Caring for kitten post cardiac arrest

[Jaytea]

Hello, first time cat owner (as an adult) and first time poster to the forums (unfortunately under grave circumstances).

My 5-6 mo. Kitten experienced cardiac arrest on Thursday. Here's what happened:

About 3 months ago, my partner and I decided to take in and raise two, male feral kittens (littermates). We've been taking pretty good care of them, having them get all their vaccines and de-worming meds as scheduled. They've warmed up dramatically over the last few months and are social, happy, and loving; in short, I absolutely adore them. Aside from some fleas, worms, and dirty ears, they've appeared healthy at all their check ups. (And they've been treated for those problems). Basically, we've done everything we're supposed to.

They're about 6 months old, and this past Thursday, we had them neutered at an extremely reputable low cost clinic (state-wide non-profit org).

Pictured, a healthy Charlie before surgery.

Long story short, one cat (Neo) did fine, but the other (Charlie) underwent cardiac arrest when coming out of anesthesia. We don't know how long he was without oxygen, but they did resuscitate him using CPR. When they discharged him, the vets at the clinic didn't seem too concerned, and said to take him to our primary veterinarian for a vitals check, and had suggested we'd be able to bring him home afterwards. Their lack of concern belied what was to come.

Things didn't seem right when we picked him up. He wasn't moving when we picked him up from the clinic, aside from what appeared to be muscle spasms and his sporadic, rapid breathing. He did not look good; it looked like he was sleeping and having a very bad dream. We were surprised the vet at the clinic seemed so unconcerned, but I guess our animal wasn't their problem. :/

Well, we booked it immediately to our primary veterinarian and they immediately put him on oxygen and fluids and monitored him for hours. This was around 2pm. Before they closed for the evening at 5pm, he hadn't improved. We had to decide there whether to put him down, or see if he would recover in emergency care over the next few days. The vet said there was no way of telling the extent of his damage. He may have brain damage, he may be dull, he may not be the same cat afterwards, but we had no way of knowing 100%.

We opted to give him a chance, despite the costs of care and not knowing the odds of survival and full recovery. The first night, they had him in oxygen. By the second night, he was able to sit upright. During our visit with him three days after the surgery and cardiac arrest, he was able to walk around (wobbly), despite bumping into things. His eyes were open and he meowed several times, and he was eating some food. The vets caring for him at the animal hospital have seemed optimistic about his recovery, despite the fact that many cats don't survive or don't fully recover. They say with him being some young, there's a decent possibility he will continue to improve over the next week or two. We finally brought him home Monday evening after 4 days in treatment at the animal hospital.

He may be home be he's still recovering. He doesn't have full vision (tho the vet thinks there's good chance it will return, just slowly), and bumps into everything when walking. He walks slightly low to the ground, without his legs fully extended (we're continuing PT at home). He also seems to walk around without much purpose, and isn't reacting much to being reunited with his brother (brother Neo is being very gentle and even cleaned his face after I gave Charlie some food). In general, his senses seem dull and it's scary to think this may be as far as he gets mentally. He responds to wet food when presented, but mostly licks at it and I'm worried he may not be getting enough sustenance. (I will be following up with the vet)

What I'm mostly nervous about is everything after now that he is home. I don't know what to expect at all in terms of him getting back to normal, and may have to except that Charlie will have a new normal from now on. For instance, he's urinating and pooping on pee pads in his carrier (when we're not supervising his movement around our home), and seemingly doesn't have control over when he goes. If he's never able to use a litterbox, I don't know what his day to day care is going to look like with me and my partner working full time jobs. Luckily my partner works from home and can provide care (ensuring meds are given on time, feeding him, etc.) for a couple weeks while he recovers, but if Charlie hits a recovery plateau and never improves, I'm very nervous about how we can make him happy and comfortable in the months to come. I want to do everything we can for him and am hoping for the best. There's just a lot of unknowns right now, and not a lot of info online about what recovery for this looks like.

Basically, if anyone has experience with a similar situation, or knows any good resources (articles, videos, etc) about caring for a car after cardiac arrest, I'm all ears.

I know each case is different when it comes to traumatic events for people and animals, but even anecdotal stories can be valuable (and hopefully give some hope to us, too)

TLDR; my 5 mo. old kitten got neutered and underwent cardiac arrest while under anesthesia. He's still recovering from a state where he was barely moving. After a few days, he's walking again, but his senses are dull and he has low appetite and seemingly no control over bladder/bowel movements. Seeking any and all advice on his health or even anecdotal stories of what other cats have been through.

I appreciate you all listening and bearing with this long post. <3

Charlie recovering in the animal hospital a couple days ago. He's home now.

 

[di and bob]

Since all this happened Thursday, I think he is doing remarkably well. ANY improvement is good and gives hope for continuing improvement to come. Something like this takes a long time to get over. I really think it will take several months for you to see what his final prognosis will be. Animals, especially cats, have a remarkable ability to heal. He is now in the best healing environment he can be in, his home that he knows and loves, surrounded by love and concern. I have seen cats with horrible injuries, including brain damage from being hit by a car, that I would NEVER think they could have survived, and they have come back. So never give up hope and encouraging him to continue on. Good, nutritious food, immune supplements, and researching supplements that help with heart health would surely benefit him. Make sure you clear anything with your vet first. His bladder control, etc. will slowly improve as he heals. This often happens to humans too, and it takes many months for this to return.
Remember, he most likely had a reaction to the anesthesia, so although future surguries are not out of the question, make sure you find out what kind it was to warn the surgeon. They can also give what they call a 'twilight' anesthesia which does not put them under as deep. this is often used with elderly cats.
Remember to celebrate each and every tiny improvement in his condition. He can be bolstered by this. Praise him for trying. I'll pray bfro your sweet boy, as miracles still do happen you know. Most of all just love him and be there for him, thatt is the best healing treatment there is........

 

[Leomc123]

i am really sorry to hear about charlie having a cardiac arrest from anesthesia. I am not a vet .Did your vet say that your cats oxygen levels, blood preasue levels and cardiac functions have stabilized when you took your cat from the vet ? I think it is a good sign that your cat is able to walk around, as moving around will increase oxygen into your cats blood, brain and muscles. I would keep an eye on your cat to make sure if he is going to the litter box and is urinating, and to check his breathing patterns. If your cat starts panting then it could mean he isnt getting enough oxygen or getting fluid in the lungs and needs to be seen by a vet asap. I think your cat may be disorienated from the anesthesia, the cardiac arrest, cpr ,but i think he will get better in time and with a little assistance to get to the litter tray and him moving around the house. There are articles that do state that some cats who have a bad reaction to anesthesia do have some personality changes, some may become aggressive, cranky . But you also need to remember your little charlie also went through surgery as well so the poor thing is probably hurting a little in his privates, also the pain meds making him drowsy. The poor little might also had cardiac arrest , so i think charlie has been through alot , i wouldnt be myself if i had that all happen to me. I think give charlie some time to recover. I wish charlie all the best in his recovery. I think he will get better.

I found some information regarding cardiac arrest Post cardiac arrest : http://veterinarycalendar.dvm360.com/managing-post-arrest-patient-proceedings

There are several physiologic events that occur following a cardiac arrest, including hypotension, hypothermia, acid-base disturbances, arrhythmias, renal and neurologic dysfunction. Tissue ischemia secondary to poor perfusion is the cause of such injury to vital organs. Coined the "post resuscitation syndrome", tissue re-oxygenation after successful CPR causes a reperfusion injury by inciting the production of inflammatory cytokines and coagulation disorders such as disseminated intravascular coagulation (DIC). The consequences of tissue hypoxia to certain organs such as the brain may be permanent.

Urinary output should be closely monitored in order to assess renal function. Sustained hypotension in the post-arrest phase will only exacerbate renal tubular damage and impair renal blood flow. Blood pressures and central venous pressures should be frequently evaluated to ensure proper renal support. A urinary catheter with a closed urine system should be placed in all post-resuscitation patients for measurement of urine output. Urine sedimentation should be analyzed for the presence of casts or renal epithelial cells, suggestive of acute renal failure. Pharmacokinetic agents such as dopamine, furosemide, and mannitol can be administered to stimulate urine output. Body weight and "ins and outs" should be monitored frequently to ensure proper intravenous fluid administration.

 

[di and bob]

As long as he is urinating anything, that means his kidneys are functioning, another good sign that improvement is possible. Definitely push water, and let him do what he can do in his own way. encouraging play would improve his circulation, but don't push too hard.

 

[Meowmee]

So sorry about Charlie, sending love and support for his recovery <3 it sounds like the dvm who did the neuter messed up and then released a very sick kitty.

 

[Jaytea]

Since all this happened Thursday, I think he is doing remarkably well. ANY improvement is good and gives hope for continuing improvement to come. Something like this takes a long time to get over. I really think it will take several months for you to see what his final prognosis will be. Animals, especially cats, have a remarkable ability to heal. He is now in the best healing environment he can be in, his home that he knows and loves, surrounded by love and concern. I have seen cats with horrible injuries, including brain damage from being hit by a car, that I would NEVER think they could have survived, and they have come back. So never give up hope and encouraging him to continue on. Good, nutritious food, immune supplements, and researching supplements that help with heart health would surely benefit him. Make sure you clear anything with your vet first. His bladder control, etc. will slowly improve as he heals. This often happens to humans too, and it takes many months for this to return.
Remember, he most likely had a reaction to the anesthesia, so although future surguries are not out of the question, make sure you find out what kind it was to warn the surgeon. They can also give what they call a 'twilight' anesthesia which does not put them under as deep. this is often used with elderly cats.
Remember to celebrate each and every tiny improvement in his condition. He can be bolstered by this. Praise him for trying. I'll pray bfro your sweet boy, as miracles still do happen you know. Most of all just love him and be there for him, thatt is the best healing treatment there is........

Hi di and bob. Thanks for your post. Your stories help give us some hope. We've had him home since Monday evening, and were a little worried yesterday since he didn't have any bowel movements until Friday evening. But we had him (and his brother) check out at our primary vet, and they impressed by Charlie and cautiously optimistic about him improving as time goes on.

The vet also prescribed Royal Canin recovery food, with extra calories to give him the calories he desperately need to make up for some weight loss. The texture is also easier for him to eat, so it looks like it's a good fit. I was excited to have him finish nearly a whole can just last night.

I do hope we see improvements with bladder control. We keep him in a mesh play pen lined with pee pads at night and after meals, so he can just go where ever. But it's scary to think that this could be his future. He needs a lot of care right now, and I'm just glad my partner works from home and my job is "task focused" more than "time focused."

Thank you for praying for Charlie and for your comforting words.

i am really sorry to hear about charlie having a cardiac arrest from anesthesia. I am not a vet .Did your vet say that your cats oxygen levels, blood preasue levels and cardiac functions have stabilized when you took your cat from the vet ? I think it is a good sign that your cat is able to walk around, as moving around will increase oxygen into your cats blood, brain and muscles. I would keep an eye on your cat to make sure if he is going to the litter box and is urinating, and to check his breathing patterns. If your cat starts panting then it could mean he isnt getting enough oxygen or getting fluid in the lungs and needs to be seen by a vet asap. I think your cat may be disorienated from the anesthesia, the cardiac arrest, cpr ,but i think he will get better in time and with a little assistance to get to the litter tray and him moving around the house. There are articles that do state that some cats who have a bad reaction to anesthesia do have some personality changes, some may become aggressive, cranky . But you also need to remember your little charlie also went through surgery as well so the poor thing is probably hurting a little in his privates, also the pain meds making him drowsy. The poor little might also had cardiac arrest , so i think charlie has been through alot , i wouldnt be myself if i had that all happen to me. I think give charlie some time to recover. I wish charlie all the best in his recovery. I think he will get better.

Everything seems to have stabilized, otherwise I don't think we'd be allowed to care for him from home right now. He's definitely peeing and passing stool, but it looks like he may not have control over his bladder functions right now. He's peeing on pee pads, though I've placed a small, low entry litter box in his playpen to help reintroduce him to litter. My plan is to run his paws through it a few times a day, like you might do with a kitten. I also might try the "kitten attract" litter variety to see if that helps him.

I found some information regarding cardiac arrest Post cardiac arrest : http://veterinarycalendar.dvm360.com/managing-post-arrest-patient-proceedings

There are several physiologic events that occur following a cardiac arrest, including hypotension, hypothermia, acid-base disturbances, arrhythmias, renal and neurologic dysfunction. Tissue ischemia secondary to poor perfusion is the cause of such injury to vital organs. Coined the "post resuscitation syndrome", tissue re-oxygenation after successful CPR causes a reperfusion injury by inciting the production of inflammatory cytokines and coagulation disorders such as disseminated intravascular coagulation (DIC). The consequences of tissue hypoxia to certain organs such as the brain may be permanent.

Thanks for the article. It's very likely he's suffered some brain damage, thought we don't know the extent of it and how much will heal/improve over time. He's having issues with seeing, and pretty confident there's been damage to his hearing and smell, since he doesn't strongly react to loud noises, and his food needs to be placed right in front of him and placed up to his mouth before he starts eating.

It's a lot of work and heart breaking, and we're hoping to see improvements in the weeks to come.

As long as he is urinating anything, that means his kidneys are functioning, another good sign that improvement is possible. Definitely push water, and let him do what he can do in his own way. encouraging play would improve his circulation, but don't push too hard.

Thank you. He's getting around a decent amount and typically peeing a couple times a day. Now that we've found good food for him, it's a matter of seeing how far he can go with other improvements such as hearing, smelling, pottying and generally being content with his quality of life.

 

[Leomc123]

Hi jaytea how is charlie doing so far, is there any improvements with charlies bladder ?

 

[Jaytea]

Hi jaytea how is charlie doing so far, is there any improvements with charlies bladder ?

Thank you for following up! He's doing a lot better, overall. He's walking upright (even tries to run and trot a few times a day), and eats independently (if not messily), and can use the litterbox and is using it consistently.

The only issue is that he's not usually burying his pee/poop, and may need to be re-trained. It could be something he'll learn to do again over time as he heals.

The issue with not covering up his waste is that he can sometimes fall or step in it when exiting the litter box. We have been keeping him in a playpen at night, along with the litterbox inside, and most mornings I will wake up to a mess of litter and waste all over the play pen floor. I'll also have to wash his feet and legs to remove the waste that he stepped in.

I think this problem might be solved if we stop leaving him in the pen a night. I think he's moving around well enough on his own that he's not a hazard to himself on his own. I think the mess with the litter might be attributed to the fact we've been leaving him in a confined space at night without much room to walk, thus he tramples through his litter repeatedly and makes a mess

But we're really impressed with the progress he's made. As I said, he's pretty independent and not bumping into things like he used to when we first brought him home.

The only major thing off with him is that he's not really playing. At all. Which makes his brother sad, and I worry about his level of happiness and quality of life. He doesn't really respond well to being pet, as in he doesn't lean into hands or rub up against us. He DOES purr tho, which we think is a good sign. Hopefully with time he'll gain some playfulness back and show signs that he enjoys petting. I'd hate to think that petting or playing could be painful for him forever, but it could be too much for him right now during recovery

 

[Meowmee]

That is wonderful that he has improved so much! Sorry he is still having these issues with poop etc, playing/ petting. I hope in time he will improve a lot. He is young so his brain etc can probably heal a lot from whatever happened. I would keep loving him a lot, petting him etc.

 

[1 bruce 1]

Wow is all I can say.
I can't give you much advice, but I do admire your dedication to this little foundling and your care of him. He's a handsome chap, and I sure hope he gets back to 110%.
The playing I wouldn't worry about too much just yet. He's made a lot of progress, and play takes a lot of muscle, a lot of coordination (which he's getting back!), and a lot from their heart----something you don't want to stress too much now. I'd encourage him to play some, but keep it low key, like tossing a little catnip mouse for him to bat, or slowly rolling a ball towards him. In other words, save the flying flips with the cat wand toy for later until he's declared healthy again.
There are so many posts here that just make me feel like humanity isn't a lost cause. This is one of them. So much concern and love for what used to be a little feral kitten that very few people would care about. Now he's getting the royal treatment after a terrible problem. Keep up the good (great) work

 

[Jaytea]

Thanks so much meowmee and 1 Bruce 1 for the words of encouragement. This hasn't been easy, but we love him too much to have given up on him.

He's starting to run a little bit. And it appears he's trying to be playful by chasing shadows and pawing stuff I can't always see (it might be different lighting or shadows he fixates on, not sure), and after eating he tends to leap around and pounce... not really sure if he's actually feeling playful or testing his range of motion. Anyway, it's promising but sometimes scary cause he'll hit his head and he have to try to encourage him to slow down

Unfortunately still having problems with him either stepping in his poop or pooping on his foot while going to the bathroom. Happens 2 to 3 times a week. I'm thinking a bigger litter box might help... I already own three, what's one more?

Speaking of having some hope... I'm glad this site exists because y'all have been giving me some hope and encouragement and it's super appreciated right now. Thank you

 

[Meowmee]

Thanks so much meowmee and 1 Bruce 1 for the words of encouragement. This hasn't been easy, but we love him too much to have given up on him.

He's starting to run a little bit. And it appears he's trying to be playful by chasing shadows and pawing stuff I can't always see (it might be different lighting or shadows he fixates on, not sure), and after eating he tends to leap around and pounce... not really sure if he's actually feeling playful or testing his range of motion. Anyway, it's promising but sometimes scary cause he'll hit his head and he have to try to encourage him to slow down

Unfortunately still having problems with him either stepping in his poop or pooping on his foot while going to the bathroom. Happens 2 to 3 times a week. I'm thinking a bigger litter box might help... I already own three, what's one more?

Speaking of having some hope... I'm glad this site exists because y'all have been giving me some hope and encouragement and it's super appreciated right now. Thank you

You are amazing not to give up on him and he is making good progress great to hear that. I got a large stainless steel litter pan at amazon that may be good for him, or maybe one of those ones that has a lower entry area.