It’s been a tough time for our little cat. Tasha was due for a visit to the vet –annual exam, booster shots, etc.– and we’ve been worried about some other things. She has been scary thin since her skin problems and weight loss of last year but at the beginning of this month other things started happening. The skinny cat begged for food all of the time, had very stinky litter box visits (you know what we mean), and a noisy gut… and gas! A cat with gas is not a pleasant companion! The doctor visit was more stressful than usual but completed successfully with a blood draw for organ function. Twenty-four hours later Dr. G. called with the news… “It’s not just hyperthyroidism, it’s hyper-hyperthyroidism!” No humor intended: apparently the thyroid hormone levels were astonishingly high. We quickly filled her prescription for methimazole at the local Rite Aid and started dosing to control the situation. Though full control takes weeks, Tasha’s symptoms began to resolve within the first couple of days. Dr. G. recommended suspending Tasha’s low-level doses of prednisolone, intended to control stomach or bowel inflammation and vomiting. All was good and improving until Tuesday, a little better than a week after the vet visit… Tasha started vomiting. I gave her a big dose of her prednisolone and called the vet the next day; the regular course was resumed. So Tasha has been gaining weight, eating and keeping her food down, and no more gas! Though the cat may have been uncomfortable, I believe I may have suffered more with worry than she did with her tummy troubles. We know old Tasha (about 12+) doesn’t have a long life ahead but we hope it’s a happy one. For now, she’s improving and even indulges in the occasional nighttime crazies, or what we call “runnin’ and roarin'”, and we’re glad for it.
I'm finally recovering (I hope) from a particularly nasty summer "cold." It started out a week ago with a sudden painful "tightness" in my lower neck and throat. Then, as the pain lessened, the malady progressed to a painless laryngitis which lasted for two or three days. There was a night of feverish discomfort followed by a day or two of relatively minor sniffles — no big deal. Then Sunday night things really went pear-shaped. A tickle in the throat became frequent coughing and I delivered myself to the couch for a night of restless sleep in an effort to avoid waking She Who Must Be Obeyed. By Monday morning I was weak, feverish, head aching, with no appetite. I called off work, returned to bed where I spent the entire day in uncomfortable, fitful sleep. After an evening watching TV (still not eating) I went to bed and had another six hours of pretty good sleep. Arising today I felt much better. There was a headache, a bit more energy, but the definite knowledge that I belonged at home and not at work. My appetite began to return mid-morning today, the headache departed, coughs are infrequent, though I'm still a bit weak in the knees and my nose remains drippy. I expect I'll be back at work tomorrow. What a week, ugh!
This morning I turned on the lights to find that overnight Tasha had eaten every morsel of food set out for her. She hasn't done so well in about a week. I also found her reclining on the open floor instead of in her recent hiding place. Her sniffles and sneezing have cleared up. These are excellent signs of improvement for our cat. On Saturday, however, Tasha opened a new wound on her shoulder — probably from biting. To help keep kitty from further damaging her coat through excessive licking and scratching, Dr. G. gave She Who Must Be Obeyed an Elizabethan collar for Tasha. The collar is a strange looking little thing fashioned from a blue plastic fabric and tied with a little cloth bow. I hope to get a photo of Tasha with her new garb but hope we can safely remove it soon … it gets in her way a bit when she's eating, walking, jumping, sleeping. Dr. also gave us a packet of DOUXO® Seborrhea Spot-on which may be helpful is relieving the skin irritation.
We are becoming increasingly suspicious that this entire incident may have been an allergic reaction to the wheat-based cat litter we've been using for couple of months; that Tasha's skin problem is atopic dermatitis. Her litter box filler is the only change she has seen in her environment that correlates with the beginnings of her skin problems. So Saturday night I dumped all of the Swheat Scoop litter into a wooded area and replaced it with standard clay-based cat litter. I really miss the wheat stuff because I could safely flush it down the toilet (and it won't hurt the woods where I dumped it). It was also light colored and, I thought, cleaner than clay. If, however, the cat (and possibly the wife) are allergic to the stuff, well, it must go!
Tasha appears to be feeling better. The skin problem that caused her to suffer mightily has abated and she is healing. She visits the vet in another week for a second antibiotic injection to help assure the infection is gone. Her sneezing continues but the nasal congestion and resulting sneezing also seem to be diminishing, albeit not as quickly as we'd prefer. She is still hidden away most of the day, however, telling us something's bothering her. These are likely but the latest results of her living with FIV for many years, an infection she had when we adopted her. With FIV, as with HIV (the Human version), the immune system may slowly weaken making it easier for common ailments to take hold. Many cats live normal lives and pass away of causes unrelated to FIV but if they live long enough, opportunistic infections can become a danger. Tasha's about 11 years old.
We're still worried about Tasha's appetite but Dr. B. suggested and we've observed that the upper respiratory problem is likely the main issue there affecting her senses of taste and smell. The low point seemed to come this week when Tasha essentially stopped eating for about 48 hours. Her usual diet is dry food pellets which she seemed to hardly notice. So Thursday evening I bought some canned food and offered her a small dish of it when I got home. She eagerly attacked it. Overnight she ate some more of the wet food and a bit of the dry. Very encouraging.
This morning I was doing some paperwork at the dining room table when the cat came up to see what I was about. She started eating the centerpiece –a wreath of artificial leaves– so I moved that and put her food dish in its place; that was even tastier. All the while I was working and making a scheduled phone report to Dr. B., Tasha stayed on the tabletop purring, bird and chipmunk watching, eating, and socializing. A good 45 minutes to an hour of activity. Not bad. I'm cautiously optimistic she'll pull out of this one. She's feeling better.
The first flower of the season opened at home today. We thought it would be a crocus budding nearby but, no, it was a miniature iris. Absolutely beautiful, even in the early evening shade, exploding out of the dark litter and mulch. Our worry over Tasha continues despite a fairly good weekend. While she did come out and welcome us home tonight, she continues to hide most of the time and, well, just doesn't act right. We fear it could be worse than "only" a skin problem. Kind of dampens our excitement over the flowers.
This was a week of pushing to finally (really) finish the publishing project and to help Tasha cat feel better; those things, along with doing work they pay me to do, made for a full week indeed.
The document and image files finally got off to the printers. There was discovery of an omission –one of the worst two kinds of errors one can make in an annual guide– and a couple of last-minute corrections. Overall, though, when the account rep showed me the full-color proofs, I'm pretty happy with it and think the thing will look great in print! He said we may have the finished product by March 19. This year's project has been so cranky, though, I won't be surprised if we hit another bump in the road before publication. You can see what the project actually looks like if you click here!
Tasha was our other big focus. The regular bathing was giving her relief from a nasty skin problem but the relief was temporary and, it seemed, was needed more frequently to achieve results. So, with Dr. B. back in the office, we set an appointment for Thursday afternoon and took the cat in. Dr. B. had thought, despite lack of direct evidence, that the problem with kitty's skin might be mites. His opinion changed, however, when the Revolution anti-parasite medication didn't help while an antibiotic administered in January did. So Tasha got two injections on this visit: Dexamethasone (a potent, long-acting antihistamine) and Convenia (a long-acting antibiotic). The antihistamine produced relief almost immediately and Tasha was obviously more comfortable by Friday morning. The antibiotic is intended to help cure the presumed bacterial infection that was causing the extreme itching. Today, Saturday, Tasha is behaving more like the cat we know: bird watching, moving around the house, etc. She still has the odd skritch or two but it isn't the compulsive licking, scratching, and biting that produced raw, bare patches in her coat. I think we're on the right track now and that Tasha's going to be alright. It's good to have our cat back.
I walked into her hospital room tonight to discover two doctors talking with her. So, straight from the doctors' mouths… She Who Must be Obeyed is to be discharged tomorrow morning!
She is a bit feeble still, but able to walk steadily for short distances without assistance. We'll get details about post-discharge medications, suggested exercise, limitations, upon discharge.
I think She should stay home and out of sight: Her neck is all bruised and has puncture marks; her arms look that way, too. I might be accused of spousal abuse! Hmmmmm…. it is turtleneck sweater weather!
Her heart may not be bionic but it has been rebuilt so, look out world, here she comes!
I don't have a time when the surgery was completed but at 3:30 Friday, She was in the CVICU, still intubated, and sleeping.
Dr. Gillinov was able to use minimally-invasive ("robotic") techniques and repaired, rather than replaced, the failed valve. It was a long surgery, even Dr. said it was long, and had me worried by the end but the approach and the results appear to be worth the extra effort.
Gillinov first repaired the mitral valve which, on a scale of 1-4 with 4 being the worst for the amount of leakage, rated a "4." He "removed the defective piece of the valve and placed a cloth ring around the circumference — like a washer" to effect repair. Post-op, the valve's rating is now a "1," considered normal for a healthy person.
The tricuspid valve also warranted some attention, rating a "3" on the scale. It had apparently been damaged by forces generated by the failed mitral. He applied a ring as part of that repair.
I've yet to be briefed by hospital staff but her life ahead should be good and long with her heart restored to normal function without the issues involved with synthetic or natural valve replacements.
Because the surgery was less invasive, She spent the night in CVICU, was expected to move to the "Step-Down" unit (more of a regular hospital room) later today. She should be discharged next week perhaps as early as Tuesday. Since her sternum is intact (thanks to the technique used) I expect she will recover much faster than we feared going in and She should return to her normal activities very soon.
The mitral valve surgery has been scheduled for tomorrow, Friday, Dec. 4.
The surgeon is A. Marc Gillinov, MD who met with She Who Must Be Obeyed this evening. She said there was a good conversation and felt a good connection with him.
Gillinov told her he fully expected to be able to repair the valve — something others had led us to believe was improbable. He said that in the unlikely event that the valve needed to be replaced after all, he would advise biologic tissue over artificial valve; the reason being that, though it would last only about 10 years, he expected there would be superior alternatives a decade from now. So we're hoping for repair, will get biological tissue if needed, and much of what we've been led to believe up to now has been reversed!
The surgeon also told She that he would not make a decision about "traditional" vs. robotic surgical technique until the operation actually begins. A bit surprising, again, but he's the doctor, and apparently a darned good one! We think She will be in very good hands.
For her part, She says she's not worried at all and was in excellent spirits tonight. I've said it before and I'll say it again, if she was dressed in her civvies and you were talking with her you'd never even know she was in ill health.
The catheterization went fine. She Who Must Be Obeyed was unconscious for the entire procedure and that was okay by her! The most painful part of the whole thing was they had trouble setting an IV and tried several times in several vein areas; she's sore and bruised all over her arms and hands! Yikes!
The findings are that the heart's artery pressures/cyclical changes are good indicating the valves are also good. Coronary arteries are clean and clear. The mitral valve is the single culprit — one doctor not giving any clues; the other doctor that spoke with us kind of let slip that the valve simply wasn't working (was "wide open") and that replacement, not repair, is near certain. I believe I was told the left ventricle is enlarged –not good– and caused by the valve failure and congestion and that they'll be monitoring that post-op hoping to see improvement. We'll see what the surgical team comes up with. Hypertension was ruled out as the root cause — one doc simply saying She doesn't have hypertension. Real reason for the bad valve isn't known but that it was likely in slow decline and just hit a tipping point triggering this crisis. She's supposed to get another sonogram today. It's now considered a bit optimistic to expect surgery will be tomorrow and it certainly hasn't been scheduled as yet. I may or may not get more information this afternoon during or after surgical rounds.
The Eee-PC was warmly welcomed, but… I set it up, even used it in the waiting room today. There's Wi-Fi on the patient floors in the satellite waiting rooms but apparently NOT in her room just a short distance away. I'm terribly disappointed — she was giddy about the netbook until we couldn't get online in her room! If they let her get out of bed tonight (recovering from catheterization for six hours) I'll be happy to get an email from her. Hopefully her surgical recovery room will have wireless access since she'll be there for several days. In the mean time, it's something new and she can keep her mind occupied playing with it.