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With Ra being largely nourished with syringe feedings, it was decided that Dr. L should see him yesterday morning for a re-check. So I took him in. Exam done. Ra was running a temp of 103!! That's pretty hot for a cat, not a good sign since he's been on that antibiotic for about a week now. Did a thorough physical exam and noted that Ra complained most incredibly when Dr. L palpated a certain part of his tummy. Dr. L also thought he felt something abnormal in that spot, so x-rays were done.
It took him FOREVER to come back with the x-ray results, largely because he was scrutinizing them so hard. He came back into the exam room and re-palpated Ra's tummy, which caused a minor uproar. Showed me the x-rays and explained his concerns--the area where Ra complained about palpation showed an area of either food pocket or a possible mass and his colon was FULL of gas--just totally bloated with it. So Ra was diagnosed with colitis and Dr. L wanted us to follow up ASAP with VCA Aurora and Dr. M. about the possible problem area in Ra's tummy--located at the juncture between his colon and his small intestine. He recommended another ultrasound of the belly at the very least, and whatever tests Dr. M thought were necessary.
Got a 1300 appointment with VCA. J went with me. A partner vet of Dr. M's gave him his first exam. We talked about a lot of stuff--how Ra's not been getting around very well as of the last week or so--weak on his feet, uncoordinated, scared to jump, etc., Dr. L's observations about Ra's tummy and his x-rays. Partner vet palpated Ra again and felt nothing unusual and asked if Ra had perhaps had a bowel movement from the time he was seen by Dr. L and before we took him into VCA--we didn't know, so we were of no help. He tested Ra's leg's range of motion and made him walk back and forth in the room. Took him a good 40 minutes! He was THOROUGH!! Then he went to talk to Dr. M to see about next steps.
About 20 minutes later Dr. M personally examined Ra, again very thorough, again many questions about Ra and his behavior and his visit with Dr. L earlier that morning. Dr. M ordered a follow-up belly ultrasound, a neurological consult, and some blood work. We got the estimate for the treatment plan and were told it would take about two hours for what was planned. We went off to eat and came back just about around the time he was done...
Ultrasound: was negative for anything abnormal in the belly and showed basically the same as the one taken back in early June. Neurology: normal. The coordination/movement problems are largely caused by bodily weakness likely from the potassium deficiency the blood work uncovered and from lack of eating enough, and same would rectify when both of those issue were taken care of.
Blood work: Came back with the aforementioned potassium deficiency, stage II renal failure, mild anemia and VERY elevated ALT liver enzyme. Ra's ALT liver enzyme was shown to be elevated last week--went from 158 back in early June to 300 last week. Yesterday they were skyrocketed up to 1390! Holy Shit!! The first thing we asked about regarding the blood work was what about fatty liver disease?!?! Dr. M reassured us that Ra's liver showed no signs of fatty liver disease on the ultrasound, that it looked normal, and that ALT was not necessarily an indicator of fatty liver disease.
That being said--Dr. M felt it was necessary to aspirate some of Ra's liver tissue in order to find out just what might be upsetting his liver. So J approved that procedure and we waited in the very noisy and busy waiting area while that was being done. We should get the results for that test as early as Thursday night or Friday morning.
Dr. M took Ra off the antibiotic (good, as it wasn't seeming to be of much benefit anyway). He increased the prednisone for his PM dose to 5mg from 2.5mg. Put him back on potassium supplements; half a 468mg pill every twelve hours. Rest of med regimen remains the same. Encouraged us to really try to get Ra to eat the proper hypoallergenic diet, but if he wouldn't, obviously any food he'll eat is the way to go. So we picked up ten cans of hypoallergenic Royal Canin to syringe feed vs. the really rich and not hypoallergenic A/D crisis food. See Dr. L in 5-7 business days for the lab results and further treatment.
So, yeah. Ra and J and I had ourselves a day yesterday! Poor Ra--his belly fur had just sorta started growing back from the last time they shaved it for an ultrasound and they had to shave it again yesterday! :/ Tried the new canned food this morning and that went over like a brick--what a mess--he seems to prefer the A/D over the hypoallergenic; at least he doesn't try to spit out the A/D whereas he was trying to spit out the hypoallergenic this morning. Hopefully he'll get used to the new food, as it's definitely better for his guts...Sigh, let's hope!!
It took him FOREVER to come back with the x-ray results, largely because he was scrutinizing them so hard. He came back into the exam room and re-palpated Ra's tummy, which caused a minor uproar. Showed me the x-rays and explained his concerns--the area where Ra complained about palpation showed an area of either food pocket or a possible mass and his colon was FULL of gas--just totally bloated with it. So Ra was diagnosed with colitis and Dr. L wanted us to follow up ASAP with VCA Aurora and Dr. M. about the possible problem area in Ra's tummy--located at the juncture between his colon and his small intestine. He recommended another ultrasound of the belly at the very least, and whatever tests Dr. M thought were necessary.
Got a 1300 appointment with VCA. J went with me. A partner vet of Dr. M's gave him his first exam. We talked about a lot of stuff--how Ra's not been getting around very well as of the last week or so--weak on his feet, uncoordinated, scared to jump, etc., Dr. L's observations about Ra's tummy and his x-rays. Partner vet palpated Ra again and felt nothing unusual and asked if Ra had perhaps had a bowel movement from the time he was seen by Dr. L and before we took him into VCA--we didn't know, so we were of no help. He tested Ra's leg's range of motion and made him walk back and forth in the room. Took him a good 40 minutes! He was THOROUGH!! Then he went to talk to Dr. M to see about next steps.
About 20 minutes later Dr. M personally examined Ra, again very thorough, again many questions about Ra and his behavior and his visit with Dr. L earlier that morning. Dr. M ordered a follow-up belly ultrasound, a neurological consult, and some blood work. We got the estimate for the treatment plan and were told it would take about two hours for what was planned. We went off to eat and came back just about around the time he was done...
Ultrasound: was negative for anything abnormal in the belly and showed basically the same as the one taken back in early June. Neurology: normal. The coordination/movement problems are largely caused by bodily weakness likely from the potassium deficiency the blood work uncovered and from lack of eating enough, and same would rectify when both of those issue were taken care of.
Blood work: Came back with the aforementioned potassium deficiency, stage II renal failure, mild anemia and VERY elevated ALT liver enzyme. Ra's ALT liver enzyme was shown to be elevated last week--went from 158 back in early June to 300 last week. Yesterday they were skyrocketed up to 1390! Holy Shit!! The first thing we asked about regarding the blood work was what about fatty liver disease?!?! Dr. M reassured us that Ra's liver showed no signs of fatty liver disease on the ultrasound, that it looked normal, and that ALT was not necessarily an indicator of fatty liver disease.
That being said--Dr. M felt it was necessary to aspirate some of Ra's liver tissue in order to find out just what might be upsetting his liver. So J approved that procedure and we waited in the very noisy and busy waiting area while that was being done. We should get the results for that test as early as Thursday night or Friday morning.
Dr. M took Ra off the antibiotic (good, as it wasn't seeming to be of much benefit anyway). He increased the prednisone for his PM dose to 5mg from 2.5mg. Put him back on potassium supplements; half a 468mg pill every twelve hours. Rest of med regimen remains the same. Encouraged us to really try to get Ra to eat the proper hypoallergenic diet, but if he wouldn't, obviously any food he'll eat is the way to go. So we picked up ten cans of hypoallergenic Royal Canin to syringe feed vs. the really rich and not hypoallergenic A/D crisis food. See Dr. L in 5-7 business days for the lab results and further treatment.
So, yeah. Ra and J and I had ourselves a day yesterday! Poor Ra--his belly fur had just sorta started growing back from the last time they shaved it for an ultrasound and they had to shave it again yesterday! :/ Tried the new canned food this morning and that went over like a brick--what a mess--he seems to prefer the A/D over the hypoallergenic; at least he doesn't try to spit out the A/D whereas he was trying to spit out the hypoallergenic this morning. Hopefully he'll get used to the new food, as it's definitely better for his guts...Sigh, let's hope!!
