My baby had surgery yesterday- support requested.

Bless her little cat soul... a fighter. I have been following this mystery and hoping that she pulls through. Just keep us informed. Lots of healing vibes....

auchick said:

 
I'm happy to report Mia and I are back at home. I am a nurse, so I know what death looks like and I was convinced death was coming for her. She was sooo lethargic with a glazed look in her eyes, not eating, not moving and soo weak. But when I put her in the cage to go, she started crying! And she cried some more! I've never been so happy to hear her cry, I knew then she is still fighting. 

So by the time the vet saw her, she was more alert. She still wouldn't take the babyfood the vet offered her, so she got 200 ml of subQ fluids. Her weight was down again- her baseline is 9.3 lbs, she went down to 8.8 lbs on Monday at the first visit and back up to 9.3 lbs by the time I took her home Tues. Today she was down to 8.9 lbs, up to 9.1 lbs after the fluids. He also prescribed her Reglan for her nausea. He was hesistant to draw bloodwork but I really pushed for it, so that was done (chem 11 and CBC) and the results will be back tomorrow morning. He is still calling this a gastritis/pancreatitis/IBD crisis and said once she's back to herself, we can work on diet modification. He didn't feel it was renal failure based on her history, but we'll see what the bloodwork tomorrow shows. 

Thanks everybody for your prayers! She really seemed to like the subQ fluids, she was walking around a lot once we got home and her eyes weren't as glazed over. She has now settled back in to rest. 

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Poor Mia!      It really must be challenging for her to have a tummy issue now on top of a large incision that has to heal. There are a few active threads right now with cats going through pancreatitis/IBD:

http://www.thecatsite.com/t/266475/help-beloved-cat-just-diagnosed-with-pancreatitis-kidney-failure

http://www.thecatsite.com/t/264363/...suspected-pancreatitis-again/210#post_3429526 (LONG thread)

Did the vet talk to you about complications that can arise from Mia not eating? Cats can go into fatty liver disease (hepatic lipidosis) wtihin 48 hours of not eating, and can be another whole problem in of itself. As I looked through the posts, it seems it has already been over 2 days. It's important to manage her symptoms and help her to feel good again so that she'll eat soon. Otherwise, you will have to start assist-feeding her soon. Talk to your vet about pain management, anti-nausea (Cerenia), acid reduction (Pepcid), etc. I would imagine she's in a great deal of pain, between the incision/surgery and the GI issues, so pain management is important. She may need another Fentanyl patch.

I do pray your little Mia will feel better. Bless you for trying so hard to help her. If love can make her well, she should be on her way. 

Million hugs and love coming your way

auchick said:

 
mia has taken a turn for the worst. im afraid this is the end for her. we're off to the vet

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I'm hoping I'm not causing too much stress here but I'm angry and concerned.When I read the post where you thought she was going to die, my first thought was the vet killed your cat. Here is my understanding of what has transpired:

Mia was sick at her stomach, Her vomit was an unusual color or texture. She had stopped eating. You took her to the vet which was the right thing to do. The vet does an exam, then does ultrasound and X-Ray suspecting a bowel obstruction, finds nothing, but isn't able to rule it out. Doesn't run labs because he is so convinced that she has a bowel obstruction that he doesn't consider any other possibilities worth investigation. Instead he performs surgery, looking for a bowel obstruction that doesn't exist. Still doesn't run labs. You come back days later with her near death and still have to spur him to get the blood-work done.

Now I'm not a veterinarian, but I have extensive experience with cats. I have 6 cats now and have had as many as 8 (I don't recommend this). In the 30 years that I've been married we have always had cats, I had 2 and she had 2, so we started with 4. Was down to 1 for about 6mo., once. I'm 57 years old and my parents always had cats. The only time I didn't have cats was my first 4 years in the Air Force.

Now here is my problem with your vet. Between my parents and I we've had 6 cats who got sick and lost their appetite. We've had what must have been an early version of feline leukemia, back in the 60s, 3 cases of kidney disease, 1 diabetic, 1 with an inflamed gall bladder, and 1 with a massive infection. In all my years I've never had a cat with an intestinal blockage. Too the best of my knowledge, I've never known anyone whose cat had an intestinal blockage. I find it highly unlikely that my experience is unusual. In these cases my vet has always done the blood-work first. If the cat is urgent he runs it in house. In the 4 loss of appetite cases he treated, lab work has identified the problem in 3 of the cases, the 4^th was identified on X-Ray. So whats up with your veterinarian, he thinks he can solve these mysteries bases on an exam, without any collaborating evidence. If he can't run rudimentary in house labs, why not? Mine can and it isn't because of price gouging. An office visit is $19 and ALL follow-ups are free. Because I had a rough couple of months, 4 cats with major bills(over $300) he has given free of charge 1 neuter, 1 tumor removal(not the cat that died) and 1 cyst removal. I wonder how that compares to your experience. Everything I've read here indicates, you need a new vet. Don't look for one as inexpensive as mine, they're rare.

In case you think I chose mine because of his rates, I found him by recommendation of an impressively qualified dog handler. (I'm lucky)

I am so sorry this is all happening to you and I hope things get better fast and your baby gets a real diagnoses so you can get started on treatment.

I agree with the above poster about the vet maybe being not great. I had an experience last year with a dog/cat vet that I had used for my dogs with no problems that set into motion the rapid decline in Casey my parents cat after doing surgery on a tumor. I was so angry that I had even recommended him after that and took her to another vet which is a cat only vet that luckily is awesome.

Is there any other vets that might just take a look at the papers that your current vet has on the surgery and all of the tests that were done along with your babies history, like a second opinion? If they strongly disagree with the current diagnoses and are leaning towards something else that they might have experience with then maybe they can start from where you are now. I'm just throwing it out there since I know a vet can sometimes cause more problems than they are trying to fix if they haven't dealt with the particular issue before.

Please keep us updated, again I hope things turn for the better.

We were waiting on bloodwork, right?

jcornman said:

 
I'm hoping I'm not causing too much stress here but I'm angry and concerned.When I read the post where you thought she was going to die, my first thought was the vet killed your cat. Here is my understanding of what has transpired:

Mia was sick at her stomach, Her vomit was an unusual color or texture. She had stopped eating. You took her to the vet which was the right thing to do. The vet does an exam, then does ultrasound and X-Ray suspecting a bowel obstruction, finds nothing, but isn't able to rule it out. Doesn't run labs because he is so convinced that she has a bowel obstruction that he doesn't consider any other possibilities worth investigation. Instead he performs surgery, looking for a bowel obstruction that doesn't exist. Still doesn't run labs. You come back days later with her near death and still have to spur him to get the blood-work done.

Now I'm not a veterinarian, but I have extensive experience with cats. I have 6 cats now and have had as many as 8 (I don't recommend this). In the 30 years that I've been married we have always had cats, I had 2 and she had 2, so we started with 4. Was down to 1 for about 6mo., once. I'm 57 years old and my parents always had cats. The only time I didn't have cats was my first 4 years in the Air Force.

Now here is my problem with your vet. Between my parents and I we've had 6 cats who got sick and lost their appetite. We've had what must have been an early version of feline leukemia, back in the 60s, 3 cases of kidney disease, 1 diabetic, 1 with an inflamed gall bladder, and 1 with a massive infection. In all my years I've never had a cat with an intestinal blockage. Too the best of my knowledge, I've never known anyone whose cat had an intestinal blockage. I find it highly unlikely that my experience is unusual. In these cases my vet has always done the blood-work first. If the cat is urgent he runs it in house. In the 4 loss of appetite cases he treated, lab work has identified the problem in 3 of the cases, the 4^th was identified on X-Ray. So whats up with your veterinarian, he thinks he can solve these mysteries bases on an exam, without any collaborating evidence. If he can't run rudimentary in house labs, why not? Mine can and it isn't because of price gouging. An office visit is $19 and ALL follow-ups are free. Because I had a rough couple of months, 4 cats with major bills(over $300) he has given free of charge 1 neuter, 1 tumor removal(not the cat that died) and 1 cyst removal. I wonder how that compares to your experience. Everything I've read here indicates, you need a new vet. Don't look for one as inexpensive as mine, they're rare.

In case you think I chose mine because of his rates, I found him by recommendation of an impressively qualified dog handler. (I'm lucky)

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Thank you for your kind words. You do not cause any stress,  you confirmed what I was already thinking and feeling (not sure if it was evident in the original post but I felt incredibly guilty about the surgery debacle). 

I mentioned earlier my husband I moved to the area in the past year or so. I actually took them to this vet practice one month ago for a routine exam. They are very conviently located to me, belong to the AAHA, had good online reviews and always seemed busy when we would drive by so I thought I'd give them a try. We saw another vet who declared them perfectly healthy. I thought it was strange she didn't want any bloodwork (they are age 6.5) but didn't really think further about it. After the visit sunk in, I decided I didn't really care for that vet, but figured I'd have time to look around since the vet had just declared them so healthy. I asked around for recs at work and all the other places are over an hour away one way, which just isn't feasible with my work schedule. When Mia got so sick on Monday, I struggled with where to go, and decided to go with the same practice...at least I was already kind of familiar with it. When I called for the appt, I was booked with head guy. He's been a vet longer than I've been alive and has multiple impressive educational and professional achievements. Perfect, I thought.. By the time we were seen, I was totally sleep deprived, overwhelmed and couldn't really think straight. Like I said, he was so sure of the diagnosis, and given my state, I trusted him (and his resume) to fix my baby girl. After the surgery and they found nothing, everybody seemed happy she didn't have the BO afterall. They even asked if I was happy it wasn't that, and I said no- because now we don't know what her problem is. I knew the pancreatitis diagnosis was likely BS and today at the followup, it wasn't mentioned at all, strangely. I discussed with my husband that we need to find a new vet for them once she is better, but with her in the middle of such a crisis I felt it'd be better to stick with someone familiar with the case instead of throwing the mess in someone else's lap. It hasn't been cheap- $1250 so far, which appears to include multiple discounts per the bill statement but this is my baby girl. Anything to get her better. 

She continues to feel better tonight. She did vomit this afternoon when I offered food an hour or so after the first dose of Reglan. Since she was walking around more at the time and had generally perked up, I figured it just needed more doses/time to work. Tonight after her dose, she still didn't eat. I forcefed her some, which was a total mess as I have no syringes, but she kept it down and the drooling was much less than it has been.. I then passed out on my bed and woke up to a noise a few hours later...She had jumped on the bed! She's still here now sleeping next to me which is great news. She's always been my cuddler. I'm letting her sleep but will try to offer some food again later. 

Thanks again everybody for the thoughts and prayers.

Dan32 said:

 
We were waiting on bloodwork, right?

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Yes, the vet is going to call with the results in the morning.

Good news! I just got off the phone and the vet said Mia's bloodwork is "completely normal". So that rules out renal disease and liver disease... And possibly lymphoma too? Does that show up on a CBC? 

She is still not eating. I got excited she finally had a BM last night, albeit tiny, I'm glad things are starting to get moving. I did forcefeed her some again earlier and noticed after a few times, she was trembling/shivering. It was an hour after the Reglan and Pepcid so not sure if it's a side effect or if she is cold from a drafty night here plus missing half her fur. She stopped after I relocated her and put her under a blanket, so I'm leaning toward the latter. The vet said it could be a side effect of the Reglan and I can stop her doses for the day but I think I'll continue with it unless it happens again. 

I'm to call the vet again tomorrow. If she's still not eating, she may need to go in for fluids again...depending on her state. He said the next step would be steroids but wants to hold out a few more days and since her liver enzymes are ok, we still have some time to get her eating. 

I'm rather nervous as I have to go back to work over the weekend. It'll be my first shift back since she got ill. My husband will be here but he's clueless and not as invested as I am. I hope she continues to improve so I don't have to miss work again, especially since I have a large bill awaiting me. 

I have attached a photo of Mia for those curious. This was taken a few months ago... I think it really captures her personality well. 
 

She is a cutie.  I am glad that her blood work came back fine.  Blood work doesn't find small cell lymphoma but don't get ahead of yourself.  Many people here, myself included, have a cat with this digestive stuff and no definitive diagnoses.  Hopefully this is a one time thing.  If not it will be a matter of finding what will control it hopefully with just diet.

auchick said:

 

20130725_083723.jpg

• auchick
• Oct 25, 2013

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What a beauty!!! I was glad to see your update and that she is still with you! Excellent news on that blood work! Really good news. Unfortunately, blood work is not the tell-all that we would hope for but a good baseline to start with. Pancreatitis is an extremely painful condition for people and pets alike. I am sorry that she is still not doing well yet but hope the medications will begin to work so she will get her appetite back. Continuing vibes for Mia.

Continued vibes for Mia! 

I really hope she turns the corner soon.  

She's a pretty cat,love that soft gray color, looks soft to the touch.  I'm glad she's starting to improve.  Never thought poop could be so exciting, huh? 

So they may give her steroids, are they just taking another stab at it or are they treating for something specific?  I've got a cat taking methylprednisolone, for a respiratory allergy.  I keep hearing about problems with steroids, but she isn't suffering from any long-term affects.  Had another cat on prednisone for years and it didn't do him any harm.  With only two cases I'm not sure if my experience is typical.  If there are people who have different experiences, I hope they write, because if there is a problem, it would help both of us know what to look for   I wouldn't be afraid to try it and it cleared up an inflamed gall bladder in a day.  If memory serves me right, it is a good appetite stimulant, so in your case that would be a plus.  

Sounds like they still don't know what they're up against, but you've got to keep her alive to cure her.    Did they do urinalysis?  I think that's how Doc diagnosed my diabetic cat.  I don't have any experience with pancreatitis but keep hearing about it.  I also keep hearing about a condition called "Feline Infectious Peritonitis" (FIP). Seems to me that there is a specific test for pancreatitis,I don't know about FIP.  I remember discussion of IBD earlier in this thread, and steroids would probably help.  Do they say this is what  they are treating for? So many questions, so few answers.  Just racking my brain for anything that fits, hope it isn't doing more harm than good.

Hope you find answers, it's so much easier to deal with, both emotionally and therapeutically, when you know what your fighting.

She's beautiful! Bright, curious green eyes and long, lean legs. Here's hoping she's feeling better. I don't know your pain but can imagine it. I'd be beside myself if anything were to happen to my Simba or Nala.

Has your vet mentioned Nutri-Cal since she isn't eating much? I've used this for a cat that got sick and refused to eat, she got even sicker from starving herself. The Nutri-Cal made a big improvement and we got some much needed calories and other essentials into her. I'd ask for it or something you can give your kitty since you are having to force feed already.

You can probably get it and a syringe from your vet, it can be found without a script but the vet will be more likely to carry it than some pet stores will. It's not expensive online but I'd try and find it locally so you can start using it quickly. There are other similar products but this is the only one I've had experience with.

Mia is has made some small improvements since the last update. Last night, I was excited to see her actually lick the food (though she didn't "eat" any) and this morning she did actually eat a small amount of the babyfood on her own, though most of her meal was still fed by me. She is getting about a spoonful several times a day now, plus anything she may happen to consume while I'm asleep/at work. And no vomiting! Her personality is starting to come back to the Mia I know and love. I'm so happy to see this.

However, I do feel she is still in some pain. She's been in a hunched over position more often the past couple of days. Then she did the shaking thing I thought was a side effect of the Reglan but she was still doing it 24 hours after her last dose, so I'm now thinking that is also pain. I mentioned this to the vet yesterday but he said no, not pain. Additionally, I noticed she licked her wound raw in some areas overnight. Well luckily (ha!) my vet is out today so I was able to deal with a third vet at this practice. I appreciated that he listened to my concerns. He prescribed some Tramadol for her to see if it helps. He mentioned coming in for fluids again since that helped her on Wed. but I don't think she needs them today. Like I said, she is much more herself, minus this hurdle, which is a different hurdle than we had on Wednesday. 

We still don't have an official diagnosis but from what I can tell, gastritis/pancreatitis/IBD are treated much the same way. I am ok with not knowing exactly what the problem is as long as she is responding to the treatments offered, which she is sloooowly starting to do. I also hope the Tramadol works for her and suspect she'll eat better if she's not in pain. 

Great to hear that Mia is improving. 

I can understand the hunched over posture being pain related but the shaking doesn't sound like pain to me.  Cats are notorious for hiding pain and will even purr when hurting.

I remember you writing that your an hour away from any other vets.  Sounds like your more comfortable with this new vet, so maybe you can set up appointments with him only.  I was in a small town, pop 3000, and ended up working with the Junior Dr. because the owner of the clinic was just too egotistical. 

Is Mia drinking water?   I've got two cats who get subcutaneous fluids and if she isn't drinking then this may be necessary.  You've already seen how much it picks them up.  Cats get dehydrated so easily because they are not natural water drinkers. When you go in for fluids again, you may want to talk to the vet about taking ringers and an I.V. set or large syringe home with you.  All the cats (5) I've ever given subq to were very easy, probably easier than people.  With your experience it should be a breeze.  One hint, warm up the ringers in hot water first.  Cats have such a high normal temperature and crave warmth.

I hope this is of some use, and that Mia gets well soon.

I think the vets see fluids as a substitute for food when they're not eating well.  You mentioned that you were a nurse - maybe you could get the Ringer's solution IV drip setup from your vet and give her some small doses at home for a fraction of the cost?  It does often perk them up remarkably.

Keep getting food into her.  You said before you didn't have syringes.  I have used common syringes found in the baby section of the chain drug stores - Gerber's baby food or Science Diet A/D are very good in a syringe (I know it is messy).  But it is going on a week since her surgery, so it has been a while.  If she weighs 9 pounds, she should be getting about 4 oz. per day (2-2.5% of her body weight) of food into her to keep her weight up.  That is about 2 jars of baby food per day, which I know seems impossible when they aren't in the mood.

So, she is basically only getting Pepcid, Reglan (anti-emetic) and Tramadol (pain med) currently?  No talk of prednisone - that is often given when the vet's throw their hands up in cases of pancreatitis - it is an anti-inflammatory and also appetite stimulant.  If not prednisone, I have had good results with using the appetite stimulant Cyproheptadine made up into a topical cream that you rub on their ear (nothing to throw up) to get the appetite going again.  Some of the other pancreatitis cats on this board are getting Cerenia instead of Reglan - I am not sure if they are directly comparable medications.  Also metronidazole, but I don't think you mentioned any diarrhea.

On the subject of visible deformities of the small intestine - what IBD and lymphoma seem to cause is a "thickening" of the intestinal walls.  If it is very visible on an ultrasound - I would think it would also be identifiable to the doctor when she was open.  So if the doctor did not find such a thing, then she has not progressed to that stage of GI problems.  My understanding was that the "thickening" was something like scar tissue where a chronic problem has gone on for quite a while.

I'm happy to report Mia continues to be more and more like herself. Her first dose of Tramadol (1/4 tablet) ended up being a bit much (dilated pupils- obviously stoned) so I didn't give her another dose on Saturday. But she acted like she felt so much better in the meantime. No more hunched over position, no more shaking. It's been hard for me to assess how much she's been eating this weekend since I've been either sleeping or at work except for just a few hours of the day. But she was acting like she felt better and still using the litter box, so I assumed she was probably eating/drinking while I was away. 

When I came home from work Sunday morning, I put out some of the baby food again...and she ate the most yet! I noticed she was doing the hunched position after eating but no shaking so I managed to give a sliver of the Tramadol dose...perfect. She looks so comfortable and has been acting so much like herself without it being too much. When I woke up Sunday night, she was sleeping on the bed with me and when she saw I was getting up, she got up too and ran to the food bowl and started eating the dried food that was out with gusto (this is our usual routine!). I was soooo happy to see her eating!!! I noticed more hunched position again after dinner so I gave her another sliver. I just can't tell you how much she's been acting like herself. She's coming when I call her, coming to me on the sofa for some cuddles, and even pawed around with a toy a couple times. 

Thanks everybody again for helping me nurse Mia back to health!!