Hello! I have a request for anyone who's cat has undergone SRT. Could you post the anesthesia protocol your doctors used? Sally had SRT in August at NCSU and I've attached an example of the information we are looking for from her discharge summary (one from the initial visit and one from the actual procedure). The relevant section was found near the end of the discharge summary they provided via email after each visit. Information from NCSU would be best, but if you had it done someplace else, that would also be helpful. Thank you very much!
Can you tell us why you are looking for this information? I have a couple of older examples from CSU.
Hi, certainly. Sally may need to undergo a new procedure (at a different hospital) and we have concerns about her reaction to anesthesia based on a poor recovery from the second round. Trying to figure out if there was something out of the ordinary administered or not, so that we can have an informed discussion with our next vet.
Thankfully Max didn’t have any problems during the anesthesia. I’m not certain of what medications were used during Max’s CT scan and again for the SRT. Max did have to be hospitalized the day after the CT scan due to a flare of pancreatitis. They said the anesthesia could have triggered that, but he had no problems while being anesthetized.
We're glad to hear it. Can you please post the anesthesia protocol from your discharge summary in a manner similar to the example I gave above?
I’ve attached what I have in my records. This was for the CT scan anesthesia. Can’t find the meds from the SRT.
Ileus is caused by something else wrong. Was there anything else out of sorts on the bloodwork? My experience with feline ileus showed low potassium, but caused by losing control of IBD. Upping steriods made it go away. Anyway, above wasn't Neko. For her first SRT (which she went through with flying colours), she had propofol, same quantities as yours, midazolam same concentration but a 2 ml vial, plus methadone 0.5 ml of a 10 mg.ml concentration. I can't easily find the 2015 bills, paper copy only. I know they are somewhere in the house, but that was 7+ years ago! In 2015, Neko had been getting alfaxalone at the dentists and handled it fine. I know they used it for the CT scan at CSU in 2015, but she had a heart incident during that anaesthesia. I cannot remember what they did for the following SRT anaesthesia. Tagging @Jodey&Eddie&Blue who has a couple cats who have undergone SRT(s), including with issues to do with the anaesthesia.
Thanks. For the srt Sally just got alfaxalone (lots) and butorphanol. The drugs that you mentioned were what she received for the initial CT scan which she handled fine.
Postprocedural ileus is different from idiopathic ileus; while the former is sometimes associated with electrolyte imbalances, these are not considered to be its common primary cause. Administration of anesthetic agents and often particularly of opioids during and after the procedure are generally accepted to be the primary causes. In abdominal procedures, inflammation and irritation from manual manipulation of the GI tract is also a common cause, but this is of course irrelevant in Sally's case. Sally's paralytic ileus was so severe that she required several days of hospitalization with a nasogastric intubation to decompress her extremely distended stomach. Blood work was performed throughout her stay, indicating no electrolyte imbalance.
Thanks to everyone who has chimed in so far. With Sally's next visit looming, we wanted to make one more appeal for information: of particular utility would be information regarding the course of anesthesia utilized on the SRT day ("day two") at NC State. Several people in the forum community have posted about their experiences there, and if any of them could find it in their hearts to share the information we requested, it would be a huge help to Sally.
In this paper on SRT, section 2.4 has a bit about normal anaesthesia drugs used. Neko was one of the kitties in the study. There are sections later on in the paper about side effects.
Hi @SallyGT Jumping in here because I searched the forum for posts on Ileus. I hope this isn't inappropriate. My girl Kit has been in the hospital for DKA and had an e-tube installed yesterday but the doctor called me this morning to tell me she has Ileus (she's not digesting any of the food in her tube). They haven't been able to find anything else wrong with Kit besides the diabetes/DKA - they've done GI panel, ultrasound, urinalysis, bloodwork. She does have diabetic neuropathy and limited mobility in her back legs. (I have two threads going on about Kit's current situation, first part here https://www.felinediabetes.com/FDMB...increasingly-picky-eater.278522/#post-3081913 and second part here https://www.felinediabetes.com/FDMB...increasingly-picky-eater.278522/#post-3081913 ) I see your posts above are from January; how did Sally do? I'm probably going to have to decide whether to keep Kit in the hospital for longer (she's been in for 5 days already and I don't know how much more I can afford) or to take her home and hope she starts eating through her e-tube when she's back in a familiar place. I'm just trying to find any information/experiences from others whose cats have had Ileus. Thank you, Emma
Hello Emma, I'm so sorry you and Kit are going through this. I'm happy to share what I learned from Sally's experience, though many questions remain unanswered. The day after Sally's SRT procedure at NC State, we noticed that her abdomen had become very distended. She was lethargic and seemed very uncomfortable. A vet we consulted expressed dire concern and recommended that we drive her back down to NC State for treatment. There, she was diagnosed with post-procedural ileus; her nervous system was not recovering from the anesthetic and her GI tract was basically nonfunctional (she couldn't even pass gas). It took her several days of supportive care in the hospital, but she did recover. They were able to get the gas out with a nasogastric decompression tube. They also administered motility drugs...I have since read that these may not actually be effective (I can send you a link to the study, if you're interested), but who knows. In any case, I think it was about three days before things started moving in her GI tract again. In Sally's case, I think it was the correct course of action to have her hospitalized; the pressure would have been unbearable without nasogastric decompression. Is this kind of gastric distention happening to Emma? We were left feeling like decompression was perhaps the only real help the hospitalization offered, and that otherwise her return to normalcy was spontaneous, but again it's possible that the motility drugs helped more than we realized. Let me know about Emma's gastric distention (or lack thereof). We'll keep thinking about this and write back. Our cat Gary is going through his final heath crisis and things are just crazy here, but I'll keep checking the board. Thinking of you, Maia
Hi again, I just wanted to add that Sally's ileus was somewhat unusual: her procedure (SRT for pituitary tumor) had nothing to do with her GI system, and her ileus seemed to be caused by the anesthetic itself. This does sometimes happen, but ileus is even more common following procedures on the GI tract. Emma's ileus could be a result of the anesthetic she underwent, or it could be the result of handling/manipulation of her esophagus during the procedure (which is not to say that the person doing the procedure mishandled it in any way--it's just that the GI tract seems to "dislike" (for lack of a better word) being handled, and it can temporarily dysfunction when it is). It's something that does happen, in cats and in people, and it's by no means a hopeless situation. I'm sorry if I'm writing a bunch of information you already know. I didn't even know things like this happened until it happened to Sally. I have a million links saved from when I was researching this and I'd like to share some with you. I'll be back later.
Hello again Emma, I'm sorry, I of course meant to write "Kit's ileus," not "Emma's ileus." Our cat Gary is dying of CHF and we haven't slept in like four days, I'm not thinking clearly at all.
One more thought: as Wendy mentioned above, rectifying any electrolyte imbalance is an important part of ileus treatment (see, for example, this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533151/). You mentioned that Kit has been exhibiting hind-leg weakness recently. Could hypokalemia be a factor in this and, if so, is the vet doing supportive care? Sorry if you've already said something about this; I skimmed the previous threads about Kit's illness and didn't see anything, but I'm pretty out of it.
Thank you Maia and huge hugs for you and Gary. I really appreciate your responses. I'll keep updating on Kit's original thread so I don't spam this one and distract you from spending time with your kitty.
