Sad Update. Owen is gone ahead.

I have not been on this board much in recent years. It was a godsend when my two cats, Mac and Owen were first diagnosed with diabetes almost 6 years ago. Since that time - at least up until a week or so ago - both cats have done amazingly well, and were well controlled with diet alone. Back then, I learned that I had most likely caused their diabetes, through feeding them incorrectly, and felt horrible about it - but very lucky that they both "recovered" and did fine without needing insulin.

Fast forward to this past week, when Owen started to lose weight. My husband, who normally works from home, was traveling for business and thus was not around to feed the cats' usual midday lunch. I noticed that Owen looked thinner, and chalked it up to his missed meal. DH got home on Thursday, and we resumed the normal feeding schedule, but Owen didn't improve. Yesterday, he was acting kind of punky, not eating as well, and I figured I would take him to the vet first thing Monday. Huge mistake.

By this morning, Owen was clearly unwell. I took him to the animal emergency clinic and was told he is extremely ill. He is on IV fluids as he was severely dehydrated, and they are hoping to get him stabilized enough to start some insulin to get his blood sugar down, as it is over 1000. He is in kidney failure and has pancreatitis.

The bottom line is, I failed to understand how sick he was getting and waited way too long to get him to a vet. I am beside myself and cannot stop crying; he is my responsibility and I have failed him miserably. Now I am sitting here hoping he gets through this crisis and that I can manage to take care of him better if and when he gets to come home. (The vet indicated he will be hospitalized for some time, though tomorrow I will have to transfer him from the emergency clinic to the regular vet hospital, something that scares me senseless since the regular vet hospital is not monitored overnight.)

If you can spare a kind thought for my precious boy, I would really appreciate it. He is the sweetest cat imaginable and deserved a better mom than he got.

 

Re: How to handle the guilt/stress?

We are only human and we can't do/find/uncovery everything. We do make mistakes and overlook things. Sending urrs and prayers.

 

Re: How to handle the guilt/stress?

Sending prayers and hugs for you and your boy. With kitties the signs of illness can be missed especially when other things in life demand our attention. You have cared for him for many years and are a good kitty mom. We'll all be pulling for your sweet boy.

 

Re: How to handle the guilt/stress?

Oh, you poor love... (((Hugs)))

I am so sorry this has happened.

Back when my cat was first diagnosed he was in a really sorry state. I felt awful for not noticing sooner that he was ill. I still don't know why I couldn't see what must have staring me in the face for so long. I think maybe the changes are subtle at first and we put them to the backs of our minds, and maybe even get used to them; but one day there comes a 'tipping point' when we are suddenly forced to realise that something is very wrong.

As to how we deal with the guilt, well, maybe we begin by forgiving ourselves for being 'human'...?

I really DO sympathise with your situation, and send healing prayers for you and your kitty.

Elizabeth x

 

Re: How to handle the guilt/stress?

It's been well documented that cats are expert at hiding pain, so you are not alone in finding your cat being ill. I am relieved that you did notice the signs, and you acted on them. Don't forget that you have done an amazing job to keep your cats healthy and one being diet controlled is to be applauded.

The relapse to feline diabetes is something that happens to many others, but you have helped with diet to support your cat's pancreas.... I think as cats age, maybe the pancreas just can't handle its workload and needs more help. I don't see how you can blame yourself at all.

Now, to address the pancreatitis.... it's fast. Pancreatitis is not something that builds up with time; it can strike in a day, so again, you were observant to catch the signs and get him to the vet.

You've done just fine to care for your cats, and I wish you well with a speedy recovery. Pancreatitis can be managed with a little something for nausea, for pain (it is very painful, so come home with pain meds), and fluids. Many here can help you with the treating of it at home.... you can give fluids as needed, buprenex if the pain is bad, and giving pepcid twice a day will help you ward off the possibility of big flares.

Please don't feel any guilt because our cats are pretty sly at hiding pain and illness, and the stress, well there is not much we can do there because we all worry ourselves into a tizzy over our cats because we love them.

I hope you get a healthier cat home with you soon.

 

Re: How to handle the guilt/stress?

Dont feel guilty, cats are good at hiding distress but it sounds like this was a sudden attack that you were good to spot.. and it shows how much you care by simply coming here.

Let us know how he gets on and we will be here if you need diabetes support and help once he is better.. or even while he goes through this!!!

 

Re: How to handle the guilt/stress?

Thank you all for the support; it really does help more than you know.

Just got back from visiting Owen at the clinic. He has been on fluids all day, along with medication. They have also had him on a warmer all day, as he was cold when he arrived (for some reason, the thought of that kills me almost more than anything else.) They were going to re-test him at 5pm (so, right after we left) in the hopes of starting him on insulin to start bringing his numbers down.

On the bright side of things, I do think he looked somewhat improved. He was a little brighter, and purred when I stroked him. His coat/body feels a bit better, too; it's hard to describe, but I would guess it has to do with being somewhat better hydrated now. He's been able to pee, which they said was a good sign. And he was flipping his tail around a bit - something he hasn't done in the last 2 days. I would like to think it's his way of saying he is starting to maybe feel just a little bit better. The tech told me he meows to her when she walks by, and that she stops to pet him a bit since he seems to want some attention. He is a very social cat and normally follows us around very closely during the day, so I really appreciated that she took the extra time to pet him. Sadly, she does feel certain that his vision has been affected, but to what extent is unclear. As long as I get him back with some semblance of a quality of life, though, I am sure we can figure out how to manage that if necessary.

If it's not too much to ask, please keep Owen in your prayers tonight as we wait to hear how he reacts to the insulin and whether they are able to continue to stabilize him and get him on the road to recovery. Although my other two cats are here curled up on the sofa with me, it is very lonely without my little grey shadow perched in his usual spot on the back of the couch.

 

Re: How to handle the guilt/stress?

hi

You can get warming pet beds from pet stores and warming pads you microwave and things like that. I might get one for my boys although I think they would fight over it

Its good news that he is feeling a bit better and it sounds like they are giving him lots of TLC.

His eyes may recover a bit with time but if not, he will adapt. Animals are so much better than us at that.. we get so sorry for ourselves but animals are like " hmm i cant see.. thats inconvenient. So.. whats for dinner mama bean?"
I have two blind rabbits and one became blind over a few months which is fast. We dont move furniture around too much and she runs around like you wouldnt even know she is blind.. bumps into us when we move in her way but otherwise you really cant tell - she uses her other senses to compensate. And it doesnt sound like Owen is that bad.

Let us know how he gets on.. we are thinking about you guys!

((hugs))

Wendy

 

Re: How to handle the guilt/stress?

do you have a 24 hour facility that you can take him too? can he stay where he is now? I too would be concerned taking him to a place without 24 hour monitoring.

sending good thoughts for his recovery.

 

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Thank you Wendy, I really appreciate that. The news about his sight came as a shock, maybe the tech thought I knew about it already, but the vet had not said a word so it hit me like a ton of bricks. When I visited him he did seem to have some sight at least, I didn't notice anything amiss and he clearly knew where my hands were and so forth, but apparently she was pretty sure about it, and said something about him seeing shadows when they pass his cage, which just breaks my heart. Hopefully it won't be that bad and as you say, it might improve with time as well.

Getting a warming bed sounds like a great idea although I might have to get three, I can see my little menagerie fighting over them as well. I am really just hoping Owen will get to come home and of course if so, we will get him whatever he needs to be most comfortable.

Thanks again for the support. It means more than I can say.

 

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The facility where he is now is staffed overnight (they do weekend and holiday coverage for all the local clinics.) They close at 8am tomorrow, so I have to pick him up prior to that and take him to our regular vet (who opens at 8, please say a prayer that they will see him right away.) The vet at the emergency clinic said he would likely need to be hospitalized for several days. I think she meant at the regular vet's, which would be possible I suppose but they do not have overnight supervision, which is scary to me. I could take him back to the emergency clinic I guess but I am concerned about moving him around that much when he is so ill.

 

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First, WELCOME to the best place you never wanted to be...again. Prayers on lots of knees for all of you.

The blindness...no big deal really. I rescued an elderly dog blinded in a fight that was literally headed into a vehicle to be put to sleep. She lived very easily and happily in our backyard and sunroom for 3 more wonderful years. After she QUICKLY learned where things were, the only thing she ran into was the "Please Slow - Blind Dog" sign..... :roll:

BIG HUGS TOO!

 

Re: How to handle the guilt/stress?

Thank you Squeaky and everyone else for the hugs. They are really needed and appreciated.

Just got off the phone with the tech. Owen's numbers are better - his BG is half of what it was earlier today though still high of course. I would like to think that this is an encouraging sign that he is responding to treatment.

I don't believe he is blind - he was jumping from the floor up to the sink (where he likes to drink from the faucet) this morning and he did seem to see my hands in front of his eyes, although I guess that could be shadows or whatever at this point. And he ran out the door this morning with his brother (just into the backyard) this morning before we took him to the vet - he went right to his favorite spot on the fountain so I think he must see more than just a little???

 

Re: How to handle the guilt/stress?

I think my Bailey went through that at one point before we got him. His eyesight isnt that great, You throw a treat in his direction and he cant find it. Unless there is a lot of contrast between the treat and the floor.

You cant do a vision test on a cat so you cant tell but it sounds like whatever vision problems he is having, Owen is managing just fine and I wouldnt worry.

 

Re: How to handle the guilt/stress?

Aw, thanks!

Owen doesn't need to see treats to find them We joke that he can be on the other side of the house, literally fast asleep in our bed and if I throw a few treats down for his brother or out other cat, he knows how many hit the floor. My husband says he is like Rainman in that respect!

But I really just want him back home and feeling well. If his sight is not perfect, OK... we will figure things out for him. Right now I feel so helpless and worried. We are counting the minutes until we can call for another update; they are doing tests every three hours.

 

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Prayers and hugs to Owen.

 

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ok let me know - i will be here .

 

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Thank you both ... you guys are keeping me sane (or close, anyway.) We should get another update in about 45 minutes. Please God it will be good news.

 

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Any news? I hope he is doing ok...

 

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Sending a garden of healing vines to dear, sweet Owen. I hope you get good news soon!

 

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Hi Wendy, thanks for checking in on us. There was no change the last time we called; all the tech said was he is resting comfortably. I guess that is something but I would feel better if I had more specifics. I'm going to call again shortly after 11 when they test him again.

 

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Thank you so much! All the support here is such a huge help.

 

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Oh Susan I am so sorry... PLease don't feel guilty.Losing Teddy just a few days ago I feel the pain you are going through.I will say a prayer for your Owen and hope he recovers.I will be keeping you in my thoughts and prayers tonight.Wrapping you in a big hug right now.

 

Re: How to handle the guilt/stress?

Thanks, Trixie... Hugs right back to you. The clinic where Owen is tonight is not far away but right now it feels like it might as well be on the moon... We call every three hours(when they test him) to see how he is doing but there hasn't been much of an update since late afternoon. I am really hoping for a good report around 11 so I can try to get a bit of sleep. We will be picking him up at 7:30 am (when the emergency clinic closes) and taking him to the regular vet when they open at 8; hopefully by then he will be feeling a lot better. I really DON'T want to leave him there overnight tomorrow because they don't staff 24/7, so very much hoping I can bring him home instead...

 

Re: How to handle the guilt/stress?

(((Susan))) I would be keeping him at home as well overnight.If anything were to happen at least you would be there to get him back to the emerg vet.Hugs and headbutts to you...

 

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Thanks! I really do want to have him with me rather than alone at the vet's.... Think I will probably insist on that or if they really object I guess I might be able to take him back to the emergency place. They have been really kind.

 

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That is what I would do Susan....I would not want him to be alone...

 

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Exactly!

Just did get a good update from the emergency vet's overnight tech. Owen's BG is down to 226 so it seems he is responding well so far. Going to try to get a few hours of sleep now . Thank you everyone for all the support today.

 

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Yay! Get some sleep and let us know how he gets on tomorrow.

 

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Thank goodness...Now rest easy tonight...Love your boy when you see him.I truly hope it is going to get better from here on.

 

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Good news! Get some rest and resume the battle tomorrow. Hang in there!

 

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Sending more healing thoughts and hugs. If you have an old t-shirt with your smell, take it along so he has you with him during his hospitalization stay. Your boy sounds like he is making positive progress. Can't wait to hear he's back home with you.

 

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How is Owen this morning Susan? Hope he had a good night...

 

Re: How to handle the guilt/stress?

Thank you all.

Owen did well overnight at the emergency clinic. When I picked him up this morning, he was much more alert, was swishing his tail in "his" way, and was, er... meowing loudly. The tech who had monitored him overnight loved him and said they had "talked" most of the night. His sugars are way down (low 200s) and he was much better hydrated and clearly more comfortable.

I took him to the "regular" vet who is a feline specialist. He has diabetic cats and has treated lots of them, which was good to know. He was very encouraged about the progress Owen had made overnight, though he thinks he will likely need to remain hospitalized for several more days. He asked a lot of questions about Owen's diet and said that right now, getting calories into him is a big priority. He warned us that he might have to be syringe fed for a while because he likely does not have much of an appetite. I pushed back on that a little because I know one thing about Owen, and that is that he *really* likes to eat! So the vet had his tech bring in several bowls of different kinds of food - I kind of freaked out because one of them had dry kibble into it, which of course I never let him have. The vet assured me that they feel the most important thing is getting some calories into him so if he will eat the kibble, they will manage his sugar as they are monitoring him very closely.

Well... you should have seen Owie's eyes light up when he realized they had offered him dry food. He may not feel great right now but he dove into that bowl and had himself a nice little snack. I couldn't decide whether to be happy that he was eating or petrified that he would have problems from the carbs. The vet was very happy that he ate on his own, so that was encouraging.

The next item on the agenda was to get an ultrasound. Owen's left kidney is very enlarged, and it looks like his right kidney is not working at all or maybe only at a very low level of function. The vets are not sure why this is, but primarily wanted the ultrasound to rule out a tumor (which there is no sign of.) The ultrasound specialist (who is part of a specialty imaging practice, how lucky was it that he happened to be there right when we needed him?) said he might have a kidney stone, or a scar or other type of blockage that is causing the problem. He made it seem like if that is the problem, it could be very bad. On the other hand it could be an infection, although he does not think it looked like that was the case, but Owen's white blood cell count is so high they are sure he has one. If that is the case and it can be resolved with the antibiotics he is getting, that would obviously be very good news.

So, at this point we are still waiting and praying for the most part. I am very glad that Owen seems to be feeling more comfortable and I can't tell you how happy it made me to hear his signature howl this morning. Also, his sight appears to be pretty good; he is able to walk around with no difficulty, was very interested in looking out the window, checking out the exam room etc. This clinic is in an old restored house, and the exam rooms are not the typical small rooms with the exam table and a cabinet... they are "normal" rooms with furniture, rugs, and cat toys on the floor. The exam table is the usual type, but it's kind of on the side of the room instead of center stage. I loved that the vet let Owen kind of wander around the room before he attempted to examine him, and he gave him catnip after the exam and let him roll around in it a bit. He said he feels that cats heal best if they can minimize stress as much as possible, so they try to make the place feel as homey as they can. (There are obviously clinical areas/surgical suites etc, it's just the general exam rooms that are like living rooms.)

 

Re: How to handle the guilt/stress?

It sounds like a great vet and that Owen is doing really well. Hig BG due to high carb is probably the least of his issues right now.

Maybe read up on kidney problems in the meantime so you know what you might be dealing with when you get him home.. http://www.felinecrf.org

 

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This update sounds promising. Hopefully, they will figure out what is going on quickly and it will be easily treatable.

 

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Thank you for the link, I will definitely read up on it today. It gives me something to do so I feel a little less helpless.

I really liked this vet and his approach. He spent a lot of time with us and had some very interesting thoughts about diet (basically it would be ideal if my cats would both get up off the couch and spend their days hunting chipmunks in the backyard and eating 10-15 times a day.)

Meanwhile I will go back and visit Owen again in a few hours. The clinic allows visiting anytime, which is nice. It seems very likely that they will want him to stay overnight, but since their clinic is unmonitored I mentioned to the vet that I would like to bring him home for the evening and then back again in the morning. This is all assuming he is stable enough not to have to go back to the emergency clinic overnight, of course.

 

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Thank you! I hope so, too. Right now I *think* we are hoping that it is an infection and that it can be cleared up with antibiotics... although the ultrasound specialist did not seem to think that was the case. I guess right now we are in wait and see mode, mostly to find out if his kidney function improves.

 

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He is where he needs to be right now. You have done everything you can - so no more guilt.

 

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Thank you, Hillary. I do feel like he is in good hands and I really do like this vet and feel comfortable with his approach. I guess I am hoping against hope that this is "just" an infection although now that I have read more on the page that was linked above, it seems more likely that we are dealing with a stone or obstruction of some sort

I am trying not to bother the vet with a million questions a minute but I do want to speak to him later this afternoon to see what he thinks; he was going to consult with the ultrasound specialist so perhaps we will get more definitive news later today.

 

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Sounds like a wonderful clinic with a wonderful vet...And you know if it takes a bit of dry food to get some calories in him then why not,you can fix that after he is better.The main thing is getting him better and bringing him home.Our guys had grain feed dry(just a bit) and 2 meals of wet,more if he was really hungry.I am still keeping you guys in my thoughts and prayers Hugs and headbutts to you both

 

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Thanks, Trixie!!

I was so proud of Owen for diving into that bowl of food this morning. The vet seemed so sure he would not eat and was so pleased when he did.

I do really like this vet, it's a very unusual clinic and I loved that he let Owen kind of prowl around and check things out before he even tried to examine him. When he walked in, I went to get Owen (who was laying under my DH's chair) and the vet said, "you can leave him be, I always find it's better if they come to me rather than going to pick them up the minute I walk in." And sure enough, Owen finally got curious and walked over to him, and didn't seem to mind being picked up at all.

I am going to call them now and ask when it might be convenient for us to speak to the vet for a few minutes to find out what his thoughts were following the consult with the ultrasound specialist. And I want to go over to visit later this afternoon to see how he is doing, too, just want to try to stay out of their way as the cages for non-quarantined animals are in the main exam room (per the vet, so they have eyes on them all day) so I don't want to be in there way when they are busy.

 

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Do you think he would be ok,with you bringing him home overnight and taking him back for day observations?

 

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I am going to ask ... I hope so. I really do not want him there alone without oversight.

If he is not comfortable with him coming home, I will ask if he can go back to the emergency medical center, as they are staffed all night.

 

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Hi Susan
I'm glad that Owen is doing better. What does the ultrasound specialist think? Any new updates?

Sandy

 

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((((((Susan))))) Sorry - I'm just now seeing this. Sending lots of get well wishes for Owen...sounds like he's on the right track!

 

Re: How to handle the guilt/stress?

Hi Sandy,
Thank you for the kind thoughts. Owen is continuing to improve.

To be honest the ultrasound specialist was pretty upsetting. While he did not see any sign of infection or tumors, he seemed to feel that Owen almost certainly had some kind of blockage or stone that was causing his kidney issues. My DH and I were really upset about this and what we read this afternoon on CKF was alarming, to say the least.

We met with Owen's regular vet around 5-ish. He is actually very pleased with Owen's progress and thinks there is a good probability that he will continue to improve and that the kidney issues might continue to resolve with the treatment he is receiving. I am really hoping he is right and that we are not dealing with a stone, scar or other obstruction.

 

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Thank you, Gail! We really appreciate the good wishes and support on this board, what a godsend it is to be able to communicate with people who understand and care

Owen was a bit better when we saw him tonight. They have been syringe feeding him all day since he doesn't have much of an appetite, but when I arrived at 5, I was able to get him to eat about 2 T of his favorite Fancy Feast and maybe another T or so of the usually-forbidden crunchy kibble type snacks. The techs and vet were really happy to see him eat on his own Tomorrow I will go more frequently throughout the day to see if I can continue to get him to eat so he can come home.

For tonight, we decided to take him to the emergency clinic so he could be monitored. Our regular vet said he would be very comfortable leaving him in the clinic tonight but I was not comfortable having him there without supervision. (Our vet is there til 10pm but then no one would be there til 7 am.) I am maybe being overly cautious but I didn't want him to be alone. Owen is very social and is not unduly stressed by being in a busy environment; he did fine at the e-clinic last night and the same tech will be there tonight, so I figured better safe than sorry. I will go pick him up again tomorrow morning and take him back to the regular vet for the day, then maybe... just maybe... he might be able to come home tomorrow.

Thank you again to everyone here for the kind thoughts and the support. It means so much.

 

Re: How to handle the guilt/stress?

Sorry I didn't mean to scare you with crf.. I just meant that there is active treatment you can do like low phosphorous foods that can give Owen a longer and happy life.

Wendy

 

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Oh, thank you, Wendy, I didn't mean to sound unappreciative, truly. The site was very helpful!

 

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I agree on taking him to he e clinic for overnight monitoring. I would do the same as I don;t want my cats staying unsupervised.

 

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Yep, as it turned out, I was very glad we took Owen to the e clinic last night. His BG did get a little bit low and they were able to address it right away. When I picked him up this morning, he was much, much brighter and although the clinic said they were not able to get him to eat... once we got him back to the regular vet's office this morning, he dove right into his food bowl for me. (Apparently he likes the FF Beef Feast again, LOL... guess I will be out shopping again today.) He also ate a bunch of the usually-forbidden crunchy snacks - you should have seen his eyes light up when he saw that bag. It was so funny. Even the vet laughed.

His labs are much better today. The vet told us that progress now will likely be slower, but hopefully will continue to improve steadily. If he eats well today and gets to the point where he can come off the IV fluids, he might actually get to come home tonight, which would be fantastic.

Please keep your fingers (paws!) crossed for us that the kidney issues continue improving and that the xray later today doesn't turn up a stone!

 

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Keeping fingers and paws crossed for you here!

 

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Good news on the update. Forbidden dry food, amazing if given a choice they will always go for that. But I guess it's the same for us too, if you had a choice of eating a salad or french fries - which would you choose.

Once his appetite comes back then you nix the dry. Although when my civvie stopped eating due to pancreatitis (yes civvies can get it too), and I had to give her dry, it took months to take it away from her again.

Let's hope the kidney issue is nothing to be concerned about and he can come home for good today.

 

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Haha, it's true - the vet likened the crunchy snacks to potato chips too! And I guess that is accurate

Owen ate a fair amount of the canned food as well, which made me happy. The tech at this vet's is really fantastic and brought him a "selection" of three different flavors so he could pick what he likes the best. Right now it seems to be the beef one, so I will certainly go out and stock up on that. It's one of the first flavors he went for years ago when we were originally transitioning him to canned food, so I guess that makes sense. Luckily he is not usually a picky eater but for right now, he can have whatever he wants as long as he is eating!

The vet did tell me he suspects Owen will need to go on insulin following this crisis. I guess I will be learning that whole routine soon. He doesn't seem to mind the shots he is getting now, so maybe it won't be too bad.

 

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Phewwww,I am glad you took him to the emerg clinic overnight...and I am so glad he may be coming home today...Way to rally Owen Still crossing my pas and toes for you guys I don't know if you can get these treats where you are.They are called mighty lion and they are a grain free moist treat chicken or tuna...and Teddy loved them.Both cats would try and grab the bag out of my hand.And they are only 3.99 canadian a bag I am happy for you guys

 

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Thanks, Trixie, I am glad also!! To be honest I didn't like last night's vet quite as much as the first one - he read the notes wrong and almost repeated all of Owen's meds unnecessarily, plus he somehow doubled the quantity of everything on the estimate in error, so I was charged $700! Of course I got the overcharged amount sorted out this morning but it made me question his attention to detail, if that makes sense. Nevertheless, I do feel like Owen was better off there last night than being at the clinic alone, for sure. But I am REALLY hoping he can come home tonight!!!!!!!

We have a pretty nice farmer's market type store right around the corner, and they carry the Halo treats, which all three of my kitties really like. They are just dried chicken or salmon chunks, but I think they like that they are a little bit crunchy - they really missed their (high carb) kibble type snacks when we changed their diets years ago. They are unfortunately kind of $$$ but oh well. It doesn't look like the Mighty Lion treats are available anywhere near here

I am counting the minutes until I can call the vet to see how the numbers are this afternoon (and about how the xray went, which is kind of making me nervous to be honest.) Hopefully everything will go well and I will soon be posting an update saying my sweet boy is home

 

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Hi Susan
I'm glad Owen is doing better. Any news on the xray? I hope they're clear. The guy who I use for ultrasounds is a veterinary radiologist and I really trust him. I hope your ultrasound specialist is wrong about being concerned. It was good that you went ahead and had an xray done. It's so much better to know what you're dealing with.

Sandy

 

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Sounds like Owen is making progress! Keep us updated, and let us know when you are ready to talk about better managing his diabetes!

Wendy

 

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Thank you! Owen did a lot better today, but his phosphorus is still higher than the vet wants, so he is stuck being supervised at the e-clinic again tonight. The xray gave us the very good news that there does not appear to be any kind of stone ... which made us very happy. The guy who did the ultrasound is also a veterinary radiologist, and I am sure he is very good but I am pleased that his concern turned out to be unjustified. Veterinary xrays are actually something I know a bit about, as I worked in radiology product development for many years, several of them focused on veterinary imaging. I got to look at the films myself this afternoon and evaluate them, so I feel confident that they were clear.

The net net is Owen is continuing to improve across the board, it's just kind of a slow and steady thing. We are really hoping with one more day on fluids, he will be able to come home tomorrow.

 

Re: How to handle the guilt/stress?

Thanks, Wendy! He is definitely doing better, and hopefully will come home tomorrow.

Of course I am hoping that we will be able to get him back to the point where he can be well managed on diet again. If it turns out that that is not possible (and most likely he will be on insulin at least for a while) then I will certainly be asking for more advice here!

 

Re: How to handle the guilt/stress?

Hoping and praying he does well tonight and comes home to you tomorrow.....Sweet sweet Owen.I hope he has a good night.....

 

Re: How to handle the guilt/stress?

So your prayers worked and Owen had a very good night!

We had a different vet at the e-clinic last night and to be honest, I liked him even less than the guy from the night before. Owen had been eating better at the regular vet's all day so I asked them to make a note on his chart about that, and requested that they ask the e-clinic vet to try to encourage him to eat regular food before resorting to syringe feeding him. They gladly agreed to do that, and I heard the regular vet conveying those instructions to the e-clinic vet... but when we got to the e-clinic and met Vet #3 (apparently the clinic owner) he immediately said they would be putting him back on a drip and force feeding him all night. :-x

I took exception to that and said I would appreciate it if they would try to encourage him to eat on his own, gave him the food he had been eating (his fav beef flavor FF) and in return got a lecture on how important it was to get calories into him. Maybe it's because I was just very tired at that point, but I had had it with the guy's attitude. For $400 a night I felt he could make the damn effort to let my cat eat what he wants instead of just doing it the "more efficient" (and I am sure more profitable) way of force feeding him. Anyway, I had the regular vet call and discuss the issue AGAIN ... and it seems to have been effective. When we picked Owen up this morning, the (very nice) tech told me he had eaten regularly throughout the night and had "chowed down" on his breakfast this morning. He laughed and said, "Seven AM must be breakfast time, huh? Cause he was howling for his food!"

The associate vet at the regular clinic was pleased with the labs from overnight, and said they would put him back on the drip today to make sure that he continues to improve. Now that he is eating better, they hope that phosphorus level will come down, so he can come home. They are planning to let him have breaks during the day from the IV so he can run around and play a little, which I am sure he will enjoy... they have already figured out he likes to sit in the open windows, which he did quite a bit yesterday apparently. Please continue to think good thoughts that Owen can come home soon...!

 

Re: How to handle the guilt/stress?

Good news indeed. And good for you for standing up to the vet and telling him what you wanted. Sorry you had to go through that. But as we all know it is important for them to eat on their own and if he was already eating on his own, then the vet should be encouraging instead of taking the easy and I'm sure costly way out. And maybe that is what he was thinking, that it would be easier for them.

Let's hope you can bring him home tonight and be done with the eclinic. Maybe discuss it with the vet today. Tell him/her your concerns about the care at the eclinic (and the expense of course) and now that he is eating on his own, you would feel he will recover quicker at home.

Honestly, the phosphorous issue may or may not clear today, but I have a feeling it may be an ongoing issue and could be kidney related. If that is the case, then you will need to feed him low phosphorous foods, which would be 250 or less and I'm sorry to say that FF will have to go. The inexpensive food that met the phosphorous and low carb needs was Friskies Special Diet. It does come in a beef flavor along with fish, turkey and chicken. So, you may need to wean him off FF and introduce FSD or another brand that is low carb and low phosphorous.

I know, just when he shows interest again, you have to change it up and figure out what else he can eat. The food charts should help. Pull them out and start looking for ones that meet both these requirements.

 

Re: How to handle the guilt/stress?

Thanks, Hillary

I do feel like the interventional work at the e-clinic was top notch (that was Dr. Owens, who we haven't seen since) but they are not quite as good at the "monitoring" type stuff. Maybe that just comes with the territory of handling emergency after emergency and they are just kind of oriented that way... The tech last night though was really good; I think he "got" my concern and he clearly spent some time encouraging Owen and was successful getting him to eat. He laughed and said he'd never seen a cat who would eat off a fork before

But in any case, I don't think we'll be going back there for anything non-emergent after this. For one thing, we are hitting the limits of my budget as our current bill is over $5K at this point, and I also do think he will improve better at home (as long as he is stable, of course.) I will definitely speak to the vet today about bringing him home and putting him on a low phosphorus food. Owen is not generally a picky eater thankfully, so I am guessing he will adapt to a new food if necessary. Guess I will be printing out those food charts again

 

Re: How to handle the guilt/stress?

You may also want to discuss with the vet about the use of phosphorous binders. I haven't used them or know much about it, but I do know it is used for cats with kidney issues. It may be way too soon to use (it was in my case), but worth a discussion and research to become more knowledgeable about it.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

HAPPY UPDATE... OWEN IS HOME!!!

Just wanted to post a quick note to let everyone know that Owen was able to come home tonight.

As you would expect, he is very, very tired. When I got to the vet's tonight to pick him up, he was curled up on a little sheepskin pillow, sound asleep in the window of the clinic. Apparently he had a big day today, as they let him "loose" to explore the clinic a bit. He went out on their (enclosed) porch, checked out the playrooms and generally made a tour of the facility.

We got a long list of instructions for him, as he has a long way to go to return to being completely healthy. Tomorrow he will start on omeprazole, cerenia, buprenex, subQ fluids and insulin. They want him on 1u of the PZI twice a day, if his pre-shot BG is above 100. My gut says that is kind of a lot considering how much weight he has lost; he's down to 9.75 lbs now compared to his 13-14 lb normal weight. Prior to this crisis, his BG stayed in the low 100's very consistently on diet alone.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Is he prone to ketones? If not, you could wait and measure him a few days to see how he is doing first. Chances are he might not be eating properly anyway. And the you could start him on 0.5unit and see how he goes. But let's take a look at those numbers first.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

No, ketones have not been a problem (and that was the case even during this crisis, which surprised the vet a great deal.) He is currently eating a bit less than the 6-7 oz per day that the vet wants us to shoot for, and he has asked us to syringe feed him if he doesn't eat that much on his own. I am hoping that he will eat a bit better at home than he did at the clinic, where he ate best only when my DH and I were there encouraging him.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

when starting on insulin, we usually say to not shoot below 200. so if you want to play it really safe, you could up the vets recommendation of 100 to 200 and be safe.

very happy to hear he is home now and that he had a good day at the vet - an outside catio must be a real treat! I like the sound of this vet's place - playing with them, letting them roam through the place and not keeping them in sterile cages all day.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Thanks Hillary!

I would be a lot more comfortable shooting at around 200... 100 seems really low to me. He had several incidents of getting down to 60-70 at the vet's following their insulin administration, and that is just way lower than he is normally. Of course I really do like this vet and am a little fearful of not following instructions given that we are now dealing with not just the plain vanilla diabetes but also the kideny issues etc...!!!

 

Re: How to handle UPDATE: Owen is HOME! (p2)

given that he went to 60/70 which honestly are great non-diabetic numbers, I would suggest dosing at 1/2 unit and not shooting below 200. as you get more comfortable with testing and start to build your spreadsheet, you can lower the no shoot threshold and eventually even shoot a 70!

remember you hold the syringe and you are in charge. being conservative and erring on the side of caution will always keep your cat safe! and remember you have our support!

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Thanks... I do want to be conservative. Right now he is not getting wildly high although of course he has been getting insulin at the vet's when needed. I do think maybe I will start at 1/2 unit, though, that seems safer to me.

Poor guy is sleeping in my closet right now, he must be exhausted and who can blame him for hiding a bit after all he has been through? Of course I wish he would sleep in my bed like he does usually, but that is probably too much to ask right now. I don't think I am going to sleep a wink tonight

Thanks for all the support, it really helps.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

I am so so glad Owen is home Let's keep him there WTG big guy

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Thanks for the good wishes, Trixie. Unfortunately Owen's stay at home was pretty brief. He was comfortable overnight but the following morning, he had no appetite and was very lethargic despite our syringe feeding, meds and subQ fluids. We took him back to the vet that afternoon and it was determined that he needs to stay on IV fluids for now. Thus he is spending his nights at the e-clinic and his days at the regular vet's. <sob>

The IV is definitely helping him, and he ate well again this morning, so it was the right thing to do, but it's not been easy. The vet says we have a "long road ahead of us." Tonight I am going to have to ask him exactly what that means, because at $1000-1500 a day, I sadly can't do this forever. (Hence my post on whether anyone has managed to do IV fluids at home. If I can handle things for him at home overnight, and just have him do the days at the vet's, I could do this a lot longer...)

Please say a prayer that he will get better soon and be able to come home to us.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

how about asking the vet if you could give subq fluids at home - if the vet will teach you, it isn't hard and this way you can sve money and he can stay home

 

Re: How to handle UPDATE: Owen is HOME! (p2)

That was actually the plan we had when we brought him home the other day. We gave him the subq fluids without a problem but it was not sufficient to keep the BUN under control The vet feels strongly that he needs to be on the IV if we are going to have a shot at the BUN getting back to an acceptable range.

He did definitely improve on the IV and is eating voluntarily again, so it seems like the IV does help in a way that the subq fluids did not. Sigh.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

you could try to get a care credit card and see if your vets take it - as they will allow payment plan options with that card - and if they don't take care credit, ask about payment plan and maybe discount plan, hopefully they will work with you..and what if you take him to the vet durin gthe day for iv and home at night with subq, this will alleviate the eclinic charges..and may work...

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Good thoughts, thank you. The vet does not take care credit but I haven't asked about a payment plan. Unfortunately the reality is though that we cannot afford to spend an unlimited amount, even if the payments are over time. I hate that with all my heart but my DH and I have pretty much agreed that ten thousand dollars is the most we can spend. We will hit that amount, probably, in the next few days unless I can take him home at night. The subQ fluids were not sufficient when we tried that earlier, so I am trying to figure out if we can do an IV at home and then just bring him back to the vet during the day.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

good luck, hopefully he will come round real soon and you can be done with the vet visits - and he can get a job to pay for his bill....

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Thanks Hilary,

I wrote a long update on my other post (about maybe doing IV fluids at home overnight) ... basically Owen did not have a great day today but the vet feels it would be more realistic to look for significant improvement tomorrow or Sunday. He did not look good to me when we got to the vet's tonight but he did perk up quite a bit when we got him out of his cage to get ready to go to the e-clinic, and when we left there, he looked more like himself and he was resting comfortably.

We are so hoping that he is better tomorrow and that his labs continue to improve. His phosphorus was about 20% better today but the BUN values only came down a few points. The vet reminded me that his BUN was way higher on his first day and he did a lot better after 48 hours on the IV fluids... so he would expect to see improvement tomorrow or Sunday.

Please think good thoughts for my little Owie. He's hanging in there and we are desperate for him to come home.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

It sounds like he prefers you being around and would do better at home if you can do fluids there. I hope he improves soon! (Hugs)

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Thanks, Wendy.

I do feel like he does better when we are around, but at the moment it looks like the earliest he could be expected to come home would be maybe Monday. The next few days are critical. If he is not significantly better by then, we might be at the end of the road.

The vet does think it is reasonable to expect that he will be a lot better by Sunday, and if so... we have a good shot at recovery.

Thanks for all the support.

Susan

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Does the vet know even what is causing this?

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Owner stupidity.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

are you serious?! owner stupidity? meaning what? listening to vets, following they would say?

 

Re: How to handle UPDATE: Owen is HOME! (p2)

please, this needs an explanation on owner stupidity

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Owen is in such serious condition because I did not recognize that he was getting dehydrated and in trouble. I should have taken him to the vet the minute he looked like he was losing weight instead of simply upping his food.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

And who said owner stupidity - you or the vet?

Stop beating and blaming yourself. You did what you thought made sense. While we see our cats every day, we don't always realize that something is wrong and vet intervention is needed. We do have lives too and things just happen.

The point is you did realize that something was wrong, more than just needing more food and you took him to the vet. It is unfortunate that he has these problems, but you are not to blame for that. My guess is, even if you took him a week earlier, these problems may not have been present and he still would be in trouble.

There is no owner stupidity and you need to remove that thinking. It doesn't do you or Owen any good.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

That's not what I meant..!!! I meant the kidney problems, I don't know if I missed a thread but I know there was a kidney issue but they weren't sure what the issue was... That's what I was asking about.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Oh, the vet has been very kind - he hasn't said anything like that. And I really like this vet, he listens well and he is treating Owen the cat, not just a patient with various lab values and problems. When we went to pick Owen up last night to take him to the e-clinic, he looked truly awful. I said to the vet it was the first time in this whole crisis when he just doesn't look like Owen to me. He was just laying there looking out of it and miserable. Even that morning, he was recognizably himself - he meowed and he was looking around at me and out the window as we drove to the clinic. The difference at 6pm was dramatic.

I actually whispered to Owen to ask if he wanted to keep fighting and he kind of looked away. I cannot even describe the devastation I felt. The vet totally understood what I was saying, though. He said he often asks the techs during the day how the cats are and to him their subjective evaluations are just as useful as the diagnostic tests. He also said that he feels the owners usually know when the cats are ok with continuing the fight and also when they want to stop, and he respects that. We had a pretty long conversation about what Owen's prospects are for a recovery and a good quality of life. I cried a lot. My feeling is that if there is a reasonable chance that Owen can recover from this crisis and have a good quality of life, then I want to give him every chance, and I will figure out how to afford that for him. If the prospects for recovery are poor or it would require weeks and weeks of this kind of treatment, spending his days in a cage with IVs and catheters and force feeding... I am not comfortable with that. It is too much to put him through.

The vet made it very clear that he would understand, respect and support whatever we thought was best for Owen. He does still feel that Owen has a reasonable chance of recovering and having a good quality of life, even though he did not make much progress yesterday, and that was very disappointing. He told us that probably taking him home on Wed. night with the subQ fluids set us back, kind of starting the clock over (yes, I felt bad about that too.)

Then he said, "look, the lab values were much worse on Monday when he arrived than they are now, and by Wed, they were way down and he was eating well and walking around. It might just be that he needs a few more days on the IV fluids and other meds to improve, and it's not unrealistic to think he might be back to eating and walking around again by Sunday or Monday. His phosphorus has come down a lot - about 25% which is good progress. The BUN is still high (it only went down a couple points) but it took 3 days on the IV to bring it down last time, too. There is no way to know definitively what his long term kidney function is right now, or how well he will manage on whatever function he does have over time, but he could be a lot better in a few days and be able to go home early next week. He's not feeling great right now, but he's not in pain and he is tolerating the treatment well."

That made me feel like the right thing to do is to continue through Monday to see if he can improve to the point where he is likely to be able to come home and enjoy a good quality of life. He did well at the e-clinic last night and actually pawed at his cage this morning wanting to be let out. (Can I just say how much I love the overnight tech, Jennifer, who said, "hey, he's family here now, if he wants out, he doesn't have to stay in a cage.") When we arrived, he was curled up on a cushion at her feet, looking curiously at one of the dogs who was in a cage across the room. She reported that while he wasn't eating on his own, he was doing well with the syringe feeding and had had a BM in the litterbox which he had not done in a while, so that was great news. He looked so much better to me than yesterday, not like nothing was wrong obviously, but he was recognizably Owen again.

So, at this point we are hoping that he continues to improve today, and that we have more significant improvement tomorrow. If he is not a lot better by Monday we will have hard decisions to make, but I am hoping that we have turned a corner now and won't have to think about that.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

I don't think they are really sure what started this whole cascade of problems really. Maybe the dehydration came first or he could have had some sort of infection - his white cell count was sky high when we took him in, though it has come right back to normal on the antibiotics. There is still concern about a possible obstruction. The xrays do not appear to show a stone so the vet feels the most likely reason is just an accumulation of some waste that got "clogged up" there which will hopefully resolve as they diurese (sp) him with all the fluids. He is still making plenty of urine and I think they are hoping that having the urinary catheter will help things settle down some while the IV fluids do their job, too. They did up his fluids yesterday and he has been tolerating that well so far.

Today the goal is to keep getting enough calories into him and keep trying to get the BUN values down. The wonderful lead tech at the regular vet got about two full cans down him via syringe yesterday, on top of what he ate voluntarily that morning. This morning he did not eat anything on his own so they will syringe feed him again.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Ah ok. Keeping my fingers and my babies paws crossed for him and ((hugs)) for you Owen and your husband!!

Thanks for keeping us updated!!

 

Re: How to handle UPDATE: Owen is HOME! (p2)

So, we picked Owen up to take him to the e-clinic for the weekend, since our regular vet's office closes at 2 on Sat. The techs were both very sad, and feel he is not doing well. He did improve today, but only a little. He did perk up a bit when we stroked him and talked to him, and I still see Owen in his eyes. I don't think he is giving up, and the vet agreed. The vet also said that while he thinks our chances are now 50-50, if he does recover we could expect him to have a very good quality of life. So we took him back to the e-clinic, and the ER vet is taking a very aggressive approach to rehydrating him, as that is still our biggest challenge. The ER vet also thinks that if he can get him rehydrated, we may find the kidney issues are not a permanent problem (in other words that the dehydration is driving the kidney values we are seeing now, not the other way around.) He feels very confident that he can get him rehydrated if he can tolerate a pretty fast drip. The risk with that is that he could get pulmonary edema, but really we have no other choice now.

Please say a prayer that the treatment works and that Owen can tolerate it without complications. I feel like we are so close to turning a corner tonight.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

prayers, white light, vines and hugs

 

Re: How to handle UPDATE: Owen is HOME! (p2)

I haven't posted before but have been keeping up with your posts on Owen. Just wanted to add my hugs and many prayers for you and Owen that he pulls through this and is soon back home. Always in my prayers.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Hi Hope and Dian,

Thank you all for your kind thoughts and prayers for Owen. We just got back from visiting him and I am a little encouraged. The tech told me he has been moving around in his cage instead of just laying there, and he seemed brighter. We got about a third of a can of food down him without too much difficulty. He doesn't really want to eat but if I put the food on his tongue he is willing to take it. He is tolerating the fluids so far and maintaining his body temperature at a normal level, which is an improvement from earlier today.

Right now we are just praying that all his cells are absorbing those fluids and getting him rehydrated... if that goes well, we have a really good chance at recovery.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Maybe I missed it but have they tried giving him an appetite stimulant?

 

Re: How to handle UPDATE: Owen is HOME! (p2)

was just gonna ask that Hope.

 

Re: How to handle UPDATE: Owen is HOME! (p2)

Hi Hope and Dian,

I don't know if he has had any appetite stimulants - I will ask next time I see the vet. I go to visit Owen every few hours, but over the weekend he is at the e-clinic and many times the tech just brings him in to me and we don't get to talk much beyond, "how's he doing?" He is on so many different things right now - antibiotics, anti nausea, pain meds, insulin, and also some stuff they are giving him to encourage his bladder to have better tone, I believe. It is a little hard to keep up with that sort of stuff at the e-clinic because they tend to be very busy dealing with emergencies and surgeries, but the techs there are wonderful and I am sure they would know.

I feel like he is doing a bit better this morning. The tech said he was talking up a storm to her all night So far he seems to be tolerating the fluids well. We have gotten a fair amount of food down him yesterday and today, mostly by putting it on our fingers and sticking it in his mouth (works better than syringing him and he does chew and swallow it.) He also ate a little bit on his own earlier this morning (yay!) And he is drinking, peeing and pooping (yay again.)

The other interesting news is that somewhere between the regular clinic and the e-clinic, they lost his vial of PZI. It is not at the regular vet's, and the tech who received him at the e-clinic couldn't find it either. The e-clinic has a different insulin, not one I had heard of before, and they used that instead. He is responding better to it than he did to the PZI so maybe that was a blessing in disguise.