Tag Archives: surgery

On the limit of post-operative instructions…

Posted on by

When you leave the vet’s office after one of your little furballs has surgery, they send you home with a post-op care sheet. In theory, this paperwork will tell you what to do, what issues to be on the lookout for, and how to handle some basic situations if they crop up. The post-op sheet isn’t and can’t be an exhaustive reference.

The reason I know this is because it doesn’t address, in any way, the scenario I was faced with this morning. By yesterday evening, Cordelia seems to have overcome her post-surgery lethargy. I’ve seen her eating, drinking, and eliminating – all the things you’re supposed to monitor as your patient recovers.

I don’t suppose any read ahead material really prepares you for starting the day to realize that sometime during the night, the kitten has gone head first into her food dish and smeared food around the circumference of the cone. She also managed to get the edge of the cone into her litter and had that clumped to the cone.

Under normal circumstances (or perhaps with a normal kitten), you might be tempted to think I’d just remove the cone, clean it up, and then put it back on her. The thing is, Cordy remains what I politely like to call selectively feral. She’ll accept being touched on her terms, but when I initiate it, she’s off like a rocket to the nearest available hiding place. She simply will not be “handled.” Thanks to her slight build, those places are most often under things like the bed or dresser and therefore bloody inconvenient places from which to try extracting her.

This leaves me in a bit of a conundrum. I don’t want to put her in a position where she can defile her sutures, but overall, I wonder which is better, removing the cone, cleaning it, and most likely being unable to put her back in it, or leaving her to wander the house for the next week with a crud encrusted cone?

Yeah, there are definitely things the post-op instructions don’t cover.

Maybe I should just hire a staff vet…

Posted on by

It’s Groundhog Day. Again. I schlepped poor Cordelia over to Delaware to get Spayed this morning. It was one of those things that was supposed to come “free with purchase” from the shelter, but after the various go arounds with getting Anya’s eye fixed up, I was more comfortable taking both of them to my own vet. That, of course, means paying all the freight for their medical care myself. Fine. It’s only money.

I feel like we’ve spent an inordinate amount of time dealing with vets these last three months with multiple visits for both Cordy and Anya. I like to imagine we’re going to get a break now that Cordy is finally “fixed.” Given my luck with animal health, I’m trying to mentally prepare for more of the same. If we can fall into a routine of annual visits, that’s great. If it goes the other way, well, we’ll muddle through that too.

The vet says Cordy did well and sent her home with a cone and some pain meds. She isn’t a big fan of the cone. She still doesn’t like to be handled even at the best of times, so hopefully the cone stays on. Catching her and getting it refitted or applying one of the other options would be one of those things I just can’t quite manage to do as a one man band.

I should apologize in advance to anyone I need to deal with over the next 7-10 days. I may be physically elsewhere, but I’ll be entirely focused on what this cat is doing and running every conceivable, statistically improbable what if scenario in my head. Yeah. It’ll be a good time for sure. 

A continuing tale of two cats…

Posted on by

Anya has spent more of her life with me wearing a cone than not. I feel badly about that, but it has been an unfortunate, necessary evil to get her through her initial eye infection, the corrective surgery, and now her spay procedure. I wish I were half as resilient as this little seven pound cat seems to be.

All the literature is quick to point out that spaying your cat is a simple, outpatient surgery. Most of the authoritative online resources say that in 48 hours, your pet should be back to something of their normal selves. The spay itself may be an entirely common surgery, but it’s still invasive as hell, and Anya wasn’t one of those who came around in the usual fashion. Fortunately, she was eating well, drinking regularly, and moving around enough to get to and from the litter box as needed. It’s just now, a full week after her most recent surgery that she’s starting to come around to what I’d consider normal behaviors for her.

This morning she was on my bed demanding ear scratches as soon as my alarm went off. She then followed me around while I prepared and delivered breakfast to all the members of the menagerie. She perched in her overwatch position on the cat tree while I got caffeinated. It doesn’t seem particularly newsworthy unless you know she spent the last week snoozing for 22 hours out of every 24 and often not budging for 8-12 hours at a time. Based on what was reported as “normal,” my level of concern for how she was getting along was beginning to elevate dramatically.

Here’s hoping that this is the start of trending back towards normal… Which should get her there just in time for Cordelia to go under the knife for her own procedure next Monday. Getting these critters settled in has made for an awfully long spring. Had I known what I was in for, I might have made some radically different decisions when picking these two out of the mix. File it away as one of the very few times I’m glad I didn’t know then what I know now.

Maybe by Independence Day, we’ll have everyone off the sick and injured list and start seeing what normal really looks like. I’ve probably just jinxed myself by even thinking about it.

Heat…

Posted on by

Anya is scheduled for spay surgery in two weeks. It was the first available appointment with my regular vet. I could possibly had it done sooner if I’d have gone back through the shelter and used their choice of vet, but my bigger focus for the last two months has been making sure her eye issues were resolved, so I didn’t especially mind the delay. 

Now that we’re four days in to her first heat, let me be the very first to say that I wish I had been focused on both things simultaneously. She’s eight months old now, so this turn of events is not exactly unexpected. As we drew closer to her appointment, I mostly hoped that the natural course of things would just hold off a bit longer. It didn’t, of course, so I’ve been treated to a solid weekend of caterwauling and sweet Aud being an enormous pain in the ass.

All the other rescue animals who have made their way home with me have either arrived after neutering or had standing appointments to have the operation shortly after they got here. These last few days have certainly made the case in my mind for animals to be neutered before they’re placed in a home. For someone who was less tolerant of animal peculiarities or who doesn’t sleep quite as deeply as I do, I can see where the story might not end well.

At least with Anya there’s light at the end of the tunnel – or at the end of May, whichever comes first. I have to wonder, though, how many other intact animals the shelter has sent out into the world who will end up “unfixed” and contributing to the next wave of unwanted cats. I’m fully aware of the resource limitations they’re contending with, but I have to strongly recommend that Cecil County Animal Services revisit their policy of placing intact cats in the community. At some point it becomes a self-licking ice cream cone.

With Anya’s path more or less laid out, now I’m focused on getting Cordelia caught up with her vaccinations and on someone’s schedule for her own surgery. Whether that will be my regular vet or someone else, remains to be determined. Now that she has emerged from her reclusive, under bed period, I’m cautiously optimistic I’ll be able to get her contained and into a crate without tearing the entire house down in the process. Probably. Maybe.

What we’ve learned…

Posted on by

After three days with Anya closeted away under medical supervision, we’ve learned a couple of things:

My girl is a perfectly happy cat, doing normal cat stuff, right up until the point where it’s time to take her medicine. Drops, pills, or even just generally being held result in adverse consequences for those attempting to make her do what she doesn’t want to do. Otherwise, though, she’s happy to receive the attention of her temporary keepers.

She’s eating, and drinking, and pooping, and getting the meds she needs to get over the hump following her eye surgery. It’s as good a result as I could hope for a few days after surgery.

I’d be lying if I said part of me doesn’t feel just a little vindicated after claiming so many struggles trying to get her through the first 30 days of treatment. I honestly was starting to wonder if I was somehow gaslighting myself about how hard it was to get this animal to take her meds. The professionals, however, have confirmed that she can, indeed, get spicy.

I’m glad to have confirmation that it wasn’t just me somehow being ragingly incompetent. However, it raises other issues. Unless Anya learns a bit more tolerance to handling and being medicated as she gets older, it could be well near impossible for me to single handedly deliver any kind of even slightly involved or complex home care. Sooner or later, it feels like we’ll inevitably run into a situation where following the best possible medical advice simply isn’t feasible because the patient refuses to cooperate.

That’s not an ideal scenario in a cat with FHV who is likely to need some level of treatment periodically throughout her life. In my more pessimistic moments, I foresee a series of hard decisions where we have to weigh treating the illness versus treating the patient. At some point there has to be a compromise between the best possible treatment and what’s physically possible. Now that we’ve addressed what I hope will be her biggest medical problem, I think we’ll be making future decisions based on quality of life overall versus the often simpler calculus of what’s medically possible.

When the time comes, someone please remind me that sometimes the best action is no action at all. I always find that hard to remember when I’m in the moment.

A good report…

Posted on by

Anya got a good report from her surgeon. They were able to break down all of the adhesions and resect “a lot” of conjunctive material that has been hooding her eye for months. They laid in dissolvable stitches in a few spots to, hopefully, keep everything retracted as it heals. 

There’s a chance, they say, that the issue could reoccur over time. The ophthalmologist recommends this be a “one and done” shot at correcting it. If it reoccurs, the chances that it will continue to do so is apparently high no matter how many times we go after it. At that point, the course of action is to leave well enough alone since it’s not life threatening. I don’t think he or I have the appetite to chase diminishing returns.

Doc says the eye will probably end up looking “a little wonky” because of how much material they cut out. We’ll see how things look when the swelling comes down. Not that it matters. We may also have to revisit her third eyelid. He’s optimistic it will retract more on its own when the swelling goes down, but if it doesn’t, we’ll figure out what the right approach is – somewhere between do nothing and a follow-up surgery.

Our girl checked out with a bag of pills and drops to administer over the next few weeks. I’m (mostly) happy to be leaving that part of the recovery process in the hands of professionals. I’ll hate not having her here, but that’s entirely outweighed by the benefit of making sure she’s getting her meds in a more timely and less traumatic way than I could possibly manage on my own. I’d be lying if I said I wasn’t happy to have a proper medical staff watching for infection or any other potential post-operative issues… and I’m obviously thrilled that I’m not going to be the bad guy chasing her down and forcing meds on her for this stage of things. 

For now, Anya is a temporary resident of Pennsylvania. How long that lasts remains to be determined. I’m satisfied that the surgery went well and we’ve hopefully improved her quality of life in spite of whatever short term trauma we might have caused… I’ll be happier, tough, when she’s back home bouncing off every wall and flat surface in the place.

Not for the faint of heart…

Posted on by

Anya is scheduled for eye surgery next Tuesday. The plan is to remove some of the conjunctive material currently obstructing her left eye as a result of the repeated eye infections she went through early in life. The underlying eye is mostly undamaged and this operation is intended to remove the existing trouble areas in order to prevent them from eventually adhering to the eye itself. It’s not inexpensive, but it’s work that needs done that should improve both her long term health and her ongoing quality of life.

She’s expected to be discharged Tuesday afternoon with a new round of oral medication and eye drops. Some of these could need to be given as often as every six hours for the first several weeks as she recovers. How a normal person who has a job or any other commitments can arrange to do such a thing is entirely beyond me. I get that the discharge instructions present the optimal course of action, but expecting an owner to be able to pin down a cat and deliver these meds on 16 separate occasions every 24 hours strikes me as perfectly absurd. Each drop, after all, should be followed by a 5-10 minute waiting period, so it’s not as if you could grab her up just 4 times a day and apply everything in a single go. I’m not embarrassed to say that I may have hit the panic button when I caught wind of what the coming weeks could look like. There’s simply no way I could sustain that level of post-operative care for any length of time.

Over the last four or five days, Anya has gotten increasingly combative and has started running away any time I walk into a room. She’s actively avoiding me, cowering, and essentially seeing me as an enemy. With most shelter cats, the advice and expectation is that they’re going to have some amount of time – weeks or months – to decompress and acclimate themselves into their new home. Anya never got that time. Three days after her arrival, I had to start holding her down and pouring meds into and onto her. It’s little wonder she’s losing whatever little bit of trust we may have developed.

Mercifully, I’ve got a friend who helps run a large veterinary practice outside Philadelphia. She’s going to arrange medical boarding for this poor gray fur ball for the duration of multi-time a day treatment. There, the techs will be doing the heavy lifting of keeping up with the schedule seven days a week and the on-staff vets will be around should something need to be addressed immediately. So, as soon as she’s released from surgery, we’ll be taking a short road trip through southeastern Pennsylvania to her temporary home.

Since Anya’s particular flavor of eye infection is often triggered by increased stress, boarding isn’t entirely ideal. It does, however, feel like a better option than having this poor animal at home with me stressing her out and inevitably missing doses of the medication she needs to recover from the surgery in a timely manner. It’s a real devil’s bargain.

I asked the doc yesterday if waiting until Anya was more settled here at home and more comfortable being handled was a reasonable option. He was of the opinion that although the eye isn’t currently an emergency, addressing it was something better done sooner rather than later as it created less overall risk to her sight in that eye.

I absolutely hate the thought of her being gone for two weeks or more, but I hate the thought of irreparably damaging what needs to be a trusting relationship with her even more. I’ve never shied away from getting my animals the best possible medical treatment I could find, but damnit, this one is hard because I don’t have the skills, nor the ability to learn them fast enough, to even be a part of the recovery process. Even if I did, Anya isn’t in the right headspace with me yet to give me the benefit of the doubt.

I know she’s going to be in good hands. The friend who’s helping me by arranging all this for Anya was also responsible for bottle raising Hershel before he came to live with Winston, Maggie, and I. I couldn’t possibly trust anyone more to keep a proverbial eye on my girl and make sure she’s getting everything she needs to get well. Still. The next weeks are going to be tough in a whole different way than the last month was hard. There’s a mile of difference between knowing what’s best and actually wanting to do it. It’s one of those times when the best interests of the animal have to be pressed well above my own selfish desires.

When all this is over, I’ll be putting on a masterclass about the hazards of taking on “project animals” from the shelter. She’s mine now. I’ll see it through. But Jesus, it’s not for the faint of heart.

Diagnosis and the way ahead…

Posted on by

Anyanka had her follow-up exam with the ophthalmologist today and we’ve arrived at several conclusions. 

First, Anya is a carrier for feline viral rhinotracheitis (FVR), often called “cat flu” or less popularly known as kitty herpes. Odds are the virus was transmitted by her mother at or shortly after birth. The virus often presents as a standard upper respiratory infection with the expected coughing, sneezing, and watery eyes, but it can also cause a nasty infection of one or both eyes – in Anya’s case, her left. 

There’s no “cure.” Barring a breakthrough treatment, Anya will be a carrier for the rest of her life and may or may not experience further flare ups. One of the most common causes for these flares is stress – things like living in a shelter environment or suddenly finding herself thrown in a crate and taken to a new home. Given how little I enjoy change myself, I’m optimistic that as things settle into a routine here, we’ll be able to minimize whatever stress she may experience going forward.

Second, most likely as a result of ongoing infection in her eye from a very young age, Anya has conjunctival symblepharon. For lack of a proper veterinary explanation, this is a condition where her third eyelid and portions of her inner eyelid are adhered. It’s why even now that the infection is controlled, you can really only see about 1/3 of her eye. Fortunately, the eye itself doesn’t appear to be damaged. Assuming no further issues, we’ll schedule surgery in about a month to correct the adhesion and try to get her a wider field of view in that eye.

Even with surgery, it’s never likely to look “perfectly normal.” That, of course, is an issue I’m perfectly indifferent about so long as it improves her overall health and quality of life. The vet’s recommendation is that this is a “one and done” effort. If for some reason the surgery doesn’t take, it’s better to leave well enough alone than try repeatedly.

I had a hunch I was getting into something when I decided on this little gray kitten hunkered down in the back of her cage at the shelter, though admittedly this has gotten more involved than I planned for originally. Whatever. Everyone wants an “ideal” kitten. After already spending three months getting passed over, there’s no telling how much longer “the cat with the weird eye” would have lingered there or worse, been returned or dumped somewhere, once they realized the cost and level of effort required to get her fixed up. She’s in no danger of that fate here.

On the good news front, the cone of shame is now tucked in the cabinet and we’re down from four medications three times a day to two medications twice a day. That level of treatment feels much more manageable, especially since the two meds we’re continuing are basic eye drops rather than the ointment that stuck to everything or the oral suspension that she disliked mightily.

Now that we have Anya on the mend, it’s probably time to shift a little focus towards helping Cordy come out of her shell a bit. Given her background as having been “caught in the wild” just a few days before I brought her home, I can’t help but feel like this is going to be a whole different kind of project. But at this point, what’s one more thing to do?

A bloody mess…

Posted on by

The morning feeding here starts most every morning at 5:30. It’s usually a completely uneventful part of the day. Today it wasn’t, of course. It was a bloodbath.

For the prior 24 hours Maggie had been growing a fearsome looking lump under her incision. It was worrying enough that I changed her follow up appointment to this afternoon rather than waiting for Thursday, when it was originally scheduled. We fell seven hours short of that appointment when she dove into her breakfast and the dam broke – leaving a trail of blood tinged fluid dripping down her shoulder and quickly spattering the floor.

“Not good,” my initial early morning response. Maggie didn’t seem bothered at all. She didn’t even slow up on inhaling her breakfast.

Over the next three hours, what I’ve now learned is a common post operative condition called a seroma, steadily grew smaller as the fluid continued to drain – mostly into the kitchen floor. I’ve mopped today. A lot.

Our vet assured me this is all fairly normal. He was happy enough with her progress to take her sutures out, and advising “just let it drain” while handing over another 10 days worth of antibiotics just to ward off any future issues.

So here we all are, confined once again to the kitchen in an effort to keep random canine bodily fluids from soaking in to more sensitive parts of the house. I can only hope this iteration won’t take nine months.

I’m happy my girl is on the mend… though I wish it would involve just a little less oozing.

What Annoys Jeff this Week?

Posted on by

1. Numbers. This blog is my own little catharsis and never really intended as clickbait, but sometimes I really do wonder what sorcery is behind the numbers. My view and visitor numbers have been all over the map for the last few weeks. There’s no seeming rhyme or reason for days that are up or down. Posts that I think should be a hit end up idle and those that I thought fairly bland rack up visits. After fourteen years of doing this, you might be tempted to think I’d have a clue. If you thought that, however, you’d be 100% wrong.

2. Incredulity. The number of times in the last six weeks that I’ve been asked some version of “Aren’t you starting to go stir crazy?” is telling… if only because it reveals how many people don’t really “get” me at all. I’ve got books, critters, ready access to food and liquor, the ability to have almost anything on earth delivered to my front door, and can leave at any time for goods and services that need to be sourced locally. I feel no fear of missing out. Staying home isn’t punishment for me. It’s the life I thought I was going to have to wait another 15 years to have for myself… and after sampling it, I can assure you going stir crazy is the very least of my worries.

3. Persistence. Maggie has been quite a trooper, never so much as attempting to lick or scratch her enormous incision. Keeping a certain white and brown young canine sibling from trying to lick it all the time has been my other full-time job this week. Seven days into healing and he’s mostly stopped – though not before a few full-blown screaming fits on my part. I can sense him still searching for an opportunity. I usually appreciate and even respect that kind if persistence, but in this one case, I’m going to need him to knock it the hell off.