My cat has a grave prognosis-Chylothorax (LONG)

"Candace" wrote in message
oups.com...
wrote:

Hang in there Candace. I have been thinking about Abbey and hoping for
a miracle. I'm really glad you posted her story--I was really hoping
Phil would have some answers for you.

Yes, and he did. I feel a little encouraged. I wanted to see what
other people said; I guess I was ready to get feedback now and everyone
has been nice.

Thank you, she'll gladly accept a miracle.

Miracles are cats' specialty!

Phil

"Candace" wrote in message
oups.com...
Phil P. wrote:

Chylo is caused by leakage or extravasation of chyle from a thoracic
duct
or one its tiny branches- that's why surgical correction is so
difficult.
Chylo is a real sneaky disease that's usually not detectable with
routine
yearly exams- until its well established and the cat shows difficulty
breathing and weight loss.

I was sweating bullets during the entire Rutin therapy because the
longer we
waited to see if the Rutin was working the greater the risk of the cat
developing irreversible fibrosing pleuritis from the constant exposure
of
chyle. I was sure glad it all worked out- I never would have forgiven
myself
if I made the wrong call.

Phil, what does this mean? Can't she be tapped once she's on Rutin?

Sure, she can.


Or did you just mean that you couldn't *know* if the chyle was building
up?


I meant that I hoped I made the right call- rutin/taps/low-fat diet instead
of thoracic duct ligation surgery.


Because if she's on Rutin and her breathing gets bad, I would want
her tapped again. Nothing about Rutin contraindicates tapping, does
it?

Absolutely not. She'll probably need a couple or three taps until the chylo
resolves.

Sorry for not being clear- by brain is fried. I'm inundated with kittens
plus I've been playing 'commando' with the cops in a town that prohibits
feeding and releasing ferals.

Hang in there!

Phil

On Sun, 29 May 2005 14:18:39 -0700, Candace wrote:

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


Sending prayers that she doesn't suffer.. I, personally, would rather not
put my beloved pet through painful procedures especially if there is
little chance for recovery. Prayers for you to make the right decision.
MLB

Phil P. wrote:

I meant that I hoped I made the right call- rutin/taps/low-fat diet instead
of thoracic duct ligation surgery.

OIC, okay, I understand.

Unfortunately, she already has fibrosing pleuritis but the vet said she
could probably live with that if the chyle accumulation would stop.
She would just have limited lung capacity and should live a quiet life.
But she's an indoor cat and not subjected to much stress other than
one of her "brothers," who is aggressive but not toward her but toward
our other boy cat. She mostly seems to find it all interesting to
watch. We can keep her life quiet and peaceful, for the most part.

Candace

mlbriggs wrote:

Sending prayers that she doesn't suffer.. I, personally, would rather not
put my beloved pet through painful procedures especially if there is
little chance for recovery. Prayers for you to make the right decision.
MLB

I absolutely agree and that's why I won't have the surgery or a
semi-permanent chest tube placed. However, this chest tapping does not
appear to be painful. I think she may be slightly uncomfortable after
it for a couple of days, you know, sore from having the needle stuck in
and the chyle removed but I truly don't think she is in bad pain. And
then, she feels totally wonderful for a couple of weeks. If the
tapping has to be done too frequently or if there doesn't appear to be
any quality time derived from it, I won't continue.

I absolutely feel that death is not the worst thing, suffering is.

Thank you for the prayers.

Candace

"Candace" wrote in message
oups.com...
.... 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,
You are doing everything you can. That is all you can do. There is no doubt
in my mind that you will continue to do what you are able. You cannot do
what your are not able to do.
We all have different resources, financial, emotional, time, etc. Abbey also
has her own resources, and you are the best one to determine what they are.
Only you can decide when you will be doing more *to* Abbey than *for* her.
I know the decisions will not be easy, but you will make it with your
heart.
You saved Abbey from an early death and give her a good home with love and
care. Take comfort in that.
If you can provide the name and how to contact the vet, I'd be willing to
make contribution. It won't be much, but maybe it will help relieve some of
your worry.
Meanwhile, healing prayers are on the way for Abbey and prayers for strength
for you.
Hugs,
Annie

"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

**Candace,

I'm so sorry. Sounds like you are doing the absolute best you can for her
and that's plenty. I would offer to come over and help you pill her ( I know
what a total bear that can be), but I'm in FL ;-(.

I'll be praying for you and Abbey. You'll instintively know when, and if, it
is time, and that could be years from now, or maybe months. You sound like a
very good Mom, so she's certainly in good hands. As far as some of the
irritating flamers and 'know it alls" here, who act like they are so perfect
and high and mighty..forget about em! Just ignore em the best you can, and
if necessary, remind yourself that some people simply have no mannors and/or
tact.

God bless and keep doing what your doing for her..loving her!

ML

"Annie Wxill" wrote:

If you can provide the name and how to contact the vet, I'd be willing to
make contribution.


I would too.

Annie Wxill wrote:

If you can provide the name and how to contact the vet, I'd be willing to
make contribution. It won't be much, but maybe it will help relieve some of
your worry.
Meanwhile, healing prayers are on the way for Abbey and prayers for strength for you.
Hugs,
Annie

Annie, that's very kind of you but it's not necessary. I don't mean
that I'm at the end of my resources yet but I do worry about that
amount of money when the prognosis is not good and $800 per visit is a
bit steep. I can go on with her treatment for awhile but I'm not sure
if that's the best thing to go on indefinitely. I will continue to do
so for awhile, though, as long as she seems to improve after the
tappings. I just worry a little that I might put myself into big debt
rather than let her go. But it's not at that point yet so I should try
to stay in the present more rather than worrying about the future
(that's a problem of mine).

I truly appreciate what you offered but it is not necessary.

I will definitely accept the prayers for both of us, though, and thank
you very much.

Candace

"Phil P." wrote


As much as cats hate oranges- it still probably tastes better than
Tapazole!



We've got to get Candace set up somehow to pill Abbey with
no help. I guess she could check for a pharmacist who could make
a liquid to add to her food, as I have been meaning to do?