Spencer the cat

Spencer gave me a little bit of a scare. I've been so busy getting up and running this quarter (notably organic chem and biochem, but also nutrition and A&P, all in an abbreviated summer quarter), that I've kind of been letting anything that can run on autopilot do so.

Cats are good at taking care of themselves, as long as everything's going right, so outside of opening the window for him to look out of, Spencer and I hadn't had a lot of interaction this week. So when he was lying on the floor in front of me, looking emaciated, I had an awful jolt of concern that he was sick, augmented by guilt that I hadn't been paying him much attention this week.

My concerns were dispelled when I picked him up, however, and it turned out just to be a trick of the angle he was lying at. Carl Sagan famously declared "We are star stuff"; by all indications, Spencer, the little mesomorph, is neutron-star stuff.

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11/11/08

I was going to post something for Veterans Day, but it will have to be another time. Today was not a good day. I'll let Mr. thalarctos explain:

Simon, the black male kitty we got as a fill-in companion for Andy after Bear passed away, didn't make it. He was fine for a few months, but then something happened--we don't know what, possibly something kidney related, given the aberrant blood chemistry involved--and he just began spiralling down after that point. By the time we took him back to the vet today (after a sort of "hiding" incident last night), he was under 5 pounds. He would eat with gusto when he would eat, though usually not for very long at a time, and he seemed to have a great deal of energy--he certainly fought his saline treatments and pills well enough--but despite being a love kitty under normal circumstances it was clear that the ground was washing out below his surface, and eventually it would all just cave in rather abruptly. So we decided to let him go on a good day when he seemed to have a fair amount of energy and the ability to feel good enough to purr, once he'd calmed down from the drive to the vet. This just seems to get more tough every time, so it's likely we'll have no more replacements for a while--the last couple of adoptees have eaten far into my rather poor ability to live up to buddhist ideals of detachment from impermanence.

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Things are looking up, I hope

One of the kindest things I've witnessed is when someone deep in mourning for a pet nevertheless takes the time to reach out, and pass on that pet's unused food or medication for someone else in need to use. It takes compassion to get out of one's own pain and to think of others at such a difficult time, and I've always admired people who can reach out in that way.

Even by my own low baseline, I've sucked at blogging lately. I started listing the RL things that have happened in the past year, and had to stop because the list itself was so long, it became a stressor in its own right.

But things are calming down, I hope, I hope. While I'm sitting here writing a paper, and have my beloved crime shows on as background noise, and they just ran a commercial for a product called Little Allergies.

Which reminded me that back in June, I bought a similar product called Little Noses on my vet's recommendation, to use for Cleo. She was so sick, and needed surgery so badly, yet we couldn't get a handle on her upper respiratory symptoms long enough to feel confident to schedule surgery. We hoped that a combination of drugs plus manual decongestion with the saline solution would get her into shape for surgery, but it turned out to be too late for those measures. She needed surgery right away, and we didn't even have time to try the Little Noses because she had ceased eating.

I've never been much of a housekeeper at the best of times, but during the May-October extended cat emergency season this year, the place has gone even further to hell than is the norm. Now that events are ebbing a bit (I hope!) I've been cleaning up the place a bit. As I did so, I found Cleo's Little Noses, sitting unused right where I left it.

For once, it was a joy to pass on unused medication to the vet, who told me that yes, there are certainly people and animals who can use it. I am grateful that, this once, the medicine is being donated because Cleo is doing just fine without it. She's made a full recovery, and is returning to being the mesomorph she used to be.

So the tally since May: 3 emergencies, 3 good outcomes. With less than half her teeth remaining, Cleo has resumed her place on the warm pad and is watching the world go by. Isadora needs minor wound care for a little recurrent seepage at the site of her ear amputation, but otherwise doesn't miss the ear and the chronic infections a bit. Simon (Caspian) remains the most fragile, but he is trending the right way--his BUN and creatinine were so high when we took him in that the vet's instruments couldn't even read the values. They had been trending down, and currently are plateaued at very high, but readable values. The vet says with the values, he ought to be acting a lot sicker than he is--he is gaining weight, and approaching us affectionately, which encourages me that maybe--whatever is attacking his kidneys--he is fighting it off.

Speaking of fighting off, he is determinedly non-compliant about the fluids, pills, and hand-feeding I'm currently carrying out; I prefer to look at it as fighting back as an encouraging improvement, in addition to being a major pain in the ass.

So rather than tempt fate by promising a definite date when I'll be more diligent about blogging, I'll just mark that things are continuing to get better, and--despite the best efforts of RL to kick my ass--we have not given up!

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The problem with public-contact jobs...

as a friend of mine likes to say, is the public.

Like the Sapir-Whorf hypothesis, in its strong form, it's a little too absolutely misanthropic for me to go along with. In its weak form, however, there are lots of specific instances where individuals seem determined to bear it out.

Yesterday, I took Isadora in (more piccies soon--not only is she healing well, she actually makes the pinna-less look work on her!) for a post-surgical check-up. The amputation site is mostly healed, but there is still a little exudate, possibly where she managed to get the soft Elizabethan collar off and hooked herself with a claw, before we upgraded to a hard plastic collar. I ended up waiting for some time--not a problem, since between Isadora's nuzzling and the book I had brought along, I had more than enough to keep me amused. I don't know how long I waited, since I couldn't be arsed to get my phone out and check the time, but when the vet got in, she apologized profusely for the delay.

They had had two emergencies arrive within 5 minutes of each other--to conceal the species for HIPAA purposes of privacy and confidentiality, let's say a peccary with strychnine poisoning, and a wombat who suddenly crumped for no discernable reason, were brought through the door, one right after the other. Although she had initially thought they would lose them both, at the moment, both of them seemed to be hanging in there at the moment, and if they could hold that ground, perhaps they would each make it.

I was all like, don't be silly, you don't have to apologize for keeping me waiting while you're saving lives--after all, after all the pets whose lives you've prolonged for me over the years, like I'm going to begrudge other pets the exact same quality of care I know you'd give Izzy or the others in the same situation? After all, it was an emergency; the receptionist had kept me informed, I had plenty to keep me amused, and was in no rush, and if I had been, we could have rescheduled, as Izzy's not in any danger--I didn't see the problem.

Well, apparently, not everyone sees it that way--she's had people berate her for keeping her waiting during emergencies like that! It never would have occurred to me to do so, but apparently, there it is.

Oh, well, public-contact jobs, as above....I will state, as a general principle, that no one who is involved in *actively saving lives* ever has to apologize to me for keeping me waiting under the circumstances.

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Raven plans, and God laughs

Originally, June was going to look very different. I had wanted to go to Evolution 2008, and today is a workshop on ontologies and evolutionary biology that I was especially interested in attending, as it ties tightly into the work I'm doing to continue my dissertation research.

Instead, I'm playing intensive-care cat nurse x 2: Isadora's amputated ear wound site is healing nicely, and Cleo is having surgery today. She has stopped eating on her own, so I've been hand- and syringe-feeding her. She's not so sick, though, that she can't fight back against the syringe-feeding; we both hate it.

It's not quite clear what's going on with her, but there's something wrong with her mouth--whether or not that's the whole story, we don't know at this point. We do know that she has bad teeth, and a lesion in her mouth. But she's so compromised at this point--and she went downhill so quickly from being fine at the end of May--that we've been putting off anesthetising her because of the risk.

Best-case scenario: the lesion in her mouth is just inflammation from bad teeth and gums, and the dental work will alleviate it, and she'll go back to eating on her own, once the dental surgery's in her rear-view mirror.

Worst-case scenario #1: the biopsy comes back malignant from pathology. In that case, we'll euthanize her--keeping her around while a facial tumor takes its toll is not doing her any favors. We lost our cat Momo to a facial tumor in 2002, and to this day, I am not quite sure that we didn't keep her around just a little too long for Momo's quality of life because we were reluctant to let her go. We won't do that to Cleo.

Worst-case scenario #2: the biopsy comes back benign, but Cleo continues to decline after the surgery, and we never figure out what the problem is.

Sad, but not worst-case, scenario: Cleo is a very poor anesthetic risk at this point, but it's clear that this is her only chance, and we're going to take it. She may well die under the anesthesia. If she does, we'll be sad, and we'll miss her, but we won't regret going forward with the surgery. If she has a chance for any future life with any degree of quality of life, this is it. But she's DNR (do not resuscitate) if she dies in surgery.

In her favor, we've temporarily gained a little ground with steroids and antibiotics--it's not a permanent gain, but we're hoping it's enough to get her safely through dental surgery this morning. She's alert, her eyes are clear, and she's looking around for the food I normally give her by hand in the morning (she's been NPO, or nothing by mouth, since midnight).

Carpe diem. I'll let you know how it turns out.

UPDATE, Friday AM: Leaving for the vet now. Cleo is awake, alert, and the talkiest I've seen her in weeks. I love you, Cleo, and we're hoping for the best. Whatever happens in surgery, I'll remember how your old self showed itself this morning.

UPDATE, Friday night: Cleo came through the surgery fine, much better than we were expecting. Yay, Cleo! I brought her home, and she headed right for the food bowl. I think we've found and fixed the problem! I didn't let her stuff herself, because she's had quite the shock to her system today, but clearly she wants to eat.

She had about half her teeth extracted, and the biopsy is sent out, but the vet thinks it's stomatitis, or inflammation of the mouth, rather than cancer. Her canines were abcessed, and their proximity to her sinuses may account for her chronic respiratory issues--so we just may have solved another problem in addition.

Good Cleo! I'm glad you came through so well.

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Izzy's home!

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Izzy's big day

Today is the day Isadora's finally going to have her ear amputated. The chronic infections have gotten to be so bad that her quality of life is severely impacted, and continuing along the same path has become untenable.

The vets are going to begin by amputating her pinna (outer ear), and performing a lateral resection, or cutting away that portion around the ear canal on the outside. Once they get the deformed pinna out of the way, they will actually be able to see down inside and get a better idea of what is going on, something that's been impossible until now because of the extent of deformity of the cauliflower ear.

The vet expects that once she gets in, she is going to find damage all the way down into the inner ear. She expects that the eardrum is ruptured, and that evaluation at that point will indicate that the best course is to make the surgery even more radical, proceeding from the vertical canal into the horizontal canal, and removing the entire middle and inner ear as well.

I'm worried about Izzy--she's currently at a local maximum healthwise, which is why we've decided to go ahead and seize the day surgically--but even with the anemia and elevated white blood count under control at the moment, no one thinks she's an outstanding surgical candidate. They're going to take extra precautions, like putting a catheter in in advance, so if there's an emergency and they need to give her drugs to get her heart rate up, they don't lose minutes looking for a vein. But she's an old cat, with chronic health problems, and she's got the pug nose of a Maine coon cat, so there are just some realities we can't do anything about. I'm worried about the anesthetic risk, and I'm going to be on pins and needles all day until I get the word that she came through surgery ok.

I'm worried that she's going to die on the table, and I so do not want that to happen. I'm really nervous about putting her through surgery. But Mr. thalarctos and I have discussed this at length with both vets, and everyone sees it this way: the only chance for Izzy to have any quality of life at all in her remaining years is to get rid of the source of chronic infection that is causing her such distress. Her ear is so bad, and causing her so many problems, that--as drastic as this surgery is--it is the right thing to do.

I love you, Isadora, and I hope this is going to be all right.

UPDATE, Tuesday evening. It was a long day, with running errands, work, and a project management class at the end. I got the news right before going into class that Isadora had done well in surgery and is recovering. They're keeping her sedated because of the pain from the amputated ear. Once the vet got in, she found that, past the pinna, things were better than she expected, so rather than fully ablating the ear, she just took off the pinna, then cleaned up the ear inside. Izzy considerately spared them the trouble of having to take out her IV by removing it herself. After that long day, I came home and fell asleep. More later about the anatomical details, but it looks like Izzy has set out on a long road to recovery.

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Isadora update

Isadora's bloodwork is in, and the results are mostly good. The only exceptions are in the complete blood count (CBC): slightly-elevated white blood cells, and slight anemia (low red blood cell [RBC] count).

She tested negative on all the viruses she was tested for--feline leukemia, feline infectious peritonitis, and feline immunodeficiency virus.

Ruling out those viruses ruled out some of the potential causes behind the elevated WBCs--there still may be some inflammatory or infectious process going on that was not tested for, however. One thing that could have happened is that the ear infection has burst through the ear drum, and is now in the middle and inner ear. So we'll continue to treat her with systemic antibiotics, as well as topical, to address that--the cauliflower ear is so deformed and full of cysts that the vet cannot see down into it, and I can't get the eardrops in very far at all.

But even if that explains the elevated WBCs, it does not explain the anemia. The vet explained that anemias can be classified as regenerative or non-regenerative, referring to the presence of immature RBCs, indicating that the body is making up the anemia by creating new RBCs. Regenerative anemia causes include such things as acute blood loss, for example, which the body responds to by upping the production of new blood cells.

Isadora's anemia is non-regenerative, and for the moment, we do not know what's causing it. We hope that the X-rays Tuesday shed more light on what's going on in her abdomen--for example, is the liver behind both the anemia and suspected fluid in her abdomen?

I hope we have some info soon, but in the meantime, she is definitely feeling better after the antibiotic injection, the lysine for the weepy eyes, and the ear drops. She's talkier and more active, pretty much as soon as we got back from the vet. However, I dread the battle of wills that the twice-daily ear drops became last time, and now doubt will develop into again. Oh, well, as the human, I get to suck it up, because it clearly helps her feel better.

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