Pain-relief and Symptom Management for Manja

Manja is a street cat from Choa Chu Kang diagnosed with late stage intestinal cancer. She is now in our foster home to live our her last days the best we can give her.

Manja is a gift. She teaches us a lot in her own quiet feline way, about having to deal with cancer.

Manja, the pretty torbie ex-stray cat

 Lately she developed conjunctivitis and is now on Terramycin antibiotic eye ointment as the only other alternative to treat her conjunctivitis is antibiotics, something we do not want to do as it will stress and weaken her digestive system and immunity in general.

Manja having conjunctivitis, treated with Terramycin

She is also being syringed supplements of vitamins B, lysine, colostrum, omega, and probiotics, which I mix with water and a bit of sardine mashed in to flavour it. In the mixture, which is syringed fed to her (about 10ml worth) is also added Periactin (Cyproheptadine) which is an appetite-stimulant drug.

Soon to be added to her supplements are herbal extracts, mainly Burdock Root which Helga is also taking for her CRF, and Azmira ImmunoStim'R which we are getting at charity rate from The Water Dish, which makes it very affordable. Azmira ImmunoStim'R is a herbal blend similar to Essiac, which is the renowned herbal remedy for cancer, unfortunately hard to find in Singapore in our usual health stores. If you have a cat having cancer and wish to use Essiac tea as a remedy (which usually also contains Burdock), the dose is 15ml for cats weighing less than 15lb - you can buy it online at health sites like iHerb.com. We will also be adding Slippery Elm Bark as part of her herbal remedy, since her cancer is in her digestive system.

Manja has been eating less & losing even more weight

We didn't jump into herbal remedies with Manja straightaway from the time she came over because we didn't want to bombard her suddenly with syringe-feeding and pilling, and we also needed to know her better to see how she takes to both medications and supplements. Now we know she rejects canned food (so no adding of any supplements or herbs to that), has begun to hate pilling, and the only thing she is okay with is syringing. Herbal supplements will need to be syringed separately, so it means that once we start administering her with herbal remedy it will be twice a day of meeting the syringe for Manja. Hence the need to ease her into the regime. Will be starting her on herbal remedies tomorrow when our Azmira ImmunoStim'R supplement arrives.

Unfortunately the B vitamins and Periactin have not helped much in improving her appetite. These past two days she has been eating lesser and lesser. She also meows for no reason at times nowadays. Hence we came to the point where we needed to plan for her pain management, as she will likely be in pain if not already. Our medical supplies sponsor Catherine suggested donating us some pain-relief medication for Manja. There are a few that will help in pain management in the market. Buprenorphine was our first choice initially. But because it is a highly controlled medicine in the medical industry (due to Subutex drug abuse, same drug) Catherine won't be able to get that. We considered Tramadol which is either orally administered or injected, and also pain-relief patches in the form of Durogesic (Fentanyl) which were suggested by both Catherine and Dr Chong. Catherine can get Durogesic patches from the hospital with a prescription from Dr Chong, so we will be getting the prescription for Manja tomorrow at the vet and Catherine will sponsor her patches. Tramadol was ruled out because the human doses available in the medical industry are unsuitable for cats (too large even at its smallest) and Tramadol has side-effects which are quite alarming.

We talk about pain management for Manja, but eventually even pain-relief medication will not help her any more. That will be the time we will let her cross over the rainbow bridge and put her to sleep unless she lets go first.