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My cat has a grave prognosis-Chylothorax (LONG)
I haven't felt like posting on here primarily because I don't want
anyone telling me I'm not doing enough for my cat or making me second guess my decisions. But, it's a long weekend and I guess I feel like mentioning it now. FWIW, I'm in AZ, we have no vet schools here and I'm not flying her to some other state's vet school. My cat Abbey, who is only 4 (we found her abandoned in the desert on 6/17/01 and she was only about 5 weeks old) has chylothorax, which is a fairly rare condition in cats where there is a small hole in the thoracic wall where lymphatic fluids from the digestive system (chyle) seep into the pleural cavity so there is a large fluid buildup. Abbey had no symptoms that we noticed until 3 and a half weeks ago. I came home from work on a Thurs. night and she was breathing very oddly, rapidly and shallowly. My own vet was closed by this time and I didn't want to go to the actual emergency vet, as it's kinda icky there, so I called another vet who I have been to before. They are a practice who takes their own emergency calls 24 hours a day whereas my "real" vet just has a message saying to take your animal to the emergency vet. Anyway, her chest was tapped (220ml), the fluid was sent out, the diagnosis was confirmed as chylothorax. She had x-rays, full blood panel, no causes were determined--it can be caused by trauma, heart conditions, lymphoma, other cancers, or by nothing at all She is FeLV- and nothing indicated any other conditions present so her diagnosis is idiopathic chylothorax. I was told and later read on my own that chylothorax has a bad prognosis. Further complicating Abbey's condition is that she has fibrosing pleuritis, meaning that the fluid was present in her pleural cavity for awhile (cats are very good at masking their symptoms until they hit a critical mass) and scarred the outside of her lungs, making them small and contracted. This makes a bad prognosis officially a grave prognosis. She is not expected to be able to overcome this but it is, of course, a possibility. She will always have diminished lung capacity, though. She was sent home with lasix and clavamox. The first week, she was quiet, had to be coaxed to eat, seemed a little glum but not in pain really. By the end of the week, she was almost back to normal and stayed good for another 2 weeks, eating, playing, hanging out with her "brother," Scottie, my orange kitty, and avoiding her other brother Marbles, our aggressive, bizarre cat. 3 weeks to the day, last Thursday, I came home from work and she was breathing bad again. Not as bad as the first time but definitely somewhat labored. Called the vet, took her in again, same routine, drained her chest (140ml), x-rays. This was a different vet at this same practice. He talked me into keeping her the night in an incubator with oxygen running. She wound up staying 2 nights, getting several lasix injections, aminophylline injections, polycillin injections, but she wasn't eating there so we brought her home yesterday. She seems to be resting comfortably, eating a little on her own and more if coaxed, not her perky self but not as withdrawn like after the 1st time it was done. She is still on lasix, clavamox, and we are going to give her vitamin E and rutin, both things we read about that the vet said couldn't hurt but won't necessarily help. So, that's it. My sweet little girl kitty, she's very tiny, may not be with us much longer. The thing is...and I hate to say this because of potential flaming...I have a monetary limit on what I can spend when the prognosis is poor. I don't have an actual figure but each time we've gone, it has cost $700-800 so I assume if it happens again (which is "expected"), it will cost about the same. I might opt to not keep her there overnight as that didn't seem to help much, imo, but the draining and the x-rays are standard. She also had to be anesthesized for the draining this time although not the first time. I'm not asking for advice on when to stop. I guess I will have to decide that myself. Originally, I told myself that if she went a month without needing draining, I would do it again. Well, she only went 3 weeks but she had been so improved that I felt I needed to do it again. Now, once again, I feel like I will do it a third time, but practically speaking, I can't do it forever. There is a surgery but it is a very painful surgery with a low success rate where they open the chest, strip the lining off the lungs, insert chest tubes for awhile. It's painful and I wouldn't do it. Both vets said they would not subject their own cats to it. I'm sure that would require a specialist. The only other option is to insert a chest tube for several days or more but that is a procedure where she would remain hospitalized for the whole time and there's no guarantees with that either as that does nothing to seal the hole. She won't eat there, she looks miserable there, and, once again, very low success rate. Basically, everything has a very low success rate. The only thing that one can hope for is that the hole seals itself, which can happen. But that could happen after 2 drainings, 20 drainings, or never. The prognosis is very grave, that's what they keep telling me. But I have read on the internet of a cat who has survived for 3 years now with just the treatment Abbey is getting. This one cat in particular only has to have his chest drained every few months now. And he has lung scarring like Abbey does, too. So there is a glimmer of hope, it's just a matter of how long I want to put her and us through this, I guess, and also of how many times I can afford to do so, sadly. The cat I mentioned above is a shelter mascot cat who goes to a university vet shcool for his treatments so I'm sure money is not as much of an object. The shelter probably gets donations for his care (he has a webpage) and the school probably donates some of the treatment. To complicate things further, as of 6/2, I will be alone for 18 days to pill her twice a day myself. It takes both of us to do it now so it will be a major challenge. Plus any decisions that need to be made during that time will be mine alone as Tony will be in China on business. I guess at some point, TBD, when/if it happens again, when I take her in, I will have to choose euthanasia instead of the draining. If you feel so inclined, she is accepting prayers, good thoughts, and positive energy here in Phoenix, if you want to send some her way. Candace |
#2
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It seems to me you've given Abbey more time than she would have had
otherwise. And she is suffering, because of the disease and because of the treatment of it. I think you're doing right to listen to the vets, who sound pretty tactful and thoughtful, about how grave her condition is. One does have to be practical in situations like this. When the quality of the cat's life gets so low... Take care, Abbey and Candace. I hope you will continue to keep the group posted. |
#3
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I'm so sorry to hear this. I will send good thoughts. I think you will know
when it is just "for you" and not "for her". |
#4
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"Candace" wrote in message oups.com... I haven't felt like posting on here primarily because I don't want anyone telling me I'm not doing enough for my cat or making me second guess my decisions. But, it's a long weekend and I guess I feel like mentioning it now. FWIW, I'm in AZ, we have no vet schools here and I'm not flying her to some other state's vet school. My cat Abbey, who is only 4 (we found her abandoned in the desert on 6/17/01 and she was only about 5 weeks old) has chylothorax, which is a fairly rare condition in cats where there is a small hole in the thoracic wall where lymphatic fluids from the digestive system (chyle) seep into the pleural cavity so there is a large fluid buildup. Abbey had no symptoms that we noticed until 3 and a half weeks ago. I came home from work on a Thurs. night and she was breathing very oddly, rapidly and shallowly. My own vet was closed by this time and I didn't want to go to the actual emergency vet, as it's kinda icky there, so I called another vet who I have been to before. They are a practice who takes their own emergency calls 24 hours a day whereas my "real" vet just has a message saying to take your animal to the emergency vet. Anyway, her chest was tapped (220ml), the fluid was sent out, the diagnosis was confirmed as chylothorax. She had x-rays, full blood panel, no causes were determined--it can be caused by trauma, heart conditions, lymphoma, other cancers, or by nothing at all She is FeLV- and nothing indicated any other conditions present so her diagnosis is idiopathic chylothorax. I was told and later read on my own that chylothorax has a bad prognosis. Further complicating Abbey's condition is that she has fibrosing pleuritis, meaning that the fluid was present in her pleural cavity for awhile (cats are very good at masking their symptoms until they hit a critical mass) and scarred the outside of her lungs, making them small and contracted. This makes a bad prognosis officially a grave prognosis. She is not expected to be able to overcome this but it is, of course, a possibility. She will always have diminished lung capacity, though. She was sent home with lasix and clavamox. The first week, she was quiet, had to be coaxed to eat, seemed a little glum but not in pain really. By the end of the week, she was almost back to normal and stayed good for another 2 weeks, eating, playing, hanging out with her "brother," Scottie, my orange kitty, and avoiding her other brother Marbles, our aggressive, bizarre cat. 3 weeks to the day, last Thursday, I came home from work and she was breathing bad again. Not as bad as the first time but definitely somewhat labored. Called the vet, took her in again, same routine, drained her chest (140ml), x-rays. This was a different vet at this same practice. He talked me into keeping her the night in an incubator with oxygen running. She wound up staying 2 nights, getting several lasix injections, aminophylline injections, polycillin injections, but she wasn't eating there so we brought her home yesterday. She seems to be resting comfortably, eating a little on her own and more if coaxed, not her perky self but not as withdrawn like after the 1st time it was done. She is still on lasix, clavamox, and we are going to give her vitamin E and rutin, both things we read about that the vet said couldn't hurt but won't necessarily help. So, that's it. My sweet little girl kitty, she's very tiny, may not be with us much longer. The thing is...and I hate to say this because of potential flaming...I have a monetary limit on what I can spend when the prognosis is poor. I don't have an actual figure but each time we've gone, it has cost $700-800 so I assume if it happens again (which is "expected"), it will cost about the same. I might opt to not keep her there overnight as that didn't seem to help much, imo, but the draining and the x-rays are standard. She also had to be anesthesized for the draining this time although not the first time. I'm not asking for advice on when to stop. I guess I will have to decide that myself. Originally, I told myself that if she went a month without needing draining, I would do it again. Well, she only went 3 weeks but she had been so improved that I felt I needed to do it again. Now, once again, I feel like I will do it a third time, but practically speaking, I can't do it forever. There is a surgery but it is a very painful surgery with a low success rate where they open the chest, strip the lining off the lungs, insert chest tubes for awhile. It's painful and I wouldn't do it. Both vets said they would not subject their own cats to it. I'm sure that would require a specialist. The only other option is to insert a chest tube for several days or more but that is a procedure where she would remain hospitalized for the whole time and there's no guarantees with that either as that does nothing to seal the hole. She won't eat there, she looks miserable there, and, once again, very low success rate. Basically, everything has a very low success rate. The only thing that one can hope for is that the hole seals itself, which can happen. But that could happen after 2 drainings, 20 drainings, or never. The prognosis is very grave, that's what they keep telling me. But I have read on the internet of a cat who has survived for 3 years now with just the treatment Abbey is getting. This one cat in particular only has to have his chest drained every few months now. And he has lung scarring like Abbey does, too. So there is a glimmer of hope, it's just a matter of how long I want to put her and us through this, I guess, and also of how many times I can afford to do so, sadly. The cat I mentioned above is a shelter mascot cat who goes to a university vet shcool for his treatments so I'm sure money is not as much of an object. The shelter probably gets donations for his care (he has a webpage) and the school probably donates some of the treatment. To complicate things further, as of 6/2, I will be alone for 18 days to pill her twice a day myself. It takes both of us to do it now so it will be a major challenge. Plus any decisions that need to be made during that time will be mine alone as Tony will be in China on business. I guess at some point, TBD, when/if it happens again, when I take her in, I will have to choose euthanasia instead of the draining. If you feel so inclined, she is accepting prayers, good thoughts, and positive energy here in Phoenix, if you want to send some her way. Candace, Speak to your vet about Rutin (available from the Solgar Vitamin Co., Lynbrook, NY- and probably your local pharmacy) at about 50 to 100 mg/kg orally every 8 hr. I can't say with absolute certainty that Rutin cured our chylo cats by itself or if the chylo resolved spontaneously- but after a few months of low-fat diets and thoracentesis as necessary to relieve dyspnea and limit fibrosing pleuritis, both cats pulled through. A U of Minn study done on 4 chylo cats showed clinical improvement in 3 and *complete* resolution in 2 of the 4 cats-- So, I'd say its definitely worth a shot. Best hopes & wishes for you and Abbey. Phil |
#5
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"Candace" wrote in message
oups.com... snip I guess at some point, TBD, when/if it happens again, when I take her in, I will have to choose euthanasia instead of the draining. If you feel so inclined, she is accepting prayers, good thoughts, and positive energy here in Phoenix, if you want to send some her way. Candace Candace, I'm very sorry to hear that Abbey is so gravely ill. Personally, I don't think you should be flamed for not having unlimited funds to keep her alive, not to mention the fact that it may only be prolonging her pain. I know we've had our differences in the past, but sincere best wishes and positive energy are heading your way for Abbey from me and my four (who will get extra loving and scritches today in honor of Abbey). Hugs, CatNipped |
#6
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Bless you and your long-time friends, Phil. I've never heard of this cat's
condition but you've given them a ray of hope. "Phil P." wrote in message ... "Candace" wrote in message oups.com... I haven't felt like posting on here primarily because I don't want anyone telling me I'm not doing enough for my cat or making me second guess my decisions. But, it's a long weekend and I guess I feel like mentioning it now. FWIW, I'm in AZ, we have no vet schools here and I'm not flying her to some other state's vet school. My cat Abbey, who is only 4 (we found her abandoned in the desert on 6/17/01 and she was only about 5 weeks old) has chylothorax, which is a fairly rare condition in cats where there is a small hole in the thoracic wall where lymphatic fluids from the digestive system (chyle) seep into the pleural cavity so there is a large fluid buildup. Abbey had no symptoms that we noticed until 3 and a half weeks ago. I came home from work on a Thurs. night and she was breathing very oddly, rapidly and shallowly. My own vet was closed by this time and I didn't want to go to the actual emergency vet, as it's kinda icky there, so I called another vet who I have been to before. They are a practice who takes their own emergency calls 24 hours a day whereas my "real" vet just has a message saying to take your animal to the emergency vet. Anyway, her chest was tapped (220ml), the fluid was sent out, the diagnosis was confirmed as chylothorax. She had x-rays, full blood panel, no causes were determined--it can be caused by trauma, heart conditions, lymphoma, other cancers, or by nothing at all She is FeLV- and nothing indicated any other conditions present so her diagnosis is idiopathic chylothorax. I was told and later read on my own that chylothorax has a bad prognosis. Further complicating Abbey's condition is that she has fibrosing pleuritis, meaning that the fluid was present in her pleural cavity for awhile (cats are very good at masking their symptoms until they hit a critical mass) and scarred the outside of her lungs, making them small and contracted. This makes a bad prognosis officially a grave prognosis. She is not expected to be able to overcome this but it is, of course, a possibility. She will always have diminished lung capacity, though. She was sent home with lasix and clavamox. The first week, she was quiet, had to be coaxed to eat, seemed a little glum but not in pain really. By the end of the week, she was almost back to normal and stayed good for another 2 weeks, eating, playing, hanging out with her "brother," Scottie, my orange kitty, and avoiding her other brother Marbles, our aggressive, bizarre cat. 3 weeks to the day, last Thursday, I came home from work and she was breathing bad again. Not as bad as the first time but definitely somewhat labored. Called the vet, took her in again, same routine, drained her chest (140ml), x-rays. This was a different vet at this same practice. He talked me into keeping her the night in an incubator with oxygen running. She wound up staying 2 nights, getting several lasix injections, aminophylline injections, polycillin injections, but she wasn't eating there so we brought her home yesterday. She seems to be resting comfortably, eating a little on her own and more if coaxed, not her perky self but not as withdrawn like after the 1st time it was done. She is still on lasix, clavamox, and we are going to give her vitamin E and rutin, both things we read about that the vet said couldn't hurt but won't necessarily help. So, that's it. My sweet little girl kitty, she's very tiny, may not be with us much longer. The thing is...and I hate to say this because of potential flaming...I have a monetary limit on what I can spend when the prognosis is poor. I don't have an actual figure but each time we've gone, it has cost $700-800 so I assume if it happens again (which is "expected"), it will cost about the same. I might opt to not keep her there overnight as that didn't seem to help much, imo, but the draining and the x-rays are standard. She also had to be anesthesized for the draining this time although not the first time. I'm not asking for advice on when to stop. I guess I will have to decide that myself. Originally, I told myself that if she went a month without needing draining, I would do it again. Well, she only went 3 weeks but she had been so improved that I felt I needed to do it again. Now, once again, I feel like I will do it a third time, but practically speaking, I can't do it forever. There is a surgery but it is a very painful surgery with a low success rate where they open the chest, strip the lining off the lungs, insert chest tubes for awhile. It's painful and I wouldn't do it. Both vets said they would not subject their own cats to it. I'm sure that would require a specialist. The only other option is to insert a chest tube for several days or more but that is a procedure where she would remain hospitalized for the whole time and there's no guarantees with that either as that does nothing to seal the hole. She won't eat there, she looks miserable there, and, once again, very low success rate. Basically, everything has a very low success rate. The only thing that one can hope for is that the hole seals itself, which can happen. But that could happen after 2 drainings, 20 drainings, or never. The prognosis is very grave, that's what they keep telling me. But I have read on the internet of a cat who has survived for 3 years now with just the treatment Abbey is getting. This one cat in particular only has to have his chest drained every few months now. And he has lung scarring like Abbey does, too. So there is a glimmer of hope, it's just a matter of how long I want to put her and us through this, I guess, and also of how many times I can afford to do so, sadly. The cat I mentioned above is a shelter mascot cat who goes to a university vet shcool for his treatments so I'm sure money is not as much of an object. The shelter probably gets donations for his care (he has a webpage) and the school probably donates some of the treatment. To complicate things further, as of 6/2, I will be alone for 18 days to pill her twice a day myself. It takes both of us to do it now so it will be a major challenge. Plus any decisions that need to be made during that time will be mine alone as Tony will be in China on business. I guess at some point, TBD, when/if it happens again, when I take her in, I will have to choose euthanasia instead of the draining. If you feel so inclined, she is accepting prayers, good thoughts, and positive energy here in Phoenix, if you want to send some her way. Candace, Speak to your vet about Rutin (available from the Solgar Vitamin Co., Lynbrook, NY- and probably your local pharmacy) at about 50 to 100 mg/kg orally every 8 hr. I can't say with absolute certainty that Rutin cured our chylo cats by itself or if the chylo resolved spontaneously- but after a few months of low-fat diets and thoracentesis as necessary to relieve dyspnea and limit fibrosing pleuritis, both cats pulled through. A U of Minn study done on 4 chylo cats showed clinical improvement in 3 and *complete* resolution in 2 of the 4 cats-- So, I'd say its definitely worth a shot. Best hopes & wishes for you and Abbey. Phil |
#7
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Elle wrote:
I think you're doing right to listen to the vets, who sound pretty tactful and thoughtful, about how grave her condition is. One does have to be practical in situations like this. When the quality of the cat's life gets so low... After the first time we had her chest drained, I contemplated euthanasia every day because she looked so glum but then she improved and was back to normal so I was glad I didn't do it. I assume now that in a couple of days she will be feeling well again. Right now, she's looking out the back door at birdies. So I truly don't think her quality of life, per se, is low right now. And this time I caught it quicker, she wasn't breathing as hard. In fact, she ate dinner right before I took her to the vet. If I didn't think she would bounce back, I wouldn't keep doing it but she will bounce back. It's just a matter of how long she'll stay well until the next time, if there is a next time. I think part of it is her age, too. Last year, I had my beloved Cory, PTS, but he was 18. I never regretted anything about that, he had a very long, happy life. Abbey has had only a short, happy life...which I know is a lot more than a lot of other kitties get but she's still so young. Take care, Abbey and Candace. I hope you will continue to keep the group posted. Thank you. |
#8
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"Phil P." wrote in message ... Candace, Speak to your vet about Rutin (available from the Solgar Vitamin Co., Lynbrook, NY- and probably your local pharmacy) at about 50 to 100 mg/kg orally every 8 hr. I can't say with absolute certainty that Rutin cured our chylo cats by itself or if the chylo resolved spontaneously- but after a few months of low-fat diets and thoracentesis as necessary to relieve dyspnea and limit fibrosing pleuritis, both cats pulled through. It this the rutin that is, along with hesperidin, part of C-complex? |
#9
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"Catnipped" wrote in message ... "Candace" wrote in message oups.com... snip I guess at some point, TBD, when/if it happens again, when I take her in, I will have to choose euthanasia instead of the draining. If you feel so inclined, she is accepting prayers, good thoughts, and positive energy here in Phoenix, if you want to send some her way. Candace Candace, I'm very sorry to hear that Abbey is so gravely ill. Personally, I don't think you should be flamed for not having unlimited funds to keep her alive, not to mention the fact that it may only be prolonging her pain. Nobody does that here. Everyone understands, tacitly, that each and every one of us has our financial limits. Not the same thing as someone beginning a thread entitled something like "What is Your Limit," which I found disgusting. Also not the same as flaming people for just NOT TAKING their animals to the vet when they are sick. Nobody has limitless resources. I know we've had our differences in the past, but sincere best wishes and positive energy are heading your way for Abbey from me and my four (who will get extra loving and scritches today in honor of Abbey). I hope the rutin Phil mentioned will do some good. I wonder if our Resident Gargoyle Megan "I demand an Apology" has any suggestions. Poor baby Abbey--to have come through so much to have this to contend with. My heart goes out to Candace. |
#10
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Phil P. wrote:
Speak to your vet about Rutin (available from the Solgar Vitamin Co., Lynbrook, NY- and probably your local pharmacy) at about 50 to 100 mg/kg orally every 8 hr. I can't say with absolute certainty that Rutin cured our chylo cats by itself or if the chylo resolved spontaneously- but after a few months of low-fat diets and thoracentesis as necessary to relieve dyspnea and limit fibrosing pleuritis, both cats pulled through. A U of Minn study done on 4 chylo cats showed clinical improvement in 3 and *complete* resolution in 2 of the 4 cats-- So, I'd say its definitely worth a shot. Best hopes & wishes for you and Abbey. Phil Thanks, Phil. Yes, we got some Rutin today. I had read about it and the vet said it wouldn't hurt. They're big horse pills but we'll cut them down and try to find a smaller pill meanwhile. We're also going to do Vitamin E to help the scarring. A few months of thoracentesis? Wow, I hope I can afford that. Were these cats diagnosed with idiopathic chylo or was there an underlying cause determined? That study makes me more determined to continue on with the taps. Maybe my vets will work something out with me... Do you have an opinion about Vitamin E for the scarring? The vet said that wouldn't hurt either so we're trying that, too. I guess at this point nothing much "hurts." Did your chylo cats stay on lasix, too? Did they remain on it permanently? Do you have a link to the U of Minn study? That is very encouraging as is the fact that your 2 chylo cats resolved. The one vet was going to give theophylline orally but the other vet kind of talked him out of it and said it wouldn't really help. Right now, I have to coax her to eat with a/d and I know that's high fat. Do you know of any tasty low fat diets? Candace |
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