Tuesday, July 31, 2012
No noticeable improvement
We've been doing the serrapeptase for three weeks now. The eye still looks horrible, all around the ulceration the orb is bright red. I'm not sure if that's a good thing or bad, it may be the body trying to heal itself. He still usually acts like he is feeling fine...playful, good appetite, affectionate, but I don't see any indication that the enzyme is digesting any of the scar tissue that's keeping the eye open plus I see what looks like further deformation around his snout. I do believe that the serrapeptase is making it though the stomach and in to his system, we are seeing small amounts of blood leaking from the eye which I believe is due to the anti-clotting properties of the enzyme. Since yesterday Pika hasn't been very interested in the wet food we give twice a day, he still likes his treats (Pit'r'pats and greenies) but we'll have to get his weight more frequently to make sure he isn't declining. It may be time to look at other options in addition or instead of the serrapeptase, but as soon as we feel we can't keep him comfortable and pain free we will have to let him go.
Monday, July 23, 2012
Another vet visit
We took Pika back to the vet on the evening of July 16th, she said that the eye was still deteriorating badly and there wasn't anything else she could do for him. The exam report would be sent to the opthamologist and we should call her the next day to see what else could be done. She didn't even charge us for the vet visit, though we did purchase another tube of the ophthalmic ointment. The next day I called the eye clinic but our vet wasn't in, so I left a message for another of the doctors asking that the exam report be reviewed and offer ideas on our next step. The doctor who called back said that the report was very complete so there wasn't a need for us to bring him in, Dr. Park would be back on the 24th and they would discuss the case. At the time, we had just started giving him serrapeptase in hopes of softening the tissue that had become stiff with scar tissue and I wanted to give the treatment more time in hopes of seeing improvement.
So here we are. Over the last week I've been playing with the serrapeptase dosage and I believe there has been an improvement. He seems to have much better energy, but I don't know if that can be attributed to the enzyme. Betty brought home one of his favorite treats which we rarely have on hand because it is bad for his teeth...angel food cake from Dominick's. We first discovered his taste for this confection after we had bought a cake as part of a dessert. Someone didn't put the plastic cover back on securely, and the next morning I came down to find the cover on the floor and much of the top of the cake eaten off. We didn't really know what happened, so the cover was just put on properly. Later that day we found Pike trying to pop off the cover, he ended up pushing the entire container off the counter. Since then we have occasionally picked up a cake and offered the cats small amounts from time to time, but now we keep the cakes in a cabinet so Pika can't help himself. The increase in energy we have seen over the past few days may be due to the serrapeptase or due to the extra sugar and protein he is getting from the angel food cake. One thing I do attribute to the serrapeptase is the small amount of what I believe to be blood on the fur around his affected eye, the enzyme inhibits fibrin clotting which would explain the leakage. I an encouraged by this since if it is the case it would mean that the serrapeptase is making it though his stomach and in to the bloodstream. Now if it will just start working on the stiffened eyelids so they can close we may have an effective treatment here. That is my hope, but if the eye deteriorates further we will have to make a decision on whether to opt for surgical removal of the eye or euthanasia. I wasn't able to give him a dose of serrapeptase this morning as he was able to move aside the obstacles I set in place to prevent him from going under the bed, I think he likes to go there since it is completely dark under the bed and he still has some sight in his bad eye. Since he can't close the eye he may be seeking out total darkness so he can sleep. The problem is that there is no way we can get him out of there without completely disassembling the bed, which takes at least 30 minutes and can be a problem if we need to take him in to see a vet. When I get home from work he'll hopefully be out and I'll be able to give him a large dose of serrapeptase.
So here we are. Over the last week I've been playing with the serrapeptase dosage and I believe there has been an improvement. He seems to have much better energy, but I don't know if that can be attributed to the enzyme. Betty brought home one of his favorite treats which we rarely have on hand because it is bad for his teeth...angel food cake from Dominick's. We first discovered his taste for this confection after we had bought a cake as part of a dessert. Someone didn't put the plastic cover back on securely, and the next morning I came down to find the cover on the floor and much of the top of the cake eaten off. We didn't really know what happened, so the cover was just put on properly. Later that day we found Pike trying to pop off the cover, he ended up pushing the entire container off the counter. Since then we have occasionally picked up a cake and offered the cats small amounts from time to time, but now we keep the cakes in a cabinet so Pika can't help himself. The increase in energy we have seen over the past few days may be due to the serrapeptase or due to the extra sugar and protein he is getting from the angel food cake. One thing I do attribute to the serrapeptase is the small amount of what I believe to be blood on the fur around his affected eye, the enzyme inhibits fibrin clotting which would explain the leakage. I an encouraged by this since if it is the case it would mean that the serrapeptase is making it though his stomach and in to the bloodstream. Now if it will just start working on the stiffened eyelids so they can close we may have an effective treatment here. That is my hope, but if the eye deteriorates further we will have to make a decision on whether to opt for surgical removal of the eye or euthanasia. I wasn't able to give him a dose of serrapeptase this morning as he was able to move aside the obstacles I set in place to prevent him from going under the bed, I think he likes to go there since it is completely dark under the bed and he still has some sight in his bad eye. Since he can't close the eye he may be seeking out total darkness so he can sleep. The problem is that there is no way we can get him out of there without completely disassembling the bed, which takes at least 30 minutes and can be a problem if we need to take him in to see a vet. When I get home from work he'll hopefully be out and I'll be able to give him a large dose of serrapeptase.
Monday, July 16, 2012
A decline
On July 3rd we noticed that Pika's eye was looking pretty bad. The vet clinic had closed early due to the July 4th holiday and would not reopen until the 5th when we already had an appointment, so we decided to wait until then instead of taking him to the emergency clinic. We increased the frequency of ophthalmic ointment and artificial tears to try and keep him as comfortable as possible until the appointment.
The vet placed a dye in Pika's eye to make it easier to visualize the extent of the problem, he had a 10mm x 4 mm corneal ulceration. To treat the ulceration, the eye was anesthetized with drops and the ulceration was debrided using betadine soaked swabs. Then small holes were poked in the ulceration with a hypodermic needle to encourage neovascularization which will hopefully encourage healing of the ulceration. I believe this prcedure is called Anterior Stromal Puncture. The final piece of the treatment was to withdraw a blood sample, spin it down to remove cells and puts drops of the resulting serum in the eye 6 times per day for 5 days. This was the difficult part since we both work during the day and it would be difficult for one of us to be at home during the day, but we (mostly Betty) managed to do it, Betty had to go back the next week to get more blood drawn to replenish our supply of serum. I had to go out of town for a week during this time which put a pretty big strain of Betty but she did a great job with Pika's treatments.
While we were at the vet clinic I brought up a few things I had found during my research that might be useful as treatments for this disease. The first is Vitamin D therapy, which we have not tried yet since it is a fat soluble vitamin which can have some serious toxicity if too much is given. The second item, which I was more excited about, is a proteolytic enzyme called serrapeptase. This enzyme, first isolated from the digestive tracts of silk worms, digests the fibrin that is a major constituent of scar tissue. It's used to help reduce internal scar tissue from surgery or sports injury and is not regulated as a drug. The vet seemed to think this may be of value in treating Pika, so I ordered some serrapeptase from Amazon but then found that I could also get some from The Vitamin Shoppe located within walking distance of home. I picked some up from The Vitamin Shoppe the night before I had to go to Kentucky for a week, rather than start Pika on the enzyme and then skip town I opted to wait until I got back. While in Kentucky I started taking the serrapaptase myself at various dosages to see if there would be any side effects that might be a problem for the cat. I didn't notice any problems so I started Pika on a high dose of serrapeptase within an hour of returning to Chicago on Saturday the 14th. The capsules contain 40,000 activity units (AU) and the human dosages go from 1 capsule at the low end to 3 capsules (120,000 AU) at the high end twice a day. I calculated the high dose for Pika based on his body weight divided by mine (6/100) multiplied by high dose of 120,000 AU. That resulted in a dose of 7200 AU, but using the average human weight of 70kg the dose comes out to 10285 AU so I decided on a dose 8000 AU to simplify things. This means I can get 5 doses out of one capsule. I do this by dumping the contents of 1 capsule in a shot glass and adding 5 ml water. I use a syringe to suspend the powder in the water and draw 1 ml for a dose. My biggest concern now is how much of the enzyme makes it through the stomach intact and enters the bloodstream since it is no longer contained in a capsule. I may look for a low-dose capsule of serrapeptase that we can give to him intact if I can't find any information on the use of the enzyme without an enteric coated capsule.
The vet placed a dye in Pika's eye to make it easier to visualize the extent of the problem, he had a 10mm x 4 mm corneal ulceration. To treat the ulceration, the eye was anesthetized with drops and the ulceration was debrided using betadine soaked swabs. Then small holes were poked in the ulceration with a hypodermic needle to encourage neovascularization which will hopefully encourage healing of the ulceration. I believe this prcedure is called Anterior Stromal Puncture. The final piece of the treatment was to withdraw a blood sample, spin it down to remove cells and puts drops of the resulting serum in the eye 6 times per day for 5 days. This was the difficult part since we both work during the day and it would be difficult for one of us to be at home during the day, but we (mostly Betty) managed to do it, Betty had to go back the next week to get more blood drawn to replenish our supply of serum. I had to go out of town for a week during this time which put a pretty big strain of Betty but she did a great job with Pika's treatments.
While we were at the vet clinic I brought up a few things I had found during my research that might be useful as treatments for this disease. The first is Vitamin D therapy, which we have not tried yet since it is a fat soluble vitamin which can have some serious toxicity if too much is given. The second item, which I was more excited about, is a proteolytic enzyme called serrapeptase. This enzyme, first isolated from the digestive tracts of silk worms, digests the fibrin that is a major constituent of scar tissue. It's used to help reduce internal scar tissue from surgery or sports injury and is not regulated as a drug. The vet seemed to think this may be of value in treating Pika, so I ordered some serrapeptase from Amazon but then found that I could also get some from The Vitamin Shoppe located within walking distance of home. I picked some up from The Vitamin Shoppe the night before I had to go to Kentucky for a week, rather than start Pika on the enzyme and then skip town I opted to wait until I got back. While in Kentucky I started taking the serrapaptase myself at various dosages to see if there would be any side effects that might be a problem for the cat. I didn't notice any problems so I started Pika on a high dose of serrapeptase within an hour of returning to Chicago on Saturday the 14th. The capsules contain 40,000 activity units (AU) and the human dosages go from 1 capsule at the low end to 3 capsules (120,000 AU) at the high end twice a day. I calculated the high dose for Pika based on his body weight divided by mine (6/100) multiplied by high dose of 120,000 AU. That resulted in a dose of 7200 AU, but using the average human weight of 70kg the dose comes out to 10285 AU so I decided on a dose 8000 AU to simplify things. This means I can get 5 doses out of one capsule. I do this by dumping the contents of 1 capsule in a shot glass and adding 5 ml water. I use a syringe to suspend the powder in the water and draw 1 ml for a dose. My biggest concern now is how much of the enzyme makes it through the stomach intact and enters the bloodstream since it is no longer contained in a capsule. I may look for a low-dose capsule of serrapeptase that we can give to him intact if I can't find any information on the use of the enzyme without an enteric coated capsule.
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