eric135

LadyKitty

  We've made it through another tough spell with our kitty, LadyKitty. While I was gone on vacation, she stopped eating and drinking and seemed to be losing a lot of weight, so roomie took her to the vet, and the prognosis was very poor. There was even talk of possibly having to put her to sleep.

When I first got home, she looked really terrible -- could hardly stand, wanted to stay away from us and the other cats, and roomie had a hard time force feeding her food through a syringe or giving her her meds.

But after three days of round-the-clock feeding and medications, she seems to have made another miraculous turnaround. She's starting to eat (so much so that I had to run out and get more food from the vet this morning) and she's doing her business in the litterbox, and she seems to be out and about a lot more than before.

She's starting to look a lot more like her usual self.

Roomie found this excellent website, felinecrf.com, which has been a great resource. It mentions not only care for the kitty, but also has a good deal of information about the roller coaster of emotions that we suffer as caregivers.

Employee self scheduling; Jean-Watson Theory; Stocks; Ladykitty and other reasons I don't sleep right...

I've been really busy of late. Several weeks ago, I posted about how our hospital had started to institute layoffs, which has been a bit of an eye opener considering a few months before that, we were all talking about the nursing shortage. So even though I am pretty far up the food chain now, I started to apply my philosphy of "making myself indispensable." Which basically means I have totally over-extended myself.

• I recently found out that our scheduling program (called AtStaff) already has the capability for employees to enter their own schedule requests. For years, we have been told that this was something that would be available "later" but come to find out we've had it for years. Which means I could be just a few weeks away from being able to do the schedule totally on the computer, with employees entering their requests online and balancing themselves (somewhat) online. I'll still have to make the always-unpopular decisions of who to move from the overstaffed shifts to the understaffed ones, but it can all apparently happen on our intranet without the reams of paper I presently use to produce a schedule.
• However, because no one in the hospital knows how to implement this aspect of the program, I am having to learn it on my own with some webinars from our vendor. It has been a lot of time, and I'm at the hospital late or on my days off a lot more than I like.
• After I figure out how to do the program, I have to figure out how to orient my fellow charge nurses and then our 80+ employees on the process.
• I'm still working on the implementation of the Jean Watson Caring Theory of Nursing, but I am at a total standstill. Most of this is because our initial meeting with Jean Watson simply didn't impress very much of us, especially those that are as firmly rooted in the Scientific Method as I am. I've read her material and so I saw this conflict on the horizon, but now our Clinical Directors, Vice Presidents and CEO's are wondering how to get the Jean Watson model up and running when we are also supposedly into Evidenced Based Practice. I'm sure there's a way for both to co-exist, and no one would deny that many of our patients can benefit, but I have not come up with a way to either model the behavior or teach it to others, much less design a way to document that we use the theory.
• The stock market has been in a rally for the past couple of months, which basically gives me another part-time and sometimes full-time job. I run stock screens after each day's close, which I have to spend one or two hours doing research. So when I'm working, I have to get up early to do some printing and research, then when I get back at 7am I finish that, settle on the 3-5 stocks I'll stalk at the opening bell, and then I'm watching the screen on and off until the close. If I'm working, I have to set Stops and hit the sack by 10a or I'm doomed. It's been busy but at least it's also been profitable.
• LadyKitty, our 13-year old tabby, is still getting 150-200cc subcutaneous fluids pretty much every day. That's been going on now for the past 16 months. She has her good days, and her bad days. On her bad days, I put her in the closet in my room so the other cats can't bother her, and sometimes that means I am up two or three hours after I go to sleep to let her out.

Luckily, roomie has pretty much taken over running the apartment, taking care of all the cleaning and cooking.

I haven't been very motivated to write lately. There has been so much going on at werk and it has been really distracting me.

It's been a couple of months now since my boss resigned, and I still haven't gotten into the swing of things with the interim clinical director. She's s definitely more into the micro-management style, whereas the previous CD told us what she wanted and let us come up with ideas on how to get it done. Creativity was always encouraged.

Not so much anymore. As I mentioned in an earlier post, there is the distinct odor of burning bridges (I've had three resignations so far, with about as many still to come) and a lot of people running around with cut-off noses and spited faces, that sort of thing.

Shrimplate asked about LadyKitty a while back. She is our 12-year-old orange tabby that had gone into renal failure back in March, and we had brought her back after months of subcutaneous IV fluids. We had been able to get the daily 200ml Lactated Ringer's down to 100ml every other day. But about a month ago, she stopped eating and lost a lot of weight. So we brought her back to the vet for some labs, and her renal labs were out of whack again.

So we're back to daily 200ml infusions. We had been spoon feeding her baby food but after a couple of weeks she's back to eating normally, and is back to her frisky self.  The only weird thing is that, when we let her out on our balcony, she eats the potting soil from our plants. She only does this outside, she doesn't dig up any of the indoor plants. She is so fanatical about it that we don't let her go outside anymore.

So now she stands at the sliding glass door and cries to be let out.

At all times of the day and night.

But at least she's eating.

Diamonds and Pearls, or so it would seem.

LadyKitty is still hanging in there, and actually seems to have made a fair recovery. We are still doing the subcutaneous fluids, but we've cut back to 200cc/100cc lactated Ringers every other day. The picture above was taken after her morning infusion. She actually does very well with the daily needle stick, and pretty much just lies there calmly. The green towel on her back is for the bit of fluid that leaks from her site after the infusion is over.

We're also still giving the Pepcid 5mg. Her appetite is much better now, and we no longer are feeding her baby food through a syringe.

Oh and we're still running netcams in front of the food bowls and the litter boxes so we can keep a record of her "I and O's" per se. She's been having some BM's, and by my reaction, you'd think she's shitting diamonds or pearls.

Make room for the Queen!

She almost looks like her old self at this point. For the first time in a week, she's come out to join us in the living room, jumped up on the coffee table (this is her usual "domain") and jumped up to be with roomie on the couch watching TV. It was very re-assuring.

We're still having to feed her with the syringe, but she's taking more food more often. We're still waiting for a bm. It doesn't look like she's ready to try to eat on her own -- we offered her some sardines packed in oil (the smelliest stuff we could find) and she turned her nose up at it.

It has definitely been nice having her around while we watch TV. That hasn't been happening for more than a week. And when she does bless us with an appearance, all of the pampering and pushing the other kitties away from the food and water bowls and giving her a clear path to the litterbox would make someone think the Queen was coming...

And I guess she is, at that.

Better every day

We've been giving LadyKitty subcutaneous fluids now for 4 days, and she seems to be getting better every day. We're still feeding her with a 10cc syringe, but we notice she's starting to sniff at the food bowl (but still turns her nose up at it).

God what I wouldn't give for Lady to have a bm. It's been at least a week, but the vet doesn't seem to be as worried and fixated on it as I am.

We plan on taking her back to the vet early next week for a check up. I'm dreading that he'll want us to give her enemas (I've read that on the internet quite a bit lately). But enemas are better news than some sort of bowel surgery.

We do notice that her energy level is higher. She still spends most of the day in the cabinet under the sink, but she comes out to visit us every few hours.

We'll just have to see how it goes.

Ladykitty pt 2

Things have been improving over the past 12-24 hours.

We've decided to really get more aggressive feeding Ladykitty rather than just let her go without. It turns out that cats, especially older obese cats, can run the risk of hepatic lipidosis. Everything I read on the web seemed to indicate keeping the cat eating could be the one thing that helps them turn around, and letting them become anorexic could mean a PEG tube or even death. Lady hasn't been eating any of her usual food, and we have tried everything including her all-time favorite, human canned tuna, all to no avail.

The vet said that cats often will get too much acid in their digestive tract, and can cause gastric ulcers, esophagitis or mouth ulcers. So we started the Pepcid 5mg every day. Now that she's had a dose, I figure it was time to try.

Per the vet's suggestion, we bought Gerber canned baby food (we're working on the chicken one, but also have turkey -- oddly they don't have a version for tuna). We thin it down with either warm water or "cat milk" that roomie picked up today. Her first feeding at 9am only got about 5cc, but just now at 330pm we got about 18 cc into her with minimal difficulty.

I'll be ecstatic when I catch her having a bm using our fancy Litter-cam, as mentioned earlier.

Ladykitty

It has been a rough three days.

Ladykitty, our ~twelve-year-old tabby, stopped eating. We took her in to see the vet Tuesday and had her looked at, and had some blood drawn.

The news is a bit grim. Ladykitty's in chronic renal failure. Her BUN is 224 (normal for cats is 15-34) and Creatinine is 15.9 (0.8-2.3). That's pretty damn high, and when I first heard the vet tell me the actual numbers, I could feel my heart pounding in my chest.

I asked him what the options were at this point, and he suggested giving her lactated ringers 200cc subcutaneous every day. Luckily, I'm able to do that with her here at home rather than leaving her in the veterinary hospital. At least we can be with her, and she can be at home in familiar surroundings.

It's been about 24 hours since we started, and she really did perk up a lot after the first 200cc bolus. She is still much less active and spry than usual, but she comes out of her dark hiding places when we visit her, and seems to want company at least for a few minutes several times a day.

She has been making urine, so I don't think she can be in total kidney failure. To be sure, we set up the laptop in front of the room with the litter boxes and set up the webcam to snap a photo every 30 seconds. If I had to guess, she's making about 20-40cc's of clear/straw urine about every 6 hours. But she hasn't had any bm's since we've set up the monitoring system (but then again, she has not been eating since Saturday).

Our vet was quite honest about the fact that he doesn't often see a complete recovery with such bad renal labs, but he's "been surprised by more than a few older cats" that are able to turn around after 2-4 weeks of this fluid therapy, along with some Pepcid (5mg once a day). We're also giving her amoxicillin but her WBC is normal and doesn't have a fever, but I agreed with the vet that a run of antibiotics could be beneficial.

The vet said that he has a few patients, older cats, that have been supported even with chronic renal failure using subcutaneous fluid boluses for more than a year. Depending on Lady's quality of life, we'd easily be willing to do that.

The difficult times will come if she becomes very uncomfortable, or doesn't seem to be able to stand/walk/eliminate, or gets so sick she can't interact with us.

So we're under some pretty significant stress right now. As it is now, we still have hope, and thankfully, at least some time to ... oh god I can't even type the end of that sentence. Let's just leave it at Hope.

Getting caught up on some reading

LadyKitty getting caught up on her reading. She apparently has a penchant for Mythology and mystery novels.

LadyKitty, flickrWebimager

Another shot of the Alpha Female, LadyKitty.

 

I've been looking for a cheap (read: free) screen grab tool. I've been using flickrWebimager for a few days. The program allows you to capture screen shots of your computer screen. Supposedly, once the image is captured, you can click on a button and it automatically uploads the image to your flickr account. When I try to do this I keep getting an "Authentication Error" and it doesn't upload. But, the next best thing is that it will allow you to save the image as a bmp, jpg or png file on your hard drive, and then I can upload it the old-fashioned way. The other really weird glitch is that when you click to Save, the Open File dialog box opens, but if you give the image a name and attach either ".bmp", ".jpg" or ".png" to the end, it will save the file. But it serves my needs. And did I mention, it's free?