Well, that's a cherry on the shit sundae
I took my girl cat to the vet today. I'd been wanting to get her in for a while; she's already been diagnosed with early-stage kidney disease, and she had a course of antibiotics two weeks ago for an infection, but hadn't seemed much improved afterward, and had gotten more torpid in the last week, not eating much. I dropped in at the vet's (she's walking distance away) on Monday, and the vet wasn't in that day but I described the situation to one of the wonderful techs, who said the vet would call us; she tried to, but our phone was busy a lot the next day. And then in the last few days she seemed to get suddenly much worse, vomiting several times and twice unable to jump up on a chair, as well as even more torpid. I was kind of nonfunctional on Wednesday, except for having to run a church meeting that evening; the vet may have tried again to call, but she didn't get through and I didn't think to follow up from my end. But I called first thing this morning, and they said to bring her in at 2:30.
When I did, they found that her blood pressure was sky high, she seemed to have lost much of her vision, and the vet could see blood behind one of her eyes. There'd been a little blood there a few weeks before; now there was a lot more. She told me to take her straight to the vet hospital; with blood pressure that high, she wanted her observed, and since she wasn't sure what was going on, she wanted specialists to investigate. ETA: I forgot to say that she also has a heart murmur, irregular arrhythmia, something like that. I don't know if that would be because of the kidney failure, or the tumor, or something else.
So I picked Geoff up and the two of us took her to the hospital. And between what we heard after the initial evaluation, and the phone call this evening after they'd done more tests, here's the situation.
They say she isn't blind, just very sick. She has a stone in one ureter, blocking it and basically shutting down that kidney. (The stone shifting to block the ureter would be why she suddenly got worse in the last couple of days.) Because her kidneys aren't functioning well already, the other one can't compensate. So she's dehydrated and in kidney failure. They're rehydrating her -- her blood pressure did at least come down, after she was let alone for a while instead of being prodded and poked -- and about 10% of cats pass a stone like this one on their own once that's done. So that's our best-case scenario. The worst-case one is that some cats -- I didn't get a percentage there -- get into serious trouble as they're being rehydrated, and their heart fails. So she could crash tonight. If that happens, they'll phone us; we're agreed we don't want heroic measures in that case.
If neither of those happens, and she's stable tomorrow morning, then we have to decide whether to put her through surgery: they basically do a bypass, putting in a new tube to route around the blocked ureter. The intake doc said it has a pretty good success rate, maybe 85%? but wouldn't commit herself; we have to get such info from the surgeon. And she'd need follow-up; the tube has to be flushed every three months, plus monitoring and what-not.
If we don't want to put her through that, the surgery and the ongoing aftermath, we have to put her down. She can't live with only one, partially functioning, kidney.
But! There are more complications!
When they did scans at the hospital, they also saw what's almost certainly a tumor on a lung, most likely carcinoma. And there's fluid around it, which isn't a good sign. Standard treatment for that would be surgery as well, but there's no way they can do that surgery in the shape she's in, and they wouldn't do both it and the ureter bypass at the same time; it's too much. They might be able to do a needle aspiration, draw off the fluid to maybe make her more comfortable and also get a look at the cells they draw out to get a better idea of what it is.
So we don't want to put her through the ureter bypass surgery if she's going to succumb to cancer soon anyway. But we may not be able to find out much about the tumor, let alone about her prognosis with regard to it, before we have to decide whether to do the bypass. It all depends on how she's doing tomorrow, I guess; the surgeon will call us, but we don't know when.
Did I mention that -- unless he cancels -- Geoff is leaving at 11:00 tomorrow morning to visit friends in Toronto this weekend? And of course tomorrow is Armistice Day, so the hospital may be short-staffed; I don't know if the specialists we'd need to get info from, and have do tests, will even be available.
I don't want to prolong her life it it's just going to be medical procedure after painful and frightening medical procedure. But I never thought I'd have less than twenty-four hours to make the call on what to do, and it looks like that's what might happen.
Unless she passes the stone tonight. My fingers are crossed. And in the meantime, she's alone in the vet hospital, and I can't be with her. Dammit, I'd just managed to stop tearing up at the drop of a hat, and now I'm doing it again.
If anyone has had a cat go through such a procedure, I'd be very grateful if you'd share your experience. My primary concern, of course, is her comfort and quality of life.
read
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When I did, they found that her blood pressure was sky high, she seemed to have lost much of her vision, and the vet could see blood behind one of her eyes. There'd been a little blood there a few weeks before; now there was a lot more. She told me to take her straight to the vet hospital; with blood pressure that high, she wanted her observed, and since she wasn't sure what was going on, she wanted specialists to investigate. ETA: I forgot to say that she also has a heart murmur, irregular arrhythmia, something like that. I don't know if that would be because of the kidney failure, or the tumor, or something else.
So I picked Geoff up and the two of us took her to the hospital. And between what we heard after the initial evaluation, and the phone call this evening after they'd done more tests, here's the situation.
They say she isn't blind, just very sick. She has a stone in one ureter, blocking it and basically shutting down that kidney. (The stone shifting to block the ureter would be why she suddenly got worse in the last couple of days.) Because her kidneys aren't functioning well already, the other one can't compensate. So she's dehydrated and in kidney failure. They're rehydrating her -- her blood pressure did at least come down, after she was let alone for a while instead of being prodded and poked -- and about 10% of cats pass a stone like this one on their own once that's done. So that's our best-case scenario. The worst-case one is that some cats -- I didn't get a percentage there -- get into serious trouble as they're being rehydrated, and their heart fails. So she could crash tonight. If that happens, they'll phone us; we're agreed we don't want heroic measures in that case.
If neither of those happens, and she's stable tomorrow morning, then we have to decide whether to put her through surgery: they basically do a bypass, putting in a new tube to route around the blocked ureter. The intake doc said it has a pretty good success rate, maybe 85%? but wouldn't commit herself; we have to get such info from the surgeon. And she'd need follow-up; the tube has to be flushed every three months, plus monitoring and what-not.
If we don't want to put her through that, the surgery and the ongoing aftermath, we have to put her down. She can't live with only one, partially functioning, kidney.
But! There are more complications!
When they did scans at the hospital, they also saw what's almost certainly a tumor on a lung, most likely carcinoma. And there's fluid around it, which isn't a good sign. Standard treatment for that would be surgery as well, but there's no way they can do that surgery in the shape she's in, and they wouldn't do both it and the ureter bypass at the same time; it's too much. They might be able to do a needle aspiration, draw off the fluid to maybe make her more comfortable and also get a look at the cells they draw out to get a better idea of what it is.
So we don't want to put her through the ureter bypass surgery if she's going to succumb to cancer soon anyway. But we may not be able to find out much about the tumor, let alone about her prognosis with regard to it, before we have to decide whether to do the bypass. It all depends on how she's doing tomorrow, I guess; the surgeon will call us, but we don't know when.
Did I mention that -- unless he cancels -- Geoff is leaving at 11:00 tomorrow morning to visit friends in Toronto this weekend? And of course tomorrow is Armistice Day, so the hospital may be short-staffed; I don't know if the specialists we'd need to get info from, and have do tests, will even be available.
I don't want to prolong her life it it's just going to be medical procedure after painful and frightening medical procedure. But I never thought I'd have less than twenty-four hours to make the call on what to do, and it looks like that's what might happen.
Unless she passes the stone tonight. My fingers are crossed. And in the meantime, she's alone in the vet hospital, and I can't be with her. Dammit, I'd just managed to stop tearing up at the drop of a hat, and now I'm doing it again.
If anyone has had a cat go through such a procedure, I'd be very grateful if you'd share your experience. My primary concern, of course, is her comfort and quality of life.
read
comments | post a comment at Dreamwidth
How to use OpenID (optional unless you are commenting on a locked post)