My sick kitty...

[Einy's family]

Critter1, Kendall is in our prayers and we are hoping for a happy resolution. Hope she feels better soon. We're following her progress, please keep those updates coming!

[Critter1]

Hi all, thanks for your continued support. Today brought a combination of bad news and a little good news regarding Kendall, but mostly "no news".
The vet reported that she had a really bad night (last night) and lost alot of blood during the night. Now they believe that her stones and her loss of blood are NOT related, but they are still hoping that her blood loss is nothing more than a lingering side effect of the Elavil (even though she hasn't taken one since Saturday night.) They did a fecal exam today and were unable to draw any conclusions from that. The vet told me today that they simply do not know what is wrong. I am praying that the stones are not secondary to a bigger problem, but I am trying to prepare myself emotionally for the worst.
The good news is that she hasn't thrown up at all since being there and she was a little more alert today (that's not much good news, but I'll take it). She is not eating on her own but they are syringe feeding her and keeping her hydrated. She still has no desire to clean herself, so they are having to do that for her as well.
Now, my dilemma is this: I know several of the technicians very well, and I trust that they will give her special attention and make sure she is as comfortable as possible, so I have that extra peace of mind with her being where she is (plus, she has been going there since 12/99). She was a feral cat at one time and is still extremely afraid of people, and to change her to a new clinic will be additional stress. But, I'm getting worried that the vets aren't looking at *everything* to find out what the problem is. After reading through some of Traci's other posts, I realize that some conditions are very time-sensitive, especially if it involves the kidneys. How long should I wait before asking them to refer me to a specialist or another clinic? They did an x-ray of her belly last week and identified the stones... would that x-ray show other problems such as a tumor?
It's horrible to feel so helpless, so I'm at least trying to stay hopeful.
Shannon

[Traci]

Shannon, she has been there almost 24 hours now, has the vet bothered to do another urinalysis, and probably more importantly, a hematology or chemical analysis? I think I would be really concerned here with the blood loss, and would therefore keep a close eye on her platelets, your vet can also do a quick blood smear for microscopic exam to determine if this blood might be hemorrhage-related or even anemia, such as infectious. I mention this because some of the symptoms you describe with Kendall remind me of one of my own who had similar problems once.....she did not have a UTI, nor stones or crystals, but she was hemorrhaging (we never found the cause ultimately, but we tested for everything, including feline serology for infectious disease, feline AIHA, coombs, hemobart, etc)........whenever blood loss is concerning, consistent and no other cause can be found, the next step I would recommend would be at least running her platelet counts, a CBC, and of course, another urinalysis. If none of those are revealing, ask your vet about a feline serology ASAP.

I tend to agree with you, it truly doesn't sound like your vet is doing enough and is taking a wait and see approach......well, the wait has been long enough, he needs to get agressive here and find the cause of the hematuria. By this time, he could have at least referred you to an emergency clinic or a vet more knowledgeable in feline medicine. I would consider finding a new vet right away.

I'm only going by your posts, Shannon, and you've been pretty thorough, but I know when I see something amiss, and there is definately something amiss here. I am truly concerned with the blood loss and it's persistance.....please, either demand further diagnostics from your vet or get Kendall transfered to a new vet or ER vet promptly.

[LisaLisa]

Shannon,

Thanks for the update on Kendall....I hope you get to the root of her problems...I know this is such a difficult time for both you and Kendall...I don't really know what else to say other than I'll keep you both in my prayers...

[Critter1]

Good news: Kendall is doing much better today. The vet said she did not pass any blood through the night but did have diarrhea that looked normal (I never thought I'd be so happy to hear that my kittty has diarrhea.) She hasn't thrown up either, and seems much more responsive to them.
The bad news is that they closed today at Noon and will be closed tomorrow, so I won't get another report until Friday.
I know that she isn't in the clear just yet, but I'm staying hopeful.

Happy New Year!!!
Shannon

[Critter1]

Hi all and happy new year,

Kendall is doing great. I brought her home on Friday with some new medications and she seems to be happier and friskier than she has been in weeks. While I'm still a bit irritated with my vet's "wait and see" approach (as Traci noticed), I am more hopeful than ever that Kendall is on the road to recovery. She has not vomited at all and there have been no traces of blood in either her urine or feces. She continues to take Metronidazole (1/4 of 250mg pill every 12 hrs for diarrhea) and was also given Torbutrol (1/2 of 5mg pill PRN for pain), however she hasn't seemed to need any of the pain meds. Her appetite is great and she is drinking alot of water. The only thing I was concerned about was her inability to jump when I got her home on Friday (her back legs seemed "wobbly", but the vet said that was probably due to her pain meds that were wearing off.)
I will take her back to the vet in 30 days for another x-ray to see if the stones have passed, and until then, I will continue to watch her very close.
In the meantime, I have been asking around to get recommendations for other vet clinics just incase I do feel it in her best interest to get a second opinion when I take her back in.
Thanks for your prayers,
Shannon, Kendall and the rest of the gang

[Traci]

Shannon, thank you for the update....

I'm so glad to hear Kendall seems to be feeling better, but I certainly hope this isn't a masked problem.

The wobbliness you noticed on Friday...not entirely sure what that would be resulting from, but torbutrol wouldn't necessarily cause that, unless she was in a deep sedated state with injectable torbutrol. Other than that, the first thing I would have done would be a platelet check first and foremost (to rule out anemia of any type)....also, in my experience, elevil does not cause hemmorhage or blood loss, even in the highest loading dose.

If her water consumption is increased significantly, she could be dehydrated.....during this time of observation, please check out our Vitals section and perform the CRT and hydration checks on her maybe once a day or so for a few days to ensure everything seems normal. I'm stressing these two because you need to ensure she isn't suffering dehydration which could exacerbate any infection and/or crystals, and checking the gums for color and any potential tackiness/dryness as a fairly accurate gauge of dehydration. The CRT can be helpful in determining normal blood flow.

If she doesn't exhibit further signs or symptoms of illness, then the 30-day followup seems appropriate,.....however, if there is decreased urination combined with increased water consumption, if she seems dehydrated or any other symptoms develop, don't hesitate in the least to get her back and seen sooner, at which time, I would strongly suggest another urinalysis to see if they can accurately identify any crystals this time.

While it's not uncommon for some vets to treat as if individual crystal problems (in the absense of complete diagnostics), it is counterproductive when it comes to dietary management, medications, etc. (for example, you don't want to feed the incorrect diet for the wrong type of crystals). If oxalates are indeed a potential concern, these demand a bit more attention to treatment approach as do struvites....oxalates are much more difficult to manage and they are more troublesome and can cause more problems as opposed to struvites (although I'm not undermining the struvite seriousness). Your vet also needs to differentiate the different types of oxalate composition, there are about three different types. For that reason alone, I suggest if your vet is not thorough next time or can't seem to get a good urine sample for testing, or can't identify the crystals, then another vet would be more beneficial to you. I was really concerned this vet wanted to proceed with surgery before confirming whether or not oxalates were indeed the problem.

Continued good thoughts and prayers.....hang in there and don't be afraid to seek another vet or even talk to an emergency vet for referrals.

[Critter1]

Hi again,
Kendall still seems to be doing well. I have been doing the hydration checks and all seems good. Kendall is a black cat and her gums look very dark which scared me at first, but then I checked her brother, Banjo (who is also black) and his gums are also dark. I think she is hydrated; she is eating & drinking well and is urinating easily (large amounts with no straining).
The pain medication that she received while still at the vet was not torbutrol, but rather something like "diazepine" (?) I'm sure I killed that spelling, but it sounded something like that. They sent her home with the torbutrol but thus far she hasn't needed any. Her wobbly legs have progressively gotten better over the weekend (I mentioned more about that in a post to Einy's family as their kitty, Einy, was also having trouble jumping.) Kendall really seems to be doing much better, which I am truly thankful for.
It is still frustrating that I do not have a definitive answer from the vet regarding her actual condition, prognosis, etc so I will definitely ask more questions when I take her in for her re-evaluation (I have been paying attention to your suggestions and taking notes... in fact, I've had to look up alot of new words in an on-line medical dictionary... haha.)
So, thank you again, Traci, for the time you have spent helping myself and many others with answering our questions so thoroughly. And thanks to everyone else for continued thoughts and prayers.
Shannon

[Traci]

Diazepam, otherwise known as valium. Still, I have a hard time believing your vet's comments that the pain meds caused the wobbliness, and I would ask him again about that (or another vet in the clinic) during your next check-up.

[Einy's family]

Shannon, I am so happy for you and Kendall!! Best wishes for continued improvement for your little girl.