Tag Archives: vetrinary medicine

Jorah gets into the act…

Posted on by

Jorah had a vet appointment last Wednesday to get after what I assumed was an ear infection. The good and bad news is that my diagnosis was correct and there was nothing more serious underlying his endless scratching and head shakes. I haven’t entirely ruled out it all being self-inflicted because he may have been tired of staying home while the cats got to take all the field trips.

Winston was perennially bothered by ear infections – just one of the many fun bits of life with a bulldog. Maggie was, fortunately, not prone to them. It had been a while since the last time I had to go through a treatment regimen. I was expecting to come home with drops that would require me to wrestle Jorah to the ground twice a day to administer. I was decidedly happy to learn that the state of the art in treatment has progressed since I was treating Winston. 

Instead of a two week course of drops, the vet applied a single, long-lasting medication and called for a recheck in two weeks if needed. Assuming it works, I’m prepared to call this a brilliant evolution in veterinary medicine.

We also came home with a short course of prednisone. Honestly, I’d forgotten about the joys of prednisone. Most of the side effects have been minimal – except for the one where Jorah drinks water like he’s determined to drain the well. What goes in, of course, must come out. The amount of time we’re spending just hanging out in the yard is a lot more like having a puppy back in the house than I’m comfortable with.

Fortunately, we’re already well into the course of treatment where he’s being weaned off the prednisone. I really hope this is a one off and not the herald of something that’s going to be a regular feature. Maybe by the time the weekend rolls around the household will be back into its regular rhythm… because this temporary new one kind of sucks.

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.

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?

What Annoys Jeff this Week?

Posted on by

1. AFGE Local 1904. Here we are 24 weeks past the “end of max telework” and the union, such as it is, still hasn’t come through on delivering the new and improved telework agreement. So, we’re still grinding along with only two days a week like pre-COVID barbarians… as if 30 months of operating nearly exclusively through telework didn’t prove that working from home works. All this is ongoing while hearing stories of other organizations tucked in next door that are offering their people four or five day a week work from home options. It’s truly a delight working for the sick man of the enterprise. I’m sure someone could make the case that there’s enough blame to go around, but since the updated and perfectly acceptable policy for supervisors was published 24 weeks ago, I’m going to continue to go ahead and put every bit of blame on Local 1904 for failing to deliver for their members (and those of us who they “represent” against our will) and for continuing to stand in the way like some bloody great, utterly misguided roadblock. No one’s interest is served by their continued intransigence. The elected “leaders” of AFGE Local 1904 should be embarrassed and ashamed of themselves.

2. Scheduling. Short of hiring an assistant there simply isn’t a mathematical way to give Anya her medication as scheduled on days when I can’t avoid being in the office. I suppose I could take a two hour lunch every day and double my commute to two 40 mile round trips a day. Maybe I could do that for a week or two, but if the meds end up running for a month? Longer? Yeah. No. I’m fairly fanatical about getting these guys the best care I can find, but after all these years and all these animals, I’ve never cracked the code on how the hell to give them medicine every eight hours, or worse, god forbid, every six. At least three times a week there’s a middle-of-the-day dose that just doesn’t happen, so if you’ve worked out a solution, I’m all ears.

3. Russia. Are we really supposed to take a country that rolls out 60-year-old tanks to replace their “modern” armor lost in combat and then uses a manned fighter jet to sideswipe an unmanned drone seriously as a country? That’s before we even consider their questionable standing as a regional power, let alone their once held status as one of the world’s two superpowers. The Russians, like the Soviets before them, have always been a little bit “different.” Maybe it’s just me, but lately the tired old antics of the ailing Russian bear seem to make it much more an object of mockery and scorn than any kind of fear or intimidation. If they haven’t been doing the work to maintain even their most basic equipment in fighting shape, I’m left to wonder what are the chances they’ve had the time, expertise, and money to maintain anything more than the illusion of a strategic deterrence force. 

Slow progress…

Posted on by

The day to day of my world can be somewhat constrained at the best of times. It’s how I like it, so no complaints. For the last week or ten days, though, it’s constricted even more than usual. 

With Jorah, I spent the better part of six months keeping him contained in the kitchen. Fortunately, the kitchen here is spacious and well lit, so it wasn’t a particularly bad imposition in exchange for easy cleanup while we conducted remedial housetraining and cleaned up his all too frequent accidents. 

With Anya and Cordy, the confinement is considerably less spacious. It may be a generously sized guest bathroom, but the apparent space shrinks down considerably when you add in two cats, a litter box, scratching post, multiple food and water dishes, multiple beds, and some toys. At the moment, the confinement is mostly for the convenience of the repeated, daily rounds of medication I’m giving to Anya. Keeping them in a single space feels somehow more humane than chasing the poor girls through the entirety of the house thrice daily. Plus, she’s currently forced to contend with the cone of shame. Giving her the run of the house while the cone restricts her ability to squeeze into space that would let her avoid any unwanted canine attention feels distinctly unfair. 

The shelter recommended a two week decompression and adjustment period before introducing the new additions to the wider household and all of the additional room to roam. That would nominally end on Friday. The plan for the moment is to maintain the status quo at least through the weekend and Anya’s follow up appointment with her ophthalmologist on Monday. It seems that we’ve gotten a grip on the worst of the infection – her eye isn’t bright, weeping red – but there’s obviously still a lot of involvement with her conjunctiva. Assuming she’ll need continuing medication past Monday, I’ll need to reconsider our options. 

With stress being consistently listed as one of the causes for flare ups of her condition, getting her introduced into the house while also mitigating her symptoms feels like it’s going to be a fine line to walk in the coming days. I’d very much like to avoid a flare up resulting in another weeks long course of drops, ointments, and oral meds.

Anyaka has turned out to be quite the trooper. Despite our rough start and her being thoroughly annoyed with the current medical regimen, she’s purring up a storm and remarkably affectionate. Cordy remains uncertain of this new home. However, she has allowed me to touch her briefly while distracted with stinky food or toys. It’s slow progress all around, but it’s progress nonetheless.