Foreign object in cat's airway

Actually Traci the differences between men and women is very much in evidence here. For instance, your post critises me for the lapses of these veternarians.

At the end of your post you mention the crux of the situation. These doctors did not take an x-ray of the throat or esophogus area nor of the lower intestinal area even though told at least a few times about the history of the cat. That fact says it all: These doctors did not make a thorough exam of this animal.

From the beginning and just like you are doing now they fastened on on symptom only and ignored everything else.

Back to the cat: First of all, as I told the receptionist over the phone I did not call the vet on an emergency basis. I simply called in to make an appointment. I told her the cat was sick and described some of the symtoms. She asked me if it was an emergency, I said I did not think so because even though the animal was sickly, he wasn't bleeding or choking or anything like that and had been like that for about four days at that time.

She then told me that if I wanted I could bring the cat right over because they were a little slow just then. I agreed to this. Indeed when I arrived at the clinic there were no cars in parking area and no one in the waiting area.

As to Black Jack: As I said before this cat is a gulper, he gulps his food if it isn't spread out on a big plate. He has swallowed all kinds of stuff before. He once swallowed a ten inch square of platic wrap that exited his anus, I pulled this out myself. He can't be given a big piece of chicken because he will choke himself on it.

On day one he was near me when he started retching as if trying to vomit. I went to get a paper towle to pick up the wad and was suprised when nothing at all came up. Before a yellowish liquid would sometimes come up with the hairball.

That was when I noticed that he was some distress. He was wide eyed and his breathing was abdominal, faster than normal and shallow. There was not and is not now a rasping, railing or wheezing nature to his breathing. So I figured he swallowed something again and was now in a level of panic to rid himself of it.

Since this breathing continued I began watching him very closely. He preferred a sitting or a position on his stomach to all others, his temperature was normal, there was no blood, mucus or anything like that. After a while he calmed down and I started looking around thinking to find whatever is was that he swallowed but did not find anything. Over the next day or two he lost his appetite and his vigor. Occasionally he would go through this retching routine again.

by the fourth day I figured that whatever it was that went down was not coming up or down and so called the vet.

Up to this time he had been a healthy cat, very playful with Moe. He was nuetered by this doctor about seven months ago. All of my cats are indoor types, I do not let them out at all. I don't keep any kind of poisons in the house, no ant killer or anything like that.

As for the office visit itself: I was taken in immediately because there was no one else there. I told the doctor about the history swallowing, retching and so forth and told him of the breathing pattenand that I attributed this to fear. He was weighed and given one x-ray. The doctor brought him back from the x-ray machine. He said he had given the cat lasix and a antibiotic, but I did not see this. He showed me the x-ray and said he could see asthma. About ten minutes has passed by this time. Maybe fifteen.I started to ask but what about the swallowing, the retching. He ignored this and said he had ordered a battery of tests to confirm asthma.

I was shown out to the receptionist area and told the bill came to
$300. I did not like this or the way this was being handled and told her so. I told her that I should have been told before the lasix and the other shots were given. I also that I would not pay for lab tests to "confirm" asthma when I knew the animal had swallowed something.

She asked me if I was going to pay or not. She said they had a right to be paid. After a while I agreedto pay for what they said they had done, i.e., the office visit, the x-ray the and the shots but not for tests to confirm asthma. This came to $162.50.

Almost forgot, I asked about the lasix, what was it for? Oh,that's for the asthma. I said, asthma? I thought why you wanted me to pay for lab tests.

Then I left.

Fsttrk

You did not mention which veterinary clinic you work for.

Is he an inside only cat or does he go outside? Is there any heat or swelling on his body that you noticed? How is he today, is he eating and drinking okay? Have you called the vet back and calmy argued your case and asked for a free recheck? Those are just some of the questions that come to mind when I read your latest post.

Thank you Hissy. He is an inside cat only. He doesn't look sick, his eyes are bright. There are no hot spots or swelling of any kind. There is no evidence of pain. His diet is way off but did a little boiled chicken today and drank some tuna-juice.

He is still breathing from the abdomen, it is shallow and too fast, about 60 breaths per minute. If I pick him up he starts retching.

And no I have not called the doctor and asked for a retest. Because why? Because a certified letter is being prepared for his edification by my lawyer. I belong to a legal plan.

Let's face it here, this doctor committed malpractice and by that practice endangered the health and maybe the life of this animal. I have no interest in coming to terms with such a person. He is supposed to be a professional and with that status comes responsibility.

Also there is the simple fact that I questioned his diagnosis to his face. I do not care that he graduated from some veternary school. He was presented with evidence of a medical nature, he ignored the evidence that did not agree with his presumptions and therby came to an erronious conclusion. He did this because it is his practice to do this. It begs the question: How many animals has he maimed, killed or denied proper treatment to because of this bad habit?

I appreciate your elaborating in better detail, it helps.

So let's re-assess.....the vet took one x-ray of the lungs and chest cavity and offered lab/bloodwork but you declined. Perhaps he did not explain in layman's terms to you about seeing asthma while viewing the x-ray with you. If he suspected asthma based on the history you gave, and based on the findings on the x-ray, he probably had good reason to. If the lungs appeared diffuse or had "splotchy" areas or signs of inflammation, he could very well have made an accurate "presumptive" diagnosis of asthma, and wanted to perform additional labs and bloodwork to rule out other potential causes (such as fungal or other respiratory disease). Without further diagnostics, it is truly a presumptive diagnosis at this point. You can't blame him for not being able to conclude the diagnosis without further workup.

But, since you've described in better detail the original presenting symptoms, I would wager a guess on possible stomach or intestinal obstruction rather than airway obstruction (kitty not eating, in crouched/sternal position, vomiting bile). So, you can, and should, request a lower abdominal x-ray to rule out potential obstruction, inflammation or mass. If that x-ray then reveals a possible obstruction, you could then opt for a barium x-ray series to detect the exact location and type of obstruction. Yes, it will be expensive to opt for this, but it is one differential I would suggest, based on your account of the symptoms. If an obstruction is evident, it could be anything from a foreign object ingested to a compacted hairball to inflammatory condition.

You are right, the vet SHOULD have done a full-body x-ray to view all chest areas, and lower abdominal cavity to rule out a source of obstruction. Since he didn't, you still have that option and you still should demand it so that all bases are covered and not left undetected.

Lasix is a diuretic, usually used for pleural effusion (fluid in the chest cavity), or for heart conditions in which fluid builds up and has nowhere to go. The diuretic usually does it's job within minutes to hours to relieve fluid and pressure on adjacent organs, allowing for easier and uncomplicated breathing. He probably prescribed the antibiotic as a prophylactic and supportive measure, it is a common treatment in cases that are yet undiagnosed. If he felt in the least there was a potential lung infection or even fluid, antibiotics would be a proper approach.

I'm not trying or deliberately being condescending in any way. I often have to be a liason between vets and clients so I understand the need for information and deciphering that information to the client. However, again I must strongly encourage you to get agressive with the vet and demand more. If he wanted to perform labwork, ask specifically what labwork, and what he hoped to conclude with it. If he suspects asthma, ask him to go over the x-ray with you again and explain to you HOW he concludes it. Tell him specifically again that you are concerned with an obstruction and need to rule it out specifically, if that requires another x-ray, so be it, it's the only way to rule it out. If you feel he isn't or never was listening to you, then the correct action is to see another vet for a second opinion altogether. Given the current records and one x-ray on hand, half your costs are already applied, you should only have to consider another x-ray, but be prepared if asthma is again suspected with another vet, chances are, there is good reason to explore it further. Vet's don't like taking chances with a presumptive diagnosis, they know it can come back to haunt them if they misdiagnose and treat unaccordingly. For this reason, a second opinion is what I would advise.

FWIW, message boards are not a great form of communication, much gets lost in the translation, not everything is spelled in black and white, and we can only make educated guesses based on the written word. Cases of urgency, such as yours, demand a thorough approach and that's all I'm trying to do, hope you understand.....................Traci

Let me understand what you are saying. I should go back to the vet and tell him what to do, what to x-ray and what tests to make. I should instruct him on how to hold the stethiscope and which ends go into his ears.

And even though he did not perform a competent exam I am to presume that his presemptive diagnosis of asthma is correct.

Then I should pay him hundreds of dollars for his expertise.

Humor aside, I am now too switching to intestinal obstruction rather than the airway. Not only because of what you mentioned but because I have been collecting his stool and because Petromalt seem to help him. I have been really greasing him up with this stuff. And he ate a little dinner tonight. And for the first time in days he laid on his side and was sleeping.

As a matter of curiosity when viewing the x-ray the doctor mentioned very clearly that there was no fluid in the Plural areas as this would have been indicative of another problem. But I said, "what do the lungs have to do with this?, I think he swallowed one of the pieces of furniture."

I've tried to be patient to this point, but since you only want to invoke sarcasm and spend time with drawing up malpractice papers with your attorney, there is nothing more I can do to help you.

I was asked to come here and offer my help to you, I care deeply about your cat and the level of treatment and care he receives. However, my patience has run thin and the only thing further I will say is.....get your kitty to another vet for a second opinion and promptly, please.

You are wasting time...by my accounts, we share the same time zone, on a Friday night, most veterinary clinics are now closed and you now only have emergency services available to you in the event your kitty develops yet another problem. You had a slight idea what the problem was all day long and had every opportunity to get him seen by another vet during normal business hours, but until you do something about it, your KITTY suffers....I see nothing fair about that whatsoever...................Traci

Originally posted by hissy
Your vet should have put him under anesthesia and scoped him to find the foreign object. Why was this not done? Please do not attempt this on your own, without knowing what you are doing, you could cause irreversible harm.

Click to expand...

I Agree

Good morning Cat-Tech and Chelle:

Sorry to hear that you are running out Cat-Tech.

Chelle; You and Hissy are exactly correct. What should have been done was the anesthesia and scoping at the very first visit to the vet.

My very strong impression as to why this wasn't done is that the vet felt that would not generate enough cash flow. Consider:if this were done the one single visit would have ended the problem, I would have paid the bill and been gone.

On the other hand a deliberate mis-diagnosis would have me coming back again and again and of course there is all that asthma medicine they could sell me. Much more profit here.

While I know that this sound cynical to you let me share a truth with you. I worked for many years for a medical insurance company. The people I knew were medical people. My second wife is the daughter of a surgeon at G.B.M.C. So I know first hand how disease is marketed here in the U.S.

Let me bring you up to date on Black Jack. Since last night he has eaten two meals (a vast improvement). He has had a normal b.m. he looks much better and even jumped down to the floor and came over to me. He still retches but not as much. I am still giving him Petromalt.
His respiration rate has lessened but still too fast. About 40. The bowle movements suggests to me that the obstruction must be in the higher end of the tract. The "poop" ( a technical term) looks normal.

Thanks for everyone's help on this.

My last thought on this. While you were taking your time waxng philosophical and researching with a lawyer about malpractice issues, your cat could have died. While you were typing away on your Internet, your cat could have gone to a competent vet and had help. You are indeed lucky if this cat is past the crisis period and might recover, but as I rescue and I have sat up with many a sick cat, that one day was fine, and the next day was gone, I have to tell you that your priorities for this feline are a bit askrew.

The concern for most of the members here, and Traci in particular will always be the cat. They come to us with a ton of responsibility attached, and although it is wonderful to think that they will never get sick, never get poisoned or hurt, in the real world that just does not happen.

I know all about the gouging of the drug and medical world, but that doesn't stop me when my cats are ill in seeking help. In my area there is little regard for cats by the vet community. I live in a heavy farm area and most of the vets excell in taking care of horses, cows, sheeps, goats and dogs. Cats are not especially prized here. They are looked at as barn cat rated. My own vet has told me that I have taught him more about cats than any one of his patients he has. He tells me that for a layperson, I am the most knowledgable and he calls me to his office because I have the knack of being able to find cat bites that he cannot.

My point is you put your cat at great risk while chasing your disdain for what happened. I hope Blackjack will recover fully- but honestly, if he does not, you are the only one to blame. I have been known to write a hot check for a veterinary procedure then hat in hand I went to the bank and pleaded my case and won. At one time last year, our vet bill was over $2,000.00 and the cat we helped still died! So nothing is a given in life, except that these gentle creatures look to us to do the best we can do when something goes wrong with them. Stick a fork in me, because I am done.

Good bye Hissy. You are right about one thing. If this cat lives or dies is my responsibility. If I take this cat to a vet and he dies, like yours did, it is my responsibility also.

I must make a judgment call here on what is best for the cat and that call is just what I am doing.

As for my priorities being askew just look at yourself. You used $2000 in a heroic attempt to preserve the life of one cat who might have had a peaceful and comfortable death. How many cats could be spayed or neutered for that money? How many cats could be fed? You did what you did not because you are some kind of hero but because you lacked the courage to make the tough, correct decision.

Now you are making assumptions. At the time, I had a lot of cats, that $2,000.00 bill was an accumulation of vet costs (I also have horses) My point was our vet bill was out of control and I still took an injured cat that I knew we couldn't afford to help to the vet to give her a chance at life. I do not do chemo on my cats, nor blood transfusions, if they are suffering, they are put to sleep before the suffering becomes immense for them. But if there is a glimmer of hope, a chance that one of these abused or abandoned ferals can be saved, I will take it. Don't assume that you know me, that I think I am anything other than what I am. I have been rescuing abused cats for over 12 years and I have seen suffering like you wouldn't believe. I give these cats a chance at life otherwise they would be dead. I live with my husband neither of us have full-time steady jobs and I do what I can. That's all I do and nothing more. If I have a young cat appear and she is pregnant, I do not get all gaga over the prospect of having kittens, I take her in and get her spayed because i know the reality of it is, that the kittens are likely to die anyway.

You came on this board looking for help and you did not listen to sound advice coming at you from anyone. You had already chosen your path and Blackjack's. I really pray you are not going to get valium and medicate this poor cat and perform a procedure you know nothing about. For your cat's sake I pray you are smarter than that.

Greetings Hissy;

The problem here is that because you and Cat-Tech gave advice then by definition that advice is sound. Why is it sound? Why, because you said it. And this is what you have doing for twelve years.

But is it really the best thing you could have done with all that time and money? How many cats did you save? Can you count them?

Let me give you and the other ladies a hint here. The problem is that there are too many people practicing veterinary medicine. Fully one half of all vets graduate in the bottom half of their classes. Seventy-five per cent are in the bottom three/fourths of their classes. In practice this means that the odds are severely against you in finding a good vet.

The numbers of practicing vets should be limitied by law. Only the best should be allowed to be in business. Bars and nightclubs are limited by law somewhat in this way.

So if you really want to fight for cats, fight for this.

Another possibility is setting up some kind of network to identify the really competent vets and publishing that information somewhere.

If you want to spend time money to help cats, spend it on that.

To clear one thing up about putting kitty under anesthesia to check for obstruction. Since the vet suspected asthma, and given the account of presenting symptoms, anesthesia would be the last thing this vet wanted to do. You see, anesthesia (ISO anyway) requires that an esophageal tube be placed into the esophagus, and had there been an obstruction, the very act of intubating could have been disastrous. Also, if asthma was the true concern, anesthesia could have sent kitty into a depressed cardiac state or worse, cardiac arrest.

You have a personal gripe against the vet who treated your cat, and you have a personal gripe about the veterinary community as a whole. I don't care how many years you worked in a medicine community, you cannot compare that to veterinary medicine. Show me a vet who is driving around in an expensive mercedes, and I will sell you the brooklyn bridge.

As for a network for competent vets, for future reference, you can start with any AAHA-accredited veterinary hospital, these clinics undergo a rigourous standard for accredidation. On the otherhand, like human physicians, vets are not gods who can perform miracles, and one cannot expect them to be perfect. That's a fact of life in anything.

As for dollar amount on what people spend on their pets, no one has the right to question another pet owner on their choices. Until you understand that pets are a family member to many owners, you will never understand how far and how willing pet owners are willing to spend the money for a treasured pet.

It's clear you are placing a monetary value on Blackjack. That's your choice, but to come here and ask for help and spew out negatives and personal insults in return is inappropriate, and is it truly helping Blackjack? No. Enough said...................Traci

Greeting Cat-Tech:

You continually try to be insulting by suggesting that my only concern is the money.

Then you try to mask this vet's incompentence with technical gibberish. The cat could have been sedated through some other method enough to examine his throat. The Merck Manual specifically mentions this. I looked this up on my own in a few hours, this vet has been practicing how many years?

The reason you don't see vets in Mercedes is that there are too many of them. There are too many for the market.

As for your professional associations. They exist only because the vets kick in dues to represent the monetary interests of the vets themselves. You see see also in the AMA and in other professions such as lawyers and real estate agents. In fact all professional association are in reality only a breed of union specifically organized to fix prices and to propaganize their image.

Another thing about vets. Many, many of them are vets because they could not make the grade in medical or law schools so they settled on being veterinarians. It at least has more prestige than common laborer.

If you are really concerned about cats then you will learn to ignore professional propaganda and help get the bad vets out of business.

FYI, anyone can apply to pre-med human medicine and probably get in and make the grade.

FYI, veterinary pre-med is much more difficult to even get accepted. Once accepted, it is a higher level of medicine in that, one must learn and train with many various species of animals. It is a rigorous 8-year schooling, a specialty requires two or four more years of training/internship and it is much tougher than human medicine.

But, don't take my word for it. You think vet med is unionized? Please, don't insult our intelligence.

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