Bomber is sick again

[Winston]

Thanks again everyone....I received a card in the mail today from the old vet with a reminder to come in for a recheck on the urine. They are just a tad too late. He would have been finished the clavamox already and they were to test it a week before he finishes.??

SCM I never even thought about the metacam?? OMG he told me it was okay to give him a few drops when he was in pain. I guess it may have been harming him. I will mention it tomorrow.

Tabitha is sleeping at the moment and I am hoping for a yodelling free night..this has been very exhausting...

[14+kitties]

No words.

[hazelrunpack]

Sending more and s for your boy, Winston! I hope tomorrow brings you good news!

[growler~GateKeeper]

Originally Posted by chico2

My Rocky too,is very skinny,it does not show much on his pics,but you can feel every bone in his spine and he eats very good
Maybe Wellness,is not great if you want your cat to gain weightthat's all my cats eat+treats.

Rocky's lack of weight gain is due to the HyperT not the food.

Originally Posted by Winston

I had a long talk with the vet and simply asked her if she felt he was suffering...Her reply was no he is a sick kitty. That gave me some hope. She also said that she felt the fluids would make him feel a lot better

.....

His Creatinine level shot up to 1460. The C&S is still not back yet so I dont know about that. I imagine the IV fluids and antibiotics will help with the UIT if it shows what it is. She also said he is showing some pancreas issues but they are dealing with the kidney issues right now.

CRF doesn't physically pain the animal/person, but it sure makes them feel cr@ppy when not controlled. The high levels of proteinuria also contributes greatly to feeling/acting sick. The IV fluids will directly remove the toxins faster from the blood stream plus help the kidneys flush out faster.

Sometimes the urea & crea can drop all the way back into normal after a couple of days on IV, but once off it will start to climb back up. The pancreas issues may be related to the high kidney values & could reverse when the bun & crea are under control.

Originally Posted by Winston

he has a taped up front leg as if it was broken so he couldnt move really. He tried to get up but had trouble coordinating his new big paw....

Chances are Bomber tried to take the IV line out himself & they needed to ensure a stable IV line so extra wrapping.

Originally Posted by Winston

The C&S is back and she said it is negative?? So the antibiotics he was on (clavamox) from the old vet must have been working. She thought it would come back with ecoli but it didnt. I asked her what she thought about how he may be doing and she said he seems okay but the bloodwork needs to be repeated after the IV so they can see if there is any improvement in his kidney function. She may try to check his blood tomorrow.

You may be looking at:
pyelonephritis ie bacterial infection of the kidneys, in which is not uncommon for nothing to grow in a c&s, the only real way to rule out pyelonephritis is by ultrasound. There was concern that Duffy might've had pyelo but the ultrasound revealed her kidneys were free of infection, but she had a very persistant ecoli UTI.

and/or Pancreatitis which also really needs an ultrasound for accurate diagnosis. At one point after a weekend in ER on IV fluids Duffy was also suspected of having pancreatitis as the symptoms seemed to fit even though the fPLI came back normal, but as the ultrasound showed she had a very mild case of IBS & a specific protein allergy.

As I've mentioned before an ultrasound is a valuable diagnostic tool to check the structure of the kidneys & urinary tract as well as the rest of the internal organs such as the pancreas, intestines etc. Any inflammation, growth, crystals, or scarring will show on an ultrasound, giving you a clearer picture for treatment.

Originally Posted by Winston

Then she ever so kindly said that I may have to make some decisions depending on its outcome.

Don't try to cross that bridge until you get there wait for the results & see how he's feelng tomorrow & Sat morning.

Originally Posted by Winston

One thing I am questioning now is whether it is the Fortekor that made his kidneys have this problem because obviously the clavamox was working for the UTI and that would have been the origional reason for him urinating outside the box....I am going to ask the new vet what she thinks?

As mentioned earlier the Fortekor can increase the crea levels, but I suspect the combination of it with the metacam might have something to do with it, was Bomber's blood pressure taken prior to prescribing Fortekor?

http://www.felinecrf.org/treatments....epril_cautions
ACE inhibitors may cause lethargy, particularly when first begun. This may be a sign that blood pressure has fallen too low, which in turn may lead to an increase in creatinine levels as described above.

ACE inhibitors may interact with Metacam (meloxicam), a non-steroidal anti-inflammatory, so do not give both medications to your cat without checking with your vet first; but I would advise against using Metacam in a CRF cat anyway

[ancientgirl]

[cpietra16]

Bomber you need to beat this....; if you can survive dangling an inch from death....you can beat this too.....

[chico2]

Winston,to you and Bomber!

[Love4himies]

How is Bomber this morning?

for him.

[Winston]

I just came from visiting Bomber and having a check with the vet. I am happier today with the visit because Bomber seems better. I wont get my hopes up but when I came in he got up and came to me when they opened the cage. He did give me a few head butts but he was PURRING!!! I know I am not to let him know I am upset but I couldnt help the tears when he did that! it made me so happy... My boy does look miserable but yet happier than yesterday. What bothers me is when he lays down he rests his neck and head on the edge of the litter box?? looks so uncomfortable. He has figured out how to sort of get up and turn around with his extra large leg....

The vet said his kidney levels are now down to 900 from the 1400 so we are making progress. She wants to keep Bomber longer than Saturday now. Maybe Monday?? I discussed the metacam and she said she will check into it. She only uses it as a last resort and if a patient is end state. She didnt really want to comment on the other vet and that is fine but I have my own opinion. I just wish I never took Bomber back to that vet and just went with my instincts and went to the cat clinic in the first place?? Because my opinion is that the UTI should have been treated and he should not have been prescribed either the fortekor or metacam. I wish I knew then what I know now?? Because I think that the medication has forced his kidneys into this state.

She is worried that if I bring him home too soon that he will plummet...I didnt know yesterday but his temperature was low yesterday and when I went to visit it was really warm in the cage and she said that they had him on a heater. But today his temperature went back up.

They are only open till noon tomorrow so I will check in with the vet and see him tomorrow and decide what the next course of action is. They do have someone that comes in on the closed days rather than transfer them to the emergency hospital so thats good.

The biggest thing I noticed today when visiting and I mentioned to the assistant because the vet had left for lunch but Bombers eyes were beautiful looking today. The past few days they were clouded and foggy looking and the tech agreed that they look better. Hopefully this is a good thing!

I dont know what I would be doing without all of friends and support I get from this site..thank you so much everyone...keeep the good vibes coming...

[Love4himies]

I am so glad he is feeling better .

Hmmmmm, you mentioned his temp being low. That would be consistent with low blood pressure as Growler mentioned in her post from the Fortekor along with the increase in cre levels.

[chico2]

Winston,I am glad this visit was a little easier,but of course you'd cry still,you want him home and healthy and I hope that happens at least on Monday.
We are kind of a family here,a family of animal-lovers and if one is ailing or sad,I think we all feel it,so he just has to get better
Would you be allowed to bring him something from home?
Maybe one of your T-Shirts or something?

[ancientgirl]

I'm so happy to read that Bomber has improved! I think if I were in your shoes, I'd let the vet keep him until Monday. At least for me, I'd feel comfortable knowing that when I brought him home, he was passed any difficult stage .

[hazelrunpack]

Must have been such a relief to see him feeling better, Winston! I'm with AG. If there will be people there to keep an eye on him over the weekend, I'd be inclined to leave him at the vet. He's where he needs to be to get back on the right track!

[TeriM]

I'm so glad he is feeling better. Hoping for continued improvements .

[Winston]

I spent some time with Bomber today. The vet told me she discussed Bomber in great length with her colleague and they both felt it was best for him to stay longer. I have to go with what they think best.

Today Bomber wasnt as good as yesterday. He did come to me and give me some headbutts butt he was very very shaky?? The vet asked me how I thought he was doing and I mentioned the shaking when he stands up. She said they took him off Torb (pain killer) early in the am....she thought that may be why so she gave him a shot while I was there. He did seem a little more out of it after the pain shot was administered too! What bothered me was he went to the water bowl, laid down in front of it and placed his chin and mouth in the both. I thought he was getting a drink but he was just sitting there like that?? When I tried to give him a drink he had some difficulty with it?? and then placed his head back in the bowl?? it was weird...,,eventually he laid down on his side and I gave him at least 1 million pets and he seemed relaxed. I see the reason they want him to stay he appears far to weak at this point...

He pooped and has been using the litter box. His temperature is normal again today and he is eating. They are still giving him a bit with a syringe. She did not check the kidney figures today I imagine it will be Monday.

I asked about his care because they are closed and she said that either herself or her collegue will be in at least twice and then she also showed me that she watches them on a web cam from home....she will call me tomorrow and let me know how he is.

Thanks for all the positive thoughts !! lets hope the kidney values are good on Monday...

Cindy

[cpietra16]

this is so difficult for you.... It seems like the vets are giving hima fighting chance...

[sugarcatmom]

Originally Posted by Winston

then she also showed me that she watches them on a web cam from home....

Wow, that's awesome!!! I like this vet.

Continued good vibes for you and Bomber....

[ancientgirl]

I hope the time he is spending there will help him get well. It's nice to know this vet cares about her patients.

[mikischo]

I just got back from a week's vacation and I was sorry to read what you and Bomber are going through right now. Much as you don't like to leave him at the vet's, it is essential that he remain on IV fluids for several days to help bring his numbers down.

Good to hear that his numbers did go down significantly after less than two days on the IV. pawsitive thoughts that the numbers are continuing to improve. It is also a good sign that he is doing some eating on his own.

I know this is a very difficult time for you. We are all thinking of you and Bomber.

[Winston]

Thank you

[growler~GateKeeper]

Originally Posted by Winston

Today Bomber wasnt as good as yesterday. He did come to me and give me some headbutts butt he was very very shaky?? The vet asked me how I thought he was doing and I mentioned the shaking when he stands up. She said they took him off Torb (pain killer) early in the am....she thought that may be why so she gave him a shot while I was there. He did seem a little more out of it after the pain shot was administered too! What bothered me was he went to the water bowl, laid down in front of it and placed his chin and mouth in the both. I thought he was getting a drink but he was just sitting there like that?? When I tried to give him a drink he had some difficulty with it?? and then placed his head back in the bowl?? it was weird...,,eventually he laid down on his side and I gave him at least 1 million pets and he seemed relaxed. I see the reason they want him to stay he appears far to weak at this point...

Bomber was given Torbugesic? It's more a sedative than pain med

A conventional vet in 2009 gave Duffy a small dose of Torbugesic prior to a manual stool evacuation -after not allowing me to instead give her a homeopathic remedy she'd had before- & I was told it would clear her system in about 2 hours & she would be fine.............12 hours later she was still loopy - totally out of it, unable to eat/drink/walk she was so unsteady. I had to run out to the Homeopath Vet at 11pm after they were closed to pick up a remedy they left outside for me in order to counteract the effects.

http://www.vasg.org/perioperative_pa...nt_part_ii.htm

BUTORPHANOL (torbugesic, torbutrol) is a kappa agonist with moderate sedative effects capable of providing mild analgesia. Often the sedation outlasts the analgesia. Canine studies have failed to demonstrate analgesia past 45 minutes[i],[ii]. Feline studies have failed to show analgesia past 90 minutes[iii],[iv]. In fact some studies have failed to show analgesia of any significance in dogs and cats[v],[vi]. Interestingly, Lascelles & Robertson’s research in cats failed to demonstrate a difference in the analgesic intensity or duration as the dose was increased from 0.1 mg/kg to 0.8 mg/kg4. A significant number of these healthy cats demonstrated dysphoria when butorphanol was used as a sole agent.

**Dysphoria is defined as depression, anxiety, irritability, restlessness**

Butorphanol 0.2 to 0.4 mg/kg can be combined with either acepromazine or medetomidine in healthy patients to create an effective preanesthetic or procedural sedation combination. Butorphanol can also be combined with a benzodiazepine, either midazolam or diazepam, to sedate aged and less healthy patients. Butorphanol is not an effective analgesic when delivered by the oral route as butorphanol undergoes significant first-pass metabolism after oral administration. Couple the low oral bioavailability with butorphanol’s short duration of effect and you would have to give a dog at least 1.0 mg/kg every 45 minutes to gain any meaningful analgesia.

A logical companion for butorphanol is buprenorphine. Butorphanol’s analgesic onset is rapid but the mild analgesia is of short duration. Buprenorphine’s time to peak analgesic effect is quite slow even when given by the IV route but its analgesic duration can be quite long. When administered together, butorphanol’s short-term analgesia wanes as buprenorphine is reaching its peak effect.

One additional application for butorphanol is that of a mu antagonist. If a patient is exhibiting undesirable mu agonist effects while on morphine or hydromorphone (dysphoria, excess sedation, or excessive respiratory depression) butorphanol can reduce the unwanted mu agonist effects without total loss of patient analgesia.

In general, butorphanol does NOT give you much bang for the buck. Butorphanol costs about ten times more than morphine, per dose, while providing much more limited analgesia of much shorter duration.

After the experience Duffy had w/torbugesic I would not allow it to be used on any animal of mine

Hope Bomber is doing better tomorrow & for Monday's tests

[Winston]

The vet called me twice today at home to let me know about Bomber. I was out both times she called. They were just updates but she said there has really not been any signifigant change in Bomber. He was eating and was comfortable but she was hoping he would have perked back up by now.

She indicated that Bomber will be still given another 15-17 hours of IV and then we will have to have a discussion... I am to give her a call in the morning. She mentioned she was going to run the blood work again in the morning to see if there is improved kidney function.

Maybe this sounds selfish but I have been thinking about this since yesterday. I want to bring Bomber home if possible and see if he changes his mood. He is stuck in the cage which he hasnt been in one in 14yrs! its not a very large cage so he can stand up, turn around and thats about it. He isnt walking around and most imprtantly he is not at home where everything is familiar?? I think he is sort of depressed..????

I need to be sure he can come home medically though??

It certainly isnt home without him here....

[sugarcatmom]

Originally Posted by Winston

He was eating

That's a great sign! Even if he doesn't seem as perky as the vet would like, I think the fact that he's eating is hugely important.

Originally Posted by Winston

Maybe this sounds selfish but I have been thinking about this since yesterday. I want to bring Bomber home if possible and see if he changes his mood.

Not selfish at all. I definitely wouldn't make any decisions without first seeing how he does at home after he's finished with the IV fluids. Like Bomber, Aztec gets totally depressed when he has to stay at the vet clinic. He refuses to eat and tries to hide in the litter box . What you could do is get the vet to show you how to administer subQ fluids at home, in case Bomber would benefit from the extra hydration on a regular basis.

Big hugs to you

[ancientgirl]

I hope the blood tests show improvement. I don't blame you for wanting him home. I imagine he's missing his mommy and his home. Kiska hasn't done well the few times I've had to leave her overnight either.

Sending more prayers your way.

[Tundra_Queen]

Winston I'm sorry to hear about Bomber, I hope he is able to come home soon.

[Winston]

Thank you TQ..Bomber passed yesterday morning...I appreciate your kind words.

[PumpkinPal]

I'm so sorry.

Run free over the bridge, sweet angel.

Hugs to you Winston.