- Joined
- Jan 17, 2015
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I've read a lot of posts about FHL on this forum and gotten a lot of good information, so thank you up front for everyone that has helped us get this far 
My poor little furbaby, Arthur, stopped eating about 2 weeks ago. I know the dangers and had been told before to try syringe feeding meat baby food in such a situation, which I did. Arthur is also diabetic, which of course complicates things. He started acting very lethargic, thirsty, and his blood sugar levels started going crazy (swinging wildly from mid 400s to 103). A couple days after he stopped eating on his own he was looking pretty bad and I found ketones in his urine. We rushed him to the emergency vet since it was after hourse for our regular vet. She told us he wasn't actually that bad, she thought he could be treated outside the hospital, gave him some sub q fluids, and sent him on his way saying if he got worse, call the regular vet. I asked her about the ketones, and she said they were only low to moderate so no worries. I had always understood any ketones to be worrisome. She also mentioned she detected a slight heart murmur and asked if I had known about that, and I said it had never come up on an exam before. At this point we went home with him feeling a little better, but it nagged at me that what she was telling me was so at odds with my instincts, which are usually right.
By the next day Arthur was definitely not better. He finally crawled into a tiny area behind the washing machine, something he's never done before and is definitely "cat crawling off to die" behavior. I called the regular vet, who told me he will be okay and probably just needed an insulin dosage adjustment, and to take him in the next day for a glucose curve. I told them I thought it was way more serious than that, but they disagreed. As you can imagine, he did not get better overnight and even crawled into the sink with running water on his head, definitely not normal behavior for him.
Next day I took him into the regular vet. She took one look at him and ordered blood tests. She came back telling me he was incredibly sick and that she was transferring him straight to the hospital again. His liver values were seriously elevated. I told her what the hospital vet said before, and she said, "Any ketones in the blood are cause for concern, it's never not a big deal." This is what I had always understood as well. The vet's biggest concern was Arthur's potassium level, which was 2.3. He was also jaundiced, which was there a slight amount even when we had brought him to the hospital a day and a half before.
So off to the hospital we went again. They admitted him and were primarily concerned with the ketoacidosis, given his diabetes. I told them repeatedly that I thought he had developed a UTI and that was what threw all of this into motion, and I told them that I was concerned about FHL. They blew me off. At 4am they called me to say that they thought he had a UTI and they wanted to put him on antibiotics. No kidding. BY 7am they said he was looking much better and were sending him home that morning. When I went to pick him up, he was definitely NOT better. He looked as sick as he did the day before. Let me note that I do not have much money, and they knew this. I think that it seriously affected the quality of care they gave him from the beginning, even for things that they were already paid to do. We paid out of pocket for his first emergency visit, and we paid the first day in the hospital and the regular vet with care credit. I had been calling some charities during his first day in the hospital to fund a second day (which they did when I told the hospital he was definitely not well enough yet - Rose's Fund was fabulous, and Arthur's regular vet had a fund that they donated from as well).
The next morning I got a call telling me that Arthur had taken a turn for the worse and that they didn't think he was going to make it more than another 24-48 hours. I went to pick him up, prepared to make a horrible decision. What I found was a cat with more energy and more alert than the day before. Even my friend, who had driven me the day before and that day and had seen Arthur, commented on it. I asked some questions. Apparently they had only given him IV potassium "per the formula" for most of his stay at the hospital without even testing him to check if it was working. I specifically made sure that second morning to instruct them to test his potassium asap that morning to adjust if needed. They didn't bother to test him until that night at 8pm and then realized his potassium was only 2.2. THEN they finally started giving him an oral supplement and upped his IV potassium. That's hours and hours of potassium therapy he lost. I was furious.
I took him to a vet clinic that another charity said they would pay if I brought Arthur there. I brought him in, but they looked at his hospital records and said his issues were severe, the FHL was bad, and either he was admitted to the hospital, given a feeding tube, and got intensive care for nearly a week (totaling about $3k) or he would die. I don't have that kind of money, and I can't even get that amount funded on short notice (or perhaps at all, it's a lot of money). So I took him home and decided that I would try to get him on track myself. If he got worse, I would do what I had to do, but if he got better, it would be well worth it.
I went home with him armed with sub q fluids with added potassium, tumil K, clavamox, denamarin, pain meds, and extra food syringes. They also gave me mirtazapine, but after what I had read about it I didn't give it to him. Even vets seem to disagree on its safety during an FHL crisis. I'm currently unemployed, so I'm home all day to care for him. I called the hospital to find out how many calories he had eaten per day while he was there. The vet told me that he got barely 100 the day before, and that she stopped the feedings because "he was so depressed." WHAT??? Of course he was depressed, he was sick, and the treatment for that is to feed him! So that day I got 200 calories into him, and the next day and every day after that I got 300 into him. I asked him regular vet for Hills A/D, but she said that high-quality, grain-free kitten food was so close as to work as well and was a lot cheaper. She looked up formulations and found that the Wellness grain-free kitten food and the Blue Buffalo Freedom kitten food was closest to the Hills A/D formulation, both of which I found at Petco. So if anyone out there goes through this and can't afford the Hills, try that.
A few days later Arthur was definitely looking up. My cat who was supposed to be dead by then was showing interest in food (not eating on his own yet, but coming in when I fed his sister and when I cooked, plus licking an almost-empty can and a piece of bacon), walking around the house, and even meowing a couple times. Unfortunately, he used his newfound strength for evil and managed to ditch a couple potassium pills that day a good 10 minutes after I had pilled him and held him to make sure he got them. He got sicker again, though nowhere near where he was when he came back from the hospital.
So, now we are just plugging along, hoping that he pulls through. The diabetes complicates his recovery, and I would not be surprised if his pancreas is also inflamed. However, the ketones were gone when he got back from the hospital (which they didn't know because they hadn't bothered to test him, even though I even left them his ketone strips). I now suspect the ketones were from the FHL, not the diabetes. He has actually been pooping the whole time, so food is being processed. They've been rather black (I read that is probably from the bile?), though today he had one black poop and then another that was a little softer and brown-yellow. I don't know what that means, and I haven't been able to find that online. It seems like if I can get his potassium up to normal and keep feeding him, he has a good chance. Luckily he is a pretty tractable cat, especially with me, so he has tolerated the treatments as well as possible.
It infuriates me, though, that the hospital blew him off the first night we went and didn't even really do what they should have when he was there. If a cat presents with anorexia, ketones, lethargy, excessive thirst, jaundice, a heart murmur, and that weird back-leg crouch-walk, you as a vet should immediately know that it is probably FHL with a potassium deficiency. A day of internet research taught me that, so you'd think years of vet school would manage it. The other thing that drives me nuts is that none of the vets seem to listen to me. I know my pet better than them. I know his labs suck. But I also know by looking at him when he is sick and when he is better. I know what is normal and not normal for him. I know what he will tolerate at home and what he won't. And if he recovers, I am bringing him to the vets that all told me he had no chance and telling them they need to listen to the pet owners.
Arthur is the sweetest cat. I've had him since he was tiny. He was the runt of the litter for a pregnant rescue cat that was abandoned when her owners moved. He was too weak to latch onto his mom when he was born, and I fed him from a dropper the first day so he could regain strength and latch. He's a "mommy's cat," no doubt, and follows me around the house all day long. I so hope I don't lose him.
My poor little furbaby, Arthur, stopped eating about 2 weeks ago. I know the dangers and had been told before to try syringe feeding meat baby food in such a situation, which I did. Arthur is also diabetic, which of course complicates things. He started acting very lethargic, thirsty, and his blood sugar levels started going crazy (swinging wildly from mid 400s to 103). A couple days after he stopped eating on his own he was looking pretty bad and I found ketones in his urine. We rushed him to the emergency vet since it was after hourse for our regular vet. She told us he wasn't actually that bad, she thought he could be treated outside the hospital, gave him some sub q fluids, and sent him on his way saying if he got worse, call the regular vet. I asked her about the ketones, and she said they were only low to moderate so no worries. I had always understood any ketones to be worrisome. She also mentioned she detected a slight heart murmur and asked if I had known about that, and I said it had never come up on an exam before. At this point we went home with him feeling a little better, but it nagged at me that what she was telling me was so at odds with my instincts, which are usually right.
By the next day Arthur was definitely not better. He finally crawled into a tiny area behind the washing machine, something he's never done before and is definitely "cat crawling off to die" behavior. I called the regular vet, who told me he will be okay and probably just needed an insulin dosage adjustment, and to take him in the next day for a glucose curve. I told them I thought it was way more serious than that, but they disagreed. As you can imagine, he did not get better overnight and even crawled into the sink with running water on his head, definitely not normal behavior for him.
Next day I took him into the regular vet. She took one look at him and ordered blood tests. She came back telling me he was incredibly sick and that she was transferring him straight to the hospital again. His liver values were seriously elevated. I told her what the hospital vet said before, and she said, "Any ketones in the blood are cause for concern, it's never not a big deal." This is what I had always understood as well. The vet's biggest concern was Arthur's potassium level, which was 2.3. He was also jaundiced, which was there a slight amount even when we had brought him to the hospital a day and a half before.
So off to the hospital we went again. They admitted him and were primarily concerned with the ketoacidosis, given his diabetes. I told them repeatedly that I thought he had developed a UTI and that was what threw all of this into motion, and I told them that I was concerned about FHL. They blew me off. At 4am they called me to say that they thought he had a UTI and they wanted to put him on antibiotics. No kidding. BY 7am they said he was looking much better and were sending him home that morning. When I went to pick him up, he was definitely NOT better. He looked as sick as he did the day before. Let me note that I do not have much money, and they knew this. I think that it seriously affected the quality of care they gave him from the beginning, even for things that they were already paid to do. We paid out of pocket for his first emergency visit, and we paid the first day in the hospital and the regular vet with care credit. I had been calling some charities during his first day in the hospital to fund a second day (which they did when I told the hospital he was definitely not well enough yet - Rose's Fund was fabulous, and Arthur's regular vet had a fund that they donated from as well).
The next morning I got a call telling me that Arthur had taken a turn for the worse and that they didn't think he was going to make it more than another 24-48 hours. I went to pick him up, prepared to make a horrible decision. What I found was a cat with more energy and more alert than the day before. Even my friend, who had driven me the day before and that day and had seen Arthur, commented on it. I asked some questions. Apparently they had only given him IV potassium "per the formula" for most of his stay at the hospital without even testing him to check if it was working. I specifically made sure that second morning to instruct them to test his potassium asap that morning to adjust if needed. They didn't bother to test him until that night at 8pm and then realized his potassium was only 2.2. THEN they finally started giving him an oral supplement and upped his IV potassium. That's hours and hours of potassium therapy he lost. I was furious.
I took him to a vet clinic that another charity said they would pay if I brought Arthur there. I brought him in, but they looked at his hospital records and said his issues were severe, the FHL was bad, and either he was admitted to the hospital, given a feeding tube, and got intensive care for nearly a week (totaling about $3k) or he would die. I don't have that kind of money, and I can't even get that amount funded on short notice (or perhaps at all, it's a lot of money). So I took him home and decided that I would try to get him on track myself. If he got worse, I would do what I had to do, but if he got better, it would be well worth it.
I went home with him armed with sub q fluids with added potassium, tumil K, clavamox, denamarin, pain meds, and extra food syringes. They also gave me mirtazapine, but after what I had read about it I didn't give it to him. Even vets seem to disagree on its safety during an FHL crisis. I'm currently unemployed, so I'm home all day to care for him. I called the hospital to find out how many calories he had eaten per day while he was there. The vet told me that he got barely 100 the day before, and that she stopped the feedings because "he was so depressed." WHAT??? Of course he was depressed, he was sick, and the treatment for that is to feed him! So that day I got 200 calories into him, and the next day and every day after that I got 300 into him. I asked him regular vet for Hills A/D, but she said that high-quality, grain-free kitten food was so close as to work as well and was a lot cheaper. She looked up formulations and found that the Wellness grain-free kitten food and the Blue Buffalo Freedom kitten food was closest to the Hills A/D formulation, both of which I found at Petco. So if anyone out there goes through this and can't afford the Hills, try that.
A few days later Arthur was definitely looking up. My cat who was supposed to be dead by then was showing interest in food (not eating on his own yet, but coming in when I fed his sister and when I cooked, plus licking an almost-empty can and a piece of bacon), walking around the house, and even meowing a couple times. Unfortunately, he used his newfound strength for evil and managed to ditch a couple potassium pills that day a good 10 minutes after I had pilled him and held him to make sure he got them. He got sicker again, though nowhere near where he was when he came back from the hospital.
So, now we are just plugging along, hoping that he pulls through. The diabetes complicates his recovery, and I would not be surprised if his pancreas is also inflamed. However, the ketones were gone when he got back from the hospital (which they didn't know because they hadn't bothered to test him, even though I even left them his ketone strips). I now suspect the ketones were from the FHL, not the diabetes. He has actually been pooping the whole time, so food is being processed. They've been rather black (I read that is probably from the bile?), though today he had one black poop and then another that was a little softer and brown-yellow. I don't know what that means, and I haven't been able to find that online. It seems like if I can get his potassium up to normal and keep feeding him, he has a good chance. Luckily he is a pretty tractable cat, especially with me, so he has tolerated the treatments as well as possible.
It infuriates me, though, that the hospital blew him off the first night we went and didn't even really do what they should have when he was there. If a cat presents with anorexia, ketones, lethargy, excessive thirst, jaundice, a heart murmur, and that weird back-leg crouch-walk, you as a vet should immediately know that it is probably FHL with a potassium deficiency. A day of internet research taught me that, so you'd think years of vet school would manage it. The other thing that drives me nuts is that none of the vets seem to listen to me. I know my pet better than them. I know his labs suck. But I also know by looking at him when he is sick and when he is better. I know what is normal and not normal for him. I know what he will tolerate at home and what he won't. And if he recovers, I am bringing him to the vets that all told me he had no chance and telling them they need to listen to the pet owners.
Arthur is the sweetest cat. I've had him since he was tiny. He was the runt of the litter for a pregnant rescue cat that was abandoned when her owners moved. He was too weak to latch onto his mom when he was born, and I fed him from a dropper the first day so he could regain strength and latch. He's a "mommy's cat," no doubt, and follows me around the house all day long. I so hope I don't lose him.
