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Saturday, April 07, 2007  

Turning Turtle II: A Turn for the Worse

There was good news and bad news at Turtle's last visit to the vet this week. The good news was that she's gained a little weight back, her spleen felt a little smaller, her nose and gums looked pinker, and the heart murmur she'd developed as a result of having such thin blood had gotten quieter. The bad news arrived when the bloodwork came back. The week before, her red blood cell count had risen from twelve to eighteen, well on its way to a more normal and healthy twenty. This week, the count had dropped back down to fourteen. Even when Dr. M. double-checked it and even sent it to another lab. Dammit.

Dr. M. decided that we not only needed to up Turtle's daily dosage of Prednisone, but also put her on a new immunosuppressant to keep her body from destroying her red blood cells. If she were a dog, we could just train her not to destroy her red blood cells and that would be that, but after about three hours of sitting on the couch, shooting Turtle with a spray bottle every time a corpuscle went kaput, I realized I was wasting both of our time. Nothing for it but to continue the medication.

So now, twice a day, Turtle gets:
1. One Predisone tablet.
2. One half of one Prednisone tablet, in addition to the previously mentioned full tablet. This counts as number two because while it's not a full tablet, it's still a second independent object that I have to get inside of her.
3. One immunosuppressant capsule. This is a round capsule that's just big enough to irritate her yet just small enough to make it impossible to cut open and sprinkle its contents on tasty food (which she probably would not then eat anyway).
4. Half a milliliter of an antibiotic liquid suspension.

In addition to which, once a day she also gets:
5. One quarter of a tablet of something that's supposed to keep her stomach from getting upset by all the drugs I keep cramming into it.

Dr. M. feels bad about all the medicine I have to give Turtle. She even gave me some little chicken-flavored pockets for hiding pills in. It's certainly not her fault that Turtle doesn't like those even when they don't have pills in them.

The pills are the easiest, believe it or not. All I do is place one hand across the top of her head, force her jaw open, and place the pills way back on the back of her tongue so she can't spit them out. I try to do this at least two pills at a time in order to limit the number of trips I have to make into there. She recovers quickly after the first insertion, but the more I have to do it, the more upset she gets. Please do not take that last sentence out of context.

When I was talking to Dr. M. about this on the phone, she said that although she feels bad about all the pills, at least the antibiotic is easy because it's fish-flavored and Turtle should like it.

"Oh, no, she hates that most of all," I said brightly.

And it's true. Her reaction to the allegedly fish-flavored sludge I squirt into her mouth is considerably stronger than that of any of the pills. While a pill will cause her to work her jaws for up to two full seconds, she'll theatrically cough and spit and hack like Bill the Cat for minutes after the liquid dosage. In fact, I have to leave an interval between the pills and the goo, because otherwise she'll cough up the whole mess shortly thereafter. And if there's anything worse than sticking four pill fragments down the throat of an unwilling cat, it's sticking the same four pill fragments down the same throat of the same, now even more unwilling cat, after the pills have been thoroughly coated in green-brown slime.

At first I wondered if it wasn't the flavor she objected to, but just the fact of any liquid being squirted into her mouth at all. Here's how I tested that theory:

Strat is now in his fourth year of living with diabetes, thank you, and twice a day he gets a dollop of soft food before his insulin shot. Turtle and Phantom (collectively, "the girls") share what he leaves behind. The other night, Turtle was already burying her snout into Strat's leftovers. I happened to have her evening dose of antibiotic all ready to go in the plunger thingy, so I squirted it onto the soft food. She looked at me like, Why'd you have go and ruin a perfectly good treat? I picked up the little bowl and stirred the stuff in to even it out, which seemed to improve it enough in her eyes for her to grace it with one small lick. And then she stepped back and stared at me balefully.

I prepared another dose of antibiotic, explaining, "You can either eat that food with the medicine in it, or I can squirt this into your mouth. Your choice."

Do what you have to do, her basilisk glare replied. So I did. She coughed and spit and hacked. The next morning, the soft food was still there.

I don't know how long I want to keep doing this (actual answer: two weeks less than I already have been). But today, M. Small said something we've never once talked to him about. While I was downstairs with him, he heard Strat up in his room, meowing over the baby monitor. "That's your kitty," he told me. "Strat." He added, "Phantom is Mommy's kitty. My kitty is Turtle."

So I'll keep doing it for as long as it takes.


posted by M. Giant 7:13 PM 7 comments


You are just the best dad. I wish Turtle all the best, of course, but M. Small is super-duper CRAZY lucky to have you and Trash.

Come on, Turtle!

By Blogger Linda, at April 7, 2007 at 7:21 PM  

I sympathize so much -- my dog ( 120-pound Great Pyrenees) had the same attacking-her-own-red-blood-cells thing -- we discovered it when she started bruising all over -- if we'd been 12 hours later she would have been gone. Prednisone, antinausea pills, the whole works. The good news is she recovered in about 3 weeks and lived a long and healthy life, with no recurrence. It was three really rough weeks, though. Hang in there. Turtle sounds like a fighter.

By Anonymous Anonymous, at April 7, 2007 at 7:49 PM  

You have my sympathies. I remember when my kids were young how difficult it was to explain a pet's illness.
Oddly enough, my 22 year old son had this very same disease (Evan's Syndrome). I am happy to say that after a year of fighting this disease and many months in the hospital (he did end up having his spleen removed) he is in remission. Hopefully Turtle will have the same good luck!!

By Anonymous Anonymous, at April 8, 2007 at 4:14 AM  

I really enjoy your blog and wanted you to know how much pleasure your writing gives -- and "Come on, Turtle!"

By Anonymous Anonymous, at April 9, 2007 at 8:07 AM  

Java didn't like those pill pockets either (and they're expensive!) - but he was fine with soft treats (like Whisker Lickin's) smooshed around the pill. Plus, we figured - extra calories - what the heck! Worked like a charm.

By Anonymous Anonymous, at April 9, 2007 at 10:01 AM  

My father had a disease similar to this - myelodysplastic syndrome - and a course of stepped down prednisone did the trick. It completely reversed the anemia & its related issues and put the syndrome into remission. I hope the same happens for Turtle!

By Blogger Unknown, at April 9, 2007 at 10:28 AM  

I take prednisone myself, for when I have very bad asthma attacks that last for days. They are the WORST tasting pills....nothing helps to get those down. I sympathize with Turtle, poor thing- hope it does the trick.

By Blogger nancy, at April 9, 2007 at 2:57 PM  

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