Wednesday, March 03, 2010

Arthur Home With Tube In. More Vet Impressions





So I came home from class tonight (really felt like I couldn't miss class two weeks in a row) and Liz had picked Arthur up from the vet already and gotten instructions. He is feeling groggy from the anesthesia. Liz was told to keep an eye on Arthur all night tonight to make sure he doesn't fall asleep with his head in the water or food bowl and presumably to make sure he doesn't disturb the tube.

The picture above shows Arthur practically passed out in front of the bowl. He did actually eat a 1/3 to 1/2 of the bowl before he laid down again. What concerns me about this tube is the placement. Any time he rubs his head against anything (which he does all the time), he is jostling the tube. Did the vet put it in the wrong place?

He is supposed to get 4 meals a day for a total of 250 calories for the next few days. He is supposed to get his liver values checked again on Friday and hopefully we will see improvement. As I said in an earlier post, the hospital wants to do a biopsy if he doesn't improve, though Friday is not necessarily a firm deadline for improvement.

I am VERY concerned about the tube. On the one hand, I think it's necessary to help him consume enough calories. On the other, I think they positioned it very precariously on his neck. If it comes loose, if he vomits, if he bleeds, if anything happens at all, he has to be rushed to the hospital again.

Call me a nattering naybob of negativity but I'm concerned that the hospital doesn't care about helping Arthur at all. For over $5,000 in medical expenses, not only have they failed to make him better, but his liver numbers actually went up. And they don't seem even remotely interested in answering questions or providing us with the information we need to help him.

This morning, I brought a printed listed of questions to the hospital. I waited patiently for the doctor to come over and explain the procedure. Then I started asking her questions. She said "it sounds like you put a lot of thought into this, let me take your paper so I can properly answer your questions when you come in later."

When Liz came in later, she did not get to speak to the doctor, but to a vet tech instead. The vet tech handed her back the paper. You can see in the picture below how seriously she took our questions.



If you click the image, I believe it will enlarge so you can see my Qs and her As or lack there of. The first question, "how much food does Arthur need to eat each day?" is one that she would not explicitly answer for us last week and which our regular vet would not answer either, until the feeding tube was put in today and they finally said "250 calories."

Was asking about required food intake too much to ask? If we had known about that 250 calorie number over the weekend, we might have been able to act upon that information, feed him high-calorie feed and prevent him from getting worse. Instead, I was shooed away by both the vet and the hospital doctor, both of them annoyed by my questions and telling me things like "if he eats at all, you shouldn't worry" or "I can't really tell you how much your cat needs to eat" or "don't believe things you read on the Internet about how much a cat with fatty liver disease needs to eat."

Anyhow, right now, we can only pray that the feeding tube works, that Arthur gets better, and that we can move on from this.

20 comments:

Ozark Mountain Cats said...

I don't have any answers for you but just wanted to drop by and give you and your kitty a cyber hug. I totally understand the bad vet vibes. I had a super one when I was in California and there's none here in Missouri that compares at all.

Hugs and Purrz

Karen Jo said...

I am afraid that I don't know enough to be of any help to you, but that tube placement looks weird to me, too. I understand completely why you are getting the feeling that the vets don't much care about Arthur. I'm really sorry. I do hope and pray that Arthur gets better soon and Herman is sending healing purrs.

Milo and Alfie Marshall said...

Hello, we haven't visited you before, but we thought we'd pop over and send positive healing thoughts to Arthur (from Milo, Alfie and me their mom).
I know how hard it is when a precious beloved cat gets sick and you do everything in your power to try and help them get better. And if you don't feel the vets are on your side, or are interested enough, it's even harder.
So my advice is, try to think positive and remember that all you do is with the sole intention of getting Arthur well enough to enjoy quality of life again. Nothing else matters.
I sincerely hope it works.

((((((((hugs)))))))))

The Creek Cats said...

We just want you to know we are purring very hard for your sweet Arthur. (((hugs)))

Everycat said...

I am so sorry that Arthur is going through this and also sorry that you are having to deal with vets who appear apathetic to your need for information. I've had to deal with vets who are like this and it's a hard one to crack. As paying clients you are entitled to full explanations of Arthur's treatment and support to enable you to nurse him back to health. I would ask for a meeting with the lead vet treating Arthur and go through the questions one by one, face to face. If you put the questions into the context of "the more you know and understand the better able you will be to nurse Arthur" that can take some of the emotion and frustration out of the situation (just my experience there) You could ask for a named and senior vet tech/nurse to give you telephone support whilst looking after Arthur at home too. Sometimes, just a quick question on the phone answered in a friendly way can really help you cope when you have a poorly cat on your hands. Especially when things like feeding tubes are involved, they can look very precarious and scary if you are not used to seeing them. Often, just some friendly and professional reassurance is all that is needed to help you and also understand the rational of the vet treating the animal. If you don't get anywhere with this approach, ask to see the practice owner (most senior vet?) for a meeting to resolve this issue and come up with a treatment plan. You have paid a lot of money to these vets and you should be getting good communication from them.

The Merck Veterinary Manual is online (handbook for vets) here is a link to the page on Idiopathic Hepatic Lipidosis in cats:-

http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/23616.htm&word=Hepatic%2cLipidosis

It will give you some idea of the treatment and management of this condition. A science and technology dictionary is useful to have on standby to look up some of the terminology too. As cat carers; we don't often have a clue if what a vet is doing is standard protocol or not, the Merck manual is useful in that it does outline protocols and can help you get a handle on what has been done, why it has been done and what might be done in the future.

As the clients who have commissioned and paid for all of the tests for Arthur, you are also entitled to a copy of all of the results. I would ask for these now, as if you continue to be disastisfied with the current vets, you may need to go to another vet (having copies of results avoids having to repeat tests usually). In the UK clients are entitled to copies of test results, this is covered by consumer law, if you are told you can't have copies, maybe look up your local laws on this?

Again, I'm so sorry you are going through this, it's always a tough, emotional time looking after a beloved and poorly pet. Look after yourselves too, Arthur needs you to be strong for him.

We send you rumbly purrs and wishes for Arthur to get well very soon.

Jane & Whicky Wuudler

Cory said...

We are purring for Arthur. Whicky gave you great advice. We have had to force feed a kitty with liver disease. We had to feed her A/D cat food which is high in calorie but it was 3 years ago so I don't remember the amount, but our vet was very specific on how much food to give at each feeding. That is very basic information that your vet should be providing. Don't let them not give it to you. Do you have options for a 2nd opinion?

ABBY said...

Having never experienced anything remotely like what you've gone through with Arthur I don't know what to offer as far as advice on the medical end of it. Only that the care he is being given doesn't feel like it's right for you or for him and I would undoubtedly feel exactly as you do. I agree with Whicky Mom and I would get copies of all the tests that have been run and as soon as Arthur is well I would find another Vet who was much more compassionate towards the kitties and the kitty owner. It's very scary to know your little furry baby is sick and then to have to deal with extra baggage from the medical end is not good.

Abby's Mom

The Island Cats said...

Jane and Whicky gave you some good advice. It sounds like you need to talk with the vet to get more information. Considering everything that is going on with Arthur, you would think they would be willing to answer whatever questions you have. We really don't have much of anything else to add except that we are purring for Arthur and you and Liz and we hope Arthur gets better soon.

Charlemagne and Tamar said...

We don't have any good suggestions about the vet situation. Sending purrs for Arthur to improve - come on, little guy, you can do it!

Charlemagne and Tamar

Niko and Cloud said...

Is there a different vet you can try?
Mom says that if they had done that with the answer sheet with her, she would have been hissed off enough to not go there anymore.
Mom says she doesn't know enough to give any real advice, but she is praying and we are purring for you.
-Niko and Cloud and The Mom

Junior and Orion said...

I don't have any answerss for you, but ai know a place that might be able to help. Go here:

http://www.meezer.org/

Scroll down to the lower part of hte page, click on message boards. Another screen will pop up and you will have to register. Once inside, scroll down to the Meezer Central section. There is a health section, but the Meezer Central section gets the most traffic. Explain your situation and ask for any help anoyone might be able to give you. I know that some of these people do rescue work and have had to use feeding tubes. Also they may have helpful hints about all that you are facing. Yes, this is a message board for Siamese owners, but you won't be turned away just because you don't have a meezer.

I am on the board as RhondaP, you can put in your message that I sent you if you want to.

Rhonda, Junior and Orions Meowm

TrinsMom said...

Hi, I came here from the Yahoo AF board. The placement looks correct. My Kita's is in the same spot but the other side of her neck. The tube looks long, can they shorten it? It may take him awhile to recover from the tube placement, but dont panic. Keep feeding, I know this is critical. Did they give you pain meds for him? Take a look at the collars I suggested. Is his tube sutured to his neck? Kita's is sutured down in 2 places to keep it from being pulled out.

Good luck and dont hesitate to email me with any questions.

SuziQCat said...

Sorry you are struggling to find answers to help Arthur. I know how frustrating it can be...keep asking and demanding answers. You are the only one that can speak on his behalf...he needs you now more than ever. Good luck!

Amy and The House of Cats said...

Hi All, we just read about you over at the Cat Blogosphere and wanted to stop by and send some purrs for Arthur to get better. I was looking at your post about the liver biopsy - why do they need to do surgery to do the biopsy? Our cat Floyd (who passed away at the end of October last year from cancer - didn't know if I should mention that and freak you out, but I wanted to be upfront with everything)had one early last year, and they were able to do a needle biopsy. I don't see any mention of that being done for Arthur - maybe I just missed it. I have been looking at your old posts and it sounds like you need to talk to a specialist. We love our vet, but when we couldn't figure out what was going on he immediately recommended seeing a specialist. Sorry, I feel like I am bashing you and your vet and I don't mean to at all - I remember how frantic I was when Floyd first got sick and I know it is difficult. I am positive you are doing everything you can for Arthur (from what I read so far you sound like you are awesome cat owners) I just have gone through some simmilar stuff (Floyd had hepatitis (inflamed liver) along with pancreatitis and lymphoma so it sounds so similar to what you are going through, though not exactly the same, it did involve the liver and pancreas) and I just wish that no one would ever have to go through this again. The main thing I think is that if they say liver biopsy see if it is a needle biopsy - it would be so much easier on him then surgery (for Floyd they didn't even need anesthesia - it apparently isn't too painful). We are sending you lots of purrs and prayers for things to get better with Arthur.

Shaggy, Scooby and Scout said...

Just checking back to see how things are going.
We hope you are getting the answers you need and that Arthur is resting comfortably and starting to feel better.

Tiki & Kirby (& sometimes Kesey) said...

We are so sorry you are having so much trouble with the vet. We really think you should get a second opinion or at least demand some answers from the current vet. If you can get some Hills A/D, it is really high in calories. We are sending our strongest healing purrs and soft woofs.

Furkidsmom said...

We're still purring and praying for Arthur.

Sniffie and the Florida Furkids

Ikaika said...

I am so sorry that you and your Arthur are having to deal with all this. Other commenters have given you some good advice. I just wanted to reinforce the suggestion of going to the Yahoo groups/message boards. I joined the Yahoo Feline Anemia group for my CRF kitties and they are very knowledgeable and helpful. I'm sure you'll find the Meezer group and the Assist Feeding group are as well. Best wishes for Arthur's recovery.

'Kaika's mom

Marg said...

We are sending lots of purrs to Arthur. And as far as the vet goes, there is no excuse for that they are doing to you and the cat. Just the fact that they sent the cat home with the tube in that location is not good. I know it is hard, but you really need to try to find a new vet. I will be interested to know how it went today, Fri. the fifth. And there is NO excuse for the vet not to talk to you when you have a cat that sick. Hope it all gets better for you and Arthur.

Lizzy, mom to Tigger, Munchkin, Jigsaw and Patches said...

OMC--we just read about this on the CB, and we have read your post and comments.
We are so, so, sorry you are going through this.
As with most of the other comments, I don't have any veterinary medical training, and none of our kitties has ever experienced anything of this nature, so I cannot offer advice on the particulars.
However, it did seem you got a couple of folks who do have enough knowledge to have offered resources, and that is good.

I can relate on the attitude of the vets, however. We went through that for a year with our Patches, trying to get the vet to admit she had epilepsy, and not some wierd other thing they were trying to claim. Finally, my husband went in and faced down the vet and told him, "Look--I had an uncle with epilepsy--I know a grand-mal seizure when I see it!" After that, we got the proper meds, and it is now as well managed as it can be.

But, I do not take well to being stonewalled--it makes me react as the bumper-sticker saying: "51% sweetheart; 49% bi**h--don't push it." And in your circumstances, that is exactly what I would do--roll into 'bi**' mode...and reminde them that YOU are PAYING them some VERY healthy sums of money, and they, therefore, work for YOU--making YOU THEIR BOSS, and that they had bloody well better start cooperating and giving you proper answers to your questions.
In the meantime...I'd be on the search for a new and more compassionate vet.

I am so sorry to hear you are going through all this, and you may be sure that we are purring hard and sending all sorts of positive healing vibes for poor Arthur. May he get well soon!

Huggs.. Lizzy and the kitties...