05/30 Blue: out of the MRI: really need some help

Posted in chat by mistake.
I picked up Blue this afternoon from CanWest. Unfortunately, he has regrowth which I knew was the case and so we'll be seeing what comes next.
But anyway, when I picked him up, I asked about insulin and the tech told me he had no insulin this morning because anesthetic but that he had insulin last night when his BG was 8.0. However, I just opened the box with all his medications and saw that the insulin cartridge had not been opened. I just called the clinic and they confirmed in spite of what I was told that HE DID NOT GET INSULIN last night and so it's been over 36 hours since he's had insulin. At what would normally be his AM +11 (if he had insulin this morning, which he didn't), I tested him and got 223. So, I fed him and took the shot.

I am so angry with this clinic. We all know costs, for the most part, don't matter because we do what we need to do. This MRI was in the neighbourhood of $4K and the fact that they were so neglectful to give me wrong information about receiving insulin really makes me see red.

Add to all that, Blue keeps going to the kitty box and "peeing" but little comes out. Quite concerned about this.

@Wendy&Neko

 

I just called the clinic and told them about the peeing. Apparently he urinated this morning but hasn't the rest of the day (of course he was under anesthetic, etc). I'm getting worried with the going to the cat box and only a small amount of urine being expressed. He hasn't had a bowel movement either even when he was at the clinic. I really would appreciate someone commenting as I'm getting really worried as I said. Maybe it's because we aren't at home and because of the MRI results but I could use some support here. They said "monitor him if you like" (what?) and if he doesn't pee within the next 8 hours to bring him in.

I turned this into 911 because he just tried again to pee and had only a few drops. Should I bring him back to the clinic?????????

 

@Bandit's Mom Hi Bhooma, hoping you can help.

 

Hi Jodey, so he was at the clinic overnight? Has he eaten since he has come back? Has he recovered from the anesthesia or is he still a little out of it?

I would try giving him extra water in his food and see if that helps. Usually, going to the LB and straining to pee or peeing small amounts frequently is a sign of a UTI, but I'm not sure if anaesthesia could also cause that. Hopefully Wendy will be around soon and I'll also tag @Bron and Sheba (GA) for advice.


Link to previous post:
https://www.felinediabetes.com/FDMB/threads/05-28-blue-amps-180-pmps-193.278019/

 

Is he straining when he tries to pee?
If there are a few drops coming out each time, he could have cystitis when the bladder is irritated and he keeps doing tiny amounts. Has he ever had FLUTD or idiopathic cystitis?
It is also possible he has not had many fluids in the last 24 hours if he was fasting. Do you know if they gave some IV fluids when he was admitted for the MRI

 

I believe they had him on fluids. I can call back. He's never had this problem before. And, because acromegaly he usually pees a LOT.

 

Do you know how much he ate or drank today? I had a kitty with idiopathic cystitis (small pee clumps like you describe) that was set off by stress. But you said Blue is a chill dude.

Sorry cannot stay up, alarm is set for 4:30 tomorrow AM.

 

Just saw your latest, Neko peed only twice a day unless really high, nothing to do with acro.

 

No straining. Or if he is, it's well-hidden. He just sits there in the pee position.

 

My Sheba used to have episodes of idiopathic cystitis and she would start an episode by going back and forth to the LB doing tiny amounts. The vet told me to give her fluids when this happened. After probably 8 to 12 hours she would start to do more. I know it is stressful.

 

Blue pees a lot and whether or not it has to do with acro is kind of beside the point. Just right now, he's not peeing. I'm freaking out. I'm supposed to drive back to Kelowna in the morning but I'm also so worried about him.

 

Sounds like what Sheba used to do.

 

Well, Blue is usually very food focussed. He did eat and I was able to give him insulin and usually he would be all over more food. He doesn't want any. Should I do some syringe water?

 

He's never done this before. What should I do is the question. Is this serious? Should he go back to the clinic???

 

Maybe he is still getting over the anaesthetic.
Bhooma’s suggestion of mixing some water in food is a good idea

 

We're not at home. Had to travel and stay overnight where the clinic. is.

 

He's not interested in food and that is highly unusual.

 

Does his bladder feel full?
I would ask the vet if he had any fluids at all after the nil my mouth.
If he is not straining I think you can watch and wait.

 

The bladder is on his right side, back near his hind leg. Reach your hand from his back end and up to the right a bit. You might feel a squishy balloon feeling thing parallel to spine. If hard, it is full, if squishy soft, not so much.

MRI is a longer anaesthesia, which is why CT scan preferred at CSU, so he’ll be feeling more effects of it. And his tummy could feel off so less interested in food.

 

On phone to clinic: person on phone says record shows he was on fluids from 4:

His belly is usually quite pronounced (and that's an acro thing) on the right side. It feels round and squishy, like a balloon with water in it, not hard. So, maybe I can try to wait a bit, set alarm and check again.

Wendy, I think I'm just so tired and stressed right now that I'm not thinking clearly. I just called the vet and they said if I'm concerned I can bring him back but because "it's a different department" from the radiation/neurology, "so sorry but you'll have to pay the emergency fee". Not that I wouldn't but wow...

I really am stressed. I think, too, it's because of the MRI findings.

P.s. I did syringe about 3ml H2O into him.

 

They put him on fluids at 4:00 pm yesterday and kept him on until noon today and then put him on for a short while until I picked him up at 3:00 pm todsy

 

It is understandable you feel very stressed and tired. Its hard to make decisions when you are like that. We have all been there and understand.
I've had 2 cats that were blocked and they don't just sit quietly and try and pee. They will strain and moan and groan.

 

"it's a different department" from the radiation/neurology, "so sorry but you'll have to pay the emergency fee“

That really pi$$e$ me off! … Like, do they really need to squeeze more money out of you for something that could be related to the procedure? Especially when they know what you’re going through. Everybody’s all about the money these days. Unbelievable.
I hope everything‘s OK with him, and you’re right to be annoyed. That’s so ridiculous that they told you he got insulin and then admitted he didn’t. SMH
“Monitor him if you wish” ?????
How completely dismissive of them.
Sorry, I don’t wanna make you more irritated, but I’ve been through enough nonsense with vets myself, and this stuff just aggravates me.
I totally understand your frustration, and you are justified.

 

I guess the good part is he’s not straining. I’ve set my alarm and am trying to sleep. Not working. He’s acting kind of strange. Just sitting in the dark. I wish we were home.

 

I do t know if I could get any more irritated tbh, but the worry is wearing on me because we’re not at home. We’re at a hotel. This is a nightmare. I do appreciate your aggravation. It speaks to mine.

 

Sending prayers.

 

Just in case anyone is wondering, when Blue hadn’t peed by 2:00 am, I decided to return to clinic, where I am now sitting while he is being examined. I will finally be able to see a vet and have been granted a “recheck” fee rather than the emergency fee for a saving of $50.00.
I’ll update once I get news.
One other thing that was concerning me about Blue-/snd it was probably a function of the anesthesia—was that he wouldn’t lie down. He was sitting upright for hours, even when I turned off the light and tried to sleep, he was still sitting in the doorway kind of like a cat in a scary movie.
How can you tell I am exhausted.

 

I’ve been following along … and am sending positive vibes your way. I hope you get some answers.

Did they use contrast? If so, it might be worth asking if this could be some weird response to the contrast agent. (Just thinking outside the box…)

Hang in there.

 

Please let us know how you get on

 

Hi JL, thanks for dropping in. Blue will be staying overnight — he ended up peeing but when they did an ultrasound they determined his bladder was not emptying entirely. They want to monitor and hopefully he can come home tomorrow—they did use a contact, btw, and she also said during the procedure he had low blood pressure and had to be given norepinephrine.. hopefully no catheter will be necessary … I’ll have to stay another day.

 

Thank you, Carla...phew. I am so tired and now I hear the birds singing. Time to get some sleep.

 

I’m just reading through this. I hope he pees a decent amount this morning. If not please go to the vet if no pee at all after eating. Max blocked just once. It became a serious problem because the vet that saw him made a big mistake. I don’t want to scare you with details. He was only 4 or 5 when it happened. Let us know how he’s doing.

 

Good morning. I actually brought him to the clinic @ 2:30am and got out of there at 4:30am. Blue is still there. I just spoke to the vet nurse who said Blue had peed twice since then (approximately 40ml and 35ml) so no blockage. He is being evaluated this morning by the incoming vet so will know more in a few hours. They did not give him insulin nor have they fed him (they said BG 158). I said I would have given him insulin. I asked if they'd checked for ketones; she said they had not so I asked her to do that.

She also said Blue seemed a bit spacey, probably not yet recovered from yesterday's procedure. I got about 4.5 hours sleep and I'm waiting to hear if we will be staying another night away from home. I hope not.

I'll repost this for today with a link to this post.

 

Glad to hear he didn’t block!