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Cat Forum / Health and Behavior / June 2004My Siamese Has IBD (Or So Was Told)
I need an opinion please ... 2nd, 3rd, it doesn't matter. My mind is open to all possibilities and explanations. I have a 12-year old Tonkinese whom I had boarded 2 weeks ago when my family and I went out of town. I left him with a reputable vet in my area on a Friday and picked him up the next Monday. During this time, I also left instructions to go ahead with bloodwork because I had also wanted to go ahead with his dental cleaning at the same time. But time was short, so the vet simply ordered labwork and a future dental appointment was made instead. While I was gone though, the vet left me several messages saying she found, upon exam, a right ear infection that required ear flushing. I gave my consent. I was told the flushing was done Monday morning (I picked up Ming, my Siamese, Monday afternoon). When we got home, I took him out of the carrier. To my shock, he was falling all over the place. He had a staggering gait and at the very least, couldn't leap in and out of the sofa. No head tilt; no rocking eye movement though, but on his right eye, the inner lid was showing half-way consistently; very glassy and drowsy appearance. I put him on the sofa, but he was not comfortable. Intermittently, he would let out a howl (very loud; uncharacteristic of this cat). Then he vomitted at one point. For the rest of the evening, he would try to jump out of the sofa, fall, get up and stagger, find a hiding place, and howl. To say the least, he would not eat. After vomitting, he slept peacefully the rest of the night on the sofa (not his usual sleeping place by the way). He had a medication to be taken once a day: tresaderm, which I applied to his right ear the following morning (Tuesday). When I placed that in his right ear, he shook his head and then vomitted right after. I called the vet who told me to withhold the tresaderm and she replaced it with PGN which I picked up from her office. I continued to monitor his appetite. No signs, but no more vomitting episodes for the rest of the day and the cat slept all throughout. Come Wednesday morning, I applied the PGN. Again he vomitted. So I then called the vet. I also told her that Ming still hasn't eaten to say the least in that 48-hour period. She ordered him back. But during the car ride, he started foaming at the mouth. Vet gave him fluids SQ, but was concerned about the foaming. It did appear that some was also coming out of his nose and made a notation that it could be respiratory. We agreed at that point to bring him twice a day starting Thursday for fluids SQ. A new antibiotic was given (again) to replace PGN ... Baytril. Thursday morning, cat still hasn't eaten. I popped a tab of Baytril into his mouth. 15 minutes later, he vomitted again. I called the vet again. On the car ride, Ming was foaming in the mouth again. This time, she hospitalized Ming. I also picked up for her at the drugstore, a couple of prescriptions for Ming -- Carafate and Metoclopramide. She also said she was going to give him a pre-surg medication to stop the foaming. She ordered ultrasound and x-ray to rule out anything respiratory. Friday, sonogram results revealed a thickened stomach; so thick that food can't pass through, according to the vet. Vet also mentioned ulcers. I visited Ming (needless to say, broke my heart to see how lethargic he was). He preferred sleeping inside his potty box. The doctor placed an extra aluminum tray for him to sleep in. Throughout the weekend, Ming was on fluids IV. Besides the 2 drugs I mentioned, all of the previous antibiotics were stopped; but Flagyl was used instead. Sunday night, the vet told me that she has started Ming on Prednisone. My kids visited Ming Saturday. He still preferred sleeping inside the potty. I took Ming home (5/3) Monday afternoon. His vet explained to me about his gait and what she reiterated would go away in time; that the sight is more disturbing to us people than it is to Ming. I asked her what in her opinion did Ming really have and she said inflammatory bowel. I raised the possibility of the ulcers found during ultrasound being due from stress secondary to an equilibrium from the ear flushing; she believed the two were unrelated. She explained that ulcers don't develop overnight; they take time. We discussed the possibility of him having eaten a plant to have caused the ulcers. My cat is an indoor cat. He did enjoy playing with (and chewing on) tall long grasses that are sometimes included with the flowers I buy and take home. Other than that, there is no plant in this house -- I really don't have any indoors; they're fake because I'm the type who forgets to water my plants :-( $1500+ later, my cat remains unappetent, still nauseated and looking emaciated. I also signed a release statement indicating that my cat is not 100% better. At home, after the car ride from the vet, the first thing Ming did was stagger to his potty box where he promptly threw up. I called the vet to tell her this. She upped his Prednisone to twice a day. Everyday that I've had him back, I keep offering him food and water. The vet also discussed with me that it's ok to give him anything he wants (with the exception of milk) just to get him starting to eat. He would poke his head into his bowl, paw at his food, go through the motions of licking and picking up, but he wouldn't bite. It's almost as if he's scared to eat! I told the doctor this who is now afraid that it's now psychological. I won't hesitate to tell anyone that my husband has been flipping over these costs. He had just had a car accident last week Monday night as well. He came out unscathed from the accident (a 4-car pile up), but his car has been totalled. I'm a wreck between the money worries and Ming. I'm at a point where my cat is not on the threshold of death, yet does not have the will to eat. I have discussed all these concerns with the vet. I don't want to be in the position where I have to allow him to die because I can't afford it. I do have a $350 balance that the vet and I agreed to pay off next month. The vet has also said in terms that if surgery was going to be needed for Ming, she could justify euthanasia for my sake because of the surgical cost (of over $1K), but until then she really would hate not to try all means possible, medication-wise. Costs aside, I am now at a point where I'm wondering how much of Ming's predicament is primary or secondary. By admission, Ming's vet did say that she seemed to have opened a "pandora's box" when she flushed his ears. I asked if his ear drum has any tear and she said she couldn't find any, though some dirt could've attached to tear away a "pin-dot" size during the flushing. Ming is still unstable when he walks and does fall when he jumps up and out of the bed or sofa. The vet has reiterated that Ming's gastric problem and ear problem are unrelated. Yesterday after Ming came out of his potty, he sat down beside me and proceeded to clean himself (just like the good 'ol days). I was thrilled to see that. But as soon as he tilted his head up, he vomitted again. Can anyone at this point tell me that his vomitting episodes are not related to an equilibrium problem? Sonogram, according to the vet, did show ulcerations. And ulcerations "don't appear overnight". All my husband knows and calls as he sees it is this: we took a healthy, happy cat to the vet on a Friday a week-and-a-half ago. Today, my cat is so ill that the question of euthanasia is what we have been talking about most lately. I have cried and cried; and worried some more ... over everything; coming to a point where I'm hoping (praying to God) that my care for this pet shouldn't be put into test over affordability of treatment costs. But there are priorities that I cannot hugely discount. Above all, I have to give weight to my husband's concern to maintain our lives within our means. We are by far, the most humane people possible, but we are also not rich people. I just need to know if my cat will ever eat. I've withheld Prenisone the whole day yesterday as soon as Ming walked away from me to hide underneath the bed after he vomitted. He seems to "want" to eat. He looks eager to eat. But that's all he does: poke his nose into the bowl, lick, bite, but does not take the food in to eat. Today I have an appointment with the vet. She isn't pleased I withheld the prednisone, but I'm telling 'ya ... this cat's frame of mind is all I care for at this point. He hasn't thrown up yet anyway after he last vomitted yesterday morning. And yes, he did take a bite out of a small piece of bacon last night; just the size of my pinky nail, but he kept it down and hasn't vomitted since. This without prednisone. I'm so afraid to pop a pill into his mouth and be afraid to eat anything anymore, not after he took a bite out of the bacon. But that's it. And that was yesterday morning. I've had him back since Monday and it's now Thursday. This cat, being a Siamese, with his own idiosyncrasies, minus the prednisone for 24 hours now ... how much of his condition is truly IBD? I apologize for being distraught ... but I thank this board though so much in advance. ~ Zaida~ > I need an opinion please ... 2nd, 3rd, it doesn't matter. My mind is open > to all possibilities and explanations. [quoted text clipped - 25 lines] > > ~ Zaida~ Zaida, This sounds terrible! I don't have any knowledge of all of this, but the one thing I would suggest is a second opinion. ASAP! I know you said this is "a reputable vet," but it is also obvious that she really doesn't know what is wrong. Is there a university veterinary school within driving distance? Is so, I would suggest that you ask for a referral there, and as soon as possible. Call and ask them for an estimate of costs -- but when I took Duffy to the Texas A&M College of Veterinary Medicine, I was surprised to learn how low the losts were and how high the quality of care was (knowledge, facilities, *and* a caring attitude). Costs will vary, of course, depending on procedures done. Take as many records as possible with you, and ask your vet to email a detailed report to the veterinary college in advance of your visit. To me, one of the worst things about this whole episode is that Ming was sent home in this condition. How could they possibly board a cat that started out healthy, clean its ears, then send him home in this condition -- and not even *notice* the dramatic deterioration in his health??? That, alone, would cause me to consult another vet. One final suggestion of something to look for is this: check all your artificial plants (not just real ones) to see if Ming has been chewing on them. Duffy had one instance where he suddenly started vomiting -- many, many times in a single day, whereas he seldom throws up. I found that he was chewing on an a couple of artificial plants (especially an artificial palm with "grassy" foliage). The vet prescribed some medication for nausea, I got rid of the artificial plants, and Duffy was back to normal the next day. I realize that this is unlikely to be the cause of anything so severe as Ming's problems, but it could exascerbate it -- especially if he ate something that is caught in his intestines. Likewise, has he been checked for cord, string, ribbon, rubber bands, etc. he might not be able to eliminate? MaryL (take out the litter to reply) Photos of Duffy and Holly: >'o'< http://tinyurl.com/8y54 (Introducing Duffy to Holly) http://tinyurl.com/8y56 (Duffy and Holly "settle in") >> I need an opinion please ... 2nd, 3rd, it doesn't matter. My mind is open >> to all possibilities and explanations. [quoted text clipped - 30 lines] >> peacefully the rest of the night on the sofa (not his usual sleeping place >> by the way). Hi Zaida, Did you immediately call the vet back and tell him what was going on? If they sedated him, this sounds like it could be that he was still recovering from whatever drug they gave him, and unfortunately it sounds like something like Ketamine (I personally have the vet use Isoflurane, an inhalant gas, on my cats). However, if this wasn't caused by sedation, I wonder if the flushing got into his ear canal. Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecat.com/articles/claws.htm > >> I need an opinion please ... 2nd, 3rd, it doesn't matter. My mind is open > >> to all possibilities and explanations. [quoted text clipped - 45 lines] > http://www.geocities.com/rawfeeders/ForCatsOnly.html > Declawing Info: http://www.wholecat.com/articles/claws.htm Hi Lauren, You are actually replying to my comments, and I snipped a lot of the OP's message. Are you able to see the original message? If not, I could include it here because it provided a lot of information that I deleted (in an attempt to save space and bandwidth for other users). MaryL This is a classic case of "get a second opinion." If it were me (and please note that I have been deemed nuts by many), I would withdraw all the medications at this point, because he's taken so much stuff there's no way to tell what is causing his symptoms. Give him a day or two's rest (with water available, of course), then offer him some warm chicken broth and see if he takes it. I think your vet's diagnosis of IBD is baloney, because IBD doesn't come on suddenly and it doesn't cause the symptoms you're describing. Plus I've never heard of a cat getting ulcers. Second opinion. Really. Do it for Ming. -- M9 > I need an opinion please ... 2nd, 3rd, it doesn't matter. My mind is open > to all possibilities and explanations. [quoted text clipped - 149 lines] > > ~ Zaida~ Hi there, Minerva. And my many thanks to everyone who wrote to post and e-mail me privately. I've given Ming chicken broth, baby food, bland, boiled, anything that I know would be acceptably palatable to his appetite. And yes, I've withheld ALL medications, as a matter of fact, last Tuesday. Why? Because this cat has had too much. He hid from me after he vomitted Tuesday. I didn't want him to feel that I'm going to punish him by pushing anything down his throat. I'm afraid at this point, To boot, he's Siamese and he's extremely sensitive to all stimulus. I will tell you though that I sent him yesterday for fluids SQ because he needs it (it's the only thing keeping him alive) ... and I've advocated forced feeding, but this vet has adamantly said NO to forced feeding because seemingly, Ming's inability/reluctance is psychogenic in nature now. In Nursing, I'd call that "ineffective coping" ... so I did what I know best. But I also got reprimanded BIG TIME for holding off his Prednisone, a steroid to suppress bowel swelling and at the same time, stimulate appetite. She said no amount of instinct will get him to eat or drink. So far, she's right on that point because this cat will NOT drink either. She said Ming will die without Prednisone. Yes, Minerva, IBD doesn't fly with me 100% either. But I don't have any pathology report to go by. This vet relayed all sonogram "results" by phone and actually "ulcerationS" (plural form) was the term that was used to say that those were also discovered upon ultrasound. But all before that, a thickend stomach lining was the first finding that stood out. Hence, the diagnosis of "IBD". If I really wanted a full-term finding, the vet wanted me to consent to an endoscopy ... but another $1K? Yet, here I am 80% convinced that the gastric upset is triggered by nausea secondary to an equilibrium problem due to the ear flushing procedure. I mean, I can go on and on, but that is my take on the technical side. BUT there's no way for me to prove that. The vet sees this situation as entirely 2 different problems. Either that or she has to because to date, I have paid $1,250 for the gastric problems. I won't discount the fact that ulcers don't develop overnight; even the vet concedes that. Ming has been regurgitating after meals for quite sometime now; but I was never alarmed because he never did so with all foods. The vet thinks he has a GERD condition and ulcers have been developing over time, but that the ear flushing exacerbated his gastric condition and came to a full head. I'll post an update as soon as I get a private confer with the second opinion. Thanks everyone ever so much. ---------------------------------------------------------------------------- > This is a classic case of "get a second opinion." If it were me (and please > note that I have been deemed nuts by many), I would withdraw all the > medications at this point, because he's taken so much stuff there's no way > to tell what is causing his symptoms. Give him a day or two's rest (with > water available, of course), then offer him some warm chicken broth and see > if he takes it. I think your vet's diagnosis of IBD is baloney, because IBD > doesn't come on suddenly and it doesn't cause the symptoms you're > describing. Plus I've never heard of a cat getting ulcers. Second opinion. > Really. Do it for Ming. -- M9 > > "Zaida" <ZTandoc@comcast.net> wrote in message > news:Z8Kdnc82PPNRHgfdRVn-jw@comcast.com... > > I need an opinion please ... 2nd, 3rd, it doesn't matter. My mind is open > > to all possibilities and explanations. > > > > I have a 12-year old Tonkinese whom I had boarded 2 weeks ago when my > family > > and I went out of town. I left him with a reputable vet in my area on a > > Friday and picked him up the next Monday. > > > > During this time, I also left instructions to go ahead with bloodwork > > because I had also wanted to go ahead with his dental cleaning at the same > > time. But time was short, so the vet simply ordered labwork and a future > > dental appointment was made instead. While I was gone though, the vet > left > > me several messages saying she found, upon exam, a right ear infection > that > > required ear flushing. I gave my consent. > > > > I was told the flushing was done Monday morning (I picked up Ming, my > > Siamese, Monday afternoon). When we got home, I took him out of the > > carrier. To my shock, he was falling all over the place. He had a > > staggering gait and at the very least, couldn't leap in and out of the > sofa. > > No head tilt; no rocking eye movement though, but on his right eye, the > > inner lid was showing half-way consistently; very glassy and drowsy > > appearance. I put him on the sofa, but he was not comfortable. > > Intermittently, he would let out a howl (very loud; uncharacteristic of > this > > cat). Then he vomitted at one point. For the rest of the evening, he > would > > try to jump out of the sofa, fall, get up and stagger, find a hiding > place, > > and howl. To say the least, he would not eat. After vomitting, he slept > > peacefully the rest of the night on the sofa (not his usual sleeping place > > by the way). > > > > He had a medication to be taken once a day: tresaderm, which I applied to > > his right ear the following morning (Tuesday). When I placed that in his > > right ear, he shook his head and then vomitted right after. I called the > > vet who told me to withhold the tresaderm and she replaced it with PGN > which > > I picked up from her office. I continued to monitor his appetite. No > > signs, but no more vomitting episodes for the rest of the day and the cat > > slept all throughout. > > > > Come Wednesday morning, I applied the PGN. Again he vomitted. So I then > > called the vet. I also told her that Ming still hasn't eaten to say the > > least in that 48-hour period. She ordered him back. But during the car > > ride, he started foaming at the mouth. Vet gave him fluids SQ, but was > > concerned about the foaming. It did appear that some was also coming out > of > > his nose and made a notation that it could be respiratory. We agreed at > > that point to bring him twice a day starting Thursday for fluids SQ. A > new > > antibiotic was given (again) to replace PGN ... Baytril. > > Thursday morning, cat still hasn't eaten. I popped a tab of Baytril into > > his mouth. 15 minutes later, he vomitted again. I called the vet again. > > On the car ride, Ming was foaming in the mouth again. This time, she > > hospitalized Ming. I also picked up for her at the drugstore, a couple of > > prescriptions for Ming -- Carafate and Metoclopramide. She also said she > > was going to give him a pre-surg medication to stop the foaming. She > > ordered ultrasound and x-ray to rule out anything respiratory. Friday, > > sonogram results revealed a thickened stomach; so thick that food can't > pass > > through, according to the vet. Vet also mentioned ulcers. I visited Ming > > (needless to say, broke my heart to see how lethargic he was). He > preferred > > sleeping inside his potty box. The doctor placed an extra aluminum tray > for > > him to sleep in. > > > > Throughout the weekend, Ming was on fluids IV. Besides the 2 drugs I > > mentioned, all of the previous antibiotics were stopped; but Flagyl was > used > > instead. Sunday night, the vet told me that she has started Ming on > > Prednisone. My kids visited Ming Saturday. He still preferred sleeping > > inside the potty. > > > > I took Ming home (5/3) Monday afternoon. His vet explained to me about > his > > gait and what she reiterated would go away in time; that the sight is more > > disturbing to us people than it is to Ming. I asked her what in her > opinion > > did Ming really have and she said inflammatory bowel. I raised the > > possibility of the ulcers found during ultrasound being due from stress > > secondary to an equilibrium from the ear flushing; she believed the two > were > > unrelated. She explained that ulcers don't develop overnight; they take > > time. We discussed the possibility of him having eaten a plant to have > > caused the ulcers. My cat is an indoor cat. He did enjoy playing with > (and > > chewing on) tall long grasses that are sometimes included with the flowers > I > > buy and take home. Other than that, there is no plant in this house -- I > > really don't have any indoors; they're fake because I'm the type who > forgets > > to water my plants :-( > > > > $1500+ later, my cat remains unappetent, still nauseated and looking > > emaciated. I also signed a release statement indicating that my cat is > not > > 100% better. At home, after the car ride from the vet, the first thing > Ming > > did was stagger to his potty box where he promptly threw up. I called the > > vet to tell her this. She upped his Prednisone to twice a day. > > > > Everyday that I've had him back, I keep offering him food and water. The > > vet also discussed with me that it's ok to give him anything he wants > (with > > the exception of milk) just to get him starting to eat. He would poke his > > head into his bowl, paw at his food, go through the motions of licking and > > picking up, but he wouldn't bite. It's almost as if he's scared to eat! > I > > told the doctor this who is now afraid that it's now psychological. > > > > I won't hesitate to tell anyone that my husband has been flipping over > these > > costs. He had just had a car accident last week Monday night as well. He > > came out unscathed from the accident (a 4-car pile up), but his car has > been > > totalled. I'm a wreck between the money worries and Ming. I'm at a point > > where my cat is not on the threshold of death, yet does not have the will > to > > eat. I have discussed all these concerns with the vet. I don't want to > be > > in the position where I have to allow him to die because I can't afford > it. > > I do have a $350 balance that the vet and I agreed to pay off next month. > > The vet has also said in terms that if surgery was going to be needed for > > Ming, she could justify euthanasia for my sake because of the surgical > cost > > (of over $1K), but until then she really would hate not to try all means > > possible, medication-wise. > > > > Costs aside, I am now at a point where I'm wondering how much of Ming's > > predicament is primary or secondary. By admission, Ming's vet did say > that > > she seemed to have opened a "pandora's box" when she flushed his ears. I > > asked if his ear drum has any tear and she said she couldn't find any, > > though some dirt could've attached to tear away a "pin-dot" size during > the > > flushing. Ming is still unstable when he walks and does fall when he > jumps > > up and out of the bed or sofa. The vet has reiterated that Ming's gastric > > problem and ear problem are unrelated. > > > > Yesterday after Ming came out of his potty, he sat down beside me and > > proceeded to clean himself (just like the good 'ol days). I was thrilled > to > > see that. But as soon as he tilted his head up, he vomitted again. Can > > anyone at this point tell me that his vomitting episodes are not related > to > > an equilibrium problem? Sonogram, according to the vet, did show > > ulcerations. And ulcerations "don't appear overnight". > > > > All my husband knows and calls as he sees it is this: we took a healthy, > > happy cat to the vet on a Friday a week-and-a-half ago. Today, my cat is > so > > ill that the question of euthanasia is what we have been talking about > most > > lately. I have cried and cried; and worried some more ... over > everything; > > coming to a point where I'm hoping (praying to God) that my care for this > > pet shouldn't be put into test over affordability of treatment costs. But > > there are priorities that I cannot hugely discount. Above all, I have to > > give weight to my husband's concern to maintain our lives within our > means. > > We are by far, the most humane people possible, but we are also not rich > > people. > > > > I just need to know if my cat will ever eat. I've withheld Prenisone the > > whole day yesterday as soon as Ming walked away from me to hide underneath > > the bed after he vomitted. He seems to "want" to eat. He looks eager to > > eat. But that's all he does: poke his nose into the bowl, lick, bite, but > > does not take the food in to eat. > > > > Today I have an appointment with the vet. She isn't pleased I withheld > the > > prednisone, but I'm telling 'ya ... this cat's frame of mind is all I care > > for at this point. He hasn't thrown up yet anyway after he last vomitted > > yesterday morning. And yes, he did take a bite out of a small piece of > > bacon last night; just the size of my pinky nail, but he kept it down and > > hasn't vomitted since. This without prednisone. > > > > I'm so afraid to pop a pill into his mouth and be afraid to eat anything > > anymore, not after he took a bite out of the bacon. But that's it. And > > that was yesterday morning. I've had him back since Monday and it's now > > Thursday. This cat, being a Siamese, with his own idiosyncrasies, minus > the > > prednisone for 24 hours now ... how much of his condition is truly IBD? > > > > I apologize for being distraught ... but I thank this board though so much > > in advance. > > > > ~ Zaida~ circa Fri, 7 May 2004 12:20:31 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, > I will tell you though that I sent him yesterday for > fluids SQ because he needs it (it's the only thing keeping him alive) ... > and I've advocated forced feeding, but this vet has adamantly said NO to > forced feeding because seemingly, Ming's inability/reluctance is psychogenic in nature now. I cry "bullshit". Utter bullshit. Cats don't just become psychologically averse to eating. They don't eat because of *physical" causes, and your vet's lack of raising other possible causes is very troubling to me. > In Nursing, I'd call that "ineffective coping" ... so I did what I know best. Understood, and my call of "bullshit" isn't for you, it's for your veterinarian. > But I also got reprimanded BIG TIME for holding off his Prednisone, > a steroid to suppress bowel swelling and at the same time, stimulate appetite. Which is true, but as I've said, your vet seems to be missing a far more likely cause for the problem. > She said no amount of instinct will get him to eat or drink. Because he is *physically* sick, not because he is psychologically hampered from doing so. > So far, she's right on that point because this cat will NOT drink either. > She said Ming will die without Prednisone. Frankly, I think Ming will die without a second opinion. Prednisone is a palliative treatment, not a cure, and saying that your cat will die without it isn't an accurate way of putting it, because prednisone *mitigates the symptoms of an underlying condition but doesn't cure the condition*. > Yes, Minerva, IBD doesn't fly with me 100% either. > But I don't have any pathology report to go by. > This vet relayed all sonogram "results" by phone [quoted text clipped - 4 lines] > the vet wanted me to consent to an endoscopy ... > but another $1K? Endoscopy is much less effective if the thickening is where you say it is. Personally, exploratory surgery and biopsy seems to make more sense to me right now (unless they're planning to go through the cat's mouth for the endoscopy to get a biopsy). It's time for a different vet. > Yet, here I am 80% convinced that the gastric upset is triggered > by nausea secondary to an equilibrium problem due to the ear flushing procedure. But what is far more likely is that the equilibrium problem was caused by vestibular syndrome resulting from the primary disease. > I mean, I can go on and on, but that is my take on the technical side. > BUT there's no way for me to prove that. > The vet sees this situation as entirely 2 different problems. Which is why I now seriously question her skills. > Either that or she has to because to date, I have paid $1,250 for the gastric problems. > I won't discount the fact that ulcers don't develop overnight; even the vet concedes that. And yet, she still hasn't mentioned lymphoma? > Ming has been regurgitating after meals for quite sometime now; > but I was never alarmed because he never did so with all foods. Oh, lord, this SO sounds like lymphoma. Let me guess- Ming has also been losing weight, and his vomit isn't just undigested food, but also contains liquid, partially digested matter. > The vet thinks he has a GERD condition and ulcers have been developing > over time, but that the ear flushing exacerbated his gastric condition > and came to a full head. I'm really beginning to think your vet is incompetent. I'm sorry to sound so doom-and-gloom, and I could be totally wrong in thinking that this is lymphoma, but the fact that your vet has mentioned neither lymphoma nor vestibular syndrome scares the bejeezus out of me, because your cat's symptoms *scream* of both. > I'll post an update as soon as I get a private confer with the > second opinion. Thanks everyone ever so much. It is DEFINITELY time for a second opinion. The fact that your vet seems to have mentioned neither vestibular syndrome nor the possibility of lymphoma, despite the fact that your cats symptoms are CLASSIC lymphoma symptoms, concerns me greatly. As a total aside, are you posting in HTML? Your text doesn't wrap in my newsreader and I had to go put in line breaks manually to reply to this post. Laura  SignatureA proverb is a short sentence based on long experience. -Miguel de Cervantes > circa Fri, 7 May 2004 12:20:31 -0700, in rec.pets.cats.health+behav, > Zaida (ZTandoc@comcast.net) said, [quoted text clipped - 16 lines] > > > > Laura I agree! This cat needs to be seen by another vet ASAP. Moreover, you have concerns over finances -- and I think you will find that the rates you have been charged are excessive. If you think this vet won't give you the records, ask the new vet to request them directly. And, I would like to repeat the suggestion I made a few days ago: If possible, contact a university veterinary hospital. I used Texas A&M College of Medicine. The staffing, facilities, and care were first-rate -- and the fees were very reasonable. Make it clear when you call that this is an *emergency* because it sounds like you may not have much time. If you can't go to a college of medicine, then at least find another reputable vet and try to get Ming in immediately. MaryL Hi, just jumping on the "get a second opinion" bandwagon. Make sure you take all the records from the first vet to the second one, so they can review the series of events. You may want to try a/d cat food. I know you can get it from the vet's, not sure if it's available at pet supply stores. It's really hard to say if the intestinal problems and the ear issues are related. I don't know if the thickened intestinal walls can develop suddenly or not. It's possible (just guessing, not sure) that she could have had the IBD, and the stress of the ear problems and boarding set it off. If you are anywhere near Tufts University in MA, I highly reccommend them. Signature-Kelly kelly at farringtons dot net Check out www.snittens.com > I need an opinion please ... 2nd, 3rd, it doesn't matter. My mind is open > to all possibilities and explanations. [quoted text clipped - 149 lines] > > ~ Zaida~ circa Thu, 6 May 2004 11:28:26 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, <various snipping throughout> > I need an opinion please ... 2nd, 3rd, it doesn't matter. My mind is open > to all possibilities and explanations. [quoted text clipped - 23 lines] > peacefully the rest of the night on the sofa (not his usual sleeping place > by the way). Have you heard of vestibular syndrome? To me, this certainly fits it. My lymphoma cat had a bout with it early in his illness, and although some of the symptoms were either the result of his lymphoma or indistinguishable from the vestibular syndrome symptoms, the neurological effects you describe do seem to fit vestibular syndrome. > ordered ultrasound and x-ray to rule out anything respiratory. Friday, > sonogram results revealed a thickened stomach; so thick that food can't pass > through, according to the vet. Vet also mentioned ulcers. Did the vet mention the possibility of cancer, specifically lymphoma? A thickened digestive tract can be a very strong indicator of such (along with other causes, but that's just one that jumps to mind that I didn't see mentioned in your post). > I took Ming home (5/3) Monday afternoon. His vet explained to me about his > gait and what she reiterated would go away in time; that the sight is more > disturbing to us people than it is to Ming. That sounds to me like the vet might think it's vestibular syndrome or something similar. Are you sure she hasn't mentioned this as a possibility? > I asked her what in her opinion > did Ming really have and she said inflammatory bowel. Are his bowels thickened, or just his stomach? Does his bloodwork show any unusual values, such as elevated calcium? > I raised the > possibility of the ulcers found during ultrasound being due from stress > secondary to an equilibrium from the ear flushing; she believed the two were > unrelated. She explained that ulcers don't develop overnight; they take > time. We discussed the possibility of him having eaten a plant to have > caused the ulcers. To me, this doesn't sound like ulcers, but I'm not qualified to say with any certainty. > $1500+ later, my cat remains unappetent, still nauseated and looking > emaciated. I also signed a release statement indicating that my cat is not > 100% better. At home, after the car ride from the vet, the first thing Ming > did was stagger to his potty box where he promptly threw up. I called the > vet to tell her this. She upped his Prednisone to twice a day. Honestly, I think it's time for a second opinion and investigating the possibility of lymphoma as well as IBD. If this is lymphoma, it is crucial that you get it diagnosed before the cat has been on prednisone for any length of time, as use of prednisone can decrease the efficacy of subsequent chemotherapy. I'm not assuming that you would choose to go with chemo if this did turn out to be cancer, but if it did, and if you wanted to explore that option, I'd be happy to tell you of my experiences with chemotherapy to treat my cat who had lymphoma. It's much less expensive than you might think, and side effects are quite low in cats. And lymphoma is one of the most responsive cancers to chemo. > Everyday that I've had him back, I keep offering him food and water. The > vet also discussed with me that it's ok to give him anything he wants (with > the exception of milk) just to get him starting to eat. He would poke his > head into his bowl, paw at his food, go through the motions of licking and > picking up, but he wouldn't bite. It's almost as if he's scared to eat! I > told the doctor this who is now afraid that it's now psychological. Or it's nausea. All of those behaviors were exhibited by my lymphoma kitty shortly before and early in his chemotherapy, and it was nausea (not caused by the chemo). Is he making any chewing motions or grinding or gnashing his teeth? Those are also hallmarks of nausea. > I won't hesitate to tell anyone that my husband has been flipping over these > costs. He had just had a car accident last week Monday night as well. He [quoted text clipped - 8 lines] > (of over $1K), but until then she really would hate not to try all means > possible, medication-wise. I was very lucky in that when my cat got sick, I had a lot of disposable income. I ended up keeping my old car so I could keep my old cat, but as I said at the time, I'd rather have the old cat than the new car. However, I do understand tight finances, and given that your vet has been willing thus far to let you pay over time, perhaps she'll let you work something out. Again, though, I'd be asking her about the possibility of lymphoma. If the prednisone isn't working, that's another sign that lymphoma is something to investigate. Prednisone is used in the treatment of lymphoma (typically as a palliative), but prednisone often won't mitigate the symptoms of lymphoma as well as it will IBD. Again, I'm not saying that your cat has lymphoma, just that the symptoms you're describing are textbook and completely congruent with what I saw in my own cat. > Costs aside, I am now at a point where I'm wondering how much of Ming's > predicament is primary or secondary. By admission, Ming's vet did say that [quoted text clipped - 4 lines] > up and out of the bed or sofa. The vet has reiterated that Ming's gastric > problem and ear problem are unrelated. Unless it's vestibular syndrome caused by cancer. This link is about dogs, but still applicable to cats: http://www.vetinfo.com/dencyclopedia/devestib.html > Yesterday after Ming came out of his potty, he sat down beside me and > proceeded to clean himself (just like the good 'ol days). I was thrilled to > see that. But as soon as he tilted his head up, he vomitted again. Can > anyone at this point tell me that his vomitting episodes are not related to > an equilibrium problem? No. > Sonogram, according to the vet, did show > ulcerations. And ulcerations "don't appear overnight". True, but CNS symptoms *can* appear overnight in a cat that has a larger primary disease. > All my husband knows and calls as he sees it is this: we took a healthy, > happy cat to the vet on a Friday a week-and-a-half ago. Today, my cat is so [quoted text clipped - 19 lines] > bacon last night; just the size of my pinky nail, but he kept it down and > hasn't vomitted since. This without prednisone. Prednisone boosts appetite. I don't think you should be withholding it, personally, but I do think that before continuing much longer with prednisone, you need to definitively rule out cancer unless you have no plans to treat cancer should it turn out to be the cause. > I'm so afraid to pop a pill into his mouth and be afraid to eat anything > anymore, not after he took a bite out of the bacon. But that's it. And > that was yesterday morning. I've had him back since Monday and it's now > Thursday. This cat, being a Siamese, with his own idiosyncrasies, minus the > prednisone for 24 hours now ... how much of his condition is truly IBD? Possibly none. I don't want to project my own experiences onto what you describe, but I went through *every single thing you describe* with my cat, and it was all because of lymphoma. I really, really think your vet should investigate this as a possible cause. I am sorry you're going through this, but as I said, if this does turn out to be lymphoma, please post as I can give you information about my experiences with chemo for my cat, both from a financial perspective and from the perspective of whether it was worthwhile to have done it. (In my case, it most definitely was.) Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. Hi Laura ... sorry for the HTML format. > Have you heard of vestibular syndrome? To me, this certainly fits it. > My lymphoma cat had a bout with it early in his illness, and although > some of the symptoms were either the result of his lymphoma or > indistinguishable from the vestibular syndrome symptoms, the > neurological effects you describe do seem to fit vestibular syndrome. It was mentioned somewhere in this thread or maybe in the alt.med.veterinary NG. However I look at all the possibilities, it appears to me that with the exception of vestibular syndrome, lymphoma or IBD are not acute illnesses. What are the symptoms of lymphoma? > Did the vet mention the possibility of cancer, specifically lymphoma? > A thickened digestive tract can be a very strong indicator of such > (along with other causes, but that's just one that jumps to mind that > I didn't see mentioned in your post). Yes, as a matter of fact, she did. She didn't specifically say lymphoma. She did say cancer, but if it was, she said cancer of the stomach or its related structure. Lymphoma is an entirely different illness involving the lymph vessels, right? Ming's vet wanted to go for endoscopy with biopsy to rule out cancer ... that was the only reason for doing endoscopy, yes. And as sad as I am to have to say this, I have to reiterate that it is extremely difficult for me to weigh between my cat's life and the staggering costs. An endoscopy would put me in another $1K is what I was told by the vet. > That sounds to me like the vet might think it's vestibular syndrome > or something similar. Are you sure she hasn't mentioned this as a > possibility? Nope. No mention of vestibular syndrome by her. > To me, this doesn't sound like ulcers, but I'm not qualified to say > with any certainty. I specifically asked what was found in the ultrasound exam. I specifically asked if ulcers (ulcerations) were picked up by the test and she answered positively. > Honestly, I think it's time for a second opinion and investigating > the possibility of lymphoma as well as IBD. The old vet is unfortunately out of town (my dumb luck) but since time is of the essence to maintain Ming's fluids, I have been going back to the same vet for fluids SQ every other day. And by the way, yes, I have been force-feeding Ming. Yesterday, I was able to make him take a jar (2-1/2 oz.) of baby food. He hates it, but his stomach hasn't acted up (no vomitting) and he has used the potty. I'm due for his fluids today. If this is lymphoma, it > is crucial that you get it diagnosed before the cat has been on > prednisone for any length of time, as use of prednisone can decrease > the efficacy of subsequent chemotherapy. I'm not assuming that you > would choose to go with chemo if this did turn out to be cancer, but > if it did, and if you wanted to explore that option, I'd be happy to > tell you of my experiences with chemotherapy to treat my cat who had > lymphoma. It's much less expensive than you might think, and side > effects are quite low in cats. And lymphoma is one of the most > responsive cancers to chemo. With this vet, nothing is inexpensive. In the beginning, each office visit had a charge. My husband was really aghast. All he wanted was a little show of "humanity" for us; after all, he is hard-pressed for convincing that all this medical problem with Ming was not triggered by the vet's ear flush procedure on Ming. If this is vestibular syndrome ("syndrome" to me indicating that a group of symptoms are happening together to form a pattern), then indeed, all these are HER fault ... at least a negligence somewhere in the procedure. > Or it's nausea. All of those behaviors were exhibited by my lymphoma > kitty shortly before and early in his chemotherapy, and it was nausea > (not caused by the chemo). Is he making any chewing motions or > grinding or gnashing his teeth? Those are also hallmarks of nausea. Ming IS nauseated. He would take a gulp (swallowing motion) and lick his mouth. His chewing motions do not appear normal to me. I am treating his ears now with Silvadene. > > Unless it's vestibular syndrome caused by cancer. Wow. I'm at a complete tizzy here now. Well, this vet did raise the possibility of cancer. IF cancer has been developing over time, then the ear flushing to treat his ear infection simply exacerbated what illness is already underway. IF that's so, then this vet has been right all along ... ??? > > True, but CNS symptoms *can* appear overnight in a cat that has a > larger primary disease. But Ming had no CNS symptoms before the ear flushing procedure. This was an active Siamese that liked getting into mischief. The ONLY discernible symptom he ever had was his regurgitating episodes of certain foods. That behavior was consistent with him if he ate wet food. He was fine with dry food. He was even greater with R/D. > Prednisone boosts appetite. I don't think you should be withholding > it, personally, but I do think that before continuing much longer > with prednisone, you need to definitively rule out cancer unless you > have no plans to treat cancer should it turn out to be the cause. I don't know, Laura. I'm very saddened by all this, yet want to do what's best for this cat. The diagnostic procedures that this vet requires equate to a staggering amount that my husband and I can't afford. We are not lucky in that regard. Ming is 12 years old; still young according to his vet. If money weren't an object, I would definitely shoot for the moon, no questions asked. > I am sorry you're going through this, but as I said, if this does > turn out to be lymphoma, please post as I can give you information > about my experiences with chemo for my cat, both from a financial > perspective and from the perspective of whether it was worthwhile to > have done it. (In my case, it most definitely was.) Thank you very much. I will most certainly bring up the possibility of Lymphoma to her when I see her this afternoon. ==== Zaida circa Sat, 8 May 2004 09:16:34 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, > Hi Laura ... sorry for the HTML format. > [quoted text clipped - 8 lines] > to me that with the exception of vestibular syndrome, lymphoma or IBD are > not acute illnesses. What are the symptoms of lymphoma? The *exact* symptoms you describe. > > Did the vet mention the possibility of cancer, specifically lymphoma? > > A thickened digestive tract can be a very strong indicator of such [quoted text clipped - 5 lines] > related structure. Lymphoma is an entirely different illness involving the > lymph vessels, right? No. Lymphoma is *cancer*. Lymphosarcoma, to be exact. > Ming's vet wanted to go for endoscopy with biopsy to > rule out cancer ... that was the only reason for doing endoscopy, yes. And > as sad as I am to have to say this, I have to reiterate that it is extremely > difficult for me to weigh between my cat's life and the staggering costs. > An endoscopy would put me in another $1K is what I was told by the vet. Find a new vet. My cat's exploratory surgery and biopsy were nowhere near that. > > That sounds to me like the vet might think it's vestibular syndrome > > or something similar. Are you sure she hasn't mentioned this as a > > possibility? > > Nope. No mention of vestibular syndrome by her. New vet. New vet. New vet. > > To me, this doesn't sound like ulcers, but I'm not qualified to say > > with any certainty. > > I specifically asked what was found in the ultrasound exam. I > specifically asked if ulcers (ulcerations) were picked up by the test and > she answered positively. Ulcerations != ulcers. Ulcerations can be caused by things such as *cancer*. The term "ulcers" usually refers to digestive tract ulcers caused by compromise of linings and subsequent injury by acids in the tract. > > Honestly, I think it's time for a second opinion and investigating > > the possibility of lymphoma as well as IBD. [quoted text clipped - 5 lines] > oz.) of baby food. He hates it, but his stomach hasn't acted up (no > vomitting) and he has used the potty. I'm due for his fluids today. It's good that you're force feeding and keeping him hydrated. > If this is lymphoma, it > > is crucial that you get it diagnosed before the cat has been on [quoted text clipped - 9 lines] > With this vet, nothing is inexpensive. In the beginning, each office > visit had a charge. My husband was really aghast. New vet. > All he wanted was a > little show of "humanity" for us; after all, he is hard-pressed for [quoted text clipped - 3 lines] > to form a pattern), then indeed, all these are HER fault ... at least a > negligence somewhere in the procedure. Again, vestibular syndrome is generally caused by something other than an ear flushing. Please google on the syndrome. I know it's natural to want to blame the vet, but your cat's symptoms are *exactly* like my cat's symptoms were, and his vestibular syndrome was caused by his *lymphoma*. > > Or it's nausea. All of those behaviors were exhibited by my lymphoma > > kitty shortly before and early in his chemotherapy, and it was nausea [quoted text clipped - 4 lines] > mouth. His chewing motions do not appear normal to me. I am treating his > ears now with Silvadene. Please get this cat to a different vet. > > > > Unless it's vestibular syndrome caused by cancer. [quoted text clipped - 4 lines] > already underway. IF that's so, then this vet has been right all along ... > ??? Well, if she raised the possibility of cancer, then yes, she may have been right all along. Vestibular syndrome is caused by compromise or infection of a specific set of nerves- lymphoma can cause this, as can other infections or injuries. > > > > True, but CNS symptoms *can* appear overnight in a cat that has a [quoted text clipped - 5 lines] > behavior was consistent with him if he ate wet food. He was fine with dry > food. He was even greater with R/D. Again, though, just because the symptoms appeared after the ear flushing doesn't inherently mean that they were *caused* by it. It may just be coincidence. > > Prednisone boosts appetite. I don't think you should be withholding > > it, personally, but I do think that before continuing much longer [quoted text clipped - 7 lines] > money weren't an object, I would definitely shoot for the moon, no questions > asked. I honestly think you can get a diagnostic for far less than your vet is saying it will cost. As I recall, Alex's exploratory surgery and biopsy was in the neighborhood of $200. > > I am sorry you're going through this, but as I said, if this does > > turn out to be lymphoma, please post as I can give you information [quoted text clipped - 4 lines] > Thank you very much. I will most certainly bring up the possibility of > Lymphoma to her when I see her this afternoon. Good. Please post back; I'm very interested in this. Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. > circa Sat, 8 May 2004 09:16:34 -0700, in rec.pets.cats.health+behav, > Zaida (ZTandoc@comcast.net) said, [quoted text clipped - 161 lines] > > Laura Can't toxoplasmosis also cause vistibular problems? Karen circa Sat, 08 May 2004 11:54:50 -0500, in rec.pets.cats.health+behav, Karen Chuplis (kchuplis@alltel.net) said, > Can't toxoplasmosis also cause vistibular problems? Yes, I believe so, and I'm not saying that the ear cleaning *wasn't* the cause of the problem mentioned, but it could *so* be tied to a more serious disease that I felt I needed to mention it. Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. > circa Sat, 08 May 2004 11:54:50 -0500, in rec.pets.cats.health+behav, > Karen Chuplis (kchuplis@alltel.net) said, [quoted text clipped - 5 lines] > > Laura The thing is if it is something like Toxo, it *can* be treated, but you have to get on the right stuff. It can take a while, but dang, they should at least look at that. Karen circa Sat, 08 May 2004 18:11:32 -0500, in rec.pets.cats.health+behav, Karen Chuplis (kchuplis@alltel.net) said, > > circa Sat, 08 May 2004 11:54:50 -0500, in rec.pets.cats.health+behav, > > Karen Chuplis (kchuplis@alltel.net) said, [quoted text clipped - 9 lines] > to get on the right stuff. It can take a while, but dang, they should at > least look at that. That's one of the reasons I'm wondering about the bloodwork. I mean, from the sounds of it, the vet hasn't even mentioned vestibular syndrome, regardless of what may have caused it, and there are soooo many other symptoms that are hallmarks of lymphoma that it seems a natural connection to make. Lymphoma is known to cause neurological effects and the whole description of the cat's stomach...well, I already said that. :-) Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. Laura - YOU HIT IT - I think you and someone else did, but his old vet faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get my message) ... but there are 4 pages of reference materials he sent with the heading "Ideopathic Vestibular Syndrome". He hasn't called to ask to see Ming. I have yet to get copies of Ming's medical records, lab work, etc. The receptionist of the current vet is not lukewarm to my request, saying I need the vet's permission. Well, there's another vet I'm waiting to hear from. So I have a new dilemma now. If I receive 2 differing diagnosis from that (IBD) which Ming has been given by his current vet, I know first thing to have him checked, and certainly have his medications and diet revised or changed accordingly. But what do I do with the vet? All told, Ming's expenses (after the ear flush procedure) from lab, ultrasound and hospitalization came up to $1500+. Can I recover all that and if so, how do I go about it? I only want what's fair if I can't recover everything, at least some to help defray future office visits and treatments for Ming. I also think I ought to mention, since this new 2nd opinion came out, that yesterday when I took Ming to his current vet for his follow-up (and by the way, is it a normal occurrence to be charged for a *follow-up* for the same illness?) she reprimanded me big time for "tweaking" with Ming's Prednisone. She said Ming WILL DIE WITHOUT PREDNISONE. Prednisone is the ONLY thing that's keeping him alive. She said to forget her initial order of once-daily-then-every-other-day. She wants it bumped up to twice a day. Knowing the long-term effects of this steroid, I asked her for how long. She said probably forever. She further said this to me: "It's not up for you to change his dosage, that's my job." And when I told her I was fearful of the long-term effects of Prednisone, she said "I will tell you when, where and what to give Ming and until then, you will do exactly as I say." She further added that "I don't understand why you want your cat to die. You've already spent thousands to treat him and if he deteriorates because you don't follow my orders, your husband will get mad at you for even more costly medical problems because of this." Because I was thisclose to screaming at her, I said nothing though I've been dying to mention about Ming's black stools and acrid, pungent, urine smell worse than ammonia. Let's just say I left her office very upset. There's another follow-up that Ming has this coming Monday. Oh I'm sure though it's a "follow-up", I will be charged again. I will definitely cancel because I now have to select between the 2 vets I'm pinning my hopes on. I'm simply waiting for the other 2nd opinion to come in. Thanks much for everything, everyone! You've all been such a great moral support to me. > circa Sat, 08 May 2004 18:11:32 -0500, in rec.pets.cats.health+behav, > Karen Chuplis (kchuplis@alltel.net) said, > > > circa Sat, 08 May 2004 11:54:50 -0500, in rec.pets.cats.health+behav, > > > Karen Chuplis (kchuplis@alltel.net) said, > > >> Can't toxoplasmosis also cause vistibular problems? > > >> > > > Yes, I believe so, and I'm not saying that the ear cleaning *wasn't* > > > the cause of the problem mentioned, but it could *so* be tied to a > > > more serious disease that I felt I needed to mention it. > > > > > > Laura > > > > The thing is if it is something like Toxo, it *can* be treated, but you have > > to get on the right stuff. It can take a while, but dang, they should at > > least look at that. > > > That's one of the reasons I'm wondering about the bloodwork. I mean, > from the sounds of it, the vet hasn't even mentioned vestibular > syndrome, regardless of what may have caused it, and there are soooo > many other symptoms that are hallmarks of lymphoma that it seems a > natural connection to make. Lymphoma is known to cause neurological > effects and the whole description of the cat's stomach...well, I > already said that. :-) > > > Laura > -- > I am Dyslexia of Borg, > Your a.s will be laminated. > Laura - YOU HIT IT - I think you and someone else did, but his old vet > faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get my > message) ... but there are 4 pages of reference materials he sent with the > heading "Ideopathic Vestibular Syndrome". No way, man, Laura's just a Big Bad Twoll who never posts nuthin' but flames. The "Professor" sed so. ;) > > Laura - YOU HIT IT - I think you and someone else did, but his old vet > > faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get my [quoted text clipped - 5 lines] > > ;) I never said that, Mara. Why do you use the name Mary when you post? LOL ... Laura cool <thumbs up> > "Mary" <rosefan@email.com> wrote in message > news:R3coc.38402$jU.2197567@twister.southeast.rr.com... > > > > "Zaida" <ZTandoc@comcast.net> wrote in message > > news:bJqdnZq2SPGYojzdRVn-hA@comcast.com... > > > Laura - YOU HIT IT - I think you and someone else did, but his old vet > > > faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get > my > > > message) ... but there are 4 pages of reference materials he sent with > the > > > heading "Ideopathic Vestibular Syndrome". > > > > No way, man, Laura's just a Big Bad Twoll who never posts > > nuthin' but flames. The "Professor" sed so. > > > > ;) > I never said that, Mara. Why do you use the name Mary when you post? circa Tue, 11 May 2004 23:47:45 GMT, in rec.pets.cats.health+behav, Professor (vze3vvj2@verizon.net) said, > > > Laura - YOU HIT IT - I think you and someone else did, but his old vet > > > faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get [quoted text clipped - 8 lines] > > ;) > I never said that, Mara. Why do you use the name Mary when you post? Why do you use the name "Professor" when you obsess and stalk, but "Mommy" when you're typing one-handed? Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. "Laura R." <UseFirstInitialPlusRobinson@technologist.com> wrote > Why do you use the name "Professor" when you obsess and stalk, but > "Mommy" when you're typing one-handed? Ahaha! I'm still waiting to find out I'm really Mara and how he found me out. > > > Laura - YOU HIT IT - I think you and someone else did, but his old vet > > > faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get [quoted text clipped - 8 lines] > > ;) > I never said that, Mara. Why do you use the name Mary when you post? Heh. Oh, I DON'T KNOW, why don't you tell me? circa Tue, 11 May 2004 22:02:25 GMT, in rec.pets.cats.health+behav, Mary (rosefan@email.com) said, > > Laura - YOU HIT IT - I think you and someone else did, but his old vet > > faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get my [quoted text clipped - 5 lines] > > ;) SHHH! You're gonna ruin my reputation with the guys in the football ng! ;-) Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. > Laura - YOU HIT IT - I think you and someone else did, but his old vet > faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get my [quoted text clipped - 41 lines] > Thanks much for everything, everyone! You've all been such a great moral > support to me. I think your vet sounds like they have terrible bedside manners. As far as charging, all vets have different policies. Mine doesn't usually charge much if anything for followups, my mothers does. I really don't know that pred can be said to be keeping Ming alive. It's not a cure. It's an anti inflamatory and may be keeping Ming more comfortable. I think you have to wait on a final diagnosis before you have a way to think about getting some fo your money back. I hope Ming is still eating. karen circa Tue, 11 May 2004 14:00:52 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, > Laura - YOU HIT IT - I think you and someone else did, but his old vet > faxed me today (NO CONFIRMATION THOUGH because I never thought he'd get my [quoted text clipped - 3 lines] > The receptionist of the current vet is not lukewarm to my request, saying I > need the vet's permission. Then it's time to push for those records. It's ridiculous for you not to be able to get a copy of them. I have never had a vet (or one of their receptionists) hesitate to give me copies of my cats records when I've asked for them, and I can't believe they're giving you the runaround on this. Get pushy if you have to. > Well, there's another vet I'm waiting to hear > from. [quoted text clipped - 7 lines] > I go about it? I only want what's fair if I can't recover everything, at > least some to help defray future office visits and treatments for Ming. Well, wait to see what the other vets say. While your vet may not have diagnosed exactly what ends up being the cause of Ming's problems, from what you've said, she has, at least, followed a pretty typical path of diagnosis- she just seems to charge a helluva lot to do it. > I also think I ought to mention, since this new 2nd opinion came out, that > yesterday when I took Ming to his current vet for his follow-up (and by the > way, is it a normal occurrence to be charged for a *follow-up* for the same > illness?) Honestly, I'm not sure. I just know that every time I take the beasties in, it costs money, but they are always there to have something done. I do know, however, that when Alex was having chemo, the total cost each week for the treatments from my local vets (versus the monthly trips to the oncologist) was nineteen dollars. Total. So I guess my vets weren't charging me any fees other than the cost of Alex's injection supplies and the three people who it took to hold him still long enough to do the injections (he was a bastard at the vets', too. They loved him. :-) ) > she reprimanded me big time for "tweaking" with Ming's Prednisone. > She said Ming WILL DIE WITHOUT PREDNISONE. Prednisone is the ONLY thing > that's keeping him alive. That is a strange statement, IMO. > She said to forget her initial order of > once-daily-then-every-other-day. She wants it bumped up to twice a day. > Knowing the long-term effects of this steroid, I asked her for how long. > She said probably forever. Well, as I said in another post, prednisone in low doses is an anti- inflammatory, and in high doses is an immunosuppressive, so it's pretty common for IBD (or cancer) cats to be put on high doses to help suppress the immune system responses that are causing the symptoms. So that doesn't sound strange to me. Also, for what it's worth, Alex was on prednisone for the last two years of his life with no ill effects. > She further said this to me: "It's not up for > you to change his dosage, that's my job." And when I told her I was fearful [quoted text clipped - 4 lines] > you don't follow my orders, your husband will get mad at you for even more > costly medical problems because of this." Now, that kind of statement is just bizarre. I can't imagine any veterinarian I've ever had talking to me in a fashion even remotely resembling that. My vets have all been extremely willing to discuss any of my questions to my satisfaction. The fact that yours doesn't seem to want to do so would actually be the chief reason I'd recommend a different vet at this point. You're just having way too many problems getting answers that she should be providing you willingly. > Because I was thisclose to screaming at her, I said nothing though I've > been dying to mention about Ming's black stools and acrid, pungent, urine [quoted text clipped - 3 lines] > cancel because I now have to select between the 2 vets I'm pinning my hopes > on. I'm simply waiting for the other 2nd opinion to come in. Good idea. Make sure you get copies of those records and take them to the other vets when you bring Ming in. You certainly don't want them having to repeat tests because they don't have the original results available, especially given financial concerns. > Thanks much for everything, everyone! You've all been such a great moral > support to me. That's one of the nice things about this particular group- people here have been through darned near everything, so there's usually somebody who can give you information about their experiences. Please keep updating us on how Ming is doing. Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. > Then it's time to push for those records. It's ridiculous for you not > to be able to get a copy of them. I have never had a vet (or one of > their receptionists) hesitate to give me copies of my cats records > when I've asked for them, and I can't believe they're giving you the > runaround on this. Get pushy if you have to. ** I will. The receptionist did say she'll just give them to me on Ming's next check-up. I'm hoping to hear from the other vet so I won't have to bring him back Monday. I can't wait to get those records. Should I tell the receptionist that I need them to take with me for a 2nd opinion? She just said she'll hand them to me on my next visit. > > Well, wait to see what the other vets say. While your vet may not > have diagnosed exactly what ends up being the cause of Ming's > problems, from what you've said, she has, at least, followed a pretty > typical path of diagnosis- she just seems to charge a helluva lot to > do it. ** The charges, I wouldn't have given any qualms if only the diagnosis fit the bill. The problem is I know now that IBD is a condition; not a disease in and of itself. And now that I've gotten a 2nd opinion that it's Vestibular, what am I supposed to think but: how did Ming get it if she didn't flush his ears in a manner that got him in this condition? > Well, as I said in another post, prednisone in low doses is an anti- > inflammatory, and in high doses is an immunosuppressive, so it's > pretty common for IBD (or cancer) cats to be put on high doses to > help suppress the immune system responses that are causing the > symptoms. So that doesn't sound strange to me. Also, for what it's > worth, Alex was on prednisone for the last two years of his life with > no ill effects. ** What is high, Laura? Ming is on 5 mg. Twice a day. > > > She further said this to me: "It's not up for > > you to change his dosage, that's my job." And when I told her I was f earful > > of the long-term effects of Prednisone, she said "I will tell you when, > > where and what to give Ming and until then, you will do exactly as I say." > > She further added that "I don't understand why you want your cat to die. > > You've already spent thousands to treat him and if he deteriorates because > > you don't follow my orders, your husband will get mad at you for even more > > costly medical problems because of this." > > Now, that kind of statement is just bizarre. I can't imagine any > veterinarian I've ever had talking to me in a fashion even remotely > resembling that. ** I stepped on her bright, shiny ego. :-T My vets have all been extremely willing to discuss > any of my questions to my satisfaction. The fact that yours doesn't > seem to want to do so would actually be the chief reason I'd > recommend a different vet at this point. You're just having way too > many problems getting answers that she should be providing you > willingly. ** Because I've a feeling she doesn't want me questioning her judgment. I'm not in the position to challenge her expertise. And I don't disagree. I know that I know diddly-squat. She reacted only when I said that I decided to give the prednisone to Ming at *only* once daily (since he's already eating). I wanted to discuss her diagnosis, but she firmly said, "Yes, he's got IBD; that's my diagnosis." But consider this: what stood between Monday morning when he was perfectly fine and Monday afternoon when I picked him up and was as sick as hell? The ear flush procedure! Try convincing my husband that there's no correlation between the gastric problem and the ear flushing. Before the procedure, he was eating as strong as a horse. By the time we got him and now 3 weeks after, we were considering euthanasia at one point. Imagine all of this. :-( circa Tue, 11 May 2004 22:49:12 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, Sorry for the late response... > > Then it's time to push for those records. It's ridiculous for you not > > to be able to get a copy of them. I have never had a vet (or one of [quoted text clipped - 7 lines] > the receptionist that I need them to take with me for a 2nd opinion? She > just said she'll hand them to me on my next visit. I hope you were able to get the records before Ming went to another vet; were you? > > > > Well, wait to see what the other vets say. While your vet may not [quoted text clipped - 8 lines] > Vestibular, what am I supposed to think but: how did Ming get it if she > didn't flush his ears in a manner that got him in this condition? It really depends on what else is going on with Ming, as there certainly seems to be more than just the possibility of vestibular syndrome. > > Well, as I said in another post, prednisone in low doses is an anti- > > inflammatory, and in high doses is an immunosuppressive, so it's [quoted text clipped - 5 lines] > > ** What is high, Laura? Ming is on 5 mg. Twice a day. That seems a bit high to me, but I'm not a veterinarian. Alex was on 5mg daily, as I recall. It may even have been reduced to 2.5mg. I'm sure it was never 10mg, though. > > > > > She further said this to me: "It's not up for [quoted text clipped - 17 lines] > > ** I stepped on her bright, shiny ego. :-T Out of curiosity, how old is this veterinarian? > My vets have all been extremely willing to discuss > > any of my questions to my satisfaction. The fact that yours doesn't [quoted text clipped - 9 lines] > already eating). I wanted to discuss her diagnosis, but she firmly said, > "Yes, he's got IBD; that's my diagnosis." Given that she's not ruled out other possible causes, I'd question her making such a firm diagnosis, myself. While she may know more about veterinary medicine than you or I, *you* know your cat. Regardless of your level of knowledge, her responses to you are not indicative of a vet with a willingness to educate her clients. That alone would be distasteful to me. > But consider this: what stood > between Monday morning when he was perfectly fine and Monday afternoon when [quoted text clipped - 3 lines] > as a horse. By the time we got him and now 3 weeks after, we were > considering euthanasia at one point. Imagine all of this. :-( I've been there, honestly. All I can say is, regardless of whether the ear flushing caused the vestibular symptoms, it does sound as though Ming has something else going on, as well. Please let us know what you've found out since you posted this. Thanks, Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. circa Sat, 8 May 2004 09:16:34 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, I'm posting a second follow-up as I think I may have omitted a couple of responses in my other one... > Hi Laura ... sorry for the HTML format. No worries; your text is wrapping fine now. :-) > > Have you heard of vestibular syndrome? To me, this certainly fits it. > > My lymphoma cat had a bout with it early in his illness, and although [quoted text clipped - 6 lines] > to me that with the exception of vestibular syndrome, lymphoma or IBD are > not acute illnesses. What are the symptoms of lymphoma? Weight loss Nausea Diarrhea Vomiting- varying in degree and frequency, usually not undigested food, although that depends on where the lymphoma infiltration is heaviest. With my cat, his vomit was all liquid, but his infiltration was at the beginning of his intestine. Dehydration because of the diarrhea and vomiting CNS disorders, often appearing suddenly (often diagnosed as "ideopathic vestibular syndrome", usually because the actual cause hasn't yet been diagnosed, in my experience and readings) Increased or decreased appetite, with weight loss in either case Enlarged lymph nodes may or may not be present- with my cat, they weren't until shortly before he was euthanized after he'd gone off chemo and his lymphoma returned. Elevated calcium levels- these also were not present in my cat. Abnormal white cell counts- Alex had low white counts early in his chemo a couple of times, precluding chemo that week. Thickening of the digestive tract. These are all symptoms related to lymphosarcoma in the digestive tract, by the way. There are other symptoms if it's affecting the kidneys, liver, etc. This link actually provides a good summary: http://www.purinaone.com/catcare_cond_atoz_article.asp?Seed=626 &ArticleNumber=13&ICDB_Session=1 or http://tinyurl.com/2zcqj > > That sounds to me like the vet might think it's vestibular syndrome > > or something similar. Are you sure she hasn't mentioned this as a > > possibility? > > Nope. No mention of vestibular syndrome by her. This still concerns me, even after reading your other updates. > I don't know, Laura. I'm very saddened by all this, yet want to do what's > best for this cat. The diagnostic procedures that this vet requires equate > to a staggering amount that my husband and I can't afford. We are not lucky > in that regard. Ming is 12 years old; still young according to his vet. If > money weren't an object, I would definitely shoot for the moon, no questions > asked. Alex was 12 when he developed lymphoma, and he lived for more than two years from when his symptoms first appeared, a bit less than two years from when his diagnosis was finally made. It cost me somewhere in the neighborhood of $10,000 and five or six months to obtain that diagnosis because of all the *other* things that were investigated first. At one point, he had a pharangeal feeding tube. Another time, he had to go to Maryland to see an opthamalogical specialist, who ended up diagnosing the aforementioned ideopathic vestibular syndrome. That two-day stay cost several thousand dollars. Once the diagnosis was made, costs for his treatment dropped *dramatically*. > Thank you very much. I will most certainly bring up the possibility of > Lymphoma to her when I see her this afternoon. Did you? Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. circa Sat, 8 May 2004 09:16:34 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, > What are the symptoms of lymphoma? Crud, I forgot some- Pain, expressed by vocalization or by the cat posturing ("meatloaf" position, lying on stomach with paws tucked under) Inability to find a comfortable position Self-isolation (hiding) Lethargy Dull fur All of these were present in Alex at one point or another, primarily before the chemo. Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. Hi again, Laura. I've done my reading on Lymphoma. Ming's is indicative of Alimentary Lymphoma. This then explains the vet's need for endoscopy with biopsy. The ultimate consideration on her part was my unableness to foot the bill, Laura, if anything; not because she was unwilling to explore all the possible causes. My husband's determination was to tie up the ear flushing with the problems that were mediated from a negligent procedure; at least for the sake of empathy, if not for us, then for Ming. That's all my husband ever wanted ... *consideration* on her part. But because consideration was seemingly lacking or half-hearted, the hindrance laid with our having a very short pocket. :*( circa Sat, 8 May 2004 09:40:56 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, > Hi again, Laura. I've done my reading on Lymphoma. Ming's is indicative of > Alimentary Lymphoma. This then explains the vet's need for endoscopy with [quoted text clipped - 6 lines] > consideration was seemingly lacking or half-hearted, the hindrance laid with > our having a very short pocket. :*( Believe me, I understand. I do, however, think that you can probably find a vet who can give you a better price for diagnostic, and it may actually be cheaper to do exploratory surgery and biopsy. Ask your vet (or another vet) about it. Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. > Hi again, Laura. I've done my reading on Lymphoma. Ming's is indicative of > Alimentary Lymphoma. This then explains the vet's need for endoscopy with [quoted text clipped - 6 lines] > consideration was seemingly lacking or half-hearted, the hindrance laid with > our having a very short pocket. :*( How´s your cat doing now? I suspect she developed labyrinthitis from the procedure or the procedure hurt her labyrinth. I do not know if she can recover on her own or if she needs medical care though. > > How?s your cat doing now? I suspect she developed labyrinthitis from > the procedure or the procedure hurt her labyrinth. I do not know if > she can recover on her own or if she needs medical care though. Keeping in mind the Prednisone might be palliative (as opposed to curative), I just wanted to say that Ming took his first meal today. <big smile> He ate half a can of his C/D Prescription Diet. No forced feeding this time. No vomiting either (I monitored for 2 hours - wow). I couldn't be happier. It could be the Silvadene working (3 to 4 drops that I put in his ear twice a day since Tuesday). His coordination is way much better. I know what labyrinthitis is, Liz. I've had it. I know Ming doesn't have it. My eyeballs had that jerky rolling movement (up to side) and I tilted towards the side that was affected (it was my right ear then). It was also the first signs the vet looked for: head tilt, eye roll, so she ruled out anything affecting the inner ear. If anything, she said possibly a pin-dot tear at the ear drum. Still that would make me nauseated if that were me. I called the vet's office to leave a note for her on this. The receptionist was ecstatic for me. Minutes after I left the message, the receptionist called back to say the doctor wants me to continue with the current dosage of Prednisone for Ming. Right now, he's at twice a day. I'm wondering though if it's necessary to continue with this dosage. I have been doing more reading on Prednisone and long-term therapy may do more harm in the long run. I also found this thread on IBD (which describes all the steps my vet took, so now I'm wondering if I should still seek a 2nd opinion after this read). Source is a page about IBD from: http://www.vetinfo4cats.com/cibd.html#IBD%20and%20Prednesone All of Ming's symptoms are described here with the exception of diarrhea. It is also worth noting that I mentioned before that prior to the beginning of all this havoc, Ming would regurgitate or vomit after meals, but not all the types of food he eats. After learning more about IBD, I am becoming more convinced that he has, all this time, food allergy. That being the case, I will talk to his vet on Monday and discuss my concern about the long-term therapeutic use of Prednisone. _______________________________ Inflammatory Bowel Disease in Cats Inflammatory bowel disease (IBD) is probably the most common cause of chronic vomiting or diarrhea in cats under the age of 8 to 10 years. It is unclear at this time whether this is one condition or several conditions that appear very much alike. In older cats, hyperthyroidism is also a common cause of vomiting or regurgitation. This disorder can occur at young ages but is more common in middle aged and older cats. Many cats do not exhibit any clinical signs other than chronic vomiting. The vomiting may occur intermittently and often the cat does not appear to be affected at all other than vomiting frequently. The cyclic nature of this disease makes it difficult to evaluate the success of treatment in some cases and causes many cat owners to put off treatment longer than they should. While vomiting is the most common clinical sign, diarrhea, weight loss, depression and behavioral changes can also occur. This problem must be distinguished from other fairly common causes of vomiting, including hyperthyroidism, lymphosarcoma, feline heartworm disease, intestinal parasites, viral illnesses and pancreatic disease. Testing should be done to rule out these conditions, if possible. IBD can only be diagnosed accurately from intestinal biopsy samples. The most common way to biopsy the intestine is through endoscopy. Flexible endoscopes that can be passed into the intestinal tract are used to visualize and biopsy the intestine. It is important to rule out the other possible problems by labwork, if possible, prior to considering intestinal biopsy. In some cases, it is hard to arrange for biopsy to be done. In this case, therapeutic trials of anti-inflammatory medications may aid in the diagnosis. Once it is established that inflammatory bowel disease is present, there are several treatment options. Mild cases of IBD tend to respond well to corticosteroid administration. If caught early, this treatment can eliminate the problem as a future concern in some cats. In older cats or where the disease is well established, medication may be necessary lifelong. Other medications used for this include metronidazole and azathioprine. These medications can be used in combination in severe cases of IBD. Some cats may have IBD due to food allergies. It is always a good idea to consider this possibility and to use a diet free from any ingredients the cat has previously eaten for a period of several months to be sure that food allergies are not present. Your vet can help you design a good diet for this purpose or provide you with commercial foods made to be hypoallergenic. Curing cats of this condition is not always possible but most will respond to treatment and be able to live fairly normal lives. Mike Richards, DVM circa Sat, 8 May 2004 17:32:14 -0700, in rec.pets.cats.health+behav, Zaida (ZTandoc@comcast.net) said, > > > > How?s your cat doing now? I suspect she developed labyrinthitis from [quoted text clipped - 34 lines] > case, I will talk to his vet on Monday and discuss my concern about the > long-term therapeutic use of Prednisone. I don't disagree with anything you're pondering, but I do have one compelling question- what about the thickened stomach? That is not typical of IBD, as I understand it, nor of food allergy. I certainly hope tha |
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