Clapton
I have seen many pets come and go from our treatment room during my last eight years at MRAH, and on occasion have had my share of the routine stuff for my two cats. I've lent my support to concerned pet owners, helped them through, played with their pets as they healed, and prayed more times than I could count for their pet's speedy recovery. But things changed drastically for me this past June, when the newest four-legged family member at my home suddenly changed my status at MRAH from that of employee to concerned & scared client.
I had gone on vacation this past spring leaving the “boys” at home. Brian was well accustomed to taking care of the cats while I was away, and really didn't have any huge problems. I got home, said hello to our two Siamese, and looked around for Clapton (Brian's baby), the newest cat in the household. I found him and could immediately tell there was something wrong. His coat was dull, he looked depressed, he was much thinner than normal, and although our bathroom has bad lighting it was obvious to me that his color looked funny inside his ears. My suspicions about his weight were confirmed when I picked him up to pet him--he weighed next to nothing-or so it seemed! When I held him up to our fluorescent lights in our kitchen his skin was a scary yellow. I knew enough from my years working in animal hospitals that Clapton was very sick. I offered him a can of tuna--none of the cats would ever turn their nose up to that!--and he didn't even bat an eye. He wanted nothing to do with it. And when he finally did use the litterbox--his urine was an unhealthy dark orange. Not good.
I anxiously brought Clapton in to work the next morning and Dr. Duncan immediately set an I.V. for his dehydration, drew blood, and evaluated him. His condition got worse as Clapton began vomiting. Dr. Duncan couldn't feel any masses in his belly, which had me relieved a bit. A liver malfunction of some sort was definitely going on because of his color, but more definitive results would be pending blood analysis. We just had to sit and wait and hope the antibiotics, appetite stimulants, and fluid therapy would get our poor cat feeling better. We mutually decided to bring him home that night, and subsequent nights after giving him a bolus of fluids to keep him hydrated, since he still wasn't eating. We kept trying to figure out what had happened. What caused Clapton to get so sick? Did we do something wrong? Should we have noticed his condition previously? Would he recover? These and other questions would continue to plague us nightly and daily for the next three weeks.
The initial bloodwork came back earlier that first day supporting the notion of acute onset pancreatitis--a dangerous condition for both dogs and cats. He hadn't really improved much overnight--I guess I was hoping for a miracle. He still looked depressed, was lethargic, refused to eat, and his urine was still a bright orange color. Again he would spend his day hooked up to fluids in our treatment room at MRAH. When the rest of the bloodwork came in both Dr. Duncan & Dr. Klarquist agreed that pancreatitis as well as hepatic lipidosis was the final diagnosis. Hepatic lipidosis is a dangerous condition cats can get when they suddenly stop eating. This is especially dangerous for overweight cats. When these cats stop eating for a period of time (it could be short or it could be long), the liver will start to shut down, leading to other organ failure, which then perpetuates the problem. Cats with hepatic lipidosis don't want to eat because their body tells them not to. They usually get ill and vomit if they try. But, the only way they will get better is by eating. Did the pancreatitis start first and then cause the hepatic lipidosis? Did it matter? No one really knows for sure.
Hearing this diagnosis was good because at least we knew how to proceed with treatment, but scary because either condition is hard for cats to recuperate from, let alone both. And it can take a long time. Unfortunately, we still didn't know why Clapton got sick in the first place. Was there a tumor somewhere? We were officially in a "wait-and-see" pattern--the hardest of all. Let the drugs take effect, give his body a chance to recover--let's hope he begins to eat on his own. But how long do you wait?
We went through the weekend and decided on Tuesday, after continued hospitalization, an ultrasound was in order. Clapton still wasn't eating and a feeding tube had been place in his nose so we could begin force feeding him. I kept my fingers crossed he wouldn't vomit with the tube in—that would mean his recovery was headed in the wrong direction. Did he indeed have a tumor somewhere? Would we have to subject him to exploratory surgery? The ultrasound revealed a very "angry" pancreas and liver, but we couldn't clearly identify a tumor. We were going hold off on exploratory surgery for now--and move back to the "wait-and-see" status.
After about 5 days of force feeding small amounts of liquid like food every 3-4 hours through his ng tube, Clapton still looked yellow and was still turning his nose up at food. Brian and I started to deliberate about whether we were we doing the right thing? Were we causing Clapton to suffer needlessly because of our selfish desire to fix him? Was he going to get over this after all? How much longer would we have to force feed him and hospitalize him throughout the day? It is never easy to question how to proceed when it comes to one of your pets. How much financially were we willing to spend? And, would he get better after all?
We decided to proceed with the next step in his treatment. He wasn't vomiting anymore, and his condition appeared to be improving, although he still wouldn't eat for us. Dr.'s Klarquist and Duncan were very supportive of our decision and felt like Clapton was a very good candidate to still recuperate. His bloodwork showed no signs of further deterioration, even though he still wasn't eating, and he had youth on his side. The next step was sedating him for a tube that would be placed through his neck, into his esophagus so we could feed him "gruel" instead of liquid. We'd be able to get more food in him more quickly, hopefully making him feel better so he would eat!
We continued another four to five days of force feeding him through this larger tube in an effort to make him feel better. He had been off of his antibiotics for about a week, and had discontinued his appetite stimulants (as sometimes after prolonged use they can have the opposite effect). Brian and I were both tired of feeding him every 4 -5 hours through the nights, and I was especially thankful for our dedicated staff who would help me through the days working while he was here hospitalized. It had been a little over two weeks now since we'd started treatment-but we refused to give up on him now. His bloodwork wasn't improving, but still not getting worse, and he appeared to act a little more like himself--more bright and alert.
FINALLY, Clapton ate some food, on about his 15th day into treatment, while he was home with us over a weekend. And he didn't vomit-yea! We were ecstatic , to say the least. He ate just a small amount, but it gave us hope that we hadn't felt since his treatment started. We continued to tube feed him, because we didn't want him to go back downhill. Over the course of the next two days he steadily improved, eating more and more on his own and gaining strength and his spunkiness back. Clapton, himself, removed the esophageal tube at home-so we knew he was on his way back to feeling better.
I brought him in for the last time almost three weeks from the day I first brought him in. It had been a long journey for all of us, and Brian, myself and Dr's Duncan & Klarquist were hopeful that he had turned his last corner, and was on they way to a full recovery. Although he was still very thin, looked like a newly groomed poodle with his belly, neck and both front legs shaved from all of his procedures, and still a bit yellow, he was finally eating on his own and his urine had returned to a near normal color. We were told the yellow pigmentation of his skin would fade with time-it took about 3 weeks, and his hair would be slow to grow back as well.
As you can see from his photos, Clapton is back to his regular self. It's been about four months since his hospitalization and his hair only started growing back about 1 month ago. We decided to switch back to the way things were for Clapton before he came to live with the Siamese. We went back to clumpable litter, switched to foods we knew Clapton would eat, as well as added a little bit of canned food in the mornings—no one really knows why cats stop eating so we decided to return things to as normal as possible for Clapton's sake. But I have to say, it really is worth the inconveniences to have him healthy again! Clapton has virtually returned to the way he was when he first moved in last winter--his belly is much larger and those three pounds he lost have found their way back. Our persistence, the medical wonders of Dr.s D & K here at MRAH, and of course Clapton's will to live saved the youngest of our brood of cats. Now we both truly know what it feels like to be blessed!
Jessica Reedy
