Cat in ICU (now out) 7/26 [bg broke 200's]

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I wish I had magic answers to help your kitty and you. What a mess that happened. Idk about meds you've mentioned. But for food: might try the old standbys, baby food diluted with a little water if need be ....spoon feed or assist feed?
And sending heaps of :bighug::bighug:healing vines :bighug::bighug: for you both
 
We are heading home and I'm having a crying jag. Leaving means leaving the opportunity to receive medical intervention for my cat and taking home my happy cat. He's not happy. He was so happy before we came. He was off his meds and back to himself and he was happy. I ruined his happy.
 
MJW said:
Can your regular vet intervene with a vet in the area where you are now?
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No, the university vet will not change mind.

I told her that I don't want the quality of life for him that he is now in. He's been here before and the only way it's been fixed is when I bring him to the u and get Mannitol.

We came down last year. With the same doc, I said he needs Mannitol. Doc saI'd no. Doc said would do and MRI. I'm guessing doc thought MRI would prove doc right. It showed fluid on the brain. He had Mannitol. Did the same thing another time.

Because he can't have and MRI, and all I have is behavioral evidence and the full knowledge that I am the expert in my cat's behavior, it's not science.

Doc told me the previous times when I requested Mannitol and the MRI showed fluid, was coincidence.

My local vet told me the pressure in his head is the worst headache anyone could every experience. Pain like you can't image. I don't want him to live in pain and said so. U doc said, 'If you are telling me that you will euthanize him just to get me to do Mannitol, I won't do it."

So, I appreciate all your suggestions, I don't know what would make things change to get him Mannitol.

He is in pain.
 
I am so sorry you are going through all this. Gentle scritches for your kitty.

My Neko had an issue while undergoing anesthesia for a CT at a vet teaching university, and it was a completely different experience. She had a heart block and they rushed in the specialists and called me right away. I loved the customer experience at that vet school. Too bad not all are the same.
 
If it was a pill doc would give it, bit wouldn't because it is done via iv.

Then said: Mannitol is not good for diabetic cats.
 
Wendy&Neko said:
I am so sorry you are going through all this. Gentle scritches for your kitty.

My Neko had an issue while undergoing anesthesia for a CT at a vet teaching university, and it was a completely different experience. She had a heart block and they rushed in the specialists and called me right away. I loved the customer experience at that vet school. Too bad not all are the same.
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CSU

Edit: I didn't go to CSU, was asking if you did.
 
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Sorry to hear that, I had a great experience there twice. In the internal medicine and radiation oncology departments.
 
Wendy&Neko said:
Sorry to hear that, I had a great experience there twice. In the internal medicine and radiation oncology departments.
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I was asking if you went to CSU?

I didn't go there. Considered it. Just calling there and dealing with the people on the phone ($10 to talk with someone) and trying to get him set up there was an unpleasant experience.

Juat the phone calls were nothing like Jeff described.

I was told there is more demand than capacity. Not enough people so, it seemed very cookie cutter. You fit their mold, not meeting the needs of the cat.
 
This makes me sad. We are at a rest stop and he loved to look out the window and people watch. He has no idea there is any one to watch. He's just sitting in my lap. I gave him his bupe and we are back on the road.
 
I am sure he will feel better once he is home. :bighug:

Yes it was CSU. I never paid for a phone call, did all the bookings via email.
 
God love you both. :bighug::bighug::bighug:

Have you spoken to your regular vet, could they intervene on your behalf?
 
apple said:
No I haven't. It won't change the university.

Please see comments in above sections.
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I have read them but, thought if your vet intervened he/she may be able to 'refer' you to them for that treatment specifically?
The only other option is to find somewhere else, even if it's far away?

Here I have been referred to other vets for specialist care for certain conditions by my own vet and had the hospital and my vet work together, it's probably different there. I'm just trying to think of any way round this for you that I can. Sorry if I'm repeating stuff others have suggested.
 
TempestsMum said:
I have read them but, thought if your vet intervened he/she may be able to 'refer' you to them for that treatment specifically?
The only other option is to find somewhere else, even if it's far away?

Here I have been referred to other vets for specialist care for certain conditions by my own vet and had the hospital and my vet work together, it's probably different there. I'm just trying to think of any way round this for you that I can. Sorry if I'm repeating stuff others have suggested.
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Don't be sorry. I need all the help I can get in order to help him.

The local vet can refer. What happens at the u is decided at the u. If the local vet could say give Mannitol and the u would do it. I wish the local vet could make the u give the drug.
 
I have worked at university medical centers for literally decades. There are a few things you can do.

Make an appointment to speak with the Department Chair of Anesthesiology to discuss how your cat and you were treated. (You might want to ask your vet to request your cat's records from this recent incident and then get the copy of the records from your vet.) You can also make an appointment to speak with the Dean of the medical school. It sounds like this is a distance from you so doing this by phone may be easier. Be as clear as you can about how you were treated and what the consequences were to your cat. Both the Dept. Chair and the Dean should have the authority to make this situation right. I might also suggest you ask if the vet hospital has someone in risk management. (This is the hospital attorney. This is the person that does whatever he or she can to prevent you from suing for malpractice. If they have a risk management office, it's often a good place to start.)

Report the anesthesiologist to the State Veterinary Board. All professionals are licensed. The licensing board is empowered to investigate what happened. At the most extreme, they can pull a license. Not every intervention is that extreme but given that your input was ignored, this is a concern.

One thing that most universities rely on are donors. People do not donate when there is bad press. Put comments about your experience on social media (e.g., Yelp for the area where the vet hospital is located.) I don't know if there is enough information for local news to investigate but you could contact the campus newspaper.

My biggest concern is that you were being ignored. If you had told these vets your cat was allergic to something, would they have likewise not listened and figured they knew your cat better than you?
 
Sienne and Gabby (GA) said:
I have worked at university medical centers for literally decades. There are a few things you can do.

Make an appointment to speak with the Department Chair of Anesthesiology to discuss how your cat and you were treated. (You might want to ask your vet to request your cat's records from this recent incident and then get the copy of the records from your vet.) You can also make an appointment to speak with the Dean of the medical school. It sounds like this is a distance from you so doing this by phone may be easier. Be as clear as you can about how you were treated and what the consequences were to your cat. Both the Dept. Chair and the Dean should have the authority to make this situation right. I might also suggest you ask if the vet hospital has someone in risk management. (This is the hospital attorney. This is the person that does whatever he or she can to prevent you from suing for malpractice. If they have a risk management office, it's often a good place to start.)

Report the anesthesiologist to the State Veterinary Board. All professionals are licensed. The licensing board is empowered to investigate what happened. At the most extreme, they can pull a license. Not every intervention is that extreme but given that your input was ignored, this is a concern.

One thing that most universities rely on are donors. People do not donate when there is bad press. Put comments about your experience on social media (e.g., Yelp for the area where the vet hospital is located.) I don't know if there is enough information for local news to investigate but you could contact the campus newspaper.

My biggest concern is that you were being ignored. If you had told these vets your cat was allergic to something, would they have likewise not listened and figured they knew your cat better than you?
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Thank you.

I've been refused records for this week. I was told they have to be signed-off on and will be sent.
 
Sienne and Gabby (GA) said:
I have worked at university medical centers for literally decades. There are a few things you can do.

Make an appointment to speak with the Department Chair of Anesthesiology to discuss how your cat and you were treated. (You might want to ask your vet to request your cat's records from this recent incident and then get the copy of the records from your vet.) You can also make an appointment to speak with the Dean of the medical school. It sounds like this is a distance from you so doing this by phone may be easier. Be as clear as you can about how you were treated and what the consequences were to your cat. Both the Dept. Chair and the Dean should have the authority to make this situation right. I might also suggest you ask if the vet hospital has someone in risk management. (This is the hospital attorney. This is the person that does whatever he or she can to prevent you from suing for malpractice. If they have a risk management office, it's often a good place to start.)

Report the anesthesiologist to the State Veterinary Board. All professionals are licensed. The licensing board is empowered to investigate what happened. At the most extreme, they can pull a license. Not every intervention is that extreme but given that your input was ignored, this is a concern.

One thing that most universities rely on are donors. People do not donate when there is bad press. Put comments about your experience on social media (e.g., Yelp for the area where the vet hospital is located.) I don't know if there is enough information for local news to investigate but you could contact the campus newspaper.

My biggest concern is that you were being ignored. If you had told these vets your cat was allergic to something, would they have likewise not listened and figured they knew your cat better than you?
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My cat was behaviorally not himself and the vet said, he looks great. I've never seem him like that before. He was walking and because he couldn't see he was walking over and in things. If you didn't know him, he looked like a cat exploring. That is one of the exact reasons I know he's off. He would never do that. He sits at the vet and hisses and spits.

She can make a decisions visually, but when it's my cat. My visual input in not valid.
 
I found it in writing about not giving it to diabetic cats....
Mannitol is administered intravenously at dosages ranging from 1 to 2 g/kg over 30 minutes. The reduction in intraocular pressure (IOP) generally begins within 30 minutes to one hour, with effects lasting six to 10 hours. Mannitol is not metabolized but can elevate blood glucose concentrations and should not be administered to diabetic patients. It should be administered through a filter because of its propensity to form crystals.
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I am going to tag @Marje and Gracie
because she might be a resource to find out who else could administer this besides the place you went.


I have dealt with Dr's who can't think outside of the box.... and so far I've luckily been able to find ones that at least try to move past their formal training. My ear dr is wonderful and knows that I know my ear better than he does.... so he listens to me, my input counts.

I'm sorry you had to deal with a closed minded one who dismisses you summarily.
It's obvious you will put up with whatever you have to to help his pain.
I hope when you get home , and he relaxes that he will feel better ....

continued prayers....


this situation reminds me of when I first got here and saw a member who was rushing to the vet hospital, got stopped for speeding, and she argued with the officer who handcuffed her, arrested her, took her to jail and left her cat in the carrier in the backseat when she was crying that it was a life and death emergency.
 
@rhiannon and shadow (GA) tagged me but since I don't know where you live or what state you are close to, it's difficult to make any suggestions on neurologists. I don't know, right off hand, of any that give Mannitol but then I've never needed it for veterinary purposes so there may be someone.

If you are anywhere near Arizona, I've have used Dr. Scott Plummer at Veterinary Neurological Center. I found him to be extremely knowledgeable and compassionate. But, I have no idea if they use Mannitol.

Do you think the anesthesia could have caused Horners Syndrome? I've seen this in several cats as a reaction to anesthesia.

Sending many vines for your sweet boy.
 
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No to Horners.


We are home and he has:
Eyes that don't move in their sockets
Tail that drags behind him or is horizontal, not vertical
Walking low on back legs
And he's constantly on the go, stops for a second or two. Even if he lays down, it's for a moment and then he goes. He has no reason or purpose for going, he just goes. And goes, and goes, and goes. If you try and stop him, he gets ???? not sure of word I want to pick, but he will try and chew his way out. He was chewing on the bars of his cage, arms out of the cage.
He was a good rider. Been rising since he was 10 days old. I could take him anywhere. He washed, looks out the bars, stretches out, washes some more, then sleeps.

He was awake the while time. He no longer sleeps.

He was in his wire pen at the hotel, so I could have some mental rest (not much sleep) and he was trying to break out of the bars.

When the Neuro was watching him "patrol the perimeter march" she commented on how "he's never behaved like this, look at him go" when I express that in the context / rubric that is my cat this is inappropriate, I get told not to argue.


Stating my opinion and standing up for my cat is not arguing. Yes, she did tell me that I constantly argue. However, I don't. I state my said.
 
Gave first dose furosemide .3ml. Starting small.

Should I throw the lantus out? I have another in the fridge, so if the travel bottle should be tossed, I'm still okay for supplies. Not sure how high the furosemide will raise him. Not sure if I can get him off patrol to test.
 
Oh dear, I feel so bad for you and your kitty. There has to be an answer to get him some relief, somewhere! Is there another university that might have the mannitol and be willing to at least listen to you??? Nobody knows your cat better than you. I can't believe that vet accused you of constantly arguing. Once you've had a chance to get a bit of rest, start calling everywhere you can think of to see if anyone can help.

Your Lantus should still be good. It will keep out of the fridge, just not as long.

I hope the furosemide helps Apple at least a little bit. :bighug::bighug:
 
the going and going sounds very much like dysphoria. That would be because of the bupe.
What is the dose you are giving?

Shadow had that with pain medicines. She would pace, roam, sit lay down in one spot just to get up and move again. Her eyes were fixed and she could not sleep.

It usually can be lessened by lowering the bupe dosage. I had to keep Shadow on the lowest dose possible. She just didn't tolerate it well
at all.
 
rhiannon and shadow (GA) said:
the going and going sounds very much like dysphoria. That would be because of the bupe.
What is the dose you are giving?

Shadow had that with pain medicines. She would pace, roam, sit lay down in one spot just to get up and move again. Her eyes were fixed and she could not sleep.

It usually can be lessened by lowering the bupe dosage. I had to keep Shadow on the lowest dose possible. She just didn't tolerate it well
at all.
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Not from bupe. He was like that before bupe. He's like that after it wears off.
Dose recommended .2ml
Dose given .05ml
 
apple said:
And he's constantly on the go, stops for a second or two.
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Hi Apple Mom,

So so sorry about what you have to go thru:bighug:

My DH, human med professional read the symptoms you posted and questioned Apple’s electrolyte balance… First off, he believes that brain compression is doubtful because it would give Apple lethargic state, at least that’s how it is with humans. He would not be walking at all but lying down.I thought it was good news.

About the electr. balance: if Apple was on diuretics (is that right?) one of the side effects of diuretics is washing out sodium and potassium ions. That by itself will cause weakness and frustration and disorientation causing him walking back & forth without purpose or reason. You said: ..”And he's constantly on the go, stops for a second or two.”

Different diuretics wash out different ions. Is there a chance to run electrolyte test?

Also due to diuretics an organism can become water depleted and Ringer’s or isotonic salt solution 0.9% (for humans) is recommended.

How much does he urinate?

What is his diagnosis?

The remainder of the issues can be addressed after the electrolytes are in balance. It might take several days.

Our hearts go out to you and Apple. I DO NOT GIVE YOU ACTING PLAN but rather a food for thoughts and something to research further. My DH is talented in HUMAN diagnostics, but Ducia is his first sick kitty and it was a while since his med training. The difference between cats and humans is lesser than we used to think but MUST be accounted for as a factor. Perhaps discussing the electrolyte issue/ SQ fluids therapy with vet over the phone is the best way to proceed.

I just wish we could do something to help Apple right away…
 
Tanya and Ducia said:
Hi Apple Mom,

So so sorry about what you have to go thru:bighug:

My DH, human med professional read the symptoms you posted and questioned Apple’s electrolyte balance… First off, he believes that brain compression is doubtful because it would give Apple lethargic state, at least that’s how it is with humans. He would not be walking at all but lying down.I thought it was good news.

About the electr. balance: if Apple was on diuretics (is that right?) one of the side effects of diuretics is washing out sodium and potassium ions. That by itself will cause weakness and frustration and disorientation causing him walking back & forth without purpose or reason. You said: ..”And he's constantly on the go, stops for a second or two.”

Different diuretics wash out different ions. Is there a chance to run electrolyte test?

Also due to diuretics an organism can become water depleted and Ringer’s or isotonic salt solution 0.9% (for humans) is recommended.

How much does he urinate?

What is his diagnosis?

The remainder of the issues can be addressed after the electrolytes are in balance. It might take several days.

Our hearts go out to you and Apple. I DO NOT GIVE YOU ACTING PLAN but rather a food for thoughts and something to research further. My DH is talented in HUMAN diagnostics, but Ducia is his first sick kitty and it was a while since his med training. The difference between cats and humans is lesser than we used to think but MUST be accounted for as a factor. Perhaps discussing the electrolyte issue/ SQ fluids therapy with vet over the phone is the best way to proceed.

I just wish we could do something to help Apple right away…
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Thank you. It means lot that you would ask someone on his behalf. I don't think the ICU took blood. Blood before CT was good. Don't think he was on any diuretics. He has done the no stop movement since he was returned to me.
 
Tanya and Ducia said:
I thought you posted he was on furocemid..? It washes out the potassium.
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His first dose was last night. The non stop motion has been happening since I got him back on Thursday.

Immediately, when I got him back, I went over what was not right and requested Mannitol. I was told no.

Now, he's trying to get out if the bedroom. He doesn't know I'm here. He's biting and pulling the carpet and chewing on the door. He can't get out so he's in motion moving and over vocalizing. If he was himself. He'd be snuggled on my face. He went to the window and now he's moving again.

When he gets like this, His behavior has been journaled and I have note books of this constant activity.
 
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Tanya and Ducia said:
Symptomatic of water depletion/dehydration or hypo valemic state.
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Somehow for him, his head doesn't clear fluid.

Grabbing his face, tilting head back, insert pill. Will create pain and fluid on the brain.

My mom accidentally hit his head with a book inside a canvas bag and all this happened. He had an MRI, fluid on brain, Mannitol, back to normal.
 
Oh, my...
Still, the thought here is to get the electrolytes test ASAP...
Sq f therapy is easy to do at home and you only need to confirm by A vet that it wouldn't make any damage. DH says you have nothing to loose.. Think about it. If you have a plan I think you yourself will feel better. And you need to restore you strength.
 
He has no idea I'm in the room. I'm laying on the floor and when he patrols, he just walks over me. He doesn't place his feet strategically or carefully and loses traction and grips and slips and slides.

My cat doesn't even know I exist.
 
Prayers for you as you observe and make your decision. I had to let mine go far too early so it's a gut wrenching decision.
Your love for him is obvious and if he can't improve and doesn't. It's the last gift you have.

I pray for him to turn around on his own.
:bighug::bighug:
 
I wish I could convey my absolute empathy with you right now. I wish I could create my tone through written words and I mean this in the gentlest way.

If mannitol is out of the question, its may be best you try not to fixate on it. I know and understand that it works and has worked in the past.

It's time to consider other possibilities and open your mind to them. Isn't it worth taking a chance and trying something, anything at this point?
At least speak to your own vet?

I know you are beyond tired and beyond weary, and I'm sending a massive hug to you both. Just please don't give up yet. :bighug::bighug:

I just remembered there is a site online called do I need a vet it's run by a retired u.k vet, it may be worthwhile getting his opinion?
 
apple said:
I'm wondering if we've reached the end.
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Not until you tried the SQ f .....
I am not being sadistic, truly.
apple said:
He needs Mannitol.
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Yes... but he cannot have it, unfortunately.
apple said:
I've never been able to do that with him.
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From the very bottom of my heart: it is not as awful as it sounds. I promise. Or can it be done at a vet?

I would certainly give it a try before making irreversible decision...

I understand that Mannitol gave him immediate relief and that's how it stuck in your mind - a magic solution... But what if something as simple as balancing the electrolytes can help? DH says that Manitol was used when operating on a human brain - the liquids literally drained from the head in minutes causing hypovalumic condition. I do understand why you value it so much...How much fluids was in the brain and where was it located? How long ago?

Forgive me if I appear to be pushing you, I don't...Only there might be a way to help other than Mannitol..I honestly think it cannot be ruled out completely, not yet.:bighug:
 
https://en.m.wikipedia.org/wiki/Mannitol

As a medication, it is used to decrease high pressures in the eyes, seen in glaucoma, and to lower increased intracranial pressure.[3][2]Medically, it is given by injection. Effects typically begin within 15 minutes and last up to 8 hours

Mannitol is in the osmotic diuretic family of medications and works by pulling fluid from the brain and eyes.[4]

The discovery of mannitol is attributed to Joseph Louis Proust in 1806.[5] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system

I wonder if injection really means injection since iv is usually written differently. I've always thought it must be delivered via iv filter in hospital.

I'm going to test his Bg to see where he is at.
 
rhiannon and shadow (GA) said:
the going and going sounds very much like dysphoria. That would be because of the bupe.
What is the dose you are giving?

Shadow had that with pain medicines. She would pace, roam, sit lay down in one spot just to get up and move again. Her eyes were fixed and she could not sleep.

It usually can be lessened by lowering the bupe dosage. I had to keep Shadow on the lowest dose possible. She just didn't tolerate it well
at all.
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I think of his behavioral expression as manic. Could manic and dysphoria be the same idea?
 
apple said:
the most effective and safe medicines needed in a health system
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Yes, but it is an emergency medication and should be Rxed only once in the EMERGENCY situation. If given more often or on a regular basic it will harm the organism by hypovalimia/water depletion...
The organisms need balanced liquids.
Mannitol isn't a safe medication at all.
 
Is there any one that knows if Mannitol can be done by injection? If so, more options.
 
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7/23 Bg 143
Yesterday's dose of furosemide .3ml
No lantus shot at this time.
Force feed ad.

I need to do some positives:
He held his tail a little higher while walking.

I guess that's not much of a list
 
Tanya and Ducia said:
Yes, but it is an emergency medication and should be Rxed only once in the EMERGENCY situation. If given more often or on a regular basic it will harm the organism by hypovalimia/water depletion...
The organisms need balanced liquids.
Mannitol isn't a safe medication at all.
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It's what he's got.
To get blood vet sedates. Not an option for him after what happened.

He is usually the most compliant animalin the world. Will do anything for me. Loves having his toes tested. He purrs and helps me. Not anymore. He didn't seem to know I was there.

Force feed. He never mineded it. Like a little bird he would sit in my lap and open his mouth. Today it was a struggle. I now have an idea of why people say force feeding is hard.

My mom is here. Another pair of eyes. She says his motion has no purpose. He just goes. She agreed he was in one of his Mannitol needing states.

Fluids, there is no way I could get him to do that.

I'm going to email to neurologist and ask for help.

She saw him motor non-stop I the exam room, maybe if I write about context and seeing a snippet of something colors one's view.

@Tanya and Ducia Where does you husband put the non stop motion?
 
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Mannitol is iv only. Your regular vet should be able to give it. They might have to order it and if they do surgeries where they use iv they can administer it. If nothing else they should be able to find someone local for you.
 
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