Bedtime

I think the first time that I became aware that something was wrong was when I realized that Flower did not come to get me to tell me that it was time to go to bed. Thinking back I try to fill in the blanks. I suppose she stopped eating and became lethargic because the lymphoma was already attacking her intestine, making her nauseated. When we would try to administer meds to her the first week, she wouldn't take them. She hated all of that stuff. That was really hard. Administering sub-q fluids was a little easier; she didn't fight as much. But she still didn't like it, and I felt like it was a last resort type of effort. The doctor's at VCA felt like she was having complications with FIV and that was causing her sickness. We should have started then looking for problems associated with FIV, but they wouldn't give me any treatment options for her.

Flower would always come to get me at night to tell me that it was time for bed. In fact that helped me get to bed at the right time so that I could get a good night's sleep. She would come over to my desk, where I was usually studying, and put her paws up on my leg and meow. She was pretty persistent about it if I didn't get up right away. Then she would kind of follow me around while I got ready for bed; she would go with me into the kitchen or sit outside the bathroom while I brushed my teeth. Often I would put her on my bed, but if I didn't stay in my room with her, she would get up and follow me again. Sometimes at night I still expect to find her waiting for me.

Playtime

I used to always come home and wake up in the morning to find the rugs on the floor all out of place and twisted around. Because we have hardwood (Pergo) floors, the rugs would shift and slide around and sometimes get bunched and folded up when Flower would run around. She had always been a lively and playful cat. She would run around and chase things that weren't really there, and I was sorry that I didn't get more toys for her earlier. She never really seemed that interested in a lot of toys though. Certain things she liked; Ashley got her a laser pointer for Christmas which she would chase around and pounce on for quite awhile before tiring of the pointless game that she could not catch. Flower also liked to catch crickets which somehow got into the house often. She would typically play with them for a short time and them eat them; maybe she liked the crunch. One day she found a spot on the wall that she played at for what seemed like forever. She pawed at the wall and then ran away, and she did this repeatedly. I don't know what got into her that day in particular, but she was certainly in a playful mood. She always found something to pretend to chase after. It was typical that the rug in the hall would be folded over in the morning because she would run up and down the halls, and when she tried to stop on the rug, she would slide right into Ev's door. At night too, when I got home from class or work, the rugs in the front room and the hall would be in that state. So, I was always happy to know that she was an active, healthy kitty who enjoyed playtime.

Doing Homework

Flower always liked to be where the people were. She often sat in the front window on her little house, which Ashley gave her for Christmas, where she could see everything in the front room. Before that, she would lie on a towel that I placed on the floor by my desk, or more frequently, she would go into Varr's room because it was carpeted. Sometimes she would sit in the doorway to the hall where she could look at me at my desk but also down to Varr's room. She also liked to sit on the front couch. You could tell her favorite spot if you saw it because on the white couch it's the spot that's covered in black cat hair. Typically though, she would prefer to sit in the front window or by my desk for awhile, but I think she really liked her spot on the couch. Once in awhile I would move my stuff over to the couch and sit there. Whenever I did this she would come and enjoy the company on the couch. I would sit in the middle or on one side and she would sit on her side. Flower was very comfortable here and content to simply lie next to me and let me do whatever school work I had. She never pestered me, and in fact, I often wished that she would come and spend more time with me and sit on my lap or something like that. Occasionally I picked her up at my desk and placed her on my lap. She tended to move from there up to my desk and sit or lie kind of off to the side, in front of my laptop. Because my desktop is glass, it's usually cold, and so, Flower never stayed there long. But I was glad that she liked being there for a bit. I always had wanted to get a table or something that I could put next to my desk with a blanket or cat bed for her to sit on so that I could enjoy her company and give her a comfortable place next to me. I am, however, glad that she enjoyed going to Varr's room as well. I know that Varr had a special way of petting her that she liked a lot. She tended to not stay in one place for long when I pet her, but she really liked Varr's pets. I was happy, too, that my roommate enjoyed having her around and enjoyed giving her love and attention. Even Ev let her in to his room a few times, where she would sit in the window and look outside; that's what he told me. Before she ever became sick, I would miss her a little bit when she wasn't around where I could see her. I had to remind myself sometimes that it was better that she enjoyed everone's company and got love from all of us.

I closed the door to my room for basicly three years before Flower. Since she came here, I always had my door open for her, even at night. I think it will be uncomfortable for me to close my door tonight.

Belly Rubs

Flower loved belly rubs. But sometimes she could only handle them for so long. When she had had enough or she was in a feisty mood (often in the morning, when I would pet her before getting out of bed), she would grab my hand with her front paws, bite it with her teeth, and scratch at my hand with both of her hind paws. I was a often surprised that she never broke the skin while doing this. I never figured out for sure if she thought she was playing or not. She liked these pets, though, and I liked to give them to her. Sometimes she would lie in the sun, and sometimes she would be on the white couch in the front room or on her house in the front window or on the blue rug in the sun by the door. It didn't matter where she was, really. But I guess I always knew when she had enough. Other times she seemed to lie there forever. The more vigorous the rub, the better. I could tell when she really wanted one because she would roll over on her back when I walked in the room. I don't think I knew a cat who enjoyed belly rubs as much as Flower.

A Little Bit of Closure

Dr. Ikeda thinks that Flower may have had lymphosarcoma, or lymphoma. Her liver and kindey where spotted, and he looked at samples of these tissues under microscope. He emphasized that he is not a pathologist, but he suspected that Flower had developed this cancer. It can act quickly, as it is blood borne.

Dr. Ikeda also said that her intestine was essentially swollen in a few areas and was not as soft as it should be. This is was also the case for the pylorus from the stomach to the small intestine. It is likely that it was difficult for her to pass food from her stomach to her intestine because of the problem with this valve.

Flower was also completely spayed, having had all of her reproductive organs removed. We cannot know, then, whether she may have ever had kittens or not. One of the few things we do know about her previous life is that she must have been overweight because she was placed on a weight-reducing diet at the shelter before we got her.

My cat Flower

waiting for a belly rub in one of her favorite spots in the sun

Flower died today. I sat and held her until she passed. I showed her the window where she liked to sit in my room, and I spoke to her to make sure she knew it was me who was there with her. I was at times sad and at times relieved; Flower fought so hard this past month. I can't imagine the endurance that it took. I knew that it was her time, but her time came too soon. I let her know how much I loved her and that it was okay for her to go. I wanted her to know that I understood that she was suffering; I had only wanted to help her be better throughout her ordeal, but in retrospect, she was hardly herself for the past month. The Flower that I will remember is the Flower who was affectionate, and who loved snacks and treats, and who loved the sun in the morning and would wake my up by biting my chin. That is who Flower was.

Valentine's Day

Today was a real downer for Flower. The day started off fine. She vomited some last night, which I cleaned up this morning. Then, when I got home from work, I found where she had tracked some stool across my bed. I have several extra layers of blankets and sheets on my bed in anticipation of this, so it wasn't really a problem; I just take off the top 2 layers, replace them with clean, and put them in the wash. Today I decided that I should just go ahead and was all of my linens though. I moved Flower to the front window, where I also fed her her normal 6PM dinner. Ashley came over a little later on and we went to Petsmart to get a couple things for Flower (including some shampoo, since she was in dire need of a bath), then to Blockbuster to rent a movie, and finally to pick up a pizza at Round Table. I don't think we were home for 5 minutes with the pizza when Flower threw up. This was particularly bad, however, because she was lying in a blanket on a low table in the front window. I guess she must have tried to get up quickly and got caught because, when I heard her and turned around, she was on the floor, on her back, pinned between the bases of two tables, with the blanket covering most of her, and vomit all over her face and paws. I came as soon as I turned around; when I heard her I knew immediately that something was wrong, but I wasn't prepared to see her lying helpless and supine on the floor. I felt so badly for her, for how helpless she is right now. This is not the Flower I have come to know. I decided to go ahead and give her a bath right then so that I could clean the vomit off of her as well as clean her behind. This went better than the first time; I don't know if she was tired or if it was because I had Ashley's help. I used the bathtub this time also, instead of the sink. While I cleaned her backside, she moaned and cried; it must have hurt her badly, all of the feces that had built up in just about 48 hours. I continued to bath her and then rinse her off. I held her in a towel for several minutes to try to help dry her off. Since then she has been sleeping with very little effort to do anything else. She even remained unmoving through her midnight meal.

I figured that the vomiting of the past few days would pass as it had seemed to diminish in quantity with each subsequent episode, but tonight was significantly demoralizing. I just have to keep going though, I feel like she has been making progress and I can't stop here if that's the case. I need to maintain some degree of objectivity in assessing her progress in order to make the best choice for her.

Tired

Flower has not been cleaning herself, and I had to wipe her butt once before, but today I noticed that she was getting really dirty. In fact I think I could smell it on her. At first I started to clean her up with a wash-clothe, but I quickly realized that I was going to need to give her a bath in order to get her clean. I ran some water in the bathtub, and when I took her in and began to lower her into the tub, the claws came out. I decided to try this in the kitchen sink instead, which was only slightly less painful. I was encouraged, however, by Flower's new found zeal and strength to avoid that water. Eventually I managed to keep her in the sink long enough to get her wet. It was pretty difficult to get her washed up, and I'll probably have to repeat the process in a couple of days since I didn't have any soap that I felt was appropriate. I'll have to get some help with this next time.

The other issue today was that Flower has avoided using her litter box on several occasions now. This started when she either couldn't get out of my room at night or couldn't get in to the bathroom. The last couple of times, however, I have found stool on the floor of the bathroom next to the litter box and I have found pee in my closet (on my dirty laundry). Most of the afternoon I spent doing laundry and cleaning carpet. I now have a litter box in my room in addition to the one that's in the bathroom. My closet (which does not have a door) is also blocked by a large piece of cardboard. The laundry is still getting done; there's at least one more load to do. I even washed her new kitty bed, which had poop on it. Flower is now OFF of the clindamycin, which should help to avoid the loose stools which had become ever-present. Hopefully with her food staying in her system longer, she will begin to see improvement as she is able to extract more nutrients from it over the longer time. Until Monday, at least, we are waiting and hoping for some signs of progress from her.

I realized this evening that I have already begun to shift my thinking to a new "normal" for Flower. I used to come home expecting her to be at the door, waiting for me, feeling better and like herself again. Now I come home and know that I need to check for stool and pee around the house. I don't want to think of Flower in these terms; I miss her following me into the kitchen, begging for food, and I miss her coming to get petted while I'm at my desk doing homework and coming to get me when it's time for bed. And I miss that she doesn't wake my up in the morning or at night when she needs to get out of my room to use the litter box. I know that Flower is a good cat and likes to follow the rules; she'll make sure that I let her. I'm tired of seeing her suffering, sleeping all day, not able to clean herself.

Observations: Relapse

Flower threw up again today. She hasn't thrown up in nearly a week since we started her on ondansetron. The odd thing is that I checked her food afterward, and I found pieces of plastic, as if from a zip-loc bag, in her food. I imagine these pieces were maybe larger to begin with but since I put them through the food processor they could easily have been cut into smaller pieces. I don't know how they got in the food, but I wonder if they have something to do with her vomiting today. I hate to think that I've been feeding her food with this stuff in it. After she vomited, Flower was visible chewing on something with a loud, sharp crunching sound. I don't know if this might have been from her litter. I was thinking that maybe she was chewing her litter to make herself vomit because she's not feeling well with the food that we're forcing in her via the feeding tube.

Status Report: Relapse

Flower threw up again today. She hasn't thrown up in nearly a week since we started her on ondansetron. The odd thing is that I checked her food afterward, and I found pieces of plastic, as if from a zip-loc bag, in her food. I imagine these pieces were probably larger to begin with but since I put them through the food processor they could easily have been cut into smaller pieces.

An Accident

I didn't leave my door open enough for Flower tonight, so unfortunately I awoke at 1:30AM to the sound of a tiny waterfall. I don't know if she tried to wake me and couldn't, or if she simply saw that she couldn't get out and found a place. She didn't urinate on the bed or in the middle of the floor, but instead, she found an old bag of mine in my closet to pee on. Actually, when I first woke up, I couldn't find the pee and thought that it must have been my imagination, although I did find a stool on the rug. But even this she did reluctantly, because after I got up and opened the door, she went to the litter box and finished her poop. Note to self: be sure to keep the door open enough for her to get out or bring the litter box into my room.

Status Report

Today Dr. Ikeda informed me that Flower does have active FIV. I'm not exactly sure what that means for her prognosis, though. He and Dr. Duesberg both indicate that a cat with FIV is treated for illness in the same manner as any other cat; it's just that her immune system is already compromised and not as efficient as another cat's. Dr. Ikeda also said that he still feels like this is more a GI problem than a direct result of the FIV infection. It's tough for me to know what to think because I see Flower and she is so weak, and I can't tell if she's in pain or really tired from fighting these infections or both. All I know is that I don't want to make her suffer for no reason.

Flower has been unable to clean herself effectively for the past week because of the bandage on her neck. I've been worried because she has some stool stuck in her fur around the anus; I have no doubt that this has gotten worse in the past couple of days since I started her on the clindamycin, at which time I began to notice significantly runnier stools. I did notice that she was licking herself this evening, however, which gives me hope for her. Other than going to the bathroom, Flower simply sleeps or stays in bed all day lately. I picked her up and took her to the front window this morning and then tried to put her by my desk with me this afternoon, but both times she stayed for only a few minutes and then went back to bed when she couldn't get comfortable. She is handling her meals very well, and the meds too. Tonight I will begin to add in one additional feeding for a total of 5. The goal is to have her keeping down at least 30-35cc in each meal, but tonight I will start with 20-25cc.

I found myself thinking today about when we brought her home from ACCIM last week and she was still feeling the effects of the anesthetic. But she was so affectionate and loving and she was actually looking at her food and eating. The fact that she didn't stay that way was really hard for me the past couple of days. I'm confident in her ability to get better and recover from this but I'm impatient and I don't know how long I can wait to see improvement. Little improvements are good though and so I have to focus on those. Flower is a strong cat and she can recover from this with my help.

Oversleeping and Observations

I overslept this evening, missing Flower's mealtime. I laid down at 10:30PM to take a nap before her midnight meal, but I slept through my alarm and woke up at 3AM. This makes about 9 hours between meals, which is much longer than I wanted. It did, however, make me think about changing her overall feeding schedule to try to get nearly the entire volume of one can of food in. If I feed her 35cc at each meal and give them at 6AM, Noon, 6PM, 10PM, and 2AM then I can feed her 175cc daily; most recently I mixed one can with a minimal amount of Pedialyte to make a total volume of 200cc. If one can is 220 Cal (not 100% certain about this), and I assume 0 Cal for Pedialyte, then 175cc gets Flower to about 192 Cal per day: not quite 220 but close. If I increase each serving to 40 cc then I can get the full can of food in. I need to double-check with the doctors about this volume.

On another note, she's seems to be getting stuffy in her nose. There have been several times now when she will breathe her mouth, make an odd type of purring sound, something that could almost become a growl. I think from the doctors that this is a sign that she is developing an upper respiratory infection, somthing to keep in mind. I don't want her to get any sicker right now if I can help it, but I think the meds are taking their toll on her as well.

The meal for tonight/this morning was @3:30AM. It's now about 4:00 and she's purring or breathing heavily, I'm not sure which. I gave her ondansetron and cyproheptadine with her meal just now and about 30cc of food. When I fill the syringe to 35+cc of food, eject the food into a container to heat it, and then refill the syringe, I always come up shorter than I expect. She seems content right now; I was worried about taking so long between doses of ondansetron that she might vomit again, but she seems fine so far.

Status Report: New Meds

I talked to Dr. Deusberg this afternoon after she got Flower's test results back. The biopsy came back with moderate inflammatory bowel syndrome; the cytology on the pancreas came back as what could be considered sub-acute pancreatitis; and the toxoplasmosis test came back with a low positive for IgM. So we have no clear winner here for what's making Flower sick but rather several mild conditions that can all each result in lethargy and nausea. Add to that the side-effects of the various medications and we've got one sad little kitty. The doctor said that I can reduce the cypro to one dose per day to see if that helps, and the doctor's assistant said that once Flower has had a few days on the various new treatments, I may begin to reduce her ondansetron to see if that helps as well. I'm full of mixed feelings as I look at Flower; the fact is I still have a sick cat. I can't keep her like this forever if all I have is hope. She needs to show some life and some vitality for this to serve it's purpose. If these meds don't get her feeling better then I'm going to have to reconsider our course moving forward. I also need to be sure to keep pushing with the food in order to get to one whole can of food daily. Right now I'm only getting about half of a can. Flower has stayed strong and now it's time for us to get her some results.

Flower sleeping with her face in the blanket.

Status Report

@7:15 AM Flower got 26cc of her food/pedialyte/ranitidine/prednisolone mixture (1 can food and pedialyte combined to make a total volume of 250cc) and 5/6cc flush of water/cypro. She slept through the night without getting out of bed. This morning behavior is unchanged: still lethargic and unresponsive to petting with only a small flick of the tail. At some point during the last 2 weeks she began to bury her face under her blanket; I think because she can't bend her neck normally.

Looking Up

Flower's doing much better over the past couple days. I think she's mad at me though. She's been pretty friendly with Ashley and with Varr, but she ignores me most of the time lately. If she can keep her food down tonight, that will be 2 days (8 feedings) without vomiting. (I'm keeping my fingers crossed right now, because I just fed her the last meal of the day less than 15 minutes ago.) Dr. Duesberg prescribed ondansetron for vomiting/nausea and cyproheptadine (again) for appetite. The anti-vomiting medication must be working but I'm not so sure that the cypro is doing its job. Cyproheptadine can cause sedation (or excitation), which seems to be the case for Flower; and ondansetron can cause headaches and dizziness. So we have a host of side effects that reinforce her lethargic behavior. At her worst times she won't even acknowledge me. She's that way right now; I pet her and she stares straight ahead without even responding to my touch. I hate this. I'm separating her ondansetron and cyproheptadine doses beginning tonight so that I can evaluate the effects of each on her mood and energy level. I gave her ondansetron tonight so I'll give cyproheptadine in the morning and continue alternating; she's getting a meal every 6 hours. I'm also anxious to hear back on the test results for the biopsies and the pancreas (aspiration). The medications right now are just alleviating some of her symptoms in order to help get food down, but we're going to have to start treating the cause soon. On the bright side though, over the last two days she's been able to keep down almost one whole can of food. She continues to urinate regularly and had the first stool tonight that she's had in a week. These are all good signs but I still want to see her back to her old self! Hopefully she and I won't have to wait too much longer.

Observations: Back from the Internist's

Today was pretty rough. At the internist's this afternoon the ultrasound revealed a bright pancreas. So because Flower had her pancreatic enzymes checked at the previous vet, I was immediately distraught and saw this as going down the same path of checking and rechecking the same things, on some kind of wild goose chase. The internist was confident, however, that the pancreas was inflamed and suggested taking a sample via aspiration. The other thing that she suggested, with no other apparent symptoms in Flower from ultrasound, was to endoscopically examine her esophagus, stomach and duodenum. I began to see that I might be sending Flower down a path of increasingly invasive procedures with few results. Plus there was the cost to consider. I thought about this hard, and I thought about the consequences of the procedure. My fear was for Flower to go under anesthesia again, having a tube placed in her throat, waking up groggy and sore and worse for all of it. The benefits seemed uncertain. If ulcers were found, medicate; if inflammation was found, medicate; if lymphoma was found, medicate. So at this point I knew that this was the last of it. If this didn't reveal some definitive and effective treatments then I would be done torturing Flower with continued and probably unnecessary procedures. I decided to take this one last chance; it was and is my desire to avoid future vet visits. She has had so much stress and still is not eating on her own and barely holding down food.

I had to go to work so Ashley would have to go back to pick Flower up. Unfortunately I also had a lab to make up for chemistry after work, so I was anticipating not getting done until at least 9. More unfortunately I was delayed several times and did not end up leaving the lab until nearly 11 PM. I was worried and frustrated with repeated test ands no answers and, more importantly, a declining Flower. I was, however, relieved and surprised to find a lively, affectionate, and outgoing Flower when I came home. Ashley gave me the run down from the doctor, but I could hardly believe it when I saw Flower walk up to a plate of food. She had remained attentive to food but had shown little interest, especially in the previous 3 or 4 days. For a while her face just hovered over the bowl, but at least that's progress. To my amazement, she actually started eating on her own from the dry food. this afternoon and evening was probably one of the hardest days that I have had, but tonight, when Flower was up and walking around and enjoying people, I felt like I had, in fact, made the right choice.

At the Internal Medicine Vet

We're at the vet's office again, waiting. Yesterday Flower took four meals without vomiting. This was the best we've done so far. This morning, however, I was not so fortunate with her. She threw up her entire meal after about 30 minutes. This is one of the longest delays Flower has had between feeding and vomiting, with the longest being one hour. I had hoped after yesterday that these feedings would get easier, but I we're not out of the woods yet. So here we are, at the internist, waiting on an ultrasound, still trying to figure out what we can do for Flower.

Watching

Flower threw up most of her food in her last meal last night at midnight. This morning, however, she has so far kept her meal down. She was up for a little while, looking out the window. These are my favorite times. I see that she's still interested if only for a short tim each day. I'm just not sure if these short periods are enough for her right now. I hope I'm not making her suffer. She also began to lick and bite at the bandage on her left paw this morning. This was a pleasant surprise to see her again interested in her own comfort level. Especially after last night. Each time she throws up, it knocks her down a little more. Last night she was so tired that she slept threw the night without even getting up to turn around. I kept the window open for fresh air and covered her with a towel to keep her warm. We're on the way to the doctor's again this morning to see what our options are since she's not able to keep the necessary amount of food down. I'm still hopeful, but I'm ready for some answers. I can't put Flower through this forever.

Observations: Gag Reflex

I had a bad idea earlier. I was eating my bagel and Flower looked curious. I decided to let her smell it. If I had stopped to think about this I would have realized that this was a bad idea given her history of the gag reflex. But I didn't think about it. The good news is she didn't throw up. She did gag two or three times, however, before she settled down. And even then, she continued to stick out her tongue in a licking motion for a couple minutes afterward. Then she went to the litter box but didn't urinate or pass stool as far as I could tell. She's sleeping soundly now; this happened about an hour ago.

Status Report: Portion Control

Flower has the feeding tube in and is slowly getting used to it. She also still has the IV catheter in her left paw, and I think she'll feel a little better (and more nimble) when that comes off. At first she had the cone/hood on so that she wouldn't chew at the bandage on her paw, but now she is either so tired to care or has gotten used to it so we leave the hood off. She still sleeps more than usual.

We began feeding on Friday evening and this went okay. She vomited a little bit before the feeding, which seemed to be mostly saliva. It was a little thick and "drooly" but also mostly clear; there seemed to be little food or bile in the vomit. Varr helped me with the first feeding and we got through it fine. Flower didn't like it much, but she was still getting used to it at that point. No more vomit that night and a little urine in the litter box.

Saturday morning we missed. I was at work in the morning and if I had realized how much food she needed for the day I would have done her first feeding in the morning. But I waited until the afternoon. We tried the first feeding and I didn't set everything up just right so I ended up with a little too much food including the meds mixed in. The metronidazole is an antibiotic that is mixed separately from the prednisolone (steroid) and the lexotinic (iron supplement), so I had two portions of food. The first step is a 10 cc flush, followed by food (mixed with prednisolone and lexotinic). Then I plugged the feeding tube and refilled the syringe with the second portion of food (mixed with metronidazole). After feeding this to her, I gave Flower her dose of amoxicillin and then flushed with 10 cc more water. After all of this, she was pretty disgruntled and she threw everything up within 5-10 minutes. I should have thought more about the total volume before hand which probably was very near to 60 mL. I need to be more aware of the total volume of everything going in when mixing and preparing the different portions.

The second feeding on Saturday happened about 2 hours after the first one. I paid attention to the total volume and used a little less food as well. I mixed the meds into the appropriate portions and delivered a total volume of 40-45 mL. She kept this food down fine and continued to sleep through the afternoon.

In order to try to get her full compliment of food in for the day, but in a shorter period of time, I decided to try smaller feedings spread out into more intervals. This also has the effect, however, of delivering a larger total volume of water to her during a given time period. I chose 3 hour intervals; Flower would be fed at 7:30, 10:30, and 1:30. The first two of these should be food only and the last one should include her second daily dose of meds. After the 7:30 feeding she threw up a little: maybe 5-10 mL within 10 minutes. I was nervous about the rest of the feeding after this but I decided I needed to try anyway. At 10:30 the feeding went very well and after 20 minutes I was content that she wouldn't throw up. I decided to try to sleep and relax before the 1:30 feeding. At 11:30 Flower woke me up when she vomited again. This was more than the first, but I didn't get a good look at the amount. It seemed to be about 1.5-2 times the volume of the first. After this, I decided not to follow-up with the scheduled 1:30 feeding but to wait until morning. After Flower threw up, she went to the litter box and urinated. Then she went to Varr's room and I let her sleep in there for awhile. At 3:30 I woke up and went to retrieve her from Varr's room and bring her back into my room. We slept the rest of the night more-or-less soundly. I woke up briefly because she was making some odd sounds which I could not distinguish as snoring or burping, but I eventually got back to sleep.

Sunday morning: Ashley came over to help me this morning. Last night I developed a method to help keep all of the food warm and prep the medications as well. I also came up with a schedule to divide the portions up and to avoid having to deliver multiple portions of food mixed with different medications at the same feeding. I have a pan of water on the stove with a thermometer in the water. The heat is on the lowest setting which keeps the water between 100ºF and 120ºF. I mix Flower's food with water in a ziploc bag, which I can then keep warm until feeding time in the hot water. I cut a hole in the bag and dump the food directly into the syringe. This way I can monitor the volume a little more closesly. Then I deliver the medication into the syringe, with the food and shake well. For the water flush, I simply use warm tap water from a bowl. This morning's feeding consisted of 1/6 of can of Hill's A/D, prednisolone, and clavamox (amoxicillin). The total volume of food and prednisolone was 16 mL with 1 mL of amoxicillin administered separately. I used a 10 mL flush before and after the food for a total volume of about 37 mL.

I am going to try to continue with several small portions today every three hours. I may reduce the flush slightly in order to keep the total volume down.