My cat has a grave prognosis-Chylothorax (LONG)

Candace, my heartfelt sympathies and purrs for your and Abbey's situation --
please know we're thinking of you.
Christine and Omar, Oreo, Midnight, Robin & Tucker
"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" wrote in message
ups.com...
I will definitely accept the prayers for both of us, though, and thank
you very much.
Candace
You've got it. You and Abbey will remain in my thoughts and prayers.
Annie

Candace, I don't know if this might be useful for you but I have found a
compounding pet pharmacy in Arizona that is very good -- my vet's office
found it for me and so far I've been very pleased with them. They have the
ability to use all kinds of flavors for their meds; currently I'm giving two
of mine triple-fish-flavored clomipramine. They were very responsive to my
needs and shipped meds out for my cats without my having had to pay for them
first, which really impressed me, and I could pay by check when I received
the product. You could try talking to them:

Pet Health Pharmacy
Youngstown, AZ
1-800-742-0516

regards,
Christine
"Candace" wrote in message
oups.com...
Mary wrote:

I wonder if the Rutin and the other things you need to give her
could be ground into a favorite food for the 18 days you will be
alone? Rutin and the other citrus bioflavonoids are present in
the white stuff inside an orange peel, so it should not taste bad.
(I ground my cat's Tapazole for about a week and put it in her
cat food but it tastes so bad she detected it and would not eat
it all.)

I'm worried about you trying to pill her by yourself for nearly
three weeks.

Me, too. It makes me sick thinking about it. It takes 2 of us to drag
her out from wherever she's hiding as, of course, she *knows* when
we're getting ready to pill her. I already have half the house blocked
off from her but it's impossible to get rid of all the hidey holes.
Then we have to burrito wrap her so her paws are restricted. Even
sick, she's a fighter.

I'll have to taste the Rutin and see if it tastes citrus-y. Hope not.
The thing is she's not eating much right now and only eats a/d if I
spoon feed her so hiding the pills is hard as she is just licking at
the spoon. Once she has her appetite back, I can try to stick it in
something but cats are just smarter than dogs and harder to trick.

I may have to get my neighbor to come in and help me round her up but I
think that would scare Abbey plus I really can't expect this woman to
do it in the mornings, maybe for the evening dose, but not the morning
one.

Candace

Candace,

What a shock to have happen to your baby! I can't believe she hid some
of the symptoms for awhile.

I know animals are so good at just doing their best, and not feeling
sorry for themselves. Abbey sounds like a real trooper.

I will send lots of good vibes for her, hoping she can turn the corner
and start getting over this.

Take care,

Rhonda

Candace wrote:


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.

Oooh, that turned my stomach so early in the morning! Cats, those
darling little carnivores.

Thanks for the info on the pharmacy, that could come in handy -- even
for our rabbits.

Take care,

Rhonda


Christine Burel wrote:

currently I'm giving two
of mine triple-fish-flavored clomipramine.

"Christine Burel" wrote in message
...
Candace, I don't know if this might be useful for you but I have found a
compounding pet pharmacy in Arizona that is very good -- my vet's office
found it for me and so far I've been very pleased with them. They have
the
ability to use all kinds of flavors for their meds; currently I'm giving
two
of mine triple-fish-flavored clomipramine. They were very responsive to my
needs and shipped meds out for my cats without my having had to pay for
them
first, which really impressed me, and I could pay by check when I received
the product. You could try talking to them:

Pet Health Pharmacy
Youngstown, AZ
1-800-742-0516

Yippee!! This is exactly what Candace needs! In fact I need to find one
near me.




regards,
Christine
"Candace" wrote in message
oups.com...
Mary wrote:

I wonder if the Rutin and the other things you need to give her
could be ground into a favorite food for the 18 days you will be
alone? Rutin and the other citrus bioflavonoids are present in
the white stuff inside an orange peel, so it should not taste bad.
(I ground my cat's Tapazole for about a week and put it in her
cat food but it tastes so bad she detected it and would not eat
it all.)

I'm worried about you trying to pill her by yourself for nearly
three weeks.

Me, too. It makes me sick thinking about it. It takes 2 of us to drag
her out from wherever she's hiding as, of course, she *knows* when
we're getting ready to pill her. I already have half the house blocked
off from her but it's impossible to get rid of all the hidey holes.
Then we have to burrito wrap her so her paws are restricted. Even
sick, she's a fighter.

I'll have to taste the Rutin and see if it tastes citrus-y. Hope not.
The thing is she's not eating much right now and only eats a/d if I
spoon feed her so hiding the pills is hard as she is just licking at
the spoon. Once she has her appetite back, I can try to stick it in
something but cats are just smarter than dogs and harder to trick.

I may have to get my neighbor to come in and help me round her up but I
think that would scare Abbey plus I really can't expect this woman to
do it in the mornings, maybe for the evening dose, but not the morning
one.

Candace

Christine Burel wrote:

Pet Health Pharmacy
Youngstown, AZ
1-800-742-0516

Thanks, Christine, I'll call them tomorrow.

Candace

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

Was this confirmed by x-rays (i.e., rounded lung lobe borders or
constriction)?


but the vet said she
could probably live with that if the chyle accumulation would stop.


Both of our cats had some degree of fibrosing pleuritis and they both did
well. I didn't have a history on either cat, so, I don't know how long they
were chylo. But since they were strays for who knows how long and in a
shelter for at least a few weeks, my guess is they were chylo longer than
Abbey. Knowing how observant and sensitive you are to your cat's behavior,
I don't think she's been chylo for very long. So, I wouldn't expect severe
fibrosis.


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.


Has she had an echocardiogram? Right-sided CHF could cause chylo because it
causes an increase in systemic venous pressure which could cause the
lyphatics to leak.

Keep the faith.

Phil

Phil P. wrote:
"Candace" wrote in message

Unfortunately, she already has fibrosing pleuritis

Was this confirmed by x-rays (i.e., rounded lung lobe borders or
constriction)?

Yes, her lung borders are very rounded, I saw the x-rays. The vet
originally said this made her prognosis "in the tank."

But since they were strays for who knows how long and in a
shelter for at least a few weeks, my guess is they were chylo longer than
Abbey. Knowing how observant and sensitive you are to your cat's behavior, I don't think she's been chylo for very long. So, I wouldn't expect severe fibrosis.

I don't know, I might have missed it. She certainly never coughed or
panted but she has always seemed to have a high respiration rate, all
her life, so I might have missed something.

Has she had an echocardiogram? Right-sided CHF could cause chylo because it
causes an increase in systemic venous pressure which could cause the
lyphatics to leak.

No, she hasn't had one. I'm calling the vet tomorrow to ask about an
ultrasound or echocardiogram. I don't know if I can afford both.

Thanks,
Candace

I'm calling the vet tomorrow to ask about
an ultrasound or echocardiogram. I don't
know if I can afford both.

Don't worry. An echocardiogram uses ultrasound to examine the heart.
You'll only have to pay for one thing.

Megan



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