Saturday, March 06, 2010

Arthur Still Very Sick, But We Feel a Little Better Due to New Vet

First of all, I just want to thank everyone who has been commenting on these posts and replying to my questions on various forums. I'm sorry that I haven't had time to respond to everyone personally, but I want you to know that Liz and I are really inspired and encouraged by your comments, well wishes, and prayers and I think they are making a huge difference in our health and Arthur's! Please keep them coming!

The photo above was taken on Liz's camera phone a few minutes ago. That's a sleepy, unkempt me tube feeding Arthur while Beowulf sleeps next to him and leans his head on my feeding arm to support me and his brother. That's the kind of being Beowulf is; he is always there to heal and support me, Liz, and his brother, always there to lean on you, purr, and make you feel better. Don't believe the glowing eyes in the shot!

This afternoon we had our first appointment with our new vet, Dr. Plotnick of Manhattan Cat Specialists. I deliberately avoided naming him in the prior post before where I said I had made an appointment with a new vet, because I didn't want to name names until I had actually had my appointment and met him. Now, I definitely have a strong opinion. Dr. Plotnick and his entire staff are incredible and, after our visit, Liz and I felt like we had a new lease on life for ourselves, not just Arthur.

Dr. Plotnick spent a long time with us, answering every one of our questions and putting our minds very much at ease about the feeding tube and what could happen with it. Where the vet hospital had put the fear of God into us about the tube popping out at any moment and Arthur neednig to be rushed into the hospital for emergency treatment, Dr. Plotnick explained that, even if the tube came out, we would simply put a band aid over the open hole in Arthur's neck and then bring him in the next day.

On a side note, his staff also rewrapped the tube and repositioned it so it isn't bumping into everything now. Strangely, the hospital had used a really long tube which complicated things.

He and his team explained to us that we did not need to stay up 24/7 watching Arthur to make sure he does not pull the tube loose. That may sound like a very minor thing to say, but to us, it's a lifesaver.

I could spend a much longer post -- and perhaps I will at some point-- talking about everything that is right with Dr. Plotnick and Manhattan Cat Specialists, because they are just amazing. But right now I'm going to selfishly go to bed in a few minutes and enjoy some of the lost sleep Dr. Plotnick has given back to me.

But before I sign off this post, here's an update on the most important thing, Arthur's health. The doctor agrees with the diagnosis that Arthur has fatty liver disease. However, he did discover (something our old vet did not) that Arthur has a fever. He believes the fever is evidence of some kind of underlying infection, but none of the prior tests done by the hospital or our old vet were able to detect an infection.

The old vet / hospital did put him on the Enrofloxacin antibiotic because they suspected some kind of infection, but they never could tell what it was. Without doing further tests -- which he does not recommend at this time -- our new doctor cannot tell what the infection is. However, he prescribed an additional antibiotic that should fight other types of infection so, even though we don't know the exact infection, we're hopefully fighting it. We're also getting another liver med that is going to help with the bile flow (I forget the name, but I can share that later).

Dr. Plotnick told us not to retest the liver values too frequently; he said this whole process is going to take several weeks and that we shouldn't even test Arthur's blood again for three weeks. What a difference from the hospital and other vet who wanted to retest his liver values today and then possibly rush him into exploratory surgery if we didn't see improvement or if the number didn't at least hold steady. Dr. Plotnick told us that liver values may go up and down throughout treating this disease and you can't just keep looking at them every day or even every week.

Despite the fact that we don't need a new blood test for a while, we are going to bring Arthur over to MCS weekly until his next test, just because Liz and I want the staff to check his tube, take his temp, and look at his weight, just to see if there's any trouble with those things. Finally, we have a plan and next steps for Arthur that don't involve rushing him to the hospital or setting frightening deadlines like "if he doesn't get better soon, we might want to cut him open."

Oh, and on another note, Dr. Plotnick did tell us what he normally does / would have done if we had been his patients when this all started. He said he would have done a single procedure where
he did a sonogram-guided liver biopsy and inserted a feeding tube at the same time. Apparently, a sonogram-guided biopsy is a better way to get results than the myriad of aspirate biopsies and separate sonograms that were conducted by the hospital and our old vet. It also sounds like it would have been thousands of dollars cheaper.

Before I go to bed, which I must, I have one open question here. What do I say to our old vet? She actually, without prompting, called today and left me a voicemail message asking us to come in for the next liver test (the same one we're not doing for 3 weeks) and to pick up some medication (cream-based antibiotics) she had ordered last week that we no longer need. I suppose Liz or I need to call her back and tell her, but I'm not looking forward to it. I think I will just say that we've chosen a more "full service" vet and leave it at that. The thousands of dollars that she got us to spend on a haphazard patchwork of tests and emergency hospitalizations are gone and I can't see anyway to get them back, though I hope our pet insurance will reimburse us some of it. The potentially dangerous advice that she gave us by saying "as long as he eats, he'll be ok" is water under the bridge now.

There's probably no point in arguing and I guess I should thank her for detecting Arthur's illness in the first place, though I'm sure another vet would have also and would have handled it a lot better. What would you say?


Leslie Kaufman said...

Just catching up on reading these posts, Avram. You do such a great job of updating us on Arthur's condition and your quest for the vet that is right for you. So glad you were able to connect with Dr. P on more than one level. Arthur is in my thoughts constantly. He is certainly on the road to recovery!

Happy Cat Family said...

Avram, I was waiting for this post to go to bed... I am sooooo relieved for you and Arthur! It sounds like he is in excellent hands now, and boy, I am glad you have insurance! I tell you, reading cases like this makes me be sure that I am doing the right thing to have insurance too... Which bring me to the answer to your question about what to say to them...
Have you filled in the claim forms, with the vet signatures in it? Because you will need that for the insurance, and you probably will want to get that ASAP... So, I would drop by the office tomorrow, or the next day your vet is scheduled to be in to have all the paperwork completed and signed. At that time I would tell them I changed vets, after going to a second opinion.
Listen, it is your right as a pet parent to go for second opinions, and your obligation to do what's best for your pet. If they don't understand, oh well.
I would be nice though, because you do have high insurance bills, and your insurance will call them to verify diagnostic and history - you don't want them to create any problems that delay your claim.
They will also need to fax Arthur's history to the new vet - this is something usual, and needs to be done.
Do not be afraid to say you changed vets though... Just be nice about it, and know it is your right to do so...
The bottom line here is that Arthur now will get the care he deserves; and financially you want your money back from insurance.
If you already got the claim forms filled, just give them a call and inform them you changed vets, and ask them to fax Arthur's history to the new vet's office.
Good luck to you, and all the vibes and prayers to Arthur!

Marg said...

First of all, I am so excited that you got a new vet. I have been through something similar and I love my new vets. Now Arthur should start making some improvements. We are still praying for him that he will get better.
I would just nicely say to the old vet that you just wanted to get a second opinion on Arthur and so are trying another vet. Do not say who it is.
I can tell you that I was very rude and never told my old vet anything. I was so mad at the way I was treated, I didn't feel like I owed her an explanation which is not nice but I was furious.

The Island Cats said...

Oh we are so happy to hear that you have a new vet that you are totally comfortable with and is giving you the answers you need. Is this the same Dr. Plotnik that we see quoted over and over again in Cat Fancy magazine?? If so, we think Arthur is in great hands.

As far as your other vet, we understand that will be an uncomfortable conversation. But we think you should be honest and say that you were so worried about Arthur and felt you weren't getting the answers you needed and therefore sought out another vet for another opinion...and this vet is a full service vet that can do everything...what's really important here is Arthur and for him to get better...

Brian said...

We're still purring for your sweet Arthur. I think you should be honest, which is tougher for humans, and tell the former vet you were just not comfortable with the course of treatment and are going in a different direction. Or, you could have Donald Trump tell her.

Anonymous said...

Haha! I agree with Island Cats and Brian (Donald Trump, lol). You do need to be sure you have the proper signatures for your insurance before you "fire" your old vet. But if they are professionals, they will actually appreciate you telling them something like... "We needed a second opinion about all these tests and we decided to go with another vet"... don't name the new vet, I agree with that, unless your old vet asks (unlikely)... but do be sure you've taken care of the paperwork and make sure you give the old vet your new vet's FAX number (they may be able to figure out who the new vet is from this number, they probably see this FAX number a lot from disgruntled humans, lol). Anyway, I am clicking my heels today with joy that you and Liz and especially Arthur have a new "kitty doctor" who will be SO MUCH BETTER!! YAY!!! Good work Avram and Liz. You did good. (from socidoc)

Franny Syufy said...

Avram, I'm so relieved that you found Dr. P, and that you and he are working out a solid treatment program with him for Arthur's care and convalescence. You all look 100% more relaxed than the mental picture I had when we last talked. The short feeding tube must be a relief for all, as well as the "just put a bandaid" advice.

As for what to tell the old vet/hospital: Happy Cat Family's advice is excellent - I really couldn't improve over it. The only thing I could add/alter is this:

When you visit your old vet to get insurance claim papers signed, don't mention that you've changed vets unless asked about a new appointment. If asked, you can simply say "That's won't be necessary as I have a new vet." If questioned further, say something like "You will be hearing from his office soon." (Or just decline to respond. Heaven knows, they have done the same thing to you often enough.)

Then, ask Dr. P if his office can contact your former vet clinic, notify them that both Arthur and Beowulf are now in his care, and request ALL their medical records, including tests, films, etc.

Doing a happy cat dance for all of you! Now get some much-needed rest!

Love and hugs,


ABBY said...

I am so happy to learn of the positive outcome with Arthur. I cannot add too much to the already great advise give to you regarding your old vet, except to say, that you never know when you may need some assistance from them so being courteous and polite will go a much longer way than fire and brimstone. Although I am sure that was never your thought, just mine, because I would want to really give them a BIG chuck of my true opinion on the way they handled this entire situation.

The best thing is that Arthur is on the road to getting better and you and Liz are finally able to breathe and get some much needed rest.

Rachel said...

Dr. Plotnick is amazing - I would still be taking my girls to him if we had not moved to Brooklyn. Rest assured - the other vets in the office are equally talented, we went to him for 2 years.

Please give both Arthur and Beowulf a nuzzle - they are both so lucky to have a mom and a dad like you and Liz!