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?

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