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WARNING: This is a long post.
THE TL;dr VERSION: Min recently had major surgery for a condition only mentioned a couple times on the 'Lair so I wanted to delve into this diagnosis a bit for those interested. Min's small intestine telescoped in on itself, knotting, and requiring the removal of the obstruction. Thanks to my vet, Min was operated on in time and will be okay. But the road to get there was stressful for all involved -- which is why I couldn't speak of this on the 'Lair forums until I knew Min would be okay and was well on the way to recovery.
Now for the details...
DISCOVERY
Saturday, February 11, Min dragged off Hubby's Dragon puppet and chewed its tail end off... and I'm suspecting ingested it. She never chewed on the dragon before. But this is Min.
Normally when she chews things she chews them up so much that there's nothing left and she either throws up the remains or poops it out. I won't tell you how many times I raced her to the vet, had her x-rayed, only to be told there's no blockage.
Well, on Sunday, February 12 she was poorly. She vomited quite a number of times. I kept her hydrated and gave her Laxatone (this always pushes things through the couple of times I've had to use this in the past for her or Max; always keep Laxatone in your home kitty med kit). She slept all day, no eating, no drinking on her own, and no poop or pee.
Early Monday, February 13 she tried to steal a drink from Hubby's half full water glass so he got up (I sleep like the dead), filled his glass up, and held it out to her while she was in her cave bed. She drank lots (I eventually woke up). Then she slept and slept... no food, no poop, no pee. I called my vet (it was a holiday here in BC) and he spent a half hour on the phone with me. He told me what to watch out for and what to not be concerned with. He told me that he'd open the hospital for me if I wanted and told me to call him if there were any signs of worsening.
Late Monday night she rallied a bit. I gave her water and more Laxatone. I cancelled my Tuesday, February 14 appointments so I could be home with her. She woke up late, but did wake up on her own. She had some breakfast, water, peed and pooped (looked like foam from the dragon tail... sigh). She even romped around a bit and gave Hubby and I cuddles and purrs.
Tuesday afternoon she didn't eat lunch or dinner and slept a lot. I decided to take her to the vet first thing on Wednesday, February 15. I shouldn't have waited until Wednesday, but hindsight is 20/20.
INITIAL DIAGNOSIS
On Wednesday, February 15 I saw the vet who gave Min a thorough exam and x-rays revealing no foreign objects in her system. He said that when an animal behaves as Min with the persistent vomiting and exhaustion, it's a result of any of the following:
The suspicions were gastroenteritis, possibly pancreatitis, resulting from EATING too many foreign objects. At the time we were content that at least Min didn't have a blockage requiring surgery.
FALSE RECOVERY
I returned home with Min the night of Wednesday. Her bloodwork was good except for that which indicated a mild infection and pancreatitis. Bottom line with pancreatitis is it's usually from something ingested. Given Min's proclivity for chewing and swallowing toys, I had been instructed to remove all toys and did so.
The vet said we may need to put her on calming meds if she doesn't stop chewing things. He hates the idea and so do I, but what else can we do? It'll be a last resort.
I was given about a week's worth of meds to get Min's body righted and then blood work in a month to see if there was improvement.
Wednesday night, Min seemed to be doing really well. She was energetic, cuddly, and ate and drank.
On the morning of Thursday, February 16 it was back to square one. Min wouldn't eat, hid in her tube, and vomited up her meds. It was back to the vet for the day for fluids/nutrients. The vet took another set of x-rays and sent these, along with the previous x-rays, to a specialist to look for more specific issues (he has one of those super high res x ray machines).
Suffice to say I was absolutely frazzled at this point.
ANOTHER DIAGNOSIS
The radiologist determined that Min DID have an obstruction at the entrance to her stomach (not visible on the previous days' x-rays). The vet needed to operate, of course, and did so Thursday night (late). In fact, my vet got another vet in to assist as it's a two person procedure. I reminded about ketamine and he said "Of course not, we have iso." He remembered... it's also all over her chart.
So the pancreatitis seemed to be linked to her ingestion of the dragon or whatever. I asked the vet to keep whatever he pulled out of her.
Min was in surgery Thursday night for quite some time. Once they opened her up, they did not discover a foreign body blockage, but an intussusception (links below) of her small intestine.
Essentially, the intestine folded in on itself so it was the actual obstruction. They had to remove the affected part of her intestine, and was told that she should be just fine. We caught it fairly early by comparison to the same diagnosis in other cats. I saw the removed part of her intestine the next day and the tissue was not necrotic -- just folded in with some fecal matter in the knot.
The cause of the intussusception: in Min's case, it's more or less unknown but could be attributed to all her chewing and swallowing of toy bits. The vet's putting it down as unknown but he's aware of her chewing issue but can't pin it on that conclusively.
So Min slept through Thursday night at the vet's and I didn't pick her up until Saturday. The vet and his staff were in constant contact by phone, which was great.
Intussusception in Cats
Intussusception of the Intestines in Cats
Here's a video of me visiting Min on Friday, February 17: http://xandria.ca/Min/20170217_142251.mp4
She was all high energy and ready to be busted out of jail, but alas! I couldn't spend as much time as I would have liked as she was just going crazy.
PAINFUL START TO RECOVERY
So I picked Min up on Saturday, February 18. She was awfully skinny but will fatten up soon enough. She was very happy to see me and go home. I was given lots of meds for her and lots of instructions.
Also, I have to keep Max from licking her wound. She was given a special diet for 7 days. And her staples are to be removed in 14 days.
Once home, Min wandered around. Max was very happy to see her and gave her a good sniff and little hip lick. She eventually settled down on the bed in front of the fire but Max was anxious to play with her. I intervened a few times and he got the message. He was concerned over her too and missed her quite a bit.
Sunday, Feburary 19 was not as joyous as the homecoming. Min was so full of energy when we left the hospital, but as Saturday wore on she slept more and more and ate less and less. By the end of the day she wasn't eating at all.
Sunday morning was more of the same thing. Min was also "hiding" in the cat tubes, which she doesn't normally do. I called the vet and he asked me to give her her pain meds early, and sadly, force feed her.
I gave her some Nutrical, watered down a bit, with her pain meds. Then I tried force feeding her.
I received some cuddles and nuzzles from her Saturday night but on Sunday morning she didn't seem right.
The vet told me to call if she worsens. She was drinking, so that was at least something good. But she had also spit up some fluid Sunday morning when I picked her up and after the pain meds she vomited up a little blackish fluid.
The vet actually called a half hour after our last conversation and told me to come in to the hospital with her. She was given additional pain meds and anti-nausea injections plus some other meds to clear up any bleeding that might be going on. The vet reminded me that she DID have major surgery so it's going to take a bit of time and the pain is pretty severe. But he told me to call any time, day or night, if I had concerns. I had been preventing Max and Min from interacting but the vet said I should now encourage it as Min needed as much love and consoling as she could get.
Min's meds:
By Sunday night Min had her first poop -- nasty as it was, at least she pooped!
On Monday, February 20 I was still concerned that I had to keep force feeding Min so I brought her to the vet again. He gave her more pain meds and subQ fluids to last 3 days. She was clearly in so much pain.
RECOVERY BREAKTHROUGH
On Tuesday, February 21 Min came downstairs for breakfast on her own and finally ate without force feeding. To say I was relieved was an understatement. She kept the food down and became more active.
Today, Thursday February 23, I'm happy to report that Min is back on her raw food diet (she began turning her nose up at the gastro food yesterday), active, alert, and doing super. She wants to play but realizes it hurts when she does too much. She and Max are cuddling lots and playing a bit together -- I think Min knows her limitations.
At the moment she is still way too thin, but with a few more days or weeks on her raw diet, I think she'll start putting on the weight. She's almost back to eating what she formerly did. Her wound site looks great. The vet did a wonderful job and her staples come out next Wednesday. She'll have a sexy scar to show off for Toa. Her tummy still gurgles a bit now and again, but she's pooping, peeing, eating, drinking, and all her vitals are excellent. The road to recovery is long, but it will get there.
MESSAGE TO MY FELLOW 'LAIRIANS
An intussusception is nothing to ignore. Unfortunately the symptoms are very similar to so many other issues that it can take a while to diagnose. Even on Min's second x-ray all that was seen was a blockage. But at least even with a blockage there is a need to operate and expose the real issue.
This whole process was not without a dent in finances, but I am lucky to have insurance. Even if I didn't, I'd find a way to make this work. The total bill is about $3,000 CAD if anyone is interested. The surgery etc. around $2,000 and initial visit, stay and sundry added on to that.
Intussusception can happen for no apparent reason. I encourage you to read the articles linked to above if you want to know more. It's not a common ailment, but it's a bugger to diagnose and if left undiagnosed too long is not good.
Hugs to all.
Xan
Pics below...
My poor little cone girl. I switched her to the donut almost immediately.
Max saying hello to his sister.
I kept the donut off until her licking the wound site was even a concern. My poor skinny girl.
She had some marks/surface bruising from where the mask was over her face.
Donut girl!
Min's wound site. I wish the staples were put in neater, but hopefully it won't be an issue.
She's doing great now though.
THE TL;dr VERSION: Min recently had major surgery for a condition only mentioned a couple times on the 'Lair so I wanted to delve into this diagnosis a bit for those interested. Min's small intestine telescoped in on itself, knotting, and requiring the removal of the obstruction. Thanks to my vet, Min was operated on in time and will be okay. But the road to get there was stressful for all involved -- which is why I couldn't speak of this on the 'Lair forums until I knew Min would be okay and was well on the way to recovery.
Now for the details...
DISCOVERY
Saturday, February 11, Min dragged off Hubby's Dragon puppet and chewed its tail end off... and I'm suspecting ingested it. She never chewed on the dragon before. But this is Min.
Normally when she chews things she chews them up so much that there's nothing left and she either throws up the remains or poops it out. I won't tell you how many times I raced her to the vet, had her x-rayed, only to be told there's no blockage.
Well, on Sunday, February 12 she was poorly. She vomited quite a number of times. I kept her hydrated and gave her Laxatone (this always pushes things through the couple of times I've had to use this in the past for her or Max; always keep Laxatone in your home kitty med kit). She slept all day, no eating, no drinking on her own, and no poop or pee.
Early Monday, February 13 she tried to steal a drink from Hubby's half full water glass so he got up (I sleep like the dead), filled his glass up, and held it out to her while she was in her cave bed. She drank lots (I eventually woke up). Then she slept and slept... no food, no poop, no pee. I called my vet (it was a holiday here in BC) and he spent a half hour on the phone with me. He told me what to watch out for and what to not be concerned with. He told me that he'd open the hospital for me if I wanted and told me to call him if there were any signs of worsening.
Late Monday night she rallied a bit. I gave her water and more Laxatone. I cancelled my Tuesday, February 14 appointments so I could be home with her. She woke up late, but did wake up on her own. She had some breakfast, water, peed and pooped (looked like foam from the dragon tail... sigh). She even romped around a bit and gave Hubby and I cuddles and purrs.
Tuesday afternoon she didn't eat lunch or dinner and slept a lot. I decided to take her to the vet first thing on Wednesday, February 15. I shouldn't have waited until Wednesday, but hindsight is 20/20.
INITIAL DIAGNOSIS
On Wednesday, February 15 I saw the vet who gave Min a thorough exam and x-rays revealing no foreign objects in her system. He said that when an animal behaves as Min with the persistent vomiting and exhaustion, it's a result of any of the following:
- gastroenteritis
- dietary
- pancreatitis
- foreign object
The suspicions were gastroenteritis, possibly pancreatitis, resulting from EATING too many foreign objects. At the time we were content that at least Min didn't have a blockage requiring surgery.
FALSE RECOVERY
I returned home with Min the night of Wednesday. Her bloodwork was good except for that which indicated a mild infection and pancreatitis. Bottom line with pancreatitis is it's usually from something ingested. Given Min's proclivity for chewing and swallowing toys, I had been instructed to remove all toys and did so.
The vet said we may need to put her on calming meds if she doesn't stop chewing things. He hates the idea and so do I, but what else can we do? It'll be a last resort.
I was given about a week's worth of meds to get Min's body righted and then blood work in a month to see if there was improvement.
Wednesday night, Min seemed to be doing really well. She was energetic, cuddly, and ate and drank.
On the morning of Thursday, February 16 it was back to square one. Min wouldn't eat, hid in her tube, and vomited up her meds. It was back to the vet for the day for fluids/nutrients. The vet took another set of x-rays and sent these, along with the previous x-rays, to a specialist to look for more specific issues (he has one of those super high res x ray machines).
Suffice to say I was absolutely frazzled at this point.
ANOTHER DIAGNOSIS
The radiologist determined that Min DID have an obstruction at the entrance to her stomach (not visible on the previous days' x-rays). The vet needed to operate, of course, and did so Thursday night (late). In fact, my vet got another vet in to assist as it's a two person procedure. I reminded about ketamine and he said "Of course not, we have iso." He remembered... it's also all over her chart.
So the pancreatitis seemed to be linked to her ingestion of the dragon or whatever. I asked the vet to keep whatever he pulled out of her.
Rad Report:
RADIOGRAPHIC FINDINGS
2 radiographs of the abdomen are available for review and are compared to radiographs made to previous day (4 total).
Several segments of small intestine, including the descending duodenum are severely dilated with gas and homogenous soft tissue opacity. There are other segments of small intestine which are normal in size, creating 2 populations of bowel. The stomach is also severely dilated with gas and homogenous soft tissue opacity consistent with fluid. The colon contains gas and a small amount of heterogenous soft tissue opacity. There is less fecal material within the colon as compared to the previous study. The stomach remains severely dilated on both studies. Abdominal serosal detail is adequate. No abnormalities of the renal silhouettes or urinary bladder are seen. The liver and spleen are unremarkable. The portion of the thorax included is normal.
RADIOGRAPHIC CONCLUSIONS
Severe segmental small intestinal and persistent gastric dilation, consistent with small intestinal mechanical obstruction.
WHAT REALLY HAPPENEDRADIOGRAPHIC FINDINGS
2 radiographs of the abdomen are available for review and are compared to radiographs made to previous day (4 total).
Several segments of small intestine, including the descending duodenum are severely dilated with gas and homogenous soft tissue opacity. There are other segments of small intestine which are normal in size, creating 2 populations of bowel. The stomach is also severely dilated with gas and homogenous soft tissue opacity consistent with fluid. The colon contains gas and a small amount of heterogenous soft tissue opacity. There is less fecal material within the colon as compared to the previous study. The stomach remains severely dilated on both studies. Abdominal serosal detail is adequate. No abnormalities of the renal silhouettes or urinary bladder are seen. The liver and spleen are unremarkable. The portion of the thorax included is normal.
RADIOGRAPHIC CONCLUSIONS
Severe segmental small intestinal and persistent gastric dilation, consistent with small intestinal mechanical obstruction.
Min was in surgery Thursday night for quite some time. Once they opened her up, they did not discover a foreign body blockage, but an intussusception (links below) of her small intestine.
Essentially, the intestine folded in on itself so it was the actual obstruction. They had to remove the affected part of her intestine, and was told that she should be just fine. We caught it fairly early by comparison to the same diagnosis in other cats. I saw the removed part of her intestine the next day and the tissue was not necrotic -- just folded in with some fecal matter in the knot.
The cause of the intussusception: in Min's case, it's more or less unknown but could be attributed to all her chewing and swallowing of toy bits. The vet's putting it down as unknown but he's aware of her chewing issue but can't pin it on that conclusively.
So Min slept through Thursday night at the vet's and I didn't pick her up until Saturday. The vet and his staff were in constant contact by phone, which was great.
Intussusception in Cats
Intussusception of the Intestines in Cats
Here's a video of me visiting Min on Friday, February 17: http://xandria.ca/Min/20170217_142251.mp4
She was all high energy and ready to be busted out of jail, but alas! I couldn't spend as much time as I would have liked as she was just going crazy.
PAINFUL START TO RECOVERY
So I picked Min up on Saturday, February 18. She was awfully skinny but will fatten up soon enough. She was very happy to see me and go home. I was given lots of meds for her and lots of instructions.
Also, I have to keep Max from licking her wound. She was given a special diet for 7 days. And her staples are to be removed in 14 days.
Once home, Min wandered around. Max was very happy to see her and gave her a good sniff and little hip lick. She eventually settled down on the bed in front of the fire but Max was anxious to play with her. I intervened a few times and he got the message. He was concerned over her too and missed her quite a bit.
Sunday, Feburary 19 was not as joyous as the homecoming. Min was so full of energy when we left the hospital, but as Saturday wore on she slept more and more and ate less and less. By the end of the day she wasn't eating at all.
Sunday morning was more of the same thing. Min was also "hiding" in the cat tubes, which she doesn't normally do. I called the vet and he asked me to give her her pain meds early, and sadly, force feed her.
I gave her some Nutrical, watered down a bit, with her pain meds. Then I tried force feeding her.
I received some cuddles and nuzzles from her Saturday night but on Sunday morning she didn't seem right.
The vet told me to call if she worsens. She was drinking, so that was at least something good. But she had also spit up some fluid Sunday morning when I picked her up and after the pain meds she vomited up a little blackish fluid.
The vet actually called a half hour after our last conversation and told me to come in to the hospital with her. She was given additional pain meds and anti-nausea injections plus some other meds to clear up any bleeding that might be going on. The vet reminded me that she DID have major surgery so it's going to take a bit of time and the pain is pretty severe. But he told me to call any time, day or night, if I had concerns. I had been preventing Max and Min from interacting but the vet said I should now encourage it as Min needed as much love and consoling as she could get.
Min's meds:
- Clavamox (antibiotic) twice a day for 7 days.
- Meloxicam (pain) once a day for 4 days with food.
- Famatodine (tummy settler) twice a day, .5 hour before food.
- Sucralfate (heals/prevents ulcers; for bleeding) twice a day.
By Sunday night Min had her first poop -- nasty as it was, at least she pooped!
On Monday, February 20 I was still concerned that I had to keep force feeding Min so I brought her to the vet again. He gave her more pain meds and subQ fluids to last 3 days. She was clearly in so much pain.
RECOVERY BREAKTHROUGH
On Tuesday, February 21 Min came downstairs for breakfast on her own and finally ate without force feeding. To say I was relieved was an understatement. She kept the food down and became more active.
Today, Thursday February 23, I'm happy to report that Min is back on her raw food diet (she began turning her nose up at the gastro food yesterday), active, alert, and doing super. She wants to play but realizes it hurts when she does too much. She and Max are cuddling lots and playing a bit together -- I think Min knows her limitations.
At the moment she is still way too thin, but with a few more days or weeks on her raw diet, I think she'll start putting on the weight. She's almost back to eating what she formerly did. Her wound site looks great. The vet did a wonderful job and her staples come out next Wednesday. She'll have a sexy scar to show off for Toa. Her tummy still gurgles a bit now and again, but she's pooping, peeing, eating, drinking, and all her vitals are excellent. The road to recovery is long, but it will get there.
MESSAGE TO MY FELLOW 'LAIRIANS
An intussusception is nothing to ignore. Unfortunately the symptoms are very similar to so many other issues that it can take a while to diagnose. Even on Min's second x-ray all that was seen was a blockage. But at least even with a blockage there is a need to operate and expose the real issue.
This whole process was not without a dent in finances, but I am lucky to have insurance. Even if I didn't, I'd find a way to make this work. The total bill is about $3,000 CAD if anyone is interested. The surgery etc. around $2,000 and initial visit, stay and sundry added on to that.
Intussusception can happen for no apparent reason. I encourage you to read the articles linked to above if you want to know more. It's not a common ailment, but it's a bugger to diagnose and if left undiagnosed too long is not good.
Hugs to all.
Xan
Pics below...
My poor little cone girl. I switched her to the donut almost immediately.
Max saying hello to his sister.
I kept the donut off until her licking the wound site was even a concern. My poor skinny girl.
She had some marks/surface bruising from where the mask was over her face.
Donut girl!
Min's wound site. I wish the staples were put in neater, but hopefully it won't be an issue.
She's doing great now though.
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