2/5 AMPS +2 230 PMPS 478 +2 419 - Fortune hospital update - HE IS HOME!!!

RachelG

RachelG

Member Since 2021
Previous update

He is coming home!!! We are picking him up at 5pm.

Not sure if this is the right place to post, but wanted to provide an update.

He has non-regenerative anemia, and with that information the IM now thinks it is due to the kidney disease or cancer infiltrating his rt kidney, especially based on his u/s yesterday.

He is getting a shot of erythropoietin (EPO) to help him create more red blood cells, and if his levels stay up he can come home to us tonight!!

He is back on long acting insulin, down to 1.5 IU, and his BG was last 230.

Right now I'm trying to stay focused on how to make him as comfortable as possible. We need to follow up with our GP next week, and we have an appt with the oncologist on Tuesday. I want to see if we can take him to Red Bank Vet Hospital (thank you @Bronx's dad (GA) for the suggestion!), but I'm not sure if we have much time left and if we should spend it dragging him around. Conversely, what if the right doctor could make Fortune more comfortable? Lots of conflicting feelings. We will need to assess how he is when he gets here.

Thank you for all of the well wishes and kind words! I don't pray often, but I found myself reading from psalms last night and pray vociferously for Fortune. Today, I am meditating on getting the strength to know what to do for him, and that he responds well to the treatment.
 
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This is definitely the right place to post your update:). Sending many red blood cell producing vines to Fortune, strength and clarity to you, and many prayers.
 
Hurray for Fortune coming home :bighug: you are an excellent mama bean and will continue to make decisions with is best interest in mind :cat:
 
I was peaking at your update on the SCL group too. :bighug::bighug: I am so glad Fortune is coming home. I hope you can still have lots of quality time left with him. I hope the doctors come up with a good plan to keep him comfortable. If things are what doctors are suggestion, you can probably step back on the dosing to just keep him in decent numbers that don't stress the kidneys too much.

She's not much, but if she is, I seem to remember @LizzieInTexas guy was getting EPO.
 
Are they sending him home with more epogen as it’s usually given 2-3 times a week? I hope it helps build red blood cells. :bighug::bighug::bighug:
 
Thank you all for the warm wishes!

We spoke to the IM doctor and got a small update. Fortune is eating very well, and we are picking him up in 30 minutes! He will keep getting prednisolone and chlorambucil until we see the oncologist on Tuesday.

I called to speak to the IM doctor anbout some questions regarding CKD (in fact, the questions from the SCL group, @Wendy&Neko ) but the IM doctor spoke to the one from Sunday - you may remember from my previous post how outright condescending and rude she was to us. Well, now I think she is trying to cover her @$$ because she told the current doctor that she had instructed us to go down to 2 IU because Fortune was hypo on Sunday.

Mind you - she didn't KNOW he was hypo because they tested his BG. In fact, they ran no lab work or testing, nor make a recommendation for treatment other than to see an oncologist and dose down insulin and not to change it so frequently. The hospital itself told us to fast Fortune for the appointment and to ADMINISTER HIS USUAL DOSE. WE determined, with the help of this forum, to give him a half dose.

And then, just three days after this visit, he almost died from severe anemia.

So the recounting of the event second hand by the IM doctor who saved Fortune's life was similarly condescending and scolding in nature. She did not allow me to explain what happened, only that "Fortune was hypo because you are giving him too much insulin," which is clearly only partially true. She was passive aggressively asserting that the dose we reported on admission could "not be accurate, because the discharge instructions told you 2IU."

ARRGGHH. :banghead:

And this BS is going into Fortune's medical records, and I'm concerned will affect his care if we keep going to this hospital. We are seeing the oncologist on Tuesday, and she is not giving us the EPO injection to do at home, rather that he "will be checked with your GP or oncologist."

I'm trying to make an appointment with the Oradell Specialty and Emergency hospital for a second opinion. I'm very grateful that they saved Fortune's life, but also very frustrated with how they treat me. We are complex beings - both things are true...it doesn't make it any easier!

I'm focusing on getting Fortune home and comfy, and then I plan to send an email recounting a more accurate account of the event on 1/31 for it to also be included in his medical records.
 
tiffmaxee said:
Are they sending him home with more epogen as it’s usually given 2-3 times a week? I hope it helps build red blood cells. :bighug::bighug::bighug:
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They aren't. :rolleyes: I was told that our GP or the onc on Tuesday will check if he needs it (?!!!).

Honestly, I think it's because of the difference in opinion regarding insulin administration.
 
So glad he can come home!

I have no experience with this, but if it were me I'd be calling whoever I needed to in order to get everything accurately documented. No different than if it were my child, I want everything in the medical record accurate for a number of reasons.
 
FrostD said:
I have no experience with this, but if it were me I'd be calling whoever I needed to in order to get everything accurately documented. No different than if it were my child, I want everything in the medical record accurate for a number of reasons.
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I agree! Thanks for the idea to speak to someone. I was going to send an email as documentation recounting what happened from my POV, but I like the idea of speaking to someone and following up with an email.

It feels so sh***y to be thinking about this, but I am genuinely concerned about the care Fortune will get because they are trying to use his hypo incident to cover their behinds!

I reached out to the other specialty hospital near us, but haven't heard back. The Red Bank Vet Hospital is not currently accepting new oncology patients.
 
Does Red Bank have suggestion as to where you can go? They must have it they are turning pets away with no care. Only ones I can think of are Cornell in NY or Penn State. What if you went through Red Bank ER?

I don't see how a hypo could result in anemia.
 
RachelG said:
They aren't. :rolleyes: I was told that our GP or the onc on Tuesday will check if he needs it (?!!!).

Honestly, I think it's because of the difference in opinion regarding insulin administration.
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I have to wonder if they even know if it’s nonregenerative anemia due to the kidneys or it’s from lymphoma at this point. It’s a complicated case that is needlessly further complicated by a big headed vet. I hope you can go elsewhere for a second opinion but I sure hope that it’s not influenced by the arrogant vet. :bighug: I’m so glad he’s coming home.
 
FORTUNE IS HOME!

Oh my goodness was he happy to see us! He started headbutting his carrier when we put him in the car, and I let him out to get loved on a bit. His purr is still not there, but he was headbutting and rubbing his face all over us! He kept going between my partner and I in the car. Truly a happy moment.

We administered his meds. They gave him insulin at 6am this morning, but we didn't get him until 5:45pm, so he got his shot at 6:45pm. We will keep moving it back 15min to get to a better time.

He was "crunching" when chewing his food, his back left leg is behaving funny (maybe neuropathy?) and his left eye is wonky so I'm going to try and get him seen by our vet tomorrow. I'm also LIVID about the discharge note. It is filled with condescension and typos.

"We did give him an injection of darbepoietin [she had originally told us EPO) that is only required based on his PCV, and this will be determined in subsequent visits (not for you to give at home."

"It is important to follow recommendations for this insulin dose and diabetes."

And at the end of her paragraph, she literally COPY/PASTED the first IM doctors note "explaining his diagnoses."

It's exhausting. I'm grateful he is with us, but I don't have faith in the care they are providing.

I'm working hard to get him seen by an oncologist ASAP. I understand that this is a progressive disease, however Fortune still seems to have a lot of life left, and is so happy, that I want to give him as much of a chance as I can, and just caving because he has a "progressive disease that has progressed," doesn't seem like the right thing right now.

Lisa & Oberon said:
You could also try AERA in Fairfield.
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Appreciate the suggestion! It looks like they have IM, but not oncology.

tiffmaxee said:
I have to wonder if they even know if it’s nonregenerative anemia due to the kidneys or it’s from lymphoma at this point. It’s a complicated case that is needlessly further complicated by a big headed vet.
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The discharge papers say GI bleeding because his BUN is elevated but on u/s there was "no evidence" of GI bleeding. It could also be the lymphome, or the kidney disease (even though they are just outside of normal and have remained stable), or the mass on his right kidney. They just kinda shrugged about the cause. :banghead:

Fortune is in his little shark bed in front of the heating vent taking a little nap after eating THREE cans of FF Chicken (his fave). He must be so tired. My sweet boy is home!!!
 
Yay!! So happy he is home with his family! Sorry about all of the condescension from the vet. I got similar treatment from Butters’ internal medicine vet and it became worse when I admitted that I hadn’t held butters’ dose at .5u like she had instructed. I remember how awful it felt to be talked to that way. You are doing everything right for Fortune no matter what that vet says or writes. :bighug:
 
RachelG said:
FORTUNE IS HOME!
Appreciate the suggestion! It looks like they have IM, but not oncology.

Fortune is in his little shark bed in front of the heating vent taking a little nap after eating THREE cans of FF Chicken (his fave). He must be so tired. My sweet boy is home!!!
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Oh, that's too bad. I consulted with one there when my previous cat Orpheus was diagnosed with lymphoma, but that was years ago.

So glad he's home and happy!
 
Thank you for all the well wishes! We loving on him like crazy.

Butters & Lyla said:
I got similar treatment from Butters’ internal medicine vet and it became worse when I admitted that I hadn’t held butters’ dose at .5u like she had instructed. I remember how awful it felt to be talked to that way. You are doing everything right for Fortune no matter what that vet says or writes. :bighug:
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I keep getting the message to keep him at 2IU even though he is in the mid-high 400s! UGH! My poor boy. I'm just so torn about what to do, and how much time we have left. I appreciate the validation! They see that I am clearly very invested in my cat. :rolleyes: The only thing that is reassuring is I know the dosing DID NOT CAUSE THE ANEMIA, but their negligence in properly examining him did not help.

Lisa & Oberon said:
I consulted with one there when my previous cat Orpheus was diagnosed with lymphoma, but that was years ago.
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I'll give them a call tomorrow, then. I just was going off of their site, it looks like they specialize in emergency and opthamology, but it can't hurt to call and ask!

We have second opinion consults on 2/23 and 3/26 respectively - I just am so scared he won't make it to those dates without an intervention.

Fortune is stubborn and resilient - and I'm pretty sure that is why he is still here today. :bighug:
 
YAYAYAYAY I'm so happy he's home! I'm going to pick up my baby in an hours time and I'm so excited.

Regarding the way they have been treating you, they sound like they're the F&*(&$*(ing WORST! It's so frustrating when they think they're right and won't even bother to listen to what you have to say. At the end of the day, you know your boy and you've fought for him so well. I hope you can find another hospital that will listen to you and make you feel happier knowing he's in good hands.

Enjoy your time with your baby <3
 
I'm so happy Fortune is home, I just want to love him up myself.
He is a real fighter.
I hope you can get in with Oradell soon.
Please let us know what your GP says on Tues
When I had to give Tyler's brother Perry the epogen injections every three days
they really did help.
Give him kisses for me.
You and your partner are doing an amazing job.
Please keep us updated ♥:bighug::bighug::bighug:
 
Thank you for the kind words!!

I'm going to push really hard for the GP to see Fortune tomorrow. We noticed that his teeth look very painful, and at the very least I want him comfortable!

I'm also attaching his discharge report, with the copy/paste of the notes from Sunday. I thought it would be interesting to get a take on the information under diabetes mellitus...
 

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I'm glad you're there for Fortune! Sad that vets feel the need to talk down to pet-parents who obviously only want to do what's right by their fur babies...

But you've got him...stick to your instincts! Let that negative talk slide right on by.

Sending vines and prayers your way! :bighug::bighug::bighug::bighug:
 
Wendy&Neko said:
I seem to remember @LizzieInTexas guy was getting EPO.
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Yes, Gizmo was on Epogen. We never knew why he was anemic. It is $$, was difficult to obtain, $$ to ship as it had to be shipped overnight express, on ice! BUT, it worked!!! We got his numbers back to normal and the maintained normal levels with weekly injections.

@RachelG, I read though the release documents and see what Fortune is on Ursodiol, in have a whole rx that I will be happy send you. Just shoot me a PM with your address and I will put it in the mail to you. :bighug::bighug:
 
LizzieInTexas said:
Yes, Gizmo was on Epogen. We never knew why he was anemic. It is $$, was difficult to obtain, $$ to ship as it had to be shipped overnight express, on ice! BUT, it worked!!! We got his numbers back to normal and the maintained normal levels with weekly injections.

@RachelG, I read though the release documents and see what Fortune is on Ursodiol, in have a whole rx that I will be happy send you. Just shoot me a PM with your address and I will put it in the mail to you. :bighug::bighug:
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Hi Lizzie Tyler's brother Perry was on Epogen, and boy was it expensive
The only place I could find that would sell one vial was Petco
It was 47.00 for the vial and 25.00 for the over night express.

But it did work
 
Wow. There's so much hear to read and comment on. My kitty, Tabitha (CKD) was on first Epogen (works quickly) then Darbepoetin injections at home. It was very effective at bringing up the hematocrit. She felt a lot better. I'll read more about what you've written here and in the small cell group. Praying for you and Fortune!
 
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