Hope for Liver Shunt Cats

A Rose by Any Other Name

Would smell like …

Pineapple?!

In the continuing mysterpee of Pookie, we have an interesting new development. You may have heard me mention how the fumes from his normal output can peel wallpaper? Yeah – pretty rank stuff.

In the hyper-vigilant, obsessive box monitoring days since his return home, have noticed something. Or, rather, a distinct lack of something.

My eyes aren’t watering! No stench of Pookie Pee?

What on earth?

Closer olfactory inspection indicates that his current output has a distinct, non-offensive aroma. In fact, it has a rather sweetish fragrance – possibly similar to that of … pineapple? Any of you owners of cats with urinary obstructions ever smelled anything “different” when your kitty came home after removal of the obstruction(s)?

I know I’ve smelled the aroma before, but can’t quite place it. Am not a fan of pineapple, so we don’t have any in the house that I could compare. Cat Daddy’s been working practically round the clock, so he’s not been available. And I just CAN’T bring myself to impose upon the nice neighbors with a cheerful “Hey, can you smell my cat pee?” request.

(They already think I’m a weird enough for spinning dog fur and drying my fur “fleeces” in the front yard!)

His vets have, of course, been informed, and are consulting. Still can’t say enough great things about his care team – active, involved, caring and communicative.

Finally found him some cranberry concentrate and he had a bit of that with his lunch. He’s eating well, acting normally, eating his soupy snacks and enjoying his daytime juices and evening “cocktails.” Output remains at satisfactory levels, yay!

So, since we’re all friends here, and I’m a little stumped …

Wanna smell my cat pee?

Dear Dog

Dear Dog,

If I had known what lovely yarn your fur was going to make, I would have been a LOT less annoyed with your neurotic nature. The only thing that has kept you in my good graces over the years has been your incredible connection with Newt.

Nothing in the world like seeing an almost 90 pound Lassie carefully cleaning and caring for a 9 pound, runty little spotted weasel varmint kitty bunny named Newt.

Wait! Why are you running? It’s already been a whole day since I last brushed you, and I neeeeeeeeeeeeed more fiber!

So, uhm .. yeah. Perhaps I’ve been a leeeetle overzealous in harvesting cheingora for my spinning attempts. But the last few harvests have been PATHETIC! How am I supposed to spin yarn if my fiber source is not producing?

I never thought I would say that I was looking forward to the Spring Coat Blowing Season LOL.

But, Newt and I need that fiber! Newt especially, as he stole the last big fluffy wonderful batch when he annexed my wool bag while the Collie fur was waiting to be spun. That luscious harvest of fluffy springy yumminess has been flattened into a flatter than flat cat mat – and yet, Newt STILL insists on sleeping in the bag.

Yes, Newt’s doing MUCH better! Output is almost back to normal, and he has been acting quite normal most of the time, sleeping in his preferred spots, tanning at his normal tanning appointments, and gulping soup like a fiend.

Sometimes I just have to shake my head. Trying to adjust his diet to ensure we are meeting all of his Newt-rition requirements, and dealing with his often finicky nature when it comes to the amount of liquid in his food? A smidge too much liquid and he refuses to touch his meals.

Puh-leeze!

The little beast has been slurping down soup like crazy! Hooray! It’s not an ideal solution, I know, but at least he’s getting liquids – and a LOT of them! So far his favorite is still the sardine soup, sprinkled with a soupcon of grated parmesan and romano.

We took one 5.5 oz can (162 ml) of sardines in tomato sauce – his fave – and blended it with 3.5 cups (875 ml) of water. He’s drinking 1/4 cup (60 ml) of it on each of his four daily meals, plus also getting another 1/4 cup every couple of hours for between meal snacks.

Did the same thing with a can of tuna, and he’s also drinking low sodium beef broth, and is still pretty fond of the juice from low sodium spicy southern style greens. His marrow soup is still iffy; sometimes he likes it, and sometimes he doesn’t. So far the main hit is the sardine; we’re just trying other things to get the liquid intake up, and to hopefully keep him from getting bored with the sardines.

As for me? I’m actually beginning to enjoy the smell of fish soup in the morning. As long as I don’t accidentally mix his creamy tuna shake into my coffee again …

Happy Valentine’s Day!

For those of you who celebrate Valentine’s Day, I’m a bit stumped. While Cat Daddy and I don’t usually make a big deal out of the day, we usually surprise each other with some small, sweet or amusing token.

My original plan was to dye and spin some fiber, then make him a little red heart from The Dog’s fur. However, because of all the recent excitement, am reverting to plan B, C, D – heck I think I’m on plan X at this point!

With the current minor tweaks to Newt’s diet – primarily that of an assortment of tasty soups, do you think that Cat Daddy would enjoy a saucer full of steaming sardine soup? No? How about warm beef broth? An ice cold tuna shake?

You’re right. I didn’t think so, either.

However, Newt will have any / all of those for his Valentine’s Day present tomorrow, as they seem to be working! He is eating his Cosequin on his food, and enjoying lots of extra broth and soups. Yesterday’s intake was 1.25 cups (295 ml), and his output is approaching normal – yay!

Guess I’ll have to do something else for Cat Daddy.

I know! I’ll send him this valentine!

Pookie Pecker Power!

Newt is still at home and stable. Not nearly back to his normal prodigious output levels, but eating, drinking, playing, snuggling and being his adorable self.

Still monitoring very closely. Vet visit today went well. She wasn’t as dire and full of doom as the releasing ER vet was, but understands too well the gravity of the situation and the delicate balance that we need to keep him safe while juggling the dietary and medicinal conflicts of urinary crystals vs liver shunt.

He has no stones, but some Struvite crystals – NOT the ammonium urate variety typically associated with a liver shunt cat. No sign of underlying infection. His pH is high, but not overly so. Maybe a chicken and egg thing brought on from the UO?

For now, no real answers or options. Get him to drink as much as possible, minimize as much stress as possible, keep a VERY close eye on his output, and … Hope.

He’s having Cosequin once per day, and we are likely going to add Cranberry Extract. No major changes to his diet yet, but research is ongoing to hunt for possible subtle tweaks. We’ve been so lucky to find the right diet and “Newt-rition” to keep him stable, it’s going to be tricky to make any major changes. Plus, not only are we his personal chefs, we are now working on recipes for kitty cocktails.

While he IS drinking, I don’t think he is drinking quite as much as he normally does (which is usually a LOT), and he is soooo particular about the amount of marrow soup in his food! Too much and he simply will not eat. Same thing with his sardine goo or cod goo. He does love his cream and also his spicy seasoned greens, so am going to see if he will drink a watered down saucer of cream, or the juice from his spicy greens.

He’s not usually a fan of watered down cream (or watered down ANYTHING); he wants it straight up, thankyouverymuch! So, that’s where the mixology is coming into play. I feel like a kitty cocktail chemist – how many tablespoons of water to teaspoons of cream with how many mls of sardine juice and how many drops of cod flakes will turn out to be the perfectly flavored kitty cocktail? While Newt may not be enjoying all of our juice experimentations, The Dog is certainly loving it!

Good thing he’s not litter shy, what with me setting the alarm to check his pee every hour overnight. The little exhibitionist even leapt into a litter pan for his vet and wizzed on demand. What a guy!

Oops, gotta go, the pee alarm is sounding! Thanks again to all his many friends around the world for the love, Hope, healing songs, mojo, vibes, pawprayers and well wizzer wishes.

A special thanks to his knitting buddy for today’s title. The Supersized Font screaming a simple, yet elegant,”POOKIE PECKER POWER” gave both Cat Daddy and me a MUCH-needed giggle and a reminder that so many people are pulling for our Pookie and his little pecker. You guys are helping more than you can ever know.

With Love and Hope,

Newt’s Mum

Home Again, Home Again, Jiggity Jig

He’s home! Will try to post a more detailed update once I’ve had a chance to absorb it all.

Short version is he’s home and under careful observation. We have pee and seriously hope this trend continues.

Sorry to make this so short, never did get that nap in today – but don’t tell Cat daddy, okay? He worries about me almost as much as he worries about his New New – but that’ll be our little secret Took almost four hours today to do all his updates and answer his email. I think Newt’s secretary needs a secretary!

Seriously, thanks
bunches for all your singing and well wishes. Newt’s friends and care team are the most
amazing folks we know, and we are so grateful to everyone.

Sticks and Stones May Break One’s Bones

Or hurt one’s little whizzer!

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.

But for now, need to sleep a bit.

A Stone’s Throw

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.

Happy Boxing Day!

Newt in the Box Happy Boxing Day!

Newt is still sleeping off the excitement of his first episode-free Christmas yesterday. Even though it was a quiet Christmas here in Newtopia, he still had a grand old time. Like several other liver shunt kitties, Newt does seem to be triggered by stress, so even though it was “fun” stress, we weren’t sure how the day would play out.

What a joy that we were celebrating his third Christmas, and with no hepatic encephalopathy signs. It was wonderful to see him so excited and having so much fun.

Much hilarity ensued. Newt Devours Nip Toy

With a gleeful gleam in his glorious copper eyes, he annexed every opened box; leapt and writhed and gnawed on his new catnip toy (after repeated and determined earlier attempts to steal the fleecey bits that I had been marinating in the Valerian and nip oil so I could make the toy); and, ended the day by co-annexing the new dog bed I’d made for The Dog.

Another Newt Box Wisely, he has NOT (yet) attempted to annex the Slasher Queen’s new bed. It’s probably only a matter of time, though.

Or, perhaps not, assuming we celebrate our “boxing day” by letting him KEEP one or two of the empty boxes he annexed yesterday!

Pecker Flicker

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.

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.

Maybe later, after Newt and I have a little nap.

Annex Bed #47

Newt Helps Treadle Between The Dog barking and Newt acting jealous and destructive, my spinning wheel practice has been haphazard at best. Until today. Newt seems to have gotten past his annoyance, now that he has annexed Bed #47.

Couldn’t figure out where he had flitted off to as every time I attempt to practice, he’s either been been hanging from wool I’m trying to feed into the wheel, batting at the tools and decoration hanging from the wheel, or, climbing my leg while I’m treadling.

Where's Newt? Ah well, no worries, as it was about time for his afternoon nap. I could spin in peace – or so I thought.

Tried to lift the bag to reach for more wool, and ugh! It was heavy! What on earth?

I rooted around in the now solid and heavy bag, (formerly light and airy, in spite of the pile of wool inside). Poked around underneath the wool, and who did I find burrowed inside?

What’s a girl to do? I readily admit that Newt gets everything he wants (which is why he already HAS 46 Annex Beds), but I need that wool for practice!