finally cracked this ! and I found out the issue, it was the VPN I was using, I had to switch to the US one in order to get access, this is the bane of living in this country... so cool you had training at Eckhart Tolle's School of Awakening, I literally gave away so many copies of his The Power of Now book as gifts to all my friends ever since I read it 20 years ago !

Do you know what his most recent albumin was? The body can lose lots of protein in the urine yet still maintain a normal blood protein level.

Yes, the latest albumin from last week was 35g/L - the safe range is 22 - 40. ALB/GLOB is 0.6
So the SDMA and creatinine are elevated but albumin is normal. The local vet said he was dehydrated on that day so the albumin level could be a false positive.

Here's what Gemini (Google AI) says about physiological side-effects in people:

Common Side Effects (1–10% of users)

• Dizziness and Lightheadedness: Particularly when sitting up or standing quickly, due to lowered blood pressure.
• Upper Respiratory Symptoms:
  Sore throat, nasal congestion, and sinus issues.
• • Fatigue and Weakness: Generalized tiredness or influenza-like symptoms.
  • Gastrointestinal Distress: Diarrhea, abdominal pain, heartburn, and nausea.
  • Pain: Back pain or pain in extremities.

Serious Side Effects and Warnings

• Kidney Function: Telmisartan can cause renal impairment or failure, especially if taken with NSAIDs (ibuprofen, naproxen).
• Fetal Toxicity: Avoid use during pregnancy as it can cause harm or death to the fetus.
• Severe Enteropathy: A rare syndrome of severe diarrhea and weight loss, mimicking celiac disease, which can appear months or years after starting.
• Hyperkalemia/Metabolic Changes: Potential for high blood potassium levels and increased liver enzymes.
• Hypotension: Excessive reduction of blood pressure, causing fainting.
• Allergic Reactions/Angioedema: Rare but serious swelling of the face, tongue, or throat.

Other Considerations

• Withdrawal: There are no specific addictive withdrawal symptoms, but stopping blood pressure medication abruptly can lead to a rebound increase in blood pressure.
  
  
• Long-Term: Chronic use may be associated with rare risks such as severe skin reactions or metabolic issues like high cholesterol.

Thank you for checking this out for us !

So I ended up having a chat with Gemini

"The USG of 1.015 is the "smoking gun" here. In a dehydrated cat, the kidneys should be working overtime to save water, resulting in very concentrated urine (usually above 1.035). A value of 1.015 confirms Isosthenuria, meaning the kidneys are failing to concentrate the urine at all.

The combination of elevated SDMA/Creatinine, weight loss and low USG confirms Chronic Kidney Disease (CKD), likely IRIS Stage 2 or 3.

On SQ Fluids :

• The "Standard" Rule: Most vets start at 10-20cc per 2.2lbs (which would be about 35-70cc for him). Giving 100cc is a "flushing" dose, often used when creatinine and SDMA are quite high to help physically wash toxins out of the blood - is 100cc of SQ fluid daily too much for a 7.6lbs cat in your opinion?
• The Benefit: It explains why his albumin is still normal despite the high UPC (1.10). You are keeping his blood volume up, which helps "dilute" the protein loss - does this make sense to you ? what does it mean "helps to dilute the protein loss" ?
• The Risk: With a high dose like 100cc, there is a small risk of fluid overload, especially if he has any underlying heart issues.

Why Seminar (telmisartan) is considered safe for your cat:

• Targeted Action: Unlike older medications, Semintra is highly targeted. It blocks specific receptors (AT1) that cause blood vessel constriction and kidney damage while leaving "good" receptors (AT2) alone.
• Kidney-Friendly: Studies show it is well-tolerated in more than 90% of cats. Its excretion is largely independent of kidney function, meaning it doesn't put an extra "filtering load" on his already struggling kidneys.
• Protein Reduction: For a cat with a UPC of 1.10, Semintra is often life-extending because it rapidly reduces the amount of protein leaking into the urine, which slows down the progression of Chronic Kidney Disease (CKD).

Important Safety Rules:

• Hydration is Key: You should never give Semintra to a cat that is currently dehydrated. Since your cat has been on daily Sub-Q fluids for a week, he is likely in the "safe zone," but your vet should confirm this.
• Common Side Effects: These are typically mild and include temporary vomiting, diarrhea, or a slight decrease in appetite.
• Monitoring Required: Because it acts on the blood system, your vet will need to monitor his red blood cell count (to check for mild anemia) and blood pressure periodically."

I suspect the higher dose SQ fluid might be causing fluid overload and affected his appetite? When I stopped for a day on Friday, he ate well through the day on Saturday. When he continued with the fluid on Saturday (and today), his appetite dropped drastically. And he threw up everything 2 hours after an assist feeding.

He seems overall weaker with lower BEAM now than before the diagnosis of CKD and the whole Sub-Q routine that started a week ago.

Energetically, any synthetic drug can be an obstacle to deep cure.

I concur on drugs being an obstacle to real cure and he never does well on them which is why I always struggle whenever a prescription is given by the vets. The local vet had basically wanted him to start the locally made Telmisartan and SQ fluid right away (without checking his blood pressure and the other blood chemistry panels) and then go back to recheck all the labs again in 2 weeks.

And tho I feel that less is more, I agree with Dr. Geoff!

Yes, I love that guy !! and thank you for sharing your stand on this, it means a lot to have this support from you

I have been holding off Telmisartan also because my gut has been nagging me to check his blood pressure before considering it. So that's what I am going to do tomorrow, and if it's good to go, I will order the imported Semintra version (it will just take a day to arrive) and let Jerome have a lower dose to start with to control the protein loss while monitoring his response until we get the appointment with Dr Yasson and receives the remedy for a deeper cure.

I will also make a fresh batch of flash-seared raw meals after I check his phosphorus and calcium level next (do you have a recommended feline nutritionist for his cancer and renal issues?), cut out the extra liver treats and use the Assisi Loop to help with the inflammation of the kidneys, the gut and small intestines from his previous ultrasound. And continue with acupuncture, moxa, reiki and homeopathy to raise his BEAM.

Do you agree with this game plan ?

p.s. on a side note, our TCVM vet advised to bring him for acupuncture only on his good days as acupuncture can use up his energy.


best,
brenda

 

[Dr. Jeff]

is 100cc of SQ fluid daily too much for a 7.6lbs cat in your opinion?

You may want to start with half that amount and work up based on BEAM, drinking, etc.

- does this make sense to you ?

Nope, it doesn't. IMO the normal blood and abnormal albumin along with his renal values and dilute urine indicates kidney dis-ease affect the glomeruli (filter) of the kidney.

I suspect the higher dose SQ fluid might be causing fluid overload and affected his appetite?

Very possibly, and easy to find out (decrease the fluids for a few days).

However anorexia, weight and muscle loss are also a big part of CRF.

He seems overall weaker with lower BEAM now than before the diagnosis of CKD and the whole Sub-Q routine

Is getting fluids super stressful for him? Stress is a huge energy leak resulting in lower BEAM. Sleep, fun, play and happiness are just the opposite.

do you have a recommended feline nutritionist for his cancer and rena issues

Dr. Sue Howell is an awe-some vet (there are a few Empower Hours! featuring Sue) who focuses on finding the best fresh foods to use and tests their energetic qualities:

Thrive Wholistic Veterinary Care

thrivepetvet.com

Do you agree with this game plan ?

Yes! And I feel strongly that Jerome appreciates everything you are doing for him!!

 

[BrendaT]

You may want to start with half that amount and work up based on BEAM, drinking, etc.

Will do !

Nope, it doesn't. IMO the normal blood and abnormal albumin along with his renal values and dilute urine indicates kidney dis-ease affect the glomeruli (filter) of the kidney.

That makes sense. He really wants to eat whenever his body is able to handle it. He would head to the kitchen for food almost after every time he throws up, possibly feeling better right away.

Very possibly, and easy to find out (decrease the fluids for a few days).

ok!

However anorexia, weight and muscle loss are also a big part of CRF.

It was very apparent these symptoms escalated after the cryo, possibly from the anesthesia and antibiotics overloading the kidneys.

Is getting fluids super stressful for him? Stress is a huge energy leak resulting in lower BEAM. Sleep, fun, play and happiness are just the opposite.

He is a little stressed when I pinch his skin away for the SQ as he never likes physical touch, but he is calm during the process and I split into 2 x 50cc so there would be a little break in between.

Dr. Sue Howell is an awe-some vet (there are a few Empower Hours! featuring Sue) who focuses on finding the best fresh foods to use and tests their energetic qualities:

Thrive Wholistic Veterinary Care

thrivepetvet.com

I will be sure to check out the webinars and get in touch with her, thank you !

Yes! And I feel strongly that Jerome appreciates everything you are doing for him!!

+ all of you amazing people

I am very grateful for your time, and for sharing your incredible knowledge, perspective and thoughtful reminders by way of the beautiful articles you wrote @Dr. Jeff. All that have brought so much clarity and confidence for me to move forward, so thank you !

 

[Dr. Jeff]

Here's what Dr. Sue wrote after reading your thread about Jerome:

It would also be nice to know if the kitty is cool seeking or warm seeking

This is the kidney diet she recommends (for those who don't make their own kidney food):

Kidney Support Diet For Cats – Medicus

medicusveterinarydiets.com

You'll need to inquire about availability in China.

It’s freeze dried raw fresh food and has a phosphate binder (chitosan) in it. To enhance the smell, I would add warm water or ideally warm bone broth. That may be where she’s getting into the appetite issues with her raw diet. It may not have enough odor? I do have a recipe for a home prepared kidney diet that has been created by board certified nutritionist. Again, it contains rice. I guess it depends on whether the cancer is the bigger deal or the renal disease

And here are others:

Diet and Chronic Renal Disease

 

[BrendaT]

Here's what Dr. Sue wrote after reading your thread about Jerome:


This is the kidney diet she recommends (for those who don't make their own kidney food):

Kidney Support Diet For Cats – Medicus

medicusveterinarydiets.com

You'll need to inquire about availability in China.



And here are others:

Diet and Chronic Renal Disease

Wow that was super speedy, thank you !

That's the thing, sadly there is no lesser evil between the two dis-eases. Jerome cannot do rice nor carbs because of his cancer as much as I would love for him to regain some of his weight. And I am pretty sure I am unable to get the Medicus freeze dried here.

Jerome is cool seeking - I will write to Dr Sue

xx b

 

[Dr. Jeff]

OK!

And she asked if you have accesss to injectable or liquid vit B12?