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family night at the vet's
Embla: 9 lbs even, temp 101.2, pulse 180. All normal; check bloodwork and BP Septemberish.
Baldur: 8 lbs 7 oz, which is a cause for concern. (He's now half the cat he once was.) At this point I'm feeding him anything he will eat that isn't poison. Tuna seems to be working well. Can someone local with a Costco or Sam's membership help me buy that in bulk?
Temp 99.1, pulse 240 but cranky. All bloodwork except T4 is normal. Vet suggests trying to catch a urine sample.
T4 (hyperthyroid number) is 3.5 despite having increased meds a few months back. We also changed to a different formulation of the drug that the vet thought might work better; since that doesn't seem to be the case and it's more difficult to administer, we're going back to the old version at a higher dose. He will now be getting 15mg/day of methimazole, half in the morning and half in the evening. Even Embla was never that high.
Erik: *sigh*
6 lbs 5 oz! I thought he was hovering around 7. He is not having appetite problems (worse than usual, I mean), nor is he lethargic. The vet thinks he's a little dehydrated (it's really hard to tell on uber-skinny cats), so he is now getting fluids daily instead of a couple times a week. He does seem to drink a reasonable amount of water, but the vet suggested that a fountain might encourage him more. She also suggested giving him chicken or turkey.
Temp 100.1, pulse 200, definite murmur.
T4 is 0.3, so lower his methimazole to 5mg/day (split), but belay that later. Bilirubin 1.5, which is way high (that's the jaundice number). Also, he is anemic at 20.7% (normal is 28%). She said "non-regenerative anemia", which I think is the less-bad kind. BUN (that's a kidney number) is 51, but she thinks that's a side-effect of the anemia (I think). Creatinine (also kidney number) is normal so she doesn't think we're looking at kidney disease.
Ok, so what could be causing this? She felt something and wondered if it could be gallstones (would she be able to feel that, she wondered?), which we know he has from the last ultrasound two years ago. At that time we consulted a surgeon who didn't think surgery was a good idea. My vet suggested an ultrasound to see what's going on, but when she called today to schedule that the ultrasound doc said, basically, "how would seeing inside him change your behavior?" -- meaning he doesn't think there's anything we could learn that wouldn't end up at the surgery discussion. Kudos to that doctor for saying so instead of just taking my money anyway. Other bloodwork plus long history would seem to rule out malignant tumors; it's always possible that there is a benign tumor, but that's back to surgery.
We started the regularly-pulsed antibiotics the day after the visit (last week), so the vet would like to see him in two weeks at the end of that round. Also, because methimazole can aggravate liver problems, I am to suspend that for those two weeks. His T4 will rise (that's what she wants to check then), so this is not permanent.
The anemia might just be the result of chronic organ disease; five and a half years of liver disease might be catching up with him. I asked: if we can't treat the cause can we treat the symptoms? That is, can we improve his red-blood-cell count to avoid secondary effects from anemia? There is a hormone that I didn't catch the name of that can make the body produce more, but it has serious risks. She also suggested that prednizone could help, but has serious risks. (One of those serious risks is risk of sepsis, which is acutely fatal.) Can she quantify any of that? No. So these are things to note but not yet act on; first we'll see what daily fluids and the med changes do.
Erik seems perfectly happy. He eats, wants attention, snuggles with me, and moves around as much as normal for him. His body has been trying to beat him down for five and a half years and so far he's winning. But he's losing weight and the anemia and jaundice are new factors and balancing meds against each other is an art and not just a science, and he's 18 years old. I think we can carry on like this for a while yet -- God willing Pennsic should be safe -- but I really don't know what the longer term looks like.
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> There is a hormone that I didn't catch the name of that can make the body produce more, but it has serious risks.
Erythropoetin, it sounds like. (Our kids got it.) One of the risks is clotting. As labeled for use in humans, the drug has some scary-looking warnings put on the box.
I wonder if they could treat the symptoms with pure brute force, a blood transfusion... the Internet tells me there are cat blood banks but I would guess the supply is pretty tight given the limited altruism of cats.
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let me know
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But for a cat that old, it sounds like he's doing pretty well. Geriatric cats are complicated. Hugs to you all as you work out what they all need.
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I am still surprised that Claudia wasn't in the least bit upset about her neck wound, she was doing everything as usual. Erik may just be the same way and if he is finally bothered it may be really bad at that point. Good for you for staying on top of it.
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That's it. Thanks!
She did mention that transfusions might be something to think about later, depending on how things go, though she sounded a little dubious. Cats are not altruistic, but Baldur is his brother so maybe there's a matching source available. (Do cats have blood types too, I wonder?)
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Their mother was still alive last fall, the last time I saw her owner. Longevity appears to run in the family. :-)
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