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Unread 07-05-2013   #1 (permalink)
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Default Petra's Story, Part 1

In 2002, I wanted to adopt another cat to be a companion for my 11-year-old female cat, Tobie. I wanted a kitten, preferably male. My friend, Kris, worked at the local emergency animal hospital and said sometimes people bring in their pets, can’t afford the care, and give the pets over to the animal hospital. The hospital then cares for them as good samaritan cases, and the animals are adopted by staff. I told her, as long as the kitten wouldn’t need round-the-clock care that me and my husband couldn’t give, I didn’t care what conditions the kitten had.

Well, Kris told me the story of a 5-week-old male black and white kitten that was brought in. His previous owners had stepped on his head, and he was bleeding from his mouth and nose. They gave him a 40 % chance of living. After a seizure, and lots of antibiotics, he made a miraculous recovery! I went to see him with girls I work with and discovered he was not black and white, but black and white and ORANGE, and was actually as she! A week after being admitted, my new kitten Petra came home with me. She was 8 inches long and weighed just under a pound!

It sort of backfired, really. *smiley* Tobie hated Petra on sight. Petra tried to get close to Tobie (and continued to try throughout Tobie’s life), but Tobie would just hit her hard on the head! Petra definitely showed signs of brain damage. She had “learning disabilities”, she had some vision issues, and she never groomed herself. She had reactions to vaccines - I actually found her hot and unresponsive after one vaccine. When I took her to the vet, he said she was in anaphylactic shock, and to give her Benadryl! Needless to say, I never vaccinated her again! Also, when she was spayed, the vet said her uterus was “small and tied in really tight” and that he’d never seen one like it. That fact, the fact that at six months old she developed a “fat belly sag” that I’ve only ever seen in older cats, and the fact that she remained small, made me think her initial head trauma caused damage to her pituitary and/or hypothalamus. It’s like she didn’t grow properly - her kitten body got fat instead of growing big!

But she ate, drank, and used the litter box, was cute as a button, and a sweet cat. I took her in her cat carrier all over to family gatherings because she didn’t mind riding in the car and tolerated being on a leash. She was such a hit and everyone loved her! Did I mention she was cute? *wink*

In 2007 she got sicker and sicker, and I took her to the vet, where she was diagnosed with kidney disease, at only 5 years old! This was right around the time when the pet food poisonings were going on, but her illness wasn’t caused by food. The vet recommended that I put her down, but I told him I’d do anything I could to help her. He gave me fluids, told me how to do them at home, and gave me B12 injections to give her. After a few days of her not responding - not eating, extreme lethargy - I called up my vet and he got back to me after hours. He just kind of said, “I don’t know what to tell you.” I was so upset, I called my friend Kris who recommended I call around for a second opinion. I was able to get into Cats Exclusively, a good 45 minutes away from my home. I remember me being worried about her having polycystic kidney disease because she is part Persian, but the vets did a quick ultrasound to rule it out. Her kidneys were small, but not polycystic. I don’t remember the name of the vet who I saw, but she and Dr. Andy told me Petra was a very sick kitty. Her body temperature was very low - it got down to 93F! - and she needed to be admitted to the emergency animal hospital, where they would slowly increase her temperature. In addition, her electrolytes were very screwed up, and she needed to be on IV fluids to slowly correct them. Fast warming and fast electrolyte balancing would kill her, and there was the possibility she wouldn’t even survive the slow treatments. Sadly, and thinking I would never see her again, I brought her to the hospital that I adopted her from and gave her a nose scratch before crying and saying goodbye.

One week and many thousands of dollars later, I brought her home, where she slowly healed and recovered. They thought it was a kidney infection, and her electrolytes got messed up because her kidneys were compromised, so I gave her antibiotics, an appetite stimulant, and sub-Q fluids. I never went back to the vet that told me to put her down, and now use Cats Exclusively only; Dr. Andy and his crew are the best! Expensive, but worth every penny! By the next year I was fostering a litter of kittens and a momma cat that I had rescued, as well as dealing with Tobie’s own kidney failure (due to old age). Petra had another “allergic” reaction, this time to Drontal, a wormer that I needed to give her because the kittens I rescued had worms, and I found her cold and unresponsive! Off to the vet we go, where she slowly improved. I guess it’s a known reaction to Drontal that cats can have. Apparently if there’s a reaction to a medication, Petra’s going to have it.

The following year, 2009, brought with it another kidney infection, and so we went off to Cats Exclusively again with lack of appetite, vomiting, and lethargy. Her electrolytes were so high, they had to dilute her blood in order to get her sodium levels (which at the highest were off the charts in the 220s, IIRC), and her temp was again low - 95.5F. In fact, the vets were baffled to see her alert and responsive at that temperature - cats are normally comatose when that hypothermic. In addition, with her sodium so high, she should have been blind from high blood pressure, but her blood pressure was normal and her vision fine! Everything about her had the vets scratching their heads and wondering how she was able to function in such a compromised state. Biologically, it didn’t make sense.

She was admitted to the emergency hospital again for slow warming and IV fluids, but by this time, I was spending lots of money on Tobie’s illness, on food and litter for my fosters cats, and I was financially strapped on top of it all! I was so upset that I’d have to have Petra put to sleep because I couldn’t afford to help her! I managed to pay for a few days in the hospital, and worked out a plan with my vet where they cared for her and gave her IV fluids during the day and I took her home at night to care for her. It was a very stressful week, but she made a slow but sure turn-around. The hospital had ordered an ultrasound, which showed an enlargement of one ureter and renal pelvis, and the ureter being very tortuous. The “swelling” of the ureter and pelvis seemed to indicate she might have an infection in that kidney. So, we came home with more antibiotics, more appetite stimulants, and more fluids.

Sadly, in 2010, I lost my beloved girl Tobie. She was the first pet I’d had as an adult, and the first I’ve had to let go. I did everything I could before she let me know it was time. She was a few months shy of 19 years old. I miss her immensely and still cry. I don’t regret anything I did for her - I don’t have kids - my animals are my children.

Now, I’m not rich, and I’ve spent most of my life living by month to month, like so many people do. I’ve never had any savings to speak of. There’s always bills to pay. Usually it goes the way of car repairs, because I put about 20,000 miles a year on my car, going back and forth to work, and I live in the northeast US, where salt and sand rust out and damage car parts. Recently, things have been better, but I’ve had many tight times. After Tobie’s death and Petra’s 2009 illness, I worked out a plan with my vet where I paid them $350/month for over a year until I no longer had a balance. In 2011, Petra and Rudy (I adopted one of my foster cats) needed dental work to the tune of $1000 - Petra had pretty bad stomatitis and needed all teeth past her canines pulled. Petra had another kidney infection last October, and needed bloodwork and exams totalling $700. And again in March and again this past May. Each time she’s recovered with antibiotics, appetite stimulants, and fluids. I figure I’ve spent about $10,000 on her medical bills over her lifetime.

To be continued, because it's so long, here:
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Unread 07-05-2013   #2 (permalink)
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Default Petra's Story, Part 2

Because of the increasing frequency of infections, and that fact that her WBC count was higher after a month on antibiotics, instead of lower, the vets at Cats Exclusively suggested that Petra go in for an abdominal ultrasound and a consult with internal medicine specialist Dr. Koch at the emergency animal hospital. On the table as possibilities were cancer, IBD, pancreatitis (which she’d tested positive for years ago). We also discussed the fact that Petra’s abnormal bloodwork was partially due to her initial head trauma. A new vet at Cats Exclusively was amazed when he saw her hematocrit (percentage of red blood cells) went from the anemic range (21 % - just above recommending Epotin to treat her) to normal within a few months. In fact, her hematocrit has bounced around from normal, to very high, to normal range, to very low, all in a matter of months. The best we can describe it is that her feedback loop is damaged. Think of a pendulum that swings. Most animals keep their bodily functions in a tightly controlled balance. The body is always measuring the amount of red blood cells and starts to make more when they are needed, and knows to stop making them before there are too many of them. That’s a feedback loop. Petra’s doesn’t work so well, and her pendulum swings widely and farther than expected. For example, her body doesn’t realized that she needs to make more red blood cells until they are way below the level where a normal body would start making them, and it doesn’t know to stop making them until there are too many. Her WBC counts could be a result of this messed up feedback loop, too - they might be produced in quantity for a major infection when it’s only a small infection. Her reactions to vaccines and Drontal, as well as her stomatitis can all be described as “overreactions” of her immune system - stomatitis is an “autoimmune” disease where the body attacks plaque buildup on the teeth. All signs of a feedback loop gone wrong, and probably caused by her initial head trauma. The pituitary and hypothalamus glands play important parts in the body’s metabolic signalling and in feedback, and as previous stated, I’ve always thought Petra’s were damaged in some way. This might explain how she was able to function with low body temperature and high sodium levels, but we’ll probably never know for sure. She’s certainly a medical miracle and the fact that she continues to live with critical values that swing so widely is a testament to the strength of her spirit and of the body to handle such wide fluctuations.

At the hospital, tests were taken and an ultrasound done, and the results were better than I had hoped for - no cancer! No inflammatory bowel disease! Her bladder, pancreas, and entire digestive tract look perfectly normal! All except for her kidneys…

Her kidneys are small, as I already knew, and show signs of chronic disease - there is not much differentiation between her cortex and medulla. The “swollen” renal pelvis and ureter seen in 2009 are extremely swollen now! To the point that the the ureter is 1 cm wide! It quickly fades away (still tortuous) and they think there is a stricture somewhere farther downstream. Dr. Koch thinks the enlargement seen in 2009 was caused by the same stricture, and the ureter has grown from that enlargement to what it is now, probably from her spay or from stones. He doesn’t think it’s from a tumor, as it would have grown so large in 4 years to be seen on the ultrasound, and most likely would have blocked the ureter completely. I’m thinking the damage is because of her spay, based on what the spaying vet said, but it could be from stones. I’ve learned that sometimes, you can’t tell cats even have had stones! Dr. Koch seems to think that because of her altered anatomy, she has a low grade infection in that kidney. We’ll be starting antibiotics again soon, as it can take months - 2 to 3, although sometimes 6 to 8! - to cure kidney infections.

Her right kidney:

Her left kidney:

So, what do we do now? How do we prevent that ureter from rupturing? If the ureter completely closes off, that kidney will be a goner, and she’s already working with damaged kidneys to begin with! I initially considered kidney transplant, but ruled that out because of the cost ($15,000 - $20,000), because Petra would have to be on nasty anti-rejection meds twice a day for the rest of her life, and because there is a significant (to me) risk of death! Dr. Koch recommended a stent in her ureter, which is done by vets in Manhattan. I also considered just taking the kidney out entirely! The next few days were spent doing a lot of research online!

It turns out that the stent is the best option, and it’s not really a stent like we think of stents in arteries, but a bypass, where the plastic tube is inserted in the kidney, and then it goes outside of the ureter, bypassing it entirely, then back into the bladder. The stents that work best are the types where part of the tube is put in the subcutaneous layer between the muscular wall and the skin to hold it in place. I guess the surgery is done without large openings, so that there’s not much recovery time and it’s got a very high success rate. Dr. Allyson Berent of Animal Medical Center in Manhattan does the surgeries (I tried to put a link, but it won't let me).

Dr. Berent is also conducting a clinical trial using stem cells to help regrow kidney tissue and restore function (I tried to put a link but it won't let me). If Petra could have that, and it works, then she could possibly no longer be in kidney failure! She would still have her feedback loop problems, but her kidneys would have the ability to properly filter and keep the bad chemicals out of her bloodstream. That would mean she wouldn’t have these bouts of nausea and vomiting because her bloodstream has high values of toxins that the kidneys should be filtering out. I spoke with a man who had both the bypass and stem cells performed on his cat, and she’s doing wonderfully! He said the stem cells are almost more important than the bypass, although we all know the bypass is necessary because of the stricture in Petra’s ureter.

The downside is the cost. The bypass surgery is a flat $7,500, not including transportation to Manhattan and hotel costs. Unfortunately, Petra would never qualify for clinical trial funding for the stem cells because she has a stricture in her ureter, but she’d still be able to get them. That cost is approximately $2,000, with expensive follow-ups every 3-6 months. My main priority is getting the bypass. If I can afford it, and if I can raise enough money, I want her to get the stem cell treatment as well. It could mean a drastic and amazing change in her life! I have $1,000 in savings that was going to be used to put a down payment on a car, but that will be going to Petra’s surgery now. I have $1,300 in Care Credit I can use. Other than that, I’m willing to take out loans, credit cards, and fundraise in order to get Petra the surgery she needs!

This is where you come in. Would you be willing to donate $5 or $10? Would you be willing to pass this story along to everyone you know? If I can raise $7,000, she will definitely be getting both the surgery and stem cell treatment. That’s $1 from 7,000 people, or just $10 from 700 people! If you have any money to spare, please consider donating. Petra is such an amazing, sweet cat that has lived with so many health problems her entire life! Please help her get better! Please help her get the necessary surgery she needs!

Please do a search of Fundrazr. com for "Petra" and you'll see her Fundrazr account.

Thank you!
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