I thought I'd start her own super-thread rather than the individual concerns I've been having. This way those who want updates only need to follow one thread. This is Krista. Over Christmas, her eating went way down. I thought it was her displeasure that we were running out of Rad Cat and I was transitioning her to homemade. After a week of struggling over the holidays with her appetite and fussiness, I finally got her into the vet's office on Jan 2. We took blood to screen her for anesthesia and made her a dental appointment for this Monday. I knew her teeth were bothering her but until Christmas, she was still eating very healthily and I figured it could wait. Bloodwork came back last Thurs and her liver enzymes (not GGT though, normally associated with choleoangiohepatitis) and bilirubin were elevated. Terrible news! Poor candidate for anesthesia. The dental appointment was changed to an ultrasound and some fasting blood tests (bile acid test and B-12 because we've never measured that before.) I don't have the bile acid test results in front of me but that came back abnormal. The B-12 is good. Krista, my girl, she threw a fit during the ultrasound and got herself sedated. Once sedated, her wonderful vet performed the dental after all. One broken canine, two (one of those being the broken one) with deep pockets, trapped food, and roots dissolving. She had those canines extracted and has just one left now. She had one extracted last year. Whew! So she should be feeling a lot better once her mouth heals. Except she still hasn't eaten since Sunday. She's been on IV fluids since Monday. She had a bupe SR shot on Monday and by Tuesday night she was still in a lot of pain. So I asked for something else for her. She got a gabapentin shot which seemed to help a lot with her pain but it gave her nystagmus (involuntary eye movements.) When I visited last night, her pain was returning so I asked for another gabapentin but at a lower dose. This morning she seems in far less pain. The nystagmus, if present at all, is only so slight that I'm not sure that's even what I'm seeing. However, she's now showing some signs of Horner's Syndrome. Her right ear had waxy build up and possibly a mass. The vet cleaned as much as she could and inserted antibiotic. The other vet (there are two cat vets who split the week's hours) thinks it could be the first vet "stirred the pot" (my words, not hers) and that her eardrum may have ruptured putting this stuff in her middle ear. She has a right-side tilt to her head, her right pupil is constricted, and her right eyelid droops a little. Aside from this, she looks so much more comfortable and alert this morning than she has all week. But she also has ataxia from the ear (or the GBP?) And she's still not eating. She did eat a couple of fish flakes but no mousse topper. If she doesn't want the topper, there's no point in offering her food. So.... The vets finally agree with me that, risky a patient she may be, a feeding tube is the best next action in her recovery. This allows us to finally start the liver and gallbladder medicine. We can also shift from the bupe SR to something shorter so that we can give her more if she needs it. Today she will get the feeding tube and I will pick up her prescriptions for denamarin and ursodiol. The ultrasound and aspirate are pointing more towards bile duct obstruction than liver disease. Though given her history with IBD and pancreatitis, it would seem likely that she would develop liver dysfunction at some point. I've taken to calling her Hat Trick. Also on the plan for today is to recheck the blood chemistry to see whether her liver enzymes/bilirubin got any worse or better being on IV fluids this week. We may still need some exploratory, a biopsy, or bile duct stents. But I've made it clear to the vet that we take this in order of least invasive, least radical diagnostics and treatments first and escalate only as needed. But for the first time since she got the teeth extracted, I feel like we'll be moving forward again. If anyone has questions, suggestions, experiences they can share with me to help direct her care from here, it would make this a lot easier than going it alone with Dr Google and the vets. The vets are great but they have their protocols, decision trees, and expectations. Sometimes, while thorough, they can get to be a bit much. For instance, I don't want to start with bile duct stents when we haven't even tried the ursodiol yet. I've been visiting with her twice a day in the morning and at night. I have an iPod with her "cat rock" (Music For Cats) that she listens to at home. I've been picking up the iPod in the morning visit, charging it up during the day, and dropping it off for her for the overnight to play until it runs out of battery. The staff says she really appreciates it as I know she does. I've seen her laying next to the soundbar at home when one of the more purr-y tracks is on. Day by day she's getting better. She won't eat the mousse yet but she did eat the couple of fish flakes I offered her. Small victories. She also gave me a couple of weak trills last night. But most encouraging, she has found her voice when the staff lift her out of and into her cage again. "You tell 'em! Tell them how much fight you still have left in you!" Tonight I will hopefully come back to her with a feeding tube inserted and probably her first real calories since Sunday night. I never thought I'd be excited about getting a feeding tube inserted into my cat. But now she can get the food and medicine she needs to eventually make her way back home once more. It's been too quiet at home this week.