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Case Report: Cessna - His tail's not all it's cracked up to be... - 07/10/2017
This handsome 8 year old came to see us for the first time in May, this year, with a particular tale to tell. His owners had found him on April 18th, with an injured tail and a trail of blood through the house, leading back to their daughter’s bedroom and under her bed, where he loved to sleep. His owners had no idea what could have happened to his tail.
Cessna's damaged tail bone
They rushed him to a veterinary hospital on emergency basis and they repaired the injury by amputating the injured tip of his tail. About a month later, he returned to the hospital, having traumatized it again. He had been wearing an Elizabethan collar all the time and still managed to injure himself.In addition, he was hiding, no longer social and good natured. It was recommended that the rest of his tail be amputated. Cessna’s family was uncertain that was what they wanted to do, so they brought him to Exclusively Cats Veterinary Hospital for a second opinion.
On May 24th, there was no sign of infection, and the tail tip seemed to be healing well, so we re-bandaged it and attempted to manage his apparent chronic pain with a prescription for Tramadol. At this visit (and previously, at the other veterinary hospital), Cessna was notably quite grumpy and intolerant of much handling.
Cessna's new, short tail
Cessna’s hind end was very sensitive and his owners were not able to look at his tail at home, and was also very difficult to medicate. On May 30th he managed to remove his bandage and get at his tail, again. On June 16th, Cessna’s family found a tick on him and wanted to have us look at him. He had been doing well on the Tramadol, but still seemed bothered by his tail. At least, however, he was not attacking it anymore. On the ride into the hospital, he started attacking his tail again, and urinated and defecated on himself. His family was distraught because they felt that he was miserable and could not live with this issue. They wondered if he needed his entire tail amputated. We took x-rays of the tip of his tail, and it appeared that due to his attacks, he had either exposed a sliver of bone, or some nerve tissue or tendons. At this time, his owners opted to pursue another tail amputation, and another 2 inches of tail needed to be removed. The concern about amputating completely was that if the entire tail was removed and he was still painful, he might start attacking his hindquarters and cause irreparable damage to himself. We applied a pain patch, gave him a mild sedative, an epidural, and a cocktail of other pain medications. He recovered from surgery well, and we sent him home on phenobarbital for pain control, sedation, and suppression of hyperesthesia-like symptoms.
Abnormal bone-like material in one of the tail joints
He went home again, but went into hiding. He started attacking his tail again on the 18th. His appetite decreased and started trying to bite his mom when she medicated him. He hid under the bed and defecated on himself when his family members tried to get him out from under the bed.
Cessna was a little embarrassed by his Thundershirt, at first...
His family was beginning to lose hope. Cessna was miserable, and they wondered if it wouldn’t be kinder to euthanize him. He was no longer the loving cat they had known, and he seemed to be in constant pain and distress for no known reason. We examined his tail again and reviewed the x-rays from the previous hosptal and discovered an abnormal joint much closer to the base of the tail that did not flex as nicely as the rest. We x-rayed the area and discovered a very small round mineralized object located in the joint space between two tail vertebrae. This is likely abnormal bony growth due to arthritis. Because it is located between two vertebrae, it likely sends shooting pain down the length of the spine whenever he moves his tail. Since the pain was radiating down the length of the tail, Cessna was attacking the part of his tail that he could easily reach, and not the area that was causing the pain.
We amputated the tail behind the affected joint, leaving about 3-4 inches of tail for him to wave, and crossed our fingers. He received another pain patch, a local nerve block and was started on a medication regimen of gabapentin for neuropathic pain, phenobarbital again, and Onsior for inflammation. In addition, Cessna started wearing a Thundershirt. He stayed with us at the hospital for 18 days as we balanced his pain medications – little enough that he could walk around, eat, and use the litterbox, but enough that he would ignore his tail. Over the time that he was here, he grew continually more affectionate and well-mannered. He began asking for attention, rather than hiding. He was allowed some exercise time to sit in the office with the doctors while they worked on paperwork, and he sat on the cat tree with Mr. A.
Cessna became more outgoing after a while
At first, the Thundershirt was hard for him, because he wanted to curl up in a ball and not move with it on, but by the time he was discharged, he was jumping up into laps for cuddle time. Our entire staff enjoyed his antics as he became more adventurous and learned how to steal tuna fish from Dr. Demos, or snuck through the door to visit the receptionists. On July 6 th, we took his sutures out and for the rest of the morning, he was angry at his tail again, so we gave him an injection of Simbadol, which is a long-acting pain medication. We suspect that his tail was a little painful again, because we meddled with the tail and scrubbed it to clean the incision area.
On July 7, he went home to his family, and the purrs that rumbled out of his chest were so loud they could be heard across the room! We are hoping that he continues to improve over the next few weeks so that we can stop his medications and continue with just the Thundershirt. We’ll have him wear the Thundershirt for another couple weeks after that before we have his family try to take it off. At that time, we hope that his life can get back to normal – his long tale cut short for good reason!
Environmental enrichment (tuna in a cup) becomes Cessna's preferred method of keeping his tail safe
Case Report: Tangled Newborn Kittens - 04/21/2017
Being a veterinarian can be very humbling, sometimes, because no matter how long a veterinarian practices, there is still the likelihood that each day, they may see something they have never seen before. Exclusively Cats Veterinary Hospital has been around for 25 years, and Dr. Bailey has been practicing even longer than that, and he observed, "In all my years of practice, I have never seen anything like this before!"
Dr. Brooks was presented with 5 kittens that were two days old, born to a feral mother that had been trapped. The foster owner had not been able to access the kittens well, because the mother cat would not let her near them, and she did not want to disturb the litter because all the kittens seemed to be nursing well and appeared active and content. That morning, the mother cat had moved away from the kittens and it became apparent that something was wrong. One of the kittens was nursing on the mother cat, but the other 5 kittens were together in a pile across the cage, struggling and crying. When she reached into the cage to pick up one of the kittens to check on it, she realized that it somehow seemed to be stuck to the other 5 kittens!
Desperately, the foster owner called veterinary hospital after veterinary hospital, looking for help. Time after time, she was told that there was nothing the hospital could offer, or that they didn't work with neonatal kittens. Finally, when she called Exclusively Cats, we told her to rush the kittens in. When she arrived, Dr. Brooks discovered that the kittens were entangled in their umbilical cords. Often, young cats do not know enough to separate kittens from the placenta effectively, and this can cause complications. Sometimes, kittens may end up missing tails or legs because the mother cat is unaware of what she is doing, and in this case, because she only separated a couple of kittens, the rest became ensnared as they moved around. At first, they were happily nursing, but as time went on, they became even more tangled and eventually, the mother cat abandoned them across the cage, because she couldn't figure out what to do.
Immediately, all of our technicians started dropping what they were doing to come to the aid of the kittens. Some held small feet and tails out of the way of Dr. Brooks' work, while she attempted to disentangle them, others weighed, cleaned, fed and warmed the kittens as they were separated. Two of the kittens had hind limbs that were too badly injured to save, and two kittens had umbilical hernias, so Dr. Bailey also jumped in as we cleaned and prepped four of the kittens for emergency surgery. Two leg amputations and two abdominal surgeries later, all five kittens were warm, fed and snuggling in warmed blankets. They received antibiotics and tube feedings because they would not drink from a bottle and the mother had not allowed them to feed recently. At that age, too, kittens cannot urinate or defecate on their own - the mother must stimulate them to eliminate, and so all the kittens were "pottied" as well.
Once all the kittens were recovered, fed and warmed, we taught the foster mom how to tube feed them, if necessary and sent them home. We hoped that they could be re-introduced to the mother so that they could nurse. The prognosis for the tangled kittens is very grave, as there is a huge risk of infection in kittens so small, and with such daunting beginnings. Fortunately, as soon as they were put back with their mother, she accepted them and they started nursing! this is great news, since they will do better with their mother's milk than with kitten milk replacer.
Overnight, one of the kittens who had an abdominal hernia passed away. Two days later, the foster mom brought in the kittens to weigh them. One of the kittens was euthanized due to a septic infection in the leg that was amputated. All the other kittens gained weight, but the kitten that was not part of the entanglement outweighs the others by about 40 grams! Hopefully, with heavy doses of antibiotics and close observation and care, the rest of the kittens will survive this ordeal!
Meet our Holiday Kitties: Snickers and Skittles! - 12/12/2016
SNICKERS AND SKITTLES
Snickers (orange and white)-age 16.5, 10lbs & Skittles (white)- age 14.5, 13 lbs. Skittles has one green and one blue eye. Both are Russian Siberians They have been patients with Exclusively Cats since they were kittens.
Mommy adopted me (Snickers) first from a breeder and then I told her I was lonely so she got Skittles from a different breeder. She got us from a breeder because at the time the person she was living with was allergic, and we are considered hypo-allergenic because we have very low levels of the dander protein that many are allergic to, called FeL d 1.
We love to go outside in our tent and are good buddies. We like to play fight and even though I am smaller, I still beat up Skittles and mom has to break up our fights.
Me in my window
I'm the life of the party!
Hi! I am mommy’s little person.I sleep on her head every night We have a great bond as I have been with her for a long time.She says I am emotionally in tune with her and people: if someone is sick, I take care of them and I always know when mommy needs cheering up.I even greet everyone as they come in.As you can see I really love the Christmas tree.When the tree isn’t up I like to lounge in the window and get my sun on or sleep on the top of my cat post.When I occasionally feel like playing, I love the little mice that shake and the laser beam.I am a very social cat so I am always at the dinner table…usually I sit on the floor and hope food comes my way, but when one of the seats is open...I take it!I also like to drink my water out of a Dixie cup on the bathroom sink. It is always filled up as I am being monitored for kidney disease.I love to eat, and wet food is my favorite.I also am always looking for cat treats but Cool Whip and turkey are my favorites!The team at Exclusively Cats is great but I turn into a very bad boy at the vet.I think I have scratched everyone there. :( Mommy feels bad about it and now I have to be put under sedation for some procedures.
and always have to be in on the action.
I love the holidays!
My little brother (see what I did there? He is small in the photo!) showing off his three legs
Skittles' beautiful eyes
This is Skittles, he is my little brother.We are very different as he is always the nonsocial one and runs and hides when people come to visit.However, that mellow attitude makes him a good boy at the vet, unlike me.He loves the dry food more than wet which I think is crazy.He also loves the occasional small piece of cheesy puffs but doesn’t beg so that means more food for me!Skittles is on special dry food because about 10 years ago he got a urinary blockage but we caught it in time and now he is good.While I like to snuggle, he loves to be roughed up.It is not unusual for him to yell and run around the house for no reason. He also likes the laser and our new cat dancer toy.
In May of 2015 mom noticed a very small lump on his back leg. After visiting Dr. Bailey for a check-up, we found out the lump was a fibrosarcoma that maybe he got from being vaccinated. Mommy decided to have surgery performed, since amputation was the best option to try to rid him of the cancer.It’s almost 2 years and he is still cancer free.It’s funny but his personality has really changed since the surgery.We call him “thumper” because you can always here him coming. :)He is so much more outgoing and is out and around all the time now.He has a stool to help him get on the big bed that is one of his favorite places.He is also demanding and yells at mom and dad when he wants them to sit on the couch so he can come up and lay on them on the blanket.He has even become a snuggler in bed. I think he has become daddy’s boy. He isn’t any different to any of us as a tripod. No one wants to hear the word cancer, but if it is an option to amputate do it.Cats are so resilient and we couldn’t imagine not having these moments with him!
Skittles the snuggler
Happy Holidays from S&S!!!!
Esophagostomy tubes (E-tubes) and cats - 12/02/2016
There are a number of reasons that a veterinarian might recommend the placement of an esophagostomy tube or e-tube if your cat is ill. The most common reason to place a tube is due to poor appetite - whether from pancreatitis or cancer or other illness. Other reasons could be to give fluids and medication to a cat in renal (kidney) failure or in the case of an oral or facial injury that makes it difficult for the cat to eat. Many people are concerned about the idea of placing a tube in their cat's neck because they fear that it will bother the cat, or it may look strange, or it may be difficult to maintain, but in reality, most people find that their cats are not bothered, the tube is surprisingly easy to maintain, and it is not as strange to look at as they thought. We thought that we would share a couple of recent experiences with you, and we invite you to share your own experiences, if you have had a cat with a tube placed.
An esophagostomy tube is a tube that is placed in the side of a cat's neck and sutured into place. The opening to the tube is located behind one ear, and the other end is located near the spot where the esophagus meets the stomach. There is a cap on the end of the tube behind the cat's ear, and the cat wears a small cloth collar to help protect the tube site and prevent too much motion of the tube.
Ms. Poof -
Ms. Poof with her tube
We would like to share our experience with the feeding tube that we decided to use for our cat.
At age 15 she has develop kidney disease. After several weeks of trying different ways to maintain her weight and make sure she got enough fluids, Drs. Bailey and Demos spent a great deal of time helping us though several treatment plans
They offered the potential use of the feeding tube. It sounds much worse than it is! We decided to try it
The procedure was quick. Our cat is fairly fussy, but she has had no reaction. The little cloth collar doesn't bother her at all- and she would never tolerate a regular collar.
This has made caring for her so much easier. We can get her the necessary fluids and can also administer any necessary medications-we all know how stressful it is the get a cat to take a pill! She plays and eats and sleeps normally with the tube.
I would recommend giving serious consideration to using the tube if the doctors make the suggestion. The entire staff at Exclusively Cats are phenomenal.
They care for our cats as if they were their own.
I'd be happy to talk to anyone about our experience.
Peabody, our renal failure kitty -
Thanks for asking me to write about our experience with Peabody and using an e-tube while he was
Peabody snoozing with his buddy Lewis
in renal failure. Peabody was our second renal failure kitty. His sister, Kimba Girl, had it as well. Kimba lived to be 18, and she was on sub Q fluids for 18 months. She just kept going and going! Still, it was quite a commitment to give her the injections every day, more injections as time went on. She accepted them quite well.
Peabody and Lewis sharing a heated bed
We were given the option for an e-tube with Kimba, but we truly thought that once she was on fluids, it would only be a matter of months. We didn’t want to put her through the surgical procedure at 16. Since we had to give her injections for well over a year, we knew that, for Peabody, we would do the tube right off the bat, because he could be on fluids for quite a while.
Peabody enjoying the outdoors with his tube
I was, at first, surprised by how long the tube stuck out from his neck. I was concerned about his collar bothering the tube. He had to wear a little cloth sleeve to protect the tube incision site as well. For the most part, it didn’t seem to bother him and, while we did have a few challenges with the tube, I believe it was a good choice for Peabody overall.
Our cats do go outside in the yard a bit. This was the hardest adjustment, because Peabody could not eat grass once the tube was in. The grass-induced vomiting put him at risk of coughing up the tube. Still, he wanted to go out every day and enjoy the sun, roll in the dusty driveway, rub his face in the catnip, and eat grass. As a result, I spent plenty of time just following him around the yard monitoring him to ensure he didn’t eat any grass. Sometimes I stood in the sun, for 10, 20, 30, minutes, while he just nosed around, rolled, etc. I must admit it drove me nuts sometimes, but I’d love to do it one more time with him.
As luck would have it, he did vomit the tube up in our living room just a couple weeks after having it put in. It is something that happens. We just did not give him fluids that day, & got him back to the vet the next day, and the tube was replaced.
The incision site needs to be cleaned daily. This did not prove to problematic; I just did it before or after giving the fluids, while the cat was already next to me. I kept the supplies in a little bowl, and I did it on the sofa. Peabody did not like to be carried to the bathroom counter for such things.
We did run into an unusual problem about 9 months in. We noticed some sort of black stuff – possibly a mold – growing inside the tube. Very weird. Not sure how it ever got in there. We tried pushing a tiny syringe of coca cola thru it, but that did not work. I even bought some tiny pipe cleaners, dipped it in cola, and tried to scrub the tube interior, with no improvement. However, by doing that, I think I tugged a bit on the stitches attaching the tube to the neck, so we once again had to take him in and have that addressed. Since the tube had this mold, it had to be replaced – again – and it was stitched up again. We had no further problems with the tube. The good vets at E-Cats indicated they had never seen that before, so it’s unlikely you would run into that particular concern.
As far as giving the fluids, there are several advantages of using the tube. First, it is so much easier
Peabody's tube did not interfere with his favorite sport - extreme napping
than using bagged fluids, heating it up, filling syringes, and giving your cat several 2 oz injections. I just put warm tap water in a mug, filled a 2 oz syringe from the mug, and took the syringe and mug to the sofa. I would no sooner sit down and Peabody would hop up next to me, purring. He loved getting his water. He curled up and just purred loudly while I slowly pushed the water. I assume it felt warming, and filled his belly. He was always happy to have it. It was a very loving experience.
Another advantage of giving the fluids through a tube, is that it was easier for my husband to do participate as well. His eyesight is not the best, so filling the syringes quickly and making sure he was injecting the cat properly was difficult for him. That meant most of the work fell to me, and it was hard for him if I was out of town. With the tube, he could easily give Peabody the fluids and have some nice “sofa-time” with sweet Pea.
As Peabody occasionally got constipated, we needed to give him some Miralax every day. With Kimba, we added it to her food, and could never be sure if she ate it, or one of the other cats. With Peabody, we just stirred the Miralax into the cup of warm water, and it went in with his fluids. Easy peasy.
The little cotton collars do need to be laundered. Peabody’s tube stuck out quite a ways, and I was always concerned about it hurting if he got in a tussle with another cat, or while scratching. I sewed a little piece of elastic to the collar so that I could tuck the tube under that, and keep it “hugging” closer to his neck.
A loving memorial to a singular cat
We now have our 3rd renal failure kitty, Lewis. Lewis was recently put on fluids just for a few days, and he improved. Eventually we know we will have to make the choice again – do we give him daily injections or the tube? A major factor will be that Lewis likes to go outside much more than Peabody, and his favorite thing is eating grass. We will have to decide if we want the convenience and ease of the tube for ourselves, or to let him continue to enjoy the yard and eat grass. We’ll have to wait and see.
Meet Mr. October: Ahote - 10/07/2016
Ahote has a very special story - we didn't just pick an orange cat because it is October and the leaves are changing colors. Ahote was brought to us in September as a stray cat that one of our clients had noticed hanging around for a number of weeks. She brought him in for a checkup and he had a microchip! We scanned the microchip and it was registered to a Michigan phone number but a Chicago address. We tried several times to contact the owner at the phone number, but we were unable to contact the owner, so suspect that the contact information is not current. It is VERY important to keep your microchip information current in case of situations like this one! We did learn that the cat's name was Ahote, which means "restless one" in the Hopi language.
Cloudy fluid from Ahote's abdomen
In the meantime, he did not seem to be feeling well. At first, it seemed like he might be coming down with an upper respiratory infection, but he didn't want to eat and seemed very uncomfortable, so we decided to take an x-ray. We were very surprised to see his x-ray when it was developed - there was a BB in him, and a large amount of fluid and debris (effusion) in his abdomen. We tapped his abdomen and found that he had evidence of inflammation in the abdomen (peritonitis) , but no obvious bacterial infection. However, the presence of the BB in him and the sheer number of white blood cells made us concerned that he may have had a perforation in his digestive tract. Other concerns were a condition called steatitis, which is an inflammation of the abdominal fat, and pancreatitis, which is an inflammation of the pancreas.
Abdominal fluid with WBC, RBC, plasma and fat - layers from bottom to top
Ahote was upgraded to a critical case at 8pm that night (a Thursday) and we ran bloodwork and prepped him for surgery. His blood clotting times were prolonged, so we knew that he might require a
blood transfusion during surgery, and we were right to be prepared! Dr. Demos and Dr. Bailey quickly performed an exploration of the abdomen, found no leaks in the intestinal tract, but did find some firm lumps of necrotic (decomposing) fat. This confirmed that Ahote had a case of steatitis. We were able to flush the remaining debris from his abdominal cavity and complete the surgery, which was good, because the samples that we had collected from his abdomen earlier grew bacteria, as did the lumpy fatty material we collected from his abdomen. We started him on multiple antibiotics because both the white blood cell count in his blood stream and the cell count from his abdominal fluid were high. A normal white blood cell count in a cat his age should not be higher than 15,000 cells per deciliter of blood. His WBC count was 43,400 cells per deciliter! The white cell count from his abdominal fluid was 156,400 cells per deciliter. Ahote was losing a lot of blood and protein during this procedure, and his blood pressure was so low that it would not register on the blood pressure machine.
Ahote getting prepped for surgery
Once we knew he was going to need a transfusion, Mr. A was prepped for a donation. We needed fresh whole blood ASAP! In addition, while one of our technicians was in surgery with him and the surgeons, another technician was gathering blood from Mr. A, and a third was preparing to get blood on a second cat, as several of our staff members were contacted to bring donors from home on their days off! When the other cats arrived, we continued to use our teamwork to efficiently prepare donors and collect blood and transport it to surgery for administration.
He received two blood transfusion during surgery and several more post-surgery - a total of four whole-blood transfusions and 2 fresh frozen plasma transfusions, because his protein levels were still low after surgery. By 10pm, he was out of surgery, but the doctors were in disagreement as to whether he was going to pull through. He was on blood pressure support medications for 4 days post-surgery, and IV fluids for 6 days after surgery, but he started eating again, and we had hope that he would persevere.
Ahote rubs your legs for his ENTIRE length - even his toes!
As of the last week of September, his white count is almost normal, and he is active and affectionate, though his name, "restless one" definitely fits - he winds around our legs and head-butts and climbs all over us, but is definitely not a lap-sitting cat. He has a peculiar habit of rubbing against a person's leg and then sticking one leg out straight behind him, pointing his toes, and stretching. It is an adorable thing to see!
He is still taking multiple antibiotics for his peritonitis, as well as Vitamin E and liver supplements for their free-radical scavenging and anti-oxidant properties, to treat the steatitits. We hope that when he is fully recovered, we will be able to find him a good home. We may never know why he developed steatitis, but generally the most common cause is a poor diet, deficient in Vitamin E.
Ahote's care was in-part funded by Foxy's Fund - made possible by generous donations from people like you! Without your help, care for cases like Ahote would not always be feasible for us to manage. Thus far, Ahote has received over $5000 worth of care and treatment. If his story moves you, we hope you would consider donating to his cause through Foxy's Fund and theVeterinary Care Foundation.
Ahote hopes that he can look forward to a bright and happy future!