I will preface this post by saying Duffy is fine now & back home.
We had a scarey crisis here over the last couple of days, all started Thursday at 5 am with straining to poop from the inability to pass fairly normal looking/feeling poop plus some granule bits of poop and diarreah, combined with vomiting and open mouth panting. This all resulted in a trip to the conventional vets cuz they were open (plus closer), Duffy was manually evacuated of normal size & consistancy poop and diarreah. She was taken into the back briefly for xrays which did not reveal any blockages, nor any definative reason for her other symptoms of elevated breathing and heart rate, though her temperature was fine, and she was shaky on her back legs when straining.
I left there at 10am since I had to go into to work that day & could not stay home to monitor her, she spent the day in hosp for monitoring and by 1:30 when I called to check on her she was still the same as earlier, with the addition of drooling and laying in the litterbox :sad:
The hosp ran some in-house blood work which showed out of normal values:
- elevated pCO2 partial pressure carbon dioxide
- decreased tCO2 total carbon dioxide
- decreased K potassium
- normal BUN/Urea
- slightly elevated Creatinine but lower than the test run 2 weeks ago
- elevated AST aspartate aminotransferase a liver enzyme that rises relatively easily and is not as important in liver evaluation as ALP elevations but a substantial increase may also warrant follow up liver testing
- decreased ALKP alkaline phosphatase - liver and bone disease are the most common causes for
increased values in cats but nothing I've found so far defines why it would be
lower except the kidneys rapidly excrete any excess
At this point she stiil wasn't feeling any better, hadn't eaten the Wellness I had my mum bring out for her, was still straining and they were unable to get a urine sample for testing. The Dr was concerned about liver damage & wanted her on IV fluids LRS with KCl Potassium Chloride added plus meds & to stay in hosp overnight however they did not have anyone staying, just someone who came in periodically for treatments. I of course wanted 24 hr monitoring so we arranged for me to transfer Duffy to the Animal Emergency Clinic. At this point she was still feeling sickly but looked so much better than when I saw her in the morning and no more drooling. When we got there she was reassesed, had blood drawn again & this time sent out the the lab for an accurate comparison to the tests taken 2 weeks ago, her BP checked 120 nomal, more xrays taken, hooked back up to the IV & kept overnight. The ER vet was not too concerned about the liver enzyme that was elevated since that one AST does not generally indicated liver disease in small animals, she was more concerned about the possibility of pancreatitis. I did get to go visit with her in the back for a bit and to say goodnight. They asked what I wanted them to feed her since I didn't have time to pick anything up but they did have a can of Wellness on hand for her to have, she did eat some overnight & Friday morning.
Early Friday afternoon I discharged her from the Animal ER and transferred her to her Homeopath Vet for monitoring for a couple of hours till they closed, there she was given a remedy for the kidneys, the liver and nausea, set back up on IV. The homeopath also opened up a large can of Wellness for her which I took for her back to ER. When I went to pick her up from the Homeopath she was in even better spirits than earlier but we still hadn't gotten the lab results back so I transferred her back to the ER for overnight monitoring. Back in ER she was hooked back up to the IV and I gave the vet instructions on the next 2 doses of the remedy, we briefly discussed the results of the pancreas panel that came back negative. I was later allowed in the back to visit, coax her into eating, and say goodnight.
I got a copy of the lab results that were sent from the ER out of normal:
- elevated glucose to which the lab attiributes to stress
- decreased potassium - same value as the inhouse blood work despite having KCl added to the IV in the meantime - the lab has attributed this to anorexia lack of eating proper portion amounts
- elevated AST but lower than the inhouse test to which the lab attributes to muscle injury
- elevated CK Creatinine Kinase - this value elevates during struggling while blood is taked/hit by car/stress so not always indicative of - damaged muscles produce creatinine kinase, which goes into the bloodstream. High values indicate problems with muscle, possibly including the heart - the lab has also attributed this to muscle injury
The really interesting thing is:
- BUN/Urea is still in normal range but lower still than the inhouse test that was run
- Creatinine has dropped again from the inhouse test and is now in normal range!
Saturday morning I was to call ER between 9-10am for an update and speak to the vet on staff but they had 2 emergencies that came in so she didn't get back to me until ~ 11:45am. We spoke briefly and I was told I would be speaking to a vet upon discharge so I didn't get to ask all the questions I wanted to about the test results/theories of possible causes etc. She said they would wean her off the IV during the afternoon. I was then to call back at 1:30 pm to arrange a discharge time - that was set for 5pm.
They had a couple more emergencies that came in that afternoon, when I arrived at 5pm for Duffy's discharge appt they set Duffy & I up in an exam room with litterbox, water & food so I could get her to eat - I guess she hadn't had very much for them - and the Dr was to come talk with me. Duffy certainly looked ready to go home at that point. I asked the tech about her still having the catheter in since as of the morning they were going to discharge her then, but they wanted to keep her a few more hours longer to make sure she didn't vomit the food I was able to get her to eat. The Dr was not able to come in to talk to me then because while I was feeding Duffy there were several emergencies that just walked in. The tech came back in to take Duffy back to the kennel & reset the IV. I was told to check back around 9pm and she could be discharged around 10pm.
So I hung around the general area of the clinic for the next 4 hours, got something to eat then went for a walk & went back at 9pm which at that point I saw they had even more emergencies come in. The receptionist told someone on the phone at 9:30pm that the wait time to see the Dr for a less critical case was 4 hours. At that point I knew I would be waiting until about midnight, the receptionist came over to tell me about the new emergencies & that they couldn't discharge Duffy without me speaking to the Dr and having her instructions. The next 3 hours I waited in the clinic during which more emergencies came through, until midnight when I was finally given Duffy's discharge papers/instructions but I still never got to talk to the vet. Called a cab & got home at 1am Sunday morning.
I have a theory about the cause being a combination of a bad reaction to the new protein - duck - she had on Wed resulting in the diarreah but all other symptoms a result of the metabolic acidosis that was shown on the test 2 weeks ago but was normal on these last 2 tests plus the decreased potassium levels from these 2 tests. I want the vets opinion on the probability of that being the cause, since her ER discharge papers have undetermined cause.
Right now Duffy is doing good she's still a tiny bit shakey on the back legs but also has been kenneled for 64 hours, she's been to the litter box for both pee & poop - which was a little bit of a strain at first but came out normal size, consistancy and not at all dry. She has her appetite back is enjoying the canned Wellness she will be on for the next couple of days to settle her tummy down until the homeopath vet gives the go ahead to switch back to raw. I will be home Monday to monitor her, and will try to get her in for a check up and repeat bloodwork & do a UA on Wednesday. Unfortuately this weekend the homeopath is closed Sun/Mon - Murphy's Law
