Tuxedo is at the emergency vet

[Barbara Boehmer]

Tuxedo is at the emergency vet and expected to be there until Monday morning, then I will go and get him and transfer him to my regular vet. After 4 or 5 years of twice daily insulin injections, it appeared he had ceased being diabetic. His blood glucose was between 141 and 177 without insulin for a week. However, he was skinny and dehydrated. He had a blood sample taken Friday for a full blood panel and also a urine sample. I got the results today and was told that he is having kidney problems and is severely anemic. I was told that he has non-regenerative anmeia where new blood cells are not being produced. I was told he should be in a 24-hour facility where he can have intravenous fluids and elecrolytes for the next 48 hours and possibly a blood transfusion, then run another set of tests on Monday, but my regular vet is closed on Sundays and evenings. So, I took him to the emergency clinic that is open on weekends, holidays, and evenings. I will visit him sometime tomorrow. His blood glucose was 230 and there was no sugar in his urine, but his creatinine was high (4.1) and his bun was high (75) and his red blood cell count was low (1.7) and his hct was low (12%) and he has too much protein in his blood and in his urine and a bunch of other things were too low or too high. It is thought that the anemia is caused by the kidney problem and unknown what causes the kidney problem. Apparently he is now going to need a low protein diet for his kidney problem, the opposite of what he needed when he was diabetic, and daily fluids, if he can make it through this crisis. Tuxedo is 16 years old. I have a 21-year-old cat that is hyperthyroid and has kidney problems. She is on a low protein diet (science diet k/d) and getting daily fluids and doing a lot better than Tuxedo, but she was never a diabetic.

[GabrielDeafBlindPupFamily]

Oh, Barbara! I am so sorry Tuxedo is having so many problems. I had no idea diabetes was reversible. 16 used to seem old in my mind, but Andy's cat, StarrAncientCat is going on 20something. So 16 is just middle age. I hope they come up with a regimen that will allow him to make a good recovery and come home to you. You can subq him at home (not something I ever wanted to do, but I did it...) Please let us know what Tuxedo's condition is today, and if you need anything at all.
Prayers going up for answers and his recovery.

[Dianne]

Barbara,

I'm really sorry to hear of Tuxedo's illness. You're trying to do the best you can for him. I hope that he gets better and comes home to you soon.

Dianne

[critters]

Poor Tuxedo!! I've never heard of somebody being undiabetic before!! There are several kitties at CIC http://catsincrisis.org/phpBB/?submit.x=98&submit.y=10 , including one of the owners' kitties, who are CRF. You are welcome to post whether or not you need financial aid. There are a number of good listservs, and VetPet, http://www.vetpetpartners.org/ , is good, too. Good luck!!

[moo]

Barbara,

I am so sorry to hear about your cat. I am not very religious but I pray that he will get better and be snuggled up in your lap in no time. Cats seem to be very resilient so stay strong .And keep your chin up.

Amanda & Simba

[Barbara Boehmer]

I went to visit today. He is still critical. He is getting i.v. fluids and science diet k/d. While I was there, he ate a little and urinated. He is alert and responsive, but lethargic. He was not bothering the i.v catheter, so they did not have an elizabethan collar on him. They will be leaving the i.v. catheter in his paw. I will pick him up in the morning, bring him home for a brief visit, then take him to the day vet to continue i.v. fluids. He may need a blood transfusion. I may end up having to bring in my youngest, biggest healthiest cats to see if we can find a blood type match. I may have to take him back to the night and weekend vet Monday evening. If so, I will bring him home again for a short visit between facilities.

[GabrielDeafBlindPupFamily]

Well, that is a bit of good news anyway... He seems to be better?
Well. What an emotional physical rollercoaster for you both. My stomach tightens just knowing what you are going thru.
Come on Tuxedo! You can do it!

[Christine]

Dear Barbara,

Your Tuxedo is being sent loads of healing prayers and good thoughts from our end of the world. Looking forward to your next post of good news for your baby.

Love,

[Pam (Riley's mom)]

My prayers are with you and Tuxedo. I hope he's home with you again soon.

[Dianne]

Barbara,

We're hoping that you will soon be able to bring him home for a recovery. It is good that he is still eating.

Sending healing thoughts to both of you.

Dianne

[Barbara Boehmer]

Tuxedo is home for the night. He goes back to the day vet tomorrow for more i.v. fluids. The vet ordered some epogen (procrit) that is supposed to stimulate the bone marrow to produce red blood cells. I don't know yet how soon it will be available. I am also awaiting the results of a test to determine his blood type. Once his blood type is known, there is a cat blood bank about 50 miles from here, where I can go get some blood of the proper type, that has been screened for parasites and diseases, for a blood transfusion. I have been told that is safer than attempting cross-matching with one or more of my other cats.

[connie]

poor tux,
give him a hug from me. don't think he'd like a slurp from cricket. lol. you are both in my prayers, hope things are better soon.
hugs,
connie and cricket

[Cindidoxiemom]

Barbara~
I know getting to spend the night at home was very comforting for Tuxedo. I will continue to pray for his healing.
Cindi

[FYI]

http://www.vet.utk.edu/bloodbank/vet_banking.shtml

[Barbara Boehmer]

I just got a call from the vet. She got the results of most of the latest tests, including something called a reticulocite count. She said that he has highly regenerative anemia. She said that means that his bone marrow is producing red blood cells extremely rapidly, but something is killing them faster than he can produce them, but it is not caused by the kidney problem. This is very different from non-regenerative anemia, where the kidneys don't produce the hormone to stimulate the bone marrow to produce red blood cells. So, the procrit (epogen) would not help, as all it does is stimulate the bone marrow to produce red blood cells, which it is already doing. It is most likely some sort of cancer that is killing the red blood cells. There is no indication of any internal bleeding or infection or anything else, so it is presumed to be some sort of cancer.

The vet said that I could take him to a specialty place where they could do things like a bone marrow aspirate, ultra-sound, and x-rays, that might tell what type of cancer it is and surgery and/or radiation and/or chemo-therapy might buy him a little more time (a couple of weeks or months), but it is ultimately fatal and soon. I have tried this with two other cats and found that putting them through all the tests only confirmed that there was nothing that could be done for them and they died within 3 days of arrival at the specialty facility. It only caused them to spend their last few days undergoing uncomfortable procedures in a strange, scary place, instead of spending their last few days at home. I have let a couple of other cats die peacefully at home instead. They got weaker and weaker, then died in their sleep in comfortable familiar surroundings with me and their fellow cats by their side. So, that is what I have decided to do for Tuxedo and the vet agrees that is probably best.

I still plan to provide Tuxedo with one or more blood transfusions to try to buy him a little extra quality time, but that won't work indefinitely. I will continue to give him subcutaneous fluids and pepcid to make him more comfortable. If he stops eating, I will feed a mixture of canned food and water by squirting it in his mouth, as I have done with the other two. He usually urinates shortly after I give him his subcutaneous fluids, so I can stick a urine test strip in his urine flow to test for glucose in his urine and I have a home glucometer so I can test his blood glucose occasionally as well, so I will know if his diabetes returns and can give him insulin if needed.

He is still eating, drinking, pooping, peeing, and walking on his own. He gets in and out of the kitty litter box, goes out the back kitty door to the safe enclosure and sits in his favorite spot of grass in the morning sun, gets up and down off the couch, and sleeps by my side at night. There is no glucose in his urine and his blood glucose is remaining between 141 and 177. He is just skinny, dehydrated, weak, and lethargic. I am letting him eat whatever he wants. At this point he is rejecting all canned food and eating lots of Iam's dry food. I plan to also get him some Nutro MaxCat Senior dry cat food and fishy-smelling canned cat foods that they typically like and offer those.

Since he was diabetic until a week and a half ago, then was diagnosed with kidney problems, anemia, and presumably cancer, I have posted messages on various forums for diabets, crf, and anemia, and appreciate all of the responses and e-mails. Some of you have asked for more specific test results. I do have some specific numbers on some things, but I think it is pretty much a moot issue now. At this point, I would welcome any suggestions for extending his quality time or making him more comfortable.

I just lost another older cat in January and have a 21-year-old cat with hyperthyroidism and kidney failure, so I am going through one old cat dying after another. All of my cats are seniors now. At least each successive cat benefits from what I learn from the experiences with the previous ones. I know not to go for the extensive tests at far-away specialty facilities and I know how to do force feeding and give subcutaneous fluids and subcutaneous injections and do home glucose monitoring. I haven't had to do expressing, but will figure that out if I need to. Tuxedo still purrs a bit at home. He yowls when I put him into the carrier, because he knows it means he is going to a vet. Hopefully when I take him for his transfusion, it will be his last trip and I can do everything else at home. I have not seen any signs of pain, but if he does show signs of pain, I will not let him suffer and will take him in to be euthanized.

Has anybody else been through something similar and have any estimate as to how much time he might have left? I am told that a blood transfusion might provide him with a couple of extra weeks. If I do not provide replies to your posts for a while, please know that I will be checking periodically for responses and suggestions, but will plan to spend most of my time with Tuxedo, instead of on the computer. Sometimes he will sit in my lap or beside me while I type and I can do both.

This has gone from being a diabetes problem to a kidney problem to an anemia problem to a cancer problem to a hospice situation, so I will move it to the other problems forum now.

By the way, the black cat with white whiskers and gold eyes that I use with my signature looks just lot like Tuffy, my last cat to die in January. He was always all over my computer and keyboard and such, which is why I use that with my signature. Tuffy was Tuxedo's best pal since Tuxedo was a kitten. Tuffy was older.