Author: livershuntcat

Another Lesson

Uhm.

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!

Cat Liver Shunts

When new acquaintances ask about Newt, I try to give them my “elevator speech” (the quick, 30-second overview), and not overwhelm them with too many of the details which are routine to us, but might be mind-boggling for others.

So, here’s my personal version of the quick and dirty on liver shunts in cats:

A liver shunt is a condition where the blood is not properly purified, because it bypasses the liver. As a result, toxins can accumulate and cause “Very Bad Things” to happen. Liver shunts are even more rare in cats than in dogs, affecting approximately 1 in every 10,000 cats. However, there is Hope – many cats with liver shunts are able to live normal, happy lives!

Okay, that was one floor; if they haven’t gotten out of the elevator yet, and want more info, the next part goes like this:

A liver shunt may also be known as a portosystemic shunt (PSS), and be intra-hepatic, extra-hepatic, or some combination of both. Treatment options include surgery and/or medical management, using a combination of diet and medicine. More studies and statistics are available on surgical options, but we are now seeing more anecdotal evidence regarding successful medical management, both pre-operative, and in lieu of, surgical correction, as with our Newt.

Is the listener still on the elevator with me, or are they planning to jump out whether or not the next floor is theirs?

The “Very Bad Things” that can happen are a result of Hepatic Encephalopathy (HE), where the toxins have accumulated and start causing problems. Depending on the severity of the HE episode, signs can include, but are not limited to, lethargy, circling, head-pressing, drooling, blindness, seizures, and neurological impairments. However, many owners are able to control/minimize these episodes in their liver shunt cats through a combination of diet, medication, and/or surgery.

Which takes us back to the first (and most important) part of the whole elevator speech, which is simply …

“Cats with liver shunts – there is Hope.”

If It Ain’t Broke, Don’t Fix It, Part 2

How many minor annoyances do you endure before you call it a night, pack up your toys and go home? (or to shop elsewhere?)

I
am reminding myself how truly fortunate we are with Newt, for so many
reasons. His liver shunt was diagnosed early; we found protocols that
worked to stabilize him; we have an amazing team of caregivers and
service providers on Team Newt; we are in a position to be able to
afford his care; his care is not nearly as expensive and invasive as
that of other cats with more serious conditions; we live in an area
where products and services are readily available … the list goes on,
and on.

So why do these minor annoyances tend to send my blood
pressure skyrocketing, and my language far, far out of bounds from any
sort of propriety?

I arrived at 6:20 PM – well after the 4PM time
I was given as ready for pick up. My mood was only heightened by the
freezing rain pouring down, dampening my spirits, as well as my
clothing.

I was greeted warmly, by friendly staff. My optimism rose a couple of notches, but it was short-lived.

No, they did NOT have a prescription on file for Newt. When was it
called it? I’m pretty sure I managed to NOT let my voice drip as icily as
the rain outside when I replied “last THURSDAY – four and a half days ago.”

The
chipper little pharmacist quickly stepped in to take over, and rummaged
thru paperwork, then politely informed me that it had just arrived, and they would prepare it right then, if I wanted to wait.

Great! How long could it possibly take? I was the only person in the shop.

Let’s just say that during the ensuing 40 minutes, I was really wishing
I’d brought a knitting project with me. Ah well. At least I did
remember to ask if they could put it in a dropper dispensing bottle. “No
problem!” they cheerfully replied.

When I was given the bag, I looked inside, and … no dropper dispensing bottle. Granted, it wasn’t a normal bottle; it had some sort of special lid, designed to fit the accompanying 1 ml syringe.

“I’m so sorry.” I apologized. “Is it not possible to obtain a dropper dispensing bottle?”

“Oh this is a dropper!” I was told.

Uhm,
no. “That is what I had in mind.  You know, small? Like an EYE dropper? A bottle
with a built-in dropper for dispensing the medication?”

“Ah. That’s okay. You can use the syringe!”

(If I had WANTED a syringe, I would have ASKED FOR a syringe!)

I tiredly replied that actually, no, the syringe was not as suitable as the eye dropper type of dispenser.

“No problem! I’ll get you one.”

“Great!” I think.

The
pharmacist goes over to a display and happily hands me a bigass dropper
– one that I already have in healthy quantities, thanks to it coming
with every bottle of Lactulose.

“You can use this one!”

“Uhm, no. No, I can’t, but thank you anyway.”

“No charge!”

“No, really, I don’t need it, but thank you.”

“Why not? It’s a dropper.”

Yes, it is a dropper, but it’s HUGE. It won’t fit in his mouth! Besides, I already have several of those, but thank you.”

I just wanted to get home, see if Newt would take the new med, and then curl up on a heating pad and have some NewtSnuggles.

“OH! You want a smaller one? Like an eye dropper?”

“YES! I practically sobbed. “Yes! That would be great!”

“Okay, if you have one of his old bottles, bring it in, and I’ll see what we can do.”

By
this time, I really wanted to simply escape before either bursting into
tears, or bursting forth with a string of colorful invectives – neither
of which would have helped solve anything.

Upon arrival at home, I
must have spilled half the bottle – on me, on Newt, on the counter, on
The Dog – trying to figure out how to use the fancy cap to draw the
correct dose into the syringe. Luckily, it smelled … okay, and tasted not unpleasant. Certainly not as bad as some of the prior efforts of years’ past. 
Newt did not try to run away, and tolerated my awkward manipulation of
the syringe.

“Maybe this is going to be okay,” I thought.

Not seeing a “refrigerate” warning on the label as with his past version, I called to verify.

The
pharmacist first cheerfully asked if Newt had liked the taste, then
said he would check the paperwork. “No, not refrigerated. Just store in a
cool, dry place.”

Heating pad, here I come!

Nope, the
phone rang.  It was the chirpy pharmacist, calling to trill at me that I
needed to adjust Newt’s dose, as they had made an error in mixing the
Neomycin.

“Excuuuuuuuuuuuuuuuuuuuuuuuuuuuse me, WHAT did you just say?!?!?!”

(Count to ten, count to ten, count to ten …. breeeeeeeeeeeaathe breeeeeeeeeeathe …)

“I
just read the original instructions, and you need to adjust his dose.
It’s supposed to be mixed 100g/ml, and I mixed 50 g/ml. Just double his
dose and it will be fine. It’s no problem, just give him one ml instead of one-half ml. “

At this point, I resorted to banging my head on the counter.

With a sore head, and smelling of some sort of powdery, flowery,
candy-coated chicken, I whimpered my way onto the couch, and mentally began to
count our blessings, to counter the frustration.

Newt is stable. Newt has protocols and medicine that work to KEEP him
stable. The new pharmacy has friendly, happy, cheerful staff, and is
conveniently located. They are inundated with unexpected new patients,
in the same boat as us.  They promised that they would make things
right, if we weren’t happy.

Well. I’m NOT happy. Nothing horrible is wrong – this time. The error
was discovered after only one dose, and it wasn’t an egregious error –
THIS time. Do I trust that this mistake will help ensure extra attention
to prevent future mistakes, or do I start the dance over again, with
another new partner, and hope that things go better?

If It Ain’t Broke, Don’t Fix It!

Things have been cruising along here in Newtopia. No major changes, no surprising new developments.

Until Thursday.

No, no, don’t panic. Newt is FINE. I, on the other hand, am a bit … unsettled.

I always used to pride myself on being an early adopter – eager for new technology, new experiences, new improvements.

And then I got old. And we got Newt.

I’d like to say it’s our steely determination to maintaining Newt’s protocols that has turned me cautious. Alas,  I’m pretty sure it’s just me turning into a hide-bound, crotchety old curmudgeon, thrown for six with any unplanned changes in my, or Newt’s, routines.

I’ll confess, I’ve been holding my breath since winter hit, as historically, some of Newt’s most challenging times seem to have occurred deep within winter’s icy grip. I dared to relax a bit, in that our winter so far has been pretty mild, and Newt has been doing so well. Everything has been going according to plan, in its comfortable, dull routine.

Until I called in the refill of his antibiotic and was shocked to find the local mom and pop shop is no longer a pharmacy.

What?!?!

Add into the shock the fact that they are – err, WERE – one of the few pharmacies in the area that can / will compound prescriptions.

A few years ago, Newt was switched from his previous Amoxicillin onto Neomycin, compounded in a chicken flavor. The pharmacist, Dr. Bob, was so kind and
patient and worked diligently to find a compound that Newt would
tolerate. (Tastes like chicken, my ass!)

And now, not only are the pharmacy staff involuntarily transferred, and/or looking for jobs, and an area  landmark hailed for its commitment to affordable prescription services is no longer offering its main service, patients like us are scrambling to find alternatives for the specialty compounding service that they provided. Normal patients had their prescriptions transferred to one of the big box pharmacy chains, and the helpline gave me the names of other compounding pharmacies in the area. They said it was all quite sudden, and everyone is still in a bit of shock.

So, I called the closest provider, and am not really a happy camper.  There seems to be some communication issues at play.  New pharmacy says of course they can compound, just have the vet call in the RX. Great! Initial questions are what flavor is needed; will I be picking it up;  my contact info, etc. I’m trying to find the silver lining here, and stress the fact the new pharmacy is so close, I can easily pick it up.

Next I’m told that they will be delivering it.  No, I don’t WANT delivery.  I said I was happy they were so close so I could PICK IT UP.

Next exchange is that of course they can MAIL it.

Mail it? What part of “I will pick it up” translates into “mail”?!

And then I get “No, it’s fine, they are happy to mail it to the post office box.”

This is a prescription that must be refrigerated – W. T. F. ?!?!

Final exchange had me growling and muttering very unladylike language when I hung up the phone. The discussion began Thursday morning, and by the last exchange, I was told they might have it ready after 4PM on Monday.

What!?!  Four working days to compound a chicken flavored antibiotic? This new relationship is not getting off to a very good start!

Luckily, he is not completely out of his Neomycin, and worst-case scenario, we could obtain a bit of Amoxy from the ER vet to tide him over. As it is, for Newt, we consider the antibiotic almost secondary to his Lactulose in terms of necessity. He can miss a few doses of his antibiotic with no major effects, but Lactulose is his “must have at all costs” medicine.

So. we shall see what happens tomorrow night. I am trying desperately to remain optimistic that 1) it will be ready on time, 2) the flavor they provide will be palatable to Pookie, and 3) there will be no months’-long adjustment period like we had the last time his meds got changed.

Wish us luck!

All Quiet in Newtopia

Quick hello! Not much to report on Newt; he’s doing very well.

Yesterday’s “excitement” consisted of him demanding snuggles while I was at the computer trying to catch up on his emails. He fell asleep in my arms which were leaned on my desk, and I fell asleep while I was kissing his little head. Cat Daddy woke us up laughing at the adorable sight.

After that rude awakening, Newt had a long bath, (complete with cleaning my chin), then we once again fell asleep in the same position, til Cat Daddy made us go nap on the couch.

At 9PM.

Hey, at least I was engaging in a bit of self-care, and getting some rest, right?!

Thankful

Just a quick hello. We had a nice, quiet Thanksgiving Day in Newtopia.  Hope that if you were celebrating, your day was as peaceful and joyful as was ours.

Not much to report. I took advantage of the perfect weather, and took the tiny spinning wheel outside with The Dog to do a bit of spinning of the never-ending Pink Silk of Doom. Newt enjoyed a variety of snackies and morsels throughout the day.  He particularly enjoyed the grilled roast. (I was a mean mummy and did not share my Klöße with him!)

As with every day, we gave thanks that our darling little Schnookerdoodle was hale and hearty. And since I was a slug and didn’t say it on Thanksgiving Day, please permit me to say it now:

I’m thankful for you – each of our, and Newt’s, friends who has been so kind, so gracious, and, so helpful and encouraging. Our journey with Newt and his liver shunt has been enriched by you.

Thank you.

No News is Good News – Again

Goodness gracious, has it REALLY been that long since my last post? Yikes! I’m so sorry. Haven’t forgotten you, I promise!

Just nothing much to report, really. The new gig is still wearing me thin. (Trying to adjust to being a “normal” grown up is hard work LOL)

Everyone’s favorite Spotted Schookums is once again burrowed onto my chest for mumsnuggles. I wonder if the cooler weather is making him even more affectionate than usual?

No excuses, really, for not writing. I just don’t have anything fun or exciting to say.

Newt’s doing well, and we are preparing for a long, hard winter – if the Almanac and bajillion acorns in the yard are any sort of indicators. Well, that, and the layer of winter fat that Newt and I have accumulated. Ooops!  I think his is attributable to all the extra helpings of soup he’s been getting. Not sure what I can blame mine on. Maybe because I eat his “cat food?” ::snork gasp wheeze::

Sorry, Cat Daddy and I tease each other about eating “cat food” whenever Newt demands (and usually gets) nibbles of whatever meal or snack we are having at the time. It seems that each liver shunt cat’s diet is as unique as they are, but I would confess, Newt’s diet isn’t exactly making his vet very happy – especially not since he gained a pound in less than six months. Eek!

So I guess today’s post can be a Public Service Announcement! Eating “cat food” makes you fat – if your cat’s food happens to include pizza, cookies, macaroni & cheese, mayonnaise-laden sub sandwiches, heavy whipping cream, cheese, spaetzle, lasagna, waffles, pierogies  ….

Camel Whisperer?

Or, how Newt almost got a new, not-so-little friend this weekend.

A shared concern by many owners of cats with liver shunts is that we often get so wrapped up in taking care of our special kitties, that we often neglect our own self-care. I freely admit to being pretty self-neglectful, and it’s gotten even more difficult with the strains of the new gig. In the interest of trying to de-stress me, darling Cat Daddy has been
once again making noises about me needing to get away from it all, at
least for a few hours, and try to relax. I guess it’s the Quarterly
Spousal Mandate for Relaxation?

Whatever it is, I ended up with some free time over the weekend, and with his gentle urging, decided to have a mini-vacation by spending a few hours visiting a Fiber Festival. Not that I need any more fiber, mind you. Haven’t had a chance to even touch my spinning wheel for months. But, you know, FIBER WHEELS BUNNIES YARNZ!!!

Ahem.

As with prior fiber festivals, Cat Daddy reminded me “Honey, you are not allowed to bring home any bunnies. Or sheep. Or goats.” Remembering how last time, I almost scored an alpaca because it was NOT on the verboten list, he quickly added “Or alpacas. Or llamas.”

Curses, foiled again!

Satisfied that he had exhausted the ever-growing list of new, fiber-producing friends I am not allowed to buy for Newt and host in our house or backyard, he kissed me and sent me on my way, urging me to “have a good time and buy something fun!”  (Have I mentioned lately how much I love that man?)

The drive was nice, with the slightly cooler air, and the leaves just beginning to turn. The festival itself was small and friendly, lots of time to visit with vendors, fondle yarn and fiber, and meander around, relaxing and admiring all the lovely items. I decided to stroll through the barns, just to chat with some of the sheep and goats. Suddenly, the light coming from the other end of the barn was blocked, and I looked up to see …

a CAMEL?

Okay, so I thought I was recently hallucinating Ariana the Chicken, but no fracking WAY was there a camel. Right? RIGHT? It HAD to be a stress-induced hallucination.  A CAMEL?

Holy Cow – errr, holy camel, as it were – it WAS a camel! A glorious, beautiful, Bactrian camel gazing down upon me.

I was smitten! A real live camel, up close and personal!  I’ve been fascinated by camels for years, but never in my wildest dreams did I ever think I would get to meet one.

It was big. REALLY big. Like, hugely big. Its feet were as big as my head. Its double humps towered and swayed gracefully far above my reach. Its eyes gazed contentedly at me, while chewing and pondering and watching the amazed people go by.

I began to talk to it, asking how it ended up in this part of the world, telling it how beautiful it was, all the while trying to find any sort of owner or sign indicating whether or not I might be permitted to ::gasp:: touch it?

Several other folks were taking pictures, and a few brave souls had reached out to pet it. It neither burped nor bit, but stood calmly,  swaying serenely, and looking at me expectantly.

Slowly, I reached out my hand. The camel reached its face down, ever closer to mine, and as its chin met my upturned palm, I slowly began to scratch.

Yes, just as if it were a VERY LARGE CAT, I scratched its chin.

The camel gave a deep, contented sigh, and as I continued to scratch its chin, slowly began to sink to the ground, finally coming to rest on its belly, with its legs comfortably tucked underneath.

There was a collective gasp from the small crowd around the pen, and hushed comments of “Wow! Did you SEE that? She must be a camel whisperer!”

I gave the camel one more gentle chin scratch, then it turned its attention to nibbling the hay as I thanked it for the privilege of petting it. Still awe-struck from this wonderful exchange, I floated out of the barn, and then managed to call Cat Daddy.

“So, you said I should buy something ‘fun’ today, right?”

“Of course, sweetie, you’ve been working really hard, you should spoil yourself!”

“Okay. I want to buy a camel. Newt NEEDS a camel. I found a camel! I petted a camel! People called me a camel whisperer! Can I have a camel?”

After all these years of dealing with me, my darling husband is pretty accustomed to my unusual outbursts. He never even missed a beat. Cheerfully he replied “Of course you can have a camel! As long as you can fit it in the car.”

Oops. No way would that camel fit in the car. Why does Cat Daddy always have to be so practical?!

Needless to say, Newt did not get a camel that day. I, on the other hand, had a wonderful vacation, and obtained an amazing memory.

(I did, however, buy camel down, and Newt WILL have his own camel!)

Chicken Dance

It’s that time of year again, the crisp autumn air, the beer, the lederhosen, and the Chicken Dance – all staples of  America’s version of Munich’s famous Oktoberfest. (My preference: dem Brezels, dem Bundhosen – ooh la la! – und das Fliegerlied)

With all the Oktoberfesting going on (hush up, it is TOO a verb!) I thought perhaps the other night I had achieved a maximum overdose of the Chicken Dance.

I was out battling the English (ivy, that is), when I experienced what
I perceived to be auditory hallucinations – the trilling of tiny
humans, calling “Hey, you want to see my chicken? Look at my chicken! HEY, LOOK AT MY CHICKEN!”

I froze in frightened confusion, certain that the trauma of dealing with my own rabid chicken
was coming home to roost.

I vigorously slapped the mutant mosquitoes away from my ears, and yet, the chorus continued.

“Turn around and LOOK AT MY CHICKEN!!!”

Slowly I turned, and, instead of the Ghost of Octoberfests Past, found the neighbor
children pressed up against the fence, standing neatly in a row, proudly clutching … a … CHICKEN!

I blinked.

I blinked again.

I rubbed the ivy debris from my face and blinked again. Nope, there was still a bigass chicken sitting on top of the fence, proudly propped up by a horde of small children.

Uhm … okay. Were I still back on the ranch, the sighting of a chicken would not be nearly so exciting and note-worthy. However, in our little corner of suburbia, backyard chickens are verboten, in spite of numerous sustainability initiatives.

Pleased that they finally had my undivided attention, the chorus of tiny humans continued to sing.

“Isn’t she nice? Her name is Ariana! She can FLY. Do you want to pet my chicken?”

They had her tied with a leash on one leg and offered her up to be
admired. I, of course, held and admired her. She is a pretty thing (Rhode Island Red, as near as I can tell), and very well
behaved.  Alas, no signs of a chicken coop, so I told them to ask their parents if they want me to build Ariana
a chicken house to help protect her from less-than tolerant eyes and hungry neighborhood wildlife.

Cat Daddy’s confused, and keeps asking me “Why is there a stealth chicken living next door?” And “Are you really going to build a chicken safe house? What’s next, the Poultry Protection Program?”

Personally, I’m just happy Ariana isn’t a rooster.

As far as Newt? We haven’t told him yet, lest he decide to invite himself over to the neighbor’s house for “dinner.”