Hi Leslie --
> Thank you soo much JJ& Gwyn!! You are always sooo helpful!! She did go into a diabetic coma
> and then had a heart attack about 15 mins after I had found her. I had just gotten her to the
> vet at the time she had the heart attack and they did bring her back. I have not been told she
> has any heart problems when they listen to her heart...they have said everything was fine.
When they listen to Alley's heart, they're listening for things like how strong it is and how fast it's beating and whether they hear a murmur, etc. The ability to throw clots is often completely unsuspected until it actually happens. In our case, while we knew that Gwyn had had a mild, intermittent heart murmur since she was 4 months old, we didn't know she was having major heart problems until after her fourth stroke. We brought Gwyn to an oncologist for something else entirely, and the oncologist referred us to a cardiologist for a work-up.
The cardiologist took one look at Gwyn's extended medical history, did an ultrasound of her heart, and said that the 'weird neurological meltdowns' she'd been having were probably strokes and that the two months of hind-limb paralysis was almost certainly a saddle thrombus. We'd seen a *lot* of specialists in the intervening years, and this was the only one that could offer any explanation at all for what was happening with Gwyn. (In defense of the specialists we saw, Gwyn almost always managed to present her problems with atypical symptoms, and she generally responded somewhat atypically to treatment.)
But the down-side of not getting the saddle thrombus diagnosed until 18 months after it occured was that by then Gwyn had recovered the ability to walk on her own. I've no idea whether there's any treatment that we could have done at the time to increase her chances or speed the recovery; we did it all alone.
If Alley were my cat, I'd take Jess' advice:
Do you have a cardiologist in your area? Do you think you could get her in today to be seen? If you tell them your cat is a suspected ATE they will try to fit you in.
If it is a saddle thrombus, it's possible that Alley will recover on her own, but there may be something a cardiologist can do to increase her chances. And, unfortunately, you should know that not all cats *do* recover the ability to walk. However, given that Alley was able to make some effort earlier today, I'd be very hopeful.
In addition to the ultrasound, the cardiologist can prescribe medication to reduce the possibility of Alley throwing more clots in the future. Jess has always advocated very highly for board-certified cardiologists; you can find them on
this site here. Again, tell them that your cat has a suspected ATE (saddle thrombus) and see if they can fit you in that day.
> [lots of stuff about exactly what happened with Alley goes here]
This isn't what happened with Gwyn but, as I said, Gwyn tends to present with atypical symptoms. Gwyn had had a couple of previous strokes at the time, both of which had affected her left side and her ability to walk. She fully recovered from those. When the thrombus occured, I first thought it was another of her 'weird neurological meltdowns' (which is what I had taken to calling them, in the absence of any diagnosis from the host of specialists we'd taken Gwyn to). It wasn't until a couple hours in that I realised that Gwyn wasn't just having trouble walking, but that she *couldn't* walk -- couldn't even stand.
> Did your cat have a couple of days where she could walk but very badly or was it all at once?
> Did the vet give her anything for the strombus?
It hit Gwyn around 2am. I had a huge debate with myself over whether to bring her in to the emergency vet, or wait until 7.30am when my regular vet opened. Given Gwyn's extremely complicated medical history at that point, I opted to wait. Our vet fit us in immediately and ran a bunch of tests, but didn't manage to reach a diagnosis. So there was some generic treatment stuff (I don't remember what, but I'd guess fluids, steroids, painkillers, etc), but nothing specific to help dissolve the clot. It's possible that if this had been diagnosed that night, there might have been some treatment available and Gwyn might have recovered quicker; I don't know.
> Alley has seen several vets but the er vet that was there in the middle of the night was not very helpful
> at all and just seemed to tell me..that she is not going to get better and I should put her down!! That
> really upset me...because Alley has come back from everything..a coma, heart attack where shee died,
> diabeties etc and that vet was just RUDE. She actually told me I was grasping at straws!!
I've had that, and most of the time it turned out that the vet was wrong: Gwyn *did* manage to recover. Of course, you have to balance that with the possibility that the vet *isn't* wrong and what kind of quality of life Alley will have if the vet's right. For every person, striking that balance comes out at a different place.
> All the other vet at this specialty vet..have been great!! I am going to send a letter about that night.
> The other 2 vet vets she saw didn't say there was a way to check for strombus..is there??
Honestly, I don't know. As I said, we didn't actually know it was a clot until 18 months later, when the cardiologist went over Gwyn's history and took all sorts of assorted weirdnesses (both ailments and behaviours) and wove it into a cohesive whole. And when I went and did research on what he said, it was like getting hit in the head with a board: everything he pulled together *was* symptomatic of the specific heart problems Gwyn had, *and* he predicted some of the difficulties Gwyn faced in the future (a need for lower amounts of sub-Q fluids, risks of anesthesia, possibility of future strokes, etc).
> He said that he just thought it... could have been a serzure, a disc problem or the aniema. They
> said the only way to check for a disc is an MRI....which they would not opertate on her..so that
> is not something to do. They said that an xray would not show a clot..is that right??
I don't *think* a clot would show up on an x-ray, though again, Jess would be the best person to answer that. At least one of the other folks in this thread has suggested that it might be a disc problem, so that seems like that could be a possibility and that the paleness and coldness of the hind limbs is a coincidence. An extended seizure *can* cause neurological problems, but were you with Alley before all this started? If you're around when a seizure occurs, it's usually pretty obvious. I know nothing about anemia in cats, so I can't comment on that possibility.
> When I got her home last night after about 2 hrs...she did get up and walk about 10 steps but VERY
> wobbley and to the side..then she fell down and hasn't walked since. She is still able to move around
> in a circle.
The fact that she could stand and walk on her own is *very* encouraging. Does she have movement in her tail??
When Gwyn had her strokes, she could only move in a forward direction by walking semi-sideways and with her body curled around to the right; that sounds kinda similar to Alley being able to go in circles.
> I will do the massage on her legs. Her legs are very boney and almost fell like there isn't any
> muscle there anymore. Will the phosphous binder help that get better?
I honestly have no idea. I don't think we ever used phosphorus on Gwyn.
> I have been an absolute mess since this has happened!! It is soo hard to watch her not be able to
> walk, but she is alert and seems fine otherwise.
That was pretty much always my criteria: as long as Gwyn was alert, had her own personality, wasn't unhappy and wasn't in pain, I figured everything else was something we would either deal with or work around.
> It has helped a lot to read this and know not to give up yet...and that there is a chance she
> could get her legs back as several people have said on here!! I have stopped crying for a few hrs now

.
I wasn't at all sure that Gwyn would ever walk again, but we were lucky and she did. (The picture of her in my icon was taken during the saddle thrombus paralysis; she started walking about ten days later.)
> The bed you made...way it just foam on the side..or all over and built up on the sides to help
> keep them upright?
The bed I made was just a foam pad to put beneath her, no sides at all. (If you get an egg-crate mattress, the cones go upward, to prevent too much pressure residing on any one spot. You still need to rotate Alley, though.) To prop Gwyn up to eat and drink, I have a small, very under-stuffed pillow that was easy to moosh into whatever shape I needed.
In my post in the other thread, I mentioned lying Gwyn on her side on a towel in the litterbox, so she could do her business without pressure on her abdomen. I should note that, by this time, we weren't using a normal size litterbox. We were using a litterbox that was actually made for miniature dogs
here. Benefits prior to the thrombus (after two other strokes) included a very wide lowered lip across the front, so that Gwyn was able to get inside much more easily, and a wider footprint so that she could take a wide stance to keep herself balanced, yet not step in used litter. The benefit of this box after the saddle thrombus was that we could easily lay her on her side in the box, leaving her butt over the side of the towel, and yet still not have to prop her against the hard side of the litterbox.
(I'll say ahead of time that pressure sores were a terrible concern to me. I've worked in nursing homes and seen how bad they can be and how difficult they can make life -- and a cat has less positions that you can prop a body into so that the sores can heal. And human diabetics sometimes have problems healing sores like that, and Gwyn was immune-suppressed -- I was absolutely *terrified* of pressure sores. I don't know how reasonable a fear it was, but I definitely had it ... )
> Also did your cat have cold back feet and pale? I was not told that a clot could go away...or
> that they could get their legs back!!
I don't remember Gwyn's legs being cold or pale -- but at the time, I didn't know to check for these things, so I might well have missed that if it occured.
I can't think of anything else to add at the moment, except {{hugs)) to you, and please give Alley some ear scritches from me --
Jean and her Gwyn