Lulu P.

Living With IBD - Lulu P.

Lulu P – Wiltshire, Southwest England, United Kingdom
Female, Somali Cat
Born February 20, 1999
Diagnosed with IBD in June of 2009
Diagnosed with iris melanoma on May 2, 2012

First Entry: April 14, 2011
I collected Lulu from a breeder at 4 months old. She was initially fed on a mixture of Iams dry kibble kitten food,
High Society and Whiskers Kitten wet/canned food with fresh cooked Coley (white fish), turkey and scraps from
the Sunday joint, while at the breeder. I continued with this for some time before gradually progressing mainly to
Whiskers canned Kitten food, and then progressing to Felix and Whiskers canned adult food and kibble, which
she was fed on until Ted was diagnosed with IBD in May 2005.

It soon became very clear just how difficult it is to keep certain cats on a strict diet, when you have a multi cat
household, therefore because the prescription diet of Royal Canin Sensitivy Control (SC31) capelin and tapioca
kibble is a complete food diet and considered to be an excellent protein source, all three cats were slowly
converted to this food. After the manufacturer stopped production of this food all three cats were converted to
Royal Canin sensitivity control Chicken and Rice and/or Duck and Rice moist pouch food and kibble and Royal
Canin Blue Whiting sensitivity control kibble.

Prior to diagnosis in June 2009, Lulu had been a member of a multi cat house hold. I was the proud owner of
four beautiful cats, different breed types, colours and within various age ranges, none of which were related.
Ellie, female, (1990 -2004) beautiful long haired tortoiseshell, mixed breed domestic cat who was euthanized in
July 2004 after being diagnosed with terminal and un-treatable cancer of the stomach at 14 years of age.
Gismo, male, beautiful silver tabby and white chinchilla Persian cross, moggy domestic cat, (1996 - 2010), (see
Gismo’s case history on the Tributes Page of this site). And Teddy, male Somali (DOB: 2001), (see Teddy’s
case history in the Living With IBD section).

Lulu had always been an extremely healthy, hardy, playful kitten and cat. In fact she continued to remain in good
health throughout most of her young to mid mature years. However, she was a fussy eater on occasion. Lulu
was generally well and fed lightly boiled chicken and/or white fish when a boat of IBD occurred. She had a slow
progression to Royal Canin sensitivity control Chicken and Rice and/or Duck and Rice moist pouch food and
kibble and kibble and Royal Canin Blue Whiting sensitivity control kibble. Despite her occasional condition Lulu
was generally a happy and sociable cat.

As of January 1, 2009, Lulu was fed on 50gms Royal Canin Sensitivity Control kibble and 25gms Royal Canin
Chicken & Rice moist pouch food per day. Generally well, happy and content cat. Wormed with Drontal, had
occasional occurrences of fresh blood from bottom and occasional vomiting. Prescribed ½ x metronidazole
tablet 250mg twice daily for 7 days. On April 26, stools were sent for lab analysis to eliminate the possibility of
parasitic and bacterial infections, negative result found. Vet discussed benefits of carrying out a Bile acid
stimulation test, pre/post food, in order to understand and diagnose GI, pancreas, and/or liver disease. May 13,
blood samples were taken; hematology (hl) and pre-op biochemistry (in house) B12/Foliate (b3) to see how well
the gut worked/absorbed and any other abnormalities in the blood count including liver disease, GI and
pancreatic problems. Generally all samples were within normal range, mild increase in acids, further testing to be
done.

On May 18 Lulu was hospitalized where they took 3 dynamic bile acid samples. Bile acid stimulation test were
done, looking for Liver disease, GI and pancreatic problems. In the meantime I was to feed a bland diet chicken
and/r white fish. On May 22 a gastroduendenoscopy (endoscopy), ultrasound examination and two x-rays were
carried out. The vet prescribed 21 x metronidazole tablet 200mg, ½ (100mg) twice daily and 5 x Losec 10mgs,
half tablet once daily (am). By June 7th she was very unwell, vomiting clear fluid and not eating. Her general
demeanour was not very good. She was tuckered up, miserable and ran and hid when it was time for her
medication. I contacted the vet to tell her that she was also losing weight. The vet advised to feed bland diet and
Hills Canine Ad (156gms tins). Also to withdraw the metronidazole and treat her with Clavaspeptin, which is
gentle on the stomach, but less effective in the lower bowl. She was still vomiting clear fluid, unable to take high
dose of metronidazole (bitter taste), was totally off her food, not eating and losing weight. It was very upsetting to
see her like that. Vet prescribed 20 x Clavaspeptin 50mgs tablets. The results of the endoscopy were mild GI
and IBD.

On June 15 the vet prescribed 1 tube of 15ml Protexin Pro Kolin Paste, 1ml three times and 3 x Cerinia 16mg
tablets at ¼ daily for 6 days. Cerenia is licensed for use in Dogs but effective in cats too. It's an anti-nausea
tablet that affects the area of the brain that is responsible for vomiting. Weight 2.6kg (decreased) target weight
3kg. She was underweight due to being starved for three days in order to carry out Endoscopy and related tests,
also due to high dose of metronidazole effecting her appetite. Vet recommended to slowly introduce Royal Canin
Feline Hypoallergenic food (DR25) and advised to slowly increase the amount of (DR25) while reducing the
amount of white fish, aiming to be on 100% (DR25) by June 24th.

I was to Keep Teddy and Lulu on Hypoallergenic food for 5 weeks (first day on 100%) in order to allow all other
food substances to expel from their bodies. This would enable us to see the effect of the new food on their
digestive systems, and give us an understanding of possible causes, either food allergy OR idiopathic bought of
inflammatory bowel disease. She had occasional bouts of vomiting and diarrhea. August 22nd vet examination
showed her condition to be good, weight 3.89kg. Given 1 x cat booster (combination booster including feline
leukaemia) and was prescribed Pro-Kolin and Katalax to protect the bowl and rule out fur balls.

By December 29th, Lulu has developed black ear wax in both ears (in fact Gismo and Teddy had too). The vet
said it was a possible ear mite infection, although very late in season. (In retrospect I've learned this is a
symptom of IBD). She was then prescribed Canaural ear drops, two drops twice daily in each ear for 7 days.
Everyone's bedding was washed. Changed diet to Purina Ha and lightly boiled chicken. By March 24th, she had
been de-wormed again with Drontal and vet suggested changing from lightly boiled chicken to lightly boiled
turkey and Purina HA. Over the next couple of months we continued with the ¼ Zantac daily and tried various
ratios of boiled turkey and Purina HA, working up and down the ratios to either 100% turkey or 100% Purina HA
(Gismo was very ill at this point too).

In May, 2010 we continued the above diet, varying the ratios, with 80% Purina HA and 20% lightly boiled turkey,
giving the best result. She vomited only occasionally, no particular pattern to the vomiting. Hard dehydrated toilet
most days. Generally very good in herself. By June she was on 100% Purina HA biscuits. After the loss of Gismo
and the devastating effects of the diseases and treatments on Gismo’s body I had decided to check out
alternative, more naturals ways of finding a solution to Teddy’s and Lulu’s on-going health problems. I searched
websites informative books on cat care and health in a desperate attempt to ensure Teddy & Lulu did not suffer
the same fate as my poor Gismo. I discovered this website, IBD Kitties, and Jaspers site, www.laurieulrich.com
and also purchased ‘Your Cat’ simple new secrets to a longer, stringer life by Elizabeth M Hodgkins, D.V.M, Esq.

I discovered each to be an excellent source of accurate information. I introduced one Efavet 330 (oil of evening
primrose and marine oil) casual daily (Efavet330, is a known natural anti- inflammatory supplement). Introduced
Evian bottled water instead of filtered tap water after reading an article on chemicals in our water supply and
page 313 of New Choices in Natural Healing for Cats & Dogs by Amy D. Shojai and the Editors of Prevention for
Pets. Evian is free from Chloride and according to this article, chloride can cause bacterial over growth in the
digestive process and can cause bleeding in IBD.

With continued use of above products I observed a marked improvement in Lulu’s toilet which was perfect No
blood or mucus, firm and no vomiting, it’s truly amazing. I introduced Synbiotic D-C capsule, a probiotic and
prebiotic powder in a capsule to restore the gut microflora, once daily. Was on 100% Purina HA biscuits
(hydrolysed soya based diet).

July 8th she was drinking 3/4 times more than usual and not vomiting. Urine sample taken showed range 0-35,
Lulu’s is 50, a good result. Kidneys were okay, generally healthy, however working hard. Sample indicated Lulu
possibly not drinking enough, also could be a combination of eating dry kibble (was on 100% Purina HA) and the
hot weather at the time caused a slight weight reduction. Vet suggested that the increase in water intake may be
due to the fact that cats have an excellent sense of smell and do not like drinking water that contains chemicals,
therefore Lulu may just like the taste of the Evian more. Vet happy with general condition of cat and said that
Efavet is a known natural anti-inflammatory and was happy for me to continue administering it to her.

I began searching for a more suitable food since discovering cats are obligate carnivores via ‘Your Cat’ book.
Referred to this website for suitable cat food products and suppliers. At that point, almost all of the food on this
site was not available in the UK (Europe). Despite contacting manufactures directly in America, they were unable
to sell their products within Europe due to importing and licensing laws, the only exception being Orijen Dry
kibble. I introduced Orijen Chicken kibble into Lulu’s diet and reduced the quantity of Purina HA biscuits, slowly
increasing quantity of Orijen to 100% over the next week (7 days). By July 18th she was on 100% Orijen
Chicken kibble and showed a definite improvement in condition of toilet; normal, not dehydrated. And she also
liked the taste of Orijen. There still had occasional vomiting, normal toilet, but not dehydrated. I was concerned
about feeding dry kibble only, because it makes the kidneys work harder. I began to introduce a 10% canned wet
food, Bozita Chicken. Lulu loved the taste of the Bozita (97% pure organic meat with no gain) Perfect toilet, no
issues, no vomiting.

I cut her Orijen Chicken kibble to 60% and started to introducing 40% canned wet food Bozita Chicken. I started
the withdrawal of Synbiotic D-C capsule, fed 60% Orijen Chicken kibble and 40% canned wet food Bozita
Chicken. No issues with vomiting or toilet consistency. Generally, very happy and content cat. Then went 50/50
with dry and wet food and saw a 100% improvement. She had soft, silky fur, lots of energy and was very playful.
I was very pleased with the outcome. Lulu was a picture of health and full of energy.

Late October of 2010, Lulu had a vet check–up and an annual boost was given. The vet was very pleased with
Lulu’s general condition. Her weight had increased to 3.52 kg, excellent weight for her size. Personal choice, I
decided to have the general boost, but exclude FelV (feline leukaemia) because Lulu has limited access to a
secure garden, therefore does not come into contact with other cats and have read various article about injection
site sarcoma. It has been such a battle to get my cats well that I am afraid to introduce more health risks.

On January 1, of 2011, I introduced 1/2 (1000mg) B12 methylcobalamin (Natural Factors) daily, slowly working
up to 1 x (1000mg) B12 methylcobalamin (Natural Factors) daily over the coming month. Continued with bottled
Evian water, fresh supply daily in their drinking bowls. Continued mainly with to 50% Orijen Chicken kibble and
50% canned wet food Bozita Chicken. Occasionally I substitute (twice or three times a week) the Bozita with
Ziwipeak veal & fish daily cuisine and/or lightly cooked fresh minced turkey tight meat and chicken liver, served
in the cooking water for extra moisture. Toilet is perfect, no mucus, no blood. Occasional fur ball vomit, remedied
with Katalax. Happy, healthy, playful and loving cat and happy caregiver at last.

Update: October 23, 2011
In March, while we where away for a few days Lulu started to loose interest in Bozita canned food. At first I
thought it was because we had been away, as she still ate and very much enjoyed the Orijen kibble. I think it is
just that she has gone off it, she still continues to turn her nose up at the Bozita. So I gradually introduced her to
Almo canned food, fish varieties and chicken varieties, which included: Ocean fish, Mackerel, Tuna and Chicken
and pumpkin, Chicken and shrimp, with each 70gm can contains, 75% meat/fish, 24% broth and 1% rice. My vet
recommended “encore” in similar varieties, again with each 70gm can containing: 75% meat/fish, 24% broth and
1% rice. However all fish varieties of “encore” have a minimum of 25% tuna in ALL their fish mix varieties per
can, whereas Almo have some fish varieties totally without tuna, within their fish mix varieties per can. And
having recently read an interesting article within ibdkitties newsletter detailing how too much tuna in a kitties diet
has a negative effect on the vitamin e level within their bodies (it depletes it over time) I have stopped giving all
my cats tuna on a regular basis, they can have it for a treat, but not often. Also, both Almo and “encore” are
totally natural, therefore nothing is added, not even taurine, so must be supplemented or fed with other complete
foods such as Orijen.

Although Lulu very much enjoys eating and licking these canned foods (Almo & encore), as the months have
gone by I started to notice that Lulu has what I believe to be, an intolerance to the rice within them, because she
started to develop black ear wax, which I cleaned regularly with Clean Aural. She also started to scratch and
developed the occasional debris in the corner of her eyes (similar to what poor Gismo had). On a few occasions
Teddy has sampled the canned food too, as he is quicker to Lulu’s dish, than me!! He ate up all she had left,
which is typical of Ted. However he just vomited it back up on each occasion, I think they both have an
intolerance to rice Smartie (my 11 month old kitten-cat) eats Almo and encore with no problems at all.

I tried to source food without rice, grain and tuna, there’s not much currently available on the market, but I did
find the following: Porta 21 “Pure Chicken”, Schesir “Chicken & Sea Bass”, Animonda Carny “Ocean” and Terra
Felis “Meat Menus”. Lulu has been on these brands for a three months now and she loves these varieties, also
the ear wax and scratching have totally disappeared. Her eyes are lovely clear and bright and she is full of
energy. So will continue to feed her these with the odd tin of Almo and encore on the days when she is particular
fussy and its a case of feeding her these or her not eating.

Update: October 24, 2011
Teddy and Lulu went to the vets today for their flu jabs. I had a biochem of their blood done, so we have a better
understand of their body chemist and how healthy they are. We were not able to collect a blood sample from
Lulu despite three tries, so she looks like a pin cushion now with a shaven neck and paws!

We saw a different vet, one we have not seen before (three vets from our practice have moved on this year).
The new vet noticed that Lulu has a slight curve to her spine (scoliosis) she has no history of this. Her back
seamed sore when the vet examined her, so this is a new one to me. Smartie keeps chasing her and is very
rough with her, so I try to separate them. But I’m not sure what he gets up to when I’m not around. The vet thinks
it is best to do the biochem and when the results are back and everything is ok we can think about putting her on
a supplement of glucosamine & chondroitin as she thinks the curve is becoming more pronounced due to
arthritis. Lulu has hyper-pigmentation in both eyes but her right one is affected more. The vet said to keep and
eye on it, as if it changes and becomes more pronounced or less diffused it could indicate that it is becoming
malignant. I explained to the vet that it is slightly less pronounced since I have been supplementing her diet with
taurine.

Update: October 29, 2001
Finally got some blood for her biochemist test today, they had to use anaesthetic on her to get it, she may be tiny
but boy she's feisty!!! So should have the results back toward the middle or end of next week. Her weight has
increased she is now 4 kg, which is half a kg more than before (3.52kg) which I think is the new food because
she loves it.

Update: November 18, 2011
Lulu’s blood biochem results came back today and they were very good, so I am very happy. All areas are within
the normal range, the only exception was the urea which showed a slightly higher protein level. The vet said it
was probably due to slight dehydration at time of testing. We discussed the uses of glucosamine & chondroitin
but have decided to await for more info. on Teddy first, as Lulu is not showing any signs of discomfort, and she
is still very active and can jump up high without any difficulty.

Update: February 3rd 2012
Spoken with vet today, vet suggested trying Lulu on Metacam for 10 days too see if her back is less sore /
inflamed, then we will have a better understanding as to the cause, arthritis or toxoplasmosis. Note: she is not
showing any outward signs of pain, discomfort or inability to move. In fact she is quite normal in her movements
and manner, but vet was concerned as Lulu complained a lot while the vet examined her back and diagnosed a
curvature of the spine, also cats are notorious for hiding pain and discomfort. To collect Metacam on February
8th 2012.

Update: February 19th 2012
10 day trial of 4ml of Metacam once daily finished yesterday, with no obvious improvement observed, except
Lulu complained less when I clean her teeth while she was on Metacam (I clean them 3 times a week with Virbac
tooth brushes and tooth paste). Next appointment booked for April 16th, 2012 for a toxoplasmosis blood test, eye
and teeth/mouth examination.

Update: April 16, 2012
Lulu went to the vet today, no evidence of infection or decay in her teeth or mouth. In fact they were generally in
good condition; she may have some discomfort in her neck, due to arthritis, when cleaning her teeth, because
her head is facing upward, creating an angle between her head and back bone. Metacam recommended, as it is
not acute pain and can be easily administered at home, buprenex discussed with vet but not recommended by
vet for this type of pain, as has to be injected in the surgery, generally only lasts for two days at a time and is
generally used for acute pain. Lulu’s right eye has more hyper-pigmentation of the iris than before, resulting in
more surface area of the iris having a dark ring effect around the entire edge of the iris and less of the coloured
section showing now. Possibly enlarged area of hyper-pigmentation, iris rubinosis, uveitis, appointment book
with ophthalmologist for April 25, 2012. Blood test taken for FELV, FIV and toxoplasma.

Update: April 18, 2012
Lulu’s FELV (feline leukaemia virus) and FIV (feline immunodeficiency virus) results were negative, which is
excellent, awaiting toxoplasma results next week.

Update May 2, 2012
Lulu was examined by an ophthalmologist on May 2, 2012. Diffused Iris melanoma was diagnosed in her right
eye, which has elevated the pressure within her right eye to 21, in comparison to her left eye at 12, although the
right eye is not distorted by the pressure at this stage it is on its way to glaucoma, which in turn leads to
blindness and becomes very painful. The only option is to surgically remove (enucleation) her right eye because
melanoma can metastasizing and rapidly cause death if left untreated. The ophthalmologist is hopeful of the
outcome if the eye is removed within the next two weeks as it has not effected the white section (sclera) of her
eye yet, which is very good news. The removed eye will be sent to histology, body CT scan or chest x-ray
images and ultrasound examinations could be carried out to see if the melanoma has metastasized, but if they
are very small (less than 2mm) they may not show up, but may still be there. Lulu’s toxoplasma results were
negative.

Update: May 20, 2012
Lulu had her surgery and spent the night in hospital on May 16th, I collected her the following morning. The
operation was very successful and went to plan with pathology results expected in three weeks. Postoperative
examination booked with ophthalmologist on May 23rd . The eye area is sore, but she is coping very well without
it at the moment. We have been sleeping in the spare bedroom with the mattress on the floor, so we snuggle up
together all night, its lovely. I plan to spend as much time with her as I can, to ensure she does not scratch the
area or damage the stitches which will disintegrate in 9 days time. She came home wearing an Elizabethan collar
but soon made it clear that she was having none of it. As soon as I took it off she settled down nicely. Only had
one occasion when the wound was drying up and itching that I had to use it again, but only for about half an hour
and she was fine again.

Its sad to see her like it but she still looks beautiful and will hopefully be healthier now, finger crossed. Lulu’s
appetite is good which is a good sign and I have been giving her all her favourites and she is on pain relief and
claveseptin twice daily. Lulu’s pre-op bloods were good except the kidney results were elevated, so she
probable has slightly less kidney function, but her liver was good. The T4 for hyperthyroid was 25 which is mid
range, so she does not have hyperthyroidism thankfully and the vet said that her removed eye did not have
glaucoma, so that was caught early too. Her weight pre-op was 3.8kg and the elevated kidney result was 12.8
which is only just elevated.

Update: May 23, 2012
Lulu is back in the hospital, she started to vomit Monday morning (21st May) and had diarrhea once, then
vomited twice more during the day with blood in the last vomit of the day. So I took her back up the vets at 7 pm
that evening and they gave her a Zantac injection to calm her tummy. All other areas were okay, temperature
was normal and she was not dehydrated despite not eating anything all day except two teaspoons full of
steamed white fish, so they let me take her home again. Weight is 3.64 Kg.
Despite being given the injection earlier that evening and being bright in herself Lulu vomited up a white foam
liquid size (two desert spoons full) and small amount of blood at 12 am and 2 am and again at 4 am. Each time
with slightly more blood, fresh red blood, although she settled down and went to sleep between each episode of
vomit, 6 am brighter and drank some water. 8 am (22nd May) examined by vet who hospitalized her and put her
on a drip to hydrate her stomach where she spent the remainder of the day and night on Aantac, losec, Cerenia,
cytotex and Antepsin, vet not sure what has caused it, most probable a combination of stress from the operation,
anesthetic and post op mediation for pain relief or some other unknown pathological cause. I visited her
yesterday evening for an hour and she had not vomited at all while hospitalized, was content and purred for the
full hour.

Update: May 25, 2012
Lulu came home on Wednesday after she was examined by the ophthalmologist vet. she is still having losec
once daily and antepsin 1.25ml and cytotex three times daily. She is not eating much still, its a real job to get her
to eat anything. She just has about 2 or 3 teaspoons three times a day, but I ensure it is moist food. I serve it
warm, freshly cooked in the cooking juices, chicken and/or white fish. I offered her encore chicken and ham
which she usually loves, but still has no appetite. She is more comfortable at home, loving and bright in herself,
so just need her to get her appetite back now.

I went straight to the vets yesterday evening before they closed at 8 pm and got a box of 8 x 100 gm. trays for
royal canin Recovery food and ample syringes. By 8.45 pm she had been syringe fed 20 gms of recovery food ,
which looks and smells delicious when I added a couple of drops of warm boil water to it to make it smell more. I
left it till 11.30 pm for the next feed because I was worried I would over load her stomach and it make her vomit it
all back up, but at 11.30 pm I got her to have another 10 gms via the syringe. She slept all night till 6.30 am,
when she woke me wanting her breakfast, I followed her down stairs and she patiently sat by her place mat
waiting for her breakfast. I did the same again and added a couple of drops of warmed boiled water to 25 gms,
but this time I put it in her dish and she licked the bowl clean. I offered another 20 gms but she did not want any
more, so I binned it and we both went back to bed after her medication. At 9.30 am I offered her 10 gms more but
she did not eat it so I syringe fed it and got her to take the full 10 gms. In the last 13 hrs I got her to eat 65 gms,
which is really good.

I will see how she goes and continue to syringe fed her and slowly build up the amount she has to the daily
recommend requirement. If she still does not have an appetite after her tummy calming meds have finished I will
ask for the cyproheptadine, but really only want to add any additional meds if I really have too, because her poor
little body has really had a lot to deal with lately and I can manage the syringe feeding as she is so good to feed
like that, but its nice to know what to ask for, just in case.
She is brighter in herself this morning, but has been scratching her wound, so is wearing her Elizabethan collar
at the moment.

Update: May 30, 2012
Finished last dose of 1.25 ml Anseptin this morning, but has no appetite and soft poo with blood in it, therefore
booked vet appointment. Vet examination observed slight dehydration, normal temp, weight 3.55 kg which is the
same as when recently hospitalised for vomiting. Possibly not eating due to possible pain in lower digestive
system, colon / bowels, hence fresh blood in stools, if it was dark blood it would have indicated the stomach.
Advised to put on normal IBD diet asap, because the Royal Canin recovery food is probably too rich for her
digestive system and causing GI/ IBD flare up. Prescribed 0.2 ml Vetergesic 3 x daily for the pain and 1 ml
canikur paste 2 x daily to help eliminate any toxin in the gut left from the anaesthetic, Metacam and recovery
food, it will also help the stomach retain moisture. 1st June, within two days of this treatment Lulu is back to
normal, has an appetite, bright, content and purring. Last Vetergisic given on 3rd June, still continuing with the
Canikur paste and still normal in her appetite and manner today 5th June. Eye surgery wound heal nicely, so she
does not need the collar now.

Update: June 13, 2012
I got Lulu’s results back today and the prognosis is fair, without evidence of scleral invasion, therefore a low
mitotic rate. So its a good job we got the eye removed before it infected other areas. The ophthalmologist is
going to look into a vaccination against melanoma that has just come out for canines and may be suitable for
Lulu too. I have attached a copy of the lab report:

Histopathological examination confirms feline diffuse iris melanoma, with early involvement of the iridocorneal
angle likely to be responsible for the reported mild glaucoma; at the time of enucleation, secondary changes in
the retina and optic nerve associated with glaucoma are not yet manifest. As you are aware, the mitotic index,
tumour size, and extension into the
ciliary body stroma, sclera or posterior iris epithelium are considered prognostic, and distant metastasis to liver,
spleen, kidney and occasionally other organs is documented. In this case the tumour shows extension into the
ciliary body but only relatively early involvement of the iridocorneal angle, without evidence of scleral invasion,
and a low mitotic rate, and therefore the prognosis is probably fair with enucleation at this stage.

Update: December 4, 2012
Lulu was not interested in wet food for a few days but did not show any other signs of illness, except being less
vocal and slightly less active. So I took her to the vets for a check up. Initially the vet thought she may possibly
have a urine or bacterial infection, so the vet took a urine sample with a needle. The urine test revealed nice
strong urine which meant that her kidneys and liver where working very well and tested her urine for sugar,
which was normal. Her weight was 3.60 kg, 0.65kg less than in October 2012. Her temperature was 40.5 Celsius
which is high for a cat (normal range 38 to 39.2 Celsius). Most probable cause, throat infection and some back
pain, possibly from previously diagnosed slight scoliosis. Metacam and antibiotic injection given due consultation
and prescribed 14 x clavaseptin twice daily and 12 x onsior (anti-inflammatory pain relief) once daily. The vet
also examined her eye, which was healthy, with NO signs of diffuse iris melanoma evident.

First day of treatment, resulted in Lu vomiting clear liquid after her first onsior tablet, then refused to eat no
matter what I offered her, I even tried warm Hill’s recovery food to tempt her. In the end I liquified lightly boiled
mini chicken breast and offered little and often. I finally got her to eat one teaspoon full, per five feeds,
throughout the day. Second day of treatment I just gave her the clavaseptin in the morning and did not give
onsior because she had not eaten properly for about 5 days now, which I explained to the vet during her check
up later that day on December 6th 2012. During consultation the vet explained onsior was still needed to get her
temperature down, it had reduced from 40.5 C to 39.5 C, but still needed to drop a bit more, I asked for
something to settle her tummy, he prescribed Zantac liquid 0.5 ml twice daily. I also asked him to check her teeth
as he runs the first opinion dental service, which revealed a slight build up and possibly one small cavity. When
she is well, it maybe worth getting her teeth professionally clean and possibly getting her tooth filled or removed,
but that was not the reason why she was not eating as there was no sign of infection or gingivitis. Lulu continued
with her medication at home, but it was a real battle to get her to eat, her demeanour improved as the days went
by, she was soon back at her window seat watching the birds !

Update: January 4, 2013
Although her medication ended on December 16th 2012, and her appetite returned to normal, I took her for a
check up today to make sure her back (scoliosis) was not hurting also, I had noticed that she had been
scratching and pulling out clumps of fur. During examination, Lulu’s back did not show any signs of pain or
discomfort, her weight was 3.73 kgs, her skin and ears were very clean and did not show any sign of mites or
infections. Most probable cause, moulting, due to central heating during the cold weather. Her heart was beating
fast during examination, her lungs and temperature where fine.

Update: April 5, 2013
Lulu had her teeth cleaned and she had a blood test taken before the procedure to ensure her kidneys and liver
could cope with the anaesthetic. It resulted in no significant anomalies, so it all went a head as planned on the
day. Two tiny front incisor had fractures and one had a suspected infection developing around the root. So both
were extracted and the gum sutured closed with dissolving stitches. The teeth where examined, scaled and
polished, she now has a movie star smile! I was really impressed with what the vet did and how happy Lulu has
been since. I thought she would have a sore mouth and would be unwell afterword, but she ate three small
dishes of freshly cooked white fish the evening of the procedure, then was very interested in the birds at the
window feeder, in fact since she has had them done she is such a happy, loving little cat.