Harriet - in the hospital AGAIN

Harriet is one of the cats at work. She was in the hospital on August
5th for severe constipation. Again on 8/22. I took her home over
Labor Day, and she didn't poop. She was back in the hospital on 9/6.
I took her home this past weekend and she did poop some, on Saturday &
Monday but only one turd each time.

This morning I get to work, medicate her, feed her breakfast. She will
usually eat some and then walk away, but she'll come back within a
couple of minutes for seconds. When she walked away, I saw blood on
the rim of the bowl. I picked her up but she looked okay. I got a
good view inside her mouth as she hissed at me. I thought the blood
might have been from my finger, since I had checked my blood sugar
shortly before feeding her. I wiped off the blood and she came back in
a minute to eat some more. When she walked away, there was more blood
on the bowl. Again, I checked her all over and couldn't see where it
was coming from. Harriet went off to sleep. A little while later I
picked her up and saw that her nose was indeed all bloody. When I woke
her up, she licked her nose clean and it looked perfectly normal.

I call the vet, they say bring her in. While I was in the exam room
holding Harriet, waiting for the vet to come in, she sneezed and blood
sprayed all over my arm. I got a paper towel and cleaned myself off.
When the vet came in her nose was all clean again. He weighed her and
while she was on the scale she sneezed again, and blood went
everywhere.

She doesn't have a fever, but he said maybe she has a cold or hit her
nose on something., He said it could be a growth, and if it is there's
really nothing that can be done. And, of course, her colon was full of
feces. He said that it's looking like she will end up needing surgery
to remove the colon. The medications (Lactulose & Cisapride) don't
seem to be working. Last time I mentioned that to my boss, he said
that he wouldn't want to put Harriet through that. Right now I can't
afford surgery either, but if I have to I'll work out a payment plan
with my boss to make sure she gets it.

So, they're going to give her another enema today and start her on
antibiotics. Hariet just turned 8 and I'd like to keep her around for
another 8. I hope that the antibiotics work, and that she doesn't have
a growth inside her little nose. She's been through so much this past
month but she's such a trooper, and always forgives me when I bring her
home from the vet, or back to work after having her with me for the
weekend.

--
Liz

"Elizabeth Blake" wrote

Hariet just turned 8 and I'd like to keep her around for
another 8. I hope that the antibiotics work, and that she doesn't have
a growth inside her little nose. She's been through so much this past
month but she's such a trooper, and always forgives me when I bring her
home from the vet, or back to work after having her with me for the
weekend.


Poor Harriet I don't have any advice, just posting to say I hope her
nose is fine and the poop issue resolves somehow. Crossing my fingers that
she won't need surgery.

--
-Kelly

Poor Harriet (( Purrs and hugs.

"Elizabeth Blake" wrote in message
ups.com...
Harriet is one of the cats at work. She was in the hospital on August
5th for severe constipation. Again on 8/22. I took her home over
Labor Day, and she didn't poop. She was back in the hospital on 9/6.
I took her home this past weekend and she did poop some, on Saturday &
Monday but only one turd each time.

This morning I get to work, medicate her, feed her breakfast. She will
usually eat some and then walk away, but she'll come back within a
couple of minutes for seconds. When she walked away, I saw blood on
the rim of the bowl. I picked her up but she looked okay. I got a
good view inside her mouth as she hissed at me. I thought the blood
might have been from my finger, since I had checked my blood sugar
shortly before feeding her. I wiped off the blood and she came back in
a minute to eat some more. When she walked away, there was more blood
on the bowl. Again, I checked her all over and couldn't see where it
was coming from. Harriet went off to sleep. A little while later I
picked her up and saw that her nose was indeed all bloody. When I woke
her up, she licked her nose clean and it looked perfectly normal.

I call the vet, they say bring her in. While I was in the exam room
holding Harriet, waiting for the vet to come in, she sneezed and blood
sprayed all over my arm. I got a paper towel and cleaned myself off.
When the vet came in her nose was all clean again. He weighed her and
while she was on the scale she sneezed again, and blood went
everywhere.

She doesn't have a fever, but he said maybe she has a cold or hit her
nose on something., He said it could be a growth, and if it is there's
really nothing that can be done. And, of course, her colon was full of
feces. He said that it's looking like she will end up needing surgery
to remove the colon. The medications (Lactulose & Cisapride) don't
seem to be working. Last time I mentioned that to my boss, he said
that he wouldn't want to put Harriet through that. Right now I can't
afford surgery either, but if I have to I'll work out a payment plan
with my boss to make sure she gets it.

So, they're going to give her another enema today and start her on
antibiotics. Hariet just turned 8 and I'd like to keep her around for
another 8. I hope that the antibiotics work, and that she doesn't have
a growth inside her little nose. She's been through so much this past
month but she's such a trooper, and always forgives me when I bring her
home from the vet, or back to work after having her with me for the
weekend.

--
Liz

"Elizabeth Blake" wrote in message
ups.com...
Harriet is one of the cats at work. She was in the hospital on August
5th for severe constipation. Again on 8/22. I took her home over
Labor Day, and she didn't poop. She was back in the hospital on 9/6.
I took her home this past weekend and she did poop some, on Saturday &
Monday but only one turd each time.

This morning I get to work, medicate her, feed her breakfast. She will
usually eat some and then walk away, but she'll come back within a
couple of minutes for seconds. When she walked away, I saw blood on
the rim of the bowl. I picked her up but she looked okay. I got a
good view inside her mouth as she hissed at me. I thought the blood
might have been from my finger, since I had checked my blood sugar
shortly before feeding her. I wiped off the blood and she came back in
a minute to eat some more. When she walked away, there was more blood
on the bowl. Again, I checked her all over and couldn't see where it
was coming from. Harriet went off to sleep. A little while later I
picked her up and saw that her nose was indeed all bloody. When I woke
her up, she licked her nose clean and it looked perfectly normal.

I call the vet, they say bring her in. While I was in the exam room
holding Harriet, waiting for the vet to come in, she sneezed and blood
sprayed all over my arm. I got a paper towel and cleaned myself off.
When the vet came in her nose was all clean again. He weighed her and
while she was on the scale she sneezed again, and blood went
everywhere.

She doesn't have a fever, but he said maybe she has a cold or hit her
nose on something., He said it could be a growth, and if it is there's
really nothing that can be done. And, of course, her colon was full of
feces. He said that it's looking like she will end up needing surgery
to remove the colon. The medications (Lactulose & Cisapride) don't
seem to be working. Last time I mentioned that to my boss, he said
that he wouldn't want to put Harriet through that. Right now I can't
afford surgery either, but if I have to I'll work out a payment plan
with my boss to make sure she gets it.

So, they're going to give her another enema today and start her on
antibiotics. Hariet just turned 8 and I'd like to keep her around for
another 8. I hope that the antibiotics work, and that she doesn't have
a growth inside her little nose. She's been through so much this past
month but she's such a trooper, and always forgives me when I bring her
home from the vet, or back to work after having her with me for the
weekend.

Liz, please find another vet- you're not getting anywhere with this one.
And this new problem. Did he mention the possibility of a nasopharyngeal
polyp (don't get nervous or upset, they're easily removed)?

Did he modify the doses and dosing schedule for lactulose and cisipride?

Phil

Phil P. wrote:

Liz, please find another vet- you're not getting anywhere with this one.
And this new problem. Did he mention the possibility of a nasopharyngeal
polyp (don't get nervous or upset, they're easily removed)?

Did he modify the doses and dosing schedule for lactulose and cisipride?

Phil

He did mention that there could be a growth in her nose. He said that
if there is, there's really nothing that could be done because a cat's
nose is so small, they wouldn't be able to operate.

I just called and they want to keep Harriet overnight. Her bleeding
has slowed down.

I wrote out a list of questions to take with me when I pick her up.
I'm usually so upset when I get there I forget everything. I'm going
to find out what dosage the cisapride is, and if she should be taking
it before both meals and not just in the morning.

Harriet was weighed today, and she's 8 lb 15 oz. She has deifinitely
lost weight. At her heaviest she was over 11 pounds, and she looked
fat. That was when certain co-workers were buying bags of treats and
feeding them to her all day, every day (Harriet is a junk food junkie).
When that stopped, she went back to just under 10 pounds. She looked
much better and people stopped asking us if she was pregnant.

Is it possible that either medication (Lactulose or cisapride) could
cause the nose bleeds?

What were the doses for both meds that you recommended for a 9 pound
cat? Right now she's getting 2ml of Lactulose twice a day, and one
capsule of cisapride (dosage unknown) in the morning. I'd like to have
numbers to bring with me tomorrow.

I don't know why I brought her back to the same vet today. They have
all of her records and my boss' credit card on file for payments.
There is another place, cats only, that I'd rather bring her. They
treated her for the constipation last year, but they didn't do anything
different that the regular vets so it's hard to compare. If surgery is
mentioned I am definitely going to the cats only vet for a second
opinion.

Any other questions I should ask when I go back tomorrow? Last time I
had to pick her up I asked (on the phone, before I went) if I could
speak with the vet and she said sure. Of course I didn't get to once I
was there. Tomorrow I'm not leaving unless I speak to the vet, not a
tech or the girl at the front desk.

--
Liz

Elizabeth Blake wrote:

So, they're going to give her another enema today and start her on
antibiotics. Hariet just turned 8 and I'd like to keep her around for
another 8. I hope that the antibiotics work, and that she doesn't have
a growth inside her little nose. She's been through so much this past
month but she's such a trooper, and always forgives me when I bring her
home from the vet, or back to work after having her with me for the
weekend.

Oh, no! I'm sorry and hope all will be okay with little Harriet.

Candace

"Elizabeth Blake" wrote in message
oups.com...
Phil P. wrote:

Liz, please find another vet- you're not getting anywhere with this one.
And this new problem. Did he mention the possibility of a
nasopharyngeal
polyp (don't get nervous or upset, they're easily removed)?

Did he modify the doses and dosing schedule for lactulose and cisipride?

Phil

He did mention that there could be a growth in her nose. He said that
if there is, there's really nothing that could be done because a cat's
nose is so small, they wouldn't be able to operate.

Liz, I know of 4 cats - *first hand* - that had nasopharyngeal polyps
removed. One cat had a slight head tilt and nystagmus for a few days after
removal but that resolved on its own.

Here's a a short description of one of the procedu

"Removal of the nasopharyngeal polyp usually is easily accomplished while
the cat is anesthetized by grasping with forceps and applying slow steady
traction. During this task, the pedicle may be seen emerging from the
eustachian tube. Postoperative hemorrhage into the nasopharynx is minimal
and easily controlled by packing swabs into the nasopharynx for a few
minutes."

The other procedure is called "bulla osteotomy" and is used if the polyp
can't be reached by the first technique.


I just called and they want to keep Harriet overnight. Her bleeding
has slowed down.

I wrote out a list of questions to take with me when I pick her up.
I'm usually so upset when I get there I forget everything. I'm going
to find out what dosage the cisapride is, and if she should be taking
it before both meals and not just in the morning.

Harriet was weighed today, and she's 8 lb 15 oz. She has deifinitely
lost weight. At her heaviest she was over 11 pounds, and she looked
fat. That was when certain co-workers were buying bags of treats and
feeding them to her all day, every day (Harriet is a junk food junkie).
When that stopped, she went back to just under 10 pounds. She looked
much better and people stopped asking us if she was pregnant.

Is it possible that either medication (Lactulose or cisapride) could
cause the nose bleeds?

I have never seen or heard of either drug causing nose bleeds. The only
adverse effects known to occur in cats from these drugs are GI-related
(diarrhea, gas, cramps).



What were the doses for both meds that you recommended for a 9 pound
cat? Right now she's getting 2ml of Lactulose twice a day, and one
capsule of cisapride (dosage unknown) in the morning. I'd like to have
numbers to bring with me tomorrow.


Lactulose 2-3 ml/t.i.d. The cisapride was compounded locally so I have no
idea of the strength - it might be stronger or weaker than the commercial
formulation. The standard recommended dose for cats up to 10 lbs. is 2.5
mg/t.i.d. 15-30 mins. before feedings. But that weight spread is a little
too wide and the dose might be a little light since her weight is close to
the upper limit for that dose. We've had the best luck with .5 to 1 ml/kg-
b.i.d.- t.i.d. 15-20 min. before feeding and adjusting the dose based on the
response. Because she has a recurring problem, I would probably speak to
the vet about 1 mg/kg/t.i.d. or about 4 mg t.i.d. If she develops diarrhea,
you can always taper the doses. Remember to mention that cisapride is more
effective if given before meals.




I don't know why I brought her back to the same vet today. They have
all of her records and my boss' credit card on file for payments.

Always get a copy of your cats medical records for each visit and keep them
together in a folder and also scan them into your computer for a back up.
The records will not only provide another vet with Harriet's complete
medical history if you want to get a second opinion, but having the records
may save precious time in the event of an emergency- IOW, the emergency
clinic won't have to waste time repeating tests.


There is another place, cats only, that I'd rather bring her. They
treated her for the constipation last year, but they didn't do anything
different that the regular vets so it's hard to compare. If surgery is
mentioned I am definitely going to the cats only vet for a second
opinion.

Any other questions I should ask when I go back tomorrow? Last time I
had to pick her up I asked (on the phone, before I went) if I could
speak with the vet and she said sure. Of course I didn't get to once I
was there. Tomorrow I'm not leaving unless I speak to the vet, not a
tech or the girl at the front desk.


I think you should get better explanation for the bloody nose- was he sure
the blood came from her nose and not her mouth? I gotta tell you Liz, this
vet is making me nervous- my instincts are usually right (I just don't
follow them all the time).

Keep the faith.

Phil

"Phil P." wrote in message
...

"Elizabeth Blake" wrote in message
oups.com...
Phil P. wrote:

Liz, please find another vet- you're not getting anywhere with this
one.
And this new problem. Did he mention the possibility of a
nasopharyngeal
polyp (don't get nervous or upset, they're easily removed)?

Did he modify the doses and dosing schedule for lactulose and
cisipride?

Phil

He did mention that there could be a growth in her nose. He said that
if there is, there's really nothing that could be done because a cat's
nose is so small, they wouldn't be able to operate.

Liz, I know of 4 cats - *first hand* - that had nasopharyngeal polyps
removed. One cat had a slight head tilt and nystagmus for a few days
after
removal but that resolved on its own.

It does sound like Liz needs a new vet. Liz, where are you, maybe I
can help you find a good vet. Poor little Harriet.

"Phil P." wrote in message
...

Liz, I know of 4 cats - *first hand* - that had nasopharyngeal polyps
removed. One cat had a slight head tilt and nystagmus for a few days
after
removal but that resolved on its own.

Here's a a short description of one of the procedu

"Removal of the nasopharyngeal polyp usually is easily accomplished while
the cat is anesthetized by grasping with forceps and applying slow steady
traction. During this task, the pedicle may be seen emerging from the
eustachian tube. Postoperative hemorrhage into the nasopharynx is minimal
and easily controlled by packing swabs into the nasopharynx for a few
minutes."

The other procedure is called "bulla osteotomy" and is used if the polyp
can't be reached by the first technique.

How do you know if there is a polyp/cyst in there? The vet said that she
would need an MRI (? I could be completely wrong.. maybe a sonogram) which
they don't do. He said I'd have to take her someplace else and it would be
very expensive, and that even if they did see something they wouldn't be
able to remove it, since you can't operate in a cat's nose.

I have never seen or heard of either drug causing nose bleeds. The only
adverse effects known to occur in cats from these drugs are GI-related
(diarrhea, gas, cramps).

I did a Google search and couldn't find anything either. The manager at
work, who I have fought with time & again, immediately started blaming the
medication. I really want to kill her, and today I controlled myself and
walked away before I wrapped my hands around her throat. She always knows
exactly what's wrong (she is an expert at *everything* having to do with
cats. That was sarcasm) and she says everything to me in an accusatory
tone, as if I made Harriet sick and everything I do will make it worse.
She's often said that she'd love to take Harriet home. She has two cats,
and one of them terrorizes her other (elderly) cat. Whenever she talks
about taking Harriet home, I mention:
1. she's actually afraid of Harriet. Harriet is a biter, and I've seen her
go to pet Harriet and then immediately withdraw her hand. She usually ends
up knocking something over or hitting her hand in her haste to get away.
She has never actually picked up or held Harriet because she's afraid of
being bit. I have no problems with this. I know how to avoid her tetth
when I have to pick her up. She hasn't bitten me in ages. Even when she's
not happy about it, she just doesn't try to bite me.
2. she's already got two cats, including the psycho one, who has also
attacked her. I'm sure he's never been picked up either.
3. Harriet is now a very expensive cat. She'd never be able to afford her
4. I mention how she wouldn't even give Harriet her medication when I asked
her to, on a day I wouldn't be in last month.

This person is leaving & moving to another stare at the end of the month. I
plan on having Harriet home with me for at least the last week, just in case
she does get any ideas.

Sorry for the rant... I just can't wait for her to leave.


Lactulose 2-3 ml/t.i.d. The cisapride was compounded locally so I have no
idea of the strength - it might be stronger or weaker than the commercial
formulation. The standard recommended dose for cats up to 10 lbs. is 2.5
mg/t.i.d. 15-30 mins. before feedings. But that weight spread is a little
too wide and the dose might be a little light since her weight is close to
the upper limit for that dose. We've had the best luck with .5 to 1 ml/kg-
b.i.d.- t.i.d. 15-20 min. before feeding and adjusting the dose based on
the
response. Because she has a recurring problem, I would probably speak to
the vet about 1 mg/kg/t.i.d. or about 4 mg t.i.d. If she develops
diarrhea,
you can always taper the doses. Remember to mention that cisapride is
more
effective if given before meals.

The hard thing about medicating her is that she's in a store. I can handle
doing it twice a day, but three times would be tricky since I'm usually only
there for 8-9 hours a day. The cats are also fed only twice a day. Stinky
would love to be fed more often, but Harriet probably wouldn't be interested
in one or more of the meals if she was fed too often. She is getting better
about eating more of the canned food right away, instead of licking it for
30 seconds and burying it.

The cisapride dosage is one of the questions I want to ask about tomorrow.
The vial has no information other than the name.

Always get a copy of your cats medical records for each visit and keep
them
together in a folder and also scan them into your computer for a back up.
The records will not only provide another vet with Harriet's complete
medical history if you want to get a second opinion, but having the
records
may save precious time in the event of an emergency- IOW, the emergency
clinic won't have to waste time repeating tests.

The only things I have are the bills. They show the basic services
performed (enema, x-ray, fluids etc) but they don't have any results. I'll
see if I can get copies tomorrow.


I think you should get better explanation for the bloody nose- was he sure
the blood came from her nose and not her mouth? I gotta tell you Liz,
this
vet is making me nervous- my instincts are usually right (I just don't
follow them all the time).

It did look like the blood was from her nose. I got a good look in her
mouth, because she tends to hiss when picked up. She opened real wide for
me when I first went to check. As she was just laying there, I could some
blood coming from her right nostril. When she sneezed, it sprayed
everywhere. She had no cuts in her mouth, her gums or teeth weren't
bleeding. The blood seemed to be coming only from the right nostril.

I've got to call them back at 10:00am tomorrow. No matter what happens, I
think this will be the last time she goes back to that practice.

--
Liz

On 2005-09-13 21:30:12 -0500, "Elizabeth Blake"
said:

"Phil P." wrote in message
...

Liz, I know of 4 cats - *first hand* - that had nasopharyngeal polyps
removed. One cat had a slight head tilt and nystagmus for a few days after
removal but that resolved on its own.

Here's a a short description of one of the procedu

"Removal of the nasopharyngeal polyp usually is easily accomplished while
the cat is anesthetized by grasping with forceps and applying slow steady
traction. During this task, the pedicle may be seen emerging from the
eustachian tube. Postoperative hemorrhage into the nasopharynx is minimal
and easily controlled by packing swabs into the nasopharynx for a few
minutes."

The other procedure is called "bulla osteotomy" and is used if the polyp
can't be reached by the first technique.

How do you know if there is a polyp/cyst in there? The vet said that
she would need an MRI (? I could be completely wrong.. maybe a
sonogram) which they don't do. He said I'd have to take her someplace
else and it would be very expensive, and that even if they did see
something they wouldn't be able to remove it, since you can't operate
in a cat's nose.


I really don't think that is true. I don't remember who, but someone
here a few months back had a cat that had this HUGE polyp removed from
it's nose (I think?) they posted pics. It was amazing. If she is on
lactulose, I have *heard* (but do not know if it is true) that it takes
fluid from the other parts of the body, which then I could see a
connection to a bloody nose, but I don't know for sure.

Wow, I never thought about the difficulties of a shop cat not having
ONE owner. I sure hope you find out something. I think at this point it
is complicated enough with both problems to warrant seeing the
specialist vet. (Call the other vet and see what the price of a scan
is. It may not be as expensive as you think. Pearl's ultrasound was
only $125. )