Monday, December 19, 2011

Indy's 2nd day at the hospital

I'm back now, after spending 10 hours with Indy at the hospital today.

In a nutshell, the only good news is that I managed to forcefeed Indy AD twice and he held it down. The not-so-good news is he is still refusing to eat on his own and despite a repeat ultrasound, the vets still do not know what is wrong with him.

Here's how my day at the hospital began...

Indy did not look good at all this morning when I opened the door to his room. That was quite disheartening as I had hoped he would have perked up after being on drips for a day. Indy looked really down. However, his eyes did light up when I called him and he saw it was me.

Soon, Indy stood up and licked some water.
This was really good!

However, his back legs were very wobbly and he almost could not balance at all. I guess that's due to spending hours sitting down in a small cage with no chance to stretch.

The vet had asked me to bring all the food that he liked. I brought his RC Renal, Hill's KD and Fussie Cat. Indy wasn't interested in any of them. I brought his Ultraman pillow as well. He wasn't interested in that either. I didn't expect him to be, of course, but I just wanted him know his familiar things are still available and that he is not far from home. This is so hard, isn't it? How do you make a cat understand that he would be going home and that the clinic is just a temporary arrangement?

The paw where the drip is inserted had become very swollen, so I asked the vet if this was normal. He said there was nothing to worry about, but soon another vet came in and said he could remove the blue tape since I'd be monitoring Indy all day. After the blue tape was removed, the vet massaged Indy's paw and after a few hours, the swelling subsided a little.

I brought Indy out of the cage so that he could walk around, but he wasn't interested. He wanted to go back to the cage. The vet came round to take his temperature and he had a low-grade fever of 39.4 degrees. The vet then administered something to bring the fever down.

Later, Indy was willing to lie on my lap.

I asked the vet if there were any plans to do the Barri Meal today, she said the Barri would only be justified if Indy is still vomiting. Well, he has not vomited today, but we also had not fed him.

The clinic was extraordinarily busy today (as with all Sundays, I'm told), the vets simply had no time to attend to Indy's needs except to inject his medicines through the IV-tube. I asked if I could feed Indy since all the vets were so busy. The vet said to try feeding him 1/8 can of the AD. with a syringe.

It was quite difficult to syringe the AD in with Indy inside the cage. Remember yesterday the vet first fed him inside the cage and he did not regurgitate, but later when the other vet took him out to the table, Indy started salivating and after the feeding, he vomited everything out.

I would have to be really careful this time. So since the syringe was difficult to handle, I used my finger, but only very, very small amounts at a time.

Indy wasn't too happy with being forcefed, though.

He sat facing the wall.

I understand, Indy. You don't feel like eating and yet we are forcing you to eat. Sigh...but if you don't eat, you'll go down and you can't be on the drip for life, Indy.

I later brought him out. All in, I took half an hour to slowly feed him tiny amounts of the AD. I'd sing one verse of a song, feed him one mouthful, then sing another verse or two, and another mouthful. Indy did not spit out the food, and this was already an improvement.

The acid test was to wait one hour to see if he would regurgitate the food. I waited 1 1/2 hours. There was no regurgitation. Phew...only then did I go take a quick lunch.

The senior vet finally found some time to look at yesterday's ultrasound and he came round to tell me that he wants to do another ultrasound of the stomach as there was some abnormality in there. That was at about 3.30pm.

We waited many hours for the ultrasound as the clinic was really packed with people and their pets.

By 5.15pm, the senior vet still had not had time to do the ultrasound yet, so I asked if I should forcefeed Indy again. The vet said just a small amount of AD.

We repeated the same procedure - very small amounts in between 1-3 verses of a song. The song, Itipiso, seemed to calm him down. A friend had told me once that this song is very calming when sung to sick people. It calmed me, too, so that's "hitting two humans with one stone" (this is my politically-corrected version of the adage, note I did not say "killing" but "hitting", at most we break their bones with the stone but we do not kill them).

This time, I managed only about 3 teaspoons for food in all. Indy started salivating to tell me he had had enough. I too had not planned on giving him too much as his ultrasound was going to be done.

Right after that, the senior said to bring Indy to the ultrasound room.

This time, the stomach was normal. Phew...that was a relief. I was really worried about the possibility of stomach cancer or something like that. There was no more "fluid" above the gas in the stomach, so we don't really know what this was in yesterday's scan.

Everything else looked normal too, except for the fact that the right kidney is significantly smaller than the left. The vet things this right kidney is not doing its job (or could be infected or even dying), so the left is compensating (hence, it is bigger). He said it is quite physiologically normal for the body to do that.

However, if the right kidney is infected badly and not healing (thus, that is the cause of the whole problem), then it may have to be surgically removed. But how can we determine if the right kidney is infected? The only way may be to do an IVP but this is a risky procedure.

But then again, what if the cause of Indy not eating is due to Baytril? The senior vet thinks the next thing to do is to remove Baytril tomorrow and see if Indy would eat. While Baytril is not known to cause such a reaction, but maybe it's a one-off idiosyncratic reaction for Indy.

As we look back to the last 4 days, the problem of not eating (coincidentally or otherwise) started after Baytril was given. Maybe it's not just the forced medication that turned Indy off psychologically (as we first thought) but it is the Baytril itself that is causing a reaction of not wanting to eat in Indy.

The vet had earlier told me that vomiting may not only be from the stomach, it can be controlled from the mind as well. There is a part in the brain that controls vomiting. That is why some people and animals can self-induce vomiting. We had earlier thought Indy was vomiting as a sign of protest, but maybe it is one of the drugs that is causing the vomiting? Is it Baytril or Clavomox? Is it the drugs? Or is it the force medication?

There is no answer again.

Is the right kidney infected or dying? Should it be removed? There is no way of knowing.

So what is the plan now?

The senior vet says his plan is to remove the Baytril from the protocol tomorrow and continue with the new antibiotic, Ceftriaxone. But we are not sure if Ceftriaxone is toxic to the kidneys.

You see how we actually have nothing much to go on with?

Meanwhile, Indy is still not eating on his own which is the main cause for concern.

By evening, his temperature was back to normal.

The plan is to continue with the drips for another day, and we'll see how things go tomorrow.

It was only after closing that the vets were free for me to speak with them. To cut a long story short, we still do not know what is wrong with Indy. The closest lead we have now is the right kidney being smaller than the left, and we don't know why. It would be good if we knew. But there is no way of knowing this.

It's frustrating, but that's something I need to accept. We all know western medicine, as with all human knowledge, does not provide all the answers or the treatments to cure all ills.

I have to go home now, Indy. Ultraman will look after you and keep your company. I'll see you tomorrow, and I hope you will feel better soon, then we can go home.

Indy has not urinated the whole day today, but the vet checked just before I left and said his bladder was not turgid, so he should urinate later.

I would have taken Indy home today, but the senior vet prefers Indy to be on the drip for another day and to see if we have more clues tomorrow. He says for my convenience and for Indy as well (no more oral medication, only injectibles), we should be nearer home, hence we could well be coming home tomorrow, but whether Indy still needs to be on drips would depend on how he fares tomorrow. I said I could forcefeed Indy small amounts regularly throughout the day, if that would help.

Our Subang vet does not have Ceftriaxone injectibles, so we'd have to get that from the PJ vet. Right now, the Subang vet thinks Baytril should be continued while the PJ vet thinks it should be stopped. It is not uncommon for vets to have a difference in opinion, so I guess I'll have to make the call.

Now, that is difficult. My vet told me to search the internet for more facts on the drugs.

My plan is actually to give Indy acupuncture treatment to strengthen his kidneys and spleen, get his qi flowing stronger and hopefully, this helps with whatever is wrong in his body. As for the medication, I have no knowledge so I'd just have to rely on the vets. But which vet?

I reached home at 8.45pm, my brood was waiting to be fed. I had made some home-cooked Udo-chicken earlier today, so everyone ate some, mixed with Fussie Cat. Cow was willing to eat the chicken alone. I guess he would, because he is the connoisseur for Bobby's food every morning. Tiger and Bunny did not like the Udo-chicken at all. Cleo only wanted raw chicken skin, as always.

By the way, Bunny refused to come downstairs and I'm a little worried about him. His body still feels warmer than usual, but he will not allow his temperature to be taken. He is so strong, even two of us cannot handle him. It would be good if Indy comes back here so that I don't have to camp in PJ with Indy. I can at least look after both Indy and Bunny.

I gave Bunny the Fussie Cat with Udo-chicken, and he left all the chicken behind.

Bunny still eats, so that's not so worrying, but his body feels warm, and he hasn't come downstairs at all.

Tomorrow will be another day.

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