Visit to vet #2
Oct. 11th, 2008 11:53 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
nlbarberFriday morning was the appointment with Dr. Dunn, the vet I like who has just moved from Dr. Walton's practice to "Pets Are People Too", owned by megacorp Veterinary Corporation of America. It's a decidedly down-market office from Dr. Walton's Lavista Animal Hospital (which is certainly not plush)--it's hard by Ansley Mall in a strip shopping center that's under some high-voltage power lines. Small office, 4 separate hard chairs for the waiting area (which means you must hold your pet carrier on your knees if you want to reach in and reassure your pet), 3 or 4 small exam rooms. And noisy--while in an exam room, I could still hear all the animal noises from both the waiting area and the back. This becomes important later...
I did have to wait quite a while (30 minutes or so) after getting into an exam room and having the vet tech take Aggie's temperature. After 15 minutes, Dr. Dunn popped in briefly to say hello and that it would be a while longer--it was one of those mornings, it seems. When she did get to us, I told her what Dr. Walton had said: detached retinas, lens had migrated within the eye, all this was because of age only, and that he had given her a steroid shot for allergies because of the continued nasal congestion plus hair loss with her flea allergy. Dr. Dunn found all this...interesting. Sort of. As she left to go get her ophthalmoscope, she said "I need a drink".
Recall that I asked Dr. Walton if this was related to any other health condition (I was thinking brain tumor), and he firmly said no, it was age. Dr. Dunn immediately tied the detached retinas to probable hypertension (just as I'd googled), and tied that to Agatha's long-standing kidney disease, which her July bloodwork (done at Walton's office and in the file that was in front of him as he talked to me...which he didn't look at) showed was starting to get a little worse. I will now have a little guilt trip going, as I wonder if I could have pre-empted the blindness if I had gotten Agatha to Dr. Dunn in the last couple of months for a follow-up exam. She hadn't given me a time frame for that, she just said "we'll need to watch this", but.... OK, it's done. We go from here.
Back to Dr. Dunn's exam: Kidney disease in cats, at least, will cause other problems--hypertension and anemia being the ones she mentioned. With the retinal detachments and kidney disease present hypertension is likely, so the next step is to take the cat's blood pressure. I gather that there is more than one type of equipment for this, but the one that was available involved, like the human instrument, a cuff to restrict circulation in a limb and a sensor to hear the heart. It's the details of execution that differ: to put the sensor where it will hear a heartbeat, you must shave the hair--on Agatha, they went for a hind leg and shaved the bottom of her foot above the pad. Then the cuff was applied to the leg above the joint, the sensor was coated in goo and put on the shaved area, and we all listened to the static-filled speaker to try to hear her heartbeat. Any movement of the sensor gave a wave of static, especially when Aggie jerked her leg in protest. And all those extraneous dog barkings, cat wailings, and people conversations filtering into the exam room contributed to the problem of listening to the faint heartbeat.
Anyway, whenever the sensor caught the heartbeat, they would pump the little cuff and try to catch a pressure measurement. The conclusion was that hers was somewhat high but not critically so, and we've now started on medication (Amlodipine) to try to bring it down. There's some faint hope that she might get a little vision back as the blood pressure drops, but I'm not counting on it--she's old and it has been several days, probably, since the detachment. I've also got prescription kidney disease food for her, though I won't push to get her on it until I'm home next Friday. I did try it on her, and to my surprise it seems to be tasty. The problem will be keeping the other 2 from eating it, not getting her to go for it.
Agatha has lived with the kidney disease at a stable level for a long time, but it looks like we're now starting to slide downhill. The goal is to make the slide as slow as possible while keeping her comfortable.
I've rambled long enough, I guess, but the bottom line is vet #1 was right about the retinas, wrong about the lenses, and was seriously wrong when he failed to look at anything beyond that. Was he making his own call that no more efforts should be put into a 17 year old cat, or did he just fail to look at the chart and see the kidney disease, or is he completely unaware of the connection of detached retinas and hypertension? I don't know, but I'm sure I will not take another pet to see him.
I did have to wait quite a while (30 minutes or so) after getting into an exam room and having the vet tech take Aggie's temperature. After 15 minutes, Dr. Dunn popped in briefly to say hello and that it would be a while longer--it was one of those mornings, it seems. When she did get to us, I told her what Dr. Walton had said: detached retinas, lens had migrated within the eye, all this was because of age only, and that he had given her a steroid shot for allergies because of the continued nasal congestion plus hair loss with her flea allergy. Dr. Dunn found all this...interesting. Sort of. As she left to go get her ophthalmoscope, she said "I need a drink".
Recall that I asked Dr. Walton if this was related to any other health condition (I was thinking brain tumor), and he firmly said no, it was age. Dr. Dunn immediately tied the detached retinas to probable hypertension (just as I'd googled), and tied that to Agatha's long-standing kidney disease, which her July bloodwork (done at Walton's office and in the file that was in front of him as he talked to me...which he didn't look at) showed was starting to get a little worse. I will now have a little guilt trip going, as I wonder if I could have pre-empted the blindness if I had gotten Agatha to Dr. Dunn in the last couple of months for a follow-up exam. She hadn't given me a time frame for that, she just said "we'll need to watch this", but.... OK, it's done. We go from here.
Back to Dr. Dunn's exam: Kidney disease in cats, at least, will cause other problems--hypertension and anemia being the ones she mentioned. With the retinal detachments and kidney disease present hypertension is likely, so the next step is to take the cat's blood pressure. I gather that there is more than one type of equipment for this, but the one that was available involved, like the human instrument, a cuff to restrict circulation in a limb and a sensor to hear the heart. It's the details of execution that differ: to put the sensor where it will hear a heartbeat, you must shave the hair--on Agatha, they went for a hind leg and shaved the bottom of her foot above the pad. Then the cuff was applied to the leg above the joint, the sensor was coated in goo and put on the shaved area, and we all listened to the static-filled speaker to try to hear her heartbeat. Any movement of the sensor gave a wave of static, especially when Aggie jerked her leg in protest. And all those extraneous dog barkings, cat wailings, and people conversations filtering into the exam room contributed to the problem of listening to the faint heartbeat.
Anyway, whenever the sensor caught the heartbeat, they would pump the little cuff and try to catch a pressure measurement. The conclusion was that hers was somewhat high but not critically so, and we've now started on medication (Amlodipine) to try to bring it down. There's some faint hope that she might get a little vision back as the blood pressure drops, but I'm not counting on it--she's old and it has been several days, probably, since the detachment. I've also got prescription kidney disease food for her, though I won't push to get her on it until I'm home next Friday. I did try it on her, and to my surprise it seems to be tasty. The problem will be keeping the other 2 from eating it, not getting her to go for it.
Agatha has lived with the kidney disease at a stable level for a long time, but it looks like we're now starting to slide downhill. The goal is to make the slide as slow as possible while keeping her comfortable.
I've rambled long enough, I guess, but the bottom line is vet #1 was right about the retinas, wrong about the lenses, and was seriously wrong when he failed to look at anything beyond that. Was he making his own call that no more efforts should be put into a 17 year old cat, or did he just fail to look at the chart and see the kidney disease, or is he completely unaware of the connection of detached retinas and hypertension? I don't know, but I'm sure I will not take another pet to see him.
(no subject)
Date: 2008-10-16 02:23 am (UTC)