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?