Thursday, April 24, 2014

Feline Fatty Liver Disease

I had heard some years ago that obese cats must reduce their weight very slowly and carefully to avoid getting Fatty Liver Disease. Lately, I've been wondering about the effect Henry's rapid weight loss has had on his liver. Normally, when a body is undernourished or starved, the body automatically moves fat from its reserves to the liver to be converted into lipoproteins for energy. Cat's bodies are not designed to convert large stores of fat, so when a cat is in starvation mode, the fat that is released to the liver is not processed efficiently, resulting in a fatty and low functioning liver.

God is so great! Back at Day 10 of Henry's massive vomiting when I prayed and was inspired to find a new way to get nutrition into him, I didn't realize that I was treating Fatty Liver Disease perfectly! I wondered a few days later why Henry's stools were abnormally green for several days. This was a symptom of Fatty Liver Disease. Or why he hung his head down - another symptom - of very low potassium - also an indicator of the disease. Why he's lost some fur on his muzzle and paw. And there are other examples, too.

The bottom line is that 4% of the cases of Fatty Liver Disease in cats is caused by rapid weight loss due to respiratory infections. It's a real miracle and blessing the way that my prayers were answered in how I should treat Henry, at home, to save his life and that the things I was guided to do were things that addressed a condition I didn't even know he'd developed and addressed it in the most perfect way, according to veterinary medicine standards.

Henry is looking and acting more like a real cat every day. Progress is, understandably, slow, given how severely ill he was. While his breathing is still labored at times, he is now moving enough air to be able to cough a little bit, which helps clear his lungs. He is no longer spewing up lung crud several times a day. Yesterday, he only did it once and today, I haven't seen any at all, but I hear him swallowing it, so it's still coming up, which is good. I am still doing coupage and it really gets things loose, which causes a bit of respiratory distress until Henry can get it up, but it's much, much less severe than it was only a few days ago. He's not used his oxygen concentrator in nearly two days! He needed it last only after coupage when air was restricted while he was working some stuff up. He and I are back to sleeping on my bed - for the first time in 5 weeks! He has tried a few times to lay across my neck, but he still can't breath well that way so he doesn't last very long in that position. His belly is rounded, which concerned me until I followed him around until I saw him have a BM and it was soft, but seemed difficult for him to pass anyway. Tonight I'll give him some sub-Q fluids and that should help. It's what caused me to look into Fatty Liver Disease, too, and see that he's had it and come out on the other side of it already.

Henry is using the cat scratcher a little each day. His eyes are bright again and he's sleeping well and he looks so much more relaxed and comfortable. I can't imagine what it's been like for him to spend two months struggling for every single life-sustaining breath. He is coming back to life and it's a miracle to behold!

Monday, April 21, 2014

Happy Easter!

Easter is such a special day. I love Easter church services; they are my favorite! As I sat in church this morning, I thought about all the billions of people all over the world celebrating the resurrection of our Savior Jesus Christ and what that means for all of us. What it means to me and how I live my life and what I teach my children and the hopes I have for them, that they may one day walk in total faith. I cannot put my feelings into words, but today was profound as I pondered more fully the depth of the meaning of the Atonement and Christ's love for all of us and the commitment I have made in accepting Him as my Savior.

Sunday, April 20, 2014

Henry's Recovery

Warning, there are some graphic pictures at the end of this post.

Henry is continuing to heal. I see progress every day, but it's painstakingly slow. He started turning the corner last Monday. I think the scale at the vet's office was very wrong because I finally unpacked mine and he was nearly a pound lighter than what the vet's scale indicated. Henry got down to 4 lb. 1.6 oz. That is absolutely skeletal! He has gained 8 ounces in the last 4 days!!! He's never gained that much that fast, 1/4 pound, but I could feel the difference when I held him. I feed him 150% what I was when he was healthy, in small meals around the clock, plus still give him sub-Q Ringer's Lactate every 24-36 hours since he can't drink enough yet to stay fully hydrated since a full stomach puts too much pressure on his lungs.

I can't begin to explain how I knew Henry would live and wanted to live, and he had more strength of will than I did. At one point I felt so terrible, that after all he's done to fight this awful pneumonia that he still wouldn't live and he'd have suffered for nothing, but I was wrong and I'm so glad I gave him a chance to prove himself.

Right now he's resting beside me on the sofa, lying on his side, something he can now start to do again periodically. It's been impossible for him to breathe in this position until just a couple of days ago. Even just a few minutes ago, his mouth opened and he started having trouble breathing, but I now know that when he does this, he's about to hack up some nasty mucus from his lungs and, sure enough, that's exactly what he did (but it's still scary to watch). And I took a picture of it to show you all how viscous and nasty this stuff is. The red stuff in it is a little bit of his food. Tonight's mucus was a new level of yucky, as he's finally starting to expel the stuff that's very deep in his lungs. The amount you see in the pictures came up all at once. I'm so grateful for this even though it's gross and messy and I have to stop him from eating it, because it gives him digestive trouble, just like Apple got when she kept swallowing her mucus when she had pneumonia. It's crazy how much comes out of such a tiny little cat. When I get a chance, I'll see if I can put pictures of his x-rays up for you all to see. I know when it's best to do coupage in his feeding schedule so he doesn't lose a meal with the mucus. He's started to groom again, but tires out very, very, very easily, then just sort of collapses where he is and rests up. He still uses his oxygen tent a few times per day, just for a rest, and I've found Brother in there with him a couple times now. I'm also still using a warm mist vaporizer and he actually likes it. He's on three antibiotics, but it's the Azithromycin that really kicked the mycoplasma and saved his life. He's also on Baytril and Clavamox. I give him feline digestive enzymes and probiotics, too, for his digestive tract.

I'm in awe of this little cat. Tonight as I laid beside him, he kept in constant contact with my body, if I moved, he'd reach out a paw to find me. I arranged for a friend to feed him the day I had to be out-of-town for Apple's casts removal and he was clearly peeved at me all the next day. He and Brother have more facial expressions than any animals I've ever seen. They are both very expressive and easy to read, it's amazing. The other night I settled Henry in the living room and then I pottered around the house a little bit more and when I finally came in and sat near him on the sofa, he was so clearly relieved to have me near. He's known from the very beginning that he's absolutely dependent on my for his life. He understands about needing his medicine. He takes ALL his meds willingly and without any problems at all.

Despite his skeletal appearance, Henry is comfortable, eating voraciously, eliminating well, and showing many signs of recovery. I know it's hard to see him this way, but he has been direly, desperately ill and it's a miracle he's pulled through. His recovery will take some time, but he will enjoy a very good quality of life again, and, hopefully, many more years filled with good health. All the pictures below were taken today.

Henry's spine.

Saturday, April 19, 2014

Casts Are Off

Last Thursday, Apple got her casts off. It was just in time as it's turned rather hot here and she was over-heating just walking around the house. She's already using her new fingers, but they are, understandably, weak from being in the casts and the new configuration needs time to learn to move, she drops her spoon every couple of bites, but they'll soon strengthen right up.

Today, I had to remind her that she can now play with her toys, especially her books, which are her favorites.

She does have a complication. Not on her hands, but the abscess on her head has turned out to be colonized with MRSA. I am working with the doctors to decide the best course of care and treatment, but would welcome most of all, your prayers - specifically, that the wound will heal without the need of surgery. It would be best for our family and, especially Apple, if we can postpone any further surgeries until fall. This last recovery seemed quite hard on her. She really needs a break.

So, the casts came off without any problems. Apple didn't much like it. She's really fed up with anything medical right now and doesn't even tolerate a chux pad being laid across her lap or even being weighed. I love how she looked at her new fingers. She did keep her arms bent for about 30 minutes after the casts came off, but started to straighten them once I let her play in the washing water.

Monday, April 14, 2014

Doing Better

Blossom and Jie Jie have been going through a bit of a rough patch, but finally committed to doing their best and putting forth effort in all they do and what a great difference we're experiencing now!

I have a few new homeschooling tools and this one is helping the girls put words of a sentence into grammatically correct order. They really like it and think it's fun. The second sentence was the hardest for them since "to" was used twice. The last sentence is a much longer one and for fun, but they got it put in order quickly.

Henry's Recovery

Henry is still alive, but last Thursday I took him to the vet because he'd started to get worse. The x-ray showed more fluids in the lungs. The vet didn't really know what more to do and suggested IV antibiotics, the same ones he's been taking orally. However, I wasn't comfortable with that since they clearly weren't working. He'd maintained his weight, 4.9 pounds, but tonight when I weighed him on my scale, he was 4.1 pounds - shocking to have that big a difference in scales, but I trust mine because he looks that skeletal.

Since I still didn't know what to do, the vet went to give me an estimate for the IV treatment and realized she didn't even have the antibiotic she wanted to use in stock. She also suggested the possibility of using a diuretic to try and rid the lungs of fluid, but it's very risky so I declined. I brought Henry home and gave some serious thought again to his quality of life. His appetite was voracious and that's not a cat ready to die so I called my old vet and caught her on a layover in the Denver airport on her way flying back east. She suggested the antibiotic Azithromycin. It made perfect sense since this antibiotic targets mycoplasma, tiny bacterial cells that act like a virus and don't have a cell wall. The other antibiotics Henry was taking target the cell walls and prevent the bacteria from forming a cell wall and then they die. Azithromycin prevents mycoplasma bacteria from growing by interfering with their protein synthesis. It binds to the 50S subunit of the bacterial ribosome, inhibiting translation of mRNA so it can't replicate. There is definitely progress! His breathing is so much better now and he's learning to relax in his oxygen tent.

He had a very good sleep last night. He's resting during the day much better. He's extremely thin, though, scary thin, so nutritional rehab is still of upmost importance. I also have to watch for toxicity with azithromycin since cats don't clear it very well. Today Henry drank water for the first time on his own though not enough to stay properly hydrated so I'm still giving him sub-Q fluids. Poor thing hates the needle. It must be so painful in his condition. He also tried to bury his waste. Until now it was all he could do to get in and out of the litter box.

I made him a much more comfortable oxygen tent using my packing shrink wrap and a little kid table. Today he went inside willingly for the first time so I think he's understanding it helps him. The first day, he looked like he was in jail. I took the pictures below on the first day.