Tuesday, March 24, 2015

Crispy the Cat and her New Challenges

MAR 17, 2015 8:00pm - In 2001, while working at the ASPCA, I encountered a kitten in their hospital’s ICU. She was one of the cruelty cases. Some horrible person had put her in very hot water. The tips of her ears fell off, as did her tail. The doctors and staff at the ASPCA took excellent care of her, slathering burn cream on her wounds and tending to her medical needs. I vowed, if she survived this ordeal, that I would take her home and make sure the remainder of her life was completely trauma free.

I kept my word. The little diva, who I dubbed “Crispy”, turned out to be the most intelligent cat I’ve ever owned, and we formed quite a bond. I can read perfectly every thought of hers, and she apparently can read mine. It’s been like this for 14 years.

This past Thursday, during a visit to my hospital for her annual grooming and lab tests, I felt a mass in her abdomen.

Ultrasound showed it to be a tumor involving her small intestine. We aspirated the tumor, expecting it to be lymphoma. Surprisingly, the aspirates were non-diagnostic. Lymphoma exfoliates its cells readily into the needle, so I was hopeful this wasn’t lymphoma. I was still hoping for a benign tumor.

Today at 2:30, she had her surgery at my hospital. (I had a board-certified surgeon come in to do it; I can’t operate on my own cat.) At surgery, a very weird, hemorrhagic intestinal mass was identified and removed. Neither the surgeon nor I could venture a guess as to what this could be. I sent the mass to the laboratory for histopathology.

Crispy, however, did not recover well from surgery. Her blood pressure dropped and her gums became very pale. Her respiratory rate became very rapid. A quick test in the hospital showed her to be dangerously anemic post-operatively. She needed an emergency transfusion. My staff started bundling her up to be transported by cab to BluePearl Veterinary Partners, the nearest emergency facility. As an afterthought, I took a drop of her blood and blood-typed her, just to make sure she was blood type A. About 99% of domestic shorthaired cats are type A, but I thought I’d check anyway. Leave it to Crispy to be difficult. To my shock and dismay, she is blood type B! Of all the times to discover that she has royal lineage.

I called Blue Pearl. They did not have type B blood. I called the Animal Medical Center. They did not have type B blood. I started to panic. I called Fifth Avenue Veterinary Specialists. Amazingly, they had type B blood on hand.

I grabbed a cab and implored the driver to get me to 5th Avenue and 15th Street ASAP. Crispy still had her endotracheal tube in her throat. I was prepared to remove it if she started to wake up, but she didn’t wake up in the cab. I started to worry that she might actually die on the cab ride there, but she held steady.

I rushed her into the emergency room, and they started transfusing her, warming her up, hooking her up to an EKG and giving her oxygen. Her blood pressure wasn’t registering on the monitor. Finally, after about forty-five minutes, she woke up from anesthesia.

She is now in the ICU at Fifth Avenue Veterinary Specialists, getting a second unit of type B blood. I will visit her tonight. I’m hoping the transfusions were all that she needed. She survived some pretty serious kittenhood trauma, and I’m confident she can pull through this.


MAR 17, 2015 9:40pm - Well well...look who's awake with a normal body temperature and blood pressure!


MAR 18, 2015 3:00pm - Just visited Crispy. She's okay, but there are a few little complications. Her incision is oozing a little and her blood pressure has been rocky. Her veins are terrible, and it's been hard to get blood to check her anemia. She's not too interested in food, either. Was hoping to take her home tonight, but she'll have to stay another night. 

I brought her favorite toy (a tiger tail, given to her by my technician Hiromi about ten years ago). She made herself comfortable in my arm, and then tucked her head in, like she always does, for a nap. I sat there for 45 minutes like that. She was purring when I left, so I'm glad. We will visit again tonight.


MAR 18, 2015 5:40pm - Sigh. What an emotional roller coaster I'm on. The emergency clinic just called. Crispy continues to ooze a lot from her abdominal incision. They think it's coming from somewhere between the body wall and the skin, and not from inside the abdomen, because ultrasound shows only a small amount of fluid inside her abdomen. They've been putting cotton bandages on her abdomen, but when she gets up and moves, the bandage gets soaked with fluid coming through the incision. They've been icing it, trying to constrict whatever vessel(s) that might be oozing, but it's not helping. They're taking her back into surgery tonight. Hopefully there's just a stupid skin bleeder that they can find and cauterize. If not, they may have to open her abdomen again. I'm very worried. I really don't want them to do this, but she can't keep oozing buckets of fluid from her abdomen, either. I'm worried sick here. I'm terrified she won't recover from this second procedure.


MAR 18, 2015 9:06pm - She lives! Details to follow.


MAR 18, 2015 9:26pm - Okay...just got back from Fifth Avenue Veterinary Specialists. There were a few vessels that were oozing. No one vessel was bleeding a lot, but taken together, it was enough to cause really quite a lot of bleeding. The surgeon ligated several vessels. The intestinal surgery site itself looked fine. Crispy recovered pretty well, and she looked up at me while she was on the recovery table. So relieved.


MAR 19 2015 6:21pm - Crispy is home, finally. I just picked her up this afternoon. She looks pretty darn good, considering what she’s been through. She was very vocal in the cab on the way home and kept trying to break out of her Sherpa bag, but she conked out on her favorite fuzzy blanket once she got here.

I’ve been so fortunate to have such caring and compassionate friends, colleagues, and co-workers to talk to, and share these tumultuous 72 hours with. The folks at Fifth Avenue Veterinary Specialists have been absolutely wonderful. They took excellent care of her, calling me with frequent updates and even sending me a video of Crispy strolling around their hallway, to let me know how good she was feeling. I can’t praise them highly enough. Thank you to everyone who commented on my posts and texted me their best wishes. Thank you Jennifer T., vet tech extraordinaire, who slathered burn cream on little Crispy 14 years ago at The ASPCA and who called FAVS this morning to check up on her, and then instant-messaged me at 5:30 this morning to tell me Crispy did well overnight. And to my client Kate 'Pinky' P., who volunteered her little 6-pound Persian, Coco, as a blood donor if Crispy needed another unit. I’m humbled by such generosity. It’s no surprise your cat Firkin is 20 years old and looks fantastic; you’re getting the karma you deserve.


Now comes the difficult part. Crispy’s intestinal mass turned out to be a hemangiosarcoma. This is a very malignant tumor that carries a poor prognosis. It’s a rare tumor in cats, and there’s very limited data, but a paper published a few years ago lists a median survival time of 77 days. The longest survival time in the report was 296 days. She’s beaten tough odds before. All I can do is take it day by day, I guess.

This has been quite a learning experience for me. I’ve been treating other people’s animals for 27 years, but remarkably, my own pets have all been very healthy and I have not had to go through the gut-wrenching despair of having a sick pet that required life-saving transfusions and multiple surgeries and nights in an ICU. I have a much deeper appreciation for what it’s like to be on the other side of the exam table now, and I can only hope it makes me a better veterinarian.

I’ll keep everyone updated on Crispy’s progress. If you have cats at home, hug them now and treat them like royalty, and don’t ever take them for granted.

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