Any advice before surgery? I'm scared

IndyJones

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As for the surgery, as yourself this, would the surgery improve his quality of life? Personally I think it would. Gallstones are quite painful.

If the prednisolone was working I would start using it again, get things back under control then decide what to do about the stones.

Try to stay calm, being all upset will only make things worse, cats pick up on out emotional state.
 
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Musiaka

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As for the surgery, as yourself this, would the surgery improve his quality of life? Personally I think it would. Gallstones are quite painful.

If the prednisolone was working I would start using it again, get things back under control then decide what to do about the stones.

Try to stay calm, being all upset will only make things worse, cats pick up on out emotional state.
The thing is, his gallstones, big as they are, don't cause much, if any, symptoms. If he's in pain, why does he run as fast as he can, jump on furniture and hang on them with his nails, having a crazy look in his eyes? He gets crazy every single even when he vomits. He's eating well and is scavenging for crumbles all the time (which end up causing him to throw up, especially when he licks the frying pan). He's not jaundiced, doesn't get apathetic, doesn't lose weight. His liver holds up. The vets are split about the pain. His old vet in Sweden says gallstones only cause pain in cats if they're blocking the ducts. Vets in my city all say they're painful. The surgeon said when it's painful, the behaviour of a cat changes significantly. The only change I've seen he's more angry when I try to pick him up when he's laying down or if I want to pick him up and carry him home when we're outside. Otherwise he exposes his belly to me for rubs.

When I tried to explain all that to the surgeon, she said that if I don't see much external signs surgery might not be necessary, but they want to run tests on him themselves. The surgery is VERY rare on cats (more common for dogs) and is very, very complicated. The gallbladder is connected to the liver with many blood vessels and there is a risk for hemorrage during and post surgery. Musiaka would have to eat a special low-fat food which he adamantly refuses right now - risk for hepatic lipidosis and an ibd flareup on top of post operation complications. I get convinced by our local vets to go through with the surgery and then I come home and start reading on it and become convinced this surgery will kill my cat. The surgeon did sound surprised when I described the quality of Musiaka's life right now.

We will see the specialists at the clinic. But there is low chance we will do the surgery... i won't let anyone shorten his life for nothing.
 
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Musiaka

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Just wanted to add that if the specialists will insist on surgery we will do it... just don't know how we will be able to handle food. He won't eat the special low-fat food, I tried it out these last days. I'm afraid that surgery + refusing food will end in hepatic failure.
 

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Be very up front with the vet that the low fat diet will not work and ask what the ramifications or possible alternatives are after gall bladder surgery.
 
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Musiaka

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Be very up front with the vet that the low fat diet will not work and ask what the ramifications or possible alternatives are after gall bladder surgery.
I did ask that when I talked to the surgeon that we were booked at. She said that ibd creates serious issues when it comes to healing after the surgery. There is no way he could be earting his previous food after it. I also talked to a vet from another clinic that offers gallbladder removal surgery and a third vet from my city who has many years of experience, but Musiaka is not a patient there because it's the trickiest place for us to get to and they don't offer some procedures. Everyone is saying that the surgery might not be necessary if Musiaka is not experiencing any obstructions and jaundice. The third vet I talked to said "i understand that the surgery seems like a quick sollution to just get rid of the gallbladder issues, but it's a slippery slope. I'd rather let the cat live with the stones for as long as it's possible and try removing the gallbladder as a last resort thing. Be sure to seek a second opinion and repeat the ultrasound somewhere else". One of the clinics I called said gallbladder is frequently removed for dogs and rarely for cats and not to rush with it if the cat is in a good condition overall. Our current vet bases her positive views on gallbladder removal on two dogs that were her patients and had it removed which made their life quality better. But she never had any experience with cats and it's apparently vastly different.

I asked her if I could put Musiaka on Ursodiol and she said no, better not because the stones are too large for it to work now. I asked again if it won't help clear some sludge and she said no it won't. What? It usually is prescribed for bile sludge and inflammation of the liver, how could it not be beneficial? According to that other vet, Ursodiol does not melt gallstones at all and it's in general is mainly an anti-oxidant for the liver. I put Musiaka back on Ursodiol anyway (we used it for a little while before). At this point I don't trust our current vet and doubt we will be returning there. When we came in I was happily telling her how good the last 6 months were for Musiaka, how much healthier he looks and how playful he now is. I only wanted to up his pred for a week because he recently started flaring up with hairballs and whatnot. When we came out I was crushed, like I suddenly have a terminally ill cat. How can this be? When a cat is not doing well, it's so visible, isn't it? From the way it looked he seemed better than ever, except the recent flareup and the food-change + sudden pred stop flareup, which is what happened already after the visit :(((
 
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