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- Feb 6, 2015
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Hi everyone,
I apologize for the length of this post, but I want you to have as much information as I do.
I have a cat named Pumpkin who is almost 5 years old. She was a stray at my daughter's high school and was about 9 months old and feral when we trapped her. She has always been in good health once we got her weight up to normal and had her dewormed, vaccinated, etc.
She is an amazing jumper. She used to be able to jump on top of a wall cabinet that is 7 feet high just by springing from the ground. My vet laughed watching her in the exam room one time, saying it looks more like she levitates than jumps. She was my only cat I allowed outside with me for a little while each day because she is my only cat who doesn't kill anything. My husband built a large cat house that our cats can go into when they want to be outside to watch the birds and squirrels.
On July 4, 2014, Pumpkin was in the back yard with me and was fine one minute and nearly comatose-acting the next minute. She was sitting in a hunched forward position with her head low and her eyes squeezed shut. She didn't even open her eyes when I talked to her. I immediately took her to a large emergency/specialty clinic in our area. The veterinarian agreed that she seemed to be in great pain and upon palpating her, thought she had hurt her back somehow. The emergency vet did CBC/chemistry, FeLV/FIV test and x-rays. All were normal. They gave her subcutaneous fluids and said to watch for trouble urinating, difficulty breathing, or any unusual neurological activity. None of those symptoms followed, but she has never been the same cat since that day.
A few days later, I took her back to the emergency/specialty clinic and they rechecked her, saw that she still had a sensitive area in her back, and gave her buprenorphine (pain reliever) and robenacoxib (non-steroidal anti-inflammatory).
I have never taken her outside with me since July 4th. She has become a much more lethargic cat, completely lacking the high energy and mischievousness that she once had. For most of the past 7 months, she hasn't jumped up to her favorite high spots at all. She will jump up on furniture, radiators, or other objects that are no more than 4 feet off the ground. However, she sometimes grunts when she lands after jumping down from these heights. Other than that, her appetite and everything else are normal.
Starting about a month ago, she became very irritable with our other animals (a dog and 4 other cats). She would vocalize and swipe at them with her paw if they came close to her. She would also scratch or bite us if we touched her. She has never liked being touched by us due to her feral nature, but she would usually allow us to pet her a bit, never scratching us until recently. She also was very sweet with all the other animals until a month ago. At that time, she became less interested in eating and began isolating herself in the basement.
I took her to our vet right away and gave a thorough history. Our vet ran a CBC, SMAC test (blood sugar level, electrolyte and fluid balance, kidney function, and liver function), and a lipase test (can indicate pancreas problems). All tests came back normal. However, Pumpkin tried to bite the vet whenever the vet palpated her back. Assuming the irritability was due to back pain, she put Pumpkin on a week's worth of buprenophine (pain reliever) and metacam (non-steroidal anti-inflammatory). There was no improvement. I took Pumpkin back to our vet and asked her to recheck Pumpkin and do some x-rays. Unfortunately, our vet doesn't have ultrasound equipment. The x-rays were normal and our vet gave me more buprenorphine.
A day later, around midnight, I noticed that Pumpkin had labored breathing. She was breathing the way you would if you were in a lot of pain. With each breath, she would hunch up her shoulders and squeeze her eyes shut. That night, I immediately took her to the emergency/specialty clinic again. I brought the x-rays with me. They kept her for a day and reviewed her x-rays, did all new blood work and performed an abdominal ultrasound. They saw some minor changes in a small area of Pumpkin's intestine and a small part of her pancreas that could indicate inflammation. Their conclusion was that Pumpkin's possible causes of pain were inflammation of her GI tract (enteritis and pancreatitis) or spinal/orthopedic pain. They had her on IV fentanyl (pain reliever) and medication to treat GI irritation (maropitant, metronidazole and famotidine) while they kept her. We continued all of those medications for the GI tract when we brought her home, with the exception of substituting buprenorphine for the fentanyl for pain relief. Pumpkin was on 15 times (!!!) the dose of buprenorphine that our vet had her on when we brought her home, but she still had breakthrough pain between doses. The specialty clinic internist told us to increase the frequency of the pain medicine. For reference, she is now on a total of 2.0mL of buprenorphine per day, divided into 4 doses. Our vet had her on .1mL of buprenorphine per day. At the 2.0mL level, I can even tell that Pumpkin has been hallucinating a bit.
I brought her back to the emergency/specialty clinic a few days ago because she seemed no better. The internist rechecked her. A radiologist did a new ultrasound just in case the internist might have missed something, but he didn't find anything of significance on the ultrasound. In fact, her intestines and pancreas looked completely normal to him. At that point, a surgeon examined her. She found Pumpkin had pain in her back where the thoracic vertebrae join the lumbar vertebrae.
We met with the surgeon for a consult yesterday. She wants to do a myelogram (contrast dye test that looks at the spinal cord, nerve roots and other tissues) and a CT scan (looks at the vertebrae and disks to look for ruptures, tumors, etc.). She plans to move right into surgery if she finds a herniated disk. She would then do a hemilaminectomy. This procedure would remove a part of a vertebrae to allow access to trimming off any bulging disk material. The goal is to alleviate any pinched nerves that are causing Pumpkin's pain. They would keep her for 48 hours after the surgery. That would be followed by 4 weeks of cage rest at home, as well as follow-up physical therapy.
I brought up the idea of trying a course of oral steroids first to see if the inflammation could be reduced, thus reducing nerve pain. The surgeon said steroids would only work a little better than the metacam Pumpkin had been on for a week on which she didn't improve, so she didn't think it was worth trying this before moving right into surgery. She also pointed out that Pumpkin is on a HUGE amount of pain medication, so she didn't think anything less than surgery would eliminate her pain. I am worried about aggressively moving into surgery since there are several risks with it, one of them being lameness. Since all of this began, Pumpkin has never even had a limp or any weakness in her legs.
I have a call in to the surgeon to reapproach the subject of a trial of steroids. Right now, Pumpkin is scheduled for the myelogram, CT scan and surgery this Tuesday, Feb. 10th. I have some concerns with this emergency/specialty clinic. My dog had a $6000 surgery there a year and a half ago (anal sac cancer) and is doing well. However, they never presented any alternatives to us other than surgery, radiation and chemotherapy. This clinic always moves quickly into the most aggressive treatments for everything. For example, we chose to only do the anal sacculectomy surgery, not the chemotherapy and radiation, which would have cost an additional $21,000. As it was, our dog had severe fecal incontinence for more than a month after the surgery. She also had two factors that worsened the prognosis: hypercalcemia and a malignant abdominal lymph node. Adding the radiation and chemotherapy would have only bought her an average of about 3 months according to the studies I've read, but imagine what pain she would have gone through if we had chosen to have the 20 radiation treatments to her anal area. I always get a clear sense of disapproval when I don't do everything they suggest. I fully expect the surgeon to disagree with a trial of steroids when she calls back, but if she is unwilling to do that, I'm going to talk with my own vet about a steroid trial before moving into surgery. We've spent $5000 at the clinic to get to this point. The myelogram, CT and surgery will be another $4000. They have not yet given us an estimate for the post-surgical physical therapy that will be needed.
Has anyone had a similar experience with back pain in their cat? What did you do and how successful was it? I'd do almost anything for our pets, but we are not wealthy by any means, and I want to approach this rationally, not just emotionally. I am grateful to anyone who slogged their way through this entire post.
Thank you, in advance, for your input.
Julie
(Pumpkin is my avatar. That's her with her little shaved leg after coming home from the hospital.)
I apologize for the length of this post, but I want you to have as much information as I do.
I have a cat named Pumpkin who is almost 5 years old. She was a stray at my daughter's high school and was about 9 months old and feral when we trapped her. She has always been in good health once we got her weight up to normal and had her dewormed, vaccinated, etc.
She is an amazing jumper. She used to be able to jump on top of a wall cabinet that is 7 feet high just by springing from the ground. My vet laughed watching her in the exam room one time, saying it looks more like she levitates than jumps. She was my only cat I allowed outside with me for a little while each day because she is my only cat who doesn't kill anything. My husband built a large cat house that our cats can go into when they want to be outside to watch the birds and squirrels.
On July 4, 2014, Pumpkin was in the back yard with me and was fine one minute and nearly comatose-acting the next minute. She was sitting in a hunched forward position with her head low and her eyes squeezed shut. She didn't even open her eyes when I talked to her. I immediately took her to a large emergency/specialty clinic in our area. The veterinarian agreed that she seemed to be in great pain and upon palpating her, thought she had hurt her back somehow. The emergency vet did CBC/chemistry, FeLV/FIV test and x-rays. All were normal. They gave her subcutaneous fluids and said to watch for trouble urinating, difficulty breathing, or any unusual neurological activity. None of those symptoms followed, but she has never been the same cat since that day.
A few days later, I took her back to the emergency/specialty clinic and they rechecked her, saw that she still had a sensitive area in her back, and gave her buprenorphine (pain reliever) and robenacoxib (non-steroidal anti-inflammatory).
I have never taken her outside with me since July 4th. She has become a much more lethargic cat, completely lacking the high energy and mischievousness that she once had. For most of the past 7 months, she hasn't jumped up to her favorite high spots at all. She will jump up on furniture, radiators, or other objects that are no more than 4 feet off the ground. However, she sometimes grunts when she lands after jumping down from these heights. Other than that, her appetite and everything else are normal.
Starting about a month ago, she became very irritable with our other animals (a dog and 4 other cats). She would vocalize and swipe at them with her paw if they came close to her. She would also scratch or bite us if we touched her. She has never liked being touched by us due to her feral nature, but she would usually allow us to pet her a bit, never scratching us until recently. She also was very sweet with all the other animals until a month ago. At that time, she became less interested in eating and began isolating herself in the basement.
I took her to our vet right away and gave a thorough history. Our vet ran a CBC, SMAC test (blood sugar level, electrolyte and fluid balance, kidney function, and liver function), and a lipase test (can indicate pancreas problems). All tests came back normal. However, Pumpkin tried to bite the vet whenever the vet palpated her back. Assuming the irritability was due to back pain, she put Pumpkin on a week's worth of buprenophine (pain reliever) and metacam (non-steroidal anti-inflammatory). There was no improvement. I took Pumpkin back to our vet and asked her to recheck Pumpkin and do some x-rays. Unfortunately, our vet doesn't have ultrasound equipment. The x-rays were normal and our vet gave me more buprenorphine.
A day later, around midnight, I noticed that Pumpkin had labored breathing. She was breathing the way you would if you were in a lot of pain. With each breath, she would hunch up her shoulders and squeeze her eyes shut. That night, I immediately took her to the emergency/specialty clinic again. I brought the x-rays with me. They kept her for a day and reviewed her x-rays, did all new blood work and performed an abdominal ultrasound. They saw some minor changes in a small area of Pumpkin's intestine and a small part of her pancreas that could indicate inflammation. Their conclusion was that Pumpkin's possible causes of pain were inflammation of her GI tract (enteritis and pancreatitis) or spinal/orthopedic pain. They had her on IV fentanyl (pain reliever) and medication to treat GI irritation (maropitant, metronidazole and famotidine) while they kept her. We continued all of those medications for the GI tract when we brought her home, with the exception of substituting buprenorphine for the fentanyl for pain relief. Pumpkin was on 15 times (!!!) the dose of buprenorphine that our vet had her on when we brought her home, but she still had breakthrough pain between doses. The specialty clinic internist told us to increase the frequency of the pain medicine. For reference, she is now on a total of 2.0mL of buprenorphine per day, divided into 4 doses. Our vet had her on .1mL of buprenorphine per day. At the 2.0mL level, I can even tell that Pumpkin has been hallucinating a bit.
I brought her back to the emergency/specialty clinic a few days ago because she seemed no better. The internist rechecked her. A radiologist did a new ultrasound just in case the internist might have missed something, but he didn't find anything of significance on the ultrasound. In fact, her intestines and pancreas looked completely normal to him. At that point, a surgeon examined her. She found Pumpkin had pain in her back where the thoracic vertebrae join the lumbar vertebrae.
We met with the surgeon for a consult yesterday. She wants to do a myelogram (contrast dye test that looks at the spinal cord, nerve roots and other tissues) and a CT scan (looks at the vertebrae and disks to look for ruptures, tumors, etc.). She plans to move right into surgery if she finds a herniated disk. She would then do a hemilaminectomy. This procedure would remove a part of a vertebrae to allow access to trimming off any bulging disk material. The goal is to alleviate any pinched nerves that are causing Pumpkin's pain. They would keep her for 48 hours after the surgery. That would be followed by 4 weeks of cage rest at home, as well as follow-up physical therapy.
I brought up the idea of trying a course of oral steroids first to see if the inflammation could be reduced, thus reducing nerve pain. The surgeon said steroids would only work a little better than the metacam Pumpkin had been on for a week on which she didn't improve, so she didn't think it was worth trying this before moving right into surgery. She also pointed out that Pumpkin is on a HUGE amount of pain medication, so she didn't think anything less than surgery would eliminate her pain. I am worried about aggressively moving into surgery since there are several risks with it, one of them being lameness. Since all of this began, Pumpkin has never even had a limp or any weakness in her legs.
I have a call in to the surgeon to reapproach the subject of a trial of steroids. Right now, Pumpkin is scheduled for the myelogram, CT scan and surgery this Tuesday, Feb. 10th. I have some concerns with this emergency/specialty clinic. My dog had a $6000 surgery there a year and a half ago (anal sac cancer) and is doing well. However, they never presented any alternatives to us other than surgery, radiation and chemotherapy. This clinic always moves quickly into the most aggressive treatments for everything. For example, we chose to only do the anal sacculectomy surgery, not the chemotherapy and radiation, which would have cost an additional $21,000. As it was, our dog had severe fecal incontinence for more than a month after the surgery. She also had two factors that worsened the prognosis: hypercalcemia and a malignant abdominal lymph node. Adding the radiation and chemotherapy would have only bought her an average of about 3 months according to the studies I've read, but imagine what pain she would have gone through if we had chosen to have the 20 radiation treatments to her anal area. I always get a clear sense of disapproval when I don't do everything they suggest. I fully expect the surgeon to disagree with a trial of steroids when she calls back, but if she is unwilling to do that, I'm going to talk with my own vet about a steroid trial before moving into surgery. We've spent $5000 at the clinic to get to this point. The myelogram, CT and surgery will be another $4000. They have not yet given us an estimate for the post-surgical physical therapy that will be needed.
Has anyone had a similar experience with back pain in their cat? What did you do and how successful was it? I'd do almost anything for our pets, but we are not wealthy by any means, and I want to approach this rationally, not just emotionally. I am grateful to anyone who slogged their way through this entire post.
Thank you, in advance, for your input.
Julie
(Pumpkin is my avatar. That's her with her little shaved leg after coming home from the hospital.)
