Thursday, September 25, 2008

Another trip to the chiropractor/holistic vet

Scruffy's been increasingly cranky about being touched below his "waist" - or however you would describe the lower regions of his chunky little body. And he seems - although he's still hopping up on the bathroom sink and the table beside my chair and stuff without appearing to have any difficulty - but he seems stiffer and less mobile somehow. I had had an appointment for chiropractic follow-up back in December, which I cancelled because of the weather and then never got around to making another one. So, this morning, we got up early - a lot earlier than planned because Milk had a seizure at 6:30 AM - and got ready - oh, so casually so as not to alert the Cranky One! Who, in that mystical way cats have, apparently was fully aware that I planned to cram him into the carrier again and drag him someplace where he didn't want to go for the 3rd time in a week. And who, immediately, disappeared into the lower reaches of the house. I went downstairs, accompanied by the sea of furry creatures that trails along behind me everywhere I go (except for Milk, who was under the couch upstairs) to try and grab Scruffy and get on the way. No luck. I got out the feather toy - although he did watch Tootle play with it, he wasn't about to come near it himself. And then he started racing around the perimeter of the room, behind all the furniture and Rege's boxes and bags and folders and junk. I opened the sliding door - thinking that he would never be able to resist peeking outside from downstairs, where the door is almost never open, but it wasn't enough to entice him, either. I finally located him behind the recliner. I climbed on it, reached around the back and attempted valiantly to grab him by his scruff. He's bulky, and quite strong, and there's NO loose skin anywhere. Eventually, it was quite clear that I wasn't gonna be able to get hold of anything but one of his front legs and I'd better do THAT fast because he was about to squirt out of my reach. So, apologizing fervently, I dragged him around the corner of the chair by his leg, and plunked him in the carrier. And he hissed and spit and POUTED the entire one-hour trip to Vanport. He actually sat with his back to me in the car - meaning he was looking at the closed end of the cat carrier most of the trip. Even when I stuck my finger in the grill and tried to pet him - no interest.

When we got to the office, they called him in almost right away, but the vet didn't come for about ten minutes. He carried on royally about getting OUT of the carrier. When I slide the kitty pi out, which always works because he just sits curled up in it and ignores everyone - even that wasn't a success - he climbed out of it in the carrier and let it go without him. Expressing his displeasure required quite a lot of hissing and spitting. And in the meantime, the technician said she had to poke around him - for a "required" wellness exam - and that included the ultimate insult, temperature-taking. Needless to say, not a happy camper by the time the vet arrived in the room.

More hissing during the treatment, and personalized glares that include eye squinching so we'd know he MEANT it followed. There was one spot in the middle of his back that provoked the most violent reaction yet. All in all, the whole treatment took only a couple of minutes. I asked about the possibility of his having arthritis in those hips. Dr. K. said - examining what he could of them through the spitting and commotion - that he thought that xrays would be necessary to be sure, and that he could give me a sample tablet of a glucosamine preparation he uses in his practice. I told him about Scruffy's telling the animal communicator that he didn't NEED cosequin any more. (I thought he, of all people, would appreciate that story; didn't appear to...)

Anyway, we left it that I would bring Scruffy back for a follow-up adjustment after the surgery and the cone-wearing-period were over. Which I'm sure would be just fine and dandy for the Puffer.

Additional comments - teeth are a mess. (Yes, I know.) About two pounds overweight, at 12 pounds, 8 ounces. (Well, he's solid, that's for sure.) He's not happy being here. (Duh.)

Oh, and most of the way home, Scruffy was SO happy he spent most of the trip rolling around on his back, with his feet in the air! Rubbing and purring and rolling. It was hysterical. So, I guess we can conclude with some reliability that the treatment worked....

Tuesday, September 23, 2008

Surgery is scheduled.

We had our appointment yesterday with Dr. B, who was also the ophthalmologist who cared for my Black Kitty when he had glaucoma back in 2000. Dr. B. did say that he has not done the laser surgery for a cat, either, but he has done five or six dog iris melanosis treatments. At this point, I am confident with his ability and skill, and the reality of trying to arrange to have the procedure done elsewhere is too difficult. So.......

Here's the plan:

Surgery is scheduled for 10/7/08, when I'm supposed to appear at the hospital with a starving Scruffy in hand at 7 AM. The surgery will be performed (under general anesthesia - isofluorane) somewhere between 9:00 and 10:00 or so, and is expected to take about an hour and a half. He will recover at the hospital, and I will be able to come and pick him up later in the afternoon. He will have to wear a cone to prevent his rubbing or scratching his eye. He will have eye drops, metacam for the post-surgical inflammation, probably buprinex for pain, and I don't know what else. Oh, Dr. B said that it would be possible to use non-steriod eyedrops afterward, which is a plus. He's gonna be one unhappy little cat. I want to be sure to remember to tell them about not touching his tail or his back legs, particularly the left one, too. I wish I'd thought of it yesterday while we were talking to the doctor.

About a week prior to the surgery (presuming that the new antibiotic prescribed yesterday for what seems like an herpes attack/possible sinus infection is effective) , Scruffy is to have the "met check" xray package - three views of his lungs, intended to ascertain that there has not been any sort of metastases of possible melanoma from his eye. And blood work, to check his kidneys in particular, because of the anesthesia, and because Dr. B feels that the best anti-inflammatory treatment for post-surgery is metacam. This stuff will be done at our regular vet. Who Scruffy is not fond of, to say the least, but I think it's preferable to having them done at the specialty hospital. He's never had xrays, to my knowledge, and how they're going to convince him to let them do it is a total mystery to me. I don't even want to think about it.

Here's the surgical caution we were given:

"Laser surgery is approximately 65% successful to induce regression (in some cases) of the pigmented iris mass (iris melanosis site.) Some patients will need additional laser (and/or other) surgical procedures. There is the potential for post laser-induced ocular lesions such as glaucoma, uveitis (inflammation), cataract, lens luxation, retinal changes, tumor spread, misshapen pupil, others. He may need maintenance ophthalmic medication. He will need to wear the E-collar for ~3 weeks post-op. " There is also an additional warning regarding anesthesia and patients with "metabolic abnormalities (ie. diabetes)."

Not exactly a bright and sparkling prospect, huh? The cost estimate is between $935 and $1057.

I did finally get copies of the doctor's notes from the previous visits, but there is really not much of any significance on them. (Aside from the note that there was "slight" (underlined!) progression in the left eye's melanosis between the appointments on 9/28/07 and 2/21/08. The pictures are posted below - it sure didn't seem "slight" to me. And despite Dr. K's overt disinterest in my pictures at each visit, you certainly couldn't have looked at the squiggles she made on the report form and had even the remotest idea what that thing in Scruffy's eye looked like.

Just to make the poor cat really miserable - and in case there's any extra money left in the account (two $150 appointments at the Speciality Hospital in a week!), I'm taking the Puffer back to Dr. Doug on Thursday for a chiropractic appointment. I had cancelled his last one, back in December, because of the weather. But he's gotten increasingly cranky about having his "lower forty" touched, and he seems to have major discomfort/difficulty doing things like standing up now. I would like to know if he's got arthritis or something that can be treated back there. I really don't want him in unnecessary pain. His life is hard enough as it is.

One last thing - Dr. B. estimates that Scruffy's about 8 years old. He said that - I guess judging from the condition of his eyes - he is definitely not 10 or near that. That fits, I guess - when I first got him, back in 2003, the guess was that he was around 2 years old. And I've had him now for 5 years. My sweet boy.

I'm very nervous about all this. The metacam, and diabetes, and the cone, and the cancer possibility, and everything else. Nothing to do but hope, I guess. And try not to embarrass myself by bursting into tears at the least provocation.

It just occurred to me to wonder how you put a cat wearing a cone into a carrier?

Wednesday, September 10, 2008

Today's appointment

Well, it appears that Scruffy will be getting his melanosis lasered, and in Pittsburgh. Dr. K offered today to ask Dr. B - who was the ophthalmologist for my beloved Black Kitty some years ago - if he would do the surgery. They took Puffy back for him to take a quick look at the eye, and he apparently agreed to do it. (Although, if he was able and had experience with it, which is what Dr. K said today - how come she had to get a protocol from some vet in Virginia?) The initial plan was for me to bring him in early (next Monday, it appeared) to meet with Dr. B, and then for them to do the surgery right afterward. That set up - which I had a little trouble with because I always need time to "prepare" for stuff (to stew and moan and whine and adjust to the potential change) also was troublesome because of Milk's morning medication, which I try very hard not to mess around with. Eventually, we decided to schedule an afternoon appointment for me to meet with Dr. B - I guess I'm supposed to bring Scruffy with me, since he really didn't get to look at the Puffer's eye with his instruments, etc. - and then they will schedule the surgery at that time. I think that's better anyway. I'm nervous enough about the whole thing to begin with.

I took along a bunch of the "diet-controlled diabetic" information today, as well as the eye picture from 8/9/08, but there wasn't any discussion of either. Nor did I get to ask for any sort of summary of the visit again. I did get a bottle of some sort of eye drops that I'm supposed to give Scruffy for several days prior to the surgery. At first, they were going to be steroid drops, but Dr. K said that there was a non-steroid option. Unfortunately, he will probably need steroids after the surgery, though. I'm torn - I feel like I should have enjoyed this last five months without insulin a whole lot more than I have, and despite the fact that I feel much better informed about using Lev, etc, now than I was before, it's still not a happy prospect to think that he might end up insulin-dependent again. For him, I mean - I'm so tied down with Milk's medications that it doesn't make much difference to me if Scruffy needs shots or not. Plus, now I have a spreadsheet...... Whoopee.

I'm scared for my poor sweet old brown kitty. Nothing I've ever tried to do for him that was supposed to be beneficial has worked out that way. It was my fiddling around that made him end up a diabetic in the first place.