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.

Tags: acc, chf, jax, renal failure, tests
Current Mood: crappy

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!

Tags: acc, crf, max, sub-q fluids
Current Mood: relieved

Max is still at the hospital, where he had a transfusion yesterday, and is still on fluids/antibiotics as I write this. He's up, alert, using the litterbox without discomfort, wandering around, and starting today he also regained his appetite.

His levels are coming down, but it's fairly slow progress. Unfortunately, having his metabolic system "deranged" (as one vet put it) caused him to have one brief seizure at mid-day. The internist said that this is actually a common issue for cats with chronic renal failure (crf) to experience, and that they don't usually see full improvement of the creat/BUN until 3-5 days of fluids treatment. So we're on track, just behind schedule, and while he said some people choose to euthanize, he did say he felt it was "certainly appropriate" to continue treatment.

I feel terrible about this, because I had seen the signs of illness, but failed to recognize them or react. In retrospect, something was obviously very wrong... I know enough to have seen that, especially since I cared for his mother through the same illness. I can guess that I was too overloaded from caring for everyone else at once, but that doesn't make it any better.

My mother is hunting down all of the financial aid orgs we didn't have success with two months ago. (Hospital care is expensive on its own, but it's doubly problematic considering Bastian just had a pricey recheck-with-tests last week!) Meanwhile, I'm trying to find out from old chats whether Max was one of the cats that ate the food I had originally bought for Whoosey after her operation, since some of it was on the major recall list. Hard to say whether that would be a factor if he did, since it would be once rather than over a long period of time, but it would be good to know.

Since all of this isn't enough, we suddenly have an unexplained upper-respiratory illness going round the clowder. Most are handling it well, as usual, but Whoosey has an ear infection that I'm needing to treat with drops & lysine, while Bastian just needs a ton of extra lysine to make sure his doesn't cause heart-lung issues.

It's now time to get ready and go see him again...

Tags: acc, crf, max
Current Mood: exhausted

I started writing last night, but was so tired that the results were just dull and near-unreadable.

We got to take Whoosey home on Friday night, with various caveats because she wasn't recovering properly. But the amazing good news was that just like the fluid tested back in December, the official large biopsy tests came back benign -- and while the tumor will grow, it could take years to really cause problems! :-)

She came home primarily because she was too stressed to eat, just like Bastian always does there... At first, she seemed to not remember how to eat -- she sniffed the food and even licked her lips, but then stopped. I "taught" her by putting a little juice from the canned food on her lips, then letting her lick it off my fingers, then having some of the actual food there for her to lick off, etc. She just started eating kibble and drinking freely, which was a huge "woohoo!!!" because if she hadn't by Tuesday, they were going to install a feeding tube.

So, until Saturday evening, things went quite well... That was when some slightly fast breathing I had noticed at the hospital suddenly got a lot worse, and she became very passive. I recognized it more definitively as being the kind of thing Bastian does when his lungs are filling with fluid.

We rushed her back up to the hospital, where an x-ray told us that she had pleural effusion. They tapped 90ml (!) out and sent the fluid off to the labs to find out what it's coming from. There wasn't anything that night vet (not a favorite) could come up with to change, so we were just sent back here with the usual "return if she gets worse."

Since getting back, she has finally been breathing almost like a normal cat, purring, eating/drinking on her own... Generally showing us the results we've been hoping for. :-) The official recheck with Dr. A is on Tuesday, let's hope that we don't have to return to ACC before then. (We were very lucky that ACC held off on charging us the final chunk of payment until Tuesday, so we can get the various grants/aid in order and find more.)

Tags: acc, benign tumor, diagnosistics, good news, whoosey iiii
Current Mood: surprised
Current Music: New Hitchhiker's Guide Radio (via "Awayteam" channel on Shoutcast)

I've been off in mental lala land filling out grant/aid forms, possibly getting a "yes" or two now... We got to meet Whoosey's surgeon, Dr. A today (Tuesday) to discuss her case and set up the surgical appointment. The cardiologist Dr. M tapped her to get the situation maximized for going under a general anesthetic -- hit a new record with 52ml. The physical relief was so intense that she spent the afternoon/evening being super-affectionate as if drunk on catnip.

Things are a little more complicated than I had really realized. Her pericardium and diaphragm never quite got around to separating, so instead of a tiny pericardium surrounding the heart, she has a pericardium that takes up most of her chest cavity and had a couple of abnormal-looking liver lobes develop inside of it. So the resulting job is going to be to remove the pericardium, remove the bad bits of liver, re-inflate the lungs, place a tube to drain fluid from the chest cavity, then fix the diaphragm.

Her prognosis depends entirely on what they find... Good if all goes according to plan, ranging down to "fair" if there are complications. This is assuming they don't find something truly horrifying, of course.

The operation will take 2-3 hours, starting with anesthesia at around 1pm. We're to arrive at 10am to check her in, though... So we'll check in, do whatever they want us to do up there, rush home briefly around noon to give Bastian his meds, then rush back up to the hospital to wait.

If everything goes smoothly, we'll be able to visit her briefly post-op once they have safely brought her back to a heavily sedated consciousness. Hope. Hope. Hope. I want many years cuddling with the little kitty with bunny/chinchilla fur, being kneaded, loved on...

Tags: acc, cardiology, surgery, whoosey iii
Current Mood: scared