05/29/18 Texas Gizmo PMPS=197, +2=161, +4=164, +11=210

05/28

AMPS=200

IM visit this morning @ 10:30a. I will admit, I am scared.

Off to take my shower and then get his paperwork in order.

 

Sending vetty vines for Gizmo and prayers for you.

 

Sending vetty vines

 

Vetty vines for Gizmo today. Be nice and sweet, dear fella.
This morning is civie Spunky’s ear-polyp recheck, too. Hope she will be nice and sweet, too, as she can be quite “demonstrative,” too.
Vines for a good day for all

 

Sending prayers to you and Gizmo , Lizzie ❤️ . The IM report will be positive and helpful

 

Sending Vines and prayers and hugs!!!

 

Adding more good kitty & positive news vines!

 

More vetty vines! Update when you can.

 

Paws crossed for a good Vetty visit.

 

Vetty vines for Gizmo today.

 

Sending prayers for great Spunky report , Sina ❤️ @HWright

 

Lots of vetty vines for Gizmo and for you.

 

Still at IM. Doing full BW, urinalysis, ultrasound of abdomen and heart. They have already taken him back.

There is still blood in urine because he pee'd on the towel in the carrier and it is pink.

 

Sending more vetty vines

 

Massive vetty vines for Gizmo! I know you are scared, but I feel confident they will figure out what’s going on and hopefully he will be on some antibiotics and feeling so much better soon.

 

As much as that’s not a good thing, at least it is happening while he is at the vet so they have some evidence. Way better than “my cat keeps doing this” and then they don’t do at the vet, right?

 

Vetty vines and yes, as Stacey sez, better that they see the pee evidence for themselves.

 

Prayers and hugs and all good things coming to you and Gizmo right now, Lizzie ❤️

 

Update....
This is from memory so I may get some "terms" wrong or not quite right. The IM will be emailing the write up later today and the labs/urinalysis results tomorrow (hopefully).

Gizmo was left in the carrier while I gave history and all info and concerns to the IM (about 30 min). We reviewed all his labs, meds, supplements, eating habits, drinking habits, and LB behavior. The IM then wanted to do a physical exam. Physical exam went as well as could be expected. Gizmo was muzzled as usual (at my request) and settled down except for the vocal growling/hissing. I was able to quiet him down while the doc listened to his heart and lungs. Weight at their place was 11# 8oz. After physical exam doc remarked that he was in good physical condition and was not dehydrated. Eyes and fur were in good condition.

Came back with estimate and recommendations of US of heart/abdomen, full BW and urinalysis. ~$1,000 (which I didn't think was too bad). They said they could do it today (right then). Sedation would be involved. I gave my concerns with sedation (as a precaution) and gave the go ahead.

US of heart showed a little thickening of the muscle but no enlargement. So there is mild heart disease but no recommendation for any heart meds at this time.

US of abdomen was unremarkable and no changes from the last two (the first on was done by them/BluePearl in Nov 2017). No changes to thickness of intestines, kidneys were NOT enlarged, pancreas was enlarged but given the chronic pancreatitis this was not out of the ordinary. No indication from US of kidney infection but still not ruled out.

Bladder - there is a spot that has blood flow to it. It is small but of concern. Per IM - it could be cancer but he didn't emphasis this. Treatment, if cancer, wouldn't be an option as it would "destroy" the kidneys. He is taking a wait-and-see and wants the BW and urinalysis results. Basically, we will treat symptoms if necessary. I did not ask what it could be if it was NOT cancer but again, he wasn't too concerned except that it had blood flow to it but did say something about UTI/kidney infection in relation to it (IDK).

They examined his mouth while sedated and there was nothing alarmingly wrong or of concern on visual exam.

They got a blood pressure after the US/urinalysis just as he was coming out of sedation - 130! And they trimmed his nails really well

 

Sounds like a good visit to me. Glad to read this!

 

I think so.

Forgot to mention that the IM is very interested to see what the HCT level is and if it is low again, its relationship to the lethargy.

 

When will the BW results be in?

 

Tomorrow. Lab (Antech?) is right next door. I think they are running a culture on the urine as well so that will 3-4 days on that but I should have the initial results tomorrow.

 

That's great!

 

Nice report from the IM!

 

So they are waiting for the culture to decide what to do about the blood in the urine? But it sounds like they may treat anyway even if nothing grows? This is all pretty good stuff, nothing stands out or seems too crazy, but sounds like they are willing to help him. He’s on meds for BP already, right? I’m curious to see his HCT too. What did you think of the IM? Less dismissive than the vet that passed you along it sounds. I’m glad he was mildly sedated and they were able to give him a good once over.

 

Sounds like a reasonable report. Hope Gizmo is getting over the indignities well.

 

Glad it all went well

 

All in all , a good report Lizzie ❤️ Glad it’s over with

 

So happy that the IM visit went well.

 

I think more on the BW (specifically WBC) and urinalysis to see if uti. I think the culture is "just because" and hoping something shows to indicate infection of some sort.

Yes. Amlodipine 0.625/day.

I really, really liked him. I prefaced the whole appointment with "Look, I know he is 15yo, has a lot of issues... I am not looking for the magic pill or fountain of youth for him, only to provide the best QOL for what time he has left" So I kinda set the tone right up front.

I just think Gizmo, with his many issues, were a bit out of his comfort level. The wife Dr. Cole (Jen) is wonderful, the hubby (Dr. Wil Cole) not so much . They are still writing prescription (etc) for me so they haven't completely abandoned me.

 

In hope the BW & urinalysis give some sign of infection, it would be really, really nice if something grew in the culture too so they can pinpoint what antibiotic would be most effective, but with CKD and FD on the scene doing double duty diluting urine, that’s like looking for a unicorn and I won’t hold my breath.

That was a great way to approach it and I’m glad he was on board for that. Yay for IM vet win! I guess it would be asking too much if Gizmo liked him! Asia likes anybody and everybody, but only if she meets them at our house. If she has to be brought to the meeting, they are automatically in the suspect persons pile!

I’m glad the Ms. Dr. Cole is still on team Gizmo and can give you Rx and things. That is quite helpful. It is a big ask to say “here’s my geriatric cat with 50 issues at the same time, what to do?” I have to remind myself of that sometimes, but the right answer probably should be “time for an IM” and thus far it hasn’t been suggested by my vets.

Hope he’s feeling so much better soon! FWIW as I said in my condo, my vet said bladder cancer is very rare in cats.

 

PMPS=197

History:
AMPS=200, +2=214, +4=180, +5=192, +11=218

 

Link to preliminary report here <click>

Here is the notes re: the bladder:
Impression: The lesion in the urinary bladder is persisting and contains blood flow at its base. This may be an indicator of a soft tissue mass or polyp with blood clot associated with the surface. Although it possible this lesion may purely be a blood clot from previous cystocentesis, the duration of its presence is more worrisome for an actual polyp or mass.

 

Vines and hope you both can relax tonight. Long day for you both.

 

What did the vet say about Spunky's polyp? Why do you have to go back in a week?

 

They’re trying to get a really clear look see at the inner ear drum, where the polyp had been dormant and not growing for quite some time. Although there was less pus in her ear today than at last visit, the microscopic of it still shows what they describe as “degraded neutrophils” = bacterial infection still present according to them. Relief vet did good and gentle deep clean and flush but still couldn’t see all the way in bc is pus still way in there. She did see that Spunky had scratched her ear. Ugh.

 

It sounds like a good vet visit overall.

 

I'm heartened to hear this. By the way, as to the thingy on the bladder is it? Did I not read recently, right here, that bladder cancer is extremely rare?

Your IM vet sounds terrific. I think you're right about your regular guy vet. Since he couldn't treat nor diagnose what was going on, he just wanted you and Gizmo to , well, vanish.

Hugs for all tests to come back indicating Gizmo's spiffy condition