Hello. It’s me again. The reluctant blogger with the world’s most adorable liver shunt cat? Oh, I know, all of you owners think your OWN liver shunt cat is the cutest, but humour me, okay? I need a bit of tea and sympathy, and possibly a swift kick in the ass.
I think we’ve gotten Newt’s annual ER visit out of the way.
He’s been doing so well. Cat Daddy had been out of town for a few
days, and I was trying to complete some major home improvement projects,
and my vigilance slipped. I’m trying desperately to not feel guilty,
but … it’s my fault.
Any sort of change can affect my special little snowflake, so between
the moving of furniture, the painting, the slightly off-kilter feeding
schedules, the dashing to and fro from the store, the missing his daddy,
my own personal stress of family crisis, and various other stimuli,
well, he was already showing mild pre-episodic signs, but I was hoping a
full-blown Hepatic Encepalopathy episode might be averted.
I carefully prepped his meals and soups, trying to keep him on some semblance of order while Cat Daddy was away. Things were going really well, in spite of the frenzy.
Until some dumbass (that would be moi) forgot to pull the bowls of
Forbidden Food after Other Cats had lunch on Sunday. By the time I realized what had
happened, and began administering extra Lactulose, it had already gotten a
firm hold. This was his worst episode in almost 5 years. Not as bad as
the worst early ones, but pretty worrisome. Heavy drool, progressing to appareent blindness, low temp, weakness and neurological impairments.
If things had been worse at
the ER and they had insisted on keeping him, I woulda been begging for
mojo like I did when he had his little Pecker Problem. But a Lactulose
enema, some fluids, and chilling under the expert care of Cat Daddy (who
returned home JUST in time) had him right as rain again.
I seriously doubt that he learned anything about stealing Other Cats’ Food, but I certainly got a rude lesson!
Newt had another urinary obstruction. Another procedure to remove, then catheterized and transported to the 24 hour care facility for overnight observation and more IV fluids.
I tried desperately to remain as calm as I could with the reminder that many of his liver shunt cat friends have had repeated issues with urinary obstructions, and that this can be a normal part of the shunt game.
He is doing well. MUCH
better than he was on Monday and Tuesday. He’s eaten well, taken his meds, and is
resting comfortably. ER vet is cautiously optimistic they will pull the
cath around 8AM and he may be released Wednesday afternoon.
Am home for a quick nap and will be going back up with
his breakfast and snacks in a couple of hours. Just wanted to say a quick thanks to everyone who has been so kind and concerned. Will update more when I can, including his labs, full diagnostics including type of crystals, prognosis, new care protocols, etc.
Well, darn. Just got back from another vet visit for Newt’s little wizzer. Not a mucous plug this time; instead we definitely had a blockage.
::sigh::
We’ve been soooo lucky as far as his shunt goes. In spite of his challenges, he remains relatively stable for the overwhelming majority of the time, and we have, so far, managed to escape the urinary blockage issues that plague several of the other liver shunt (feline PSS) cats.
Until recently.
His December visit was “just” a mucous plug, and some inflammation and irritation, and he’s been fine, bladder-wise, since then. Until this morning.
Caught him perched in the pee position in his litter before breakfast. Uh oh. No pee. Moved him, and he wandered off to nibble a bit of breakfast, and then spent the rest of the morning lounging comfortably in sun puddles.
Lunch time – same thing. Perched in the box, unproductive, and then he began straining when he moved out of the box. Uh oh, this is NOT good. Phone call to the vet ASAP.
Have I mentioned lately how much I LOVE Newt’s vet care team?
We were instructed to bring him straight in, and they already had an action plan in place before we ever even walked in the door. In less than two minutes of arrival, he was whisked into the back and being prepared for the procedure.
I’d barely made it home when I got the call that he was coming round, and the doctor would be calling later. We’ll have lab results soon, and the whole clinic bragged on what a good little boy he was. He was still pretty loopy from the pain meds, and his pupils were quite dilated, with the copper definitely much darker than usual. I’m pretty sure it was the pain meds, as they knocked him for six after his neutering, too.
So now, we’re going to be re-thinking some of his protocols. I’m trying very hard not to panic, but urinary health for some of the liver shunt kitties can be a bit … challenging. And medical management of a liver shunt cat is pretty uncharted territory. I desperately hope this is an anomaly, and not a new pattern we are seeing with his shunt.
We had already taken him back to the basics, diet-wise, trying to avert another winter merry-go-round like last year. For the last two weeks, he’s been getting no snacks outside of meals, unless they are dosed in Lactulose, and his meals have been minimized back to the basics.
Now we need to see what else we can tweak to try and protect his little pecker. We’re going to switch from his clay litter to a non-clumping, add Cosequin as a supplement (and hope he will EAT it), and are discussing getting a fountain. He usually drinks quite a bit anyway, but if a fountain will help, why not? Have already been adding extra water and goo to his meals, since December, but he’s so fussy. Too soupy and he won’t eat. Need to find the perfect amount, and actually measure it instead of estimating it.
Change is SCARY. Yes, that’s true. But blockages are scarier. And a stone can throw little Newt into a big crisis, so we’re open to any and all suggestions you may have for ideas on what we can do to help support his urinary health.
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.
Waiting.
Waiting.
Waiting.
He finally moved from the box, and then assumed the “poop position” outside of his box.
Well, THIS was new!
More waiting.
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.
Nope.
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.
Eeeek!
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.
Well, here we are, on this fourth Thursday of November – the day Americans celebrate as their national day to give thanks. If you guys are celebrating today, Happy Thanksgiving!
Cat Daddy and I are very thankful that Newt is here for his third Thanksgiving with us. We did not expect he would see his first Thanksgiving, so this is a very special day for us!
We are also thankful for each owner of a cat or kitten with a liver shunt who has contacted Newt, or joined his support group. Thank you for sharing your kitty’s stories with other owners around the globe, and providing Hope. Big hugs!
As with everything in Newtopia, today is uncertain. Even on this happy day of celebrating, there is a minor undercurrent of worry, and a bit of an imbalance in the Force.For quite a while, Newt was on a merry-go-round of intermittent drooling one day, hen fine, the next. The last couple of weeks, he’s been perfectly normal, but, for the last couple of days, he’s been mildly drooling and slightly off his food.
Back to normal last night, but this morning, more very mild drool.
That certainly has not interfered with his appetite or enjoyment of the day so far! He was sunning himself in one of his favorite spots before breakfast, and began eating with gusto. Alas, because he is mildly symptomatic, we will likely not be preparing his customary four-course Thanksgiving feast, scattered throughout the day. Instead, we will stick with the basics (and his favorite – chicken!) Should his appetite diminish, we will, of course, be offering the tried and true tidbits to tempt his palate.
These very mild episodes seem to last less than six hours, so it is quite likely that later today, when Cat Daddy is in full Chef Mode, that Newt will be dining on hand-fed morselettes from mum’s plate. But for now, we are again reminded of just how MUCH we have to be thankful for, with our darling little liver shunt cat.
Each day is a gift for which we are thankful, and that the good days far outweigh the bad. His quality of life remains paramount, and on days like today, even while showing a bit of drool, he is happily sunning, eating with gusto, and reminding us that every day of Hope is a day to give thanks.
Random update on Newt. He’s been having an odd time lately. Mostly
wonderful, but having regular mini-episodes. Am not terribly worried, as
he’s had these spells before.
Your favorite Spotted Schnookums is back to normal after a really odd night last night. He went on a food strike and wasn’t drinking either – both of which usually happen when he’s in the middle of a medium to strong episode, complete with full drool.
However, aside from a minor bit of drool early in the evening, no other drooling. Several of his other ep signs were presenting, but NO DROOL. Weird. And frustrating. Long night spent alternating Lactulose and water via direct dosing. Finally, this morning, after 15 blippy hours, within a half hour time span, he made a 180 and was on the counter gobbling snacks, and drinking deeply.
Perhaps you heard that deep sigh of relief I uttered?
So, Newt is back to normal, but now his friend Pingu has had a bit of a crisis. You’ve read about Pingu on here before, and so many of you responded that you were joining us in a song heard round the globe. Your singing worked, and Pingu rallied wonderfully and was doing much better! However, he had another crisis earlier today, and as singing a song of healing seems to have quickly become a tradition for our cat liver shunt support group, am asking you again to Sing for Ping.
After this past week of me being back on-site, working a new contract, and Cat Daddy taking his usual, excellent care of the Great Spotted Newt, it would appear that he’s gone episodic today.
Was it my cooking?
As much as I hate to take pictures of Schnookie when he’s sickly, today I decided to try and grab a quick snap to show you what a medium drool day looks like for him.
Never in my life did I ever imagine I would have accumulated such a diverse knowledge of the various degrees of drool and progressions of poo!
But, living with a liver shunt cat can do that. As Lactulose can be such a critical aspect of medical management, and its dosing can be as much an art as a science, determining the exact dosage is based upon careful observation and monitoring of kitty’s litterbox (assuming you are able to beat the dog to the scat snacks, that is!) For those kitties who have drool as one of their symptoms, you learn to gauge how bad the drool is, how long the episode will probably last, and how much Lactulose to administer, in order to help minimize the episode.
Here’s the pic of Newt’s medium drooly day today. And don’t worry, no poo pics, as the Dog beat me to it
SugarMint’s mum has asked for your healing energies, love, prayers, and whatever
support you’d care to send to Newt’s shunt friend Sugarmint. She’s had a rough prior 48
hours, and there may have been some seizure
activity involved. She is snowed in; unable to get out to a vet right now.
Latest
update seems to indicate that Sugarmint may be coming out of an
episode, but is still having impaired vision and wobbledies. She has been relatively stable for quite some time. This has been her
worst ep since her initial diagnosis.
Please send your Love, Hope and Healing Energies to Sugarmint and her mum.
Little brat broke into the “food safe” and ate eight times his normal amount of fish last nite! He’s okay so far this morning, but monitoring closely.
We had prepared cod for his upcoming meals – at least 1/2 cup of it. Some for yesterday’s snacks, and the rest to freeze for later. We placed it in the “food safe,” also known as a bigass, glass cake dome, which has worked very at preventing Pookie’s pilfering.
Until last night.
Totally my fault. Was motivated and productive yesterday, clearing out excess crafting supplies to donate. (An aside – do any of you know any animal rescue groups, or struggling owners who may want supplies to make things to raise money for their pet’s care? Please let me know! I really prefer to have my stuff go to help liver shunt kitties, or rescued animals, if at all possible.)
In my rush, I may have not gotten the cake dome flush against the stove, and possibly a small sliver of entrée was left – just enough for a mangy tabby’s little lizard toes to slide underneath, crack open the safe, and gorge on the contents like a deranged and starving piranha.
I left for the dog park to sneak in some knitting at 9:55 pm. When Cat Daddy got home at 10:07pm, the dome was slid across the stove, and fish flakes were scattered across the stove, the counters, the floor, the Newtster …
Yes, I smelled his breath!
Not surprising, as that boy inhales his food, and can clean out a full bowl of food in seconds. Ten minutes would be a veritable eternity for him to burp, slurp and gorge himself silly on whatever he happened to find. We’ve already had to put safety locks on the cabinet to keep him from breaking into where The Dog’s kibble is kept, and move any appealing items in the fridge up on the top shelves (and yes, we have caught him clinging like a limpet as he climbs the shelves to get to the good stuff!) So, a valuable lesson – Schnookie is a safecracker!
His usual protein per meal is approximately one (1) US Tablespoon. We’re estimating he ate at least eight (8) tablespoons. Immediate direct dose of Lactulose, followed by another dose three hours later. Needless to say, he did NOT get his midnight snack last night.
Yes, I confess, I punished my Pookie by sending him to bed without any supper!
Monitored closely through the night for any signs of trouble. He was fine, but I wasn’t LOL.
So far, he’s okay today. I, on the other hand, am a bit groggy and nervous, but hopeful that today will be normal for him.
