Femoral head incision

[Desley (booktigger)]

Well, Molly and Ginger were rarely at the vets, but think they are the only 2 out of 13! Although Molly did end up getting misdiagnosed with cancer and my old doom and gloom vet suggested possible cancer when she developed a mouth abscess!

[Sue P (Paddysmum)]

I know.     None of yours have ever been "easy" if I recall, Desley. 

[Desley (booktigger)]

Yes, it does Sue, just a shame it's hard to treat

[Sue P (Paddysmum)]

It sounds like cause for cautious optimism, Desley.  Hope the scan results are back sooner, rather than later.     

[Desley (booktigger)]

Scan is arranged for Tue, I may get results then, or we may have to wait for a report. Had to speak to a different vet tonight for blood test results, calcium is down, everything else is within normal limits, which is good as her liver values weren't and it means her kidneys are coping with the diuretics. She feels with the other test results that the CT scan will come back fine and then we are looking at idiopathic. It is the hardest to deal with, as you can only treat the symptoms and not the cause, but better than some of the options.

[Desley (booktigger)]

Yeah, it did end up getting to me last night, she was very grumpy, we got growled at just for talking to her. She spent most of the night on the bed with Me, and is currently on my knee, I'm so proud (and relieved) that she isn't avoiding me

[Sue P (Paddysmum)]

Oh Hell, Desley.  What an absolute and utter mess.  And not looking at all good for Lucy.  I do hope the Insurance will cover the cost for the scan.   

[Desley (booktigger)]

We've managed to get sub-cut fluids into her and they can do a scan Mon or Tue - we are looking at £1.5k! Petplan have sent a pre-authorisation form, so just need to get the vets to fill it in and see what they say - afraid if they say no, I can't justify it. If she eats tonight and tomorrow we are good, if not I'll ring tomorrow for more advice. We have cancelled the x-ray on Wed though, and will decide on bloods after the scan. The vet is hopeful that its idiopathic as she is overweight, but I think that is unlikely due to the sickness and loss of appetite and she isn't that overweight anymore.

While on the phone, I discovered that the insurance claim lady has already put a claim in for her treatment, despite me not asking them to!! She has put it in as hypercalcemia which means it's been treated as a new condition so I've paid yet another excess (ironically, what the vets owed me!) - if they decide it's osteomyelitis, will be interesting to see if they would be happy to refund me that!! Told the receptionist and he couldn't see why I was unhappy - but the initial bloods that picked this up had been claimed as hip dysplasia, so by doing things before being asked, it's a bit of a mess. They have paid £1725 in vet fees though, which doesn't include the acupuncture!! 

[Sue P (Paddysmum)]

The concerns you have are valid concerns, and definitely worth raising again when you go this afternoon.  I've never ben above a bit of a "hearty discussion" with a vet when I've felt they weren't listening.

[Desley (booktigger)]

Yeah, that is a good point, especially as her normal vet has left, so as nice as this one is, she has only just met Lucy. I am worried that we won't be able to get her levels under control though - clearly the frusemide isn't enough.

[Sue P (Paddysmum)]

You know her better than anyone Desley, and your gut instinct is telling you things are not right.  I'd be listening to that, rather than the vet.  "An odd cat" - maybe, but she's yours, and you know her like no-one else.

[Desley (booktigger)]

No, it certainly isn't. Still waiting for the scan people, but the vet did ring, and I've suggested that rather than having to sedate her today to put her on fluids, and have an unhappy cat who needs handfeeding, try sub-cut fluids this afternoon. So am finishing early to get her there, but the vet did say she might just be an odd cat. I think that's unlikely as she was sick last night, and hadn't eaten her tea by supper time, so I put her biscuits on it, and she didn't finish eating it till some point overnight. I did do a quick google, and do have a question about her liver values, as they were also initially high.

[Lyn (Slugsta)]

Oh Desley! That is not what you wanted to hear   

[Sue P (Paddysmum)]

Oh Desley.  That's really a bit of a low blow for you both.  I have my fingers crossed Petplan will approve the scan.  Let us know how you get on. 

[Desley (booktigger)]

I did wonder if it was the weather, but rang the vet for her test results, and her values have gone back up to 3.55, which is as high as when we first picked it up  As they have gone up despite the meds, the vet wants to do a CT scan, they are ringing me back with details, as I've said if it is 2k, I'm going to have to get approval from Petplan first. Depending on when or where they can do a CT scan, depends on whether she goes to the Halifax branch to be on fluids over the weekend.

[Sue P (Paddysmum)]

Good point Carol.  It could be the heat, but I think it might be worth a call to the vet (again).  Sorry Desley.  You're really going through it with Lucy at the moment.   

[CarolM (Wendolene)]

I wonder if the heat could have  something to do with it Desley.  It was very hot yesterday (unusual for our neck of the woods).

[Desley (booktigger)]

Well, last night was the first time this week lik e lix failed, so she didn't get her ab's. I also had to take her leftover tea to bed so she'd eat it. She's not devouring breakfast either

[Sue P (Paddysmum)]

How is she now, Desley?

[Desley (booktigger)]

Thanks guys. Am worried again, she's been sick tonight 

[pandorawarlord]

so sorry your having a time and a half, 

[Judecat (Paula)]

As I said I misunderstood and I agree that there is no point in putting her, and her kidneys through an unnecessary procedure. Poor Lucy is going through enough with necessary stuff and medications. I wouldn't be happy either, I am sure that the nurse understood.

I am pleased that she is being forgiving though. Maybe she realises that it is all for her own good.

[Desley (booktigger)]

There is Sue, and it's just a shame it happened around the time of her usual vet leaving, so now I am dealing with vets who I don't know that well, who are now throwing new things in the pot, we've just spent two weeks ruling things out. The other problem with the scan is that to avoid going to a specialist, my vets use a mobile company, which comes around once a month, but of course a CT needs sedation, and next week's x-ray needs sedation, and she has already had 2 this year, and I'm also conscious that that isn't good for her kidneys. It appears I trusted the old vet too much, and didn't ask enough questions, but there is very little online about this kind of operation in cats, so there wasn't anything I could find to question what I was being told, or complications. The irony with the medication is that the nurses were the ones medicating her for the first 4 days (well, apart from the first day when her usual vet popped in on her day off), so you'd have thought they might have questioned if there is an easier option. The only positive I can take is that the first thing she did when we got home last night was rub against my leg, so bless her, she's being so tolerant of all this messing about (she ended up in the carrier for over an hour last night, as I didn't have time to drop her off before going to the other branch), so the operation must have done something, as she's not known for being so placid at things, and she is still sitting on my knee and coming to bed with me at night.

I could do with a break, but not much point if I can't relax because I'm worrying about Lucy. Luckily I'm staying with my brother, so I won't loose too much if I have to cancel.

[Sue P (Paddysmum)]

Yes, I can see why your mind is whirling Desley, as there's a lot to take in.

I agree, some vets are inclined to fiddle about more if they know insurance is available, and if it isn't really necessary then there seems little point in the scan.  After all, we rely on their professional opinion.  if there was some uncertainty, fair enough, but there doesn't appear to be, so I think you're right not to consider it at this stage.

Also understand the frustration about now being told the bone could regrow and cause problems.  It would've been useful to know that before the op.  Poor Lucy.  After all, she's the one at the bottom of the surgery and the treatment.  Surely anything that makes it easier (given her background) should've been suggested at the start.       I would've been feeling a bit snappy too, I think.

In your shoes, I'd end up thinking about not going away too, and that's a pity because I sense you could do with a break. 

[Desley (booktigger)]

Well, had a mixed vet visit yesterday – I do like the vet we saw, she specialises in orthopaedics, but my brain is that focused on the calcium side that I wasn’t in the mood for discussing her leg. She did have a feel of her leg, and said that there is a slight click, which needs monitoring, as apparently that bone can re-grow, and if that happens, she would need more surgery, which I wasn’t happy about, as that was never mentioned as a potential issue. She got blood with no issue, then I gave her the antirobe for her to pill her – she was just about to, when she realised that rather than giving her 2 x 25mg, why don’t we give her 1 x 75mg?? Then she said that to reduce the Frusemide, we’d need to give her a ¼ tablet twice a day, which I said would not only be hard to quarter the tablets, but harder to actually administer, which is when she told me it comes in liquid form, but I had to go to one of the other branches for it – unfortunately by the time I got there, I had a bit of a rant at the poor nurse who asked if I was OK, although I did apologise when I left!! Can’t believe she has been on these for 10 days before someone thought of pointing out there was an easier way of doing it!! I asked her about the CT, and she said ‘if your insurance will pay for it, why not? Some cancers don’t show on an x-ray’ – my response was ‘you’ve looked at her x-rays, is there anything on them that makes you think we need to worry about cancer’, she said that no, there isn’t, so let’s see what next week’s x-ray shows and take it from there. I do think that vets are more likely to push things if you are insured, and just because we can doesn’t always mean we should.  Last night it just didn’t feel like there was an end in sight, and my neighbour isn’t helping by keep asking if I’m regretting the decision to operate - the irony is that this could be unrelated to the operation, although we wouldn’t have already had to deal with the 8 weeks of recovery. Then there is the fact that I’m having to use treats to medicate her, so her weight is going up, which is a concern with her hip, and the diuretics aren’t good for her already dodgy kidneys, so they are underlying worries that I can’t ignore until this is resolved. My other issue is that I’m going away in 9 weeks, and as this is dragging on and on, I know I won’t want to leave her if we don’t have it resolved by then, and if she is still having tests, I can’t leave her for a week, even if anyone else could catch her and take her, I wouldn’t be able to do it. 

[Lyn (Slugsta)]

Desley, I am so sorry that younhave this uncertainty, it is always easier when we know what we are facing! 

[Desley (booktigger)]

I don't know Sue - they were fairly confident it wasn't cancer last week, as the only bit they haven't x-rayed is her front legs and head, although I know some don't show up on x-ray. Will have a chat with the more experienced vet tonight.

[Sue P (Paddysmum)]

Is your reluctance gut instinct, Desley, or a feeling of not wanting to hear the most unwelcome of diagnoses? 

If it's gut instinct, then I'd trust it. 

[Desley (booktigger)]

Her parathyroid tests have come back normal – randomly, that only rules out secondary and tertiary hyper-parathyroidism, not primary. We still can’t rule out idiopathic. The plan at the moment is that if her bloods tonight show calcium levels are staying down, we will reduce the diuretic, then she is going back to the main branch next week to re x-ray and repeat bloods. If her levels are staying down on the reduced diuretic, we will then stop them and re-test after a week to check they are OK with no diuretic. If the x-ray shows the irregularity has gone/reduced, then we would be looking at osteomyelitis – if it shows that there is still an irregularity, it should also indicate that, but then she would need a longer course of a/b’s. If the x-ray is fine, and calcium levels don’t stay down, it would be likely idiopathic, and then it would be long term diuretics, and possibly steroids – neither of which are good with kidney issues.

I told the vet my preference would be osteomyelitis, then it can be connected to the op, he was surprised as he didn’t think I’d want the insurance pot reducing. When I told him said pot was £7k, he suggested a CT scan, which would definitively rule out cancer – I’m reluctant for some reason.

[Desley (booktigger)]

Vet has just rang, her calcium levels have gone up today, they were 3.02 on Sat, and 3.12 today. The vet did wonder if sending her home would help because she isn’t eating much there, but I’ve asked for her to have some diuretics today in the hope that tomorrows test will show an improvement. It was so tempting to say yes to picking her up, but I’d be too worried.

[Sue P (Paddysmum)]

Sending lots of positive vibes for Lucy, Desley, and hoping you can get to see the vet you want - I agree, I wouldn't want her released too soon.   

[Lyn (Slugsta)]

 

[Desley (booktigger)]

Well, I've been able to visit her yesterday and today. Yesterday I got growled at, but was allowed to feed her chicken, took a good 5 mins before she would tolerate being stroked, but then she was really enjoying it. Got about 12 dreamies in her yesterday. She was much better this morning, she hissed, but wanted to be stroked rather than eating, I then got a slice of chicken into her, before having lovely cuddles and fusses, then got 25 dreamies and about 25 renal biscuits in her, plus a bit of wet food. She has wee'd and poo'd today, which is good. the weekend vet thinks they might just release her tomorrow, but I really hope the normal vet wants to recheck first, I'd rather her stay another 24 hours than be sent home too early. I'll post some pics from my phone. We have 2 outstanding tests, so depends what they show as to what we do next.

[Desley (booktigger)]

Thanks Lyn, me too.

[Lyn (Slugsta)]

Desley, I am so sorry Lucy is causing so much concern. I do hope the cause of the problem is soon found and easily treated 

[Desley (booktigger)]

The vet rang this afternoon, they re-did the bloods, and her calcium is down to 3.2 (was 3.5 yesterday) so pretty much rules out human error. She still has to stay overnight on a drip though, then they will re-do bloods to decide if it has come down enough to be sent home - vet was hopeful, as it came down with sub-cut. She is off tomorrow, but lives close, so has said she could pop in to take bloods if needs be. X-ray shows the operation site has healed well, there is a slight irregularity near the top of her leg, so they are treating it as osteomyelitis - I wished them luck tableting her. Specific gravity is fine, so pretty much rules out kidney disease as being the cause, she has sent off a sample for a urine culture to check for infection. The ionised calcium results aren't back yet, and they have sent off a parathyroid test, which could take a week to come back. She has had a pelvic and chest x-ray, so unless there is something in her front legs or head, cancer is unlikely. unfortunately, a lot of cases are idiopathic.

[Sue P (Paddysmum)]

Keeping everything possible crossed for Lucy, Desley, and hope that the prognosis won't be as you fear the worst case scenario.   

[Desley (booktigger)]

Was concerned that Lucy has been sick more recently, so she had bloods done on Wed, vet rang yesterday to say that they have shown an issue, but not the one I expected! Her calcium levels are high, and her liver values are out. Best case scenario is that there is a human error, but given the liver values, and the fact she is drinking more and being sick more makes that unlikely. There are numerous things that can cause high calcium, but with her history, the most likely reason is osteomyletitis, which is basically a bone infection. They are sending what is left to an external lab to test for ionised calcium, but she wants to act like it is that as untreated high calcium can cause issues, so I had to take her to the main branch so she can have fluids, and they are going to try and get a urine sample to test for specific gravity. Other main reason is hyper-parathyroid, which is rare, but this is my cat!! The reason for the fluids is that high calcium can leave deposits around the body, normally the kidneys. They are hoping to get the results tomorrow, but there are numerous reasons for high calcium, none really good. If the vet is right, she'll need strong antibiotics or she could lose the leg. Spoke to the vet this morning, unsurprisingly Lucy wouldn’t allow them to put her on fluids, so the vet did sub-cut instead. She is incredibly grumpy this morning, so they are going to sedate her this morning to put her on fluids, which has the advantage they can x-ray her leg, which will show if it is osteomyelitis or not. She has also spoken to the ortho vet for his thoughts, and he agrees it is the most likely scenario, and possibly the best of the reasons for high calcium levels. She has given me a tip for getting antirobe into her if that is the outcome. The night staff have put a ‘tiger’ note on her cage to warn the day staff!! If she is right, worst case scenario is she could lose her leg. Feel so gutted, we were just getting back to normal after surgery, and now this setback.

[Desley (booktigger)]

Maybe. Poor thing is exhausted now.

[Judecat (Paula)]

Perhaps, although the vet says that there is more to do re muscle mass, she has lost fat and is building muscle. It does weigh more than fat. Only thing I can think of. I am so glad that Lucy is doing well Desley.