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moggy_woobies
We ended up going to ACC after all, since the other place's vet evidently had a crappy attitude about giving us directions to their emergency center (I didn't talk to her), and dealing with someone combative that also doesn't realize I have any knowledge about vet care didn't appeal to me.

So last night, they gave him a shot of Pepcid AC (famotidine, not unusual) and ran a blood panel, then had us give him 100ml sub-q fluids at home. He has no interest in food, water, or the litterbox.

This morning, they called and informed us that his creatinine & BUN -- kidney values (where lower is better) -- are quite high. Three possibilities:
1) Acute renal failure, in which case we're screwed because the treatment is hospitalization with IV fluids, both not an option for financial reasons and because it'd cause his congestive heart failure to crash

2) Chronic renal failure, which would mean going into the "dance" (as some call it) of managing both diuretics for his heart and fluid for his kidneys. Yes, somehow a lot of people do succeed at this. Also, there's the question of whether he has primary kidney disease so his kidneys were screwed-up on their own, or if it's acquired from the Lasix usage overworking them to get rid of the fluid in his abdomen, or both.

The problem is that we can't tell offhand which of the two above categories he's in, because we also can't afford ultrasound to inspect them; all the vet could feel is that they're lumpy. (Usually failing kidneys are also tiny.) Things aren't looking good, though.

Oddly enough, I also just got bloodwork results recently warning that my own creat/BUN is abnormally high, and the doctor wants to see me ASAP since we know one of them went into failure once already. The situation with Jax, which has now mangled the ability to pay for Bastian's pricey anti-clot med, brought to mind the nasty situation with my father last Spring, and the "face reality that they 'just die'" aspect in particular. So when my mother reminded me to call for that appointment, I calmly refused: I'll get an appointment as soon as I can afford Bastian's medicine, and you two can think about 'facing reality' that people like me 'just die' without expensive medical care, too."

Still no eating, drinking, or litterbox, dammit. We're moving him back in here (he spent the night with my mother since he's kind of fed up with me) in case he likes my facilities more. I feel like I should make a sign labeled "Infirmary" and stick it above the staircase leading up to our rooms at this point. :-/

I'm waiting for a phone call from the emergency vet on duty to tell me how much (if any) Lasix Jax should get, but for now I need to get his Enalapril and Bastian's regular meds ready.

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Oh dammit, I don't need this. Jax has been sick for 24+ hours now -- vomiting, increasing lethargy, zero appetite, etc. -- and it's past what I can figure out how to handle, so we have to head up to an emergency vet. I was going to wait until tomorrow, but the guy's symptoms are getting too disturbing; I'm worried he might even be throwing little clots or something.

We'll be going to a place called "Emergency Animal Hospital of Santa Rosa" this trip... I no longer trust the staff at our old standby ACC, aside from Bastian's cardiologist (who is still away) and Max's internal medicine vet. I'm not up to writing about why yet, aside from saying it has to do with what happened in October.

I'm much less calm than I sound here. Poor Jaxie is looking/acting like Bastian was during that horrid month before he went onto CHF meds.

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The universe is laughing at me.  At least this time it was something I could laugh at with it...

Since heart failure (or problems in general) cause lack of appetite or even nausea in cats, Jax has been refusing to eat voluntarily since Thursday.  That's extremely dangerous, because cats develop a serious condition called "fatty liver syndrome" after not eating for ~5 days, and it's usually fatal.

I've been trying every food on-hand and approach I could think of, "assist" feeding him along with meds in the meantime, and becoming increasingly worried.  Having run out of ideas, I was just about to finally search the web & support groups for anything that might help...

...and he promptly leapt onto the bed, then to the dresser, and started eating the boring kibble that I figured he'd have zero interest in.  He didn't eat a lot, but anything is good, and he knows what his body can handle right now.  [Edit: Several hour later, while editing this, he ate again, this time quite a bit more.]

A couple of cute pictures of him from over the years, as a reminder since I posted them in the distant past....Collapse )

Now off I go -- just did Max's sub-cutaneous fluids (which he likes now), now it's time for Bastian and Jax to get their meds...hopefully to bed at something resembling a reasonable hour this time.

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Yes, I've been up all night doing cat care...those first days are a real bitch.

Friday night through early Saturday morning, I took matters into my own hands and gave Jax more Lasix; one pill per day was really obviously not going to do the job.  (I gave him 1.75 more at the six-hour mark, just as Bastian gets.)  By morning, he already didn't look bloated in the middle, and was breathing much more quietly.  Unfortunately, he also has no appetite and is nauseous, which are both expected for uncontrolled heart trouble; he'll feel better once that's handled, but until then I'm stuck forcing food on him (or trying to figure a way to make him want to eat it).

We went to a new vet for abdominal tap (which is just $8) on Saturday, but he turned out to not need it.  The new vet was absolutely excellent, low-priced, plus he already knows our cardiologist from having other patients also under her care.  He had it arranged so Jax could have a good panel of bloodwork to be sure nothing else was causing problems, and results will be emailed to me on Monday.  The doctor said that sometimes something in flame retardants and similar environmental factors can all cause trouble (like hyperthyroidism) that leads to early-onset organ failure.

My brain is fried, so I'll go to bed now.  Just wanted to let people know the basics of what is going on.

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I really don't have the words, once again, I feel tired and confused, I don't know enough about this yet... I almost started crying on the way home just under the weight of everything happening.  I keep almost doing it now.

Jax is now formally diagnosed as having dialated cardiomyopathy with massive fluid retention in the abdomen and gallop rhythm.  The said "it" is early-stage, so I can only guess "it" is congestive heart failure.  I just (per orders) started him on 2.5mg Enalapril/day and 12.5 Furosemide or less as-needed; he's dozing on my bed.  Normally he'd be over here "kissing" (opening mouth & running lips along mine) and "hugging" (sitting up and putting his forearms around my neck)...

If I could afford it, I'd take him to the "good" emergency place we normally go, make sure that the first vet was on-target... Whenever B was in trouble like this, they held him overnight, so I'm not at all used to actually having this kind of problem on-hand.  It's scary... I don't have the kind of equipment a vet does to monitor or deal with crises, I just have a box full of pills.  

I need to learn about DCM in-depth now, I guess... Make sure that I do everything for him (especially right now) that is really possible, and ensure this vet got things right enough to avoid tragedy.

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Whoosey the Third: Summer 2000 - October 15, 2007

(Her legs had vet wrap on; the photo was from right after her operation in February)


I don't really want to write about it -- there's really no words for how shattered and angry I feel right now. All I can think of is that she should be here, that she wasn't ready and was still so full of life...it all happened in under 12 hours, and I had no choice at the end but to make the decision and hold her as she was put to sleep.

Whoo was one of the absolute sweetest, smartest, softest-furred cats I've ever gotten to spend time with... She taught me the meaning of the term "loving life" with her playful, inquisitive, enthusiastic, affectionate personality; she was seven years old, but still had the cute attitude of a kitten. Almost nothing has gotten me to do more than smile in the last several years, but even on the worst of days, she'd set off a little burst of laughter from sheer loving joy just by being herself.

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I haven't gone to bed yet. I haven't managed to get to bed before 6am in over a week, and before that, I hadn't managed before 4:30am. Which means I then oversleep (despite every alarm I use) and wake up feeling blech. (Or more blech, given my allergies/asthma are going unusually nuts from kitty shedding season.)

Whoosey is sick -- her immune system evidently is messed (like Bastian's) so she's on round II of antibiotics for a nasty inner-ear infection. During all of this, not only has she had little (or no) sense of balance, she started losing weight since she couldn't eat much without becoming nauesous for a whie. She's eating fine now, but is having to pull herself up from being underweight. :-( I'd push to have her held at the vet for more aggressive care, but at several hundred per day (not counting the initial several hundred for testing) right now it's not possible. So I'm quite worried about her, that maybe she has permanent brain damage or won't make it or something.

Max was doing great, and got a great "report" when we took him in for a recheck. However, now he's starting to need more fluids, which is a sign his kidney function is declining. Dammit. Worse, fluids put a strain on his heart, which already has a significant murmur, and thus puts him at risk of developing congestive failure. No, thanks, let's not do that, okay?

Bastian got over his first round of illness, then started developing another...got him back mostly under control, but the dreaded vein in his right eye (signals cardiac stress) was back for a while. (I'm hoping it's not there right now.) Given there's zero funds for hospitalization, him showing any signs of trouble is terrifying.

We were set back about a hundred dollars last month because the vet staff kept failing to send the refill permission in to the online pharmacy, forcing me to buy through them (including their $20 "fee" per prescription pickup) twice plus pay next-day shipping for the online medication.

Speaking of which... I was wondering why the anti-clot medication I ordered (way ahead of time) wasn't here yet, so I went into the online tracking...it was cancelled. As it turns out, this is because the above-mentioned payment to the vet dropped my bank account a few dollars below the cost of the anti-clot medication plus shipping. Which means I was also hit with an "insufficient funds" fee. No, they couldn't notify me, because with the kind of luck only I tend to have, we changed our phone number at around the same time.

If I could scream in frustration, I'd be doing it right now.

I just re-ordered that medication...so his medication is way the hell up in Calgary and we're already in the backup supplies. Great. I haven't figured out just how I'm going to handle this situation, though first I need to start going through all of the old bottles, and hoping desperately I can scrape together enough to last till it gets here. No idea what I'll do if it doesn't; I'm already giving him 5.25 units (instead of the 6 I'm supposed to) in order to make it last without going too far. Guess I'll price in-country Lovenox and hope someone carries it for less than the going rate...

Ugh, time for W's antibiotics, then I really do need to get some sleep. Maybe if I set my cellphone to screech near me at a certain hour it will wake me up, since I should call the pharmacy to make SURE they'll ship it today. The pathetic thing is that this is just the feline aspect of how life is a big fricking mess for me at the moment: other things are matching it. No matter how hard I try to plan everything well in advance, something goes wrong and derails it. (Generally in a way that sets off a wild domino effect, crashing other things in the process.)

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Whoosey and Bastian are both on Clavamox for the nastiest upper respiratory infection I've ever seen... No idea where it came from, but it seems to go from virtually no symptoms straight to ear/nose/eye gunk -- and in Whoosey's case, moved to the inner/middle ear. So I have one little miserable gray cat (who has a history of catastrophic heart problems when sick) sneezing, pawing at his ears/nose, and .and a little tuxedo kitty that looks relatively fine but keeps staggering/falling sideways. :-(

I mentioned to a clerk last week that all of the canned food is used for hiding medications, and she introduced me to chewy kitty treats that you can hide pills in called Pill Pockets. I had assumed in the past that they were just a silly gimmick, but got a baggie anyway just in case. Glad I did...they kick ass!!! Seriously, if you have a cat or dog that needs pills, try these things. If it's a big pill, like some of the ones here are, just cut it up into tiny fragments. :-)

Of course, that's not going smoothly here, either... Whoosey isn't interested in that particular flavor/scent (I'm going to buy and try their "chicken" variety today) -- so I'm still having to force-feed her meds. Bastian originally was wild for the Pill Pockets, but then I experimented with loading a few, and so of course he bit into the pill fragment a couple of times...suffice to say he's willing to nibble a little bit of a pill pocket now, but doesn't want to touch them enough to actually take a pill.

So I'm off to get another flavor of pill pockets, more food, more potassium (we're out), and generally try not to scream at (or smack) everyone in sight, because stress/worry plus being up until after six in the morning giving a sick cat antibiotics that he doesn't want (after a couple of weeks with similarly fucked-up hours due to kitty stuff) = psycho-Moggy. :-p

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I forgot how exhausting the first days home with a cat newly-diagnosed with a medical problem can be. Let alone doing it while also trying to keep the other "special care" cats from getting too jealous, learning about CRF & Anemia (thank the FSM for the two support Yahoogroups)...

The vets were relieved when I said that Max actually did have some of the recalled foods, surprisingly. They said that they could see there was a cause to his renal failure from its particular progression (I guess), so me saying it wasn't the food really had them frustrated and perplexed. If all goes well through the mire of red tape, his vet costs will be reimbursed.

Max was really iffy-at-best through the middle part of the week, despite his kidney values slowly improving. He even ended up needing another transfusion, and then having his fluids reduced because we'd pushed so hard that his heart briefly had trouble keeping it out of his lungs.

But after the second transfusion, he started rallying... By Friday afternoon, he spent a good chunk of his time wandering the room, and Saturday he was energetic enough that he was up and wandering/flirting steadily on his feet the couple of hours we were there! So, since we suspected his kidney values were at the best that the IV fluid therapy could do, he got to come home.

We gave our first sub-cutaneous fluid therapy to him tonight, which I had been dreading. Preparation too a long time as we had to learn all the steps, but the actual procedure was an extremely easy five minutes! I think the big thing is that we used 20-gauge needles on him, which are much smaller than the 16-18 ones we tried on Whoosey back in February. (16 is used for injections in goats and sheep!)

So he's napping on my mother's bed, and I need to get Bastian's meds done so *I* can get some sleep. Though just being able to relax is a huge bonus... Let's hope things stay calm for a while!

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keepingawake just nudged me elsewhere to ask what was going on with Max, so I'm going to write a quick update in between one thing and the next.

He looks and behaves a lot better every day, thankfully. Sunday he urinated and then went back to resting... Wednesday, I put my hand under him and held some of his weight (as he's low on hind end muscle tone) and he was up/around eagerly exploring -- couch, each corner, doctor's stool, counter by stool -- for around 45 minutes, maybe more.

Progress with his bloodwork is really unpredictable, though. Each day until Wednesday, everything improved; then his creatinine stalled at 8.2. Today, we were told that his creat was in the 6.2 range. His red blood cell count had dropped to 10 today (from 20 after transfusing), so he was put on Epogen, and it's now up to 14. He also had switched from eating to not eating, so we're not sure WTF is with that.

The two internists that have followed him so far (they rotate) both decided independently that his renal damage is far too severe, and the decline far too rapid, to have been age-related. So, at their strong urging, we're now gathering receipts to contact the companies we bought from (Iams-Eukanuba, Nutro, Science Diet) in February. Eating the food is the only explanation we have.

I'm now researching CRF more aggressively, since his case is complicated enough that I want to be more involved in treatment decisions. I don't want his longevity or comfort left up to the recommendation of a single vet; been there, done that.

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