TNRM receipts for October

For the 17 cats we neutered at Block 15 Upper Boon Keng last month here are the receipts.

Transport, trapping and boarding costs for the 2 rounds of sterilisation as billed by Acodia (Damy)

Sterilisation receipts as issued by the vet

The veterinary receipts shown above issued by Clinic for Pets are being mailed out to Cat Welfare Society for sterilisation reimbursement. The amount reimbursed will go back to our Sterilisation Fund so we can neuter more stray cats.

Helga passed away on 5 November 2010 at 5:55pm.

It started with respiratory distress. I found her having difficulty breathing in the afternoon. But when I listened to her lungs, her airways were clear of fluid and there was no wheezing. Yet her heart rate and breathing rate escalated beyond the normal range.

Vets being closed for the public holiday, I called the doctor's hotline and spoke to Dr Hsu. He said that she was probably having difficulty breathing because she was trying to expel the excess urea and creatinine in her system. We placed Helga in the recovery position with her head elevated and covered her with a blanket (2 of the things to do when a cat is having difficulty breathing). One of Helga's major financial supporters, Catherine, contacted Mount Pleasant's after hours clinic and we brought her there. When we left home Helga was already losing body temperature and I transported her carrier with a hot water bottle to the Mount Pleasant clinic.

There they placed her on oxygen. However, the prognosis was no good. Helga was showing signs of leaving us very soon. Low body temperature, continued difficulty breathing. We reported Helga's urea and creatinine levels to the vet. At best if we opted to put her on IV and oxygen therapy and hospitalise her she would live for a few more hours. But it meant that Helga would die alone in the clinic. Also, it wasn't an economical route to take as Catherine has already sponsored far too much of Helga's care, where the financial resources can be triaged to better rescue efforts. Helga was already in suffering. Her kidneys had officially failed. So, we took the vet's advice and let her go via euthanasia.

It wasn't as hard to see her die as it was with the other cats that have died in our custody before her. Simply because it was painless and Helga knew it was time for her to go. She left with much dignity and in no pain. Witnessing a cat's struggle to live and eventually die in your arms in distress is a far more traumatic experience for both us and the cats. If we had been able to euthanise every cat that was on the brink of death to save them the final hours and minutes of gasping for air or heart failure etc. we would have.

[Video of Helga's passing via euthanasia was recorded but Youtube has yet to upload it successfully. Will update this blog post with the video when it is up.]

Despite the process being painless for both us and her, we feel her absence immensely. Having gone through abandonment, braving muscle loss, sub-cutaneous injections and medicating with her strongest front, being a purring manja cuddly bundle of fur, being at ease with all the other cats and foster kittens in the house, loving visitors - all that of Helga is no longer with us.

She leaves behind renal dietary food, medication, and sub-cutaneous injection sets. We will be trying to sell these items to folks having a CRF cat to try and reclaim some of the donated funds that were used to purchase these items for Helga.

Helga's remains will be sent for cremation tomorrow.

Caring for a Senior Cat

We will love our cats till the day they die, so there will come a time your cat reaches its senior years. Here are some things you should look out for when your cat becomes old.

Veterinary check-ups: These should now be scheduled 6-monthly instead of annually when your cat gets older. Apart from checking for onset of feline diseases by doing blood tests, also get your vet to check its teeth, and for growths. This is important because early detection of feline illnesses is important to ensure quality treatment and the prolonging of your cat's good life with you.

Grooming: When cats get older they will groom themselves less. This may mean more showers are necessary. However, older cats tend to have drier skin. So you need to select a shampoo that is more moisturising, or use conditioner. Also, blow-dry your senior cat after showers, because they may not have the energy or dexterity to lick themselves dry. This is to prevent fungal growth from moisture collecting in their fur. You may need to brush your cat more often as well. Also pay attention to their ears and clean them from wax buildup to prevent fungal growth.

Claws: Cats are less prone to stropping to keep their claws in check when they are older. They are also less able to retract their claws when scratching themselves, and may end up getting claw wounds which will need first aid attention to prevent inflammation. You will need to check your senior cat's claws more often and help them to trim their claws to prevent claw wounds as well as ingrown nails that overgrow.

Diet: Do not feed your cat less. A protein level of 30-40% is still ideal for senior cats unless your vet advises otherwise. Also they will need the vitamins and minerals from their diet. Consider adding supplements to your senior cat's diet. Calcium is one important mineral. Also, probiotics, essential for cats every age, may become more important in their senior years due to a weaker digestive system. You can also consider supplements good for cardiac health such as the omegas (fish oil, flaxseed oil, olive oil) and CoQ10.

Incontinence: Your senior cat may be less able to control its urination and bowels and may need more litter boxes, especially closer to where they like to hang out around the house. Stock up on paper towels and toilet paper because there might be more 'accidents' outside the box. Likewise because of this your senior cat definitely will need more conditioning showers and grooming to keep themselves clean from peeing and pooing on themselves.

Fur loss: Your cat may begin to show signs of fur loss, be it when you stroke her and find your hand full of her fur, or simply bald patches appearing on her body. Her fur will also grow less slowly than before. 

Safety and solitude: Your cat may now prefer quiet activities such as suntanning and snoozing more than other things. Ensure that there are quiet corners your cat can spend its days in, especially if you have a multi-cat or noisy household. You can consider igloo beds or cat baskets specially for your senior cat.

Exercise: Because your senior cat will not be really into playing on its own anymore, you will need to ensure it gets enough exercise. You may find that your cat only responds to some toys only, and no longer others. Pay more attention to which toys she prefers and play with her using them more often to ensure her mind and body are engaged.

Planning for the inevitable: When your cat eventually goes over the rainbow bridge, allow some time for the rest of the family members to grieve, even the pets. It is normal for the other pets to wonder where their older brother or sister has gone. Eventually they will accept that nature is as such and continue in their daily life - this is one thing animals can teach us about resilience and of the natural order in life. You may also have to make the difficult decision of euthanising your cat if she is in suffering, or to let her live out her live naturally. Either choice is a difficult one to make. Also note that it is illegal to bury pets in public areas. Cremation rates start at $80 for a cat, including pick up. To enquire more on pet cremation rates, call Alvin of Mobile Pet Cremation Services at 94556355 from 8am to 5pm daily.  

Be prepared: Your senior cat may develop a chronic feline condition that will need routine care. You will have to be mentally prepared that he or she will need daily medication, regular visits to the vet, injections and such. Just as we need to be prepared to take care of our senior parents, we need to be prepared for our senior cats. 

This article is inspired by the senior foster cats that have come into our lives: Helga and Manja.

Latest update on Helga

Being on sub-cutaneous saline injections for her CRF, one thing we need to monitor Helga on is fluid-overload. Fluid-overload is the retention of fluid in the body due to too large a dose of sub-cutaneous injections; in Helga it is manifested by water retention in her foreleg.

Helga initially started on 150ml S-C injections 2-3 times weekly and did very well on it. She is now on 50ml once daily. I have tried her on 75ml and 100ml and she fluid-overloads. The administration of S-C saline is 25-30ml per kg of body weight, as advised by our vet; Helga is now 1.8kg so 50ml is right for her size.

Unfortunately 50ml daily doesn't seem to increase her appetite like the larger doses did in past. She hasn't eaten today nor yesterday. We know that it is only alarming if she doesn't eat for 4 or more days. So we will need to keep her on 50ml S-C a day, and monitor her appetite. I fear she may need to be syringe-fed like Manja before she left.

The thing is that while she may eat more on larger doses of S-C, fluid overload is dangerous, so we will just have to bear with the fact that S-C is no longer increasing her appetite like before and syringe-feed her if it gets bad, else hospitalise her once again.

Do note that if S-Cs cause fluid overload even though it is the right dose for the animal's body weight, it could mean a concurrent cardiac condition, another thing we worried about when we noticed Helga's fluid overloads. Thankfully, it is more likely because she is losing muscle mass due to her CRF and therefore weight.  

In other updates: Helga's loss of body mass means she can no longer walk or climb as well, but she still does, through sheer will power. Because of her weak hind legs I have reinstated a blanket covered with peepads for her in her pen even though she will pee on it and sit in her pee. Daily. So we make up for that by grooming her with grooming powder daily and more showers (with lots of oatmeal conditioner, a must for senior cats because of their drier skin). Just so she can rest more comfortably (the floor of her pen is lined with tiles, not as comfy as blanket).

The growth on her tail is still prone to scabbing and needs cleaning every day. Thankfully she doesn't groom herself any longer and it doesn't get inflamed - fur merely gets stuck to it and cleaning her growth is just one more thing we need to do for her daily. No picture of it, because it is quite disgusting to regular folks.

Did you know that Persian cats are prone to a shorter life span? Because Persians carry a lot of genetic disorders such as CRF among others in their lineage, they live shorter lives and are more prone to falling gravely ill towards their senior years. In any case, all our cats will grow old one day, and learning to care for senior cats is one valuable lesson that Helga (and in fact, Manja too during her short stay) has been teaching us to prepare us for when our own cats enter their twilight years.

@CatWelfareSG documentary screening and discussion panel

Andy and I were privileged to attend the event Dogs Cats and Humans on Saturday, invited by the Cat Welfare Society folks. We learned a lot and we would like to share with you our thoughts and insights garnered from the event.

Dogs Cats and Humans documentary
One of the leading themes behind the topic is on euthanasia in shelters, both government and private. We believe in euthanasia in the human concept where it is no longer a viable option to prolong a person's pain and suffering. But euthanasia in shelters is due to lack of space, where they prioritise who lives and who dies. Some of the methods employed are more humane - quick and painless, others are long drawn-out processes. The priorities as to who lives and who dies are set differently by each shelter. Many of the animals surrendered to these shelters shown in the documentary are borne out of unsterilised pets at home. As in a hospice or nursing home for humans, every surrendered pet that comes in, borne out of an unsterilised pet at home, is a competition for space in the shelter. Someone has to die or be adopted for that space.

Another topic that was brought up is the concept of 'no-kill' shelters. Currently very popular in the UK and US, these no-kill shelters do not practise euthanasia on surrendered pets. This is an extremely good concept. However, like Marxism is good on paper but fails terribly when practised by Communists, the no-kill concept is not viable in practice, and euthanasia can only be minimised but not eradicated. Why this is so - the insight on this was shared by SPCA advocate Jaipal Gill. Basically, if you have a no-kill shelter, and are full, you are simply forcing the animals needing rescue to other organisations, effectively pushing the burden of euthanasia on to others. Likewise, and this is our own insight, if you decide to let a cat become stray because you can no longer care for it, you may eventually be pushing the burden of euthanasia to animal control by AVA and pest control companies. Euthanasia for lack of space can only be minimised but not eradicated. When we eventually become a full-fledged cattery at Love Kuching, we aim to be 'no-kill' unless the vet makes the call to euthanise a rescue due to severe injury. And we believe still very much in euthanasia when a rescue has an illness that cannot be treated and is in obvious pain and suffering. Depending on resources available, euthanising these rescues may very well be a better way to channel resources to rescues that can be saved and eventually re-homed. This will apply for sick cats we care for like Helga. When funds no longer come in for her treatment, her special diet, or when she exhibits suffering and pain, we will definitely be putting her to sleep. We would also have sent Manja to the vet for euthanasia but her deterioration and death was firstly too quick for us to evaluate the decision as to when to euthanise her, and secondly it occurred in the middle of the night and therefore it was not possible for us to get a vet at the time to put her to sleep.

The last topic that was deeply covered in the documentary is the overall issue of animal welfare. A seasoned veteran veterinarian said to the filmmaker, that, "Animal welfare will only improve when the welfare of humans is on the uprise." This much we agree with. In countries where there is economic stability, of course there are resources to advocate for animal welfare. In the UK, the pet shops do not sell cats and dogs at all, only grooming services and pet supplies. It was impossible to find one selling live pets, save for small animals. The concept of adoption is so prevalent it has become ingrained in pet owners potential and current. Considering that in Singapore we are in peacetime and not in an economic slump mirroring that of war - the example of the Japanese war during WW2 was used in the film - we ought to be much more change-making in the realm of animal welfare. Promoting adoption, fighting the ban of sale of cats and dogs in pet shops which are bred from farms in extremely inhumane conditions. We are still fighting for that paradigm shift in Singapore and we will not relent till the paradigm is ingrained in the hearts of Singaporean society.

What we glean from this is that the only long-term solution to the problem is in education. You, the public, needs to stop contributing to overcrowding shelters. Shelters will always have the overcrowding issue, because in economics, resources will always be scarce. The 3 things you need to change in, and in fact inspire others around you to do the same:

1. Never buy a pet cat or dog or kitten or puppy from a pet shop. 
2. Always neuter your pet and not even allow it to have one litter or to impregnate others.
3. A pet is a lifetime companion - there is no excuse for pet abandonment.

These 3 facets of an important message cannot be propagated by shelters and organisations alone. It has to come from you, telling others and setting the example for those in your circle of influence to follow.


Discussion panel with SPCA, AVA, CWS, HRSS, Zeus (an independent rescue group like us)
(ASD Ricky Yeo was a no show, so there was no response on the dog advocacy front by the only registered charity for dog welfare. Obviously, it only means not much is being done on the dog welfare front.)

Many misconceptions were clarified both during the discussion panel and the networking session afterward. Firstly, AVA and SPCA are not the enemies. Regardless of how many times we at the community level have slammed them, they are not the enemies. Let me proceed to clarifiy some of the misconceptions about these organisations.

AVA started the Animal Welfare department to monitor, audit and check the breeding conditions of licensed pet shops and farms in Singapore for humane standards. However, this department is new. It only has 3 people. These 3 people cannot possibly be as stringent as say, MAS in auditing banks for their compliance to the law simply because there are only 3 of them.

AVA does not ban home breeders. This means that if you are a breed fancier, and you know jolly well not to buy a pedigree cat or dog from a pet shop or farm, you have to rely on home breeders. AVA does not regulate home breeders unless there is a cruelty issue apparent, with evidence to back up in order for them to raid and prosecute the abusive breeder.

If you are a breed fancier and not an animal lover, please do your own audit of the breeder you are purchasing a (usually at the time unborn) pedigree kitten or dog from. Ask for medical records of the parents. Ask how many litters are produced each year. Ask for sonograms of the pregnancy. Inspect the home of the breeder to make sure it is comfortable for the mother and father and subsequent leader. If you do not do this before you decide to purchase from a breeder, you are basically leaving the entire backyard breeding industry to police itself which means you are an enabler of animal cruelty. AVA cannot regulate the pedigree home breeders as 'other countries do not do the same either'. Hence, if you want some sort of regulation body to certify your pedigree breeder you have to turn to Singapore Kennel Club or Feline Fanciers Society of Singapore to accredit home pedigree breeders.

As for penalising animal cruelty and mistreatment cases, there are many cases of abuse, neglect and abandonment reported, but often a lack of witnesses and material evidence sufficient to render the accused guilty. This can only mean one thing. You the public have to be the witness, to be the evidence gatherer, the vigilante investigator of suspected animal cruelty around you. AVA or the police cannot prosecute without witnesses to testify or material evidence to prove guilt.

SPCA does more than rescue dogs, cats and small animals like hamsters and rabbits. They also investigate cruelty to other species of animals such as birds and rats. When stray cats are brought to them with a treatable illness that is not contagious they will treat the animal, neuter it and return it to its territory. A lot the the work that SPCA does in preventing animal cruelty is subtle and they are only endeavouring harder every year on year to raise the bar on its mission to Prevent Cruelty to Animals.

SPCA does shelter kittens require bottle feeding that are 3-4 weeks of age and above (unless they have cat flu' in which case they are euthanised to prevent an epidemic), seconding volunteers and staff to take home the kittens to bottle feed through the nights. Younger kittens of newborn to 2 weeks of age die easily so they will not be bottle fed and rehabilitated and are usually euthanised. So it is not true that SPCA does not at all have the resources to bottle feed kittens that need milk. While limited, they do have volunteers and staff that stay up through the night like we do to feed rescued kittens.

One of the issues that was brought home during the discussion is that the stray cats and dogs problem is a community problem - because we the community live with the strays in our neighbourhood. We can definitely vouch that Cat Welfare Society is promoting this mindset repeatedly, through encouraging independent rescue groups like us, through subsidising independent volunteers who conduct TNRM in their area. Until that night, we thought no one cared for neutering stray dogs much except for Project Just Kindness. But Zeus Communications who was also represented at the discussion panel also advocates sterilisation and return of stray dogs to help with the long term agenda of dog welfare. So while official dog welfare advocacy is missing in Singapore, there are independent groups that pick up the slack in sterilisation of stray dogs.

So, before you call us, the independent rescue groups, or the welfare organisations like SPCA and Cat Welfare, think how much you as part of the community can do first. It is your problem too. Let's solve it together and advocate on all levels for better animal welfare in this country.

Kirin got adopted!

By Siti and family who also live in Ubi. Siti and her hubby have 2 little girls, so we recommended them the more confident kittens who would bond well with children. Kirin was the most comfortable with the little girls, enjoying playing with them lots! Sapporo was a bit shy but eventually warmed up, and Siti is considering adopting Sapporo if Kirin gets lonely in his new home. For now, Kirin already at his new home as we speak! Look at him nose-kissing his new sister in this pic! -

We are so happy that Kirin now has a forever family!

Helga's visit to the vet this month

Helga is an abandoned Persian cat diagnosed with Chronic Renal Failure. She requires a vet visit every two months and will be fostered by us until she passes on. 

She had her kidney function test done (pre-op test) and it turns out it is still on the decline.

Her urea levels went to 99 (up from 77) and creatinine 3.8 (up from 2.9). Unfortunately, CRF can either be a steady decline or it may spike, so it is hard to estimate how long Helga has to live left. An optimistic estimate is a year if she doesn't spike.

Helga is also losing more and more muscle mass due to the CRF, so she was given another steroidal injection today. Her weak hind legs are caused by this muscle loss, causing her to drag her hind legs when she walks.

I also asked Dr Hsu about the growth on Helga's tail. Upon inspection, it is a cosmetic growth and she will not require or actually even survive surgery to remove it. It is not an abscess and can't be lanced, but is a solid growth around which it bleeds and needs daily cleaning with peroxide and Baneocin antiseptic powder daily. It seemed to have grown in size merely because of the scabbing. Helga now has a permanently bald spot on her tail with a horribly bleeding growth.

Her sub-cutaneous injections are now reduced to only 50ml per load, as she has lost weight - 1.8kg now. But because the amount is so small (tried higher load of 75ml, still fluid overload) it will have to be done daily from now on instead of a few times a week.Good thing she is now so used to it.

Topped up her supply of Royal Canin Renal pouch food for her today as well as her Azodyl kidney-specific probiotics. Our Veterinary Fund is now in deficit. If you would like to help share in our veterinary expenses, please see how to donate here.

The good thing is that Helga is not in any pain. Her now-daily sub-cutaneous injections will help her eat more so we are looking forward to more emptied bowls of hers. She is still on a herbal remedy as well.

Manja left us quietly at 3:40a.m. this morning.

She did not want us to see her go. She held on while we were stroking her, massaging her paws, talking to her. She finally let go when we placed her back in her pen on a fresh sheet scented with catnip, and turned off the lights leaving only a vanilla candle burning. When she took her last breath, one of our foster kittens Kirin immediately went to Manja's side. I checked for pulse and breathing. She was gone.

Before she left, her body communicated to us that it was going to break down, so we knew and stayed up with her. I had syringe-fed her some Natural Balance chicken canned food mixed with pet milk and her usual supplements earlier - she had difficulty swallowing even when I slowly dispensed her what turned out to be her last meal. I took her out of her pen to give her a massage using baby oil infused with bergamot and eucalyptus essential oil and placed her in the recovery position. She later started to breathe heavily in a laboured fashion, so we knew it was time. Her paws started to grow cold and her central nervous system was also in distress, causing her to spasm a bit here and there but not violently, she was very graceful in that way.

We will be sending her remains for cremation and Iva her rescuer will be asking Manja's caregiver when she was a street cat if she would like to have Manja's ashes.

Cat personalities! Which one do you prefer?

There are various ways to classify cats' personalities into types. Knowing this will make a difference when you adopt a new cat, and in understanding and communicating with your own cat based on his personality type.

One way to classify a cat's personality type is very useful in cat adoption and adopted by some animal shelters overseas. Cats can be classified as:

• Extraverted, confident and outgoing
• Reserved at first, but affectionate given time
• Independent, does not seek much physical affection

Extraverted cats are playful and adventurous. Imagine a boisterous kitten with boundless energy, connecting with you via play, cuddles and purring. An adopter who seeks this kind of personality trait in a cat is looking for lots of fun. Extraverted kittens are almost like dogs (but without the needs for walks and are litter trained!) who enjoy play time a lot and make for great entertainment.

Initially reserved cats are usually shy upon meeting strangers but can be affectionate once they get to know you. This kind of cat is very loving, probably purrs as much as the extraverted cat or even more, but they need time, and should be allowed to come to you instead of you to them. The appeal is in winning them over to you! Adopting a cat like this makes for good quiet companionship like lying beside you while you watch TV.

Independent cats that want to be left alone are the epitome of the typical cat personality - a bit anti-social, acts like a Master, while you are the Slave that feeds, waters and cleans its litter box. And gives the occasional head-scratch. A human attracted to such a cat is understanding of cats' eccentricities very well, and prefers such a cat to accompany a work-hectic lifestyle and preference for peace and quiet upon coming home. These cats are usually adults or senior cats, or at the very least older kittens. So if you are a workaholic who likes to chill out alone when you get home, an older cat is very much a more compatible companion for you than a young kitten.

If you know what you prefer, finding out about the cat's personality type as above will be useful when you adopt a rescued cat from a shelter or foster home (like ours!). It may be however a bit difficult to know when you adopt from a large shelter that hasn't interacted with the cats enough to know which kind of personality type they are: if this is important to you, adopt from an independent rescuer or rescue group that really knows the cats well.

So you bring your kitty home. Another classification of cat personalities is according to Dr Andrew Edney's book ASPCA Complete Cat Care Manual (a must have for cat owners, this book is really good). The personalities listed are more like 'problems' that can be solved with the right socialisation and training.

• Intraverted cats: Timid cats
• Intraverted cats: Dependent cats
• Extraverted cats: Aggressive cats
• Extraverted cats: Straying cats

Intraverted timid cats are easily scared of humans, loud noises and such. Socialisation is key for this kind of cat, and a lot of patience. They will need to come to you and not you to them, and need safe 'corners' for themselves. Only expose them to strangers when they are more socialised.

Intraverted dependent cats are attention-seeking, often wanting affection and attention, and like to 'talk' to you. They also easily suffer from loneliness and will do well with another kitty companion.

Extraverted aggressive cats are those that play rough even with humans. They need to be trained to play only with their toys and not bite and scratch your hands and feet as if they were live mice. Do not allow your kitten to play with your bare hands as this will only encourage them to do the same when they grow up.

Extraverted straying cats are usually un-neutered cats who are looking to mate. Neuter your cat. And be disciplined in keeping him indoors. He will probably meow a lot to be let out but this is unsafe for him and you will need to take some time to let him adjust to being a fully indoor cat.

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.