Somber cat updatelet: The results from yesterday's blood draw aren't great either. It's time for a diet change and subcutaneous fluids for the foreseeable future to see if we can get the dehydration under control and weight to where it should be.

Current catus: Just doing a snooze.

I'm actually way more fucked up about Moses' declining health than I thought I would ever be.

I wish I still had his kitten photos. The vet asked if I'd neutered him late; he had big paws and a big head.

Yes, but he's always been like that, with whiskers going to all ends.

Current catus: Cromch, cromch, cromch.

Not so somber cat updatelet: 400mL water intake.

That's still on the low end of where I really want him to be, but it's about 2x higher than I've seen in recent history. Somewhere between 410mL and 530mL is appropriate.

Well, it looks like he's here to reprise his role as my copilot as I work through some last-minute items while sitting at my desk.

(Feat. laundry I was just not in the mood to deal with and my plastic IKEA desk chair for its resistance against clawing.)

This certainly assuades my fears as to whether he's going to tolerate a diet change. He sniffed this bag out from around the door of the cabinet I stashed it in!

C'mon, cat. I've gotta go to bed.

Cat updatelet: Hey, Moses, calm down! You'll get fed soon enough! Don't give yourself whisker fatigue, you impatient creature, you.

I don't think I've truly seen him this interested in food in recent history.

I put down 1/3 cup of the baggie I'd labeled #9, and we immediately went to chow town.

Current catus is "mouth dry, brb drimking" though.

(This cat is notoriously hard to photograph well. He's remarkably camera shy!)

I think this might be the only face-on photo I have of him.

He's had that entropion the last 15 years, and no vet was able to fix it the three times I've had it attempted.

Also unusual is the fact that his paws are tucked in. Before moving into this house, he never did that.

Cat updatelet: He's gone through about 1/6 of the 1/3 of a cup of dry food I laid out. He's been bouncing between it and his existing dry food.

I'm mildly frustrated by his disinterest in his existing wet food.

He's been pretty diligently hitting up the water fountain though.

Cats have a lot of subcutaneous space, it turns out. It's very odd to be able to fit a 100mL bolus of lactated Ringer's there, but that's apparently how it goes when your primary vocalizations are trills and meows.

Minor cat updatelet: The bolus of fluids has migrated, and it makes it kinda look like he's hella built in one of his forelegs.

I don't have a photo, and I'm not yet all that sure if I want such a photo hanging around.

Cat anatomy is weird, man.

In case none of you took anatomy and physiology in your school's nursing program just for shits and grins, humans don't have that much sub-Q space.

We have hella adipose tissue though.

This is one of the reasons why the usual route for fluids for us is in a peripheral IV line.

Cat updatelet: It's amazing what fluids will do for you. That 100mL infusion was tolerated extremely well; I woke up to a very friendly, very vocal for attention cat this morning.

As I write this, he's at the water fountain, snarfing down another mass quantity of the stuff.

On a hunch, thinking that he may be hesitant to eat because of possible dental problems, I went ahead and added another 150mL or so of water in a bowl right next to his food.

I originally got the fountain because he'd play in his water bowl and dirty it by drowning things in it.

It just so happens that I may need to rely on his tendency to drown things in water to stimulate his appetite again, which the fountain prohibits.

Wouldn't you know? He went right for the bowl of water and stood there for a good, solid two or three minutes just drinking.

So far, since I added the bowl, his MO has become: "Drink a lot, go walk around some, rest a little, repeat."

This is fairly promising.

Over the course of a couple of hours, he's brought the level down by 90mL, and he's started using it to "drown" the dry food I've left out.

Gauging by how far the bowl itself moved, it seems he's enthusiastic about this approach.

Need I say I'm similarly enthusiastic?

(Confidentially between you and me, I'd much prefer to have him on a wet diet, but in true and typical cat fashion, he's frustratingly persnickety about it.

There have been times when he'd eat it right out of the can, but for the most part, I've always had to mix wet and dry.)

It's almost that time when I refill the water receptacles, and while I don't think he's touched the fountain at all since I woke up, I've refilled the bowl once so far today.

He's also fully absorbed the 100mL infusion from the looks of it as well.

Cat updatelet: 410mL total water intake, 25g of old food, 6g of 1:1 old+new mix. Water so far is trending where I want it, so hopefully, food will follow.

He had a somewhat "complicated" BM that required intervention, probably due to the dehydration. Loud yowls were heard.

A bit of trivia: "Why 'Moses?'"

He showed up as a kitten on my doorstep, quite literally, in 2005. Max, my dog at the time, was out with my mother as she was doing yard work, and he happened upon the cat.

He proceeded to groom him. Moses calmly told Max to cease, and it was so.

It could be said that Moses had lain down the law that day in mid-September and issued a commandment to Max that he shouldn't groom the cat.

There's also the fact that the tabby coat pattern affords such cats an "M" on their foreheads. This may have also factored into it.

Happy lazy Caturday!

Cat updatelet: We're trending in a positive direction. Overnight, he had 160mL of water and 18g of the old food. Didn't touch the 1:1 old+new mix at all, at least according to my scale.

That 18g is huge for just eight hours. He had 31g combined all day yesterday.

Cat updatelet: Not even halfway through the day already, and he's up to 33g combined food consumption and 210mL of water.

He's making sure to get some outside time in as well, not to mentioning continuing on grooming that luxe coat of his.

Today's cat numbers: 290mL water and 61g of combined food consumption. We're slowly getting there.

He also pooped today, so things are still flowing.

I just need to set up litter box monitoring now, and I'll be able to track inflow and outflow through my cat.

I'm fearing that I may have to have him hospitalized. He's continuing to lose more weight than I'm comfortable with.

310mL water and 22g consumed overnight.

The other side of this is that I don't have a scale that I feel is accurate enough for weighing him, so he could actually be holding steady at his current weight.

The tuners across the street from me aren't helping things much either. The revving looks to be stressful for him.

That said, there's good news: He's still sociable, personable, playful, nimble, holding his head up high, diligently caring for his coat, and eating and drinking at least something.

He hasn't given me anhedonia yet, so while I'm worried, I'm not worried about imminent crisis.

Cat updatelet: 460mL water and 57g combined food.

While I was feeding him, he actually got a little vocal with me, as if he was starting to get his appetite back.

Shot the vet an email asking questions about B vitamin supplementation given anemia upon physical examination.

Cat updatelet: I graduated him to the big water bowl with 400mL in it last night. I can't tell yet if this will have a significant enough impact on his intake, given that he's only brought it down by 125mL.

He ate 5g out of the 1:1 new+old food bowl, which is disappointing.

Cat updatelet: Moses is meeting some sort of a calorie goal, I suppose. Vet has also let me go up to a 100mL sub-Q bolus twice weekly.

He was 4.4kg a couple nights ago and 4.5kg last night. He feels a fair bit less like he's losing weight, and his ribs are less apparent.

I also posed some hard questions to the vet regarding the anemia, in particular whether a reticulocyte count had been ordered.

It had been asserted that he was anemic because of ineffective erythropoiesis without any evidence to back that up. Sorry, no, show your work please.

Cat updatelet: He came out weighing 4.47kg again today, so we're into maintaining weight territory now.

I still need to compute numbers for food and water for the last few days, but it all looks like we've stabilized at a new baseline for the time being.

Neat fun fact: Cats can also develop Addison's disease! The same adrenocorticotropic hormone is administered to tickle the HPA axis so that serum cortisol can be measured for diagnosis as in humans.

I'm now wondering what Addisonian crisis looks like in cats.

Cat updatelet: Tonight brings another 100mL SQ infusion, but we haven't gotten there yet.

No, I'm ordering feeding syringes and on the prowl for my immersion blender to make cat food slurry because 210kcal/day isn't anywhere near enough. The vet wants, like, 430kcal/day.

we;lp

The saving grace with all of this is that Moses is (1) extremely comfortable, to the point where he's tucking in his paws and "bread loafing" everywhere and (2) continuing to take extremely good care of his coat.

He's still just so damn soft. It's unbelievable.

This all said, I brought up to the vet that the symptoms I'm noticing are less nausea and more just general anorexia. Something else is at play here.

He actually attempts to chow down, but he (seemingly unintentionally) drops his food an awful lot. Dental problems maybe?

I found my immersion blender, but I wound up having to order more syringes. That is honestly just fine.

I'll be able to prepare a whole day's worth of feedings all at once instead of having to draw one at a time as I go along, which is a welcome change.

Cat updatelet: He's very sociable. He came upstairs to say hello and stay awhile!

Unfortunately, going downstairs revealed that he'd had an emetic episode overnight. It looked more like regurgitation given the lack of bile, and one of his food bowls is extremely low.

My working suspicion is that he overfed a little too much. In a sense, that's good; I've found something that he really, really wants to eat.

On the other hand, the trick is now finding the sweet spot that lets me be lazy but also makes him not lose his lunch.

Cat updatelet: He's discovered a food that he particularly likes. I'll just say that I've been putting down 80g/day, and he's been doing a good job of going through that. That's 2/3 of the way.

His face is also very consistently wet, so he's spending a lot of time drinking.

Okay, now that I actually have a bag of the new food, I've done a bit of math.

430kcal/day is the target to meet. At 4085kcal/kg, this means 105g daily intake.

At 1:1 with old food at 3613kcal/kg, that gives me a mix of 53g:59g. That seems imminently attainable.

He's continuing to maintain weight at 4.5kg. I haven't had enough energy to go back and compute the daily food/water deltas, but I'm recording everything and gut checking myself as I go.

He went through 60g of 1:1 mix last night, and he had 26g in one sitting this evening.

Cat updatelet: I withdrew the old food a day or so ago, and he's had nothing but a 1:1 mix by caloric density.

Over 24 hours, he had 112g of the 130g I had given him. That meets the 110g final target for getting him to 430kcal for the day.

This makes me very happy.

Cat updatelet: He has enough interest in water, not to mention the energy, to jump on the bathroom countertop again.

Imagine having a cat clawing fervently at the door while you're washing your hands, only to have him quickly jump up to investigate when the door opens.

Cat updatelet: 4.6kg! He continues to go to chow town.

He still has a lot of interest in jumping up on the bathroom countertop and getting all up in someone's business while they wash their hands.

He's also obnoxiously sociable when I'm in the kitchen.

Cat updatelet: My lactated Ringer's infusion set expired, so I get to see if the pharmacy is open today.

He's also graduated up to a 2:1 food mix today, which he adores.

I'm getting a little annoyed with the kibble in the water bowl, so I'm exploring options to combat that.

I suspect the kibble in the water bowl stems from two things: Cats have really poor vision up close, and being a Maine Coon in part, he really likes water.

The kibble probably helps him better determine the water level, and it probably gives him something for amusement.

It annoys me because the kibble makes the water dirty, and after a certain point, he won't drink anymore.

I still want to foster that play behavior since it seems to motivate him a lot to drink, but I need to keep the water clean.

He's bored of the water fountain too.

Cat updatelet: It's just shy of 30 degrees in the house, so he's conked out on the linoleum floor where it's nice and cool. We're also holding steady at 4.5kg and 60g food/300mL water intake per day.

Also, I have alerts now that tell me when he goes to eat or drink!

Cat updatelet: He continues to take exceedingly good care of his ridiculously soft coat, and he's curled up next to me on the futon here.

He spent a rather sizable chunk of today chowing down. He took the bowl from 174g to 85g, which makes me happy.

(Holding my thumbs that he doesn't wind up losing it in an emetic episode later. That's always the worry.)

Cat updatelet: So far, no lost lunch, so I'm going to take this as a good sign that his recent endeavors in chowing down won't be in vain.

Changing his water every eight hours seems to be doing the trick to coax him to drink more, which also gets him to eat more.

Cat updatelet: He's feeling less bony!

He's spent a fair amount of time the last couple of days jumping up on the chairs around the kitchen table, so I think that he's having more good days than bad.

That said, we haven't quite slain this jabberwock. No frabjous day for us yet.

Cat updatelet: In true Maine Coon fashion, Moses has begun playing in the water bowl with his paws again. The faux wood linoleum is now covered with wet pawprints.

Overall, this is a good sign, but I really wish he wouldn't.

Sure enough, I came downstairs to reset his food and water, and he'd brought the level down from 500mL to 280. Under normal circumstances, I'd be rejoicing, but I have no idea how much of that is actually drinking versus splashing, so I can't draw error bars.

That said, I'd put out 224g of food last night before bed, and he's already brought it down to 170g, yielding a 54g change over 12 hours. Assuming he doesn't lose it all later and keeps it up, that is absolutely worthy of rejoice.

Cat updatelet: The upward trend continues, quite literally. For the first time in almost a month, Moses saw fit to jump up onto the ersatz cat perch we'd set up behind the couch and hang out for a while.

He continues to fill out as he drinks more and eats more.

Apropos hydration, I've just come to learn to live with the fact that his front paws are going to be a little damp from playing in the water bowl whenever I encounter him.

If that's the price I have to pay, so be it.

He has a new routine: Perch, munch, drink, repeat.

Given the creaky old man joints and the weight gain, jumping up is a little problematic for him. He does well enough with it though, especially as he creeps toward 4.7kg.

Overall, I'm pleased.

Cat updatelet: Splish splash.

That's it. That's the updatelet.

Oh, yeah. I bought this wool cat bed/house for him a while back, and he hasn't seen fit to hang out in it for extended periods until very recently.

His routine has become spending a few odd moments in there to snooze and then bouncing between eating, drinking, and perching.

Cat updatelet: Today, we had his monthly blood draw and urine collection. Now comes the anxiety-inducing part.

The upshot? He's tucking his paws in, resting in socially conspicuous areas of the house, devouring his food, getting ample water, and taking care of himself.

Ever since coming home from the vet, he's had a little bit of a problem with keeping his head out of his water and food bowls.

Actually, if you inject too much energy into him to begin with, he just eats and drinks.

… does my cat have a stress eating problem?

Cat updatelet: For the past two days, Moses has been resorting to coming upstairs on his own volition to pester me if I'm not downstairs by 10am to feed and play with him.

This was the order of things prior to a month ago, and seeing him return to business as usual is nice.

Cat updatelet: The numbers are much improved over last month, and his heart murmur is benign. (There was much rejoicing.)

His airway is also patent. Fetching a glass of water from the kitchen results in a lot of attention and questioning from him.

Cat updatelet: He had a slightly worse day today, but he still managed to chow down on 67g (at 3849kcal/kg: 258kcal) worth of food. His RER is 210kcal, but I'd like him closer to 430kcal.

If that's what a bad day looks like, I'll absolutely take it.

Cat updatelet: Slurp, slurp, slurp.

He drinks very loudly.

Cat updatelet: He's resumed pawing at me to ask for pets and giving nibbles when the pets are just right.

He continues to splash water everywhere and make a big mess.

Cat updatelet: He's mostly back to being a normal cat. Though, the last couple of days have been a little slower with respect to fluid and food intake.

He had a small emetic episode a day or so ago, but I didn't see any foam production.

I went downstairs to go fetch water, and he proved to me that his airway was still patent. I picked him up, and he quieted down.

Immediately upon placing him back onto firm ground, he decided to let me know that, yes, his windpipe was still unobstructed.

Is this my life now?

Cat updatelet: This is, in fact, my life now.

Cat updatelet: Cue resumption of using the downstairs bathroom as an echo chamber for him to sing the song of his people.

It's a little late for Caturday, but here's an action shot of him downing 100mL in a single sitting from a 500mL non-borosilicate beaker with a handle that's labeled with crazy-ass units for American household use.

I would think whisker fatigue is a problem, but apparently not?

He left for a minute or two and came back to down another few tens of mL.

I'm just going to leave the glassware on his mat and see if that improves his water intake any.

Heaven help me if he spills the damn thing…

He came back yet again, this time when I was in the middle of setting this up.

The aim is for the sides of the bowl, in conjunction with a liner in the bottom of it, to provide a little friction and resistance to tipping.

I'm glad to know he'll still drink out of it.

Cat updatelet: Over the last week, he slowed down quite a lot on his water intake, so I've moved him back to a more traditional bowl. Cue 350mL/day intake again.

He's also begun using the second litter pan I'd set out, after having it out for months at this point.

Insomniac cat updatelet: Cue resumption of 100mL LRS SQ q 48h.

I intensely dislike the drip sets my vet gives me. They have those dumb pinch clips on them, and they're such a pain in the ass to close during an "oh, shit!" moment. I much prefer thumb locks.

Happy Caturday! He's discovered that sleeping with the shoes by the front door is more comfortable than sleeping in his little woolen cat house in a dark corner of the living room.

An additional upshot: He gets a lot more sunbeam time now.

Cat updatelet: He feels obviously much better after his subQ infusions. 50g food and 150mL water intake over 12 hours.

I've moved to 50mL q 24h both to get him used to the routine again and to give him smaller amounts to absorb at a whack.

Cat updatelet: I want to take away his woolen cat house. His fur is matted, and I haven't been able to keep up with brushing enough to prevent it. The wool makes it worse.

Well, he's made my decision for me; he's taken to sleeping in the coat closet, which has a cedar floor.

Cat updatelet: He got ~300mL of LRS via SQ over the course of the day. At 60mL/kg, that's right about where I want him.

He seems to be tolerating it well. He's still walking kinda funny because, y'know, constipated, but we'll see what he's like in the morning.

I added another litter pan upstairs since that's where he's seen fit to hang out for the moment. In the interest of keeping him comfortable, it seemed like the logical choice.

Cat updatelet: 100mL LRS SQ q 6h seems to be doing the trick? Maybe?

He's perked up a lot. The last 10 minutes were spent splashing around in his water bowl and shoving his face into his food dish, which is better than the 24 hours previous.

He still needs to poop though.

Add to my list of recent searches: "i pooped today tshirt baby infant"

Also, another 200mL LRS down.

Cat updatelet: He was at 4.40kg when all of this began, and he's down to 4.30kg now, which is better than I was expecting.

No more LRS until first thing after I wake up tomorrow and then run out to get more (and a not-trash drip set?) from the pharmacy.

Cat updatelet: Well, he's super into being spoon-fed a wet diet.

Given this recent scare with constipation (and the fact that I have to administer SQ fluids), I'm keen on keeping him on it if he'll continue to tolerate it.

Cat updatelet: He's grooming himself again for the first time in a couple weeks that I've seen.

This is a super good sign.

Cat updatelet: Well, I brought out the mirtazapine.

He's eating, so I feel less concerned about hepatic lipidosis being a possibility, but he doesn't have the best appetite.

(Honestly, he never has, but his appetite the past day or two has been particularly crummy.)

Cat updatelet: Day two of mirtazapine. I've noticed a pronounced increase in his appetite since the first application of it to his right ear yesterday evening.

He continues to pass bowel movements without incident or complication, so I think we're out of the thick of it now.

Cat updatelet: It's day three of mirtazapine, and he sounds quite a bit more ravenous when he's chowing down.

One side-effect of the mirtazapine that I've noticed is some pretty heinous drowsiness that also manifests in him being a little wobblier than usual.

He gets around plenty fine, even if he's mostly been sticking to hanging out upstairs, likely because there's carpet up there.

Cat updatelet: He's done quite a good job keeping me awake with his ravenous slurping. We'll see in a couple hours just how much he's eaten.

Funny that xerostomia was reported in the list of side-effects for this particular medicament. I've found him drooling more than once.

Cat updatelet: The numbers are in. He's exceeding his 230kcal maintenance target at 282kcal for a 24-hour period.

He's still pooping.

Let's see if this continues to trend upward. The hope is that he meets his 410kcal gain target.

Cat updatelet: He's discovered the wonder that is a heating pad. I have the odd feeling that he's going to wind up spending a lot of time there.

Cat updatelet: He continues to adore the heating pad, and when he isn't basking, he's grooming.

He's still a tiny bit wobbly when he walks, but there's a marked improvement in his gait with each passing day, so I suspect that'll go away in time, especially as he eats more.

Cat updatelet: This is day six of mirtazapine, and he's continuing to exceed his daily maintenance goals. He feels noticeably heavier, and he's filled back out a little.

He's far, far less wobbly. I'll take that for the success it appears to be.

Cat updatelet: After a little over a week of mirtazapine and a more baseline regimen of SQ fluids (~50-75mL every day), he's back at 4.58kg, up from 4.30kg when the fit of constipation started.

For those keeping score at home, I'm looking for him to gain another 1kg at a minimum, which will probably put him comfortably into BCS 3/9 (or perhaps 4) territory but not into 5 as I'd like him to be.

I'm exhausted from just how aggressively I've had to pursue this.

He seems thankful enough though; he's been much more present socially the past couple of days.

Cat updatelet: Good morning.

Okay, back to bed.

Cat updatelet: I think I'm finally back to a point where I can roll back to 100mL LRS SQ q 48h. q 24h was getting to be a bit much.

He's drunk 250mL over 24 hours and eaten 50g of canned food over 12, so I'm willing to see how he does hydration-wise somewhat on his own.

Cat updatelet: He's getting closer to where I want him. Granted, I fucked up measuring, but he got 100g±20% of the canned food yesterday combined with 40g of the dry.

Putting down the canned is greeted with a fanfare of snarfing noises.

I'll weigh him later, but I'm very happy.

I can't really put into words just how smitten I am with this outcome.

The fuzzy boy just eats!

(He still poops too, just to make it clear that we haven't actually had a regression.)

Cat updatelet: Well, I applied the mirtazapine to his ear, and he's been spending the night having the zoomies. He darted back up the stairs!

At the dose I've been giving him, I'm not afraid of his having developed serotonin syndrome, but I am concerned about hyperactivity.

Cat updatelet: He ate 80g roughly equally split between canned and dry. Water wasn't exactly where I wanted it to be, but he managed to stay still long enough to get a 100mL LRS infusion.

He weighed in at 4.61kg.

Correction: He ate 80g canned, 40g dry. I got a little ahead of myself.

Whatever. He continues to pig out. He continues to be a delightful companion. He continues to poop.

Given the circumstances, I can't really ask for more than that.