lena update: still with us
Aug. 16th, 2009 09:58 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
jaeclecticShort version: As of yesterday afternoon, she was unable to stand or walk. If that had continued, clearly her quality of life would not be tenable. But the brain is an amazing thing, and apparently the feline brain repairs with astonishing rapidity, because she is in fact doing much better today. I'm still pretty freaked out, though, since another stroke could happen anytime.
Long version:
After Lena's last vet visit 3 weeks ago, I had a couple of weeks of cautious optimism. She had completely stopped vomiting (high marks for the efficacy of acupuncture stomach points) and seemed much calmer, as we got back into a routine after the general household disruption surrounding Ash's illness.
This past week, I'd been actively worrying again. Her mobility seemed to have taken a step change down -- not worse than I'd ever seen it, but as bad. Her appetite dropped off, and she also wasn't defecating. (Those of you who have been following the saga of Lena for a while may recall a dramatic instance of severe constipation once before.) As of Thursday, I decided to start giving her some of the anti-constipation medicine (lactulose) I had left over. I thought about taking her to the vet, but knew that I had a vet appointment already set up for Saturday, and none of the signs seemed to be at crisis level, so I waited.
At the vet yesterday morning, I had that weirdly simultaneously comforting and discomforting experience where the vet agreed with all of my concerns -- not a one got shrugged off. She speculated that Lena had had another stroke, and said she could see that Lena's mobility had declined since 3 weeks ago. There was also something (presumably neurological) wrong with her vision in one eye, because she didn't show the normal flinch response to something approaching the eye. Fortunately, she didn't seem severely constipated (having actually had a small bowel movement, mostly on the other side of the room from the litter box, sometime during the night or morning), but Dr A agreed that I had done the correct thing in giving her the lactulose. Also, she has lost more weight, not a good trend, and has lost muscle mass in her hind legs.
We came up with a plan of attack: continue the lactulose, start an appetite stimulant, do blood work to check for thyroid issues and make sure her potassium level is stable. But Dr A also said, she could have another stoke anytime.
Well, anytime proved to be mid-afternoon. At some point, I heard Lena scrabbling and went to see what she was doing, and found her halfway onto one of her pillows and unable to get the rest of the way on. I helped her and she settled in. I was disturbed, but didn't yet realize something new had happened.
Then a little while later, I saw her trying to walk. She just couldn't keep her back legs under her at all. She'd barely stand, then fall over again. As you might expect, she was really distressed. This has been my major fear all along: that she would have another stroke and not be able to get around -- and therefore not have a reasonable quality of life.
At this point, it was about 4:15 and I didn't think VCA would see me that late, but I guess being a regular has it's benefits. I got Dr A on the phone and she said to come back in. I was completely convinced at that point that I had to say goodbye, and sobbed in the car the whole way.
But, Dr A's recommendation was to take her home overnight. She said there was a high probability she would continue having a series of strokes and die overnight. But also a possibility that she would regain function. We decided to give her some pain medication, in part to help keep her calm.
I spent the evening just focusing on Lena, cuddling her and helping her walk when she wanted to get up, giving her the food she likes the best, thinking this was probably her last night.
I honestly wasn't expecting things to be any better in the morning, but to my surprise, she is getting around -- a little bit worse than before yesterday afternoon, but not completely incapacitated.
So, I have to readjust from saying-goodbye mode, back to just being scared. I am worried that the next stroke will come when I am at work, or come when I am out of town. In one way, it would be easier on me to have the situation be unambiguous now, on a day when I can focus on her. Hard as saying goodbye would be (will be, whenever the time comes), at least today I could do so without juggling any other responsibilities.
But it's also possible she could improve from here and have years of life left. I know people make remarkable recoveries from strokes, and the change in her since yesterday is really astonishing. I just watched her climb up her "steps" to get onto the bed. She hesitated getting from the second to third step; and then going from the third step to the bed, she got her front paws up and did a bunny hop to bring up both hind legs at once. It was incredibly cute, and I was awed by the adaptability of the feline brain.
So now I'm waiting to see what today brings. Still having bouts of weeping. Still kind of scared to leave the house for fear she'll get stuck somewhere and be lying there crying. Worrying about going to work tomorrow, and wondering if I should cancel my early-September trip.
Stay tuned.
Long version:
After Lena's last vet visit 3 weeks ago, I had a couple of weeks of cautious optimism. She had completely stopped vomiting (high marks for the efficacy of acupuncture stomach points) and seemed much calmer, as we got back into a routine after the general household disruption surrounding Ash's illness.
This past week, I'd been actively worrying again. Her mobility seemed to have taken a step change down -- not worse than I'd ever seen it, but as bad. Her appetite dropped off, and she also wasn't defecating. (Those of you who have been following the saga of Lena for a while may recall a dramatic instance of severe constipation once before.) As of Thursday, I decided to start giving her some of the anti-constipation medicine (lactulose) I had left over. I thought about taking her to the vet, but knew that I had a vet appointment already set up for Saturday, and none of the signs seemed to be at crisis level, so I waited.
At the vet yesterday morning, I had that weirdly simultaneously comforting and discomforting experience where the vet agreed with all of my concerns -- not a one got shrugged off. She speculated that Lena had had another stroke, and said she could see that Lena's mobility had declined since 3 weeks ago. There was also something (presumably neurological) wrong with her vision in one eye, because she didn't show the normal flinch response to something approaching the eye. Fortunately, she didn't seem severely constipated (having actually had a small bowel movement, mostly on the other side of the room from the litter box, sometime during the night or morning), but Dr A agreed that I had done the correct thing in giving her the lactulose. Also, she has lost more weight, not a good trend, and has lost muscle mass in her hind legs.
We came up with a plan of attack: continue the lactulose, start an appetite stimulant, do blood work to check for thyroid issues and make sure her potassium level is stable. But Dr A also said, she could have another stoke anytime.
Well, anytime proved to be mid-afternoon. At some point, I heard Lena scrabbling and went to see what she was doing, and found her halfway onto one of her pillows and unable to get the rest of the way on. I helped her and she settled in. I was disturbed, but didn't yet realize something new had happened.
Then a little while later, I saw her trying to walk. She just couldn't keep her back legs under her at all. She'd barely stand, then fall over again. As you might expect, she was really distressed. This has been my major fear all along: that she would have another stroke and not be able to get around -- and therefore not have a reasonable quality of life.
At this point, it was about 4:15 and I didn't think VCA would see me that late, but I guess being a regular has it's benefits. I got Dr A on the phone and she said to come back in. I was completely convinced at that point that I had to say goodbye, and sobbed in the car the whole way.
But, Dr A's recommendation was to take her home overnight. She said there was a high probability she would continue having a series of strokes and die overnight. But also a possibility that she would regain function. We decided to give her some pain medication, in part to help keep her calm.
I spent the evening just focusing on Lena, cuddling her and helping her walk when she wanted to get up, giving her the food she likes the best, thinking this was probably her last night.
I honestly wasn't expecting things to be any better in the morning, but to my surprise, she is getting around -- a little bit worse than before yesterday afternoon, but not completely incapacitated.
So, I have to readjust from saying-goodbye mode, back to just being scared. I am worried that the next stroke will come when I am at work, or come when I am out of town. In one way, it would be easier on me to have the situation be unambiguous now, on a day when I can focus on her. Hard as saying goodbye would be (will be, whenever the time comes), at least today I could do so without juggling any other responsibilities.
But it's also possible she could improve from here and have years of life left. I know people make remarkable recoveries from strokes, and the change in her since yesterday is really astonishing. I just watched her climb up her "steps" to get onto the bed. She hesitated getting from the second to third step; and then going from the third step to the bed, she got her front paws up and did a bunny hop to bring up both hind legs at once. It was incredibly cute, and I was awed by the adaptability of the feline brain.
So now I'm waiting to see what today brings. Still having bouts of weeping. Still kind of scared to leave the house for fear she'll get stuck somewhere and be lying there crying. Worrying about going to work tomorrow, and wondering if I should cancel my early-September trip.
Stay tuned.