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View Full Version : Espy in hospital (Phil, you around?)


dgk[_2_]
July 12th 09, 12:36 PM
Bad. He was limping yesterday, rear left leg. It didn't appear to be a
saddle clot since it was warm and looked more like it hurt than that
he couldn't use it. Off to the specialty vet.

By way of review, he wouldn't eat two weeks back, the vet found
abnormal liver enzymes and a huge blocked bladder. Specialty vet says
he has a heart murmur. He was getting better since then and was just
about back to normal yesterday.

They found no apparent reason for the limp (he wouldn't even limp for
them - adrenalin rush I guess) and we were all set to go home. The
bladder was full however so I asked the vet if she could express it
just to make sure that there wasn't another blockage. Well, there was.
Half an hour later out comes the vet with a whopping bill covering the
next four days of care.

Minimum 1600, maximum 2300 if nothing else goes wrong. Really no
choice though. If I take him home, maybe he pees but maybe he dies. So
I held him a bit, already covered in alcohol. They look so pathetic
with the fur all plastered down. Then I left him.

Some minor good news. Last night, they were able to get a catheter in
him so the bladder is drained. Now Ihave to wait for more news. I
still don't know why the blockage is occuring though. If he needs a
prescription diet we're going to have a real problem because this is
one very picky eater.

Billy
July 12th 09, 08:49 PM
Please review the abdominal xrays (there should be 2 views) and the
chest xray. Be sure there is no tumor in the area of the bladder
blocking or restricting normal urination when bladder is fuller, or in
the kidney area as well. With the vaugue and intermiddent symptoms and
the prices you should be getting definitive diagnosis and fast.

Also limping in hind legs and murmor potential could be both pointing to
heart related issues as well. These may be, or a consequence of another
primary condition.

What breed is espy, any Maine coon in him?

There is some type of vein or arterty that goes from the heart to liver
and both were brought up as possible issues. Ask the doc about these too
and any interconnection or relation to the food and excretion issues.

Good luck! keep us posted.

dgk > wrote:
> Bad. He was limping yesterday, rear left leg. It didn't appear to be a
> saddle clot since it was warm and looked more like it hurt than that
> he couldn't use it. Off to the specialty vet.
>
> By way of review, he wouldn't eat two weeks back, the vet found
> abnormal liver enzymes and a huge blocked bladder. Specialty vet says
> he has a heart murmur. He was getting better since then and was just
> about back to normal yesterday.
>
> They found no apparent reason for the limp (he wouldn't even limp for
> them - adrenalin rush I guess) and we were all set to go home. The
> bladder was full however so I asked the vet if she could express it
> just to make sure that there wasn't another blockage. Well, there was.
> Half an hour later out comes the vet with a whopping bill covering the
> next four days of care.
>
> Minimum 1600, maximum 2300 if nothing else goes wrong. Really no
> choice though. If I take him home, maybe he pees but maybe he dies. So
> I held him a bit, already covered in alcohol. They look so pathetic
> with the fur all plastered down. Then I left him.
>
> Some minor good news. Last night, they were able to get a catheter in
> him so the bladder is drained. Now Ihave to wait for more news. I
> still don't know why the blockage is occuring though. If he needs a
> prescription diet we're going to have a real problem because this is
> one very picky eater.

cybercat
July 12th 09, 10:44 PM
"dgk" > wrote in message
...
> Bad. He was limping yesterday, rear left leg. It didn't appear to be a
> saddle clot since it was warm and looked more like it hurt than that
> he couldn't use it. Off to the specialty vet.
>
> By way of review, he wouldn't eat two weeks back, the vet found
> abnormal liver enzymes and a huge blocked bladder. Specialty vet says
> he has a heart murmur. He was getting better since then and was just
> about back to normal yesterday.
>
> They found no apparent reason for the limp (he wouldn't even limp for
> them - adrenalin rush I guess) and we were all set to go home. The
> bladder was full however so I asked the vet if she could express it
> just to make sure that there wasn't another blockage. Well, there was.
> Half an hour later out comes the vet with a whopping bill covering the
> next four days of care.
>
> Minimum 1600, maximum 2300 if nothing else goes wrong. Really no
> choice though. If I take him home, maybe he pees but maybe he dies. So
> I held him a bit, already covered in alcohol. They look so pathetic
> with the fur all plastered down. Then I left him.
>
> Some minor good news. Last night, they were able to get a catheter in
> him so the bladder is drained. Now Ihave to wait for more news. I
> still don't know why the blockage is occuring though. If he needs a
> prescription diet we're going to have a real problem because this is
> one very picky eater.

Oh, I am so sorry he is sicker than they first thought. Phil will chime in
soon, I am sure. Poor baby, I know it was hard for you to leave him there.
The money you spend taking such good care of him will come back to you. I
will keep you both in my thoughts and prayers. How old is Espy?

Phil P.
July 13th 09, 09:51 AM
"dgk" > wrote in message
...
> By way of review, he wouldn't eat two weeks back, the vet found
> abnormal liver enzymes and a huge blocked bladder.

Were crystals or plugs found as the cause of the obstruction?
How was the obstruction relieved?
Was Espy catheterized during his first obstruction?

<snip>

The
> bladder was full however so I asked the vet if she could express it
> just to make sure that there wasn't another blockage. Well, there was.

What was causing the blockage?
Was a crystal or plug retreived?
Was the vet able to express Espy's bladder? -which isn't a good idea because
the bladder is very fragile when its overdistended and could rupture easily.

Anyway, if the vet was able to express Espy's bladder, then he probably
didn't have an actual outflow obstruction. You said during his previous
episode he had a "huge blocked bladder". I assume you meant his bladder
was overdistended. Overdistention can cause damage to the bladder detrusor
muscle by separating the tight junctions between the muscle fibers- kinda
like streching a sock. Loss of the tight junctions between muscle fibers
prevents the flow of motor nerve impulses that make the bladder contract.
So, even after the obstruction has been removed, the cat still can't
voluntarily empty his bladder. If this is the case, the only thing you can
do is keep his bladder empty so that the tight junctions can reform.

Another aftermath of an obstruction is urethral spasms- these can also
prevent a cat from urinating even though he doesn't have another
obstruction.

Another strong possibility is the vet might have damaged your cat's urethra
during catheterization- especially if he tried to reverse flush the urethra.


Best of luck,

Phil

dgk
July 13th 09, 01:48 PM
On Mon, 13 Jul 2009 08:51:38 GMT, "Phil P." >
wrote:

>
>"dgk" > wrote in message
...
>> By way of review, he wouldn't eat two weeks back, the vet found
>> abnormal liver enzymes and a huge blocked bladder.
>
>Were crystals or plugs found as the cause of the obstruction?
>How was the obstruction relieved?
>Was Espy catheterized during his first obstruction?
>
><snip>
>
>The
>> bladder was full however so I asked the vet if she could express it
>> just to make sure that there wasn't another blockage. Well, there was.
>
>What was causing the blockage?
>Was a crystal or plug retreived?
>Was the vet able to express Espy's bladder? -which isn't a good idea because
>the bladder is very fragile when its overdistended and could rupture easily.
>
>Anyway, if the vet was able to express Espy's bladder, then he probably
>didn't have an actual outflow obstruction. You said during his previous
>episode he had a "huge blocked bladder". I assume you meant his bladder
>was overdistended. Overdistention can cause damage to the bladder detrusor
>muscle by separating the tight junctions between the muscle fibers- kinda
>like streching a sock. Loss of the tight junctions between muscle fibers
>prevents the flow of motor nerve impulses that make the bladder contract.
>So, even after the obstruction has been removed, the cat still can't
>voluntarily empty his bladder. If this is the case, the only thing you can
>do is keep his bladder empty so that the tight junctions can reform.
>
>Another aftermath of an obstruction is urethral spasms- these can also
>prevent a cat from urinating even though he doesn't have another
>obstruction.
>
>Another strong possibility is the vet might have damaged your cat's urethra
>during catheterization- especially if he tried to reverse flush the urethra.
>
>
>Best of luck,
>
>Phil
>

On the initial visit to my vet he expressed the bladder without a
catheter. Urinalysis showed (going by memory here) amporphus urate
crystals. The bladder was very large on the xray and he said that it
was impinging on other parts making it difficult to poop as well.

The specialty vet certainly used a catheter (two since I understand
Espy objected to the first one and dislodged it). I think they did
flush the bladder. The rest of the potential problems you mentioned
seem like the reason that they want to keep him four days.

I just spoke to my vet. He says that it is possible Espy will need to
have PU surgery. I guess that makes sense but I think he will never
forgive me. First I neuter him then cut off his penis. Going to be one
angry cat. I can't imagine what this is going to cost.

Espy has been transferred from ICU to the medicine division at the
Specialty vet. I'll talk to them later today. The really bad thing is
that I'm going away next Wednesday (not this one at least) and will be
gone for a week. I very well might need to board him at the vet.

dgk
July 13th 09, 01:53 PM
On Sun, 12 Jul 2009 19:49:03 +0000 (UTC), Billy >
wrote:

>Please review the abdominal xrays (there should be 2 views) and the
>chest xray. Be sure there is no tumor in the area of the bladder
>blocking or restricting normal urination when bladder is fuller, or in
>the kidney area as well. With the vaugue and intermiddent symptoms and
>the prices you should be getting definitive diagnosis and fast.
>
>Also limping in hind legs and murmor potential could be both pointing to
>heart related issues as well. These may be, or a consequence of another
>primary condition.
>
>What breed is espy, any Maine coon in him?
>
>There is some type of vein or arterty that goes from the heart to liver
>and both were brought up as possible issues. Ask the doc about these too
>and any interconnection or relation to the food and excretion issues.
>
>Good luck! keep us posted.

Espy is pure DSH. I don't know if anyone even took a chest Xray. I'll
be yelling about that later. I'll talk to the specialty vet around
10am ET and know more then.

dgk
July 13th 09, 01:53 PM
On Sun, 12 Jul 2009 17:44:26 -0400, "cybercat" >
wrote:

>
>"dgk" > wrote in message
...
>> Bad. He was limping yesterday, rear left leg. It didn't appear to be a
>> saddle clot since it was warm and looked more like it hurt than that
>> he couldn't use it. Off to the specialty vet.
>>
>> By way of review, he wouldn't eat two weeks back, the vet found
>> abnormal liver enzymes and a huge blocked bladder. Specialty vet says
>> he has a heart murmur. He was getting better since then and was just
>> about back to normal yesterday.
>>
>> They found no apparent reason for the limp (he wouldn't even limp for
>> them - adrenalin rush I guess) and we were all set to go home. The
>> bladder was full however so I asked the vet if she could express it
>> just to make sure that there wasn't another blockage. Well, there was.
>> Half an hour later out comes the vet with a whopping bill covering the
>> next four days of care.
>>
>> Minimum 1600, maximum 2300 if nothing else goes wrong. Really no
>> choice though. If I take him home, maybe he pees but maybe he dies. So
>> I held him a bit, already covered in alcohol. They look so pathetic
>> with the fur all plastered down. Then I left him.
>>
>> Some minor good news. Last night, they were able to get a catheter in
>> him so the bladder is drained. Now Ihave to wait for more news. I
>> still don't know why the blockage is occuring though. If he needs a
>> prescription diet we're going to have a real problem because this is
>> one very picky eater.
>
>Oh, I am so sorry he is sicker than they first thought. Phil will chime in
>soon, I am sure. Poor baby, I know it was hard for you to leave him there.
>The money you spend taking such good care of him will come back to you. I
>will keep you both in my thoughts and prayers. How old is Espy?
>

He's only 7, maybe not even that.

cybercat
July 13th 09, 05:20 PM
"dgk" > wrote
>
> He's only 7, maybe not even that.

This gives him a better shot. What worries me, from the catheter story, is
that Phil may be right and the second vet may have damaged his urethra.

---MIKE---
July 13th 09, 06:20 PM
dgk wrote:

>The really bad thing is that I'm going
> away next Wednesday (not this one at
> least) and will be gone for a week. I
> very well might need to board him at the
> vet.

If it were my cat I would not go on the trip. Espy will really need you
to be there for him.


---MIKE---
>>In the White Mountains of New Hampshire
>> (44 15' N - Elevation 1580')

dgk
July 13th 09, 07:05 PM
On Mon, 13 Jul 2009 13:20:18 -0400,
(---MIKE---) wrote:

>dgk wrote:
>
>>The really bad thing is that I'm going
>> away next Wednesday (not this one at
>> least) and will be gone for a week. I
>> very well might need to board him at the
>> vet.
>
>If it were my cat I would not go on the trip. Espy will really need you
>to be there for him.
>
>

That would be difficult but if I must miss it (family get togther)
then I will.

dgk
July 13th 09, 07:31 PM
On Mon, 13 Jul 2009 12:20:13 -0400, "cybercat" >
wrote:

>
>"dgk" > wrote
>>
>> He's only 7, maybe not even that.
>
>This gives him a better shot. What worries me, from the catheter story, is
>that Phil may be right and the second vet may have damaged his urethra.
>

Maybe, and I'm always concerned about such things, but I wouldn't bet
on it here. These folks are really very good. It's one of those places
with 20 doctors with various specialties. I brought Jackie there to
have all of her teeth pulled; they have (well, had) a dental
specialist. It's this place:

http://www.myvetspecialist.com/

Also, some good news. The vet reviewed the various results from my vet
and is not concerned about the liver enzymes. Apparently they are not
very far from normal. Nor are they concerned about the limp, which
likely is unrelated. Espy has been lively and peeing so they are
likely to let me take him home today.

Funny, they're not concerned about the liver enzymes, and my vet isn't
concerned about the heart murmur. I, of course, remain concerned about
both.

But if he eats and acts normal, I'll likely leave him home when I go
away next week. That's also if the poop cam and software continues to
track the litterbox activity. I did have to reboot it once but
otherwise it does a fine job of keeping me an informed pet slave.

My plan (if all goes well) is to check twice a day or so and review
the videos. If I don't see Espy going, or if I see him going
repeatedly, then I tell the cat sitter to take him to the vet. This is
a wonderful use of technology.

Billy
July 13th 09, 10:29 PM
I'm sorry to say this but I would cancel the trip. Technoly will not
replace being there and your hearing that from a 20 year tech veteran.
If Epsy has to go through surgery that is.

I keep hearing this doc is not concerned, that doc is not
concerned....but i would recommend that you take a step back (i know
it's hard) and re-assess all of the facts, not just the opinions of the
vets. What do the vets facts point to, what is ruled out? Finding out a
root issue is sometimes ruling out all others with a direction based on
clues, if no clear facts present themselves definitively.

I hope you get an answer soon.

> wrote:
> On Mon, 13 Jul 2009 12:20:13 -0400, "cybercat" >
> wrote:
>
> >
> >"dgk" > wrote
> >>
> >> He's only 7, maybe not even that.
> >
> >This gives him a better shot. What worries me, from the catheter
> > story, is
> >that Phil may be right and the second vet may have damaged his
> > urethra.
> >
>
> Maybe, and I'm always concerned about such things, but I wouldn't bet
> on it here. These folks are really very good. It's one of those places
> with 20 doctors with various specialties. I brought Jackie there to
> have all of her teeth pulled; they have (well, had) a dental
> specialist. It's this place:
>
> http://www.myvetspecialist.com/
>
> Also, some good news. The vet reviewed the various results from my vet
> and is not concerned about the liver enzymes. Apparently they are not
> very far from normal. Nor are they concerned about the limp, which
> likely is unrelated. Espy has been lively and peeing so they are
> likely to let me take him home today.
>
> Funny, they're not concerned about the liver enzymes, and my vet isn't
> concerned about the heart murmur. I, of course, remain concerned about
> both.
>
> But if he eats and acts normal, I'll likely leave him home when I go
> away next week. That's also if the poop cam and software continues to
> track the litterbox activity. I did have to reboot it once but
> otherwise it does a fine job of keeping me an informed pet slave.
>
> My plan (if all goes well) is to check twice a day or so and review
> the videos. If I don't see Espy going, or if I see him going
> repeatedly, then I tell the cat sitter to take him to the vet. This is
> a wonderful use of technology.

dgk
July 15th 09, 02:05 PM
On Mon, 13 Jul 2009 21:29:20 +0000 (UTC), Billy >
wrote:

>I'm sorry to say this but I would cancel the trip. Technoly will not
>replace being there and your hearing that from a 20 year tech veteran.
>If Epsy has to go through surgery that is.
>
>I keep hearing this doc is not concerned, that doc is not
>concerned....but i would recommend that you take a step back (i know
>it's hard) and re-assess all of the facts, not just the opinions of the
>vets. What do the vets facts point to, what is ruled out? Finding out a
>root issue is sometimes ruling out all others with a direction based on
>clues, if no clear facts present themselves definitively.
>
>I hope you get an answer soon.


Oh, I'd cancel if surger was needed, but surgery has been ruled out.
The specialty vet said that they don't consider that until other
options have been tried. They count this as strike one. I need to feed
him only wet food - until now I gave him dry food after he finished
eating the wet food. All quallity stuff but still, no dry food at all
now.

I should even add some water to his wet food and they recommend a pet
fountain. I already have a pet fountain (the platinum one of course -
no less for my felines). I've even been adding some water to his wet
food such as Wellness Turkey, turning it into a slurry. He always
likes the juice so this works well. He ate a lot this morning but I
had to follow him around placing it under his face.

They really don't have a cause for this but there may not be one. It
is apparently unrelated to the liver or heart. Could be.

The ransom payment was around $1,600 - less than originally projected.
That, of course, doesn't count the $800 spent the previous week.

Some good news is that they feel that many cats outgrow getting urine
blockage by the age of 7 or 8, so he's closing in on that.

Let's review the facts. He wouldn't eat. X-ray shows enlarged bladder
and possibly a kidney that was a bit dark. Lab results show a slightly
elevated liver enzyme; I need to get that more specific. Apparently no
kidney problem. The bladder gets expressed and he comes home. The vet
asks me to call every few days to report on how he is doing. He gets
better consistently until he shows up limping on Saturday.

The specialty vet detects a heart murmur. Nothing done about that. No
one even got an Xray - I wasn't pleased. Bladder is enlarged and a
catheter can get in so no surgery at least. They flush out the
bladder, hopefully getting any existing crystals and perhaps some
mucous. We're still waiting for the urine culture but it should be
negative.

Mostly the last few days were to allow the urethra to calm down from
the catheter and make sure that he's peeing normally.

That's the current state of Espy. He's home, eating and peeing,
hopefully pooping though apparently he wouldn't eat enough at the
hospital to keep an insect alive. He did eat some though. I'll watch
the PP came closely to make sure he does both.

Thanks for everyone's help.

cybercat
July 15th 09, 04:24 PM
"dgk" > wrote
>
> Oh, I'd cancel if surger was needed, but surgery has been ruled out.
> The specialty vet said that they don't consider that until other
> options have been tried. They count this as strike one. I need to feed
> him only wet food - until now I gave him dry food after he finished
> eating the wet food. All quallity stuff but still, no dry food at all
> now.

Think maybe you want to save yourself some money in the long run, Kalmia,
you cheap *******?


>
> I should even add some water to his wet food and they recommend a pet
> fountain. I already have a pet fountain (the platinum one of course -
> no less for my felines). I've even been adding some water to his wet
> food such as Wellness Turkey, turning it into a slurry. He always
> likes the juice so this works well. He ate a lot this morning but I
> had to follow him around placing it under his face.
>
> They really don't have a cause for this but there may not be one. It
> is apparently unrelated to the liver or heart. Could be.
>
> The ransom payment was around $1,600 - less than originally projected.
> That, of course, doesn't count the $800 spent the previous week.
>

THIS is what can happen to male cats on dry food, esp. the cheap stuff you
are feeding your cat.

cybercat
July 15th 09, 04:25 PM
"dgk" > wrote in message
...
> On Mon, 13 Jul 2009 21:29:20 +0000 (UTC), Billy >
> wrote:
>

> That's the current state of Espy. He's home, eating and peeing,
> hopefully pooping though apparently he wouldn't eat enough at the
> hospital to keep an insect alive. He did eat some though. I'll watch
> the PP came closely to make sure he does both.
>

Beautiful job, dgk. I am so glad you had the money to take such good care of
your cat. I know you had better things to do with that money. I hope Espy
recovers completely and has no more problems.

Billy
July 16th 09, 01:42 AM
Remember that all this stress and dr visits can temporarily change
epsy's eating habits as well. She might be off for a while.


"cybercat" > wrote:
> "dgk" > wrote in message
> ...
> > On Mon, 13 Jul 2009 21:29:20 +0000 (UTC), Billy
> > >
> > wrote:
> >
>
> > That's the current state of Espy. He's home, eating and peeing,
> > hopefully pooping though apparently he wouldn't eat enough at the
> > hospital to keep an insect alive. He did eat some though. I'll watch
> > the PP came closely to make sure he does both.
> >
>
> Beautiful job, dgk. I am so glad you had the money to take such good
> care of
> your cat. I know you had better things to do with that money. I hope
> Espy
> recovers completely and has no more problems.

dgk
July 16th 09, 01:23 PM
On Thu, 16 Jul 2009 00:42:06 +0000 (UTC), Billy >
wrote:

>Remember that all this stress and dr visits can temporarily change
>epsy's eating habits as well. She might be off for a while.
>
>

Argh! Urine culture results are back, he has Proteus Mirablis. Not the
worst bacteria but he needs to be pilled for two weeks. That is one
more week than I'm going to be home. I'm going to try to crunch the
pill into some expensive Fancy Feast appetizer I bought at Target
yesterday - this kind of thing:

http://www.petfooddirect.com/store/product_detail.asp?pf_id=30335925&dept_id=17


If it works, then maybe the cat sitter can do the same. She'll
actually have an advantage since the other two cats are likely to hide
when she's there.

I suspect, however, that Espy is getting boarded (and very bored) for
the week. I hate the thought of him being in a cage for a whole week
but he will get the best care that way.