Krista's Care

daftcat75

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We had a 🤮 right before lunch. A three-fer. I think she just stuffed herself, and try as she might, her stomach wasn't emptying fast enough. I woke up late this morning. I was missing my furry alarm clock. So she got first breakfast around 6:30 am instead of an hour earlier. Then I have an 8:30 staff meeting on Thursdays so she got second breakfast nearly on top of first.

Just in case, I tried to give her a B-12 poke 🤺 after her vomiting. But that didn't go well. I don't think the needle went in far enough or at all the first try as she ended up with a wet neck. Then the second try, she squirmed halfway into the plunge and ended up wearing that dose too. So I think she maybe got 1/3 of the dose inside her today. Let's hope today was nothing more sinister than having too much to eat and not enough time between meals.
 

tarasgirl06

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We had a 🤮 right before lunch. A three-fer. I think she just stuffed herself, and try as she might, her stomach wasn't emptying fast enough. I woke up late this morning. I was missing my furry alarm clock. So she got first breakfast around 6:30 am instead of an hour earlier. Then I have an 8:30 staff meeting on Thursdays so she got second breakfast nearly on top of first.

Just in case, I tried to give her a B-12 poke 🤺 after her vomiting. But that didn't go well. I don't think the needle went in far enough or at all the first try as she ended up with a wet neck. Then the second try, she squirmed halfway into the plunge and ended up wearing that dose too. So I think she maybe got 1/3 of the dose inside her today. Let's hope today was nothing more sinister than having too much to eat and not enough time between meals.
Been there and done that, personally and catually. And also with the needle on my sub-Q beauty. Yeah, really hope it was just overenthusiasm.
 

daftcat75

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Hmm....

Her stomach was gurgling something mighty not 20 minutes ago. But she sat up and went to her plate to check for eatables. She didn't seem to be gripping the floor. I fixed her a snack. It's either gas/diarrhea brewing or it's hunger. And I'm hoping it's hunger.
 

tarasgirl06

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Hmm....

Her stomach was gurgling something mighty not 20 minutes ago. But she sat up and went to her plate to check for eatables. She didn't seem to be gripping the floor. I fixed her a snack. It's either gas/diarrhea brewing or it's hunger. And I'm hoping it's hunger.
Yeah, poor girl! All this stuff she has to take!!! But her appetite is good and that's excellent.
 

daftcat75

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She is so sweet! She starts to circle beneath the chair.

“No, you can’t come up. But I can come down.”

No sooner do I come down to the floor and recline into the pillow stack, she comes climbing onto my chest for her daily belly ride.

😻
 

daftcat75

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Yesterday I woke an hour late. Today I woke an hour early. She won’t mind. She used to get overnight feeders.

Despite all the rumblings and gas coming out of that girl yesterday afternoon 🙊, this morning’s 💩 was perfect! 👍 I don’t know what yesterday’s soup was about. But keep up the good ones, hon! 😻

She’s done with breakfast in 15 minutes. I will disable the 5am lights and alarm and enjoy an extra hour of sleep between the breakfasts. 😴
 

daftcat75

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Have whatever symptoms that lead to her recent surgery abated?
As I understood it, it had to have gotten really bad for her to show the symptoms she did in the first place. Her surgeon said it could be a long road to full recovery. However, yes, she is improving. When she went into the hospital for the surgery, she was walking on her hocks because her balance was so bad. She's walking mostly normal now. But she can still shake herself off her feet when she shakes her head. Earlier in her recovery, when I would change out her food, she would fall over trying to look up at me and circle around the pen. Now she's mostly got that covered too. Yesterday she mostly climbed onto me for the belly ride without tumbling off the other side. I may have given her a forearm bumper to arrest her slide. But that was still mostly her improved stability.

When she had Horner's last year, that was at least a month of recovery. I expect it will take at least as long this time. The location of the infection is basically outside of the body. Yes, it's the inner ear. But that's an air-filled chamber bordered by the skin of the ear, the eardrum, and the bones that make up the hearing apparatus. That's why she has to take an antibiotic for so long. It's hard to get at that infectious material. That's also why she needed the surgery and not just a course of antibiotics. As long as her input and output remain good and her balance improves, I'm not too worried.

We must be doing something right. Her blowout poops and poop barfs were almost everyday before this. She had one double-ended blowout--my Father's Day gift. That was probably too much salmon oil in her diet trying to reboot her appetite. Yesterday she had the runny poop in the morning but that was it for that. None of the multi-box or carpet bombing campaigns. And yes, she did barf yesterday. But I'm pretty sure that was just too much food too close together because of my schedule yesterday. I set alarms today and woke up before them. She should be good.
 

daftcat75

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The antibiotic.... the compounded version cannot come fast enough. I suspect it has already been delivered to my other vet's office (because I don't trust the delivery services to do anything but ding-dong-ditch it on my doorstep because of the pandemic) and I just never received the tracking information. I will call later.

I tried to smush each 1/8 pill into pieces of her tripe treat. But that defeats why she likes those treats. They are naturally soft and easy for Her Toothlessness to enjoy. When I try to push a piece a piece of pill into one and ball the rest around it, they become harder. Or easier for her to gnaw around the pill. So after a few aborted attempts at that, I collected the bits of pill and further crushed them directly into her food. I see an empty plate. But we also have seen how much of the plate doesn't make it into her. So 🤷‍♂️ . She was trilling, purring, and giving plaintive meows all at the same time. She was far too adorable to wrestle this morning. I'll keep at this until we land upon something we both can abide.
 

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As I understood it, it had to have gotten really bad for her to show the symptoms she did in the first place. Her surgeon said it could be a long road to full recovery. However, yes, she is improving. When she went into the hospital for the surgery, she was walking on her hocks because her balance was so bad. She's walking mostly normal now. But she can still shake herself off her feet when she shakes her head. Earlier in her recovery, when I would change out her food, she would fall over trying to look up at me and circle around the pen. Now she's mostly got that covered too. Yesterday she mostly climbed onto me for the belly ride without tumbling off the other side. I may have given her a forearm bumper to arrest her slide. But that was still mostly her improved stability.

When she had Horner's last year, that was at least a month of recovery. I expect it will take at least as long this time. The location of the infection is basically outside of the body. Yes, it's the inner ear. But that's an air-filled chamber bordered by the skin of the ear, the eardrum, and the bones that make up the hearing apparatus. That's why she has to take an antibiotic for so long. It's hard to get at that infectious material. That's also why she needed the surgery and not just a course of antibiotics. As long as her input and output remain good and her balance improves, I'm not too worried.

We must be doing something right. Her blowout poops and poop barfs were almost everyday before this. She had one double-ended blowout--my Father's Day gift. That was probably too much salmon oil in her diet trying to reboot her appetite. Yesterday she had the runny poop in the morning but that was it for that. None of the multi-box or carpet bombing campaigns. And yes, she did barf yesterday. But I'm pretty sure that was just too much food too close together because of my schedule yesterday. I set alarms today and woke up before them. She should be good.
No carpet bombing or cluster bombing campaigns? Good news! ;) 😑 Oh, don't you love those orchestrals? :cloud9:
 

daftcat75

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Well, we just had an extra 💩 👍 this afternoon. It was a good one. I just wasn't expecting an afternoon one seeing as she left me a morning one. Whatever it takes to be comfortable.

EDIT: I'm not sure that she is. She's doing a lot of booty duty. 😿
 

daftcat75

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We're past the bonus watch. 👍 We're also past the stomach grumbles. 😺

And it smells a lot better in the office today so I'm guessing we're past the gas...with no gas passed. 😹
 

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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.
View attachment 270153

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.
On “stirring the pot” — isn’t iatro the ultimate worst thing ever? I can relate and sympathize. Sending encouragement from me and Chairman.
 

daftcat75

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Just happened to wake at 2:30 just as she was leaving a perfect 💩👍.

Right on! I swapped out the box. Cleaned the dirty. Fixed her a snack. Now I’m heading back to bed and I can push my 5 am alarm to 6.

I also don’t have to worry about her being penned with her poop until I wake for it like other mornings. Everyone’s a winner!

Wow! Two more bonus rounds. 💩💩 Good thing I have the box swap method down. Also a good thing I have a camera in there.

I’ll keep an eye on her for a bit longer to make sure we’re all done for this shift. 🤞
40CBDD6A-B137-44C6-B802-A3823200C83A.jpeg
 
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Oysterbay

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Just happened to wake at 2:30 just as she was leaving a perfect 💩👍.

Right on! I swapped out the box. Cleaned the dirty. Fixed her a snack. Now I’m heading back to bed and I can push my 5 am alarm to 6.

I also don’t have to worry about her being penned with her poop until I wake for it like other mornings. Everyone’s a winner!

Wow! Two more bonus rounds. 💩💩 Good thing I have the box swap method down. Also a good thing I have a camera in there.

I’ll keep an eye on her for a bit longer to make sure we’re all done for this shift. 🤞
View attachment 340690
Didn't think I'd ever meet another litterbox vigilante. Chairman has me trained: when I hear her scratching her box, I drop everything including sleep and head on over. Though those days have passed. "How high?" is my favorite question.
 
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