Emmy's sick. :(

[Tina B and crew]

Awww, silver (((hugs))) to you and Emmy....I'm glad she perked up with the inject. I hope it isn't anything serious and is just a fluke. Will keep up my prayers.

[Traci]

Do you mean Lasix?

I'm confused. Generally, when a patient is presented with fluid in the abdomen or chest, it is aspirated, then looked under a slide, then a sample is sent to a lab to rule out specific bacteria etc.

Was fluid aspirated? It surely HAD to be at the appointment, in order for Emmy to breathe better. If the fluid is that great, aspiration is NECESSARY.

In emergency cases, aspiration and sometimes oxygen support are also necessary, I hope your vet warned you about what signs and complications to possibly expect?

Chylothorax, pneumonia, congestive heart failure, infection from any vital organ (including the intestine which is where chyle usually originates), bacteria and fungal need to be ruled out. This "recheck" should not be in one month, it should be in ONE WEEK or sooner if breathing gets distressed again, lethargic, anorexic, etc etc. Additional diagnostics should also be done at that time, or, SOONER to ensure everything has been ruled out and not missed!

Warning: Playing or strenuous, exciteable exercise etc should not be encouraged. If she has diminished lung capacity, she could collapse a lung, go into shock, any number of things that aren't good. Did the vet not tell you to try to restrict her activity?

[slvrwhispr]

Nope, I mean Salix, but it's the same thing. That's what I thought at first too; I thought Jon meant Lasix, but I googled it and apparently it's a veterinary-specific version.

http://www.intervetusa.com/products/130 ... 13891.aspx

I asked DH if they aspirated any of the fluid in the office and his reply was, "The word sounds familiar for some reason, but I can't remember." I'm going to assume that's a yes. He said they did "something else with a needle". Next appointment will be made when I'm not at work... *ahem* He means well... I'll call the vet in the morning and make sure she took a look at the fluid to make sure there's nothing alarming there.

We do have a whole bunch of print-outs about the meds and the diagnosis, what to watch for, what constitutes an emergency. I had DH ask those questions specifically. She did say try and restrict activity; we've been keeping a close eye on her. When I say she's "bugging" Izzy and Tyler, I mostly mean she plays peek-a-boo around corners with them, or sneaks up and bats at their tails. No running, no jumping. All human hands are on deck making sure she stays calm... which is kinda funny to see in action.

[slvrwhispr]

Oh, and we did bring in a nice, fresh stool sample for inspection as well. I don't know if they test that in house or not. I'll ask when I call in the morning, but I assume if there was anything alarming about that, it would have been mentioned.

Traci, I wish I could just have you on speakerphone or something when I take my girls to the vet so you can ask all the good questions for me... lol.

[momPaws]

Holding a good thought for her, Sw!

[Traci]

Well, it scares me about the fluid and the suddenness. Then you said she only has 1/3 lung capacity, which is also concerning. It could be the fluid is pressing against her lung, causing the breathing problem, but fluid in the chest can also cause the same problem with the heart.

Whenever there is fluid in the chest or abdomen, testing is CRITICAL to ensure that all bacteria, viral, fungal etc and differential diagnoses are done so that nothing is missed before things escalate.

Aspiration involves the needle.... as in, it draws fluid (or air if pneumothorax, lungs etc), out of the cavity to allow for the lungs to expand, making breathing easier. However, in most emergency cases, this sometimes has to be done every couple of hours because the fluid is coming from somewhere (or some injury), and will keep accumulating until the source is detected and corrected. This is not a wait and see thing where you can wait a month for a recheck. Testing is necessary to rule out every potential cause of why there is fluid and where it's coming from to stop it and treat it effectively.

Is there any chance she fell or was playing too rough with the dog or other cat, as in, she might have gotten stepped on, rolled over against something hard, etc? Anything else in the environment you might have missed?

Please call your vet tomorrow and take notes, ask her these questions and ask about additional testing to ensure nothing is missed.

[slvrwhispr]

I can guarantee she wasn't playing too hard with Tyler. His preferred method of dealing with her is to give her a good lick and watch her scamper away to groom all the dog ick off her... But he's too arthritic to chase her, so. That's a no. And she and Izzy just play tag. Never seen it involve anything other than running. I suppose she could have slid on the wood floor and hit something? But there's no obvious sign of trauma, no swelling, no broken bones on the x-ray. As for getting stepped on, I asked everyone. No one said there's been an incident. She's pretty quick at getting out of the way if she's underfoot. She's definitely more of a runner than a jumper. She likes to hide under things, whereas Izzy is my climber who always wants to be up high.

I'm not even sure what else to look for around here. I mean, we've got the 9 month old in the house, so everything is pretty well baby-proofed... which conveniently doubles as cat-proofing as far as chemicals, cords, and anything at floor or counter-level is concerned.

We do have the Salix pills that we're supposed to give her twice a day; I'm assuming the vet believes this will keep the fluid down. There's a CHANCE that, in hindsight, this has been coming on for a while and just got bad enough to notice this morning. She's been doing a lot of sitting kinda curled up nearby, but not wanting to be on us, which I found odd, but she'd engage in playtime and came running for treats, so I didn't think too much of it. In retrospect, it might have been a sign that she's been feeling ill for a while. No way to tell.

Anyway, I'll give the vet a call in the morning now that I've had time to think about some things. In the meantime, I've got her in the bedroom with me for the night. Will be keeping a very close eye on her.

[Traci]

Yes, do keep an eagle eye on her, watch her respirations, watch her chest rise and fall and try to determine she's not in distress. The best thing for her is lots of rest and no compromise on that lung, she needs to gain full capacity again, quickly.

When you call the vet in the morning, please ask if fluid was indeed aspirated and if it was looked at under a slide exam, and if it warrants being sent off to a lab. Emmy is pretty young to be going through a problem like this, so if it's the heart, or heart fluid, a full cardiac workup would be in order. Don't want to prematurely worry you about a heart problem, but you want to keep that under consideration.

Otherwise, infection MUST be ruled out, that fluid should be analyzed to make sure infection is not present, even elsewhere in the body. Chylothorax, for example, is a nasty infection, and if not caught at the onset, can be difficult to treat.

As a general rule, cats who sit in a rather tight sternal position (crouched, head low, paws and tail tucked underneath) and don't want to be touched or held, is a tell-tale sign something might be wrong. While they may do this when cold, scared, etc, whenever you suspect a health problem, that tight sternal position is most often a warning sign. When you found her laying on her side, she might have already collapsed the lung and she was too weak to right herself.

Again, be very thorough with your vet in the morning, ask questions, and ask her what she intends to rule out.

[slvrwhispr]

Good news: Emmy takes her pills like a champ. Once she figured out what I wanted her to do, she did it with no issues whatsoever. What is this? A cat that doesn't mind being pilled? I am speechless.

Bad news (but not that bad): The vet who saw Emmy wasn't in today. Left a message; hopefully talk to her tomorrow. Still seeing clear improvement; Emmy greeted me with her cute little chirps when I came home. Realized I hadn't heard her chirp at me in a while. So glad to hear it. She's breathing MUCH better now, and not sitting all hunched over all the time.

[Traci]

Good to hear she's feeling better but continue keeping an extremely close eye on her.