Katharine Saw Neurologist Today for the May 14 Incident

Katharine saw the neurologist today for an exam. He manipulated her legs, watched her walk, then tested her facial responses by flicking his fingers and using a long Qtip to touch her face. He saw right sided decreased response in face and legs as we noticed when she had her episode May 14. If it's a seizure, he believes it could be a left side brain tumor (as with humans, the left brain controls the right side of the body, etc.) Tomorrow she returns for the actual MRI and if that is clear, then a spinal tap to look for inflammation/infection. She was NPO this a.m. in case they did the MRI but they couldn't today due to two emergency cases. She'll be NPO tonight again as of ten p.m. So, she's just now, at 1:46 EST, eating for the first time today. Tomorrow, she goes in at 9 a.m. and will be there for the MRI all day. The MRI will take about four hours from start to finish. Then she'll go to recovery and then she will be released about 5 p.m. or later depending on when the MRI actually begins.

The cost: $2000 for the MRI and an additional $500 for the spinal tap. She will be under anesthesia for both. If she has a tumor, surgery will be required. No, I didn't ask for the price. I can imagine that it's twice the cost of the MRI. While concerned about the cost, I'm far more concerned about Katharine. At least we know her heart is in good shape and she can withstand the operation. So, we'll know more tomorrow. For today's exam, I wrote up her medical history, medication list, gave copies of the ER/cardio/vet tests related to the May 14 episode, and copies of past blood work just in case it was useful. Writing up a detailed history and current medication list always helps the new vet or vet specialist get a better picture of the cat's history, especially if there have been any illnesses.

Update on Katharine-No Clot, No HCm, and No Reason To Be Sick

Update on Katharine-nothing. Cardio recheck showed nothing. Praise the Lord! There's no murmur presenting at all; no SAM; no thickening; no reason to throw a clot. Unlike with humans, pets do not get clots at all unless there's an injury to the area (the leg) or there's heart disease or cancer or some other disease that would produce hypercoagulation. It's possible she had a clot in the leg. But Dr. D, the cardio, reviewed the video we had of Sunday/Monday and Katharine was not in pain-which a clot in the leg would have produced.

It's possible she had a seizure and the leg was part of the process but not physically affected or somehow had neuropathy due to a seizure or something. (https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061)

Xrays show no signs of other disease but she will need an MRI and one is scheduled for next week.

At the cardio, they ran a urinalysis and there was no glucose (which was high in the blood but could be due to physical stress of the situation and the visit to the ER. If she was diabetic for example, the glucose would be in the urine as well.) And there's little protein-which could be from using a needle to draw the sample-the sample being mixed with some blood which is protein.

So we are now doing a albumin/creatinine ratio test:

"The urine albumin test or albumin/creatinine ratio (ACR) is used to screen people with chronic conditions, such as diabetes and high blood pressure (hypertension) that put them at an increased risk of developing kidney disease...Virtually no albumin is present in the urine when the kidneys are functioning properly. However, albumin may be detected in the urine even in the early stages of kidney disease...Most of the time, both albumin and creatinine are measured in a random urine sample and an albumin/creatinine ratio (ACR) is calculated. This may be done to more accurately determine how much albumin is escaping from the kidneys into the urine. The concentration (or dilution) of urine varies throughout the day with more or less liquid being released in addition to the body's waste products. Thus, the concentration of albumin in the urine may also vary..."

She's still on gabapentin. She's showing no other signs of recurrence. I have her on Renal K potassium gel and powder since her potassium level was 3.7-something not seen except with Myrna who was on high levels of lasix as well as potassium.

We will continue to monitor.