My cat was poisoned and I need some advice.

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Traci
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Re: My cat was poisoned and I need some advice.

Post by Traci »

Was it the bloody froth from the mouth the first symptom you noticed that prompted you to think rodenticide? Was that the vet's first suspicion? Is there any chance Bob got into other toxins like aspirin, human meds, or outdoor hazards other than rodenticides? Is there a chance he was hit by a car, or attacked by a dog or other animal? Were puncture wounds visible? Did the vet in fact take an xray to rule out internal traumatic injury? Is he FELV-negative? How old is he?

When did this occur exactly, that is, when did you notice the first symptom of illness and when was he taken to the vet? I'm just trying to establish the number of days since the first day of treatment until now. If rodenticide toxicity, and if treated appropriately within the first 24 hours, one could hope to expect signs to diminish and recovery to start after the 24 hours or so, depending on the amount ingested....providing of course, the vet treated with appropriate meds, and didn't overload on the vit K, and used the correct type of vit K.

So, if it's been longer than 3-5 days since the first day of treatment, it's possible the vet needs to consider this may not have been rodenticide toxicity but something else that is causing blood loss (intestinal, internal organ puncture, ruptured speen, lung or other organ bleeding, or hemobartonella, viral disease, etc). An xray could be helpful for this, but MUST limit stress during an xray. And again, pcv and hematocrit essential.

I'm keeping Bob in my thoughts and prayers, I hope your husband is in the position to talk to the vet, and get a more experienced vet's opinion and treatment recommendation.....Do I understand correctly, you are in the UK right now, your husband is in Oman, can you call your own vet in the UK for advice and help??
..........Traci
kim
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Re: My cat was poisoned and I need some advice.

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I think that rat poison is the assumed culprit because it seems that a lot of dead rodents and pigeons have been turning up dead. I believe the bloody froth, a foamy discharge, drooling and a vigorous shaking of the head were the first symptoms. (husband can't really remember - he's traumatized) Bob was taken to the vet right away. It's extremely doubtful that he got into any human medication because there really isn't any he could possibly get. He never had a temperature. I'm getting mixed stories about the paralysis. From what I can deduce, there isn't any paralysis. Bob has gotten extremely thin (The indiginous Omani cats are pretty thin and wiry.) The one thiing the vet says that Bob has going for him is that up until now, he was very strong and healthy. He's had all his shots and was neutered and we guess he's about 9 months old. He was living in and around the garbage bins and followed my kids home when they were on a visit. We've had him about 7 months. Hubby tells me that he's now painfully thin. Is there any way to get nourishment in him? Would the cat equivalent of a saline drip be helpful at this point? I'm kind of in limbo at this point, because it's the middle of the night in Oman, and I won't know until UK afternoon if he's survived.
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Traci
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Re: My cat was poisoned and I need some advice.

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Depending on where the blood loss is coming from, would depend on the necessity of IV fluids support. IV fluids could possibly be contraindicated if there was free-flowing blood in the chest or abdomen, as a result from a serious hemorrhage...yet, in regenerative anemia, for example, IV fluids can be a crucial form of treatment, as can blood transfusions if the condition is life-threatening. Only thing is, we don't know the experience level of the vet in this form of treatment, a blood transfusion for example MUST start with a proper cross-match (either plasma or healthy, tested donor cat), and sometimes, just by giving a blood transfusion, this can actually increase RBC destruction temporarily (in other words, it gets worse before it gets better), it depends on cause and the case. That's why I suggested that hubby try to find another vet or convince the current vet to consult with a specialist and for the vet to check PCV, hematocrt and blood clotting factors, it is imperative he knows exactly what he's treating because some treatments are contraindicated.

The weight loss would be an expected problem, since both dehydration occur as well as blood loss. If he is at least stabilized, the vet should attempt to tempt him with small amounts of food and water, bland food, or a prescription recovery diet (not sure of availability there, but Hill's A/D would be good), and if Bob shows an interest in food and water, continue offering small amounts more often. If not vomiting occur, that would be a good thing, but if vomiting occurs, the best course of action would possibly be IV fluids. The bloody diarrhea still remains a concern, diarrhea causes dehydration too, so even sub-q fluid therapy might be helpful if he is dehydrated.

I feel so frustrated and helpless because I know nothing of this vet or his experience level or even if he has a lab in the clinic in which to do bloodwork. Can you call your own vet there in the UK for direction? Explain what your hubby has told you (from the vet), what the suspicion is (rodenticide toxicity), but that the anemia does not seem to be resolving, and it sounds like Bob is not yet stabilized. I have no idea what type of injections he is giving him, and you would want to know in the event they may be contraindicated! Can your husband possibly get a copy of any bloodwork done or treatment done, and have you discuss them with your own vet in the UK?

It's hard to know if Bob is stabilized or not. If not, the vet needs to be working diligently with the PCV, etc to determine why he is anemic and not responding to whatever treatment he's giving, the treatment needs to be questioned!
..........Traci
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Tambrey
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Re: My cat was poisoned and I need some advice.

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I just wanted to pop in and say that even though I am not a vet or have any medical experience...I am rooting for Bob!..Please keep us posted and prayers that he will recover...
kim
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Re: My cat was poisoned and I need some advice.

Post by kim »

Much to the vets surprise, Bob made it through the night and now they've decided he's got a chance. Bob went back again to the vet for more injections and an enema. I think the thought was to clean out necrotic tissue and introduce some fluids into Bob since he's clearly very dehyrdated. He was also given a miniscule (.005) of a sedative and another dose of a muscle relaxant. The vet says his heart is still strong and they have decided that Bob wants to live.

The results of the enema were that some tarry, bloody "gunk" was cleaned out, and I'm hoping that since there doesn't appear to be a great deal of fresh bleeding, that it hasn't done any harm. Husband tells me they introduced a liter and a half of fluid into him if that's important. Bob actually made it into the litter tray later on (with a few accidents along the way) where he promptly fell asleep, but I assume that the enema, coupled with the sedative was responsible. Some time later he actually managed to get on the bed! All is quiet for now except for some occasional retching, and Bob goes into hospital tomorrow while husband is off on a trip.

I don't have a vet in the UK since we don't have any pets here, so I don't have anyone to ask. Sadly, things are pretty primitive in Oman. They do the best they can with very limited resources. They reuse equipment that we would consider disposable in the US because it's all they've got. Cyclone Gonu was devastating for the country and has stretched all their available resources.

I know that you're frustrated at my inability to provide you with more definitive information, but I'm in the room with you on that one. Husband is so distraught (and squeamish) that he simply can not concentrate enough to ask cogent questions. I'm not sure it would make any difference if I was there because their resources are so limitied. The tests you describe are barely done on humans unless you have private insurance or lots of cash (from what our neighbor doctor tells him).

I do want you to know the comfort I've taken in knowing that you didn't write Bob off completely when I first posted this and he's proven to be quite the little fighter. I'm still praying (and crying) with all my might and believe we may see a positive outcome from all this. As always, I will keep you posted.
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Traci
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Post by Traci »

The difficulty is communicating a sick kitty thousands of miles away with a vet who is most likely inexperienced and/or ill-equipped to appropriately treat. Therein lies a multitude of problems, not to mention the number of toxicities and various rodenticides that would need to be identified in order to determine the exact toxin Bob was exposed to. Treatment varies per toxin, and the most crucial part of diagnosis and choosing the most effective treatment is availability of lab equipment to determine and monitor blood parameters. The PCV and clotting factors are crucial in the process, it's almost the only way to determine if treatment is working.

Another concern is the stress factor. The fact that Bob is brought to and from the vet on numerous occasions when he is most likely not stabilized, adds additional stress and this compounds an anemic crisis. I realize the plan is to have Bob hospitalized Monday for a time (?), but I would suggest that if your husband returns in a few days, that all measures are taken to reduce stress for Bob....make his trips to the vet calm, and when home, keep somewhat confined, because activity increases blood losses when there is already a blood-loss occuring. Your husband should check Bob's vitals frequently (at least twice a day, without stressing him), such as CRT, mucous membrane color and dehydration status, and if anything is unusual to contact the vet immediately.

Not that I oppose the fluids given, but that's a pretty large amount of fluids for a small cat (9 months of age, and I assume only around 5 pounds at this point, if not less), and I do hope the vet gave these over a period of time, say, within at least a 12-18 hour time frame or longer. Overloading of fluids is risky, and you might instruct your husband to be watchful of that until Bob is taken back to the hospital. Don't confuse retching with coughing for example, which would be a sign of fluid overload, other signs would include obvious weight gain, a "cushy" feeling when feeling his abdomen/skin, restlessness, coughing, nasal discharge, chemosis (swelling of the tissue/conjunctiva that lines the eyelids and surface of the eye), pulmonary congestion and pulmonary edema which are immediate veterinary emergencies, and can be fatal if not treated appropriately.

If vit K administration is still being given to Bob, ask your husband to ensure the vet is NOT giving these intramuscularly, they need to be given sub-cutaneously, or in a suspension oral form. Any injections given, including antibiotics, should be limited, because of severe anemia that causes hematomas at the injection site. Oral suspension antibiotics would be better, but I'm not even sure antibiotics are warranted here. Knowing that poorly educated and trained vets in other countries do with antibiotics, I would question that approach. (they tend to use livestock products, or dog products on cats, or do not dose appropriately or misuse of penicillin-drugs, the latter being painful when injected intramuscularly)

If Bob is indeed wretching, this could indicate nausea which may or may not be related to dehydration, your husband should at least attempt to get Bob to drink water, in tiny amounts, and if he can hold it down, introduce tiny amounts of food (which should be given to help absorption after a vit K administration anyway).....the food should be bland, easily digestible, and given in small amounts, providing no vomiting occurs. If a sedative plus muscle relaxants were given, these meds could be causing nausea, and neither food nor water should be given until at least 4-6 hours after full recovery from the sedative, since vomiting WILL occur if food and water are given too soon before the sedative wears off. Some muscle relaxants can also cause sedation.

I assume the sedative and muscle relaxant was given as an "anesthetic" before the enema? Otherwise, the muscle relaxant may be given to a rodenticide poisoned patient if limbs are rigid due to the effects of the toxin, but this is not always necessary.

The best thing I can advise at this point, is for your husband to get notes or a health record from the vet noting all treatment given to Bob, any diagnostics performed, medications given, etc, and have you call a vet in the UK for direction. Ask a friend for the number of their own vet, or call an emergency veterinary facility and explain your situation. Of course, there would be no vet/patient/client relationship with any vet you call, and they may or may not advise you based on that lack of a relationship, but it's worth a try, particularly if you stress your concerns and lack of appropriate care, ask what they might advise in this situation. The other option would again, have your husband contact the embassy or consulate or his collegues etc for help in translation to call another more experienced vet for guidance in treatment. Again, my concern is not knowing if this is indeed rodenticide toxicity or some immune-mediated condition, and without proper labwork on blood paramaters, let alone monitoring the PCV and platelets, etc, the vet could be treating blindly. I would hate to think he could be causing more harm than good, or that he is delaying vital treatment and recovery due to incomplete diagnosis or inappropriate treatment.

While I am thrilled to hear that Bob seems to have slight improvement, he is not out of the woods yet, and may have a ways to go, but if there is ANY way whatsoever for you and your husband to try to get a more experienced vet or at least another vet's guidance involved, the chances for Bob's complete recovery are greater.

I'm holding Bob in my thoughts and prayers....don't give up, he needs both you and your husband more than ever.
..........Traci
kim
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Re: My cat was poisoned and I need some advice.

Post by kim »

Monday Bob update. Bob is still hanging in there! The terrific news (I hope) is that he is now drinking on his own and peeing! He is also navigating around the house albiet very slowly. He goes into the vet in an hour for a few days and I am hoping that having him under their noses will encourage them to find some way of getting nourishment into him and will limit his stressful travelling. He now drinks without choking and doesn't seem to be vomiting or shaking his head. There is still some bloody discharge from his bottom, but I'm hoping that could still be a result of the enema. It's not a lot, but still worrisome. I'm starting to get my hopes up.
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Tambrey
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Re: My cat was poisoned and I need some advice.

Post by Tambrey »

That is good to know he is still fighting and getting a bit better day by day....
prayers for continued improvements....does your hubby have a t-shirt or something he wears that he has not washed that he can send along to the vet, so Bob has something familiar while he is there?....Does Bob sleep on a blankie or have a favourite stuffed animal that can go along with him...his own food and water dishes and litterbox...anything that is HIS to make his stay at the vet's as stressless as possible!

Hopefully the vet will be keeping you posted on progress while hubby is away?
kim
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Re: My cat was poisoned and I need some advice.

Post by kim »

Bob's all tucked in with an unwashed t-shirt and I think he'll get the best care they're able to give. We've exchanged email addresses and can try to call, but that doesn't always work. Vet isn't as hopeful as we are, but I'm hoping they're being conservative. They do say his heartbeat is very strong.
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Tambrey
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Re: My cat was poisoned and I need some advice.

Post by Tambrey »

prayers that the vet clinic will witness a miracle this week!
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