Tuesday, May 24, 2011

One Day at a Time

Tired is the best word I can think of to describe our household. The last few weeks have been a merry-go-round of visits with doctors, dentists, and vets.

It started with Loco and his ehrlichiosis (one day I will not have to google this to remember how to spell it). His third bout with this tick-borne disease in the almost 6 years he's been with us. Loco is allergic to the Frontline drops, so the only way to control ticks is to manually go through his fur and pull them off. When I got back from Canada at the beginning of March there was a huge tick on his shoulder, and he was sick. Antibiotics and vitamins made him feel well again. We don't know what his platelet level is, but we know that he is considered clear of the disease. For now, a recurrence is just another infected tick bite away. Luckily, the dog at the corner that was loaded with ticks is no longer around, so Loco seems to be free of ticks. Miguel always blamed that dog for dropping ticks around our house, I guess he was right.

Several weeks ago I noticed that Blacky had a sore eye. When the vet stopped by to check on Luna I asked him to look at the eye, and he said it was dry and told me to start putting antibiotic ointment in the eye. It took several days before I saw the kind of improvement I expected, but after a week of ointment 3 times a day Blacky scratched her eye and it left a string of white tissue hanging in the lower lid. I called Blacky's regular vet, Pepe, who said he would come that evening, but he didn't make it. He finally made it two days later, and was dismayed to find Blacky's cornea was damaged and the pressure in the eye was elevated. He gave Blacky 3 shots, and left me with drops to put in the eye twice a day. The drops helped within a day, Blacky was able to open her eye and it looked better. Since then Pepe has been by every 3 days to give shots and check the eye. The last visit he was able to declare that Blacky will not lose her eye, but it will take about a month for full recovery as eye injuries don't fix themselves overnight.

About 2 months ago I started having pain in my groin and hips when in bed. It got to the point where I could not lie on either side, and eventually I was unable to sleep due to the pain. A trip to the Naval hospital and an orthopedic specialist who ordered xrays revealed a scoliosis (curvature) of the upper spine, and a bad section of the lumbar-sacral spine where two vertebrae were rubbing together (no space between them). This could cause the nerves to be pinched resulting in the pain. Pain medication and anti-inflammatory pills provided relief, not only for the hip and groin pain but also for my feet and other areas that have been bothering me. Good stuff but when I went back after two weeks I asked to be given a different medication because I did not want to become addicted to the medication Tramadol. The doctor wanted me to agree to steroid injection, but since I was not military, it would have to be done in his private clinic. When I said we didn't have any money and he asked "why"?, I felt he was looking at me as a rich foreigner and not prescribing the best therapy for me. Seriously, after only two weeks of medication I should abandon that option and agree to steroid injection? No, sorry. So he prescribed other medication that does not deal quite as well with the pain but is good enough that I can sleep and am not really in much pain. I will not go back to him however, as I don't feel comfortable with him. I will go to my Cancun gynecologist and see who she recommends. As well, my sister in Canada has some ideas and we'll be there in a few weeks, so I'll manage until then.

Miguel developed a sore tooth but a trip to the dentist didn't reveal anything obvious, so he just prescribed antibiotics and anti-inflammatory/pain meds for 7 days. After just 5 days Miguel forgot and bit on a piece of watermelon on the affected tooth, and he just about went through the ceiling from the pain. I urged him to call the dentist right away but he would not call right then - he said he would call 'later'. Well, later was two days later, and then he didn't tell the dentist how much pain he was having, so he accepted the appointment that was given - 5 days later. I bit my tongue as much as I could, but by the time the day of the appointment arrived, Miguel's face was all puffy, he was in extreme pain and unable to sleep. The dentist took xrays this time and found the source of the problem, but with the extensive infection, he could not work on the tooth other than to open up the area to allow drainage. He put in a cotton plug afterwards to keep the open tooth clean, but that night Miguel was in agony and by the next morning his face was even worse. So we made a trip to the Naval hospital and Miguel had a consultation with the dentist there (a different dentist). She prescribed a new antibiotic and changed the cotton plug, which almost immediately reduced the swelling. Finally, after 5 days, Miguel is looking normal and no longer has pain and is in the process of getting the tooth fixed. Since it was a crown (done by a dentist in Cancun that many have highly recommended), I'm not sure what the local dentist will have to do to save the tooth - probably another crown. Meantime Miguel is still on meds that upset his stomach, and I think he learned a lesson - to speak up!

And Luna - we are starting our 6th week with Luna and her liver failure. It's amazing that she is still alive. After my last post, when she came home, it has been day to day. She has been back at the clinic almost every day - for meds, for fluids, for bladder expression. She has had good days, ok days, and bad days. Last week I was ready to stop the treatment, she seemed so weak and wasted and like she no longer cared. I put it to Delfino like this - "can she recover?", and he could not say absolutely No, only that he didn't know. He said her liver might be functioning at 10%, we don't know. So with a slim chance that she might have a chance at survival, we continued the treatment - subcutaneous fluids to prevent dehydration, meds injected with that fluid to help the liver recover, and forced syringe feedings. A day after I was ready to call it quits Luna was much better - washing her face after the feeding and she walked downstairs.

Luna has spent time alone in dark areas, and other days she lies on the couch beside me. She has used the kitty litter, and other days she goes more than 24 hrs without going 'pee' so Delfino expresses her bladder. I have graduated her feedings from mostly broth to a mush of chicken, rice, and carrot - liquid enough that I can use the syringe. I force feed Luna 6 times a day, mostly she accepts it. Over the weekend she went 72 hrs without supplemental subcutateous fluids, and by yesterday morning she was enjoying lying on the terrace and then walked over to me and stood to be petted. She really felt great. But after the visit to the clinic, she wasn't feeling well - she vomited when I tried to feed her, and she is sore. So it's back to slow forcing of mostly liquid broth to a full feeding of mush that I will attempt after I post this. Luna did wash her face again last evening and licked her paw this morning - normal cat behaviour that is a small but rewarding piece of information to tell me how she is feeling.

Luna's liver is huge, she is still very jaundiced, but this disease is a long process and as long as she is not suffering in pain, we will stay the course. I am hoping for a positive outcome for her. It's exhausting, but it is giving Luna a chance.

Miguel needs a visa to visit Canada, a royal pain in the butt - a law put into effect two years ago to deal with a problem with refugees, a patch to fix something that affects all Mexicans wanting to go to Canada...the opposite of the 80-20 rule, but the government won't rescind it, so we have to play along. The documentation is different than the last time we had to do it, but finally everything was put together and sent off via DHL (meaning a trip to Cancun). Unfortunately, that pile of paperwork wasn't enough - the embassy called from Mexico City and wanted more proof of 'ties to Mexico' and 'proof of finances'. So more documentation was sent off (another trip to DHL in Cancun), and now we wait. Honestly, Miguel has been to Canada 4 times before, he always comes back to Mexico, we have no intention of staying in Canada...just LET US VISIT MY DAUGHTER, WILL YOU? Pissed off is the best way I can describe my disgust with this requirement.

I am glad we are into low season. Along with our health issues, the construction of the main road in town has resulted in no water in the hose from early morning to evening. We have to watch how much water we use, and hope the pressure will be enough to fill the tanks during the few hours we actually get water through the hose. Our neighbor has been noisy repairing and moving his boats. The dogs in neighboring colonias are noisy most of the night - not sure what is going on with them. The last guests left 3 days early because they decided they wanted to go to Cuba - I was happy to see them go even though we gave them a refund (they didn't ask for it, said to keep it, but it was the right thing to do since we didn't lose business due to their reservation). I have turned down other requests to stay in our home right now - we need this time more than we need the money (and trust me, we really need the money).

Thursday, May 12, 2011

She's home!

Eating on her own today. Still skinny and weak, but looking very good and interested in life again. Delfino is optimistic!

Tuesday, May 10, 2011

Update for Today

I had one orange purring kitty in my lap today. Visited Luna at the clinic and without her IV (she disconnected it again), she could be out of the cage to sit with me and enjoy some petting. Apparently she ate a bit last night and this morning, did not eat tonight but she looks good. Fingers crossed.

Monday, May 9, 2011

The situation with Luna

Yes, I have stalled writing anything here because for the last 3 weeks Luna has been seriously ill and I expected that each day would be her last. I posted a lot of details on Facebook during the first week and a half, but then changed course when it became clear that action was needed to help Luna either get better or make her way over the pet rainbow. Luna has liver disease - she's yellow, and some days she's orange. It's a horrible disease and usually fatal for cats. We don't know the cause, it came up suddenly 3 weeks ago when she showed up with obvious abdominal pain, nausea and vomiting. And she was jaundiced. A vet was called.

After a week of monitoring, rest, and a few injections for pain and liver protection, a starving Luna was eager to get back outside. Since she just moped under the bed when forced to stay indoors, the vet said to set her free to see how she did out in the jungle, hoping she would eat geckos or birds and get her liver working again. For the first few days she drank water and then went off until the next day. She was still rejecting any type of food I put in front of her, and in fact, just the smell of food made her vomit the precious water she drank - the only thing keeping her alive. At first she seemed to get stronger and her jaundice improved, and there was hope she would mend herself. Then one day after a nice cuddle in the hammock, she just didn't come back. I let it go for that day and the next, and when we still didn't see her by the following afternoon, I went looking for her.

I went through the jungle near the house, around an abandoned, unfinished building, gently calling her name, never expecting to find her because I was sure she must have died. But amazingly, out of the bottom hole in the building, crawled Luna. She was skin and bones, and crouched as if in incredible pain, and she was very yellow and dehydrated. I was not going to just leave her there, she came out to me so she must not have wanted to be left alone. I brought her home, put her up in the room on the third floor, and called the vet. The message I left was basically that I needed him to come and put her down as she was suffering.

But it was Saturday evening, so the vet did not get my message. All day Sunday Luna laid in her sheltered area in the room, taking sips of water when offered, but otherwise just looking miserable. I didn't expect her to live to Monday morning, but when I went up there to check on her, there she was - looking at me with those yellow eyes. I called Delfino again Monday morning and told him the situation - he said he would come around 2:30.

And he did. Except he picked up Luna and looked her over and said she had hepatitis and rather than put her down, he wanted two days to work her up. Ok, if the vet thinks the cat has a chance, I'm not one to argue, especially when I fully trust the vet to know when the cat is suffering beyond hope.

So...Delfino put Luna on IV. A resident black cat took up watch on top of Luna's cage, and even when Luna was moved to a different cage in a different part of the room, the cat continued to sit on top of her cage. It was like Luna had a friend keeping the faith with her. The IV ran well for a day and a half before Luna removed it during her second night there. She then received subcutaneous fluids, which she disconnected on Wednesday afternoon. So since she was feeling stronger and looking better, Delfino sent her home, hoping she'd eat where she felt comfortable.

But no luck, Luna turned up her nose at everything offered, and just slunk under the bed and camped out. She did drink fresh water when offered, but just for that short time out of the clinic she got orange again. Delfino brought her some Ensure, saying that cats like sweet liquids. Maybe most cats do, but Luna isn't most cats. It was a struggle to force a teaspoon of Ensure into her every two hours.

After the forced feeding I spent some time just sitting with Luna on my lap. She enjoyed stroking around her chin and face, but was so weak she really just wanted to sleep. Delfino said if she was no better by Friday morning to take her back to the clinic. So...back we went.

Delfino restarted the subcutaneous fluids on Friday, and by evening she looked much better. So much better that during the night she disconnected her IV again and broke out of her cage - nobody knows how she did it. I suspect the black cat may have helped her, the two of them poking at the springs from both sides may have succeeded in prying it open.

They were shocked to find Luna missing from her cage on Saturday morning, but finally they found her tucked into a corner in the bathroom, safe and sound. And still refusing to eat, so she went back to the cage where Delfino said they would watch to see how she got out. When I went to see her Saturday evening she had her subcutaneous fluids running, and was in a smaller cage, so I suspect she broke out of the other cage again and they had to put her in a different one.

So there she sits. Her eyes are bright, she 'talks' to me when I speak to her, and she enjoys the physical contact I give her. I visit her twice a day to keep her hopes up (and maybe ours?). She still won't eat although they keep putting food in the cage with her, which she eyes with disgust. I even took a piece of fish to her the other night, thinking she wouldn't be able to resist a taste. But she turned her nose up at that too. She simply does not want to eat, and if you read up on the disease, it is a common problem but one that must be overcome in order for the liver to start working normally again.

The fish smell drove all the other cats in the room nuts - they all started crying and the big black cat that had been Luna's mascot, jumped from the other table, misjudged and smashed its face on the edge of the table. It fell to the ground and its jaw was open - I thought it might have broken the jaw, but maybe it was just displaced because the cat fixed it. One drop of blood on the floor and the cat went off still shaking off the pain from the bad jump.

I've had dreams that Luna died, I am prepared for her to die as I know how serious this disease is for cats, but Luna continues to just sit there and glare at us. She is no longer in pain, she is not suffering other than her dignity at being confined to a cage. Delfino says we just stay the course, and wait for the day she will start to eat again. We shall see, we are all hoping for a recovery for Luna. She's one spunky cat.

This picture was taken a month ago, just one week before Luna became ill.