Dear Kyle: A vet who isn't on the same page with you is a tough one. There is the option of finding another vet who will be more cooperative but I can understand your not wanting to seem ungrateful for the fact he cared enough to use his own cat as the blood donor for Brissle.
I would definitely prepare the letter PDQ; if he's not a native speaker of English and doesn't have an office assistant to do that for him, he may even appreciate the gesture, but be sure and tell him, very diplomatically, that you did so as you thought he might be very busy and you didn't want to put an undue burden on him but just want to expedite the process, for Brissle's sake. But there is also a limit to how much slack you should give a vet whose treatment protocol just isn't what you think it should be. You did pay for his services for the transfusion, did you not? I isn't like he did it for free, so if you continue to feel uncomfortable, I'd start shopping around for a vet who is not afraid to communicate with you and allow you to be an active participant in Brissle's treatment. Where are you located? Are there other vets available within a reasonable distance? I'd start calling around and make a list of questions to ask that will help you decide if another vet will be more cooperative and perhaps better informed about treating FeLV. If not, it sounds like this vet is at least willing to try to treat Brissle and is not totally close minded about it. If you have some VO already and Brissle's condition starts to deteriorate, you may want to decide on your own whether or not to give it, yourself. Do you know how to give an injection? The needles for that type of med/dose are very small so it is only a small prick for the cat. Nina can tell you how she has done it for her cats. You could tell your vet because of the number of days and timing, you need to learn how to do it yourself and ask him to show you, or, tell him you'd like to learn so you can give her the Vitamin B shots at home, to reduce the stress of having to bring her to the clinic each time. Reducing stress for immunocompromised cats is a valid concern and he should understand that. I can sympathize with your situation. I do rescue and $ is always an issue so I appreciate a vet who will cooperate and help me learn to do as many things, myself, as possible. One of the most reasonable vets, $-wise, in my area is Chinese and sometimes communicating with him is an effort, making sure he understands where I'm coming from and that I understand what he is saying. He is not high tech and he's generally traditional, but his instincts based on his years of experience are good and doesn't believe FeLV+ cats must to be PTS. When I come in with a new idea, he kind of chuckles now. Sometimes it takes time to build up a good rapport with a vet, though in a critical situation with an FeLV+ kitty crashing, time is of the essence. As I understand it, the main reason for the on/off protocol for the interferon-alpha is because of the possibility for a cat to build up antibodies, but I also understand with the lower dosage (1 ml is most typically prescribed), that is unlikely. It is much more of a consideration when higher doses are used. It does not seem logical that you would need to wait to start with the VO, which is feline-specific, so the production of antibodies should not be an issue. Is your vet concerned about some sort of interaction with the Immunoregulin? I don't understand enough about what type of effect interferon is supposed to have...if it is just an immune booster, what part of the immune system it affects and if it also has a balancing effect on immune function. Here's hoping you figure out a way to convince your vet to see things your way, and here's hoping the good effect from that transfusion will keep Brissle feeling better and eating and the VO will benefit her further and she'll keep making enough RBC to hang in there. Sally in San Jose
