My littlest fattest buddy.

Last Tuesday, one week ago, was our Banana's last day. Our wonderful vet came to our house and gave us (and him) hugs and the end was so peaceful, and for that I am very grateful. The past year and a half of his life was not very peaceful at all, and we were glad we were able to put an end to all of his trauma in the least traumatic way possible.

Still: it was hard. So hard. He was such a sweet, hilarious, mischievous, affectionate cat. I've never had a cat before who sought human attention when he was feeling stressed, but this one did. Every time Ben vacuumed he insisted on getting under the covers with me, and when we were at the vet he wanted to be held in a tight little ball with his face buried in somebody's neck. He was just the best boy that we could have ever hoped for when we picked him from the SPCA, even considering he was pretty great in those first few minutes of getting to know him. He will be very much missed.

Within a very short period of time after his passing, though, we realized just how much his problems had come to dominate our lives. When you have to do a thing like medicate a cat every 8 to 12 hours for 18 months, you sort of lose sight of how taxing it is, keeping to that schedule. You forget what it was like to just have a cat you feed and pet once in a while and can leave for long periods of time. I definitely have some guilt over how much I've appreciated the freedom of life without Banana's epilepsy, but as Ben said, we wouldn't have put him to sleep if the negatives hadn't come to outweigh the positives for all of us. And that is true.

Papaya seems mostly unaffected. She has been a little more affectionate than she used to be - she wants to sit on our laps in the evenings now, which was only an occasional thing before - and she is very upset every morning at 5:00 a.m. that nobody is willing to be awake with her, but I'm hoping she'll settle down a little bit with that over time. We think she's going to be just fine as a solo cat overall.

The end of an era! It's just not fair we only got five years with him. There will never be another Banana.

Okay, everybody.

I think this guy is going to be okay.

He had a seizure on August 22nd. For the week after that he had stopped itching but still seemed on edge a lot of the time - he was grooming himself for long, long periods of time, to the point where he was having hairballs every 4-5 days, which has never happened before in his life. On Saturday the 30th of August he was a nervous disaster almost every waking second and by the end of the day I was at the end of my rope. I know I have said this before but this was FOR REAL. END OF MY ROPE. I assumed he was going to have another seizure any second and just be an anxious mess all the rest of the time for however long he managed to live. I went to bed that night seriously thinking about his quality of life (and ours!) and whether it was worth it to keep dragging this out.

But since then, he's been pretty much normal. No more seizures, no more nervous grooming, no more hairballs. He's demandingly affectionate and has a normal cattish amount of wild spells followed by relaxed sleeping and cuddles. He loves his thrice daily treats and gets very demanding when he knows it's time for them. (Thank the baby Jesus for that veterinary compounding pharmacy.) He's essentially a normal cat. It's incredible. 

So I think it just took a really really long time for that phenobarbital to get out of his system. Even with tapering so slowly to practically nothing, it was still almost a month after the last dose before he stopped being anxious and uncomfortable. But now - he's not. He's okay. Maybe a touch jumpier than he used to be, but well within normal limits, and probably even less so than his neurotic sister. The people on my forum says it's even possible that his recent seizure was caused by the phenobarbital levels dropping in his system. I don't want to assume that's true, however, because I think it's unrealistic to not expect more seizures in the future. There's no denying he's epileptic. But I feel like as long as he is healthy and happy otherwise, I can totally 100% deal with this - emotionally, financially, whatever. Yeah, if he lives ten years he's going to cost us a lot more money than (hopefully) all our other cats will cost us in our lives combined. And will require 3x a day pet sitting when we go places. But I feel like we can go places! And do things! I'm really proud of us for sticking with it and figuring out his issues. Our little special needs buddy. He's worth it, no doubt. Sometimes I have been thinking that God gave Banana epilepsy so I will be sure to appreciate him every day. I don't even believe in God! But you never know, I guess. I'm sure not taking a single day with him for granted.

Cooking for Two

For the past month or so I've been obsessed with The Complete Cooking for Two Cookbook. I got it from the library and after a week's worth of recipes ordered it from Amazon. I don't really know much about cooking meat and it has a really comprehensive range of ingredients and cuisines. I also love that it only makes enough for two portions, so I'm not tempted to overeat and/or don't end up with a bunch of leftovers. I've done a poor job of taking pictures but here is one thing I made last week, a summer quinoa/corn chowder with avocado and cheese.

I like the book so much I'm considering going through the entire thing in a systematic way, checking off the recipes like I haven't done since Appetite for Reduction!

In other news, I don't have any new pictures of him but Banana's recovery since coming off the phenobarbital completely has been pretty stunning. He is back to being a curious, affectionate pain in the ass, jumping on top of the 6-foot bookcases and knocking things off the counters onto the floor. Sometimes he scratches for a few seconds but never to the point where I'm worried he's going to hurt himself, and it's getting better all the time. He still has about a week before the drug will be completely out of his system, and we're pretty optimistic that he'll be completely over the itching by then. It's amazing. AMAZING. I guess when you stop giving an animal a medication to which he's allergic, the results are going to be pretty positive.

Catch you later, phenobarbital!

Today is the first phenobarbital-free day of Banana's life since May 5th. It has been an extremely long and stressful road for this entire household. I tapered more slowly than the neurologist even recommended, stretching out another two weeks based on recommendations from the epileptic cat owners' forum I belong to. The overall trend over the last couple of weeks especially has been positive for sure, although he does still have some minor itchy issues that bother him from time to time. 

Personality and mobility wise, though, he is much, much better. His coordination and balance are completely normal, which was never the case when he was on a therapeutic dose of phenobarb. 

He's also curious and active again, playing with Papaya and running to the windows to look at birds. 

So now we just have to wait and see if the itchiness goes away completely over the next couple of weeks. The phenobarb will stay in his system for at least that long yet. If he's still itching after that, we can look into other things - food allergy, maybe? - but I am 100% confident we've done the right thing getting him off phenobarbital. 

I feel like I have my cat back, finally. For now, I guess - I am still holding my breath a little bit. At least his issues are infrequent and tolerable for the time being. And hopefully by mid-August they'll be gone completely! If not, well, we'll cross that bridge when we come to it. 

Fajitas!

Remember when this was a fun blog about food? The Mexican place by our house has had these tropical fajitas as the special all summer and I'm pretty obsessed with them. They mix up carnitas, chorizo, and chicken with peppers and onions and serve it in half a pineapple. So fancy!

It's a huge amount of food, too. When we went there on Wednesday there was enough left over for Ben and I to share for dinner the next night. 

As far as the cat goes, I'm pretty sure we are on the right track. Banana is much, much more like himself even after only a few days on Keppra. 

He's clumsier than ever, but at least he WANTS to jump on stuff now. Yesterday he didn't fall off the kitchen counter even once, so I think it might be starting to get a little better. The combo of a full dose of Keppra with the phenobarbital still in his system has got to be pretty potent. We still have 3 weeks or so before we get him off the phenobarb so I'm hoping that by early August we'll have a good idea of what he'll really be like on the Keppra. Whoever invented compounding medication into seafood flavored treats deserves some kind of award. Here's what they look like. 

It has made our (and his) life so much better, and I can't wait until we are done with the phenobarb so we don't have to give him any pills at all. 

Oh, and that whole plan of an early morning dose and then lunchtime and evening worked for exactly 2 days. I can't tell you much about them, though, because I was so exhausted I didn't retain any information. We have switched to before and after work and right before bed. It's not exactly 8 hours between dosages, but it's the best we can do and I think it will be good enough. Compared to what I am reading on my forum, his condition seems to be relatively easy to control, at least for now. There are a lot of cats who still have regular seizures even on meds, so thank goodness we don't have to deal with that. Knock on wood. 

Phase Two

Since last week Banana has been more or less fine. Not normal, mind you, but not self-destructive and insane. He last had a crazy itching/grooming session last Tuesday night, three days after we started decreasing the phenobarbital. And three days after switching to the soy-free food. So convenient that both of those things occurred precisely at the same time, so we can't be sure what is having the positive effect. He's still on 15mg of phenobarb twice a day, which is the dose he was taking when he clawed his ear bloody - so either his body has gotten used to it to an extent, or that food did not agree with him. I (jokingly!) suggested doing an experiment wherein we give him the old food again to see what happens, but Ben nixed that idea. He should be eating the lower calorie food anyway.

Regardless, we press on. He is very wobbly and uncoordinated on the phenobarbital and it's hard on the liver so it's the right decision to get him off it. One happy surprise is that the compounded version of Keppra is only $59 a month - half the cost of the pills I got from the Target pharmacy. The 4th of July holiday pushed us back a couple of days - the compounded Keppra has to be Fed Exed from Arizona - but it has arrived so we're going to start that tonight.  Keppra only takes a couple of days to reach therapeutic dosage, so I'm going to decrease the phenobarb again starting on Friday. I really really want to get him off that crap.

He still has glimpses of wanting to be bad - attempting to jump onto the top closet shelf is a classic Banana maneuver - which makes it all the harder when he, for example, falls off the kitchen counter because he turns around too fast.

He is still pretty affectionate a lot of the time.

Possibly we keep the air conditioning turned down too low. They have been all over the warm stovetop lately.

So we'll see what happens with this Keppra. The worst part of this medication, which is (supposedly) free of side effects, is that it has to be given three times a day. I can't see a way around getting up at 6am every day given that we both have to be at work all day long. And one of us is going to have to come home every single day at lunch for the midday dose. SIGH. And let's not even get into whether or not we will ever be able to spend a night away from home again. 

I'm also finding myself forgetting about the seizure aspect entirely, writing it off as unlikely to ever happen again, which I know is dangerous thinking. It's been two months since this all started but lots of cats go months with no seizure activity and then it crops up again. We're just going to have to take it slowly and see how it goes. Most vets want to try weaning cats off medication if they haven't had a seizure in a year, and I'm having trouble not flashing forward to next summer, imagining how great it will be if I can just have my regular healthy cat back. Is it likely? I have no idea. But I hope so.

Changing it up

Well, naturally everything has gotten much much worse since that last post. I am mostly writing this as a record for myself (and others googling cat epilepsy?) so sorry, people who aren't interested. But here is a picture of Banana. 

Thursday night he fell apart again with the crazy overgrooming and scratching of  his feet and entire head. By Friday morning his right eye was half shut from scrabbling at his temple. 

It occurred to me that we started a new food less than 2 weeks before this all started with his seizures on May 5th. We had them on Royal Canin Urinary SO Moderate Calorie, and then I switched them to the regular because my vet didn't have the low cal. I did some research and discovered the primary symptom of food allergies in cats is itching, especially of the face and ears. And food allergies can also cause seizures. And soy is a common allergen, present in the regular version of that food but not in anything he had ever eaten prior. So THAT is all very interesting. The first thing I did Friday morning was call my vet, who said she would put in a call to the neurologist to see if he had other cats with this problem. Then I went and got the Moderate Calorie food and took away the other stuff. 

I took the afternoon off work and when I got home at 1:30 he was still a twitchy disaster. Finally I talked to the vet, who said the neurologist didn't think the phenobarb was causing the itching, but she disagreed and thinks we should taper off the phenobarb and switch to a new medication called Keppra. I agreed 100% with this plan. She called in Keppra to the pharmacy and I picked it up and it was $115 for a month's supply and the pills were enormous, far too big to give to a cat. SIGH. 

I drove to the vet's office to show her the pills and she agreed they were ridiculous and that I should return them. We talked about it and agreed to start decreasing his phenobarb immediately regardless as clearly he is not tolerating it well. Compounding pharmacies can turn Keppra into treat-like form, so she is going to call on Monday and see how much that costs. She's worried it will be expensive but at this point I do not care. We don't have kids; what else are we going to spend our money on? She gave me some sample treat flavors to see if he likes one more than the other and THANK GOD he loves them all. It's going to be much more awesome giving him a treat 3 times a day as opposed to shoving a pill down his throat. 

So after all that I went home and Banana was relaxed and affectionate all evening like nothing had even happened. ARGHGH. That makes me wonder about the food, though - maybe I really am onto something there. We are decreasing the phenobarb anyway because clearly it isn't doing a good job of controlling his symptoms regardless, and it also makes him pathetically clumsy and is hard on the liver long-term. 

This morning he purred and cuddled with me for hours. He did have a moderately compulsive grooming session this afternoon and sort of half-heartedly scratched in the direction of his head, but we were able to ward it off for the most part and it was nothing like the horribleness of the last few days. 

So we will see! This has been an incredible learning experience and I think it is far from over, which sometimes I am fine with and sometimes makes me want to cry. Once we get him stable I'm semi-seriously thinking of starting a feline epilepsy website because it is so difficult to find information about this stuff. Even my vet is learning a lot, I think. It's just a super rare condition. We sure are lucky. 

One Day at a Time

Ben said I have to make a new post because that picture of Banana makes him too sad to look at. So here he is a few days ago. 

He is doing better since increasing the phenobarb, but he's also just now starting to really come out of the sedation phase, so who knows what's going to happen when that wears off. I am starting to get over the idea that the meds are going to be a magic pill that returns him to the way he was before, and accept that he may always be a little off and have issues. It's sad! My buddy! But he still sleeps on my pillow and purrs and cuddles, so as long as we can keep him seizure-free and the compulsive stuff under control, I can live with that. 

Banana Update

I was pretty anxious about leaving Banana to go on that trip, as I'm sure you can imagine. We have a great pet sitter who has been taking care of them for years, though, and I trusted her to take good care of them. She did have some drama giving him his medicine a few times, but overall it went fine.

When we got back, we were surprised at how normal he was acting, much moreso than before we left. We had his phenobarbital levels checked and they were within the normal range, although on the low side of average. He was not having any symptoms at all so the plan was to recheck in 6 months to make sure everything was okay.

Then a few days later he started FREAKING OUT. The slightest out of the ordinary event will now send him into a tailspin of anxious overgrooming, biting at his feet, and scratching his right ear, causing it to swell up like so.

It sucks. Our vet consulted with the head of neurology at NC State and they thought he might be reacting to a different formulation of phenobarbital that was in the refill I picked up at Target pharmacy. So I went back to the vet school to get some of their version (which is made by the same manufacturer, so I had my suspicions this strategy would not work). It didn't work. He's been off the Target phenobarb since Saturday and last night he was worse than ever with the ear scratching. It's like a vicious cycle - he scratches because of anxiety to the point of irritating it, and then continues to scratch because it's irritated. ARGH.

Eventually he does get tired and fall asleep, which allows the ear to calm down and when he wakes up he is sometimes okay. Until the next stressful thing happens (this morning: having to take his medicine) and it starts all over again.

Fortunately, I have found an absolutely incredible online forum for owners of epileptic cats. I would be lost without those people - from them I have learned that this type of compulsive behavior goes hand in hand with feline epilepsy and that his urinary tract issues may very well be related, too. I can't believe that there is so little information out there about this disease that average cat owners are a better source of information than veterinarians - but it's true. My vet is fabulous but she clearly doesn't have a lot of experience with this because it's so rare.

Anyway, from the forum people I learned that this behavior is very typical and almost certainly means his phenobarb dose is too low. Given that my vet said his blood levels were below the median, I suspect this is the case and that we're going to have to increase his dose. I hope we can do that today because I am so tired of worrying about him. 

I miss my cat. 

Epileptic Banana Update

It's been about 10 days now since the seizures and starting phenobarbital. It has been an extremely trying 10 days for me. It's a good thing I don't have human children because apparently I do a poor job of handling it when someone I love is sick. 

Banana is, as you know, a feisty and mischievous cat. That's why I think it's been so hard to see him spend much of the past week and a half in a daze. Even when he'd do bad things his eyes would have a sort of vacant look. 

But he really is slowly coming around. It hasn't been a linear progression - he'll seem pretty normal one day and then take a step back toward grogginess the next day. Overall, though, the trend is positive. And today, he's been awake and wandering around for the whole 2 hours we've been up so far and is currently chasing Papaya around the house. And, most importantly, he hasn't had any more seizures at all. 

So, I think things are probably going to be okay. MAYBE. I hope. We'll see. 

I guess feline epilepsy is a thing.

I cannot even believe this week has really happened. 

On Monday at 4:30am we were awakened by Banana having a grand mal seizure. Off to the emergency vet once again! They did bloodwork and an exam and said there was nothing obviously wrong with him, and that sometimes cats just have a one-off seizure. They do?

So I took him home and sat around for a while trying to get some sleep. At 11:00 or so I gave up and decided to go to work. When I stood up he had another seizure. Cat seizures are SCARY. and awful.

Since our regular vet was open, I took him there. You can see how completely unaffected he was by any of this, except for the actual seizure part. He was immediately fine afterward both times. 

My vet said we could either start him on phenobarbital, or if we had the money she really recommended a full neurological work up at NC State to find out what was causing the seizures. Two in one day like that is rare and warranted some kind of immediate intervention either way. Ben and I talked about it and tried to decide whether to do the neuro consult, but as soon as I had Banana back in the car I knew there was no way I could take him home not knowing what was going on. I drove straight down to NC State and handed over my credit card. 

He ended up staying overnight for observation and then getting an MRI and spinal tap the next day. They also started him on phenobarbital, which is making him pathetically groggy and uncoordinated. 

Long story short: he just has epilepsy. Hardly any cats have epilepsy. Every vet I talked to said it's extremely rare. But there are cats out there with it, and now I've got one. He has to take phenobarbital twice a day for the rest of his life. 

The grogginess is finally starting to let up today, his fourth on the medication. The vets say he should be back to his normal self in a week to 10 days. It's hard to believe right now - he is so sad and tired and uncoordinated. It's tough to see. 

I kind of can't believe how much money I've spent on my cat. We may have to skip the trip to Europe we had planned for November. But when it comes down to a week in Paris or Copenhagen vs 10 more years of Banana? No contest. This is a good cat. He's worth it.