Wednesday, May 6, 2015

Myrna Had Sudden Saddle Thrombosis-Brief; And a Rant re: Vets

So, Myrna: she had a saddle thrombosis clot Monday night in the rear legs even if the ER vet didn't think so because by the time we arrived, Myrna was no longer lame. Let me complain about the ER vet for a moment or five: someone I've never worked with. Thank goodness for the vet tech I've worked with before-and she with Myrna. At least someone knew what they were talking about. 
She didn't believe what I described was saddle thrombosis because the blood lymphatic test-which I believe it was called-which basically tests for damage done to the muscle and tissues in the legs once a clot cuts off blood circulation (and oxygen) which means they are now deprived and are dying (technically)-came back negative for damage. Includes something also about testing the front vs back legs and comparing the results to determine extent of damage. EXCEPT-what I described was classic leg lameness caused by a clot, which is caused by a clot in the heart which has broken off into parts that have traveled, which we know Myrna to have clots in the heart, and we know she has heart disease that caused the clots. 
Because she didn't have access to Myrna's full chart (because we met Tuesday in another local office with the cardio where she is now on Tuesdays so she took the complete chart with her) the ER vet said she "didn't know" what was the condition of Myrna's heart. But she wouldn't accept my information as "fact". So because the blood test came back negative and because she wouldn't accept my information, she said that Myrna was simply weak. And this was due to the fact that she wasn't getting enough oxygen or oxygenating enough when she tried to breathe. 
So, the second problem-she didn't understand what is CHF. CHF is when there's fluid-any minuscule amount-in or around the lungs. (Maybe also body cavity when the cat has HCM? Not sure. Maybe that's only edema.) CHF is NOT only when the vet hears crackling sounds which is what she claimed. She said there's some fluid but it's not CHF because there were no sounds in the lungs. She was wrong. She said she could try to tap what little was in the pleural cavity around the lungs but I said no. And I said ss long as Myrna was stable enough to come home, I would wait to see what the cardio said about the need to tap. I thought if Myrna had fluid, and Myrna was breathing fast, which she was when we arrived, that Myrna had a lot of sudden fluid build-up or reaction to it (tipping point) and would need tapping. But she disagreed and I didn't trust her to try to tap Myrna. Apparently, Myrna was breathing fine enough in the ER despite fluid. 
Which led to the next problem-her repetitive thread of discussion on what is "stable", "normal", and end of life issues. When I said "stable" she asked what I meant by that. Then she kept saying things such as "You have to understand that she's not stable as in normal" (paraphrase) "You shouldn't get used to changes in her as new normals because then you accept them", "You have to look at the quality of her life and see how she's changed", etc. I said stable as in she can breathe out of oxygen and won't crash going home. She said yes she's fine that way but...and would start her various threads again. I said we have had three weeks with her and the last week was just wonderful with her but we've had time to accept that she's in the end stages of the disease; that we don't see quality of life as important as quantity of life left in her that she wants to express-which the ER vet didn't like so she lectured me on "quality": (paraphrase) "If there are ten things she once did and she no longer does most of them, then quality of life has greatly diminished." 
What I wanted to say is-well, where do you want to start counting from when you talk about not accepting changes as new normal or counting what was once done and no longer is as if there's a diminished quality of life? How about when she was 8 months old and first sick? Or 8 months old and sick and stopped being able to jump three feet into the air to catch a toy? When by the time she was one year old she was on five heart meds and began running and hiding when it was time to give them? And now that she's six she was sleeping as much as her siblings, even if playing less often; but still enjoying birds, windows, food, catnip, etc. And last week, she was still physically with us hanging out, cuddling, vocal, playing with her toys, and eating well, and since it was sunny, she was in the windows a lot watching what was outside. Sure, today, now this week, may be closer to the end for her than three weeks ago. But last week she still had quantity to give. And today as she cuddles next to me there's some quantity left. She's been here before but able to recover and she's never not eaten so yes, it's troubling. And yes, I want to try to figure out what she needs and help her recover to yet another new normal. 
Because sometimes that's all we have are new levels of normal. If great changes happen to us, we are told to rejoice and accept them as new normals. But if bad changes happen, we are told to change them-or accept them depending on what they are. But when it happens to our pets, we are told to put them down. Yet if this were an old person, sick, or a person with a disease, not yet in hospice zoned out on morphine, no one would "pull the plug" (let's not get into a Jack Kevorkian right to die thread of discussion.) 
This has become a rant that I want to use it to illustrate to you that a-don't give up until you can no longer figure out what needs to be done; b-don't ever let someone tell you that you can't describe or have the information about your pet's health. Sure, we screw up remembering some things but I think we know when our cats' hearts have clots or not and should be able to describe what we see them do even if we don't always know why or what it's called; c-how can we put down a pet that's able to rest comfortably, walk around, use the litter box, drink, breathe? And Praise God-that finally ate a whole plate of food (about 3TB) at 7:30 p.m. And d-is it selfish to keep a pet going? Is it selfish to spend all this money, time, effort, lose sleep all these years? Maybe and it's called attachment, love, stubbornness, unwillingness to give up and do what seems so easy to do-pull the plug-but which really isn't.

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