Monday, April 27, 2009

Sally's Regime


Here is our daily routine.

The white board is used to keep track of Sally's chemo days. She takes her Leukeran every other day so I need some help keeping track of it. I also use it to note when she needs appointments for CBCs, ultrasounds, B-12 shots, etc.

The pill bottle on the left is the Leukeran (brand name for Chlorambucil). I have to wear gloves when handling it, especially when it's cut in half. It's a 2 mg pill and she takes 1 mg every other day. It has to be refrigerated to keep it in an inactive state. It's a carcinogen so it's vital to handle it correctly. The pill gun in the plastic bag marked "Chemo Only" is used only for Leukeran.

The three pill bottles in the center from left to right are Lasix (brand name for Furosemide), Diltiazem and Enalapril. These are her heart meds. She takes 1/2 tablet of Furosemide every 12 hours, 1/4 tablet of Diltiazem every 12 hours and a whole Enalapril once a day.

Diltiazem is our old friend. She has been taking it since she was 2. It is a calcium channel blocker that relaxes her heart muscle. Her Hypertrophic Cardiomyopathy causes the heart muscle to thicken and stiffen up, interfering with normal heart function. In Sally's case, it effects her left ventricle.

Enalapril is her newest med. Her cardiologist, Dr. Orvahlo, prescribed it for her after an unltrasound last May revealed mitral valve regurgitation. The mitral valve is where the blood re-enters the heart from the lungs. Sally's leaks. Enalapril is an ACE Inhibitor and, among other things, lowers her blood pressure to take the stress off her mitral valve. It has the unfortunate side effect of putting strain on her kidneys so that's why she has her kidney values checked every time she has a CBC.

Furosemide is a diuretic. It keeps fluid from building up in her chest. It was prescribed for her after her first episode of congestive heart failure last May. It works like a dehydrator so she drinks A LOT of water. It also causes her kidneys to work harder.

The small vial in the center is B-12. The syringes next to the bottle are very small. Her dosage is 1/4 cc. She was found to be deficient as a result of the thickening and layering in her intestines caused by her lymphoma. B-12 deficiency is serious all on its own and can make cats VERY ill. She now gets an injection every time she gets her CBC because I can not bring myself to do the injecting. Sally has no body fat and the shot needs to be given in a muscle. She's very tricky to inject. Dr. Hansche and some of the techs have had trouble with her too so I'm glad to know it's not just me!

The Cosequin for her arthritis is in the box. It's powder in a capsule so I sprinkle one over her canned food in the morning.

Next to the box is a pill cutter, her pill gun and her daily pill minder.

I give her a small amount of canned food every time she gets pills for several reasons. She can't hide them in the corner of her mouth to spit out later if she eats. Also, since she's getting several meds at a time, I figured it would be easier on her stomach if there was a little food in there too. She thinks she's getting a treat for being a good girl. She is actually very easy to pill, at least for me. We've just had lots of experience!

Dr. Hansche okayed giving a 1/4 of a Pepcid to help with nausea in the early days of her chemo. Before I could start giving it to her, the vomiting went away but we have it in case she ever needs it.

Sally can't have raw food or vaccinations because she's on chemo. Even though her red and white blood cell counts are normal now, her immune system is compromised because of the Leukeran. A little repsiratory infection could potentially turn into pneumonia so we have to be careful that she doesn't get sick.

Sally only gets filtered water. She drinks a lot because of her kidney disease and Oceanside's water is very very hard.



Here is her dry food. I buy a 6 lb bag of Royal Canin Prescription Limited Ingredient Diet Duck and Green Pea and mix it with a 4 lb bag of Prescription Diet K/D. They are both low in protein to help relieve some of the strain on her kidneys.

All of these things help us manage her lymphoma, HCM, CRF, mitral valve regurgitation and arthritis. Some days I don't know how I keep it straight but it's all vital to keep my little girl alive and healthy.

RC - $35 per bag
K/D - $18 per bag
Leukeran - $53 for an 8 week supply
Furosemide - $9 for a 60 day supply
Enalapril - $4 for a 30 day supply
Diltiazem - $4 for a 90 day supply
B-12 & syringes - no charge (thanks to Dr. Hansche)
Cosequin - $20 for 80 capsules
Pill gun - $8 each
Pill cutter - $10 each
CBC - $120 every 3 months
Cardiac Ultrasound - $495 + $75 office visit once/year
Abdominal Ultrasound - $395 + $75 office visit once/year

Healthy & happy cat in remission - priceless!

2 comments:

  1. Oh Sally Maria, you cause your Mother so much grief but she loves you to pieces!! Im so glad she is in remission!! She is such a beauty!

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  2. I am grateful for every day I've had with her since her diagnosis on 4/23/08. We just take things one day at a time. Most days are good. Some (like today) aren't so hot but as long as the good outweighs the bad, we keep on as we are. She's my baby and I'd be lost without her so I'm glad she's so stubborn!!

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