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Cat Forum / Cat Anecdotes / January 2005Sam Update #2
I just got off the phone with the vet who initially treated Sam. She said that every time they tried to extend the time between Terbutaline injections past 4 hours he suffers another episode and has to go back on oxygen. She suggested that he stay another night with them where they can treat him with injections and oxygen. This is an emergency only vet clinic and they aren't open and don't have personnel in house during "normal business hours" so tomorrow morning I'll have to pick him up by 8 am and possibly transfer him to our regular vet. X-rays show that he had a collapsed lung lobe and extensive bronchial activity. Incidental findings include a slightly enlarged heart which she doesn't think is part of what is happening now, possibly heartworms (previous or active) since he was a stray for the first 6 years of his life. He has evidence of previous trauma including a poorly healed broken pelvis which has left an abnormally narrow pelvic passage. She told me he could have trouble defecating which could lead to constipation. Do you remember in September when I took him to the vet before our vacation because of a problem that looked like blockage or constipation? Now I know what that problem was about. He also has had a previously, untreated fracture of the sternum and a broken rib. He is slightly dehydrated and constipated so she's given him something to help with that. At this point she can't rule out a secondary bacterial disease so she is going to prescribe an antibiotic that will treat the bacteria or any possible mycoplasm. She said I'd give it to him daily for 5 days and then every other day. She's also going to try to find a pharmacy that carries inhalers that she can prescribe. She said I would buy an infant mask and use that if he needs to be treated. We're going to go visit Sam in a little while. I laid down earlier because of a headache and I listened to DH tell each cat how sick Sam was and that they needed to purr for him. He's as worried as I am so we're going to go visit our buddy. I thought we were going to have a better 2005 than 2004. <sigh> I'll title this chapter "How to spend $1,000 in 24 hours". But what else can you do? Again, thank you all for your purrs. Sam's a very sick kitty and I'm sure he appreciates them as much as I do. Julie ps: I learned that the orange and white kitty was the victim of being hit by a car. It suffered severe head trauma and made the trip to the Bridge last night. Many, many purrs on the way. - Cindy >I just got off the phone with the vet who initially treated Sam. She said >that every time they tried to extend the time between Terbutaline [quoted text clipped - 40 lines] > by a car. It suffered severe head trauma and made the trip to the Bridge > last night. > I just got off the phone with the vet who initially treated Sam. She > said that every time they tried to extend the time between Terbutaline [quoted text clipped - 41 lines] > hit by a car. It suffered severe head trauma and made the trip to the > Bridge last night. Poor Sam!! I sure hope that you can get this under control. He is truly a sick little baby. Many many purrs. Just catching up. Megapurrs coming for Sam's speedy recovery. Tweed >I just got off the phone with the vet who initially treated Sam. She said >that every time they tried to extend the time between Terbutaline [quoted text clipped - 40 lines] > by a car. It suffered severe head trauma and made the trip to the Bridge > last night. > Just catching up. Megapurrs coming for Sam's speedy recovery. > [quoted text clipped - 44 lines] >>by a car. It suffered severe head trauma and made the trip to the Bridge >>last night. Purrs and purrayers for Sam to get well soon. Also purrs for the orange and white kitty as he or she traverses the path to the bridge. > Just catching up. Megapurrs coming for Sam's speedy recovery. > > Tweed Same here. Lots of purrs and healing thoughts for Sam. Also lots of RB trip purrs for the little orange and white kitty from us all. Pam, Rob, and the Fayetteville five + Calvin and Speedy the d-thing >> Just catching up. Megapurrs coming for Sam's speedy recovery. >> [quoted text clipped - 4 lines] > > Pam, Rob, and the Fayetteville five + Calvin and Speedy the d-thing Thank you Pam, Rob, Christina and everyone else here. We visited with Sam this evening for about an hour and he looks a lot better. Of course, when we last saw him he could barely breath and couldn't even lift his head. He's still getting the brochodialator every four hours but its obvious that he's feeling better. The vet spent a lot of time with us tonight and showed us all the X-rays that had been taken including one within a few hours of his initial exam and another taken today. There are obvious improvements. Howard, thank you for your response. He isn't being give corticosteriods now because he was given two doses within the last 5 weeks with a dose of a long acting steroid being administered on January 4th. They're reluctant to give him any more at this time. I believe they are giving him Albuterol now. At least that is what I've been given a prescription to fill. I'm to get an inhaler with infant spacer and small face mask. If he has an episode tomorrow he can have two puffs. Ummmm, can I admit that I am terrified of what might happen when I bring him home tomorrow. I'm not sure if my regular vet is open tomorrow. They normally open at 8 am so I'll find out right after I pick up Sam. If they aren't open I'll find someone near me that is open just in case I need help. Then on Tuesday, the vet recommended that I arrange to take him to the vet for the day (I'm off tomorrow but not Tuesday) (For those of you not in the US, tomorrow is Martin Luther King Day which is a federal holiday and one recognized by some non-federal employers but not all). I also have a prescription for Zithromax (azithromycin) suspension 100 mg/5 ml. He'll get 1.5 ml once daily for 5 days and then every 48 hours for the next 10 - 14 days. Hopefully we're over the worst of this and Marina, I'm hoping that Sam is as response as Nikki is to medication and we'll probably call on you for advice from time to time. I just keep thinking about how fortunate we were with timing. I wonder what would have happened if this had occurred when we were at work or even when we were in bed asleep. I'm rethinking our out of town protocol. We have had someone check on the cats every other day when we're out of town but I now understand how quickly a cat can get into life threatening situations. But then again, if someone came in once a day the timing could still be off. Fortunately I don't have to go anywhere until the middle of March. Julie and Sam [[I'm rethinking our out of town protocol. We have had someone check on the cats every other day when we're out of town but I now understand how quickly a cat can get into life threatening situations. But then again, if someone came in once a day the timing could still be off. Fortunately I don't have to go anywhere until the middle of March.]] When Melody was being treated for lymphoma, I checked her into the cat hospital when I had to go away for a weekend. Had she been healthy, it would have been OK to let her stay at home. But she wasn't only on daily meds (prednisolone), she was at risk of taking an abrupt turn for the worse. Leaving her at home unattended, or even having someone check in on her once per day, was not an option. So I boarded her at the vet's. It was worth the peace of mind that someone qualified was keeping an eye on her. That might be a viable option for Sam, if you have to be away from home for more than a day. Donna In article <7fab11a7be958e602ae583b48e8c44e1@localhost.talkaboutpets.com>, "Gabey8" <gabey8-@-aol-dot-com (formerly dgabriel-at-netaxs-dot-com)> wrote: > [[I'm > rethinking our out of town protocol. We have had someone check on the [quoted text clipped - 16 lines] > That might be a viable option for Sam, if you have to be away from home > for more than a day. I don't know if it's available in your area, but at least one of the pet sitter services (Capitol Pet Sitters) in the DC area will do pills and some injections, and can even be arranged to stay overnight with the furkid. Not cheap, but may be worth the lower stress. > >> Just catching up. Megapurrs coming for Sam's speedy recovery. > >> [quoted text clipped - 19 lines] > weeks with a dose of a long acting steroid being administered on January > 4th. They're reluctant to give him any more at this time. Then that makes sense. Again, I can speak only from human medicine -- if he could get an inhaled corticosteroid, they aren't absorbed significantly and would give anti-inflammatory effects in addition to the albuterol. Unfortunately, the inhaled corticosteroids of which I'm aware are powders, so they can't be mixed with liquid albuterol. >I believe > they are giving him Albuterol now. At least that is what I've been > given a prescription to fill. I'm to get an inhaler with infant spacer > and small face mask. If he has an episode tomorrow he can have two > puffs. Do check how often that can be repeated. At least in humans, albuterol is relatively short acting (2-6 hours, with peak in 30 minutes to 2 hours). >Ummmm, can I admit that I am terrified of what might happen when > I bring him home tomorrow. I'm not sure if my regular vet is open [quoted text clipped - 9 lines] > mg/5 ml. He'll get 1.5 ml once daily for 5 days and then every 48 hours > for the next 10 - 14 days. That's a good drug for the purpose. > I just got off the phone with the vet who initially treated Sam. She > said that every time they tried to extend the time between Terbutaline > injections past 4 hours he suffers another episode and has to go back on > oxygen. She suggested that he stay another night with them where they > can treat him with injections and oxygen. Hugs and purrs! I'm extrapolating from human medicine here, but I'm puzzled why they aren't giving him a corticosteroid as well. Terbutaline works by actively expanding brochial vessels, as do human short-acting inhalers like albuterol. Without more detail of the X-rays, it's hard to tell if it's upper or lower airway disease. If it were upper airway disease (e.g., asthma), there would be no question of the corticosteroids. Asthma is a disease of inflammation, and the way to control it for any length of time is to stop the inflammation. Terbutaline is treating the results of inflammation. If the inflammation is due to a bacterial infection, then antibiotics are indicated. Lower airway disease, such as chronic obstructive pulmonary disease in humans as well as certain pneumonias, is more of a treatment challenge. Still, bronchodilators like terbutaline, as well as corticosteroids, certainly should be considered. Any infection should be treated. There are additional drugs that can help humans here, such as ipratropium bromide inhalers. Atropine might give some relief by injection; it dries secretions. Depending on the extent of the lung collapse, human physicians would, at some point, consider inserting a tube through the chest wall, connected to suction, to reinflate the lung. Lungs expand because the pressure in the chest cavity is less than the atmospheric pressure. >This is an emergency only vet > clinic and they aren't open and don't have personnel in house during [quoted text clipped - 18 lines] > going to prescribe an antibiotic that will treat the bacteria or any > possible mycoplasm. Probably azithromycin (Zithromax) or clarithromycin (Biaxin). Excellent for respiratory disease. > She said I'd give it to him daily for 5 days and > then every other day. She's also going to try to find a pharmacy that > carries inhalers that she can prescribe. She said I would buy an infant > mask and use that if he needs to be treated. I'm not going to start learning about pharmacology until February, but I have to agree with Howard's recommendation for hte collapsed lung. Of course he's the doctor, and I'm not. :) Kristi > I'm not going to start learning about pharmacology until February, but > I have to agree with Howard's recommendation for hte collapsed lung. > Of course he's the doctor, and I'm not. :) > > Kristi Kristi, Sam's lung seems to be in better condition. I'm not expert on what I'm talking about and you may understand better than I do, but on his first x-rays there was a lot of white around the black of his lungs and the lung that had collapsed was almost all white. On the x-ray taken today there was a lot less white. The vet explained that the white was fluids around his lungs and that had responded to the medication. I have a renewed admiration for you and anyone else working in the vet field. I've spent about 5 hours in the past 24 hours in this emergency clinic and I've seen some heartbreak going in and out the door. I wouldn't want to have to deal with that on a daily basis. I don't doubt that there is a lot of personal satisfaction as well, but whew, I couldn't stand it. Julie > > I'm not going to start learning about pharmacology until February, but > > I have to agree with Howard's recommendation for hte collapsed lung. [quoted text clipped - 10 lines] > there was a lot less white. The vet explained that the white was fluids > around his lungs and that had responded to the medication. OK, that makes sense. There are several reasons a lung, or part of it, can collapse. An air leak into the cavity surrounding the lung is one, but fluids are another. In this case, it's very logical the fluids come from the infection. I'm glad that he's responding without a chest tube. I have had them and they are definitely not fun, but I was variously sedated enough, or aware enough, not to move around. I'd imagine a cat would have to be restrained. It might help you visualize what was happening on the X-ray to know that chest tubes are placed at different levels depending on whether the problem is air or liquid. If a human has an air leak, the tube goes in high on the chest, since air goes up. For fluids or blood, it goes much lower in the chest, to help gravity drain. The lungs are in a sac that has a lower pressure than outside air, so air coming in with breathing tends to inflate them. Breathing itself comes when the diaphragm muscle below the lungs expands, making the pressure even lower, and contracts, driving the air out with higher pressure. > I have a renewed admiration for you and anyone else working in the vet > field. I've spent about 5 hours in the past 24 hours in this emergency [quoted text clipped - 4 lines] > > Julie >> > I'm not going to start learning about pharmacology until February, but >> > I have to agree with Howard's recommendation for hte collapsed lung. [quoted text clipped - 18 lines] >I'm glad that he's responding without a chest tube. I have had them and >they are definitely not fun, but I was variously sedated enough, or >aware enough, not to move around. I'd imagine a cat would have to be >restrained. > >It might help you visualize what was happening on the X-ray to know that >chest tubes are placed at different levels depending on whether the >problem is air or liquid. If a human has an air leak, the tube goes in >high on the chest, since air goes up. For fluids or blood, it goes much >lower in the chest, to help gravity drain. > >The lungs are in a sac that has a lower pressure than outside air, so >air coming in with breathing tends to inflate them. Breathing itself >comes when the diaphragm muscle below the lungs expands, making the >pressure even lower, and contracts, driving the air out with higher >pressure. Speaking from first-hand experience, lung collapse isn't fun. I had some minor surgery in 1989, outpatient but done under general anaesthesia, and, to everyone's surprise, one of my lungs partially collapsed. My lips and fingernail beds were blue when I was sent home from the hospital. It took me about a week to get back full lung function. That hasn't happened again since then, despite having had one other surgery involving general anaesthesia, and (as far as I know) the doctors never decided what had triggered it.  SignatureJohn F. Eldredge -- john@jfeldredge.com PGP key available from http://pgp.mit.edu "Reserve your right to think, for even to think wrongly is better than not to think at all." -- Hypatia of Alexandria > Speaking from first-hand experience, lung collapse isn't fun. I had > some minor surgery in 1989, outpatient but done under general [quoted text clipped - 4 lines] > had one other surgery involving general anaesthesia, and (as far as I > know) the doctors never decided what had triggered it. This is one of the reasons an anesthesiologist colleague once commented, "Anyone can put a patient to sleep. Getting them to wake up is the challenge." Surgical anesthesiology is one of those things with hours of boredom punctuated by moments of sheer terror. Properly managed lung collapse, without major underlying disease, isn't a crisis. Indeed, deliberate lung collapse (obviously one at a time) was used to "rest" tubercular lungs, and I vaguely remember a recent article suggesting the technique may be coming back in updated form. Still, it's not fun. When I've had chest tubes inserted, I was still under general anesthesia after coronary artery bypass. Some surgeons believe in giving you a local anesthetic when removing them, while others don't. Mine didn't, and while it wasn't the most painful thing I ever experienced, let me have a local next time! While the tube isn't uncomfortable while it's in, it can't move around safely, so I'd imagine whenever they are used in cats, the furry one needs heavy sedation and/or restraint. > I'm not going to start learning about pharmacology until February, but > I have to agree with Howard's recommendation for hte collapsed lung. > Of course he's the doctor, and I'm not. :) > > Kristi To be accurate, I'm not a doctor. I just simulate them in software. :-) If you haven't gathered it, pharmacology is one of my passions. I got my first textbook for my tenth birthday. Lots of purrs for Sam. Winnie >I just got off the phone with the vet who initially treated Sam. She said >that every time they tried to extend the time between Terbutaline [quoted text clipped - 40 lines] > by a car. It suffered severe head trauma and made the trip to the Bridge > last night. > I just got off the phone with the vet who initially treated Sam. She > said that every time they tried to extend the time between Terbutaline [quoted text clipped - 41 lines] > hit by a car. It suffered severe head trauma and made the trip to the > Bridge last night. Purring for Sam and the orange and white kitty's trip to the Bridge. MLB Keeping up the prayers for Sam's quick improvement and speedy recovery. God bless Sam for having come through so many things in his life already! He sure is lucky to have found a Meowmy and a Paw to love him! And also for the orange-and-white kitty's peaceful start on his/her journey to the Bridge, as well as for the kitty's human parent(s) who are grieving their cat's passing. Sigh. Donna Purrs coming your way from Texas... Nina in Texas, servant to: Snickelfritz (RB), Pixel (RB 12/03), Rusty (RB 9/9/04), Seth (RB 12/27/04), Skeeter, Kyle, Jake, and Fred SignatureProfessional proofreading doesn’t cost – it pays! ninaproofs@earthlink.net www.ninaproofs.com > Again, thank you all for your purrs. Sam's a very sick kitty and I'm > sure he appreciates them as much as I do. [quoted text clipped - 4 lines] > hit by a car. It suffered severe head trauma and made the trip to the > Bridge last night. Many more purrs for Sam, and also purrs for the little ginger and white kitty who went to the bridge. :( Helen M > I just got off the phone with the vet who initially treated Sam. She > said that every time they tried to extend the time between Terbutaline [quoted text clipped - 4 lines] > house during "normal business hours" so tomorrow morning I'll have to > pick him up by 8 am and possibly transfer him to our regular vet. Persia has staked out my spot on the couch and is purring like mad for Sam. I'm very sorry about the orange and white kitty... lighting a candle for him. Jill >I just got off the phone with the vet who initially treated Sam. She said >that every time they tried to extend the time between Terbutaline [quoted text clipped - 40 lines] > by a car. It suffered severe head trauma and made the trip to the Bridge > last night. Wow, Julie. It doesn't rain but what it pours. Purring double-time for Sam's recovery. Sounds like the poor guy's been through a bunch - as have you. Sam ((((((((Julie)))))))) -- our best purrs are coming for Sam and for you and DH. Sorry about the pocketbook, too. We'll be sending strong recovery purrs for Sam. Also, purrs to accompany the poor little orange and white kitty's trip to the RB. Christine > I just got off the phone with the vet who initially treated Sam. She > said that every time they tried to extend the time between Terbutaline [quoted text clipped - 41 lines] > hit by a car. It suffered severe head trauma and made the trip to the > Bridge last night. > ((((((((Julie)))))))) -- our best purrs are coming for Sam and for you and > DH. Sorry about the pocketbook, too. We'll be sending strong recovery > purrs for Sam. Also, purrs to accompany the poor little orange and white > kitty's trip to the RB. > Christine Thanks Christine for the purrs. The pocketbook will be all right. DH and I decided, while waiting to see Sam tonight, that we'd just give up our symphony tickets this year. Sam's purrs are much more pleasing to the ear than the Atlanta Symphony anyhow. Julie and Sam >I just got off the phone with the vet who initially treated Sam. She >said that every time they tried to extend the time between Terbutaline [quoted text clipped - 4 lines] >"normal business hours" so tomorrow morning I'll have to pick him up by >8 am and possibly transfer him to our regular vet. Purrs for the trip to the Bridge for the orange and white kitty. With all of Sam's physical traumas, he was lucky to be alive to find you. Now it looks like he is going to need serious continual care. How great it is that he found such caring slaves. I pray that he becomes stable very soon. Purrs, -- CATherine > I just got off the phone with the vet who initially treated Sam. Poor Sam, he's really been through the wars. We're still purring hard for him, and for his worried parents. Purrs for the orange-and-white cat and its slaves, as well. You're right, this was supposed to be a good year. Someone messed up. SignatureMarina, Frank and Nikki marina (dot) kurten (at) pp (dot) inet (dot) fi Pics at http://uk.pg.photos.yahoo.com/ph/frankiennikki/ and http://community.webshots.com/user/frankiennikki > I just got off the phone with the vet who initially treated Sam. She > said that every time they tried to extend the time between Terbutaline > injections past 4 hours he suffers another episode and has to go back on > oxygen. (big snip) Awww, poor Sam! It sounds like he'd had an awfully hard life before he found you. We are sending mighty purrs for his recovery, and nerve-soothing purrs to you and Rusty. I hope that by this time tomorrow everyone is feeling *much* better. We will light a candle for the orange and white kitty, and send purrs to those who will miss him. ------ Krista >I just got off the phone with the vet who initially treated Sam. <snip> Still purring awaay here for Sam. It really sounds like he had a tough time earlier in his life. Also lighting a candle for the other patient's jouurney to the Bridge and his/her family SignatureSteve Touchstone, faithful servant of Sammy and Little Bit stouchst@JUNKsirinet.net [remove Junk for email] Home Page: http://www.sirinet.net/~stouchst/index.html Cat Pix: http://www.sirinet.net/~stouchst/animals.html Wilson and I are still sending huge healing Purrs for Sam's recovery and well being Jean.P. and Wilson. > >I just got off the phone with the vet who initially treated Sam. > [quoted text clipped - 12 lines] > Home Page: http://www.sirinet.net/~stouchst/index.html > Cat Pix: http://www.sirinet.net/~stouchst/animals.html I'm sorry, Julie; I haven't been able to catch up with the NG the last few days and just read this. Purrs for Sam, and for you. > I just got off the phone with the vet who initially treated Sam. She said > that every time they tried to extend the time between Terbutaline injections [quoted text clipped - 40 lines] > by a car. It suffered severe head trauma and made the trip to the Bridge > last night. Signaturemonique, roommate of Oscar the (female) grouch ~~~~~~~~~~~~~~~~~~ Eros was adopted! Eros has a home now! *cheer!* <snip> > Again, thank you all for your purrs. Sam's a very sick kitty and I'm > sure he appreciates them as much as I do. [quoted text clipped - 4 lines] > hit by a car. It suffered severe head trauma and made the trip to the > Bridge last night. Continuing purrs for Sam. He must have had an awful life before he owned you. I will light a candle for the orange and white kitty. SignatureAdrian (Owned by Snoopy & Bagheera) A house is not a home, without a cat. |
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