Thursday, June 21, 2018
We had a health scare this past week. Last weekend-June 8-I noticed Baby breathing hard. I kept noticing it, then noticed that it wasn't just when she was grooming or active or upset. It happened at rest. The breathing rate was 40s-50s. So, I took her to the vet on Tuesday. Xrays showed a possible enlarged heart-one rib larger than last time. Now, the actual mathematical equation used to calculate size of heart to ribcage is more involved than just counting ribs. But to my experienced but untrained eye, it looked larger from both views. The lungs were clear. They emailed the results and xrays to her cardiologist. The dear woman was away at a conference but her office was concerned and called her to take a look. She texted me for feedback and after discussion-she saw no congestion-but since there were no appointments until the following week to see the cardio, she put Baby on lasix 5mg BID (twice a day.) Baby responded well Thursday and Friday morning but the breathing rate was up again so I put her on 5mg TID (three times a day.) She responded well to that. Her breathing rate fell to about 24-32, and she was perkier, and playful.
At some point, I said "No, not again. And poor Baby. But she is 13 so this could happen at any time as she ages."
Finally, we saw the cardio yesterday. And...nothing.
No enlarged heart-it's just slightly larger because it can happen as a cat ages but that is not due to internal workings and does not affect her health. Plus, she wasn't centered well on the xrays. But the echo was clean, no heart size changes, no SAM, no murmurs, no other obstructions or physical changes, no congestion, no fluid in or around the heart or lungs, and no signs of fluid in the body.
So what gives? We had a good laugh because she said my kitties are always coming up with some odd medical thing she's never seen. It's possible it's allergies or asthma kicking up when it was hot and humid. It's possible she needs her albuterol (for asthma) twice a day now instead of once. It's possible that she responded to the lasix because it can have a bronchial effect that is lost with long term use but was there in the short term. So, she's off lasix. She will receive albuterol BID and I may need to put her on the steroid Flovent. But we'll see.
HUGE sigh of relief and a prayer. And a good laugh. Because really-you must laugh.
A recent increase in heart disease in dogs, specifically dilated cardiomyopathy (DCM), eating certain types of diets may shed light on the role of diet in causing heart disease. It appears that diet may be increasing dogs’ risk for heart disease because owners have fallen victim to the many myths and misconceptions about pet food.
Lately, there has been a huge upswing in dog breeds that are not usually affected by DCM becoming diagnosed with the disease. Turns out most of these affected dogs were eating boutique, grain-free, or exotic ingredient diets.
Linked below is an article from a veterinary nutritionist and a professor at Cummings School of Veterinary Medicine at Tufts University regarding the link between these grain-free diets, taurine deficiency and DCM.
Jimmy's ALT-liver value-decreased this past month while on Denamarin (a supplement for livers) but after also not having had Solequin (behavioral supplement) for the past month. ALT is 169 from 191. He should be no higher than about 130 so we still have a ways to go.
Katharine's phenobarbital blood level is 23 and the therapy range is 15-30 so she seems to be doing well. And she's physically doing well so far. We must give her Mirtazapine because her appetite has suffered. But a 1/4 of Mirt seems to last a few days. Hopefully, the lack of appetite corrects itself. I tried Cerenia and cypro but they did not help her to have an appetite. If you recall, Katharine developed seizures suddenly last month and they thankfully turned out not to be due to a brain tumor, cardio, kidneys, or any other disease or physical ailment.
Saturday, May 26, 2018
Katharine is doing better. When she gets her pill, within 15 minutes, she slows down into a trance like state which lasts about 15 minutes. She's aware but is quiet and usually lays down. Then she slowly comes around to a more normal activity level within two hours. That's how it worked last night and this morning.
And her spinal tap is clear. So, she will have a gastro ultrasound and phenobarbital and we'll go from there. And her breathing rate is finally more normal, around 30 instead of 40-60.
Yesterday, after coming home from the ER, she was very hyper despite her med and needed me to be with her, to pay attention, to pet her, to reassure her, etc. And she was always vocal. When I moved from room to room, she followed and was very vocal. Once she fell asleep, if I moved, it would disturb her and she would start the crying/pet me process all over. She finally fell asleep around 1. Then I did around 2. When I woke up at 3, she followed me to the other room until she finally settled down. She was also more steady on her feet and could jump up and down more easily. I felt reassured enough to leave the house for a couple hours of shopping. She was in the window seat in the bedroom when I left and was not anxious (I could see her from outside.) She was calm when I returned. And she was calm last night.
I kept her isolated upstairs during the day, although she had the full run of the second floor. I let her downstairs in the evening but only to the living room. This morning I let her downstairs. I wiped her down with a wet wipe so that she wouldn't smell like the ER.
That vet smell doesn't bother her sisters but it bothers Jimmy. He growls, hisses, sniffs the trail like a dog and howls if it's too strong. Those smells have always bothered him. He has in the past, acted like this when I brought Myrna home from the vet (and she went so frequently that it became a huge issue that we had to mitigate when we returned home.) We quickly learned to not go too far into the house with our shoes on and to take them off at the door. Nor could we set down the crate. I would release Myrna into the front hall and set down the crate and close the door. Then I would clean the floor with cleanser where I first came in and wipe off my shoes as well. Then I would clean the crate and wipe down Myrna. She would be isolated for a couple of hours or so until she smelled like home. Jimmy would still sniff and hiss but then he would quickly lose the trail of strange scent. If I was successful, Myrna would smell neutral and he wouldn't bother her. If I wasn't, he would sniff and hiss at her and swipe. This morning, he sniffed Katharine and looked puzzled, then sniffed the floor where she had walked and followed her trail. Then he gave up, and walked away. When I first brought her home Thursday after the MRI, he was in the front hall and sniffed and hissed and growled at the crate (Katharine was inside) and then ran off, so totally upset.
Friday, May 25, 2018
I realized when Katharine got sick May 13/14, that once again, my to do list has been interrupted and I realized how much time I've wasted not getting to it. When Myrna was sick, I devoted my time and life to her. I got things done when she was well which happened for what seemed like long stretches. But not that last year, when she needed more of my time. I have my excuses. There have been many things going on that have taken up my time since the holidays. But I have wasted a lot of time. And just when I was about to make time for that list-and not just clean the yard but serious, life goals-Katharine became ill. She has been to a vet seven times since May 13/14. And she will go a few more before we figure this out. I don't think even Myrna had that record. When Katharine is stable and more secure, I will have to make time to get back to that list.
Thursday, May 24, 2018
Katharine's MRI today was clear-no tumors, no bleeding, nothing that indicated any changes in the brain to cause seizures. They did a spinal tap to see if there is any inflammation. If that is clear, then blood work to rule out certain diseases and issues and an echo of her gastro system and anything else will be performed. The vet said to continue gabapentin and to keep an eye out for any seizures. If they occur, to give her more gabapentin. If there are too many close together, then they will put her on phenobarbitol. But she had been clear for a week and we did not expect her to have any more seizures.
I brought her home and 40 minutes later, she had two seizures a few minutes apart. Each lasted for a minute. I filmed both. By the end of the one in the video, I knew she had to be seen by a vet. Then she had one in the car. I took her to an ER, a new one recommended by the oncall staff of the neurologist's office only because it is close to the neurologist's office. In the end, they decided to keep her overnight, give phenobarbitol as a steady, slow dose, give fluids, run some blood work, etc.
While the new ER is 20 minutes away, I should have gone to our ER that we favor that is 40 min. away, especially because Katharine is now staying overnight in an unfamiliar ER. The new one is shabby but at least the people are nice. But the new one kept me waiting for an hour before someone came in to get her history. Then I was alone for another hour before someone came in to say the vet would be in soon to talk to me. Then I was alone for 30 min. before he did. Yes, he was busy. Yes, they had had many other more critical pets before mine. But at our usual ER, they whisk the pets to the back before spending 10 min. checking in the pet. Then 10-15 min. later, someone comes out and gives an update and asks for history. Then 10-15 min. later, the vet comes in to say what they've seen, what they'd like to do, etc. Then 30 min. to an hour later, they let you know what is going on, results of tests, what they recommend, etc. The focus is on the patient. Only at the end do they ask for money.
I will pick her up in the morning and she'll come home unless the neurologist wants to see her again.
Wednesday, May 23, 2018
Katharine saw the neurologist today for an exam. He manipulated her legs, watched her walk, then tested her facial responses by flicking his fingers and using a long Qtip to touch her face. He saw right sided decreased response in face and legs as we noticed when she had her episode May 14. If it's a seizure, he believes it could be a left side brain tumor (as with humans, the left brain controls the right side of the body, etc.) Tomorrow she returns for the actual MRI and if that is clear, then a spinal tap to look for inflammation/infection. She was NPO this a.m. in case they did the MRI but they couldn't today due to two emergency cases. She'll be NPO tonight again as of ten p.m. So, she's just now, at 1:46 EST, eating for the first time today. Tomorrow, she goes in at 9 a.m. and will be there for the MRI all day. The MRI will take about four hours from start to finish. Then she'll go to recovery and then she will be released about 5 p.m. or later depending on when the MRI actually begins.
The cost: $2000 for the MRI and an additional $500 for the spinal tap. She will be under anesthesia for both. If she has a tumor, surgery will be required. No, I didn't ask for the price. I can imagine that it's twice the cost of the MRI. While concerned about the cost, I'm far more concerned about Katharine. At least we know her heart is in good shape and she can withstand the operation. So, we'll know more tomorrow. For today's exam, I wrote up her medical history, medication list, gave copies of the ER/cardio/vet tests related to the May 14 episode, and copies of past blood work just in case it was useful. Writing up a detailed history and current medication list always helps the new vet or vet specialist get a better picture of the cat's history, especially if there have been any illnesses.