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Rhapsody's follow-up with Syracuse internist

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  • Jim Sinclair
    We are at Rhapsody s second appointment with the internist here at home who is following up with the recommendations by the internist and the neurologist in
    Message 1 of 4 , Jul 18, 2013
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      We are at Rhapsody's second appointment with the internist here at home who
      is following up with the recommendations by the internist and the
      neurologist in Michigan. Rhapsody has been getting Flovent and doing well
      in terms of his respiratory symptoms. His heart and lungs sound good today,
      breathing is fast probably due to stress and/or pain, but not wheezy or
      raspy.

      The big concern now is his gut, which is very big (he looks pregnant with
      six or eight full-term kittens) and seems painful. He has been pooping
      every day, and his stools are a good consistency, not hard and dry, not
      mushy, but disproportionately big and sometimes hard for him to push out.
      The week before last he passed some very bloody stools. Our regular vet
      recommended decreasing his prednisolone dose (if he has an ulcer, pred will
      make it worse), reducing lactulose and cisapride from three to two times a
      day in case they're causing irritation, and resuming Tylan. On that regimen
      he hasn't had any more visibly bloody stools, but has had big stools that
      he had to strain to pass.

      Last night he appeared to be in so much pain that I gave him a glycerin
      suppository (only ingredients are glycerin and water, as other ingredients
      in human OTC enemas can be bad for cats), and that promptly elicited what
      looked like a normal cat bowel movement but made barely a dent in
      Rhapsody's hugely distended belly.

      So today the internist and I discussed more medication and diet adjustments
      (more liquid, more protein, less fiber), and we agreed that he should have
      an enema to give him immediate relief of what looks to be a really
      miserable belly ache, then proceed with the adjusted regimen and hope he
      doesn't get to this point again. If he does have continued difficulty at
      home, I will need to give enemas at home.

      They gave him the enema in the room with me and let me record it so I can
      learn how to do it myself. Then they left us alone here in this room with a
      litter box.

      And so far nothing has happened. We are waiting and waiting and waiting and
      waiting. And nothing is happening.

      An odd thing happened, before the enema, after the vet examined Rhapsody
      and while we were talking about the options. Rhapsody was on my lap. All of
      a sudden his head sort of flopped down on my arm, and his body kind of
      jerked. The jerk looked like a hiccup, and he proceeded to have several
      more of what looked like ordinary hiccups, which would not have been
      alarming except that at the same time he seemed floppy and out of it, as if
      he'd fainted. After a few minutes the hiccups stopped and he began holding
      his head up and seemed alert again. Anyone have any idea what that could
      have been?

      Still waiting for the enema to work.

      Jim Sinclair jisincla@...


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    • Jim Sinclair
      Rhapsody did not poop after getting nearly a full 60 ml syringe of enema at the hospital. After a long wait, we decided to do another enema. I did this one
      Message 2 of 4 , Jul 18, 2013
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        Rhapsody did not poop after getting nearly a full 60 ml syringe of
        enema at the hospital. After a long wait, we decided to do another
        enema. I did
        this one myself with a clinic staff person coaching, to make sure I
        was able to do it. This time he took an entire 60 ml, and still
        nothing happened.

        It seemed odd to me that what they used as an enema solution was warm
        water with some KY jelly mixed into it. I asked, what about using
        glycerin? Amazingly, they did not have any glycerin at the hospital!

        After we waited and waited and waited some more, and he still didn't
        poop, I finally brought him home. On the way home he sat on my lap and
        did open-mouth panting. Since it was about 120 degrees in the van and
        the air conditioner is once again not working, I figured the panting
        was more likely from the heat than from asthma or heart disease.
        Instead of turning around and taking him back to the hospital, I
        rushed home as fast as I could and got him into the house (where it
        was "only" 86 degrees) and put him into a cage with a litter box so I
        could monitor his output. He got right into the litter box and pooped!
        A nice normal-looking poop, which would have been fine if he didn't
        have such a huge distended belly, but wasn't nearly enough for the
        amount of distention he had.

        I got a freezer block out of the freezer, wrapped it in a pillow
        cover, and put it in the cat bed in his cage to help him keep cool.
        Then I went out to buy ingredients for his latest diet adjustment.
        When I came home he still had not produced any more poop, so I gave
        him another glycerin suppository like the one I used last night. And
        just like last night, within about two minutes of getting the
        glycerin, he pooped. So he had two normal-looking bowel movements and
        no longer looks like he's in an advanced state of pregnancy, but I
        really expected the enemas to clear more than that out of him.

        Then I made him a batch of his new low-fiber food, and fed him dinner,
        and he liked it. :-)

        After dinner he lay next to me breathing very fast. It was up to 88 in
        here, so I think the heat was getting to him. I took the freezer block
        (which by that time was still cool but no longer ice cold) out of the
        cage and put it on my bed next to him, but I couldn't tell if it
        helped him or not.

        The heat wave is supposed to peak tomorrow, with temperatures even
        higher than today's and heat index over 100. I'm trying to figure out
        how I can help the critters make it through until the weekend when
        it's finally supposed to cool down.

        Jim Sinclair jisincla@...
      • Laurie Stead
        Can you borrow an a/c from someone for at least one window so there is one cool room in the house?  The heat is not good for a kitty with a heart condition. 
        Message 3 of 4 , Jul 19, 2013
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          Can you borrow an a/c from someone for at least one window so there is one cool room in the house?  The heat is not good for a kitty with a heart condition.  He needs to be able to maintain a normal temp without effort.

          Does he receive miralax daily?  That will help soften new forming stool now that it sounds like his constipation has been relieved.  You don't want to put him through more suppositories and enemas unless completely necessary.

          He went through a lot yesterday. Hoping his breathing is better today.

          Laurie





          ________________________________
          From: Jim Sinclair <jisincla@...>
          To:
          Sent: Friday, July 19, 2013 1:13 AM
          Subject: [FH] Rhapsody's follow-up with Syracuse internist



           
          Rhapsody did not poop after getting nearly a full 60 ml syringe of
          enema at the hospital. After a long wait, we decided to do another
          enema. I did
          this one myself with a clinic staff person coaching, to make sure I
          was able to do it. This time he took an entire 60 ml, and still
          nothing happened.

          It seemed odd to me that what they used as an enema solution was warm
          water with some KY jelly mixed into it. I asked, what about using
          glycerin? Amazingly, they did not have any glycerin at the hospital!

          After we waited and waited and waited some more, and he still didn't
          poop, I finally brought him home. On the way home he sat on my lap and
          did open-mouth panting. Since it was about 120 degrees in the van and
          the air conditioner is once again not working, I figured the panting
          was more likely from the heat than from asthma or heart disease.
          Instead of turning around and taking him back to the hospital, I
          rushed home as fast as I could and got him into the house (where it
          was "only" 86 degrees) and put him into a cage with a litter box so I
          could monitor his output. He got right into the litter box and pooped!
          A nice normal-looking poop, which would have been fine if he didn't
          have such a huge distended belly, but wasn't nearly enough for the
          amount of distention he had.

          I got a freezer block out of the freezer, wrapped it in a pillow
          cover, and put it in the cat bed in his cage to help him keep cool.
          Then I went out to buy ingredients for his latest diet adjustment.
          When I came home he still had not produced any more poop, so I gave
          him another glycerin suppository like the one I used last night. And
          just like last night, within about two minutes of getting the
          glycerin, he pooped. So he had two normal-looking bowel movements and
          no longer looks like he's in an advanced state of pregnancy, but I
          really expected the enemas to clear more than that out of him.

          Then I made him a batch of his new low-fiber food, and fed him dinner,
          and he liked it. :-)

          After dinner he lay next to me breathing very fast. It was up to 88 in
          here, so I think the heat was getting to him. I took the freezer block
          (which by that time was still cool but no longer ice cold) out of the
          cage and put it on my bed next to him, but I couldn't tell if it
          helped him or not.

          The heat wave is supposed to peak tomorrow, with temperatures even
          higher than today's and heat index over 100. I'm trying to figure out
          how I can help the critters make it through until the weekend when
          it's finally supposed to cool down.

          Jim Sinclair jisincla@...



          [Non-text portions of this message have been removed]
        • Jordan
          Jim, My Sheba is a heart kitty and has feline asthma. I have started to give her about 1/8 tsp of psyllium powder 2x per day to produce bulky stools, and
          Message 4 of 4 , Jul 19, 2013
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            Jim,

            My Sheba is a heart kitty and has feline asthma. I have started to give her about 1/8 tsp of psyllium powder 2x per day to produce bulky stools, and it seems to be working. Previously her stools were long and narrow.

            I have another kitty, Cameo, who once was backed up from a bad reaction to antibiotic (clindamycin) that killed all the good flora in her GI tract. Enemas did not work for her either. She required a deobstipation (surgical flushing) and was good as new and has never had a problem since. She though, is not a heart kitty.

            Good luck,
            Jordan, Sheba and Cameo


            [Non-text portions of this message have been removed]
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