nlbarber: (Agatha)
Agatha
1991-2009

Agatha and I made the last trip to Dr. Dunn today. She had gotten really bony and weak, and this morning went part-way under the guest bed to sleep instead of one of her usual sleeping spots. I think it was the "find a place to hide" behavior, and certainly I've been expecting it. Advanced kidney disease, high blood pressure, blindness, and most probably cancer finally have overwhelmed her.

more, and pictures )

Good bye, Miss Agatha-cat. You are missed.

Agatha cat

May. 12th, 2009 04:47 pm
nlbarber: (Agatha)
My old lady Agatha-cat is failing. She's lost a pound (dropping from 9 to 8 pounds) in the last 6 weeks, and last Thursday she almost completely stopped eating. I took her to "her" vet, Dr. Dunn, on Friday, but there wasn't any obvious cause or anything much to do. We gave her subcutaneous fluids in case it might be just a temporary imbalance that could be corrected and get her eating again. However, all my tempting with baby food and cat treats got no more than a few teaspoons or so down her on Saturday. A phone consult with Dr. Dunn on Sunday led to a suggestion of Pepcid, as she's swallowing hard, but that didn't change anything, though a can of tuna did interest her in lapping at a little most of the day. Monday's phone consult reached the conclusion that it's probably something like cancer that's in the esophagus or stomach, perhaps spread from the mammary lumps that appeared a few months ago. At Agatha's age (17 and a half) and with the advanced kidney disease, high blood pressure, and blindness, extraordinary treatments for a cancer just seem cruel. I vetoed even an overnight stay at the vet for additional supportive care, as Agatha hates cages and strange locations. I think she's better off at home.

She seems comfortable, and does sometimes eat a little though the tuna has ceased to be interesting. When I left for the hospital to spend a few hours with my father, she was in her favorite day-time spot under a lamp, basking in the heat. She still moves around fairly well though she's been trembling a little when she stands up. If she starts to look like she's in pain, or if she goes to find a corner to hide, it will be time for the last trip to the vet.
nlbarber: (Agatha)
Agatha's on a 3-month checkup schedule now that the blood pressure seems stable, and today was the day. Summary: things are still OK, so keep with the current medication and come back in 3 months.

Longer report:

longer report behind the cut )
Oh, and one bit of very helpful information, garnered when I told Dr. Dunn that I'd be asking for a prescription from an online vet pharmacy for the Amlodipine, which VCA charges >$6.50/pill for, but online sources offer for as low as $0.19. (I'm still not sure I believe that one, but a different source offers it at $0.76.) Though they only tell you this if you ask, VCA will match prices for certain online pharmacies, and the $0.19 place is one of them, supposedly. You can bet I'll be checking that out when next I need a refill. It's worth something to have them quarter the little bitty tablets for me, but it's not worth over $6 a pill.
nlbarber: (Agatha)
My father will come up here Wednesday for the oncologist appointment on Friday. My sister-in-law will go get him, then I'll take him home either Sunday or Tuesday--Monday being out because I have a conference call at work. That means Agatha's comfy nest area she's been using since she went blind must be dismantled--it's the guest bathroom. At a minimum the litterbox that pokes into the main floor area by the bathtub has to move. The basket she sleeps in under a furnace vent probably needs to go too, as that infringes on the area where you would stand in front of the sink. The food and water dishes can probably stay if pushed further back beside the toilet--but there might not be much point in it if she stops spending time in there.

Today's task was moving the litterbox, along with the puppy pad that it sits on to catch when she pees over the edge of the box (nearly 100% of the time, I think). After debating putting it in my bathroom (really no room at all), or perhaps in the laundry room blocking the coat closet door, I decided to try it in the Cat Room despite that being the location of the other 2 boxes. I moved the box, induced Agatha to walk to the Cat Room by herself, gently pushed her towards the box so she could smell it, then put her front feet in it, too. She of course stepped out immediately and left to go back to the cat basket in the guest bathroom. You can put a cat in the litterbox, but you can't make her use it...

Despite that initial reaction, so far this seems to be a success. The puppy pad was peed on sometime during the day, and neither the floor nor the bathroom rug were. Tomorrow I'll decide if I'm going to try to shift the cat basket. That will be harder on her--it's not the only place she sleeps, but it's the most common. And the second most common is a spot in the guest bedroom, which will be off limits to her (at night at least)while Daddy is here. She'll just have to move down her list of favored sleeping spots for a while.
nlbarber: (Agatha)
Got home from The Land of the Mouse last night without hassle--blog entries for the remaining days are in various states, and might or might not get posted sometime...

This morning in a make-up cat attention session, I found lumps near 2 of Agatha's nipples, and one of the nipples itself is enlarged. I managed an appointment with Dr. Dunn this afternoon, and it is probably either cancer or (I think I got the right phrase) mammary hyperplasia. Feline mammary cancers have a very bad prognosis--generally they metastasize, and the life expectance is 1-2 years with aggressive treatment. The hyperplasia, if I have the diagnosis right, can have various effects on quality of life too, but is not generally fatal in itself. Dr. Dunn thinks Agatha does not have any sort of treatable infection causing the lumps, in any case.

We're going to do nothing. Not going to worry about the exact cause, and just treat any secondary effects as they show up. Aggie's life expectancy at age 17 and with the kidney disease worsening isn't going to be significantly different either way, and trying to treat a cancer would definitely be too hard on her.

She's very annoyed with me for the vet visit on top of the 8-night trip to Disney World, and is hiding under the guest bed. Fred, on the other hand, who had her annual checkup this morning, is actively seeking attention just as she was before the vet trip.

Interesting side note: Fred is extremely vocal at home, complaining, demanding, or just talking. She gave maybe 2 meows on the trip to the vet, and was completely silent while there and on the way home. Agatha, who speaks only on rare occasions to demand some action on my part, cried all the way there and some on the way home, even though she was on my lap most of the return trip. Some sort of inverse action caused by the cat-carrier, perhaps...
nlbarber: (Agatha)
I made it back to Atlanta without great difficulty Saturday, though traffic made the normally 3-1/2 hour trip into 4+. Trip entertainment was largely the Georgia-Georgia Tech football game, which Tech won! First time in 7 years or so...it's been a long drought.

Sunday was a no-effort day, as I let the head cold take over. Spent a lot of the day napping or reading in bed. Cold is no better today, though, ungrateful thing. I left work early due to non-productivity, and took another nap.

Had to bestir myself to get Agatha to a 6 PM vet appointment, for another followup on the CRF. I underestimated the drive time in rush-hour traffic, but we had to wait anyway--lots of people picking up boarders after the holiday weekend, plus ailments, so there wasn't a treatment room for us for a few minutes.

Once we got in, Dr. Dunn mostly focused on Agatha's eyes, checking the pressure again and looking at the retinas and blood vessels. Things look stable, but not great--the retinas still look OK (not like that very first visit, when they apparently flapped like a flag in the wind), but it still looks like the blood pressure is up. Dr. Dunn suggested going to twice a day on one of the medications, but to wait until I'm back from my Disney World trip so I can observe the effects and stop it if she gets lethargic or otherwise acts oddly. Dr. Dunn also had me put Agatha down on the floor so she could try to see how much vision Agatha has. Same conclusion as we had reached earlier: probably seeing light and shadow, but not much else. We'll go back for another check in 3 months unless something comes up, and I can send updates via email. Oh, and I have a topical cortisone spray to try on the part of Aggie's back where she's pulling out the hair, in either a stress or allergic reaction. We've treated this before with a cortisone shot, but those are not good with the progression of the CRF. And so we go on.
nlbarber: (Agatha)
Agatha went back to see Dr. Dunn today, for a three-week check on how the high blood pressure is responding to medication. Short answer: fairly well, but more is needed.

on the blood pressure... )

...and the blindness.... )

...and on the new cat carrier (with photo behind the cut) )
Agatha also likes the new crate, or perhaps she just got comfortable this morning. During one of our waits for Dr. Dunn to check on medication amounts, Agatha lay on her side (abandoning the defensive position of feet underneath/ready to run) and seemed ready to take her morning nap. Pity the various noises of the vet office kept disturbing her peace....
nlbarber: (Default)
Day two at the ag. show--hot. Lots of people, but it tailed off dramatically mid-afternoon, which normally happens on Thursday but not Wednesday. I talked to fewer people, I think, but still had some good conversations. Also showed off our realtime streamflow page on the new toy, when the iPod Touch was connected to the somewhat flaky WiFi in the building. The show is down in attendance and vendors, for sure--there are always some booths where vendors pulled out at the last minute, but there are more this year. And the Ginsu knife guy isn't here! He's been a fixture since 1994, at least. Must try to find out what's happened to him, at least.

Talking to fewer people means I got to sit more instead of standing on the concrete floor, so the feet are in better shape today. But it got pretty hot--the high was 87, I think, and inside the building the air doesn't circulate real well. Luckily another exhibitor was giving away little battery-powered personal fans...

Word from sister-in-law, who's cat-sitting for me in the evenings (the pro cat sitter is doing mornings and giving Agatha her pill), Agatha is looking more confident, and has moved back to spending more time on my bed instead of staying under the guest bed. The other two are doing their usual "Mom's away from home, and we're starved and neglected" routine. I'm very relieved--I was not at all sure how Agatha was going to do adapting to this, especially when I disappeared on her.
nlbarber: (Agatha)
Friday 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. The office, and starting the exam... )

Hypertension, or how *do* you take a cat's blood pressure? )

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.
nlbarber: (Agatha)
A couple of days ago I noticed that Agatha-cat's pupils seemed to be too dilated, but I hadn't managed to make a vet appointment--next week is the Sunbelt Agricultural Expo where I man an exhibit for my office, and I'm in frantic mode trying to get stuff together for that plus complete some other critical tasks. But when I got home last night, it became apparent that she wasn't seeing anything, or at least not much. She'd set out across the kitchen, get to the doorway on the far side and walk up to the door frame. Stop. Back up a step, move over, go through the door. In the bedroom, she once got off her intended path and walked into two or three corners before finding her way to the pet-steps beside the bed. She also tried to walk into or on top of the other cats when they got in her way--she just didn't see them.

I took her in to Dr. Walton this morning, and his diagnosis is detached retinas, caused by age--she's almost 17. Maybe some genetic predisposition, but not some other health issue. (I'd spent a restless night thinking "brain tumor".) In her case, he said, the lenses have broken loose and migrated to the back of the eye, again probably because they shrank with age, and that probably triggered the retina detachments by changing the pressure on the fluid in the back of the eye. Or something like that. Googling seems to always attribute detached retinas to hypertension and says that should be treated immediately. I have a call in to the vet... [Note from later--he didn't call back, so the question will be asked of Dr. Dunn tomorrow.]

Which brings up another reason why I delayed some on this, plus some other less critical problems Agatha has. I dislike Walton, and the vet that I do like, Dr. Dunn, has left Walton's practice to go to a Pets Are People, Too--one of those Evil Mega-Corporation places that's buying up lots of independents. And the office Dunn has gone to is 20 minutes or so away, where Walton's office is 2 minutes. Distance is important when you have a cat who finds all carriers and car trips traumatizing. This morning I first tried to see Dunn, but she was not in today. Made an appointment for tomorrow, anyway, and went ahead with the emergency visit to Walton. If the drive isn't too much for Agatha, and if this other office setup seems OK, I will probably keep going to Dr. Dunn for Agatha.
nlbarber: (Agatha)
Poor old lady Agatha was back at the vet again this morning, this time because she's been snorting and making gakking sounds like her nose is stopped up. But not continuously, and she has not been mouth-breathing, so I let it go on longer than I should have. I really noticed how bad it had gotten when I was at home Monday, but Wednesday is one of the days the good vet is there so I waited.

The tentative diagnosis is a sinus infection. (I didn't know cats could get sinus infections.) I've got tuna-flavored liquid antibiotic to give her every day for a week, and the vet's email to send updates or questions to. She (good vet) had me make a follow-up appointment for next Wednesday, but depending on how things progress, I might not need it. Or might need to go in sooner, if this doesn't seem to work. Vet also noted that on Agatha's last blood work her blood sugar was a little high, so we need to watch for diabetes.

Current status: Agatha is in her usual evening spot here on the desk, under the heat of the lamp. There's a lot of snorting, swallowing, and the occasional gakking fit going on, and I wish I could hold up a tissue like parents do to toddlers and say "Blow your nose, Agatha! Harder!" Unfortunately this doesn't work well with cats. :(
nlbarber: (Agatha)
Agatha was indeed allowed to come home yesterday, and indeed had continued to refuse to eat at the vet's . I went in and got a short lesson in giving hairball medicine with a syringe (she's never been willing to lick a full dose off my finger, and can sling any that is put on a paw with sufficient force to embed it in the wall paint, rug, and nearby furniture), and took her home.

Miss Agatha demands service...and privacy )

Fish report: the seemingly bottomless bottle of antibiotic finally got emptied this morning, and the cystitis symptoms have eased. Fish will be unhappy to miss his spoonful of baby food tonight, I imagine. He apparently decided the medication process was not all that traumatic, as he never hid from me when I came to get him for the towel-wrapping.
nlbarber: (Agatha)
Now it's Agatha who's spending the night at the vet's. I got in from work yesterday to find that someone had thrown up rather extensively in the Cat Room (half-digested food in places on the floor, and liquid on much of the counter). But it wasn't apparent who, so I waited. Agatha didn't want dinner but that isn't all that unusual, and neither Fish nor Fred were eating enthusiastically either, so I waited some more.

It was a little before midnight when I heard ominous sounds and got up to see Agatha throwing up. The results were clear fluid but with blood spots, so I hauled her into the vet first thing this morning. After blood work and an exam, the verdict is a hairball--those can irritate the digestive tract enough to get blood like that. Vet administered IV fluids (Agatha has kidney disease and can't be allowed to get dehydrated) and a laxative, but at the end of the day she still wasn't eating and hadn't passed the hairball so she is being kept overnight.

I'll check in the morning, and hope to go get her in the early afternoon, after my 11:30-1:30 conference call. Probably even if she hasn't eaten, because knowing Miss Agatha, she may well refuse to eat as long as she is held in durance vile. (She's the only cat I've ever had who so despises a carrier that she has to be prodded to go back into it at the vet's.)

The Fish report: symptoms of the cystitis have vanished, but the little bottle of antibiotic is showing signs of being bottomless. I keep thinking there's one, maybe two doses left...the last 3 times I've thought this. The success rate at getting the stuff into his mouth and keeping it there still varies--100% this morning, but maybe 50% last night. The spoonful of meat paste he gets afterwards doesn't reduce the fighting, but it does seem to soothe him down.
nlbarber: (Default)
Fish, despite some occasional success, has not really mastered the skill of opening a door that has been left open a crack. I got to watch his current technique today.

I was outside with Agatha, letting her eat a little grass and enjoy the sunshine while I watered some stuff I planted on Friday. The door was left open a crack in case Agatha panicked from the water spray or the moving hose (SNAKE!) and wanted back into the safety of the house. But she was fine, plus she wanted to keep an eye on me since I'd been away for 2 nights, so she settled down in the sun on the doormat. After finishing the watering, I joined her and started some head skritches, provoking some steady purring.

Fish was inside, and wanted out to join the fun. He managed to widen the crack enough to get a paw out, but he just can't get the knack of then pulling to open the door further. So the paw would slide a couple of inches across the door, then slide back, trying to rake the door along its width. After several attempts at this, he gave up at getting outside, and decided to try to bedevil Agatha from where he was. So the full length of a looong white paw extended through the door, and waved around in the air over her back. Agatha remained oblivious--Fish never managed to touch her.
nlbarber: (Agatha)
I've been worried about Agatha--she seemed to be drinking a lot, leaving the kitchen water bowl dry several times when I wasn't watching. (There's another bowl in the bathroom, so she never ran out completely.) And then over the last couple of weeks I've noticed how wet the litter box was. Several years ago, she was on steroids for quite a while to treat an overgrooming problem, and the vet had warned me of the possibility of feline diabetes--mentioning flooding the litter box as the primary symptom. So, I made the appointment fully expecting that she might have diabetes. Recent discussions on piffle of the difficulties of getting a cat stabilized had me worried, plus all the attendent thoughts of "how can my cat-sitters cope with this when I have to travel?" Nothing like crossing the bridge well before you come to it.

Turns out she has "renal tubular disease", not diabetes. Her kidneys still filter the wastes out, but the parts that should then concentrate the urine aren't working any more. Almost all the liquid that comes in, goes out. And she has to keep drinking to stay hydrated, as she isn't re-absorbing fluid in the kidneys any more. The vet says she can just live with this, at her age (she's 12)--all I have to do is make sure she doesn't ever run out of water. And change the litter box more frequently, I assume. I didn't think to ask if there is any treatment, period.

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