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Ra came home today. - Paint It Black
Living the American dream one heartbreaking piece at a time
Ra came home today.
I gave the vet's office a call at 8:30 this morning, per the directions I received Saturday evening. Doctor Landoch wasn't available, so I left a message and sat by the phone, just waiting. Around 10:15 I got a call back and was given a status update on Ra's condition. First we went over the numbers from his most recent batch of bloodwork. His ALT levels (the ones that indicate cellular damage to the liver) were down from 850 to 426. He's still clocking in at more than 3 times the acceptable "high" mark on the test, but it showed that there was improvement. The GTP levels were down from 19 to 16. That's 16 times the acceptable "high" mark for that enzyme, but again it was indicative of the improvement in his state. As Doctor Landoch said, "We're heading in the right direction." We talked for a few minutes more to get some other things laid out on the table. The decision to do an exploratory surgery has been postponed as things seemed to be getting better. Unfortunately, Ra's appetite was absent and so they were having to force-feed him -- but he wasn't vomiting, which meant he was getting nutrition. Another thing that was somewhat worrying is that Ra was still showing signs of being jaundiced, but it is apparently normal for that condition to lag a bit behind the recovery curve. At this point the doctor felt we should switch over from intravenous to oral medications. As we concluded the call I was informed that I would be free to pick him up at any time in the afternoon.

I got ahold of roho and enveri online and made arrangements to meet them in Vernon Hills for lunch at BD's, my first meal of the new year at my favorite restaurant. The plan afterwards was to head to Schaumburg to claim my cat and pay his bills before driving back to Z'ha'dum to pamper and love on him.

I arrived at BD's a few minutes after noon to find my party already seated and waiting for me. I ate two bowls of stir-fry and talked with a few of our favorite employees before we paid the tab and took the short drive down to the vet clinic.

When I got to the animal hospital I was actually shaking and had to take a moment to steady myself before ringing the bell for admittance (Sunday is emergency-only access at this hospital). After I was buzzed into the reception area I was left to wait for a few minutes (something that only served to increase my tension) and then was escorted into a consultation room. I was presented with the bill for services -- which tipped the scales at $928.75, a little more than half the cost he incurred during his stay from November of 2001. To say that it's worth every penny is an understatement. While I talked with the vet tech who escorted me in, another went into the back of the hospital with Ra's carrier to retrieve him. During the wait I went over the new medications Ra would be treated with and the recommended dosage plans and schedules for each of them. We'd only gotten partway through when Doctor Landoch showed up to talk with me. I shook that man's hand and thanked him profusely for everything he'd done to help my cat, then finished up the consultation over the medications. As of tonight I'm to return Ra to his regular dosage of Prednisone at 2.5mg once a day. He's being treated to prevent secondary infection with Amoxidrops (Amoxicillan in a bubble-gum flavored suspension, which he's had before and which I have not-so-fond memories of from childhood), which he receives 2cc's of twice a day. Along with that is Metronidazole, another systemic antibiotic that he receives 0.5cc of twice daily. To help with the inflammation of his digestive tract, prevent nausea and increase the contractions of Ra's stomach and intestines is Metoclopramide. Ra had Metoclopramide back in 2001 after the surgery and absolutely detested the stuff. He's getting that at a rate of 1cc three times daily, thirty minutes before food (so it has time to work on his digestive tract and get things moving).

Right as I got my credit card and receipts back we finished up with the discussion of medications and dosing. The doctor wants to see Ra on Wednesday again to run another blood workup to ensure that his ALT and GTP levels are continuing to drop. When the tech showed up with Ra in his carrier ... I think I can safely say that's when I started to fall completely apart. I gave him a few soft words of encouragement and looked in at him to find a much more bright-eyed and alert cat looking back at me. Unable to help myself I opened up the carrier and he practically bolted out and into my arms. Seeing his belly shaved from the Saturday ultrasound and the gauze taped to his right foreleg was something of a shock in spite of the reality that I knew those would be there. Having him cuddled in against me and purring, feeling his warmth and weight in my arms once again after 2 days of his absence and over a week of worry ... it was emotional overload for me and quickly cascaded into something that was more than I could handle. I started to cry. I'm sure that I made a pretty foolish sight to behold in the clinic, with my face buried in his neckruff and tears rolling down my cheeks... but I was so glad to have him back after the stress and worry that I couldn't help myself. I mumbled some more words of encouragement to him and told him how happy I was that he was coming home again before I put him back in his carrier and made my way out to the Expedition.

Forty-five minutes or so later I was pulling into the driveway and was both surprised and pleased to hear him maiowing in protest at his unjust incarceration. I brought him inside, put up his food bowl so he couldn't get at it, then let him loose. He sauntered around the house, sniffing and rubbing against all the furniture as if to say That's right, I'm back and walking tall. It was so perfectly Ra that I couldn't help but choke up again. Genet, Roho and I spent fifteen or twenty minutes watching him and encouraging him, then settled in on the couch to watch Starship Troopers on DVD while Ra opted to bask in a sunbeam. After the movie we were all quite hungry, but we couldn't leave just yet as he needed to be dosed up with antibiotics. This is when I found that he does indeed remember the Amoxidrops... and that the Metronidazole is about sixty-five times more foul than the Metoclopramide could ever hope to be. I mean, what you need to understand is that not only is the Metronidazole viscous and require vigorous shaking before administration, it comes in a "beef-flavored" suspension and causes Ra to drool like a rabid bulldog with gum disease almost immediately upon administration. It is quite possibly the most disgusting thing I've ever seen him do, and I had to spend a solid five minutes chasing him around the house before I could catch him and wipe the drool off his jaw, cheek and chest... then I had to go clean up all the spots around the house that he'd snotted up while I was persuing him.

We opted for dinner at Applebee's since I had a coupon. I've dined at my local Applebee's before and never had a problem but tonight the joint was in rare form. From the annoying music to the absent wait-staff to the cold food (and missing salt shakers) the restaurant pretty much hit zero for three. My food tasted mighty good, don't get me wrong, but the service was something akin to what you'd expect to receive at a ghetto Denny's. We smoked a few cigarettes, made some small talk and then went back to my house. Once we were home I filled up the third syringe of the night with the Metoclopramide and gave Ra his dosing, something that went reasonably well. I checked on Ra's bowl and found that he hadn't eaten on his own, so decided I'd have to follow Doctor Landoch's advice and force-feed him. Out came the 40cc syringe, into which I packed 30cc's of Eukanuba high-calorie wet cat food. That stuff smells like puree'd liver, and is about the same consistancy and color. Yum! Everything a growing body needs. Rather than stay to watch the side show that would undoubtedly unfold when I attempted to feed him, Roho and Genet said their good nights and left for home. A minute or so after they left, the half-hour waiting period was up and I gathered Ra into my arms to try my hand at force-feeding him.

The best way I can describe the events that transpired would be to ask if anybody remembers "Super Sloppy Double-Dare" from the 1980s. It was a lot like that. Which is to say things did not go as well as I might have hoped.

I can dose him with pills as easy as one-two-three, it's a skill you master after three years of day-in, day-out routine. I'm sure that by tomorrow afternoon I'll be just as proficient as I used to be at giving him his liquid medications as well. But force-feeding? This isn't something that either of us are going to adapt to any time soon. A 40cc syringe is immense and is nearly impossible to weild when you have a squirming, growling cat in your arms. I estimate that with this first feeding approximately 7 to 10cc's of the wet food ended up on the floor. Another 3 to 5cc's ended up on Ra's muzzle, cheeks and chest. I'm guessing that another 5 to 8cc's of the food ended up on my pants and shirt before we were concluded with the session. That leaves about 7cc's of food that (presumably) went down his gullet to his stomach. That's not even 25%. This is unacceptable, and I'm going to have to find a better way of doing this if I want him to receive nutrition and prevent fatty liver disease from setting in.

I'm strongly hoping that tomorrow and the days following go a bit better when it comes to getting him to eat. If he doesn't get sick of me ineptly trying to squirt semi-solid liver down his throat and start eating on his own I'm going to be in a world of hurt. Right now he's curled up in the den and is being markedly quiet, which isn't something I'm terribly happy to see. But after the incredibly difficult time he's had this last week, I am perhaps expecting him to bounce back a little too quickly. I might just need to readjust my expectations and give him some more time to heal and overcome this. Regardless, I will be spending every free moment that I am away from the office with him and doing everything I can to help bring him back to full health.

I've a long road to walk this coming week, but I'm going to give it my all. This cat means everything to me.

So take these broken wings and learn to fly again

Current Mood: worried worried
Current Music: Dido - Life for Rent

14 thoughts or Leave a thought
genevra From: genevra Date: January 24th, 2005 02:36 am (UTC) (Link)
I'm glad he's back home and doing better. And it sounds like he knows one thing to do to help himself heal: "while Ra opted to bask in a sunbeam." Jaundice is caused by the excess biliruben from the liver and sunlight actually helps the body process and get rid of that biliruben. So, the more sun he gets, the better.

I can't even imagine trying to force feed my cats... You should have taken a picture of the aftermath!
shelbystripes From: shelbystripes Date: January 24th, 2005 02:38 am (UTC) (Link)
It's great to hear that he's getting better...

I know what it's like going through something like that with a four-legged friend. I hope he continues to improve... He will probably need time, but remember, even if it's a little at a time, he's still getting better...
rustitobuck From: rustitobuck Date: January 24th, 2005 04:02 am (UTC) (Link)
It's good to hear Ra's home, and on the mend. I'm encouraged by the fact that he's got the strength to be feisty. That's a good sign.
brianblackberry From: brianblackberry Date: January 24th, 2005 04:45 am (UTC) (Link)
Hey man, I am glad to hear that Ra is doing better now, I hope his recovery continues.
calisi From: calisi Date: January 24th, 2005 04:52 am (UTC) (Link)
I'm glad the news was good, and that Ra's back home where he belongs. *hugs*
fiskblack From: fiskblack Date: January 24th, 2005 06:59 am (UTC) (Link)
If you're having trouble feeding him, you might want to call the vet and ask for alternatives. Some cats take it better than others and they might have other options.

I remember when I made the decision to let Fisk go. There was no way, on my income, I could justify the expense of repeated treatment for a cat who's kidneys were barely functioning anymore. I wish I could have, but I had to be realistic to my situation, given that he would never recover from the condition. The best he could do was get a fluid treatment that would have him well for another month or two and then be back in the vet. Each time, the doctor told me it would get progressively worse until after about a year of it, nothing more could be done. I really didn't want to put Fisk through that for a year, or have me forced to witness it over and over. In his case, I think it was the best course I could have taken. I won't get into details on my emotions because they're still largely private, but very real.

If I were local, I'd offer to come over regularly and help hold the little guy down so you could probably have more success in getting him to eat. He's a good kitty.

Jay Naylor
kinkyturtle From: kinkyturtle Date: January 24th, 2005 07:06 am (UTC) (Link)
Here's wishing the best of luck and strength to you and Ra!
duncandahusky From: duncandahusky Date: January 24th, 2005 11:19 am (UTC) (Link)
There's a long way yet to go, but things are really starting to look up. I'm really happy to hear this.

Incidentally (and as a cat owner, I'm sure you've considered this) would the towel-assisted "cat burrito" method of immobilization be useful when feeding him? Or would that do more harm than good?
collie13 From: collie13 Date: January 25th, 2005 04:17 am (UTC) (Link)
That was going to be my suggestion too -- a great big fluffy towel wrapped snugly around him. ;)

Also, please don't think for a moment the folks in the vet's office thought you foolish for crying over your kitty. When I was a veterinarian's surgery tech, we were always so happy to see someone who wasn't afraid to show they cared about their animals -- because then we knew they'd actually listen to and (more importantly) follow the medication directions. Just use a kleenex and don't worry about it.
harlee_one From: harlee_one Date: January 24th, 2005 12:17 pm (UTC) (Link)
*hugs and scritches to you both* I am sooo HAPPY to hear the Ra is back home where he belongs and I have to agree with genevra on the jaundice and sunlight for both of my younger children had a touch of it and were both put into a willobi blanket. I used to call them my little glo-worms, they looked cute as one and glowed like one too. *wipes a few tears* I started crying mostly throughreading this and I wish you waould know how good that made me feel to hear that Ra is doing better and home again.I could tell by the way you talk about him that he means soo much to you.. My prayers and loves goes out to you both..xoxo
nekosensei From: nekosensei Date: January 24th, 2005 08:04 pm (UTC) (Link)
Wow. What an ordeal! I'm glad that Ra is home with you though.

By the way, this may sound like a stupid question, but have you tried feeding him tuna? I've discovered that almost no cat who is able to eat can turn down tuna. Cosette wouldn't eat after I had her declawed and we had to force feed her for the longest time. However, I tried giving her a little bit of tuna and she hoggie doggied it down. After that, she started eating on her own again. Do you suppose you could give him a small bit of tuna to see if you can stimulate his appetite? It may not be the appropriate thing for him in terms of nutrition, but at least it's something in his stomach, right? And then when you have him eating again, you could switch him back to his kitty food? Just a thought!
tuftears From: tuftears Date: January 24th, 2005 08:42 pm (UTC) (Link)
Yay for Ra being back! Maybe you need to get someone to help you with the force-feeding?
equivocally_me From: equivocally_me Date: January 25th, 2005 09:01 am (UTC) (Link)

comfort calling late

I rarely check on LJ these days, as it's just a mass of too-many updates when you can't obsessively check every thirty minutes, so I don't know how many entries I may have missed on this subject, but ... I'm thinking of you.

(side note: I do check email.)
points From: points Date: January 27th, 2005 03:06 am (UTC) (Link)
*Hugs for you and Ra*
14 thoughts or Leave a thought