Warmest spot in the house

I couldn't find Mack when I came home for lunch to feed him. I wasted a good 10 minutes checking the basement hiding places, as well as behind all the closed doors (remembering when I locked him in the linen closet last week!). Finally, I looked in the living room again ... and there he was -- in the warmest spot in the house: on top of the snake cage, right over the warming light. I didn't even see him there when I walked in the door. It's been so long since he felt well enough to jump up there.

This is another great sign!







Speaking of the snake, for anyone who hasn't seen her in a long time (or ever), here's another picture of her. She's over 6' long, and the circumference of a soda can, at her widest. She seemed very interested in the mammal on top of her enclosure ... but she wouldn't be able to eat him, even if she could get out. She's built to consume other snakes, as well as SMALL animals ... and even anorexic, Mack would be too big for her to swallow.


And, finally, here is a picture of John feeding Mack. I know it sounds kind of icky to have a cat with a feeding tube, but it's really not as awful as it sounds. And it does seem to be doing him some good, so we are very grateful that it's even a possibility!

And besides, we won't need to feed him through a tube forever. After all, there are plenty of indications that he is getting better and better: Mack came to the door (with Lucky and Reggie) to greet John when he came home tonight, and later Mack was wrestling with the catnip toy again! Best yet -- when John filled the food dishes with dry food for the other cats, Mack walked over and sniffed it.

I know, I know ... sniffing food might not sound like a big deal ... but he hasn't showed ANY interest in food of any sort in a LONG time, so this is significant progress. Sooner or later, he's going to want to eat regular food, on his own ... and then I can stop spilling, dribbling, and shooting watered down liver pate all over my kitchen!

We just have to be patient.

Catnip

It's so good to see Mack is feeling well enough to actually curl up and sleep, instead of holding himself upright in a tight little ball for hours on end.

How many optimistic postings can you handle? When things get good, do people lose interest? I don't know ... but I have more good news.

Not only has Mack taken in larger amounts of food today (including a final feeding of 30cc!), he is apparently feeling better than ever!

Evidence? First, he actually got off the couch and wandered around a bit, instead of making trips directly to and from the litter box. Second, in his wanderings, he stopped to sniff, then lick, then take a tumble with (!) a new catnip toy John brought home from the vet's office last weekend.

MACK WAS PLAYING!

Hooray!

Math Challenge

10cc = just over 2 teaspoons
25cc = just over 5 teaspoons, or about 1.7 tablespoons

We are excited! Mack took 25cc of food last night (yea, John!) and 26cc of food this morning. And he kept it down!

As I was contemplating just how much progress we've made -- it was a week ago today that the feeding tube was put in place -- I was struck by how little food our dear Mack has actually been living on this week. It's difficult to get into perspective, when it's compressed in the syringe ... but the truth is ... it's not much!

Of course, he's not very big, either.

I just did some math. (Don't roll your eyes ... it happens!)

10 teaspoons of food for Mack is like 4.11 cups of food for me. That's not bad. Very sustainable.

Mack got 90 cc of food yesterday ... about 18 teaspoons. That would be almost 33 cups of food for someone my size.

Also, remember that Mack's food is about 1/3 water. Even so ... that's a lot of food! Yea!

The Good News

Although it is considered tacky to discuss bodily functions in polite company, sometimes that's what life is all about.

This evening, Mack surprised us by actually jumping into my lap after going down to the basement to visit the litter box. It's the first time in weeks that he has initiated this kind of contact, and I can only take it as a FABULOUS sign that he's feeling better ... despite the fact that his underside was ... um ... wet ... because he still hasn't come around to being the fastidiously clean cat he used to be before he fell ill.

BUT -- more good news -- today is the first day we have seen him make ANY effort whatsoever to clean himself in the last several weeks. The fact that he got one leg in the air, bent his head down, and then froze ... well ... we still see this as progress. Thank goodness we bought (and used) those little pet-cleaning wipes we noticed at Pet Supplies Plus.

AND -- still more good news! Mack has not (knock on wood, cross your fingers) rejected any of the food we've given him in the last two days!!! This, despite the fact that John and I seem to be having a good-natured "cc" war: John fed him 20cc yesterday after I gave him 16. Today, I gave him 22cc, and John upped the ante to 25. It's crazy here ... but the one who is benefitting is our beloved Mack!!

Next week, he'll go in for blood tests. But I don't need blood tests to know he's feeling better. I have the purr test, and the jump-in-my-lap test, and the ohmygosh-I-have-to-clean-myself test.

Life is good.

Notes to Self

1. Regardless of reasons or rationalization, it is inadvisable to mix consumption of even a moderate amount of wine with operation of heavy equipment, automobiles, or cat-feeding syringes.

2. Heavy duty spray cleaner with bleach *will* effectively remove the 2' x 2' spatter pattern from the ceiling that results from imprudent disregard for Note to Self #1. It will also leave white spots on your favorite raspberry-colored cotton sweater.

3. While incredibly effective for keeping hair in place, a high-fat, high calorie prescription cat food enriched with appetite stimulants, antibiotics, and various liver-support supplements is NOT a desirable alternative to hairstyling mousse, due to its pungent aroma, which is no doubt intended to entice anorexic cats.

4. Arrange to meet Sue's coworker who described tube-feeding a cat as "messy and putzy, but well worth it," to bestow Understatement of the Year award.

Purrfectly Wonderful

Mack is not only taking more food, he's keeping it down, and he's more relaxed since I started spending time just petting him. I don't know why it takes me so long to stumble on the obvious!

I can't tell you how good it feels to have my kitty back.

This morning, again, instead of giving him the anti-nausea medicine, I sat with Mack for 20 minutes and just petted him. 20 minutes straight of purring ... it did my heart good.

John was also able to give him *20cc* of food, both last night and this morning!!

(My husband is so competitive, it's hilarious. I gave Mack 16cc earlier in the evening, thinking we could gradually increase to 17, 18, 19, and finally get to 20 ... no ... John is not to be outdone! Gave him 20 last night and Mack kept it down! John is triumphant. He claims he's not competitive, but the way he does it, it's one of his more amusing and endearing qualities!)

It's nice to be able to celebrate.

Purring

I am learning so much about myself.

Mack has been spending the last couple of days in the basement. Aside from covering him with one of my fleece pullovers (which he sits on top of, instead) I've pretty much left him there because I know he feels lousy and wants to be alone.

But it's cold down there. And depressing. And he just sits in an upright, tight, little ball. I don't think he even dozes very much. Just endures.

I've been a little frustrated that, no matter what I do differently, the feedings Mack rejects most frequently are the ones where I've conscienciously ground up all the medications he is supposed to get. He's still keeping down only about two-thirds to three-quarters of what we feed him.

John spent some time in the basement with Mack yesterday evening, just petting him after a feeding. He also wanted to be sure he wouldn't reject what he'd just been fed. Mack didn't respond at all, and just stayed a tense little ball, paws turned in and under himself, staring.

Before I went to bed, when I knew it had been hours since his last feeding (so he wouldn't throw up), I went downstairs and picked him up. He pushed his head under my chin, like he used to. I carried him to the living room, sat on the rattan papasan, and just held him ... petting him for several minutes. When he wanted to walk away, I let him ... but he didn't go back downstairs. He sat next to me. I continued to pet him, and could see him relax just a little -- the double-folded paws under his chest relaxed into a single fold.

I went to John and told him this:

- I've been so wrapped up in the MECHANICS of getting Mack the right medications at the right doses and the right times, that by the time I'm done grinding the pills, mixing them with water-thinned prescription canned food, calculating how to get the meds completely into the feeding syringe without losing any or leaving any in the tip, and then go to feed him, I'm so wound up that I probably carry that stress to him, and probably even administer the feeding too fast.

- So I need help.

- I need to let go of the idea or feeling that only I can do this, or only I can do this right, or that if I do this just right (and all by myself), then Mack will be okay. I'm not making things better by making myself a wreck.

- So I asked John to feed him, again, last night ... slowly.

And he did. And Mack kept it down. And Mack stayed upstairs on the papasan.

He was there this morning when I woke up and went to check on him ... completely upright, wound into a tight little ball.

I didn't want to start the cycle all over again ... approaching him just to give him something he'd likely throw up. Then it occurred to me ... if he's throwing up the medicine that's supposed to keep him from throwing up, maybe I'll just skip that pill.

I took the time I would normally have used to grind, mix, thin, stir, load syringe, and fire ... to sit beside Mack, instead. And I just pet him. Tentatively, at first, aware he wasn't really sure he wanted to be touched.

And then, more firmly. I played with his ears, as if he wasn't sick. I like to feel whether they're cold or hot ... and he doesn't mind when I run them between my fingers. He leaned into me. I pet him under his chin and across his forehead and avoided the feeding tube, and cupped his whole head in my hand the way he likes, with his ears between my fingers, just as if he wasn't sick. And he tipped over a little to one side and let his paws peek from underneath him.

I petted his tummy, rubbed his skin between my fingers, and felt him relax under my touch. He was getting a massage, and he was relaxing. If I listened carefully, I could even hear the faintest of purrs!

Tears. Mine. This was much better than grinding and mixing and loading and firing. Apparently ... for him, too. Mack tipped over on his side and continued purring, and finally closed his eyes for a bit.

I mixed the rest of his meds into a new batch of food, loaded the syringe, and John fed him ... slowly, petting him the whole time. Mack stayed relaxed. He took 15cc and kept it down without the meds to keep him from throwing up.

I'm learning so much about myself.

Mack is still alive

Mack is keeping down about 2/3 of what we're giving him. I was really discouraged yesterday, because it seemed that whenever I gave him a feeding with the meds (antibiotic, appetite stimulant, anti-emetic) THAT was what he barfed up. So I went back to just mixing the meds in with a larger batch of food ... that way, he doesn't get the all-at-once dosage the vet was hoping for, but at least he gets SOMEthing!

His coat looks a lot better than it did last week ... it was looking and feeling just like fake fur, but with a BAD case of dander. Already on Friday, that was looking better. He's still not doing anything to clean himself, but that's probably good, because if he cared, he might try to remove the feeding tube. And that would not be a good thing.

He is obviously not feeling well, though. He's retreated, for the most part, to the basement again. He keeps trying to find new places to hide, but I keep finding him. I try not to move him to feed him, as it invariably results in his not keeping the food down anyway. He has an aversion to being held, and seems not to want to be petted, either, which is understandable, but sad.

The plan was to feed him 10cc's at a time each hour for 2-3 days, then graduate to 20cc's every 2 hours for another few days. I've decided I'm thrilled with anything I can get into him without him gagging and erping it up again ... so sometimes it's 9cc, sometimes it's 15cc ... I haven't gone over 15, because there's still the water that needs to be pushed through the tube to flush it, and I don't want to cause an overflow.

Yesterday, I was pretty down ... I could hear every breath he took, in and out, as if he was on oxygen. We tortured him a bit to clear the crusted discharge from his nostrils (using vitamin E oil with calendula) and now he's much better. His poor nose is probably sore, and he hasn't used his mouth to do anything but vomit for so long ... he must have a horrible case of dry mouth.

But he is ALIVE! We are so glad we didn't keep that appointment on Tuesday. I hope, some day in the not-too-distant future, he will be too.

Holding Steady

I'm not sure if we're coasting on even ground, on a gentle incline, or a slow decline -- the roller coaster has slowed down so that our trajectory is imperceptible ... but that's okay. I can use the breather.

Amy did a stellar job today, feeding Mack on the hour for 8 hours straight. Combined with the three feedings I did in the previous 4 hours, that makes 11 feedings in 16 hours. That's GREAT! And, in fact, perhaps a little too much?

After Amy administered her 8th feeding today ... Mack jumped off the couch, meowed the meow we only hear when our cats REALLY want to make a point, and heaved. Not everything ... but enough to say, "ENOUGH!"

So we're giving him a break. I'll give him one or two more feedings tonight, to get him the prescribed meds, and then let him sleep.

He doesn't look very happy. He's not quite the tight little ball he was when I got home (just after he overflowed), but he's still quite tense. We were told to watch for lethargy and/or depression ... but it's hard to tell, when he's been so miserable for so long, so John's going to take him in to see The Cat Doctor tomorrow, to have a blood test to make sure he hasn't developed a life-threatening anemia, which is apparently a possibility for cats in his situation.

Many thanks to everyone who has been pulling for Mack. Things seem to be going in a positive direction. Tomorrow, I'll be out of town and away from my computer, so unless something HUGE happens, I probably won't be updating.

I would be happy with slow, steady, boring, positive progress.

Have a great weekend, all!

Last night, I was overwhelmed. Seven prescription bottles were arrayed in front of me:

-- the two on the left side of the table were to be crushed into the food and administered twice a day;

-- each of the three on the right were to be crushed into the food and given only once a day;

-- the two I placed farther away from me, on the counter, were special -- one needed to be administered twice a day, but BEFORE the food -- and the other was to be given whole, orally, after food ... as were the two little capsules in a plastic ziplock bag that remained in my purse.

I just couldn't add those last ones to the gathering right now. I was too overwhelmed.

It's not like I could just grab Mack and drop these pills down his throat. I had to grind them and mix them with prescription canned food thinned with water to a consistency that would easily go through the syringe into the feeding tube that ended up in Mack's esophagus.

My mind was swimming ... all these pills ... distributed over the course of 3-5 hours worth of hourly feedings. How do I space out the dosages? Should he be getting the whole dose in one feeding? How do I manage that, when I have to feed him only 10 cc of food each hour?

And how am I going to force a pill down his throat, when he doesn't want to swallow anything at all? (That one, I decided to leave until later to worry about.)

I finally made the new batch of watery canned food, mixed in the appropriate batch of medications, and set it aside. I cut one of the 1/2-pill medications in two, mixed it with water and injected it into the feeding tube ... about 15 minutes before giving him the food.

Remember Sue said her friend reported that this process is "kinda messy and putzy, but well worth it" ?? I'm sure, once I'm organized, I'll have the confidence of experience that will allow me to report with the same kind of wisdom and perspective. Right now, it's still overwhelming.

BUT -- that was a report about ME. Here's a report about Mack:

He has kept down MOST of what has been put into his stomach through the feeding tube. That's 11 out of 13 feedings, so far, that have come off without incident!

Last evening, at around 8, we administered the food too fast, and he threw up.

This morning, once, he threw up BEFORE Amy could administer the scheduled feeding ... but I think it may have been caused by a little bit of stress -- Amy's home doing this alone, and it's pretty tough to get both syringes (food and water to flush the feeding tube afterward) lined up, find the cat, calm him down, arrange him in your lap so he can't run away -and- you can hold the end of the tube, remove the cap, remove the cap from the syringe, inject the food, inject the water, and close it up again ... all slowly enough to avoid an instant vomiting reaction.

I am so grateful that Amy is taking over the feedings during the day while John and I must be at work. I also give her a lot of credit for discovering a strategy to avoid the stress-related upset: she goes to the cat, rather than bringing the cat to the food. Apparently, Mack hardly notices when she does it this way ... she doesn't even hold him, just sits next to him on the floor or in the basement where he's resting.

Good work, Amy ... and Mack!

They got the tube in ... and have gotten food into Mack twice already, as of about 2:20 p.m.

Yea!

I'm leaving work at 3:30 to go pick him up and learn what I need to do to feed him. I figured that would give them another hour and a half to see how he's tolerating the food. And to adjust any instructions, based on what they see.

Sue wrote:

"It’s better than you think. I was updating Rick at lunch re: Mack & a friend of ours overheard and piped up that SHE had had a cat that had Fatty Liver Syndrome and she said they had had to go the feeding tube route. She said her cat ( Casper ) started eating on his own about 2-3 weeks (the article I sent the link for said 6-8 wks, so it could be sooner!) after the tube was in and not only survived, but lived to the ripe old age of 18!! She said they were given prescription food that had to be mixed with water & syringed into the feeding tube, which was located under his chin in the neck area. She said it was kinda messy and putzy, but well worth it. As you said – Priceless!!"

The roller coaster car keeps climbing.

I talked with the vet, and got some answers. Tube: $130-$150. Meds and food for 2 weeks: $185. Making Mack well: priceless. We could be a mastercard ad!

She got a little defensive when I asked what our chances of success are ... I understand, because she doesn't even have the biopsy that would tell her if it is JUST fatty liver. She got a little defensive when I told her I was concerned about the psychotic episode Mack had last night. She said there are side effects with most of the anti-emetics. Sigh.

She thought she'd start working on him at about 11. He should be ready to come home, as long as he's tolerating everything well, between 3 and 6 tonight.

At least there's hope. I wonder if it would be better to know what a biopsy would say, or better to just live in the hope? I used to think I wouldn't want to know if I had breast cancer, because the treatments were so awful I didn't want to face them. Now things are different, and I think I'd want to know. In Mack's case, though .... the worst case scenario is that he feels better, gets some nutrition, and has a longer time to bless us with his living presence.

I don't want to know. I just want him to get better.

Mack's Long and Winding Road

This has been such an emotional roller coaster for us ... I can only imagine the physical and emotional roller coaster Mack is on!

We brought him home Monday thinking there was no hope, and wanting to curtail his suffering. When he seemed NOT to be suffering, we canceled the Tuesday appointment for euthanasia, and spent the day with him, instead. He seemed happier at home, more relaxed after his ordeal at the emergency hospital. He really wasn't even retching on a regular basis ... just when he smelled food on Monday, and shortly after getting up in the morning on Tuesday. We thought, perhaps, without the stress, he might just turn around and eat. But would he have enough time to do a turnaround, if he didn't get anything into his system to sustain him? No.

So we decided to take him back to The Cat Doctor for fluids and, if they agreed, something to quell the nausea and vomiting reflex, so maybe, eventually, he could eat.

The Cat Doctor wants to treat it as fatty liver syndrome, even without the biopsy. If it's not ... if it is cancer, then it won't help, but it won't hurt, either. So he got anti-nausea drugs yesterday, in addition to subcutaneous fluids. And he's back at the Cat Doctor today. They will probably be inserting a tube (not through nose or mouth, but into his stomach), so we can use a syringe to put food into his stomach and bypass his mouth altogether. He'll get anti-nausea meds, too. And maybe some antibiotics.

But I have questions, first.

I'm waiting for the doctor to call me so I can understand how he will keep food in his stomach (I know ... the anti-nausea meds), and what will happen to it if his body won't process it. This seemed to be a concern for the emergency doctors, as well as our former vet. I just want to understand.

I'm also more than a bit concerned that the drugs he got yesterday threw him into an altered state of mind. Prior doses of anti-nausea meds had the effect of actually perking him up; he acted as if he was feeling better. Last night, in contrast, he was a tense little ball of anxiety and grumpiness that actually froze from time to time, mid-motion. I was afraid he would fall down the basement stairs, but he seemed oblivious. I was afraid he'd fall off the bed, but he seemed unable to let his muscles relax. He hid under the bed until John insisted we pull him out to sleep with us. I'm glad he did ... eventually, Mack came around to being himself again, and by morning he was curled up and (very slightly) purring again.

He let me pick him up and cuddle him this morning. He trusted me again. I felt bad taking him in to have more procedures. But they might save his life. And that is the point of all of this. As long as he has the quality of life he deserves. If he will be the paranoid schizophrenic freezing cat he was last night ... that doesn't seem like a life he'd want to be living.

He'll be home again tonight. We'll pump him with food. We're on our way, slowly climbing -- again -- the incline of hope on this roller coaster. I hope, on the other side of the hill, there is just a gentle glide to the end of the ride.

The Mack Saga Continues

Mack is home. His blood levels skyrocketed between Sunday and Monday, and emergencies prevented them from doing the ultrasound / biopsy right away in the morning. So, rather than incurring more costs, and making Mack more miserable, we brought him home.

I had an appointment to take him this morning for euthanasia, but I couldn't do it. He was resting so peacefully ... doesn't seem to be in pain at all. I don't think he got any rest the whole time he was at the hospital.

Perhaps we'll just let him be, and see what happens. No need to rush into anything permanent.

I don't think I'll tell anyone at work we didn't do it. It's all just been so long and drawn out and dramatic. It's over now, as far as they're concerned.

I do hope he starts eating or drinking. Or at least doesn't suffer. And, finally, goes peacefully ... whether it's in hours or days or years.

Waiting to hear ....

John and I visited Mack last night at the hospital.

We arrived at 7:30, and didn't get to see Mack until 8:30, although the day-shift vet spoke with us about 8:00 ... please bear in mind, his shift ended at 6:00. The place was VERY busy, and it was all they could do to keep up with incoming patients, much less deal with visiting families. But we had come a long way, and waited a long time, so it didn't make sense to go home without seeing him.

The report from the daytime vet was less than encouraging. They had tried syringe-feeding Mack twice since they'd spoken with me in the morning. He hadn't kept any of it down, either time. There wasn't much more to report, because they won't know anything else until after the ultrasound that should be happening sometime this morning (Monday).

We did talk about "what ifs" ... and Mack has a long road to travel before he is a well kitty, even if he doesn't have cancer. Of course, first and foremost, he has to be able to take in nutrition and water orally ... and keep them down.

We're also worried that if this is "fatty liver" disorder, and the combination of factors that pushed him to stop eating to begin with are (a) Cinnamon's death, (b) me moving the food from downstairs to the kitchen -- what was I thinking?!?!, and (c) the introduction of a new cat to the household ... we can only control one of those absolutely, and one ... well, Amy will have to contain her cat, I guess.

We spent between a half hour and 45 minutes with him, just petting him and picking the dried, rejected food out of his fur. He started purring shortly after we started holding and petting him, and by the time we left, he seemed more like himself, and less like some drugged and abandoned pet who hadn't had a good catnap in days because of all the lights, strangers, other animals, and activity that happens in the open treatment room of the hospital.

The only other piece of news is this: I didn't know (or didn't remember) that Mack was also tested for something called leptospirosis. The tech that brought him for our visit had latex gloves on and had him wrapped in a towel. I asked if we could hold him, and she asked if we wanted gloves, too. Why? Because they won't know the results of the leptospirosis test for 5-7 days (it was sent out last Friday), and it IS possible for people to get it! Not really a concern unless you've had direct contact with the urine of an infected animal, apparently. So I shouldn't be worried ... except that on Wednesday night I inadvertently ... well ... here's what I wrote to a friend about it:

"Had a little scare this morning when I couldn't find Mack ANYwhere ... not in his hermit cave in the basement or among ANY of the things stored down there, not in the kitchen soffit, not in the living room behind the corner desk or under the recliner, not in the dining room in the bookcase.

So I started looking in impossible places: behind the bedroom closed doors, in every nook and cranny with a flashlight, behind the toilet and ... in the linen closet. Apparently, he parked himself there when I was brushing my teeth, and I didn't notice. I shooed 3 cats out of the bathroom in the middle of the night, but didn't turn on a light or figure out what they were drawn to, in there.

Mack was eager to get out, and I removed all towels he seemed to have scrambled during his attempts to be free. There's a 4" space between the door and where shelves end, and he seemed to have disturbed things on 5 of 7 shelves.

But when I grabbed a hand towel to dry my hair, after my shower, I discovered Mack had, indeed, been processing the fluids he received yesterday. I THOUGHT that towel seemed a bit less rigid than it ought to have been ... and then I saw the big yellow spot. Sigh. My hair has a special sheen today, though. :-)"

I didn't think much more about it until last night.

Let's hope his leptospirosis test comes back absolutely NEGATIVE!

The Six Million Dollar Cat

Round-the-clock care, 24-hour access for updates or visits -- I never dreamed we'd spend this much to find out what is wrong with a cat. I'm not sure what the outcome will be, but I know it's getting more expensive every moment. Part of me cringes at the cost; part of me doesn't care.

This morning's update:

Mack is still on IVs for fluids and nutrition. They've had food and water available the whole time, of course, as we did at home. He's just not interested. They tried syringe-feeding him twice: once last night, and again between 5 and 6 a.m. Both times, Mack was "struggling with food aversion," and both times he threw up the food they got him to ingest. They're now offering him a liquid nutrition orally, but he's still showing absolutely no interest.

They did test his blood yesterday, again. His bilirubins are down (4.3), compared to when he was admitted to the hospital (6.8) ... but they need to be between 0 and .5 to be normal.

I'm not sure how useful the information is, because I'm not sure what to make of the values, but the vet told me Mack's ALT values on admission Friday night were 362, and were down slightly to 346 when tested last night. Something I heard as "elk fass" was UP, from 549 to 656. For anyone interested in knowing more, I found a website that could help you understand a bit about how to read lab tests. I'm thinking the "elk fass" might be the Alkaline Phosphotase (ALKP) which could easily be abbreviated to "alk phos" by those in the business. Normal readings, according to the website I found, would be between 10-130 for the ALT, and 20-220 for the ALKP.

Bottom line, Mack still has a low-grade inflammation in his liver, and won't take food or water orally. They won't try again soon, since they don't want to have him develop a total food-aversion, which could happen if he associates eating/drinking with nausea. (Could be too late for that worry?)

Tomorrow, Monday, when the lab technicians return, I'm sure they'll test his blood again, and I know they will do the ultrasound and possibly an "aspirate" of the liver tissue. The difference between that (done with a long needle) and a biopsy (slicing a bit of the liver tissue) is that the aspirate is less invasive and will give Mack less to heal from.

After the ultrasound, and aspirate (if they do it), we'll know more about the nature of the liver dysfunction, and whether it can be cured.

The cost of waiting until the weekend to hospitalize him is very high. We could have had the ultrasound done right away, any other day of the week. Sigh. It's only money?

More Mack News

Just got a call from Dr. Beltz at the Wisconsin Veterinary Referral Center. Here's the report:

Mack is doing well, clinically, which means he's responding well to the supportive care of IV fluids and nutrition. Tonight, when he's had a good 24 hours of this supportive care, they will attempt to switch to syringe or tube feeding, because they need to know whether he can take food orally without the vomiting reflex kicking in. I agree!

They're still planning to do an ultrasound on Monday when the technician is back, to find out whether he has a liver infection or more serious problem (cancer). I'm unclear whether they still need the biopsy to be certain. I'd think so.

I asked about the x-rays they took last night. They showed an enlarged liver with rounded borders, which is indicative of an inflammatory problem. I asked whether he thought the cortisone shot Mack had earlier in the week had helped the situation at all. He said it didn't help and he wouldn't have expected it to. In low doses, he explained, steroids can act as an anti-inflammatory, but in high doses, they work to suppress the immune system, instead. (I wonder why anyone thought the cortisone was a good idea, then.) Step One should have been to determine the cause of the liver problem.

I asked about the blood tests they did last night. Dr. Beltz confirmed that Mack's blood values were much worse than the ones taken last Saturday. At that time, his values were twice normal; last night they had doubled THAT. They won't plan to retest his blood until Sunday or Monday. If they do them Sunday, they'll need to use a different instrument because the Marshfield clinic they use is only available to them Monday through Saturday, which would make it difficult to actually compare the values. If they retest on Monday, they will be better able to tell how much he's improving, if at all.

We're welcome to visit Mack in the hospital, we just need to call ahead so they can tell us whether it's a good time (depends on other activity in the emergency center).

Mack Update

I waited all day for our regular vet to call me, in response to a letter I dropped off at the clinic when they opened at 8:00 Friday morning. I called later in the morning, to be sure our vet was actually IN that day ... yes, but he was in surgery this morning. Okay. I can understand that.

At 1:45 I called again, only to be told our vet was at lunch. I can understand that, too.

At 3:15 he still hadn't called and still hadn't OPENED my letter, which I had WRITTEN to avoid "phone tag," and to update him on the fact that, despite his optimism that the cortisone shot from Tuesday might still "kick in" and get Mack to eat, Mack hadn't done so yet. The subcutaneous fluids he'd been given on Wednesday had to be pretty much gone by now ... what was the vet's recommendation for "next steps" ???

Everyone in my office has cats. One colleague's cousin has worked at the Los Angeles animal hospital for over 10 years, and has asked vets there to look at the results of Mack's bloodwork and x-ray. Shortly after 3 p.m., my colleague realized that an email she sent me on WEDNESDAY hadn't left her email "outbox." In it, her cousin communicated that a veterinary internal medicine specialist had not been discouraged by Mack's test results, and recommended an ultrasound, which the LA Animal Hospital routinely administers without anesthesia, and without traumatizing the animal -- if the techs know what they are doing.

THAT put me over the edge. Suddenly, I realized Mack's condition may not be as dire as our vet has been leading me to believe. And now, I'd been waiting for him to call me back when it seems he's just waiting for Mack to DIE! I'd wasted a precious WEEK of Mack's life, waiting for this man to recommend something POSITIVE we can DO for him!

Three of my four colleagues take their cats to a place called, simply, The Cat Doctor. I had taken Lucky there 3 years ago, after our dear Dr. Hoppe had retired, when I had grown frustrated with the remaining vets at the clinic we'd been using for the last decade and a half.

I was fortunate to get an appointment at The Cat Doctor for 5:00. It was 3:45. I still had to get home and get the cat! John headed downtown to The Cat Doctor to fill out paperwork; I went home and grabbed Mack, the photocopies of his recent blood tests, and the folder of veterinary records I could lay my hands on.

My cell phone rang as I carried Mack across the street to The Cat Doctor's office. It was our old vet. I listened to what he had to say, all negative about how putting tubes down Mack's throat to force food into his stomach would be traumatic, and if his body wasn't processing properly, the food would just ferment in his stomach anyway, if he didn't just reject it outright. He suggested we could give him more subcutaneous fluids, if we wanted to prolong things. I asked him why, when I had put in my request at 8 a.m., had it taken until almost 5 p.m. for him to call me. Well, he said, he had been running late and very busy all day ... and he KNEW I DIDN'T WANT TO DO MUCH for Mack, so he had to prioritize ... did he make time to see the woman with sick turtles, three of which had already died, or did he call me first? He said, even now, he had a patient who had arrived 1/2 hour late, who was waiting to see him. I told him he should go take care of them.

I CAN'T BELIEVE he had ASSUMED we "didn't want to do much!!!" Why? Because we ASKED how much procedures actually COST before authorizing them?!?! Because we took HIS recommendation NOT to "traumatize" Mack with an ultrasound and/or biopsy before trying other treatments?!?! That was the limit. This man is now our FORMER vet.

The Cat Doctor was also running late. At about 5:30, she examined Mack, looked over his blood test results, and suggested a range of options. We chose to take Mack to the emergency care facility the cat doctor recommended in Waukesha. When we told her we live very close to an emergency facility in Glendale, she simply stated again that she recommends the place in Waukesha. That's where he is right now.

The emergency care vet who examined Mack last night was very thorough in his questioning regarding the situation, and recommended an aggressive plan including IVs to get Mack fluids and nutrition, antibiotics to fight any infection that may attempt to take hold in his weakened condition, and new x-rays to get a better idea of what the liver looks like. He thinks it might just be "fatty liver" disease, which happens when a cat stops eating, even for a couple of days. Mack hasn't kept food down for (at least) a week. It's likely to have been much longer. But it's not over YET!!!