Sunday, May 7, 2023

Bette Has Evening Trip to ER after Radiation Weakens Her System

Saturday May 6:

So-despite doing better, today Bette decided she was not. She seemed fine this morning and ate. But hasn’t eaten, nor had water-except for the 9ml we gave every three hours-hasn’t eliminated, and both eyes are closing, she hates being touched, hated her mouth touched, was drooling. This happened over the course of the day. By 4 pm I thought something was wrong. I reread the information from her radiologist about how certain symptoms can appear and be normal; how others are life threatening. By 7pm I thought she was worse and since the drive to the vet school is an hour-they have emergency also, have her records, nothing needs to be explained except about what happened today-I took her then instead of waiting even later and risk coming up here with her at midnight. (We are not strangers to midnight visits to our regular ER.) 

They believe she is exhausted from treatment, and is dehydrated; she is not crashing-radiation can cause fistula-a hole-in the colon or bladder leading to death and those signs would appear quickly after occurrence, she would vomit and be lethargic and be unresponsive. Her eyes are closing and they will check both. They will do another urine test. They may change the antibiotic. They will do an ultrasound to make sure her bladder and colon are fine. She doesn’t have a fever. Breathing and heart rate are normal. 

She arrived very weak but once in the examination area, tried to bolt very fast on three legs anytime they let go of her.

She presented clinically with issues but NOT when tested. She had normal temp/breathing rate/heart rate/pulse; was not congested nor wheezy as I thought; and was not dehydrated-not in the blood work, not in the skin test. Her right eye no longer has an ulcer but both are irritated. Her kidney/liver/electrolytes were normal. The ultrasound showed no fistulas or blockages. She does have a UTI with a high level of bacteria, no crystals, normal pH. 

They thought the drooling and not wanting to be touched in the mouth was from nausea. Similar to humans with indigestion and burping, the mouth can get irritated and uncomfortable. They gave her a new med Ondansetron. Cerenia is to stop vomiting and helps with nausea, also. But when a cat presents with strong nausea that causes drooling and mouth aversion, this med is necessary. 

They will do a urine culture to see if we need to change the antibiotic. 

They did not give fluids since she was fine. 

They cleaned her eyes and face (the eye gel gets messy.) We are to continue use of the eye gel but we don't need to use as much and only twice a day (so far.) 

But why had she not eliminated? They don't know why. She had a small bladder and they withdrew some for the test. 

She ate very well for them after not eating all day at home and BEFORE she received the Ondansetron. She left looking more chipper for no reason other than having ate finally. She was perfectly fine once home. She received the new med and her bedtime Gabapentin and ate some more. BUT she still did not eliminate. 

Sunday May 7:

We got up this morning and was fine. We seculded her in the dining room on her own so that I knew if she was the one using the litter box. She ate, etc. She was tired but alert. She slept a lot. I could not express her bladder (I'll need to learn how.)

Then at 2:30 she got into the litter box, and finally urinated-in the box, over the box, on the pad; then moved out of the box, laid down and finished urinating on a pad. She was soaking wet with urine on her backside, legs, and tail. I used a pad to wrap her up so that I could carry her to the laundry room without dropping urine all over. The pad also soaked up a lot of it from her. I gave her a bath in our blessedly very deep laundry room sink from which she could not jump. It also has a hose. I sprayed her down while holding her up in one arm because the bandaged port line in the front left leg cannot get wet. I shampooed and rinsed. Then I wrapped her up in a large towel to dry her, took her outside and sat on the deck in the sun for about 15 minutes, turning her over every so often to dry her. Then I brought her back inside, and she laid on the blankets while we finished cleaning up the pads. 

She also eventually began this afternoon to drink water out of the bowl on her own again after not drinking all of Saturday. 

I'm not sure what happened yesterday. Is it possible she did not get enough of her prednisolone? Maybe I didn't see an air gap that can occur which decreases the amount in the syringe. (Wedgwood sends orange syringes to go with their orange bottles.)

We continue to take this one day at a time. 






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