Newt has had a string of great days, including yesterday, and yet, we got to spend most of another night at the emergency vet hospital.
Don’t worry, he’s fine now. We’re both in need of a nap to sleep off the excitement. Will try to write as many of the details as I can, but some things are a bit hazy, and I’ll need to go back over my notes and his file once I’m more awake.
The Good News – once again, knowing your cat’s unique behaviors, along with careful and vigilant monitoring pays off. Crisis averted.
The even better news: No major crisis! Minor crisis? Yes, but, NOT the possible and likely major crisis.
While Newt’s urine output is both prodigious and frequent, his fecal output is fairly predictable. Usually at least twice a day, after a meal, and accompanied by a bit of a post-potty vocalization. (Oh dear, I can NOT believe I am actually turning into one of “those people” and talking about my baby’s bathroom habits! All in the name of shunt sharing, I suppose.)
Newt’s been great, eating well, playing, doing all his normal Newt things. After his dinner last night, I went into his lunchroom to let him out and wash his bowl (he had cleaned his plate), but he was perched precariously hanging off the *outside* of his litter box.
Interesting. (The outside-the-box part, not the precarious part). He typically has a rather unusual litter box stance, sort of bracing his long little lizard toes, with one front paw and one back paw teetering on the edge of the box, and waiting … waiting, before he finally eliminates. Kind of makes cleaning the box a challenge, as he loves to “help” by leaping in, mid-clean, and doing his business during the scooping process.
But, I digress.
He seemed frozen in place, so I gently flipped him round so the business end was facing back in the box, thinking that perhaps not having his supporting paws in the litter might have thrown him off his game.
I waited. He waited.
I waited some more. He waited some more.
I stared at him. He stared at the wall.
He finally moved from the box, and then assumed the “poop position” outside of his box.
Well, THIS was new!
I told Cat Daddy what was happening (or, NOT happening, as it were). We thought perhaps constipation.
Odd, when you consider that Newt is on the highest dose of Lactulose of any of the other shunt kitties we know. However, the pharmacy had substituted his Lactulose yesterday. One would think that the same med, but different manufacturer, would not make that much of an impact, right? (::groans aloud at the inadvertent bad pun:
However, this IS our special little snowflake we are talking about, so, who knows?
Newt had moved a bit further outside the box, and was still straining. I picked him up, gently palpated his abdomen, but didn’t feel anything, aside from his usual after-dinner full tummy. He didn’t seem uncomfortable with my rude tummy squishing, so we set him down again.
Wiped the affected area with a wash cloth, like a good mamacat.
Tried gently inserting a well-lubricated thermometer. (Note to self: Replace thermometer STAT)
Nope. No poop, just Newt glaring at meanie poopy-head mum and Cat Daddy for the indignity.
More crouching and straining. This was decidedly NOT cool, so off to the ER we went.
By the time the vet arrived, Newt was still straining, but his posture had changed from the crouching at a semi-vertical position, to straining with his back more horizontal, and his tail quivering. Vet said that this posture appeared to be more indicative of a urinary blockage as opposed to constipation.
Oh, shyte (or, not, as it were).
VERY not cool. Here I was, all calm and zen-like, thinking maybe a quick suppository or enema, then suddenly, we’re faced with sedation to treat a probable urinary blockage, quite possible in light of his liver shunt.
VERY long story shortened a bit. After X-rays showed enlarged bladder, and lots of soft stool, along with firmer stool further up the tail pipe, Newt was sedated with Isoflurane and the vet immediately located a mucous plus in his penis. Flicked the plug from his little pecker, and whooooosh, there she blows!
Lactulose enema yielded an impressive array of much-firmer-than-normal Newt poop, compounded with lots of hair, culminating in one impressive, hardened, hairball.
Wowza. No wonder the poor baby was straining!
The vet was very pleased with the blood work, especially the post-prandial ALT. Slightly on the high side, but well within acceptable parameters for a kitty with a shunt. Same thing with the ammonia levels.
Urinalysis yielded the happiest news – NO Struvite crystals! A lot of Bilirubin crystals, (apparently not surprising with his condition) and some signs of inflammation. Aftercare instructions included a two-week dose of Clavamox, and advice to start using a flea comb to help remove some of that extra hair. Follow up with his normal vet within a week, and we are back in business.
Was amazed at how quickly he came out from the Isoflurane, and returned to his normal, foraging, cleaning, flitting self.
Vet was really complimentary at intake; said that immediately noticing the change in Newt’s behavior certainly helped and earliest intervention yields the best results (especially in a blockage situation). He was also very impressed at Newt’s overall health and appearance, considering his liver shunt. He seemed very intrigued with Newt’s condition, and we had quite an interesting discussion on how different types of anesthesia can affect the liver, how Bilirubin levels can affect eye color, and, how long-term Lactulose can affect the normal anal gland process, so periodic expression may be suggested.
More lessons learned in the ever-evolving body of “Newt knowledge” and more pieces of the puzzle to research and share with fellow shunt cat owners.
Maybe later, after Newt and I have a little nap.