Updates

so, it has been a while since we updated the world on bowser.

his AIHA has been controlled and he has been stable since september.  his last blood draw showed that his hematocrit levels are the highest they've been since we started this roller coaster ride almost five months ago.  that's a good sign.  we've been steadily decreasing his predisone; he's only taking 10mg a day now.

he has had some ongoing, yet undiagnosed issues with his liver.  his liver counts have been up since september, though through a variety of meds, have been decreasing slightly over time.  this could all be due to the prednisone, and his liver not taking a liking to those meds, or it could just be something we don't know about yet.  I'm more inclined to believe the former as the numbers are coming back down toward normal since we've begun decreasing the meds.  he has been taking denamarin daily and we've added ursodiol into the mix, too, to counteract the effects of the prednisone.

also during this time, his pancreatic enzymes have been a little off.  he's had a couple of ultrasounds to see if there are any issues.  one thought was pancreatitis, though that was not the case.  since nothing was really jumping out as an obvious reason for the fluctuating levels, it was put on the back burner as something to keep watch on, but not directly treat.  during the past month, however, he had some additional symptoms including excessive appetite, frequent defecation (up to 6x a day), eating his own feces, indescribably stinky gas, and weight loss.  upon further testing, it was determined that bowser has EPI, or, exocrine pancreatic insufficiency.  his pancreas no longer secretes the enzymes required to properly digest and absorb food and nutrients into his body.  there have been specific vitamin deficiencies that have cropped up, specifically B12.  his cobalamin levels have been low, too, which could end up impeding his progress with the AIHA since B12 can supplement healthy red blood cells (at least that's what the doc says).  lastly, EPI's effects could potentially create more problems, like diabetes.

so this is our newest battle: EPI.  we are hopeful that this can be managed long-term both effectively and relatively inexpensively.  the specific medication (powdered digestive enzymes) is a huge financial burden of $200-$350/month (depending on where you buy it).  our alternative solution is to feed bowser raw pancreas, which is a much less expensive option, though clearly more difficult to find.  In the meantime, to supplement his vitamin deficiencies, bowser will be getting B12 injections: once weekly for six weeks, then monthly after that.  We have also been provided some meds from the vet that will get us through the next couple weeks until we can fully determine what we need to do and how to get it done.

overall, bowser has made some significant progress.  he's started playing with toys again (though still infrequently); he's remembered how to get up onto the couch; he's cleverly figured out how to use the pile of clean laundry to get up onto the bed to wake mommy up in the morning; he's getting back his old personality.  gone are the days of slow-moving, groggy mr. face, and we're welcoming back his perky attitude.  it's been a long few months, but we're getting through it day-by-day.

more to come as we learn about EPI and how to manage the disease!